Factors associated with abstinence and efficacy of a smoking cessation program
Keywords:
TOBACCO, TOBACCO USE DISORDER, STOP THE USE OF TOBACCO
Abstract
Smoking is the first cause of evitable mortality and morbility in Occident.
Objective: to assess the efficacy of a smoking cessation program and associated risk factors.
Methods: the Program accounted for 517 people, 357 attended at least two sessions. Sex, age, marital status, education level, associated diseases, familial smoking environment, previous attempts of smoking cessation, smoking history and dependence assessment using the Fagerström scale were evaluated.
An 8-week multicomponent program was conducted: a cognitive behavior based, a pharmacist based (bupropion or other nicotinic replacement) and group therapy managed.
Abstinence was verified by exhaled carbon monoxide levels.
Results: the population of the program, aged from 20 and 77 years (mean age 50,58 ± 11,24), were 61,1% women, 82,9% had had previous attempts to stop smoking, smokers of 44,22 ± 26,30 pack/year, mean age of first smoking 17,93 ± 3,65 years, smoking 28,38 ± 13,45 cigarettes/day, dependence by Fagerström was 5,99 ± 2,12, 89,4% were under pharmacological treatment; 113 participants (31,6%) stopped smoking over a year. A smaller rate of smoking cessation is associated with women, higher dependence by Fagerström, and continued smoking in the initial weeks and at three months.
Conclusions: the program reached smoking cessation rates of 31,6% a year, similar to published data of other centers, efficacy is related to sex, nicotine dependence and early cessation, at the begining of the program.
References
(1) A clinical practice guideline for treating tobacco use and dependence: A US Public Health Service report. The Tobacco Use and Dependence Clinical Practice Guideline Panel, Staff and Consortium Representatives. JAMA 2000; 283(24): 3244-54.
(2) Fiore MC, Bailey WC, Cohen SF, Dorfman SF, Goldstein MG, Gritz ER, et al. Treating Tobacco Use and Dependence: Clinical Practice Guidelines; Rockville, Md: US Department of Health and Human Services. Public Health Service, June 2000.
(3) MacKay JL, Eriksen M. The Tobacco Atlas 2002. Ginebra: WHO, 2002. 17 p.
(4) Schroeder S. What to do with a patient who smokes. JAMA 2005; 294(4): 482-7.
(5) World Health Organization. Guidelines for controlling and monitoring The Tobacco Epidemic, Ginebra: WHO, 1998.
(6) Esteves E, Goja B, Blanco A, González J. Servicios de salud con humo de tabaco: OXIMORON médico, ético y social. Montevideo: Proyecto Ambientes Libres de Humo de Tabaco. OPS, 2004. 80 p.
(7) Tobacco Control Report. Tobacco or Health in the European Union. Past, Present and Future. European Commission, October 2004. Belgium. Disponible en: http://www.ersnet.org. (consulta: 6 mar. 2006).
(8) Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years’ observations on male British doctors. BMJ 2004; 328(7455): 1519-28.
(9) Uruguay. Ministerio de Salud Pública. Estadísticas vitales: Mortalidad 2003. Disponible en: http//www.msp.gub.uy. (consulta: 6 mar 2006).
(10) Junta Nacional de Drogas (Uruguay); PNUD. 3ª Encuesta Nacional de Prevalencia de Consumo de Drogas. Montevideo: JND, 2001.
(11) Muiño A, López Varela MV, Menezes AM. Prevalencia de la enfermedad obstructiva crónica y sus principales factores de riesgo: Proyecto PLATINO en Montevideo. Rev Med Urug 2005; 21: 37- 48.
(12) García M, Schiaffino A, Twose J, Borrell C, Saltó E, Peris M, et al. Abandono del consumo de tabaco en una cohorte de base poblacional. Arch Bronconeumol 2004; 40: 348-54.
(13) Fagerström KO, Schneider NG. Measuring nicotine dependence: a review of the Fagerström tolerance nicotine questionnaire. J Behav Med 1989; 12: 159-82.
(14) Fung P, Snape-Jenkinso S, Godfrey M, Love K, Zimmerman P, Yang I, et al. Effectiveness of Hospital-Based Smoking Cessation. Chest 2005; 128: 216-23.
