{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T22:36:55Z","timestamp":1765233415377,"version":"build-2065373602"},"reference-count":29,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2022,9,28]],"date-time":"2022-09-28T00:00:00Z","timestamp":1664323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Smoking is the main preventable cause of illness and early death worldwide. Thus, it is better to promote smoking cessation than to treat tobacco-related diseases. The objective of this study was to assess the implementation and effectiveness of smoking cessation pharmaceutical services offered in primary health care (PHC) in a large Brazilian city through a type 1 effectiveness\u2013implementation hybrid study. The services were offered through individual or group approaches (Jan\/2018\u2013Dec\/2019). The service indicators were described and the incidence of cessation in the services was evaluated. Factors associated with cessation were assessed by Poisson regression analysis. The services were offered in most PHC centers (61.2%) and by most pharmacists (81.3%). In total, 170 individual (9.7%) and 1591 group (90.3%) approaches occurred, leading to cessation in 39.4% (n = 67) and 44.8% (n = 712) of these, respectively. The use of nicotine plus antidepressants (RR = 1.30; 95%CI = 1.08\u20131.57; p = 0.006) and the number of sessions with pharmacists (RR = 1.21; 95%CI = 1.19\u20131.23; p &lt; 0.001) were positively associated with cessation; a very high level of dependence was negatively associated (RR = 0.77; 95%CI = 0.67\u20130.89; p = 0.001). The smoking cessation services were effective and should be encouraged.<\/jats:p>","DOI":"10.3390\/ijerph191912305","type":"journal-article","created":{"date-parts":[[2022,9,28]],"date-time":"2022-09-28T20:58:47Z","timestamp":1664398727000},"page":"12305","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Assessment of Pharmaceutical Services for Smoking Cessation: An Effectiveness\u2013Implementation Hybrid Study"],"prefix":"10.3390","volume":"19","author":[{"given":"Maria Eduarda Pinheiro","family":"Laborne-e-Valle","sequence":"first","affiliation":[{"name":"Center for Pharmaceutical Care Studies, College of Pharmacy, Federal University of Minas Gerais, Belo Horizonte 31270-901, Minas Gerais, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Em\u00edlia de Oliveira","family":"Ahouagi","sequence":"additional","affiliation":[{"name":"Belo Horizonte Municipality, Belo Horizonte 30130-003, Minas Gerais, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5791-0572","authenticated-orcid":false,"given":"Debora Gontijo","family":"Braga","sequence":"additional","affiliation":[{"name":"Belo Horizonte Municipality, Belo Horizonte 30130-003, Minas Gerais, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabela Vaz Leite","family":"Pinto","sequence":"additional","affiliation":[{"name":"Belo Horizonte Municipality, Belo Horizonte 30130-003, Minas Gerais, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8722-0190","authenticated-orcid":false,"given":"C\u00e9lio Rezende","family":"Lara-J\u00fanior","sequence":"additional","affiliation":[{"name":"Center for Pharmaceutical Care Studies, College of Pharmacy, Federal University of Minas Gerais, Belo Horizonte 31270-901, Minas Gerais, Brazil"},{"name":"Belo Horizonte Municipality, Belo Horizonte 30130-003, Minas Gerais, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabrina Gon\u00e7alves","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Center for Pharmaceutical Care Studies, College of Pharmacy, Federal University of Minas Gerais, Belo Horizonte 31270-901, Minas Gerais, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula de F\u00e1tima Fernandes","family":"Blunk","sequence":"additional","affiliation":[{"name":"Center for Pharmaceutical Care Studies, College of Pharmacy, Federal University of Minas Gerais, Belo Horizonte 31270-901, Minas Gerais, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adriano Max Moreira","family":"Reis","sequence":"additional","affiliation":[{"name":"Pharmaceutical Products Department, College of Pharmacy, Federal University of Minas Gerais, Belo Horizonte 31270-901, Minas Gerais, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1465-9167","authenticated-orcid":false,"given":"Edna Afonso","family":"Reis","sequence":"additional","affiliation":[{"name":"Statistics Department, Exact Sciences Institute, Federal University of Minas Gerais, Belo Horizonte 31270-901, Minas