[Smoking cessation counseling center in a French hospital: Effectiveness at one year and predictors of outcome].
OBJECTIVE
To assess the effectiveness at 1 year of a hospital clinic providing individual management of persons seeking to stop smoking and the factors predictive of failure.


METHODS
This prospective descriptive study included smokers seeking assistance at this hospital clinic over a 1-year period. This analysis excludes persons with schizophrenia and those who came only to a first consultation. Treatment methods were those recommended by the 1998 consensus conference: nicotine substitutes or slow-release bupropion, depending on the level of nicotine dependence, cognitive-behavioral therapy appropriate for smoking in all cases, and the prescription before cessation of a selective serotonin re-uptake inhibitor (SSRI) for patients with anxiety or depressive disorders. Assessment was based on patients' self-report at 3 months, 6 months and 1 year.


RESULTS
Of 99 smokers who came for at least one consultation, 38 were excluded and 61 were considered in the analysis. At one year, 18 patients (29.5%) were still not smoking. Of the 43 patients who resumed smoking, 27 (63%) did so during the first three months after cessation. According to the multivariate analysis, only female sex (p = 0.0173) and early end to follow-up (p = 0.0023) were significantly associated with the risk of relapse at 1 year.


CONCLUSIONS
The study confirmed the usefulness of specialized medical support over a one-year period and highlighted the difficulties of smoking cessation for women, who appear to need a new not yet invented approach. The other standard factors predictive of failure were not observed, possibly because of either the broad prescription of SSRIs in cases of anxiety- or depression-related comorbidity or the statistical limitations associated with the population size.
de la Blanchardière
Arnaud
A
Service des maladies infectieuses, CHU Côte de Nacre, Caen (14). delablanchardiere-a@chu-caen.fr
Depieds
Dominique
D
Gueyffier
François
F
D000328:Adult; D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D016642:Bupropion / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009538:Nicotine / Q000008:administration & dosage; D017063:Outcome Assessment, Health Care; D010044:Outpatient Clinics, Hospital; D011446:Prospective Studies; D012008:Recurrence; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D012737:Sex Factors; D016540:Smoking Cessation / Q000379:methods*
D018687:Antidepressive Agents, Second-Generation; D016642:Bupropion; D009538:Nicotine; D017367:Selective Serotonin Reuptake Inhibitors