Identifying attendance patterns in a smoking cessation treatment and their relationships with quit success.
While important for substance use outcomes, knowledge about treatment attendance patterns, and their relation with clinical outcomes is limited. We examined the association between attendance patterns and smoking outcomes in a randomized, controlled smoking cessation intervention trial.



In addition to standard smoking cessation treatment, participants were randomized to 15 weeks of an exercise intervention (n=72) or an education control condition (n=64). Latent class growth analysis (LCGA) tested whether intervention attendance would be better modeled as qualitatively distinct attendance patterns rather than as a single mean pattern. Multivariate generalized linear mixed modeling (GLMM) was used to evaluate associations between the attendance patterns and abstinence at the end of treatment and at 6-month follow-up.



The LCGA solution with three patterns characterized by high probability of attendance throughout (Completers, 46.3%), gradual decreasing probability of attendance (Titrators, 23.5%), and high probability of dropout within the first few weeks (Droppers, 30.1%) provided the best fit. The GLMM analysis indicated an interaction of attendance pattern by treatment condition, such that titration was associated with lower probability of quit success for those in the control condition. Probability of quit success was not significantly different between Titrators and Completers in the exercise condition.



These findings underscore the importance of examining how treatment efficacy may vary as a function of attendance patterns. Importantly, treatment discontinuation is not necessarily indicative of poorer abstinence outcome.
Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, SEA 4.208, 108 E. Dean Keeton Stop A8000, Austin, TX, 78712-1043, USA. Electronic address: jolene.jacquart@utexas.edu.
Jolene
J
Jacquart
Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, SEA 4.208, 108 E. Dean Keeton Stop A8000, Austin, TX, 78712-1043, USA.
Santiago
S
Papini
Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, SEA 4.208, 108 E. Dean Keeton Stop A8000, Austin, TX, 78712-1043, USA.
Michelle L
ML
Davis
Department of Psychology, Southern Methodist University, PO Box 750442, Dallas, TX, 75275-0442, USA.
David
D
Rosenfield
Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, SEA 4.208, 108 E. Dean Keeton Stop A8000, Austin, TX, 78712-1043, USA; Baylor University Medical Center, 3500 Gaston Ave, Dallas, TX, 75246, USA.
Mark B
MB
Powers
Department of Psychology, Rowan University,201 Mullica Hill Rd., Glassboro, NJ, 02028, USA.
Georita M
GM
Frierson
National Center for PTSD, VA Palo Alto Health Care System,795 Willow Rd., Menlo Park, CA, 94025, USA.
Lindsey B
LB
Hopkins
Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, SEA 4.208, 108 E. Dean Keeton Stop A8000, Austin, TX, 78712-1043, USA.
Scarlett O
SO
Baird
Department of Family and Preventive Medicine, University of California at San Diego, 9500 Gilman Dr.-0628, La Jolla, CA, 92093-0628, USA.
Bess H
BH
Marcus
Pennington Biomedical Research Center, Louisiana State University,6400 Perkins Rd., Baton Rouge, LA, 70808, USA.
Timothy S
TS
Church
Department of Psychology and Department of Psychological and Brain Sciences, Boston University, 64 Cummington Mall, Boston, MA, 02215, USA.
Michael W
MW
Otto
Department of Psychology, University of Houston,3695 Cullen Boulevard Room 126,Houston, TX, 77204-5022, USA; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Unit 1330, P.O. Box 301439, Houston, TX 77230-1439, USA.
Michael J
MJ
Zvolensky
Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, SEA 4.208, 108 E. Dean Keeton Stop A8000, Austin, TX, 78712-1043, USA.
Jasper A J
JAJ
Smits
D000328:Adult; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010352:Patient Dropouts / Q000706:statistics & numerical data; D012907:Smoking / Q000628:therapy; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000628:therapy; D016896:Treatment Outcome
Anxiety sensitivity; Attendance; Dose-response; Dropout; Exercise; Smoking cessation