The Gold Standard Programme: smoking cessation interventions for disadvantaged smokers are effective in a real-life setting.
OBJECTIVE
To evaluate the real-life effect of an evidence-based Gold Standard Programme (GSP) for smoking cessation interventions in disadvantaged patients and to identify modifiable factors that consistently produce the highest abstinence rates.


METHODS
Observational prospective cohort study.


METHODS
GSPs in pharmacies, hospitals and communities in Denmark, reporting to the national Smoking Cessation Database.


METHODS
Disadvantaged patients, defined as patients with a lower level of education and those receiving unemployment benefits.


METHODS
6-week manualised GSP smoking cessation interventions performed by certified staff.


METHODS
6 months of continuous abstinence, response rate: 80%.


RESULTS
Continuous abstinence of the 16 377 responders was 34% (of all 20 588 smokers: 27%). Continuous abstinence was lower in 5738 smokers with a lower educational level (30% of responders and 23% of all) and in 840 unemployed (27% of responders and 19% of all). In respect to modifiable factors, continuous abstinence was found more often after programmes in one-on-one formats (vs group formats) among patients with a lower educational level, 34% (vs 25%, p=0.037), or among unemployed, 35% (vs 24%, p=0.099). The variable 'format' stayed in the final model of multivariable analyses in patients with a lower educational level, OR=1.31 (95% CI 1.05 to 1.63).


CONCLUSIONS
Although continuous abstinence was lower among disadvantaged smokers, the absolute difference was small. If the programme had been as effective in disadvantaged as in non-disadvantaged groups, there would have been an extra 46 or 8 quitters annually, respectively. Promoting individual interventions among those with a low education may increase the effectiveness of GSP.
WHO CC, Clinical Health Promotion Centre, Bispebjerg University Hospital, Copenhagen, Denmark.
Tim
T
Neumann
Mette
M
Rasmussen
Nermin
N
Ghith
Berit L
BL
Heitmann
Hanne
H
Tønnesen
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003718:Denmark; D004522:Educational Status; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D011446:Prospective Studies; D012907:Smoking; D016540:Smoking Cessation / Q000379:methods*; D014029:Tobacco Use Disorder / Q000628:therapy*; D016896:Treatment Outcome; D014478:Unemployment; D035862:Vulnerable Populations; D055815:Young Adult