Predictors of Success at 6-Month Follow up for Smokers Treated at a Smoking Cessation Clinic

Impediment Profiling for Smoking Cessation: Application in the Worksite

Purpose.

To replicate results of a pilot smoking cessation study and demonstrate applicability to a worksite setting.

Methods.

Smokers employed by a community hospital participated in an onsite smoking cessation program. Participants used an “impediment profiling” instrument to rate personal barriers to cessation and were assigned to between one and seven interventions. Cessation was defined as carbon monoxide concentration in expired air of ≤ 10 ppm.

Results.

Fifty-one employees participated. Subjects lost to follow-up were assumed to be smoking, resulting in a 39.2% 1-year quit rate; 47.5% of program completers (n = 40) were smoke-free at 1 year. Self-reported quit rate at 2.5 years was 25.5% (17 lost to attrition assumed to be smoking) with 38.2% of program completers smoke-free.

Discussion.

This study suggests that impediment profiling holds promise for smoking cessation and demonstrates feasibility in a worksite setting. Further evaluation of this intervention in the context of randomized controlled trials is warranted.

Results of a specific smoking cessation program for patients with arthritis in a rheumatology clinic

The purpose of this study is to evaluate an intervention program in smoker patients. We selected consecutive active smoker patients with rheumatoid arthritis, spondyloarthritis, or connective tissue diseases. The intervention consisted of the following: (1) a baseline visit, which included verbal and written advice by the rheumatologist, emphasizing the practical benefits of smoking cessation. Patients completed a questionnaire that included smoking dependence tests and previous attempts to quit. (2) A follow-up visit to the nurse in the 3rd month for reinforcement and the receiving of pharmacological treatment to help patients quit smoking. The primary outcome was total abstinence in the last 7 days of a phone interview at 3, 6, and 12 months. The secondary outcome was a reduction in cigarette consumption by at least 50%. A total of 945 patients were screened. About 185 (19.5%) were current smokers, and 152 were included for intervention. In the previous 5 years, the mean annual withdrawal rate was 4.6%. The smoking cessation rate was 11.8, 14.4, and 15.7% at 3, 6, and 12 months (OR compared with previous cessation rate 3.8 (CI 95% 1.8-8.1)). Twenty-nine patients (19%) reduced ≥50% of the cigarette consumption at 12 months. The linear regression analysis showed that a score of less dependence (p = 0.03) and previous attempts to quit smoking (p = 0.04) were significantly associated with definitive smoking cessation at 12 months. One out of six patients quit smoking with the aid of an educational program which included verbal and written advice by the rheumatologist and the nurse. As far as we know, this is the first interventional study in smoker patients with arthritis.

Predictors of success at six-month follow-up at a public smoking cessation clinic in South Korea

INTRODUCTION

Our objective was to identify the factors related to returning to smoking by analyzing data obtained from a smoking cessation clinic.

METHODS

We analyzed data from 2,089 subjects (age 44.0 ± 12.9 years) who started a smoking cessation program between 16 July 2007 and 31 December 2008 in a community health center in the city of Ulsan. We analyzed demographic information and clinical variables using Kaplan-Meier survival analysis and calculated the hazard ratio for returning to smoking.

RESULTS

Mean abstinence time differed according to the following factors: sex, past attempts to quit, employment status, type of health insurance, CO levels, results from Fagerstrom test for nicotine dependence (FTND), number of cigarettes smoked daily, use of a nicotine replacement, and number of contacts in the program. Using multivariate analysis, we identified negative relationships between treatment intensity and hazard ratio for the following: visits ≤4 (Exp(B) = 3.752, P < 0.001, reference: 5 visits ≤), telephone contacts ≤5 (Exp(B) = 10.528, P < 0.001, reference: 6 calls ≤) and SMS ≤ 20 (Exp(B) = 3.821, P < 0.001 in 0-10 group; Exp(B) = 1.407, P = 0.003 for the 11-20 group; reference: 21 messages ≤).

DISCUSSION

Type of insurance, baseline CO, FTND level, and intensity of smoking cessation intervention positively affects outcomes in a smoking cessation clinic. A cost-effectiveness study on the intensity of interventions in smoking cessation clinics is needed.

Stop smoking clinics in Malaysia: characteristics of attendees and predictors of success

INTRODUCTION

As Stop Smoking Clinics (SSCs) become more common across the globe, it is important to know how far one can make broad generalisations concerning characteristics of smokers who attend these clinics and factors that predict their success. This involves accumulation of data from different countries.

OBJECTIVE

The aim of this study was to identify characteristics of smokers and factors leading up to quitting with clinics in Malaysia.

METHOD

Records from 629 smokers who had sought help from five selected SSCs in Malaysia from January 2006 to June 2007 were analysed.

RESULTS

The characteristics of smokers attending Malaysian smoking clinics were broadly similar to those in Western countries. Consistent with the findings from other countries, older age and longest duration of previous quit attempts were associated with successful smoking cessation. Greater baseline carbon-monoxide readings (OR 0.96, 95% CI 0.93-0.99; p=0.013), but not Fagerstrom Test for Nicotine Dependence (FTND), predicted failure to quit at six-month in multivariate analysis. Success rates varied greatly between clinics even after adjusting for all other predictors.

CONCLUSION

In these rare data from a non-Western culture some predictors of successful smoking cessation appeared to generalise from Western smokers but the universal validity of the FTND in particular needs to be examined further.