Nurse practitioner interventions for smokers with chronic hepatitis C

Abstract

Background:Smoking is a grossly overlooked risk factor for people with chronic hepatitis C with regard to disease progression. It is unclear whether current smoking cessation interventions are effective for this population.Purpose:The purpose was to evaluate the effectiveness of a telephone counseling and nicotine replacement therapy (NRT) intervention for smokers with chronic hepatitis C to quit or reduce rates of smoking.Methods:A randomized controlled trial was conducted with participants randomized and stratified according to heaviness of smoking. Ninety-two eligible adults who smoked cigarettes and attended hepatology outpatient clinics were recruited. The intervention included NRT and telephone counseling compared with telephone counseling alone. Data collection occurred from December 2010 to November 2011. Data were collected at baseline, 6, and 12 weeks to assess smoking cessation. Change scores were analyzed using analysis of variance to examine the differences between smoking interventions.Results:At 6 weeks, both control and intervention groups had quit or reduced the number of cigarettes smoked daily. However, over 12 weeks, the intervention group showed sustained quitting or reduced smoking, with 5.8 (confidence interval [CI]: 2.4, 9.3) fewer cigarettes smoked per day from baseline. The control group maintained an average reduction of 1.6 (CI: -1.9, 5.2) fewer cigarettes per day.Implications for practice:Nicotine replacement therapy and individualized telephone counseling interventions increase the prospects of smoking cessation. Interventions such as these, introduced at routine clinic appointments in the outpatients' setting, by a nurse practitioner (hepatology) showed clinically important results for smoking cessation in this population.