Predictors of long-term outcome of a smoking cessation programme in primary care.
BACKGROUND
It would be helpful for general practitioners to know which smokers are the most or the least likely to achieve long-term cessation, so that efforts in promoting lifestyle changes can be prioritised.


OBJECTIVE
To identify predictors of abstinence and assess effectiveness over a two-year follow-up of a smoking cessation programme in routine general practice.


METHODS
Quasi-experimental non-randomised controlled trial.


METHODS
Primary healthcare centres of the Basque Health Service, Spain.


METHODS
All smokers attending seven intervention (n = 1203) and three control (n = 565) practices during one year (from September 1995 to October 1996) were included. The associations between attempts to stop smoking, relapses, and sustained biochemically confirmed abstinence between 12 and 24 months' follow-up, with baseline characteristics and patients' preference with regard to three possible therapeutic options, were assessed by means of logistic regression and survival analyses.


RESULTS
Sustained abstinence was biochemically confirmed in 7.3% of smokers in the intervention practices (relative probability = 2.8, 95% confidence interval [CI] = 1.6 to 4.7; probability difference = 4.7%, 95% CI = 2.7% to 6.7%); in 5% of smokers who received advice and a handout (adjusted odds ratio [AOR] = 1.9, 95% CI = 1.0 to 3.4), in 16% who received advice, a handout and follow-up (AOR = 6.6, 95% CI = 2.9 to 14.6), and in 22% who received advice, a handout, follow-up and nicotine patches (AOR = 13.1, 95% CI = 6.6 to 25.9). Positive predictors included previous attempts to stop smoking (AOR = 1.8, 95% CI = 1.1 to 2.7), and age (for each 10 years AOR = 1.32, 95% CI = 1.13 to 1.44). The Fagerström nicotine dependence score was negatively associated (for each point AOR = 0.89, 95% CI = 0.82 to 0.97).


CONCLUSIONS
The intensity of the programme can be tailored to the probability of long-term cessation estimated by the statistical model including these predictors.
Grandes
Gonzalo
G
Unidad de Investigación de Atención Primaria Osakidetza, Luis Power 18, E-48014 Bilbao, Spain. grandesg@ap.osakidetza.net
Cortada
Josep M
JM
Arrazola
Arantza
A
Laka
Jon P
JP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D016001:Confidence Intervals; D018849:Controlled Clinical Trials as Topic; D005194:Family Practice / Q000379:methods; D006293:Health Promotion; D006801:Humans; D008016:Life Change Events; D008875:Middle Aged; D010349:Patient Compliance; D011237:Predictive Value of Tests; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology*; D013030:Spain