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Gender difference and effect of pharmacotherapy: findings from a smoking cessation service

BACKGROUND: Smoking cessation services are available in England to provide assistance to those wishing to quit smoking. Data from one such service were analysed in order to investigate differences in quit rate between males and females prescribed with different treatments. METHODS: A logistic regres...

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Autores principales: Walker, N. J., van Woerden, H. C., Kiparoglou, V., Yang, Y., Robinson, H., Croghan, E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5048401/
https://www.ncbi.nlm.nih.gov/pubmed/27716223
http://dx.doi.org/10.1186/s12889-016-3672-y
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author Walker, N. J.
van Woerden, H. C.
Kiparoglou, V.
Yang, Y.
Robinson, H.
Croghan, E.
author_facet Walker, N. J.
van Woerden, H. C.
Kiparoglou, V.
Yang, Y.
Robinson, H.
Croghan, E.
author_sort Walker, N. J.
collection PubMed
description BACKGROUND: Smoking cessation services are available in England to provide assistance to those wishing to quit smoking. Data from one such service were analysed in order to investigate differences in quit rate between males and females prescribed with different treatments. METHODS: A logistic regression model was fitted to the data using the binary response of self-reported quit (failed attempt = 0, successful attempt = 1), validated by Carbon Monoxide (CO) monitoring, 4 weeks after commencing programme. Main effects fitted were: client gender; age; region; the type of advisory sessions; and pharmacotherapy, Nicotine Replacement Therapy (NRT) or Varenicline. A second model was fitted including all main effects plus two-way interactions except region. These models were repeated using 12-week self-reported quit as the outcome. RESULTS: At 4 weeks, all main effects were statistically significant, with males more likely (odds ratio and 95 % CI, females v males = 0.88 [0.79–0.97]), older smokers more likely (adjusted odds ratios [OR] and 95 % confidence interval [CI] respectively for groups 20–29, 30–49, 50–69 and 70+ vs 12–19 age group: 1.79 [1.39–2.31], 2.12 [1.68–2.68], 2.30 [1.80–2.92] and 2.47 [1.81–3.37] and for overall difference between groups, χ(2)(4) = 53.5, p < 0.001) and clients being treated with Varenicline more likely to have successfully quit than those on NRT (adjusted OR and 95 % CI for Varenicline vs NRT = 1.41 [1.21–1.64]). Statistically significant interactions were observed between (i) gender and type of counselling, and (ii) age and type of counselling. Similar results were seen in relation to main effects at 12 weeks except that type of counselling was non-significant. The only significant interaction at this stage was between gender and pharmacotherapy (adjusted OR and 95 % CI for females using Varenicline versus all other groups = 1.43 [1.06–1.94]). CONCLUSION: Gender and treatment options were identified as predictors of abstinence at both 4 and 12 weeks after quitting smoking. Furthermore, interactions were observed between gender and (i) type of counselling received (ii) pharmacotherapy. In particular, the quit rate in women at 12 weeks was significantly improved in conjunction with Varenicline use. These findings have implications for service delivery.
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spelling pubmed-50484012016-10-11 Gender difference and effect of pharmacotherapy: findings from a smoking cessation service Walker, N. J. van Woerden, H. C. Kiparoglou, V. Yang, Y. Robinson, H. Croghan, E. BMC Public Health Research Article BACKGROUND: Smoking cessation services are available in England to provide assistance to those wishing to quit smoking. Data from one such service were analysed in order to investigate differences in quit rate between males and females prescribed with different treatments. METHODS: A logistic regression model was fitted to the data using the binary response of self-reported quit (failed attempt = 0, successful attempt = 1), validated by Carbon Monoxide (CO) monitoring, 4 weeks after commencing programme. Main effects fitted were: client gender; age; region; the type of advisory sessions; and pharmacotherapy, Nicotine Replacement Therapy (NRT) or Varenicline. A second model was fitted including all main effects plus two-way interactions except region. These models were repeated using 12-week self-reported quit as the outcome. RESULTS: At 4 weeks, all main effects were statistically significant, with males more likely (odds ratio and 95 % CI, females v males = 0.88 [0.79–0.97]), older smokers more likely (adjusted odds ratios [OR] and 95 % confidence interval [CI] respectively for groups 20–29, 30–49, 50–69 and 70+ vs 12–19 age group: 1.79 [1.39–2.31], 2.12 [1.68–2.68], 2.30 [1.80–2.92] and 2.47 [1.81–3.37] and for overall difference between groups, χ(2)(4) = 53.5, p < 0.001) and clients being treated with Varenicline more likely to have successfully quit than those on NRT (adjusted OR and 95 % CI for Varenicline vs NRT = 1.41 [1.21–1.64]). Statistically significant interactions were observed between (i) gender and type of counselling, and (ii) age and type of counselling. Similar results were seen in relation to main effects at 12 weeks except that type of counselling was non-significant. The only significant interaction at this stage was between gender and pharmacotherapy (adjusted OR and 95 % CI for females using Varenicline versus all other groups = 1.43 [1.06–1.94]). CONCLUSION: Gender and treatment options were identified as predictors of abstinence at both 4 and 12 weeks after quitting smoking. Furthermore, interactions were observed between gender and (i) type of counselling received (ii) pharmacotherapy. In particular, the quit rate in women at 12 weeks was significantly improved in conjunction with Varenicline use. These findings have implications for service delivery. BioMed Central 2016-10-03 /pmc/articles/PMC5048401/ /pubmed/27716223 http://dx.doi.org/10.1186/s12889-016-3672-y Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Walker, N. J.
van Woerden, H. C.
Kiparoglou, V.
Yang, Y.
Robinson, H.
Croghan, E.
Gender difference and effect of pharmacotherapy: findings from a smoking cessation service
title Gender difference and effect of pharmacotherapy: findings from a smoking cessation service
title_full Gender difference and effect of pharmacotherapy: findings from a smoking cessation service
title_fullStr Gender difference and effect of pharmacotherapy: findings from a smoking cessation service
title_full_unstemmed Gender difference and effect of pharmacotherapy: findings from a smoking cessation service
title_short Gender difference and effect of pharmacotherapy: findings from a smoking cessation service
title_sort gender difference and effect of pharmacotherapy: findings from a smoking cessation service
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5048401/
https://www.ncbi.nlm.nih.gov/pubmed/27716223
http://dx.doi.org/10.1186/s12889-016-3672-y
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