Strategic partnerships for addressing tobacco use.
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Cooperative Behavior↗
Biomedical subjects
W Bjornson
Publications and source records attributed to W Bjornson.
Smoking cessation in primary care clinics.
OBJECTIVES: To document smoking cessation rates achieved by applying the 1996 Agency for Health Care Policy and Research (AHCPR) smoking cessation guidelines for primary care clinics, compare these quit rates with historical results, and determine if quit rates improve with an additional motivational intervention that includes education as well as spirometry and carbon monoxide measurements. DESIGN: Randomized clinical trial. SETTING: Two university-affiliated community primary care clinics. PATIENTS: Two hundred five smokers with routinely scheduled appointments. INTERVENTION: All smokers were given advice and support according to AHCPR guidelines. Half of the subjects received additional education with spirometry and carbon monoxide measurements. MEASUREMENTS AND MAIN RESULTS: Quit rate was evaluated at 9-month follow-up. Eleven percent of smokers were sustained quitters at follow-up. Sustained quit rate was no different for intervention and control groups (9% vs 14%; [OR] 0.6; 95% [CI] 0.2, 1.4). Nicotine replacement therapy was strongly associated with sustained cessation (OR 6.7; 95% CI 2.3, 19.6). Subjects without insurance were the least likely to use nicotine replacement therapy ( p =.05). Historical data from previously published studies showed that 2% of smokers quit following physician advice, and additional support similar to AHCPR guidelines increased the quit rate to 5%. CONCLUSIONS: The sustained smoking cessation rate achieved by following AHCPR guidelines was 11% at 9 months, which compares favorably with historical results. Additional education with spirometry did not improve the quit rate. Nicotine replacement therapy was the strongest predictor of cessation, yet was used infrequently owing to cost. These findings support the use of AHCPR guidelines in primary care clinics, but do not support routine spirometry for motivating patients similar to those studied here.
Adult↗
Designing an effective counteradvertising campaign--Oregon.
In this report, the authors describe the key components for development of the soon to be created counteradvertising campaign. Emphasis is placed on numerous factors, including training, selection of target groups, the need for multiple media channels, and scientific assessment of media strategies.
Advertising↗
Evaluation: methods and strategy for evaluation--Oregon.
The authors describe the development of comprehensive mechanisms for the evaluation of Oregon's newly funded tobacco control efforts through building on established surveillance systems.
Humans↗
Gender differences in smoking cessation after 3 years in the Lung Health Study.
OBJECTIVES: An analysis of gender differences in smoking cessation was conducted among 3923 participants in the Special Intervention group of the Lung Health Study. This report focuses on gender differences in sustained quit rates at 12 and 36 months. METHODS: Special Intervention participants were offered a 12-session, 12-week smoking cessation program using nicotine gum and were followed for 3 years. Self-reported smoking status was validated with carbon monoxide and salivary cotinine. RESULTS: Men had higher sustained quit rates at 12 and 36 months; gender differences were found in baseline variables that also predicted sustained abstinence; and controlling for selected baseline variables reduced the association between gender and sustained abstinence. When other variables were controlled, gender predicted sustained abstinence at 36 months (odds ratio [OR] = 1.24, 95% confidence interval [CI] = 1.04, 1.48) but not 12 months (OR = 1.08, 95% CI = 0.92, 1.27), reflecting more late relapse among women. CONCLUSIONS: Demographics and smoking history were more important than gender per se in sustained smoking cessation in the Lung Health Study. Programs tailoring smoking cessation by gender need to include coping skills for problems associated with less education and social support and for improving persistence with quit attempts.
Adult↗
Intervention for relapse to smoking: the Lung Health Study restart programs.
The Lung Health Study enrolled 3,923 participants in a smoking cessation intervention program, and followed them for 5 years. The study provided intensive group interventions for participants who had relapsed. The purpose of this analysis was to describe and evaluate these Restart programs. Among 1,004 relapsed participants, the percent not smoking at 5th year was higher for men who had used Restart (47) compared to those who had not (28), but not for women (42 vs. 33). Overall, there was equivocal evidence of the impact of the Restart programs due to limitations in the evaluation design. Because relapse is a common feature of efforts to quit smoking, relapse intervention programs need further study and more rigorous evaluation.
Adult↗