Navigation Links
Stopping smoking cessation treatments too soon may reduce odds of success for 45 percent of smokers
Date:9/1/2010

PORTLAND, Ore. A study led by researchers in the Oregon Health & Science University Smoking Cessation Center may change the way clinicians make treatment decisions for their patients who smoke.

Their findings published online in the journal Addiction suggest that current treatment theories that maintain any smoking after the planned target quit day predicts treatment failure need to be expanded to take into account a more dynamic quitting process. The team's analysis points to two types of successful quitters: those who quit immediately and remain abstinent through the end of treatment and those who are "delayed" in attaining abstinence but achieve success by the end of treatment.

"In 'real-world' clinic settings, health care providers must decide whether or not to continue a specific treatment based on their clinical judgment and the published reports in the scientific literature. They can lose confidence that a specific cessation treatment is effective when the patient is unable to quit on the recommended target quit day or if the patient is unable to maintain total abstinence within the early weeks of treatment," said David Gonzales, Ph.D., the study's lead author and a senior clinical investigator in Pulmonary and Critical Care Medicine at the OHSU Smoking Cessation Center, OHSU School of Medicine.

"Patients also can become discouraged that a treatment is not working and worry about continuing to pay for treatments they believe do not work. As a result, cessation treatment for some patients may be discontinued before the prescribed treatment period is completed and the patient and/or the treatment considered a failure."

In this study, however, the data show a substantial proportion of smokers who became 'successful quitters' by the end of 12 weeks of treatment smoked in one or more weeks during the first eight weeks and were delayed in achieving a period of continuous abstinence. This was true of successful quitters treated with varenicline, bupropion and with counseling alone [placebo], Gonzales explained, and appears to be a previously unreported and natural pattern of quitting for motivated smokers who seek treatment to quit.

"Had treatment been interrupted or discontinued for these 'delayed quitters,' opportunities for achieving continuous abstinence could have been lost for up to 45 percent of quitters who were ultimately successful," Gonzales said.

Gonzales and colleagues analyzed data from two identically designed, published studies (Gonzales et al. JAMA 2006 and Jorenby et al. JAMA 2006) conducted between June 2003 and April 2005. Participants included 2,052 generally healthy adult smokers who randomly received either a smoking cessation drug varenicline or bupropion or a placebo for 12 weeks of treatment plus 40 weeks of follow-up. All participants received brief smoking cessation counseling at clinic visits and investigators were blinded to the treatment assignments.

Successful quitters were defined as smokers who achieved continuous abstinence, not even one puff, for the last four weeks of treatment (weeks nine through 12). Among successful quitters, two groups were identified: "immediate quitters," smokers who quit and remained abstinent from their target quit date through the end of week 12; and "delayed quitters," smokers who had periods of smoking prior to attaining continuous abstinence for at least the last four weeks of treatment.

The overall end-of-treatment quit rates for the two studies were previously shown to be higher for varenicline, but in this analysis, the researchers found cumulative continuous abstinence increased similarly for all treatments during weeks three through eight. They also found quitting patterns among delayed quitters were similar regardless of whether they took varenicline, bupropion or received counseling only (placebo).

While delayed quitters did not fare quite as well as immediate quitters following the end of active treatment, they still accounted for approximately one-third of those who remained continuously abstinent at 12 months regardless of treatment group.

"Based on these findings, we believe that treatment failure, or success for that matter, should not be assessed until the recommended period of treatment is completed. An analogy with antibiotic treatment, while not totally appropriate, is, nevertheless, a useful framework for illustrating some of the dynamics of the quitting process," explained Gonzales. "We know that some patients quit taking antibiotics when there is relief of symptoms [success] and others quit taking medication if symptoms don't seem to be resolving [failure]. In both cases discontinuing treatment prematurely risks treatment failure. Stopping smoking cessation treatment seems to have similar risks."

The take-home message for clinicians and patients, according to Gonzales, is that 'real-world' quit rates may be significantly increased by just continuing cessation treatments without interruption for patients who remain motivated to quit despite lack of success during the first eight weeks of treatment.


'/>"/>

Contact: Tamara Hargens-Bradley
hargenst@ohsu.edu
503-494-8231
Oregon Health & Science University
Source:Eurekalert

Related medicine news :

1. The Infrex Plus is Revolutionizing Pain Control by Stopping Pain & Eliminating Drugs for Chronic Pain Patients Who Suffered For Years
2. Non-IV-administered medication just as effective in stopping seizures
3. New Report: $1 Cigarette Tax Increase Would Raise $418.8 Million for Texas and Cut Youth Smoking
4. New Report: $1 Cigarette Tax Increase Would Raise $18.6 Million for Montana and Cut Youth Smoking
5. New Report: $1 Cigarette Tax Increase Would Raise $24.8 Million for Wyoming and Cut Youth Smoking
6. New Report: $1 Cigarette Tax Increase Would Raise $43.3 Million for Utah and Cut Youth Smoking
7. New Report: $1 Cigarette Tax Increase Would Raise $113.9 Million for Colorado and Cut Youth Smoking
8. New Report: $1 Cigarette Tax Increase Would Raise $65.3 Million for Iowa and Cut Youth Smoking
9. Quitting smoking especially difficult for select groups
10. New intervention helps Latino parents of asthmatic children quit smoking
11. Warning: Immigrating to North America may foster smoking in children
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/3/2016)... ... ... Each year, about 800,000 people suffer from cerebral vascular accidents, or strokes. ... for one death every four minutes. Many people who survive a stroke are ... a video series called “Your Brain,” in conjunction with its medical journal “Balance,” in ...
(Date:5/3/2016)... Toronto, ON (PRWEB) , ... May 03, 2016 ... ... been recognized as one of Canada’s top Information and Communication Technology (ICT) companies ... top Canadian and Multinational ICT companies operating in Canada, as ranked by revenue. ...
(Date:5/3/2016)... (PRWEB) , ... May 03, 2016 , ... Branches, Inc. ... its Grow & Climb children and youth programs in South Miami. Macy’s is a ... , The Grow Program provides afterschool tutoring, mentoring, enrichment and academic support to ...
(Date:5/3/2016)... ... May 03, 2016 , ... ... healthcare organizations, especially medium and small physician practices, to better grasp and implement ... step-by-step approach that guides practices on a well-defined, expert-created path to compliance. HIPAA ...
(Date:5/2/2016)... Denver, CO (PRWEB) , ... May 02, 2016 , ... ... will serve as the keynote speaker for five events throughout the month of May. ... for a number of national news outlets. He also frequently appears on the Science ...
Breaking Medicine News(10 mins):
(Date:4/29/2016)... Glycotope GmbH, a clinical-stage immuno-oncology ... appointment of Dr. Alfredo Zurlo as Chief ... with many years clinical experience and a proven track ... role was at Mologen AG where he was Chief ... Dr. Zurlo held various positions at F Hoffmann La ...
(Date:4/28/2016)... , April 28, 2016  Marking its ... accessible breast and ovarian cancer risk test, ... analyzing 30 genes that highly impact the most ... Available today, the Color Test analyzes hereditary cancer ... stomach, and uterine cancers. The Color Test is ...
(Date:4/28/2016)... Dr. Vivek Ahuja , ... Ste phen Schmidt Join the ... software solutions for life sciences, today announced key new leaders have ... insight to a growing business.  This will bolster the company,s safety ... joined ArisGlobal in the position of Vice President - Safety. ...
Breaking Medicine Technology: