Are smoking cessation treatments associated with suicidality risk? An overview

May combine two claims.

Nicotine helps regulate mood and reduce negative effects that may lessen anxious and impulsive symptoms, potentially lowering suicidality risk.

“Nicotine has been demonstrated to help regulate mood and reduce negative effects that may reduce anxious and impulsive symptoms, thus potentially reducing suicidality risks.18”

• cites [18] sourceDisputed

  The Introduction (page unavailable) says smokers with elevated anxiety sensitivity may smoke to regulate negative affect, but describes reduced negative affect partly as an expectancy, not a demonstrated effect of nicotine. More importantly, it reports a positive association between nicotine dependence and suicide attempts, contrary to the claim that nicotine may lower suicidality risk. It does not report reduced impulsive symptoms. (LLM, conf=0.88)

  Checked by a reasoning model — may be wrong.

  Experimental — accuracy not yet measured

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

Baillie et al. established a baseline abstinence rate of 7.33% for unassisted individuals, consistent with the Kotz et al. study.

“Researchers Baillie et al.92 established a baseline abstinence rate for unassisted individuals of 7.33%, consistent with Kotz et al.90 study.”

• cites [92] sourceNot checked — no full text of the source
• cites [90] sourceDisputed

  The Results (p. 11) report an unadjusted abstinence rate of 14.8% for people using none of the treatments studied, not 7.33%. Kotz et al. therefore do not provide a matching unassisted abstinence rate for the claimed consistency; the paper does not establish what Baillie et al. reported. (LLM, conf=0.86)

  Checked by a reasoning model — may be wrong.

  Experimental — accuracy not yet measured

May combine two claims.

Thomas et al. found no evidence that bupropion raised the risk of fatal or non-fatal self-harm (HR 0.83; 95% CI 0.30-2.31) or treated depression (HR 0.63; 95% CI 0.46-0.87) compared with NRT.

“and also demonstrated no evidence that patients prescribed bupropion had a higher risk of fatal or non-fatal self-harm (hazard ratio: 0.83; 95% confidence interval: 0.30–2.31) or treated depression (hazard ratio: 0.63; 95% confidence interval: 0.46–0.87) than patients prescribed NRTs.”

• cites [21] sourceSupported

May combine two claims.

Cognitive behavioral therapies have been shown to improve quit rates and may reduce suicide risk during smoking cessation.

“Cognitive behavioral therapies have been shown to increase success rates and may mitigate suicide risk during smoking cessation.22”

• cites [22] sourcePartly supported

  The Results section on addiction and substance use reports reduced smoking relapse with coping skills partly based on CBT and better smoking-cessation outcomes for CBT than nicotine replacement therapy alone. It does not report that CBT mitigates suicide risk during smoking cessation; its separate discussion of suicidal behaviors concerns children and says evidence is scarce. Page numbers were not available in our copy. (LLM, conf=0.88)

  Experimental — accuracy not yet measured

May combine two claims.

Psychological factors such as depression, anxiety, emotional instability, and antisocial personality increase suicide risk.

“The risk of suicide is increased by the presence of psychological factors such as depression, anxiety, emotional instability, and antisocial personality.15”

• cites [15] sourcePartly supported

  Section 1, “The Complex Challenge of Suicide” (page unavailable), identifies major mood disorders as suicide risk factors and says suicide rates are high among people with anxiety disorders. It also mentions elevated risk among impulsive-aggressive people, but does not establish emotional instability or antisocial personality as risk factors. (LLM, conf=0.88)

  Experimental — accuracy not yet measured

May combine two claims.

Some smoking cessation pharmacotherapies may increase suicide risk, although not all research supports this.

“Some of the pharmacotherapies may carry an increased risk of suicide,20 although not all of the research supports this.21”

• cites [20] sourceSupported
• cites [21] sourceSupported

May combine two claims.

