Success rates in smoking cessation: Psychological preparation plays a critical role and interacts with other factors such as psychoactive substances

Abstract

IntroductionThe aim of this study was to identify factors associated with the results of smoking cessation attempts.MethodsData were collected in Clermont-Ferrand from a smoking cessation clinic between 1999 and 2009 (1,361 patients). Smoking cessation was considered a success when patients were abstinent 6 months after the beginning of cessation. Multivariate logistic regression was used to investigate the association between abstinence and different factors.ResultsThe significant factors were a history of depression (ORadjusted = 0.57, p = 0.003), state of depression at the initial consultation (ORa = 0.64, p = 0.005), other psychoactive substances (ORa = 0.52, p<0.0001), heart, lung and Ear-Nose-Throat diseases (ORa = 0.65, p = 0.005), age (ORa = 1.04, p<0.0001), the Richmond test (p<0.0001; when the patient’s motivation went from insufficient to moderate, the frequency of abstinence was twice as high) and the Prochaska algorithm (p<0.0001; when the patient went from the ‘pre-contemplation’ to the ‘contemplation’ level, the frequency of success was four times higher). A high score in the Richmond test had a greater impact on success with increasing age (significant interaction: p = 0.01). In exclusive smokers, the contemplation level in the Prochaska algorithm was enough to obtain a satisfactory abstinence rate (65.5%) whereas among consumers of other psychoactive substances, it was necessary to reach the preparation level in the Prochaska algorithm to achieve a success rate greater than 50% (significant interaction: p = 0.02).ConclusionThe psychological preparation of the smoker plays a critical role. The management of smoking cessation must be personalized, especially for consumers of other psychoactive substances and/or smokers with a history of depression.

Predictors of Quitting Smoking in Cardiac Rehabilitation

“…This was in line with the finding of a meta-analysis of 42 trials by Hitsman et al, in which major depression had a moderate adverse effect on quitting smoking [53]. This finding was also in agreement with previous studies that concluded that patients who quit smoking were less likely to have depression and that depression greatly decreased the likelihood of quitting smoking [29,30].…”

“…Smoking-related variables include tobacco dependence, the baseline number of cigarettes smoked per day, the number of previous quit attempts, motivation to quit, and the proportion of smokers in the household, all of which might influence the success of quitting smoking [18,22,[27][28][29]. Predictors of successful quitting include lower levels of depression [29,30]. Better designed observational studies are needed to determine the factors that are associated with successfully quitting smoking in CR attendees.…”

<p>Personalized medicine for patients with COPD: where are we?</p>

“…The challenge here is to motivate those at risk to actively participate in preventive measures and to overcome the high dropout rate of lifestyle interventions. A personalized motivational approach, taking into account the individual psychosocial background, would likely improve the intervention success 43. In addition, specific preventive measures against comorbid diseases (for example treatment of hypertension or dyslipidaemia) have to be taken into account, and alpha1 antitrypsin augmentation therapy may be considered in deficient individuals.…”

Características biopsicosociales relacionadas con el consumo de cigarrillo y la intención de cesación en fumadores en un entorno universitario

“…El consumo de cigarrillo es un comportamiento complejo que, junto con la intención de cambio, implican variables biopsicosociales y contextuales, que deben ser identificadas y consideradas en conjunto para hacer una mejor comprensión de lo que supone el cambio comportamental y poder establecer elementos efectivos de intervención, así como factores predictivos para el éxito de los procesos de cesación, tanto en población general como en grupos específicos (63,64). Los resultados complementan la información disponible sobre los factores vinculados al inicio y/o mantenimiento del consumo de tabaco, así como a la intención de cesación, favoreciendo la comprensión de la problemática de consumo y del cambio conductual requerido respecto de la cesación tabáquica en entornos universitarios.…”