Colleagues and I have monitored the RCT literature for many years for policy-important findings, but this study launched in the 80s only recently crossed our radar: A large smoking-cessation RCT found sizable impacts on sustained quit rates & mortality over 14.5 years.

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Program & Study Design:

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• The US Lung Health Study randomized 5,887 smokers with early COPD to treatment (T) vs control (C, usual care). The treatment was an intensive 10-week smoking cessation program that included a strong physician message & 12 two-hour group sessions using behavior modification and nicotine gum.

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• Quitters in the treatment group also entered a 5-year maintenance program that stressed coping skills. The program's total cost was roughly $3000 per person.

 

Findings:

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• The rate of biochemically-confirmed, sustained abstinence was 22% T vs 5% C at the 5 year mark, and virtually unchanged over the next 6 years. At 14.5 years, all-cause mortality per 1000 person-years was 8.8 T vs. 10.4 C. These effects were all statistically significant.

 

Comment:

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• Based on careful review, this was a well-conducted RCT - e.g., low sample attrition, biochemical validation of smoking, and use of National Death Index to measure mortality for 98% of sample. Thanks to Joe Gitchell for sharing the study.