Despite many years of education, social pressure, physician advice and effective treatments, the average smoker tries to quit only once every three years; thus, interventions to prompt smoking cessation are needed. This application tests whether a behavioral instruction program plus nicotine gum will induce a large and durable reduction in smoking and whether this will serve as a success experience and thereby prompt a quit attempt. Smokers who do not plan to quit smoking in the next month will be randomly assigned to one of four groups: non-specific therapy + brief advice to quit, a behavioral instructional program to reduce smoking + brief advice to quit, behavioral instructions to reduce + advice + placebo gum, or behavioral instructions to reduce + advice + nicotine gum. To increase generalizability, treatment will be delivered via written materials and five telephone contacts. Our major hypothesis is that both behavioral instructions to reduce and nicotine gum will each increase quit attempts over the ensuing 12 months. We will also test whether increased self-efficacy or the magnitude and duration of reduced smoking mediate any increase in quit attempts. Finally, we will monitor the safety of concurrent use of gum and cigarettes. The present application is not designed to test reduced smoking as a treatment for cessation among smokers trying to quit (i.e., """"""""gradual reduction""""""""). It also is not a test of reduced smoking as a goal in itself (i.e., """"""""harm reduction""""""""). Rather, the application focuses on using reduced smoking to prompt cessation. Current public health strategies discourage reduced smoking. If we show reduced smoking prompts quit attempts, it will suggest reconsideration of reduced smoking as an intermediary step toward quitting smoking.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Research Project (R01)
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Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Grossman, Debra
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University of Vermont & St Agric College
Schools of Medicine
United States
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Zapawa, Lisa M; Hughes, John R; Benowitz, Neal L et al. (2011) Cautions and warnings on the US OTC label for nicotine replacement: what's a doctor to do? Addict Behav 36:327-32
Hughes, John R; Rennard, Stephen I; Fingar, James R et al. (2011) Efficacy of varenicline to prompt quit attempts in smokers not currently trying to quit: a randomized placebo-controlled trial. Nicotine Tob Res 13:955-64
Hughes, John R; Solomon, Laura J; Livingston, Amy E et al. (2010) A randomized, controlled trial of NRT-aided gradual vs. abrupt cessation in smokers actively trying to quit. Drug Alcohol Depend 111:105-13
Hughes, John R; Callas, Peter W (2010) Data to assess the generalizability of samples from studies of adult smokers. Nicotine Tob Res 12:73-6
Peters, Erica N; Hughes, John R (2009) The day-to-day process of stopping or reducing smoking: a prospective study of self-changers. Nicotine Tob Res 11:1083-92
Hughes, John R; Cohen, Bevin; Callas, Peter W (2009) Treatment seeking for smoking cessation among young adults. J Subst Abuse Treat 37:211-3
Hughes, John R; Marcy, Theodore W; Naud, Shelly (2009) Interest in treatments to stop smoking. J Subst Abuse Treat 36:18-24
Hughes, John R (2009) Ethical concerns about non-active conditions in smoking cessation trials and methods to decrease such concerns. Drug Alcohol Depend 100:187-93
Hughes, John R; Peters, Erica N; Callas, Peter W et al. (2008) Attempts to stop or reduce marijuana use in non-treatment seekers. Drug Alcohol Depend 97:180-4
Hughes, John (2008) An algorithm for choosing among smoking cessation treatments. J Subst Abuse Treat 34:426-32

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