Extended treatment of older cigarette smokers
- 6 May 2009
- Vol. 104 (6), 1043-1052
- https://doi.org/10.1111/j.1360-0443.2009.02548.x
Abstract
Aims Tobacco dependence treatments achieve abstinence rates of 25–30% at 1 year. Low rates may reflect failure to conceptualize tobacco dependence as a chronic disorder. The aims of the present study were to determine the efficacy of extended cognitive behavioral and pharmacological interventions in smokers ≥ 50 years of age, and to determine if gender differences in efficacy existed. Design Open randomized clinical trial. Setting A free‐standing, smoking treatment research clinic. Participants A total of 402 smokers of ≥ 10 cigarettes per day, all 50 years of age or older. Intervention Participants completed a 12‐week treatment that included group counseling, nicotine replacement therapy (NRT) and bupropion. Participants, independent of smoking status, were then assigned randomly to follow‐up conditions: (i) standard treatment (ST; no further treatment); (ii) extended NRT (E‐NRT; 40 weeks of nicotine gum availability); (iii) extended cognitive behavioral therapy (E‐CBT; 11 cognitive behavioral sessions over a 40‐week period); or (iv) E‐CBT plus E‐NRT (E‐combined; 11 cognitive behavioral sessions plus 40 weeks nicotine gum availability). Measurements Primary outcome variable was 7‐day point prevalence cigarette abstinence verified biochemically at weeks 24, 52, 64 and 104. Findings The most clinically important findings were significant main effects for treatment condition, time and the treatment × time interaction. The E‐CBT condition produced high cigarette abstinence rates that were maintained throughout the 2‐year study period [(week 24 (58%), 52 (55%), 64 (55%) and 104 (55%)], and was significantly more effective than E‐NRT and ST across that period. No other treatment condition was significantly different to ST. No effects for gender were found. Conclusions Extended cognitive behavioral treatments can produce high and stable cigarette abstinence rates for both men and women. NRT does not add to the efficacy of extended CBT, and may hamper its efficacy. Research is needed to determine if these results can be replicated in a sample with a greater range of ages, and improved upon with the addition of medications other than NRT.Keywords
This publication has 50 references indexed in Scilit:
- Nanostructured and Spiky Gold Shell Growth on Magnetic Particles for SERS ApplicationsNanomaterials, 2020
- A Clinical Practice Guideline for Treating Tobacco Use and Dependence: 2008 UpdateAmerican Journal of Preventive Medicine, 2008
- Extended cognitive behavior therapy for cigarette smoking cessationAddiction, 2008
- The Benefits of Stopping Smoking and the Role of Nicotine Replacement Therapy in Older PatientsDrugs & Aging, 1996
- Mood management and nicotine gum in smoking treatment: A therapeutic contact and placebo-controlled study.Journal of Consulting and Clinical Psychology, 1996
- Mood management and nicotine gum in smoking treatment: A therapeutic contact and placebo-controlled study.Journal of Consulting and Clinical Psychology, 1996
- The MOS 36-ltem Short-Form Health Survey (SF-36)Medical Care, 1992
- The Fagerström Test for Nicotine Dependence: a revision of the Fagerstrom Tolerance QuestionnaireBritish Journal of Addiction, 1991
- Development and validation of a geriatric depression screening scale: A preliminary reportJournal of Psychiatric Research, 1982