ATTUD Journal Club Postings

How Prevalent is Use of Face-to-Face Counseling for Smoking Cessation

Most US surveys report that about a third (36%) of smokers trying to quit seek treatment; many (32%) used medications but few (4%) smokers used counseling (Shiffman, Am J Prev Med 34:103-111, 2008). However, a new survey suggests use may be greater (Borland, Addiction 107:197-205). In a survey of 10 countries, the incidence of use […]

Read More

Does Promoting Insight into Addiction Help or Hinder Smoking Cessation?

Oftentimes those addicted to drugs deny they are addicted. Methods to convince them they are, indeed, addicted (many of which are confrontational) to break down “denial” are common in the treatment of non-nicotine addictions. Randomized trials of breaking down denial as a treatment are not available. In fact, others have argued that emphasizing addiction undermines […]

Read More

Pros and Cons of Describing Addiction as a Brain Disease

A recent editorial (Gartner et al, Addiction 107:1199) discussed the pros and cons of describing addiction as a “brain disease.” It noted that advocates of this view believe it reduces stigma, increases treatment seeking, suggest treatment rather than legal interventions, and increases funding for addiction treatment and research.

Read More

Scheduling of Counseling for Smoking Cessation

Most of you know that the incidence of relapse after trying to quit is high in the first few weeks, but you may not realize how high it is. Most studies find that, among self-quitters, half of smokers relapse in the first 2 days and two-thirds in the first week. Even with intensive treatment over […]

Read More

Do Ex-smokers Return to Normal?

We all have been at cocktail parties and heard innumerable stories of how smokers quit. Often we will hear former smokers say they can’t believe they ever smoked and have no desire at all to return to smoking; others say they have to remain vigilant because they still have desires to smoke at times. I […]

Read More

Marijuana Intoxication

Recently there has been an increase in emergency room visits for marijuana intoxication, perhaps due to the stronger potency of marijuana recently. The most common symptoms of intoxication are euphoria, misperception of time, sedation, disturbed perceptions, continuous giggling, red eyes, increased heart rate, dry mouth and increased appetite. Death from intoxication is very rare. Also, […]

Read More

The diplomacy of smoking cessation “advice”

Many of us see smokers who want to quit but are not quite ready (about 80% of smokers).  The USPHS recommends using the 5 A’s algorithm with such clients: i.e.,  “Ask about tobacco use, Advise to quit, Assess willingness to make a quit attempt, Assist in quit attempt and Arrange followup.”   If a smoker is […]

Read More

Recent Survey Data on Smoking and Quitting in the US

Two new CDC surveys (MMWR 60:1207-1211, Sept 9, 2011 and MMWR 60:1513, Nov 11, 2011) report some outcomes of interest to TTSs. The first survey reports that now, among daily smokers, 16% smoke less than 10 cigs/day. In addition, other surveys have found that 20% of smokers are non-daily smokers, so when you add the […]

Read More

Extended Counseling Improves Quit Rates: Empirical Support for What We Do

In prior blogs I have reported the results of Sharon Hall’s and others’ studies of keeping treatment ongoing after the first few weeks. In the past Sharon and others have examined extending both medication and counseling but I want to focus on the latter. Two prior randomized trials have examined extending counseling with a cognitive-behavorial […]

Read More

Recycling Relapsers

This month’s blog focuses on options once a smoker has relapsed (is smoking regularly – usually defined as smoking for 7 consecutive days). The advice for lapses in the last blog also applies for relapses; i.e., discuss the possibility of lapse/relapse at treatment initiation, explore what caused the relapse and problem solve, continue medication, and […]

Read More