WTS database

Title	Pub Year Sort ascending	Author	SearchLink
Varying nicotine patch dose and type of smoking cessation counseling	1995	Center for Tobacco Research and Intervention, University of Wisconsin-Madison, USA.	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Jama Periodical, Abbrev. JAMA Pub Date Free Form 1-Nov Volume 274 Issue 17 Start Page 1347 Other Pages 1352 Notes LR: 20151119; JID: 7501160; 6M3C89ZY6R (Nicotine); 7U1EE4V452 (Carbon Monoxide); K5161X06LL (Cotinine); CIN: JAMA. 1996 Jun 26;275(24):1882-3. PMID: 8648863; CIN: JAMA. 1995 Nov 1;274(17):1390-1. PMID: 7563566; ppublish Place of Publication UNITED STATES ISSN/ISBN 0098-7484; 0098-7484 Accession Number PMID: 7563558 Language eng SubFile Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; AIM; IM DOI Output Language Unknown(0) PMID 7563558 Abstract OBJECTIVE: To compare the efficacy and safety of 22-mg and 44-mg doses of transdermal nicotine therapy when it is paired with minimal, individual, or group counseling to improve smoking cessation rates. DESIGN: An 8-week clinical trial (4 weeks double-blind followed by 4 weeks open label) using random assignment of participants to both dose (22 or 44 mg) and counseling (minimal, individual, or group) conditions. PARTICIPANTS: Daily cigarette smokers (> or = 15 cigarettes per day for at least 1 year) who volunteered to participate in a study of smoking cessation treatment. A total of 504 participants were enrolled at two sites. INTERVENTION: Four weeks of 22- or 44-mg transdermal nicotine therapy followed by 4 weeks of dosage reduction (2 weeks of 22 mg followed by 2 weeks of 11 mg). Counseling consisted of a self-help pamphlet (minimal); a self-help pamphlet, a brief physician motivational message, and three brief (< 15 minutes) follow-up visits with a nurse (individual); or the pamphlet, the motivational message, and eight weekly 1-hour group smoking cessation counseling visits (group). All participants returned weekly to turn in questionnaires and for assessment of their smoking status. MAIN OUTCOME MEASURES: Abstinence from smoking was based on self-report, confirmed by an expired carbon monoxide concentration lower than 10 ppm. Withdrawal severity was assessed by means of an eight-item self-report questionnaire completed daily. RESULTS: Smoking cessation rates for the two nicotine patch doses and three levels of counseling did not differ significantly at either 8 weeks or 26 weeks following the quit date. Among those receiving minimal contact, the 44-mg dose produced greater abstinence at 4 weeks than did the 22-mg dose (68% vs 45%; P < .01). Participants receiving minimal-contact adjuvant treatment were less likely to be abstinent at the end of 4 weeks than those receiving individual or group counseling (56% vs 67%; P < .05). The 44-mg dose decreased desire to smoke more than the 22-mg dose, but this effect was not related to success in quitting smoking. Transdermal nicotine therapy at doses of 44 mg produced a significantly greater frequency of nausea (28%), vomiting (10%), and erythema with edema at the patch site (30%) than did a 22-mg dose (10%, 2%, and 13%, respectively; P < .01 for each adverse effect). Three serious adverse events occurred during use of the 44-mg patch dose. CONCLUSIONS: There does not appear to be any general, sustained benefit of initiating transdermal nicotine therapy with a 44-mg patch dose or of providing intense adjuvant smoking cessation treatment. The two doses and all adjuvant treatments produced equivalent effects at the 26-week follow-up, and the higher patch dose produced more adverse effects. Higher-dose (44-mg) nicotine replacement does not appear to be indicated for general clinical populations, although it may provide short-term benefit to some smokers attempting to quit with minimal adjuvant treatment. Descriptors Administration, Cutaneous, Adult, Analysis of Variance, Carbon Monoxide/metabolism, Combined Modality Therapy, Cotinine/blood, Counseling, Double-Blind Method, Female, Humans, Logistic Models, Male, Middle Aged, Nicotine/administration & dosage/therapeutic use, Smoking Cessation/methods, Substance Withdrawal Syndrome Links Book Title Database Publisher Data Source Authors Jorenby,D. E., Smith,S. S., Fiore,M. C., Hurt,R. D., Offord,K. P., Croghan,I. T., Hays,J. T., Lewis,S. F., Baker,T. B. Original/Translated Title URL Date of Electronic PMCID Editors
