title: Comparative effectiveness of intervention components for producing long-term abstinence from smoking: a factorial screening experiment.
abstract: OBJECTIVE
  To identify promising intervention components that help smokers attain and maintain abstinence during a quit attempt.
  
  
  METHODS
  A 2 × 2 × 2 × 2 × 2 randomized factorial experiment.
  
  
  METHODS
  Eleven primary care clinics in Wisconsin, USA.
  
  
  METHODS
  A total of 544 smokers (59% women, 86% white) recruited during primary care visits and motivated to quit.
  
  
  METHODS
  Five intervention components designed to help smokers attain and maintain abstinence: (1) extended medication (26 versus 8 weeks of nicotine patch + nicotine gum); (2) maintenance (phone) counseling versus none; (3) medication adherence counseling versus none; (4) automated (medication) adherence calls versus none; and (5) electronic medication monitoring with feedback and counseling versus electronic medication monitoring alone.
  
  
  METHODS
  The primary outcome was 7-day self-reported point-prevalence abstinence 1 year after the target quit day.
  
  
  RESULTS
  Only extended medication produced a main effect. Twenty-six versus 8 weeks of medication improved point-prevalence abstinence rates (43 versus 34% at 6 months; 34 versus 27% at 1 year; P = 0.01 for both). There were four interaction effects at 1 year, showing that an intervention component's effectiveness depended upon the components with which it was combined.
  
  
  CONCLUSIONS
  Twenty-six weeks of nicotine patch + nicotine gum (versus 8 weeks) and maintenance counseling provided by phone are promising intervention components for the cessation and maintenance phases of smoking treatment.
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.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Fiore
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.
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 Pennsylvania State University, The Methodology Center and Department of Human Development and Family Studies, State College, 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.|William S. Middleton Memorial Veterans Hospital, Madison, WI, USA.
authors.forename: Jessica W
authors.initials: JW
authors.lastname: Cook
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, 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: Timothy B
authors.initials: TB
authors.lastname: Baker
mesh_terms: D057186:Comparative Effectiveness Research; D003376:Counseling / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018722:Nicotinic Agonists / Q000627:therapeutic use; D016540:Smoking Cessation / Q000379:methods / Q000706:statistics & numerical data*; D061485:Tobacco Use Cessation Devices / Q000706:statistics & numerical data; D014029:Tobacco Use Disorder / Q000628:therapy*; D016896:Treatment Outcome; D016903:Drug Monitoring
chemical_list: D018722:Nicotinic Agonists
keywords: Chronic care smoking treatment; Multiphase Optimization Strategy (MOST); Phase-Based Model of smoking treatment; comparative effectiveness; electronic medication monitoring; factorial experiment; medication adherence; nicotine replacement therapy; primary care; relapse prevention; smoking cessation; tobacco dependence