A cluster-randomized effectiveness trial of smoking cessation modified for at-risk smoker subgroups

A. Batra, S.E. Collins, I. Torchalla, M. Schroter, and G. Buchkremer (2008) showed that smokers reporting higher levels of nicotine dependence, novelty seeking/hyperactivity, and depressivity (i.e., at-risk smokers) evinced higher rates of posttreatment smoking than smokers reporting lower scores on self-report psychological symptom measures (i.e., lower risk smokers). This study aimed to replicate the smoker subgroups and test the comparative effectiveness of standard pharmacobehavioral smoking cessation versus modified smoking cessation matched to at-risk smokers' needs. On the basis of their self-report responses, adult regular smokers (N = 268) were classified into smoker subgroups. At-risk smokers were randomly assigned to receive the standard or modified treatments; lower risk smokers received standard treatment. Modified treatment produced higher abstinence rates than the standard treatment for depressive smokers but not for other at-risk smokers. Overall, abstinence rates among at-risk smokers receiving modified treatment were not significantly different from those of lower risk smokers; however, abstinence among higher dependence smokers receiving modified treatment decreased at higher rates than among lower risk smokers. (C) 2010 Elsevier Inc. All rights reserved.