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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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 […]

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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 […]

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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 […]

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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 […]

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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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