Journal
INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
Volume 10, Issue 9, Pages 4186-4199Publisher
MDPI
DOI: 10.3390/ijerph10094186
Keywords
smoking cessation; abstinence; heavy smokers; intensive program; nationwide database; group program; individual program; Denmark
Funding
- Danish National Board of Health
- Danish Ministry of Interior and Health
- Danish Smoking Cessation Database
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Background: High-intensity smoking cessation programs generally lead to more continuous abstinence, however, lower rates of success have been reported among heavy smokers. The aim was to evaluate continuous abstinence among heavy smokers during the intensive 6-week Gold Standard Program (GSP) and to identify modifiable factors associated with continuous abstinence. Methods: In this nationwide clinical study based on 36,550 smokers attending an intensive cessation program in Denmark. Heavy smoking was defined as 7 points in the Fagerstrom Nicotine Dependency Test, smoking 20 cigarettes daily or 20 pack-years. Results: Overall, 28% had a Fagerstrom score 7 points, 58% smoked 20 cigarettes daily and 68% smoked 20 pack-years. Continuous abstinence was 33% in responders (6-months response rate: 78%); however, abstinence was approximately 1-6% lower in the heavy smokers than the overall population. Attending GSP with an individual format (vs. group/other, OR 1.23-1.44); in a hospital setting (vs. pharmacy/municipality services, OR 1.05-1.11); and being compliant (attending the planned meetings OR 4.36-4.89) were associated with abstinence. Abstinence decreased in a dose-dependent manner with increasing smoking severity. Conclusions: Abstinence after GSP was 1-6% lower in the heavy smokers than in the overall study population. Modifiable factors may be used for small improvements in continued abstinence. However attempts to improve compliance seemed especially promising.
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