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Real-world comparative study of behavioral group therapy program vs education program implemented for smoking cessation in community-dwelling elderly smokers.

Pothirat C, Phetsuk N, Liwsrisakun C, Deesomchok A - Clin Interv Aging (2015)

Bottom Line: Demographic characteristics and smoking history were similar between both groups, including age, age of onset of smoking, years of smoking, smoking pack-years, education level, and nicotine dependence as measured by the FTND scale.The CAR of the behavioral therapy group at the end of the study (month 12) was significantly higher than the education group (40.1% vs 33.3%, P=0.034).Similar results were also found throughout all follow-up visits at month 3 (57.3% vs 27.0%, P<0.001) and month 6 (51.7% vs 25%, P<0.001).

View Article: PubMed Central - PubMed

Affiliation: Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

ABSTRACT

Background: Tobacco smoking is known to be an important contributor to a wide variety of chronic diseases, especially in older adults. Information on health policy and practice, as well as evaluation of smoking cessation programs targeting older people, is almost nonexistent.

Purpose: To compare the real-world implementation of behavioral group therapy in relation to education alone for elderly smokers.

Materials and methods: Elderly smokers ready to quit smoking were identified from a cohort who completed a questionnaire at a smoking exhibition. They were allocated into two groups, behavioral therapy (3 days 9 hours) and education (2 hours), depending on their preferences. Demographic data, the Fagerstrom test for nicotine dependence (FTND) score, and exhaled carbon monoxide level were recorded at baseline. Smoking status of all subjects was followed at months 3, 6, and 12. Statistical differences in continuous abstinence rate (CAR) between the two groups were analyzed using chi-square tests.

Results: Two hundred and twenty-four out of 372 smoking exhibition attendants met the enrollment criteria; 120 and 104 elected to be in behavioral group therapy and education-alone therapy, respectively. Demographic characteristics and smoking history were similar between both groups, including age, age of onset of smoking, years of smoking, smoking pack-years, education level, and nicotine dependence as measured by the FTND scale. The CAR of the behavioral therapy group at the end of the study (month 12) was significantly higher than the education group (40.1% vs 33.3%, P=0.034). Similar results were also found throughout all follow-up visits at month 3 (57.3% vs 27.0%, P<0.001) and month 6 (51.7% vs 25%, P<0.001).

Conclusion: Behavioral group therapy targeting elderly smokers could achieve higher short-and long-term CARs than education alone in real-world practice.

No MeSH data available.


Related in: MedlinePlus

Flowchart showing subject participation throughout the study.Abbreviation: F/U, follow-up.
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f1-cia-10-725: Flowchart showing subject participation throughout the study.Abbreviation: F/U, follow-up.

Mentions: A health risk-screening questionnaire was administered to elderly members (age >60 years) of the Chiang Dao elderly club, Chiang Dao district, Chiang Mai province. All subjects who aimed to “quit smoking within a month” were invited to a smoking cessation exhibition at Chiang Dao Hospital. The design of the study was observational, including convenience sampling of these elderly smokers. The inclusion criteria were age more than 60 years, current smokers with a smoking history of at least 10 pack-years, and “readiness to quit” state of mind. Exclusion criteria were current pharmacological use to quit smoking, the presence of an unstable or life-threatening medical condition, current unstable psychiatric illness, and alcohol addiction. Participants were allocated into two groups based on their preference: behavioral group therapy (group A) and education alone (group B) (Figure 1). Both groups attended an education program that included a lecture on the health consequences of smoking for 2 hours. Only group A participants further attended behavioral group therapy sessions for 3 hours per day in the following 3 days, totaling 9 hours. The behavioral therapy program consisted of two parts. The first was a demonstration of formalin-preserved specimens of smoking-related diseases like lung cancer, emphysematous lung, and myocardial infarction with coronary artery occlusion, as well as slides and video clips showing the adverse effects of cigarette smoking in the form of advanced diseases. The second part included coping and social skills training, contingency management, self-control, cognitive-behavioral interventions, reinforcement, and relaxation with a focus on sharing experiences. The participants were equally divided and rotated daily into three stations of video training, behavioral therapy, and socialization, each supervised by two staffs. Subjects who could quit smoking at the end of each day were commended and rewarded with an origami star. Demographic data were collected by face-to-face interview and included age, sex, history of smoking, level of education, economic status, and type of cigarettes smoked. Three levels of economic status were determined based on annual household income: low income (≤70,000 Baht), moderate (70,001–195,749 Baht), and high income (≥195,750 Baht).17 The average number of cigarette smoked was, therefore, calculated by dividing the average native cigarette weight by standard manufactured cigarette weight which was equivalent to 4–12 standard manufactured cigarettes.18 In addition, native cigarettes consist of crudely cut tobacco mixed with grinded tamarind pod in a loose roll. All participating subjects had their level of nicotine dependency measured by the Fagerstrom test for nicotine dependence (FTND) questionnaire which was validated in many studies,19,20 the scale of which consists of six items.21 The questionnaires were explicit and informative, and the participants were able to fill them by themselves without supervision. Total possible scores ranged from 0 (no dependence) to 10 (very high dependence) and were categorized as low dependence (score 0–3), medium dependence (score 4–6), or high dependence (score 7–10).6,22,23


Real-world comparative study of behavioral group therapy program vs education program implemented for smoking cessation in community-dwelling elderly smokers.

