Abstinence rates and predictors of outcome for smoking cessation: do Brazilian smokers need special strategies?
OBJECTIVE
To study tobacco abstinence and risk factors for failure in smoking cessation program and to evaluate the need for special strategies in a Brazilian cohort of smokers.


METHODS
A non-randomized, prospective, open clinical trial.


METHODS
We studied smokers who attended the Smoking Cessation Clinics of Hospital Sao Lucas da PUCRS, in Porto Alegre, Brazil between July, 1999 and June, 2003. All participated in the same behavioral therapy program and, according to the Fagerstrom test, also received nicotine patches and/or bupropion. Sustained abstinence was confirmed by exhaled CO measurements </= 10 parts per million (p.p.m.). Quit rates were evaluated at 12 months. The study included 381 patients (62% women, mean age +/- SD 47.4 +/- 11.5 years).


RESULTS
Smokers treated with only counseling, counseling + NRT, counseling + bupropion, and counseling + bupropion + NRT had an abstinence rates at the end of 12 months of 14.5%, 25.4%, 22.8% and 38.5%, respectively (P < 0.001). The estimated success rate was 23.2% at 12 months. The likelihood of failure in smoking cessation at the end of 12 months increased with higher nicotine dependence (HR: 1.63; 95% CI: 1.13-2.35; P = 0.009). Failure occurred significantly less in those patients treated with counseling + NRT + bupropion (HR: 0.39; 95% CI: 0.24-0.63 P < 0.001).


CONCLUSIONS
The higher percentage of smoking cessation was achieved using multiple therapies (counseling + NRT + bupropion). The only significant predictor of failure detected was severe nicotine dependence.
Chatkin
José Miguel
JM
Hospital São Lucas da PUCRS, Porto Alegre, Brazil. jmchatkin@pucrs.br
Mariante de Abreu
Carolina
C
Haggsträm
Fábio Maraschin
FM
Wagner
Mário Bernardes
MB
Fritscher
Carlos Cezar
CC
D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil; D016642:Bupropion / Q000627:therapeutic use*; D003376:Counseling; D018765:Dopamine Uptake Inhibitors / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000627:therapeutic use; D010342:Patient Acceptance of Health Care; D011446:Prospective Studies; D012307:Risk Factors; D016540:Smoking Cessation / Q000379:methods*; D016896:Treatment Outcome
D018765:Dopamine Uptake Inhibitors; D016642:Bupropion; D009538:Nicotine