Seasonal variations in the occurrence of environmental mycobacteria in potable water	1995	Kubalek, I., 77900 Olomouc, Czech Republic	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full APMIS Periodical, Abbrev. APMIS Pub Date Free Form 1995/ Volume 103 Issue 5 Start Page 327 Other Pages 330 Notes Place of Publication ISSN/ISBN 0903-4641 Accession Number Language SubFile DOI Output Language Unknown(0) PMID Abstract A fluctuation in the prevalence of environmental mycobacteria in relation to nutritional conditions in nature has been repeatedly described in the literature. A seasonal difference in the potable water supply system has not yet been documented. Potable water samples from the supply systems of 16 identical localities were analyzed. Samples of running water and tap swabs or tap scrapings were collected twice a year, in the spring and in the autumn. The samples were processed as stipulated by the international standards. McNemar's test was used to analyze the difference in the occurrence of environmental mycobacteria between the vernal and the autumnal samples. A significant change in the presence of environmental mycobacteria in the potable water supply system was observed, the vernal samples yielding more positive results, This finding supports other observations respecting surface water. We suggest that this effect on the potable water supply system may be caused by the change in temperature. Contamination rates were similar, with no statistically significant differences between running water samples and those from swabs or scrapings. No time trend in the period 1984-1989 respecting the prevalence of mycobacteria was detected. Direct microscopy showed massive colonization with environmental mycobacteria of the potable water supply system. The public health consequences of these findings should be further evaluated, as colonization of water pipes can be associated with outbreaks of mycobacterial disease in immunocompromised patients. There has also been an increase in the incidence of mycobacterioses in the North Moravian region in recent years. Descriptors water, article, environmental sanitation, Mycobacterium, nonhuman, priority journal, seasonal variation, water contamination Links Book Title Database Embase; MEDLINE Publisher Data Source Embase Authors Kubalek,I., Komenda,S. Original/Translated Title URL Date of Electronic PMCID Editors
The spring-fall variations in the prevalence of environmental mycobacteria in drinking water supply system	1995	Kubalek, I., 779 00 Olomouc, Czech Republic	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Central European journal of public health Periodical, Abbrev. Cent.Eur.J.Public Health Pub Date Free Form 1995/ Volume 3 Issue 3 Start Page 146 Other Pages 148 Notes Place of Publication ISSN/ISBN 1210-7778 Accession Number Language SubFile DOI Output Language Unknown(0) PMID Abstract The fluctuation in the prevalence of environmental mycobacteria in relation to nutritional conditions in nature was repeatedly described in literature. The seasonal difference in potable water supply system had not yet been documented. Potable water samples from water supply systems of 16 localities were analyzed. The samples of running water, and tap swabs or tap scrapings were collected twice a year, in the spring and in the autumn. McNemar's test was used to analyze the difference of the occurrence of environmental mycobacteria between the vernal and the autumnal samples. A significant change in the presence of environmental mycobacteria in the potable water supply system was observed: the vernal samples yielded more positive results. This finding supports other observations of superficial water. We infer that this effect in potable water supply system may be caused by the change in temperature. Contamination rates were similar with no statistically significant difference between running water samples and that of swabs or scrapings. No time trend in the period 1984 - 1989 in the prevalence of myobacteria was detected. Direct microscopy showed massive colonisation with environmental mycobacteria of potable water supply system. Public health consequences of these findings should be further evaluated, as colonisation of water pipes can be associated with outbreaks of mycobacterial disease in immunocompromised patients. These has been also an increase in the incidence of mycobacterioses in North Moravian Region in recent years. Descriptors drinking water, article, Czechoslovakia, mycobacteriosis, seasonal variation Links Book Title Database Embase; MEDLINE Publisher Data Source Embase Authors Kubalek,I., Komenda,S., Mysak,J. Original/Translated Title URL Date of Electronic PMCID Editors
