Implementation and evaluation of a smoking cessation group session program

Introduction

Prevalence rates for tobacco use in Russia are among the highest in the world. At the same time tobacco control is a low priority in the country. In particular, the effect of addiction on users is underestimated and very little assistance is provided in the country, particularly from the state public health service, for smokers to stop smoking. Our aim was to create, implement and evaluate an effective smoking cessation service.

Design and measurements

We developed a smoking cessation group session (SCS), which consisted of a lecture by a specialist, examination with a carbon-monoxide detector, exchange of personal experiences and discussions about issues related to smoking cessation including pharmacotherapy. All smokers completed a questionnaire prior to beginning SCS to measure social, psychological and behavioral factors in order to assess possible determinants of SCS efficacy. Attempts were made to follow up all participants.

Results

Over 1400 smokers ages 18–74 years participated in SCS over a period of 2 years. The majority of smokers, 73% of men and 56% of women were highly tobacco dependent (⩾5 points on the Fagerstrom test). Follow up was unavailable for 29% of the participants. Of those with follow up, 41% stopped smoking for some period of time and 18% reduced their daily consumption of cigarettes by at least 25% of their pre-treatment level. No attempt at smoking cessation was made by 31% of all smokers after their participation in SCS. A large proportion of smokers, even after participation in SCS, were not sufficiently motivated and ready to stop smoking. Past quit attempts, number of cigarettes smoked per day, level of tobacco dependence, and the degree of motivation were associated with abstinence.

Conclusions

SCS is an effective model of smoking cessation assistance particularly for those motivated to quit. It should be used in most public health settings and thus integrated into the national health care system in Russia. Further research should address cost-effective ways of enhancing the impact of this program.