Improving the effectiveness of pharmacist-assisted tobacco cessation: a study of participant- and pharmacy-specific differences in quit rates

Ann Pharmacother. 2015 Mar;49(3):303-10. doi: 10.1177/1060028014563949. Epub 2014 Dec 19.

Abstract

Background: The New Mexico Pharmaceutical Care Foundation provided a pharmacist-assisted tobacco cessation program from 2004 to 2010. In evaluating the program, discrepant 6-month quit rates were observed between pharmacies.

Objective: To identify participant- and pharmacy-specific factors associated with improved quit rates.

Methods: To supplement data regarding participant characteristics and quit rates, semistructured interviews of 7 participating pharmacists were conducted. Multivariate logistic regression quantified associations between successful abstinence at 6 months and participant characteristics and pharmacy-specific factors.

Results: Quit rates by pharmacy ranged from 1.1% to 59.4% (mean = 19.1%). There were 1235 participants enrolled at 7 pharmacies, and because of missing participant data, 883 were included in the quantitative analysis. Three pharmacy-specific characteristics distinguished 6-month success rates: number and duration of follow-ups and format of counseling sessions. Participants followed up at least 3 times were more likely to quit at 6 months than those contacted once or twice (odds ratio [OR] =4.9; 95% CI = 1.6-15.0). Compared with follow-ups of <15 minutes, longer durations of follow-ups were associated with higher success rates: 15 to 30 minutes, OR = 7.2, 95% CI = 3.7-14.3); >30 minutes, OR = 10.0, 95% CI = 3.5-28.9. Participants who attended group sessions were more likely to quit at 6 months than those who attended individual sessions: OR = 8.2; 95% CI = 2.8-23.9. Most pharmacists (88%) noted that participants' high or low commitment to quit was associated with success or failure, respectively. Several pharmacists (43%) noted difficulties with follow-up associated with participants' relapse. Time constraints were an obstacle noted by 70% of pharmacists.

Conclusions: Pharmacy-specific factors, including counseling format and program intensity, affected success.

Keywords: evaluation; pharmacists; quit rates; tobacco cessation.

MeSH terms

  • Adult
  • Attitude to Health
  • Counseling
  • Female
  • Humans
  • Logistic Models
  • Male
  • New Mexico / epidemiology
  • Pharmaceutical Services / standards
  • Pharmaceutical Services / statistics & numerical data
  • Pharmacies / standards
  • Pharmacies / statistics & numerical data*
  • Pharmacists* / standards
  • Pharmacists* / statistics & numerical data
  • Professional Role
  • Recurrence
  • Smoking Cessation / economics
  • Smoking Cessation / methods*
  • Smoking Cessation / statistics & numerical data*
  • Socioeconomic Factors
  • Time Factors
  • Tobacco Use Cessation Devices / economics
  • Tobacco Use Cessation Devices / statistics & numerical data
  • Treatment Outcome
  • Young Adult