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.

News

  • The ugly relapse curve

    A while ago I published a paper describing the relapse curve in self-quitters (Addiction 99:29) showing most smokers cannot even remain abstinent f...
  • Recent Cochrane Reviews

    This year Cochrane updated 5 reviews. It is important to note that all of these were based on those already motivated to quit and did not assess the ability of the intervention to prompt new quit attempts.
    The 75 studies of print-based self-help materials found that non-tailored materials had almost no benefit but tailored materials did (RR= 1.3) but these tailored benefits were also more intense. I would note that the Cochrane review on internet and social media treatments has not been recently.....
  • Tobacco Treatment Specialists Are Needed

    In prior blogs on 11/2/04, 1/31/13 and 12/21/15 (see ATTUD website) I presented evidence on whether TTSs achieve quit rates greater than brief advice or Quitlines. One important study that I missed should be added to those reviews (Kotz et al, Addiction 109:491, 2013). This study used a survey of UK smokers. It is important for two reasons. The UK is the only country with lots of TTSs. And this study examined many more confounders (e.g. that those seen...
  • Partner Support for Smoking Cessation

    A recent Cochrane Review (“Enhancing Partner Support... 2018) concluded that the 11 RCTs indicate providing partner support to smokers trying to quit does not increase quit rates. There are multiple lines of evidence that partner support is associated with greater quitting. For example, living with another smoker decreases quit rates and if a smoker quits, his/her partner is more likely to later quit. Also, having a partner who is an ex-smoker increases quit rates, even more than having a never-smoker partner. Increasing partner support has been found effective for weight loss, diabetes compliance, and alcohol/drug abuse....
  • How Clinical Trial Statistics Can be Misleading

    A recent review paper (Rosen et al, Addiction, in press) quantified how some cessation statistics can be misleading. Let’s see if I can summarize that without too much jargon.
    The most commonly reported effectiveness statistics are the Odds Ratio (OR) and Relative Risk (RR). They are usually very similar and...
  • Is it Best to Switch or Add to New Treatment When Trying to Quit Again?

    A recent article based on very large prospective study reported that smokers who failed a quit attempt on one medication, tried again and used a different medication, had 3 times higher success rates than those who tried again and used the same medication (Heckman et al Am J Prev Med, in press). Although this is not an experimental study, it does suggest switching is better. The effect did not appear to be due to switching to a more effective medication....
  • Repeat quit attempts: Use new therapy or old therapy?

    Most smokers who seek individual treatment for smoking cessation have tried to quit in the past and many have already used a behavioral or pharmacological treatment. Assessing why past treatments were used, compliance and perceived benefit of the prior treatment is recommended in most treatment guidelines. However, whether it is best to repeat old treatments or use new treatments is unclear. Several studies have examined re-treatment with the same medication (i.e., recycling)...
  • Recent Data on Quitting Smoking in the US

    A recent CDC report (MMWR 65:1457) reports that the incidence of at least one quit attempt/yr has increased from 50% to 55%. That may sound encouraging but that also means that, despite stigmatization, taxes, smoking restrictions, free treatment in most states, almost half of smokers tried to stop. In addition, the CDC reports that 32% of smokers say they are not at all interested in quitting. Also only 31% used a treatment when they tried to quit and only 5% used....