Changes in the profiles of smokers seeking cessation treatment and in its effectiveness in Galicia (Spain) 2001-10

Elisardo Becoña, Ana López-Durán, Elena Fernández del Río, Úrsula Martínez, Elisardo Becoña, Ana López-Durán, Elena Fernández del Río, Úrsula Martínez

Abstract

Background: In recent years, the prevalence of daily smokers has decreased in all developed countries due to a great variety of factors. Despite this decrease, the effectiveness of clinical treatments has decreased and several studies report a change in smokers' characteristics. The purpose of the present study is to analyze the changes in the characteristics of Spanish smokers who seek smoking cessation treatment between 2001 and 2010 and the changes in the effectiveness of such treatment.

Methods: The sample was made up of 870 smokers who sought psychological treatment for giving up smoking at the Smoking Cessation Unit in the Faculty of Psychology of the University of Santiago de Compostela (Spain) during the period 2001 to 2010.

Results: Smokers in the 2006-2010 group, compared to those in the 2001-2005 group, were older, smoked fewer cigarettes per day and of a brand with fewer mg/nicotine, had been smoking longer, were less motivated to give up smoking, and had more antecedents of depression. Quit rates were validated by testing smokers' carbon monoxide (CO) levels.Percentages of abstinence were higher in the 2001-2005 group than in the 2006-2010 group (58.7% vs. 52.15 at the end of treatment, p = 0.05); 30.8% vs. 24.2% at 6 months follow-up, p = 0.031; 27.5% vs. 22% at 12 months follow-up, p = 0.059). Although abstinence decreased more than 5% in the 2006-2010 group there were no differences between the two groups in nicotine dependence. Those participants who did not assist to the follow-up were considered smokers at pretreatment level.

Conclusions: In Spain there has been a qualitative change in the profile of the smokers seeking smoking cessation treatment. Treatment effectiveness has decreased, and the variables predicting intervention outcome have changed.

Figures

Figure 1
Figure 1
Abstinence at three stages of smoking treatment by period.

