Approach bias retraining to augment smoking cessation: A pilot randomized controlled trial. (1st September 2022)

• Record Type: Journal Article
• Authors: Smits, Jasper A.J.; Rinck, Mike; Rosenfield, David; Beevers, Christopher G.; Brown, Richard A.; Conroy Busch, Haley E.; Dutcher, Christina D.; Perrone, Alex; Zvolensky, Michael J.; Garey, Lorra
• Is Part Of: Drug and alcohol dependence. Volume 238(2022)
• Publication Date: 2022-09-01
• Subjects: Smoking cessation -- Cognitive bias modification -- Approach-avoidance bias -- Behavioral intervention -- Nicotine-replacement therapy; ST+ABR Standard Treatment + Approach Bias Retraining -- ST+Sham Standard Treatment + Sham -- AAT The Approach-Avoidance Task -- RT Reaction Time -- ABR Approach Bias Retraining; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2022.109579
• Languages: English
• ISSNs: 0376-8716

Abstract

Abstract: Background: Approach tendency to smoking-related cues has been associated with greater cravings, nicotine dependence, and the likelihood of relapse. In this pilot randomized clinical trial, we examined the efficacy of approach bias retraining (ABR; i.e., increasing avoidance tendency) for enhancing standard smoking cessation treatment (ST). Methods: Adult smokers ( N = 96) motivated to quit were randomly assigned to 7 weekly in-person treatment sessions consisting of either (1) cognitive-behavioral therapy for smoking cessation (ST) and ABR (ST+ABR) or ST and sham retraining (ST+Sham). All participants also received optional nicotine replacement therapy for up to 8 weeks following the scheduled quit date (week 6). We measured avoidance tendency from weeks 1–7. Point prevalence abstinence (PPA) and prolonged abstinence (PA) were measured up to 3 months following the quit attempt (week 18 follow-up). Results: Consistent with our hypothesis, participants in ST+ABR evidenced higher abstinence rates than those in ST+Sham at the final follow-up ( b =0.71, 95 % CI: [0.14, 1.27], t [1721]=2.46, p = 0.014, OR=2.03, 95 % CI: [1.15, 3.57]). Specifically, PPA and PA rates were 50 % and 66 % in ST+ABR compared to 31 % and 47 % in ST+Sham. As expected, participants assigned to the ST+ABR condition also showed a greater training-compatible increase in avoidance tendency scores relative to those assigned to the ST+Sham condition ( b =248.06, 95 % CI: [148.51, 347, 62], t [84]=4.96, p < .001). Conclusions: The current pilot randomized clinical trial provides initial evidence for the efficacy of integrating standard smoking cessation with ABR. These findings encourage the testing of the long-term efficacy and mechanisms of action of this integrated intervention. Highlights: ST+ABR promotes abstinence after a quit attempt in adult smokers interested in quitting. ABR results in increased avoidance tendencies of smoking-related cues. Those higher in initial avoidance tendencies may respond better to ST+ABR.