Long-term effectiveness of a nurse-led smoking cessation clinic at a comprehensive cancer center

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.