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.


  • Striking While the Iron is Hot Revisited

    In prior blogs, I have reviewed the retrospective studies suggesting that smokers who quit spontaneously do not have worse outcomes and often have better outcomes than those who delay and plan their quit attempt. These findings challenge the common practice of asking smokers to delay quitting in order to engage in several preparatory activities (e.g. gather social support, self‐monitor when smoke during the day, or explore medication use). Recent work now challenges ....
  • Extended Counseling Improves Quit Rates: Empirical Support for What We Do

    In prior blogs I have reported the results of Sharon Hall’s and others’ studies of keeping treatment ongoing after the first few weeks. In the past Sharon and others have examined extending both medication and counseling but I want to focus on the latter. Two prior randomized trials have examined extending counseling with a cognitive-behavorial therapy (CBT) focus. One found a nonsignificant trend that extended treatment lead to higher quit rates. The other, by Dr Hall, more clearly showed extended CBT to be more effective. In a third, just published study, she again found more CBT improved quit rates (Am J Pub Hlth, 2011). The treatment was eleven individual, outpatient cognitive-behavioral treatment sessions lasting about 20-30 min between weeks 12 and 52. Even 2 yrs after the quit date, she found highest quit rates in the two CBT....
  • Recycling Relapsers

    This month’s blog focuses on options once a smoker has relapsed (is smoking regularly - usually defined as smoking for 7 consecutive days).
    The advice for lapses in the last blog also applies for relapses; i.e., discuss the possibility of lapse/relapse at treatment initiation, explore what caused the relapse and problem solve, continue medication, and smoke as little as possible. There is a belief that it’s best for relapsers to wait and recover from the disappointment of failure before they try to stop again. There is no evidence...