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Clinical pharmacy and clinical trials (including case series)
Smoking cessation pharmacotherapy improves patients adherence and increases the ability to achieve abstinence from cigarette smoking in a Brazilian teaching hospital
  1. A.B. Sousa,
  2. J.P.B. Lotufo,
  3. M.H. Fukuoka,
  4. M.C. Sakai,
  5. G.F. Galvão,
  6. E. Ribeiro,
  7. N.N. Wasicovichi,
  8. C.L. Fuchida,
  9. P.S.K. Takahashi,
  10. E.T.C. Souza
  1. 1University of São Paulo, Pharmacy Service from University Hospital, São Paulo, Brazil
  2. 2University of São Paulo, Medical Service from University Hospital, São Paulo, Brazil

Abstract

Background The cessation smoking group (CSG) of University Hospital of University of São Paulo consists of a multidisciplinary team composed of pharmacists, a doctor, a psychologist, nurses, a system analyst, and dentists. Counselling and medicines, such as nicotine replacement therapy, bupropion, and varenicline, are available, free of charge, to treat nicotine dependence on the employees of University of São Paulo. CSG also offers smoking-cessation counselling to all other citizens from the community of São Paulo city who desire to participate in it, yet The authors do not delivery these medicines free of charge for this population.

Purpose The authors aimed to: a) verify patients adherence to CSG in those who received smoking cessation pharmacotherapy plus counselling (G1) compared to those who received only counselling (G2) and b) measure success in smoking cessation within these two groups.

Materials and methods A total of 303 smokers were followed at CSG from 2009 to 2010. The program included active follow-up during one year after quitting. 157 patients belonged to G1 and 146 to G2. Treatment adherence was defined as any subject who took >or=1 dose of any medicine prescribed for >or=80% days during the minimum 12-week treatment period for G1 and the frequency to the meetings >or=80% for G1 and G2. Smoking abstinence was assessed using breath carbon monoxide confirmed weekly and self-reported tobacco cessation.

Results There were no difference between G1 and G2 related to: gender (female 63%), age when enrolled at CSG (41-50 years old, 38%), years smoking (21 – 30 years, 38%), age at initiation of smoking (11-15 years old, 41%), current smoking intake (> 20 units/day, 50%) and Fagerströn test (80%>5). On the other hand, there were statistically significant differences between G1 and G2 for: the outcome ‘adheres to CSG’: 68.8 versus 53.4%, respectively, p=0.006, RR=1.288, OR=1.92, CI 95% from 1.20 – 3.07 and the outcome ‘quit smoking’ (more than one year): 44.6% versus 22.6%, respectively, p=0.001, RR=1.97, OR=2.75, CI 95% 1.67 – 4.54.

Conclusions It is of utmost importance to maintain the supply of medicines to achieve abstinence from cigarettes in programs such as CSG since it was found in the present study that patients who received anti-smoking medication free of charge not only dropped out less from CSG but also better able to quit smoking.

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