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Comparing Smoking Cessation Interventions for Work-Site Disease Management

  • Practical Disease Management
  • Published:
Disease Management and Health Outcomes

Abstract

Smoking cessation continues to be one of the most cost-effective preventive measures for work-site disease management. The US Public Health Service Clinical Practice Guideline, entitled ‘Treating Tobacco Use and Dependence,’ provides guidance for evaluating and choosing smoking cessation programs for work sites.

Smoking cessation interventions can be characterized by the resource intensity of the effort, the format and methods of interacting with patients and the focus and objectives of the content. These features are compared with typical group, phone and Internet-based program options. Pharmacotherapy treatment recommendations are reviewed as well as characteristics of first-line nicotine replacement therapy (NRT) medications (e.g. nicotine patch, gum, spray and inhaler) and bupropion.

It is suggested that work-site recruitment and participation campaigns may fail for a variety of reasons including: (i) too narrowly cast recruitment messages; (ii) inadequate exposure to campaign messages; (iii) lack of immediate and accessible enrollment mechanisms; and (iv) passive rather than active outreach. Four broad issues to consider when comparing outcomes data from potential smoking cessation programs are: (i) at what follow-up point(s) is the quit rate measured?; (ii) is there a comparison group?; (iii) how was quit status determined?; and (iv) how is the status of participants who are lost to follow-up calculated in the outcomes data?

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References

  1. Matheson D, Robinson T. The Boston Consulting Group. Disease management takes flight [online]. Available from: URL: http://www.bcg.com/ [Accessed 2001 Aug 1]

  2. LaRock S. Two Employers say yes and — prove it. Benefit Plan Rev 1994 Sep; 49(3): 51–4

    Google Scholar 

  3. Fiore MC, Bailey WC, Cohen SJ, et al. Treating tobacco use and dependence. A clinical practice guideline. AHRQ Publ. No. 00-0032. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services, 2000

    Google Scholar 

  4. The Smoking Cessation Clinical Guideline Panel and Staff. The agency for health care policy and research smoking cessation clinical practice guideline. JAMA 1996 Apr; 275(16): 1270–80

    Article  Google Scholar 

  5. CDC. Medical-care expenditures attributable to cigarette smoking —United States, 1993. MMWR Morb Mortal Wkly Rep 1994; 43: 469–72

    Google Scholar 

  6. Miller VP, Ernst C, et al. Smoking-attributable medical care costs in the USA. Soc Sci Med 1999; 48: 375–91

    Article  PubMed  CAS  Google Scholar 

  7. Coffield AB, Maciosek MV, McGinnis JM, et al. Priorities among recommended clinical preventive services. Am J Prev Med 2001; 21(1): 1–9

    Article  PubMed  CAS  Google Scholar 

  8. Warner KE. Smoking out the incentives for tobacco control in managed care settings. Tobacco Control 1998; 7 Suppl: S50–4

    Article  PubMed  Google Scholar 

  9. Bartlett JC, Miller LS, et al. Medical-care expenditures attributable to cigarette smoking, United States. MMWR Morb Mortal Wkly Rep 1993; 43(26): 469–72

    Google Scholar 

  10. Miller DP, Villa KF, Hogue SL, et al. Birth and first-year costs for mothers and infants attributable to maternal smoking. Nicotine Tob Res 2001 Feb; 3(1): 25–35

    Article  PubMed  CAS  Google Scholar 

  11. Haire-Joshu D, Glasgow RE, Tibbs TL. Smoking and diabetes. Diabetes Care 1999 Nov; 22(11): 1887–98

    Article  PubMed  CAS  Google Scholar 

  12. Krumholz HM, Cohen BJ, Tsevat J, et al. Cost-effectiveness of a smoking cessation program after myocardial infarction. J Am Coll Cardiol 1993 Nov; 22(6): 1697–702

    Article  PubMed  CAS  Google Scholar 

  13. Lok P, The Conference Board of Canada. Smoking and the bottom line: the costs of smoking in the workplace [online]. Available from: URL: http://www.hc-sc.gc.ca/hppb/tobaccoreduction//workplace/bottom_line/contents.htm [Accessed 2001 Aug 3]

  14. Warner KE, Smith RJ, Smith DG, et al. Health and economic implications of a work-site smoking-cessation program: a simulation analysis. J Occup Environ Med 1996 Oct; 38(10): 981–92

    Article  PubMed  CAS  Google Scholar 

  15. Baillie AJ, Mattick RP, Hall W. Quitting smoking: estimation by meta-analysis of the rate of unaided smoking cessation. Aust J Public Health 1995 Apr; 19(2): 129–31

    Article  PubMed  CAS  Google Scholar 

  16. Shuster III GS, Utz SW, Merwin E. Implementation and outcomes of a community-based self-help smoking cessation program. J Community Health Nurs 1996; 13(3): 187–98

