Effectiveness of the Gold Standard Programme (GSP) for smoking cessation on smokers with and without a severe mental disorder : a Danish cohort study
Menée au Danemark à partir de données portant sur 38 293 fumeurs ayant participé à un programme de sevrage tabagique entre 2006 et 2016, cette étude évalue, du point de vue du taux d'abstinence tabagique continu à 6 mois et en fonction de l'état mental des participants (présence ou non de troubles mentaux graves), l'efficacité d'une intervention standard comportant, sur une période de 6 semaines, 5 réunions destinées à présenter un manuel pédagogique d'aide au sevrage tabagique et à prodiguer des conseils
Objectives : We compared the effectiveness of an intensive smoking cessation intervention among smokers with and without a severe mental disorder (SMD) and identified factors associated with successful quitting. The main hypothesis was that smokers with an SMD would be less likely to stay continuously smoke-free for 6 months. Design : A prospective cohort study. Setting In all, 302 smoking cessation clinics in Denmark from municipal clinics, pharmacies, hospitals, midwives, primary care facilities and other private providers who reported data to the national Danish Smoking Cessation Database from 2006 to 2016 participated in this study. Participants : A total of 38 293 patients from the Danish Smoking Cessation Database. Patients with an SMD were identified by linking data to the Danish National Patient Register. Diagnoses of organic mental disorders (F0 chapter) or intellectual disabilities (F7 chapter) were not included. Smokers ≥18 years old who were attending a Gold Standard Programme (GSP) with planned follow-up were included. Smokers not wanting contact after 6 months were excluded. Interventions : A comprehensive manual-based smoking cessation intervention comprising five meetings over a 6-week period (the GSP). Main outcome measures : Self-reported continuous abstinence at the 6-month follow-up. Results : In all, 69% of the participants participated in the follow-up after 6 months. The overall rate of successful quitting was high but significantly lower in SMD smokers (29% vs 38%; OR 0.74; 95% CI 0.68 to 0.80). Variables associated with successful quitting were compliance (defined as attending ≥75% of the planned meetings), older age and male gender as well as not being disadvantaged, heavy smoking or recommendation of intervention by health professionals. Conclusions : Only 29% of smokers with an SMD successfully quit smoking which was significantly lower than the 38% of smokers without an SMD. Compliance was the most important predictor for successful quitting. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.