Gender differences in success at quitting smoking: Short- and long-term outcomes

Authors

  • Adriana Marqueta Unidad de Tabaquismo. Universidad de Zaragoza
  • Isabel Nerín Unidad de Tabaquismo. Universidad de Zaragoza Departamento de Medicina, Psiquiatría y Dermatología. Facultad de Medicina, Universidad de Zaragoza
  • Pilar Gargallo Departamento de Métodos Estadísticos, Facultad de Ciencias Económicas y Empresariales, Universidad de Zaragoza
  • Asunción Beamonte Departamento de Métodos Estadísticos, Facultad de Ciencias Económicas y Empresariales, Universidad de Zaragoza

DOI:

https://doi.org/10.20882/adicciones.826

Keywords:

Smoking, smoking cessation, gender and health, women, survival analysis.

Abstract

Smoking cessation treatments are effective in men and women. However, possible sex-related differences in the outcome of these treatments remain a controversial topic. This study evaluated whether there were differences between men and women in the success of smoking cessation treatment, including gender-tailored components, in the short and long term (> 1 year). A telephone survey was carried out between September 2008 and June 2009 in smokers attended in a Smoking Cessation Clinic. All patients who have successfully completed treatment (3 months) were surveyed by telephone to determine their long-term abstinence. Those who remained abstinent were requested to attend the Smoking Cessation Clinic for biochemical validation (expired CO ≤10 ppm). The probability of remaining abstinent in the long-term was calculated using a Kaplan-Meier survival analysis. The treatment success rate at 3-months was 41.3% (538/1302) with no differences by sex 89% (479/538) among those located in the telephonic follow-up study and 47.6% (256/479) were abstinent without differences by sex (p = .519); abstinence was validated with CO less than 10 ppm in 191 of the 256 (53.9% men and 46.1% women). In the survival analysis, the probability of men and women remaining abstinent in the long-term was not significant. There are no differences by sex in the outcome of smoking cessation treatment that included gender-tailored components in the short and long term (> 1 year).  

References

Álvarez, F. J., Ferrer, M., Ruiz, A., Medina, J. F., Romero, B., Sáez, A., y Romero, A. (2015). Predictors of 10-year smoking abstinence in smokers abstinent for 1 year after treatment. Addiction, 111, 545-551. doi: 10.1111/add.13220

Amos, A., Greaves, L., Nichter, M., y Bloch, M. (2012). Women and tobacco: a call for including gender in tobacco control research, policy and practice. Tobacco Control, 21, 236-243. doi: 10.1136/tobaccocontrol-2011-050280.

Banegas, J. R., Díez-Gañán, L., Bañuelos-Marco, B., González-Enríquez, J., Villar-Álvarez, F., Martín-Moreno, J. M.,… Jiménez-Ruiz, C. (2011). Smoking-attributable deaths in Spain. Medicina Clínica, 136, 97-102. doi: 10.1016/j.medcli.2010.03.039.

Bjornson, W., Rand, C., Connett, J. E., Lindgren, P., Nides, M., Pope, F., …O’Hara, P. (1995). Gender differences in Smoking Cessation after 3 Years in the Lung Health Study. American Journal of Public Health, 85, 223-230.

Bohadana, A., Nilsson, F., Rasmussen, T., y Martinet, Y. (2003). Gender differences in quit rates following smoking cessation with combination nicotine therapy: Influence of baseline smoking behavior. Nicotine & Tobacco Research, 5, 111-116.

Borrell, C., García-Calvente, M. M., y Martí-Boscà, J. V. (2004). La salud pública desde la perspectiva de género y clase social. Gaceta Sanitaria, 18, 2-6.

Chatkin, J. M., Abreu, C. M., Blanco, D. C., Tonietto, R., Scaglia, N., Wagner, M. B., y Fritscher, C. C. (2006). No gender difference in effectiveness of smoking cessation treatment in a Brazilian real-life setting. The International Journal of Tuberculosis and Lung Disease, 10, 499-503.

Cepeda, A., Reynoso, J. T., y Erath, S. (2004). Meta-Analysis of the Efficacy of Nicotine Replacement Therapy for Smoking Cessation: Differences Between Men and Women. Journal of Consulting and Clinical Psychology, 72, 712-722.

