Effectiveness of residential versus outpatient therapy for smoking cessation: The START randomized clinical trial.

Background and Aims: Tobacco smoking represents a major cause for preventable death and morbidity. Results from non‐randomized studies suggest that smoking cessation therapy in a residential setting might be a new viable way to facilitate smoking abstinence. We aimed to test the effects of residenti...

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Publicado en:Addiction Vol. 119; no. 10; pp. 1762 - 1774
Autores principales: Dickreuter, Jonas Levin, Schmoor, Claudia, Jähne, Andreas, Bengel, Jürgen, Pschichholz, Barbara, Lorz, Christina, Schulz, Christina, Vozelj, Jana, Leifert, Jens Albert
Formato: research tables/charts randomized controlled trial Journal Article
Publicado: Wiley-Blackwell Oct2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2024
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      pub: Wiley-Blackwell
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        atl: Effectiveness of residential versus outpatient therapy for smoking cessation: The START randomized clinical trial.
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        au:
          Dickreuter, Jonas Levin
          Schmoor, Claudia
          Jähne, Andreas
          Bengel, Jürgen
          Pschichholz, Barbara
          Lorz, Christina
          Schulz, Christina
          Vozelj, Jana
          Leifert, Jens Albert
        affil: Comprehensive Cancer Center (CCCF), Medical Center and Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
      sug:
        subj:
          Smoking Cessation
          Psychotherapy, Group Methods
          Socioenvironmental Therapy
          Ambulatory Care
          Treatment Outcomes
          Human
          Male
          Female
          Adult
          Middle Age
          Randomized Controlled Trials
          Random Assignment
          Equivalence Trials
          Descriptive Statistics
          Germany
          Comparative Studies
          Advertising
          Odds Ratio
          Confidence Intervals
          Group Processes
          Self Report
          Funding Source
          Tobacco Products Adverse Effects
          Smoking Complications
          Substance Abstinence
          Rehabilitation Centers
          Behavior Therapy
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Background and Aims: Tobacco smoking represents a major cause for preventable death and morbidity. Results from non‐randomized studies suggest that smoking cessation therapy in a residential setting might be a new viable way to facilitate smoking abstinence. We aimed to test the effects of residential multicomponent group therapy for smoking cessation compared with outpatient group therapy. Design: Prospective parallel‐group open‐label randomized superiority trial, with assessments at baseline, 6 and 12 months. Setting: Recruitment throughout Germany via media advertisements. Participants: Adult smokers (≥10 cigarettes/day) randomly assigned to residential (n = 157) or outpatient (n = 158) therapy. 51.8% female; mean age 53.2 years; mean years of smoking 34.4. Intervention and Comparator: Residential 9‐day smoking cessation group therapy comprising six daily therapy sessions and supportive interventions for cessation and daily structure embedded in the routines of a somatic rehabilitation center, compared with weekly outpatient smoking cessation group therapy (3–7 weeks) provided in routine care courses close to the participants' places of residence, both including at least 9 h of behavioral therapy. Measurements Co‐primary outcomes were self‐reported continuous 6‐ and 12‐month abstinence (hierarchically ordered). Primary analyses were conducted in the therapy‐uptake population including participants who started therapy with sensitivity analyses in the intention‐to‐treat population of all randomized participants. Findings Intervention uptake rates were 87.3% (n = 137) in the residential and 60.1% (n = 95) in the outpatient group. In the therapy‐uptake population, abstinence rates were 46.7% in the residential versus 26.3% in the outpatient group at 6 months (odds ratio [OR] = 2.46, 95% confidence interval [CI] = 1.39–4.33, P = 0.0019) and 39.4% versus 24.2% at 12 months (OR = 2.04, 95% CI = 1.14–3.64, P = 0.017). Biochemically validated abstinence rates at 12 months were 33.1% in the residential versus 17.4% in the outpatient group (OR = 2.35, 95% CI = 1.22–4.51, P = 0.011). In the intention‐to‐treat population, self‐reported and biochemically validated abstinence rates at 12 months were 34.4% in the residential versus 14.6% in the outpatient group (OR = 3.08, 95% CI = 1.77–5.34, P < 0.0001) and 28.6% versus 10.3% (OR = 3.48, 95% CI = 1.85–6.52, P = 0.0001), respectively. Conclusions: Residential therapy exclusively for smoking cessation is feasible and effective and could be a beneficial new treatment for smokers.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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