Evaluating the impacts of screening and smoking cessation programmes on lung cancer in a high-burden region of the USA: a simulation modelling study.

PubMed

Tramontano, Angela C; Sheehan, Deirdre F; McMahon, Pamela M; Dowling, Emily C; Holford, Theodore R; Ryczak, Karen; Lesko, Samuel M; Levy, David T; Kong, Chung Yin

2016-02-29

While the US Preventive Services Task Force has issued recommendations for lung cancer screening, its effectiveness at reducing lung cancer burden may vary at local levels due to regional variations in smoking behaviour. Our objective was to use an existing model to determine the impacts of lung cancer screening alone or in addition to increased smoking cessation in a US region with a relatively high smoking prevalence and lung cancer incidence. Computer-based simulation model. Simulated population of individuals 55 and older based on smoking prevalence and census data from Northeast Pennsylvania. Hypothetical lung cancer control from 2014 to 2050 through (1) screening with CT, (2) intensified smoking cessation or (3) a combination strategy. Primary outcomes were lung cancer mortality rates. Secondary outcomes included number of people eligible for screening and number of radiation-induced lung cancers. Combining lung cancer screening with increased smoking cessation would yield an estimated 8.1% reduction in cumulative lung cancer mortality by 2050. Our model estimated that the number of screening-eligible individuals would progressively decrease over time, indicating declining benefit of a screening-only programme. Lung cancer screening achieved a greater mortality reduction in earlier years, but was later surpassed by smoking cessation. Combining smoking cessation programmes with lung cancer screening would provide the most benefit to a population, especially considering the growing proportion of patients ineligible for screening based on current recommendations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The internet and the industrial revolution in smoking cessation counselling.

PubMed

Etter, Jean-François

2006-01-01

The internet can provide wide access to online smoking cessation programmes developed by highly qualified professionals. Compared with one-to-one counselling in smoking cessation clinics or on telephone quitlines, the mass-level dissemination of automatised, individualised counselling on the internet is comparable to the industrial revolution, when skilled craftsmen working in small shops were replaced by huge plants. Hundreds of websites provide information and advice on smoking cessation, but very few of them have been evaluated scientifically. Therefore, it is not yet known whether web-based smoking cessation interventions are effective in the long term, and which of their components are most effective for subgroups of smokers. Claims for efficacy found on some popular websites have not been evaluated. The internet is being used increasingly by tobacco companies to promote their products. The overall effect of internet smoking cessation programs on smoking prevalence is unknown. Greater efforts should be expended to improve the reach and efficacy of smoking cessation websites.

Optimising text messaging to improve adherence to web-based smoking cessation treatment: a randomised control trial protocol

PubMed Central

Graham, Amanda L; Jacobs, Megan A; Cohn, Amy M; Cha, Sarah; Abroms, Lorien C; Papandonatos, George D; Whittaker, Robyn

2016-01-01

Introduction Millions of smokers use the Internet for smoking cessation assistance each year; however, most smokers engage minimally with even the best designed websites. The ubiquity of mobile devices and their effectiveness in promoting adherence in other areas of health behaviour change make them a promising tool to address adherence in Internet smoking cessation interventions. Text messaging is used by most adults, and messages can proactively encourage use of a web-based intervention. Text messaging can also be integrated with an Internet intervention to facilitate the use of core Internet intervention components. Methods and analysis We identified four aspects of a text message intervention that may enhance its effectiveness in promoting adherence to a web-based smoking cessation programme: personalisation, integration, dynamic tailoring and message intensity. Phase I will use a two-level full factorial design to test the impact of these four experimental features on adherence to a web-based intervention. The primary outcome is a composite metric of adherence that incorporates general utilisation metrics (eg, logins, page views) and specific feature utilisation shown to predict abstinence. Participants will be N=860 adult smokers who register on an established Internet cessation programme and enrol in its text message programme. Phase II will be a two-arm randomised trial to compare the efficacy of the web-based cessation programme alone and in conjunction with the optimised text messaging intervention on 30-day point prevalence abstinence at 9 months. Phase II participants will be N=600 adult smokers who register to use an established Internet cessation programme and enrol in text messaging. Secondary analyses will explore whether adherence mediates the effect of treatment condition on outcome. Ethics and dissemination This protocol was approved by Chesapeake IRB. We will disseminate study results through peer-reviewed manuscripts and conference presentations related to the methods and design, outcomes and exploratory analyses. Trial registration number NCT02585206. PMID:27029775

Effectiveness of a Multi-Component Smoking Cessation Support Programme (McSCSP) for Patients with Severe Mental Disorders: Study Design

PubMed Central

Garcia-Portilla, Maria Paz; Garcia-Alvarez, Leticia; Saiz, Pilar Alejandra; Diaz-Mesa, Eva; Galvan, Gonzalo; Sarramea, Fernando; Garcia-Blanco, Josefa; Elizagarate, Edorta; Bobes, Julio

2013-01-01

Only a few studies have examined the efficacy and safety of smoking cessation programmes in patients with mental disorders. The aim of this paper is to describe in detail the methodology used in the study as well as the Multi-component Smoking Cessation Support Programme in terms of pharmacological treatments and psychological interventions. An open-label 9-month follow-up study was conducted in Spain. A total of 82 clinically stable outpatients with schizophrenia, schizoaffective or bipolar disorder were enrolled. Treatment consisted of a programme specifically developed by the research team for individuals with severe mental disorders. The programme consisted of two phases: (1) weekly individual motivational therapy for 4–12 weeks, and (2) a 12-week active treatment phase. During this phase, at each study visit patients received a one- or two-week supply of medication (transdermal nicotine patches, varenicline or bupropion) with instructions on how to take it, in addition to group psychotherapy for smoking cessation. Evaluations were performed: (1) at the time of enrolment in the study, (2) during the 12-week active treatment phase of the study (weekly for the first 4 weeks and then biweekly), and (3) after the end of this phase (two follow-up assessments at weeks 12 and 24). Evaluations included: (1) smoking history, (2) substance use, (3) psychopathology, (4) adverse events, and (5) laboratory tests. The importance of this study lies in addressing a topical issue often ignored by psychiatrists: the unacceptably high rates of tobacco use in patients with severe mental disorders. PMID:24368428

Competitions and incentives for smoking cessation.

PubMed

Cahill, Kate; Perera, Rafael

2011-04-13

Background Material or financial incentives may be used in an attempt to reinforce behaviour change, including smoking cessation. They have been widely used in workplace smoking cessation programmes, and to a lesser extent within community programmes. Public health initiatives in the UK are currently planning to deploy incentive schemes to change unhealthy behaviours. Quit and Win contests are the subject of a companion review. To determine whether competitions and incentives lead to higher long-term quit rates. We also set out to examine the relationship between incentives and participation rates. We searched the Cochrane Tobacco Addiction Group Specialized Register, with additional searches of MEDLINE, EMBASE, CINAHL and PsycINFO. Search terms included incentive*, competition*, contest*, reward*, prize*, contingent payment*, deposit contract*. The most recent searches were in November 2010. We considered randomized controlled trials, allocating individuals, workplaces, groups within workplaces, or communities to experimental or control conditions. We also considered controlled studies with baseline and post-intervention measures. Data were extracted by one author (KC) and checked by the second (RP). We contacted study authors for additional data where necessary. The main outcome measure was abstinence from smoking at least six months from the start of the intervention. We used the most rigorous definition of abstinence in each trial, and biochemically validated rates where available. Where possible we performed meta-analysis using a generic inverse variance model, grouped by timed endpoints, but not pooled across the subgroups. Nineteen studies met our inclusion criteria, covering >4500 participants. Only one study, the largest in our review and covering 878 smokers, demonstrated significantly higher quit rates for the incentives group than for the control group beyond the six-month assessment. This trial referred its participants to local smoking cessation services, and offered substantial cash payments (up to US$750) for prolonged abstinence. In the remaining trials, there was no clear evidence that participants who committed their own money to the programme did better than those who did not, or that contingent rewards enhanced success rates over fixed payment schedules. There is some evidence that recruitment rates can be improved by rewarding participation, which may be expected to deliver higher absolute numbers of successful quitters. Cost effectiveness analysis was not appropriate to this review, since the efficacy of most of the interventions was not demonstrated. With the exception of one recent trial, incentives and competitions have not been shown to enhance long-term cessation rates. Early success tended to dissipate when the rewards were no longer offered. Rewarding participation and compliance in contests and cessation programmes may have potential to deliver higher absolute numbers of quitters. The one trial that achieved sustained success rates beyond the reward schedule concentrated its resources into substantial cash payments for abstinence rather than into running its own smoking cessation programme. Such an approach may only be feasible where independently-funded smoking cessation programmes are already available. Future research might explore the scale and longevity of possible cash reward schedules, within a variety of smoking populations.

[Group therapy and smoking cessation].

PubMed

Møller, A M; Tønnesen, H

1999-09-06

Smoking cessation programmes in which groups of smokers have the opportunity to learn behavioural techniques and benefit from mutual support for quitting are widely available. The aim of this review is to determine the effectiveness of smoking cessation programmes delivered in a group format, for helping smokers achieve long-term smoking cessation. The Tobacco Addiction Group specialised register was used to identify trials in which one or more treatment arms used behaviour therapy, group therapy or cognitive therapy. Randomised trials which compared group therapy with self-help, individual counselling, another intervention or usual care or waiting list control were selected. Trials which compared two group programmes with manipulation of the group interaction and social support components were also included. There had to be a minimum of two group meetings, and follow-up of smoking status at least six months after the start of the programme. Trials in which group therapy was provided to both active therapy and placebo arms of trials of pharmacotherapies were not included unless they had a factorial design. The outcome ceasure extracted was the number of successful quitters at the maximum follow-up using the strictest definition of abstinence, with biochemical validation where possible. Participants lost to follow-up were classified as still smoking. Meta-analysis was performed using a fixed effects model. Ten studies compared a group programme with a self-help programme presenting the same or similar information and behavioural techniques. There was an increase in cessation with the use of a group programme (OR 2.10 (95% C.I. 1.64-2.70). The direction of effect and significance was robust whether or not trials randomizing workplaces rather than individuals, and trials carried out during campaigns with televised cessation programmes were included. There was no evidence from two trials that group therapy was more effective than a similar intensity of individual counselling, and the trend favoured individual treatment. Comparison of group therapy with advice from a physician or nurse advice found no evidence for an effect, with heterogeneity in the results. Group programmes were more effective than no intervention or minimal contract interventions (OR 1.91 (95% C.I. 1.20-3.04). There was no evidence that manipulating the social interactions between participants in a group programme had an effect on outcome. There is reasonable evidence that groups are better than self-help, and other less intensive interventions. There is not enough evidence on their effectiveness compared to intensive individual counselling. From the point of view of the consumer who is motivated to make a quit attempt it is probably worth joining a group if one is available--it will increase the likelihood of quitting. From the public health perspective, groups are unlikely to make a substantial impact because of the low uptake.

A qualitative evidence synthesis of employees’ views of workplace smoking reduction or cessation interventions

PubMed Central

2013-01-01

Background The need to reduce smoking rates is a recognised public health policy issue in many countries. The workplace offers a potential context for offering smokers’ programmes and interventions to assist smoking cessation or reduction. A qualitative evidence synthesis of employees’ views about such programmes might explain why some interventions appear effective and others not, and can be used to develop evidence-based interventions for this population and setting. Methods A qualitative evidence synthesis of primary research exploring employees’ views about workplace interventions to encourage smoking cessation, including both voluntary programmes and passive interventions, such as restrictions or bans. The method used was theory-based “best fit” framework synthesis. Results Five relevant theories on workplace smoking cessation were identified and used as the basis for an a priori framework. A comprehensive literature search, including interrogation of eight databases, retrieved 747 unique citations for the review. Fifteen primary research studies of qualitative evidence were found to satisfy the inclusion criteria. The synthesis produced an evidence-based conceptual model explaining employees’ experiences of, and preferences regarding, workplace smoking interventions. Conclusion The synthesis suggests that workplace interventions should employ a range of different elements if they are to prove effective in reducing smoking among employees. This is because an employee who feels ready and able to change their behaviour has different needs and preferences from an employee who is not at that stage. Only a multi-faceted intervention can satisfy the requirements of all employees. PMID:24274158

Predictors of smoking cessation among staff in public Universities in Klang Valley, Malaysia.

PubMed

Yasin, Siti Munira; Masilamani, Retneswari; Ming, Moy Foong; Koh, David

2011-01-01

Smoking cessation studies are often performed in clinic based settings. The present example aimed to find predictors of success among staff in worksite smoking cessation programmes in two major public universities in Klang Valley, Malaysia. All staff from both universities received an open invitation via staff e-mail and letters to participate. At the start of treatment, participants were administered the Rhode Island Stress and Coping Questionnaire and Family Support Redding's Questionnaire. Behaviour therapy with free nicotine replacement therapy (NRT) were given as treatment. After two months, they were contacted to determine their smoking status. 185 staff from University A (n=138) and University B (n=47), responded and voluntarily showed interest to quit. There was no significant difference in respondents with respect to socio demographic characteristics and smoking history. After two months of treatment, quit rates were 24% in University A vs. 38 % in University B (p>0.05). Univariate predictors of cessation were adherence to NRT (p<0.001), smoking fewer cigarettes per day (p<0.05) and the number of behaviour therapy sessions attended (p<0.001). Logistic regression identified 3 significant predictors of smoking cessation. Participants attending more than one session (OR= 27.00; 95% CI : 6.50; 111.6), and having higher pre-treatment general stress (OR= 2.15; 95% CI: 1.14; 4.05) were more likely to quit, while a higher number of cigarettes smoked (OR= 0.19: 95% CI: 0.06; 0.59) reduced the likelihood of quitting. Increasing age, ability to cope with stress and family support were not significant predictors. We conclude that factors such as the number of counseling sessions, the amount of cigarettes smoked at baseline, adherence to NRT and pretreatment stress are important considerations for success in a worksite smoking cessation programme.

Self-efficacy with application to adolescent smoking cessation: a concept analysis.

PubMed

Heale, Roberta; Griffin, Mary T Q

2009-04-01

This paper is a report of a concept analysis of adolescent smoking cessation self-efficacy. Smoking cessation is a key preventive care/health promotion strategy offered by nurses worldwide. Most programming is tailored to adults although the reasons for smoking, along with coping strategies, resources and developmental stage, differ in adolescence. Understanding of the concept of self-efficacy as it relates to the adolescent population will assist nurses in addressing smoking cessation behaviours with this population. The CINAHL and Proquest Nursing databases were searched for papers published between 1977 and 2007 using the keywords self-efficacy, adolescents and smoking cessation. The Walker and Avant method of concept analysis was applied. Adolescent smoking cessation self-efficacy is the confidence, perceived capacity and perceived ability that the teen possesses to quit smoking. Identified antecedents include developmental stage, past life support, emotional support, coping strategies, resources and emotional status. Consequences are smoking cessation: positive or negative. Empirical measures are identified. Levels of self-efficacy have been shown to be an important consideration in the approach of nurses to smoking cessation counselling with the adolescent client. The theoretical definition for this concept will provide the basis for nurses to design appropriate interventions for use in smoking cessation programmes targeted to adolescents. This definition identifies the key attributes of this concept that should be addressed when caring for this population.

Optimising text messaging to improve adherence to web-based smoking cessation treatment: a randomised control trial protocol.

PubMed

Graham, Amanda L; Jacobs, Megan A; Cohn, Amy M; Cha, Sarah; Abroms, Lorien C; Papandonatos, George D; Whittaker, Robyn

2016-03-30

Millions of smokers use the Internet for smoking cessation assistance each year; however, most smokers engage minimally with even the best designed websites. The ubiquity of mobile devices and their effectiveness in promoting adherence in other areas of health behaviour change make them a promising tool to address adherence in Internet smoking cessation interventions. Text messaging is used by most adults, and messages can proactively encourage use of a web-based intervention. Text messaging can also be integrated with an Internet intervention to facilitate the use of core Internet intervention components. We identified four aspects of a text message intervention that may enhance its effectiveness in promoting adherence to a web-based smoking cessation programme: personalisation, integration, dynamic tailoring and message intensity. Phase I will use a two-level full factorial design to test the impact of these four experimental features on adherence to a web-based intervention. The primary outcome is a composite metric of adherence that incorporates general utilisation metrics (eg, logins, page views) and specific feature utilisation shown to predict abstinence. Participants will be N=860 adult smokers who register on an established Internet cessation programme and enrol in its text message programme. Phase II will be a two-arm randomised trial to compare the efficacy of the web-based cessation programme alone and in conjunction with the optimised text messaging intervention on 30-day point prevalence abstinence at 9 months. Phase II participants will be N=600 adult smokers who register to use an established Internet cessation programme and enrol in text messaging. Secondary analyses will explore whether adherence mediates the effect of treatment condition on outcome. This protocol was approved by Chesapeake IRB. We will disseminate study results through peer-reviewed manuscripts and conference presentations related to the methods and design, outcomes and exploratory analyses. NCT02585206. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Demographic, psychological and smoking characteristics of users of an on-line smoking cessation programme in the Spanish language.

PubMed

Mañanes, Guillermo; Vallejo, Miguel A; Vallejo-Slocker, Laura

2016-01-01

To determine the characteristics of users of a smoking cessation programme run by the Open University of Spain (Universidad Nacional de Educación a Distancia [UNED]). We examined the demographic, psychological and smoking characteristics of 23,763 smokers who participated in the on-line smoking cessation program of the UNED. The programme was open to any smoker, free of charge, and was fully automated and with direct access. A total of 93.5% of the users were Spaniards, with an equal percentage of participation among men and women. The mean age was 39 years. Somewhat less than half were married and had a university education. The participants smoked a mean of 19.3 cigarettes per day, showing a mid-range level of nicotine dependence according to the Heaviness of Smoking Index. The results of the Anxiety and Depression subscales of the Symptom Checklist-90-Revised (SCL-90-R) and Perceived Stress Scale were not clinically significant. In a secondary analysis of the data, we found gender differences in all the variables measured. The results of this study confirm the digital divide, with lower participation among people with a lower educational level. No association was observed between stress, anxiety or depression and cigarette consumption. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

What explains willingness to pay for smoking-cessation treatments - addiction level, quit-rate effectiveness or the opening bid?

PubMed

Olsen, Jan Abel; Røgeberg, Ole J; Stavem, Knut

2012-11-01

Several countries have now passed laws that place limitations on where smokers may smoke. A range of smoking-cessation treatments have become available, many of which have documented increased quit rates. Population surveys show that most smokers wish to quit, and most non-smokers would prefer to reduce the prevalence of smoking in society. The strengths of these preferences, however, as measured by their willingness to pay (WTP), have not yet been investigated. This study aims to identify variables that explain variations in people's answers to WTP questions on smoking-cessation treatments. A representative sample of the Norwegian population was asked their WTP in terms of an earmarked contribution to a public smoking-cessation programme. A sub-group of daily smokers was, in addition, asked about their WTP for a hypothetical treatment that would remove their urge to smoke. The impact of variation in the question format (different opening bids) on stated WTP was compared with that of factors suggested by economic theory, such as quit-rate effectiveness, degree of addiction as measured by the 12-item Cigarette Dependence Scale (CDS-12), and degree of peer group influence as measured by the proportion of one's friends who smoke. In both programmes, the most important determinant for explaining variations in WTP was the size of the opening bid. Differences in quit-rate effectiveness did not matter for people's WTP for the smoking-cessation programme. Addiction, and having a small proportion of friends who smoke, were positively associated with smokers' WTP to quit smoking. Variations in WTP were influenced more by how the question was framed in terms of differences in opening bids, than by variables reflecting the quality (effectiveness) and need (addiction level) for the good in question. While the WTP method is theoretically attractive, the findings that outcomes in terms of different quit rates did not affect WTP, and that WTP answers can be manipulated by the chosen opening bid, should raise further doubts on the ability of this method to provide valid and reliable answers that reflect true preferences for health and healthcare.

