Theory of Addiction

West, Robert; Brown, Jamie

doi:10.1002/9781118484890

Cited by 383 publications

(251 citation statements)

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“…However, in agreement with PRIME theory (West, 2006; West & Brown, 2013), beliefs about what should be done (e.g. stop smoking given awareness of the negative consequences) will not bring about behavior change unless they generate strong enough motivation.…”

Section: Discussionmentioning

confidence: 74%

“…Three main areas were covered: 1) smoking history, 2) attitudes towards smoking, and 3) thoughts and experiences of quit attempts. The development of the topic guide involved discussions between members of the research team and drew on concepts from a then pre-publication version of the PRIME theory (West, 2006; West & Brown, 2013) available to the authors. This comprehensive theory of motivation encompasses influences on behavior from reflexes and habits through drives to evaluations and plans.…”

Section: Methodsmentioning

confidence: 99%

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Progression towards smoking cessation: Qualitative analysis of successful, unsuccessful, and never quitters

Tombor

Vangeli

West

et al. 2017

Journal of Substance Use

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Background: Understanding how people transition between phases of not making a quit attempt to stopping smoking successfully is important in order to optimize interventions. This study aimed to explore differences in attitudes towards smoking and quitting among smokers and ex-smokers. Methods: Adult (age 18 and over) successful (n = 8), unsuccessful (n = 8) and never quitters (n = 7) were recruited through stop-smoking services in England. Semi-structured interviews were conducted and data were analysed using framework analysis. Results: Seven themes (starting to smoke, positive appraisal of smoking, responsibility for past/current smoking, negative effects of smoking, reasons to quit, process of quitting, and identity) were identified in all groups. Sub-group differences were explored and used to derive six typologies with descriptive characteristics: committed smokers, aware smokers, forced attempters, struggling attempters, pragmatic ex-smokers, and committed non-smokers. Using these typologies and the smallest number of differentiating factors between them (awareness of negative effects, motivation to stop and acceptance of responsibility), a parsimonious model of progression towards smoking cessation was developed. Conclusions: Awareness of negative effects, motivation and, crucially, a sense of commitment for taking responsibility to take actions towards behavior change may be important for whether smokers attempt to quit and progress to a successful quit attempt.

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Section: Discussionmentioning

confidence: 74%

Section: Methodsmentioning

confidence: 99%

Progression towards smoking cessation: Qualitative analysis of successful, unsuccessful, and never quitters

Tombor

Vangeli

West

et al. 2017

Journal of Substance Use

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“…Consequently, after cessation, urges to smoke should be lower and this makes cessation more likely to be successful. 13 Aside from this addiction-based mechanism, three other mediational hypotheses have been advanced for the mechanism of action of preloading. The first relates to medication adherence, which some evidence suggests is poor in smoking cessation.…”

