Smoking Cessation Intervention for Reducing Cigarette Use

Overseen By Christine Sheffer

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Roswell Park Cancer Institute

Must not be taking: Nicotine replacement, Bupropion, Varenicline

Disqualifiers: Drug abuse, Others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 4 weeks

96 Participants Needed

Trial Summary

What is the purpose of this trial?

This clinical trial evaluates the effectiveness of active episodic future thinking (EFT) stimuli for reducing cigarette consumption in cigarette smokers. EFT is an innovative framing method shown to significantly activate brain regions involved in future thinking, planning, and other executive functions. Active EFT stimuli are positive events, unrelated to smoking, that participants anticipate, look forward to, and can vividly imagine happening up to 1 year in the future. Control EFT stimuli are positive past events, unrelated to smoking, that participants can vividly remember happening in the recent past. Active EFT stimuli may help reduce cigarette consumption among cigarette smokers by exposing them to personally relevant future oriented stimuli.

Will I have to stop taking my current medications?

The trial requires that you are not currently using nicotine replacement therapy, bupropion, or varenicline. If you are using these, you would need to stop before participating.

What data supports the effectiveness of the treatment for smoking cessation?

Research shows that Episodic Future Thinking (EFT), which involves imagining positive future events, can reduce cigarette craving and delay discounting (the tendency to prefer smaller immediate rewards over larger future ones), which are both linked to smoking behavior. This suggests that EFT may help people quit smoking by making them less impulsive and reducing their desire to smoke. ^{1 2 3 4 5}

Is episodic future thinking (EFT) safe for use in smoking cessation interventions?

Episodic future thinking (EFT) has been studied as a method to help reduce cigarette craving and demand, and no significant safety concerns have been reported in the research available. It is generally considered safe for use in smoking cessation interventions. ^{1 2 3 6 7}

How is the Smoking Cessation Intervention (EFT) different from other smoking cessation treatments?

The Smoking Cessation Intervention using Episodic Future Thinking (EFT) is unique because it involves imagining future scenarios to reduce cigarette use, which is different from traditional methods like nicotine replacement or counseling. This approach focuses on changing how individuals think about their future, potentially making it a novel way to address smoking habits. ^{8 9 10 11 12}

Research Team

Christine Sheffer

Principal Investigator

Roswell Park

Eligibility Criteria

This trial is for cigarette smokers who smoke at least 10 cigarettes daily, do not use other tobacco products regularly, have a smartphone with texting ability, and can vividly imagine visual images. People using nicotine replacements or certain medications, those who've used drugs of abuse recently, or live with someone in the study cannot join.

Inclusion Criteria

Smoke >= 10 cigarettes daily

Score > 32 on the Vividness of Visual Imagery Questionnaire (VVIQ)

No regular use of other tobacco products

Exclusion Criteria

I am currently using nicotine replacement, bupropion, or varenicline.

Use of drugs of abuse in the past 30 days

Living in the same household as a participant already enrolled in this study

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either the active or control EFT stimulus and use the iCOquit Smokerlyzer carbon monoxide monitor

4 weeks

Weekly visits (in-person or virtual)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

• Medical Device Usage and Evaluation
• Smoking Cessation Intervention
• Smoking Cessation Intervention (control)

Trial Overview The trial tests if active episodic future thinking (EFT)—imagining positive future events—can help smokers cut down on smoking compared to recalling past positive events. It also assesses how well participants engage with this method through their smartphones.

Participant Groups

Group I: Arm 1 (active EFT) Experimental Treatment 2 Interventions

Participants receive the active EFT stimulus and use the iCOquit Smokerlyzer carbon monoxide monitor on study.

Group II: Arm II (control EFT) Active Control 2 Interventions

Participants receive the control EFT stimulus and use the iCOquit Smokerlyzer carbon monoxide monitor on study.

Who Is Running the Clinical Trial?

Roswell Park Cancer Institute

Lead Sponsor

Trials

427

Recruited

40,500+

Findings from Research

The combination of cognitive-behavioral treatment (CBT) and episodic future thinking (EFT) for smoking cessation in a group of 29 smokers with substance use disorders was found to be acceptable, with a high satisfaction rating of 8.83 out of 10.

