The Effect of Smoking Cessation Counseling at Health Checkup

Abstract

Smoking cessation counseling is an important element of tobacco control in the workplace, but it is not easy to persuade workers to stop smoking. We performed a controlled intervention trial to evaluate the effectiveness of a new cessation program developed by Nakamura et al., which consisted of one brief individual counseling session and 4 follow-up telephone calls. Two hundred and twenty-eight smokers who visited our center for an annual health checkup were randomly divided into two group: 117 were assigned to the intervention group, and 111 were controls. Smoking status questionnaires were administered to assess the smoking habit of each subject and to evaluate their stages of change toward smoking cessation before the counseling session. Stage-matched cessation counseling was then provided to the intervention group by nurses who had completed training courses for this program. During the counseling session, carbon monoxide in expired air and nicotine metabolites in urine were measured to enhance self-perception of smoking. Only those clients who set a quit date during their counseling sessions received follow-up telephone calls. It was easy to implement this program (15 to 20 minutes long) during a health checkup. No significant differences were observed in the baseline characteristics of the two groups. The cross-sectional smoking cessation rates at 6 months and 1 year of follow-up were 6.2 times higher in the intervention group than in the control group. The continuous smoking cessation rate at 1 year of follow-up was 7.6 times higher in the intervention group than in the control group. In the intervention group, the lower level of nicotine metabolites in urine and higher smoking stage were related to cessation success, but other baseline characteristics were similar in those who quit smoking and those who did not. The effectiveness and easy applicability of this cessation program was proved in the present study. Further examinations in various settings are expected to clarify the effectiveness of this program.

Nursing intervention and smoking cessation: Meta-analysis update

“…35,38,52 Almost all of the intensive interventions were delivered either by dedicated project staff or nurses with a health promotion role. In studies in which intense interventions were delivered by nursing staff with other major responsibilities, there seemed to be problems in getting them delivered consistently.…”

“…In some trials, the recruitment took place during a clinic visit, and in others the invitation to enroll was made by letter. Three studies focused on community samples [51][52][53] and one study recruited mothers taking their children to a pediatric clinic. 40 Sixteen of the studies focused on adults with diagnosed cardiovascular health problems.…”

“…There was one trial 36 with a significant negative effect for treatment and three trials with rather large and significant positive effects. 35,38,52 Pooling all trials gave an OR of 1.36 (95% CI 1.22-1.51) at the longest follow-up. Because of the heterogeneity, data were reanalyzed using a random effects model.…”

Psychological Determinants of Physical Activity in Japanese Female Employees

“…It was developed by Prochaska and DiClemente as a general model of intentional behavior change 4) . TTM was originally developed for application in the area of smoking cessation, and this model was also applied to a smoking cessation program in workplaces in Japan 5) . Recently it has been extended to research on many forms of health behavior including exercise in Europe and the United States 6) .…”

Diffusion of Health Education Programs with Reference to Health Behavior Theories in Japanese Workplaces: Present Status and Future Plans

“…A variety of health behavior theories, such as the stage of change theory posited by the transtheoretical model 2) , the self-efficacy theory representative of social cognitive theory 3) , and other theories based on behavior science including selfmonitoring, goal-setting and social support 4) , have been applied to many health promotion programs. Previous studies in the workplace have shown the effectiveness of programs which target physical activity 5) , smoking 6) , stress 7) , and comprehensive lifestyle including diet [8][9][10][11] . However, not all health education programs that include health behavior theories are effective.…”