[Analysis of quality of life in patients with Chronic Obstructive Pulmonary Disorder (COPD) who give up smoking].

PubMed

Jimenez-Ruiz, C A; Pascual Lledó, J F; Cícero Guerrero, A; Cristóbal Fernández, M; Mayayo Ulibarri, M; Villar Laguna, C

2017-09-13

To analyse the impact in COPD patients' quality of life who stop smoking. We studied a group of COPD patients who received smoking cessation treatment. All patients were treated with bronchodilators according to the severity of their disorder. This treatment was not changed during the process of smoking cessation. Patients received a smoking cessation programme that consisted of a combination of pharmacological treatment plus cognitive-behavioural treatment. All subjects fill in CAT questionnaire before starting smoking cessation programme and after 6 months of abstinence. All subjects included had stop smoking. The study included 59 patients, with 27 (45.8%) males, and a mean age of 61.8 (7.5) years. Mean CAT score before quitting was 18.9 (7.3) points, and after 6 months of abstinence was 8.1 (6.1) points, P=.038. Multiple regression analysis showed: a) the higher the baseline CAT score the greater is the difference after quitting, at 6 months, at same age, gender, and grade of severity of COPD, and b) the older the age, the lower is the difference between baseline CAT score and the 6 months CAT score. Smoking cessation is associated with improvement in the quality of life in COPD patients. Those with worse quality of life get the biggest benefit from quitting, although this difference can be diminished in ageing patients. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

Reflections on 30+ years of smoking cessation research: from the individual to the world.

PubMed

Lando, Harry A

2006-01-01

This is a personal retrospective in which I describe my career as a smoking cessation researcher and place cessation into an overall perspective of tobacco reduction. I spent approximately the first 15 years focusing primarily upon small group approaches to cessation emphasising relatively intensive behavioural interventions. It became apparent, however, that these types of approaches in isolation, even if broadly disseminated, would have relatively minimal impact on overall tobacco use. In part because I became discouraged with the potential of group programmes to reduce overall smoking prevalence, I began to focus more on population-based studies, especially in the context of 'teachable moments' including pregnancy, hospitalisation, forced abstinence in the military and existing smoking-related disease. I became concerned especially with the fact that there has been relatively little work with hard-core medically compromised smokers. It also became apparent that promoting cessation would be most likely to be effective with a comprehensive evidence-based tobacco reduction strategy including school and community-based prevention programmes, enforcement of ordinances restricting minors' access to tobacco, restrictions on tobacco advertising and promotion, counter advertising and strong smoke-free policies. In recent years I have become very concerned about the overall global tobacco epidemic and the projections of dramatically increasing tobacco morbidity and mortality in developing countries. I am now devoting my primary career emphasis to global tobacco reduction initiatives, including cessation research in India and Indonesia, cessation as part of broader tobacco reduction strategies and networking to increase resources and emphasis devoted to global tobacco reduction.

Smoking cessation in European patients with coronary heart disease. Results from the EUROASPIRE IV survey: A registry from the European Society of Cardiology.

PubMed

Snaterse, M; Deckers, J W; Lenzen, M J; Jorstad, H T; De Bacquer, D; Peters, R J G; Jennings, C; Kotseva, K; Scholte Op Reimer, W J M

2018-05-01

We investigated smoking cessation rates in coronary heart disease (CHD) patients throughout Europe; current and as compared to earlier EUROASPIRE surveys, and we studied characteristics of successful quitters. Analyses were done on 7998 patients from the EUROASPIRE-IV survey admitted for myocardial infarction, unstable angina and coronary revascularisation. Self-reported smoking status was validated by measuring carbon monoxide in exhaled air. Thirty-one percent of the patients reported being a smoker in the month preceding hospital admission for the recruiting event, varying from 15% in centres from Finland to 57% from centres in Cyprus. Smoking rates at the interview were also highly variable, ranging from 7% to 28%. The proportion of successful quitters was relatively low in centres with a low number of pre- event smokers. Overall, successful smoking cessation was associated with increasing age (OR 1.50; 95% CI 1.09-2.06) and higher levels of education (OR 1.38; 95% CI 1.08-1.75). Successful quitters more frequently reported that they had been advised (56% vs. 47%, p < .001) and to attend (81% vs. 75%, p < .01) a cardiac rehabilitation programme. Our study shows wide variation in cessation rates in a large contemporary European survey of CHD patients. Therefore, smoking cessation rates in patients with a CHD event should be interpreted in the light of pre-event smoking prevalence, and caution is needed when comparing cessation rates across Europe. Furthermore, we found that successful quitters reported more actions to make healthy lifestyle changes, including participating in a cardiac rehabilitation programme, as compared with persistent smokers. Copyright © 2018 Elsevier B.V. All rights reserved.

Mobile phone-based interventions for smoking cessation.

PubMed

Whittaker, Robyn; Borland, Ron; Bullen, Chris; Lin, Ruey B; McRobbie, Hayden; Rodgers, Anthony

2009-10-07

Innovative effective smoking cessation interventions are required to appeal to those who are not accessing traditional cessation services. Mobile phones are widely used and are now well integrated into the daily lives of many, particularly young adults. Mobile phones are a potential medium for the delivery of health programmes such as smoking cessation. To determine whether mobile phone-based interventions are effective at helping people who smoke, to quit. We searched MEDLINE, EMBASE, Cinahl, PsycINFO, The Cochrane Library, the National Research Register and the ClinicalTrials register, with no restrictions placed on language or publication date. We included randomized or quasi-randomized trials. Participants were smokers of any age who wanted to quit. Studies were those examining any type of mobile phone-based intervention. This included any intervention aimed at mobile phone users, based around delivery via mobile phone, and using any functions or applications that can be used or sent via a mobile phone. Information on the specified quality criteria and methodological details was extracted using a standardised form. Participants who dropped out of the trials or were lost to follow up were considered to be smoking. Meta-analysis of the included studies was undertaken using the Mantel-Haenszel Risk Ratio fixed-effect method provided that there was no evidence of substantial statistical heterogeneity as assessed by the I(2) statistic. Where meta-analysis was not possible, summary and descriptive statistics are presented. Four studies were excluded as they were small non-randomized feasibility studies, and two studies were excluded because follow up was less than six months. Four trials (reported in five papers) are included: a text message programme in New Zealand; a text message programme in the UK; and an Internet and mobile phone programme involving two different groups in Norway. The different types of interventions are analysed separately. When combined by meta-analysis the text message programme trials showed a significant increase in short-term self-reported quitting (RR 2.18, 95% CI 1.80 to 2.65). However, there was considerable heterogeneity in long-term outcomes, with the much larger trial having problems with misclassification of outcomes; therefore these data were not combined. When the data from the Internet and mobile phone programmes were pooled we found statistically significant increases in both short and long-term self-reported quitting (RR 2.03, 95% CI 1.40 to 2.94). The current evidence shows no effect of mobile phone-based smoking cessation interventions on long-term outcome. While short-term results are positive, more rigorous studies of the long-term effects of mobile phone-based smoking cessation interventions are needed.

Nurses' competence in advising and supporting clients to cease smoking: a survey among Finnish nurses.

PubMed

Pelkonen, M; Kankkunen, P

2001-07-01

The article describes the results of a survey of Finnish nurses (n = 882). The purpose of the study was to describe how nurses' education, working experience and their own smoking habits relate to their self-reported competence in advising and supporting clients to cease smoking. Nurses evaluated their skills fairly highly, but did not believe that advice alone was helpful to clients who wished to cease smoking. Nurses had minimal knowledge of smoking substitutes. Lower general education, a fairly short time from graduation and a history of smoking were positively related to nurses' competence to guide clients. Nurses who smoked daily were found to have better skills in giving advice and support than their non-smoking colleagues. The results have implications for the design of smoking cessation programmes. More education and guidance is required for nurses, so that they can develop their understanding and a positive view as to the effectiveness of smoking cessation programmes.

Lung-cancer reduction from smoking cessation and radon remediation: a preliminary cost-analysis in Northamptonshire, UK.

PubMed

Groves-Kirkby, C J; Timson, K; Shield, G; Denman, A R; Rogers, S; Phillips, P S

2011-02-01

Domestic radon levels in parts of the United Kingdom are sufficiently high as to increase the risk of lung-cancer among residents. Public health campaigns in the county of Northamptonshire, a designated radon Affected Area with 6.3% of homes having average radon levels in excess of the UK Action Level of 200 Bq m(-3), have encouraged householders to test for radon and then, if indicated to be necessary, to carry out remediation in their homes. These campaigns have been only partially successful, since to date only 40% of Northamptonshire houses have been tested, and only 15% of those householders finding raised levels have proceeded to remediate. Those who remediate have been shown to have smaller families, to be older, and to include fewer smokers than the average population, suggesting that current strategies to reduce domestic radon exposure are not reaching those most at risk. During 2004-2005, the NHS Stop-Smoking Services in Northamptonshire assisted 2847 smokers to quit to the 4-week stage, the 15% (435) of these 4-week quitters remaining quitters at 1year forming the subjects of a retrospective study considering whether smoking cessation campaigns contribute significantly to radon risk reduction. Quantitative assessment of the risk of lung-cancer among the study population, from knowledge of the individuals' age, gender, and smoking habits, together with the radon levels in their homes, demonstrates that smoking cessation programmes have significant added value in reducing the incidence of lung-cancer in radon Affected Areas, and contribute a substantially greater health benefit at a lower cost than the alternative strategy of reducing radon levels in the smokers' homes, while they remain smokers. Both radon remediation and smoking cessation programmes are very cost effective in Northamptonshire, with smoking cessation being significantly more cost effective, and these are potentially valuable programmes to drive health improvements through promotion of the uptake or environmental management for radon in the home. Copyright © 2010 Elsevier Ltd. All rights reserved.

Effect of incorporating a 10 minute point of care test for salivary nicotine metabolites into a general practice based smoking cessation programme: randomised controlled trial.

PubMed

Barnfather, Kristian D; Cope, Graham F; Chapple, Iain L

2005-10-29

To investigate the effect of immediate feedback from a point of care test for salivary nicotine metabolites in promoting smoking cessation and reduction in tobacco use. Prospective, operator blinded, randomised controlled trial. General dental practice, London. 100 adult smokers. Participants completed a questionnaire on smoking, undertook a clinical examination, and received counselling in smoking cessation. Saliva samples were analysed at presentation and at eight weeks for salivary nicotine metabolites using a 10 minute semiquantitative point of care test. Smoking cessation measured by salivary nicotine metabolite values (scale 0-6), patient feedback on the perceived value of the test (visual analogue scale) in quitting, and reduction in tobacco use. A higher smoking quit rate was achieved with the point of care test (23% cases v 7% controls; P < 0.039), and overall tobacco use also decreased (68% cases v 28% controls; P < 0.001). Baseline values for salivary nicotine metabolites did not differ between the groups (cases, mean 4.1, SD 1.3 and 4.3, 1.4; P = 0.51). 87 participants reattended at eight weeks (44 cases, 43 controls). Mean nicotine metabolite values at eight weeks were 2.58 (2.0) for cases and 4.29 (1.8) for controls (P < 0.001). Incorporation of individualised personal feedback using a point of care test for salivary nicotine metabolites into a general practice based smoking cessation programme increased quit rates by 17% at eight weeks and reduced tobacco use.

Changes in body weight and food choice in those attempting smoking cessation: a cluster randomised controlled trial

PubMed Central

2012-01-01

Background Fear of weight gain is a barrier to smoking cessation and significant cause of relapse for many people. The provision of nutritional advice as part of a smoking cessation programme may assist some in smoking cessation and perhaps limit weight gain. The aim of this study was to determine the effect of a structured programme of dietary advice on weight change and food choice, in adults attempting smoking cessation. Methods Cluster randomised controlled design. Classes randomised to intervention commenced a 24-week intervention, focussed on improving food choice and minimising weight gain. Classes randomised to control received “usual care”. Results Twenty-seven classes in Greater Glasgow were randomised between January and August 2008. Analysis, including those who continued to smoke, showed that actual weight gain and percentage weight gain was similar in both groups. Examination of data for those successful at giving up smoking showed greater mean weight gain in intervention subjects (3.9 (SD 3.1) vs. 2.7 (SD 3.7) kg). Between group differences were not significant (p = 0.23, 95% CI −0.9 to 3.5). In comparison to baseline improved consumption of fruit and vegetables and breakfast cereal were reported in the intervention group. A higher percentage of control participants continued smoking (74% vs. 66%). Conclusions The intervention was not successful at minimising weight gain in comparison to control but was successful in facilitating some sustained improvements in the dietary habits of intervention participants. Improved quit rates in the intervention group suggest that continued contact with advisors may have reduced anxieties regarding weight gain and encouraged cessation despite weight gain. Research should continue in this area as evidence suggests that the negative effects of obesity could outweigh the health benefits achieved through reductions in smoking prevalence. Trial registration Current Controlled Trials ISRCTN73824458 PMID:22642755

Large multi-centre pilot randomized controlled trial testing a low-cost, tailored, self-help smoking cessation text message intervention for pregnant smokers (MiQuit).

PubMed

Naughton, Felix; Cooper, Sue; Foster, Katharine; Emery, Joanne; Leonardi-Bee, Jo; Sutton, Stephen; Jones, Matthew; Ussher, Michael; Whitemore, Rachel; Leighton, Matthew; Montgomery, Alan; Parrott, Steve; Coleman, Tim

2017-07-01

To estimate the effectiveness of pregnancy smoking cessation support delivered by short message service (SMS) text message and key parameters needed to plan a definitive trial. Multi-centre, parallel-group, single-blinded, individual randomized controlled trial. Sixteen antenatal clinics in England. Four hundred and seven participants were randomized to the intervention (n = 203) or usual care (n = 204). Eligible women were < 25 weeks gestation, smoked at least one daily cigarette (> 5 pre-pregnancy), were able to receive and understand English SMS texts and were not already using text-based cessation support. All participants received a smoking cessation leaflet; intervention participants also received a 12-week programme of individually tailored, automated, interactive, self-help smoking cessation text messages (MiQuit). Seven smoking outcomes, including validated continuous abstinence from 4 weeks post-randomization until 36 weeks gestation, design parameters for a future trial and cost-per-quitter. Using the validated, continuous abstinence outcome, 5.4% (11 of 203) of MiQuit participants were abstinent versus 2.0% (four of 204) of usual care participants [odds ratio (OR) = 2.7, 95% confidence interval (CI) = 0.93-9.35]. The Bayes factor for this outcome was 2.23. Completeness of follow-up at 36 weeks gestation was similar in both groups; provision of self-report smoking data was 64% (MiQuit) and 65% (usual care) and abstinence validation rates were 56% (MiQuit) and 61% (usual care). The incremental cost-per-quitter was £133.53 (95% CI = -£395.78 to 843.62). There was some evidence, although not conclusive, that a text-messaging programme may increase cessation rates in pregnant smokers when provided alongside routine NHS cessation care. © 2017 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

Maori women's views on smoking cessation initiatives.

PubMed

Fernandez, Carole; Wilson, Denise

2008-07-01

Smoking is particularly prevalent among Maori women over the age of 15 years and remains a concern despite anti-smoking campaigns. This raises questions about the effectiveness of current smoking cessation initiatives as mainstream tobacco control programmes have not benefited Maori to the same extent as non-Maori. Limited research is available on the effectiveness of smoking cessation initiatives for Maori. In this descriptive qualitative study five Maori women who had ceased smoking were interviewed about such initiatives and what was more likely to influence Maori women to quit. A focus group was used to discuss smoking cessation initiatives and the data were thematically analysed using Boyatzis' (1998) approach. Two themes were identified: (a) Transmission of Whanau (immediate and extended family) Values that includes the sub-categories whanau experiences, being mothers, and role models; and (b) Factors Crucial in Influencing Change that includes the sub-categories choices and exercising own will, a positive perception of self and a Maori approach. The findings provide insight for nurses into Maori women's perspectives. These highlight the importance of whanau and supportive relationships, and can be used to inform strategies to assist Maori women in smoking cessation.

Predictors of sustained six months quitting success: efforts of smoking cessation in low intensity smoke-free workplaces.

PubMed

Yasin, Siti Munira; Retneswari, Masilamani; Moy, Foong Ming; Taib, Khairul Mizan; Ismail, Nurhuda

2013-08-01

This study aims to identify the predictors of a 6-month quitting success among employees involved in workplace smoking cessation with low-intensity smoke-free policy. A multicentre prospective cohort study was conducted among employees from 2 different public universities in Malaysia. Interventions include at least 2 sessions of behavioural therapy combined with free nicotine replacement therapy (NRT) for 8 weeks. Participants were followed up for 6 months. Independent variables assessed were on sociodemographic and environmental tobacco smoke. Their quit status were determined at 1 week, 3 months and 6 months. One hundred and eighty- five smokers volunteered to participate. Among the participants, 15% and 13% sustained quit at 3 months and 6 months respectively. Multivariate analysis revealed that at 6 months, attending all 3 behavioural sessions predicted success. None of the environmental tobacco exposure variables were predictive of sustained cessation. Individual predictors of success in intra-workplace smoking cessation programmes do not differ from the conventional clinic-based smoking cessation. Furthermore, environmental tobacco exposure in low intensity smoke-free workplaces has limited influence on smokers who succeeded in maintaining 6 months quitting.

Exercise to Support Indigenous Pregnant Women to Stop Smoking: Acceptability to Māori.

PubMed

Roberts, Vaughan; Glover, Marewa; McCowan, Lesley; Walker, Natalie; Ussher, Michael; Heke, Ihirangi; Maddison, Ralph

2017-11-01

Objectives Smoking during pregnancy is harmful for the woman and the unborn child, and the harms raise risks for the child going forward. Indigenous women often have higher rates of smoking prevalence than non-indigenous. Exercise has been proposed as a strategy to help pregnant smokers to quit. Māori (New Zealand Indigenous) women have high rates of physical activity suggesting that an exercise programme to aid quitting could be an attractive initiative. This study explored attitudes towards an exercise programme to aid smoking cessation for Māori pregnant women. Methods Focus groups with Māori pregnant women, and key stakeholder interviews were conducted. Results Overall, participants were supportive of the idea of a physical activity programme for pregnant Māori smokers to aid smoking cessation. The principal, over-arching finding, consistent across all participants, was the critical need for a Kaupapa Māori approach (designed and run by Māori, for Māori people) for successful programme delivery, whereby Māori cultural values are respected and infused throughout all aspects of the programme. A number of practical and environmental barriers to attendance were raised including: cost, the timing of the programme, accessibility, transport, and childcare considerations. Conclusions A feasibility study is needed to design an intervention following the suggestions presented in this paper with effort given to minimising the negative impact of barriers to attendance.