Despite the positive reception, adherence to the EFT component was low, with only 15.8% of participants practicing it as recommended, indicating a need for adjustments in future studies to enhance compliance and effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Episodic future thinking for smoking cessation in individuals with substance use disorder: Treatment feasibility and acceptability. Aonso-Diego, G., González-Roz, A., Martínez-Loredo, V., et al.[2021]

Episodic future thinking (EFT) significantly reduces delay discounting and cigarette craving among smokers, suggesting it may help in smoking cessation efforts.

Imagining smoking-related illness (SRI) increased delay discounting but also reduced craving, indicating that while SRI can heighten the perceived value of immediate rewards, it may also help in managing cravings when combined with EFT.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Episodic Future Thinking about Smoking-Related Illness: A Preliminary Investigation of Effects on Delay Discounting, Cigarette Craving, and Cigarette Demand. Ruhi-Williams, P., King, MJ., Stein, JS., et al.[2022]

Episodic future thinking (EFT) shows promise as an intervention for reducing problematic substance use and substance use disorders, based on a systematic review of 16 studies that demonstrated benefits in self-reported and task-based outcomes.

The review highlights the need for further research to assess the feasibility, generalizability, and long-term effects of EFT, as well as to identify factors that influence its effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Imagining the future can shape the present: A systematic review of the impact of episodic future thinking on substance use outcomes. Collado, A., Stokes, A.[2023]

The addition of contingency management (CM) to cognitive behavioral treatment (CBT) with episodic future thinking (EFT) significantly increased 24-hour tobacco abstinence rates from 20% to 50% among 54 treatment-seeking participants, indicating a more effective approach for smoking cessation.

While not statistically significant, the CM group showed improved in-treatment behaviors such as higher retention rates and more sessions attended, suggesting that CM may enhance overall treatment engagement and adherence to nicotine reduction guidelines.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Contingency management for smoking cessation among individuals with substance use disorders: In-treatment and post-treatment effects. Aonso-Diego, G., González-Roz, A., Krotter, A., et al.[2021]

Episodic Future Thinking (EFT) and Future Thinking Priming (FTP) are promising remote interventions that can help reduce delay discounting in individuals trying to quit smoking, with a small study of 20 participants showing significant differences in language use that indicate a greater focus on future orientation in the active conditions.

The study confirmed the internal validity of EFT and FTP, suggesting that these interventions are effective in promoting risk-avoidance and future thinking, which are important for successful smoking cessation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Internal Validity of Two Promising Methods of Altering Temporal Orientation among Cigarette Smokers. O'Connor, RJ., Carl, E., Shevorykin, A., et al.[2021]

Individuals with psychiatric disorders show significant deficits in episodic future thinking (EFT), with an overall effect size of g = -0.84, indicating less specific and detailed future event simulations compared to control groups.

Subgroup analyses revealed that these deficits are particularly pronounced in depression, bipolar disorder, and schizophrenia, suggesting that these conditions may impair the ability to mentally simulate future experiences.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Psychopathology and episodic future thinking: A systematic review and meta-analysis of specificity and episodic detail. Hallford, DJ., Austin, DW., Takano, K., et al.[2019]

Episodic future thinking (EFT) is a promising behavioral intervention that can help reduce delay discounting and improve health behaviors, but there is significant variability in how EFT is implemented across studies.

The review highlights the need for standardized methods in generating EFT cues and suggests best practices, while also identifying gaps in research that need to be addressed to enhance the efficacy and effectiveness of EFT as an intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Putting prospection into practice: Methodological considerations in the use of episodic future thinking to reduce delay discounting and maladaptive health behaviors. Brown, JM., Stein, JS.[2023]

A review of smoking cessation interventions from 1999 to 2007 found that methods like individual counseling, group therapy, and nicotine replacement therapy are significantly effective for helping both healthy and sick patients quit smoking.

