Efficacy of the Ascure Smoking Cessation Program: Retrospective Study

Abstract

Background Smoking cessation helps extend a healthy life span and reduces medical expenses. However, the standard 12-week smoking cessation program in Japan has several notable problems. First, only 30% of participants complete this program. Second, participants may choose not to participate unless they have a strong motivation to quit smoking, such as health problems. Third, the program does not provide enough support during the period between clinical visits and after 12 weeks. Objective This study examined the efficacy of the 24-week ascure program to address the problems of accessibility and continuous support. The program combines online mentoring, over-the-counter pharmacotherapy, and a smartphone app. Methods Using a retrospective study design, we investigated data for 177 adult smokers who were enrolled in the ascure smoking cessation program between August 2017 and August 2018. The primary outcomes were continuous abstinence rates (CARs) during weeks 9-12 and weeks 21-24. To confirm smoking status, we performed salivary cotinine testing at weeks 12 and 24. We also evaluated the program adherence rate. Finally, we performed exploratory analysis to determine the factors associated with continuous abstinence at weeks 21-24 to provide insights for assisting with long-term continuous abstinence. Results The CARs of all participants for weeks 9-12 and weeks 21-24 were 48.6% (95% CI 41.2-56.0) and 47.5% (95% CI 40.0-54.8), respectively. Program adherence rates were relatively high throughout (72% at week 12 and 60% at week 24). In the analysis of the factors related to the CAR at weeks 21-24, the number of entries in the app’s digital diary and number of educational videos watched during the first 12 weeks were significant factors. Conclusions The ascure program achieved favorable CARs, and participants showed high adherence. Proactive usage of the smartphone app may help contribute to smoking cessation success in the long-term.

Rigid reduced successor representation as a potential mechanism for addiction

“…Reasons for this, and whether there are reasons common to substance and nonsubstance reward, remain elusive. Although much effort has been devoted to developing clinical programs including technology‐based therapies (e.g., Gustafson et al., 2014; Kato et al., 2020; reviewed in Newman et al., 2011; Haskins et al., 2017), the lack of mechanistic understanding of the undesired addictive habit is an obstacle for further improvement. Computational modeling has become a powerful approach to elucidating the mechanisms of psychiatric disorders including addiction (Huys et al., 2016; Kato et al., 2020; Montague et al., 2012; Wang & Krystal, 2014).…”

Heated tobacco products and a telemedicine smoking cessation programme: A retrospective study

“…First, overall smoking cessation success rates by the Linkage telemedicine smoking cessation programme were favourable in both short- and long-term periods: 55.8% for CAR9-24 and 42.4% for CAR9-52. Kato et al previously reported the effectiveness of the 6-month online smoking cessation programme in Japan for conventional cigarette smokers using online mentoring by trained smoking cessation experts, over-the-counter nicotine patches for medication, and a unique smartphone app 11 . They found that the CAR9-12 and CAR21-24 of patients who received the ascure online program were 48.6% and 47.5%, respectively, which were almost consistent with our results.…”

“…In Japan, nicotine-dependent patients, including HTP users, are eligible for a 12-week standard smoking cessation treatment programme with clinic visits and an initial screening interview in which their exhaled carbon monoxide levels are checked 10 . Moreover, some commercial telemedicine smoking cessation programmes are available for members of corporate health insurance societies (a public body that provides health insurance to corporation employees) 11 . However, biochemically check smoking cessation status through exhaled carbon monoxide, which is currently measured at every visit in a standard smoking cessation programme, is not effective for HTP use 12 .…”

“…However, biochemically check smoking cessation status through exhaled carbon monoxide, which is currently measured at every visit in a standard smoking cessation programme, is not effective for HTP use 12 . Moreover, it has not yet been assessed whether these smoking cessation programmes are helpful for smokers who use HTPs since they were initially made for cigarette smokers 10,11 .…”

Reduced Successor Representation Potentially Interferes with Cessation of Habitual Reward-Seeking

“…Although much effort has been devoted to developing clinical programs including technology-based therapies (e.g. (Gustafson et al , 2014; Kato et al , 2020b); reviewed in (Newman et al , 2011; Haskins et al , 2017)), the lack of mechanistic understanding of the undesired habit is an obstacle for further improvement. Computational modeling has become a powerful approach to elucidating the mechanisms of psychiatric disorders including addiction (Montague et al , 2012; Wang & Krystal, 2014; Huys et al , 2016; Kato et al , 2020a).…”