Abstract
BackgroundAchieving lifelong tobacco abstinence is an important public health goal. Most studies use 1-year follow-ups, but little is known about how good these are as proxies for long-term and life-long abstinence. Also, intervention intensity is an important issue for development of efficient and cost-effective cessation treatment protocols.The study aims were to assess the long-term effectiveness of a high- and a low-intensity treatment (HIT and LIT) for smoking cessation and to analyze to what extent 12-month abstinence predicted long-term abstinence.Methods300 smokers attending dental or general health care were randomly assigned to HIT or LIT at the public dental clinic. Main outcome measures were self-reported point prevalence, continuous abstinence (≥6 months), and sustained abstinence. The study was a follow-up after 5–8 years of a previously performed 12-month follow-up, both by postal questionnaires.ResultsResponse rate was 85% (n=241) of those still alive and living in Sweden. Abstinence rates were 8% higher in both programs at the long-term than at the 12-month follow-up. The difference of 7% between HIT and LIT had not change, being 31% vs. 24% for point prevalence and 26% vs. 19% for 6-month continuous abstinence, respectively. Significantly more participants in HIT (12%) than in LIT (5%) had been sustained abstinent (p=0.03). Logistic regression analyses showed that abstinence at 12-month follow-up was a strong predictor for abstinence at long-term follow-up.ConclusionsAbstinence at 12-month follow-up is a good predictor for long-term abstinence. The difference in outcome between HIT and LIT for smoking cessation remains at least 5–8 years after the intervention.Trial registration numberNCT00670514
Highlights
Achieving lifelong tobacco abstinence is an important public health goal
The median follow-up time was 6.2 (q1 5.9; q3 6.7) years (HIT median 6.1, q1 5.8; q3 6.7, Low-Intensity Treatment program (LIT) median 6.3, q1 6.0; q3 6.8, p=0.135). It was measured from the planned cessation date until the date when the questionnaire was completed or the telephone interview was performed
We found a significant association between Nicotine Replacement Therapy (NRT)-use and abstinence, controlling for program
Summary
Achieving lifelong tobacco abstinence is an important public health goal. Most studies use 1-year follow-ups, but little is known about how good these are as proxies for long-term and life-long abstinence. The study aims were to assess the long-term effectiveness of a high- and a low-intensity treatment (HIT and LIT) for smoking cessation and to analyze to what extent 12-month abstinence predicted long-term abstinence. Achieving lifelong abstinence is an important public health goal and a goal for tobacco control policies and smoking cessation treatment [5]. Most studies report follow-up results up to 1 year [21], but less is known about to what extent being smoke-free at 12 months predicts more long-term abstinence. The question of intensity of a smoking cessation program is important, because if a minimal intervention can result in even a small increase in cessation rates, this would have a large public health impact
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