Original Article
Effectiveness of a Cognitive Orientation Program With and Without Nicotine Replacement Therapy in Stopping Smoking in Hospitalised Patients
Efectividad de un programa de orientación cognitiva con y sin tratamiento sustitutivo con nicotina en la cesación tabáquica en pacientes hospitalizados
Francisco Ortega
, Arturo Vellisco, Eduardo Márquez, José Luis López-Campos, Ana Rodríguez, María de los Ángeles Sánchez, Emilia Barrot, Pilar Cejudo
Corresponding author
Sección de EPOC y Rehabilitación Respiratoria, Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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We have also analyzed whether the combination of intervention with nicotine replacement therapy (NRT) can increase smoking abstinence rates after 12 months of follow-up.</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">We studied 2,560 active smokers during their hospital stays. Of these, 717 smokers declined to participate in the study, and after minimal intervention they were asked for permission to telephone them one year later to ask if they continued to smoke. The remaining 1,843 smokers received high-intensity cognitive therapy and were randomized to receive NRT or not. The follow-up after hospital discharge was completed either in the outpatient consultation or by telephone sessions.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">One year later, 7% of the patients who declined to participate in the study maintained smoking abstinence, compared with 27% of those who did participate in the study (p<0.001). There were significant differences between the group that only received behavioral treatment (21% abstinence) compared with the group that also received NRT (33% abstinence; p = 0.002). In this last group, there were significant differences (p = 0.03) between those who attended outpatient consultation (39% abstinence) and those who had telephone sessions (30%). In the multivariate analysis, the predictors for abstinence 12 months later were: having used NRT (OR 12.2; 95% CI, 5.2-32; p = 0.002) and a higher score on the Richmond test (OR 10.1; 95% CI, 3.9-24.2; p = 0.01).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Cognitive orientation interventions initiated in hospitalized smokers increase 12-month abstinence rates compared with minimal intervention, and said rates increase significantly when NRT is added.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Analizamos la eficacia de una intervención conductual-cognitiva de alta intensidad frente a una intervención mínima iniciada durante un ingreso hospitalario, y si la combinación con tratamiento sustitutivo con nicotina (TSN) puede aumentar las tasas de abstinencia a los 12 meses de seguimiento.</p> <span class="elsevierStyleSectionTitle">Método</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Se estudiaron 2.560 fumadores activos durante un ingreso hospitalario. De ellos, 717 fumadores rehusaron entrar en el estudio y tras una intervención mínima se les solicitaba poder telefonearlos al año para preguntar si continuaban fumando. El resto, 1.843 fumadores recibieron tratamiento cognitivo de alta intensidad y fueron aleatorizados para recibir o no TSN. El seguimiento tras el alta se realizaba en consultas externas o con sesiones telefónicas.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Al año de seguimiento, el 7% de los que rehusaron entrar en el estudio se mantenían sin fumar frente al 27% de los que entraron en el estudio (p < 0,001). Existían diferencias significativas entre el grupo que realizó solo tratamiento conductual (21% de abstinencia) frente al grupo que además realizó TSN (33% de abstinencia; p = 0,002). En este último grupo existían diferencias significativas (p = 0,03) entre los que realizaron el seguimiento en consultas (39% de abstinencia) frente a los que hicieron el control telefónico (30%). En el análisis multivariante, los predictores de abstinencia a los 12 meses fueron: haber utilizado TSN (OR 12,2; 95% de CI, 5,2–32; p = 0,002) y mayor puntuación en el test de Richmond (OR 10,1; 95% de CI, 3,9–24,2; p = 0,01).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Una intervención de orientación cognitiva iniciada en fumadores ingresados aumenta las tasas de abstinencia a los 12 meses frente a una intervención mínima, y aún aumenta de forma más significativa dichas tasas si se le añade TSN.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:29 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Encuesta Nacional de Salud 2003. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 October | 21 | 10 | 31 |
