Comparison of Effectiveness between Transdermal Nicotine Replacement Therapy and Group Counseling Therapy for Smokers among Military Personnel in Hualien,Taiwan

• Main Authors: Tzer-Tzong Liou, 劉澤宗
• Other Authors: Pesus Chou
• Format: Others
• Language: zh-TW
• Published: 2005
• Online Access: http://ndltd.ncl.edu.tw/handle/77539248203011155836

碩士 === 國立陽明大學 === 公共衛生研究所 === 93 === Abstract Background: High prevalence of smoking rate was noted among military personnel after surveyed by Pro. Chu. on 2001 and which smoking cessation model is best or probably doing for military personnel at Hualien city in East Taiwan. Our study purpose is to evaluate what is the effectiveness model of clinical intervention trials for smoking cessation will be satisfied during this military career. After Review many reference articles showed active smoking cessation interventions are offered in all clinical settings to all smokers willing to make a quit attempt. About one and one-half to two Odds were noted when compared NRT with placebo while in abstinence clinical trial model. Since the effectiveness and comparison of routine provision of group smoking cessation programs counseling therapy (GCT) and nicotine replacement therapy with brief counseling (NRT) to smokers serving in military have not been established, a randomized controlled trial of these interventions given together was performed in military personnel. The nicotine withdrawal syndrome reduced by NRT may be also proved after this clinical trial model. Methods: A randomized controlled trial of serving in military more than 18-year-old male who were current smokers were randomized to receive either group smoking cessation programs counseling therapy (120 minutes intervention with written materials or a series of lectures including Nutrients, Dentist, Psychologist and Medical doctors) or NRT plus brief counseling (counseling intervention with a 8 weeks course of NRT served by doctors and nurses) during July 1 to December 31 on 2004. Statistical Analysis with independent sample t-Test and paired sample t-Tests for effectiveness and difference of these two groups and evaluate odds ratio for two groups by Chi-square t-test by SPSS 11.5 software. Point prevalence abstinence from smoking (validated by exhaled carbon monoxide <6 ppm) was measured at 1, 3 & 6 months, and self-reported reduction in cigarettes consumption in smokers was assessed at 1, 3 & 6 months. Continuous prevalence abstinence from smoking (validated by exhaled carbon monoxide <6 ppm) was measured at 3 & 6 months and assessed for successful abstinence by FTND less than 4 (minimal nicotine dependent) . Results: The crude smoking prevalence are 29.1% and there are 828 military personnel smoking screen from 2849 military. There are 157 military personnel smokers were enrolled after satisfied the inclusion and exclusion criteria. The basic demographic data showed no difference between these two groups after performed randomized controlled trial. The intervention of group smoking cessation programs counseling therapy revealed increase the body weight about 0.9 kilogram, BMI 0.3, diastolic pressure 2.2mmHg, and decrease the heart rate about 2.5bpm, exhaled carbon monoxide 3.0ppm, FTND 3.4 scores and cigarettes of smoking 9.5 cigarettes and these changes with statistical significance and the intervention with transdermal nicotine replacement therapy plus brief counseling revealed decrease the exhaled carbon monoxide 4.9ppm, FTND 4.1 scores and cigarettes of smoking 10.9cigarettes and these changes with statistical significance.( The NRT decrease obviously than group counseling therapy in clinical findings). NRT can improve nicotine withdrawal syndrome than GCT and these difference are statistical significance (α=0.05). Outcome measures revealed the first month point abstinence are 3.8% and 7.7% between NRT (n=79) and GCT(n=78), OR=0.474(95% CI:0.114~1.965), P=0.328>0.05; 3 months point abstinence are 10.1% and 7.7%, OR=1.352 (0.446~4.095), P=0.593; 6 months point abstinence are 12.7% and 9.0%,OR=1.470 (0.529~4.081), P=0.458. The difference of point abstinence between the groups there are no statistical significance. Continuous 3 months abstinence from smoking between NRT and GCT are 3.8% and 7.7%, OR=0.474(95% CI: 0.114~1.965), P=0.328>0.05 and continuous 6 months abstinence are 7.6% and 7.7%, OR=0.986(0.304~3.202), P=0.982. The difference of continuous abstinence between the groups there are also no statistical significance, α>0.05 respectively). Conclusions: NRT given with brief counseling and the group smoking cessation programs counseling therapy are all effective individually in smoking cessation to military personnel whoever in clinical or statistical respectively. NRT plus brief counseling is an effective intervention in reduced diastolic pressure, FTND(nicotine dependence score) and withdrawal syndrome than GCT but no significant difference in body weight, BMI, SBP, Heart rate and exhaled carbon monoxide. The intervention with NRT plus GCT model may be a probably abstinence strategy for the military personnel in the future. Key words: Nicotine replacement therapy, group counseling smoking cessation programs, military personnel, Abstinence clinical trials, exhaled carbon monoxide.