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Cited by 70Smoking Behavior and CessationSubstance Abuse Treatment and OutcomesBehavioral Health and Interventions

Behavioural therapy for smoking cessation: the effectiveness of different intervention types for disadvantaged and affluent smokers

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Hiscock, Rosemary, Murray, Susan, Brose, Leonie S., McEwen, Andy, Bee, Jo Leonardi, Dobbie, Fiona, Bauld, Linda·2013·Addictive Behaviors
DOI 10.1016/j.addbeh.2013.07.010PMC PMC3776925
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Abstract

BACKGROUND: Disadvantaged smokers are less likely to be successful when trying to stop smoking than more affluent smokers. In the UK, NHS Stop Smoking Services (SSS) provide a range of pharmacotherapy and behavioural support, delivered by advisors with a range of backgrounds. Whether the types of support provided and who provides it influence differences in quit rates amongst low SES smokers compared with high SES smokers has not previously been examined. METHODS: 202,084 records of smokers in England who attended a NHS Stop Smoking Service between July 2010 and June 2011 were acquired. Smokers were followed-up by services at four weeks post quit date. Multilevel logistic regression models of CO validated quits were employed. Disadvantage was explored through the National Statistics Socio-Economic Classification (NS-SEC) and by eligibility for free prescriptions, an indicator of low income amongst adults aged between 19 and 59 in England. RESULTS: Affluent smokers were more likely to quit than disadvantaged smokers (OR 1.38 (1.35 to 1.42) for clients who paid for prescriptions compared to those eligible for free prescriptions). 80% of service clients received one-to-one counselling but open group forms of behavioural therapy were more successful (main effect OR 1.26 (1.12 to 1.41)) except amongst some of the most disadvantaged clients (long-term unemployed and prisoners). Closed groups were little deployed and they were not significantly more successful than one-to-one behavioural therapy after controls. Who delivered treatment did make a difference for some clients, with all but the most affluent less likely to be successful if they had been treated by a nurse compared with other types of advisers, including smoking cessation specialists (main effect OR 0.73 (0.65 to 0.83)). CONCLUSION: This study provides further evidence that disadvantaged smokers find quitting more difficult even when they have attended a smoking cessation programme. The findings suggest that open groups should be promoted, although they may not be as effective as other forms of behavioural therapy for the long-term unemployed or prisoners. Further research is required to explore why most groups of smokers who attended services staffed by nurses were less likely to quit than those who received treatment from other types of advisors.

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Crossref · 10.1016/j.addbeh.2013.07.010

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53 of 53 references verified0 citation errors · 0 not checkable

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  • Large differences have been identified between the quit rates achieved by services in different locations, which may be partly because of the quality of behavioural support delivered by the practitioner who offers it.

    “Large differences have now been identified between the quit rates achieved by services in different locations, which may be partly because of the quality of behavioural support delivered by the practitioner who offers it.[26][27][28]”

    From Evaluating Long-term Outcomes of NHS Stop Smoking Services (ELONS): a prospective cohort study (2015) · cites this paper as [26]

  • Practitioner type did make a difference for some clients, with all but the most affluent less likely to be successful if they had been treated by a nurse compared with other types of practitioners, including smoking cessation specialists [main effect aOR 0.73 (95% CI 0.65 to 0.83)].

    “Practitioner type did make a difference for some clients, with all but the most affluent less likely to be successful if they had been treated by a nurse compared with other types of practitioners, including smoking cessation specialists [main effect aOR 0.73 (95% CI 0.65 to 0.83)].”

    From Evaluating Long-term Outcomes of NHS Stop Smoking Services (ELONS): a prospective cohort study (2015) · cites this paper as [26]

  • Closed groups were little deployed and they were not significantly more successful than one-to-one behavioural therapy after controls.

    “Closed groups were little deployed and they were not significantly more successful than one-to-one behavioural therapy after controls.”

