Effectiveness of Switching Smoking-Cessation Medications Following Relapse.
BACKGROUND
Nicotine dependence is a chronic disorder often characterized by multiple failed quit attempts (QAs). Yet, little is known about the sequence of methods used across multiple QAs or how this may impact future ability to abstain from smoking. This prospective cohort study examines the effectiveness of switching smoking-cessation medications (SCMs) across multiple QAs.


METHODS
Adult smokers (aged ≥18 years) participating in International Tobacco Control surveys in the United Kingdom, U.S., Canada, and Australia (N=795) who: (1) completed two consecutive surveys between 2006 and 2011; (2) initiated a QA at least 1 month before each survey; and (3) provided data for the primary predictor (SCM use during most recent QA), outcome (1-month point prevalence abstinence), and relevant covariates. Analyses were conducted in 2016.


RESULTS
Five SCM user classifications were identified: (1) non-users (43.5%); (2) early users (SCM used for initial, but not subsequent QA; 11.4%); (3) later users (SCM used for subsequent, but not initial QA; 18.4%); (4) repeaters (same SCM used for both QAs; 10.7%); and (5) switchers (different SCM used for each QA; 14.2%). Abstinence rates were lower for non-users (15.9%, OR=0.48, p=0.002), early users (16.6%, OR=0.27, p=0.03), and repeaters (12.4%, OR=0.36, p=0.004) relative to switchers (28.5%).


CONCLUSIONS
Findings suggest smokers will be more successful if they use a SCM in QAs and vary the SCM they use across time. That smokers can increase their odds of quitting by switching SCMs is an important message that could be communicated to smokers.
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina; Cancer Control and Prevention, Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina. Electronic address: heckmanb@musc.edu.
Bryan W
BW
Heckman
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina; Cancer Control and Prevention, Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina.
K Michael
KM
Cummings
Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York.
Karin A
KA
Kasza
Nigel Gray Fellowship Group, Cancer Council Victoria, Melbourne, Victoria, Australia.
Ron
R
Borland
Department of Psychology, University of Kentucky, Lexington, Kentucky; Markey Cancer Center, University of Kentucky, Lexington, Kentucky.
Jessica L
JL
Burris
Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada; School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada; Ontario Institute for Cancer Research, Toronto, Ontario, Canada.
Geoffrey T
GT
Fong
UK Centre for Tobacco and Alcohol Studies, King's College London, Strand, London, United Kingdom.
Ann
A
McNeill
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina; Cancer Control and Prevention, Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina.
Matthew J
MJ
Carpenter
D000328:Adult; D001315:Australia / Q000453:epidemiology; D002170:Canada / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention / Q000379:methods*; D061485:Tobacco Use Cessation Devices / Q000706:statistics & numerical data*; D014029:Tobacco Use Disorder / Q000453:epidemiology / Q000517:prevention & control*; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology; D014481:United States / Q000453:epidemiology