Approach bias modification offers no added benefit to smoking cessation treatment

Cognitive-behavioural smoking cessation treatment (treatment as usual [TAU]) coupled with approach bias modification (ApBM) does not appear to be any better than TAU plus sham training or TAU only, a recent study has shown.

The intention-to-treat analyses revealed no significant differences in abstinence rates at 6 months among treatment groups: TAU plus ApBM (19.3 percent, 95 percent confidence interval [CI], 12.13‒26.53), TAU plus sham training (17.4 percent, 95 percent CI, 10.36‒24.42), and TAU only (16.2 percent, 95 percent CI, 9.46‒23.02).

“ApBM has been included in Australian and German alcohol use disorder treatment guidelines, but this randomized controlled trial shows that positive effects do not apply to tobacco use disorder,” the researchers said.

A total of 351 individuals were included in this randomized, controlled, double-blind, single-centre superiority trial. Participants received a 1-day TAU and were subsequently randomized to either TAU plus ApBM (n=119), TAU plus sham training (n=115), or TAU only (n=117). Training sessions were conducted over 7 days. Prolonged abstinence at 6-month follow-up was the primary outcome.

The researchers classified participants as either nonsmoking (continuous abstinence for 6 months, ≤5 cigarettes since quit attempt, and breath CO level ≤9 ppm) or relapsed (no objective verification of smoking status, breath CO level ≥10 ppm, >5 cigarettes since quit attempt).

“Smoking is associated with an approach bias toward smoking-related stimuli,” the researchers said. “ApBM, a computerized training specifically designed to modify this approach bias, has shown positive effects in patients with alcohol use disorder; however, its efficacy as an add-on in smoking cessation treatment is inconclusive.”