Croghan, I. T., Ebbert, J. O., Hurt, R. D., Hays, J. T., Dale, L. C. Warner, N. y Schroeder, D. R. (2009). Gender differences among smokers receiving interventions for tobacco dependence in a medical setting. Addictive Behaviors, 34, 61-67. doi: 10.1016/j.addbeh.2008.08.010.

Fagerström, K. O. y Schneider, N. G. (1989). Measuring nicotine dependence: a review of the Fagerström Tolerance Questionnaire. Journal of Behavioral Medicine, 12, 159-182.

Fernandez, E., Schiaffino, A., Borrell, C., Benach, J., Ariza, C., Ramon, J. M.,… Kunst, A. (2006). Social class, education, and smoking cessation: Long-term follow-up of patients treated at a smoking cessation unit. Nicotine & Tobacco Research, 8, 29-36.

Fidler, J., Ferguson, S. G., Brown, J., Stapleton, J., y West, R. (2013). How does rate of smoking cessation vary by age, gender and social grade? Findings from a population survey in England. Addiction, 108, 1680-1685. doi: 10.1111/add.12241.

Fiore, M. C., Jaen, C. R., Baker, T. B., Baikey, W. C., Benowitz, N. L., Curry, S. J., ... Wewers, M. E. (2008). Treating tobacco use and dependence. A report of the US Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, 257p.

Hughes, J. R., Keely, J. P., Niaura, R. S., Ossip-Klein, D. J., Richmond, R. L, y Swan, G. E. (2003). Measures of abstinence in clinical trials: issues and recommendations. Nicotine & Tobacco Research, 5, 13-25.

Iliceto, P., Fino, E., Pasquariello, S., D´Angelo Di Paola, M. E., y Enea, D. (2013). Predictors of success in smoking cessation among Italian adults motivated to quit. Journal of Substance Abuse Treatment, 44, 534-540. doi: 10.1016/j.jsat.2012.12.004.

Jarvis, M. J., Russell, M. A., y Saloojee, Y. (1980). Expired air carbon monoxide: a simple breath test of tobacco smoke intake. British Medical Journal, 281, 484-485.

Killen, J. D., Fortmann, S. P., Varady, A., y Kraemer, H. C. (2002). Do Men Outperform Women in Smoking Cessation Trials? Maybe, But Not by Much. Experimental and Clinical Psychopharmacology, 10, 295-301.

López, A. D., Collishow, H. E., y Piha, T. (1994). A descriptive model of the cigarette epidemic in developed countries. Tobacco Control, 3, 242-247.

López, A. D., Mathers, C. D., Ezzati, M., Jamison, D. T., y Murray, C. J. (2006). Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet, 367, 1747-1757.

Marqueta, A., Nerín, I., Jiménez-Muro, A., Gargallo, P., y Beamonte, A. (2013). Factores predictores de éxito según género en el tratamiento del tabaquismo. Gaceta Sanitaria, 27, 26-31. doi: 10.1016/j.gaceta.2011.12.011

Marqueta, A., Jiménez-Muro, A., Beamonte, A., Gargallo, P., y Nerín, I. (2010). Evolución de la ansiedad en el proceso de dejar de fumar en fumadores que acuden a una Unidad de Tabaquismo. Adicciones, 22, 317-324.

Munafo, M., Bradburn, M., Bowes, L., y David, S. (2004). Are there sex differences in transdermal nicotine replacement therapy patch efficacy? A meta-analysis. Nicotine & Tobacco Research, 6, 769-776.

National Institute of Mental Health, 2009. Women and depression. Recuperado de: http://www.nimh.nih.gov/health/publications/women-and-depression-discovering-hope/depression-what-every-woman-should-know.pdf

Osler, M., Prescott, E., Godtfredsen, N., Hein, H. O., y Schnohr, P. (1999). Gender and determinants of smoking cessation: a longitudinal study. Preventive Medicine, 29, 57-62.

Perkins, K. A. y Scott, J. (2008). Sex differences in long-term smoking cessation rates due to nicotine patch. Nicotine & Tobacco Research, 10, 1245-1251. doi: 10.1080/14622200802097506.

