Long-term effectiveness of a nurse-led smoking cessation clinic at a comprehensive cancer center

Cristina Martínez; Yolanda Castellano; Marcela Fu; Anna Riccobene; Marta Enríquez; Maite Narváez; Judith Saura; Arianda Feliu; Esteve Fernández

doi:10.1111/jnu.12891

Long-term effectiveness of a nurse-led smoking cessation clinic at a comprehensive cancer center

J Nurs Scholarsh. 2023 May;55(3):681-691. doi: 10.1111/jnu.12891. Epub 2023 Mar 14.

Authors

Cristina Martínez^{1

2

3

4

5}, Yolanda Castellano^{1

2}, Marcela Fu^{1

2

3

5}, Anna Riccobene^{1

2

5}, Marta Enríquez^{1

2}, Maite Narváez^{1

2}, Judith Saura^{1

2}, Arianda Feliu^{1

2

5}, Esteve Fernández^{1

2

5

6}

Affiliations

¹ Tobacco Control Unit, Cancer Control and Prevention Program, Institut Català d'Oncologia-ICO, Barcelona, Spain.
² Cancer Control and Prevention Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Barcelona, Spain.
³ Department of Nursing Public Health, Maternal and Mental Health, School of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.
⁴ Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, California, USA.
⁵ Consortium for Biomedical Research in Respiratory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain.
⁶ Department of Clinical Sciences, School of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.

PMID: 36916452
DOI: 10.1111/jnu.12891

Abstract

Purpose: Smoking cessation interventions should be promoted in cancer centers to improve clinical outcomes among cancer patients and the quality of life of cancer-free patients and survivors. The aim of the present study was to examine long-term abstinence (1, 3, and 5 years) among smokers who received an intensive nurse-led smoking cessation intervention.

Design: A prospective follow-up study was conducted in a smoking cessation clinic in Barcelona.

Methods: The study included 479 smokers who received a nurse-led smoking cessation intervention that included motivational interviewing, psychological support, behavioral change counseling, promotion of smoke-free policies, and relapse-prevention strategies, as well as pharmacotherapy if necessary, for 12 months. We calculated overall and sex-specific 1-, 3-, and 5-year abstinence probabilities (Kaplan-Meier curves) and adjusted hazard ratios (aHRs) of relapse with 95% confidence intervals (CIs) using Cox regression.

Findings: The overall probability of abstinence at 1 and 5 years was 0.561 (95% CI: 0.516-0.606) and 0.364 (95% CI: 0.311-0.417), respectively. Females had a higher, but not significant, hazard ratio for relapse compared to males (aHR = 1.180; 95% CI: 0.905-1.538). Attending <5 visits was the most remarkable determinant of relapsing compared to attending 5-9 visits or ≥10 visits, both overall and by sex (p for trend: overall, p < 0.001; males, p = 0.007; and females, p < 0.001).

Conclusions: Abstinence probability decreased over the 5-year follow-up but was relatively high. Males had higher abstinence rates than females in all follow-up periods. Completeness of the intensive intervention was the main predictor of cessation.

Clinical relevance: Smoking cessation interventions should consider sex and incorporate strategies to increase adherence to obtain higher long-term abstinence rates.

Keywords: abstinence; cancer; nursing; relapse; smoking cessation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Female
Follow-Up Studies
Humans
Male
Neoplasms*
Nurse's Role
Prospective Studies
Quality of Life
Recurrence
Smoking Cessation*