Long-term follow-up of a high- and a low-intensity smoking cessation intervention in a dental setting-- a randomized trial
Mené sur 300 fumeurs recevant des soins dentaires ou des soins de médecine générale, cet essai randomisé évalue, du point de vue du taux d'abstinence, l'efficacité à long terme (12 mois puis plus de 5 ans après l'intervention) de deux programmes d'interventions pour arrêter de fumer, l'un reposant sur la thérapie comportementale, l'accompagnement du patient et des conseils pharmacologiques, l'autre sur des exercices comportementaux et des tests à effectuer de façon autonome
BACKGROUND : Achieving lifelong tobacco abstinence is an important public health goal. Most studies use 1-year follow-ups, but little is known about how good these are as proxies for long-term and life-long abstinence. Also, intervention intensity is an important issue for development of efficient and cost-effective cessation treatment protocols.The study aims were to assess the long-term effectiveness of a high- and a low-intensity treatment (HIT and LIT) for smoking cessation and to analyze to what extent 12-month abstinence predicted long-term abstinence. METHODS : 300 smokers attending dental or general health care were randomly assigned to HIT or LIT at the public dental clinic. Main outcome measures were self-reported point prevalence, continuous abstinence (>=6 months), and sustained abstinence. The study was a follow-up after 5--8 years of a previously performed 12-month follow-up, both by postal questionnaires. RESULTS : Response rate was 85% (n=241) of those still alive and living in Sweden. Abstinence rates were 8% higher in both programs at the long-term than at the 12-month follow-up. The difference of 7% between HIT and LIT had not change, being 31% vs. 24% for point prevalence and 26% vs. 19% for 6-month continuous abstinence, respectively. Significantly more participants in HIT (12%) than in LIT (5%) had been sustained abstinent (p=0.03). Logistic regression analyses showed that abstinence at 12-month follow-up was a strong predictor for abstinence at long-term follow-up. CONCLUSIONS : Abstinence at 12-month follow-up is a good predictor for long-term abstinence. The difference in outcome between HIT and LIT for smoking cessation remains at least 5--8 years after the intervention.Trial registration number: NCT00670514