Skip to main content
Top
Published in: BMC Primary Care 1/2022

Open Access 01-12-2022 | Research

Smoking quit rates among patients receiving pharmacotherapy who received general practitioner counselling versus intensive counselling: a retrospective cohort study

Authors: Ilan Yehoshua, Limor Adler, Sharon Alon Hermoni, Miri Mizrahi Reuveni, Avital Bilitzky, Keren Oren, Galia Zacay

Published in: BMC Primary Care | Issue 1/2022

Login to get access

Abstract

Background

Behavioral treatments can augment the success of pharmacotherapy in smoking cessation. The aim of this study was to compare smoking quit rates between patients receiving individual counseling with their general practitioner during office visits or intensive counselling with behavioral support, both augmented by varenicline.

Methods

A nationwide retrospective cohort study conducted in a large Healthcare Maintenance Organization in Israel. We selected randomly patients who filled a prescription for varenicline and received either individual consulting by their general practitioner or intensive counselling with behavioural support, and asked them to answer a questionnaire. The outcome variables were smoking cessation 26–52 weeks following the beginning of treatment and satisfaction with the process.

Results

870 patients were contacted and 604 agreed to participate (a response rate of 69%); 301 patients in the general practitioner group, 300 in the intensive counselling group and 3 were excluded due to missing date. The quit rate was 36.5% in the general practitioner group and 42.3% in the intensive counselling group (P = 0.147). In a logistic regression analysis, controlling for age, gender, socioeconomic status, ischemic heart disease, chronic obstructive pulmonary disease, pack years and duration of varenicline consumption, the adjusted OR for quitting in the general practitioner group was 0.79 (95% CI 0.56,1.13). The adjusted OR was higher in the group with the highest socioeconomic status at 2.06 (1.39,3.07) and a longer period of varenicline consumption at 1.30 (1.15,1.47). Age, gender and cigarette pack-years were not associated with quit rate. In the general practitioner group 68% were satisfied with the process, while 19% were not. In the intensive counselling group 64% were satisfied and 14% were not (P = 0.007).

