University of Twente Student Theses


Randomized controlled non-inferiority trial of blended smoking cessation treatment versus face-to-face smoking cessation treatment : Comparing prolonged abstinence

Gils, C.T. van (2020) Randomized controlled non-inferiority trial of blended smoking cessation treatment versus face-to-face smoking cessation treatment : Comparing prolonged abstinence.

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Embargo date:23 July 2022
Abstract:Background: Online treatment is a recent, emerging development in achieving behavioural change. Web-based components are increasingly added to or blended with traditional face-to-face treatment. In blended treatment, the strengths of one method are expected to compensate for the weaknesses of the other method (van der Vaart et al., 2014). For this reason, blended smoking cessation in considered promising. Aim": The primary objective of this research is to evaluate the effectiveness of the blended smoking cessation treatment (BSCT) compared to face-to-face treatment(F2F) by measuring prolonged abstinence (i.e. 15 months after the start of treatment, 12 months after the set quit date of treatment) and testing for non-inferiority of BSCT. Setting: The face-to-face components of both treatments were organised at the outpatient smoking cessation clinic at the hospital Medisch Spectrum Twente. The web-based components could be accessed at home via the Tactus’s website of addiction treatment The intensity, content, and flexibility were similar for both treatments. Participants: The participants were patients (at least 18 years old) who were referred by their treating physicians of Medisch Spectrum Twente or by their general practitioners to the outpatient smoking cessation clinic at the hospital in Enschede, Netherlands. The participants all smoked at least one cigarette a day, had access to the internet, and sufficient Dutch reading and writing skills. Of the 344 participants who started treatment, 177 participants were randomly assigned to F2F and 167 participants were randomly assigned to BSCT. 46 participants (F2F: n=29, BSCT: n=17) finished the 15 months follow-up questionnaire. Findings: The non-inferiority analysis showed a significantly lower biochemically validated prolonged abstinence rate for BSCT (1.8%) compared to F2F (9.8%), with a difference of 8% (CI: 2.95 – 13.18; P=0.002) Self-reported abstinence shows similar results, 3% showed prolonged abstinence for BSCT and 11.3% for F2F (difference 8,3% (CI:4.39 – 15.49; P=0.003)). In regard to adherence, there was no significant difference found between treatments. However, within BSCT there was a significant difference in adherence between the F2F-mode and Web-mode (p=0.001). Of 125 patients, 72% were classified as high adherent to the F2F-mode whereas only 28% was high adherent to Web-mode. Additionally, the majority of patients (89,6%) who followed BSCT were more adherent to the F2F-mode compared to the Web-mode. Furthermore, low adherence in combination with BSCT compared to low adherence in F2F, was not identified as an indicator for quitting smoking (p=0.997), which could also be said for high adherence (p=0.997). Conclusion: The non-inferiority analysis was inconclusive. Furthermore, tthere was no interaction effect of BSCT found on adherence and the outcome. However, it is confirmed that the strength of F2F, adherence, is able to compensate for the weakness of BSCT.
Item Type:Essay (Bachelor)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:77 psychology
Programme:Psychology BSc (56604)
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