The English smoking treatment services: short-term outcomes.

AIMS To examine the impact of socio-demographic factors, smoking-related behaviour and service characteristics on CO-validated quit rates at 4-week follow-up in English smoking treatment services, and to compare the results with those for self-reported quitters. DESIGN Observational study of administrative information linked with survey data for 6959 recipients of smoking treatment services who set a quit date between October 2001 and March 2003. SETTING Two contrasting areas of England, Nottingham and North Cumbria, consisting of nine primary care trust (PCT) localities. MEASUREMENTS Routine monitoring data specified by the Department of Health included information about basic demographic characteristics, postcode of residence from which a deprivation category was identified, nature of intervention and smoking status at 4-week follow-up. These data were supplemented with additional information about referral pathways, socio-economic status and smoking-related behaviours obtained from consenting service recipients by NHS advisers. FINDINGS More than one-half of clients (53%) were CO-validated as quitters at 4 weeks, rising to 60.7% when self-reported cases were included. Age (OR 1.026; CI 1.0221.029) and being extremely determined to quit (OR 1.46; CI 1.261.71) were associated positively with CO-validated cessation, whereas women (OR 0.85; CI 0.770.94), users with lower socio-economic status (OR 0.92; CI 0.880.95), those smoking 31 or more cigarettes daily (OR 0.75; CI 0.640.88) and those with relatively poor health status (OR 0.72; CI 0.630.82) were less likely to quit. Although the vast majority of users received one-to-one support, those who had group counselling were more likely to be successful in their quit attempt (OR 1.38; CI 1.091.76). Self-report and CO-validated quitters were similar in terms of their characteristics. CONCLUSIONS These results obtained from routine services support those obtained from clinical trials and confirm the effectiveness of counselling combined with pharmacotherapies to assist smokers to quit in the short term. However, the relative effectiveness of group interventions raises questions about why one-to-one counselling is used much more commonly. The importance of socio-demographic and nicotine-related dependency factors also suggests that local service targets for smoking cessation need to take account of the social distribution of these characteristics.

[1]  L. Bauld,et al.  The English smoking treatment services: one-year outcomes. , 2005, Addiction.

[2]  A. Buist,et al.  Gender differences in smoking cessation after 3 years in the Lung Health Study. , 1995, American journal of public health.

[3]  N Hymowitz,et al.  Baseline factors associated with smoking cessation and relapse. MRFIT Research Group. , 1991, Preventive medicine.

[4]  L. Stead,et al.  Effectiveness of interventions to help people stop smoking: findings from the Cochrane Library , 2000, BMJ : British Medical Journal.

[5]  P. Schnohr,et al.  Gender and determinants of smoking cessation: a longitudinal study. , 1999, Preventive medicine.

[6]  Anjali Jain.  Treating nicotine addiction , 2003, BMJ : British Medical Journal.

[7]  Stephen Sutton,et al.  Assessing 'stage of change' in current and former smokers. , 2002, Addiction.

[8]  R. Jeffery,et al.  The smoking cessation process: longitudinal observations in a working population. , 1995, Preventive medicine.

[9]  R. Richmond,et al.  Multivariate models for predicting abstention following intervention to stop smoking by general practitioners. , 1993, Addiction.

[10]  M. Osler,et al.  Psychosocial, behavioural, and health determinants of successful smoking cessation: a longitudinal study of Danish adults , 1998, Tobacco control.

[11]  Robert West,et al.  Smoking cessation guidelines for health professionals: an update , 2000, Thorax.

[12]  L. Bauld,et al.  Impact of UK National Health Service smoking cessation services: variations in outcomes in England , 2003, Tobacco control.

[13]  M. Raw,et al.  General practitioners' views on and referral to NHS smoking cessation services. , 2005, Public health.

[14]  K. McKenna,et al.  Factors influencing smoking cessation in patients with coronary artery disease. , 1997, Patient education and counseling.

[15]  T. Coleman,et al.  Delivering the English smoking treatment services. , 2005, Addiction.

[16]  Shaomin Li,et al.  Age interacts with heaviness of smoking in predicting success in cessation of smoking. , 1992, American journal of epidemiology.

[17]  R. West,et al.  Smoking cessation and smoking patterns in the general population: a 1-year follow-up. , 2001, Addiction.

[18]  A. Folsom,et al.  Differences in smoking cessation strategies between men and women. , 1989, Addictive behaviors.

[19]  S. Khuder,et al.  Age at smoking onset and its effect on smoking cessation. , 1999, Addictive behaviors.

[20]  K. Cummings,et al.  Predictors of smoking cessation in a cohort of adult smokers followed for five years. , 1997, Tobacco control.

[21]  Robyn L Richmond,et al.  Measures of abstinence in clinical trials: issues and recommendations. , 2003, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[22]  W. Velicer,et al.  Biochemical verification of tobacco use and cessation. , 2002, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[23]  E. Gilpin,et al.  Demographic differences in patterns in the incidence of smoking cessation: United States 1950-1990. , 2002, Annals of epidemiology.

[24]  L. Bauld,et al.  How effective are the English smoking treatment services in reaching disadvantaged smokers? , 2005, Addiction.

[25]  Judith K. Ockene,et al.  ArticleBaseline factors associated with smoking cessation and relapse , 1991 .