Real-world comparative study of behavioral group therapy program vs education program implemented for smoking cessation in community-dwelling elderly smokers

Abstract

Background

Tobacco smoking is known to be an important contributor to a wide variety of chronic diseases, especially in older adults. Information on health policy and practice, as well as evaluation of smoking cessation programs targeting older people, is almost nonexistent.

Purpose

To compare the real-world implementation of behavioral group therapy in relation to education alone for elderly smokers.

Materials and methods

Elderly smokers ready to quit smoking were identified from a cohort who completed a questionnaire at a smoking exhibition. They were allocated into two groups, behavioral therapy (3 days 9 hours) and education (2 hours), depending on their preferences. Demographic data, the Fagerstrom test for nicotine dependence (FTND) score, and exhaled carbon monoxide level were recorded at baseline. Smoking status of all subjects was followed at months 3, 6, and 12. Statistical differences in continuous abstinence rate (CAR) between the two groups were analyzed using chi-square tests.

Results

Two hundred and twenty-four out of 372 smoking exhibition attendants met the enrollment criteria; 120 and 104 elected to be in behavioral group therapy and education-alone therapy, respectively. Demographic characteristics and smoking history were similar between both groups, including age, age of onset of smoking, years of smoking, smoking pack-years, education level, and nicotine dependence as measured by the FTND scale. The CAR of the behavioral therapy group at the end of the study (month 12) was significantly higher than the education group (40.1% vs 33.3%, P=0.034). Similar results were also found throughout all follow-up visits at month 3 (57.3% vs 27.0%, P<0.001) and month 6 (51.7% vs 25%, P<0.001).

Conclusion

Behavioral group therapy targeting elderly smokers could achieve higher short-and long-term CARs than education alone in real-world practice.

Keywords:

• smoking cessation
• behavioral
• education
• elderly

Acknowledgments

The authors wish to thank the participants who kindly took part in this study and to acknowledge the staff members of the Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University for their contribution to this trial. Their gratitude also goes to Miss Thitaree Liewhiran and Miss Udomsri Kamphor for their contribution in developing the smoking cessation programs and their expertise as skillful counselors for smoking cessation.

Authors’ contributions

The first author developed study design and carried out acquisition and interpretation of data, statistical analysis, manuscript preparation, and critical revision of intellectual contents. The other authors contributed to acquisition and interpretation of data, revision of the article for important intellectual content, and final approval of the version to be published.

Disclosure

The authors have no conflicts of interest in connection with this work.