Conclusion

We did not detect a statistically significant difference in smoking quit rates, though there was a trend towards higher quit rates with intensive counselling.
Literature
1.
go back to reference Samet JM. Tobacco smoking: the leading cause of preventable disease worldwide. Thorac Surg Clin. 2013 23(2):103–12.CrossRef Samet JM. Tobacco smoking: the leading cause of preventable disease worldwide. Thorac Surg Clin. 2013 23(2):103–12.CrossRef
3.
go back to reference GBD 2015 Tobacco Collaborators, Reitsma MB, Fullman N, Ng M, Salama JS, Abajobir A, et al. Smoking prevalence and attributable disease burden in 195 countries and territories, 1990–2015: a systematic analysis from the Global Burden of Disease Study 2015. Lancet. 2017;389(10082):1885–906.CrossRef GBD 2015 Tobacco Collaborators, Reitsma MB, Fullman N, Ng M, Salama JS, Abajobir A, et al. Smoking prevalence and attributable disease burden in 195 countries and territories, 1990–2015: a systematic analysis from the Global Burden of Disease Study 2015. Lancet. 2017;389(10082):1885–906.CrossRef
5.
go back to reference Hartmann-Boyce J, Livingstone-Banks J, Ordóñez-Mena JM, Fanshawe TR, Lindson N, Freeman SC, et al. Behavioural interventions for smoking cessation: an overview and network meta-analysis. Cochrane Database Syst Rev. 2021;1:CD013229. Hartmann-Boyce J, Livingstone-Banks J, Ordóñez-Mena JM, Fanshawe TR, Lindson N, Freeman SC, et al. Behavioural interventions for smoking cessation: an overview and network meta-analysis. Cochrane Database Syst Rev. 2021;1:CD013229.
6.
go back to reference Lindson N, Klemperer E, Hong B, Ordóñez-Mena JM, Aveyard P. Smoking reduction interventions for smoking cessation. Cochrane Database Syst Rev. 2019 ;30(9):CD013183. Lindson N, Klemperer E, Hong B, Ordóñez-Mena JM, Aveyard P. Smoking reduction interventions for smoking cessation. Cochrane Database Syst Rev. 2019 ;30(9):CD013183.
7.
go back to reference West R, McNeill A, Raw M. Smoking cessation guidelines for health professionals: an update. Thorax. 2000 ;55:987–99.CrossRef West R, McNeill A, Raw M. Smoking cessation guidelines for health professionals: an update. Thorax. 2000 ;55:987–99.CrossRef
8.
go back to reference Clinical practice guideline treating tobacco use and dependence 2008 update panel, liaisons, and staff. A clinical practice guideline for treating tobacco use and dependence: 2008 update. A U.S. Public Health Service report. Am J Prev Med. 2008 ;35(2):158–76. Clinical practice guideline treating tobacco use and dependence 2008 update panel, liaisons, and staff. A clinical practice guideline for treating tobacco use and dependence: 2008 update. A U.S. Public Health Service report. Am J Prev Med. 2008 ;35(2):158–76.
9.
go back to reference Hartmann-Boyce J, Hong B, Livingstone-Banks J, Wheat H, Fanshawe TR. Additional behavioural support as an adjunct to pharmacotherapy for smoking cessation. Cochrane Database Syst Rev. 2019;6:CD009670. Hartmann-Boyce J, Hong B, Livingstone-Banks J, Wheat H, Fanshawe TR. Additional behavioural support as an adjunct to pharmacotherapy for smoking cessation. Cochrane Database Syst Rev. 2019;6:CD009670.
10.
go back to reference van Rossem C, Spigt M, Viechtbauer W, Lucas AEM, van Schayck OCP, Kotz D. Effectiveness of intensive practice nurse counselling versus brief general practitioner advice, both combined with varenicline, for smoking cessation: a randomized pragmatic trial in primary care. Addiction. 2017 ;112:2237–47.CrossRef van Rossem C, Spigt M, Viechtbauer W, Lucas AEM, van Schayck OCP, Kotz D. Effectiveness of intensive practice nurse counselling versus brief general practitioner advice, both combined with varenicline, for smoking cessation: a randomized pragmatic trial in primary care. Addiction. 2017 ;112:2237–47.CrossRef
11.
go back to reference Byers MA, Wright P, Tilford JM, Nemeth LS, Matthews E, Mitchell A. Comparing smoking cessation outcomes in nurse-led and physician-led primary care visits. J Nurs Care Qual. 2018;33(3):272–8.CrossRef Byers MA, Wright P, Tilford JM, Nemeth LS, Matthews E, Mitchell A. Comparing smoking cessation outcomes in nurse-led and physician-led primary care visits. J Nurs Care Qual. 2018;33(3):272–8.CrossRef
