"Tobacco with FDNY": The New York City Fire Department World Trade Center tobacco cessation study

Matthew P. Bars, Gisela I. Banauch, David Appel, Michael Andreachi, Philippe Mouren, Kerry J. Kelly, David J. Prezant

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

Context: After the World Trade Center (WTC) collapse, 15% (1,767) of rescue workers from the Fire Department of the City of New York (FDNY) considered themselves to be current cigarette smokers. Post-WTC collapse, 98% reported acute respiratory symptoms, and 81% reported health concerns. Nonetheless, 29% of current smokers increased tobacco use, and 23% of ex-smokers resumed cigarette smoking. Objective: To determine the effect of a comprehensive tobacco-cessation program using combination tobacco-dependency treatment medications adjusted to the individual's daily tobacco use. Design: FDNY cigarette smokers enrolled in "Tobacco Free With FDNY," a no-cost quit-smoking program providing counseling, support, and medications. At the end of the 3-month treatment phase and at the 6-month and 12-month follow-up visits, abstinence rates were confirmed by expired carbon monoxide levels or by the verification of a household member. Setting: FDNY Bureau of Health Services between August 1, 2002 and October 30, 2002. Participants: A total of 220 current cigarette smokers from the FDNY. Results: At study enrollment, the mean (± SD) tobacco use was 20 ± 7 cigarettes per day, and the mean tobacco dependency, as assessed by a modified Fagerstrom test score, was 6.7 ± 2.5 (maximum score, 10). Based on tobacco use, 20% of enrollees used three types of nicotine medications, 64% used two types, 14% used one type, and 3% used no medications. Additionally, 14% of enrollees used bupropion sustained release. The confirmed continuous abstinence rates were 47%, 36%, and 37%, respectively, after 3 months of treatment and at the 6-month and 12-month follow-up. Abstinence rates did not correlate with the history of tobacco use but correlated inversely with tobacco dependency. Adverse events and maximal nicotine medication use were unrelated, and no one experienced a serious adverse event. Conclusion: Tobacco dependency treatment using combination nicotine medications is effective and safe. Future studies should consider the following: (1) both history of tobacco use and withdrawal symptoms to determine the number and dose of nicotine medications; and (2) continuing combination treatment for > 3 months.

Original languageEnglish (US)
Pages (from-to)979-987
Number of pages9
JournalChest
Volume129
Issue number4
DOIs
StatePublished - Apr 2006

Keywords

  • Firefighters
  • Tobacco cessation
  • World Trade Center

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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