Abstract
Background
The Tobacco Longitudinal Care study was a randomized controlled trial for smoking cessation. It demonstrated that longitudinal care for smoking cessation, in which telephone-based counseling and nicotine replacement therapy were offered for 12 months, was more effective than the standard 8-week treatment.
Purpose
This study aims to identify for whom and how longitudinal care increased the likelihood of abstinence.
Methods
Mediated moderation analyses were utilized across three time points.
Results
There was a trend towards smokers who did not respond to treatment (i.e., were still smoking) by 21 days being more likely to be abstinent at 6 months if they received longitudinal care rather than usual care. Similarly, those who did not respond to treatment by 3 months were more likely to be abstinent at 12 months if they received longitudinal care. At both time points, the likelihood of abstinence did not differ across treatment conditions among participants who responded to treatment (i.e., quit smoking). The effect on 6-month outcomes was mediated by satisfaction and readiness to quit. Cessation self-efficacy, satisfaction, and readiness to quit mediated the effect on 12-month outcomes. The effect of treatment condition on the likelihood of abstinence at 18 months was not moderated by response to treatment at 6 months.
Conclusions
Smokers who did not respond to initial treatment benefited from longitudinal care. Differential effects of treatment condition were not observed among those who responded to early treatment. Conditional assignment to longitudinal care may be useful. Determining for whom and how interventions work over time will advance theory and practice.
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References
Collins LM, MacKinnon DP, Reeve BB. Some methodological considerations in theory-based health behavior research. Health Psychol. 2013; 32: 586-591.
MacKinnon DP, Luecken LJ. How and for whom? Mediation and moderation in health psychology. Health Psychol. 2008; 27: S99-S100.
Joseph AM, Fu SS, Lindgren B, et al. Chronic disease management for tobacco dependence: A randomized, controlled trial. Arch Intern Med. 2011; 171: 1894-1900.
Abrams DB, Orleans CT, Niaura RS, Goldstein MG, Prochaska JO, Velicer W. Integrating individual and public health perspectives for treatment of tobacco dependence under managed health care: A combined stepped-care and matching model. Ann Behav Med. 1996; 18: 290-304.
McLellan AT, Lewis DC, O'Brien CP, Kleber HD. Drug dependence a chronic medical illness: Implications for treatment, insurance, and outcomes evaluation. JAMA. 2000; 284: 1689-1695.
Steinberg MB, Schmelzer AC, Lin PN, Garcia G. Smoking as a chronic disease. Curr Cardiovasc Risk Rep. 2010; 4: 413-420.
Fiore MC, Jaen CR, Baker TB, et al. Treating tobacco use and dependence: 2008 update. Clinical practice guideline. Rockville: US Public Health Service; 2008.
Schlam TR, Baker TB. Interventions for tobacco smoking. Annu Rev Clin Psychol. 2013; 9: 675-702.
Saitz R, Larson MJ, LaBelle C, Richardson J, Samet JH. The case for chronic disease management for addiction. J Addict Med. 2008; 2: 55-65.
Curry SJ, Orleans CT, Keller P, Fiore M. Promoting smoking cessation in the healthcare environment: 10 years later. Am J Prev Med. 2006; 31: 269-272.
Cummins SE, Bailey L, Campbell S, Koon-Kirby C, Zhu S-H. Tobacco cessation quitlines in North America: A descriptive study. Tob Control. 2007; 16: i9-i15.
Hughes JR, Keely J, Naud S. Shape of the relapse curve and long‐term abstinence among untreated smokers. Addiction. 2004; 99: 29-38.
Zhu S-H, Anderson CM, Tedeschi GJ, et al. Evidence of real-world effectiveness of a telephone quitline for smokers. New Engl J Med. 2002; 347: 1087-1093.
Etter JF, Sutton S. Assessing ‘stage of change’in current and former smokers. Addiction. 2002; 97: 1171-1182.
Gwaltney CJ, Metrik J, Kahler CW, Shiffman S. Self-efficacy and smoking cessation: A meta-analysis. Psychol Addict Behav. 2009; 23: 56-66.
Hall PA, Fong GT. Temporal self-regulation theory: A model for individual health behavior. Health Psychol Rev. 2007; 1: 6-52.
