Long-term effectiveness of a clinician-assisted digital cognitive behavioral therapy intervention for smoking cessation: secondary outcomes from a randomized controlled trial
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Author(s)
Type
Journal Article
Abstract
INTRODUCTION: This study evaluated the secondary effectiveness outcomes for Quit Genius, a digital clinician-assisted cognitive behavioral therapy (CBT) intervention for smoking cessation. METHODS: Adult smokers (N=556) were randomly assigned to Quit Genius (n=277), a digital, clinician-assisted CBT intervention or Very Brief Advice (VBA) to stop smoking, an evidence-based, 30-second intervention designed to facilitate quit attempts, coupled with referral to a cessation service (n=279). Participants were offered combination nicotine replacement therapy (patches and gum) tailored to individual nicotine dependence. Analyses (N=530), by intention-to-treat, compared Quit Genius and VBA at 4, 26, and 52 weeks post-quit date. The primary outcome was self-reported seven-day point prevalence abstinence at 4 weeks post-quit date. Consecutive seven-day point-prevalence abstinence, defined as abstinent at two or more consecutive timepoints, was examined at weeks 26 and 52 to indicate long-term effectiveness. Abstinence was verified using a random sample of participants with carbon monoxide breath testing of <5 parts per million (n=280). RESULTS: Self-reported consecutive seven-day point prevalence abstinence at weeks 26 and 52 for Quit Genius was 27.2% and 22.6% respectively, compared to VBA which was 16.6% and 13.2% (RR=1.70,95% CI,1.22-2.37;p=0.003, 26 weeks; RR=1.71,95% CI,1.17-2.50; p=0.005, 52 weeks). Biochemically verified abstinence was significantly different at 26- (p=0.03) but not 52 weeks (p=0.16). Quit Genius participants were more likely to remain abstinent than those who received VBA (RR=1.71,95% CI 1.17-2.50;p=0.005). CONCLUSIONS: This study provides secondary evidence for the long-term effectiveness of Quit Genius in comparison with VBA. Future trials of digital interventions without clinician support and comparisons with active treatment are needed. IMPLICATIONS: The long-term effectiveness of clinician-assisted digital smoking cessation interventions has not been well-studied. This study established the long-term effectiveness of an extended CBT-based intervention; results may inform implementation of scalable approaches to smoking cessation in the health system.
Date Issued
2022-04-26
Date Acceptance
2022-04-25
Citation
Nicotine and Tobacco Research, 2022, 24 (11), pp.1763-1772
ISSN
1462-2203
Publisher
Oxford University Press
Start Page
1763
End Page
1772
Journal / Book Title
Nicotine and Tobacco Research
Volume
24
Issue
11
Copyright Statement
© The Author(s) 2022. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/35470860
PII: 6574261
Subjects
Science & Technology
Life Sciences & Biomedicine
Substance Abuse
Public, Environmental & Occupational Health
SELF-EFFICACY
MEDICATION
ABSTINENCE
MODEL
Adult
Humans
Smoking Cessation
Tobacco Use Cessation Devices
Carbon Monoxide
Tobacco Use Disorder
Cognitive Behavioral Therapy
Humans
Tobacco Use Disorder
Carbon Monoxide
Smoking Cessation
Adult
Cognitive Behavioral Therapy
Tobacco Use Cessation Devices
Public Health
1103 Clinical Sciences
1117 Public Health and Health Services
1505 Marketing
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2022-04-26