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PhD: Intensive Smoking Cessation Interventions in Denmark – Based on data from the Danish Smoking Cessation Database
Fredag, 12 Oktober 2018, 14:00 - 17:00
af svend

Læge Mette Rasmussen

English summary
Background
Tobacco smoking is by far the most deadly and preventable lifestyle factor for public health, both globally
and nationally. The aim of this thesis was to evaluate the effect of intensive smoking cessation
interventions (ISCI) on successful quitting through different study designs, synthesised from cohort
studies and a review of randomised controlled trials.
Studies
A systematic review with meta-analysis was set up to compare ISCI and shorter interventions of
randomised controlled trials (RCT). 9,569 unique papers were identified, and 18 RCTs investigating
10,131 smokers were included. The body of evidence were graded moderate to low. Meta-analyses
revealed that ISCI were significantly more effective compared to shorter interventions. A methodological
study was undertaken describing the development of the Danish National Smoking Cessation Database
(SCDB) and the most commonly registered smoking cessation interventions (SCI), as well as the data
collection and validity. Two cohort studies using data from the SCDB were conducted to evaluate the
effectiveness of SCI in real life. One study investigating the effectiveness of five different SCIs found that
the intensive Gold Standard Programme’ (GSP - Standard SCI in Denmark) was the only intervention that
was effective for both men and women. The other study investigated the effectiveness of the GSP in
smokers diagnosed with severe mental disorder (SMD). The study showed that smokers with SMD were
significantly less likely to become successful quitters compared to smokers without mental disorders.
However, one in every four smokers with SMD was continuously smoke-free for at least 6 months
compared to one in three in the comparison group.
Conclusion
This thesis adds to the evidence on intensive smoking cessation interventions (ISCI) through different
study designs. The results from both study designs favoured ISCI, although the GSP was significantly
less effective in smokers with SMD compared to smokers without mental illness.

Dansk resume
Baggrund
Rygning er ubetinget den mest dødelige men forebyggelige livsstilsfaktor for folkesundheden både globalt
og nationalt. Formålet med denne afhandling var at evaluere effekten af intensive rygestopprogrammer
målt ved succesfyldt rygestop. Dette blev undersøgt gennem forskellige studie-design i form af
kohortestudier og en systematisk litteraturgennemgang af randomiserede studier.
Studier
Et systematiske review sammenlignede intensive rygestopprogrammer med kortere programmer i
randomiserede forsøg (RCT). 9.569 artikler blev identificeret, og 18 RCT’er, med 10.131 rygere blev
inkluderet. Kvaliteten af evidensen blev vurderet som moderat til lav. Meta-analyser viste at intensive
rygestopprogrammer var signifikant mere effektive end kortere programmer. Der blev udført et
metodestudie med beskrivelse af udviklingen af Rygestopbasen, de mest almindelige
rygestopprogrammer, procedurer for dataindsamling samt validiteten af databasen. To kohorte studier
baseret på data fra Rygestopbasen for at evaluere effekten af rygestopprogrammer implementeret i den
kliniske hverdag blev gennemført. Ét undersøgte effekten af fem forskellige rygestopprogrammer, og
viste at det intensive danske ’guld standard program’ (GSP) var det eneste program med en signifikant

effekt for både mænd og kvinder. Et andet undersøgte effekten af GSP i rygere med svær mental
sygdom. Rygere med svær mental sygdom havde signifikant lavere effekt af GSP end rygere uden
mental sygdom. På trods af den lavere effekt, var hver fjerde ryger med svær mental sygdom kontinuert
røgfri efter 6 måneder, sammenlignet med hver tredje ryger uden mental sygdom.
Konklusion
Denne afhandling bibringer ny viden om intensive rygestopprogrammer gennem forskellige studie-design.
Resultaterne fra begge anvendte design peger på intensive rygestopprogrammer som de mest
effektfulde, på trods af en signifikant lavere effekt blandt rygere med svær mental sygdom.

Sted Bispebjerg Hospital, Uddannelsescenteret, bygning 50, Auditoriet