Randomized Trial of Telephone-Delivered Acceptance and Commitment Therapy Versus Cognitive Behavioral Therapy for Smoking Cessation: A Pilot Study
Randomized Trial of Telephone-Delivered Acceptance and Commitment Therapy Versus Cognitive Behavioral Therapy for Smoking Cessation: A Pilot Study
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DOI：
10.1093/ntr/ntu102
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发表时间：
2014-11-01
影响因子：
4.7
通讯作者：
Heffner, Jaimee L.
中科院分区：
文献类型：
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作者：
Bricker, Jonathan B.;Bush, Terry;Heffner, Jaimee L.
我们进行了一项电话传递接受和承诺疗法（ACT）与认知行为疗法（CBT）戒烟的初步随机试验，参与者为121名未投保的南卡罗来纳州戒烟热线呼叫者，他们是成年吸烟者（至少10支烟/天），并希望在未来30天内戒烟。参与者被随机分配到ACT或CBT电话咨询的5个阶段，并提供2周的尼古丁替代疗法（NRT）。ACT参与者比CBT参与者完成更多的电话咨询（ACT中M = 3.25，CBT中M = 2.23; p = 0.001）。关于满意度，100%的ACT参与者报告他们的治疗对戒烟有用（CBT为87%; p = .03），97%的ACT参与者会向朋友推荐他们的治疗（CBT为83%; p = .06）。在随机化后6个月的意向治疗30天时点戒烟率的主要结局方面，ACT组的戒烟率为31%，CBT组为22%（比值比[OR] = 1.5，95%置信区间[CI] = 0.7-3.4）。在基线抑郁的参与者中（n = 47），ACT组的戒烟率为33%，CBT组为13%（OR = 1.2，95%CI = 1.0-1.6）。与ACT的理论一致，在基线时接受渴望的参与者中（n = 57），ACT的戒烟率为37%，而CBT为10%（OR = 5.3，95%CI = 1.3-22.0）ACT通过电话提供是可行的，戒烟热线呼叫者高度接受，与标准CBT戒烟热线咨询相比，戒烟率非常有希望。由于结果受到试验设计的限制（例如，小样本），现在需要进行全面的疗效试验。
We conducted a pilot randomized trial of telephone-delivered acceptance and commitment therapy (ACT) versus cognitive behavioral therapy (CBT) for smoking cessation.Participants were 121 uninsured South Carolina State Quitline callers who were adult smokers (at least 10 cigarettes/day) and who wanted to quit within the next 30 days. Participants were randomized to 5 sessions of either ACT or CBT telephone counseling and were offered 2 weeks of nicotine replacement therapy (NRT).ACT participants completed more calls than CBT participants (M = 3.25 in ACT vs. 2.23 in CBT; p = .001). Regarding satisfaction, 100% of ACT participants reported their treatment was useful for quitting smoking (vs. 87% for CBT; p = .03), and 97% of ACT participants would recommend their treatment to a friend (vs. 83% for CBT; p = .06). On the primary outcome of intent-to-treat 30-day point prevalence abstinence at 6 months postrandomization, the quit rates were 31% in ACT versus 22% in CBT (odds ratio [OR] = 1.5, 95% confidence interval [CI] = 0.7-3.4). Among participants depressed at baseline (n = 47), the quit rates were 33% in ACT versus 13% in CBT (OR = 1.2, 95% CI = 1.0-1.6). Consistent with ACT's theory, among participants scoring low on acceptance of cravings at baseline (n = 57), the quit rates were 37% in ACT versus 10% in CBT (OR = 5.3, 95% CI = 1.3-22.0).ACT is feasible to deliver by phone, is highly acceptable to quitline callers, and shows highly promising quit rates compared with standard CBT quitline counseling. As results were limited by the pilot design (e.g., small sample), a full-scale efficacy trial is now needed.