Shear bond strength of a resin composite to enamel etched with maleic or phosphoric acid	1994	Oral Health Program, Brisbane South Region, University of Texas Health Science Center at San Antonio.	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Australian Dental Journal Periodical, Abbrev. Aust.Dent.J. Pub Date Free Form Oct Volume 39 Issue 5 Start Page 292 Other Pages 297 Notes LR: 20131121; JID: 0370612; 0 (Adhesives); 0 (Composite Resins); 0 (Dentin-Bonding Agents); 0 (Maleates); 0 (Phosphoric Acids); 0 (Resin Cements); 0 (Z100 composite resin); 7631-86-9 (Silicon Dioxide); 90881-69-9 (Scotchbond); 91XW058U2C (maleic acid); C6 Place of Publication AUSTRALIA ISSN/ISBN 0045-0421; 0045-0421 Accession Number PMID: 7811206 Language eng SubFile Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; D; IM DOI Output Language Unknown(0) PMID 7811206 Abstract The purpose of this study was to evaluate the effect of 10 per cent maleic and 37 per cent phosphoric acid on the shear bond strength of Z100 composite resin with Scotchbond Multi-Purpose adhesive to primary and permanent tooth enamel. Four groups of 20 teeth each were established: 1, permanent teeth, 10 per cent maleic acid etched for 15 seconds; 2, permanent teeth, 10 per cent maleic acid etched for 30 seconds; 3, permanent teeth, 37 per cent phosphoric acid etched for 15 seconds; 4, primary teeth, 10 per cent maleic acid etched for 15 seconds. Five teeth from each group were randomly assigned for SEM examination of the etched enamel surface. Scotchbond Multi-Purpose primer and adhesive were applied to the etched enamel surface of the remaining 15 teeth and cured following the manufacturer's instructions. Z100 composite resin was placed in a nylon cylinder and cured for two 40 second intervals. Following thermocycling, the specimens were sheared on an universal testing machine and debonded areas were examined visually with a stereo microscope and with SEM. The mean shear bond strengths in MPa were: 1, 17.00; 2, 14.58; 3, 14.66; 4, 11.18. ANOVA and Student-Newman-Keuls analyses revealed no statistically significant difference among the groups. SEM examination showed the majority of specimens fractured at the adhesive-resin interface. Descriptors Acid Etching, Dental, Adhesives/chemistry, Analysis of Variance, Composite Resins/chemistry, Dental Bonding, Dental Enamel/drug effects/ultrastructure, Dentin-Bonding Agents/chemistry, Humans, Maleates/administration & dosage/pharmacology, Materials Testing, Microscopy, Electron, Scanning, Phosphoric Acids/administration & dosage/pharmacology, Resin Cements, Silicon Dioxide/chemistry, Stress, Mechanical, Surface Properties, Time Factors, Tooth, Deciduous, Zirconium/chemistry Links Book Title Database Publisher Data Source Authors Hallett,K. B., Garcia-Godoy,F., Trotter,A. R. Original/Translated Title URL Date of Electronic PMCID Editors
The effects of alternative smoking policies on indoor air quality in 27 office buildings	1994	Department of Design and Environmental Analysis, Cornell University, Ithaca, New York.	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full The Annals of Occupational Hygiene Periodical, Abbrev. Ann.Occup.Hyg. Pub Date Free Form Jun Volume 38 Issue 3 Start Page 265 Other Pages 278 Notes LR: 20151119; JID: 0203526; 0 (Tobacco Smoke Pollution); 142M471B3J (Carbon Dioxide); 1HG84L3525 (Formaldehyde); 6M3C89ZY6R (Nicotine); 7U1EE4V452 (Carbon Monoxide); ppublish Place of Publication ENGLAND ISSN/ISBN 0003-4878; 0003-4878 Accession Number PMID: 8048788 Language eng SubFile Journal Article; Research Support, Non-U.S. Gov't; IM DOI Output Language Unknown(0) PMID 8048788 Abstract The effect of alternative smoking policies, which prohibited or restricted smoking, on indoor air quality was studied in 27 air-conditioned office buildings. Carbon monoxide, carbon dioxide, respirable particulates, formaldehyde, ultraviolet particulate matter (u.v.PM), nicotine, air temperature, relative humidity and illumination were measured at