Section: Mechanisms Of Action Of Preloadingmentioning

confidence: 99%

Nicotine preloading for smoking cessation: the Preloading RCT

Aveyard

Lindson

Tearne

et al. 2018

Health Technol Assess

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BackgroundNicotine preloading means using nicotine replacement therapy prior to a quit date while smoking normally. The aim is to reduce the drive to smoke, thereby reducing cravings for smoking after quit day, which are the main cause of early relapse. A prior systematic review showed inconclusive and heterogeneous evidence that preloading was effective and little evidence of the mechanism of action, with no cost-effectiveness data.ObjectivesTo assess (1) the effectiveness, safety and tolerability of nicotine preloading in a routine NHS setting relative to usual care, (2) the mechanisms of the action of preloading and (3) the cost-effectiveness of preloading.DesignOpen-label randomised controlled trial with examination of mediation and a cost-effectiveness analysis.SettingNHS smoking cessation clinics.ParticipantsPeople seeking help to stop smoking.InterventionsNicotine preloading comprised wearing a 21 mg/24 hour nicotine patch for 4 weeks prior to quit date. In addition, minimal behavioural support was provided to explain the intervention rationale and to support adherence. In the comparator group, participants received equivalent behavioural support. Randomisation was stratified by centre and concealed from investigators.Main outcome measuresThe primary outcome was 6-month prolonged abstinence assessed using the Russell Standard. The secondary outcomes were 4-week and 12-month abstinence. Adverse events (AEs) were assessed from baseline to 1 week after quit day. In a planned analysis, we adjusted for the use of varenicline (Champix®; Pfizer Inc., New York, NY, USA) as post-cessation medication. Cost-effectiveness analysis took a health-service perspective. The within-trial analysis assessed health-service costs during the 13 months of trial enrolment relative to the previous 6 months comparing trial arms. The base case was based on multiple imputation for missing cost data. We modelled long-term health outcomes of smoking-related diseases using the European-study on Quantifying Utility of Investment in Protection from Tobacco (EQUIPT) model.ResultsIn total, 1792 people were eligible and were enrolled in the study, with 893 randomised to the control group and 899 randomised to the intervention group. In the intervention group, 49 (5.5%) people discontinued preloading prematurely and most others used it daily. The primary outcome, biochemically validated 6-month abstinence, was achieved by 157 (17.5%) people in the intervention group and 129 (14.4%) people in the control group, a difference of 3.02 percentage points [95% confidence interval (CI) –0.37 to 6.41 percentage points; odds ratio (OR) 1.25, 95% CI 0.97 to 1.62;p = 0.081]. Adjusted for use of post-quit day varenicline, the OR was 1.34 (95% CI 1.03 to 1.73;p = 0.028). Secondary abstinence outcomes were similar. The OR for the occurrence of serious AEs was 1.12 (95% CI 0.42 to 3.03). Moderate-severity nausea occurred in an additional 4% of the preloading group compared with the control group. There was evidence that reduced urges to smoke and reduced smoke inhalation mediated the effect of preloading on abstinence. The incremental cost-effectiveness ratio at the 6-month follow-up for preloading relative to control was £710 (95% CI –£13,674 to £23,205), but preloading was dominant at 12 months and in the long term, with an 80% probability that it is cost saving.LimitationsThe open-label design could partially account for the mediation results. Outcome assessment could not be blinded but was biochemically verified.ConclusionsUse of nicotine-patch preloading for 4 weeks prior to attempting to stop smoking can increase the proportion of people who stop successfully, but its benefit is undermined because it reduces the use of varenicline after preloading. If this latter effect could be overcome, then nicotine preloading appears to improve health and reduce health-service costs in the long term. Future work should determine how to ensure that people using nicotine preloading opt to use varenicline as cessation medication.Trial registrationCurrent Controlled Trials ISRCTN33031001.FundingThis project was funded by the NIHR Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 22, No. 41. See the NIHR Journals Library website for further project information.

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“…A supportive family is considered the strongest source of identity and social support among all contextual relationships (Beattie, 2001) and hence is associated with better prognosis during alcoholism treatment. The family Systems Theory (Minuchin, 1974) has perhaps put forward the strongest support for the role of patterns and processes of communication in psychopathology (L'Abate, 1998; West, 2006). The family is conceptualized as a dynamic system that changes over time whereby individual members have a considerable degree of "circularity of influence" on each other (Nichols & Schwartz, 2006) and that the individual suffering from a maladaptive behavior is an 'identified patient' representing the level of disturbance or dysfunctionality in the family (Goldenberg & Goldenberg, 2000).…”

Section: Introductionmentioning

confidence: 99%

Family Expressed Emotion In Relapse of Alcoholism

Githae¹,

Njango²

2016

IOSR

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Abstract:-Alcoholism is a family illness that requires treatment of the whole family, because recovery after rehabilitation seems mostly achievable when both the individual and their family are involved in relapse prevention. While studies have demonstrated that the family plays an important role from the diagnosis to treatment of alcoholism, few studies have focused on the interpersonal dynamics of family members which would maintain alcoholism relatedbehaviors and lead to relapse. Such interpersonal dynamics include the family emotional expression (EE) and how it may relate to relapse of an individual dependent on alcohol. The relationship between family EE and the occurrence of relapse in alcoholism was examined. The study was underpinned by the Family Systems Theory to help understand how complex interactional patterns among family members were likely to maintainmaladaptive behaviors such as alcoholism. Samples were derived from populations of inpatient individuals that were addicted to alcohol (N=186) and their family members in Nairobi, Kenya. The study found out that EE had a predictive value R 2 = .348 and was statistically significant at p=0.000<0.05. While hostility was found to have an inverse relationship with relapse (β=-.133), criticism was found to predict relapse at R 2 =.282 and over-involvement at R 2 =.471%. The study concluded that high levels of family EE were a significant in predicting relapse of an individual dependent on alcohol during the recovery process.

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Theory of Addiction

Cited by 383 publications

References 0 publications

Progression towards smoking cessation: Qualitative analysis of successful, unsuccessful, and never quitters

Progression towards smoking cessation: Qualitative analysis of successful, unsuccessful, and never quitters

Nicotine preloading for smoking cessation: the Preloading RCT

Family Expressed Emotion In Relapse of Alcoholism

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