(15) Nerín I, Guillén D, Crucelaegui M, González A, Barranco I, San Juan S, et al. Evaluación del éxito del tratamiento multicomponente en la deshabituación tabáquica. Arch Bronconeumol 2001; 37(S): 58.
(16) Sansores R, Córdoba M, Espinosa M, Herrera L, Ramírez A, Martínez LA, et al. Evaluación de un programa cognitivo-conductual para dejar de fumar del Instituto Nacional de Enfermedades Respiratorias. Rev Inst Nal Enf Resp 1998; 11: 29-35.
(17) Jorenby D, Leischow S, Nides M, Rennard S, Johnston J, Hughes A, et al. A controlled trial of sustained-release bupropion, a nicotine patch, or both for smoking cessation. N Engl J Med 1999; 340: 685-91.
(18) Anthonisen N, Conté j, Kiley J, Altose M, Bailey W, Buist S, et al. Effects of smoking intervention and use of an inhaled anticholinergic bronchodilator on the rate of decline of FEV1. The Lung Health Study. JAMA 1994; 272: 1497-541
(19) Anthonisen N, Connet J, Murray R. For the Lung Study Research Group. Smoking and Lung Function of Lung Health Participants after 11 years. Am J Respir Crit Care Med 2002; 166: 675-9.
(20) Lancaster T, Stead LF. Individual behavioural counselling for smoking cessation (Cochrane Review). Cochrane Database Systematic Reviews 2005; 2: CD001292.
(21) Stead LF, Lancaster T. Group behaviour therapy programs for smoking cessation. (Cochrane Review). Cochrane Database Systematic Reviews 2005; 2: CD001007.
(22) West R, McNeill A, Raw M. Smoking cessation guidelines for health professionals: an update. Thorax 2000; 55: 987- 99.
(23) Roddy Elin. Bupropion and other non-nicotine pharmacotherapies. BMJ 2004; 328: 509-11.
(24) Molyneux A. Nicotine replacement therapy. BMJ 2004; 328: 454-6.
(25) Silagy C, Mant D, Fowler G, Lancaster T. Nicotine replacement therapy for smoking cessation. Cochrane Database Systematic Reviews 2000 (2): CD000146.
(26) Antidepressants for smoking cessation. Cochrane Database Systematic Reviews 2003; (3): CD00031.
(27) Camps X, Frascheri M, Buroni C. Análisis del funcionamiento de un programa de cesación de tabaquismo. Rev Urug Cardiol 2005; 20: 16-20.
(28) Goja B, Esteves E, Barros M, Blanco L, Benia W, Parodi C, et al. Caracterización de la población asistida en la Policlínica de Tabaquismo del Hospital de Clínicas y resultados del tratamiento. 2000.2003. Clínica Médica A. Hospital de Clínicas. Facultad de Medicina. Arch Med Interna (Montevideo) 2005; 27(4): 83-8.
(29) Janson C, Künzli N, de Marco R, Chinn S, Jarvis D, Svanes C, et al. Changes in active and passive smoking in the European Community Respiratory Health Survey. Eur Respir J 2006; 27: 517-24.
(30) Xu X, Li B, Wang L. Gender differences in smoking effects on adults pulmonary function. Eur Respir J 1994; 7: 477-83.
(31) Prescott E, Bjerg AM, Andersen PK, Lange P, Vestbo J. Gender differences in smoking effects on lung function and risk of hospitalization for COPD: results from a Danish longitudinal population study. Eur Respir J 1994; 10: 822-7.
(32) Tanoue LT. Cigarette smoking and Women’s Respiratory Health. Clin Chest Med 2000; 21: 47-65.
(33) Cox JL. Smoking Cessation in the elderly patient. Clin Chest Med 1993; 14(3): 423- 8.
(34) Gorecka D, Bednarek M, Nowinswki A, Puscinska E, Goljan-Gerenek A, Zielinski J. Diagnosis of airflow limitation combined with smoking cessation advice increases stop smoking rate. Chest 2003; 123: 1916-23.
(35) Ferguson JA, Patten CA, Schroeder DR, Offord KP, Eberman KM, Hurt RD. Predictors of 6 month tobacco abstinence among 1224 cigarette smokers treated for nicotine dependence. Addict Behav 2003; 28: 1203-18.