Moore et al. found that 90% of the 3,249 FDA-reported cases of suicidal/self-injurious behavior or depression associated with smoking cessation pharmacotherapies were in varenicline users, including 272 (92%) of completed suicides and 323 (85%) of suicide attempts.

“Moore et al.28 found that 90% of the 3,249 FDA-reported cases of suicidal/self-injurious behavior or depression associated with smoking cessation pharmacotherapies were found in individuals taking varenicline. This included 272 (92%) of the reported completed suicides and 323 (85%) of all reported suicide attempts.”

• cites [28] sourceSupported

May combine two claims.

Thomas et al. found no evidence that varenicline raised the risk of fatal or non-fatal self-harm (HR 0.88; 95% CI 0.52-1.49) or treated depression (HR 0.75; 95% CI 0.65-0.87) compared with NRT.

“Thomas et al.21 found no evidence that patients prescribed varenicline had a higher risk of fatal or non-fatal self-harm (hazard ratio: 0.88; 95% confidence interval: 0.52–1.49) or treated depression (hazard ratio: 0.75; 95% confidence interval: 0.65–0.87) than patients prescribed NRTs”

• cites [21] sourceSupported

May combine two claims.

Research supports CBT effectiveness for a wide range of people trying to quit smoking, including PTSD patients, people with HIV, individuals with mental illness, low socioeconomic smokers, adults with chronic pain, overweight and disadvantaged smokers, and youth.

“Research supports that CBT is effective for a wide range of individuals who are trying to quit smoking, including PTSD patients,63 people living with HIV,66 individuals with mental illness,67 low socioeconomic smokers,57 adults with chronic pain,68 overweight and disadvantaged smokers,61 and youth.65”

• cites [63] sourceCould not verify

  The section 'Clinical use of extinction and reconsolidation based therapies' discusses cue exposure therapy and preliminary findings involving cigarette smokers, not CBT for smoking cessation. Searches for CBT, youth, and the listed populations found no passage establishing the attributed effectiveness claim. Page numbers are not available in our copy. (LLM, conf=0.76)

  Experimental — accuracy not yet measured
• cites [66] sourcePartly supported

  The 'Substance Abuse Treatment Techniques and Outcomes in the Triply Diagnosed' section (page unavailable) reports reductions in some substance-use outcomes with CBT in HIV-infected cohorts. It cautions that results vary and may not generalize across drugs; it does not report CBT effectiveness for quitting smoking among people living with HIV. (LLM, conf=0.84)

  Experimental — accuracy not yet measured
• cites [67]Not matched

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

May combine two claims.

Gunnell et al. found no clear evidence that varenicline increased fatal (n=2) or non-fatal (n=166) self-harm, though a twofold increased risk could not be ruled out from the upper 95% CI limit.

“Gunnell et al.44 found no clear evidence that varenicline was associated with an increased risk of fatal (n = 2) or non-fatal (n = 166) self-harm, although a twofold increased risk cannot be ruled out on the basis of the upper limit of the 95% CI.”

• cites [44] sourceSupported

May combine two claims.

In the same reanalysis, varenicline did not increase rates of suicidal events, depression, or behavior changes.

“but not the rates of suicidal events, depression, or changes in behavior.”

• cites [48] sourceSupported

May combine two claims.

There was no evidence that varenicline increased depression (n=2244) (HR 0.88, 95% CI 0.77-1.00) or suicidal thoughts (n=37) (1.43, 0.53-3.85).

“There was no evidence that varenicline was associated with an increased risk of depression (n = 2244) (hazard ratio: 0.88 (0.77–1.00)) or suicidal thoughts (n = 37) (1.43 (0.53–3.85)).”

• cites [44] sourceSupported

May combine two claims.

CBT has been shown to improve mood symptoms, reduce cravings, and facilitate smoking cessation.

