Helping smokers with depression to quit smoking: collaborative care with quitline
Tuesday, August 2, 2011
Posted by: Natalia Gromov
Catherine J Segan, Ron Borland, Kay A Wilhelm, Sunil S Bhar, Ainslie T Hannan, David R Dunt and Ian T Ferretter
To report smokers' evaluations and uptake of Quitline–doctor comanagement of smoking cessation and depression, a key component of the Victorian Quitline's tailored call-back service for smokers with a history of depression and to explore its relationship to quitting success.
Design, participants and setting:
Prospective study followed Quitline clients disclosing doctor-diagnosed depression (n=227). Measures were taken at baseline (following initial Quitline call), posttreatment (2months) and 6months from recruitment (77% and 70% response rates, respectively).
Main outcome measures:
Uptake of comanagement (initiated by fax-referral to Quitline), making a quit attempt (quit for 24hours), sustained cessation (>4months at 6-month follow-up).
At 2-month follow-up, 83% thought it was a good idea to involve their doctor in their quit attempt, 74% had discussed quitting with their doctor, and 43% had received comanagement. In all, 72% made a quit attempt, 37% and 33% were abstinent posttreatment and at 6months, respectively, and 20% achieved sustained cessation. Among participants who discussed quitting with their doctor, those receiving comanagement were more likely to make a quit attempt than those who did not receive comanagement (78% v 63%). Participants with comanagement also received more Quitline calls (mean 4.6v 3.1) — a predictor of sustained cessation. Exacerbation of depression between baseline and 6months was reported by 18% of participants but was not related to cessation outcome.
Quitline–doctor comanagement of smoking cessation and depression is workable, is valued by smokers, and increases the probability of quit attempts. Smoking cessation did not increase the risk of exacerbation of depression.
Source: Phillip Gardiner, Dr. P. H., Social and Behavioral Sciences, Neurosciences and Nicotine Dependence, Research Administrator, Tobacco Related Disease Research Program, University of California Office of the President