ATTUD Journal Club Postings

Progesterone as a Treatment for Smoking Cessation

Most, but not all, studies have found that women smokers have lower quit rates and respond less robustly to nicotine. Hormonal differences might explain this (CNS Drugs 32:421). Most lab and clinical studies have found that progesterone decrease cigarette craving, blunts positive effects of tobacco, and improves cognitive functioning and stress during withdrawal. For example, […]

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The Efficacy of Pretreatment Treatment

A 2017 meta-analysis of mindfulness meditation noted that this treatment did not improve short term cessation but did increase long-term cessation (Oikonomou, 2017). It hypothesized that this was because the treatment needs to be practiced often to have an effect. To me, it also may be that the treatment is like taking up exercise- in […]

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The ugly relapse curve

A while ago I published a paper describing the relapse curve in self-quitters (Addiction 99:29) showing most smokers can not even remain abstinent for the first week. Some thought that the abstinence curve might not be so steep in those in treatment. A recent paper (Addiction 114:787) found this not to be true as, those […]

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Recent Cochrane Reviews

This year Cochrane updated 5 reviews. It is important to note that all of these were based on those already motivated to quit and did not assess the ability of the intervention to prompt new quit attempts. The 75 studies of print-based self help materials found that non-tailored materials had almost no benefit but tailored […]

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Pre-dosing medications to increase efficacy

Recent studies on pre-dosing suggest it does, in fact, increase quit rates.  Most studies of pre-dosing had participants use nicotine gum for about 4 weeks prior to the quit date and most did not ask smokers to try to reduce, but just smoke as usual.  The idea is that with extra nicotine in the system, […]

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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 (!) […]

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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 […]

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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, […]

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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 […]

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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 […]

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