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Gold Standard Program for Heavy Smokers in a Real-Life Setting
Clinical Health Promotion Centre, Department of Health Sciences, Lund University, Skåne University Hospital, Entrance. 108, Malmö SE 205 02, Sweden
WHO-CC Clinical Health Promotion Centre, Bispebjerg and Frederiksberg Hospitals—a part of Copenhagen University Hospital, The Capital Region, Nordre Fasanvej 57, DK-2000 Frederiksberg, Copenhagen, Denmark
Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals—a part of Copenhagen University Hospital, The Capital Region, Nordre Fasanvej 57, DK-2000 Frederiksberg, Copenhagen, Denmark
National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, DK-1353 Copenhagen K, Denmark
These authors contributed equally to this work.
* Author to whom correspondence should be addressed.
Received: 4 July 2013; in revised form: 22 August 2013 / Accepted: 30 August 2013 / Published: 9 September 2013
Abstract: 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 Fagerström Nicotine Dependency Test, smoking ≥20 cigarettes daily or ≥20 pack-years. Results: Overall, 28% had a Fagerström 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.
Keywords: smoking cessation; abstinence; heavy smokers; intensive program; nationwide database; group program; individual program; Denmark
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Neumann, T.; Rasmussen, M.; Heitmann, B.L.; Tønnesen, H. Gold Standard Program for Heavy Smokers in a Real-Life Setting. Int. J. Environ. Res. Public Health 2013, 10, 4186-4199.
Neumann T, Rasmussen M, Heitmann BL, Tønnesen H. Gold Standard Program for Heavy Smokers in a Real-Life Setting. International Journal of Environmental Research and Public Health. 2013; 10(9):4186-4199.
Neumann, Tim; Rasmussen, Mette; Heitmann, Berit L.; Tønnesen, Hanne. 2013. "Gold Standard Program for Heavy Smokers in a Real-Life Setting." Int. J. Environ. Res. Public Health 10, no. 9: 4186-4199.