Gender difference and effect of pharmacotherapy: findings from a smoking cessation service

Abstract

BackgroundSmoking cessation services are available in England to provide assistance to those wishing to quit smoking. Data from one such service were analysed in order to investigate differences in quit rate between males and females prescribed with different treatments.MethodsA logistic regression model was fitted to the data using the binary response of self-reported quit (failed attempt = 0, successful attempt = 1), validated by Carbon Monoxide (CO) monitoring, 4 weeks after commencing programme. Main effects fitted were: client gender; age; region; the type of advisory sessions; and pharmacotherapy, Nicotine Replacement Therapy (NRT) or Varenicline. A second model was fitted including all main effects plus two-way interactions except region. These models were repeated using 12-week self-reported quit as the outcome.ResultsAt 4 weeks, all main effects were statistically significant, with males more likely (odds ratio and 95 % CI, females v males = 0.88 [0.79–0.97]), older smokers more likely (adjusted odds ratios [OR] and 95 % confidence interval [CI] respectively for groups 20–29, 30–49, 50–69 and 70+ vs 12–19 age group: 1.79 [1.39–2.31], 2.12 [1.68–2.68], 2.30 [1.80–2.92] and 2.47 [1.81–3.37] and for overall difference between groups, χ2(4) = 53.5, p < 0.001) and clients being treated with Varenicline more likely to have successfully quit than those on NRT (adjusted OR and 95 % CI for Varenicline vs NRT = 1.41 [1.21–1.64]). Statistically significant interactions were observed between (i) gender and type of counselling, and (ii) age and type of counselling. Similar results were seen in relation to main effects at 12 weeks except that type of counselling was non-significant. The only significant interaction at this stage was between gender and pharmacotherapy (adjusted OR and 95 % CI for females using Varenicline versus all other groups = 1.43 [1.06–1.94]).ConclusionGender and treatment options were identified as predictors of abstinence at both 4 and 12 weeks after quitting smoking. Furthermore, interactions were observed between gender and (i) type of counselling received (ii) pharmacotherapy. In particular, the quit rate in women at 12 weeks was significantly improved in conjunction with Varenicline use. These findings have implications for service delivery.

An examination of user costs in relation to smokers using a cessation service based in the UK

“…Age-based results imply greater difficulty amongst the young (teenagers and the 20–29 year old group in this instance) in quitting, as has been reported elsewhere [ 28 ]. This age group is an important one to reach and support, given that the long term benefits of cessation are greater at this stage of life than amongst those of an older age [ 1 ].…”

“…These data show that average cost per quit amongst males was slightly reduced relative to females, a finding which is consistent with men being more likely to quit in the context of smoking cessation services [ 28 , 30 ], although the magnitude of the difference was not great when considered against the overall average costs observed (difference = £18.70 at 12 weeks). If the reason behind the different quit rates between men and women was related to anxiety about weight gain due to quitting smoking, the provision of a more comprehensive service combining both smoking cessation and weight loss may be worth considering [ 31 ].…”

Gender differences in the real-world effectiveness of smoking cessation medications: Findings from the 2010–2011 Tobacco Use Supplement to the Current Population Survey

“…(Brose et al, 2013; Prado et al, 2011; Ucar et al, 2014)); however gender differences in real-world effectiveness are understudied. Walker et al (2016) studied such differences using data from a national quit service in the United Kingdom, Quit-5. Their findings demonstrated that women were less likely than men to achieve 12-week abstinence, and that the relative advantage of varenicline over NRT was significantly greater for women compared to men.…”

Factors moderating the relative effectiveness of varenicline and nicotine replacement therapy in clients using smoking cessation services

“…We used data recorded on clients registered with Quit 51 , a provider of smoking cessation services in England, to test whether the increased quit rates expected with varenicline versus NRT are moderated by other factors (such as age, gender, ethnic group and features of service provision). An earlier analysis of data from Quit 51 focused on interactions with gender including treatment . The current work takes in approximately 6 months of further data (up to September 2015 in previous analysis, now up to March 2016) in addition to records from seven extra regions, for which data were not available in this earlier analysis.…”