Intensive care helps smokers quit, study finds

WASHINGTON (Reuters) - An intensive stop-smoking program with at least three months of counseling and free drugs can help smokers kick the habit, U.S. researchers reported on Monday.

A man smokes a cigarette outside his factory in Bordeaux, southwestern France, December 15, 2006. An intensive stop-smoking program with at least three months of counseling and free drugs can help smokers kick the habit, U.S. researchers reported on Monday. REUTERS/Regis Duvignau

Their intensive care program helped 39 percent of smokers stay tobacco-free for two years, the team at Creighton University Cardiac Center in Omaha, Nebraska reported.

“What we have shown is that a very planned and organized approach to cessation of smoking, with careful follow-up, works much better than the current practice of simply advising them to quit smoking,” said Dr. Syed Mohiuddin, who led the study.

Mohiuddin and colleagues tested a program to see how well counseling would work among a group of smokers who should be highly motivated -- patients in the coronary care unit suffering from heart attacks, severe coronary heart disease or a type of chest pain known as unstable angina.

“Our study showed that intense treatment intervention not only succeeded in getting patients to quit smoking, but it reduced hospitalizations and mortality, as well,” Mohiuddin said in a telephone interview.

They divided 209 volunteers into two groups. All were told to quit smoking and got 30 minutes of counseling with self-help materials.

Half then were given at least 12 weeks of behavior modification counseling and either nicotine replacement therapy, treatment with the drug bupropion, or both. Bupropion is an antidepressant that has also been shown to help people quit smoking.

After two years, 39 percent of the intensive treatment patients were still not smoking, compared to 9 percent of the usual care group, they reported in the journal Chest.

“That is a very impressive number,” said Dr. Joan Schiller, president of the National Lung Cancer Partnership and an oncologist at the University of Texas Southwestern Medical Center.

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Smoking is highly addictive, on a par with heroin addiction, Schiller said.

Those who got the extra care were half as likely to be readmitted to the hospital for something else in those two years. Those given advice to quit but no extra help were four times as likely to die as the extra-care patients.

“What we are suggesting is, especially in patients at high risk, that a program of cessation should be started while they are in the hospital,” Mohiuddin said.

About 25 percent of Americans smoke, and the U.S. Centers for Disease Control and Prevention estimates that smoking kills 438,000 people in the United States alone every year. It is the leading preventable cause of both cancer and heart disease.

“Yet even when the patients are given all that information, being repeatedly told by physicians to quit smoking does not work,” Mohiuddin said. “Information is never enough.”

But constant attention and drugs do help, he found.

“This is very true also of hypertension (high blood pressure) -- you get better control of hypertension if you provide not only advice but follow-up care that is intensive,” he said.

It also helps to have drugs supplied, Mohiuddin said.

“One of the unfortunate things that we have in our medical system is we are willing to pay for ... bypass surgery but we are not willing to pay for preventive therapy,” he said. “None of the insurers, including Medicare, pay for the medications which help patients quit smoking.”

They are now doing a breakdown to see just how cost-effective their program was.