Medications such as bupropion, nortriptyline, clonidine, and varenicline also showed proven efficacy, while other interventions did not demonstrate effectiveness in aiding smoking cessation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Smoking cessation with special focus on primary health care]. Bredesen, H., Lous, J.[2019]

A systematic review of 21 studies involving 8186 participants found no clear benefit of mindfulness-based interventions for smoking cessation compared to other treatments, indicating that these approaches may not significantly increase quit rates.

The evidence regarding the impact of mindfulness interventions on mental health outcomes was also inconclusive, with most studies showing no meaningful differences in mental well-being compared to other treatments, highlighting the need for further research in this area.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mindfulness for smoking cessation. Jackson, S., Brown, J., Norris, E., et al.[2023]

The Multi-Theory Model (MTM) of health behavior change offers a new framework for improving smoking cessation interventions, addressing the need for more effective strategies in helping individuals quit smoking.

An instrument has been developed to measure the constructs of MTM related to smoking cessation, which is set to be validated and tested in a randomized control trial, potentially enhancing the success rates of quitting smoking.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Applying a new theory to smoking cessation: case of multi-theory model (MTM) for health behavior change. Sharma, M., Khubchandani, J., Nahar, VK.[2022]

Cognitive Behavioral Therapy (CBT) and Mindfulness-Based Interventions (MBIs) are both effective methods for helping people quit smoking, including special populations like low-income individuals and pregnant women.

Recent studies suggest that both CBT and MBIs can be successfully delivered through mobile and online platforms, indicating their potential for widespread use, but further research is needed to identify which method works best for different groups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cognitive Behavioral and Mindfulness-Based Interventions for Smoking Cessation: a Review of the Recent Literature. Vinci, C.[2021]

Behavioral treatments for tobacco use are effective and cost-effective, comparable to pharmacotherapies, but have not advanced as quickly in recent years.

There is a need for more research on tobacco cessation interventions specifically for cancer patients, and clinicians are encouraged to use the Five A's approach to support these patients in quitting smoking.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Behavioral tobacco cessation treatments: yesterday's news or tomorrow's headlines? Brandon, TH.[2007]

References

1. United States pubmed.ncbi.nlm.nih.gov

Episodic future thinking for smoking cessation in individuals with substance use disorder: Treatment feasibility and acceptability. [2021]

2. Switzerland pubmed.ncbi.nlm.nih.gov

Episodic Future Thinking about Smoking-Related Illness: A Preliminary Investigation of Effects on Delay Discounting, Cigarette Craving, and Cigarette Demand. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Imagining the future can shape the present: A systematic review of the impact of episodic future thinking on substance use outcomes. [2023]

4. England pubmed.ncbi.nlm.nih.gov

Contingency management for smoking cessation among individuals with substance use disorders: In-treatment and post-treatment effects. [2021]

5. Switzerland pubmed.ncbi.nlm.nih.gov

Internal Validity of Two Promising Methods of Altering Temporal Orientation among Cigarette Smokers. [2021]

6. England pubmed.ncbi.nlm.nih.gov

Psychopathology and episodic future thinking: A systematic review and meta-analysis of specificity and episodic detail. [2019]

7. Switzerland pubmed.ncbi.nlm.nih.gov

Putting prospection into practice: Methodological considerations in the use of episodic future thinking to reduce delay discounting and maladaptive health behaviors. [2023]

8. Denmark pubmed.ncbi.nlm.nih.gov

[Smoking cessation with special focus on primary health care]. [2019]

9. England pubmed.ncbi.nlm.nih.gov

Mindfulness for smoking cessation. [2023]

10. Iran pubmed.ncbi.nlm.nih.gov

Applying a new theory to smoking cessation: case of multi-theory model (MTM) for health behavior change. [2022]

11. United States pubmed.ncbi.nlm.nih.gov

Cognitive Behavioral and Mindfulness-Based Interventions for Smoking Cessation: a Review of the Recent Literature. [2021]

12. United States pubmed.ncbi.nlm.nih.gov

Behavioral tobacco cessation treatments: yesterday's news or tomorrow's headlines? [2007]