Gradual vs. Abrupt Cessation Treatment for Smoking

NCT ID: NCT00297492

Last Updated: 2013-09-20

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

750 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-01-31

Study Completion Date

2008-02-29

Brief Summary

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This study tests whether stopping smoking by gradually cutting down first is more or less successful than stopping abruptly. We hypothesize that stopping by gradually cutting down first will produce more abstinence than stopping abruptly.

Detailed Description

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For cigarette smokers who intend to stop smoking, most treatment guidelines recommend abrupt cessation. There is evidence from some small studies that gradually reducing the number of cigarettes per day smoked may increase success in quitting. In this study, we will randomize smokers who want to quit smoking in the next 30 days to one of three groups: gradual reduction, abrupt cessation, and minimal intervention.

Conditions

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Smoking Cessation

Keywords

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Smoking Cessation Tobacco

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Gradual reduction

Intervention: Reduction Phone Counseling. Intervention: Pre-Quit Nicotine Lozenges. Intervention: Post-Quit Nicotine Lozenges.

Group Type EXPERIMENTAL

Reduction Phone Counseling

Intervention Type BEHAVIORAL

Counseling of smokers to undergo gradual reduction in cigarettes per day prior to quit date. This includes 5 counseling calls: 3 calls focused on reduction prior to the quit date, 1 call two days prior to the quit date to discuss common strategies for preparing to quit, and 1 call two days after the quit date to discuss relapse prevention. Telephone counseling also discusses the proper use of nicotine lozenges during reduction and after the quit date.

Pre-Quit Nicotine Lozenges

Intervention Type DRUG

2 mg lozenges for participants usually smoke their first cigarette more than 30 minutes after awaking.

4 mg lozenge for participants who usually smoke their first cigarette less than 30 minutes after awaking.

Replace each forgone cigarette during reduction with one lozenge. Use additional lozenges to combat cravings to smoke.

Post-Quit Nicotine Lozenges

Intervention Type DRUG

2 mg lozenges for participants usually smoke their first cigarette more than 30 minutes after awaking.

4 mg lozenge for participants who usually smoke their first cigarette less than 30 minutes after awaking.

Replace each forgone cigarette while abstinent with one lozenge. Use additional lozenges to combat cravings to smoke.

Abrupt cessation

Intervention: Abrupt Phone Counseling. Intervention: Post-Quit Nicotine Lozenges.

Group Type ACTIVE_COMPARATOR

Abrupt Phone Counseling

Intervention Type BEHAVIORAL

Counseling of smokers to set a quit date and not change cigarettes per day prior to quit date. This includes 5 counseling calls: 1 to set a quit date, 1 two days prior to the quit date to discuss common strategies for preparing to quit, and 3 after the quit date to discuss relapse prevention. Telephone counseling also discusses the proper use of nicotine lozenges after the quit date.

Post-Quit Nicotine Lozenges

Intervention Type DRUG

2 mg lozenges for participants usually smoke their first cigarette more than 30 minutes after awaking.

4 mg lozenge for participants who usually smoke their first cigarette less than 30 minutes after awaking.

Replace each forgone cigarette while abstinent with one lozenge. Use additional lozenges to combat cravings to smoke.

Minimal intervention

Intervention: Minimal Abrupt Phone Counseling. Intervention: Post-Quit Nicotine Lozenges.

Group Type ACTIVE_COMPARATOR

Minimal Abrupt Phone Counseling

Intervention Type BEHAVIORAL

Minimal counseling to mimic intervention at a primary care office. This includes 2 counseling calls: 1 to set a quit date and 1 two days after the quit date to discuss relapse prevention. Telephone counseling also discusses the proper use of nicotine lozenges after the quit date.

Post-Quit Nicotine Lozenges

Intervention Type DRUG

2 mg lozenges for participants usually smoke their first cigarette more than 30 minutes after awaking.

4 mg lozenge for participants who usually smoke their first cigarette less than 30 minutes after awaking.

