| Summary: | Introduction
Varenicline effectively helps smokers quit by reducing withdrawal
symptoms and blocking the reward of smoking. However, most quitters return
to smoking within one year. ‘Cue Restricted Smoking’ is a behavioral technique
designed to increase quit rates by asking smokers attempting to quit to restrict
smoking to the standing position, while alone, in an isolated area facing a wall,
with the cigarette as the only stimulus.
Methods
Using retrospective clinic records we compared quit rates in 281 smokers
(50% males) instructed in the cue restricted smoking cessation method during
2016–2018 to quit rates in 324 smokers (46% males) advised to completely stop
smoking on the target quit date which we previously used during 2011–2014. All
were prescribed varenicline for 12 weeks alone, with the addition of bupropion
if needed after 4 weeks. Follow-up consisted of behavioral support at 4–6 visits
during active drug treatment and telephone counselling at 24 and 52 weeks. The
smoking cessation rate was confirmed with exhaled carbon monoxide at the clinic
visit at 12 weeks and only by telephone at 52 weeks.
Results
The mean age of smokers was 49 years in both groups and the number of
cigarettes smoked daily was similar (18/day in the cue restricted vs 19/day in the
target quit day group). The smoking cessation rate at 12 weeks was 75% in the
cue restricted versus 45% in the target quit day group (relative risk, RR=1.8; 95%
CI: 1.4–2.2, p<0.001). At 52 weeks the quit rate was 65% vs 34%, respectively
(RR=1.9; 95% CI: 1.5–2.4, p<0.001).
Conclusions
Cue restricted smoking was associated with a substantially increased
chance of quitting compared with standard advice during treatment with
varenicline. These results should be further studied in a randomized controlled
trial.
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