Imaginal Retraining Reduces Craving for Tobacco in 1-Year Controlled Follow-Up Study

TY - JOUR

T1 - Imaginal Retraining Reduces Craving for Tobacco in 1-Year Controlled Follow-Up Study

AU - Gehlenborg, Josefine

AU - Göritz, Anja S.

AU - Moritz, Steffen

AU - Lüdtke, Thies

AU - Kühn, Simone

N1 - Funding Information: J.G. received research grants from the German statutory accident insurance (DGUV) and was employed in a research project funded by the European Union (ERC-2016-StG-Self-Control-677804) at the time of the study. S.M. received research grants from the DGUV and the German social organization Aktion Mensch. T.L. received funding from the Arctic University of Norway as a PhD student. A.G. has no conflict of interest to declare. S.K. received funding from the European Union (ERC-2016-StG-Self-Control-677804), the Max Planck Society, the German Science Foundation (TRR 169/C8, SFB 936/C7), and the Jacobs Foundation. The imaginal retraining technique was developed by S.M. and S.K. Funding Information: The study was funded by the European Union (ERC-2016-StG-Self-Control-677804) and overhead sources. Publisher Copyright: © 2021

PY - 2022

Y1 - 2022

N2 - INTRODUCTION: Imaginal retraining is a self-help technique that adapts the principles of approach bias modification to the imagination. Imaginal retraining has been shown to reduce craving and addictive behaviours in 3 randomized controlled trials (RCTs) on problematic alcohol consumption, overweight, and tobacco use. To date, there have been no studies evaluating the long-term efficacy of the intervention. The aim of the present study was to generate first hypotheses on the long-term efficacy of imaginal retraining in smokers in a controlled 1-year follow-up study.MATERIALS AND METHODS: We recontacted the 345 participants who had taken part in an RCT on imaginal retraining for smokers 1 year later. The survey was carried out online and assessed craving for tobacco (primary outcome), smoking behaviour, well-being, and subjective appraisal. Individuals who applied the technique at least once during the previous year were categorized as the training group, whereas participants who never performed the training were categorized as the no-training group. Data were analysed using linear mixed models (LMMs). The study was preregistered as DRKS00021044.RESULTS: The completion rate was 45.5%. Less than 40% used the intervention at least once in the previous 12 months. LMM analyses showed a significant reduction in craving for tobacco for the training compared to the no-training group after 1 year. No significant group differences emerged in smoking behaviour, depressive symptoms, or quality of life. Subjective appraisal of the intervention was favorable, similar to the initial study.CONCLUSION: The present study provides preliminary support for the long-term efficacy of imaginal retraining on craving for tobacco but not on smoking behaviour, highlighting the importance of multimodal treatment concepts in smoking cessation that target a variety of maintaining factors. Future studies need to investigate the long-term efficacy of the intervention in prospective RCTs that test alternative ways of conveying the technique to improve adherence.

AB - INTRODUCTION: Imaginal retraining is a self-help technique that adapts the principles of approach bias modification to the imagination. Imaginal retraining has been shown to reduce craving and addictive behaviours in 3 randomized controlled trials (RCTs) on problematic alcohol consumption, overweight, and tobacco use. To date, there have been no studies evaluating the long-term efficacy of the intervention. The aim of the present study was to generate first hypotheses on the long-term efficacy of imaginal retraining in smokers in a controlled 1-year follow-up study.MATERIALS AND METHODS: We recontacted the 345 participants who had taken part in an RCT on imaginal retraining for smokers 1 year later. The survey was carried out online and assessed craving for tobacco (primary outcome), smoking behaviour, well-being, and subjective appraisal. Individuals who applied the technique at least once during the previous year were categorized as the training group, whereas participants who never performed the training were categorized as the no-training group. Data were analysed using linear mixed models (LMMs). The study was preregistered as DRKS00021044.RESULTS: The completion rate was 45.5%. Less than 40% used the intervention at least once in the previous 12 months. LMM analyses showed a significant reduction in craving for tobacco for the training compared to the no-training group after 1 year. No significant group differences emerged in smoking behaviour, depressive symptoms, or quality of life. Subjective appraisal of the intervention was favorable, similar to the initial study.CONCLUSION: The present study provides preliminary support for the long-term efficacy of imaginal retraining on craving for tobacco but not on smoking behaviour, highlighting the importance of multimodal treatment concepts in smoking cessation that target a variety of maintaining factors. Future studies need to investigate the long-term efficacy of the intervention in prospective RCTs that test alternative ways of conveying the technique to improve adherence.

KW - Approach bias

KW - Craving

KW - Imaginal retraining

KW - Self-help

KW - Smoking

UR - http://www.scopus.com/inward/record.url?scp=85115931810&partnerID=8YFLogxK

U2 - 10.1159/000518678

DO - 10.1159/000518678

M3 - SCORING: Journal article

C2 - 34569480

AN - SCOPUS:85115931810

VL - 28

SP - 68

EP - 79

JO - EUR ADDICT RES

JF - EUR ADDICT RES

SN - 1022-6877

IS - 1

ER -