Step care treatment for smoking cessation

Jon O. Ebbert, Melissa Little, Robert Klesges, Zoran Bursac, Karen Johnson, Fridtjof Thomas, Mark W. Vander Weg

Research output: Contribution to journalArticle

Abstract

We compared the effectiveness of a 'stepped care' approach with increasing treatment intensity ('Step Care') to one with repeated treatments ('Recycle') among cigarette smokers interested in quitting smoking. Step 1 of the Step Care intervention consisted of a single counseling session, nicotine patch for six weeks and telephonic contact. For smokers not achieving tobacco abstinence 6 months after randomization with Step 1, the intensity of the intervention increased to four counseling sessions, bupropion sustained-release, nine telephone calls and three mailings (Step 2). For those not achieving tobacco abstinence 12 months after randomization, smokers received six behavioral counseling sessions, nicotine patch and nicotine gum, nine telephone calls and three mailings (Step 3). The Recycle participants received one session of health behavior counseling, six weeks of the nicotine patch and a telephone call at each step. 270 cigarette smokers were randomized. At 24 months after randomization using an intention to treat analysis, no statistically significant difference was observed in prolonged smoking abstinence between the Step Care and Recycle condition (16.9% versus 9.4%; adjusted ORp=1.88; 95% CI 0.88-4.01; P=0.10). Additional research is needed to explore whether a stepped care intervention increases long-term smoking abstinence rates compared with repeating the same intervention.

Original languageEnglish (US)
Pages (from-to)1-11
Number of pages11
JournalHealth Education Research
Volume32
Issue number1
DOIs
StatePublished - Jan 1 2017

Fingerprint

Smoking Cessation
Tobacco Use Cessation Products
nicotine
Counseling
smoking
Random Allocation
Telephone
counseling session
Smoking
Tobacco Products
Tobacco
telephone
Bupropion
Intention to Treat Analysis
Health Behavior
Nicotine
health behavior
counseling
Research
contact

All Science Journal Classification (ASJC) codes

  • Education
  • Public Health, Environmental and Occupational Health

Cite this

Step care treatment for smoking cessation. / Ebbert, Jon O.; Little, Melissa; Klesges, Robert; Bursac, Zoran; Johnson, Karen; Thomas, Fridtjof; Vander Weg, Mark W.

In: Health Education Research, Vol. 32, No. 1, 01.01.2017, p. 1-11.

Research output: Contribution to journalArticle

Ebbert, Jon O. ; Little, Melissa ; Klesges, Robert ; Bursac, Zoran ; Johnson, Karen ; Thomas, Fridtjof ; Vander Weg, Mark W. / Step care treatment for smoking cessation. In: Health Education Research. 2017 ; Vol. 32, No. 1. pp. 1-11.
@article{58c28ee6d73840a7bcf219c231e45be2,
title = "Step care treatment for smoking cessation",
abstract = "We compared the effectiveness of a 'stepped care' approach with increasing treatment intensity ('Step Care') to one with repeated treatments ('Recycle') among cigarette smokers interested in quitting smoking. Step 1 of the Step Care intervention consisted of a single counseling session, nicotine patch for six weeks and telephonic contact. For smokers not achieving tobacco abstinence 6 months after randomization with Step 1, the intensity of the intervention increased to four counseling sessions, bupropion sustained-release, nine telephone calls and three mailings (Step 2). For those not achieving tobacco abstinence 12 months after randomization, smokers received six behavioral counseling sessions, nicotine patch and nicotine gum, nine telephone calls and three mailings (Step 3). The Recycle participants received one session of health behavior counseling, six weeks of the nicotine patch and a telephone call at each step. 270 cigarette smokers were randomized. At 24 months after randomization using an intention to treat analysis, no statistically significant difference was observed in prolonged smoking abstinence between the Step Care and Recycle condition (16.9{\%} versus 9.4{\%}; adjusted ORp=1.88; 95{\%} CI 0.88-4.01; P=0.10). Additional research is needed to explore whether a stepped care intervention increases long-term smoking abstinence rates compared with repeating the same intervention.",
author = "Ebbert, {Jon O.} and Melissa Little and Robert Klesges and Zoran Bursac and Karen Johnson and Fridtjof Thomas and {Vander Weg}, {Mark W.}",
year = "2017",
month = "1",
day = "1",
doi = "10.1093/her/cyw051",
language = "English (US)",
volume = "32",
pages = "1--11",
journal = "Health Education Research",
issn = "0268-1153",
publisher = "Oxford University Press",
number = "1",

}

TY - JOUR

T1 - Step care treatment for smoking cessation

AU - Ebbert, Jon O.

AU - Little, Melissa

AU - Klesges, Robert

AU - Bursac, Zoran

AU - Johnson, Karen

AU - Thomas, Fridtjof

AU - Vander Weg, Mark W.

PY - 2017/1/1

Y1 - 2017/1/1

N2 - We compared the effectiveness of a 'stepped care' approach with increasing treatment intensity ('Step Care') to one with repeated treatments ('Recycle') among cigarette smokers interested in quitting smoking. Step 1 of the Step Care intervention consisted of a single counseling session, nicotine patch for six weeks and telephonic contact. For smokers not achieving tobacco abstinence 6 months after randomization with Step 1, the intensity of the intervention increased to four counseling sessions, bupropion sustained-release, nine telephone calls and three mailings (Step 2). For those not achieving tobacco abstinence 12 months after randomization, smokers received six behavioral counseling sessions, nicotine patch and nicotine gum, nine telephone calls and three mailings (Step 3). The Recycle participants received one session of health behavior counseling, six weeks of the nicotine patch and a telephone call at each step. 270 cigarette smokers were randomized. At 24 months after randomization using an intention to treat analysis, no statistically significant difference was observed in prolonged smoking abstinence between the Step Care and Recycle condition (16.9% versus 9.4%; adjusted ORp=1.88; 95% CI 0.88-4.01; P=0.10). Additional research is needed to explore whether a stepped care intervention increases long-term smoking abstinence rates compared with repeating the same intervention.

AB - We compared the effectiveness of a 'stepped care' approach with increasing treatment intensity ('Step Care') to one with repeated treatments ('Recycle') among cigarette smokers interested in quitting smoking. Step 1 of the Step Care intervention consisted of a single counseling session, nicotine patch for six weeks and telephonic contact. For smokers not achieving tobacco abstinence 6 months after randomization with Step 1, the intensity of the intervention increased to four counseling sessions, bupropion sustained-release, nine telephone calls and three mailings (Step 2). For those not achieving tobacco abstinence 12 months after randomization, smokers received six behavioral counseling sessions, nicotine patch and nicotine gum, nine telephone calls and three mailings (Step 3). The Recycle participants received one session of health behavior counseling, six weeks of the nicotine patch and a telephone call at each step. 270 cigarette smokers were randomized. At 24 months after randomization using an intention to treat analysis, no statistically significant difference was observed in prolonged smoking abstinence between the Step Care and Recycle condition (16.9% versus 9.4%; adjusted ORp=1.88; 95% CI 0.88-4.01; P=0.10). Additional research is needed to explore whether a stepped care intervention increases long-term smoking abstinence rates compared with repeating the same intervention.

UR - http://www.scopus.com/inward/record.url?scp=85014358761&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85014358761&partnerID=8YFLogxK

U2 - 10.1093/her/cyw051

DO - 10.1093/her/cyw051

M3 - Article

VL - 32

SP - 1

EP - 11

JO - Health Education Research

JF - Health Education Research

SN - 0268-1153

IS - 1

ER -