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Randomized Controlled Trial
. 2018 May-Jun;44(3):195-201.
doi: 10.1590/S1806-37562017000000419.

Comparison of two smoking cessation interventions for inpatients

[Article in English, Portuguese]
Antonio Carlos Ferreira Campos  1 , Angela Santos Ferreira Nani  2 , Vilma Aparecida da Silva Fonseca  3 , Eduardo Nani Silva  1   2 , Marcos César Santos de Castro  2   4 , Wolney de Andrade Martins  1   2
Affiliations
Randomized Controlled Trial

Comparison of two smoking cessation interventions for inpatients

[Article in English, Portuguese]
Antonio Carlos Ferreira Campos et al. J Bras Pneumol. 2018 May-Jun.

Abstract

Objective: This study aimed to compare the effectiveness of two cognitive behavioral therapy-based smoking cessation interventions initiated during hospitalization and to evaluate the factors related to relapse after discharge.

Methods: This was a prospective randomized study involving 90 smokers hospitalized in a university hospital. We collected data related to sociodemographic characteristics, reasons for admission, smoking-related diseases, smoking history, the degree of nicotine dependence (ND), and the level of craving. Patients were divided into two treatment groups: brief intervention (BrInter, n = 45); and intensive intervention with presentation of an educational video (InInterV, n=45). To assess relapse, all patients were assessed by telephone interview in the first, third, and sixth months after discharge. Abstinence was confirmed by measurement of exhaled carbon monoxide (eCO).

Results: Of the 90 patients evaluated, 55 (61.1%) were male. The mean age was 51.1 ± 12.2 years. The degree of ND was elevated in 39 (43.4%), and withdrawal symptoms were present in 53 (58.9%). The mean eCO at baseline was 4.8 ± 4.5 ppm. The eCO correlated positively with the degree of ND (r = 0.244; p = 0.02) and negatively with the number of smoke-free days (r = -0.284; p = 0.006). There were no differences between the groups in terms of the variables related to socioeconomic status, smoking history, or hospitalization. Of the 81 patients evaluated at 6 months, 33 (40.7%) remained abstinent (9 and 24 BrInter and InInterV group patients, respectively; p = 0.001), and 48 (59.3%) had relapsed (31 and 17 BrInter and InInterV group patients, respectively; p= 0.001). Moderate or intense craving was a significant independent risk factor for relapse, with a relative risk of 4.0 (95% CI: 1.5-10.7; p < 0.00001).

Conclusions: The inclusion of an educational video proved effective in reducing relapse rates. Craving is a significant risk factor for relapse.

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Figures

Figure 1
Figure 1. Comparison between the groups studied, in terms of the rates of relapse and abstinence, at 6 months after discharge from the hospital.
Figure 2
Figure 2. ROC curves for event-free follow-up, by group.
Figure 3
Figure 3. Scores on the Brief Questionnaire of Smoking Urges, by outcome.
Figure 4
Figure 4. ROC curve for the Brief Questionnaire of Smoking Urges score, in relation to relapse.
See this image and copyright information in PMC

Comment in

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