Understanding recruitment and retention in the NHS community pharmacy stop smoking service: perceptions of smoking cessation advisers.

PubMed

Sohanpal, Ratna; Rivas, Carol; Steed, Liz; MacNeill, Virginia; Kuan, Valerie; Edwards, Elizabeth; Griffiths, Chris; Eldridge, Sandra; Taylor, Stephanie; Walton, Robert

2016-07-07

To understand views of pharmacy advisers about smoker recruitment and retention in the National Health Service community pharmacy stop smoking programme. Thematic framework analysis of semistructured, in-depth interviews applying the Theoretical Domains Framework and COM-B behaviour change model. We aimed to identify aspects of adviser behaviour that might be modified to increase numbers joining and completing the programme. 25 stop smoking advisers (13 pharmacists and 12 support staff). 29 community pharmacies in 3 inner east London boroughs. Advisers had preconceived ideas about smokers likely to join or drop out and made judgements about smokers' readiness to quit. Actively recruiting smokers was accorded low priority due in part to perceived insufficient remuneration to the pharmacy and anticipated challenging interactions with smokers. Suggestions to improve smoker recruitment and retention included developing a more holistic and supportive approach using patient-centred communication. Training counter assistants were seen to be important as was flexibility to extend the programme duration to fit better with smokers' needs. Cessation advisers feel they lack the interpersonal skills necessary to engage well with smokers and help them to quit. Addressing advisers' behaviours about active engagement and follow-up of clients, together with regular skills training including staff not formally trained as cessation advisers, could potentially boost numbers recruited and retained in the stop smoking programme. Adjustments to the pharmacy remuneration structure to incentivise recruitment and to allow personalisation of the programme for individual smokers should also be considered. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Using policy to increase prescribing of smoking cessation medications in the VA healthcare system.

PubMed

Smith, Mark W; Chen, Shuo; Siroka, Andrew M; Hamlett-Berry, Kim

2010-12-01

Since 2002 the US Veterans Affairs (VA) healthcare system has initiated national policies and programmes to reduce smoking among its patients and to increase evidence-based treatment for smoking. To document changes in dispensing rates of cessation-related medications in VA from 2004 to 2008. Retrospective analysis of VA administrative data. Prescription fills for nicotine replacement therapy (NRT), and for bupropion among NRT users, each grew more than 60% in four years. The increase stemmed primarily from treating more people rather than from filling more prescriptions per person. The results provide strong support for the efficacy of these policies and illustrate how healthcare systems can successfully employ multiple strategies to increase evidence-based smoking-cessation treatment.

Is There a Relation between School Smoking Policies and Youth Cigarette Smoking Knowledge and Behaviors?

ERIC Educational Resources Information Center

Darling, Helen; Reeder, Anthony I.; Williams, Sheila; McGee, Rob

2006-01-01

To comply with workplace legislation, New Zealand schools are required to have policies regarding tobacco smoking. Many schools also have policies to prevent tobacco use by students, including education programmes, cessation support and punishment for students found smoking. This paper investigated the associations between school policies and the…

Barriers to the provision of smoking cessation assistance: a qualitative study among Romanian family physicians

PubMed Central

Panaitescu, Catalina; Moffat, Mandy A; Williams, Siân; Pinnock, Hilary; Boros, Melinda; Oana, Cristian Sever; Alexiu, Sandra; Tsiligianni, Ioanna

2014-01-01

Background: Smoking cessation is the most effective intervention to prevent and slow down the progression of several respiratory and other diseases and improve patient outcomes. Romania has legislation and a national tobacco control programme in line with the World Health Organization Framework for Tobacco Control. However, few smokers are advised to quit by their family physicians (FPs). Aim: To identify and explore the perceived barriers that prevent Romanian FPs from engaging in smoking cessation with patients. Methods: A qualitative study was undertaken. A total of 41 FPs were recruited purposively from Bucharest and rural areas within 600 km of the city. Ten FPs took part in a focus group and 31 participated in semistructured interviews. Analysis was descriptive, inductive and themed, according to the barriers experienced. Results: Five main barriers were identified: limited perceived role for FPs; lack of time during consultations; past experience and presence of disincentives; patients’ inability to afford medication; and lack of training in smoking cessation skills. Overarching these specific barriers were key themes of a medical and societal hierarchy, which undermined the FP role, stretched resources and constrained care. Conclusions: Many of the barriers described by the Romanian FPs reflected universally recognised challenges to the provision of smoking cessation advice. The context of a relatively hierarchical health-care system and limitations of time and resources exacerbated many of the problems and created new barriers that will need to be addressed if Romania is to achieve the aims of its National Programme Against Tobacco Consumption. PMID:25010432

Why do physicians lack engagement with smoking cessation treatment in their COPD patients? A multinational qualitative study.

PubMed

van Eerd, Eva Anne Marije; Bech Risør, Mette; Spigt, Mark; Godycki-Cwirko, Maciek; Andreeva, Elena; Francis, Nick; Wollny, Anja; Melbye, Hasse; van Schayck, Onno; Kotz, Daniel

2017-06-23

Smoking cessation is the only effective intervention to slow down the accelerated decline in lung function in smokers with chronic obstructive pulmonary disease. Nevertheless, physicians often do not routinely provide evidence-based smoking cessation treatment to their patients. To understand underlying reasons, we explored how physicians engage in smoking cessation treatment in their chronic obstructive pulmonary disease patients. In total, 21 focus group discussions were held with general practitioners and pulmonologists in seven different countries in Europe and Asia. We generated three themes, whereby some of the issues concerned smokers in general: first, 'physicians' frustration with chronic obstructive pulmonary disease patients who smoke'. These frustrations interfered with the provision of evidence-based treatment and could result in this group of patients being treated unequally. Second: 'physicians' limited knowledge of, and negative beliefs about, smoking cessation treatment'. This hindered treating smokers effectively. Third: 'healthcare organisational factors that influence the use of smoking cessation treatments'. Money and time issues, as well as the failure to regard smoking as a disease, influenced how physicians engaged in smoking cessation treatment. Our results indicate that there is a number of barriers to the provision of effective smoking cessation treatment in patients with chronic obstructive pulmonary disease and smokers in general. Introducing an informative smoking cessation programme, including communication skills and ethical issues, in the vocational and postgraduate medical training may help to address these barriers. This is important in order to increase engagement with smoking cessation treatment and to improve quality of chronic obstructive pulmonary disease care. CHANGING ATTITUDES TO HELP PATIENTS STOP SMOKING: Doctors should be given careful, ethically-informed guidance during medical training to help them to support patients to quit smoking. The most important part of treatment for patients with chronic obstructive pulmonary disease (COPD) is help to stop smoking. However, there is evidence to suggest that doctors don't always motivate COPD patients to quit. Eva Anne Marije van Eerd at Maastrict University, The Netherlands, together with an international team of scientists, conducted focus group interviews with doctors in seven different countries to assess barriers to smoking cessation. They found that doctors' frustration with and negative attitudes towards patients who continued to smoke contributed to poor cessation management and treatment inequalities in some cases. Many doctors also cited a lack of experience with smoking cessation techniques alongside time and money issues as barriers to effective treatment.

Effectiveness of a web-based self-help smoking cessation intervention: protocol of a randomised controlled trial.

PubMed

Kramer, Jeannet Jam; Willemsen, Marc C; Conijn, Barbara; van Emst, Andrée J; Brunsting, Suzanne; Riper, Heleen

2009-01-22

Cigarette smoking is a major risk factor for many chronic and fatal illnesses. Stopping smoking directly reduces those risks. The aim of this study is to investigate the effectiveness of a web-based interactive self-help programme for smoking cessation, known as the StopSite, by comparing it to an online self-help guide. Both interventions were based on cognitive-behavioural and self-control principles, but the former provided exercises, feedback and interactive features such as one-to-one chatrooms and a user forum, which facilitated mutual support and experience sharing. We conducted a randomised controlled trial to compare the interactive intervention with the self-help guide. The primary outcome measure was prolonged abstinence from smoking. Secondary outcomes were point-prevalence abstinence, number of cigarettes smoked, and incidence of quit attempts reported at follow-up assessments. Follow-up assessments took place three and six months after a one-month grace period for starting the intervention after baseline. Analyses were based on intention-to-treat principles using a conservative imputation method for missing data, whereby non-responders were classified as smokers. The trial should add to the body of knowledge on the effectiveness of web-based self-help smoking cessation interventions. Effective web-based programmes can potentially help large numbers of smokers to quit, thus having a major public health impact. ISRCTN74423766.

The association between smoking cessation before and after diagnosis and non-muscle-invasive bladder cancer recurrence: a prospective cohort study.

PubMed

van Osch, Frits H M; Jochems, Sylvia H J; Reulen, Raoul C; Pirrie, Sarah J; Nekeman, Duncan; Wesselius, Anke; James, Nicholas D; Wallace, D Michael A; Cheng, K K; van Schooten, Frederik J; Bryan, Richard T; Zeegers, Maurice P

2018-07-01

Smoking is a major risk factor for bladder cancer, but the relationship between smoking cessation after initial treatment and bladder cancer recurrence has been investigated less frequently and not prospectively yet. 722 non-muscle-invasive bladder cancer (NMIBC) patients (pTa, pT1, and CIS) from the prospective Bladder Cancer Prognosis Programme (BCPP) cohort, selected in the UK between 2005 and 2011, provided complete data on smoking behavior before and up to 5 years after diagnosis. The impact of smoking behavior on NMIBC recurrence was explored by multivariable Cox regression models investigating time-to-first NMIBC recurrence. Over a median follow-up period of 4.21 years, 403 pathologically confirmed NMIBC recurrences occurred in 210 patients. Only 25 current smokers at diagnosis quit smoking (14%) during follow-up and smoking cessation after diagnosis did not decrease risk of recurrence compared to continuing smokers (p = 0.352). Although quitting smoking after diagnosis might reduce the risk of recurrence based on retrospective evidence, this is not confirmed in this prospective study because the number of NMIBC patients quitting smoking before their first recurrence was too low. Nevertheless, this indicates an important role for urologists and other health care professionals in promoting smoking cessation in NMIBC.

Nurses' Attitudes toward Intervening with Smokers: Their Knowledge, Opinion and E-Learning Impact.

PubMed

Králíková, Eva; Felbrová, Vladislava; Kulovaná, Stanislava; Malá, Kateřina; Nohavová, Iveta; Roubíčková, Eva; Pánková, Alexandra; Bialous, Stella A; Wells, Marjorie J; Brook, Jenny; Sarna, Linda

2016-12-01

Numbering about 90,000, nurses represent the largest group of health care providers in the Czech Republic. Therefore, nurses can make a significant impact in the treatment of tobacco dependence, particularly in applying brief interventions to smokers. During 2014, 279 nurses from the Czech Republic participated in an e-learning education programme consisting of two Webcasts with additional web-based resources about smoking cessation in relation to health and treatment options in daily clinical practice, particularly regarding brief intervention methods. Before viewing the e-learning programme, and three months after viewing it, the nurses completed a questionnaire documenting their interventions with smokers and their knowledge, attitudes and opinions regarding nurses' roles in smoking cessation. The responses in all of the following categories significantly improved: usually/always asking patients about smoking from 58% to 69% (OR 1.62, CI=1.14-2.29, p=0.007); recommendations to stop smoking from 56% to 66% (OR 1.46, CI=1.03-2.06, p=0.03); assessing willingness to quit from 49% to 63% (OR 1.72, CI=1.23-2.42, p=0.002); assisting with cessation from 21% to 33% (OR 1.85, CI=1.26-2.71, p=0.002); and recommending a smoke-free home from 39% to 58% (OR 2.16, CI=1.54-3.04, p<0.001). The increase in arranging follow-up from 7% to 10% did not constitute a statistically significant improvement, however, this finding is understandable in relation to the status of nurses in the Czech Republic. However, nurses' confidence in helping smokers to quit smoking, their senses of responsibility and determining the appropriateness of these interventions remains inadequate. The nurses' brief intervention skills improved significantly after the completion of the e-learning programme, even though reservations remain among this group. The systematic education of nurses aimed at smoking cessation intervention and analyzing their motivation for treatment may contribute to improved nursing care, and thus lead to a reduction of smoking prevalence in the general population. Copyright© by the National Institute of Public Health, Prague 2016

Smoking Cessation and Socioeconomic Status: An Update of Existing Evidence from a National Evaluation of English Stop Smoking Services

PubMed Central

Hiscock, Rosemary; Dobbie, Fiona; Bauld, Linda

2015-01-01

Smokers from lower socioeconomic groups are less likely to be successful in stopping smoking than more affluent smokers, even after accessing cessation programmes. Data were analysed from 3057 clients of nine services. Routine monitoring data were expanded with CO validated smoking status at 52-week follow-up. Backwards logistic regression modelling was used to consider which factors were most important in explaining the relationship between SES and quitting. The odds ratio of stopping smoking among more affluent clients, compared with more disadvantaged clients, after taking into account design variables only, was 1.85 (95% CI 1.44 to 2.37) which declined to 1.44 (1.11 to 1.87) when all controls were included. The factors that explained more than 10% of the decline in the odds ratio were age, proportion of friends and family who smoked, nicotine dependence, and taking varenicline. A range of factors contribute to lower cessation rates for disadvantaged smokers. Some of these can be modified by improved smoking cessation service provision, but others require contributions from wider efforts to improve material, human, and social capital. PMID:26273602

A Scotland-wide pilot programme of smoking cessation services for young people: process and outcome evaluation.

PubMed

Gnich, Wendy; Sheehy, Christine; Amos, Amanda; Bitel, Mark; Platt, Stephen

2008-11-01

To conduct an independent, external evaluation of a Scotland-wide youth cessation pilot programme, focusing upon service uptake and effectiveness. National Health Service (NHS) Health Scotland and Action on Smoking and Health (ASH) Scotland funded a 3-year (2002-2005) national pilot programme comprising eight projects which aimed to engage with and support young smokers (aged 12-25 years) to quit. Process evaluation was undertaken via detailed case studies comprising qualitative interviews, observation and documentary analysis. Outcomes were assessed by following project participants (n=470 at baseline) at 3 and 12 months and measuring changes in smoking behaviour, including carbon monoxide (CO)-validated quit status. Recruitment proved difficult. Considerable time and effort were needed to attract young smokers. Advertising and recruitment had to be tailored to project settings and educational activities proved essential to raise the profile of smoking as an issue. Thirty-nine participants [8.6%, 95% confidence interval (CI) 5.0-11.2%] were CO-validated quitters at 3 months and 11 of these (2.4%, 95% CI 1.90-3.8%) were also validated quitters at 12 months. Older participants were more likely to be abstinent at 3 months. The overall quit rate was disappointing. As a result of low participant numbers, it was impossible to draw conclusions about the relative effectiveness of different project approaches. These findings give little support to the case for developing dedicated youth cessation services in Scotland. They also highlight the difficulties of undertaking 'real-world' evaluations of pilot youth cessation projects. More action is needed to develop environments which enhance young smokers' motivation to quit and their ability to sustain quit attempts.

Assessing beliefs and risk perceptions on smoking and smoking cessation in immigrant Chinese adult smokers residing in Vancouver, Canada: a cross-sectional study

PubMed Central

FitzGerald, J Mark; Poureslami, Iraj; Shum, Jessica

2015-01-01

Objectives We aimed to conduct culturally-based participatory research to assess cultural and belief contexts for smoking behaviours within Mandarin and Cantonese communities. Outcome variables were smoking-related knowledge, smoking patterns, attitudes and beliefs, and perceived barriers and facilitators to successful cessation. Design A community-based approach was applied involving smokers, community key-informants and professionals in study design and implementation. Initially, focus groups were conducted and findings were used to develop study instrument. Participants responded once to study questionnaire after informed consent. Setting Community based in the Greater Vancouver Area, Canada. Participants 16 Chinese smokers participated in focus groups and subsequently, 167 current Chinese immigrant (137 males and 30 females) smokers from Mandarin and Cantonese communities, recruited with the help of community agencies and collaborating physicians, were enrolled in a cross-sectional study. Results We found that a majority believed smoking was harmful on their health. Younger smokers (<35 years of age) did not mind smoking in front of young children compared to older smokers (≥35 years of age) (p<0.001). People with high school or lower levels of education believed that they would benefit more from smoking than suffering from withdrawal symptoms compared to better educated smokers (p<0.05). Mandarin smokers were significantly more likely to encourage others to quit than Cantonese smokers (p<0.05). Many indicated not receiving adequate support from care providers and lack of access to culturally and linguistically appropriate cessation programmes impacted on their ability to quit smoking. Conclusions Our study highlighted the importance of tobacco beliefs and perceptions among Mandarin and Cantonese speaking immigrants with limited access to healthcare information and for younger smokers whose attention to health consequences of smoking may be limited as well. Study participants were generally aware of the health risks and were willing to quit. Access to appropriate cessation programmes would fulfil their willingness. PMID:25649211

[Readiness to provide smoking cessation counselling--results of a survey among general practitioners in Brandenburg].

PubMed

Skoeries, B A; Ulbricht, S; Koepsell, S; Rumpf, H-J; John, U; Meyer, C

2010-04-01

The effectiveness of brief interventions on smoking cessation together with regular visits to the general practitioners (GP) has been proven. Nevertheless, the guidelines for smoking cessation are not currently implemented sufficiently. A lack of financial resources, time, and consulting abilities prevent GPs from offering systematic advice on smoking cessation. This study examine 1) to what extent GPs ask their patients to provide information about their smoking habits and to what extent they document this, 2) how willing, and 3) how confident GPs are to offer all smoking patient counselling, and 4) which factors influence their level of confidence. From August 2005 until May 2006, a questionnaire was sent to all 1 247 GPs in Brandenburg. In all 68 practices was excluded for several reasons (closed practice, death, not providing primary care) a total of 54.0% (n=637) of the GPs took part. 30.0% of the GPs documented the smoking status of their patients during the first consultation. 12.9% had already offered advice to all their smoking patients, while 27.6% were not willing to offer advice to all smoking patients. The average confidence of GPs to offer all smoking patients advice on smoking cessation was 4.1 (SD=2.6) on scale of 1 to 10 (1=not at all confident and 10=very confident). The confidence of non-smoking GPs to offer an advice was higher in comparison with smoking GPs. To motivate GPs to offer advice on smoking cessation, it seems necessary to change some conditions. This includes programms, initiated by professional medical associations, to help colleagues stop smoking. Further studies should indicate whether the inclusion of practice colleagues in screening and regular updates of the patient's smoking status increase the number of regular counselling. Georg Thieme Verlag KG Stuttgart, New York.

Tobacco control programmes for universities: a feasibility study.

