Koshi Nakamura1, Makoto Watanabe2, Nagako Okuda3, Katsushi Yoshita4, Mai Kabayama5, Sayuki Torii6, Toru Kuribayashi7, Kazuyoshi Itai8, Kei Kamide5, Katsuyuki Miura6,9, Akira Okayama10. 1. Department of Public Health, Hokkaido University Faculty of Medicine. 2. Department of Preventive Cardiology, National Cerebral and Cardiovascular Center. 3. Department of Health and Nutrition, University of Human Art and Science. 4. Department of Food Science and Nutrition, Graduate School of Human Life Science, Osaka City University. 5. Division of Health Science, Osaka University Graduate School of Medicine. 6. Department of Public Health, Shiga University of Medical Science. 7. Faculty of Humanities and Social Sciences, Iwate University. 8. Faculty of Nutritional Sciences, Morioka University. 9. Center for Epidemiologic Research in Asia, Shiga University of Medical Science. 10. Research Institute of Strategy for Prevention.
Abstract
AIM: We investigated whether 2 types of personalized health guidance (repeated and single counseling) in the Japanese nationwide cardiovascular prevention system promoted smoking cessation among smokers. METHODS: The study included 47,745 Japanese smokers aged 40 to 74 years classified into 2 personalized health guidance schemes. After a 1-year follow-up, we compared the rates of smoking cessation between individuals who had received counseling ("supported") and those who had not received counseling ("unsupported"). Using propensity score matching analysis, we estimated the average treatment effect (ATE) of each approach on smoking cessation after balancing out the characteristics between the supported and unsupported groups. The propensity score regression model included age, medical insurance type, weight gain since the age of 20 years, exercise, eating habits, alcohol intake, quality of sleep, readiness to modify lifestyle, willingness to receive support, and body mass index. RESULTS: In the repeated counseling scheme, the age-adjusted rates of smoking cessation in the supported and unsupported groups were 8.8% and 6.3% for males, and 9.8% and 9.1% for females respectively. In the single counseling scheme, the corresponding rates were 8.4% and 7.3% for supported and unsupported males, and 11.0% and 11.7% for supported and unsupported females respectively. The ATE of repeated counseling was ＋2.64% (95% confidence interval: ＋1.51% to ＋3.77%) for males and ＋3.11% (－1.85% to ＋8.07%) for females. The ATE of single counseling was ＋0.61% (－1.17% to ＋2.38%) for males and －1.06% (－5.96% to ＋3.85%) for females. CONCLUSIONS: In the Japanese cardiovascular prevention system, repeated counseling may promote smoking cessation among male smokers.
AIM: We investigated whether 2 types of personalized health guidance (repeated and single counseling) in the Japanese nationwide cardiovascular prevention system promoted smoking cessation among smokers. METHODS: The study included 47,745 Japanese smokers aged 40 to 74 years classified into 2 personalized health guidance schemes. After a 1-year follow-up, we compared the rates of smoking cessation between individuals who had received counseling ("supported") and those who had not received counseling ("unsupported"). Using propensity score matching analysis, we estimated the average treatment effect (ATE) of each approach on smoking cessation after balancing out the characteristics between the supported and unsupported groups. The propensity score regression model included age, medical insurance type, weight gain since the age of 20 years, exercise, eating habits, alcohol intake, quality of sleep, readiness to modify lifestyle, willingness to receive support, and body mass index. RESULTS: In the repeated counseling scheme, the age-adjusted rates of smoking cessation in the supported and unsupported groups were 8.8% and 6.3% for males, and 9.8% and 9.1% for females respectively. In the single counseling scheme, the corresponding rates were 8.4% and 7.3% for supported and unsupported males, and 11.0% and 11.7% for supported and unsupported females respectively. The ATE of repeated counseling was ＋2.64% (95% confidence interval: ＋1.51% to ＋3.77%) for males and ＋3.11% (－1.85% to ＋8.07%) for females. The ATE of single counseling was ＋0.61% (－1.17% to ＋2.38%) for males and －1.06% (－5.96% to ＋3.85%) for females. CONCLUSIONS: In the Japanese cardiovascular prevention system, repeated counseling may promote smoking cessation among male smokers.
Entities:
Keywords:
Average treatment effect; Health guidance; Obesity; Propensity score matching analysis; Smoking cessation