Pothirat C, Phetsuk N, Liwsrisakun C, Deesomchok A - Clin Interv Aging (2015)

Flowchart showing subject participation throughout the study.Abbreviation: F/U, follow-up.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4403818&req=5

f1-cia-10-725: Flowchart showing subject participation throughout the study.Abbreviation: F/U, follow-up.
Mentions: A health risk-screening questionnaire was administered to elderly members (age >60 years) of the Chiang Dao elderly club, Chiang Dao district, Chiang Mai province. All subjects who aimed to “quit smoking within a month” were invited to a smoking cessation exhibition at Chiang Dao Hospital. The design of the study was observational, including convenience sampling of these elderly smokers. The inclusion criteria were age more than 60 years, current smokers with a smoking history of at least 10 pack-years, and “readiness to quit” state of mind. Exclusion criteria were current pharmacological use to quit smoking, the presence of an unstable or life-threatening medical condition, current unstable psychiatric illness, and alcohol addiction. Participants were allocated into two groups based on their preference: behavioral group therapy (group A) and education alone (group B) (Figure 1). Both groups attended an education program that included a lecture on the health consequences of smoking for 2 hours. Only group A participants further attended behavioral group therapy sessions for 3 hours per day in the following 3 days, totaling 9 hours. The behavioral therapy program consisted of two parts. The first was a demonstration of formalin-preserved specimens of smoking-related diseases like lung cancer, emphysematous lung, and myocardial infarction with coronary artery occlusion, as well as slides and video clips showing the adverse effects of cigarette smoking in the form of advanced diseases. The second part included coping and social skills training, contingency management, self-control, cognitive-behavioral interventions, reinforcement, and relaxation with a focus on sharing experiences. The participants were equally divided and rotated daily into three stations of video training, behavioral therapy, and socialization, each supervised by two staffs. Subjects who could quit smoking at the end of each day were commended and rewarded with an origami star. Demographic data were collected by face-to-face interview and included age, sex, history of smoking, level of education, economic status, and type of cigarettes smoked. Three levels of economic status were determined based on annual household income: low income (≤70,000 Baht), moderate (70,001–195,749 Baht), and high income (≥195,750 Baht).17 The average number of cigarette smoked was, therefore, calculated by dividing the average native cigarette weight by standard manufactured cigarette weight which was equivalent to 4–12 standard manufactured cigarettes.18 In addition, native cigarettes consist of crudely cut tobacco mixed with grinded tamarind pod in a loose roll. All participating subjects had their level of nicotine dependency measured by the Fagerstrom test for nicotine dependence (FTND) questionnaire which was validated in many studies,19,20 the scale of which consists of six items.21 The questionnaires were explicit and informative, and the participants were able to fill them by themselves without supervision. Total possible scores ranged from 0 (no dependence) to 10 (very high dependence) and were categorized as low dependence (score 0–3), medium dependence (score 4–6), or high dependence (score 7–10).6,22,23

Bottom Line: Demographic characteristics and smoking history were similar between both groups, including age, age of onset of smoking, years of smoking, smoking pack-years, education level, and nicotine dependence as measured by the FTND scale.The CAR of the behavioral therapy group at the end of the study (month 12) was significantly higher than the education group (40.1% vs 33.3%, P=0.034).Similar results were also found throughout all follow-up visits at month 3 (57.3% vs 27.0%, P<0.001) and month 6 (51.7% vs 25%, P<0.001).

View Article: PubMed Central - PubMed

Affiliation: Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

ABSTRACT

Background: Tobacco smoking is known to be an important contributor to a wide variety of chronic diseases, especially in older adults. Information on health policy and practice, as well as evaluation of smoking cessation programs targeting older people, is almost nonexistent.

Purpose: To compare the real-world implementation of behavioral group therapy in relation to education alone for elderly smokers.

Materials and methods: Elderly smokers ready to quit smoking were identified from a cohort who completed a questionnaire at a smoking exhibition. They were allocated into two groups, behavioral therapy (3 days 9 hours) and education (2 hours), depending on their preferences. Demographic data, the Fagerstrom test for nicotine dependence (FTND) score, and exhaled carbon monoxide level were recorded at baseline. Smoking status of all subjects was followed at months 3, 6, and 12. Statistical differences in continuous abstinence rate (CAR) between the two groups were analyzed using chi-square tests.

Results: Two hundred and twenty-four out of 372 smoking exhibition attendants met the enrollment criteria; 120 and 104 elected to be in behavioral group therapy and education-alone therapy, respectively. Demographic characteristics and smoking history were similar between both groups, including age, age of onset of smoking, years of smoking, smoking pack-years, education level, and nicotine dependence as measured by the FTND scale. The CAR of the behavioral therapy group at the end of the study (month 12) was significantly higher than the education group (40.1% vs 33.3%, P=0.034). Similar results were also found throughout all follow-up visits at month 3 (57.3% vs 27.0%, P<0.001) and month 6 (51.7% vs 25%, P<0.001).

Conclusion: Behavioral group therapy targeting elderly smokers could achieve higher short-and long-term CARs than education alone in real-world practice.

No MeSH data available.


Related in: MedlinePlus