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2007, Number 1

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Arch Med Fam 2007; 9 (1)

Role of Intensive Counseling in Smoking Cessation. A Multicausal Prospective Study in the Primary Care Setting

Afek BS, Hekselman I, Segev D, Burstein E, Horesh I, Kahan E

Language: English
References: 29
Page: 21-29
PDF size: 113.35 Kb.


ABSTRACT

Background: Group counseling for tobacco dependence is based on behavior counseling with or without pharmacotherapy. Objective: To evaluate the success of three smoking cessation protocols in the primary care setup. Design: Prospective, nonrandomized natural experiment. Variables affecting successful outcome were evaluated by logistic analysis. Intervention: Eight sessions of behavioral therapy with or without nicotine replacement therapy and/or pharmacotherapy (bupropion SR) as per subject’s choice. Outcome Measures: Self-report of smoking cessation with validation by level of carbon monoxide in exhaled air. Results: Most of the patients were under 50 years old and otherwise healthy. More than 85% had smoked more than 20 cigarettes a day. Smoking cessation rates were 71.6% immediately after the program, 52.8% at 6 months, and 43% at one year. Participation in more group sessions was a positive predictor of success, and high Fagerström score was a negative predictor. There was no significant difference in outcome among the three groups. Conclusions: Group counseling in the primary care setting is an effective aid for patients who seek to quit smoking. Compliance with counseling is an important factor for success. Nicotine replacement and pharmacotherapy, either alone or combined, do not significantly increase the smoking cessation rate. Practice Implications: We recommend that physicians evaluate the level of addiction to smoking of patients referred to smoking cessation programs.


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