Rothman AJ, Baldwin AS, Hertel AW. Self-regulation and behavior change: Disentangling behavioral initiation and behavioral maintenance. In: Baumeister RF, Vohs KD, eds. Handbook of self-regulation: Research, theory, and applications. New York: Guilford Press; 2004: 130-148.
Baldwin AS, Rothman AJ, Hertel AW, et al. Specifying the determinants of the initiation and maintenance of behavior change: An examination of self-efficacy, satisfaction, and smoking cessation. Health Psychol. 2006; 25: 626-634.
Hertel AW, Finch EA, Kelly KM, et al. The impact of expectations and satisfaction on the initiation and maintenance of smoking cessation: An experimental test. Health Psychol. 2008; 27: S197-S206.
Procheska J, Diclemante C. Stage of processes of self change of smoking: Toward an integrative model. J Consult Clin Psych. 1983; 56: 520-528.
Miller N, Frieden TR, Liu SY, et al. Effectiveness of a large-scale distribution programme of free nicotine patches: A prospective evaluation. Lancet. 2005; 365: 1849-1854.
Hettema JE, Hendricks PS. Motivational interviewing for smoking cessation: A meta-analytic review. J Consult Clin Psychol. 2010; 78: 868-884.
Kleinjan M, Engels RC, van Leeuwe J, et al. Mechanisms of adolescent smoking cessation: Roles of readiness to quit, nicotine dependence, and smoking of parents and peers. Drug Alcohol Depend. 2009; 99: 204-214.
Preacher KJ, Hayes AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods. 2008; 40: 879-891.
Cox LS, Wick JA, Nazir N, et al. Predictors of early versus late smoking abstinence within a 24-month disease management program. Nicotine Tob Res. 2011; 13: 215-220.
Biener L, Abrams DB. The contemplation ladder: Validation of a measure of readiness to consider smoking cessation. Health Psychol. 1991; 10: 360-365.
MacKinnon DP, Fairchild AJ, Fritz MS. Mediation analysis. Annu Rev Psychol. 2007; 58: 593-614.
Hayes AF. Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. New York: Guilford Press; 2008.
Fairchild AJ, MacKinnon DP. A general model for testing mediation and moderation effects. Prev Sci. 2009; 10: 87-99.
Muller D, Judd CM, Yzerbyt VY. When moderation is mediated and mediation is moderated. J Pers Soc Psychol. 2005; 89: 852-863.
Baker TB, Mermelstein R, Collins LM, et al. New methods for tobacco dependence treatment research. Ann Behav Med. 2011; 41: 192-207.
Michie S, Hyder N, Walia A, West R. Development of a taxonomy of behaviour change techniques used in individual behavioural support for smoking cessation. Addict Behav. 2011; 36: 315-319.
Michie S, Abraham C. Interventions to change health behaviours: Evidence-based or evidence-inspired? Psychol Health. 2004; 19: 29-49.
Segan CJ, Borland R, Greenwood KM. Do transtheoretical model measures predict the transition from preparation to action in smoking cessation? Psychol Health. 2002; 17: 417-435.
Kirchner TR, Shiffman S, Wileyto EP. Relapse dynamics during smoking cessation: Recurrent abstinence violation effects and lapse-relapse progression. J Abnorm Psychol. 2012; 121: 187.
Acknowledgments
This work was funded by the Transdisciplinary Tobacco Use Research Center (TTURC) on Tobacco Exposure Reduction, NCI/NIDA: P50 DA01333. This material is the result of work supported in part with resources and the use of facilities at the Minneapolis VA HSR&D Center for Chronic Disease Outcomes Research. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.
Authors’ Statement of Conflict of Interest and Adherence to Ethical Standards
Authors Burns, Rothman, Fu, Lindgren, Vock, and Joseph declare that they have no conflict of interest. All procedures, including the informed consent process, were conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.
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Burns, R.J., Rothman, A.J., Fu, S.S. et al. Longitudinal Care Improves Cessation in Smokers Who Do Not Initially Respond to Treatment by Increasing Cessation Self-Efficacy, Satisfaction, and Readiness to Quit: A Mediated Moderation Analysis. ann. behav. med. 50, 58–69 (2016). https://doi.org/10.1007/s12160-015-9732-1
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DOI: https://doi.org/10.1007/s12160-015-9732-1