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      Effectiveness of additional follow-up telephone counseling in a smoking cessation clinic in Beijing and predictors of quitting among Chinese male smokers

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          Abstract

          Background

          No previous studies have investigated whether additional telephone follow-up counseling sessions after face-to-face counseling can increase quitting in China, and whether this strategy is feasible and effective for promoting smoking cessation is still unclear.

          Methods

          A non-randomized controlled study was conducted in Beijing. We compared the quit rates of one group which received face-to-face counseling (FC) alone (one session of 40 min) to another group which received the same face-to-face counseling plus four follow-up sessions of brief telephone counseling (15–20 min each) at 1 week, 1, 3 and 6 month follow-up (FCF). No smoking cessation medication was provided. From October 2008 to August 2013, Chinese male smokers who sought treatment in a part-time regular smoking cessation clinic of a large general hospital in Beijing were invited to participate in the present study. Eligible male smokers ( n = 547) were divided into two groups: FC ( n = 149) and FCF ( n = 398). Main outcomes were self-reported 7-day point prevalence and 6 month continuous quit rates at 12 month follow-up.

          Results

          By intention to treat, at 12 month follow-up, the 7-day point prevalence and 6 month continuous quit rates of FC and FCF were 14.8 % and 26.4 %, and 10.7 % and 19.6 % respectively. The adjusted odds ratios (95 % confidence intervals) of quitting in FCF compared to FC was 2.34 (1.34–4.10) ( P = 0.003) and 2.41 (1.28–4.52) ( P = 0.006), respectively. Stepwise logistic regression showed that FCF, being married, unemployed and a lower Fagerström score were significant independent predictors of 6 month continuous quitting at 12 month follow-up.

          Conclusions

          Using systematically collected data from real-world practice, our smoking cessation clinic has shown that the additional telephone follow-up counseling sessions doubled the quit rate.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12889-016-2718-5) contains supplementary material, which is available to authorized users.

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          Most cited references25

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          Measuring degree of physical dependence to tobacco smoking with reference to individualization of treatment.

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            Telephone counseling for smoking cessation: effects of single-session and multiple-session interventions.

            Smokers (N = 3,030) were randomized to receive 1 of 3 interventions: (a) a self-help quit kit, (b) a quit kit plus 1 telephone counseling session, or (c) a quit kit plus up to 6 telephone counseling sessions, scheduled according to relapse probability. Both counseling groups achieved significantly higher abstinence rates than the self-help group. The rates for having quit for at least 12 months by intention to treat were 5.4% for self-help, 7.5% for single counseling, and 9.9% for multiple counseling. The 12-month continuous abstinence rates for those who made a quit attempt were 14.7% for self-help, 19.8% for single counseling, and 26.7% for multiple counseling. A dose-response relation was observed, as multiple sessions produced significantly higher abstinence rates than a single session. The first week after quitting seems to be the critical period for intervention.
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              A clinical practice guideline for treating tobacco use and dependence: A US Public Health Service report. The Tobacco Use and Dependence Clinical Practice Guideline Panel, Staff, and Consortium Representatives.

              To summarize the recently published US Public Health Service report Treating Tobacco Use and Dependence: A Clinical Practice Guideline, which provides recommendations for brief clinical interventions, intensive clinical interventions, and system changes to promote the treatment of tobacco dependence. An independent panel of 18 scientists, clinicians, consumers, and methodologists selected by the US Agency for Healthcare Research and Quality. A consortium of 7 governmental and nonprofit organizations sponsored the update. Approximately 6000 English-language, peer-reviewed articles and abstracts, published between 1975 and 1999, were reviewed for data that addressed assessment and treatment of tobacco dependence. This literature served as the basis for more than 50 meta-analyses. One panel meeting and numerous conference calls and staff meetings were held to evaluate meta-analytic and other results, to synthesize the results, and to develop recommendations. The updated guideline was then externally reviewed by more than 70 experts and revised. This evidence-based, updated guideline provides specific recommendations regarding brief and intensive tobacco cessation interventions as well as system-level changes designed to promote the assessment and treatment of tobacco use. Brief clinical approaches for patients willing and unwilling to quit are described. Major conclusions and recommendations include: (1) Tobacco dependence is a chronic condition that warrants repeated treatment until long-term or permanent abstinence is achieved. (2) Effective treatments for tobacco dependence exist and all tobacco users should be offered those treatments. (3) Clinicians and health care delivery systems must institutionalize the consistent identification, documentation, and treatment of every tobacco user at every visit. (4) Brief tobacco dependence treatment is effective, and every tobacco user should be offered at least brief treatment. (5) There is a strong dose-response relationship between the intensity of tobacco dependence counseling and its effectiveness. (6) Three types of counseling were found to be especially effective-practical counseling, social support as part of treatment, and social support arranged outside of treatment. (7) Five first-line pharmacotherapies for tobacco dependence-sustained-release bupropion hydrochloride, nicotine gum, nicotine inhaler, nicotine nasal spray, and nicotine patch-are effective, and at least 1 of these medications should be prescribed in the absence of contraindications. (8) Tobacco dependence treatments are cost-effective relative to other medical and disease prevention interventions; as such, all health insurance plans should include as a reimbursed benefit the counseling and pharmacotherapeutic treatments identified as effective in the updated guideline. JAMA. 2000;283:3244-3254
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                Author and article information

                Contributors
                wlyg0118@163.com
                86-10-66876411 , yhe301@x263.net
                jiangbin301@sina.com
                1041129652@qq.com
                liuqinghui301@163.com
                zhangli781230@163.com
                zhouchangxi2002@yahoo.com.cn
                liumiaolmbxb@163.com
                hongychen@sina.com
                k.k.cheng@bham.ac.uk
                nssophia@hkucc.hku.hk
                hrmrlth@hku.hk
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                22 January 2016
                22 January 2016
                2015
                : 16
                : 63
                Affiliations
                [ ]Department of Epidemiology, Institute of Geriatrics, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
                [ ]Beijing Key Laboratory of Aging and Geriatrics, Chinese PLA General Hospital, Institute of Geriatrics, 28 Fuxing Road, Beijing, 100853 China
                [ ]State Key Laboratory of Kidney Disease, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
                [ ]Nanlou Faculty of Clinical Medicine, Department of Acupuncture, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
                [ ]Nanlou Faculty of Clinical Medicine, Department of Respiration, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853 China
                [ ]Nanlou Faculty of Clinical Medicine, Department of Rehabilitation, Chinese People’s Liberation Army General Hospital, Beijing, China
                [ ]Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK
                [ ]School of Nursing, The University of Hong Kong, Hong Kong, China
                [ ]Department of Community Medicine and School of Public Health, The University of Hong Kong, Hong Kong, China
                Article
                2718
                10.1186/s12889-016-2718-5
                4722719
                01c5468c-974c-4d9e-8135-756eafb44b76
                © Wu et al. 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 7 February 2015
                : 8 January 2016
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2016

                Public health
                face-to-face counseling,additional telephone follow-up counseling,chinese male smoker,quit rate,predictors of quitting

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