title: Implementing a hospital-based smoking cessation programme: evidence for a learning effect.
abstract: OBJECTIVE
  This study assessed a newly set-up, hospital-based smoking cessation clinic with regard to continuous abstinence rates and the effectiveness of concomittant nicotine replacement therapy.
  
  
  METHODS
  Smoking status of 369 participants of this 8-week cognitive-behavioural smoking cessation group programme was obtained using exhaled carbon monoxide at the end of the course as well as self-report 6 months after the course. In addition to demographic data, FTND score, SDS score, and usage of nicotine replacement products were recorded.
  
  
  RESULTS
  Overall, 29.8% of all participants reported to have been continuously abstinent for 6 months after the course. Success rates increased significantly during the first year after initiation of the programme (from 15 to 35%, p<0.001), indicating a learning process of the staff running the course. Nicotine replacement therapy was used by 51.3% of participants, but 58% of these discontinued its use within 5 weeks. Nicotine substitution for more than 5 weeks was associated with a 50% success rate after 6 months.
  
  
  CONCLUSIONS
  Our data indicate a learning effect of smoking cessation course staff and a possible minimum duration required for nicotine replacement to be effective.
  
  
  CONCLUSIONS
  The observed learning effect in smoking cessation programmes should be considered when evaluating newly established interventions of this kind. Patients tend to stop nicotine replacement therapy too early, thereby decreasing their chances of middle-term abstinence.
authors.affiliation: Department of Cardiology and Pneumology, University Hospital Goettingen, Germany. raupach@med.uni-goettingen.de
authors.forename: Tobias
authors.initials: T
authors.lastname: Raupach
authors.forename: Lion
authors.initials: L
authors.lastname: Shahab
authors.forename: Karin
authors.initials: K
authors.lastname: Neubert
authors.forename: Dorothea
authors.initials: D
authors.lastname: Felten
authors.forename: Gerd
authors.initials: G
authors.lastname: Hasenfuss
authors.forename: Stefan
authors.initials: S
authors.lastname: Andreas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000458:organization & administration* / Q000523:psychology; D015928:Cognitive Behavioral Therapy / Q000458:organization & administration; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009538:Nicotine / Q000627:therapeutic use; D018722:Nicotinic Agonists / Q000627:therapeutic use; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic / Q000458:organization & administration*; D016730:Program Development; D015397:Program Evaluation; D012657:Self-Help Groups / Q000458:organization & administration*; D012907:Smoking / Q000378:metabolism / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology; D000074606:Smoking Prevention; D018709:Statistics, Nonparametric; D013997:Time Factors
chemical_list: D018722:Nicotinic Agonists; D009538:Nicotine