PubMed

Willcox, M L

1997-03-01

University may be a good time for smoking cessation, because younger, lighter smokers are more successful at stopping. An initial survey of 4141 students at Cambridge and Anglia Polytechnic universities identified the prevalence of smoking; questionnaires were given to smokers asking about desire to stop. Some respondents were invited to a discussion, but very few came. Those wanting to quit were sent a second questionnaire about what help they wanted. On National No Smoking Day, 101 students were interviewed about "stop smoking' advertisements, and those wanting to stop smoking were offered different forms of help. Lastly, student union welfare officers at 54 universities in the United Kingdom were interviewed over the telephone, about what motivation and support they provide for students to stop smoking, and what more they would consider providing. Prevalence of smoking varied according to university, subject studied and sex. Desire to quit varied with subject studied, duration of habit and amount smoked. Some "stop smoking' TV adverts were widely remembered, but their motivational impact remains unclear. Most of those wanting to stop found it difficult, but few requested help unless approached directly. Only books were widely used, and innovative ones seemed most popular. Few student unions provided effective encouragement or help for students to stop smoking. Most said they would consider doing more. There is a need for smoking cessation programmes at universities. More research is needed on ways of motivating those who do not want to stop. "Direct marketing' of books seems the best way of reaching those who want to stop. The effectiveness of different books needs to be evaluated. There is great potential for improving the quality, quantity and availability of cessation aids through student unions.

French general practitioners' attitudes and reported practices in relation to their participation and effectiveness in a minimal smoking cessation programme for patients.

PubMed

Slama, K; Karsenty, S; Hirsch, A

1999-01-01

To examine the participation and effectiveness of GPs in offering a minimal smoking cessation intervention according to attitudinal and reported behaviour variables. General practitioners were surveyed about their practices and attitudes and then matched pairs of smoking and non-smoking doctors were invited to participate in a regional smoking cessation intervention. The relationship of survey responses and the degree of participation and effectiveness in a smoking cessation trial was examined. Primary care doctors in a large region of southern France, Provence-Alpes-Côte d'Azur (PACA). Two thousand, eight hundred and sixty GPs from the PACA region in France were interviewed about their attitudes and behaviours. From among 371 smoking GPs and 375 non-smoking GPs invited to take part in a smoking cessation trial with patients, 170 smokers and 202 non-smokers participated. The GPs' attitudes and reported professional and personal practices were assessed in a telephone interview. These responses were compared with the GPs' participation in the cessation trial, and with GP "success" (1 or more patients stopping smoking at 1 month, 12 months or both) or "non-success" (no patient cessation at 1 month or at 12 months). A significantly lower proportion of smokers than non-smokers among the GPs who initially accepted did not participate in the study (45% vs. 54.1%, chi 2 = 5.147 df = 1, p < 0.05, difference: 8.3% 95% CI: 1.2%; 15.5%), but thereafter, there were no significant associations between GPs' reported smoking practices and attitudes and the extent of their participation or effectiveness. The study results indicate that, when minimal advice has an effect, it is due more to the systematic nature of the provision of the intervention than to the attitudes or reported practices of the practitioner providing the advice.

Stuck in the catch 22: attitudes towards smoking cessation among populations vulnerable to social disadvantage.

PubMed

Pateman, Kelsey; Ford, Pauline; Fizgerald, Lisa; Mutch, Allyson; Yuke, Kym; Bonevski, Billie; Gartner, Coral

2016-06-01

To explore how smoking and smoking cessation is perceived within the context of disadvantage, across a broad cross-section of defined populations vulnerable to social disadvantage. Qualitative focus groups with participants recruited through community service organizations (CSO). Metropolitan and regional settings in Queensland, Australia. Focus groups were held at the respective CSO facilities. Fifty-six participants across nine focus groups, including people living with mental illness, people experiencing or at risk of homelessness (adult and youth populations), people living with HIV, people living in a low-income area and Indigenous Australians. Thematic, in-depth analysis of focus group discussions. Participant demographic information and smoking history was recorded. Smoking behaviour, smoking identity and feelings about smoking were reflective of individual circumstances and social and environmental context. Participants felt 'trapped' in smoking because they felt unable to control the stressful life circumstances that triggered and sustained their smoking. Smoking cessation was viewed as an individual's responsibility, which was at odds with participants' statements about the broader factors outside of their own control that were responsible for their smoking. Highly disadvantaged smokers' views on smoking involve contradictions between feeling that smoking cessation involves personal responsibility, while at the same time feeling trapped by stressful life circumstances. Tobacco control programmes aiming to reduce smoking among disadvantaged groups are unlikely to be successful unless the complex interplay of social factors is carefully considered. © 2015 Society for the Study of Addiction.

Wanting to attend isn’t just wanting to quit: why some disadvantaged smokers regularly attend smoking cessation behavioural therapy while others do not: a qualitative study

PubMed Central

2014-01-01

Background Attendance of a behavioural support programme facilitates smoking cessation. Disadvantaged smokers have been shown to attend less than their more affluent peers. We need to gain in-depth insight into underlying reasons for differing attendance behaviour in disadvantaged smokers, to better address this issue. This study aims to explore the underlying motivations, barriers and social support of smokers exhibiting different patterns of attendance at a free smoking cessation behavioural support programme in a disadvantaged neighbourhood of The Netherlands. Methods In 29 smokers undertaking smoking cessation group therapy or telephone counselling in a disadvantaged neighbourhood, qualitative interviews were completed, coded and analysed. Major themes were motivations, barriers to attend and social support. Motivations and social support were analysed with reference to the self-determination theory. Results Two distinct patterns of attendance emerged: those who missed up to two sessions (“frequent attenders”), and those who missed more than two sessions (“infrequent attenders”). The groups differed in their motivations to attend, barriers to attendance, and in the level of social support they received. In comparison with the infrequent attenders, frequent attenders more often had intrinsic motivation to attend (e.g. enjoyed attending), and named more self-determined extrinsic motivations to attend, such as commitment to attendance and wanting to quit. Most of those mentioning intrinsic motivation did not mention a desire to quit as a motivation for attendance. No organizational barriers to attendance were mentioned by frequent attenders, such as misunderstandings around details of appointments. Frequent attenders experienced more social support within and outside the course. Conclusion Motivation to attend behavioural support, as distinct from motivation to quit smoking, is an important factor in attendance of smoking cessation courses in disadvantaged areas. Some focus on increasing motivation to attend may help to prevent participants missing sessions. PMID:25002149

Wanting to attend isn't just wanting to quit: why some disadvantaged smokers regularly attend smoking cessation behavioural therapy while others do not: a qualitative study.

PubMed

Benson, Fiona E; Stronks, Karien; Willemsen, Marc C; Bogaerts, Nina M M; Nierkens, Vera

2014-07-07

Attendance of a behavioural support programme facilitates smoking cessation. Disadvantaged smokers have been shown to attend less than their more affluent peers. We need to gain in-depth insight into underlying reasons for differing attendance behaviour in disadvantaged smokers, to better address this issue. This study aims to explore the underlying motivations, barriers and social support of smokers exhibiting different patterns of attendance at a free smoking cessation behavioural support programme in a disadvantaged neighbourhood of The Netherlands. In 29 smokers undertaking smoking cessation group therapy or telephone counselling in a disadvantaged neighbourhood, qualitative interviews were completed, coded and analysed. Major themes were motivations, barriers to attend and social support. Motivations and social support were analysed with reference to the self-determination theory. Two distinct patterns of attendance emerged: those who missed up to two sessions ("frequent attenders"), and those who missed more than two sessions ("infrequent attenders"). The groups differed in their motivations to attend, barriers to attendance, and in the level of social support they received. In comparison with the infrequent attenders, frequent attenders more often had intrinsic motivation to attend (e.g. enjoyed attending), and named more self-determined extrinsic motivations to attend, such as commitment to attendance and wanting to quit. Most of those mentioning intrinsic motivation did not mention a desire to quit as a motivation for attendance. No organizational barriers to attendance were mentioned by frequent attenders, such as misunderstandings around details of appointments. Frequent attenders experienced more social support within and outside the course. Motivation to attend behavioural support, as distinct from motivation to quit smoking, is an important factor in attendance of smoking cessation courses in disadvantaged areas. Some focus on increasing motivation to attend may help to prevent participants missing sessions.

Rapid reduction versus abrupt quitting for smokers who want to stop soon: a randomised controlled non-inferiority trial

PubMed Central

Lindson, Nicola; Aveyard, Paul; Ingram, Jackie T; Inglis, Jennie; Beach, Jane; West, Robert; Michie, Susan

2009-01-01

Background The standard way to stop smoking is to stop abruptly on a quit day with no prior reduction in consumption of cigarettes. Many smokers feel that reduction is natural and if reduction programmes were offered, many more might take up treatment. Few trials of reduction versus abrupt cessation have been completed. Most are small, do not use pharmacotherapy, and do not meet the standards necessary to obtain a marketing authorisation for a pharmacotherapy. Design/Methods We will conduct a non-inferiority randomised trial of rapid reduction versus standard abrupt cessation among smokers who want to stop smoking. In the reduction arm, participants will be advised to reduce smoking consumption by half in the first week and to 25% of baseline in the second, leading up to a quit day at which participants will stop smoking completely. This will be assisted by nicotine patches and an acute form of nicotine replacement therapy. In the abrupt arm participants will use nicotine patches only, whilst smoking as normal, for two weeks prior to a quit day, at which they will also stop smoking completely. Smokers in either arm will have standard withdrawal orientated behavioural support programme with a combination of nicotine patches and acute nicotine replacement therapy post-cessation. Outcomes/Follow-up The primary outcome of interest will be prolonged abstinence from smoking, with secondary trial outcomes of point prevalence, urges to smoke and withdrawal symptoms. Follow up will take place at 4 weeks, 8 weeks and 6 months post-quit day. Trial Registration Current Controlled Trials ISRCTN22526020 PMID:19682359

Mental health service user and staff perspectives on tobacco addiction and smoking cessation: A meta-synthesis of published qualitative studies.

PubMed

Malone, V; Harrison, R; Daker-White, G

2018-05-01

WHAT IS KNOWN ON THE SUBJECT?: There are high rates of tobacco smoking in people living with mental illness, and rates are much higher than the general population. People living with mental illness experience high rates of cardiovascular disease and other physical health problems as a result of tobacco smoking. There is a lack of evidence on successful interventions for reducing the rates of smoking in people living with mental illness. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: A meta-synthesis of data from a number of studies to support mental health nurses to access data quickly and support the translation of findings into practice. Studies found staff working in mental health services expressed they did not have the confidence to adequately address smoking cessation for people living with mental illness. People living with mental illness would like support and encouragement support to help them achieve successful smoking cessation. People living with mental illness want support from mental health service staff to increase their confidence in smoking cessation rather than mainstream smoking cessation services. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Existing evidence-based interventions for smoking cessation has had limited impact on the smoking rates of people living with mental illness. Research is needed into innovative smoking cessation interventions and the service delivery of these interventions for people living with mental illness. Interventions to support people living with mental illness in smoking cessation could be part of mainstream mental health service delivery. Opportunities for smoking cessation training for mental health service staff could be provided. Introduction People with mental illness are up to three times more likely to smoke and experience greater challenges and less success when trying to quit and therefore have higher risk of smoking-related morbidity and mortality. There is a lack of evidence on successful interventions to reduce the smoking rates in people living with serve mental illness. A meta-synthesis was undertaken to summarize the data from multiple studies to inform the development of future smoking cessation intervention studies. Methods MEDLINE, PsycINFO, Embase and CINAHL were searched in March 2017. A total of 965 titles and abstracts were screened for inclusion with 29 papers reviewed in full and 15 studies that met inclusion criteria. Included studies were assessed for quality using the Critical Appraisal Skills Programme tool. Key data across studies were examined and compared, and a thematic analysis was conducted. Results Analysis and synthesis developed five analytical themes: environmental and social context, living with a mental health illness, health awareness, financial awareness and provision of smoking cessation support. Themes generated the interpretive construct: "Whose role is it anyway?" which highlights tensions between staff perspectives on their role and responsibilities to providing smoking cessation support and support service users would like to receive. Relevance to mental health nursing Routine smoking cessation training for mental health professionals and research on innovative smoking cessation interventions to support people living with mental illness are needed. The Cochrane tobacco group has not found sufficient direct evidence of existing evidence-based interventions that have beneficial effect on smoking in people living with mental illness. With this in mind, mental health professionals should be encouraged to engage in future research into the development of new interventions and consider innovative harm reduction strategies for smoking into their practice, to reduce the morbidity and mortality many people living with mental illness experience from tobacco smoking. © 2018 John Wiley & Sons Ltd.

Costs of employee smoking in the workplace in Scotland

PubMed Central

Parrott, S.; Godfrey, C.; Raw, M.

2000-01-01

BACKGROUND—Employers have responded to new regulations on the effects of passive smoking by introducing a range of workplace policies. Few policies include provision of smoking cessation intervention.
OBJECTIVE—To estimate the cost to employers of smoking in the workplace in Scotland to illustrate the potential gains from smoking cessation provision. Costs vary with type of smoking policy in place; therefore, to estimate these costs results from a survey were combined with evidence drawn from a literature review.
STUDY DESIGN—A telephone survey of 200 Scottish workplaces, based on a stratified random sample of workplaces with 50 or more employees, was conducted in 1996. Additional evidence was compiled from a review of the literature of smoking related costs and specific smoking related effects.
RESULTS—167 completed responses were received, of which 156 employers (93%) operated a smoking policy, 57 (34%) operated smoke free buildings, and 89 (53%) restricted smoking to a "smoke room". The research literature shows absenteeism to be higher among smokers when compared to non-smokers. The estimated cost of smoking related absence in Scotland is £40 million per annum. Total productivity losses are estimated at approximately £450 million per annum. In addition, the resource cost in terms of losses from fires caused by smoking materials is estimated at approximately £4 million per annum. In addition, there are costs from smoking related deaths and smoking related damage to premises.
CONCLUSION—This study shows how smoking cessation interventions in the workplace can yield positive cost savings for employers, resulting in gains in productivity and workplace attendance which may outweigh the cost of any smoking cessation programme.


Keywords: costs of employee smoking; Scotland; smoking related absence PMID:10841855

Internet-based interventions for smoking cessation.

PubMed

Civljak, Marta; Sheikh, Aziz; Stead, Lindsay F; Car, Josip

2010-09-08

The Internet has become a regular part of daily life for the majority of people in many parts of the world. It now offers an additional means of effecting changes to behaviour such as smoking. To determine the effectiveness of Internet-based interventions for smoking cessation. We searched the Cochrane Tobacco Addiction Group Specialized Register, with additional searches of MEDLINE, EMBASE, CINAHL, PsycINFO, and Google Scholar. There were no restrictions placed on language of publication or publication date. The most recent search was in June 2010. We included randomized and quasi-randomized trials. Participants were people who smoked, with no exclusions based on age, gender, ethnicity, language or health status. Any type of Internet-based intervention was eligible. The comparison condition could be a no-intervention control or a different Internet site or programme. Methodological and study quality details were extracted using a standardised form. We selected smoking cessation outcomes at short term (one to three months) and long term (6 months or more) follow up, and reported study effects as a risk ratio with 95% confidence intervals. Only limited meta-analysis was performed, as the heterogeneity of the data for populations, interventions and outcomes allowed for very little pooling. Twenty trials met the inclusion criteria. There were more female than male participants. Some Internet programmes were intensive and included multiple outreach contacts with participants, whilst others relied on participants to initiate and maintain use.Ten trials compared an Internet intervention to a non-Internet based smoking cessation intervention or to a no intervention control. Six of these recruited adults, one recruited young adult university students and three recruited adolescents. Two trials of the same intensive automated intervention in populations of adult who smoked showed significantly increased cessation compared to printed self-help materials at 12 months. In one of these, all trial participants were provided with nicotine replacement therapy (NRT). Three other trials in adults did not detect significant long term effects. One of these provided access to a website as an adjunct to counselling and bupropion, one compared web-based counselling, proactive telephone-based counselling or a combination of the two as an adjunct to varenicline. The third only provided a list of Internet resources. One further short-term trial did show a significant increase in quit rates at 3 months. A trial in college students increased point prevalence abstinence after 30 weeks but had no effect on sustained abstinence. Two small trials in adolescents did not detect an effect on cessation compared to control, whilst a third small trial did detect a benefit of a web-based adjunct to a group programme amongst adolescents.Ten trials, all in adult populations, compared different Internet sites or programmes. There was some evidence that sites that were tailored and interactive might be more effective than static sites, but this was not detected in all the trials that explored this factor. One large trial did not detect differences between different Internet sites. One trial of a tailored intervention as an adjunct to NRT use showed a significant benefit but only had a 3-month follow up. One trial detected evidence of a benefit from tailored email letter compared to a non-tailored one. Trials failed to detect a benefit of including a mood management component (three trials), or an asynchronous bulletin board. Higher abstinence rates were typically reported by participants who actively engaged with the programme (as reflected by the number of log-ins). Results suggest that some Internet-based interventions can assist smoking cessation, especially if the information is appropriately tailored to the users and frequent automated contacts with the users are ensured, however trials did not show consistent effects.

Assessing beliefs and risk perceptions on smoking and smoking cessation in immigrant Chinese adult smokers residing in Vancouver, Canada: a cross-sectional study.

PubMed

FitzGerald, J Mark; Poureslami, Iraj; Shum, Jessica

2015-02-03

We aimed to conduct culturally-based participatory research to assess cultural and belief contexts for smoking behaviours within Mandarin and Cantonese communities. Outcome variables were smoking-related knowledge, smoking patterns, attitudes and beliefs, and perceived barriers and facilitators to successful cessation. A community-based approach was applied involving smokers, community key-informants and professionals in study design and implementation. Initially, focus groups were conducted and findings were used to develop study instrument. Participants responded once to study questionnaire after informed consent. Community based in the Greater Vancouver Area, Canada. 16 Chinese smokers participated in focus groups and subsequently, 167 current Chinese immigrant (137 males and 30 females) smokers from Mandarin and Cantonese communities, recruited with the help of community agencies and collaborating physicians, were enrolled in a cross-sectional study. We found that a majority believed smoking was harmful on their health. Younger smokers (<35 years of age) did not mind smoking in front of young children compared to older smokers (≥35 years of age) (p<0.001). People with high school or lower levels of education believed that they would benefit more from smoking than suffering from withdrawal symptoms compared to better educated smokers (p<0.05). Mandarin smokers were significantly more likely to encourage others to quit than Cantonese smokers (p<0.05). Many indicated not receiving adequate support from care providers and lack of access to culturally and linguistically appropriate cessation programmes impacted on their ability to quit smoking. Our study highlighted the importance of tobacco beliefs and perceptions among Mandarin and Cantonese speaking immigrants with limited access to healthcare information and for younger smokers whose attention to health consequences of smoking may be limited as well. Study participants were generally aware of the health risks and were willing to quit. Access to appropriate cessation programmes would fulfil their willingness. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Slimming World in Stop Smoking Services (SWISSS): study protocol for a randomized controlled trial.

