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Possenti I, Scala M, Lugo A, Clancy L, Keogan S, Gallus S. The effectiveness of Allen Carr's method for smoking cessation: A systematic review. Tob Prev Cessat 2023; 9:29. [PMID: 37780488 PMCID: PMC10540232 DOI: 10.18332/tpc/172314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/13/2023] [Accepted: 09/14/2023] [Indexed: 10/03/2023]
Abstract
INTRODUCTION Allen Carr's (AC) method is a pharmacotherapy-free approach to quit smoking that is delivered through seminars, online courses, or in the form of a book. It has gained popularity, but its effectiveness remains controversial due to a lack of scientific evidence. This systematic review aims to provide an updated overview of the current evidence on the effectiveness of the AC method. METHODS We conducted a systematic literature review of all epidemiological studies evaluating the effectiveness of the AC method for smoking cessation, published in PubMed/MEDLINE and Embase up to March 2023. RESULTS Among 34 original studies identified through the literature search, six met the inclusion criteria. These studies were published between 2006 and 2020, with sample sizes ranging from 92 to 620 participants. Of the six studies, two did not have a comparison group while four, including two randomized control led trials (RCT), had a comparison group. The included studies showed cessation rates for people who attended the seminars from 19% to 51%. An observational study found an odds ratio (OR) of abstinence for those attending AC single-session seminars of 6.52 (95% confidence interval, CI: 3.10-13.72) compared with controls with no treatment. One RCT found higher quit rates for AC single-session seminars compared with the online Irish National service (OR=2.26; 95% CI: 1.22-4.21). Another RCT reported no significant difference between AC single-session seminars and a specialist stopsmoking service. One single study on patients with head and neck disorders analyzed the effectiveness of reading the AC book, showing no significant results. CONCLUSIONS The AC seminar may be an effective intervention for smoking cessation. This approach deserves further RCTs with large sample sizes to strengthen the evidence. Scant data are available on the effectiveness of reading the AC book.
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Affiliation(s)
- Irene Possenti
- Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Marco Scala
- Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Alessandra Lugo
- Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Luke Clancy
- Tobacco Free Research Institute Ireland, Focas Institute, Dublin, Ireland
| | - Sheila Keogan
- Tobacco Free Research Institute Ireland, Focas Institute, Dublin, Ireland
| | - Silvano Gallus
- Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
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Di Prinzio RR, Bondanini G, De Falco F, Vinci MR, Camisa V, Santoro A, Arnesano G, Dalmasso G, Raponi M, Di Brino E, Cicchetti A, Magnavita N, Zaffina S. Feasibility of a Stop Smoking Program for Healthcare Workers in an Italian Hospital: Econometric Analysis in a Total Worker Health® Approach. Ann Glob Health 2023; 89:56. [PMID: 37663224 PMCID: PMC10473173 DOI: 10.5334/aogh.4153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/13/2023] [Indexed: 09/05/2023] Open
Abstract
Background Over 20% of healthcare workers (HCWs) are active smokers. Smoking is a targeted issue for workplace health promotion (WHP) programs. Objective Our study aims to evaluate the effectiveness of the Stop Smoking Promotion (SSP) intervention, a 6-hour training course for HCWs, which took place from May 2018 to July 2019. Methods We compared HCWs who successfully quit smoking (n = 15) to those who did not (n = 25) in terms of Sickness Absence Days (SADs). Moreover, we conducted an econometric analysis by calculating the return on investment and implementing a break-even analysis. Findings Among the 40 enrolled workers, a success rate of 37.5% was observed after a span of over two years from the SSP intervention (with nurses and physicians showed the best success rate). Overall, participants showed a noticeable absenteeism reduction after the SSP intervention, with a reduction rate of 85.0% in a one-year period. The estimated ROI for the hospital was 1.90, and the break-even point was 7.85. In other words, the organization nearly doubled its profit from the investment, and the success of at least eight participants balanced costs and profits. Conclusion Our pilot study confirms that WHP programs are simple and cost-saving tools which may help improve control over the smoking pandemic in healthcare settings.
