Publication Title
Annals of behavioral medicine : a publication of the Society of Behavioral Medicine
Document Type
Article
Publication Date
11-9-2019
Keywords
Adult; Cigarette Smoking; Counseling; Female; Follow-Up Studies; Health Behavior; Humans; Male; Middle Aged; Outcome and Process Assessment, Health Care; Smoking Cessation
Abstract
BACKGROUND: Understanding the characteristics of smokers who are successful in quitting may help to increase smoking cessation rates.
PURPOSE: To examine heterogeneity in cessation outcome at 6 months following smoking cessation behavioral counseling with or without weight management counseling.
METHODS: 2,540 smokers were recruited from a large quitline provider and then randomized to receive proactive smoking cessation behavioral counseling without or with two versions of weight management counseling. A Classification and Regression Tree (CART) analysis was conducted to identify the individual pretreatment and treatment characteristics of groups of smokers with different quitting success (as measured by point prevalence of self-reported smoking of any amount at 6 months).
RESULTS: CART analysis identified 10 subgroups ranging from 25.5% to 70.2% abstinent. The splits in the CART tree involved: the total number of counseling and control calls received, whether a smoking cessation pharmacotherapy was used, and baseline measures of cigarettes per day, confidence in quitting, expectation that the study would help the participant quit smoking, the motivation to quit, exercise minutes per week, anxiety, and lack of interest or pleasure in doing things. Costs per quitter ranged from a low of $US270 to a high of $US630. Specific treatment recommendations are made for each group.
CONCLUSIONS: These results indicate the presence of a substantial variation in abstinence following treatment, and that the total extent of contact via counseling calls of any type and baseline characteristics, rather than assigned treatment, were most important to subgroup membership and abstinence. Tailored treatments to subgroups who are at high risk for smoking following a quit attempt could increase successful smoking cessation.
Clinical Institute
Mental Health
Specialty/Research Institute
Behavioral Health
