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...
| Publicado en: | Addiction Vol. 119; no. 10; pp. 1762 - 1774 |
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| Autores principales: | , , , , , , , , |
| Formato: | research tables/charts randomized controlled trial Journal Article |
| Publicado: |
Wiley-Blackwell
Oct2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=179962425&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 179962425 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09652140 AIO jtl: Addiction issn: 09652140 maglogo: Y pubinfo: dt: Oct2024 vid: 119 iid: 10 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 179962425 178330651 179962425 179962425 10.1111/add.16594 179962425 ppf: 1762 ppct: 12 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Effectiveness of residential versus outpatient therapy for smoking cessation: The START randomized clinical trial. aug: 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 refInfo: holdings: @attributes: islocal: N |
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