Helping Smokers Before a Quit Attempt Increases Chances for Success; So Does Using Medication for Longer

An ambitious, National Cancer Institute-funded, multi-experiment evaluation of over 15 smoking treatments identified ones that were especially helpful to smokers. Amongst the findings were that smokers who got coaching and medications before a quit attempt—along with continued coaching after quitting—were more likely to quit smoking. These results were published in the journal Addiction.

When participants received nicotine gum plus intense coaching as they prepared to quit, nearly half succeeded in quitting smoking. Only a third of participants who didn’t receive this treatment quit smoking.

“What we found was that it helps to provide treatments to patients before they actually stop smoking,” said Dr. Tim Baker, a Principal Investigator and Director of Research at UW-CTRI. “It's a bit like teaching a person how to parachute before the person jumps out of a plane. This study helped people quit and measured which treatments given before, during, and after a quit attempt show the most promise.”

The findings resulted from a five-year study known as the UW Partnership to Assist and Serve Smokers (UW-PASS).

UW-PASS included three projects that recruited and worked with over 1500 smokers in Dean and Aurora Health Care primary-care clinics across southern Wisconsin.

Project 1 offered help for smokers who weren’t ready to quit but were willing to cut down. Treatments included:

Behavioral-Reduction Counseling to help participants learn strategies to reduce how many cigarettes they smoked a day and to gain control of their smoking.

Motivational interviewing, designed to help participants clarify their goals as well as explore reasons they may wait to quit.

Participants also were asked to use nicotine patches, nicotine gum or a combination of both while still smoking in order to reduce their craving for nicotine (and smoking). 

Two types of treatment were found to be especially promising for smokers who are not ready to quit:

  • Nicotine gum.
  • Behavioral-reduction counseling.

Project 2 of UW-PASS studied whether smokers who were motivated to quit could use of medication and coaching before trying to quit to help them become smoke-free. Other interventions were delivered after the quit attempt and were designed to help smokers quit and stay quit.

Three types of treatments were found to be especially promising in helping smokers to quit:

  • Nicotine Gum or Patch used to prepare to quit.
  • Coaching to reduce smoking before the quit date.
  • Intensive in-person coaching early during the quit attempt.

Project 3 studied ways to help smokers stay smoke-free long-term.  It tested long-term smoking medication, long-term phone counseling, and methods to increase the long-term use of quit-smoking medication. Most smokers don’t use enough medication or use it in the most effective way. The goal was to see what happened if a patient took medication as prescribed vs. skipping doses or stopping it early. 

Two types of treatment were found to be especially promising in helping smokers quit and remain so:

Extending medication to 26 weeks, versus 8 weeks, helped people to be smoke-free a year after the quit date. 

Extended phone counseling could help smokers stay quit.