“Through changing thoughts and behaviors, this treatment has been demonstrated to help improve mood symptoms and reduce cravings as well as facilitate smoking cessation.22,50”

• cites [22] sourcePartly supported

  The Results section on addiction and substance use reports that CBT-based approaches reduced smoking relapse and that CBT outperformed nicotine replacement therapy alone in a smoking-cessation meta-analysis. The Discussion also reports support for CBT in treating depressive symptoms. Neither passage reports reduced cravings, so that part of the attributed claim is unsupported (page numbers unavailable). (LLM, conf=0.88)

  Experimental — accuracy not yet measured
• cites [50] sourceNot checked — no full text of the source

May combine two claims.

Compared with NRT, the hazard ratio for self-harm was 1.12 (95% CI 0.67-1.88) for varenicline and 1.17 (0.59-2.32) for bupropion.

“Compared with nicotine replacement products, the hazard ratio for self-harm among people prescribed varenicline was 1.12 (95% CI: 0.67–1.88), and it was 1.17 (0.59–2.32) for people prescribed bupropion.”

• cites [44] sourceSupported

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

CBT theory holds that mental disorders including mood and addiction disorders are maintained by cognitive, emotional, and behavioral factors, though etiology may be multicausal including genetic components.

“Cognitive behavioral therapies (CBTs) theorize that mental disorders, including mood and addiction disorders, are maintained by cognitive, emotional, and behavioral factors, although the etiology of such disorders may be multicausal, including genetic components.”

• cites [22] sourcePartly supported

  The paper’s Abstract describes cognitive and behavioral maintenance factors, and says emotional components also play a role in maintaining disorders. It discusses CBT for mood and addiction disorders, but our copy does not support the added claim about multicausal etiology or genetic components (searched: genetic components, multicausal etiology). No page number was provided. (LLM, conf=0.87)

  Experimental — accuracy not yet measured
• cites [96] sourcePartly supported

  The Summary and Clinical Elements of CBT for SUDs (page unavailable) describe substance use disorders in terms of learning, reinforcement, cognition, affect, and behavior, supporting that part of the paraphrase. The paper does not extend this account to mood disorders generally or discuss a multicausal etiology that includes genetic components. (LLM, conf=0.87)

  Experimental — accuracy not yet measured

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

Mindfulness-based therapies have been demonstrated to help patients overcome psychiatric disorders including anxiety and depression.

“Mindfulness-based therapies have been demonstrated to help patients overcome psychiatric disorders including anxiety and depression.77”

• cites [77] sourcePartly supported

  The Results report that mindfulness-based therapy improved anxiety and mood symptoms in patients with anxiety and mood disorders. The paper measures symptom improvement, not whether patients overcame or recovered from those disorders, so the claim overstates the finding. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

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

Brewer et al. concluded that mindfulness training is an effective method to help people quit smoking.

“Brewer et al.78 concluded that mindfulness training is an effective method to help people quit smoking.”

• cites [78] sourcePartly supported

  The Results (section 3.2) report higher smoking abstinence with mindfulness training than with the comparison treatment at 17 weeks. But the paper’s Conclusions describe this as an initial trial whose findings suggest mindfulness training *may* confer benefits; the claim presents its effectiveness as a settled conclusion. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

May combine two claims.

Studies of CBT show improvement in depression, anxiety, and negative affect.

“and studies of CBT demonstrate improvement in depression, anxiety, and negative affect,65,72”

• cites [65] sourcePartly supported

  In “The Prevention of Depression” (page unavailable), the paper discusses CBT studies and compares CBT’s effects on depression with those of ACT and behavioral activation, supporting the depression portion. The passages found do not report CBT studies demonstrating improvement in anxiety or negative affect; the reported anxiety reduction followed acceptance instructions, not CBT. (LLM, conf=0.82)

  Experimental — accuracy not yet measured
• cites [72] sourceNot checked — no full text of the source

May combine two claims.

