Aim-To examine changes in nicotine withdrawal, nicotine craving, self-efficacy to quit smoking, and perceived control over withdrawal symptoms as predictors of smoking cessation following behavioral counseling and nicotine replacement therapy in a sample of smokers.Design and Setting-Data were ascertained from a randomized effectiveness trial comparing nicotine patch to nicotine lozenge. Predictors of smoking cessation were assessed at baseline and five weeks post-baseline, and 24-hour point prevalence abstinence, biochemically confirmed, was assessed at the end-of-treatment (week 15) and 6-months after a target quit date (week 27).Participants-642 treatment-seeking smokers randomized to twelve weeks of nicotine patch or nicotine lozenge.Findings-Participants who showed a greater increase in self-efficacy to quit smoking (OR = 1.09, 95% CI: 1.02-1.16, p = .01) and perceived control over withdrawal symptoms (OR = 1.02, 95% CI: 1.00-1.04, p = .05) were significantly more likely to have quit smoking at week 15. Participants who showed a greater increase in self-efficacy to quit smoking (OR = 1.04, 95% CI: 1.01-1.06, p = .01) © 2010 Elsevier Ltd. All rights reserved. * Requests for Reprints: Robert A. Schnoll, Ph.D., Department of Psychiatry, University of Pennsylvania, 3535 Market Street, 4 th Floor, Philadelphia, PA, 19104; Phone: 215.746.7143; schnoll@mail.med.upenn.edu.. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. DECLARATIONS OF INTERESTThis study was funded by grant RSGPB-05-240-01-CPPB to Dr. Schnoll from the American Cancer Society and National Institutes of Health grant U10 101178 to Dr. Paul Engstrom. This work was also supported in part by grants: P50 CA143187, R01 CA126969, R01 DA025078, and R21 DA026889. The ACS and NIH had no further role in the study design, data collection, analysis and interpretation, or in the preparation and submission of this manuscript for publication. All authors, except for Dr. Daron Ferris, declare no conflict of interest. Dr. Ferris has received grant funding through his institution to conduct research trials for GSK and Novartis during the past 3 years. were significantly more likely to have quit smoking at week 27. Changes in withdrawal symptoms and craving were not related to week 15 or week 27 abstinence rates. NIH Public Access Conclusions-The results highlight two relatively under-studied potential psychological predictors of abstinence following treatment for nicotine dependence. Behavioral counseling interventions to promote smoking cessation should help smokers develop confidence in their ability to quit smoking a...

For patients with depression symptoms, bupropion increases abstinence rates, lowers withdrawal, and increases quality of life. However, abstinence rates among patients with depression symptoms were low vs. patients without depression symptoms, who exhibited similar abstinence rates when treated with bupropion or transdermal nicotine and counseling alone. These results can guide future smoking cessation intervention studies with cancer patients.

While numerous studies show that higher levels of smoking cessation self-efficacy predicts motivation to quit smoking and successful smoking cessation, few studies have evaluated factors related to smoking cessation self-efficacy that could be targets of behavioral interventions to promote greater confidence to quit smoking. This study, using a large community sample of smokers enrolled in a smoking cessation treatment program, evaluated potential associations between self-efficacy to quit smoking and demographic (e.g., age, race), smoking-related (e.g., rate, cessation history, past use of treatments), and psychosocial (e.g., stress, cue reactivity, self-medication smoking) variables. The results indicated that Hispanic-American smokers, relative to smokers of other racial/ethnic groups, report significantly lower self-efficacy to quit smoking when facing internal stimuli (e.g., feeling depressed), as do smokers who report that they have little confidence to control abstinence-induced symptoms (F(9,576) = 6.9, p < .001). The results also indicated that smokers who reported that they have little confidence to control abstinence-induced symptoms and report high smoking urge reactivity to situations that illicit positive affect (e.g., at a bar, with coffee, at a party) report lower self-efficacy to quit smoking when facing external stimuli (e.g., during a celebration; F[7,600] = 9.05, p < .05). These findings can be used to refine behavioral smoking cessation interventions to increase self-efficacy to quit smoking.

Background: Nicotine replacement therapies are efficacious for treating nicotine dependence. However, limited data exist on benefits of different NRTs and predictors of treatment outcome. This study compared the effectiveness of transdermal nicotine vs. nicotine lozenge for smoking cessation and identified predictors of treatment response.

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