Seasonal Variation in Demand for Smoking Cessation Treatment and Clinical Outcomes.
Saturday, June 19, 2021
Posted by: Natalia Gromov
Veldhuizen
S, Zawertailo L, Ivanova A, Hussain S, Selby P.
Seasonal Variation in
Demand for Smoking Cessation Treatment and Clinical Outcomes.
Nicotine Tob Res. 2021 May 24;23(6):976-982. doi: 10.1093/ntr/ntaa214. PMID:
33085765.
Introduction.
Smoking behaviour shows seasonal variation, with cigarette consumption and
youth smoking onset highest in summer and smoking-related web searches and
sales of nicotine replacement products highest in winter. Variation in demand
for clinical care and in outcomes has not been explored.
Aims and methods.
We measure seasonal variation in enrolments, total clinical visits, visits per
enrolment, and treatment outcome (7-day abstinence at 6-month follow-up) from
2015 to 2018 in a large (n = 85 869) clinical cohort from 454 clinics across
Ontario, Canada. We model seasonality using harmonic logistic and negative
binomial regression. For individual-level outcomes, we adjust for variables,
selected a priori, known to be associated with treatment use or outcomes. Data
are nearly complete for 3 outcomes, but 6m abstinence is missing for 45% of
participants. We use multiple imputation to adjust for missing data.
Results.
All four outcomes showed significant seasonal variation (all p <.001). Total
enrolments and visits were 20%-25% higher in January-April than in
June-September. Visits per enrolment varied slightly, with lowest levels from
May-July. Abstinence at 6 months was lowest among individuals enrolled from
February-May and highest for those enrolled from July-November, with an
absolute peak-trough difference of 4.3% (95% CI = 3.2% to 5.5%).
Conclusions.
There is meaningful seasonal variation in demand for, and outcomes of, smoking
cessation treatment. Climate and weather may be indirectly responsible.
Seasonal differences underscore the general importance of contextual factors in
smoking cessation, may be useful in program promotion, and may explain some
variability in outcomes in evaluation and research.
Implications.
Demand for tobacco cessation treatment and clinical outcomes vary seasonally.
This underscores the importance of context in substance-related problems, and
implies that some variability in research and evaluation results may be due to
the time of year data were collected. Promotion efforts might usefully consider
seasonal effects to smooth out demand and possibly improve outcomes.
|
|
Email to a Friend