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- Title
Long‐term effectiveness of a nurse‐led smoking cessation clinic at a comprehensive cancer center.
- Authors
Martínez, Cristina; Castellano, Yolanda; Fu, Marcela; Riccobene, Anna; Enríquez, Marta; Narváez, Maite; Saura, Judith; Feliu, Arianda; Fernández, Esteve
- Abstract
Purpose: Smoking cessation interventions should be promoted in cancer centers to improve clinical outcomes among cancer patients and the quality of life of cancer‐free patients and survivors. The aim of the present study was to examine long‐term abstinence (1, 3, and 5 years) among smokers who received an intensive nurse‐led smoking cessation intervention. Design: A prospective follow‐up study was conducted in a smoking cessation clinic in Barcelona. Methods: The study included 479 smokers who received a nurse‐led smoking cessation intervention that included motivational interviewing, psychological support, behavioral change counseling, promotion of smoke‐free policies, and relapse‐prevention strategies, as well as pharmacotherapy if necessary, for 12 months. We calculated overall and sex‐specific 1‐, 3‐, and 5‐year abstinence probabilities (Kaplan–Meier curves) and adjusted hazard ratios (aHRs) of relapse with 95% confidence intervals (CIs) using Cox regression. Findings: The overall probability of abstinence at 1 and 5 years was 0.561 (95% CI: 0.516–0.606) and 0.364 (95% CI: 0.311–0.417), respectively. Females had a higher, but not significant, hazard ratio for relapse compared to males (aHR = 1.180; 95% CI: 0.905–1.538). Attending <5 visits was the most remarkable determinant of relapsing compared to attending 5–9 visits or ≥10 visits, both overall and by sex (p for trend: overall, p < 0.001; males, p = 0.007; and females, p < 0.001). Conclusions: Abstinence probability decreased over the 5‐year follow‐up but was relatively high. Males had higher abstinence rates than females in all follow‐up periods. Completeness of the intensive intervention was the main predictor of cessation. Clinical Relevance: Smoking cessation interventions should consider sex and incorporate strategies to increase adherence to obtain higher long‐term abstinence rates.
- Subjects
SPAIN; NURSING audit; SMOKING prevention; EVALUATION of medical care; HEALTH policy; NURSE administrators; SPECIALTY hospitals; SMOKING cessation; DRUG abstinence; SCIENTIFIC observation; SOCIAL support; CONFIDENCE intervals; MOTIVATIONAL interviewing; MULTIVARIATE analysis; OUTPATIENT medical care management; CANCER treatment; SEX distribution; DISEASE relapse; RISK assessment; RESEARCH funding; QUESTIONNAIRES; KAPLAN-Meier estimator; DESCRIPTIVE statistics; BUPROPION; NICOTINE replacement therapy; SMOKING; VARENICLINE; NURSING interventions; LONGITUDINAL method; BEHAVIOR modification; HEALTH promotion; PROPORTIONAL hazards models; DISEASE risk factors
- Publication
Journal of Nursing Scholarship, 2023, Vol 55, Issue 3, p681
- ISSN
1527-6546
- Publication type
Article
- DOI
10.1111/jnu.12891