Maintaining abstinence from cigarette smoking: Effectiveness of group counselling and factors predicting outcome

The aim of the study was to assess the effectiveness of worksite group coun selling interventions designed to prevent smoking relapse after abstinence has been achieved following 3 months therapy using group support and/or tra nsdermal nicotine replacement therapy. After 3 months, abstinent subjects w ere randomly allocated either to a counselling group led by professional ps ychologists (PG), to a counselling group led by former smokers (SG) or to n o intervention group (NG). The 3 and 12 months abstinence were defined, res pectively, as a sustained smoking cessation during the last month, and the last 9 months. Complete abstinence was confirmed by expired carbon monoxide and by urine cotinine concentrations. The abstinence rate at 3 months was 35.1%. After 12 months abstinence rates were not statistically different in the PG, the SG and the NG (respectively 57.8, 53.4 and 49.6% of those rand omised). In multivariate analyses, baseline variables associated with 12 mo nths abstinence were non-smoking family, gender (male), lower daily intake of nicotine and better psychological adjustment. Mean weight gain at 3 mont hs in abstinent versus relapsed subjects was, respectively, 4.1 and 2.4kg. Baseline variables associated with weight gain at 3 months were higher Fage rstrom score, gender (male) and professional status (blue collar worker). G roup support after abstinence has been achieved did not significantly impro ve the abstinence. This study shows the difficulty of preventing smoking re lapse with monthly group counselling. The results indicate the need to inve stigate further specific programmes focusing on factors such as gender, fam ily, nicotine dependence, psychological and weight concerns/issues which ma y precipitate relapse. (C) 1999 Elsevier Science Ltd. All rights reserved.