Extended treatment for cigarette smoking cessation: a randomized control trial.

AimTo test the potential benefit of extending cognitive-behavioral therapy (CBT) relative to not extending CBT on long-term abstinence from smoking. DesignTwo-group parallel randomized controlled trial. Patients were randomized to receive non-extended CBT (n=111) or extended CBT (n=112) following a 26-week open-label treatment. SettingCommunity clinic in the United States. ParticipantsA total of 219 smokers (mean age: 43years; mean cigarettes/day: 18). InterventionAll participants received 10weeks of combined CBT+bupropion sustained release (bupropion SR)+nicotine patch and were continued on CBT and either no medications if abstinent, continued bupropion + nicotine replacement therapy (NRT) if increased craving or depression scores, or varenicline if still smoking at 10weeks. Half the participants were randomized at 26weeks to extended CBT (E-CBT) to week 48 and half to non-extended CBT (no additional CBT sessions). MeasurementsThe primary outcome was expired CO-confirmed, 7-day point-prevalence (PP) at 52- and 104-week follow-up. Analyses were based on intention-to-treat. FindingsPP abstinence rates at the 52-week follow-up were comparable across non-extended CBT (40%) and E-CBT (39%) groups [odds ratio (OR)=0.99; 95% confidence interval (CI)=0.55, 1.78]. A similar pattern was observed across non-extended CBT (39%) and E-CBT (33%) groups at the 104-week follow-up (OR=0.79; 95% CI=0.44, 1.40). ConclusionProlonging cognitive-behavioral therapy from 26 to 48weeks does not appear to improve long-term abstinence from smoking.