PubMed

Lycett, Deborah; Aveyard, Paul; Farmer, Andrew; Lewis, Amanda; Munafò, Marcus

2013-06-19

Quitting smokers gain weight. This deters some from trying to stop smoking and may explain the increased incidence of type 2 diabetes after cessation. Dieting when stopping smoking may be counterproductive. Hunger increases cravings for smoking and tackling two behaviours together may undermine quitting success. A meta-analysis of randomized controlled trials (RCTs) showed individualized dietary support may prevent weight gain, although there is insufficient evidence whether it undermines smoking cessation. Commercial weight management providers (CWMPs), such as Slimming World, provide individualized dietary support for National Health Service (NHS) patients; however, there is no evidence that they can prevent cessation-related weight gain.Our objective is to determine whether attending Slimming World from quit date, through referral from NHS Stop Smoking Services, is more effective than usual care at preventing cessation-related weight gain. This RCT will examine the effectiveness of usual cessation support plus referral to Slimming World compared to usual cessation support alone. Healthy weight, overweight and obese adult smokers attending Stop Smoking Services will be included. The primary outcome is weight change in quitters 12 weeks post-randomization. Multivariable linear regression analysis will compare weight change between trial arms and adjust for known predictors of cessation-related weight gain.We will recruit 320 participants, with 160 participants in each arm. An alpha error rate of 5% and 90% power will detect a 2 kg (SD = 2.5) difference in weight gain at 12 weeks, assuming 20% remain abstinent by then. This trial will establish whether referral to the 12-week Slimming World programme plus usual care is an effective intervention to prevent cessation-related weight gain. If so, we will seek to establish whether weight control comes at the expense of a successful quit attempt in a further non-inferiority trial.Positive results from both these trials would provide a potential solution to cessation-related weight gain, which could be rolled out across England within Stop Smoking Services to better meet the needs of 0.75 million smokers stopping with NHS support every year. Current Controlled Trials ISRCTN65705512.

[The frequency of performing smoking cessation outpatient clinic in chest disease specialists who are members of Turkish Thoracic Society and factors affecting this performance].

PubMed

Pazarli Bostan, Pınar; Elbek, Osman; Kilinç, Oğuz; Akçay, Müşerref Şule; Kiran, Sibel

2014-01-01

Although helping patients to stop smoking is a good clinical practice that has to be carried out by physicians everywhere and in every area, it is known that carrying out this help systematically in accordance to a programme in smoking cessation outpatient clinics significantly improves the chance of success. The study is a cross-sectional survey performed among chest disease specialists who are members of Turkish Thoracic Society (TTS), between June 2010 and February 2011. As independent variables relevant to status of performing/not performing Smoking Cessation Outpatient Clinic (SCOC); sex, age (younger or older than 40), being graduated before or after 1996, being or not being in a consultant position, work place (Hospital of Ministry of Health/private hospital/university hospital), having or not having an education for smoking cessation help and being or not being member of a City Tobacco Control Committee (CTCC) were investigated. Data was collected via a web-questionnaire prepared by using WHO Global Health Professionals Questionnaire which was sent to members through TTS secreteriat. 41% (699/1701) of members of TTS responded. 39.5% of responders reported that they perform SCOC. When the factors possibly affecting the performance of SCOC are evaluated with logistic regression analysis; being graduated after 1996, having an education for smoking cessation help, being a member of CTCC and not being an active smoker are found to improve this performance. Our study showed that having an education for smoking cessation help (and tobacco control) makes chest disease specialists get more responsibility on this topic. Accordingly, continuous efforts for improving awareness of personal and social responsibilities of all physicians, especially chest disease specialists, have to be made to provide their taking active roles in tobacco control.

The freeze on mass media campaigns in England: a natural experiment of the impact of tobacco control campaigns on quitting behaviour.

PubMed

Langley, Tessa; Szatkowski, Lisa; Lewis, Sarah; McNeill, Ann; Gilmore, Anna B; Salway, Ruth; Sims, Michelle

2014-06-01

To measure the impact of the suspension of tobacco control mass media campaigns in England in April 2010 on measures of smoking cessation behaviour. Interrupted time series design using routinely collected population-level data. Analysis of use of a range of types of smoking cessation support using segmented negative binomial regression. England. Use of non-intensive support: monthly calls to the National Health Service (NHS) quitline (April 2005-September 2011), text requests for quit support packs (December 2007-10) and web hits on the national smoking cessation website (January 2009-March 2011). Use of intensive cessation support: quarterly data on the number of people setting a quit date and 4-week quitters at the NHS Stop Smoking Services (SSS) (quarter 1, 2001 and quarter 3, 2011). During the suspension of tobacco control mass media spending, literature requests fell by 98% [95% confidence interval (CI) = 96-99], and quitline calls and web hits fell by 65% (95% CI = 43-79) and 34% (95% CI: 11-50), respectively. The number of people setting a quit date and 4-week quitters at the SSS increased throughout the study period. The suspension of tobacco control mass media campaigns in England in 2012 appeared to markedly reduce the use of smoking cessation literature, quitline calls and hits on the national smoking cessation website, but did not affect attendance at the Stop Smoking Services. Within a comprehensive tobacco control programme, mass media campaigns can play an important role in maximizing quitting activity. © 2013 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

YouTube as a source of quit smoking information for people living with mental illness.

PubMed

Sharma, Ratika; Lucas, Maya; Ford, Pauline; Meurk, Carla; Gartner, Coral E

2016-11-01

YouTube is the most popular video sharing website, and is increasingly used to broadcast health information including smoking cessation advice. This study examines the quality and quantity of YouTube quit smoking videos targeted at people living with mental illness (MI). We systematically searched YouTube using selected relevant search terms. The first 50 videos obtained for each search term were screened for relevance and further videos screened through snowball sampling. Forty unique, English language videos focussing on people with MI were included in the assessment and evaluated for general video characteristics, themes, format, targeted smoking cessation and harm reduction information. Most videos either discussed the problem of high smoking rates among people with MI (n=12) or smoking cessation programmes and policies at an institutional level (n=13). Only nine videos were aimed at providing quit smoking advice to this population. One video recommended higher doses of nicotine replacement therapy (NRT) for people with MI while six videos referred to possible changes in medication dosage on quitting smoking. Four videos suggested cutting down smoking for harm reduction. Very few YouTube videos specifically focus on the problem of high smoking rates among people with MI and even fewer provide targeted smoking cessation and harm reduction advice for this priority population. There is a need to develop comprehensive, evidence based, quit smoking video resources for smokers with a MI. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Do u smoke after txt? Results of a randomised trial of smoking cessation using mobile phone text messaging

PubMed Central

Rodgers, A; Corbett, T; Bramley, D; Riddell, T; Wills, M; Lin, R; Jones, M

2005-01-01

Objectives: To determine the effectiveness of a mobile phone text messaging smoking cessation programme. Design: Randomised controlled trial Setting: New Zealand Participants: 1705 smokers from throughout New Zealand who wanted to quit, were aged over 15 years, and owned a mobile phone were randomised to an intervention group that received regular, personalised text messages providing smoking cessation advice, support, and distraction, or to a control group. All participants received a free month of text messaging; starting for the intervention group on their quit day to assist with quitting, and starting for the control group at six months to encourage follow up. Follow up data were available for 1624 (95%) at six weeks and 1265 (74%) at six months. Main outcome measures: The main trial outcome was current non-smoking (that is, not smoking in the past week) six weeks after randomisation. Secondary outcomes included current non-smoking at 12 and 26 weeks. Results: More participants had quit at six weeks in the intervention compared to the control group: 239 (28%) v 109 (13%), relative risk 2.20 (95% confidence interval 1.79 to 2.70), p < 0.0001. This treatment effect was consistent across subgroups defined by age, sex, income level, or geographic location (p homogeneity > 0.2). The relative risk estimates were similar in sensitivity analyses adjusting for missing data and salivary cotinine verification tests. Reported quit rates remained high at six months, but there was some uncertainty about between group differences because of incomplete follow up. Conclusions: This programme offers potential for a new way to help young smokers to quit, being affordable, personalised, age appropriate, and not location dependent. Future research should test these findings in different settings, and provide further assessment of long term quit rates. PMID:16046689

Smoking habits of radiotherapy patients: did the diagnosis of cancer make an impact and is there an opportunity to intervene?

PubMed

Hsu, Charlie Chia-Tsong; Kwan, Gigi Nga Chi; Chawla, Aakriti; Mitina, Natalia; Christie, David

2011-10-01

To investigate the impact of a cancer diagnosis on smoking habits in patients receiving radiotherapy and assess the opportunity to intervene. One hundred consecutive patients were interviewed. They included patients newly diagnosed with cancer of any type and receiving radiotherapy. Detailed information was collected including smoking habits before and after the diagnosis, the timing of and reasons for any changes. We also asked about patients' view of the role of the radiation oncologist in smoking cessation and the opportunities for intervention. Analysis of results involved simple descriptive statistics. Although there were only 14 current smokers, only two had decided to quit. Five smokers decreased smoking, six did not change and one increased smoking. One non-smoker (1/34) took up smoking. Nearly all changes occurred within the first 30 days of diagnosis. Most (79%, 11/14) smokers believed that the treating radiation oncologist should discuss smoking cessation with their patients and that the ideal timing is at either the first consultation or when decisions about treatment have been finalised. The diagnosis of cancer can motivate patients to reduce smoking, but few quit altogether and a smaller number increase or even take up smoking. These changes occur early after receiving a diagnosis of cancer. Patients with a smoking history believed that the treating radiation oncologist should discuss smoking cessation with their patients and that the ideal timing is at the first consultation. The periodic nature of treatments and consultations at radiation oncology centres suggest there is the potential for an effective smoking cessation programme. © 2011 The Authors. Journal of Medical Imaging and Radiation Oncology © 2011 The Royal Australian and New Zealand College of Radiologists.

Adverse Reaction to Nicotine Gum in Malay Female Smoker: A Case Report

ERIC Educational Resources Information Center

Noorzurani, Md Haris Robson; Bond, Alyson; Wolff, Kim

2008-01-01

Nicotine replacement therapies (NRT) are prescribed in smoking cessation programmes to help smokers stop smoking. The ideal dosage of NRT should control cravings and withdrawal symptoms but avoid adverse reactions. This report describes a case of adverse reaction to nicotine gum in a female Malay smoker. Assays taken 2 h after the gum, showed that…

Deconstructing myths, building alliances: a networking model to enhance tobacco control in hospital mental health settings.

PubMed

Ballbè, Montse; Gual, Antoni; Nieva, Gemma; Saltó, Esteve; Fernández, Esteve

2016-01-01

Life expectancy for people with severe mental disorders is up to 25 years less in comparison to the general population, mainly due to diseases caused or worsened by smoking. However, smoking is usually a neglected issue in mental healthcare settings. The aim of this article is to describe a strategy to improve tobacco control in the hospital mental healthcare services of Catalonia (Spain). To bridge this gap, the Catalan Network of Smoke-free Hospitals launched a nationwide bottom-up strategy in Catalonia in 2007. The strategy relied on the creation of a working group of key professionals from various hospitals -the early adopters- based on Rogers' theory of the Diffusion of Innovations. In 2016, the working group is composed of professionals from 17 hospitals (70.8% of all hospitals in the region with mental health inpatient units). Since 2007, tobacco control has improved in different areas such as increasing mental health professionals' awareness of smoking, training professionals on smoking cessation interventions and achieving good compliance with the national smoking ban. The working group has produced and disseminated various materials, including clinical practice and best practice guidelines, implemented smoking cessation programmes and organised seminars and training sessions on smoking cessation measures in patients with mental illnesses. The next challenge is to ensure effective follow-up for smoking cessation after discharge. While some areas of tobacco control within these services still require significant improvement, the aforementioned initiative promotes successful tobacco control in these settings. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

STOP smoking and alcohol drinking before OPeration for bladder cancer (the STOP-OP study), perioperative smoking and alcohol cessation intervention in relation to radical cystectomy: study protocol for a randomised controlled trial.

PubMed

Lauridsen, Susanne Vahr; Thomsen, Thordis; Thind, Peter; Tønnesen, Hanne

2017-07-17

To evaluate the effect of a smoking-, alcohol- or combined-cessation intervention starting shortly before surgery and lasting 6 weeks on overall complications after radical cystectomy. Secondary objectives are to examine the effect on types and grades of complications, smoking cessation and alcohol cessation, length of hospital stay, health-related quality of life and return to work or habitual level of activity up to 12 months postoperatively. The study is a multi-institutional randomised clinical trial involving 110 patients with a risky alcohol intake and daily smoking who are scheduled for radical cystectomy. Patients will be randomised to the 6-week Gold Standard Programme (GSP) or treatment as usual (control). The GSP combines patient education and pharmacologic strategies. Smoking and alcohol intake is biochemically validated (blood, urine and breath tests) at the weekly meetings and at follow-up. Herein, we report the design of the STOP-OP study, objectives and accrual up-date. This study will provide new knowledge about how to prevent smoking and alcohol-related postoperative complications at the time of bladder cancer surgery. Till now 77 patients have been enrolled. Patient accrual is expected to be finalised before the end of 2017 and data will be published in 2018. ClinicalTrials.gov, ID: NCT02188446 . Registered on 28 May 2014.

[Smoking and young people; effectiveness of smoking prevention and cessation programmes].

PubMed

Monshouwer, K; Onrust, S; Rikkers-Mutsaerts, E; Lammers, J

2017-01-01

- In this article, we discuss the scientific knowledge on the effects of interventions that help young people to quit smoking and interventions that should prevent young people from starting to smoke.- We also describe the interventions in the Netherlands that, after a quality assessment, have been included in the database of the National Institute for Public Health and the Environment (RIVM) Centre for Healthy Living.- Interventions have varying degrees of success in helping young people to quit smoking. There are only indications of a modest effect of behavioural interventions.- Preventive interventions mostly occur in a school setting and are making a modest contribution to the reduction of the number of young people that start smoking.- There are preliminary indications of the effectiveness of interventions in a medical setting. However, research into this is rare and there is no insight in long-term effects.- The database of the RIVM Centre for Healthy Living includes mainly preventive interventions in a school setting and only one smoking cessation intervention.

Empowering Malaysian dentists to tobacco dependence treatment conduct.

PubMed

Nordin, Amer Siddiq Amer; Kadir, Rahimah Abdul; Yahya, Nurul Asyikin; Zakaria, Hazli; Rashid, Rusdi Abdul; Habil, Mohamed Hussain

2014-08-01

As a signatory to the World Health Organisation 2003 Framework Convention on Tobacco Control, Malaysia has policies in place and funded 300 public Quit clinics. Unfortunately, government dentists are not included to run tobacco dependence treatment. A cross-sectional exploratory survey was carried out to seek Malaysian dentists' opinion on their knowledge, perception and willingness to conduct tobacco dependence treatment. Participation was voluntary from those who attended a specially designed one-day, four-module workshop on tobacco cessation intervention. Data were collected using the Audience-Response-System equipment which tracked immediate responses covering four domains namely: smoking as a public health problem, smoking as an addiction, the role of dentists in the programme and confidence in conducting smoking cessation in the clinic. Sample comprised more female dentists (73.5%), mean age 33.6 (SD 8.99) years and with more than 3 years working experience. Findings indicated that the majority agreed Malaysia has a rising problem in the prevalence of smoking (71.6%) and predicted that it will affect mostly the young (81.9%). Only half of the dentists surveyed (58.9%) routinely recorded their patients' smoking habits. The majority (71.6%) believed that dentists are effective in helping their patient to stop smoking and 76.3% agreed that dentists should discuss the smoking habit with their patients; however, 60% agreed that doing so is too time consuming. In addition, only 24.7% knew of more ways to treat a smoking habit. The majority felt comfortable giving advice to patients about changing their habits (76.5%) or discussing treatment options (60.5%): 75% would opt for a combined programme of counselling and use of medication if they have to do, 15% would choose to go on counselling only, while 8% did not want to treat. In conclusion, the findings suggest that dentists have a strong potential to contribute significantly to providing smoking cessation treatment if adequately trained. © 2014 FDI World Dental Federation.

Affordability of programmes to prevent spontaneous preterm birth in Austria: a budget impact analysis.

PubMed

Zechmeister-Koss, Ingrid; Piso, Brigitte

2014-02-01

Preterm birth is a rising health problem in Europe generally, and in Austria specifically. Decision makers require objective information on the effects and costs of measures to prevent preterm birth. We undertook a budget impact analysis from a public payer perspective and for a 1-year and 5-year time horizon for five prevention approaches to reduce preterm birth. These were cervix screening + progesterone application, progesterone injection, smoking cessation, fish oil supplementation and infection screening. We analysed affordability in terms of programme costs and potential cost savings. Programme costs range from below €50 000 (cervix screening in high-risk pregnancy) to €500 000 (universal infection screening). The lowest health effects have been shown for smoking cessation programmes (-10 preterm births per year), whereas infection screening demonstrated the largest effect (-230 preterm births per year). In the base-case analysis, all programmes are potentially cost saving (-€500 000 to -€13 million per year). In the sensitivity analyses, preterm birth costs, target group size and (partly) unit costs of programme components have an influence on potential cost savings. However, except for two programmes, the results are robust concerning an overall economic net benefit of the programmes analysed compared with no programme. The study is mainly limited by the quality of some cost data and choice of the reference scenario. When considering potential cost savings, the five prevention programmes analysed seem affordable, with cervix screening and infection screening likely being the most promising in Austria.

Impact of a negative emotional antitobacco mass media campaign on French smokers: a longitudinal study.

PubMed

Guignard, Romain; Gallopel-Morvan, Karine; Mons, Ute; Hummel, Karin; Nguyen-Thanh, Viêt

2018-01-13

Mass media campaigns to encourage smoking cessation have been shown to be effective in a context of comprehensive tobacco control programme. The effectiveness of antismoking ads that evoke negative emotions remains unclear, in particular in countries with high smoking prevalence and among smokers with low perceived susceptibility, low self-efficacy or who are not users of smoking cessation services. To evaluate short-term and long-term effects of a 1-month French national highly emotional media campaign, with a focus on these specific targets. A 6-month longitudinal survey by Internet. A sample of 3000 smokers were interviewed before the media campaign (T0). They were contacted again just after (T1) and 6 months after the campaign (T2). Perceived susceptibility to the risks of smoking, self-efficacy to quit smoking, use of smoking cessation services (quitline and website) and 7-day quitting. The analysis was carried out on 2241 individuals who answered at T1 and T2. Multiple logistic regressions were computed to test the association between the change in each outcome at T1 and T2 and the level of exposure based on self-reported recall. Self-reported recall was associated with an increase in perceived susceptibility and with use of cessation services. Campaign recall was also associated with higher 7-day quitting immediately after the campaign (OR=1.8 (1.0 to 3.2), P<0.05). Fear-appeal mass media campaigns can be effective in encouraging cessation among smokers in a country with high smoking prevalence (France), but should be accompanied by convincing self-efficacy messages. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Intervention for Smokers through New Communication Technologies: What Perceptions Do Patients and Healthcare Professionals Have? A Qualitative Study

PubMed Central

Fábregas Escurriola, Mireia; Lozano Moreno, Maribel; Burón Leandro, Raquel; Gomez Quintero, Ana María; Ballve, Jose Luis; Clemente Jiménez, María Lourdes; Puigdomènech Puig, Elisa; Casas More, Ramón; Garcia Rueda, Beatriz; Casajuana, Marc; Méndez-Aguirre, Marga; Garcia Bonias, David; Fernández Maestre, Soraya; Sánchez Fondevila, Jessica

2015-01-01

Background The use of information and communication technologies (ICTs) in the health service is increasing. In spite of limitations, such as lack of time and experience, the deployment of ICTs in the healthcare system has advantages which include patient satisfaction with secure messaging, and time saving benefits and utility for patients and health professionals. ICTs may be helpful as either interventions on their own or as complementary tools to help patients stop smoking. Objectives To gather opinions from both medical professionals and smokers about an email-based application that had been designed by our research group to help smoking cessation, and identify the advantages and disadvantages associated with interventions based on the utilization of ICTs for this purpose. Methods A qualitative, descriptive–interpretative study with a phenomenological perspective was performed to identify and interpret the discourses of the participating smokers and primary healthcare professionals. Data were obtained through two techniques: semi-structured individual interviews and discussion groups, which were recorded and later systematically and literally transcribed together with the interviewer’s notes. Data were analyzed with the ATLAS TI 6.0 programme. Results Seven individual interviews and four focal groups were conducted. The advantages of the application based on the email intervention designed by our research group were said to be the saving of time in consultations and ease of access for patients who found work timetables and following a programme for smoking cessation incompatible. The disadvantages were thought to be a lack of personal contact with the healthcare professional, and the possibility of cheating/ self-deception, and a greater probability of relapse on the part of the smokers. Conclusions Both patients and healthcare professionals viewed the email-based application to help patients stop smoking as a complementary aid to face-to-face consultations. Nevertheless, ICTs could not substitute personal contact in the smoking cessation programme. PMID:26340346

Intervention for Smokers through New Communication Technologies: What Perceptions Do Patients and Healthcare Professionals Have? A Qualitative Study.

