title: Efficacy of harm reduction programs among patients of a smoking cessation clinic in Tehran, Iran.
abstract: BACKGROUND
  Recently, harm reduction programs have been used to reduce mortality and morbidity among smokers. The main objective of this study was to evaluate the effect of harm reduction programs on the smoking patterns of subjects who presented to a smoking cessation clinic in Tehran, Iran.
  
  
  METHODS
  This observational study was conducted between September 2008-September 2009 on 132 patients who were unable to quit smoking. Patients were enrolled by the first come first service method. During the study period, subjects were assigned to either group or individual visits every 15 days in conjunction with the use of nicotine gum. The main objective of this study was to evaluate at the third and sixth months of follow-up: the number of smoked cigarettes, level of expired carbon monoxide (CO), and numbers of nicotine gum used. Data were analyzed by the Wilcoxon rank, Fisher's exact, and Pearson's chi-square tests and SPSS version 17 software.
  
  
  RESULTS
  A total of 87.1% of the subjects were males. We noted decreases in the number of cigarettes smoked daily and the level of expired CO, whereas the amount of nicotine gum used significantly increased during the time interval between the first session and the third and sixth month follow-up visits (p < 0.001 for all variables). During the follow up sessions, 64.4% of subjects reduced the number of cigarettes they smoked daily by at least 50% and 12.9% of subjects quit smoking.
  
  
  CONCLUSIONS
  Behavioral and pharmacological therapy in harm reduction programs result in a decrease in the number of cigarettes smoked daily and a reduction in the amount of expired CO. Therefore, these methods can be beneficial in achieving complete smoking cessation.
authors.affiliation: Tobacco Prevention and Control Research Center (TPCRC), Masih Daneshvari Hospital, Shaheed Beheshti Medical Science University, Tehran, Iran.
authors.forename: Hooman
authors.initials: H
authors.lastname: Sharifi
authors.forename: Roghieh
authors.initials: R
authors.lastname: Kharaghani
authors.forename: Habib
authors.initials: H
authors.lastname: Emami
authors.forename: Zahra
authors.initials: Z
authors.lastname: Hessami
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Masjedi
mesh_terms: D040261:Harm Reduction; D006801:Humans; D007492:Iran; D009538:Nicotine; D012907:Smoking; D016540:Smoking Cessation; D014029:Tobacco Use Disorder
chemical_list: D009538:Nicotine