Effects of different types of smoking cessation behavioral therapy in disadvantaged areas in the Netherlands: an observational study

Background Smokers in disadvantaged areas smoke more and make less successful quit attempts than smokers in other areas. Smoking cessation behavioural therapy (SCBT) +/- pharmacotherapy, can increase quit success, however, several different types of counselling are available. Settings also differ. The type of counselling which best assists smokers in disadvantaged areas to quit is unknown. We investigated the effect of four different types of SCBT offered in disadvantaged areas of the Netherlands (individual face-to-face, telephone, rolling group and fixed group counselling), and explored differences of effect between intervention types. Methods Data from 415 participants were collected from Dutch SCBT programmes serving disadvantaged areas. Settings included hospital, community, and primary care. Data collection included repeated survey and medical record research. Participants’ self-reported and CO-validated continuous abstinence prevalence per intervention type initially, and at 6 and 12 months were calculated. Predictors of continuous cessation at 12 months were analysed using logistic regression analysis. Results Overall, 19% of participants were of low educational level. There was a 30% overall self-reported continuous abstinence prevalence at 12 months, which was highest in rolling group counselling (41%) and individual face-to-face counselling (35%). Fixed group counselling in hospital setting was more effective than in other settings. Both group counselling types were equally effective in a hospital setting. Conclusion Group counselling in a hospital setting is the most successful type of intervention in supporting smokers in disadvantaged areas to quit. We recommend that services in disadvantaged areas concentrate on offering group counselling, given in a hospital setting, where possible.