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.
Although there has much press about e-cigarettes recently, we should not forget that smokeless tobacco use is increasing in the US. For example, in a very recent survey, 2.4% of Americans were currently using smokeless vs 2.3% using e-cigarettes (Lee et al, Preventive Med 62:14-19). A recent Cochrane review concluded that person-to-person counseling was helpful for cessation of smokeless tobacco. However, neither NRT nor bupropion was consistently effective. One study...
Many members of ATTUD provide face-to-face individual counseling. Since funding for tobacco treatment often originates from public health funding, many funders are concerned that the increased cost of such treatment is not warranted, given the known efficacy of group and phone counseling. As in many fields, the onus for burden of proof of the utility of more intensive treatment lies with those who believe such treatment is needed. One
A recent Cochrane review (“Behavioral Interventions as adjuncts to pharmacotherapy for smoking cessation”, Issue 12, 2012) reviewed 38 studies found individual in-person or phone counseling of at least 4 sessions were 1.3 times higher than that with medications alone (mostly NRT) with some evidence of greater quit rates with greater intensity of treatment. In comparison, in....