Analyzing Milestones in Smoking Cessation Illustration in a Nicotine Patch Trial in Adult Smokers

• Published in: Journal of consulting and clinical psychology Vol. 74; no. 2; pp. 276 - 285
• Main Authors: Shiffman, Saul, Scharf, Deborah M, Shadel, William G, Gwaltney, Chad J, Dang, Qianyu, Paton, Stephanie M, Clark, Duncan B
• Format: Journal Article
• Language: English
• Published: Washington, DC American Psychological Association 01-04-2006
• Subjects: Addiction; Addictive behaviors; Administration, Cutaneous; Adult; Adult and adolescent clinical studies; Adults; Biological and medical sciences; Clinical psychology; Diaries; Double-Blind Method; Drug Addiction; Drug Therapy; Female; Health Services; Human; Humans; Maintenance Therapy; Male; Medical sciences; Medical tests; Medical treatment; Nicotine; Nicotine - administration & dosage; Nicotine - therapeutic use; Nicotinic Agonists - administration & dosage; Nicotinic Agonists - therapeutic use; Outcomes of Treatment; Psychology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Smoking; Smoking - therapy; Smoking Cessation; Smoking Cessation - methods; Tobacco Smoking; Tobacco, tobacco smoking; Toxicology; nicotine addiction; nicotine replacement; nicotine patch; heavy smokers; nicotine cessation treatments; Human; Alkaloid; Poison withdrawal; Smoker; Tobacco smoking; Adult; Nicotine
• ISSN: 0022-006X; 1939-2117
• DOI: 10.1037/0022-006X.74.2.276

Tests of addiction treatments seldom reveal where treatment exercises its effect (i.e., promoting initial abstinence, preventing lapses, and/or impeding progression from lapse to relapse). The authors illustrate analyses distinguishing effects on these milestones in a randomized trial of high-dose nicotine patch (35 mg;
n
= 188) versus placebo (
n
= 136) in adult smokers, who used electronic diaries to monitor smoking in real time during 5 weeks of treatment. High-dose patch promoted initial abstinence (hazard ratio [HR] = 1.3) and decreased the risk of lapsing among those who achieved abstinence (HR = 1.6). The biggest effect of treatment was to prevent progression to relapse among those who had lapsed (HR = 7.1). Analysis of effects by milestones may enhance understanding of cessation treatments and their mechanisms of action.