Smoking Cessation Clinical Trial
Official title:
Effectiveness of a Stepped Primary Care Smoking Cessation Intervention Based on an Evidence Based Clinical Practice Guideline (ISTAPS Project)
Primary care centers can play a very important role in helping people to stop smoking. There is a large body of research on the effectiveness of specific interventions especially addressed to people who want to stop smoking. In addition to that, there are no studies with a large sample of individuals included that tested the complete range of interventions recommended nowadays for helping people in the different smoking cessation stages of change and with different degrees of physical and psychological dependence, especially including motivational interviewing in those not interested in cessation in the very next weeks. This study will test a complex intervention that at first classifies smokers in stages and after that treats every smoker according to what stage he/she is in at the moment, his/her degree of dependence and his/her own characteristics.
OBJECTIVES:
- To evaluate the effectiveness of a stepped smoking cessation intervention based on a
transtheoretical model of change that uses the pharmacological and no-pharmacological
methods proposed by evidence based Clinical Practice Guidelines for smoking cessation
from primary care centers.
- To assess the health status change in relationship with the smoking cessation process.
DESIGN: Cluster randomized clinical trial
Unit of Randomization: Care basic unit (family physician or nurse that cares for the same
group of patients). Intention to treat analysis.
PARTICIPANTS: 2911 smokers (ages 14-75 years) consulting for any reason to primary care
centers
INTERVENTION: 6-month implementation of recommendations of a Clinical Practice Guideline
that includes motivational consulting for smokers at the precontemplation - contemplation
stage; brief intervention for smokers in preparation-action who do not want help; intensive
intervention with pharmacotherapies for smokers in preparation-action who want help; and
reinforcing intervention in the maintenance stage.
CONTROL: Usual care
MEASUREMENT: Self reported abstinence confirmed by an expired air carbon monoxide
concentration of 10 parts per millions or less; Point prevalence at the end of intervention,
1 and 2 years after the beginning of intervention; Continuous abstinence rate for 1 year;
Change of stage in the smoking cessation process; Health status measured by SF-36.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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