NICOTINE GUM ASSISTED GROUP-THERAPY IN SMOKERS WITH AN INCREASED RISKOF CORONARY-DISEASE - EVALUATION IN A PRIMARY CARE SETTING FORMAT

Smoking cessation with the aid of nicotine chewing gum in a primary ca re setting format is reported to be more effective when additional beh avioural training is introduced. We developed a standardized comprehen sive treatment programme using nicotine chewing gum (Nicorette 2 mg) i n conjunction with nutritional information for the prevention of weigh t gain, behavioural training for the promotion of self-management tech niques and the prescription of a date when to quit. The programme was conducted by 11 family physicians in a group setting format with 12 we ekly 90 min sessions and three booster sessions. After an introduction to the programme, each physician selected smokers with additional ris k factors for coronary heart disease from the files. Experimental and control subjects were matched for age, gender, cigarette consumption a nd duration since smoking onset. Complete data were obtained from 86 t reated and 53 control subjects. The drop-out rate among the treated su bjects was 5.8%. After the 3 month follow-up, data assessment shows an abstinence rate of 63.9% in the experimental subjects, a fact verifie d by CO measurements. Compared to the control group, blood pressure, h eart rate, cholesterol and glucose levels did not change significantly during treatment. Weight increased by 1.7 kg. After a 12 month follow -up, abstention rates decreased to 52.3%. Abstainers reported less phy sical complaints and increased well-being when compared to control sub jects or to treatment failures at both follow-up assessments. Changes in the risk profile, apart from smoking, were not verified.