期刊论文详细信息
BMC Public Health
Long-term follow-up of a high- and a low-intensity smoking cessation intervention in a dental setting– a randomized trial
Ásgeir R Helgason5  Per Tillgren3  Åke Tegelberg2  John Öhrvik1  Eva Nohlert4 
[1] Department of Medicine, Karolinska Institutet, Stockholm, Sweden;Faculty of Odontology, Malmö University, Malmö, Sweden;School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden;Centre for Clinical Research, Uppsala University, Västerås, Sweden;Reykjavik University, Reykjavik, Iceland
关键词: Questionnaire;    Health care;    Public health;    Treatment intensity;    Tobacco cessation;   
Others  :  1162090
DOI  :  10.1186/1471-2458-13-592
 received in 2012-11-29, accepted in 2013-06-11,  发布年份 2013
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【 摘 要 】

Background

Achieving lifelong tobacco abstinence is an important public health goal. Most studies use 1-year follow-ups, but little is known about how good these are as proxies for long-term and life-long abstinence. Also, intervention intensity is an important issue for development of efficient and cost-effective cessation treatment protocols.

The study aims were to assess the long-term effectiveness of a high- and a low-intensity treatment (HIT and LIT) for smoking cessation and to analyze to what extent 12-month abstinence predicted long-term abstinence.

Methods

300 smokers attending dental or general health care were randomly assigned to HIT or LIT at the public dental clinic. Main outcome measures were self-reported point prevalence, continuous abstinence (≥6 months), and sustained abstinence. The study was a follow-up after 5–8 years of a previously performed 12-month follow-up, both by postal questionnaires.

Results

Response rate was 85% (n=241) of those still alive and living in Sweden. Abstinence rates were 8% higher in both programs at the long-term than at the 12-month follow-up. The difference of 7% between HIT and LIT had not change, being 31% vs. 24% for point prevalence and 26% vs. 19% for 6-month continuous abstinence, respectively. Significantly more participants in HIT (12%) than in LIT (5%) had been sustained abstinent (p=0.03). Logistic regression analyses showed that abstinence at 12-month follow-up was a strong predictor for abstinence at long-term follow-up.

Conclusions

Abstinence at 12-month follow-up is a good predictor for long-term abstinence. The difference in outcome between HIT and LIT for smoking cessation remains at least 5–8 years after the intervention.