(36) Hymowitz N, Cummings M, Hyland A, Lynn W, Pechacecek T, Hartwell T. Predictors of smoking cessation in a cohort of adult smokers followed for five years. Tobacco Control 1997; 6(S): S57-S62.
(37) Chandola T, Head J, Bartley M. Sociodemographic predictors of quitting smoking: how important are household factors? Addiction 2004; 99: 770.
(38) Torrecilla M, Barrueco MJ, Hernández M, Jiménez C, Maderuelo J, Plaza M. Intervención mínima: factores predictores de abstinencia tabáquica a los 12 meses de la intervención. Arch Bronconeumol 2001; 37(S): 59.
(2) Fiore MC, Bailey WC, Cohen SF, Dorfman SF, Goldstein MG, Gritz ER, et al. Treating Tobacco Use and Dependence: Clinical Practice Guidelines; Rockville, Md: US Department of Health and Human Services. Public Health Service, June 2000.
(3) MacKay JL, Eriksen M. The Tobacco Atlas 2002. Ginebra: WHO, 2002. 17 p.
(4) Schroeder S. What to do with a patient who smokes. JAMA 2005; 294(4): 482-7.
(5) World Health Organization. Guidelines for controlling and monitoring The Tobacco Epidemic, Ginebra: WHO, 1998.
(6) Esteves E, Goja B, Blanco A, González J. Servicios de salud con humo de tabaco: OXIMORON médico, ético y social. Montevideo: Proyecto Ambientes Libres de Humo de Tabaco. OPS, 2004. 80 p.
(7) Tobacco Control Report. Tobacco or Health in the European Union. Past, Present and Future. European Commission, October 2004. Belgium. Disponible en: http://www.ersnet.org. (consulta: 6 mar. 2006).
(8) Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years’ observations on male British doctors. BMJ 2004; 328(7455): 1519-28.
(9) Uruguay. Ministerio de Salud Pública. Estadísticas vitales: Mortalidad 2003. Disponible en: http//www.msp.gub.uy. (consulta: 6 mar 2006).
(10) Junta Nacional de Drogas (Uruguay); PNUD. 3ª Encuesta Nacional de Prevalencia de Consumo de Drogas. Montevideo: JND, 2001.
(11) Muiño A, López Varela MV, Menezes AM. Prevalencia de la enfermedad obstructiva crónica y sus principales factores de riesgo: Proyecto PLATINO en Montevideo. Rev Med Urug 2005; 21: 37- 48.
(12) García M, Schiaffino A, Twose J, Borrell C, Saltó E, Peris M, et al. Abandono del consumo de tabaco en una cohorte de base poblacional. Arch Bronconeumol 2004; 40: 348-54.
(13) Fagerström KO, Schneider NG. Measuring nicotine dependence: a review of the Fagerström tolerance nicotine questionnaire. J Behav Med 1989; 12: 159-82.
(14) Fung P, Snape-Jenkinso S, Godfrey M, Love K, Zimmerman P, Yang I, et al. Effectiveness of Hospital-Based Smoking Cessation. Chest 2005; 128: 216-23.
(15) Nerín I, Guillén D, Crucelaegui M, González A, Barranco I, San Juan S, et al. Evaluación del éxito del tratamiento multicomponente en la deshabituación tabáquica. Arch Bronconeumol 2001; 37(S): 58.
(16) Sansores R, Córdoba M, Espinosa M, Herrera L, Ramírez A, Martínez LA, et al. Evaluación de un programa cognitivo-conductual para dejar de fumar del Instituto Nacional de Enfermedades Respiratorias. Rev Inst Nal Enf Resp 1998; 11: 29-35.
(17) Jorenby D, Leischow S, Nides M, Rennard S, Johnston J, Hughes A, et al. A controlled trial of sustained-release bupropion, a nicotine patch, or both for smoking cessation. N Engl J Med 1999; 340: 685-91.
(18) Anthonisen N, Conté j, Kiley J, Altose M, Bailey W, Buist S, et al. Effects of smoking intervention and use of an inhaled anticholinergic bronchodilator on the rate of decline of FEV1. The Lung Health Study. JAMA 1994; 272: 1497-541
(19) Anthonisen N, Connet J, Murray R. For the Lung Study Research Group. Smoking and Lung Function of Lung Health Participants after 11 years. Am J Respir Crit Care Med 2002; 166: 675-9.
