Predicting treatment outcome: An examination of the mechanism of action of two pre-quit smoking cessation pharmacotherapies using EMA methods

Quit smoking medications have traditionally been started on quit day. Recently, studies have established that efficacy is improved by starting treatment prior to quitting. Understanding how pre-quit treatments influence abstinence may improve outcomes. Here we test the effects of two treatments on smoking, satisfaction, and craving, and whether reductions in these variables predict outcomes. Participants (n=213) were randomised to receive either standard patch (SP), pre-quit patch (PQP) or varenicline (VAR) and used electronic diaries to monitor their smoking and mood in real-time. PQP and VAR groups had reductions in the satisfaction gained from smoking, craving, and cigarette intake during the pre-quit period; SP group did not. Reductions during the pre-quit phase predicted post-quit outcomes. These results suggest that the reduction in smoking observed during pre-quit treatment is linked to reductions in satisfaction, and that they are a result of treatment.