Gerais, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5548-8184","authenticated-orcid":false,"given":"Djenane","family":"Ramalho-de-Oliveira","sequence":"additional","affiliation":[{"name":"Center for Pharmaceutical Care Studies, College of Pharmacy, Federal University of Minas Gerais, Belo Horizonte 31270-901, Minas Gerais, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2183-4365","authenticated-orcid":false,"given":"Mariana Martins Gonzaga do","family":"Nascimento","sequence":"additional","affiliation":[{"name":"Center for Pharmaceutical Care Studies, College of Pharmacy, Federal University of Minas Gerais, Belo Horizonte 31270-901, Minas Gerais, Brazil"},{"name":"Pharmaceutical Products Department, College of Pharmacy, Federal University of Minas Gerais, Belo Horizonte 31270-901, Minas Gerais, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,28]]},"reference":[{"key":"ref_1","unstructured":"Brazilian National Cancer Institute (INCA) (2022, August 29). Tabagismo, Available online: https:\/\/www.inca.gov.br\/assuntos\/tabagismo."},{"key":"ref_2","unstructured":"World Health Organization (WHO) (2022, August 29). Tobacco\u2014Key Facts. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/tobacco."},{"key":"ref_3","unstructured":"Brazilian National Cancer Institute (INCA) (2022, August 29). Programa Nacional de Controle do Tabagismo, Available online: https:\/\/www.inca.gov.br\/programa-nacional-de-controle-do-tabagismo."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1590\/s1806-37562016000000145","article-title":"Smoking control: Challenges and achievements","volume":"42","author":"Silva","year":"2016","journal-title":"J. Bras. Pneumol."},{"key":"ref_5","unstructured":"World Health Organization (WHO) (2022, August 29). Tobacco. Available online: https:\/\/www.who.int\/health-topics\/tobacco#tab=tab_1."},{"key":"ref_6","unstructured":"Brazilian National Cancer Institute (INCA) (2022, August 29). Dados e N\u00fameros da Preval\u00eancia do Tabagismo, Available online: https:\/\/www.inca.gov.br\/observatorio-da-politica-nacional-de-controle-do-tabaco\/dados-e-numeros."},{"key":"ref_7","unstructured":"The 2008 Public Health Service Guideline Update Panel (2008). Treating tobacco use and dependence\u20142008 update U.S. Public Health Service Clinical Practice Guideline Executive Summary. Respir. Care, 53, 1217\u20131222."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e009828","DOI":"10.1136\/bmjopen-2015-009828","article-title":"Community Pharmacy-Delivered Interventions for Public Health Priorities: A Systematic Review of Interventions for Alcohol Reduction, Smoking Cessation and Weight Management, Including Meta-Analysis for Smoking Cessation","volume":"6","author":"Brown","year":"2016","journal-title":"BMJ Open"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.sapharm.2013.04.015","article-title":"Effectiveness of Tobacco Use Cessation Interventions Delivered by Pharmacy Personnel: A Systematic Review","volume":"10","author":"Mdege","year":"2013","journal-title":"Res. Soc. Adm. Pharm."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1111\/jep.12717","article-title":"Real world evaluation of the smoking cessation services in the Rio de Janeiro municipality, Brazil","volume":"23","author":"Casado","year":"2017","journal-title":"J. Eval. Clin. Pract."},{"key":"ref_11","unstructured":"Peters, D.H., Tran, N.T., and Adam, T. (2013). Implementation Research in Health: A Practical Guide, World Health Organization (WHO)."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1097\/MLR.0b013e3182408812","article-title":"Effectiveness-implementation Hybrid Designs\u2014Combining Elements of Clinical Effectiveness and Implementation Research to Enhance Public Health Impact","volume":"50","author":"Curran","year":"2012","journal-title":"Med. Care"},{"key":"ref_13","first-page":"i6795","article-title":"Standards for Reporting Implementation Studies (StaRI) Statement","volume":"356","author":"Meissner","year":"2017","journal-title":"BMJ"},{"key":"ref_14","unstructured":"Instituto Brasileiro de Geografia e Estat\u00edstica (IBGE) (2022, August 29). Cities and States, Available online: https:\/\/www.ibge.gov.br\/en\/cities-and-states\/mg\/belo-horizonte.html."},{"key":"ref_15","unstructured":"Prefeitura Municipal de Belo Horizonte (PBH) (2022, August 29). Tobacco Control, Available online: https:\/\/prefeitura.pbh.gov.br\/saude\/informacoes\/atencao-a-saude\/promocao-da-saude\/controle-do-tagagismo."