(20) Lancaster T, Stead LF. Individual behavioural counselling for smoking cessation (Cochrane Review). Cochrane Database Systematic Reviews 2005; 2: CD001292.
(21) Stead LF, Lancaster T. Group behaviour therapy programs for smoking cessation. (Cochrane Review). Cochrane Database Systematic Reviews 2005; 2: CD001007.
(22) West R, McNeill A, Raw M. Smoking cessation guidelines for health professionals: an update. Thorax 2000; 55: 987- 99.
(23) Roddy Elin. Bupropion and other non-nicotine pharmacotherapies. BMJ 2004; 328: 509-11.
(24) Molyneux A. Nicotine replacement therapy. BMJ 2004; 328: 454-6.
(25) Silagy C, Mant D, Fowler G, Lancaster T. Nicotine replacement therapy for smoking cessation. Cochrane Database Systematic Reviews 2000 (2): CD000146.
(26) Antidepressants for smoking cessation. Cochrane Database Systematic Reviews 2003; (3): CD00031.
(27) Camps X, Frascheri M, Buroni C. Análisis del funcionamiento de un programa de cesación de tabaquismo. Rev Urug Cardiol 2005; 20: 16-20.
(28) Goja B, Esteves E, Barros M, Blanco L, Benia W, Parodi C, et al. Caracterización de la población asistida en la Policlínica de Tabaquismo del Hospital de Clínicas y resultados del tratamiento. 2000.2003. Clínica Médica A. Hospital de Clínicas. Facultad de Medicina. Arch Med Interna (Montevideo) 2005; 27(4): 83-8.
(29) Janson C, Künzli N, de Marco R, Chinn S, Jarvis D, Svanes C, et al. Changes in active and passive smoking in the European Community Respiratory Health Survey. Eur Respir J 2006; 27: 517-24.
(30) Xu X, Li B, Wang L. Gender differences in smoking effects on adults pulmonary function. Eur Respir J 1994; 7: 477-83.
(31) Prescott E, Bjerg AM, Andersen PK, Lange P, Vestbo J. Gender differences in smoking effects on lung function and risk of hospitalization for COPD: results from a Danish longitudinal population study. Eur Respir J 1994; 10: 822-7.
(32) Tanoue LT. Cigarette smoking and Women’s Respiratory Health. Clin Chest Med 2000; 21: 47-65.
(33) Cox JL. Smoking Cessation in the elderly patient. Clin Chest Med 1993; 14(3): 423- 8.
(34) Gorecka D, Bednarek M, Nowinswki A, Puscinska E, Goljan-Gerenek A, Zielinski J. Diagnosis of airflow limitation combined with smoking cessation advice increases stop smoking rate. Chest 2003; 123: 1916-23.
(35) Ferguson JA, Patten CA, Schroeder DR, Offord KP, Eberman KM, Hurt RD. Predictors of 6 month tobacco abstinence among 1224 cigarette smokers treated for nicotine dependence. Addict Behav 2003; 28: 1203-18.
(36) Hymowitz N, Cummings M, Hyland A, Lynn W, Pechacecek T, Hartwell T. Predictors of smoking cessation in a cohort of adult smokers followed for five years. Tobacco Control 1997; 6(S): S57-S62.
(37) Chandola T, Head J, Bartley M. Sociodemographic predictors of quitting smoking: how important are household factors? Addiction 2004; 99: 770.
(38) Torrecilla M, Barrueco MJ, Hernández M, Jiménez C, Maderuelo J, Plaza M. Intervención mínima: factores predictores de abstinencia tabáquica a los 12 meses de la intervención. Arch Bronconeumol 2001; 37(S): 59.
Published
2007-03-31
How to Cite
1.
López Varela MV, Anido T, Rovira M, Goja B, Tubino M, Alfonso G, Vezoli M, Garateguy E, Bermúdez F, López Soto R. Factors associated with abstinence and efficacy of a smoking cessation program. Rev. Méd. Urug. [Internet]. 2007Mar.31 [cited 2024Nov.15];23(1):25-3. Available from: http://www2.rmu.org.uy/ojsrmu311/index.php/rmu/article/view/632
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Original Articles
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