PubMed

Trujillo Gómez, Jose Manuel; Díaz-Gete, Laura; Martín-Cantera, Carlos; Fábregas Escurriola, Mireia; Lozano Moreno, Maribel; Burón Leandro, Raquel; Gomez Quintero, Ana María; Ballve, Jose Luis; Clemente Jiménez, María Lourdes; Puigdomènech Puig, Elisa; Casas More, Ramón; Garcia Rueda, Beatriz; Casajuana, Marc; Méndez-Aguirre, Marga; Garcia Bonias, David; Fernández Maestre, Soraya; Sánchez Fondevila, Jessica

2015-01-01

The use of information and communication technologies (ICTs) in the health service is increasing. In spite of limitations, such as lack of time and experience, the deployment of ICTs in the healthcare system has advantages which include patient satisfaction with secure messaging, and time saving benefits and utility for patients and health professionals. ICTs may be helpful as either interventions on their own or as complementary tools to help patients stop smoking. To gather opinions from both medical professionals and smokers about an email-based application that had been designed by our research group to help smoking cessation, and identify the advantages and disadvantages associated with interventions based on the utilization of ICTs for this purpose. A qualitative, descriptive-interpretative study with a phenomenological perspective was performed to identify and interpret the discourses of the participating smokers and primary healthcare professionals. Data were obtained through two techniques: semi-structured individual interviews and discussion groups, which were recorded and later systematically and literally transcribed together with the interviewer's notes. Data were analyzed with the ATLAS TI 6.0 programme. Seven individual interviews and four focal groups were conducted. The advantages of the application based on the email intervention designed by our research group were said to be the saving of time in consultations and ease of access for patients who found work timetables and following a programme for smoking cessation incompatible. The disadvantages were thought to be a lack of personal contact with the healthcare professional, and the possibility of cheating/ self-deception, and a greater probability of relapse on the part of the smokers. Both patients and healthcare professionals viewed the email-based application to help patients stop smoking as a complementary aid to face-to-face consultations. Nevertheless, ICTs could not substitute personal contact in the smoking cessation programme.

Use of action planning to increase provision of smoking cessation care by general practitioners: role of plan specificity and enactment.

PubMed

Verbiest, Marjolein E A; Presseau, Justin; Chavannes, Niels H; Scharloo, Margreet; Kaptein, Ad A; Assendelft, Willem J J; Crone, Mathilde R

2014-12-30

Strategies are needed to help general practitioners (GPs) promote smoking cessation as recommended by guidelines. This study examines whether the quality of action planning among GPs improves their provision of smoking cessation care. The effectiveness of a 1-h training programme was examined in a cluster randomised controlled trial in which 49 GPs participated. GPs who followed the training (intervention group; n = 25) formulated action plans related to i) enquiring about smoking, ii) advising to quit smoking, and iii) arranging follow-up for smokers motivated to quit. GPs also formulated a coping plan for encountering smokers not motivated to quit. The quality of these plans (plan specificity) was rated and, 6 weeks after the training, GPs reported on the performance of these plans (plan enactment). Multilevel regression analyses were used to examine the effects of plan specificity and plan enactment on patient-reported smoking cessation activities of the GPs in the intervention group (n = 1,632 patients) compared with the control group (n = 1,769 patients). Compared to the control group, GPs who formulated a highly specific action plan during the training asked their patients about smoking more often after the training compared to prior to the training (OR 2.11, 95% CI 1.51-2.95). GPs were most likely to have asked patients about smoking after the training compared to prior to the training when they had enacted a highly specific formulated action plan (OR 3.08, 95% CI 2.04-4.64). The effects of GP plan specificity and plan enactment on asking patient about smoking were most prominent among GPs who, at baseline, intended to provide smoking cessation care. A highly specific action plan formulated by a GP on when, how, and by whom patients will be asked about smoking had a positive effect on GPs' asking patients about smoking, especially when these professionals also reported to have enacted this plan. This effect was most prominent among GPs who intended to provide smoking cessation care prior to the intervention. Training in devising personalised coping plans is recommended to further increase GPs' provision of advice to quit smoking and arranging follow-up support to quit smoking.

Impact of the 2009 Taiwan tobacco hazards prevention act on smoking cessation.

PubMed

Chang, Fong-Ching; Sung, Hai-Yen; Zhu, Shu-Hong; Chiou, Shu-Ti

2014-01-01

In January 2009, the government of Taiwan amended the 1997 Tobacco Hazards Prevention Act by extending smoke-free areas to include almost all enclosed work-places and public places, adding graphic health warnings to cigarette packages, totally banning tobacco advertisements, promotion and sponsorship and increasing tobacco taxes. This study examined the impact of the 2009 amended Act on smoking cessation in Taiwan. Taiwan Adult Tobacco Surveys 2007 and 2010, each with a nationally representative sample of adults aged 18 years and older (n = 16 588, and n = 16 295, respectively). All recent active smokers (current smokers plus former smokers who quit smoking within the past 12 months) were used for the analyses (n = 3783 in 2007, and n = 2777 in 2010). Quit attempt rate and annual cessation rate (defined as having succeeded in quitting for at least 3 months) among recent active smokers were compared between the pre-Act (2007) and post-Act (2010) periods. The quit attempt rate increased significantly from 39.4% in 2007 to 42.9% in 2010. The annual cessation rate increased significantly from 7.1 to 8.9%. A multivariate analysis, controlling for demographic characteristics, showed that the implementation of the 2009 Act was associated with an increase in the quit attempt rate [odds ratio (OR) = 1.14; 95% confidence interval (CI) = 1.03-1.25] and the annual cessation rate (OR = 1.28; 95% CI = 1.08-1.53). The comprehensive tobacco control programme introduced in 2009 in Taiwan, which combined smoke-free legislation with a tobacco tax increase, graphic health warning labels and a total ban on tobacco advertisements, was associated with increases in quit attempt rate and annual cessation rate. © 2013 Society for the Study of Addiction.

Investing in youth tobacco control: a review of smoking prevention and control strategies

PubMed Central

Lantz, P.; Jacobson, P.; Warner, K.; Wasserman, J.; Pollack, H.; Berson, J.; Ahlstrom, A.

2000-01-01

OBJECTIVE—To provide a comprehensive review of interventions and policies aimed at reducing youth cigarette smoking in the United States, including strategies that have undergone evaluation and emerging innovations that have not yet been assessed for efficacy.
DATA SOURCES—Medline literature searches, books, reports, electronic list servers, and interviews with tobacco control advocates.
DATA SYNTHESIS—Interventions and policy approaches that have been assessed or evaluated were categorised using a typology with seven categories (school based, community interventions, mass media/public education, advertising restrictions, youth access restrictions, tobacco excise taxes, and direct restrictions on smoking). Novel and largely untested interventions were described using nine categories.
CONCLUSIONS—Youth smoking prevention and control efforts have had mixed results. However, this review suggests a number of prevention strategies that are promising, especially if conducted in a coordinated way to take advantage of potential synergies across interventions. Several types of strategies warrant additional attention and evaluation, including aggressive media campaigns, teen smoking cessation programmes, social environment changes, community interventions, and increasing cigarette prices. A significant proportion of the resources obtained from the recent settlement between 46 US states and the tobacco industry should be devoted to expanding, improving and evaluating "youth centred" tobacco prevention and control activities.


Keywords: youth smoking prevention; teen cessation programmes; community interventions; policy PMID:10691758

Electronic nicotine delivery system (ENDS) use during smoking cessation: a qualitative study of 40 Oklahoma quitline callers.

PubMed

Vickerman, Katrina A; Beebe, Laura A; Schauer, Gillian L; Magnusson, Brooke; King, Brian A

2017-04-01

Approximately 10% (40 000) of US quitline enrollees who smoke cigarettes report current use of electronic nicotine delivery systems (ENDS); however, little is known about callers' ENDS use. Our aim was to describe why and how quitline callers use ENDS, their beliefs about ENDS and the impact of ENDS use on callers' quit processes and use of FDA-approved cessation medications. Qualitative interviews conducted 1-month postregistration. Interviews were recorded, transcribed, double-coded and analysed to identify themes. Oklahoma Tobacco Helpline. 40 callers aged ≥18 who were seeking help to quit smoking were using ENDS at registration and completed ≥1 programme calls. At 1-month postregistration interview, 80% of callers had smoked cigarettes in the last 7 days, almost two-thirds were using ENDS, and half were using cessation medications. Nearly all believed ENDS helped them quit or cut down on smoking; however, participants were split on whether they would recommend cessation medications, ENDS or both together for quitting. Confusion and misinformation about potential harms of ENDS and cessation medications were reported. Participants reported using ENDS in potentially adaptive ways (eg, using ENDS to cut down and nicotine replacement therapy to quit, and stepping down nicotine in ENDS to wean off ENDS after quitting) and maladaptive ways (eg, frequent automatic ENDS use, using ENDS in situations they did not previously smoke, cutting down on smoking using ENDS without a schedule or plan to quit), which could impact the likelihood of quitting smoking or continuing ENDS use. These qualitative findings suggest quitline callers who use ENDS experience confusion and misinformation about ENDS and FDA-approved cessation medications. Callers also use ENDS in ways that may not facilitate quitting smoking. Opportunities exist for quitlines to educate ENDS users and help them create a coordinated plan most likely to result in completely quitting combustible tobacco. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Predictive value of the transtheoretical model to smoking cessation in hospitalized patients with cardiovascular disease.

PubMed

Chouinard, Maud-Christine; Robichaud-Ekstrand, Sylvie

2007-02-01

Several authors have questioned the transtheoretical model. Determining the predictive value of each cognitive-behavioural element within this model could explain the multiple successes reported in smoking cessation programmes. The purpose of this study was to predict point-prevalent smoking abstinence at 2 and 6 months, using the constructs of the transtheoretical model, when applied to a pooled sample of individuals who were hospitalized for a cardiovascular event. The study follows a predictive correlation design. Recently hospitalized patients (n=168) with cardiovascular disease were pooled from a randomized, controlled trial. Independent variables of the predictive transtheoretical model comprise stages and processes of change, pros and cons to quit smoking (decisional balance), self-efficacy, and social support. These were evaluated at baseline, 2 and 6 months. Compared to smokers, individuals who abstained from smoking at 2 and 6 months were more confident at baseline to remain non-smokers, perceived less pros and cons to continue smoking, utilized less consciousness raising and self-re-evaluation experiential processes of change, and received more positive reinforcement from their social network with regard to their smoke-free behaviour. Self-efficacy and stages of change at baseline were predictive of smoking abstinence after 6 months. Other variables found to be predictive of smoking abstinence at 6 months were an increase in self-efficacy; an increase in positive social support behaviour and a decrease of the pros within the decisional balance. The results partially support the predictive value of the transtheoretical model constructs in smoking cessation for cardiovascular disease patients.

Mobile phone-based interventions for smoking cessation.

PubMed

Whittaker, Robyn; McRobbie, Hayden; Bullen, Chris; Borland, Ron; Rodgers, Anthony; Gu, Yulong

2012-11-14

Innovative and effective smoking cessation interventions are required to appeal to those who are not accessing traditional cessation services. Mobile phones are widely used and are now well-integrated into the daily lives of many, particularly young adults. Mobile phones are a potential medium for the delivery of health programmes such as smoking cessation. To determine whether mobile phone-based interventions are effective at helping people who smoke, to quit. For the most recent update, we searched the Cochrane Tobacco Addiction Group Specialised Register in May 2012. We also searched UK Clinical Research Network Portfolio for current projects in the UK and the ClinicalTrials register for on-going or recently completed studies. We searched through the reference lists of identified studies and attempted to contact the authors of ongoing studies, with no restrictions placed on language or publication date. We included randomized or quasi-randomized trials. Participants were smokers of any age who wanted to quit. Studies were those examining any type of mobile phone-based intervention. This included any intervention aimed at mobile phone users, based around delivery via mobile phone, and using any functions or applications that can be used or sent via a mobile phone. Information on risk of bias and methodological details was extracted using a standardised form. Participants who dropped out of the trials or were lost to follow-up were considered to be smoking. We calculated risk ratios (RR) for each included study. Meta-analysis of the included studies was undertaken using the Mantel-Haenszel fixed-effect method. Where meta-analysis was not possible, summary and descriptive statistics are presented. Five studies with at least six month cessation outcomes were included in this review. Three studies involve a purely text messaging intervention that has been adapted over the course of these three studies for different populations and contexts. One study is a multi-arm study of a text messaging intervention and an internet QuitCoach separately and in combination. The final study involves a video messaging intervention delivered via the mobile phone. When all five studies were pooled, mobile phone interventions were shown to increase the long term quit rates compared with control programmes (RR 1.71, 95% CI 1.47 to 1.99, over 9000 participants), using a definition of abstinence of no smoking at six months since quit day but allowing up to three lapses or up to five cigarettes. Statistical heterogeneity was substantial as indicated by the I² statistic (I² = 79%), but as all included studies were similar in design, intervention and primary outcome measure, we have presented the meta-analysis in this review. The current evidence shows a benefit of mobile phone-based smoking cessation interventions on long-term outcomes, though results were heterogenous with findings from three of five included studies crossing the line of no effect. The studies included were predominantly of text messaging interventions. More research is required into other forms of mobile phone-based interventions for smoking cessation, other contexts such as low income countries, and cost-effectiveness.

Smoking cessation counseling in Qatar: community pharmacists' attitudes, role perceptions and practices.

PubMed

El Hajj, Maguy Saffouh; Al Nakeeb, Reem Raad; Al-Qudah, Raja'a Ali

2012-08-01

Smoking is a major public health problem in Qatar. The potential for community pharmacists to offer smoking cessation counseling in this country can be high. To determine the current smoking cessation practices of community pharmacists in Qatar, to examine their attitudes about tobacco use and smoking cessation, to evaluate their perceptions about performing professional roles with respect to smoking cessation and to assess their perceived barriers for smoking cessation counseling in the pharmacy setting in Qatar. Community pharmacies in Qatar. The objectives were addressed in a cross sectional survey of community pharmacists in Qatar from June 2010 to October 2010. A phone call was made to all community pharmacists in Qatar (318 pharmacists) inviting them to participate. Consenting pharmacists anonymously completed the survey either online or as paper using fax. Data was analyzed using Statistical Package of Social Sciences (SPSS®) Version 18. Qatar community pharmacists' smoking cessation practices, their attitudes toward tobacco use, smoking cessation and smoking cessation counseling and their perceived barriers for smoking cessation counseling. Over 5 months, we collected 127 surveys (40 % response rate). Only 21 % of respondents reported that they always or most of the time asked their patients if they smoke. When the patients' smoking status was identified, advising quitting and assessing readiness to quit were always or most of the time performed by 66 and 52 % of respondents respectively. Only 15 % always or most of the time arranged follow-up with smokers and 22 % always or most of the time made smoking cessation referrals. Most respondents (>80 %) agreed that smoking could cause adverse health effects and that smoking cessation could decrease the risk of these effects. In addition, the majority (>80 %) believed that smoking cessation counseling was an important activity and was an efficient use of their time. The top two perceived barriers for smoking cessation counseling were lack of time (65 % of respondents) and lack of patients' interest in smoking cessation (54 %). Qatar community pharmacists have positive attitudes toward smoking cessation counseling. These attitudes need to be translated into action. Interventions should be implemented to overcome perceived barriers and to improve smoking cessation activities among pharmacists.

Smoking Cessation Intervention for severe Mental Ill Health Trial (SCIMITAR): a pilot randomised control trial of the clinical effectiveness and cost-effectiveness of a bespoke smoking cessation service.

PubMed

Peckham, Emily; Man, Mei-See; Mitchell, Natasha; Li, Jinshuo; Becque, Taeko; Knowles, Sarah; Bradshaw, Tim; Planner, Claire; Parrott, Steve; Michie, Susan; Shepherd, Charles; Gilbody, Simon

2015-03-01

There is a high prevalence of smoking among people who experience severe mental ill health (SMI). Helping people with disorders such as bipolar illness and schizophrenia to quit smoking would help improve their health, increase longevity and also reduce health inequalities. Around half of people with SMI who smoke express an interest in cutting down or quitting smoking. There is limited evidence that smoking cessation can be achieved for people with SMI. Those with SMI rarely access routine NHS smoking cessation services. This suggests the need to develop and evaluate a behavioural support and medication package tailored to the needs of people with SMI. The objective in this project was to conduct a pilot trial to establish acceptability of the intervention and to ensure the feasibility of recruitment, randomisation and follow-up. We also sought preliminary estimates of effect size in order to design a fully powered trial of clinical effectiveness and cost-effectiveness. The pilot should inform a fully powered trial to compare the clinical effectiveness and cost-effectiveness of a bespoke smoking cessation (BSC) intervention with usual general practitioner (GP) care for people with SMI. A pilot pragmatic two-arm individually randomised controlled trial (RCT). Simple randomisation was used following a computer-generated random number sequence. Participants and practitioners were not blinded to allocation. Primary care and secondary care mental health services in England. Smokers aged > 18 years with a severe mental illness who would like to cut down or quit smoking. A BSC intervention delivered by mental health specialists trained to deliver evidence-supported smoking cessation interventions compared with usual GP care. The primary outcome was carbon monoxide-verified smoking cessation at 12 months. Smoking-related secondary outcomes were reduction of number of cigarettes smoked, Fagerstrom test of nicotine dependence and motivation to quit (MTQ). Other secondary outcomes were Patient Health Questionnaire-9 items and Short Form Questionnaire-12 items to assess whether there were improvements or deterioration in mental health and quality of life. We also measured body mass index to assess whether or not smoking cessation was associated with weight gain. These were measured at 1, 6 and 12 months post randomisation. The trial recruited 97 people aged 19-73 years who smoked between 5 and 60 cigarettes per day (mean 25 cigarettes). Participants were recruited from four mental health trusts and 45 GP surgeries. Forty-six people were randomised to the BSC intervention and 51 people were randomised to usual GP care. The odds of quitting at 12 months was higher in the BSC intervention (36% vs. 23%) but did not reach statistical significance (odds ratio 2.9; 95% confidence interval 0.8% to 10.5%). At 3 and 6 months there was no evidence of difference in self-reported smoking cessation. There was a non-significant reduction in the number of cigarettes smoked and nicotine dependence. MTQ and number of quit attempts all increased in the BSC group compared with usual care. There was no difference in terms of quality of life at any time point, but there was evidence of an increase in depression scores at 12 months for the BSC group. There were no serious adverse events thought likely to be related to the trial interventions. The pilot economic analysis demonstrated that it was feasible to carry out a full economic analysis. It was possible to recruit people with SMI from primary and secondary care to a trial of a smoking cessation intervention based around behavioural support and medication. The overall direction of effect was a positive trend in relation to biochemically verified smoking cessation and it was feasible to obtain follow-up in a substantial proportion of participants. A definitive trial of a bespoke cessation intervention has been prioritised by the National Institute for Health Research (NIHR) and the SCIMITAR pilot trial forms a template for a fully powered RCT to examine clinical effectiveness and cost-effectiveness. Current Controlled Trials ISRCTN79497236. This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment, Vol. 19, No. 25. See the NIHR Journals Library website for further project information.