Brewer et al. found 36% abstinence in mindfulness training participants versus 15% in the alternative treatment group, and after 17 weeks 31% versus 6% remained abstinent.

“These researchers found that 36% of participants receiving mindfulness training achieved abstinence compared to 15% of participants in the alternative treatment group. After a 17-week follow-up, 31% of the mindfulness cohort remained abstinent compared to just 6% of participants receiving the alternative.”

• cites [78] sourceSupported

May combine two claims.

Ruscio et al. found that the mindfulness intervention group had significant reductions in overall negative affect, immediate post-meditation craving, and cigarettes smoked per day over time.

“Based on results from 37 participants, for the intervention group, she reports significant reductions in overall negative affect, F(1, 1798) = 13.8, P = 0.0002; reduced craving immediately post-meditation, (Group × Assessment Type interaction, F(2, 1796) = 12.3, P = 0.0001); and reduced cigarettes smoked per day over time (Group × Day interaction, F(1, 436) = 5.50, P = 0.01).”

• cites [88] sourceCould not verify

  The Method (Participants and Procedure; page unavailable) describes an ecological momentary assessment study of people with MDD, GAD, or neither, not a mindfulness intervention. The Results passages address rumination and affect after stressful events. Searches for post-meditation craving, cigarettes smoked, 37 participants, and the quoted statistics found no passage addressing the attributed findings. (LLM, conf=0.76)

  Experimental — accuracy not yet measured

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

Brewer et al. reported a 17-week point prevalence odds ratio of 6.75 in the mindfulness group, significantly larger than the average odds ratio of behavioral therapies in current clinical practice guidelines.

“These authors further promote that the 17-week point prevalence odds ratio of 6.75 in their mindfulness-based intervention group was significantly larger than the average odds ratio of behavioral therapies as reported in the current clinical practice guidelines”

• cites [78] sourcePartly supported

  The Discussion (section 4) reports a 17-week point-prevalence odds ratio of 6.75. It calls this significantly larger than the average odds ratio of 1.76 in a meta-analysis of group counseling, and separately says it was larger than odds ratios for therapies in clinical practice guidelines. It does not say the comparison with the guideline figures was statistically significant. (LLM, conf=0.87)

  Experimental — accuracy not yet measured
• cites [82]Not matched

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

May combine two claims.

Recent reviews indicate that mindfulness-based therapies are efficacious for promoting abstinence and reducing cravings.

“recent reviews of the evidence indicate its efficacy for promoting abstinence and reducing cravings.51,78–80,95”

• cites [51] sourcePartly supported

  In “What is mindfulness training and does it work for smoking cessation and other addictions?” (page not provided), the review reports preliminary evidence of reduced cigarette cravings and improved smoking abstinence. It also cautions that addiction-treatment evidence remains preliminary and that the smoking trial is not definitive, so the claim overstates how firmly efficacy has been established. (LLM, conf=0.86)

  Experimental — accuracy not yet measured
• cites [78] sourcePartly supported

  The Results (section 3.2; page unavailable) report higher smoking abstinence with mindfulness training than with the comparison treatment at 17 weeks. But this paper is a randomized trial, not a review, and its stated outcomes were abstinence and cigarettes smoked per day; it does not establish that the therapy reduced cravings. (LLM, conf=0.87)

  Experimental — accuracy not yet measured
• cites [79] sourceNot checked — no full text of the source
• cites [80] sourceNot checked — no full text of the source
• cites [95] sourcePartly supported

  The Background reports that a recent review found reduced substance consumption, including cigarette use, and that several studies in the review found reduced craving. It separately cites preliminary RCT evidence of increased smoking cessation rates. The paper presents these findings as promising but limited, rather than establishing that reviews demonstrate efficacy for abstinence. (LLM, conf=0.84)

  Experimental — accuracy not yet measured

May combine two claims.

Contextual CBTs such as mindfulness-based therapy and Acceptance and Commitment Therapy appear to succeed in treating nicotine addiction and promoting smoking cessation with minimal or no reported increased suicidality risk.

