Opt-Out Treatment Can Help Reluctant Smokers Quit Smoking

TOPLINE:

A higher desire to quit smoking is associated with higher smoking abstinence rates; however, the effectiveness of an opt-out treatment for tobacco use is not diminished even when individuals express lower initial desire to quit smoking.

METHODOLOGY:

• Researchers conducted a secondary analysis of a randomized clinical trial to check if the effectiveness of an opt-out treatment program diminished in participants with a lower initial desire to quit smoking.
• They included 739 participants (mean age, 51.4 years; 47.2% women) who were hospitalized smokers. Participants were randomly assigned to either a group that received quitting smoking materials that they would not receive if they actively opted out or an opt-in group, in which people only received materials if they selected help.
• Treatment included nicotine replacement therapy, prescriptions for post-discharge medications, a 2-week medication starter kit, treatment planning, and four outpatient counseling calls.
• Participants were instructed to indicate their initial readiness to quit smoking on a scale of 0-10, with 0 representing no thoughts about quitting and 10 representing active efforts to quit.
• The association of the desire to quit smoking and its interaction with the treatment group at 1-month follow-up was assessed.

TAKEAWAY:

• A higher desire to quit smoking was associated with higher smoking abstinence rates in the overall population.
• The abstinence rate for smoking was 32% (95% CI, 25%-40%) in participants with level 10 desire to quit smoking in the opt-out group.
• In participants with level 0 desire to quit smoking, the smoking abstinence rate was at 8% (95% CI, 3%-16%) in the opt-out group.

IN PRACTICE:

“These findings may inform clinical decision-making. Even though people with a lower desire to quit had lower quit rates, the advantage of opt-out treatment was constant,” the authors wrote.

SOURCE:

This study was led by Byron Gajewski, PhD, of the Department of Biostatistics and Data Science at the University of Kansas School of Medicine in Kansas City, Kansas, and was published online on September 17, 2024, in JAMA Network Open.

LIMITATIONS:

This study was limited to people who were hospitalized and smoked from a Midwestern hospital. The follow-up duration was only for 1 month.

DISCLOSURES:

The study was supported by grants from the National Heart, Lung, and Blood Institute; the National Institute of General Medical Sciences of the National Institutes of Health; and other sources. The authors reported no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.