title: Identifying effective intervention components for smoking cessation: a factorial screening experiment.
abstract: OBJECTIVE
  To identify promising intervention components intended to help smokers to attain and maintain abstinence in their quit smoking attempts.
  
  
  METHODS
  A fully crossed, six-factor randomized fractional factorial experiment.
  
  
  METHODS
  Eleven primary care clinics in southern Wisconsin, USA.
  
  
  METHODS
  A total of 637 adult smokers (55% women, 88% white) motivated to quit smoking who visited primary care clinics.
  
  
  METHODS
  Six intervention components designed to prepare smokers to quit, and achieve and maintain abstinence (i.e. for the preparation, cessation and maintenance phases of smoking treatment): (1) preparation nicotine patch versus none; (2) preparation nicotine gum versus none; (3) preparation counseling versus none; (4) intensive cessation in-person counseling versus minimal; (5) intensive cessation telephone counseling versus minimal; and (6) 16 versus 8 weeks of combination nicotine replacement therapy (nicotine patch  +  nicotine gum).
  
  
  METHODS
  Seven-day self-reported point-prevalence abstinence at 16 weeks.
  
  
  RESULTS
  Preparation counseling significantly improved week 16 abstinence rates (P = .04), while both forms of preparation nicotine replacement therapy interacted synergistically with intensive cessation in-person counseling (P < 0.05). Conversely, intensive cessation phone counseling and intensive cessation in-person counseling interacted antagonistically (P < 0.05)-these components produced higher abstinence rates by themselves than in combination.
  
  
  CONCLUSIONS
  Preparation counseling and the combination of intensive cessation in-person counseling with preparation nicotine gum or patch are promising intervention components for smoking and should be evaluated as an integrated treatment package.
authors.affiliation: Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, 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: Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, 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
authors.affiliation: Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, 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: Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: David
authors.initials: D
authors.lastname: Fraser
authors.affiliation: University of Wisconsin, Department of Educational Psychology, Madison, WI, USA.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Bolt
authors.affiliation: The Methodology Center, The Pennsylvania State University, 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: Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, 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: Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, 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: Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, 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, Department of Statistics, Madison, WI, USA.
authors.forename: Wei-Yin
authors.initials: WY
authors.lastname: Loh
authors.affiliation: Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, 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
mesh_terms: D003376:Counseling / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016540:Smoking Cessation / Q000379:methods*; D061485:Tobacco Use Cessation Devices / Q000706:statistics & numerical data*; D014029:Tobacco Use Disorder / Q000628:therapy*; D016896:Treatment Outcome; D014922:Wisconsin
keywords: Chronic care smoking treatment; Multiphase Optimization Strategy (MOST); Phase-Based Model of smoking treatment; comparative effectiveness; factorial experiment; nicotine replacement therapy; primary care; smoking cessation; tobacco dependence