The number of smokers needed to screen and treat in a smoking cessation programme.
OBJECTIVE
Smoking cessation is an important factor in reducing cardiovascular mortality, but considerable effort is needed to successfully persuade patients to quit smoking. We studied the efficiency of the Minimal Intervention Strategy (C-MIS) in addition to nicotine replacement therapy (NRT) for smoking cessation in cardiovascular outpatients in relation to the outcome of mortality.


METHODS
Prospective cohort data studying the C-MIS in three outpatient clinics: cardiology, vascular surgery and vascular medicine.


METHODS
Two thousand, two hundred and seventy-five consecutive patients attending the clinics for first or routine follow-up visits were screened for atherosclerosis and smoking. The efficiency of the C-MIS was expressed as the number of smokers needed to screen and needed to treat in relation to the number of deaths prevented over a 5-year period. Mortality estimates were derived from the literature.


RESULTS
One thousand, four hundred and thirty-one patients were screened at first-time follow-up visits and 1294 at routine follow-up visits. With a rate of effectiveness of 4.3% for the C-MIS, the number needed to treat was 240 (min-max: 64-infinity) to prevent one death. The corresponding number needed to screen was 687 (min-max: 141-infinity) in the cardiology clinic, 574 (min-max: 134-infinity) in the vascular surgery clinic and 444 (min-max: 90-infinity) in the vascular medicine clinic. Within 5 years, 10 (min-max: 0-58) deaths could be prevented in all three clinics together. With the effectiveness of the C-MIS for first-time and routine follow-up attendees, only six (min-max: 0-36) and zero (min-max: 0-25) deaths could be prevented, respectively.


CONCLUSIONS
In terms of the efficiency of the C-MIS in addition to nicotine replacement therapy, there is some benefit for first-time attendees and no benefit for routine follow-up attendees in preventing death.
Storm-Versloot
Marja N
MN
Department of Vascular Surgery, Academic Medical Center, University of Amsterdam, The Netherlands.
Vermeulen
Hester
H
Wiggers
Louise C W
LC
Smets
Ellen M A
EM
de Haes
Hanneke C J M
HC
Peters
Ron J G
RJ
Legemate
Dink A
DA
de Vos
Rien
R
D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D003376:Counseling; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009426:Netherlands; D018722:Nicotinic Agonists / Q000627:therapeutic use*; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D010565:Persuasive Communication; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012907:Smoking / Q000009:adverse effects* / Q000401:mortality; D016540:Smoking Cessation / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
D018722:Nicotinic Agonists