ATTUD Journal Club Postings

How effective is internet treatment? Should we replace or add to our in-person/quitline programs?

Currently, 77% of Americans have a smartphone and 88% have daily access to the internet via computer or smart phone, with only a slightly lower prevalence in smokers. The major advantages of e-therapy are easy access, affordability and reach. A recent meta-analysis (Do et al, Patient Preference and Adherence 2018:12, p 2065) examined 108 (!) […]

Read More

Tobacco Treatment Specialists Are Needed

In prior blogs on 11/2/04, 1/31/13 and 12/21/15 (see ATTUD website) I presented evidence on whether TTSs achieve quit rates greater than brief advice or quitlines. One important study that I missed should be added to those reviews (Kotz et al, Addiction 109:491, 2013). This study used a survey of UK smokers. It is important […]

Read More

Partner Support for Smoking Cessation

A recent Cochrane Review (“Enhancing Partner Support… 2018) concluded that the 11 RCTs indicate providing partner support to smokers trying to quit does not increase quit rates. There are multiple lines of evidence that partner support is associated with greater quitting. For example, living with another smoker decreases quit rates and if a smoker quits, […]

Read More

Is Marijuana Legalization Increasing Tobacco Use?

The title of a recent article stated that smoking is actually increasing over time in those using illegal drugs (Addiction 113:719). But when I read it, found that it was more complicated than that. Seems that cigarette use in those with opioid, cocaine, etc dependence increased over time from 61% in 2002 to 68% in […]

Read More

How Clinical Trial Statistics Can be Misleading

A recent review paper (Rosen et al, Addiction, in press) quantified how some cessation statistics can be misleading. Lets see if I can summarize that without too much jargon. The most commonly reported effectiveness statistics are the Odds Ratio (OR) and Relative Risk (RR). They are usually very similar and the RR is easier to […]

Read More

Tobacco use vs Cigarette use

An analysis of the large PATH survey reports that 26% of US adults are current tobacco users and 18% are cigarette smokers (NEJM 376:342, 2016). Thus, 1/3rd of tobacco use is from products other than cigarettes. The two most common non-cigarette tobacco products in the study were cigars (7%) and ecigs (5%). A major question […]

Read More

Is it Best to Switch or Add to New Treatment When Trying to Quit Again?

A recent article based on very large prospective study reported that smokers who failed a quit attempt on one medication, tried again and used a different medication, had 3 times higher success rates than those who tried again and used the same medication (Heckman et al Am J Prev Med, in press). Although this is […]

Read More

Does the Addiction/Brain Disease Model Help or Hinder Tobacco Treatment

I and others have often tried to decrease “cessation fatigue” by decreasing self-blame of those who have failed to quit on multiple occasions (e.g. via having smokers believe that their inability to quit may not derive from poor willpower but due to a surplus of the addiction “disease”. But is this an evidence-based strategy? The […]

Read More

Repeat quit attempts: Use new therapy or old therapy?

Most smokers who seek individual treatment for smoking cessation have tried to quit in the past and many have already used a behavioral or pharmacological treatment. Assessing why past treatments were used, compliance and perceived benefit of the prior treatment is recommended in most treatment guidelines. However, whether it is best to repeat old treatments […]

Read More

Choosing a Counseling Therapy

After many years of stagnation in improving counseling approaches for helping smokers stop, we have several new counseling treatments. Most prominent are a) Motivational Interviewing, b) Reduction in cigarettes/day, c) Mindfulness Therapy, and  Acceptance and Commitment Therapy. Randomized trials show that MI (Cochrane Review, 2015) and reduction in cigarettes/day (Cochrane Review, 2015) both increase quitting […]

Read More