Cover: Analyzing Milestones in Smoking Cessation

Analyzing Milestones in Smoking Cessation

Illustration in a Nicotine Patch Trial in Adult Smokers

Published in: Journal of Consulting and Clinical Psychology, v. 74, no. 2, Apr. 2006, p. 276-285

Posted on rand.org 2006

by Saul Shiffman, Deborah M. Scharf, William G. Shadel, Chad J. Gwaltney, Qianyu Dang, Stephanie M. Paton, Duncan B. Clark

Tests of addiction treatments seldom reveal where treatment exercises its effect (i.e., promoting initial abstinence, preventing lapses, and/or impeding progression from lapse to relapse). The authors illustrate analyses distinguishing effects on these milestones in a randomized trial of high-dose nicotine patch (35 mg; n = 188) versus placebo (n = 136) in adult smokers, who used electronic diaries to monitor smoking in real time during 5 weeks of treatment. High-dose patch promoted initial abstinence (hazard ratio [HR] = 1.3) and decreased the risk of lapsing among those who achieved abstinence (HR = 1.6). The biggest effect of treatment was to prevent progression to relapse among those who had lapsed (HR = 7.1). Analysis of effects by milestones may enhance understanding of cessation treatments and their mechanisms of action.

This report is part of the RAND external publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.