Colleagues and I have monitored the RCT literature for many years for policy-important findings, but this study launched in the 80s only recently crossed our radar: A large smoking-cessation RCT found sizable impacts on sustained quit rates & mortality over 14.5 years.

Program & Study Design:

  • The US Lung Health Study randomized 5,887 smokers with early COPD to treatment (T) vs control (C, usual care). T was an intensive 10-week smoking cessation program that included a strong physician message & 12 two-hour group sessions using behavior modification & nicotine gum.

  • Quitters in the T group also entered a 5-yr maintenance program that stressed coping skills. The program's total cost was roughly $3000 per person.

Findings:

  • The rate of biochemically-confirmed, sustained abstinence was 22% T vs 5% C at the 5y mark, & virtually unchanged over the next 6 yrs. At 14.5 yrs, all-cause mortality per 1000 person-years was 8.8 T vs. 10.4 C. These effects were all statistically significant.

Comment:

  • Based on careful review, this was a well-conducted RCT - e.g., low sample attrition, biochemical validation of smoking, & use of National Death Index to measure mortality for 98% of sample. Thanks to @jgitchell for sharing the study. Here's the 14.5y report.  

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