A randomized controlled trial of web-based attentional bias modification to help smokers quit

I. Elfeddali, Hein de Vries, Catherine Bolman, Thomas Pronk, Reinout W. Wiers

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Objective: 

To assess the efficacy of a multiple-sessions Web-based Attentional Bias Modification (ABM) self-help intervention in 434 smokers who made a quit-attempt. 

Method: 

Respondents were randomized to receive 6 sessions of ABM- or placebo-training in a period of 2 weeks. Smoking-related cognitions (e.g., self-efficacy and intention to quit) and cognitive biases (i.e., attentional and approach bias) for smoking-cues were assessed before training (pretest). Primary outcome-variable was continued abstinence, 6 months after baseline. Bias reduction at the posttraining assessment was the secondary outcome. A 2 × 2 mixed analysis of variance (ANOVA) and logistic regression analyses were conducted using the whole sample (N = 434) as well as subsamples of light to moderate smokers (<15 cigarettes, N = 115) and heavy smokers (15 or more cigarettes, N = 319). Conservative analyses (coding drop-outs as smokers) as well as complete case analyses were conducted. 

Results: 

The ABM training had no significant effect regarding bias reduction and no behavioral effects in the whole sample of smokers. Subsample analyses revealed a significant positive effect on continued abstinence in heavy smokers only (complete case analyses: odds ratio [OR] = 3.15; p = .02; confidence interval [CI] = 1.24–7.99; conservative analyses: OR = 2.49; p = .02; CI = 1.13–5.48). 

Conclusion: 

Web-based ABM training is ineffective in fostering cognitive bias reduction and continued smoking abstinence. However, the positive effects in heavy smokers—as indicated by exploratory subsample analyses—warrant further research into the potential of multiple sessions ABM training to foster continued smoking abstinence in heavy smokers who make a quit-attempt.

Original languageEnglish
Pages (from-to)870-880
JournalHealth Psychology
Volume35
Issue number8
DOIs
Publication statusPublished - 2016

Keywords

  • smoking cessation
  • relapse prevention
  • attentional bias modification
  • implicit cognitive processes
  • SOCIAL ANXIETY DISORDER
  • AUTOMATIC ACTION TENDENCIES
  • OF-THE-LITERATURE
  • HEAVY DRINKERS
  • ALCOHOL CUES
  • EXPERIMENTAL MANIPULATION
  • SELECTIVE ATTENTION
  • ADDICTIVE BEHAVIORS
  • SMOKING-CESSATION
  • CIGARETTE SMOKERS

Cite this

Elfeddali, I. ; de Vries, Hein ; Bolman, Catherine ; Pronk, Thomas ; Wiers, Reinout W. / A randomized controlled trial of web-based attentional bias modification to help smokers quit. In: Health Psychology. 2016 ; Vol. 35, No. 8. pp. 870-880.
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abstract = "Objective: To assess the efficacy of a multiple-sessions Web-based Attentional Bias Modification (ABM) self-help intervention in 434 smokers who made a quit-attempt. Method: Respondents were randomized to receive 6 sessions of ABM- or placebo-training in a period of 2 weeks. Smoking-related cognitions (e.g., self-efficacy and intention to quit) and cognitive biases (i.e., attentional and approach bias) for smoking-cues were assessed before training (pretest). Primary outcome-variable was continued abstinence, 6 months after baseline. Bias reduction at the posttraining assessment was the secondary outcome. A 2 × 2 mixed analysis of variance (ANOVA) and logistic regression analyses were conducted using the whole sample (N = 434) as well as subsamples of light to moderate smokers (<15 cigarettes, N = 115) and heavy smokers (15 or more cigarettes, N = 319). Conservative analyses (coding drop-outs as smokers) as well as complete case analyses were conducted. Results: The ABM training had no significant effect regarding bias reduction and no behavioral effects in the whole sample of smokers. Subsample analyses revealed a significant positive effect on continued abstinence in heavy smokers only (complete case analyses: odds ratio [OR] = 3.15; p = .02; confidence interval [CI] = 1.24–7.99; conservative analyses: OR = 2.49; p = .02; CI = 1.13–5.48). Conclusion: Web-based ABM training is ineffective in fostering cognitive bias reduction and continued smoking abstinence. However, the positive effects in heavy smokers—as indicated by exploratory subsample analyses—warrant further research into the potential of multiple sessions ABM training to foster continued smoking abstinence in heavy smokers who make a quit-attempt.",
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A randomized controlled trial of web-based attentional bias modification to help smokers quit. / Elfeddali, I.; de Vries, Hein; Bolman, Catherine; Pronk, Thomas; Wiers, Reinout W.