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Affiliation(s)
- Reparata Rosa Di Prinzio
- Alta Scuola di Economia e Management dei Sistemi Sanitari (ALTEMS), Università Cattolica del Sacro Cuore, Rome, Italy
- Occupational Medicine Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Giorgia Bondanini
- Occupational Medicine Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
- Department of Human Science, European University of Rome, Italy
| | - Federica De Falco
- Occupational Medicine Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Maria Rosaria Vinci
- Occupational Medicine Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Vincenzo Camisa
- Occupational Medicine Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Annapaola Santoro
- Occupational Medicine Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Gabriele Arnesano
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | | | - Eugenio Di Brino
- Alta Scuola di Economia e Management dei Sistemi Sanitari (ALTEMS), Università Cattolica del Sacro Cuore, Rome, Italy
| | - Americo Cicchetti
- Alta Scuola di Economia e Management dei Sistemi Sanitari (ALTEMS), Università Cattolica del Sacro Cuore, Rome, Italy
| | - Nicola Magnavita
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Occupational Health Unit, Department of Woman, Child & Public Health, A. Gemelli Policlinic Foundation IRCCS, Rome, Italy
| | - Salvatore Zaffina
- Occupational Medicine Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
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Radaeli A, Nardin M, Azzolina D, Malerba M. Determinants of Smoking Status in a Sample of Outpatients Afferent to a Tertiary Referral Hospital. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214136. [PMID: 31717846 PMCID: PMC6862272 DOI: 10.3390/ijerph16214136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 10/25/2019] [Accepted: 10/26/2019] [Indexed: 11/16/2022]
Abstract
The identification of determinants of attempts to quit smoking and quitting smoking success is crucial for effective smoking prevention and/or cessation programs. Thus, here we have conducted a survey to determine the sociodemographic characteristics of tobacco use and the potential determinants of quitting smoking among a population of 140 subjects—101 smokers and 39 ex-smokers—referred to our clinic for respiratory diseases. Subject characteristics included demographic data, employment and education status, respiratory disease family history, smoking habits, life habits, diet, alcohol intake, and physical activity. In comparison with former smokers, active smokers were younger, lived with at least one smoking family member, and were more frequently exposed to passive smoke. They also displayed a higher coffee consumption, a higher frequency of in-between-meal snacks, and a lower chronic obstructive pulmonary disease (COPD) prevalence. In comparison with subjects who had never attempted to quit smoking, individuals who had attempted to quit smoking were younger, had a lower pack-year median, consumed a higher amount of coffee and alcohol, and conducted regular physical activity. Determinants of successful smoking cessation were older age, lower passive smoking exposure and daily coffee intake, and COPD diagnosis. Overall, our findings underscore the importance of health education in fostering successful smoking cessation in respiratory disease patients.
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Affiliation(s)
- Alessandro Radaeli
- ASST Spedali Civili di Brescia, Department of Emergency, University, 25123 Brescia, Italy;
| | - Matteo Nardin
- ASST Spedali Civili di Brescia, Department of Internal Medicine, 25123 Brescia, Italy;
| | - Danila Azzolina
- Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy;
| | - Mario Malerba
- Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy;
- Correspondence:
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Keogan S, Li S, Clancy L. Allen Carr's Easyway to Stop Smoking - A randomised clinical trial. Tob Control 2019; 28:414-419. [PMID: 30361322 PMCID: PMC6589447 DOI: 10.1136/tobaccocontrol-2018-054243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 08/17/2018] [Accepted: 08/28/2018] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To determine if Allen Carr's Easyway to Stop Smoking (AC) was superior to Quit.ie in a randomised clinical trial (RCT). SETTING Single centre, open RCT, general population based. PARTICIPANTS 300 adult smokers, 18 years plus, minimum 5 cigarettes daily, and English speaking. AC, 151 (females 44.4%) and Quit.ie, 149 (females 45.6%), mean age 44 years. outcomes for all 300 were analysed (intention-to-treat). Recruited through advertisement from July 2015 to February 2016. INTERVENTION Randomly assigned to AC (n=151) and Quit.ie (n=149), matched for age, sex and education. Block randomisation, enrolment and follow-up at 1, 3, 6 and 12 months. Primary aim was to determine if AC had higher quit rates than Quit.ie service at 3 months. Secondary aims: quit rates at 1, 6 and 12 months and analysis of associated factors including weight. AC consisted of a 5-hour seminar, in a group setting. Quit.ie is an online portal for smoking cessation. RESULTS AC had higher quit rates at 1, 3, 6 and 12 months. AC: 38%, (n=57), 27% (n=40), 23% (n=35), 22% (n=33) vs Quit.ie: 20% (n=30), 15% (n=22), 15% (n=23), 11% (n=17), respectively (all p values <0.05). Logistic regression AC vs Quit.ie, OR 2.26 (95% CI 1.22 to 4.21) p value=0.01. Weight gain 3.8 kg in AC vs 1.8 kg in Quit.ie (p value <0.05). CONCLUSIONS All AC quit rates were superior to Quit.ie, outcomes were comparable with established interventions. TRIAL REGISTRATION NUMBER ISRCTN12951013. Recruitment July 2015-February 2016.
