***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Tobacco use is the single most important preventable cause of death in military personnel . The purpose of this r and omized clinical trial was to evaluate the effectiveness of two behavioral interventions when added to nicotine-replacement therapy on smoking cessation .  The sample of 512 included 52 % active duty military , 29 % family , 11 % retirees , and 8 % Department of Defense civilians . There was a main effect of compliance at the end of the program ( EOP ) ; 69 % of those who attended 75 % of the classes were abstinent from tobacco ; regression analysis found the more intensive program to be twice as effective at EOP and at 3 months , an outcome not continued at 6 months . The longer , more intensive V and erbilt University Medical Center program was significantly more effective at helping the civilian portion of the population ( 85 % versus 60 % in the American Cancer Society program ) but not the active duty participants Subjects ( N = 139 ) were assigned to intensive behavioral or to low-contact smoking treatment and to 2-mg nicotine gum or to placebo gum in a 2 X 2 factorial design . The 2-mg gum produced higher abstinence rates than did the placebo . Subjects receiving the low-contact condition plus the 2-mg nicotine gum had excellent abstinence rates at both 26 weeks ( 56 % abstainers ) and 52 weeks ( 50 % abstainers ) . Smokers who scored at the median on a measure of physical dependence to nicotine were more likely to benefit by nicotine gum treatment than subjects who scored either higher or lower , but this relation was nonsignificant . The results of this study are compared with an earlier nonblind trial Sustained-release bupropion and nortriptyline have been shown to be effcacious in treating cigarette smoking . Psychological intervention is also recognized as efficacious . The cost and cost-effectiveness of the 2 drug therapies have not been estimated . It was hypothesized that nortriptyline would be more cost-effective than bupropion . Hypotheses were not originally proposed concerning the cost-effectiveness of psychological versus drug treatment , but the 2 were compared using exploratory analyses . This was a 3 ( bupropion versus nortriptyline versus placebo ) by 2 ( medical management alone versus medical management plus psychological intervention ) r and omized trial . Participants were 220 cigarette smokers . Outcome measures were cost and cost-effectiveness computed at week 52 .  Nortriptyline cost less than bupropion . Nortriptyline  was more cost-effective than bupropion ;  the difference was not statistically significant . Psychological intervention cost less than the 2 drug treatments , and was more cost-effective , but not significantly so . Prospect i ve investigations of the cost and cost-effectiveness of psychological and pharmacological intervention , using adequate sample sizes , are warranted Objective - To compare the effectiveness of two different stop smoking interventions . Design - A r and omised , controlled trial . Results based on intention to treat . Setting - Three towns in the south-eastern part of Norway . Interventions - Visits to GP for " practice as usual " ( GP group ) or participation in the behavioural programme SmokEnders ( SE group ) with follow-up 2 weeks , 2 months and 1 year after an agreed stopping date . Subjects - 139 smokers recruited through open invitation . Main outcome measure - Self-reported smoking stop rate 2 weeks , 2 months and 1 year after an agreed stopping date , completed with biochemical indicators by the 1-year registration . Results ? Two weeks after the agreed cessation date , 10/70 ( 14 % ) of the GP group and 46/69 ( 67 % ) of the SE group had stopped smoking . After 2 months , 9/70 ( 13 % ) in the GP group and 37/69 ( 54 % ) in the SE group were non-smokers . One year after cessation 5/70 ( 7 % ) in the GP group and 21/69 ( 30 % ) in the SE group were non-smokers . Conclusions ? Both interventions were effective as measured by the smoking cessation rate . However , the intervention in the SE group was considerably more effective than in the GP group , which suffered from a sizeable number of drop-outs BACKGROUND Sustained-release bupropion hydrochloride and nortriptyline hydrochloride have been shown to be efficacious in the treatment of cigarette smoking . It is not known whether psychological intervention increases the efficacy of these antidepressants . This study compared both drugs with placebo . It also examined the efficacy of these 2 drugs and placebo with and without psychological intervention . METHODS This was a 2 ( medical management vs psychological intervention ) x 3 ( bupropion vs nortriptyline vs placebo ) r and omized trial . Participants were 220 cigarette smokers . Outcome measures