eight sample sites in each building. Smoking policy had no effect on carbon monoxide, carbon dioxide, relative humidity, formaldehyde, air temperature or illumination for open office areas. It did have an effect on levels of respirable suspended particulates, ultraviolet particulate matter and nicotine. Descriptors Air Conditioning, Air Pollution, Indoor/prevention & control, Carbon Dioxide/analysis, Carbon Monoxide/analysis, Formaldehyde/analysis, Health Policy, Nicotine/analysis, Office Management, Organizational Policy, Particle Size, Smoking/prevention & control, Tobacco Smoke Pollution/analysis/prevention & control Links Book Title Database Publisher Data Source Authors Hedge,A., Erickson,W. A., Rubin,G. Original/Translated Title URL Date of Electronic PMCID Editors
Technical and economic criteria determining the rehabilitation and/or renewal of drinking water pipelines	1994	Herbert, H., Stadtwerke Innsbruck, A-6020 Innsbruck, Austria	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Water Supply Periodical, Abbrev. Water Supply Pub Date Free Form 1994/ Volume 12 Issue 4-Mar Start Page 105 Other Pages 117 Notes Place of Publication ISSN/ISBN 0735-1917 Accession Number Language SubFile DOI Output Language Unknown(0) PMID Abstract Descriptors drinking water, conference paper, economics, pipeline, water treatment Links Book Title Database Embase Publisher Data Source Embase Authors Herbert,H. Original/Translated Title URL Date of Electronic PMCID Editors
The integration of family planning and childhood immunization services in Togo	1994	Population Council, Dokki, Giza, Egypt.	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Studies in family planning Periodical, Abbrev. Stud.Fam.Plann. Pub Date Free Form May-Jun Volume 25 Issue 3 Start Page 176 Other Pages 183 Notes LR: 20041117; JID: 7810364; OID: PIP: 096937; OID: POP: 00231327; OTO: PIP; GN: PIP: TJ: STUDIES IN FAMILY PLANNING.; ppublish Place of Publication UNITED STATES ISSN/ISBN 0039-3665; 0039-3665 Accession Number PMID: 7940622 Language eng SubFile Clinical Trial; Journal Article; Randomized Controlled Trial; IM; J DOI Output Language Unknown(0) PMID 7940622 Abstract Improvements in the constellation of services in the African context are largely addressed through attaining better measures of service integration, which can be achieved through improved referral across categories of health programs. The use of an unobtrusive referral message that linked family planning and the Expanded Program of Immunizations (EPI) services was tested in an operations research study in Togo. The introduction of the referral message was accompanied by an 18-percent increase in awareness of available family planning services and an increase in the average monthly number of new family planning clients of 54 percent. These positive results indicate that the use of referral can have a significant and dramatic impact on family planning services in a relatively short time. In Togo, no evidence existed of a negative impact on EPI services, and a majority of the EPI providers reported satisfaction with the effect of the referral message at the close of the study.; PIP: Quality of care is currently construed to mean matching population needs with service provision. Improvements in African services are valued when there is a constellation of multiple services provided in a fixed center. In Togo, a simple intervention was developed to link childhood immunization and family planning services. Before immunizing each child, the service provider would make 3 family planning statements to the child's mother. The statements were salient and easy to remember: "Madame, your child is still young, and you should be concerned about having another pregnancy too soon." "This clinic provides family planning services that can help you delay your next pregnancy." And, "You should visit the family planning services after the immunization today for more information." Clinic staff were trained in a day and a half orientation session. The referral message was evaluated with a quasi-experimental design. Impact was measured in terms of knowledge of family planning methods and availability of family planning in the clinic, intention to use a contraceptive method, and the history of contraceptive use. 16 urban and rural clinics were involved. The sample included 1000 randomly selected