| 2024 September | 27 | 10 | 37 |
| 2024 August | 43 | 40 | 83 |
| 2024 July | 24 | 26 | 50 |
| 2024 June | 43 | 27 | 70 |
| 2024 May | 39 | 22 | 61 |
| 2024 April | 17 | 23 | 40 |
| 2024 March | 16 | 13 | 29 |
| 2024 February | 16 | 22 | 38 |
| 2023 March | 2 | 0 | 2 |
| 2023 February | 14 | 17 | 31 |
| 2023 January | 16 | 29 | 45 |
| 2022 December | 19 | 35 | 54 |
| 2022 November | 24 | 18 | 42 |
| 2022 October | 21 | 29 | 50 |
| 2022 September | 15 | 42 | 57 |
| 2022 August | 23 | 46 | 69 |
| 2022 July | 17 | 43 | 60 |
| 2022 June | 14 | 40 | 54 |
| 2022 May | 20 | 34 | 54 |
| 2022 April | 13 | 38 | 51 |
| 2022 March | 20 | 51 | 71 |
| 2022 February | 20 | 27 | 47 |
| 2022 January | 14 | 35 | 49 |
| 2021 December | 21 | 50 | 71 |
| 2021 November | 18 | 59 | 77 |
| 2021 October | 23 | 71 | 94 |
| 2021 September | 15 | 64 | 79 |
| 2021 August | 10 | 41 | 51 |
| 2021 July | 10 | 26 | 36 |
| 2021 June | 12 | 28 | 40 |
| 2021 May | 14 | 31 | 45 |
| 2021 April | 15 | 43 | 58 |
| 2021 March | 27 | 31 | 58 |
| 2021 February | 19 | 27 | 46 |
| 2021 January | 8 | 12 | 20 |
| 2020 December | 16 | 23 | 39 |
| 2020 November | 8 | 17 | 25 |
| 2020 October | 9 | 10 | 19 |
| 2020 September | 1 | 4 | 5 |
| 2020 August | 9 | 14 | 23 |
| 2020 July | 11 | 22 | 33 |
| 2020 June | 11 | 3 | 14 |
| 2020 May | 14 | 28 | 42 |
| 2020 April | 21 | 27 | 48 |
| 2020 March | 8 | 17 | 25 |
| 2020 February | 13 | 24 | 37 |
| 2020 January | 19 | 23 | 42 |
| 2019 December | 13 | 16 | 29 |
| 2019 November | 12 | 13 | 25 |
| 2019 October | 4 | 9 | 13 |
| 2019 September | 7 | 6 | 13 |
| 2019 August | 10 | 12 | 22 |
| 2019 July | 5 | 22 | 27 |
| 2019 June | 10 | 13 | 23 |
| 2019 May | 15 | 22 | 37 |
| 2019 April | 17 | 29 | 46 |
| 2019 March | 9 | 37 | 46 |
| 2019 February | 17 | 18 | 35 |
| 2019 January | 9 | 24 | 33 |
| 2018 December | 7 | 19 | 26 |
| 2018 November | 13 | 12 | 25 |
| 2018 October | 23 | 19 | 42 |
| 2018 September | 14 | 9 | 23 |
| 2018 May | 5 | 0 | 5 |
| 2018 April | 3 | 11 | 14 |
| 2018 March | 2 | 2 | 4 |
| 2018 February | 7 | 9 | 16 |
| 2018 January | 4 | 11 | 15 |
| 2017 December | 10 | 10 | 20 |
| 2017 November | 4 | 10 | 14 |
| 2017 October | 7 | 7 | 14 |
| 2017 September | 6 | 15 | 21 |
| 2017 August | 5 | 15 | 20 |
| 2017 July | 3 | 11 | 14 |
| 2017 June | 7 | 22 | 29 |
| 2017 May | 7 | 9 | 16 |
| 2017 April | 5 | 9 | 14 |
| 2017 March | 3 | 6 | 9 |
| 2017 February | 0 | 2 | 2 |
| 2017 January | 3 | 4 | 7 |
| 2016 December | 9 | 5 | 14 |
| 2016 November | 13 | 9 | 22 |
| 2016 October | 20 | 10 | 30 |
| 2016 September | 12 | 8 | 20 |
| 2016 August | 14 | 4 | 18 |
| 2016 July | 10 | 0 | 10 |
| 2016 June | 0 | 2 | 2 |
| 2016 May | 1 | 0 | 1 |
| 2016 April | 0 | 1 | 1 |
| 2016 March | 7 | 0 | 7 |
| 2016 February | 5 | 0 | 5 |
| 2016 January | 7 | 0 | 7 |
| 2015 December | 3 | 0 | 3 |
| 2015 November | 1 | 3 | 4 |
| 2015 October | 30 | 7 | 37 |
| 2015 September | 34 | 2 | 36 |
| 2015 August | 35 | 8 | 43 |
| 2015 July | 37 | 4 | 41 |
| 2015 June | 38 | 3 | 41 |
| 2015 May | 41 | 8 | 49 |
| 2015 April | 40 | 10 | 50 |
| 2015 March | 24 | 7 | 31 |
| 2015 February | 28 | 2 | 30 |
| 2015 January | 32 | 5 | 37 |
| 2014 December | 37 | 9 | 46 |
| 2014 November | 36 | 7 | 43 |
| 2014 October | 38 | 10 | 48 |
| 2014 September | 23 | 5 | 28 |
| 2014 August | 34 | 10 | 44 |
| 2014 July | 30 | 6 | 36 |
| 2014 June | 54 | 9 | 63 |
| 2014 May | 61 | 10 | 71 |
| 2014 April | 48 | 8 | 56 |
| 2014 March | 59 | 11 | 70 |
| 2014 February | 37 | 5 | 42 |
| 2014 January | 26 | 12 | 38 |
| 2013 December | 55 | 12 | 67 |
| 2013 November | 30 | 6 | 36 |
| 2013 October | 35 | 9 | 44 |
| 2013 September | 38 | 9 | 47 |
| 2013 August | 32 | 7 | 39 |
| 2013 July | 47 | 10 | 57 |
| 2013 June | 36 | 7 | 43 |
| 2013 May | 32 | 3 | 35 |
| 2013 April | 30 | 5 | 35 |
| 2013 March | 8 | 2 | 10 |
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