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Affiliation(s)
- Sheila Keogan
- TobaccoFree Research Institute Ireland, Focas Research Institute, DIT, Dublin 8, Dublin, Ireland
| | - Shasha Li
- TobaccoFree Research Institute Ireland, Focas Research Institute, DIT, Dublin 8, Dublin, Ireland
| | - Luke Clancy
- TobaccoFree Research Institute Ireland, Focas Research Institute, DIT, Dublin 8, Dublin, Ireland
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Tobacco control: prevention and cessation in Europe. MEMO - MAGAZINE OF EUROPEAN MEDICAL ONCOLOGY 2019. [DOI: 10.1007/s12254-019-0485-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Are Single-session Smoking Cessation Groups a Feasible Option for Rural Australia? – Outcomes From a Pilot Study. J Smok Cessat 2015. [DOI: 10.1017/jsc.2014.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Introduction: Single-session group smoking cessation interventions have received little attention in the literature.Aims: This study aimed to test the feasibility and outcomes of a single-session large group smoking cessation intervention in a rural area of New South Wales.Methods: Participants from a smoking cessation course (N = 42) were asked about cigarette consumption, quit attempts, and readiness and confidence to quit at registration and six months. The two-hour intervention occurred in a group setting and comprised of cognitive behaviour therapy and pharmacotherapy advice.Results: The analysis revealed a 26.2% (N = 11) quit rate based on self-report and/or carbon monoxide validation at 6 months (intention to treat). Those who quit all used pharmacotherapy: eight (73%) Nicotine Replacement Therapy (NRT); two (18%) varenicline and one (9%) bupropion with NRT. Seven people (17%) used medicines to reduce consumption of cigarettes. A paired samples t test of those still smoking showed a statistically significant decrease in the numbers of cigarettes smoked per day (p<.001).Conclusion: The quit rate of 26.2% from this large single-session smoking cessation course is comparable to that expected from groups having multiple sessions. As a pilot study, these data suggest that a multi-faceted single-session two-hour smoking cessation intervention can successfully support quit attempts in a rural location.