“contextual CBTs such as mindfulness-based therapy and ACT appear to demonstrate success in treating nicotine addiction and promoting smoking cessation with minimal or no reported increased risk of suicidality.76,78,88”

• cites [76] sourceNot checked — no full text of the source
• cites [78] sourcePartly supported

  The Results (§3.2; page unavailable) report higher smoking-abstinence rates after mindfulness training than after the comparison treatment, and the Introduction (§1; page unavailable) describes preliminary evidence for ACT in smoking cessation. The paper does not report suicidality outcomes or establish that either treatment carries minimal or no increased suicidality risk. (LLM, conf=0.88)

  Experimental — accuracy not yet measured
• cites [88] sourceCould not verify

  The Results section examines rumination and responses to stressful events in people with major depressive disorder or generalized anxiety disorder. The Measures section mentions suicidal ideation as an assessed symptom, but does not evaluate treatment-related suicidality risk. Searches for mindfulness-based therapy, ACT, nicotine addiction, and smoking cessation found no passage addressing the attributed claim. (LLM, conf=0.76)

  Experimental — accuracy not yet measured

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

Although Ruscio et al. did not directly assess suicidality, reductions in negative affect may lower suicidality risks.

“Suicidality was not assessed directly, but it may be inferred that reductions in negative affect may reduce suicidality risks.”

• cites [88] sourcePartly supported

  The Results section (page unavailable) reports negative affect and MDD/GAD symptoms as outcomes, but does not report a suicidality assessment. It finds that greater rumination predicted higher negative affect; it does not examine whether reducing negative affect lowers suicidality risk. (LLM, conf=0.83)

  Experimental — accuracy not yet measured

May combine two claims.

Capron et al. found suicidality lowered in both CBT groups, but statistically significantly lower in the augmented CBT group.

“Capron et al.18 found that suicidality as assessed by the Inventory of Depression and Anxiety Symptoms75 was lowered in both groups, but was statistically significantly lower in the group receiving the augmented CBT.”

• cites [18] sourcePartly supported

  The Results section reports significantly lower IDAS suicidality in the augmented CBT group than in the standard-treatment group after adjustment for baseline suicidality and other covariates (p = .01). The Methods > Measures section confirms use of the IDAS suicidality scale. The reported comparison does not establish that suicidality fell from baseline in both groups. (LLM, conf=0.88)

  Experimental — accuracy not yet measured

May combine two claims.

NRT is superior to placebo, helping about 80% more people quit than placebo (OR 1.84, 95% CredI 1.71-1.99).

“A 2013 Cochrane review, covering 267 studies and involving 101,804 participants who explored multiple pharmacotherapies for smoking cessation, found NRT to be superior to placebo, helping ∼80% more people to quit than placebo (odds ratios (ORs) of 1.84 (95% CredI 1.71–1.99).”

May combine two claims.

Based on the reviewed research, bupropion has similar suicidality risk to placebo or no treatment, may have lower risk than varenicline, and may have higher risk than NRTs.

“Based upon research reviewed, bupropion also has similar risk of suicidality to placebo or no treatment and may have lower risks for suicidality when compared to varenicline, but may have higher rates of risk than NRTs.”

May combine two claims.

Varenicline is more effective for sustained smoking cessation than bupropion or a single NRT, but equally effective to combined NRTs.

“Varenicline was more effective for sustained smoking cessation than either bupropion or a single NRT, but equally effective when compared to combined NRTs.29”

• cites [29]Not matched

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

May combine two claims.

Overall, the reviewed findings support that bupropion is effective for many in promoting smoking cessation and has limited and mixed support for increased suicidality risk.

“Overall, findings reviewed support that bupropion appears to be effective for many in promoting smoking cessation and appears to have limited and mixed support regarding the increased risk of suicidality with its use.”

May combine two claims.

