Trying to Stop Smoking? Medication Plus Counseling May Be Key

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If you are trying to quit smoking, don’t rely on smoking-cessation drugs alone-they are unlikely to work without counseling, according to a 2017 study in the Journal of the National Cancer Institute.

In some early clinical trials, the drugs (buproprion, varenicline, and nicotine patches) had been shown to double cessation rates, but that was probably because smokers also received intensive behavioral counseling as part of the intervention. However, in the new study, which analyzed real-world data from two large surveys on tobacco use, researchers found that the drugs did not increase the chances of long-term smoking cessation.

Though the instructions for some of the drugs suggest that quit-smoking support programs can help prevent relapses, fewer than 2 percent of users of the drugs get any counseling. To help smokers quit, many states offer free counseling over the phone.

What else might help?

Smokers trying to quit often report that certain cues, such as seeing other people smoke, cause them to crave a cigarette, which typically triggers a relapse. But memory retrieval-extinction training-a technique that alters memories associated with craving-may help, according to a study published in 2017 in JAMA Psychiatry.

Researchers selected 72 adults (average age, 48) who smoked 10 or more cigarettes per day and randomly assigned them to undergo memory retrieval-extinction training or extinction training alone. To retrieve smoking-related memories, the first group viewed a five-minute video depicting people smoking. The others viewed a video of people washing dishes. After 10 minutes, both groups completed a 60-minute extinction training session designed to break the cue-reward cycle. Here, participants were repeatedly exposed to smoking triggers but were not permitted to smoke. The process was repeated the following day.

At one month, participants in the memory retrieval-extinction training group reported, on average, less craving than the control group and they smoked fewer cigarettes each day; seven and 10, respectively. These self-reported smoking findings were corroborated by the participants’ carbon monoxide levels, which were also assessed. The authors suggest that this approach could work well with other smoking cessation interventions. Larger studies that investigate the long-term efficacy of this technique will help clarify its true value.