12.
go back to reference Lancaster T, Stead LF. Individual behavioural counselling for smoking cessation. Cochrane Database Syst Rev. 2017 ;31(3):CD001292. Lancaster T, Stead LF. Individual behavioural counselling for smoking cessation. Cochrane Database Syst Rev. 2017 ;31(3):CD001292.
13.
go back to reference Rosen LJ, Peled-Raz M. Tobacco policy in Israel: 1948-2014 and beyond. Isr J Health Policy Res. 2015 ;1(4):12.CrossRef Rosen LJ, Peled-Raz M. Tobacco policy in Israel: 1948-2014 and beyond. Isr J Health Policy Res. 2015 ;1(4):12.CrossRef
15.
go back to reference Jorenby DE, Hays JT, Rigotti NA, Azoulay S, Watsky EJ, Williams KE, et al. Efficacy of varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs placebo or sustained-release bupropion for smoking cessation: a randomized controlled trial. JAMA. 2006;296(1):56–63.CrossRef Jorenby DE, Hays JT, Rigotti NA, Azoulay S, Watsky EJ, Williams KE, et al. Efficacy of varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs placebo or sustained-release bupropion for smoking cessation: a randomized controlled trial. JAMA. 2006;296(1):56–63.CrossRef
16.
go back to reference Gonzales D, Rennard SI, Nides M, Oncken C, Azoulay S, Billing CB, et al. Varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs sustained-release bupropion and placebo for smoking cessation: a randomized controlled trial. JAMA. 2006;296(1):47–55.CrossRef Gonzales D, Rennard SI, Nides M, Oncken C, Azoulay S, Billing CB, et al. Varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs sustained-release bupropion and placebo for smoking cessation: a randomized controlled trial. JAMA. 2006;296(1):47–55.CrossRef
17.
go back to reference Dienes Z. Using Bayes to get the most out of non-significant results. Front Psychol. 2014 ;29(5):781. Dienes Z. Using Bayes to get the most out of non-significant results. Front Psychol. 2014 ;29(5):781.
18.
go back to reference Prochaska JO, DiClemente CC. Transtheoretical therapy: toward a more integrative model of change. Psychother: Theory, Research & Pract. 1982;19(3):276–88.CrossRef Prochaska JO, DiClemente CC. Transtheoretical therapy: toward a more integrative model of change. Psychother: Theory, Research & Pract. 1982;19(3):276–88.CrossRef
19.
go back to reference Prochaska JO. Flaws in the theory or flaws in the study: a commentary on “the effect of Transtheoretical model based interventions on smoking cessation”. Soc Sci Med. 2009 ;68(3):404–6.CrossRef Prochaska JO. Flaws in the theory or flaws in the study: a commentary on “the effect of Transtheoretical model based interventions on smoking cessation”. Soc Sci Med. 2009 ;68(3):404–6.CrossRef
20.
go back to reference DiClemente CC, Prochaska JO, Fairhurst SK, Velicer WF, Velasquez MM, Rossi JS. The process of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change. J Consult Clin Psychol. 1991 ;59(2):295–304.CrossRef DiClemente CC, Prochaska JO, Fairhurst SK, Velicer WF, Velasquez MM, Rossi JS. The process of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change. J Consult Clin Psychol. 1991 ;59(2):295–304.CrossRef
21.
go back to reference Prochaska JO, DiClemente CC. Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol. 1983 ;51(3):390–5.CrossRef Prochaska JO, DiClemente CC. Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol. 1983 ;51(3):390–5.CrossRef
22.
go back to reference Holm M, Schiöler L, Andersson E, Forsberg B, Gislason T, Janson C, et al. Predictors of smoking cessation: a longitudinal study in a large cohort of smokers. Respir Med. 2017 ;132:164–9.CrossRef Holm M, Schiöler L, Andersson E, Forsberg B, Gislason T, Janson C, et al. Predictors of smoking cessation: a longitudinal study in a large cohort of smokers. Respir Med. 2017 ;132:164–9.CrossRef
23.