Head-to-head comparisons showed varenicline was superior to single NRT and bupropion, and equally effective to combination NRT.

“Head-to-head comparisons with other smoking cessation pharmacotherapies showed that varenicline was superior to single forms of NRT and also to bupropion; it was of equal efficacy to combination NRT.29”

• cites [29]Not matched

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

May combine two claims.

The reviewed literature supports that NRTs do not increase suicidality rates more than bupropion or varenicline, and NRTs may have lower risks.

“Overall, it would appear that the literature reviewed appears to support that NRTs used for smoking cessation do not increase rates of suicidality any greater than bupropion or varenicline and that NRTs may actually demonstrate lower risks in this population.”

May combine two claims.

Tonstad et al. found that more than twice as many smokers with cardiovascular disease treated with bupropion SR for seven weeks had quit at one year compared with placebo, with a safety profile comparable to general smoking populations.

“Tonstad et al.31 found that more than twice as many smokers with cardiovascular disease who had been treated with bupropion SR for seven weeks had quit smoking at one year, compared with placebo; the safety profile was comparable to that observed in general smoking populations.”

• cites [31] sourceNot checked — no full text of the source

May combine two claims.

Ahmed et al. analyzed 25 published case reports from 2006 to 2012; the Naranjo causality scale indicated probable causality in 76% and definite causality in 12%.

“Ahmed et al.40 analyzed 25 published case reports spanning from 2006, when varenicline received FDA approval, to 2012. Analysis of all reports using the Naranjo causality scale, a method for estimating the probability of adverse drug reactions, indicated probable causality in 76% of the cases and definite causality in 12% of the cases.”

• cites [40] sourceNot checked — no full text of the source

May combine two claims.

These findings indicate less suicidality risk with bupropion than varenicline, and more risk with bupropion than NRT.

“These findings demonstrate less risk for suicidality in those prescribed bupropion versus those prescribed varenicline, and an increased risk for suicidality in those prescribed bupropion than for those patients receiving NRTs (as described in the NRT section).”

May combine two claims.

Pharmacotherapies such as varenicline, bupropion, and nicotine replacement, and CBTs including contextual CBT, reduce smoking and help promote and maintain abstinence.

“Pharmacotherapies such as varenicline, bupropion, and nicotine replacement, and CBTs, including contextual CBT interventions, have been found to help reduce smoking rates and promote and maintain abstinence.”

May combine two claims.

Individual NRTs are equally effective across formulations and as effective as bupropion.

“In head-to-head comparisons, individual NRTs were equally effective among the different formulations and also equally effective to bupropion.”

• cites [29]Not matched

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

May combine two claims.

A 2014 Cochrane review found no difference between bupropion and placebo or no pharmacotherapy in serious psychiatric or cardiovascular adverse events, but a marginal non-significant increase in serious adverse events with bupropion.

“A 2014 Cochrane review specifically evaluating antidepressants for smoking cessation did not detect any difference between bupropion and placebo or no pharmacotherapy controls in rate of psychiatric or cardiovascular serious adverse events but detected a marginal and nonstatistically significant increased rate of serious adverse events in people randomized to bupropion.30”

• cites [30]Not matched

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

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

Bupropion helped about 80% more smokers quit than placebo.

“A previous review had found that, similar to NRTs, bupropion helped about 80% more smokers quit than placebo.29”

• cites [29]Not matched

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

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

CBT has demonstrated effectiveness in treating addiction in general.

“and has demonstrated effectiveness in treating addiction in general,55”

• cites [55] sourceNot checked — no full text of the source

May combine two claims.

CBT added to pharmacotherapy improves compliance and reduces potential weight gain associated with smoking cessation.

“CBT added to pharmacotherapy has also been demonstrated to improve compliance and reduce potential weight gain associated with smoking cessation70”

• cites [70] sourceNot checked — no full text of the source

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

CBT has demonstrated effectiveness in treating smoking specifically.