women who has just had their children immunized. The pretest was conducted in January, 1992, and the post test was conducted in August, 1992, 6 months after the intervention in the study. Service statistics were also collected from 9 months prior to the intervention until September, 1992. Pretest and post test women were similar demographically. Recall levels were also similar. The results indicated that control group persons did not show any change in their awareness of family service availability in the clinic. The increase in the study group was from 40% to 58%. Differences between awareness in the control and study groups was 8% before the intervention and 22% after. Women desiring a longer birth-spacing period were more likely to be aware of service availability. The mean number of acceptors in the study group increased significantly from 200 to 307; average monthly number of family planning users also increased significantly from 1035 to 1311, which was a significant difference from control group users. Both groups showed significant increases in number of vaccines administered monthly in the study period. Descriptors Child Health Services/organization & administration, Child, Preschool, Family Planning Services/organization & administration/utilization, Health Knowledge, Attitudes, Practice, Humans, Immunization, Interinstitutional Relations, Operations Research, Patient Acceptance of Health Care, Program Evaluation, Referral and Consultation/organization & administration, Retrospective Studies, Time Factors, Togo, Africa, Africa South Of The Sahara, Communication, Communication Programs, Comparative Studies, Data Collection, Delivery Of Health Care, Developing Countries, Family Planning, Family Planning Programs, French Speaking Africa, Health, Health Services, Integrated Programs, Interviews, Knowledge, Organization And Administration, Pre-post Tests, Primary Health Care, Program Activities, Programs, Referral And Consultation, Research Methodology, Research Report, Service Statistics, Studies, Western Africa Links Book Title Database Publisher Data Source Authors Huntington,D., Aplogan,A. Original/Translated Title URL Date of Electronic PMCID Editors
Nicotine patch therapy for smoking cessation combined with physician advice and nurse follow-up. One-year outcome and percentage of nicotine replacement	1994	Nicotine Dependence Center, Mayo Clinic, Rochester, MN 55905.	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Jama Periodical, Abbrev. JAMA Pub Date Free Form 23-Feb Volume 271 Issue 8 Start Page 595 Other Pages 600 Notes LR: 20151119; JID: 7501160; 6M3C89ZY6R (Nicotine); 7U1EE4V452 (Carbon Monoxide); K5161X06LL (Cotinine); CIN: JAMA. 1994 Jul 6;272(1):32. PMID: 8007075; ppublish Place of Publication UNITED STATES ISSN/ISBN 0098-7484; 0098-7484 Accession Number PMID: 8301791 Language eng SubFile Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; AIM; IM DOI Output Language Unknown(0) PMID 8301791 Abstract OBJECTIVE: To determine the efficacy of a 22-mg nicotine patch combined with the National Cancer Institute program for physician advice and nurse follow-up in providing withdrawal symptom relief, 1-year smoking cessation outcome, and percentage of nicotine replacement. DESIGN: Randomized, double-blind, placebo-controlled trial. SUBJECTS: Two-hundred forty healthy volunteers who were smoking at least 20 cigarettes per day. INTERVENTIONS: Based on the National Cancer Institute program, subjects received smoking cessation advice from a physician. Follow-up and relapse prevention were provided by a study nurse during individual counseling sessions. Subjects were randomly assigned to 8 weeks of a 22-mg nicotine or placebo patch. MAIN OUTCOME MEASURES: Abstinence from smoking was verified by expired air carbon monoxide levels. Withdrawal symptoms were recorded during patch therapy, and the percentage of nicotine replacement was calculated by dividing serum nicotine and cotinine levels at week 8 of patch therapy by levels obtained while smoking. RESULTS: Higher smoking cessation rates were observed in the active nicotine patch group at 8 weeks (46.7% vs 20%) (P < .001) and at 1 year (27.5% vs 14.2%) (P = .011). Higher smoking cessation rates were also observed in subjects assigned to the active patch who had lower serum levels of nicotine and cotinine at baseline, and withdrawal symptom