    From Evaluating Long-term Outcomes of NHS Stop Smoking Services (ELONS): a prospective cohort study (2015) · cites this paper as [26]

  • Open group forms of behavioural therapy were more successful than one-to-one counselling [main effect aOR 1.26 (95% CI 1.12 to 1.41)] except among some of the most disadvantaged clients (prisons and long-term unemployed).

    “but open group forms of behavioural therapy were more successful [main effect aOR 1.26 (95% CI 1.12 to 1.41)] except among some of the most disadvantaged clients (prisons and long-term unemployed).”

    From Evaluating Long-term Outcomes of NHS Stop Smoking Services (ELONS): a prospective cohort study (2015) · cites this paper as [26]

  • Affluent smokers were more likely to be abstinent from smoking at 4 weeks post quit date than disadvantaged smokers as measured by either eligibility for free prescriptions or by occupational group (as measured by the NSSEC), for example adjusted odds ratio (aOR) 1.38 (95% CI 1.35 to 1.42) for clients who paid for prescriptions compared with those eligible for free prescriptions.

    “Results presented in the published multivariable analysis 26 showed that affluent smokers were more likely to be abstinent from smoking at 4 weeks post quit date than disadvantaged smokers as measured by either eligibility for free prescriptions or by occupational group (as measured by the NSSEC), for example adjusted odds ratio (aOR) 1.38 (95% CI 1.35 to 1.42) for clients who paid for prescript”

    From Evaluating Long-term Outcomes of NHS Stop Smoking Services (ELONS): a prospective cohort study (2015) · cites this paper as [26]

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3 of the 56 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. Dube S. Asman K. Malarcher A. Caraballo R. Cigarette smoking among adults and trends in smoking cessation — United States 2008 Morbidity and Mortality Weekly Report 58 44 2009 1227 1231 (Retrieved from http://www.cdc.gov/mmwr/PDF/wk/mm5844.pdf) 19910909
  2. Leclerc V. Behavioral psychotherapy in the general practice setting Presse Médicale 27 40 1998 2179 2184 9922797

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Authors
Hiscock, R., Murray, S., Brose, L. S., McEwen, A., Bee, J. L., Dobbie, F., & Bauld, L.
Affiliations
  • University of Bath (GB)
  • University of Stirling (GB)
  • University College London (GB)
  • Cancer Research UK (GB)
Corresponding author
Hiscock, Rosemary
ORCID
Venue
Addictive Behaviors
Publisher
Elsevier BV
Published
2013-11
Volume
38
Issue
11
Pages
2787-2796
ISSN
0306-4603 (ISSN-L)
DOI
10.1016/j.addbeh.2013.07.010
PMC
PMC3776925
OpenAlex
W2006217894
Cited by
70
References
56
Citations by year
2026: 4 · 2025: 3 · 2024: 3 · 2023: 3 · 2022: 5 · 2021: 5 · 2020: 7 · 2019: 11 · 2018: 3 · 2017: 7 · 2016: 6 · 2015: 7 · 2014: 6
FWCI
4.40
Type
journal article
Language
en
Open access
Licence
Locations
  • Addictive Behaviors (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Pure (University of Bath) (acceptedVersion, cc-by)
  • The University of Bath Online Publications Store (The University of Bath) (submittedVersion, cc-by)
  • Stirling Online Research Repository (University of Stirling) (submittedVersion, public-domain)
  • UCL Discovery (University College London) (submittedVersion)
  • Research Portal (King's College London) (submittedVersion, other-oa)
  • Bristol Research (University of Bristol) (submittedVersion)
Funders
  • British Heart Foundation
  • Cancer Research UK
  • Economic and Social Research Council
  • Medical Research Council
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
Keywords
smoking cessation, behavior therapy, socioeconomic deprivation, NHS Stop Smoking Services, nurses, long-term unemployed, prisoners, quit rates
MeSH terms
Smoking Prevention, Adult, Counseling, England, Female, Humans, Male, Middle Aged, Recurrence, Social Class, Cognitive Behavioral Therapy, Smoking Cessation, Treatment Outcome, Healthcare Disparities, Young Adult

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