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RESEARCH REPORT
Randomized trial of the effectiveness of combined behavioral/pharmacological smoking cessation treatment in Syrian primary care clinics
Article first published online: 19 NOV 2012
DOI: 10.1111/j.1360-0443.2012.04048.x
© 2012 The Authors, Addiction © 2012 Society for the Study of Addiction
Additional Information
How to Cite
Ward, K. D., Asfar, T., Al Ali, R., Rastam, S., Weg, M. W. V., Eissenberg, T. and Maziak, W. (2013), Randomized trial of the effectiveness of combined behavioral/pharmacological smoking cessation treatment in Syrian primary care clinics. Addiction, 108: 394–403. doi: 10.1111/j.1360-0443.2012.04048.x
Publication History
- Issue published online: 17 JAN 2013
- Article first published online: 19 NOV 2012
- Accepted manuscript online: 13 AUG 2012 06:19AM EST
- Manuscript Accepted: 2 AUG 2012
- Manuscript Revised: 12 MAR 2012
- Manuscript Received: 19 JAN 2012
Funded by
- PHS. Grant Number: 1R01DA024876
Keywords:
- Effectiveness;
- nicotine patch;
- primary care;
- randomized controlled trial;
- smoking;
- Syria
Abstract
Aims
Effectiveness of nicotine replacement therapy (NRT) for smoking cessation has not been evaluated in low income countries, such as Syria, where it is expensive and not widely available. We evaluated whether nicotine patch boosts smoking cessation rates when used in conjunction with behavioral support in primary care clinics in Aleppo, Syria.
Design
Two arm, parallel group, randomized, placebo controlled, double-blinded multi-site trial.
Setting
Four primary care clinics in Aleppo, Syria.
Participants
Two hundred and sixty-nine adult primary care patients received behavioral cessation counseling from a trained primary care physician and were randomized to receive six weeks of treatment with nicotine versus placebo patch.
Measurements
Primary end-points were prolonged abstinence (no smoking after a 2-week grace period) at end of treatment, and 6 and 12 months post-quit day, assessed by self-report and exhaled carbon monoxide levels of <10 p.p.m.
Findings
Treatment adherence was excellent and nicotine patch produced expected reductions in urges to smoke and withdrawal symptoms, but no treatment effect was observed. The proportion of patients in the nicotine and placebo groups with prolonged abstinence was 21.6% and 20.0%, respectively, at end of treatment, 13.4% and 14.1% at 6 months, and 12.7% and 11.9% at 12 months.
Conclusions
Nicotine patches may not be effective in helping smokers in low-income countries to stop when given as an adjunct to behavioural support.