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The British Journal of General Practice logoLink to The British Journal of General Practice
. 2000 Oct;50(459):803–807.

An evidence-based programme for smoking cessation: effectiveness in routine general practice.

G Grandes 1, J M Cortada 1, A Arrazola 1
PMCID: PMC1313821  PMID: 11127170

Abstract

BACKGROUND: Smoking cessation clinical practice guidelines are based on randomised clinical trials reporting outcomes in persons who participate in these studies. However, many practitioners are sceptical about the effectiveness of these recommendations when applied to the general population in everyday routine consultation. AIM: To evaluate the results of a comprehensive smoking cessation programme in routine primary care practice. METHOD: All smokers consulting in 10 general practices during one year participated in a non-randomised controlled trial. The percentages of subjects in the intervention (n = 1203, seven practices) and control (n = 565, three practices) groups who reported sustained abstinence between six and 12 months follow-up and were validated biochemically were compared. The effect of the programme was adjusted to baseline differences in both groups by multiple logistic regression analyses. RESULTS: The programme resulted in an increase of five percentage points (95% CI = 3.1%-6.8%) in the validated and sustained one-year abstinence probability, with 7.1% for all of the intervention practices (adjusted OR = 3.7, 95% CI = 2.4-5.7). CONCLUSION: Programmes that combine advice to stop smoking to all smokers attending general practices with the offering of support, follow-up, and nicotine patches to those willing to stop are feasible and effective in routine practice, as primary care clinicians need only identify 20 smokers to get one additional success attributable to the programme.

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Selected References

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  1. Coleman T., Wilson A. Anti-smoking advice in general practice consultations: general practitioners' attitudes, reported practice and perceived problems. Br J Gen Pract. 1996 Feb;46(403):87–91. [PMC free article] [PubMed] [Google Scholar]
  2. Donner A., Klar N. Methods for comparing event rates in intervention studies when the unit of allocation is a cluster. Am J Epidemiol. 1994 Aug 1;140(3):279–301. doi: 10.1093/oxfordjournals.aje.a117247. [DOI] [PubMed] [Google Scholar]
  3. Fiscella K., Franks P. Cost-effectiveness of the transdermal nicotine patch as an adjunct to physicians' smoking cessation counseling. JAMA. 1996 Apr 24;275(16):1247–1251. [PubMed] [Google Scholar]
  4. Goldstein M. G., Niaura R., Willey-Lessne C., DePue J., Eaton C., Rakowski W., Dubé C. Physicians counseling smokers. A population-based survey of patients' perceptions of health care provider-delivered smoking cessation interventions. Arch Intern Med. 1997 Jun 23;157(12):1313–1319. doi: 10.1001/archinte.157.12.1313. [DOI] [PubMed] [Google Scholar]
  5. González Enríquez J., Villar Alvarez F., Banegas Banegas J. R., Rodríguez Artalejo F., Martín Moreno J. M. Tendencia de la mortalidad atribuible al tabaquismo en España, 1978-1992: 600.000 muertes en 15 años. Med Clin (Barc) 1997 Nov 1;109(15):577–582. [PubMed] [Google Scholar]
  6. Heatherton T. F., Kozlowski L. T., Frecker R. C., Fagerström K. O. The Fagerström Test for Nicotine Dependence: a revision of the Fagerström Tolerance Questionnaire. Br J Addict. 1991 Sep;86(9):1119–1127. doi: 10.1111/j.1360-0443.1991.tb01879.x. [DOI] [PubMed] [Google Scholar]
  7. Humair J. P., Ward J. Smoking-cessation strategies observed in videotaped general practice consultations. Am J Prev Med. 1998 Jan;14(1):1–8. doi: 10.1016/s0749-3797(97)00010-x. [DOI] [PubMed] [Google Scholar]
  8. Kenford S. L., Fiore M. C., Jorenby D. E., Smith S. S., Wetter D., Baker T. B. Predicting smoking cessation. Who will quit with and without the nicotine patch. JAMA. 1994 Feb 23;271(8):589–594. doi: 10.1001/jama.271.8.589. [DOI] [PubMed] [Google Scholar]
  9. Prochaska J. O., Goldstein M. G. Process of smoking cessation. Implications for clinicians. Clin Chest Med. 1991 Dec;12(4):727–735. [PubMed] [Google Scholar]
  10. Raw M., McNeill A., West R. Smoking cessation guidelines for health professionals. A guide to effective smoking cessation interventions for the health care system. Health Education Authority. Thorax. 1998 Dec;53 (Suppl 5 Pt 1):S1–19. doi: 10.1136/thx.53.2008.s1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Roland M., Torgerson D. J. What are pragmatic trials? BMJ. 1998 Jan 24;316(7127):285–285. doi: 10.1136/bmj.316.7127.285. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Russell M. A., Merriman R., Stapleton J., Taylor W. Effect of nicotine chewing gum as an adjunct to general practitioner's advice against smoking. Br Med J (Clin Res Ed) 1983 Dec 10;287(6407):1782–1785. doi: 10.1136/bmj.287.6407.1782. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Russell M. A., Wilson C., Taylor C., Baker C. D. Effect of general practitioners' advice against smoking. Br Med J. 1979 Jul 28;2(6184):231–235. doi: 10.1136/bmj.2.6184.231. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Stapleton J. A., Russell M. A., Feyerabend C., Wiseman S. M., Gustavsson G., Sawe U., Wiseman D. Dose effects and predictors of outcome in a randomized trial of transdermal nicotine patches in general practice. Addiction. 1995 Jan;90(1):31–42. doi: 10.1046/j.1360-0443.1995.901316.x. [DOI] [PubMed] [Google Scholar]
  15. Yudkin P. L., Jones L., Lancaster T., Fowler G. H. Which smokers are helped to give up smoking using transdermal nicotine patches? Results from a randomized, double-blind, placebo-controlled trial. Br J Gen Pract. 1996 Mar;46(404):145–148. [PMC free article] [PubMed] [Google Scholar]

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