Smoking Cessation

A 4-year Follow-up Evaluation Of A Pharmacist-managed Smoking Cessation Programme With Emphasis On Effectiveness Of Different Treatment Modalities


Introduction:
Smoking cessation clinic (SCC) was introduced into Singapore’s healthcare setting to combat the increase in smoking prevalence. This study aims to determine (1)the effectiveness of a pharmacist-managed SCC, and (2)the association between abstinence rates and different treatment modalities, in Changi General Hospital.

Methods:

445 patients who had attended the SCC were retrospectively reviewed. These patients received structured smoking cessation counselling with or without additional cessation aid comprising of nicotine replacement therapy (NRT), varenicline or bupropion. The study end points were point-prevalence abstinence rates (1)for all subjects, and (2)associated with various treatment modalities, at the final SCC review, 6- and 12-month follow-up.

Results:
The point-prevalence abstinence rates for all patients at completion of SCC review, 6- and 12-month follow-up were 19.8%, 23.8% (p=0.033), and 25.4% (p=0.009), respectively. Abstinence rates between 6- and 12-month follow-up were not statistically different. A significant association between abstinence rates and the use of pharmacotherapy was detected at 6-months’ follow-up (p=0.005), but not at SCC review completion or 12-months’ follow-up (p>0.05). Abstinence rates were highest at 6- and 12-month with use of varenicline (37.4% and 34.3%, respectively) followed by combination NRT (21.7% and 26.1%). Furthermore, patients who had received only smoking cessation counselling had abstinence rates of 20.7% and 26.0% at 6- and 12-month follow-up.

Conclusions:
Patient participation in a pharmacist-managed SCC was associated with significantly improved abstinence rates at 6- and 12-months following programme completion. The use of pharmacotherapy was significantly associated with overall abstinence rates at 6-months’ follow-up with varenicline appearing as the most effective smoking cessation aid.

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