AIMS: To compare success rates and characteristics of smokers treated a second time by a smokers' clinic with success rates of their first treatment. DESIGN: Retrospective cohort study. SETTING: Tobacco Dependence Treatment clinic in Prague, Czech Republic, between 2005 and 2017. PARTICIPANTS: A total of 5225 smokers treated either once (n = 5006, single treatment sample, SS) or also second time (n = 219, re-treated sample, RS), on average 4.47 years after the first visit. INTERVENTION: Smokers received intensive treatment of tobacco dependence with pharmacotherapy options. Outcomes were evaluated after 1 year. In case of failure or relapse, participants could undergo re-treatment in the same setting at least 1 year after the start of the first treatment. MEASUREMENTS: Twelve-month self-reported continuous abstinence; CO-validated (≤ 6 parts per million); number of visits; type of pharmacotherapy; mental health history; Fagerström Test for Cigarette Dependence; time between first and second treatment. RESULTS: The abstinence rate in the SS was 34.8% [95% confidence interval (CI) = 33.4%, 36.1%] and in the RS was 37% (95% CI = 30.6%, 43.8%) and 39.7% (95% CI = 33.2%, 45.5%) for their first and second treatments, respectively. The samples were comparable on smoking and socio-demographic characteristics and pharmacotherapy used, but the RS in the second treatment had a higher prevalence of diagnosed mental health disorder at 39.3% (95% CI = 32.8%; 46.1%) compared with 23.7% (95% CI = 22.5%; 24.9%) in the SS. Participants who initiated their second quit attempt 1 to 2 years after the first one were less successful than those who initiated their second quit attempt later (25 versus 43%; P < 0.05). The results of the first treatment cycle were not found to be a reliable predictor for outcomes of the second cycle of treatment in univariate or multivariate logistic regression (odds ratio = 1.35, 95% CI = 0.70-2.63, P = 0.373). CONCLUSION: In Prague, Czech Republic, smokers re-attending stop-smoking treatment more than 2 years after their previous quit attempt appear to achieve similar success rates to those being treated for the first time.

• MeSH
• Ambulatory Care Facilities MeSH
• Cohort Studies MeSH
• Smoking epidemiology   MeSH
• Smokers statistics & numerical data   MeSH
• Smoking Cessation Agents therapeutic use   MeSH
• Humans MeSH
• Smoking Cessation methods   MeSH
• Tobacco Use Disorder therapy   MeSH
• Tobacco Use Cessation Devices statistics & numerical data   MeSH
• Recurrence MeSH
• Retrospective Studies MeSH
• Varenicline therapeutic use   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic MeSH

Úvod: Podpora nefajčenia, zahŕňajúca aj pomoc v odvykaní od fajčenia, by mala byť vykonávaná erudovanými zdravotníckymi pracovníkmi. Cieľom nášho výskumu bolo zistiť efektívnosť vykonávania podpory nefajčenia v poradenských centrách odvykania od fajčenia na Regionálnych úradoch verejného zdravotníctva (RÚVZ). Materiál a metodika: Údaje boli zozbierané od poradní odvykania od fajčenia na RÚVZ pomocou žiadosti o poskytnutie informácií. Žiadosť bola odoslaná do všetkých 34 poradní v Slovenskej republike, z toho 94,1 % (n = 32) nám poskytlo informácie. Údaje boli zozbierané od marca 2013 do januára 2014. Výsledky: Smokerlyzer používa 93,6 % poradní, spirometer iba 51,6 % a špecializované vybavenie na objektivizáciu fajčiarskeho návyku vlastní iba 6 % poradní. Až 69 % poradní uviedlo, že medzi poradňou a všeobecnými lekármi neexistuje žiadna spolupráca. Ako hlavný problém pri poskytovaní poradenstva uviedlo až 53 % poradní problém s motiváciou a sebadisciplínou klientov. Nedostatočné personálne zabezpečenie a materiálno-technické vybavenie uviedlo 25 % poradní. Diskusia: Efektívnosť vykonávania podpory nefajčenia zo strany poradenských centier na odvykanie od fajčenia na RÚVZ nie je na uspokojivej úrovni. Medzi hlavné problémy pri poskytovaní poradenstva v poradniach patrili problémy s motiváciou klientov, s nízkou úrovňou spolupráce centier s lekármi či s nedostatočným materiálno-technickým vybavením a personálnym zabezpečením. Záver: V praxi by pre lepšiu pomoc a zvýšenie motivácie klientov prestať fajčiť bolo vhodné doplniť dostatočné prístrojové vybavenie pre objektivizáciu fajčiarskeho návyku, personálne zabezpečenie v podobe psychológa, legislatívne uzákonenú spoluprácu medzi poradňami a praktickými lekármi či čiastočné preplácanie farmák, napr. nikotínovej náhradnej liečby poisťovňami. Pomocou týchto opatrení by bolo možné dosiahnuť mnohé zdravotné, ale i ekonomické prínosy pre spoločnosť.