},{"key":"ref_16","unstructured":"Prefeitura Municipal de Belo Horizonte (PBH) (2018). Secretaria Municipal de Sa\u00fade. Guia de Atua\u00e7\u00e3o do Farmac\u00eautico no Cuidado \u00e0 Pessoa Tabagista, Prefeitura de Belo Horizonte (PBH)."},{"key":"ref_17","unstructured":"Prefeitura Municipal de Belo Horizonte (PBH) (2022, August 29). Secretaria Municipal de Sa\u00fade, Protocolo\u2014Tratamento do Fumante na Rede SUS-BH, Available online: https:\/\/prefeitura.pbh.gov.br\/sites\/default\/files\/estrutura-de-governo\/saude\/Protocolo_tratamento_fumante-19-02-2020%20(4).pdf."},{"key":"ref_18","first-page":"73","article-title":"Adaptation into Portuguese for the Fagerstr\u00f6m test for nicotine dependence (FTND) to evaluate the dependence and tolerance for nicotine in Brazilian smokers","volume":"59","author":"Carmo","year":"2002","journal-title":"RBM Rev. Bras. Med."},{"key":"ref_19","unstructured":"Brasil. Minist\u00e9rio da Sa\u00fade (2022, August 29). Secretaria de Aten\u00e7\u00e3o Especializada \u00e0 Sa\u00fade. Secretaria de Ci\u00eancia, Tecnologia, Inova\u00e7\u00e3o e Insumos Estrat\u00e9gicos em Sa\u00fade. Portaria Conjunta n. 10, de 10 de abril de 2020. Protocolo Cl\u00ednico e Diretrizes Terap\u00eauticas do Tabagismo. Minist\u00e9rio da Sa\u00fade, Bras\u00edlia, Available online: https:\/\/www.inca.gov.br\/sites\/ufu.sti.inca.local\/files\/\/media\/document\/\/protocolo-clinico-e-diretrizes-terapeuticas-do-tabagismo.pdf."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1331\/JAPhA.2010.09034","article-title":"Effect of a tobacco cessation continuing professional education program on pharmacists\u2019 confidence, skills, and practice-change behaviors","volume":"50","author":"Martin","year":"2010","journal-title":"J. Am. Pharm. Assoc."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"3319","DOI":"10.7314\/APJCP.2015.16.8.3319","article-title":"Impact of smoking cessation training for community pharmacists in Indonesia","volume":"16","author":"Kristina","year":"2015","journal-title":"Asian Pac. J. Cancer Prev."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1111\/j.1360-0443.2008.02446.x","article-title":"A comparison of the effectiveness of group-based and pharmacy-led smoking cessation treatment in Glasgow","volume":"104","author":"Bauld","year":"2009","journal-title":"Addiction"},{"key":"ref_23","first-page":"150","article-title":"Effect of a pharmacist managed smoking cessation clinic on quit rates","volume":"3","author":"Philbrick","year":"2009","journal-title":"Pharm. Pract."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"108100","DOI":"10.1016\/j.jsat.2020.108100","article-title":"Making lemonade from SARS coronavirus-2 lemons: Transitioning a smoking cessation trial to a virtual platform","volume":"117","author":"Mahoney","year":"2020","journal-title":"J. Subst. Abus. Treat."},{"key":"ref_25","unstructured":"Brasil. Minist\u00e9rio da Sa\u00fade, and Brazilian National Cancer Institute (INCA) (2001). Abordagem e Tratamento do Fumante\u2014Consenso 2001, Brazilian National Cancer Institute (INCA)."},{"key":"ref_26","first-page":"255","article-title":"Motivational intervention in a smoking cessation consultation based on behavioral change","volume":"22","author":"Santos","year":"2006","journal-title":"Rev. Port. Clin. Geral Fam."},{"key":"ref_27","first-page":"42","article-title":"Smoking cessation in a community pharmacy: Preliminary results of a pharmaceutical care program","volume":"22","author":"Condinho","year":"2015","journal-title":"Vitae"},{"key":"ref_28","first-page":"693","article-title":"Smoking cessation program from community pharmacy","volume":"26","author":"Camacho","year":"2000","journal-title":"Aten Primaria"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"82","DOI":"10.4321\/s1699-714x2020000100023","article-title":"Pharmaceutical care to patients in a smoking cessation group at a Brazilian teaching hospital","volume":"30","author":"Sousa","year":"2020","journal-title":"Rev. OFIL Ilaphar"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/19\/12305\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:40:55Z","timestamp":1760143255000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/19\/12305"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,28]]},"references-count":29,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["ijerph191912305"],"URL":"https:\/\/doi.org\/10.3390\/ijerph191912305","relation":{},"ISSN":["1660-4601"],"issn-type":[{"type":"electronic","value":"1660-4601"}],"subject":[],"published":{"date-parts":[[2022,9,28]]}}}