were biologically verified abstinence from cigarettes at weeks 12 , 24 , 36 , and 52 . RESULTS Psychological intervention produced higher 7-day point-prevalence rates of biochemically verified abstinence than did medical management alone . With the use of point-prevalence abstinence , both nortriptyline and bupropion were more efficacious than placebo . On rates of 1-year continuous abstinence , the 2 drugs did not differ from each other or from placebo . Psychological intervention did not differ from medical management alone on rates of 1-year continuous abstinence . CONCLUSIONS Both nortriptyline and bupropion are efficacious in producing abstinence in cigarette smokers . Similarly , psychological intervention produces better abstinence rates than simple medical management . Both drugs , and psychological intervention , have limited efficacy in producing sustained abstinence . The data also suggest that combined psychological intervention and antidepressant drug treatment may not be more effective than antidepressant drug treatment alone Following an initial smoking program , 33 subjects were r and omly assigned to one of four maintenance strategy conditions developed to investigate the Marlatt and Gordon cognitive-behavioral model of relapse . Two out of three components of the model were supported . Abstinent subjects given problem solving training did not show significant relapse while those given an attention placebo control did relapse significantly . Self-efficacy expectations predicted smoking rate up to 5-month follow-up . Contrary to expectations based on the Marlatt and Gordon model , subjects taught to cope with the guilt and sense of personal failure associated with a relapse episode showed considerable relapse The present investigation assessed the effectiveness of nicotine fading as a non-aversive alternative to oversmoking . Subjects ( 66 women and 64 men ) were r and omly assigned to  oversmoking , nicotine fading , nicotine fading/smokeholding , and a nonmaintenance control . Results failed to indicate the expected superiority of nicotine fading/maintenance over the control condition . Instead , the addition of smokeholding appeared to produce a significant incremental effect over nicotine fading alone . Unfortunately , 12-month follow-up revealed considerable relapse across conditions and no significant treatment effects . Even so , absolute outcome for nicotine fading/smokeholding was encouraging . This procedure is both safe and apparently very acceptable to subjects . If the current results can be replicated , a clinical ly effective technique will have been established with applicability in both clinic and self-help setting This study is a r and omized , double-blind , placebo-controlled clinical trial examining the effects of an intensive cognitive-behavioral mood management treatment ( CBTD ) and of bupropion , both singularly and in combination , on  smoking cessation in adult smokers . As an extension of our previous work , we planned to examine the synergistic effects of CBTD and bupropion on smoking cessation outcomes in general and among smokers with depression vulnerability factors . Participants were 524 smokers ( 47.5 % female , M ( age ) = 44.27 years ) who were r and omized to one of four 12-week treatments : ( a ) st and ard , cognitive-behavioral smoking cessation treatment ( ST ) plus bupropion ( BUP ) , ( b ) ST plus placebo ( PLAC ) , ( c ) st and ard cessation treatment combined with cognitive-behavioral treatment for depression ( CBTD ) plus BUP , and ( d ) CBTD plus PLAC . Follow-up assessment s were conducted 2 , 6 , and 12 months after treatment , and self-reported abstinence was verified biochemically . Consistent with previous studies , bupropion , in comparison with placebo , result ed in better smoking outcomes in both intensive group treatments . Adding CBTD to st and ard intensive group treatment did not result in improved smoking cessation outcomes . In addition , neither CBTD nor bupropion , either alone or in combination , was differentially effective for smokers with single-past-episode major depressive disorder ( MDD ) , recurrent MDD , or elevated depressive symptoms . However , findings with regard to recurrent MDD and elevated depressive symptoms should be interpreted with caution given the low rate of recurrent MDD and the low level of depressive symptoms in our sample . An a priori test of treatment effects in smokers with these depression vulnerability factors is warranted in future clinical trials This article describes the test of the hypothesis that a cognitive-behavioral mood management intervention would be effective for smokers with a history of major depressive disorder ( MDD ) . The method was r and omized trial ; the assessment s occurred at Weeks 0 , 8 , 12 , 26 , and 52 . Ss were 149 smokers ; 31 % had a history of MDD . All received 2 mg of nicotine gum . Mood management was provided in 10 group sessions over 8 weeks . St and ard treatment was provided in 5 group sessions over 8 weeks . Outcome was continuous abstinence . History-positive Ss were more likely to be abstinent when treated with mood management . Treatment condition differences were not significant for history-negative Ss . For history-positive Ss , less anger at baseline predicted abstinence . For history-negative Ss , more years smoked and higher baseline carbon monoxide ( CO ) predicted abstinence .  