Premium
‘Real‐world’ effectiveness of smoking cessation treatments: a population study
Author(s) -
Kotz Daniel,
Brown Jamie,
West Robert
Publication year - 2014
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.12429
Subject(s) - varenicline , medicine , nicotine replacement therapy , smoking cessation , odds ratio , bupropion , medical prescription , abstinence , population , confidence interval , confounding , psychiatry , family medicine , environmental health , nursing , pathology
Background and aims There is a need for more evidence on the ‘real‐world’ effectiveness of commonly used aids to smoking cessation from population‐level studies. This study assessed the association between abstinence and use of different smoking cessation treatments after adjusting for key potential confounding factors. Design Cross‐sectional data from aggregated monthly waves of a household survey: the S moking T oolkit S tudy. Setting E ngland. Participants A total of 10 335 adults who smoked within the previous 12 months and had made at least one quit attempt during that time. Measurements Participants were classified according to their use of cessation aids in their most recent quit attempt: (i) medication (nicotine replacement therapy, bupropion or varenicline) in combination with specialist behavioural support delivered by a N ational H ealth S ervice S top S moking S ervice; (ii) medication provided by the prescribing health‐care professional without specialist behavioural support; (iii) nicotine replacement therapy ( NRT ) bought over the counter; and (iv) none of these. The main outcome measure was self‐reported abstinence up to the time of the survey, adjusted for key potential confounders including tobacco dependence. Findings Compared with smokers using none of the cessation aids, the adjusted odds of remaining abstinent up to the time of the survey were 3.25 [95% confidence interval ( CI) = 2.05–5.15] greater in users of prescription medication in combination with specialist behavioural support, 1.61 (95% CI = 1.33–1.94) greater in users of prescription medication combined with brief advice and 0.96 (95% CI = 0.81–1.13) in users of NRT bought over the counter. Conclusions After adjusting for major confounding variables such as tobacco dependence, smokers in E ngland who use a combination of behavioural support and pharmacotherapy in their quit attempts have almost three times the odds of success than those who use neither pharmacotherapy nor behavioural support. Smokers who buy nicotine replacement therapy over the counter with no behavioural support have similar odds of success in stopping as those who stop without any aid.