go back to reference Rebagliato M. Validation of self reported smoking. J Epidemiol Community Health. 2002 ;56(3):163–4.CrossRef Rebagliato M. Validation of self reported smoking. J Epidemiol Community Health. 2002 ;56(3):163–4.CrossRef
24.
go back to reference Wells AJ, English PB, Posner SF, Wagenknecht LE, Perez-Stable EJ. Misclassification rates for current smokers misclassified as nonsmokers. Am J Public Health. 1998 ;88:1503–9.CrossRef Wells AJ, English PB, Posner SF, Wagenknecht LE, Perez-Stable EJ. Misclassification rates for current smokers misclassified as nonsmokers. Am J Public Health. 1998 ;88:1503–9.CrossRef
25.
go back to reference Pérez-Stable EJ, Marín G, Marín BV, Benowitz NL. Misclassification of smoking status by self-reported cigarette consumption. Am Rev Respir Dis. 1992 ;145(1):53–7.CrossRef Pérez-Stable EJ, Marín G, Marín BV, Benowitz NL. Misclassification of smoking status by self-reported cigarette consumption. Am Rev Respir Dis. 1992 ;145(1):53–7.CrossRef
26.
go back to reference Patrick DL, Cheadle A, Thompson DC, Diehr P, Koepsell T, Kinne S. The validity of self-reported smoking: a review and meta-analysis. Am J Public Health. 1994 ;84(7):1086–93.CrossRef Patrick DL, Cheadle A, Thompson DC, Diehr P, Koepsell T, Kinne S. The validity of self-reported smoking: a review and meta-analysis. Am J Public Health. 1994 ;84(7):1086–93.CrossRef
27.
go back to reference Noonan D, Jiang Y, Duffy SA. Utility of biochemical verification of tobacco cessation in the Department of Veterans Affairs. Addict Behav. 2013 ;38(3):1792–5.CrossRef Noonan D, Jiang Y, Duffy SA. Utility of biochemical verification of tobacco cessation in the Department of Veterans Affairs. Addict Behav. 2013 ;38(3):1792–5.CrossRef
28.
go back to reference Maclaren DJ, Conigrave KM, Robertson JA, Ivers RG, Eades S, Clough AR. Using breath carbon monoxide to validate self-reported tobacco smoking in remote Australian indigenous communities. Popul Health Metrics. 2010 ;8(1):2.CrossRef Maclaren DJ, Conigrave KM, Robertson JA, Ivers RG, Eades S, Clough AR. Using breath carbon monoxide to validate self-reported tobacco smoking in remote Australian indigenous communities. Popul Health Metrics. 2010 ;8(1):2.CrossRef
29.
go back to reference Reid JL, Hammond D, Boudreau C, Fong GT, Siahpush M, ITC Collaboration. Socioeconomic disparities in quit intentions, quit attempts, and smoking abstinence among smokers in four western countries: findings from the international tobacco control four country survey. Nicotine Tob Res. 2010 ;12(Suppl):S20–33.CrossRef Reid JL, Hammond D, Boudreau C, Fong GT, Siahpush M, ITC Collaboration. Socioeconomic disparities in quit intentions, quit attempts, and smoking abstinence among smokers in four western countries: findings from the international tobacco control four country survey. Nicotine Tob Res. 2010 ;12(Suppl):S20–33.CrossRef
30.
go back to reference Cambron C, Lam CY, Cinciripini P, Li L, Wetter DW. Socioeconomic status, social context, and smoking lapse during a quit attempt: an ecological momentary assessment study. Ann Behav Med. 2020;54(3):141–50 Feb.CrossRef Cambron C, Lam CY, Cinciripini P, Li L, Wetter DW. Socioeconomic status, social context, and smoking lapse during a quit attempt: an ecological momentary assessment study. Ann Behav Med. 2020;54(3):141–50 Feb.CrossRef
31.
go back to reference Hiscock R, Bauld L, Amos A, Fidler JA, Munafò M. Socioeconomic status and smoking: a review. Ann N Y Acad Sci. 2012 ;1248:107–23.CrossRef Hiscock R, Bauld L, Amos A, Fidler JA, Munafò M. Socioeconomic status and smoking: a review. Ann N Y Acad Sci. 2012 ;1248:107–23.CrossRef
Metadata
Title
Smoking quit rates among patients receiving pharmacotherapy who received general practitioner counselling versus intensive counselling: a retrospective cohort study
Authors
Ilan Yehoshua
Limor Adler
Sharon Alon Hermoni
Miri Mizrahi Reuveni
Avital Bilitzky
Keren Oren
Galia Zacay
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2022
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-022-01953-y

Other articles of this Issue 1/2022

BMC Primary Care 1/2022 Go to the issue