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The 13th World Conference on Tobacco OR Health

Building capacity for a tobacco-free world

July 12-15, 2006, Washington, DC, USA

Thursday, July 13, 2006 - 12:00 PM

Exploring Successful Interventions: Who Leaves and How to Improve Retention

Suzanne Lee Smith, BS, RRT, MBA, Sharon R. Kimmel, Dianna M. Muhlern, and Judith N. Sabino. Community Health, Lehigh Valley Hospital and Health Network, 17th and Chew School of Nursing, PO Box 7017, Allentown, PA 18105

Objective: Identify common characteristics of patients at risk for premature drop-out from a telephone-based tobacco cessation program offering intensive counseling with access to adjunctive pharmacotherapy. Nicotine addiction involves complex factors. Successful intervention requires continuous, individualized treatment. Patients who prematurely dropout do not benefit from intervention. Programs focus only those likely to remain in counseling. This study explores behavioral, psychiatric and social differences between patients that stay in these programs (IN) to those that prematurely dropout (DO).

Methods: Patients receiving one or more intensive counseling session by this hospital-based cessation program between 1/2003 and 10/2005 were reviewed. Counselors proactively contact patients at initial assessment and scheduled post quit-date follow-ups. Patients contact counselors at any time. Behavioral/psychological factors relative to cessation were captured. Differences between DO/IN were investigated using chi-square, t-test and survival analysis.

Results: 301 patients were included; mean age 50.1613.46, 48.5% male, 61% attrition rate, median survival of 212 days. No statistically significant difference (SSD) in age or gender. On program entrance, DO were more likely to report more daily cigarettes (19.4614.40) versus IN (15.6512.98) p=.021. DO were more likely to use at an earlier age (14.936.35) than IN (16.834.84) p=.015. IN reported smoking longer (32.9313.16 years) than DC (27.6814.98) p=.014. Fagerstrom was higher for DO (5.072.76) than IN (4.222.85) p<.001); 50% DO reported morning cigarette most difficult to give up (IN 29%, p<.001). No SSD for self-report of how soon after waking patient smokes. Counselors classified 21.7% DO severely dependent versus 10% IN (p=.017). Additional indicators are compared.