Impact of tobacco control interventions on socioeconomic inequalities in smoking: review of the evidence.

PubMed

Hill, Sarah; Amos, Amanda; Clifford, David; Platt, Stephen

2014-11-01

We updated and expanded a previous systematic literature review examining the impact of tobacco control interventions on socioeconomic inequalities in smoking. We searched the academic literature for reviews and primary research articles published between January 2006 and November 2010 that examined the socioeconomic impact of six tobacco control interventions in adults: that is, price increases, smoke-free policies, advertising bans, mass media campaigns, warning labels, smoking cessation support and community-based programmes combining several interventions. We included English-language articles from countries at an advanced stage of the tobacco epidemic that examined the differential impact of tobacco control interventions by socioeconomic status or the effectiveness of interventions among disadvantaged socioeconomic groups. All articles were appraised by two authors and details recorded using a standardised approach. Data from 77 primary studies and seven reviews were synthesised via narrative review. We found strong evidence that increases in tobacco price have a pro-equity effect on socioeconomic disparities in smoking. Evidence on the equity impact of other interventions is inconclusive, with the exception of non-targeted smoking cessation programmes which have a negative equity impact due to higher quit rates among more advantaged smokers. Increased tobacco price via tax is the intervention with the greatest potential to reduce socioeconomic inequalities in smoking. Other measures studied appear unlikely to reduce inequalities in smoking without specific efforts to reach disadvantaged smokers. There is a need for more research evaluating the equity impact of tobacco control measures, and development of more effective approaches for reducing tobacco use in disadvantaged groups and communities. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Relapse prevention interventions for smoking cessation.

PubMed

Hajek, P; Stead, L F; West, R; Jarvis, M

2005-01-25

Several treatments can help smokers make a successful quit attempt, but many initially successful quitters relapse over time. There are interventions designed to help prevent relapse. To assess whether specific interventions for relapse prevention reduce the proportion of recent quitters who return to smoking. We searched the Cochrane Tobacco Addiction group trials register in September 2004 for studies mentioning relapse prevention or maintenance in title, abstracts or keywords. Randomized or quasi-randomized controlled trials of relapse prevention interventions with a minimum follow up of six months. We included smokers who quit on their own, or were undergoing enforced abstinence, or who were participating in treatment programmes. We included trials that compared relapse prevention interventions to a no intervention control, or that compared a cessation programme with additional relapse prevention components to a cessation programme alone. Studies were screened and data extracted by one author and checked by a second. Disagreements were resolved by discussion or referral to a third author. Forty studies met inclusion criteria, but were heterogeneous in terms of populations and interventions. We considered studies that randomized abstainers separately from studies that randomized participants prior to their quit date. We detected no benefit of brief and 'skills-based' relapse prevention interventions for women who had quit smoking due to pregnancy, or for smokers undergoing a period of enforced abstinence. We also failed to detect significant effects in trials in other smokers who had quit on their own or with a formal programme. Amongst trials recruiting smokers and evaluating the effect of additional relapse prevention components we also found no evidence of benefit in any subgroup. We did not find that providing training in skills thought to be needed for relapse avoidance reduced relapse, but most studies did not use experimental designs best suited to the task, and had limited power to detect expected small differences between interventions. At the moment there is insufficient evidence to support the use of any specific intervention for helping smokers who have successfully quit for a short time to avoid relapse. The verdict is strongest for interventions focusing on identifying and resolving tempting situations, as most studies were concerned with these. There is very little research available regarding other approaches. Until more evidence becomes available it may be more efficient to focus resources on supporting the initial cessation attempt rather than on additional relapse prevention efforts.

It's about time--directing our attention toward modifying the course of COPD.

PubMed

Cazzola, Mario; Hanania, Nicola A; Jones, Paul W; Mahler, Donald A; Make, Barry; Ohar, Jill; Rennard, Stephen

2008-06-01

The course of COPD has traditionally been equated with an accelerated decline in the forced expiratory volume in one second (FEVi) over time in patients with COPD, compared to healthy individuals. However, other important clinical outcomes associated with COPD also worsen over time and should also be considered in conceptualizing the course of COPD. These include health status, breathlessness related to activities of daily living, exercise capacity, the frequency of exacerbations, and peripheral muscle weakness. These outcomes are often quite responsive to therapy of COPD. Presently there is no evidence that any treatment other than smoking cessation can normalise the rate of decline of FEVi, and therefore be considered as modifying the physiologic course of the disease. Thus, smoking cessation reigns as the primary disease modifying strategy in COPD. Even though there are a number of smoking cessation products on the market and smoking prevalence continues to decrease marginally each year, more needs to be done to provide comprehensive programmes to help people quit smoking. In the US in 2004, 37.5% of preventable deaths were found to be tobacco-related. The FEVi does not reflect the clinical manifestations or the total burden of this multidimensional illness. As novel therapeutic agents become available that may alter the underlying pathology of COPD, additional markers and outcomes of disease progression will be needed to provide a more comprehensive assessment. There has been increasing interest in predicting and assessing mortality as it is the final outcome of disease progression. In this review we have considered three approaches toward modifying the course of COPD: smoking cessation, reduction in lung hyperinflation through medical and surgical approaches, and long-term pharmacotherapy.

Metabolic effects of smoking cessation.

PubMed

Harris, Kindred K; Zopey, Mohan; Friedman, Theodore C

2016-05-01

Smoking continues to be the leading cause of preventable death in the USA, despite the vast and widely publicized knowledge about the negative health effects of tobacco smoking. Data show that smoking cessation is often accompanied by weight gain and an improvement in insulin sensitivity over time. However, paradoxically, post-cessation-related obesity might contribute to insulin resistance. Furthermore, post-cessation weight gain is reportedly the number one reason why smokers, especially women, fail to initiate smoking cessation or relapse after initiating smoking cessation. In this Review, we discuss the metabolic effects of stopping smoking and highlight future considerations for smoking cessation programs and therapies to be designed with an emphasis on reducing post-cessation weight gain.

Metabolic effects of smoking cessation

PubMed Central

Harris, Kindred K.; Zopey, Mohan; Friedman, Theodore C.

2016-01-01

Smoking continues to be the leading cause of preventable death in the USA, despite the vast and widely publicized knowledge about the negative health effects of tobacco smoking. Data show that smoking cessation is often accompanied by weight gain and an improvement in insulin sensitivity over time. However, paradoxically, post-cessation-related obesity might contribute to insulin resistance. Furthermore, post-cessation weight gain is reportedly the number one reason why smokers, especially women, fail to initiate smoking cessation or relapse after initiating smoking cessation. In this Review, we discuss the metabolic effects of stopping smoking and highlight future considerations for smoking cessation programs and therapies to be designed with an emphasis on reducing post-cessation weight gain. PMID:26939981

Finnish Dentists Find Smoking Cessation Important but Seldom Offer Practical Support for Their Patients.

PubMed

Grönholm, A; Litkey, D; Jokelainen, J; Keto, J; Pöyry, M; Linden, K; Heikkinen, A M

2017-12-01

To investigate Finnish dentists' smoking cessation related attitudes, consultation practices and familiarity with the local treatment guideline on smoking cessation. An online questionnaire was sent to 1740 dentists, which corresponds to 39% of dentists in Finland. A total of 456 dentists responded (response rate 26%), of whom 435 (95%) were clinicians. The dentists' smoking cessation practices were also compared to ones reported in a previous study in Finnish physicians. Dentists found smoking cessation important and often discussed and recommended quitting to the patients, but concrete withdrawal actions were seldom provided. The local treatment guideline on smoking cessation was actively utilized by 36% of the dentists. Adherence to the guideline was associated with higher rates of smoking cessation activities and success in them. Smoking cessation activity among dentists was significantly lower than in Finnish physicians. In accordance with the literature, among dentists, the most common barriers for smoking cessation were lack of time (44%) and education (42%). Although smoking cessation is discussed with patients, dentists are less active in taking concrete actions to support the patient on withdrawal. Adherence to the local treatment guideline was associated with better capabilities in dealing with tobacco withdrawal and a more active role in smoking cessation. The results suggest that more education on the local smoking cessation treatment guideline and cessation intervention is needed in order to overcome the remaining barriers to promoting effective smoking cessation in dental practice. Copyright© 2017 Dennis Barber Ltd.

Nurses' smoking habits and their professional smoking cessation practices. A systematic review and meta-analysis.

PubMed

Duaso, Maria J; Bakhshi, Savita; Mujika, Agurtzane; Purssell, Edward; While, Alison E

2017-02-01

A better understanding of whether nurses' own smoking behaviours influence their engagement with smoking cessation interventions is needed. To establish whether the smoking status of nurses is associated with their professional smoking cessation practices. Twelve electronic databases covering English and Spanish language publications from 01 Jan, 1996 to 25 Mar, 2015 were systematically searched. Studies were included if they reported nurses' smoking cessation practices in relation to their personal smoking habits. Proportions of nurses' smoking status and smoking cessation practices were pooled across studies using random effects meta-analysis. Fifteen studies were included in this systematic review. Levels of reportedsmoking cessation interventions were generally low across the studies. The meta-analyses suggested that nurses' personal smoking status was not associated significantly with nurses always asking patients about their smoking, but nurses who smoked were 13% less likely to advise their patients to quit and 25% less likely to arrange smoking cessation follow-up. More intense interventions (assessing motivation and assisting) were not significantly associated with the smoking status of the nurse. The smoking status of nurses appears to have a negative impact in the delivery of smoking cessation practices. The overall level of nurses' engagement with the delivery of smoking cessation interventions requires attention if nurses are to be effective agents of smoking cessation. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Smoking Habits and Attitudes in Students of the Third Faculty of Medicine of Charles University in Prague.

PubMed

Schneidrová, Dagmar; Herotová, Tereza Kopřivová; Šustková, Magdaléna; Hynčica, Viktor

2016-06-01

This study seeks to assess smoking habits, attitudes and intention to quit in students of the Third Faculty of Medicine of Charles University in Prague, Czech Republic. A cross-sectional survey designed to obtain information on smoking history, current smoking status, cessation attempts, and attitudes towards smoking among health professionals was conducted in 452 students of the first and last years of a 6-year Master's Study Programme (General Medicine) and a 3-year Bachelor's Study Programme (Public Health). An anonymous questionnaire was administered during the classes in the course of academic years 2011-12 and 2012-13. 5.7% of the Master's Study Programme students (3.3% women and 9.0% men ) and 4.8% of the Bachelor's Study Programme students reported that they are regular smokers. The share of regular smokers was almost twice as big in students of the English Curriculum of the Master's Programme (10.7%) in comparison with the students of the Czech Curriculum (4.5%), and more than twice as big in students of the last years of both study programmes (3.9% in students of the 1st year and 10.8% in students of the 6th year of the Master's Programme; 3.2% in students of the 1st year and 7.0% in students of the 3rd year of the Bachelor's Study Programme). At the time of the research, 18.9% of students of the Master's Programme and 17.1% of students of the Bachelor's Programme were occasional smokers. 5.9% of students of the Master's Programme and 19.0% of students of the Bachelor's Programme reported that they quit smoking during their studies at the medical faculty; on the contrary, 9.8% of students of the Master's Programme and 14.3% of students of the Bachelor's Programme started smoking during that time. Smoking in health professionals undermines their significant role in health promotion and prevention of chronic diseases in their patients. Therefore, education at the medical faculty should focus on motivation of future health professionals towards non-smoking except providing knowledge on current research and guidance on early identification and further intervention in smokers. Copyright© by the National Institute of Public Health, Prague 2015.

Barriers to and facilitators of smoking cessation in pregnancy and following childbirth: literature review and qualitative study.

PubMed

Bauld, Linda; Graham, Hilary; Sinclair, Lesley; Flemming, Kate; Naughton, Felix; Ford, Allison; McKell, Jennifer; McCaughan, Dorothy; Hopewell, Sarah; Angus, Kathryn; Eadie, Douglas; Tappin, David

2017-06-01

Although many women stop smoking in pregnancy, others continue, causing harm to maternal and child health. Smoking behaviour is influenced by many factors, including the role of women's significant others (SOs) and support from health-care professionals (HPs). To enhance understanding of the barriers to, and facilitators of, smoking cessation and the feasibility and acceptability of interventions to reach and support pregnant women to stop smoking. Four parts: (1) a description of interventions in the UK for smoking cessation in pregnancy; (2) three systematic reviews (syntheses) of qualitative research of women's, SOs' and HPs' views of smoking in pregnancy using meta-ethnography (interpretative approach for combining findings); (3) semistructured interviews with pregnant women, SOs and HPs, guided by the social-ecological framework (conceptualises behaviour as an outcome of individuals' interactions with environment); and (4) identification of new/improved interventions for future testing. Studies in reviews conducted in high-income countries. Qualitative research was conducted from October 2013 to December 2014 in two mixed urban/rural study sites: area A (Scotland) and area B (England). Thirty-eight studies (1100 pregnant women) in 42 papers, nine studies (150 partners) in 14 papers and eight studies described in nine papers (190 HPs) included in reviews. Forty-one interviews with pregnant women, 32 interviews with pregnant women's SOs and 28 individual/group interviews with 48 HPs were conducted. The perceived barriers to, and facilitators of, smoking cessation in pregnancy and the identification of potential new/modified interventions. Syntheses identified smoking-related perceptions and experiences for pregnant women and SOs that were fluid and context dependent with the capacity to help or hinder smoking cessation. Themes were analysed in accordance with the social-ecological framework levels. From the analysis of the interviews, the themes that were central to cessation in pregnancy at an individual level, and that reflected the findings from the reviews, were perception of risk to baby, self-efficacy, influence of close relationships and smoking as a way of coping with stress. Overall, pregnant smokers were faced with more barriers than facilitators. At an interpersonal level, partners' emotional and practical support, willingness to change smoking behaviour and role of smoking within relationships were important. Across the review and interviews of HPs, education to enhance knowledge and confidence in delivering information about smoking in pregnancy and the centrality of the client relationship, protection of which could be a factor in downplaying risks, were important. HPs acknowledged that they could best assist by providing support and understanding, and access to effective interventions, including an opt-out referral pathway to Stop Smoking Services, routine carbon monoxide screening, behavioural support and access to pharmacotherapy. Additional themes at community, organisational and societal levels were also identified. Limitations include a design grounded in qualitative studies, difficulties recruiting SOs, and local service configurations and recruitment processes that potentially skewed the sample. Perceptions and experiences of barriers to and facilitators of smoking cessation in pregnancy are fluid and context dependent. Effective interventions for smoking cessation in pregnancy should take account of the interplay between the individual, interpersonal and environmental aspects of women's lives. Research focus: removing barriers to support, improving HPs' capacity to offer accurate advice, and exploration of weight concerns and relapse prevention. Interventions focus: financial incentives, self-help and social network interventions. This study is registered as PROSPERO CRD42013004170. The National Institute for Health Research Health Technology Assessment programme.

Review of perinatal partner-focused smoking cessation interventions.

PubMed

Duckworth, Adrienne L; Chertok, Ilana R Azulay

2012-01-01

One of the primary barriers to smoking cessation among pregnant women who smoke is having a partner who smokes. Prenatal tobacco exposure has been demonstrated to negatively affect infant health outcomes. Many smoking cessation interventions have been targeted at women who smoke in pregnancy, although research has indicated that one of the main barriers to cessation is lack of partner support. The family systems theory frames prenatal smoking cessation interventions in an inclusive manner for the woman and her partner. The aim of this article is to review smoking cessation intervention studies for partners of pregnant women. Efforts to promote smoking cessation among pregnant women should be inclusive of partners, recognizing that partners influence maternal prenatal health behaviors.

Testing the transtheoretical model in predicting smoking relapse among Malaysian adult smokers receiving assistance in quitting.

PubMed

Yasin, Siti Munira; Retneswari, Masilamani; Moy, Foong Ming; Taib, Khairul Mizan; Isahak, Marzuki; Koh, David

2013-01-01

The role of The Transtheoretical Model (TTM) in predicting relapse is limited. We aimed to assess whether this model can be utilised to predict relapse during the action stage. The participants included 120 smokers who had abstained from smoking for at least 24 hours following two Malaysian universities' smoking cessation programme. The smokers who relapsed perceived significantly greater advantages related to smoking and increasing doubt in their ability to quit. In contrast, former smokers with greater self-liberation and determination to abstain were less likely to relapse. The findings suggest that TTM can be used to predict relapse among quitting smokers.

Positive psychotherapy for smoking cessation enhanced with text messaging: Protocol for a randomized controlled trial.

PubMed

Kahler, Christopher W; Surace, Anthony; Rebecca, E F; Gordon, B A; Cioe, Patricia A; Spillane, Nichea S; Parks, Acacia; Bock, Beth C; Brown, Richard A

2018-06-21

Despite reductions in cigarette smoking in the U.S., improvements in the efficacy of smoking cessation treatments are needed, as rates of sustained abstinence remain disappointingly low. Both low positive affect and high negative affect contribute to smoking relapse and constitute viable targets for smoking cessation interventions. Although some clinical trials have evaluated interventions to address depression as a smoking relapse risk factor, very few have focused on positive affect. Recently, we developed and conducted a preliminary clinical trial of a smoking cessation treatment that targets positive affect and cognitions by incorporating interventions rooted in positive psychology. The current randomized controlled trial will expand upon this preliminary trial to test whether this positive psychology-informed approach results in higher smoking cessation rates compared to a time-matched standard smoking cessation treatment control. Three hundred and forty adult daily smokers will be randomly assigned to either positive psychotherapy for smoking cessation or standard behavioral smoking cessation counseling. Participants will meet weekly with a study counselor for 6 weeks and will receive transdermal nicotine patch and text messaging smoking cessation support. Additionally, text messaging in the positive psychotherapy condition will encourage engagement in positive psychology-specific strategies for boosting mood and staying smoke free. Smoking cessation outcomes will be measured at 12, 26, and 52 weeks following target quit date. Results from this study will provide evidence on whether incorporating positive psychology interventions into smoking cessation treatment can improve smoking cessation outcomes relative to standard behavioral counseling with nicotine patch and text messaging. Copyright © 2018. Published by Elsevier Inc.

A survey of UK optometry trainees' smoking cessation training.