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Dijkstra A, Zuidema R, Vos D, van Kalken M. The effectiveness of the Allen Carr smoking cessation training in companies tested in a quasi-experimental design. BMC Public Health 2014; 14:952. [PMID: 25218267 PMCID: PMC4189200 DOI: 10.1186/1471-2458-14-952] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 09/08/2014] [Indexed: 11/23/2022] Open
Abstract
Background The Allen Carr training (ACt) is a popular one-session smoking cessation group training that is provided by licensed organizations that have the permission to use the Allen Carr method. However, few data are available on the effectiveness of the training. Methods In a quasi-experimental design the effects of the existing practice of providing the ACt to smokers (n = 124) in companies on abstinence, were compared to changes in abstinence in a cohort of similar smokers in the general population (n = 161). To increase comparability of the smokers in both conditions, smokers in the control condition were matched on the group level on baseline characteristics (fourteen variables) to the smokers in the ACt. The main outcome measure was self-reported continuous abstinence after 13 months, which was validated using a CO measurement in the Act condition. Results Logistic regression analyses showed that when baseline characteristics were comparable, significantly more responding smokers were continuously abstinent in the ACt condition compared to the control condition, Exp(B) = 6.52 (41.1% and 9.6%, respectively). The all-cases analysis was also significant, Exp(B) = 5.09 (31.5% and 8.3%, respectively). Conclusion Smokers following the ACt in their company were about 6 times more likely to be abstinent, assessed after 13 months, compared to similar smokers in the general population. Although smokers in both conditions did not differ significantly on 14 variables that might be related to cessation success, the quasi-experimental design allows no definite conclusion about the effectiveness of the ACt. Still, these data support the provision of the ACt in companies.
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Affiliation(s)
- Arie Dijkstra
- University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands.
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Holahan CJ, North RJ, Holahan CK, Hayes RB, Powers DA, Ockene JK. Social influences on smoking in middle-aged and older women. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2012; 26:519-26. [PMID: 22004130 PMCID: PMC8237531 DOI: 10.1037/a0025843] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The purpose of this study was to examine the role of 2 types of social influence--general social support and living with a smoker--on smoking behavior among middle-aged and older women in the Women's Health Initiative (WHI) Observational Study. Participants were postmenopausal women who reported smoking at some time in their lives (N=37,027), who were an average age of 63.3 years at baseline. Analyses used multiple logistic regression and controlled for age, educational level, and ethnicity. In cross-sectional analyses, social support was associated with a lower likelihood and living with a smoker was associated with a higher likelihood of being a current smoker and, among smokers, of being a heavier smoker. Moreover, in prospective analyses among baseline smokers, social support predicted a higher likelihood and living with a smoker predicted a lower likelihood of smoking cessation 1-year later. Further, in prospective analyses among former smokers who were not smoking at baseline, social support predicted a lower likelihood and living with a smoker predicted a higher likelihood of smoking relapse 1-year later. Overall, the present results indicate that social influences are important correlates of smoking status, smoking level, smoking cessation, and smoking relapse among middle-aged and older women.
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Affiliation(s)
- Charles J Holahan
- Department of Psychology, University of Texas at Austin, Austin, TX 78712, USA.
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[The Fetal Tobacco Syndrome - A statement of the Austrian Societies for General- and Family Medicine (ÖGAM), Gynecology and Obstetrics (ÖGGG), Hygiene, Microbiology and Preventive Medicine (ÖGHMP), Pediatrics and Adolescence Medicine (ÖGKJ) as well as Pneumology (ÖGP)]. Wien Klin Wochenschr 2011; 124:129-45. [PMID: 22189489 DOI: 10.1007/s00508-011-0106-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Accepted: 11/13/2011] [Indexed: 10/14/2022]
Abstract
Over more than 50 years, the nocuous effects of smoking in pregnancy on the fetus are well known. In the first years of science the focus was primarily on restricted fetal growth while in more recent years over 10.000 studies investigated the incomparably big sum of detrimental effects for the unborn's health. In this statement we want to present the recent scientific findings on this topic. The statement is aimed to show all doctors who treat pregnant women the present situation and evidence. In the beginning we give a short overview about the epidemiological situation in Europe. Then we present step by step the health effects with regards to pathophysiology and clinics. Furthermore the reader will learn about possibilities for smoking cessation in pregnancy. The problem of passive-smoking in pregnancy will be dealt with in a separate chapter. At present there is strong evidence that pregnant smoking has a detrimental effect on birth-weight, placenta-associated disease, stillbirth, sudden infant death syndrome (SIDS), childhood overweight, clefts, lung function, asthma, cardiovascular diseases and mental developmental disorders. These factors can be summarized by the term Fetal Tobacco Syndrome. There is supply for more studies for less investigated health effects. Pregnancy is a chance to stop smoking as most women show a high motivation in this period. Hence doctors of all disciplines should inform pregnant women about the detrimental effects of smoking on their unborn child and show them possibilities for smoking cessation.
