High risk strategy in smoking cessation is feasible on a population-based level. The Inter99 study.
BACKGROUND
A high risk strategy is one of more strategies in public health. Smoking remains the most important contributor to the burden of disease in developed countries.


METHODS
A population-based multi-factorial intervention study, Inter99 (1999-2006), Copenhagen, Denmark, using a high risk strategy. All 2408 daily smokers were repeatedly offered individual face-to-face lifestyle counselling. Smokers in the high-intensity group were offered participation in smoking cessation groups. We measured point abstinence at 1, 3 and 5-year follow-up and compared with a control group, using adjusted intention-to treat analyses.


RESULTS
Compared with the control group it was twice as likely to be self-reported abstinent at 5-year follow-up in the high-intensity intervention group (OR: 2.19; 95%CI: 1.7-2.8; p<0.001). The effect of the intervention was significant, even when comparing validated abstinence in the intervention groups with self-reported abstinence in the control group (OR: 1.38; 95%CI: 1.1-1.8; p=0.014). Male gender, vocational training, higher age at onset of smoking, high knowledge of harm of smoking and lower tobacco consumption predicted abstinence.


CONCLUSIONS
A high risk strategy showed a significant effect on smoking in the long term. Proactive recruitment, face-to-face setting, repeated offer of assistance to quit and a multi-factorial approach may explain the success of the intervention.
Pisinger
Charlotta
C
Research Centre for Prevention and Health, The Capital Region of Denmark, Denmark. chpi@glo.regionH.dk
Glümer
Charlotte
C
Toft
Ulla
U
von Huth Smith
Lisa
L
Aadahl
Mette
M
Borch-Johnsen
Knut
K
Jørgensen
Torben
T
D000328:Adult; D003718:Denmark; D037001:Directive Counseling; D005240:Feasibility Studies; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D016540:Smoking Cessation / Q000379:methods*; D016896:Treatment Outcome