The impact of repeated cycles of pharmacotherapy on smoking cessation: a longitudinal cohort study

Abstract

Objective: To examine the uptake and effectiveness of repeated offers of pharmacotherapy to promote smoking cessation

Design: Longitudinal cohort

Settings: 50 rural primary care clinics

Participants: 726 adult smokers

Intervention: Offers of either bupropion or transdermal nicotine at 6 month intervals to continuing smokers over a two-year period

Main outcome measure: Self-reported, seven-day, point prevalence abstinence from cigarettes

Results: During the first cycle of treatment, 464 (63.9%) took smoking cessation pharmacotherapy. Among continuing smokers, 52.7% of 383, 45.8% of 177 and 64.7% of 68 took 2nd, 3rd and 4th consecutive cycles of pharmacotherapy, respectively. The odds ratios for quitting among pharmacotherapy users versus non-users was 2.56, 1.83, 1.85, and 3.08 after the 1st, 2nd, 3rd, and 4th cycles of treatment. Successful smoking cessation was not related to the number of previous pharmacotherapy-assisted quit attempts.

Conclusion: A large portion of continuing smokers are willing to engage in repeated pharmacotherapy-assisted quit attempts. The effect of pharmacotherapy does not appear to diminish even after multiple prior quit attempts.

Figures

Figure

Association between Multiple Consecutive Cycles of Pharmacotherapy and Cessation Rates