Time-varying effects of ‘optimized smoking treatment’ on craving, negative affect and anhedonia
Corresponding Author
Nayoung Kim
Center for Tobacco Research and Intervention, Division of General Internal Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Correspondence to: Nayoung Kim PhD, Center for Tobacco Research and Intervention, Department of Medicine, University of Wisconsin School of Medicine and Public Health, 1930 Monroe Street, Suite 200, Madison, WI 53711. USA. E-mail: [email protected]Contribution: Conceptualization, Formal analysis, Visualization
Search for more papers by this authorDanielle E. McCarthy
Center for Tobacco Research and Intervention, Division of General Internal Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Contribution: Conceptualization, Formal analysis, Supervision, Visualization
Search for more papers by this authorJessica W. Cook
Center for Tobacco Research and Intervention, Division of General Internal Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Contribution: Conceptualization
Search for more papers by this authorMegan E. Piper
Center for Tobacco Research and Intervention, Division of General Internal Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Contribution: Conceptualization, Funding acquisition, Investigation
Search for more papers by this authorTanya R. Schlam
Center for Tobacco Research and Intervention, Division of General Internal Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Contribution: Conceptualization
Search for more papers by this authorTimothy B. Baker
Center for Tobacco Research and Intervention, Division of General Internal Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Contribution: Conceptualization, Funding acquisition, Investigation
Search for more papers by this authorCorresponding Author
Nayoung Kim
Center for Tobacco Research and Intervention, Division of General Internal Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Correspondence to: Nayoung Kim PhD, Center for Tobacco Research and Intervention, Department of Medicine, University of Wisconsin School of Medicine and Public Health, 1930 Monroe Street, Suite 200, Madison, WI 53711. USA. E-mail: [email protected]Contribution: Conceptualization, Formal analysis, Visualization
Search for more papers by this authorDanielle E. McCarthy
Center for Tobacco Research and Intervention, Division of General Internal Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Contribution: Conceptualization, Formal analysis, Supervision, Visualization
Search for more papers by this authorJessica W. Cook
Center for Tobacco Research and Intervention, Division of General Internal Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Contribution: Conceptualization
Search for more papers by this authorMegan E. Piper
Center for Tobacco Research and Intervention, Division of General Internal Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Contribution: Conceptualization, Funding acquisition, Investigation
Search for more papers by this authorTanya R. Schlam
Center for Tobacco Research and Intervention, Division of General Internal Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Contribution: Conceptualization
Search for more papers by this authorTimothy B. Baker
Center for Tobacco Research and Intervention, Division of General Internal Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Contribution: Conceptualization, Funding acquisition, Investigation
Search for more papers by this authorAbstract
Aims
To identify when smoking cessation treatments affect craving, negative affect and anhedonia, and how these symptoms relate to abstinence, to help evaluate the effects of particular intervention components in multi-component treatments and accelerate treatment refinement.
Design
Secondary analysis of data from a two-arm randomized controlled trial.
Setting
Seven primary care clinics in Wisconsin, United States.
Participants
Adult primary care patients who smoked daily (n = 574).
Intervention and comparator
Intervention was abstinence-optimized treatment (A-OT, n = 276) comprising 3 weeks of nicotine mini-lozenges pre-target quit day (TQD), 26 weeks of combination nicotine patch and mini-lozenges post-TQD and extensive psychosocial support. The comparator was recommended usual care (RUC, n = 298), comprising brief counseling and 8 weeks of nicotine patch post-TQD.
Measurements
Time-varying effect models examined dynamic effects of A-OT (versus RUC) on the primary outcomes of nightly cigarette craving, negative affect and anhedonia from 1 week pre- to 2 weeks post-TQD. Exploratory models examined within-person relations between nicotine medication use and same-day symptom ratings. Secondary logistic regression analyses examined associations between post-TQD craving, negative affect and anhedonia and 1-month post-TQD abstinence.
Findings
A-OT significantly suppressed pre- and post-TQD craving (β = −0.27 to −0.46 across days) and post-TQD anhedonia (β = −0.24 to −0.38 across days), relative to RUC. Within individuals, using patches was associated with lower negative affect in RUC (β = −0.42 to −0.52), but not in A-OT. Using more mini-lozenges was associated with greater craving (β = 0.04–0.07) and negative affect (β = 0.03–0.05) early, and with lower anhedonia (β = −0.06 to −0.12) later. Greater post-TQD craving (OR = 0.68) and anhedonia (OR = 0.85) predicted lower odds of abstinence 1 month post-TQD.
Conclusion
Time-varying effect models showed that a multi-component treatment intervention for smoking cessation suppressed significant withdrawal symptoms more effectively than recommended usual care among daily adult smokers motivated to quit. The intervention reduced craving pre- and post-target quit day (TQD) and anhedonia post-TQD.
Supporting Information
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| add15232-sup-0001-SI.docxWord 2007 document , 380 KB |
Data S1. Supporting information. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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