title: Extended treatment for cigarette smoking cessation: a randomized control trial.
abstract: OBJECTIVE
  To test the potential benefit of extending cognitive-behavioral therapy (CBT) relative to not extending CBT on long-term abstinence from smoking.
  
  
  METHODS
  Two-group parallel randomized controlled trial. Patients were randomized to receive non-extended CBT (n = 111) or extended CBT (n = 112) following a 26-week open-label treatment.
  
  
  METHODS
  Community clinic in the United States.
  
  
  METHODS
  A total of 219 smokers (mean age: 43 years; mean cigarettes/day: 18).
  
  
  METHODS
  All participants received 10 weeks of combined CBT + bupropion sustained release (bupropion SR) + nicotine patch and were continued on CBT and either no medications if abstinent, continued bupropion + nicotine replacement therapy (NRT) if increased craving or depression scores, or varenicline if still smoking at 10 weeks. Half the participants were randomized at 26 weeks to extended CBT (E-CBT) to week 48 and half to non-extended CBT (no additional CBT sessions).
  
  
  METHODS
  The primary outcome was expired CO-confirmed, 7-day point-prevalence (PP) at 52- and 104-week follow-up. Analyses were based on intention-to-treat.
  
  
  RESULTS
  PP abstinence rates at the 52-week follow-up were comparable across non-extended CBT (40%) and E-CBT (39%) groups [odds ratio (OR) = 0.99; 95% confidence interval (CI) = 0.55, 1.78]. A similar pattern was observed across non-extended CBT (39%) and E-CBT (33%) groups at the 104-week follow-up (OR = 0.79; 95% CI= 0.44, 1.40).
  
  
  CONCLUSIONS
  Prolonging cognitive-behavioral therapy from 26 to 48 weeks does not appear to improve long-term abstinence from smoking.
authors.affiliation: Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.|Department of Psychology, Stanford University, Stanford, CA, USA.
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Laude
authors.affiliation: Department of Family Medicine, Oregon Health and Science University, Portland, OR, USA.
authors.forename: Steffani R
authors.initials: SR
authors.lastname: Bailey
authors.affiliation: Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Erin
authors.initials: E
authors.lastname: Crew
authors.affiliation: Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Ann
authors.initials: A
authors.lastname: Varady
authors.affiliation: Department of Psychiatry, Stanford University School of Medicine, Palo Alto, CA, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Lembke
authors.affiliation: Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Danielle
authors.initials: D
authors.lastname: McFall
authors.affiliation: Community Health Partnership, San Jose, CA, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Jeon
authors.affiliation: Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Diana
authors.initials: D
authors.lastname: Killen
authors.affiliation: Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.|Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Joel D
authors.initials: JD
authors.lastname: Killen
authors.affiliation: Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Sean P
authors.initials: SP
authors.lastname: David
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016642:Bupropion / Q000627:therapeutic use*; D000073865:Cigarette Smoking / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018722:Nicotinic Agonists / Q000627:therapeutic use*; D016540:Smoking Cessation / Q000379:methods*; D013995:Time; D061485:Tobacco Use Cessation Devices; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult
chemical_list: D018722:Nicotinic Agonists; D016642:Bupropion
keywords: Abstinence; adaptive treatment; bupropion SR; clinical trial; cognitive behavioral therapy; extended treatment; nicotine dependence; nicotine replacement therapy smoking cessation; smoking cessation; varenicline