    Article  PubMed  Google Scholar 

  17. Rigotti NA, Munafo MR, Murphy MF, et al. Interventions for smoking cessation in hospitalised patients: a systematic review. Cochrane Database Syst Rev 2001 Aug; 2: CD001837

    PubMed  Google Scholar 

  18. Zhu SH, Tedeschi G, Anderson CM, et al. Telephone counseling as adjuvant treatment for nicotine replacement therapy in a ‘real-world’ setting. Prev Med 2000 Oct; 31(4): 357–63

    Article  PubMed  CAS  Google Scholar 

  19. Warner KE. Cost effectiveness of smoking-cessation therapies: interpretation of the evidence-and implications for coverage. Pharmacoeconomics 1997 Jun; 11(6): 538–49

    Article  PubMed  CAS  Google Scholar 

  20. Brown BS. Observations on the recent history of drug user counseling. Int J Addict 1993 Oct; 28(12): 1243–55

    PubMed  CAS  Google Scholar 

  21. Prochaska JO. Strong and weak principles for progressing from precontemplation to action based on twelve problem behaviors. Health Psychol 1994: 51

  22. Glasgow RE, Hollis JF, Pettigrew L. Implementing a year-long, worksite-based incentive program for smoking cessation. et al. Am J Health Promot 1991 Jan; 5(3): 192–9

    Article  PubMed  CAS  Google Scholar 

  23. Lando HA, McGovern PG, Barrios FX, et al. Comparative evaluation of American Cancer Society and American Lung Association smoking cessation clinics. Am J Public Health 1990 May; 80(5): 554–9

    Article  PubMed  CAS  Google Scholar 

  24. Data on file, Behavioral Solutions, Princeton, New Jersey, 2001

  25. American Lung Association. Freedom from smoking [online]. Available from: URL: http://www.lungusa.org/ffs/ [Accessed 2001 Aug 20]

  26. QuitNet. Available from: URL: http://www.quitnet.com/ [Accessed 2001 Aug 20]

  27. Prochaska JO, Goldstein MG. Process of smoking cessation. Implications for clinicians. Clin Chest Med 1991 Dec; 12(4): 727–35

    PubMed  CAS  Google Scholar 

  28. Zhu SH, Anderson CM, Johnson CE, et al. A centralised telephone service for tobacco cessation: the California experience. Tob Control 2000; 9 Suppl. 2: 1148–55

    Google Scholar 

  29. DiClemente CC, Prochaska JO, Fairhurst SK, et al. The process of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change. J Consult Clin Psychol 1991 Apr; 59(2): 295–304

    Article  PubMed  CAS  Google Scholar 

  30. Breslau N, Peterson EL, Schultz LR, et al. Major depression and stages of smoking. Alongitudinal investigation. Arch Gen Psychiatry 1998 Feb; 55(2): 161–6

    Article  PubMed  CAS  Google Scholar 

  31. Quattrocki E, Baird A, Yurgelun-Todd D. Biological aspects of the link between smoking and depression. Harv Rev Psychiatry 2000 Sep; 8(3): 99–110

    PubMed  CAS  Google Scholar 

  32. Baer JS, Kamarck T, Lichtenstein E, et al. Prediction of smoking relapse: analyses of temptations and transgressions after initial cessation. J Consult Clin Psychol 1989 Oct; 57(5): 623–7

    Article  PubMed  CAS  Google Scholar 

  33. Lichtenstein E, Glasgow RE, Lando HA, et al. Telephone counseling for smoking cessation: rationales and meta-analytic review of evidence. Health Educ Res 1996 Jun; 11(2): 243–57

    Article  PubMed  CAS  Google Scholar 

  34. Zhu SH, Tedeschi G, Anderson CM, et al. Telephone counseling as adjuvant treatment for nicotine replacement in a ‘real-world’ setting. Prev Med 2000 Oct; 31(4): 357–63

    Article  PubMed  CAS  Google Scholar 

  35. Tate DF, Wing RR, Winett RA. Using Internet technology to deliver a behavioral weight loss program. JAMA 2001 Mar 7; 285(9): 1172–7

    Article  PubMed  CAS  Google Scholar 

  36. Hurt RD, Dale LC, Fredrickson PA, et al. Nicotine patch therapy for smoking cessation combined with physician advice and nurse follow-up. One-year outcome and percentage of nicotine replacement. JAMA 1994 Feb 23; 271(8): 595–600

    Article  PubMed  CAS  Google Scholar 

  37. Silagy C, Mant D, Fowler G, et al. Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev 2000; (3): CD000146

  38. Schneider NG, Lunell E, Olmstead RE, et al. Clinical pharma-cokinetics of nasal nicotine delivery: a review and comparison to other nicotine systems. Clin Pharmacokinet 1996 Jul; 31(1): 65–80

