[Tobacco detoxication at a primary care clinic: efficacy of medical counseling, minimal intervention and nicotine replacement therapy at the one-year follow-up].

OBJECTIVE

The main objective was to compare the efficacy of one-off tobacco counselling and of the systematic minimum intervention on making people give up smoking. A secondary aim was to evaluate the efficacy of nicotine replacement therapy (NRT) in the context of a primary care consultation.

DESIGN

Controlled and randomised clinical trial.

SETTING

Primary care.

PARTICIPANTS

Smokers who over 12 months attended a primary care clinic at an urban health centre (304 patients).

INTERVENTIONS

Two kinds of intervention were conducted at random on patients with low nicotine dependence (one-off medical counselling and counselling integrated into what is known as the minimal intervention, but conducted systematically). NRT was administered through nicotine patches (11% nicotine) to patients with moderate-to-high nicotine dependence.

MEASUREMENTS AND MAIN RESULTS

Short-term cessation a year after the minimal intervention was 39% (29.4-49.3%), and maintained cessation 30.9% (29.4-49.3%), as against 11% (5.6-18.8%) short-term cessation in the group that received one-off counselling (p < 0.0001). Short-term tobacco cessation in the NRT group was 35.3% (24.1-47.8%), and maintained cessation 30.8%.

CONCLUSIONS

Primary care is a suitable context for an intervention against tobacco dependency, through the use of any of the established interventions: one-off medical counselling, systematic minimal intervention, or specialist drug treatment through NRT. Therefore, these kinds of intervention must form part of PC clinics' daily activity.