Nicotine gum assisted group therapy in smokers with an increased risk of coronary disease--evaluation in a primary care setting format.

Smoking cessation with the aid of nicotine chewing gum in a primary care setting format is reported to be more effective when additional behavioural training is introduced. We developed a standardized comprehensive treatment programme using nicotine chewing gum (Nicorette 2 mg) in conjunction with nutritional information for the prevention of weight gain, behavioural training for the promotion of self-management techniques and the prescription of a date when to quit. The programme was conducted by 11 family physicians in a group setting format with 12 weekly 90 min sessions and three booster sessions. After an introduction to the programme, each physician selected smokers with additional risk factors for coronary heart disease from the files. Experimental and control subjects were matched for age, gender, cigarette consumption and duration since smoking onset. Complete data were obtained from 86 treated and 53 control subjects. The drop-out rate among the treated subjects was 5.8%. After the 3 month follow-up, data assessment shows an abstinence rate of 63.9% in the experimental subjects, a fact verified by CO measurements. Compared to the control group, blood pressure, heart rate, cholesterol and glucose levels did not change significantly during treatment. Weight increased by 1.7 kg. After a 12 month follow-up, abstention rates decreased to 52.3%. Abstainers reported less physical complaints and increased well-being when compared to control subjects or to treatment failures at both follow-up assessments. Changes in the risk profile, apart from smoking, were not verified.