“smoking specifically,50,56,57”

• cites [50] sourceNot checked — no full text of the source
• cites [56]Not matched

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

• cites [57] sourceNot checked — no full text of the source

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

CBT has a strong research literature showing a positive impact on mood disorders such as depression.

“CBT has a strong research literature demonstrating a positive impact on mood disorders such as depression53,54”

• cites [53]Not matched

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

• cites [54] sourceNot checked — no full text of the source

May combine two claims.

In the same cohort, depression symptoms were reported by 39 (2.98%) patients, including 24 new-onset, 14 worsening of pre-existing depression, and 1 impaired motivation.

“Symptoms of depression were reported by 39 (2.98%) patients (24 new-onset depression, 14 worsening of pre-existing depression, and 1 report of impaired motivation).”

• cites [47] sourceNot checked — no full text of the source

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

Mindfulness-based strategies may positively affect mood.

“Mindfulness-based strategies may also positively impact mood.52”

• cites [52] sourceNot checked — no full text of the source

May combine two claims.

Nicotine replacement therapies are equally effective to each other and to bupropion SR.

“equally effective to each other and to bupropion SR”

May combine two claims.

CBT added to Contingency Management is effective in reducing smoking and is more effective than Contingency Management alone.

“CBT added to Contingency Management, a purely behavioral reinforcement strategy where smokers are rewarded for abstinence with vouchers that can be exchanged for rewards, has been demonstrated to be effective in reducing smoking and was also demonstrated to be more effective than CM alone.69”

• cites [69] sourceNot checked — no full text of the source

May combine two claims.

In the Sykes and Marks randomized trial, at six-month follow-up, 21 of 122 therapy participants were abstinent and 14 had reduced consumption by at least 25%, while 6 of 107 control participants were abstinent and none had reduced consumption.

“At six-month follow-up, 21 (17.2%) of 122 participants receiving therapy were abstinent and 14 (11.5%) had reduced cigarette consumption by at least 25% of pre-treatment level. Six (5.6%) of 107 participants in the information only control group were abstinent and none had reduced consumption.”

• cites [57] sourceNot checked — no full text of the source

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

Almost two-thirds of all people seeking to quit smoking try the cold turkey method.

“In fact, almost two-thirds of all people seeking to quit try this cold turkey method.89”

• cites [89]Not matched

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

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

Lee et al. conducted a meta-analysis of 10 studies, including five smoking cessation outcome studies with an N of 918.

“Lee et al.76 conducted a meta-analysis that included 10 studies, of which, five were smoking cessation outcome studies and included an N of 918.”

• cites [76] sourceNot checked — no full text of the source

May combine two claims.

Numerous studies have linked nicotine dependence and withdrawal to depression, and nicotine-dependent individuals are more than twice as likely to experience major depressive disorder as those without a nicotine dependence history.

“Numerous studies have linked nicotine dependence and withdrawal to depression, with nicotine-dependent individuals being more than twice as likely to experience a major depressive disorder than those without a nicotine dependence history.5”

• cites [5] sourceNot checked — no full text of the source

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

Tang et al. concluded that mindfulness training increases smokers' self-control and reduces the likelihood that smokers act on cravings.

“Tang et al.83 concluded that mindfulness training increases smokers’ self-control and reduces the likelihood that smokers will act on their cravings.”

• cites [83] sourceNot checked — no full text of the source

May combine two claims.

Most CBT studies for smoking or nicotine cessation do not specifically describe how many participants report suicidality after therapy or post-treatment unless these are reported as significant adverse events, and such data rarely appear in manuscripts.

“Unfortunately, the majority of CBT studies for smoking or nicotine cessation do not specifically describe how many participants report suicidality after instigating therapy or post-treatment unless these data are reported as significant adverse events during the study, and these rarely make it into the manuscript.”

May combine two claims.

