Smokers with bipolar disorder, other affective disorders, and no mental health conditions: Comparison of baseline characteristics and success at quitting in a large 12-month behavioral intervention randomized trial.

Classified as probably not a substantial claim.

Validated mental health screeners were administered at baseline for depression, generalized anxiety, panic disorder, post-traumatic stress disorder, social anxiety, and at-risk drinking.

“Validated mental health screeners administered at baseline covered depression [CES-D (Radloff 1977); positive screen is ≥16], generalized anxiety [GAD-7 (Spitzer et al., 2006); positive screen is ≥ 10], panic disorder [ANSQ (Stein et al., 1999)]”

• cites Radloff 1977 sourceSupported
• cites Spitzer et al., 2006 sourceNot checked — no full text of the source
• cites Stein et al., 1999 sourceNot checked — no full text of the source

May combine two claims.

It is likely that some participants who self-reported a mental health disorder would not meet diagnostic criteria and some who did not self-report one would meet criteria.

“it is likely that some proportion of participants in the study who self-reported mental health disorders would not meet diagnostic criteria and that some of those who did not self-report a disorder would, in fact, meet the criteria.”

• cites Sanchez-Villegas et al., 2008 sourcePartly supported

  The Results report 46 true positives among 62 participants who self-reported depression and 34 true negatives among 42 who did not, demonstrating both kinds of misclassification for depression. The source validates self-reported depression in its own cohort, not mental health disorders generally or the participants in the citing study. (LLM, conf=0.85)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

Depression has been associated with lower use of some cessation treatments, including behavioral and pharmacotherapy interventions.

“Although depression has been linked to lower utilization of some cessation treatments, including both behavioral (Zeng et al., 2015) and pharmacotherapy (Hood et al., 2013) interventions”

• cites Zeng et al., 2015 sourceSupported
• cites Hood et al., 2013 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The Commitment to Quitting Smoking Scale and the Avoidance and Inflexibility Scale were used to measure commitment to abstinence and smoking-specific experiential avoidance.

“participants completed the Commitment to Quitting Smoking Scale (CQSS) (Kahler et al., 2007) as a measure of commitment to achieving abstinence and the Avoidance and Inflexibility Scale (AIS) (Gifford et al., 2004) as a measure of smoking-specific experiential avoidance”

• cites Kahler et al., 2007 sourceSupported
• cites Gifford et al., 2004 sourceNot checked — no full text of the source

May combine two claims.

Smokers with bipolar disorder were more likely to screen positive for current mental health conditions than both comparison groups, except that panic-disorder likelihood was similar to the other affective disorder group.

“They were also more likely to screen positive for current mental health conditions than both comparison groups, with the exception of a similar likelihood of panic disorder in BD and AD.”

May combine two claims.

On acceptance of internal smoking cues, smokers with bipolar disorder scored lower than the no mental health condition group but did not differ significantly from the other affective disorder group.

“the smokers with BD scored lower than the no MHC group but were not significantly different from the AD group.”

May combine two claims.

Smokers with bipolar disorder reported greater exposure to other smokers than smokers without mental health conditions, but were similar to the other affective disorder group on living with a smoker.

“they reported generally greater exposure to other smokers (i.e., close friends, adult smokers in home) than smokers with no MHCs, but they were similar to the AD group on living with a smoker—either a partner or other adult in the household.”

May combine two claims.

In the ACT arm, the bipolar disorder group did not differ significantly from either the no mental health condition group or the other affective disorder group on days logged in.

“but the BD group did not differ significantly from either the no MHC group (p=.064, IRR=0.79, 95% CI=0.62–1.02) or the AD group (p=.635, IRR=1.06, 95% CI=0.82–1.40).”

May combine two claims.

Compared with both comparison groups, smokers with bipolar disorder were younger and more likely to be unmarried, not working, and identify as lesbian, gay, or bisexual.

“Relative to both comparison groups, smokers with BD were younger and more likely to be unmarried, not working, and identify as lesbian, gay, or bisexual (LGB).”

May combine two claims.

The bipolar disorder subgroup had significantly lower quit rates than the no mental health condition group on the primary 12-month outcome and on all other 12-month cessation outcomes.

“the BD subgroup did have significantly lower quit rates than the no MHC group on the primary outcome of 30-day PPA at 12-months post-randomization (as well as all of the other cessation outcomes at 12-months).”

May combine two claims.

Cessation differences between bipolar disorder and no mental health conditions were present at long-term follow-up but not at 3 months.