    Article  PubMed  CAS  Google Scholar 

  39. Nichols MR. The use of bupropion hydrochloride for smoking cessation therapy. Clin Excell Nurse Pract 1999 Nov; 3(6): 317–22

    PubMed  CAS  Google Scholar 

  40. Wongwiwatthananukit S, Jack HM, Popovic NG. Smoking cessation:part 2 —pharmacological approaches. J Am Pharm Assoc (Wash) 1998 May; 38(3): 339–53

    CAS  Google Scholar 

  41. Fiore MC, Jorenby DE, Baker TB, et al. Tobacco dependence and the nicotine patch. JAMA 1992 Nov; 268(19): 2687–94

    Article  PubMed  CAS  Google Scholar 

  42. Fiore MC, Smith SS, Jorenby DE, et al. The effectiveness of the nicotine patch for smoking cessation. A meta-analysis. JAMA 1995 Jan 18; 273(3): 181–2

    Article  Google Scholar 

  43. Silagy C, Mant D, Fowler G, et al. Meta-analysis on efficacy of nicotine replacement therapies in smoking cessation. Lancet 1994 Jan 15; 343(8890): 139–42

    Article  PubMed  CAS  Google Scholar 

  44. Balfour DJ. The pharmacology underlying pharmacotherapy for tobacco dependence: a focus on bupropion. Int J Clin Pract 2001 Jan; 55(1): 53–7

    PubMed  CAS  Google Scholar 

  45. Hurt RD, Sachs DP, Glover ED, et al. A comparison of sustained-release bupropion and placebo for smoking cessation. N Engl J Med 1997 Oct 23; 337(17): 1195–202

    Article  PubMed  CAS  Google Scholar 

  46. Jorenby DE, Leischow SJ, Nides MA, et al. A controlled trial of sustained-released bupropion, a nicotine patch, or both for smoking cessation. N Engl J Med 1999 Mar 4; 340(9): 685–91

    Article  PubMed  CAS  Google Scholar 

  47. Emont SL, Cummings KM. Using a low-cost, prize-drawing incentive to improve recruitment rate at a work-site smoking cessation clinic. J Occup Med 1992 Aug; 34(8): 771–4

    Article  PubMed  CAS  Google Scholar 

  48. Grosch JW, Alterman T, Petersen MR, Murphy LR. Worksite health promotion programs in the U.S.: factors associated with availability and participation. Am J Health Promot 1998 Sep-Oct; 13(1): 36–451998

    Article  PubMed  CAS  Google Scholar 

  49. Prochaska JO, Redding CA, Evers KE. The transtheoretical model and stages of change. In: Glanz K, Lewis FM, Rimer BK, editors. Health behavior and health education: theory, research and practice. 2nd ed. San Francisco (CA): Jossey-Bass, 1997: 60–84

    Google Scholar 

  50. Gottleib NH, Nelson A. A systematic effort to reduce smoking at the worksite. Health Educ Q 1990 Spring; 17(1): 99–118

    Article  Google Scholar 

  51. Lando HA, Jeffery RW, McGovern PG, et al. Factors influencing participation in worksite smoking cessation and weight loss programs: The Healthy Worker Project. Am J Health Promot 1993 Sep–Oct; 8(1): 22–4

    Article  PubMed  CAS  Google Scholar 

  52. Maheu MM, Gevirtz RN, Sallis JF, et al. Competition/cooperation in worksite smoking cessation using nicotine gum. Prev Med 1989 Nov; 18(6): 867–76

    Article  PubMed  CAS  Google Scholar 

  53. Lando HA, Jeffery RW, McGovern PG, Forster JL, Baxter JE. Factors influencing participation in worksite smoking cessation and weight loss programs: the Healthy Worker Project. Am J Health Promot 1993 Sep-Oct; 8(1): 22–4

    Article  PubMed  CAS  Google Scholar 

  54. McDonald P. Population-based recruitment for quit-smoking programs: an analytic review of communication variables. Preventive Med 1999; 28: 545–57

    Article  CAS  Google Scholar 

  55. Nides MA, Rakos RF, Gonzales D, et al. Predictors of initial smoking cessation and relapse through the first 2 years of the Lung Health Study. J Consult Clin Psychol, 1995; 63(1): 60–9

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

I would like to thank Glen Griffiths and the leadership of Nelson Communications in supporting me to pursue a collaborative strategy for the development of patient-centered health behavior programs.

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  1. Behavioral Solutions, 202 Carnegie Center, Suite 101, Princeton, New Jersey, NJ 08540, USA

    Todd Greenwood PhD, MPH (Director of Business Development at Behavioral Solutions)

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  1. Todd Greenwood PhD, MPH
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Correspondence to Todd Greenwood PhD, MPH.

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Greenwood, T. Comparing Smoking Cessation Interventions for Work-Site Disease Management. Dis-Manage-Health-Outcomes 9, 565–576 (2001). https://doi.org/10.2165/00115677-200109100-00005

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