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  • Title: Real-life effectiveness of smoking-cessation treatments in general practice clinics in Denmark. The Escape Smoke project.
    Author: Poulsen PB, Spillemose H, Nielsen G, Hergel LL, Wedell-Wedellsborg D, Strand M, Ringbæk T.
    Journal: Respir Med; 2015 Feb; 109(2):218-27. PubMed ID: 25592244.
    Abstract:
    BACKGROUND: The smoking prevalence has not decreased in the last years in Denmark. General practice (GP) offers smoking cessation (SC) treatment. Studies of real-life effectiveness of daily practice SC-activities from the GP-setting opposed to efficacy results from randomized clinical trials are few. The study aim was to evaluate the real-life effectiveness of SC-treatments for daily smokers among Danish GP-clinics. METHODS: In a multi-centre-based observational study design Danish GP-clinics with prior SC-activity recruited daily smokers motivated for quitting. As per usual clinical practice SC-medicine could be nicotine replacement therapy (NRT), prescription-based SC-medicine (varenicline or bupropion) or no medicine. The primary endpoint was percentage of patients remaining abstinent 6 months after the quit date (ITT, self-reported continuous abstinence). RESULTS: Forty GP-clinics recruited 515 (273 females, 20% COPD) daily smokers being moderately nicotine dependent and heavy smoking (19 cigarettes/day). Receiving intensive advice, 74% did use SC-medicine paid out-of-pocket (1/3 NRT and 2/3 prescription-based). After 6 months, 187 participants had remained abstinent (36%). Adjusted for potential confounding the use of prescription-based SC-medicine plus counseling was associated with significantly doubling the chance of staying abstinent after 6 months as compared to no SC-medicine (OR: 1.97). This association could not be found for NRT. Being male and using prescription-based SC-medicine were independent significant predictors for long-term abstinence. CONCLUSIONS: Smoking cessation in Danish GP-clinics with some prior SC-activity can result in rather high long-term quit rates, especially when combining counseling and prescription-based SC-medicine. The effectiveness of prescription-based SC-medications versus NRT in the general population merits further investigation.
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