Multifaceted quit-smoking program works well
A comprehensive smoking cessation program involving counseling, support and a tailored medication regimen can help even highly stressed individuals quit, new study findings show.
The program, the New York City Fire Department’s “Tobacco Free with FDNY,” was offered free-of-charge to FDNY rescue workers and family members in the aftermath of the 2001 World Trade Center collapse.
Its effectiveness suggests that “medication alone is not as effective as medication with a social support mechanism,” study author Dr. David J. Prezant, chief medical officer of the New York City Fire Department’s Office of Medical Affairs, told Reuters Health.
The “Tobacco Free with FDNY” program included a tailored medication approach, in which multiple nicotine medications were prescribed according to the participant’s tobacco use history, as well as counseling and other support. Prezant and his team conducted the current study to investigate the program’s results, and report the findings in the journal Chest.
The 220 study participants—including 164 fire department rescue workers and 56 family members—smoked an average of 20 cigarettes per day.
Those who reported the highest levels of tobacco use were given three types of nicotine-replacement medications - a patch, inhaler and a spray. Other participants were given two types of medications, one type of medication or no medication, according to their tobacco use.
In addition, 14 percent of study participants—those who smoked over 40 cigarettes per day and were feeling anxious about quitting—supplemented the nicotine medications with bupropion, which can ease cravings.
Along with medication, the program provided individual counseling at visits every 3 or 4 weeks, and participants had phone or e-mail access to a trained counselor whenever they had questions.
At the end of the three-month program, nearly half (47 percent) of the study participants were tobacco free, the researchers report. Continuous abstinence rates at the 6-month and 12-month marks were 36 percent and 37 percent.
“The ‘Tobacco Free with FDNY’ Program demonstrated that combination medications with comprehensive tobacco-cessation counseling can be delivered successfully in a voluntary, nonpunitive, occupational setting even for highly addicted tobacco smokers experiencing extreme interpersonal and work-related stress,” Prezant and his co-authors conclude.
SOURCE: Chest, April 2006.
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