title: Real-life effectiveness of smoking-cessation treatments in general practice clinics in Denmark. The Escape Smoke project.
abstract: BACKGROUND
  The smoking prevalence has not decreased in the last years in Denmark. General practice (GP) offers smoking cessation (SC) treatment. Studies of real-life effectiveness of daily practice SC-activities from the GP-setting opposed to efficacy results from randomized clinical trials are few. The study aim was to evaluate the real-life effectiveness of SC-treatments for daily smokers among Danish GP-clinics.
  
  
  METHODS
  In a multi-centre-based observational study design Danish GP-clinics with prior SC-activity recruited daily smokers motivated for quitting. As per usual clinical practice SC-medicine could be nicotine replacement therapy (NRT), prescription-based SC-medicine (varenicline or bupropion) or no medicine. The primary endpoint was percentage of patients remaining abstinent 6 months after the quit date (ITT, self-reported continuous abstinence).
  
  
  RESULTS
  Forty GP-clinics recruited 515 (273 females, 20% COPD) daily smokers being moderately nicotine dependent and heavy smoking (19 cigarettes/day). Receiving intensive advice, 74% did use SC-medicine paid out-of-pocket (1/3 NRT and 2/3 prescription-based). After 6 months, 187 participants had remained abstinent (36%). Adjusted for potential confounding the use of prescription-based SC-medicine plus counseling was associated with significantly doubling the chance of staying abstinent after 6 months as compared to no SC-medicine (OR: 1.97). This association could not be found for NRT. Being male and using prescription-based SC-medicine were independent significant predictors for long-term abstinence.
  
  
  CONCLUSIONS
  Smoking cessation in Danish GP-clinics with some prior SC-activity can result in rather high long-term quit rates, especially when combining counseling and prescription-based SC-medicine. The effectiveness of prescription-based SC-medications versus NRT in the general population merits further investigation.
authors.affiliation: Pfizer Denmark, Lautrupvang 8, DK-2750 Ballerup, Denmark. Electronic address: peterbo.poulsen@pfizer.com.
authors.forename: Peter Bo
authors.initials: PB
authors.lastname: Poulsen
authors.affiliation: Lægehuset i Aarup (GP-clinic), Mørkmosehøj 2, DK-5560 Aarup, Denmark.
authors.forename: Heidi
authors.initials: H
authors.lastname: Spillemose
authors.affiliation: Lægerne Petersen og Schousboe (GP-clinic), Fynsvej 7 st., DK-6000 Kolding, Denmark.
authors.forename: Gerda
authors.initials: G
authors.lastname: Nielsen
authors.affiliation: Lægerne Hergel og Jønsen (GP-clinic), Jernbanepladsen 10, 3., DK-2800 Kongens Lyngby, Denmark.
authors.forename: Lise-Lotte
authors.initials: LL
authors.lastname: Hergel
authors.affiliation: Pfizer Denmark, Lautrupvang 8, DK-2750 Ballerup, Denmark.
authors.forename: Dorte
authors.initials: D
authors.lastname: Wedell-Wedellsborg
authors.affiliation: Pfizer Denmark, Lautrupvang 8, DK-2750 Ballerup, Denmark.
authors.forename: Mette
authors.initials: M
authors.lastname: Strand
authors.affiliation: Hvidovre Hospital, Pulmonary Clinic, Kettegårds Allé 30, DK-2650 Hvidovre, Denmark.
authors.forename: Thomas
authors.initials: T
authors.lastname: Ringbæk
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016642:Bupropion / Q000627:therapeutic use; D003376:Counseling; D003718:Denmark; D018765:Dopamine Uptake Inhibitors / Q000627:therapeutic use; D005260:Female; D058006:General Practice / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018722:Nicotinic Agonists / Q000627:therapeutic use; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D012307:Risk Factors; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D061485:Tobacco Use Cessation Devices; D016896:Treatment Outcome; D000068580:Varenicline / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D018765:Dopamine Uptake Inhibitors; D018722:Nicotinic Agonists; D016642:Bupropion; D000068580:Varenicline
keywords: Abstinence; Counseling; General practice; Real-life effectiveness; Smoking cessation; Smoking cessation medicine