title: Predictors of success for smoking cessation at the workplace: a longitudinal study.
abstract: BACKGROUND
  The effectiveness of worksite interventions to reduce smoking is debatable.
  
  
  OBJECTIVE
  A comprehensive smoking cessation intervention was implemented in a community of more than 17,000 employees at three different health care companies. The primary endpoint was abstinence at 24 months (self-reported and confirmed by exhaled carbon monoxide ≤ 6 parts per million). Predictors of long-term abstinence were analysed by multivariable regression analysis.
  
  
  METHODS
  The study was designed as an investigator-initiated and investigator-driven, open, multicentre, cohort study; 887 smokers were enrolled in the programme. The intervention included intensive individual counselling as well as nicotine replacement and/or bupropion according to individual preferences. Re-interventions for relapse were offered during the 24-month follow-up.
  
  
  RESULTS
  The abstinence rate was 37% at 24 months and did not differ among the various medication groups (p > 0.05 for all). Predictors of successful cessation were higher age (odds ratio, OR 1.47, 95% confidence interval, CI 1.08-2.00, p < 0.01), breathlessness on exertion (OR 2.26, 95% CI 1.1-4.9, p = 0.03), and a higher educational level (OR 1.81, 95% CI 1.06-3.09, p = 0.03). Higher Fagerström (OR 0.76, 95% CI 0.59-0.97, p < 0.01) and craving scores (OR 0.75, 95% CI 0.63-0.89, p < 0.01), chronic sputum production (OR 0.52, 95% CI 0.31-0.87, p = 0.01) and use of antidepressants (OR 0.54, 95% CI 0.32-0.91, p = 0.02) were associated with ongoing smoking.
  
  
  CONCLUSIONS
  A comprehensive smoking cessation intervention at the workplace achieves high, stable, long-term abstinence rates. Elderly, well-educated employees with breathlessness on exertion have higher odds of quitting smoking. In contrast, those with high physical dependency and more intense craving, and those reporting use of antidepressant medication or sputum production have poorer chances to quit.
authors.affiliation: Clinic of Pneumology and Pulmonary Research, University Hospital Basel, Basel, Switzerland.
authors.forename: Daiana
authors.initials: D
authors.lastname: Stolz
authors.forename: Andreas
authors.initials: A
authors.lastname: Scherr
authors.forename: Bruno
authors.initials: B
authors.lastname: Seiffert
authors.forename: Martin
authors.initials: M
authors.lastname: Kuster
authors.forename: Anja
authors.initials: A
authors.lastname: Meyer
authors.forename: Karl-Olov
authors.initials: KO
authors.lastname: Fagerström
authors.forename: Michael
authors.initials: M
authors.lastname: Tamm
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D016642:Bupropion / Q000627:therapeutic use*; D003376:Counseling; D004417:Dyspnea; D004522:Educational Status; D005260:Female; D019981:Health Care Sector; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D062405:Motivational Interviewing; D015999:Multivariate Analysis; D009538:Nicotine / Q000009:adverse effects; D018722:Nicotinic Agonists / Q000009:adverse effects; D009786:Occupational Health Services / Q000379:methods*; D011379:Prognosis; D012907:Smoking / Q000628:therapy*; D016540:Smoking Cessation / Q000379:methods*; D013375:Substance Withdrawal Syndrome / Q000209:etiology; D013557:Switzerland; D061485:Tobacco Use Cessation Devices; D014029:Tobacco Use Disorder / Q000628:therapy*; D016896:Treatment Outcome; D017132:Workplace; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents; D018722:Nicotinic Agonists; D016642:Bupropion; D009538:Nicotine