Prospective determinants of smoking cessation in COPD patients within a high intensity or a brief counseling intervention.
OBJECTIVE
The aims of this study were to identify prospective determinants of smoking cessation in COPD patients, and to assess whether prospective determinants vary between two different cessation interventions.


METHODS
Two hundred and twenty-five moderate to severe COPD patients were randomly allocated to two smoking cessation interventions. One-year cotinine-validated continuous abstinence rates were 9% for the minimal intervention strategy for lung patients (LMIS) and 19% for the SmokeStopTherapy (SST). The baseline characteristics that showed a significant univariate relationship with 1-year continuous abstinence (p<.20) were included in the logistic regression model. This procedure was performed for each intervention separately. Variables that did not remain independent predictors were removed.


RESULTS
For the SST separately, no independent significant predictor remained. For the LMIS, attitude towards smoking cessation (OR: 11.8; 95% CI: 1.7-81.5; p=.013) and cotinine level (OR: 2.1; 95% CI: 1.08-3.93; p=.028) remained significant predictors. Within the LMIS, 31% of the variance in continuous abstinence was explained by these variables (p=.003).


CONCLUSIONS
This study suggests that a moderately intensive intervention (LMIS) is primarily suitable for COPD patients with a positive attitude regarding smoking cessation. The more intensive SST can be an alternative for patients without such baseline characteristic.


CONCLUSIONS
This stepped-care approach in smoking cessation counseling may be useful in clinical practice and will enable health care providers to match interventions to individual needs and increase efficiency.
Christenhusz
Lieke
L
University of Twente, Psychology & Communication of Health & Risk, Enschede, The Netherlands. l.c.a.christenhusz@utwente.nl
Pieterse
Marcel
M
Seydel
Erwin
E
van der Palen
Job
J
D000328:Adult; D000368:Aged; D016642:Bupropion / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003376:Counseling / Q000379:methods*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D015999:Multivariate Analysis; D009426:Netherlands; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000517:prevention & control / Q000523:psychology*; D012657:Self-Help Groups / Q000458:organization & administration; D016540:Smoking Cessation / Q000379:methods / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D016642:Bupropion