relief was better in the active patch group compared with placebo. CONCLUSIONS: Clinically significant smoking cessation can be achieved using nicotine patch therapy combined with physician intervention, nurse counseling, follow-up, and relapse prevention. Smokers with lower baseline nicotine and cotinine levels had better cessation rates, which provides indirect evidence that they had more adequate nicotine replacement with this fixed dose of transdermal nicotine than those smokers with higher baseline levels. Descriptors Administration, Cutaneous, Adult, Aged, Breath Tests, Carbon Monoxide/analysis, Cotinine/blood, Counseling/methods, Double-Blind Method, Female, Humans, Logistic Models, Male, Middle Aged, Multivariate Analysis, Nicotine/administration & dosage/adverse effects/blood, Nurses, Physician's Role, Smoking/therapy, Smoking Cessation/methods/statistics & numerical data, Substance Withdrawal Syndrome/therapy, Treatment Outcome Links Book Title Database Publisher Data Source Authors Hurt,R. D., Dale,L. C., Fredrickson,P. A., Caldwell,C. C., Lee,G. A., Offord,K. P., Lauger,G. G., Marusic,Z., Neese,L. W., Lundberg,T. G. Original/Translated Title URL Date of Electronic PMCID Editors
163 Cases of Decompression Sickness Among Korean Divers	1994		Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Korean Journal of Occupational and Environmental Medicine Periodical, Abbrev. Pub Date Free Form Volume 6 Issue 2 Start Page 364 Other Pages 376 Notes ID: 289011 Place of Publication ISSN/ISBN Accession Number Language Ko SubFile DOI Output Language Unknown(0) PMID Abstract This study was performed to obtain an useful and basic information of the decompression sickness (DCS) among Korean divers. The medical records of 163 cases of Korean civilian diver, who were diagnosed as DES and received recompression therapy according to U.S. Navy Standard Recompression Treatment Table at Ocean & Underwater Medical Research & Training Center of ROK Navy, for 10 years from Jan. 1983 to Dec.1992. The total of 163 cases of DCS were catagorized into 2 groups as Type I DCS and Type II DGS group.The major results obtained were as follows:1. 70.5% of total cases were classified as type II DCS, and the ratio of type I to type II DCS was 1'2.5 and the ratio of male to female of DCS cases was about 4:1.2. About one third of cases occurred in May and June, and 38.7% of cases occurred at Chung-mu and Chin-hae in Kyung-nam province, the Southern Coast of Korean Peninsula.3. Among the type II DGS group, 85.2% occured in diving for harpshell, and 85.2% with hookah diving gear.4. There were no cases following the decompression procedure such as well known U.S. Navy's, and 86.7% of cases did not follow the any kinds of decompression procedure for preventing DCS and most of dives were conducted repetitively with 4.2 times on an average.5. The mean depth between type I(27.3m) and type 11 DCS group(33.3m) showed significant difference statistically (p0.05) .6. The rate of symptoms appeared on surfacing and within 10 min. after surfacing of type I and type II DCS were 40.0% and 70.5%, respectively. And 80.9% of type I and 92.2% of type II DCS group were aware of dysbaric symptoms within the first hour after surfacing.7. The most frequent symptoms and its percentages were "Both limb pain (37.6%) ",Joint pain(27.1%)., and "Scapular pain(22.9%)" in type I DCS group, and "Limb weakness or paralysis (68.7%)" , "Respiratory chokes(27.8%)" and "Bladder dysfunction(22.2%)"intypellDCSgroup.8. Among the type II DCS group, 54.8% attempted inwater recompression as a primary management, but 54.2% of type I DCS group did not take any kinds of therapeutic measure after onset of dysharic symptoms till commencing recompression treatment.9. Recompression treatment was delayed 126.9 hours in type I and 89.7 hours in type II DCS group on an average, and the cases of DCS, who delayed more than two days till visiting the recompression facility, were occupied 52.1% in type I and 29.6% in type II DCS group.10. Among the total cases, 32.6% were experienced one more of dysbaric symptoms in the past. Descriptors SYMPTOMS , HOUR, DECOMPRESSION SICKNESS, CASES, SECONDS Links http://pesquisa.bvsalud.org/ghl/resource/en/wpro-289011 Book Title Database GHL; http://www.globalhealthlibrary.net/ Publisher Data Source Authors Hwang,K. Y., Kim,H. J. Original/Translated Title URL Date of Electronic PMCID Editors