References

    1. Bogdanovica I, Godfrey F, McNeill A, Britton J. Smoking prevalence in the European Union: a comparison of national and transnational prevalence survey methods and results. Tob Control. 2011;20:e4.
    1. Mendez D, Warner KE. Adult cigarette smoking prevalence: declining as expected (not as desired) Am J Public Health. 2004;94:251–252.
    1. Ministerio de Sanidad, Servicios Sociales e Igualdad. Encuesta Nacional de Salud de España 2011–2012. [ . Accessed 27 July 2013]
    1. de Galicia X. O consumo de tabaco en Galicia, 2005 [Tobacco consumption in Galicia, 2005] Boletín Epidemiolóxico de Galicia. 2006;XVIII:1–2.
    1. Irvin JE, Hendricks PS, Brandon TH. The increasing recalcitrance of smokers in clinical trials II: pharmacotherapy trails. Nicotine Tob Res. 2003;5:27–35.
    1. Lando HA. Reflections on 30+ years of smoking cessation research: from the individual to the world. Drug Alcohol Rev. 2006;25:5–14.
    1. Córdoba R, Villalbí JR, Salvador-Llivina T, López-García Aranda V. El proceso en España de la adopción de una legislación eficaz para la prevención del tabaquismo [The process in Spain of adopting effective legislation to prevent smoking] Rev Esp Salud Publica. 2006;80:631–645.
    1. Villalbí JR. Valoración de la Ley 28/2005 de medidas sanitarias frente al tabaquismo [Assessment of the Ley 28/2005 on health measures against smoking] Rev Esp Salud Publica. 2009;83:805–820.
    1. Ministerio de Sanidad, Servicios Sociales e Igualdad, Secretaría General de Sanidad y Consumo. Informe a las Cortes Generales de evaluación del impacto sobre la salud pública de la Ley 42/2010 [Report to the General Court of the assessment of the impact of the Ley 42/2010 on public health] [ ]
    1. Catalina C, Sainz JC, Quevedo L, Cortés MV, Pinto JA, Gelpi JA, Calvo E, González A. Prevalencia de consumo de tabaco en población trabajadora tras la entrada en vigor de la Ley 42/2010 [Prevalence of tobacco consumption among working population after the Ley 42/2010, Spain] Rev Esp Salud Publica. 2012;86:177–188.
    1. Nebot M, Fernández E. Evaluación del impacto de la Ley de medidas sanitarias frente al tabaquismo [Assessment of the impact of the Law for health measures against smoking] Madrid: Ministerio de Sanidad y Política Social; 2009.
    1. Callinan JE, Clarke A, Doherty K, Kelleher C. Legislative smoking bans for reducing secondhand smoke exposure, smoking prevalence and tobacco consumption. Cochrane Database Syst Rev. 2010. doi:10.1002/14651858.CD005992.pub2.
    1. Fagerstrom KO, Kunze M, Schoberberger R, Breslau N, Hughes JR, Hurt RD, Puska P, Ramstrom L, Zatonski W. Nicotine dependence versus smoking prevalence: comparison among countries and categories of smokers. Tob Control. 1996;5:52–56.
    1. Fagerström KO, Furberg H. A comparison of the Fagerström test for nicotine dependence and smoking prevalence across countries. Addiction. 2008;103:841–845.
    1. Hughes JR. The hardening hypothesis: is the ability to quit decreasing due to increasing nicotine dependence? A review and commentary. Drug Alcohol Depend. 2011;117:111–117.
    1. Irvin JE, Brandon TH. The increasing recalcitrance of smokers in clinical trials. Nicotine Tob Res. 2000;2:79–84.
    1. Piper ME, Smith SS, Schlam TR, Fleming MF, Bittrich AA, Brown JL, Leitzke CJ, Zehner ME, Fiore MC, Baker TB. Psychiatric disorders in smokers seeking treatment for tobacco dependence: relations with tobacco dependence and cessation. J Consult Clin Psychol. 2010;78:13–23.
    1. Schroeder SA, Morris CD. Confronting a neglected epidemic: tobacco cessation for persons with mental illness and substance abuse problems. Annu Rev Public Health. 2010;31:16.1–16.18.
    1. de Leon J, Becoña E, Gurpegui M, González-Pinto A, Díaz FJ. The association between high nicotine dependence and severe illness may be consistent across countries. J Clin Psychiatry. 2002;63:812–816.
    1. Fiore MC, Jaén CR, Baker TB, Bailey WC, Benowitz NL, Curry SJ, Dorfman SF, Froelicher ES, Goldstein MG, Healton CG, Henderson PN, Heyman RB, Koh HK, Kottke TE, Lando HA, Mecklenburg RE, Mermelstein RJ, Mullen PD, Orlenas CT, Robinson L, Stitzer ML, Tommasello AC, Villejo L, Wewers ME. Treating tobacco use and dependence: 2008 update. Rockville, MD: U. S. Department of Health and Human Services, Public Health Service; 2008.
    1. Shiffman S, Brockwell SE, Pillitteri JL, Gitchell JG. Use of smoking-cessation treatments in the United States. Am J Prev Med. 2008;34:102–111.
    1. Bernstein SL, Boudreaux ED, Cabral L, Cydulka RK, Schwegman D, Larkin GL, Adams AL, McCullough LB, Rhodes KV. Nicotine dependence, motivation to quit, and diagnosis among adult emergency department patients who smoke: a national survey. Nicotine Tob Res. 2008;10:1277–1282.
    1. Becoña E, Míguez MC. Group behaviour therapy for smoking cessation. J Groups Addict Recover. 2008;3:63–78.
    1. Hughes JR. Depression during tobacco abstinence. Nicotine Tob Res. 2007;9:443–446.
    1. Becoña E. In: Conductas Adictivas: Teoría, evaluación y tratamiento [Addictive behaviours: Theory, assessment and treatment] Graña JL, editor. Madrid: Debate; 1994. Evaluación de la conducta de fumar [Assessment of smoking behaviour] pp. 403–454.
    1. Prochaska JO, DiClemente CC. Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol. 1983;51:390–395.
    1. Muñoz R. Preventing major depression by promoting emotion regulation: a conceptual framework and some practical tools. Int J Mental Health Prom. 1998;1:23–40.
    1. Becoña E. Programa para dejar de fumar (Programme for giving up smoking) Santiago de Compostela: Servicio de Publicaciones de la Universidad de Santiago de Compostela; 1993.
    1. Becoña E. Programa para Dejar de Fumar (Programme for giving up smoking) Vigo: Nova Galicia Edicións; 2007.
    1. West R, Hajek P, Stead L, Stapleton J. Outcome criteria in smoking cessation trials: proposal for a common standard. Addiction. 2005;100:299–303.
    1. Warner K. Tobacco control policy. San Francisco: Jossey-Bass; 2006.
    1. Yong H, Borland R, Thrasher JF, Thompson ME. Stability of cigarette consumption over time among continuing smokers: a latent growth curve analysis. Nicotine Tob Res. 2012;14:531–539.
    1. Yuong D, Borland R, Hammond D, Cumming KM, Devin E, Yuong HH. Prevalence attributes of roll-your-own smoker in the international tobacco control four country survey. Tob Control. 2006;15(Suppl III):17–23.
    1. Haukkala A, Uutela A, Vartiainen E, McAlister A, Knekt P. Depression and smoking cessation: the role of motivation and self-efficacy. Addict Behav. 2000;25:311–316.
    1. Schlam TR, Baker TB. Interventions for tobacco smoking. Annu Rev Clin Psychol. 2013;9:675–702.
    1. Fu M, Martínez-Sánchez JM, Pérez-Ríos M, López MJ, Fernández E. A comparison of the Fagerström test for nicotine dependence and smoking prevalence across countries: update data from Spain. Addiction. 2009;104:326–327.
    1. Gallus S, Pacifici R, Colombo P, La Vecchia C, Garattini S, Apolone G, Zuccaro P. Tobacco dependence in the general population in Italy. Ann Oncol. 2005;16:703–706.
    1. Borrelli B. Smoking cessation: next steps for special populations research and innovative treatments. J Consult Clin Psychol. 2010;78:1–12.
    1. Hughes JR, Giovino GA, Klevens RM, Fiore MC. Assessing the generalizability of smoking studies. Addiction. 1997;92:469–472.
    1. Le Strat Y, Rehm J, Le Foll B. How generalisable to community samples are clinical trial results for treatment of nicotine dependence: a comparison of common eligibility criteria with respondents of a large representative general population survey. Tob Control. 2011;20:338–343.
    1. Becoña E, Fernández del Río E, López A, Míguez MC, Castro J, Nogueiras L, Flórez G, Alvarez S, Vázquez D. La Escala Breve de Evaluación del Síndrome de Dependencia de la Nicotina (NDSS-S) en fumadores españoles [The Short Nicotine Dependence Syndrome Scale (NDSS-S) in Spanish smokers] Psicothema. 2011;23:126–132.
    1. Morissette SB, Tull MT, Gulliver SB, Kamholz BW, Zimering RT. Anxiety, anxiety disorders, tobacco use, and nicotine: a critical review of interrelationships. Psychol Bull. 2007;133:245–272.

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