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Nicotine Tob Res. 2018 Dec 24. doi: 10.1093/ntr/nty268. [Epub ahead of print]

Comparative-Effectiveness of Group-Delivered Acceptance and Commitment Therapy vs. Cognitive Behavioral Therapy for Smoking Cessation: A Randomized Controlled Trial.

Author information

1
Kaiser Permanente Washington Health Research Institute (formerly, Group Health Research Institute), WA, USA.
2
Fred Hutchinson Cancer Research Center Public Health Sciences 110 Fairview Ave North, WA USA.

Abstract

Introduction:

Preliminary trial data suggests group-delivered Acceptance and Commitment Therapy (ACT) might be effective for smoking cessation. If so, this could offer a viable alternative to mainstream behavioral therapies, such as those grounded in Cognitive Behavioral Therapy (CBT). The goal of the current study was to compare the effectiveness of group-delivered ACT versus group-delivered CBT in a rigorous randomized trial design with long term follow-up.

Methods:

Participants (n = 450) were recruited from the Kaiser Permanente Washington health care system and randomized to either ACT-based group counseling or an attention-matched CBT-based group program. All were prescribed an 8-week course of nicotine patches. The primary outcome was self-reported 30-day point prevalence abstinence (PPA) at 12 months post-randomization assessed with missing values imputed as smoking. Sensitivity analyses using multiple imputation and complete cases were examined, as were biochemically-confirmed and 6-month outcomes.

Results:

Thirty-day point prevalence abstinence rates at the 12-month follow up did not differ between study arms in the primary analysis (13.8% ACT vs. 18.1% CBT, adjusted OR 0.68 [0.35, 1.27], p = 0.23) or the sensitivity analyses.

Conclusions:

Group-based ACT and CBT had similar long-term quit rates in this methodologically rigorous randomized trial. Group-based ACT is a reasonable alternative to group-based CBT for smoking cessation.

Implications:

This study compared the effectiveness of group-based ACT with group-based CBT for smoking cessation using a rigorous, large-scale, attention-matched, randomized trial with one-year follow-up. One-year cessation rates did not differ between group-based ACT and CBT, suggesting ACT-based intervention is a reasonable alternative to CBT-based counseling for smoking cessation. The results add to the nascent but growing literature assessing ACT and other mindfulness-based treatments for smoking cessation.

PMID:
30590810
DOI:
10.1093/ntr/nty268

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