Replace each forgone cigarette while abstinent with one lozenge. Use additional lozenges to combat cravings to smoke.

Interventions

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Reduction Phone Counseling

Counseling of smokers to undergo gradual reduction in cigarettes per day prior to quit date. This includes 5 counseling calls: 3 calls focused on reduction prior to the quit date, 1 call two days prior to the quit date to discuss common strategies for preparing to quit, and 1 call two days after the quit date to discuss relapse prevention. Telephone counseling also discusses the proper use of nicotine lozenges during reduction and after the quit date.

Intervention Type BEHAVIORAL

Abrupt Phone Counseling

Counseling of smokers to set a quit date and not change cigarettes per day prior to quit date. This includes 5 counseling calls: 1 to set a quit date, 1 two days prior to the quit date to discuss common strategies for preparing to quit, and 3 after the quit date to discuss relapse prevention. Telephone counseling also discusses the proper use of nicotine lozenges after the quit date.

Intervention Type BEHAVIORAL

Minimal Abrupt Phone Counseling

Minimal counseling to mimic intervention at a primary care office. This includes 2 counseling calls: 1 to set a quit date and 1 two days after the quit date to discuss relapse prevention. Telephone counseling also discusses the proper use of nicotine lozenges after the quit date.

Intervention Type BEHAVIORAL

Pre-Quit Nicotine Lozenges

2 mg lozenges for participants usually smoke their first cigarette more than 30 minutes after awaking.

4 mg lozenge for participants who usually smoke their first cigarette less than 30 minutes after awaking.

Replace each forgone cigarette during reduction with one lozenge. Use additional lozenges to combat cravings to smoke.

Intervention Type DRUG

Post-Quit Nicotine Lozenges

2 mg lozenges for participants usually smoke their first cigarette more than 30 minutes after awaking.

4 mg lozenge for participants who usually smoke their first cigarette less than 30 minutes after awaking.

Replace each forgone cigarette while abstinent with one lozenge. Use additional lozenges to combat cravings to smoke.

Intervention Type DRUG

Other Intervention Names

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Commit Nicotine Lozenges Commit Nicotine Lozenges

Eligibility Criteria

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Inclusion Criteria

* Interested in quitting gradually
* At least 18 years old
* Daily cigarette smoker
* Smoke at least 15 cigarettes per day (CPD)
* No change greater than 20% in CPD in the last month
* Interested in quitting in next 30 days
* Must agree to not use non-cigarette tobacco during study
* No use of smoking cessation medication in last month
* Have phone with voice mail
* Willing to use nicotine lozenge
* No other person in household in study
* Fluent/literate in English

Exclusion Criteria

* Women who are pregnant or breastfeeding
* Currently using medication for depression or asthma
* Heart disease requiring medication
* Heart attack in last month
* Irregular heartbeat
* High blood pressure not controlled by medication
* Stomach ulcers
* Diabetes
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Institute on Drug Abuse (NIDA)

NIH

Sponsor Role collaborator

University of Vermont

OTHER

Sponsor Role lead

Responsible Party

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John Hughes

Professor of Psychiatry

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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John Hughes, MD

Role: PRINCIPAL_INVESTIGATOR

University of Vermont

Locations

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University of Vermont Human Behavioral Pharmacology Lab

Burlington, Vermont, United States

Site Status

Countries

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United States

References

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Hughes JR, Solomon LJ, Livingston AE, Callas PW, Peters EN. A randomized, controlled trial of NRT-aided gradual vs. abrupt cessation in smokers actively trying to quit. Drug Alcohol Depend. 2010 Sep 1;111(1-2):105-13. doi: 10.1016/j.drugalcdep.2010.04.007. Epub 2010 May 26.

Reference Type RESULT
PMID: 20537810 (View on PubMed)

Other Identifiers

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R01DA011557-07

Identifier Type: NIH

Identifier Source: secondary_id

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R01DA011557-07

Identifier Type: NIH

Identifier Source: org_study_id

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