Trial registration number

NCT00670514

【 授权许可】

   
2013 Nohlert et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]WHO: WHO report on the global tobacco epidemic, 2011. Geneva: World Health Organization (WHO); 2011.
  • [2]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.
  • [3]Anthonisen NR, Skeans MA, Wise RA, Manfreda J, Kanner RE, Connett JE: The effects of a smoking cessation intervention on 14.5-year mortality: a randomized clinical trial. Ann Intern Med 2005, 142(4):233-239.
  • [4]Pirie K, Peto R, Reeves GK, Green J, Beral V: The 21st century hazards of smoking and benefits of stopping: a prospective study of one million women in the UK. UK: Lancet; 2012.
  • [5]Surgeon General: The Health Benefits of Smoking Cessation In A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services; 1990.
  • [6]Fiore MC, Jaén CR, Baker TB, Bailey WC, Benowitz NL, Curry SJ, Faith Dorfman S, Froelicher ES, Goldstein MG, Healton CG, et al.: Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD, U.S: Department of Health and Human Service. Public Health Service; 2008.
  • [7]Carr AB, Ebbert J: Interventions for tobacco cessation in the dental setting. Cochrane Database Syst Rev 2012., 6CD005084
  • [8]Kahende JW, Loomis BR, Adhikari B, Marshall L: A review of economic evaluations of tobacco control programs. Int J Environ Res Public Health 2009, 6(1):51-68.
  • [9]Nohlert E, Helgason AR, Tillgren P, Tegelberg A, Johansson P: Comparison of the cost-effectiveness of a high- and a low-intensity smoking cessation intervention in Sweden: a randomized trial. Nicotine Tob Res 2013. Epub 2013/02/14
  • [10]Parrott S, Godfrey C, Raw M, West R, McNeill A: Guidance for commissioners on the cost effectiveness of smoking cessation interventions. Health Educational Authority. Thorax 1998, 53:1-38. Suppl 5 Pt 2
  • [11]Stead LF, Perera R, Bullen C, Mant D, Lancaster T: Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev 2008., 1CD000146
  • [12]Alpert HR, Connolly GN, Biener L: A prospective cohort study challenging the effectiveness of population-based medical intervention for smoking cessation. Tob Control 2013, 22(1):32-37.
  • [13]Etter JF, Laszlo E: Postintervention effect of nicotine replacement therapy for smoking reduction: a randomized trial with a 5-year follow-up. J Clin Psychopharmacol 2007, 27(2):151-155.
  • [14]Helgason AR, Tomson T, Lund KE, Galanti R, Ahnve S, Gilljam H: Factors related to abstinence in a telephone helpline for smoking cessation. Eur J Public Health 2004, 14(3):306-310.
  • [15]West R, Zhou X: Is nicotine replacement therapy for smoking cessation effective in the "real world"? Findings from a prospective multinational cohort study. Thorax 2007, 62(11):998-1002.
  • [16]Hyland A, Qiang L, Joseph B, Gary G, Steger C, Cummings M: Predictors of cessation in a cohort of current and former smokers followed over 13 years. Nicotine Tob Res 2004, 6(Supplement 3):363-369.
  • [17]Vangeli E, et al.: Predictors of attempts to stop smoking and their success in adult general population samples: a systematic review. Addiction 2011, 106(12):2110-2121.
  • [18]Hughes JR, Keely J, Naud S: Shape of the relapse curve and long-term abstinence among untreated smokers. Addiction 2004, 99(1):29-38.
  • [19]Hughes JR, Peters EN, Naud S: Relapse to smoking after 1 year of abstinence: a meta-analysis. Addict Behav 2008, 33(12):1516-1520.
  • [20]Wetter DW, Cofta-Gunn L, Fouladi RT, Cinciripini PM, Sui D, Gritz ER: Late relapse/sustained abstinence among former smokers: a longitudinal study. Prev Med 2004, 39(6):1156-1163.
  • [21]Etter JF, Stapleton JA: Nicotine replacement therapy for long-term smoking cessation: a meta-analysis. Tob Control 2006, 15(4):280-285.
  • [22]Lancaster T, Stead LF: Individual behavioural counselling for smoking cessation. Cochrane Database Syst Rev 2005., 2CD001292
  • [23]Stead LF, Bergson G, Lancaster T: Physician advice for smoking cessation. Cochrane Database Syst Rev 2008., 2CD000165
  • [24]Stead LF, Perera R, Lancaster T: Telephone counselling for smoking cessation. Cochrane Database Syst Rev 2006., 3CD002850
