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    Factors associated with previous quit attempts and motivation to quit, amongst primary care patients who are current smokers in Macedonia: a Breathe Well study
    (Centar of Family Medicine, Faculty of Medicine, “Ss. Cyril and Methodius“ University in Skopje, 2021-05)
    Stanoevski, Gjorgji
    ;
    Jordan, Rachel
    ;
    Adab, Peymanne
    ;
    Enocson, Alexandra
    ;
    Aim To explore the association between level of nicotine dependence and previous quit attempts and motivation to quit smoking amongst primary care patients. Method We analysed baseline questionnaire data from a randomized controlled trial of a smoking cessation intervention in 31 primary care practices in North Macedonia. Participants were aged ≥35 years and smoked >10 cigarettes/day. Regression models assessed associations between nicotine dependence (Fagerstrom) and intention to quit and previous attempts to quit, adjusting for sociodemographic variables. Results Data was available for 1328 patients. Participants had a mean age of 51,2 (SD 10,3) years, reported a mean smoking history of 39,3 (SD 22,7) pack years and 51% (n=679) were female. 83% (n=1100) of participants were of Macedonian ethnicity. 702 participants (52.9%) reported either moderate or high nicotine dependence. Approximately half of the participants (707/1328, 53.2%, reported previous serious quit attempts, with the majority of these (565/707, 79.9%) reporting 1-3 attempts. Regarding current motivation for quitting, the majority (69.2%) wanted to quit, and 78 (6%) intended to quit in the next 1-3 months. Participants with high nicotine dependence were less likely to have made previous quit attempts (OR=0.90; 95%CI 0.85 to 0.95). Nicotine dependency showed no significant association with current intention to quit (OR=1.00; 95% CI 0.90 to 1.12). Conclusion We found that the majority of smokers want to quit, but those with higher nicotine dependency were less likely to have made previous quit attempts. Declaration of Interest (including funding source and trial registration as appropriate) The authors declare no conflicts of interest. The NIHR Global Health Research (GHR) Programme is funded through UK Official Development Assistance (ODA) via the Department of Health and Social Care (DHSC). The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. We gratefully acknowledge IPCRG for introducing us to the primary care networks involved in this study and for its continued facilitation of clinical engagement. The study is registered at http://www.isrctn.com(ISRCTN54228638)
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    Effectiveness of Combining Feedback about Lung Age or Exhaled Carbon Monoxide Levels with Very Brief Advice (VBA) and Support for Smoking Cessation in Primary Care Compared to Giving VBA and Support Alone – Protocol for a Randomized Controlled Trial withi
    (Scientific Foundation SPIROSKI, 2020-03-25)
    Gjorgjievski, Dragan
    ;
    Ristovska, Radmila
    ;
    ;
    Farley, Amanda
    ;
    Adab, Peymane
    INTRODUCTION: In 2015, smoking prevalence in Republic of Macedonia was 36% in men and 21% in women We aim to assess the effectiveness and cost-effectiveness of two methods of motivating smokers to quit smoking compared with very brief advice (VBA) alone. To date, there are no studies investigating smoking cessation treatment in Republic of Macedonia. METHODS/DESIGN: RCT with process evaluation and cost-effectiveness analysis within 31 general practices in Republic of Macedonia recruiting smokers currently smoking >10 cigarettes per day, aged >35 years, attending primary care practices for any reason, regardless of motivation to quit smoking. Respondents will be randomized into one of three groups: (1) VBA and assessment and communication of lung age; (2) VBA and additional assessment and communication of exhaled carbon monoxide (CO) levels; or (3) control group – VBA. All participants who attempt to quit smoking will be offered behavioral support based on the UK standard program for smoking cessation. Primary outcome: Proportion of smokers who are quit at 4 weeks (7-day point prevalence, confirmed by salivary cotinine level). Secondary outcomes: Proportion who have attempted to quit smoking or have quit smoking, a proportion that has reduced the number of cigarettes and motivation to quit smoking; cost-effectiveness analysis calculating cost per quality-adjusted life year. We will evaluate the fidelity to the intervention and will explore patients’ and GPs’ experience and the acceptability of the study intervention by interview. DISCUSSION: The study will evaluate the effectiveness of combining feedback about lung age or exhaled CO levels with VBA and support for smoking cessation in primary care compared to giving VBA and support alone. It will explore how willing primary care physicians are to perform such interventions and the acceptability and effectiveness of such interventions to patients in Republic of Macedonia. TRIAL REGISTRATION: The study is registered on the ISRCTN registry (ISRCTN54228638).