Effectiveness of a nurse-managed, lay-led tobacco cessation intervention among ohio appalachian women.
OBJECTIVE
The purpose of this study was to evaluate a nurse-managed, lay-led tobacco cessation intervention delivered to adult women in Ohio Appalachia.


METHODS
A randomized controlled experimental design included intervention participants (n = 147) enrolled in a nurse-managed, lay-led protocol that incorporated nicotine replacement and behavioral counseling. Control participants (n = 155) received a personalized letter from their clinic physician, who advised them to quit smoking and requested they schedule a clinic appointment to discuss cessation.


RESULTS
Self-reported and cotinine-validated quit rates were significantly higher among intervention group participants compared with control group participants at 3-and 6-month follow-up (P < 0.02). At 12 months, self-reported abstinence was 19.1% (intervention group) and 9.0% (control group), with cotinine-validated rates of 12.2% and 7.1%, respectively (P = 0.13). Prolonged abstinence rates were significantly different between groups at 3, 6, and 12 months (P < 0.02). Logistic regression analyses indicated adjusted odds of cotinine-validated quitting was associated with cigarette consumption per day (odds ratio, 0.94; 95% confidence interval, 0.89-0.99) and Center for Epidemiologic Studies Depression Scale score > or = 16 (odds ratio, 0.39; 95% confidence interval, 0.17-0.90).


CONCLUSIONS
A lay-led approach that is managed by a nurse may serve as an effective cessation strategy among this high-risk population. Additional efforts are needed to sustain long-term abstinence, even after intensive intervention.
Wewers
Mary Ellen
ME
The Ohio State University, Columbus, 43210, USA. wewers.1@osu.edu
Ferketich
Amy K
AK
Harness
Judith
J
Paskett
Electra D
ED
D000293:Adolescent; D000328:Adult; D001061:Appalachian Region; D003367:Cotinine / Q000032:analysis; D037001:Directive Counseling; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009726:Nurses; D009820:Ohio; D017063:Outcome Assessment, Health Care; D012307:Risk Factors; D012907:Smoking / Q000523:psychology / Q000628:therapy*; D020340:Tobacco Use Cessation / Q000379:methods* / Q000523:psychology; D014029:Tobacco Use Disorder / Q000523:psychology / Q000628:therapy*; D055815:Young Adult
D003367:Cotinine