Long– and short–term effectiveness of a large–scale proprietary smoking cessation program—a 4-year follow-up of smokenders participants

Abstract

PROBLEMThe effectiveness of smoking cessation programs has been reviewed in five papers (Bernstein (l), Bradshaw (a), Hunt and Bespalec (6), Keutzer, Lichtenstein and Mees Schwarta (11)) that have surveyed a total of 184 separate studies. Many treatment modalities have been employed-nicotine substitutes, other drugs, behavior modification, psychotherapy, exhortation, stimulus satiation, conditioned aversion, etc. The number of Ss in any single study has ranged from one to several thousand. Given such great variability in method of treatment and composition of participant groups, it is not surprising that the surveys of effectiveness mentioned above have found widely varying success rates, both during the course of treatment and at various times thereafter.While the studies surveyed varied in the length of time that participants were followed, the most frequent follow-up interval was from 6 months to 1 year after the end of their participation in the smoking cessation program. A few studies managed to follow 8s for 18 months. Consistently, there was a sharp drop in the number of successful participants who had not relapsed during the first 6 months after the formal program had been completed.Only two of the studies covered in the above-mentioned review papers published a 4-year check on smoking behavior. Lawton@) found that of 17 participants in a group therapy smoking cessation project, all but 3 were smoking 4 years later, and 1 of the 3 apparently did not stop smoking as a result of the treatment. The other long-term follow-up was done by Moses ( l o ) , who used hypnosis and discussion in the treatment of individual patients. These patients were seen at different points in time over a span of 3 years and followed as a group about a year after the final patient was seen. The exact time intervals were not specified, but the success rate was 12 out of 50 who replied to the follow-up questionnaire or phone inquiry. Of the 12, 4 had been treated 4 years earlier.In addition to the studies covered by the above review articles, two 5-year follow-up studies have been reported-one by Hammer (5), the other by Wetterqvist (13). The participants in the program reported by Hammer, however, could not be considered representative of the smoking population. The study was done at a health spa and the 3861 Spatients suffered from a variety of physical disorders (e.g., 97% had circulatory problems). A multitude of treatments ranged from thermal baths and mud packs to Yoga. The immediate smoking cessation rate was 82%. Five years later, 54% still were not smoking. I n general, women found smoking cessation more difficult than did men-both initially and long-term.Wetterqvist(13) also found that men were more successful than women in smoking cessation. In a group of 192 men and 98 women, initial cessation rates were 50% for males and 33% for females. Five years later, these rates had dropped to 9% for males and 5% for females.In general, therefore, there have been few long-term follow-up studies of any smoking cessation program and ...

Effects of Nicotine Chewing Gum on Smoking Cessation in Routine Clinical Use

“…As shown in Table 1, a considerable proportion of the subjects did not respond to the follow-up questionnaire. This is a general problem in) large studies and studies with long-term follow-up [6,7,8]. However, the success rate among non-responders is known to be very low, and Schwartz et al [5] recommend that drop-outs be counted as failures.…”

Inducing Low Tar/Nicotine Cigarette Smoking in Women

“…The results suggest that for some female subjects either the manipulation of a cigarette has some reinforcing value independent of its nicotine delivery or that subjects may lose their tolerance to nicotine so that the small amounts in very low nicotine cigarettes are able to maintain the smoking behavior. Since women tend to be less successful than men in cessation programs (Kanzler, Jaffe and Zeidenberg, 1976), this finding has obvious significance.…”

Nonexercise Aspects of Pulmonary Rehabilitation

“…Some of the methods that have been attempted include information about the risk of smoking, 25 self-management, [26][27][28][29][30] self-monitoring, 31,32 aversion therapy and satiation, [33][34][35][36][37] transcendental meditation, 38 sensory deprivation, 39 individual counseling, 40 posters, 41 hypnosis, 40,[42][43][44][45] desensitization, 35,46 stimulus control, 47 nicotine chewing gum, 48,49 drug therapy, 50,51 various package programs, such as the Seventh-Day Adventist Church's Five-Day Plan to Stop Smoking, [52][53][54] and proprietary programs such as those of Schick and Smokenders. 55 Some of these techniques have been reviewed by Daughton and Fix. 56 Physician advice can be of definite benefit in getting patients to stop smoking.…”