The percent of current lighter smokers has dramatically increased in the past decade. While the risks of smoking are thought to be dose related, the health risks of lighter smoking are nonetheless substantial. It is generally assumed that lighter smokers have an easier time quitting than heavier smokers, but systematic studies comparing the effectiveness of different forms or amounts of treatment have not been conducted. The primary goal of the proposed research is to compare and determine the efficacy and cost effectiveness of two different types of medications (nicodermal patch + dummy bupropion, bupropion + dummy patch) used in conjunction with two levels of psychosocial intervention (10 weeks of 10-15 minute individual psycho educational counseling vs. four weeks of 5-minute sessions of individual medication management counseling) in a diverse population of lighter smokers. Four groups of 65 participants each will be compared using a 2 X 2 double-blind, double-dummy design. The total medication treatment period will be 9 weeks with a target quit date set for day 8 in each condition. Completion of treatment and smoking cessation at 12, 26, and 52 weeks post-treatment initiation will be the primary measures of efficacy for each condition along with cost-effectiveness. Secondarily, the study will attempt to delineate mediators associated with the different treatment conditions (medication compliance, participant views and use of self-help written material and counseling) using self-report questionnaires administered to all participants at weeks 12, 26, and 52. The research will also attempt to: 1). determine the extent to which baseline nicotine dependence severity scores (Fagerstr6m Test for Nicotine Dependence) are a negative predictor of treatment response; 2). determine whether participants with a prior history of heavier smoking respond less favorably than those without such a history; 3). determine if patients who receive bupropion exhibit greater increases in positive affect and greater decreases in negative affect, 4).determine whether any sociodemographic, psychiatric or treatment response (e.g., withdrawal symptoms, adverse events, weight gain, treatment satisfaction) characteristics of the participants are predictive of treatment response.
|Gariti, Peter; Lynch, Kevin; Alterman, Arthur et al. (2009) Comparing smoking treatment programs for lighter smokers with and without a history of heavier smoking. J Subst Abuse Treat 37:247-55|
|Gariti, Peter; Levin, Sarah; Whittingham, Thomas et al. (2008) Why do those who request smoking treatment fail to attend the first appointment? J Subst Abuse Treat 35:62-7|