Smoking quit rates among patients receiving pharmacotherapy who received general practitioner counselling versus intensive counselling: a retrospective cohort study

Abstract

Background Behavioral treatments can augment the success of pharmacotherapy in smoking cessation. The aim of this study was to compare smoking quit rates between patients receiving individual counseling with their general practitioner during office visits or intensive counselling with behavioral support, both augmented by varenicline. Methods A nationwide retrospective cohort study conducted in a large Healthcare Maintenance Organization in Israel. We selected randomly patients who filled a prescription for varenicline and received either individual consulting by their general practitioner or intensive counselling with behavioural support, and asked them to answer a questionnaire. The outcome variables were smoking cessation 26–52 weeks following the beginning of treatment and satisfaction with the process. Results 870 patients were contacted and 604 agreed to participate (a response rate of 69%); 301 patients in the general practitioner group, 300 in the intensive counselling group and 3 were excluded due to missing date. The quit rate was 36.5% in the general practitioner group and 42.3% in the intensive counselling group (P = 0.147). In a logistic regression analysis, controlling for age, gender, socioeconomic status, ischemic heart disease, chronic obstructive pulmonary disease, pack years and duration of varenicline consumption, the adjusted OR for quitting in the general practitioner group was 0.79 (95% CI 0.56,1.13). The adjusted OR was higher in the group with the highest socioeconomic status at 2.06 (1.39,3.07) and a longer period of varenicline consumption at 1.30 (1.15,1.47). Age, gender and cigarette pack-years were not associated with quit rate. In the general practitioner group 68% were satisfied with the process, while 19% were not. In the intensive counselling group 64% were satisfied and 14% were not (P = 0.007). Conclusion We did not detect a statistically significant difference in smoking quit rates, though there was a trend towards higher quit rates with intensive counselling.

Smoking cessation – better together: A retrospective cohort study

“…This finding highlights the importance of adherence to therapy in supporting participants who seek to quit smoking 24 . The method and intensity of the therapeutic framework chosen (intensive group counseling, personal phone counseling, or brief GP counseling) proved insignificant in this study, suggesting it may be best to tailor counseling to individual participants rather than adopt a ‘one-size-fits-all’ policy 9 .…”

“…We approached participants 26 to 52 weeks after the initiation of treatment and asked them to complete a self-report questionnaire using emails, text messages, and phone calls. The targeted participants attended group counseling (eight 90-minute sessions) or phone counseling (six 30-minute sessions) or received counseling from their general practitioners (GPs) 9 . All these sessions were subsidized and offered to all MHS members.…”

Experiences with smoking habits and the need for cessation among habitual smokers in Japan: a qualitative study based on semi-structured interviews

“…Effective methods of smoking cessation include pharmacological therapy [11], nicotine replacement therapy [12], and various psychological therapies such as counseling [13,14] and cognitive behavioral therapy [15,16]. Combining these pharmacological or nicotine replacement therapies with psychological therapy has been found to be the most effective [17,18], and many habitual smokers are attempting to quit on their own, one way or another.…”