Does Reducing Withdrawal Severity Mediate Nicotine Patch Efficacy? A Randomized Clinical Trial
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| Title: | Does Reducing Withdrawal Severity Mediate Nicotine Patch Efficacy? A Randomized Clinical Trial |
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| Language: | English |
| Authors: | Ferguson, Stuart G., Shiffman, Saul, Gwaltney, Chad J. |
| Source: | Journal of Consulting and Clinical Psychology. Dec 2006 74(6):1153-1161. |
| Availability: | American Psychological Association. Journals Department, 750 First Street NE, Washington, DC 20002-4242. Tel: 800-374-2721; Tel: 202-336-5510; Fax: 202-336-5502; e-mail: order@apa.org; Web site: http://www.apa.org/publications |
| Peer Reviewed: | Y |
| Page Count: | 9 |
| Publication Date: | 2006 |
| Document Type: | Journal Articles Reports - Evaluative |
| Descriptors: | Severity (of Disability), Smoking, Compliance (Psychology), Mediation Theory, Clinical Psychology, Computer Assisted Testing, Emotional Disturbances, Hypothesis Testing, Cognitive Restructuring, Recidivism, Outcomes of Treatment, Psychological Studies |
| ISSN: | 0022-006X |
| Abstract: | Nicotine replacement therapy (NRT) repeatedly has been shown to improve smoking treatment outcome. The major mechanism posited for this improvement in outcome is that NRT reduces nicotine craving and withdrawal. The authors tested this hypothesized mechanism of action using real-time data on craving and withdrawal, collected by ecological momentary assessments administered on a palm-top computer. Smokers (N = 324) were randomized to receive either active high-dose (35 mg) 24-hr patches or placebo. Increases in positive affect and decreases in craving, negative affect, and attention disturbance severity were related to lower risk of lapsing. Although NRT treatment did significantly decrease withdrawal and craving severity, these reductions only partially accounted for NRT's impact on time to first lapse: The results from a mediation analysis showed that the hazard ratio for NRT, when controlling for withdrawal and craving severity, was only a third to a half lower than the uncontrolled hazard ratio for NRT alone. This suggests that other mechanisms for the effectiveness of NRT need to be examined. |
| Abstractor: | Author |
| Entry Date: | 2007 |
| Access URL: | https://content.apa.org/journals/ccp/74/6/1153 |
| Accession Number: | EJ750780 |
| Database: | ERIC |
| Abstract: | Nicotine replacement therapy (NRT) repeatedly has been shown to improve smoking treatment outcome. The major mechanism posited for this improvement in outcome is that NRT reduces nicotine craving and withdrawal. The authors tested this hypothesized mechanism of action using real-time data on craving and withdrawal, collected by ecological momentary assessments administered on a palm-top computer. Smokers (N = 324) were randomized to receive either active high-dose (35 mg) 24-hr patches or placebo. Increases in positive affect and decreases in craving, negative affect, and attention disturbance severity were related to lower risk of lapsing. Although NRT treatment did significantly decrease withdrawal and craving severity, these reductions only partially accounted for NRT's impact on time to first lapse: The results from a mediation analysis showed that the hazard ratio for NRT, when controlling for withdrawal and craving severity, was only a third to a half lower than the uncontrolled hazard ratio for NRT alone. This suggests that other mechanisms for the effectiveness of NRT need to be examined. |
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| ISSN: | 0022-006X |
