The impact of repeated cycles of pharmacotherapy on smoking cessation: a longitudinal cohort study.

OBJECTIVE

To examine the uptake and effectiveness of repeated offers of pharmacotherapy to promote smoking cessation

DESIGN

Longitudinal cohort

SETTINGS

50 rural primary care clinics

PARTICIPANTS

726 adult smokers

INTERVENTION

Offers of either bupropion or transdermal nicotine at 6 month intervals to continuing smokers over a two-year period

MAIN OUTCOME MEASURE

Self-reported, seven-day, point prevalence abstinence from cigarettes

RESULTS

During the first cycle of treatment, 464 (63.9%) took smoking cessation pharmacotherapy. Among continuing smokers, 52.7% of 383, 45.8% of 177 and 64.7% of 68 took 2, 3 and 4 consecutive cycles of pharmacotherapy, respectively. The odds ratios for quitting among pharmacotherapy users versus non-users was 2.56, 1.83, 1.85, and 3.08 after the 1, 2, 3, and 4 cycles of treatment. Successful smoking cessation was not related to the number of previous pharmacotherapy-assisted quit attempts.

CONCLUSION

A large portion of continuing smokers are willing to engage in repeated pharmacotherapy-assisted quit attempts. The effect of pharmacotherapy does not appear to diminish even after multiple prior quit attempts.