Long-Term Treatment May Be Best Way to Help Smokers Quit

Nov. 28, 2011 -- If you had high blood pressure, you wouldn't expect your doctor to give you some pills, pat you on the back, and say good luck, would you?

Of course not, you would expect long-term treatment. What if the same principle was applied to smoking?

Well, treating smoking like a chronic disease could help people who want to give up cigarettes be more successful, results from a new study show.

Researchers enrolled smokers who wanted to quit and then randomly put them into two groups. The first had eight weeks of counseling and nicotine replacement, and the second had the same followed by 48 more weeks of counseling and treatment when needed.

Quitting was the long-term goal for both groups. But setbacks were considered part of the process for the smokers followed for at least a year, and counselors worked with these patients to set short-term goals to help get them back on track.

"Instead of treating a smoking relapse as a failure, it was seen as a step in the process," says study researcher Anne M. Joseph, MD, of the University of Minnesota. "Cutting back to five or ten cigarettes a day might be considered progress toward the goal for someone who was previously a pack-a-day smoker."

The study is published in the Nov. 28 issue of the Archives of Internal Medicine.

Most Smokers Want to Quit

Surveys consistently show that more than 3 out of 4 smokers would like to quit. While about a third try to quit each year, only about 10% are successful.

The best smoking-cessation programs combine behavioral counseling with nicotine replacement, but most last only two or three months, Joseph tells WebMD.

Many people who quit smoking during treatment end up relapsing after the programs end.

While U.S. health officials consider tobacco dependence a chronic disease like high blood pressure, high cholesterol, and diabetes, the current strategies for promoting smoking cessation do not reflect this, Joseph says.

In an effort to assess the impact of a treatment strategy that looks at smoking as a chronic disease, Joseph and colleagues recruited 443 smokers for their study.

Half of the participants received free nicotine-replacement therapy along with behavioral therapy that consisted of at least five telephone counseling calls, including an initial call to choose a quit date and a nicotine-replacement therapy (gum, patch, or lozenge).

The other half received the same treatment along with additional telephone counseling and nicotine replacement treatments, if needed, for an additional 48 weeks.