A comparison of covert sensitization and “nonspecific” treatment in the modification of smoking behavior

Sipich, James F.; Russell, Richard K.; Tobias, Lester L.

doi:10.1016/0005-7916(74)90115-3

Cited by 36 publications

(8 citation statements)

References 11 publications

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“…In one nausea trial [ 10 ], the placebo therapy consisted of talks about the child's daily life, which might have had a large reassuring effect. In the other trial [ 33 ], the smoking rate was monitored for one week before treatment in the placebo group, but not in the no-treatment group.…”

Section: Resultsmentioning

confidence: 99%

Spontaneous improvement in randomised clinical trials: meta-analysis of three-armed trials comparing no treatment, placebo and active intervention

Krogsbøll

Hróbjartsson

Gøtzsche

2009

BMC Med Res Methodol

232

192

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BackgroundIt can be challenging for patients and clinicians to properly interpret a change in the clinical condition after a treatment has been given. It is not known to which extent spontaneous improvement, effect of placebo and effect of active interventions contribute to the observed change from baseline, and we aimed at quantifying these contributions.MethodsSystematic review and meta-analysis, based on a Cochrane review of the effect of placebo interventions for all clinical conditions. We selected all trials that had randomised the patients to three arms: no treatment, placebo and active intervention, and that had used an outcome that was measured on a continuous scale or on a ranking scale. Clinical conditions that had been studied in less than three trials were excluded.ResultsWe analysed 37 trials (2900 patients) that covered 8 clinical conditions. The active interventions were psychological in 17 trials, physical in 15 trials, and pharmacological in 5 trials. Overall, across all conditions and interventions, there was a statistically significant change from baseline in all three arms. The standardized mean difference (SMD) for change from baseline was -0.24 (95% confidence interval -0.36 to -0.12) for no treatment, -0.44 (-0.61 to -0.28) for placebo, and -1.01 (-1.16 to -0.86) for active treatment. Thus, on average, the relative contributions of spontaneous improvement and of placebo to that of the active interventions were 24% and 20%, respectively, but with some uncertainty, as indicated by the confidence intervals for the three SMDs. The conditions that had the most pronounced spontaneous improvement were nausea (45%), smoking (40%), depression (35%), phobia (34%) and acute pain (25%).ConclusionSpontaneous improvement and effect of placebo contributed importantly to the observed treatment effect in actively treated patients, but the relative importance of these factors differed according to clinical condition and intervention.

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Section: Resultsmentioning

confidence: 99%

Spontaneous improvement in randomised clinical trials: meta-analysis of three-armed trials comparing no treatment, placebo and active intervention

Krogsbøll

Hróbjartsson

Gøtzsche

2009

BMC Med Res Methodol

232

192

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“…There were 54 trials (total of 5,160 patients) having more than three arms. In 18 of those [52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69], one or more additional arms were disregarded (a total of 796 patients) in order to calculate the PCE for groups that had comparable interventions. In the remaining 36 trials with more than three arms, all arms were relevant and therefore included which left a total number of 16,655 patients for the meta-analysis.…”

Section: Included Studiesmentioning

confidence: 99%

Placebo response and effect in randomized clinical trials: meta-research with focus on contextual effects

Hafliðadóttir

Juhl

Nielsen

et al. 2021

Trials

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Background Contextual effects (i.e., placebo response) refer to all health changes resulting from administering an apparently inactive treatment. In a randomized clinical trial (RCT), the overall treatment effect (i.e., the post-treatment effect in the intervention group) can be regarded as the true effect of the intervention plus the impact of contextual effects. This meta-research was conducted to examine the average proportion of the overall treatment effect attributable to contextual effects in RCTs across clinical conditions and treatments and explore whether it varies with trial contextual factors. Methods Data was extracted from trials included in the main meta-analysis from the latest update of the Cochrane review on “Placebo interventions for all clinical conditions” (searched from 1966 to March 2008). Only RCTs reported in English having an experimental intervention group, a placebo comparator group, and a no-treatment control group were eligible. Results In total, 186 trials (16,655 patients) were included. On average, 54% (0.54, 95%CI 0.46 to 0.64) of the overall treatment effect was attributable to contextual effects. The contextual effects were higher for trials with blinded outcome assessor and concealed allocation. The contextual effects appeared to increase proportional to the placebo effect, lower mean age, and proportion of females. Conclusion Approximately half of the overall treatment effect in RCTs seems attributable to contextual effects rather than to the specific effect of treatments. As the study did not include all important contextual factors (e.g., patient-provider interaction), the true proportion of contextual effects could differ from the study’s results. However, contextual effects should be considered when assessing treatment effects in clinical practice. Trial registration PROSPERO CRD42019130257. Registered on April 19, 2019.

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“…A variety of behavior modification techniques have been employed in the treatment of smoking behavior, many with a limited degree of success. One extensively used set of techniques is aversive methods which include electric shock (30,31), excessive cigarette smoke (11,18,22,23,32), and covert sensitization (3,20,34,39).…”

Section: Introductionmentioning

confidence: 99%

The effects of a multiple treatment program and maintenance procedures on smoking cessation

Powell

McCann

1981

Preventive Medicine

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This study evaluated the efficacy of a multiple treatment smoking cessation program and three maintenance strategies. Phase I of the study involved 51 subjects who participated in a 5-day smoking cessation project. The program consisted of lectures, demonstrations, practice exercises, aversive smoking, and the teaching of self-control procedures. In Phase II, all subjects were randomly assigned to one of three maintenance conditions: a 4-week support group which offered an opportunity to discuss feelings and thoughts, a 4-week telephone contact system which enabled group members to call one another, and a no-contact control group. To evaluate efficacy, extensive follow-up data were collected at the end of treatment and at 2, 4, 6, and 12 months post-treatment. The treatment program was extremely effective; 100% of the subjects were abstinent at the end of treatment, and at 1 year posttreatment, 63% of the subjects reported total abstinence. As to sex differences, at the l-year period 66% of the women and 59% of the men were ex-smokers. Recidivists reported a smoking rate that was 52% of baseline at the &month follow-up. At 2 months post-treatment, 40% of the abstainers reported that the quitting experience was easy, and subjects reported an average weight gain of only 4.69 lb. The authors offer suggestions for future smoking cessation research based upon the promising findings of this study.

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A comparison of covert sensitization and “nonspecific” treatment in the modification of smoking behavior

Cited by 36 publications

References 11 publications

Spontaneous improvement in randomised clinical trials: meta-analysis of three-armed trials comparing no treatment, placebo and active intervention

Spontaneous improvement in randomised clinical trials: meta-analysis of three-armed trials comparing no treatment, placebo and active intervention

Placebo response and effect in randomized clinical trials: meta-research with focus on contextual effects

The effects of a multiple treatment program and maintenance procedures on smoking cessation

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