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McDermott MS, Marteau TM, Hajek P. Effects of a Brief Cognitive Intervention Aimed at Communicating the Negative Reinforcement Explanation for Smoking on Relevant Cognitions and Urges to Smoke. J Smok Cessat 2011. [DOI: 10.1375/jsc.6.2.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AbstractIntroduction:The aim of the current study was to assess the impact of an intervention aimed at communicating the negative reinforcement explanation for smoking, a set of ideas derived from popular self-help books, upon participants' cognitions and urges to smoke. Methods: Smokers (n = 205) undergoing standard stop-smoking treatment were randomised to receive either the experimental intervention, a brief intervention aimed at communicating the explanation or a control intervention, a video on the health risks of smoking. Outcomes were participants' acceptance of the negative reinforcement explanation for smoking, positive outcome expectations for smoking, self-efficacy and urges to smoke reported at one week post-cessation. Results: Post-cessation urges to smoke were similar in the two groups (Adjusted expt. group mean = 2.50, Control group mean = 2.75, F(1,60) = 0.98, p = .33). Other cognitive measures were also unchanged. Conclusions: The brief cognitive intervention offered as an adjunct to standard care failed to reduce urges to smoke or alter smokers' cognitions. Changing smokers' cognitions may be as challenging as changing their behaviours. Suggestions are provided for further research.
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Mohamed MHN. Group-Based Behavioural Intervention for Smoking Cessation: Is it All in Their Heads? J Smok Cessat 2011. [DOI: 10.1375/jsc.6.1.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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[Smoking cessation therapies in Germany]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2010; 53:201-6. [PMID: 20033664 DOI: 10.1007/s00103-009-1008-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Reducing the consumption of tobacco products in Germany is a health objective that is achievable with smoking cessation treatments for smokers. This objective turns out to be more successful when using different interventions for smoking cessation than with self-initiated smoking cessation methods. This survey describes the range of smoking cessation treatments in Germany and evaluates them on the basis of international guidelines.
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Epidemiologic determinants affecting cigarette smoking cessation: a retrospective study in a National Health System (SSN) treatment service in Rome (Italy). JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2010; 2010:183206. [PMID: 20396671 PMCID: PMC2853854 DOI: 10.1155/2010/183206] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2009] [Accepted: 01/19/2010] [Indexed: 11/17/2022]
Abstract
This retrospective study aims to evaluate epidemiologic characteristics of patients attending stop smoking courses, based on group therapy, testing their influence on smoking cessation in univariate and multivariate model. A total of 123 patients were included in this study. Mean age was 53 (±11). Sixty-seven percent were women. At the end of the courses 66% of patients stopped smoking, after 12 months only 39% remained abstinent. Patients younger than 50 years statistically tended to continue smoking 6 months (P = .02–R.R. = 1.49, C.I. 95%: 1.06–2.44) and 12 months (P = .03–R.R. = 1.37, C.I. 95%: 1.02–2.52) after the end of the courses. A low self-confidence in quitting smoking was significantly related to continuing tobacco consumption after 6 months (P = .016–R.R. = 1.84, C.I. 95%: 1.14–2.99). Low adherence to therapeutic program was statistically associated to maintenance of tobacco use at 6 months (P = .006–R.R. = 1.76, C.I. 95%: 1.32–2.35) and 12 months (P = .050–R.R. = 1.45, C.I. 95%: 1.11–1.88). This association was confirmed at 6 months in the analysis performed on logistic regression model (P = .013).
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Sadr Azodi O, Lindström D, Adami J, Tønnesen H, Nåsell H, Gilljam H, Wladis A. The efficacy of a smoking cessation programme in patients undergoing elective surgery - a randomised clinical trial. Anaesthesia 2009; 64:259-65. [DOI: 10.1111/j.1365-2044.2008.05758.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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