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Outcomes of the Smoker's Health Project: a pragmatic comparative effectiveness trial of tobacco-dependence interventions based on self-determination theory.
Health Educ Res. 2016 12; 31(6):749-759.HE

Abstract

A pragmatic comparative effectiveness trial examined whether extending the duration of a cost-effective, intensive tobacco-dependence intervention designed to support autonomy will facilitate long-term tobacco abstinence. Participants were randomly assigned to one of three tobacco-dependence interventions based on self-determination theory, namely, Intensive Treatment (IT; six contacts over 6 months), Extended Need Support (ENS; eight contacts over 12 months) and Harm Reduction (HR; eight contacts over 12 months with medication use if willing to reduce cigarette use by half). Among participants who completed the interventions, analyses revealed beneficial effects of ENS (15.7 versus 3.8%; χ 2(1) = 6.92, P < 0.01) and HR (13.6 versus 3.8%; χ 2(1) = 5.26, P < 0.05), relative to IT, on 12-month prolonged abstinence from tobacco. Also, analyses revealed beneficial effects of ENS (77.7 versus 43.0%; χ 2(1) = 24.90, P < 0.001) and HR (84.0 versus 43.0%; χ 2(1) = 37.41, P < 0.001), relative to IT, on use of first-line medications for smoking cessation. Hence, two new interventions were found to be efficacious particularly among participants who completed the interventions. Smokers who stay in treatment for an additional 6 months may benefit from an additional two contacts with practitioners, and thus it seems reasonable for policy makers to offer additional contacts given the health benefits associated with prolonged tobacco abstinence.

Authors+Show Affiliations

Department of Medicine, Healthy Living Center, Center for Community Health, University of Rochester, Rochester, NY 14607, USA.Department of Clinical and Social Sciences in Psychology, University of Rochester, Rochester, NY 14627, USA niemiec@psych.rochester.edu.LiveHealthier, Inc, Bethesda, MD 20814, USA.Department of Clinical and Social Sciences in Psychology, University of Rochester, Rochester, NY 14627, USA. Institute for Positive Psychology and Education, Australian Catholic University, Sydney, Australia.Department of Clinical and Social Sciences in Psychology, University of Rochester, Rochester, NY 14627, USA.

Pub Type(s)

Journal Article
Pragmatic Clinical Trial
Randomized Controlled Trial
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

27923864

Citation

Williams, Geoffrey C., et al. "Outcomes of the Smoker's Health Project: a Pragmatic Comparative Effectiveness Trial of Tobacco-dependence Interventions Based On Self-determination Theory." Health Education Research, vol. 31, no. 6, 2016, pp. 749-759.
Williams GC, Niemiec CP, Patrick H, et al. Outcomes of the Smoker's Health Project: a pragmatic comparative effectiveness trial of tobacco-dependence interventions based on self-determination theory. Health Educ Res. 2016;31(6):749-759.
Williams, G. C., Niemiec, C. P., Patrick, H., Ryan, R. M., & Deci, E. L. (2016). Outcomes of the Smoker's Health Project: a pragmatic comparative effectiveness trial of tobacco-dependence interventions based on self-determination theory. Health Education Research, 31(6), 749-759.
Williams GC, et al. Outcomes of the Smoker's Health Project: a Pragmatic Comparative Effectiveness Trial of Tobacco-dependence Interventions Based On Self-determination Theory. Health Educ Res. 2016;31(6):749-759. PubMed PMID: 27923864.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcomes of the Smoker's Health Project: a pragmatic comparative effectiveness trial of tobacco-dependence interventions based on self-determination theory. AU - Williams,Geoffrey C, AU - Niemiec,Christopher P, AU - Patrick,Heather, AU - Ryan,Richard M, AU - Deci,Edward L, Y1 - 2016/10/22/ PY - 2015/07/29/received PY - 2016/09/23/accepted PY - 2016/12/8/entrez PY - 2016/12/8/pubmed PY - 2018/1/25/medline SP - 749 EP - 759 JF - Health education research JO - Health Educ Res VL - 31 IS - 6 N2 - A pragmatic comparative effectiveness trial examined whether extending the duration of a cost-effective, intensive tobacco-dependence intervention designed to support autonomy will facilitate long-term tobacco abstinence. Participants were randomly assigned to one of three tobacco-dependence interventions based on self-determination theory, namely, Intensive Treatment (IT; six contacts over 6 months), Extended Need Support (ENS; eight contacts over 12 months) and Harm Reduction (HR; eight contacts over 12 months with medication use if willing to reduce cigarette use by half). Among participants who completed the interventions, analyses revealed beneficial effects of ENS (15.7 versus 3.8%; χ 2(1) = 6.92, P < 0.01) and HR (13.6 versus 3.8%; χ 2(1) = 5.26, P < 0.05), relative to IT, on 12-month prolonged abstinence from tobacco. Also, analyses revealed beneficial effects of ENS (77.7 versus 43.0%; χ 2(1) = 24.90, P < 0.001) and HR (84.0 versus 43.0%; χ 2(1) = 37.41, P < 0.001), relative to IT, on use of first-line medications for smoking cessation. Hence, two new interventions were found to be efficacious particularly among participants who completed the interventions. Smokers who stay in treatment for an additional 6 months may benefit from an additional two contacts with practitioners, and thus it seems reasonable for policy makers to offer additional contacts given the health benefits associated with prolonged tobacco abstinence. SN - 1465-3648 UR - https://www.unboundmedicine.com/medline/citation/27923864/Outcomes_of_the_Smoker's_Health_Project:_a_pragmatic_comparative_effectiveness_trial_of_tobacco_dependence_interventions_based_on_self_determination_theory_ L2 - https://academic.oup.com/her/article-lookup/doi/10.1093/her/cyw046 DB - PRIME DP - Unbound Medicine ER -