Suchttherapie 2009; 10 - S114
DOI: 10.1055/s-0029-1240267

Effectiveness of medication for smoking cessation in the ‘real world‘- findings from a field study

CB Kröger 1, S Gradl 2
  • 1IFT Institut für Therapieforschung, München
  • 2IFT-Gesundheitsförderung, München

Objectives: In clinical trials, medication such as NRT, Bupropion or Varenicline showed to enhance the success of smoking cessation. Cross-sectional and longitudinal studies about the effectiveness of medication outside clinical trials reported inconsistent and different findings. This study aims to examine the effectiveness of the combination of counseling and medication for smoking cessation vs. counseling alone outside clinical trials.

Methods: The study’s sample included 181 German adult smokers who attended a cognitive-behavioural smoking cessation program. The program informs about medication as a useful strategy for quitting, but its use is not enforced. Smokers using nicotine replacement therapy (NRT) were included in the study’s sample. Smokers using Bupropion or Varenicline were due to the small number of users excluded from the sample. In a longitudinal non-randomized controlled study, a sample of N=181 medication users (n=69) and non-users (n=88) (excluded: n=11; dropouts: n=13) was investigated at three measurement times: at baseline in the first session (t0), at the end of the course (t1) and at 6-months follow-up (t2). Attrition analyses were performed. Users and non-users were comparable by gender, age and level of nicotine dependence. The effectiveness of medication was examined by binary logistic regression including Fagerstrom test for nicotine dependence (FTND) as covariate.

Results: At 6-months follow-up, regarding the abstinence rates no significant differences were found between users of medication and non-users. Abstinence rates of participants using NRT are 39.5% and of participants not using NRT are 43.4% (Intention-to-treat–analysis).

Conclusion: Outside clinical trials medication for smoking cessation seems to be less effective. An explanation for this result might be that in the real world setting NRT users do not adhere to the package inserts and recommendations as they do in observed and supervised clinical settings.