Predicting smoking cessation. Who will quit with and without the nicotine patch	1994	Center for Tobacco Research and Intervention, University of Wisconsin Medical School, Madison 53706-1532.	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Jama Periodical, Abbrev. JAMA Pub Date Free Form 23-Feb Volume 271 Issue 8 Start Page 589 Other Pages 594 Notes LR: 20151119; JID: 7501160; 6M3C89ZY6R (Nicotine); 7U1EE4V452 (Carbon Monoxide); K5161X06LL (Cotinine); ppublish Place of Publication UNITED STATES ISSN/ISBN 0098-7484; 0098-7484 Accession Number PMID: 8301790 Language eng SubFile Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; AIM; IM DOI Output Language Unknown(0) PMID 8301790 Abstract OBJECTIVE: To identify predictors of smoking cessation success or failure with and without transdermal nicotine patch treatment. DESIGN: Two independent randomized, double-blind, placebo-controlled studies using the nicotine patch assessing outcome at the end of treatment and at 6-month follow-up; each study used a different mode of adjuvant counseling. PATIENTS: Subjects were daily smokers (> or = 15 cigarettes per day), aged 21 to 65 years with expired air carbon monoxide levels of at least 10 ppm, and motivated to quit. Eighty-eight subjects participated in study 1, and 112 subjects participated in study 2. INTERVENTION: Study 1 consisted of 8 weeks of 22-mg nicotine patch therapy with intensive group counseling. Study 2 consisted of 4 weeks of 22-mg nicotine patch therapy and 2 weeks of 11-mg nicotine patch therapy with brief individual counseling. MAIN OUTCOME MEASURES: The prediction of smoking cessation (at end of treatment and after 6 months) based on pretreatment and intratreatment measures in smokers using active or placebo nicotine patches. RESULTS: Pretreatment markers, such as the Fagerstrom Tolerance Questionnaire score, number of cigarettes smoked per day, years smoked, expired air carbon monoxide level, or baseline blood nicotine and cotinine levels, showed no consistent relationship with successful smoking cessation across both studies. Of the intratreatment markers examined, withdrawal severity and nicotine replacement levels also were not consistently predictive of cessation success. However, any smoking during the second week of treatment was a consistent and powerful predictor of failure at the end of treatment and after 6 months. Among active nicotine patch patients who smoked at all during week 2 after quitting, 83% and 97% (studies 1 and 2, respectively) were smoking at 6-month follow-up. Conversely, abstinence during the second week of treatment predicted successful smoking cessation. Among active nicotine patch patients who were totally abstinent during week 2 after quitting, 46% and 41% (studies 1 and 2, respectively) were abstinent at 6-month follow-up. Of all nicotine patch patients in both studies who were smoking at 6-month follow-up, 74% began smoking during week 1 or 2. Among all placebo patch patients who were smoking at 6-month follow-up, 86% began smoking during week 1 or 2. CONCLUSIONS: Smoking status (abstinent or smoking) during the first 2 weeks of nicotine patch therapy, particularly week 2, was highly correlated with clinical outcome and can serve as a powerful predictor of smoking cessation. Early smoking behavior also predicted outcome among placebo patch users. Traditional measures of dependence are not consistently predictive of cessation success. Clinicians are advised to emphasize the importance of total abstinence after a quit attempt and to follow-up with patients within the first 2 weeks of quitting; smoking during this critical time should be assessed and treatment may be altered as appropriate. Descriptors Administration, Cutaneous, Adult, Aged, Breath Tests, Carbon Monoxide/analysis, Confidence Intervals, Cotinine/blood, Counseling, Double-Blind Method, Female, Follow-Up Studies, Humans, Logistic Models, Male, Middle Aged, Nicotine/administration & dosage/blood, Odds Ratio, Smoking/therapy, Smoking Cessation/methods/statistics & numerical data, Treatment Outcome Links Book Title Database Publisher Data Source Authors Kenford,S. L., Fiore,M. C., Jorenby,D. E., Smith,S. S., Wetter,D., Baker,T. B. Original/Translated Title URL Date of Electronic PMCID Editors

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