Gender difference and effect of pharmacotherapy: findings from a smoking cessation service.

N J Walker,V Kiparoglou,H Robinson,E Croghan,H C Van Woerden,Y Yang

doi:10.1186/s12889-016-3672-y

Abstract

BackgroundSmoking cessation services are available in England to provide assistance to those wishing to quit smoking. Data from one such service were analysed in order to investigate differences in quit rate between males and females prescribed with different treatments.MethodsA logistic regression model was fitted to the data using the binary response of self-reported quit (failed attempt = 0, successful attempt = 1), validated by Carbon Monoxide (CO) monitoring, 4 weeks after commencing programme. Main effects fitted were: client gender; age; region; the type of advisory sessions; and pharmacotherapy, Nicotine Replacement Therapy (NRT) or Varenicline. A second model was fitted including all main effects plus two-way interactions except region. These models were repeated using 12-week self-reported quit as the outcome.ResultsAt 4 weeks, all main effects were statistically significant, with males more likely (odds ratio and 95 % CI, females v males = 0.88 [0.79–0.97]), older smokers more likely (adjusted odds ratios [OR] and 95 % confidence interval [CI] respectively for groups 20–29, 30–49, 50–69 and 70+ vs 12–19 age group: 1.79 [1.39–2.31], 2.12 [1.68–2.68], 2.30 [1.80–2.92] and 2.47 [1.81–3.37] and for overall difference between groups, χ2(4) = 53.5, p < 0.001) and clients being treated with Varenicline more likely to have successfully quit than those on NRT (adjusted OR and 95 % CI for Varenicline vs NRT = 1.41 [1.21–1.64]). Statistically significant interactions were observed between (i) gender and type of counselling, and (ii) age and type of counselling. Similar results were seen in relation to main effects at 12 weeks except that type of counselling was non-significant. The only significant interaction at this stage was between gender and pharmacotherapy (adjusted OR and 95 % CI for females using Varenicline versus all other groups = 1.43 [1.06–1.94]).ConclusionGender and treatment options were identified as predictors of abstinence at both 4 and 12 weeks after quitting smoking. Furthermore, interactions were observed between gender and (i) type of counselling received (ii) pharmacotherapy. In particular, the quit rate in women at 12 weeks was significantly improved in conjunction with Varenicline use. These findings have implications for service delivery.

Highlights

Smoking cessation services are available in England to provide assistance to those wishing to quit smoking
A client accessing these services is assisted by qualified smoking cessation advisers, who utilise behavioural change techniques in combination with tailored pharmacotherapy
Whilst Nicotine Replacement Therapy (NRT) was much more frequently prescribed by smoking cessation services than Varenicline in this sample (87.4 % v 12.6 % respectively), men are more likely to receive Varenicline than women. This may in part be due to concerns over side-effects from using Varenicline during pregnancy. These results from analysis of data on patients using a smoking cessation service provide an insight into the effects of interventions in a real world setting

Summary

Introduction

Smoking cessation services are available in England to provide assistance to those wishing to quit smoking. Some studies report a statistically higher success rate for males [9,10,11,12], some suggest women are more likely to succeed in quitting [13], and in others the picture is inconclusive [14,15,16]. This lack of consistency may be related to differences between the study populations and smoking cessation interventions investigated. Different patterns are seen between male and female smokers in terms of behavioural patterns underlying smoking habit [9] and personal characteristics [17] as well as use and experience of smoking cessation services [18]

Methods

Results

Discussion

Conclusion