title: Health professional advice, use of medications and smoking cessation: A population-based prospective cohort study.
abstract: The mediating role of cessation medications in the association between health professional advice and quitting behaviors is unclear.
  
  
  
  Data were from the Ontario Tobacco Survey longitudinal study, collected between July 2005 and June 2011 in Ontario, Canada. The analytic sample included 3437 baseline smokers who were seen by health professionals during follow-up. Logistic regression with generalized estimating equations and mediation analysis techniques were used to examine the impact of advice and medications on quitting outcomes (making a quit attempt, short-term quitting 1-6months and long-term quitting>6months).
  
  
  
  Those who received advice to quit smoking were more likely to use cessation medications than those who did not receive advice (21% vs. 13%, P<0.001). Receiving advice was associated with making a quit attempt (adjusted odds ratio (OR) 1.25, 95% confidence interval (CI) 1.10-1.41) and long-term quitting (adjusted OR 1.49, 95% CI 1.10-2.02), but not with short-term quitting. Use of cessation medications was associated with making a quit attempt (adjusted OR 11.83, 95% CI 9.93-14.08), short-term quitting (adjusted OR 3.69, 95% CI 2.90-4.68), and long-term quitting (adjusted OR 2.73, 95% CI 1.95-3.82). Using prescription medications was associated with a higher likelihood of quitting short-term (adjusted OR 2.43, 95% CI 2.59-3.74) and long-term (adjusted OR 2.27, 95% CI 1.23-4.17) than using NRT. Use of cessation medications was a significant mediator in the pathway from receiving advice to quitting.
  
  
  
  Health professionals should advise smokers to quit and encourage them to use cessation medications, especially prescription medications when trying to quit.
authors: Ontario Tobacco Research Unit, Dalla Lana School of Public Health, University of Toronto, Ontario, Canada. Electronic address: bo.zhang@camh.ca.
authors: Bo
authors: B
authors: Zhang
authors: Ontario Tobacco Research Unit, Dalla Lana School of Public Health, University of Toronto, Ontario, Canada.
authors: Michael O
authors: MO
authors: Chaiton
authors: Ontario Tobacco Research Unit, Dalla Lana School of Public Health, University of Toronto, Ontario, Canada.
authors: Lori M
authors: LM
authors: Diemert
authors: Ontario Tobacco Research Unit, Dalla Lana School of Public Health, University of Toronto, Ontario, Canada.
authors: Susan J
authors: SJ
authors: Bondy
authors: Ontario Tobacco Research Unit, Dalla Lana School of Public Health, University of Toronto, Ontario, Canada; Department of Statistics and Actuarial Science, University of Waterloo, Ontario, Canada.
authors: K Stephen
authors: KS
authors: Brown
authors: Ontario Tobacco Research Unit, Dalla Lana School of Public Health, University of Toronto, Ontario, Canada; Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
authors: Roberta
authors: R
authors: Ferrence
mesh_terms: D000328:Adult; D003376:Counseling / Q000379:methods; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D018722:Nicotinic Agonists / Q000627:therapeutic use*; D009864:Ontario; D011446:Prospective Studies; D016540:Smoking Cessation / Q000379:methods* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
chemical_list: D018722:Nicotinic Agonists
keywords: Cohort study; Health professional advice; Mediation analysis; Medications; Smoking cessation