  • [25]FHI: Nationella folkhälsoenkäten [Swedish National Public Health Survey]. Östersund: Statens folkhälsoinstitut, FHI [Swedish National Institute of Public Health]; 2011.
  • [26]FHI: Tobak och avvänjning [Tobacco and weaning]. Östersund: Statens folkhälsoinstitut (FHI) [Swedish National Institute of Public Health]; 2009.
  • [27]Boldemann C, Gilljam H, Lund KE, Helgason AR: Smoking cessation in general practice: the effects of a quitline. Nicotine Tob Res 2006, 8(6):785-790.
  • [28]Nohlert E, Tegelberg A, Tillgren P, Johansson P, Rosenblad A, Helgason AR: Comparison of a high and a low intensity smoking cessation intervention in a dentistry setting in Sweden: a randomized trial. BMC Publ Health 2009, 9:121. BioMed Central Full Text
  • [29]Prochaska JO, DiClemente CC: Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol 1983, 51(3):390-395.
  • [30]Hosmer DW, Lemeshow S: Applied logistic regression. New York: Wiley; 1989.
  • [31]West R: The clinical significance of "small" effects of smoking cessation treatments. Addiction 2007, 102(4):506-509.
  • [32]Yudkin P, Hey K, Roberts S, Welch S, Murphy M, Walton R: Abstinence from smoking eight years after participation in randomised controlled trial of nicotine patch. BMJ 2003, 327(7405):28-29.
  • [33]Galanti M, Holm Ivarsson B, Helgason A, Gilljam H: Smoking cessation: gender on the agenda. Drugs: education, prevention and policy 2002, 9(1):71-84.
  • [34]Murray RP, Connett JE, Rand CS, Pan W, Anthonisen NR: Persistence of the effect of the Lung Health Study (LHS) smoking intervention over eleven years. Prev Med 2002, 35(4):314-319.
  • [35]Murray RP, Gerald LB, Lindgren PG, Connett JE, Rand CS, Anthonisen NR: Characteristics of participants who stop smoking and sustain abstinence for 1 and 5 years in the Lung Health Study. Prev Med 2000, 30(5):392-400.
  • [36]Blondal T, Gudmundsson LJ, Olafsdottir I, Gustavsson G, Westin A: Nicotine nasal spray with nicotine patch for smoking cessation: randomised trial with six year follow up. BMJ 1999, 318(7179):285-288.
  • [37]Socialstyrelsen: Befolkningens tandhälsa 2009 [The population´s oral health 2009] (in Swedish). Stockholm: Socialstyrelsen [The National Swedish Board of Health and Welfare]; 2010.
  • [38]Zhu SH, Stretch V, Balabanis M, Rosbrook B, Sadler G, Pierce JP: Telephone counseling for smoking cessation: effects of single-session and multiple-session interventions. J Consult Clin Psychol 1996, 64(1):202-211.
  • [39]Gilpin E, Pierce JP: Measuring smoking cessation: problems with recall in the 1990 California Tobacco Survey. Cancer Epidemiol Biomarkers Prev 1994, 3(7):613-617.
  • [40]Helgason AR, Dickman PW, Adolfsson J, Steineck G: Emotional isolation: prevalence and the effect on well-being among 50-80-year-old prostate cancer patients. Scand J Urol Nephrol 2001, 35(2):97-101.
  • [41]Alberg AJ, Patnaik JL, May JW, Hoffman SC, Gitchelle J, Comstock GW, Helzlsouer KJ: Nicotine replacement therapy use among a cohort of smokers. J Addict Dis 2005, 24(1):101-113.
  • [42]Fagerstrom K, Rutqvist LE, Hughes JR: Snus as a smoking cessation aid: a randomized placebo-controlled trial. Nicotine Tob Res 2012, 14(3):306-312.
  • [43]Lund KE, Scheffels J, McNeill A: The association between use of snus and quit rates for smoking: results from seven Norwegian cross-sectional studies. Addiction 2011, 106(1):162-167.
  • [44]Hung WT, Dunlop SM, Perez D, Cotter T: Use and perceived helpfulness of smoking cessation methods: results from a population survey of recent quitters. BMC Publ Health 2011, 11:592. BioMed Central Full Text
  • [45]Etter JF, Perneger T, Ronchi A: Distributions of smokers by stage: International comparison and association with smoking prevalence. Prev Med 1997, 26:580-585.
  • [46]Le Strat Y, Rehm J, Le Foll B: How generalisable to community samples are clinical trial results for treatment of nicotine dependence: a comparison of common eligibility criteria with respondents of a large representative general population survey. Tob Control 2011, 20(5):338-343.
  • [47]SRNT (Society for Research on Nicotine and Tobacco) Subcommittee on Biochemical Verification: Biochemical verification of tobacco use and cessation. Nicotine Tob Res 2002, 4(2):149-159.
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