Winhusen 2014.
Methods | Setting: 12 outpatient substance use disorder (SUD) programmes, USA Recruitment: adults enrolled in outpatient SUD, interested in quitting |
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Participants | 538 smokers (≥7 cpd), 46% F, av. age 36, av. cpd 16 Provider: Interventionists |
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Interventions | 1. Intervention: treatment as usual + extended‐release (XL) bupropion (300mg for 10w + 3d taper) and nicotine inhaler (6–16 nicotine cartridges per day for 10w + 3w taper), counselling, 10 x 10 min weekly sessions, prize‐based contingency management for smoking abstinence. 2. Treatment as usual; SUD treatment as usually provided at the participating site. |
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Outcomes | Abstinence at 6 months, 7 day PP (Primary outcome for study was stimulant abstinence) Validation: CO <8 ppm. |
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Notes | ||
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | 'eligible participants are stratified within sites, according to whether a stimulant‐positive (amphetamines or cocaine) UDS result is obtained during screening, and randomized 1:1 at a centralized site' (from Winhusen 2012) |
Allocation concealment (selection bias) | Low risk | Central randomisation |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Loss to follow‐up 21% (57) I, 20% (53) C, 'no group differences on completion rate or reasons for non‐completion' |
AHRQ ‐ Agency for Healthcare Research; av ‐ average; C ‐ control; CO ‐ carbon monoxide; COPD ‐ chronic obstructive pulmonary disease; CBT ‐ cognitive behavioural therapy; cpd ‐ cigarettes per day; d ‐ day; F ‐ female; GP ‐ general practitioner; I ‐ intervention; m ‐ month(s); M ‐ male; MA ‐ meta‐analysis; MDD ‐ major depressive disorder; MI ‐ motivational interviewing; NRT ‐ nicotine replacement therapy; NS ‐ not specified; O/P ‐ outpatient; PI ‐ principal investigator; PP ‐ point prevalence abstinence; RP ‐ relapse prevention; RR ‐ risk ratio; SC ‐ smoking cessation; S‐H ‐ self‐help; SoC ‐ Stage of Change; TC ‐ telephone counselling; TQD ‐ target quit date; wk(s) ‐ week(s)