Most patients who successfully or unsuccessfully quit smoking using CBT do not appear to increase their risk of psychopathology and are not at higher risk for suicidality.

“However, the majority of patients who successfully or unsuccessfully quit smoking using CBTs do not appear to increase their risk of psychopathology and are not at higher risk for suicidality.67”

• cites [67]Not matched

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

May combine two claims.

CBT appears to be an effective drug-free option for people seeking to reduce or quit smoking and may also be used with pharmacotherapy.

“CBT appears to be an effective drug-free option to consider for individuals looking to reduce and/or quit smoking and may also successfully be used in conjunction with pharmacotherapy.50,56,57”

• cites [50] sourceNot checked — no full text of the source
• cites [56]Not matched

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

• cites [57] sourceNot checked — no full text of the source

May combine two claims.

Because depression is linked to increased suicidality risk and abrupt quitting likely involves more difficult withdrawal, unassisted individuals may be at higher risk for depression and suicidality.

“Because depression is linked to increased risk of suicidality, and because those who quit smoking cold turkey will likely have a more difficult time dealing with nicotine withdrawal symptoms than those who are part of a longer-term intervention program, unassisted individuals are possibly at a higher risk for depression and suicidality.16”

• cites [16] sourceNot checked — no full text of the source

• AssumptionRests on an assumption: Depression is linked to an increased risk of suicidality.
• AssumptionRests on an assumption: People who quit smoking abruptly without assistance have a harder time with nicotine withdrawal than those in longer-term intervention programs.

May combine two claims.

In Tang et al., integrative body-mind training participants reduced smoking by 60% by study end, while the relaxation group showed no reduction.

“Participants receiving IBMT reduced their smoking habits by 60% by the study’s end, whereas there was no demonstrated reduction in the relaxation group.”

• cites [83] sourceNot checked — no full text of the source

May combine two claims.

Less is known about the benefits of CBT, mindfulness, and Acceptance and Commitment Therapy for reducing suicidality risk in active smokers trying to reduce or quit, and many psychotherapy studies in the smoking population do not report suicidality data.

“There is less known about the benefits of each of these psychotherapies in reducing risk of suicidality in active smokers who are trying to reduce or quit their intake, and many studies implementing psychotherapy in the smoking population do not report data regarding suicidality.”

May combine two claims.

Mindfulness-based or contextual CBTs for smoking cessation have even less published research on suicidality than CBT, and most studies do not include information about suicidality.

“Unfortunately, mindfulness based or contextual CBTs for smoking cessation have even less published research on the impact of suicidality than CBT and most studies do not include information about suicidality.”

May combine two claims.

Although mindfulness-based treatments appear to positively affect mood symptoms such as depression, there is currently little research on their impact on reducing suicidality in individuals trying to quit smoking.

“Although these mindfulness based treatments also appear to have a positive impact on mood symptoms such as depression, there is currently little research regarding their impact on reducing suicidality in individuals trying to quit smoking.”

May combine two claims.

Both bupropion and varenicline have support for effectively facilitating smoking cessation, but early research supported increased risk for negative affect, behavior, and suicidality.

“Both bupropion and varenicline appear to have support for effectively facilitating smoking cessation, but early research supported an increased risk for negative affect, behavior, and suicidality.”

May combine two claims.

Psychotherapies such as CBT do not appear to have a significant risk of increasing suicidality and appear to work at least moderately effectively to help reduce or quit smoking.

“Psychotherapies such as CBT do not appear to have a significant risk of increasing suicidality and appear to work at least moderately effectively to help reduce or quit smoking.”

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

Reasons for mixed findings may include having more well-controlled studies currently than in the past.

“Reasons for these mixed findings may include having more well-controlled studies currently, as opposed to the past.”

Classified as probably not a substantial claim.

Many psychotherapy studies have not documented suicidality.

“Many of the psychotherapy studies have not documented suicidality and this should be addressed in future studies.”