Effectiveness of Tobacco Cessation Interventions in Sweden

Study Overview
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Brief Summary
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Smoking is still one of the most important risk factors causing morbidity and mortality in Sweden. Every year, 12,000 Swedish citizens die prematurely from smoking, and smoking is responsible for up to 60% of the inequity in health. Though the smoking prevalence is relatively low in Sweden in an international context (8% and 10% for men and women respectively in 2016), specific vulnarable groups have a very high prevalence; e.g. about 80% in alcohol and drug abusers. Furthermore, Sweden has a unique high prevalence of snus users and in 2016 the daily use of tobacco was 25% for men and 14% for women. In addition, products such as cigarettes, snus, and e-cigettes are often mixed. Despite the fact that about a thousand counsellors have been trained in manual-based person-centred tobacco cessation interventions in Sweden, the effectiveness of the interventions remains unknown, as a follow-up on effect of in-person interventions is not systematically collected in Sweden. Therefore, as of today it is not possible, on a national level, to compare the effectiveness of differences in these interventions, providers, or different groups of tobacco users including disadvantaged and vulnerable groups. In this study the investigators will evaluate the effectiveness of already implemented in-person cessation interventions targeting smoking, use of snus and/or e-cigarettes, focusing on disadvantaged and vulnerable groups of tobacco users. Furthermore, important factors associated with a successful outcome after controlling for confounders will be identified (in relation to programme, patients and setting).

Official Title
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Effectiveness of Tobacco Cessation Interventions for Different Groups of Users in Sweden: a National Prospective Cohort Study

Conditions
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Tobacco Use, Smoking, Cigarette Use, Electronic

Intervention / Treatment
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* Behavioral: Tobacco cessation intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All adult tobacco users (of at least 18 years of age), including disadvantaged and vulnerable patients, receiving an in-person intervention (incl. online meetings) for tobacco cessation (smoking, snus and/or e-cigarettes) are eligible for inclusion in the project after giving informed consent. Both individual and group-based interventions can be included. Exclusion Criteria: Withdrawing consent. Reduced ability to give informed consent, due to inadequate language skills, dementia, and other conditions.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Exposed<br>Several studies will be performed based on this cohort. I each study the exposed group will be a group of tobacco users evaluatedin the relevant study. This could be a vulnarable group tobacco users such as: users without a job, with short or no education, without permanent housing, diagnosed with mental illness, diagnosed with chronic obstructive pulmonary disease (COPD), undergoing surgery, adolescents, elderly, migrants, or pregnant women. | Behavioral: Tobacco cessation intervention<br>* Already implemented in-person (including online meetings) tobacco cessation interventions in Sweden<br>|
| Unexposed<br>In each study the unexposed group will consist of tobacco user from the study cohort without the condition examined in the relevant study. | Behavioral: Tobacco cessation intervention<br>* Already implemented in-person (including online meetings) tobacco cessation interventions in Sweden<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| % of patients that are continuously smokefree | Self-reported smoking status, questionnaire completed by telephone interview | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| % of patients that are smokefree | Counsellor observed smoking status, questionnaire completed by counsellor | On completion of the tobacco cessation programme (app. 1 month after quitting) | 
| % of patients that have been smokefree for at least the latest 14 days | Self-reported smoking status, questionnaire completed by telephone interview | 6 months | 
| % of patients that are satisfied with the smoking cessation intervention | Self-reported patient-satisfaction, questionnaire completed by telephone interview | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Tobacco use cessation, National cohort study, Effectiveness, Smoking cessation, Vulnerable groups