| Summary: | Introduction
The aim of this study was to examine the efficacy of guided selfchange
(GSC), nicotine replacement therapy (NRT), and their combination,
on smoking cessation among patients with COPD.
Methods
A total of 60 participants were randomly assigned to three groups
for GSC (n=20), nicotine replacement therapy (NRT) (n=20) or their
combination (n=20), from December 2016 to November 2017. The quality
of life (QoL) questionnaire, clinical assessment test (CAT) and exhaled
carbon monoxide (CO), were measured at baseline and post-treatment.
Results
At 6, 12, and 29 weeks, the abstinence rate in the NRT group was
5.3%, 15.8% and 21.1%, in the GSC group 21.1%, 31.6% and 47.4%, and in
the combined group 36.8%, 36.8% and 47.4%, respectively. The exhaled CO
in the NRT group was greater than the GSC group, however this difference
was not statistically significant (3.4; 95% CI: -0.24–7.0; p=0.067), CO levels
in the combined group were less than the GSC group, while this difference
was also not significant (-0.75; 95% CI : -4.2–2.7; p=0.68). CAT and QoL
recovery in the GSC and combined groups were higher than in the NRT
group (9.2; 95% CI: 5.0–13.4; p=0.001) and (-4.5; 95% C: -8.1– -0.6;
p=0.02), respectively. However, differences between combined and GSC
groups were not significant (p=0.24 and p=0.41, respectively). There was
a statistically significant difference between the abstinence rate in the GSC
or combined group and the NRT group (p=0.001). The GEE model showed
that GSC reduced the odds of smoking compared with the NRT group
(interaction group effect) (OR=0.31, 95% CI: 0.022–0.545; p=0.001).
Conclusions
In our context among COPD patients, GSC was more effective
in decreasing smoking than NRT alone. Moreover, the recovery of exhaled
carbon monoxide, CAT and QoL in GSC was more than in the NRT group.
Moreover, since GSC was as effective as GSC plus NRT, the effectiveness
of the combination method for smoking cessation in COPD patients may
be attributed to GSC.
Clinical trial registration details
IRCT201609271457N11; www.irct.ir
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