Pharmacotherapy and smoking cessation at a tobacco dependence clinic

Background. Tobacco dependence medications are effective, and combinations may offer advantages. This study evaluates abstinence rates among smokers treated in a tobacco specialist clinic with individual and/or group counseling plus combination pharmacotherapy. Methods. 790 smokers treated at the Tobacco Dependence Clinic in New Jersey from 2001-2003 and contacted 4 weeks after quit-date were studied. Patients received medications and behavioral interventions. Abstinence over the previous 7 days was evaluated at 4 weeks and 6 months. Patients lost to 6-month follow-up were considered still smoking. Results. Overall, 36% of patients were abstinent at 6 months (20% who used no medications, 37% using one medication, 37% using 2 medications, 42% using 3 medications, and 42% using 4+ medications) (P = 0.017). 27% still used medications at 6 months, and had higher abstinence rates (65%) than those who stopped their medications (27%) (P < 0.001). Number of medications predicted abstinence at 4 weeks [adjusted odds ratios = 2.30 (95% CI; 1.27-4.18) for 1 medication, 4.78 (2.72-8.40) for 2 medications, 5.83 (2.98-11.40) for 3 medications, and 11.80 (4.10-33.95) for 4+ medications]. Increasing age, increasing level of education, longer time after waking to first cigarette, more than 7 clinical contacts, and more medications used were related to higher abstinence at 6 months. Conclusions. Smokers attending a specialist tobacco dependence treatment clinic who used more medications and for longer duration had higher abstinence rates.