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Extended Nortriptyline and Psychological Treatment for Cigarette Smoking
Open accessAbstract
OBJECTIVE: Accepted treatments for cigarette smoking rarely achieve abstinence rates of >35% at 1 year. Low rates may reflect failure to provide extended and multifocal treatment for this complex and chronic addiction. Using a chronic disease model of smoking, the authors undertook a study to determine the effects of long-term antidepressant and psychological treatment. METHOD: One hundred sixty smokers of > or =10 cigarettes/day were randomly assigned to one of four treatment conditions in a two-by-two (nortriptyline versus placebo by brief versus extended treatment) design. All subjects received 8 weeks of a transdermal nicotine patch, five group counseling sessions, and active or placebo treatment. Interventions for subjects in brief treatment ended at this point. Subjects in extended treatment continued taking drug or placebo to week 52 and received an additional 9 monthly counseling sessions, with checkup telephone calls midway through each session. Subjects were assessed at baseline and weeks 12, 24, 36, and 52. The principal outcome variables were repeated abstinence at each assessment after the first over a 1-year period and a point prevalence of 7 days of abstinence. RESULTS: At week 52, point-prevalence abstinence rates with missing subjects imputed as smokers were 30% for placebo brief treatment, 42% for placebo extended treatment, 18% for active brief treatment, and 50% for active extended treatment. With missing subjects omitted, these rates were 32%, 57%, 21%, and 56%, respectively. CONCLUSIONS: Comprehensive extended treatments that combine drug and psychological interventions can produce consistent abstinence rates that are substantially higher than those in the literature.
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“In a study examining the use of bupropion in individuals who quit smoking, one year use of bupropion led to significantly higher rates of success than placebo during treatment assignment (114)”
From Tobacco addiction (2008) · cites this paper as [114]
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Self-citation
Metadata
- Authors
- Hall, S. M., Humfleet, G. L., Reus, V. I., Muñoz, R. F., & Cullen, J.
- Affiliations
- University of California, San Francisco (US)
- Venue
- American Journal of Psychiatry
- Published
- 2004-11-01
- Volume
- 161
- Issue
- 11
- Pages
- 2100-2107
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2110381463
- Cited by
- 158
- References
- 25
- Citations by year
- 2026: 2 · 2024: 1 · 2023: 2 · 2022: 4 · 2021: 4 · 2020: 3 · 2019: 1 · 2018: 2 · 2017: 3 · 2016: 3 · 2015: 7 · 2014: 4 · 2013: 10 · 2012: 13
- FWCI
- 8.84
- Type
- journal article
- Language
- en
- Open access
- green
- www.escholarship.org
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institutes of Health (5k05da016752-10)
- National Institute on Drug Abuse (R01DA015732, K05 DA-016752, R01DA002538, P 50 DA9253, P50DA009253)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Keywords
- cigarette smoking, smoking cessation, nortriptyline, extended treatment, group counseling, nicotine patch, antidepressants, chronic disease model, abstinence rates, telephone follow-up
- MeSH terms
- Smoking Prevention, Administration, Cutaneous, Adult, Antidepressive Agents, Tricyclic, Behavior Therapy, Combined Modality Therapy, Counseling, Drug Administration Schedule, Female, Follow-Up Studies, Humans, Male, Nicotine, Nortriptyline, Placebos, Psychotherapy, Group, Smoking Cessation, Treatment Outcome
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