About the Blog Author-John R. Hughes, MD
John R. Hughes, MD is Professor of Psychiatry, Psychology and Family Practice at the University of Vermont. Dr. Hughes is board certified in Psychiatry and Addiction Psychiatry. His major focus has been clinical research on tobacco use. Dr. Hughes received the Ove Ferno Award for research in nicotine dependence and the Alton Ochsner Award Relating Smoking and Health. He is a co-founder and past president of the Society for Research on Nicotine and Tobacco, and the Association for the Treatment of Tobacco Use and Dependence. Dr. Hughes has been Chair of the Vermont Tobacco Evaluation and Review Board which oversees VT’s multi-million dollar tobacco control programs. He has over 400 publications on nicotine and other drug dependencies and is one of the world’s most cited tobacco scientist. Dr. Hughes has been a consultant on tobacco policy to the World Health Organization, the U.S. Food and Drug Administration, and the White House. His current research is on how tobacco users and marijuana users stop or reduce use on their own, novel methods to prompt quit attempts by such users, whether smoking cessation reduces reward sensitivity and whether stopping e-cigarettes causes withdrawal. Dr Hughes has received fees from companies who develop smoking cessation devices, medications and services, from governmental and academic institutions, and from public and private organizations that promote tobacco control.
In the past blogs I have reviewed the evidence whether treatment from a trained TTS produces higher quit rates than from a less-intensive non-TTS therapy. The Cochrane review of this question examined 5 RCTs and stated “We failed to detect a greater effect of intensive counselling compared to brief counselling (5 trials, RR 0.96, 95% CI 0.74 to 1.25).” However, my earlier journal club article pointed out several observational trials that found trained TTS achieves a higher quit rate...
In my prior entries, I have mentioned the need for studies showing that face‐to‐face counseling is worth the extra cost. Such individual treatment can never be as cost‐effective as less‐intensive treatment. In fact, in medicine there are very few cases where more intensive treatment is more cost‐effective.
Recently, two studies have tested more vs less intensive treatment. In one study, 300 smokers in dental care were randomized to low intensity treatment (one 30 min session) or high intensity treatment (eight 40 min sessions over 4 months‐i.e. 320 min)....