Peto, R., Darby, S., Deo, H., Silcocks, P., Whitley, E., y Doll, R. (2000). Smoking, smoking cessation, and lung cancer in the UK since 1950: combination of national statistics with two case-control studies. British Medical Journal, 321, 323-329.

Piper, M. E., Cook, J. W., Schlam, T. R., Jorenby, D. E., Smith, S. S., Bolt, D. M., y Loh, WY. (2010). Gender, race, and education differences in abstinence rates among participants in two randomized smoking cessation trials. Nicotine & Tobacco Research, 12, 647-657. doi: 10.1093/ntr/ntq067.

Prochaska, J. O. y DiClemente, C. C. (1983). Stages and processes of self change of smoking: toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51, 390-395.

Puente, D., Cabezas, C., Rodriguez-Blanco, T., Fernández-Alonso, C., Cebrian, T., Torrecilla, M.,… Martín, C. (2011). The role of gender in a smoking cessation intervention: a cluster randomized clinical trial. BMC Public Health, 11, 369. doi: 10.1186/1471-2458-11-369.

Raich, A., Martínez-Sánchez, J. M., Marquilles, E., Rubio, L., Fu, M., y Fernández, E. (2015). Smoking cessation after 12 months with multi-component therapy. Adicciones, 27, 37-46.

Ramon, J. M., Bruguera, E., Fernández, C., Sanz de Burgoa, V., y Ramírez, E. (2009). Motivos para dejar de fumar en España en función del sexo y la edad. Gaceta Sanitaria, 23, 539.e1-539.e6. doi: 10.1016/j.gaceta.2009.07.004.

Scharf, D. y Shiffman, S. (2004). Are there gender differences in smoking cessation, with and without bupropion? Pooled- and meta-analyses of clinical trials of Bupropion SR. Addiction, 99, 1462-1469.

SRNT Subcommittee on Biochemical Verification. (2002). Biochemical verification of tobacco use and cessation. Nicotine & Tobacco Research, 4, 149-159.

Swan, G. E., Ward, M. M., Carmelli, D., y Jack, L. M. (1993). Differential rates of relapse in subgroups of male and female smokers. Journal of Clinical Epidemiology, 46, 1041-1053.

Tarone, R. E. y Ware, J. (1977). On distribution-free tests for equality of survival distributions. Biometrika 64, 156-160.

Thun, M., Peto, R., Boreham, J., y Lopez, A. D. (2012). Stages of the cigarette epidemic on entering its second century. Tobacco Control, 21, 96-101. doi: 10.1136/tobaccocontrol-2011-050294.

US Department of Health and Human Services (USDHHS) (2001). Women and Smoking: A report of the Surgeon General. Rockville, MD. Public Health Service, Office of the Surgeon General.

US Department of Health and Human Services (USDHHS) (1980). The health consequences of smoking for women. A report of the Surgeon General. Rockville, MD. Public Health Service, Office of the Surgeon General.

Ward, K., Klesges, R. C, Zbikowski, S. M., Bliss, R. E., y Garvey, A. J. (1997). Gender differences in the outcome of a unaided smoking cessation attempt. Addictive Behaviors, 22, 521-533.

Wetter, D. W., Cofta-Gunn, L., Fouladi, R. T., Cinciripini, P. M, Sui, D., y Gritz, E. (2004). Late relapse/sustained abstinence among former smokers: a longitudinal study. Preventive Medicine, 39, 1156-1163.

Whitlock, E. P., Vogt, M. T., Hollis, J. F., y Lichtenstein, E. (1997). Does gender affect response to a brief clinic-based smoking intervention? American Journal of Preventive Medicine, 13, 159-166.

World Health Organization. Women and the tobacco epidemic. Challenges for the 21st century. Geneva: WHO, 2001. Retrieved from: http://whqlibdoc.who.int/hq/

/WHO_NMH_TFI_01.1.pdf

Xu, J., Azizian, A., Monterosso, J., Domier, C. P., Brody, A. L., Fong, T. W., y London, E. D. (2008). Gender effects on mood and cigarette craving during early abstinence and resumption of smoking. Nicotine & Tobacco Research, 10, 1653-1661. doi: 10.1080/14622200802412929.

Published

2016-06-14

Issue

Section

Originals