New Methods for Tobacco Dependence Treatment Research

Introduction Despite advances in tobacco dependence treatment in the past two decades, progress has been inconsistent and slow. This paper reviews pervasive methodological issues that may contribute to the lack of timely progress in tobacco treatment science including the lack of a dynamic model or framework of the cessation process, inefficient study designs, and the use of distal outcome measures that poorly index treatment effects. The authors then present a phase-based cessation framework that partitions the cessation process into four discrete phases based on current theories of cessation and empirical data. These phases include: (1) Motivation, (2) Precessation, (3) Cessation, and (4) Maintenance. Discussion Within this framework, it is possible to identify phase-specific challenges that a smoker would encounter while quitting smoking, intervention components that would address these phase-specific challenges, mechanisms via which such interventions would exert their effects, and optimal outcome measures linked to these phase-specific interventions. Investigation of phase-based interventions can be accelerated by using efficient study designs that would permit more timely development of an optimal smoking cessation treatment package.

...This article, in conjunction with Baker et al. [1], presents a new approach for improving smoking cessation treatments...
...Baker et al. [1] describe a phase-based framework for tobacco use cessation research...
...The intervention components under consideration stem directly from the phase-based framework reviewed in the companion article by Baker et al. [1] and constitute a diverse set representing both counseling and pharmacotherapy...
...In our work, this theoretical model is based on the phase-based framework described in detail in the companion article by Baker et al. [1], as well as various tobacco dependence theories...
...We estimated the sample size that would be needed to achieve sufficient power for a comparison of the two levels of each of the components listed in Table 1. The smallest effect size could be detected with power ≥0.9 with N=512 (this allows for 5% attrition), using number of days abstinent during the 2-week post-quit period as a shortterm outcome (the companion article by Baker et al. [1] discusses the need to choose phase-appropriate ...
...As discussed in the Baker et al. [1] companion paper, the phase-based framework, in concert with dependence theories, not only suggests intervention components but it also suggests the use of phase-specific outcomes...
...The primary outcome variables for the RCT will be phase-based outcomes [1] and the more traditional longterm outcomes (time to lapse/relapse and point-prevalence abstinence at 6 months post-quit)...
...In this article and the companion article by Baker et al. [1], we propose a comprehensive strategy for achieving more effective tobacco interventions, based on [1] use of a phasebased framework to guide the choice of intervention components and outcome measures and [2] use of the MOST framework for efficient development, optimization, and evaluation of interventions...
...In this article and the companion article by Baker et al. [1], we propose a comprehensive strategy for achieving more effective tobacco interventions, based on [1] use of a phasebased framework to guide the choice of intervention components and outcome measures and [2] use of the MOST framework for efficient development, optimization, and evaluation of interventions...

Keywords (7)

New Methods for Tobacco Dependence Treatment Research,10.1007/s12160-010-9252-y,Annals of Behavioral Medicine,Timothy B. Baker,Robin Mermelstein,Linda

Citation Context (3)

L W Hawk, et al. The Effects of Extended Pre-Quit Varenicline Treatment on Smoking Beha...

Linda M. Collins, et al. The Multiphase Optimization Strategy for Engineering Effective Tobacco...

Michael A. Diefenbach. Introduction to the Special Edition of Keynote Addresses and Master Le...

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Citations (3)

The Effects of Extended Pre-Quit Varenicline Treatment on Smoking Behavior and Short-Term Abstinence: A Randomized Clinical Trial

The Multiphase Optimization Strategy for Engineering Effective Tobacco Use Interventions (Citations: 6)

Introduction to the Special Edition of Keynote Addresses and Master Lectures Presented at the 2010 Annual Meeting of the Society of Behavioral Medicine


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