Introduction: Non-smoking promotion including assistance in quitting, should be provided by qualified health professionals. The aim of the research was to find a level of effectiveness of the implementation of non-smoking promotion in counseling centers for smoking cessation at the Regional Public Health Authorities (RPHA). Material and Methods: Data were obtained from the representatives of the advisory smoking cessation centers (ASC) at RPHA contacted by email request. The request was sent to all 34 ASC in the Slovak Republic, of which 94.1% (n = 32) responded. Data were collected from March 2013 until January 2014. Results: 93.6% of ASC use the smokerlyzer, only 51.6 % use the spirometer, and only 6 % ASC´s own specialized equipment for the objectification of smoking habits. Up to 69 % ASC´s reported no cooperation with general practicioners (GP´s). Up to 53% of the ASC reported the main problem in providing counseling, reported up to 53% of the ASC, to be the problem with motivation and self-discipline of clients. 25% of the ASC´s reported inadequate personnel and material equipment. Discussion: The effectiveness of the implementation of the promotion of non-smoking by counseling centers for smoking cessation is insufficient. The main problems in providing advice in ASC included problems with motivation of patients, low level of cooperation with general practicioners or insufficient material-technical equipment and staffing, especially a psychologist. Conclusion: In practice, for better help and higher motivation of patients to stop smoking, it would be helpful to add sufficient equipment for the objectification of smoking habits, staffing in the form of a psychologist, legally regulated cooperation between ASC´s and general practitioners, or partial reimbursement of medicaments, for example, nicotine replacement therapy by health insurance groups. We suppose that by these means we can achieve many health and economic benefits for society.

• MeSH
• Humans MeSH
• Smoking Cessation * MeSH
• Counseling MeSH
• Tobacco Use Cessation Devices statistics & numerical data   MeSH
• Surveys and Questionnaires MeSH
• Check Tag
• Humans MeSH
• Geographicals
• Slovakia MeSH

BACKGROUND AND AIMS: Cross-study comparisons of effect sizes suggest that varenicline is more effective than nicotine replacement therapy (NRT) in aiding smoking cessation, but evidence from direct comparisons is limited. This study compared biochemically verified 52-week sustained abstinence rates in smokers attending the same clinical service according to whether they used varenicline or NRT in their quit attempt. METHODS: This was a prospective cohort study of 855 smokers attending a large smoking cessation clinic who used their choice of NRT product or varenicline in their quit attempt. All received the same behavioural support programme and chose their medication option (n = 519 varenicline; n = 336 NRT). The primary outcome measure was self-report of 52 weeks' abstinence following the target quit date confirmed by expired air carbon monoxide concentration. Baseline measures included socio-demographic variables, mental health diagnoses, measures of smoking, cigarette dependence and past use of NRT or varenicline. RESULTS: The 52-week abstinence rates were 42.8% versus 31.0% in those using varenicline versus NRT, respectively (P < 0.001). After adjusting for all baseline variables, the odds of remaining abstinent for 52 weeks were 2.03 (95% CI 1.46-2.82), P < 0.001 times higher in those using varenicline than those using NRT. CONCLUSIONS: Smokers in the same behavioural support programme who use varenicline appear to have a greater probability of achieving long-term abstinence than those using their choice of nicotine replacement therapy options, even after adjusting for potentially confounding smoker characteristics.

• MeSH
• Benzazepines administration & dosage   MeSH
• Quinoxalines administration & dosage   MeSH
• Breath Tests MeSH
• Smoking MeSH
• Middle Aged MeSH
• Humans MeSH
• Nicotinic Agonists administration & dosage   MeSH
• Smoking Cessation methods   MeSH
• Carbon Monoxide analysis   MeSH
• Smoking Prevention MeSH
• Prospective Studies MeSH
• Tobacco Use Cessation Devices statistics & numerical data   MeSH
• Treatment Outcome MeSH
• Drug Administration Routes MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Comparative Study MeSH