PURPOSE: To evaluate the rates of and factors related to smoking cessation in our intensive behavior interventions program (IBI) combined with free medications.
METHODS: We evaluated consecutive smokers and offered IBI by a multidisciplinary team (pulmonary physician, psycologists and respiratory therapist) in group sessions (weekly x 4; then biweekly x 4 and monthly x 9). The choice of medications (bupropion, nicotine-patches, nicote-gums or combination) depended on the Fagerstrom’s test (FT) score, the strategy for cessation (gradual or abrupt) and the presence of comorbidities. The rates of reported abstinence and predictors of abstinence at 1 and 3-months by multivariate logistic regression (MLR) are presented.
RESULTS: 350 patients were evaluated in 20 months. The FT-score was 0-4 in 26%, 5-7 in 43% and 8-10 in 31%. The IBI was started by 75%; 88% of the patients used medications and 71% completed at least 3-months of treatment. Patients with higher FT-scores were more likely to start IBI, 68% (0-4), 72% (5-7) and 84% (8-10), p=0.02. Abstinence rate was 57% (150/262) in 1-month, 81% (150/185) in 3-months and 77% (72/94) in 6-months. In 1-month, the abstinence rate was higher for those using medications, 63% vs. 19% (p< 0.0001), attending to 3-4 vs. 1-2 sessions, 63% vs. 34% (p< 0.0001), and for men, 65% vs. 53% (although not significantly). Factors independently associated with abstinence in 1-month were: use of medication, OR 4.8 (95%CI 2.1-11.1), attendance to 3-4 sessions, OR 2.2 (95%CI 1.1-4.4), and FT-score, OR 0.8 (95%CI 0.7-0.9). Gender, age, history of previous cessation attempt, and alcohol abuse did not interfere. Predictors of abstinence in 3-months were attendance to ≥8 sessions, OR 3.4 (95%CI 1.4-8.2) and use of medication at least for the 1st month, OR 3.0 (95%CI 2.0-4.8).
CONCLUSION: In our program, patients receiving IBI combined with free medications had high rates of smoking abstinence at 1, 3 and 6-months.
CLINICAL IMPLICATIONS: Programs combining IBI with medications can be effective for smoking cessation despite moderate to high nicotine-dependence and presence of comorbidities.
DISCLOSURE: Ana Thereza Rocha, Consultant fee, speaker bureau, advisory committee, etc. I am a speaker for Pfizer.; No Product/Research Disclosure Information