The effectiveness of nationally implemented smoking interventions in Denmark

doi:10.1016/j.ypmed.2007.04.001

Preventive Medicine

Volume 45, Issue 1, July 2007, Pages 12-14

https://doi.org/10.1016/j.ypmed.2007.04.001 Get rights and content

Abstract

Objective.

The present study aimed to investigate the effectiveness of smoking cessation interventions at a national level.

Method.

A systematic follow-up was made of 3628 adults who participated in smoking cessation groups or in individual interventions in different settings in Denmark from January 2001 to March 2002.

Results.

The rates of continued abstinence from smoking were estimated as 18% and 16% after 6 and 12 months, respectively, for the 3628 participants from 101 smoking cessation units. Among participants, who accomplished at least 75% of the intervention, the rates of non-smokers after six and twelve months were 23% and 19%, respectively. Five of the investigated factors influenced continued abstinence after 12 months: gender, age, degree of nicotine dependence, the format and the setting of the cessation service.

Conclusions.

The study shows that it is possible to implement uniform smoking cessation interventions at a national level keeping the same abstinence rates as previously achieved in randomized clinical trials. The successful cessation interventions were run by nurses and equivalent staff that had received only 3 days of training and had no other particular therapeutic skills.

Introduction

A tobacco control strategy based mainly on support for smoking cessation was chosen in Denmark ten years ago. Today, most smokers have access to both group and individual smoking cessation interventions at hospitals, pharmacies and other places. The overall effectiveness of these interventions has not been presented previously.

Smoking cessation interventions have been shown to be clinically effective and cost-effective in randomized clinical trials (Fiore, 2000). The aim of the present study was to investigate the effectiveness of standard smoking cessation interventions after implementation at a national level and to identify determinants of continued abstinence at one-year follow-up. The cost-effectiveness of the Danish interventions has been presented (Olsen et al., 2006).

Section snippets

The investigation

In January 2001 the Danish National Smoking Cessation Database was established. Smoking cessation units in hospitals, pharmacies, counties and other settings could participate in an independent evaluation of their effectiveness. A total of 101 units chose to register before March 2002 and nearly all offered the same two standard interventions, a group and an individual format.

Smokers were enrolled from January 2001 to March 2002. The registration in the database was approved by the Danish Data

Baseline characteristics and follow-up rates

Altogether 101 cessation units were included in the study, with pharmacies making up the majority, 62 units. Twenty-four units were hospital departments, seven were county services and finally there were eight other units including general practices, workplaces and schools. The hospitals recruited 1395 participants (38%), pharmacies recruited 1199 participants (33%), county services enrolled 963 participants (27%), while 71 persons (2%) joined other units.

A total of 3628 smokers were registered

Discussion

The results suggest that it is possible to successfully implement smoking cessation interventions in a real-life setting, at a national level. A meta analysis of individual and group counseling interventions have found rates of continued abstinence after five months of 17% and 14%, respectively (Fiore, 2000). The rates of continued abstinence of 18% and 16% after 6 and 12 months are probably underestimated as they show a “worst-case-scenario”. There were no difference in the baseline

Conclusion

The systematic follow-up of 3628 Danes shows that it is possible to implement uniform smoking cessation interventions at a national level keeping the same abstinence rates as previously achieved in randomized clinical trials. The successful cessation interventions were run by nurses and equivalent staff that had received only 3 days of training and had no other particular therapeutic skills.

Acknowledgments

We thank all staff at the participating smoking cessation units and at the coordination office. We also thank the Ministry of the Interior and Health, Danish Institute for Health Services Research and the Clinical Unit of Health Promotion at Bispebjerg Hospital for financial support.

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