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Drug Alcohol Depend. 2015 Apr 1;149:158-65. doi: 10.1016/j.drugalcdep.2015.01.041. Epub 2015 Feb 9.

Lack of attentional retraining effects in cigarette smokers attempting cessation: a proof of concept double-blind randomised controlled trial.

Author information

1
UK Centre for Tobacco and Alcohol Studies, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK. Electronic address: rachna.begh@phc.ox.ac.uk.
2
UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol BS8 2BN, UK.
3
Department of Psychology, University of Pittsburgh, Sennott Square, 3rd Floor, 210 South Bouquet Street, Pittsburgh, PA 15260, USA.
4
School of Medicine, University of Tasmania, Private Bag 26, Hobart, TAS 7001, Australia.
5
Primary Care Clinical Sciences, University of Birmingham, Birmingham B15 2TT, UK.
6
School of Health Studies, University of Bradford, Bradford BD7 1DP, UK.
7
Behavioural Science Group, Institute of Public Health, University of Cambridge, Cambridge CB2 1TN, UK.
8
UK Centre for Tobacco and Alcohol Studies, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK.

Abstract

BACKGROUND:

Observational studies have shown that attentional bias for smoking-related cues is associated with increased craving and relapse. Laboratory experiments have shown that manipulating attentional bias may change craving. Interventions to reduce attentional bias could reduce relapse in smokers seeking to quit. We report a clinical trial of attentional retraining in treatment-seeking smokers.

METHODS:

This was a double-blind randomised controlled trial that took place in UK smoking cessation clinics. Smokers interested in quitting were randomised to five weekly sessions of attentional retraining (N=60) or placebo training (N = 58) using a modified visual probe task from one week prior to quit day. Both groups received 21 mg nicotine patches (from quit day onwards) and behavioural support. Primary outcomes included change in attentional bias reaction times four weeks after quit day on the visual probe task and craving measured weekly using the Mood and Physical Symptoms Scale. Secondary outcomes were changes in withdrawal symptoms, time to first lapse and prolonged abstinence.

RESULTS:

No attentional bias towards smoking cues was found in the sample at baseline (mean difference = 3 ms, 95% CI = -2, 9). Post-training bias was not significantly lower in the retraining group compared with the placebo group (mean difference = -9 ms, 95% CI = -20, 2). There was no difference between groups in change in craving (p = 0.89) and prolonged abstinence at four weeks (risk ratio = 1.00, 95% CI = 0.70, 1.43).

CONCLUSIONS:

Taken with one other trial, there appears to be no effect from clinic-based attentional retraining using the visual probe task. Attentional retraining conducted out of clinic may prove more effective.

CLINICAL TRIAL REGISTRATION:

UK Clinical Trials ISRCTN 54375405.

KEYWORDS:

Attentional bias; Attentional retraining; Cigarette smoking; Craving; Smoking cessation

PMID:
25697911
PMCID:
PMC4961243
DOI:
10.1016/j.drugalcdep.2015.01.041
[Indexed for MEDLINE]
Free PMC Article

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