Cognitive-behavioral therapy did not affect mood after quitting . Abstinence predictors differed as a function of baseline diagnosis Abstract The role of aversive conditioning in rapid smoking was examined by r and omly assigning smokers to one of three  aversive treatments  design ed to induce three distinct levels of central malaise . These treatments ,  full-scale rapid smoking ( FS ; n = 22 ) , truncated rapid smoking ( TC : n = 20 ) and  rapid puffing  ( RP ; n = 20 ) were combined with a full-scale counseling package . A fourth treatment ,  full-scale rapid smoking with reduced counseling ( RC ; n = 20 ) , was included to evaluate the contribution of coping response training to rapid-smoking efficacy . Among post-treatment measures of aversion , only heart rate ( HR ) response to cigarettes discriminated groups , with FS Ss exhibiting an apparent conditioned cardiac acceleration to cigarettes . Six-month follow-up data revealed that both the type of counseling and level of aversion had an impact on cigarette abstinence . At 6-months post-treatment , the FS group produced the best outcome , while the TC group and the RC group had the worst outcomes . The RP group was intermediate to these groups . Regression analysis showed that across all groups , confidence ratings of remaining abstinent were most predictive of outcome whereas within the two full-scale rapid-smoking treatments , post-treatment HR response to cigarettes was most predictive of latency to relapse . The results were discussed with respect to the contributions of aversion conditioning and full counseling to the success of aversive treatment packages for smoking cessation BACKGROUND New training programs need to be developed to help Chinese smokers achieve quitting . The objective of this study was to assess the effectiveness of a group smoking cessation intervention based on social cognitive theory among Chinese smokers . METHOD A total of 225 smokers were eligible for the study and were r and omly assigned to an intervention group ( n=118 ) and a control group ( n=107 ) . The intervention group received the course soon after a baseline survey , whereas the control group received routine training in the first 6 months , and then took the same course .  Effectiveness was evaluated at 6-month and 1-year follow-up from baseline . RESULTS After 6 months , 40.5 % ( 47/116 ) in the intervention group and 5.0 % ( 5/101 ) in the control group quit smoking ( absolute risk reduction : 35.5 % [ 95 % confidence interval ( CI ) : 24.2 - 46.8 % ] ) . The 6-month continuous abstinence rate was 28.4 % ( 33/116 ) in the intervention group and 3.0 % ( 3/101 ) in the control group ( absolute risk reduction 25.4 % [ 95 % CI : 15.6 - 35.2 % ] ) . At 1-year follow-up , the proportion of quitting and the 6-month abstinence rate in the intervention group were 35.8 % and 22.0 % , respectively . The factors associated with smoking cessation during the 6 month period were intervention ( adjusted odds ratio [OR]=6.42 [ 95 % CI : 2.46 - 13.28 ] ) , as well as anticipation of quitting ( adjusted OR=1.46 [ 95 % CI : 1.12 - 1.91 ] ) and skill self-efficacy score in the baseline ( adjusted OR=1.04 [ 95 % CI : 1.01 -  
    Output:
    
There was no evidence that group therapy was more effective than a similar intensity of individual counselling .
There was variation in the extent to which those offered group therapy accepted the treatment .
There was limited evidence that programmes which included components for increasing cognitive and behavioural skills and avoiding relapse were more effective than same length or shorter programmes without these components .
We did not find an effect of manipulating the social interactions between participants in a group programme on outcome .
AUTHORS ' CONCLUSIONS Group therapy is better for helping people stop smoking than self help , and other less intensive interventions .
There is not enough evidence to evaluate whether groups are more effective , or cost-effective , than intensive individual counselling .
There is not enough evidence to support the use of particular psychological components in a programme beyond the support and skills training normally included