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Smoking cessation treatment in a real-life setting: the Greek experience

Smoking Cessation Clinic, Pulmonary and Critical Care Department, Evgenidion Hospital, 20 Papadiamantopoulou Str., 11528, Athens, Greece, rovinanikoletta{at}hotmail.com

Ioanna Nikoloutsou

Smoking Cessation Clinic, Department of Pulmonary and Critical Care Medicine, Evgenidio Hospital, University of Athens, Greece

Efi Dima

Smoking Cessation Clinic, Department of Pulmonary and Critical Care Medicine, Evgenidio Hospital, University of Athens, Greece

Makrina Michailidou

Smoking Cessation Clinic, Department of Pulmonary and Critical Care Medicine, Evgenidio Hospital, University of Athens, Greece

Charalampos Roussos

Smoking Cessation Clinic, Department of Pulmonary and Critical Care Medicine, Evgenidio Hospital, University of Athens, Greece, Department of Critical Care and Pulmonary Services, "Evangelismos" Hospital, University of Athens

Christina Gratziou

Smoking Cessation Clinic, Department of Pulmonary and Critical Care Medicine, Evgenidio Hospital, University of Athens, Greece

Objectives: The aim of this study was to estimate the clinical efficacy of counseling combined with currently used pharmacotherapy for smoking cessation (bupropion SR and nicotine replacement therapy, NRT) in actual clinical practice, and to identify predictors of successful abstinence at the end of therapy, as well as predictors of sustained abstinence in one year.

Methods: 895 smokers, self—motivated to quit, received bupropion SR for 7 or 19 weeks and/or nicotine replacement therapy (NRT) (nicotine patch) for 9 weeks in combination with individual behavioural therapy. An intensive program including repetitive visits and telephone contacts during treatment and one year's follow-up period was available for supporting and motivating smokers to prevent relapse.

Results: Post-treatment abstinence rates were 71.6% and 53.2% in bupropion SR groups for 7 and 19 weeks of treatment, respectively, (p < 0.001), 63.4% in bupropion SR plus nicotine patch group and 45% (p < 0.001) in nicotine patch group. One year's follow-up abstinence rates were 43.1%, 29.6%, 30.4% and 18.4% (p < 0.05), respectively. Predictors of successful abstinence at the end of therapy included (a) bupropion SR, (b) lower DSM IV symptom score, and (c) lower nicotine addiction, while predictors for sustained abstinence in one year included: (a) bupropion SR, (b) lower nicotine addiction, and (c) smoker's motivation.

Conclusions: Smoking cessation interventions implementing intensive multi-component programs and constant smokers' motivation in health care settings of actual practice seem promising for increasing short and long-term abstinence rates.

Key Words: smoking cessation • abstinence • intensive intervention • actual clinical practice • motivation

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