Effects of Type of Intervention

Advice given by physicians is effective for smoking cessation.2 Interventions involving professionals from different disciplines have more effect than interventions carried out by professionals from a single discipline.2 In their Cochrane review of interventions by nurses in the area of smoking cessation, Rice and Stead indicate that intensive telephone support after discharge from hospital is an essential component of an effective intervention for heart patients.3 Brief advice given by nurses to patients with a coronary bypass is also effective. Patients with a myocardial infarct are twice as likely to be successful in stopping than are patients after a bypass operation.4

Patients with heart failure who during their stay in hospital had a twice-weekly group session and in addition to this received telephone follow-up on several occasions until 6 months after discharge

Table 29-1. Nicotine withdrawal symptoms according to the criteria of DSM-IV

• depression • concentration problems

• anger • reduced heart frequency

anxiety • weight gain had (after 12 months) a biochemically confirmed chance of stopping of 57% compared to 37% in the group of patients who only received advice to stop (numbers needed to treat = 5 (95% CI: 3-6)).5 Medicinal support for patients increases the chance of successfully stopping and is safe.6,7 More intensive behavioral counseling increases the chances of successfully stopping by a factor two to three.3,7

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