Smoking Cessation and the Help of Cravings Suppression
The most recent issue of the Journal of Consulting and Clinical Psychology contains an article that suggests that combining smoking cessation pharmacotherapies improves cessation rates, compared to individual smoking cessation therapies. Researchers from the University of Wisconsin Madison examined why smokers who received combination pharmacotherapies were more likely to quit smoking than those who received either a single agent therapy or a placebo. The data confirm that single agent therapies are more effective than a placebo and combination pharmacotherapies are better than a placebo or single agent therapies. In addition, the researchers looked at important mediators that influenced an individual’s chances of quitting smoking. These mediators were cravings, withdrawal, negative affect, positive affect, and expectation of smoking reward.
Cognitive-Behavior Therapy (CBT) & Pharmacotherapy
The researchers found that the superiority of combination pharmacotherapy was attributable primarily to its ability to suppress cravings. This is important because craving, especially very early on, when the person is attempting to quit smoking, is a serious determinant of long-term outcomes. Although there is a proven strong relationship between combination therapy and craving reduction, it is still not precisely known how this happens. Initial data suggest that different types of medications elicit complementary neuropharmacological reactions in the organism.
These results not only inform pharmacological treatment development but also shed light on important factors to be included in non-pharmacological smoking cessation treatments, such as counseling. The article asserts that craving suppression is the most likely mediator to improve smoking cessation treatment outcomes. However, treatment protocols that focus on the modifiable causes of cravings (i.e., environmental cues, distress, absence of well mapped nonsmoking responses to triggers, etc.) may be important adjuncts to combination pharmacotherapy.
Long-term Successful Smoking Cessation
Many smokers have attempted to quit multiple times. What have you tried that failed to help? Has anyone had success with combination treatments, e.g., Cognitive-Behavioral Therapy (CBT) and pharmacotherapy? Do you believe cravings are the biggest barrier to long-term smoking cessation?