title: Enhancing the effectiveness of smoking treatment research: conceptual bases and progress.
abstract: OBJECTIVE
  A chronic care strategy could potentially enhance the reach and effectiveness of smoking treatment by providing effective interventions for all smokers, including those who are initially unwilling to quit. This paper describes the conceptual bases of a National Cancer Institute-funded research program designed to develop an optimized, comprehensive, chronic care smoking treatment.
  
  
  METHODS
  This research is grounded in three methodological approaches: (1) the Phase-Based Model, which guides the selection of intervention components to be experimentally evaluated for the different phases of smoking treatment (motivation, preparation, cessation, and maintenance); (2) the Multiphase Optimization Strategy (MOST), which guides the screening of intervention components via efficient experimental designs and, ultimately, the assembly of promising components into an optimized treatment package; and (3) pragmatic research methods, such as electronic health record recruitment, that facilitate the efficient translation of research findings into clinical practice. Using this foundation and working in primary care clinics, we conducted three factorial experiments (reported in three accompanying papers) to screen 15 motivation, preparation, cessation and maintenance phase intervention components for possible inclusion in a chronic care smoking treatment program.
  
  
  RESULTS
  This research identified intervention components with relatively strong evidence of effectiveness at particular phases of smoking treatment and it demonstrated the efficiency of the MOST approach in terms both of the number of intervention components tested and of the richness of the information yielded.
  
  
  CONCLUSIONS
  A new, synthesized research approach efficiently evaluates multiple intervention components to identify promising components for every phase of smoking treatment. Many intervention components interact with one another, supporting the use of factorial experiments in smoking treatment development.
authors.affiliation: University of Wisconsin School of Medicine and Public Health, Center for Tobacco Research and Intervention, Madison, WI, USA.|University of Wisconsin School of Medicine and Public Health, Department of Medicine, Madison, WI, USA.
authors.forename: Timothy B
authors.initials: TB
authors.lastname: Baker
authors.affiliation: The Pennsylvania State University, The Methodology Center and Department of Human Development and Family Studies, University Park, PA, USA.
authors.forename: Linda M
authors.initials: LM
authors.lastname: Collins
authors.affiliation: University of Illinois at Chicago Institute for Health Research and Policy, Chicago, IL, USA.
authors.forename: Robin
authors.initials: R
authors.lastname: Mermelstein
authors.affiliation: University of Wisconsin School of Medicine and Public Health, Center for Tobacco Research and Intervention, Madison, WI, USA.|University of Wisconsin School of Medicine and Public Health, Department of Medicine, Madison, WI, USA.
authors.forename: Megan E
authors.initials: ME
authors.lastname: Piper
authors.affiliation: University of Wisconsin School of Medicine and Public Health, Center for Tobacco Research and Intervention, Madison, WI, USA.|University of Wisconsin School of Medicine and Public Health, Department of Medicine, Madison, WI, USA.
authors.forename: Tanya R
authors.initials: TR
authors.lastname: Schlam
authors.affiliation: University of Wisconsin School of Medicine and Public Health, Center for Tobacco Research and Intervention, Madison, WI, USA.|University of Wisconsin School of Medicine and Public Health, Department of Medicine, Madison, WI, USA.|William S. Middleton Memorial Veterans Hospital, Madison, WI, USA.
authors.forename: Jessica W
authors.initials: JW
authors.lastname: Cook
authors.affiliation: University of Wisconsin, Department of Educational Psychology, Madison, WI, USA.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Bolt
authors.affiliation: University of Wisconsin School of Medicine and Public Health, Center for Tobacco Research and Intervention, Madison, WI, USA.|University of Wisconsin School of Medicine and Public Health, Department of Medicine, Madison, WI, USA.
authors.forename: Stevens S
authors.initials: SS
authors.lastname: Smith
authors.affiliation: University of Wisconsin School of Medicine and Public Health, Center for Tobacco Research and Intervention, Madison, WI, USA.|University of Wisconsin School of Medicine and Public Health, Department of Medicine, Madison, WI, USA.
authors.forename: Douglas E
authors.initials: DE
authors.lastname: Jorenby
authors.affiliation: University of Wisconsin School of Medicine and Public Health, Center for Tobacco Research and Intervention, Madison, WI, USA.|University of Wisconsin School of Medicine and Public Health, Department of Medicine, Madison, WI, USA.
authors.forename: David
authors.initials: D
authors.lastname: Fraser
authors.affiliation: University of Wisconsin, Department of Statistics, Madison, WI, USA.
authors.forename: Wei-Yin
authors.initials: WY
authors.lastname: Loh
authors.affiliation: University of Wisconsin School of Medicine and Public Health, Center for Tobacco Research and Intervention, Madison, WI, USA.|University of Wisconsin School of Medicine and Public Health, Department of Medicine, Madison, WI, USA.
authors.forename: Wendy E
authors.initials: WE
authors.lastname: Theobald
authors.affiliation: University of Wisconsin School of Medicine and Public Health, Center for Tobacco Research and Intervention, Madison, WI, USA.|University of Wisconsin School of Medicine and Public Health, Department of Medicine, Madison, WI, USA.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Fiore
mesh_terms: D006801:Humans; D009042:Motivation; D054547:National Cancer Institute (U.S.); D012107:Research Design; D016540:Smoking Cessation / Q000379:methods*; D014029:Tobacco Use Disorder / Q000628:therapy*; D016896:Treatment Outcome; D014481:United States
keywords: Chronic care smoking treatment; Multiphase Optimization Strategy (MOST); cigarettes; comparative effectiveness; factorial experiment; methodology; phase-based model; primary care; quitting smoking; smoking cessation; tobacco dependence