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Nicotine Tob Res. 2019 Jul 4. pii: ntz110. doi: 10.1093/ntr/ntz110. [Epub ahead of print]

Defining and measuring abstinence in clinical trials of smoking cessation interventions: An updated review.

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Center for Tobacco Research and Intervention of Wisconsin, Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison.



Changes in tobacco products, use patterns, and assessment technology in the last 15 years led the SRNT Treatment Research Network to call for an update to the 2003 SRNT recommendations for assessing abstinence in clinical trials of smoking cessation interventions.


The SRNT Treatment Research Network convened a group of investigators with decades of experience in conducting tobacco treatment clinical trials. To arrive at the updated recommendations, the authors reviewed the recommendations of the prior SRNT Workgroup as well as current literature. Ten additional experts in the field provided feedback on this paper and these recommendations.


With respect to defining abstinence, the authors recommend: 1) continuing to use the definition of no use of combustible tobacco products (regardless of use of non-combustible tobacco products [e.g., snus] and alternative products [e.g., e-cigarettes]); and collecting additional data to permit alternate abstinence definitions: 2) no use of combustible or smokeless tobacco products, and 3) no use of combustible or smokeless tobacco products or alternative products, as appropriate for the research question being addressed. The authors also recommend reporting point-prevalence and prolonged abstinence at multiple time points (end of treatment, ≥3 months after the end of treatment, and ≥6 months post-quit or post-treatment initiation).


Defining abstinence requires specification of which products a user must abstain from using, the type of abstinence (i.e., point-prevalence, continuous), and the duration of abstinence. These recommendations are intended to serve as guidelines for investigators as they collect the necessary data to accurately describe participants' abstinence during smoking cessation clinical trials.


This paper provides updated recommendations for defining abstinence in the context of smoking cessation treatment clinical trials.


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