Smoking cessation attempts: is it useful to treat hard core smokers?
BACKGROUND
Hard core smokers have been studied in many countries but only a few trials have compared the effectiveness of smoking cessation with other smokers. The objective of this study was to compare the frequencies of success in smoking cessation between hard-core smokers and other smokers.


METHODS
Data were collected in Clermont-Ferrand from the Emile Roux dispensary 'Pneumology and Tobaccology Centre' between 1999 and 2009. Assistance with smoking cessation was proposed to 1367 patients but only 1296 patients were included: 219 HCS and 1077 other smokers. Smoking cessation was considered a success when patients were abstinent 6 months after the beginning of cessation. The profiles of the two types of smokers were compared using Chi square test and Student's t test. Multivariate logistic regression was used to investigate the association between the smoking cessation result and the type of smokers.


RESULTS
HCS more frequently consumed other psychoactive substances (41.1 % vs 25.7 % for other smokers;p< 0.001). Current depression was more frequent in HCS (46.6 % vs 34.8 % for other smokers;p= 0.001). Smoking cessation was less frequent in HCS (45.2 % vs 56.5 % for other smokers ;p= 0.002). In multivariate analysis, after controlling for other factors, the frequency of smoking cessation was not significantly associated with the type of smokers (p= 0.47). After limiting to initial factors (present before the beginning of smoking cessation), the frequency of smoking cessation was still not significantly associated with the type of smokers (p= 0.78).


CONCLUSIONS
Smoking cessation is possible for hard core smokers, who should be treated as other types of smokers taking into account other factors:the problem is how to encourage them to try to stop smoking.
Service de Biostatistique et d'Informatique Médicale (DIM), CHRU Dijon, Dijon, F-21000 France.
B
B
Joly
Service de Biostatistique et d'Informatique Médicale (DIM), CHRU Dijon, Dijon, F-21000 France.
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P
D'Athis
Service de santé Publique, CHU Clermont-Ferrand, EA PEPRADE4681 Université d'Auvergne, Clermont-Ferrand, France.
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L
Gerbaud
Service de santé Publique, CHU Clermont-Ferrand, EA PEPRADE4681 Université d'Auvergne, Clermont-Ferrand, France.
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J
Hazart
Dispensaire Emile Roux, Centre d'Aide à I'Arrêt du Tabagisme (IRAAT), Centre de Lutte Anti-Tuberculeuse (CLAT), 63100 Clermont-Ferrand, France.
J
J
Perriot
Service de Biostatistique et d'Informatique Médicale (DIM), CHRU Dijon, Dijon, F-21000 France ; INSERM, CIC 1432, Dijon, France; Dijon University Hospital, Clinical Investigation Center, Clinical epidemiology/clinical trials unit, Dijon, France ; Inserm UMR 1181 « Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases » (B2PHI), Univ. Bourgogne Franche-Comté, F-21000 Dijon, France.
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C
Quantin
Cigarette consumption; Hard core; Quit attempt; Smoking cessation