journal article
LitStream Collection
The number of smokers needed to screen and treat in a smoking cessation programme
Storm-Versloot, Marja N.; Vermeulen, Hester; Wiggers, Louise C.W.; Smets, Ellen M.A.; de Haes, Hanneke C.J.M.; Peters, Ron J.G.; Legemate, Dink A.; Vos, Rien de
doi: 10.1097/hjr.0b013e32832f4465pmid: 19738472
Objective Smoking cessation is an important factor in reducing cardiovascularmortality, but considerable effort is needed to successfully persuade patientsto quit smoking. We studied the efficiency of the Minimal Intervention Strategy(C-MIS) in addition to nicotine replacement therapy (NRT) for smoking cessationin cardiovascular outpatients in relation to the outcome of mortality.Design Prospective cohort data studying the C-MIS in three outpatient clinics:cardiology, vascular surgery and vascular medicine.Methods Two thousand, two hundred and seventy-five consecutive patientsattending the clinics for first or routine follow-up visits were screened foratheroscleroses and smoking. The efficiency of the C-MIS was expressed as thenumber of smokers needed to screen and needed to treat in relation to the numberof deaths prevented over a 5-year period. Mortality estimates were derived fromthe literature.Results One thousand, four hundred and thirty-one patients were screened atfirst-time follow-up visits and 1294 at routine follow-up visits. With a rate ofeffectiveness of 4.3% for the C-MIS, the number needed to treat was240 (min-max: 64-∞) to prevent one death. The corresponding numberneeded to screen was 687 (min-max: 141-∞) in the cardiology clinic,574 (min-max: 134-∞) in the vascular surgery clinic and 444 (min-max:90-∞) in the vascular medicine clinic. Within 5 years, 10 (min-max:0–58) deaths could be prevented in all three clinics together. Withthe effectiveness of the C-MIS for first-time and routine follow-up attendees,only six (min-max: 0–36) and zero (min-max: 0–25) deathscould be prevented, respectively.Conclusion In terms of the efficiency of the C-MIS in addition to nicotinereplacement therapy, there is some benefit for first-time attendees and nobenefit for routine follow-up attendees in preventing death.