Rohsenow 2015.
Methods | 4‐arm RCT. Recruitment: June 2002 to June 2006. End date not reported Country: USA Setting: a state‐funded inner‐city 28‐day residential substance abuse treatment programme |
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Participants | 184 people meeting current DSM‐IV substance‐use disorder (SUD) criteria, smoking at least 10 CPD for the past 6 months, not engaged in smoking treatment. CG: n = 86; IG (CV): n = 98. Gender N = 102, 55.4% women. Mean age = 34.5. Mean CPD = 22.3. Ethnicity: 83.2% (n = 153) were white, 9.2% (n = 17) were black, 7.5% (n = 14) were of other races; 6.6% (n = 12) were Hispanic. SES: mean legal income was USD 9487 in the past year, mean education level was 12.2 years. 71.2% alcohol abuse or dependence, 73.9% cocaine abuse or dependence, 52.8% opiate abuse or dependence, and 37% marijuana abuse or dependence | |
Interventions |
Control Group: BA (Brief advice): 1 x 15‐minute session to promote motivation to quit, adapted for SUD recovery issues. Advice given re: quit date, NRT, support groups, resources, smoking cessation pamphlets and corrective information, if needed. Followed up after first session at 7, 14 and 19 days (10 to 15 minutes each). Progress asked and revision of goals, if necessary Experimental Group(s): MI (motivational interviewing): 1 x 45‐minute session providing education re: smoking cessation, discussion of pros and cons, health risks and costs, corrective information, goal‐setting + written smoking cessation pamphlets. Followed up after first session at 7, 14 and 19 days (15 to 30 minutes each). Progress asked and revision of goals, if necessary Intervention and control groups then randomised into receiving either Contingency Vouchers (CV) or Non‐Contingency vouchers (NCV) Contingent voucher procedures were provided during a 5‐day reduction phase plus a 14‐day abstinent phase. CO monitoring used an EC50 Micro III Smokerlyzer. In NCV participants could earn the same payments a day for 19 days as those randomised to CV, simply for providing breath samples as scheduled Theoretical basis for intervention: MI Duration of intervention: 4 sessions for MI; 4 sessions for BA. 19 days Length of follow‐up: MI: 12 months |
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Outcomes | PPA at 12 months. CO level ≤ 4 ppm and salivary cotinine level ≤ 15 ng/ml. Timeline follow‐back method to assess smoking reduction (number of CPD), number of heavy‐drinking days, number of drug‐use days, and relapse to any heavy drinking or drug use over the 12 months | |
Notes | New for 2019 update Funding: "Supported by 1 RO1 DA13616 from the National Institute on Drug Abuse; two Senior Career Research Scientist Awards from the Department of Veterans Affairs (DJR and PMM); and K05AA019681 from the National Institute on Alcohol Abuse and Alcoholism. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs." Decarations of interest: not reported |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Stratified random assignment, using urn randomisation |
Allocation concealment (selection bias) | Unclear risk | Not reported |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Biochemically validated. CO verification not required for those in prison at follow‐up Quote: "At follow‐up, people with a CO 4 ppm, cotinine 15 ng/mL (if not using NRT), or missing CO or cotinine data, or with self‐reported smoking were coded as having smoked with the following exception: if the participant was in prison, self‐report was accepted since biological verification equipment was not allowed so lack of verification was unrelated to participant decision (Number of prisoners claiming abstinence: n = 2 at 3 months, n = 1 at 6 months, n = 3 at 12 months.)" |
Incomplete outcome data (attrition bias) All outcomes | Low risk | 12‐month follow‐up was completed by 139 (75.5%) |