ATTUD Journal Club Postings

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 […]

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Recent Data on Quitting Smoking in the US

A recent CDC report (MMWR 65:1457) reports that the incidence of at least one quit attempt/yr has increased from 50% to 55%. That may sound encouraging but that also means that, despite stigmatization, taxes, smoking restrictions, free treatment in most states, almost half of smokers tried to stop. In addition, the CDC reports that 32% […]

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Blog on Hardening

As many of you know, I have been enamored of the hardening hypothesis (in terms of ability to quit on a given attempt). However, attached is what I think is the best test of that hypothesis from Robert West’s Smoking Tool Kit and clearly it is refuting it. Also, the CA survey has found similar […]

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How many attempts does it take to quit?

We have all been asked “how many times does it take to quit smoking, on average?” I, myself, think this is a silly question. When I am asked this, I ask “why do you want to know.” What I hear is that smokers want to know whether they are abnormal in taking many attempts and […]

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Gradual Reduction for Smoking Cessation

A recent randomized trial (Annals Int Med, epublication) found that, among smokers trying to quit, gradual cessation was inferior to abrupt cessation (6 month prolonged abstinence = 15% vs 22%) and this occurred even in smokers who preferred gradual reduction. This study was replication of our earlier trial (Drug Alcohol Dependence 111:105–113) that was more […]

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Psychiatric co‐morbidity with smoking is increasing over time

Smokers with a history of a psychiatric disorder are less likely to stop smoking than those without this history. In addition, whenever a society stigmatizes a behavior and makes it more deviant, then those who, nevertheless, take up or continue the behavior are more likely to have psychiatric co­morbidity. As a result of these two […]

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Changing Multiple Behaviors Simultaneously vs Sequentially

In two prior blogs I described the theory and evidence that self‐control is like a muscle in that one has a limited amount of self‐control and using that up on one task can make it harder to be successful at another self‐control task (Self‐control as a Finite Resource 5/20/14). But on the other hand training […]

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Building the Self‐Control Muscle

An earlier blog (Self‐Control as a Finite Resource, wwww.attud.org) discussed research that found practicing self‐control on Task A makes it harder to exert self‐control on Task B (Psychol Bulletin 136:495, 2010). In that blog I suggested this results implies that when trying to stop smoking, you should not try to also diet, exercise more, etc. […]

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Results of Recent Cochrane Review on Efficacy of Different Tobacco Dependence Treatments

The Tobacco Addiction Group of Cochrane (of which I am a member) published six new or revised meta-analyses of treatments for tobacco dependence. I am a big fan of the Cohrane reviews because they are all done using the same methods, usually locate all the available trials, and use rigorous methods. An updated review of […]

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Do We Need Tobacco Treatment Specialists?

In the past blogs I have reviewed the evidence whether treatment from a trained TTS produces higher quit rates than from a less-intensive non-TTS therapy. The Cochrane review of this question examined 5 RCTs and stated “We failed to detect a greater effect of intensive counselling compared to brief counselling (5 trials, RR 0.96, 95% […]

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