In: Health Psychology, Vol. 35, No. 8, 2016, p. 870-880.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - A randomized controlled trial of web-based attentional bias modification to help smokers quit

AU - Elfeddali, I.

AU - de Vries, Hein

AU - Bolman, Catherine

AU - Pronk, Thomas

AU - Wiers, Reinout W.

PY - 2016

Y1 - 2016

N2 - Objective: To assess the efficacy of a multiple-sessions Web-based Attentional Bias Modification (ABM) self-help intervention in 434 smokers who made a quit-attempt. Method: Respondents were randomized to receive 6 sessions of ABM- or placebo-training in a period of 2 weeks. Smoking-related cognitions (e.g., self-efficacy and intention to quit) and cognitive biases (i.e., attentional and approach bias) for smoking-cues were assessed before training (pretest). Primary outcome-variable was continued abstinence, 6 months after baseline. Bias reduction at the posttraining assessment was the secondary outcome. A 2 × 2 mixed analysis of variance (ANOVA) and logistic regression analyses were conducted using the whole sample (N = 434) as well as subsamples of light to moderate smokers (<15 cigarettes, N = 115) and heavy smokers (15 or more cigarettes, N = 319). Conservative analyses (coding drop-outs as smokers) as well as complete case analyses were conducted. Results: The ABM training had no significant effect regarding bias reduction and no behavioral effects in the whole sample of smokers. Subsample analyses revealed a significant positive effect on continued abstinence in heavy smokers only (complete case analyses: odds ratio [OR] = 3.15; p = .02; confidence interval [CI] = 1.24–7.99; conservative analyses: OR = 2.49; p = .02; CI = 1.13–5.48). Conclusion: Web-based ABM training is ineffective in fostering cognitive bias reduction and continued smoking abstinence. However, the positive effects in heavy smokers—as indicated by exploratory subsample analyses—warrant further research into the potential of multiple sessions ABM training to foster continued smoking abstinence in heavy smokers who make a quit-attempt.

AB - Objective: To assess the efficacy of a multiple-sessions Web-based Attentional Bias Modification (ABM) self-help intervention in 434 smokers who made a quit-attempt. Method: Respondents were randomized to receive 6 sessions of ABM- or placebo-training in a period of 2 weeks. Smoking-related cognitions (e.g., self-efficacy and intention to quit) and cognitive biases (i.e., attentional and approach bias) for smoking-cues were assessed before training (pretest). Primary outcome-variable was continued abstinence, 6 months after baseline. Bias reduction at the posttraining assessment was the secondary outcome. A 2 × 2 mixed analysis of variance (ANOVA) and logistic regression analyses were conducted using the whole sample (N = 434) as well as subsamples of light to moderate smokers (<15 cigarettes, N = 115) and heavy smokers (15 or more cigarettes, N = 319). Conservative analyses (coding drop-outs as smokers) as well as complete case analyses were conducted. Results: The ABM training had no significant effect regarding bias reduction and no behavioral effects in the whole sample of smokers. Subsample analyses revealed a significant positive effect on continued abstinence in heavy smokers only (complete case analyses: odds ratio [OR] = 3.15; p = .02; confidence interval [CI] = 1.24–7.99; conservative analyses: OR = 2.49; p = .02; CI = 1.13–5.48). Conclusion: Web-based ABM training is ineffective in fostering cognitive bias reduction and continued smoking abstinence. However, the positive effects in heavy smokers—as indicated by exploratory subsample analyses—warrant further research into the potential of multiple sessions ABM training to foster continued smoking abstinence in heavy smokers who make a quit-attempt.

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KW - relapse prevention

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KW - implicit cognitive processes

KW - SOCIAL ANXIETY DISORDER

KW - AUTOMATIC ACTION TENDENCIES

KW - OF-THE-LITERATURE

KW - HEAVY DRINKERS

KW - ALCOHOL CUES

KW - EXPERIMENTAL MANIPULATION

KW - SELECTIVE ATTENTION

KW - ADDICTIVE BEHAVIORS

KW - SMOKING-CESSATION

KW - CIGARETTE SMOKERS

U2 - 10.1037/hea0000346

DO - 10.1037/hea0000346

M3 - Article

VL - 35

SP - 870

EP - 880

JO - Health Psychology

JF - Health Psychology

SN - 0278-6133

IS - 8

ER -