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'Real-world' effectiveness of smoking cessation treatments: a population study

Kotz, D; Brown, J; West, R; (2014) 'Real-world' effectiveness of smoking cessation treatments: a population study. Addiction , 109 (3) pp. 491-499. 10.1111/add.12429. Green open access

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Abstract

BACKGROUND AND AIMS: There is a need for more evidence on the 'real-world' effectiveness of commonly used aids to smoking cessation from population-level studies. This study assessed the association between abstinence and use of different smoking cessation treatments after adjusting for key potential confounding factors. DESIGN: Cross-sectional data from aggregated monthly waves of a household survey: the Smoking Toolkit Study. SETTING: England. PARTICIPANTS: A total of 10 335 adults who smoked within the previous 12 months and had made at least one quit attempt during that time. MEASUREMENTS: Participants were classified according to their use of cessation aids in their most recent quit attempt: (i) medication (nicotine replacement therapy, bupropion or varenicline) in combination with specialist behavioural support delivered by a National Health Service Stop Smoking Service; (ii) medication provided by the prescribing health-care professional without specialist behavioural support; (iii) nicotine replacement therapy (NRT) bought over the counter; and (iv) none of these. The main outcome measure was self-reported abstinence up to the time of the survey, adjusted for key potential confounders including tobacco dependence. FINDINGS: Compared with smokers using none of the cessation aids, the adjusted odds of remaining abstinent up to the time of the survey were 3.25 [95% confidence interval (CI) = 2.05-5.15] greater in users of prescription medication in combination with specialist behavioural support, 1.61 (95% CI = 1.33-1.94) greater in users of prescription medication combined with brief advice and 0.96 (95% CI = 0.81-1.13) in users of NRT bought over the counter. CONCLUSIONS: After adjusting for major confounding variables such as tobacco dependence, smokers in England who use a combination of behavioural support and pharmacotherapy in their quit attempts have almost three times the odds of success than those who use neither pharmacotherapy nor behavioural support. Smokers who buy nicotine replacement therapy over the counter with no behavioural support have similar odds of success in stopping as those who stop without any aid.

Type: Article
Title: 'Real-world' effectiveness of smoking cessation treatments: a population study
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/add.12429
Publisher version: http://dx.doi.org/10.1111/add.12429
Language: English
Additional information: This is the peer reviewed version of the following article: Kotz, D; Brown, J; West, R; (2014) 'Real-world' effectiveness of smoking cessation treatments: a population study. Addiction, 109 (3) pp. 491-499, which has been published in final form at http://dx.doi.org/10.1111/add.12429. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving (http://olabout.wiley.com/WileyCDA/Section/id-820227.html#terms).
Keywords: Behavioural support, bupropion, national household survey, nicotine replacement therapy, smoking cessation, varenicline, Adult, Behavior Therapy, Benzazepines, Bupropion, Cross-Sectional Studies, Dopamine Uptake Inhibitors, England, Female, Humans, Male, Middle Aged, Nicotinic Agonists, Quinoxalines, Smoking, Smoking Cessation, Tobacco Use Cessation Products, Treatment Outcome, Young Adult
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
URI: https://discovery.ucl.ac.uk/id/eprint/1418108
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