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A 10-Year Single-Center Experience of Smoking Cessation Clinic in Japan
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A6254 - A 10-Year Single-Center Experience of Smoking Cessation Clinic in Japan
Author Block: H. Tomioka, M. Yamazoe, T. Wada; Respiratory Medicine, Kobe City Medical Ctr W Hosp, Kobe, Japan.
RATIONALE: Smoking is a major cause of premature mortality and preventable morbidity worldwide. It is important to continue offering the smoking cessation treatment in an area. SETTING: Smoking cessation clinic at a 358-bed community teaching hospital in Japan. METHODS: We have conducted a prospective cohort study of cigarette smokers who participated in a 3-month smoking cessation program that was covered by the Japanese medical insurance system. A diagnosis of nicotine dependence was made by the Tobacco Dependence Screener (TDS) test (Addict Behavi 1999;24:155-66.) (5 points or more). Primary outcome was carbon monoxide-confirmed continuous abstinence for weeks 8 to 12. We evaluated change of the participants and the outcomes in our 10 years’ experience with smoking cessation therapy. RESULTS: Between August 2007 and July 2017, 797 patients with nicotine dependence participated in the program. The participants consisted of 501 men and 296 women whose age was 58.8±13.5 years (means±SD). Mean TDS score was 7.8±1.6. The Brinkman Index score was 849.3±521.0, and the exhaled CO level was 16.0±11.0 ppm. The underlying diseases included mental disorders (n=237, 29.8%), hypertension (n=164, 20.6%), diabetes (n=141, 17.7%), COPD (n=137, 17.2%) and cardiovascular diseases (n=127, 15.9%). Initial prescribed pharmacotherapy was transdermal nicotine patches in 466 subjects and varenicline in 331 subjects. The number of the participants decreased after peaking in 2011 (77 in 2008, 93 in 2009, 107 in 2010, 121 in 2011, 101 in 2012, 68 in 2013, 69 in 2014, 53 in 2015, 65 in 2016). Of the participants, 423 (53.1%) completed the program, among whom 281 (66.4%) succeeded in smoking cessation (quitters). Comparisons of baseline clinical characteristics between quitters and continuous smokers showed significant differences in mean age, duration of smoking, baseline exhaled CO levels, and complication of mental disorders. In a multivariate analysis, only exhaled CO level (odds ratio (OR) 0.94, 95% confidence interval (CI) 0.92, 0.96), and complication of mental disorders (OR 0.50, 95% CI 0.31, 0.82) were associated with success of the smoking cessation. CONCLUSION: The number of the smoking cessation program participant decreased after peaking in 2011. Baseline exhaled CO level and absence of mental disorders were predictive of success of the smoking cessation.
Author Block: H. Tomioka, M. Yamazoe, T. Wada; Respiratory Medicine, Kobe City Medical Ctr W Hosp, Kobe, Japan.
RATIONALE: Smoking is a major cause of premature mortality and preventable morbidity worldwide. It is important to continue offering the smoking cessation treatment in an area. SETTING: Smoking cessation clinic at a 358-bed community teaching hospital in Japan. METHODS: We have conducted a prospective cohort study of cigarette smokers who participated in a 3-month smoking cessation program that was covered by the Japanese medical insurance system. A diagnosis of nicotine dependence was made by the Tobacco Dependence Screener (TDS) test (Addict Behavi 1999;24:155-66.) (5 points or more). Primary outcome was carbon monoxide-confirmed continuous abstinence for weeks 8 to 12. We evaluated change of the participants and the outcomes in our 10 years’ experience with smoking cessation therapy. RESULTS: Between August 2007 and July 2017, 797 patients with nicotine dependence participated in the program. The participants consisted of 501 men and 296 women whose age was 58.8±13.5 years (means±SD). Mean TDS score was 7.8±1.6. The Brinkman Index score was 849.3±521.0, and the exhaled CO level was 16.0±11.0 ppm. The underlying diseases included mental disorders (n=237, 29.8%), hypertension (n=164, 20.6%), diabetes (n=141, 17.7%), COPD (n=137, 17.2%) and cardiovascular diseases (n=127, 15.9%). Initial prescribed pharmacotherapy was transdermal nicotine patches in 466 subjects and varenicline in 331 subjects. The number of the participants decreased after peaking in 2011 (77 in 2008, 93 in 2009, 107 in 2010, 121 in 2011, 101 in 2012, 68 in 2013, 69 in 2014, 53 in 2015, 65 in 2016). Of the participants, 423 (53.1%) completed the program, among whom 281 (66.4%) succeeded in smoking cessation (quitters). Comparisons of baseline clinical characteristics between quitters and continuous smokers showed significant differences in mean age, duration of smoking, baseline exhaled CO levels, and complication of mental disorders. In a multivariate analysis, only exhaled CO level (odds ratio (OR) 0.94, 95% confidence interval (CI) 0.92, 0.96), and complication of mental disorders (OR 0.50, 95% CI 0.31, 0.82) were associated with success of the smoking cessation. CONCLUSION: The number of the smoking cessation program participant decreased after peaking in 2011. Baseline exhaled CO level and absence of mental disorders were predictive of success of the smoking cessation.
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