Comparative evaluation of cognitive behavioral therapy and regular health education in reducing nicotine dependence among cigarette smokers: A randomized controlled trial

Introduction: It is important to introspect if the methods used in tobacco cessation counseling are effective in achieving abstinence and reducing nicotine dependence among tobacco users. The objective of this study was to evaluate the effectiveness of cognitive behavioral therapy (CBT) at tobacco cessation clinics in a teaching dental institution in reducing nicotine dependence among dental patients with the habit of cigarette smoking in comparison to regular health education to quit tobacco. Materials and Methods: This prospective, randomized controlled trial was conducted in a teaching dental institution in the state of Andhra Pradesh. 160 self-reported current cigarette smokers with no tobacco chewing habits participated in the study. 80 each were assigned to the intervention group and control group where CBT for cessation of cigarette smoking and regular health education to quit smoking were provided, respectively. Data relating to frequency of cigarette smoking and nicotine dependence scores using Fagerstrom nicotine dependence scale were collected at baseline. Both the groups were followed up for 4 months in two-monthly intervals. IBM SPSS version 20 software was used for data analysis. Results: While there was no significant difference in the mean nicotine dependence score between the study groups at baseline, a statistically significant difference was observed between the groups at follow up visits. Repeated measures analysis of variance revealed significant reduction in nicotine dependence scores with time in the intervention group (P = 0.004), whereas the differences in the control group between different study time points were not significant (P = 0.39). It was also observed that the frequency of cigarette smoking reduced significantly between the baseline and follow-up visits in the intervention group (Cochran's Q-test; P = 0.028). Conclusion: The findings of this study provide an insight into the fact that CBT as tobacco cessation counseling technique is effective in reducing nicotine dependence among subjects seeking oral health care.