Browsing by keyword "Chewing Gum"

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    • Effectiveness of nicotine-containing gum in the Physician-Delivered Smoking Intervention Study
      Rosal, Milagros C.; Ockene, Judith K.; Hurley, Thomas G.; Kalan, Kathryn L.; Hebert, James R. (1998-03-01)
      BACKGROUND: We tested the role of nicotine-containing gum (NCG) in conjunction with brief physician counseling in smoking cessation in the Physician-Delivered Smoking Intervention Project (PDSIP). METHOD: Subjects were smokers randomized to the Counseling + NCG arm of the PDSIP. However, receipt and use of NCG were not randomized. Data from base-line, were not randomized. Data from baseline, pharmacy records, and 6-month monitoring calls were used in these post hoc analyses. RESULTS: Of the 299 study subjects, 57% accepted NCG and 36% of acceptors used it for more than 7 days. Predictors of NCG acceptance included high desire to quit (OR = 1.21; 95% CI 1.10, 1.35), social support to quit (OR = 1.62; 95% CI 1.01, 2.59), being a general medicine patient compared with a family practice patient (OR = 3.22; 95% CI 2.01, 5.21), and receiving the intervention from a female physician (female physician-male patient OR = 2.27; 95% CI 0.95, 5.46; female physician-female patient OR = 1.94; 95% CI 1.06, 3.57) relative to the male physician comparisons. Subjects who refilled the NCG prescription had higher cessation rates than those who did not refill or did not accept the prescription (37% vs 19% and 20%, respectively; P = 0.04). Predictors of 6-month cessation among NCG users included a previous period(s) of abstinence > 3 months (OR = 1.23; 95% CI 1.04, 1.47), abstinence during illness (OR = 0.39; 95% CI 0.17, 0.86), and absence of smoking-related physical complaints the month prior to the physician-delivered intervention (OR = 0.40; 95% CI 0.17, 0.94). CONCLUSION: Amount of NCG use in conjunction with physician-delivered smoking cessation counseling might have contributed in helping unselected smokers quit.

    • Patient characteristics and the effect of three physician-delivered smoking interventions
      Hebert, James R.; Kristeller, Jean L.; Ockene, Judith K.; Landon, Joan; Luippold, Rose S.; Goldberg, Robert J.; Kalan, Kathryn (1992-09-01)
      BACKGROUND. This paper investigates individual patient characteristics predicting differential response to each of three physician-delivered smoking interventions after 6 months. METHODS. Participants were 1,286 currently smoking patients seen by 196 medical and family practice residents in five primary care clinics affiliated with the University of Massachusetts Medical School. Of the participants, 57% were female, 92% were white, their average age was 35 years, and they smoked an average of 23 cigarettes per day. Physicians were trained to provide the following interventions: advice only (AO), a brief (< 10 min) patient-centered counseling intervention (CI), and counseling plus prescription of the nicotine-containing gum Nicorette (CI+NCG). The CI+NCG condition included NCG only when appropriate and if acceptable to the patient. Patients were randomized to one of these three physician-delivered intervention conditions. RESULTS. Overall, stratified univariate analyses revealed that AO produced consistently lower cessation rates across most subgroups (generally 9-13%) but was somewhat more effective for certain groups of lighter smokers. Relative to AO, CI was somewhat more effective (about 20-24%) for less addicted smokers, for those with more previous quit attempts, and for those with fewer close associates who smoke, but generally failed to produce higher quit rates for harder core smokers or for women. CI+NCG had an overall pattern of greater effectiveness for both more addicted and less addicted smokers, with the highest absolute levels of cessation (about 27-30%) among less dependent smokers. Women in this group had cessation rates (20.6%) comparable to those of men (23.6%). Condition-stratified logistic regression analyses, controlling for a wide range of covariates, revealed associations similar to those observed in the univariate analyses: An overall logistic model in which intervention conditions were fitted as dummy variables produced the following significant main effects: sex, years smoked, contact with other smokers, symptoms, and CI+NCG condition. Significant interactions were observed for both CI and CI+NCG and smoking when feeling too ill to continue normal activities and CI+NCG and amount smoked. CONCLUSIONS. We observed significant main effects on cessation of variables related to addiction, sex, social factors, and physician counseling interventions. Specific interactions were observed between reported smoking when feeling ill and each of the counseling interventions as well as by amount smoked in the CI+NCG condition.

    • The physician-delivered smoking intervention project: can short-term interventions produce long-term effects for a general outpatient population
      Ockene, Judith K.; Kristeller, Jean L.; Pbert, Lori; Hebert, James R.; Luippold, Rose S.; Goldberg, Robert J.; Landon, Joan; Kalan, Kathryn L. (1994-05-01)
      Patterns of smoking cessation using 6- and 12-month follow-up data are reported for 1,261 primary care patients randomized to 3 physician-delivered smoking interventions: advice only (AO), counseling (CI), and counseling plus availability of nicotine-containing gum (CI + NCG). One-week-point-prevalence cessation rates at 12 months did not differ among the interventions: AO (15.2%), CI (12.9%) and CI + NCG (16.7%). However, maintained cessation rates (abstinent at both 6 and 12 months) increased with intervention intensity: AO (6.0%), CI (7.8%) and CI + NCG (10.0%): Test of trend chi 2 = 5.06, p = .02. CI + NCG was significantly higher than AO (p = .02). The findings support the following conclusions: Brief physician-delivered intervention with availability of nicotine-containing gum can have a beneficial long-term effect on smoking cessation, and cohort data as well as point-prevalence rates are important when assessing the long-term impact of lifestyle interventions.