“differences in cessation outcomes between smokers with BD and no MHC were present at long-term follow-up, but not at the earliest follow-up of 3 months post-randomization.”

Probably not a substantial claim: may not pass S3 (load-bearing). The quote only partly states this claim.

The 8% prevalence of self-reported bipolar disorder in this sample is consistent with national data indicating about 9% of current adult smokers in the US have bipolar disorder.

“the 8% (221/2637) prevalence of self-reported bipolar disorder among smokers in this sample is consistent with national-level data indicating that there are an estimated 3.5 million adults with bipolar disorder in the US who smoke”

• cites Lasser et al., 2000 sourceNot checked — no full text of the source
• cites Merikangas et al., 2007 sourceNot checked — no full text of the source
• cites US Census Bureau, 2012Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Classified as probably not a substantial claim.

Biochemical verification of smoking abstinence is generally considered unnecessary in population-level interventions without face-to-face contact.

“Generally, biochemical verification of smoking abstinence is considered unnecessary in population-level interventions with no face-to-face contact (SRNT Subcommittee on Biochemical Verification, 2002).”

• cites SRNT Subcommittee on Biochemical Verification, 2002 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Because the analyses were post hoc and exploratory, multiple testing was not controlled except for familywise error rate.

“Due to the post hoc, exploratory nature of the analyses, we did not control for multiple testing with the exception of controlling for familywise error rate as described previously.”

Classified as probably not a substantial claim.

Self-reported cessation outcomes are recommended for large population-based cessation trials with no face-to-face contact, minimal demand characteristics, and infeasible biochemical confirmation due to sample size.

“Self-reported cessation outcomes are recommended for large population-based cessation trials where there is no face-to-face contact, demand characteristics are minimal, and biochemical confirmation is not feasible due to sample size (SRNT Subcommittee on Biochemical Verification, 2002).”

• cites SRNT Subcommittee on Biochemical Verification, 2002 sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

Epidemiologic data suggest that smokers with bipolar disorder may have lower quit rates than smokers without mental health conditions.

“Although epidemiologic data suggest that quit rates may be lower for smokers with BD than for smokers without MHCs (17% of ever smokers with BD report being former smokers vs. 43% of ever smokers without MHC) (Lasser et al., 2000)”

• cites Lasser et al., 2000 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Baseline demographic and smoking variables were included as covariates in models if they differed by diagnostic group and were associated with the outcome.

“Baseline demographic and smoking variables were included in the models as covariates if they differed by diagnostic group and were associated with the outcome (i.e., cessation or treatment utilization).”

Probably not a substantial claim: may not pass S3 (load-bearing).

The Fagerström Test for Nicotine Dependence was used to measure nicotine dependence severity.

“participants completed the Fagerström Test for Nicotine Dependence (Heatherton et al., 1991) as a measure of nicotine dependence severity.”

• cites Heatherton et al., 1991 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Follow-up rates were 88% at 3 months, 89% at 6 months, and 88% at 12 months.

“Follow-up rates were 88% (2274/2570) at 3 months, 89% (2283/2570) at 6 months, and 88% (2249/2570) at 12-months.”

Classified as probably not a substantial claim. May combine two claims.

Because the study was exploratory and used a less conservative method for Type I error, the conclusions are preliminary.

“given the exploratory nature of the study, we used a less conservative method of controlling for Type I error stemming from multiple testing (i.e., control for familywise Type I error via the false discovery rate, or FDR), and our conclusions are best characterized as preliminary.”

May combine two claims.

This is the first demonstration with a digital cessation intervention that smokers with bipolar disorder and those with other affective disorders have similar quit rates despite baseline differences.

“This is also the first demonstration with any digital intervention for cessation that smokers with BD and those with other ADs have similar quit rates, despite smokers with BD differing from smokers with other ADs on a number of different demographics, smoking, and mental health characteristics at baseline.”

• AssumptionRests on an assumption: No prior study had compared treatment-seeking smokers with bipolar disorder to those without mental health conditions or with other affective disorders on demographic, smoking, and other cessation-relevant characteristics.

May combine two claims.

Promising quit rates, about 20% at one year, can be achieved in smokers with bipolar disorder and other affective disorders using web-based interventions, even though these rates are lower than for smokers without mental health conditions.

“It also suggests that promising quit rates (i.e., 20% quit rates at one year) can be achieved in both smokers with BD and other ADs using web-based interventions, even if those rates are lower than for smokers without MHCs.”