ATTUD Journal Club Postings

Potential Harm From Very Low Nicotine Cigarettes

Very low nicotine cigarettes (VLNC) have been proposed (and encouraged by the FDA) as a tool to reduce addiction in kids, increase smoking cessation and reduce risks from smoking. Studies suggest these benefits may be occurring and, contrary to concerns, compensatory smoking does not appear to occur. But there may be an important problem with […]

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Texts and Apps for Smoking Cessation

The use of texts and apps to deliver smoking cessation treatments has many potential advantages.  They are easy to use, cost-effective, have tailored content, can send time-sensitive information, be used for social support.  They can be especially important in places and persons where access to treatment is limited (eg, even in low and middle income […]

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Incentives for smoking cessation

This year Cochrane updated the report on using monetary incentives for smoking cessation. Its conclusions were certainly not what I anticipated The review located 16 new studies (now 33 trials) all of which had long term (6 month or more) followup. The overall RR was 1.5 and for the 10 studies in pregnant women it […]

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Community Pharmacy Personnel Interventions for Smoking Cessation

This review examined 6 RCTs which compared cessation rates when pharmacists were trained in smoking cessation counseling and provided intense counseling vs typically < 5 min of advice from untrained pharmacists. The resultant OR was significant at 2.3; however, the quality of the few studies used was poor. These were not the interventions I expected […]

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Planning the “End Game” When We Are Not Winning

Recently, tobacco control advocates have begun discussion “end game” strategies. A recent review lists the many interesting and novel strategies being considered (Tobacco Control 25:594). The problem is that the recent MMWR report (Nov 15, vol 68, Number 45) suggests this is wishful thinking. Click here for a figure from that article illustrating the change […]

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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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