PubMed

Lorencatto, Fabiana; Harper, Alice M; Francis, Jill J; Lawrenson, John G

2016-07-01

Smoking is a risk factor for a number of eye conditions, including age-related macular degeneration, cataracts and thyroid eye disease. Smoking cessation interventions have been shown to be highly cost-effective when delivered by a range of healthcare professionals. Optometrists are well placed to deliver smoking cessation advice to a wide population of otherwise healthy smokers. Yet optometrists remain a relatively neglected healthcare professional group in smoking cessation research and policy. Surveys of UK medical/nursing schools and of optometrists' training internationally demonstrate significant deficits in current curricular coverage regarding smoking cessation. This study aimed to identify the extent of smoking cessation training in UK optometry trainees' undergraduate and pre-registration training. All undergraduate optometry schools in the UK (n = 9) were invited to participate in a web-based survey of their curricular coverage and assessment related to smoking cessation, and of perceived barriers to delivering smoking cessation training. A content analysis of the College of Optometrists Scheme for Registration Trainee Handbook 2014 was conducted to identify competence indicators related to smoking cessation. Nine undergraduate optometry schools (100%) responded to the survey. The majority reported dedicating limited hours (0-3) to teaching smoking cessation, and predominantly focused on teaching the harmful effects of smoking (89%). Only one school provides practical skills training for delivering evidence-based smoking cessation interventions, including very brief advice. The majority of schools (78%) reported that they did not formally examine students on their knowledge or skills for supporting smoking cessation, and rated confidence in their graduates' abilities to deliver smoking cessation interventions as 'poor' (78%). Lack of knowledge amongst staff was identified as the key barrier to teaching about smoking cessation support. The pre-registration competency framework does not include any competence indicators related to providing support for quitting smoking. There are substantial gaps in the current curricula of UK optometry training, particularly regarding practical skills for supporting smoking cessation. Increased curricular coverage of these issues is essential to ensure trainee optometrists are adequately trained and competent in supporting patients to quit smoking. © 2016 The Authors. Ophthalmic and Physiological Optics published by John Wiley & Sons Ltd on behalf of College of Optometrists.

A Cost-Effectiveness Analysis of Stop Smoking Interventions in Substance Use Disorder Populations undergoing treatment.

PubMed

Healey, Andrew; Roberts, Sarah; Sevdalis, Nick; Goulding, Lucy; Wilson, Sophie; Shaw, Kate; Jolley, Caroline; Robson, Deborah

2018-05-04

Tobacco smoking is highly prevalent among people attending treatment for a substance use disorder (SUD). In the UK, specialist support to stop smoking is largely delivered by a national network of Stop Smoking Services, and typically comprises of behavioural support delivered by trained practitioners on an individual (one-to-one) or group basis combined with a pharmacological smoking cessation aid. We evaluate the cost-effectiveness of these interventions, and compare cost-effectiveness for interventions using group- and individual-based support, in populations under treatment for SUD. Economic modelling was used to evaluate the incremental cost-per-quality adjusted life years (QALYs) gained for smoking cessation interventions compared to alternative methods of quitting for the SUD treatment population. Allowance was made for potentially lower abstinence rates in the SUD population. The incremental cost per QALY gained from quit attempts supported through more frequently provided interventions in England ranged from around £4,700 to £12,200. These values are below the maximum cost-effectiveness threshold adopted by policy makers in England for judging whether health programmes are a cost-effective use of resources. The estimated cost-per QALY gained for Interventions using group-based behavioural support were estimated to be at least half the magnitude of those using individual support due to lower intervention costs and higher reported quit rates. Conclusions reached regarding the cost-effectiveness of group-based interventions were also found to be more robust to changes in modelling assumptions. Smoking cessation interventions were found to be cost-effective when applied to the SUD population, particularly when grouped-based behavioural support is offered alongside pharmacological treatment. This analysis has shown that smoking cessation interventions combining pharmacological treatment with behavioural support can offer a cost-effective method for increasing rates of smoking cessation in populations being treated for a substance use disorder. This is despite evidence of lower comparative success rates in terms of smoking abstinence in populations with SUD. Our evaluation suggests that medication combined with group-based behavioural support may offer better value for money in this population compared to interventions using individual support, though further evidence on the comparative effectiveness and cost of interventions delivered to SUD treatment populations would facilitate a more robust comparison.

Smoking-Cessation Counseling Practices of College/University Health-Care Providers--A Theory-Based Approach

ERIC Educational Resources Information Center

Fagan, Kathleen A.

2007-01-01

Objective: The author's purpose in this study was to examine the relation between smoking cessation counseling self-efficacy, knowledge of smoking cessation counseling, motivation to counsel smokers, and barriers to performing smoking cessation counseling, relative to the smoking cessation counseling stage of change. Participants and Methods:…

The Effect of Five Smoking Cessation Pharmacotherapies on Smoking Cessation Milestones

ERIC Educational Resources Information Center

Japuntich, Sandra J.; Piper, Megan E.; Leventhal, Adam M.; Bolt, Daniel M.; Baker, Timothy B.

2011-01-01

Objective: Most smoking cessation studies have used long-term abstinence as their primary outcome measure. Recent research has suggested that long-term abstinence may be an insensitive index of important smoking cessation mechanisms. The goal of the current study was to examine the effects of 5 smoking cessation pharmacotherapies using Shiffman et…

Investigation of Hong Kong doctors' current knowledge, beliefs, attitudes, confidence and practices: implications for the treatment of tobacco dependency.

PubMed

Abdullah, Abu Saleh M; Rahman, A S M Mujibur; Suen, Chau Wai; Wing, Lau Sun; Ling, Lau Wai; Mei, Li Yuen; Tat, Lun Chung; Tai, Mak Nin; Wing, Tsai Nga; Yuen, Wu Tsz; Kwan, Yam H

2006-10-01

Physicians play a crucial role in promoting smoking cessation. However, there are lack of data on Chinese doctors' knowledge, beliefs, attitudes, confidence and usual practices in relation to smoking cessation. Understanding of these indicators is important in the design of any effective intervention program targeting doctors. To assess Chinese doctors' knowledge, beliefs, attitudes, confidence and usual practices in relation to smoking cessation, a mailed questionnaire survey was conducted among 4,000 doctors registered with the Hong Kong Medical Association (HKMA) in 2002. Of the 757 respondents (18.9% response rate), 78% were male, 94% were non-smokers and 50% had received no basic training on smoking cessation. More than half of the doctors did not hold adequate knowledge (53%) or favorable attitudes (55%) towards smoking cessation; 44% were less confident in their smoking cessation skills. About 77% of the doctors obtained information on their patients' smoking status and recorded it in their medical record, and 29% advised all smoking patients to quit. Doctors who gave smoking cessation advice were more likely to be aged above 50 years, with more than 30 years' practice experience, working in the private sector, non- or ex-smokers, with more positive beliefs towards smoking cessation, and with higher confidence in smoking cessation skills (p < 0.001). Different factors associated with establishing and recording smoking status, arranging follow-up sessions, acquiring more knowledge and developing a more favorable attitude and greater confidence on smoking cessation-related matters were also identified. The survey has shown that existing smoking cessation service provision in Hong Kong for patients who smoke is inadequate, and has identified a lack of smoking cessation skills among doctors. Action should be taken to train doctors in smoking cessation skills and encourage them to routinely establish the smoking status of their patients and to advise all smokers to quit smoking.

[Structural Equation Modeling on Smoking Cessation Intention in Male Technical High School Students].

PubMed

Do, Eun Su; Choi, Eunsuk

2017-04-01

This study was done to develop and test a structural model on smoking cessation intention in technical high school men. The conceptual model was based on the theory of reasoned action and health promotion model. From May 29 to April 13, 2015, 413 technical high school students who smoked completed a structured questionnaire. Data were analyzed to calculate the direct and indirect effects of factors affecting smoking cessation intention. The SPSS WIN 20.0 and AMOS 21.0 programs were used. The hypothetical model was a good fit for the data. The model fit indices were χ²/df=2.36, GFI=.95, AGFI=.92, NFI=0.97, and RMSEA=.05. Self-esteem had direct and indirect effects on smoking cessation intention. Attitude, subjective norm, and self-efficacy had direct effects on smoking cessation intention. Smoking knowledge and environmental factor had indirect effects on smoking cessation intention. This model explained 87.0% of the variance in smoking cessation intention. These results indicate that technical high school students' intention to stop smoking can be improved through an increase in self-esteem, negative environmental factors, attitude toward smoking cessation, subjective norm about smoking cessation, and self-efficacy for smoking cessation. © 2017 Korean Society of Nursing Science

Mobile phone-based interventions for smoking cessation.

PubMed

Whittaker, Robyn; McRobbie, Hayden; Bullen, Chris; Rodgers, Anthony; Gu, Yulong

2016-04-10

Access to mobile phones continues to increase exponentially globally, outstripping access to fixed telephone lines, fixed computers and the Internet. Mobile phones are an appropriate and effective option for the delivery of smoking cessation support in some contexts. This review updates the evidence on the effectiveness of mobile phone-based smoking cessation interventions. To determine whether mobile phone-based smoking cessation interventions increase smoking cessation in people who smoke and want to quit. For the most recent update, we searched the Cochrane Tobacco Addiction Group Specialised Register in April 2015. We also searched the UK Clinical Research Network Portfolio for current projects in the UK, and the ClinicalTrials.gov register for ongoing or recently completed studies. We searched through the reference lists of identified studies and attempted to contact the authors of ongoing studies. We applied no restrictions on language or publication date. We included randomised or quasi-randomised trials. Participants were smokers of any age who wanted to quit. Studies were those examining any type of mobile phone-based intervention for smoking cessation. This included any intervention aimed at mobile phone users, based around delivery via mobile phone, and using any functions or applications that can be used or sent via a mobile phone. Review authors extracted information on risk of bias and methodological details using a standardised form. We considered participants who dropped out of the trials or were lost to follow-up to be smoking. We calculated risk ratios (RR) and 95% confidence intervals (CI) for each included study. Meta-analysis of the included studies used the Mantel-Haenszel fixed-effect method. Where meta-analysis was not possible, we presented a narrative summary and descriptive statistics. This updated search identified 12 studies with six-month smoking cessation outcomes, including seven studies completed since the previous review. The interventions were predominantly text messaging-based, although several paired text messaging with in-person visits or initial assessments. Two studies gave pre-paid mobile phones to low-income human immunodeficiency virus (HIV)-positive populations - one solely for phone counselling, the other also included text messaging. One study used text messages to link to video messages. Control programmes varied widely. Studies were pooled according to outcomes - some providing measures of continuous abstinence or repeated measures of point prevalence; others only providing 7-day point prevalence abstinence. All 12 studies pooled using their most rigorous 26-week measures of abstinence provided an RR of 1.67 (95% CI 1.46 to 1.90; I(2) = 59%). Six studies verified quitting biochemically at six months (RR 1.83; 95% CI 1.54 to 2.19). The current evidence supports a beneficial impact of mobile phone-based smoking cessation interventions on six-month cessation outcomes. While all studies were good quality, the fact that those studies with biochemical verification of quitting status demonstrated an even higher chance of quitting further supports the positive findings. However, it should be noted that most included studies were of text message interventions in high-income countries with good tobacco control policies. Therefore, caution should be taken in generalising these results outside of this type of intervention and context.

Smoking Cessation without Educational Instruction could Promote the Development of Metabolic Syndrome.

PubMed

Takayama, Shin; Takase, Hiroyuki; Tanaka, Takamitsu; Sugiura, Tomonori; Ohte, Nobuyuki; Dohi, Yasuaki

2018-01-01

Smoking cessation is particularly important for maintaining health; however, the subsequent risk of an increased body weight is of major concern. The present study investigated the influence of smoking cessation on the incidence of metabolic syndrome and its components in the Japanese general population. This study enrolled individuals without metabolic syndrome or a history of smoking via our annual health checkup program (n=5,702, 55.2±11.5 years). Participants were divided into three groups mentioned below and followed up with the endpoint being the development of metabolic syndrome: (1) subjects who had never smoked and did not smoke during the observation period (non-smoker); (2) those who continued smoking during the observation period (continuous smoker); and (3) those who ceased smoking during the observation period (smoking cessation). During the observation period (median 1,089 days), 520 subjects developed metabolic syndrome, and Kaplan-Meier analysis showed a higher incidence of metabolic syndrome in the smoking cessation group than in the other groups. Smoking cessation was confirmed as an independent predictor of the new onset of metabolic syndrome by multivariate Cox proportional hazard analysis after adjustment. Subjects only from the smoking cessation group showed a significant deterioration in metabolic factors during the study in correlation with an increased waist circumference after smoking cessation. Smoking cessation without instruction could be followed by the development of metabolic syndrome, and the incidence of metabolic syndrome might reduce the benefit obtained from smoking cessation. Therefore, further educational outreach is needed to prevent the progression of metabolic syndrome during the course of smoking cessation.

Study protocol for iQuit in Practice: a randomised controlled trial to assess the feasibility, acceptability and effectiveness of tailored web- and text-based facilitation of smoking cessation in primary care.

PubMed

Sutton, Stephen; Smith, Susan; Jamison, James; Boase, Sue; Mason, Dan; Prevost, A Toby; Brimicombe, James; Sloan, Melanie; Gilbert, Hazel; Naughton, Felix

2013-04-10

Primary care is an important setting for smoking cessation interventions. There is evidence for the effectiveness of tailored interventions for smoking cessation, and text messaging interventions for smoking cessation show promise. The intervention to be evaluated in this trial consists of two components: (1) a web-based program designed to be used by a practice nurse or other smoking cessation advisor (SCA); the program generates a cessation advice report that is highly tailored to relevant characteristics of the smoker; and (2) a three-month programme of automated tailored text messages sent to the smoker's mobile phone. The objectives of the trial are to assess the acceptability and feasibility of the intervention and to estimate the short-term effectiveness of the intervention in increasing the quit rate compared with usual care alone. The design is a two parallel group randomised controlled trial (RCT). 600 smokers who want to quit will be recruited in up to 30 general practices in the East of England. During a consultation with an SCA, they will be individually randomised by computer program to usual care (Control) or to usual care plus the iQuit system (Intervention). At the four-week follow-up appointment, the SCA will record smoking status and measure carbon monoxide level. There will be two further follow-ups, at eight weeks and six months from randomisation date, by postal questionnaire sent from and returned to the study centre or by telephone interview conducted by a research interviewer. The primary outcome will be self-reported abstinence for at least two weeks at eight weeks. A sample size of 300 per group would give 80% power to detect an increase in quit rate from 20% to 30% (alpha = 0.05, 2-sided test). The main analyses of quit rates will be conducted on an intention-to-treat basis, making the usual assumption that participants lost to follow up are smoking. This trial will focus on acceptability, feasibility and short-term effectiveness. The findings will be used to refine the intervention and to inform the decision to proceed to a pragmatic trial to estimate longer-term effectiveness and cost-effectiveness. ISRCTN56702353.

Promoting smoking cessation in Pakistani and Bangladeshi men in the UK: pilot cluster randomised controlled trial of trained community outreach workers

PubMed Central

2011-01-01

Background Smoking prevalence is high among Pakistani and Bangladeshi men in the UK, but there are few tailored smoking cessation programmes for Pakistani and Bangladeshi communities. The aim of this study was to pilot a cluster randomised controlled trial comparing the effectiveness of Pakistani and Bangladeshi smoking cessation outreach workers with standard care to improve access to and the success of English smoking cessation services. Methods A pilot cluster randomised controlled trial was conducted in Birmingham, UK. Geographical lower layer super output areas were used to identify natural communities where more than 10% of the population were of Pakistani and Bangladeshi origin. 16 agglomerations of super output areas were randomised to normal care controls vs. outreach intervention. The number of people setting quit dates using NHS services, validated abstinence from smoking at four weeks, and stated abstinence at three and six months were assessed. The impact of the intervention on choice and adherence to treatments, attendance at clinic appointments and patient satisfaction were also assessed. Results We were able to randomise geographical areas and deliver the outreach worker-based services. More Pakistani and Bangladeshi men made quit attempts with NHS services in intervention areas compared with control areas, rate ratio (RR) 1.32 (95%CI: 1.03-1.69). There was a small increase in the number of 4-week abstinent smokers in intervention areas (RR 1.30, 95%CI: 0.82-2.06). The proportion of service users attending weekly appointments was lower in intervention areas than control areas. No difference was found between intervention and control areas in choice and adherence to treatments or patient satisfaction with the service. The total cost of the intervention was £124,000; an estimated cost per quality-adjusted life year (QALY) gained of £8,500. Conclusions The intervention proved feasible and acceptable. Outreach workers expanded reach of smoking cessation services in diverse locations of relevance to Pakistani and Bangladeshi communities. The outreach worker model has the potential to increase community cessation rates and could prove cost-effective, but needs evaluating definitively in a larger, appropriately powered, randomised controlled trial. These future trials of outreach interventions need to be of sufficient duration to allow embedding of new models of service delivery. Trial registration Current Controlled Trials ISRCTN82127540 PMID:21854596

A meta-analysis of smoking cessation interventions with individuals in substance abuse treatment or recovery.

PubMed

Prochaska, Judith J; Delucchi, Kevin; Hall, Sharon M

2004-12-01

This meta-analysis examined outcomes of smoking cessation interventions evaluated in 19 randomized controlled trials with individuals in current addictions treatment or recovery. Smoking and substance use outcomes at posttreatment and long-term follow-up (> or = 6 months) were summarized with random effects models. Intervention effects for smoking cessation were significant at posttreatment and comparable for participants in addictions treatment and recovery; however, intervention effects for smoking cessation were nonsignificant at long-term follow-up. Smoking cessation interventions provided during addictions treatment were associated with a 25% increased likelihood of long-term abstinence from alcohol and illicit drugs. Short-term smoking cessation effects look promising, but innovative strategies are needed for long-term cessation. Contrary to previous concerns, smoking cessation interventions during addictions treatment appeared to enhance rather than compromise long-term sobriety. Copyright 2004 APA.

Effectiveness and cost-effectiveness of computer and other electronic aids for smoking cessation: a systematic review and network meta-analysis.

PubMed

Chen, Y-F; Madan, J; Welton, N; Yahaya, I; Aveyard, P; Bauld, L; Wang, D; Fry-Smith, A; Munafò, M R

2012-01-01

Smoking is harmful to health. On average, lifelong smokers lose 10 years of life, and about half of all lifelong smokers have their lives shortened by smoking. Stopping smoking reverses or prevents many of these harms. However, cessation services in the NHS achieve variable success rates with smokers who want to quit. Approaches to behaviour change can be supplemented with electronic aids, and this may significantly increase quit rates and prevent a proportion of cases that relapse. The primary research question we sought to answer was: What is the effectiveness and cost-effectiveness of internet, pc and other electronic aids to help people stop smoking? We addressed the following three questions: (1) What is the effectiveness of internet sites, computer programs, mobile telephone text messages and other electronic aids for smoking cessation and/or reducing relapse? (2) What is the cost-effectiveness of incorporating internet sites, computer programs, mobile telephone text messages and other electronic aids into current nhs smoking cessation programmes? and (3) What are the current gaps in research into the effectiveness of internet sites, computer programs, mobile telephone text messages and other electronic aids to help people stop smoking? For the effectiveness review, relevant primary studies were sought from The Cochrane Library [Cochrane Central Register of Controlled Trials (CENTRAL)] 2009, Issue 4, and MEDLINE (Ovid), EMBASE (Ovid), PsycINFO (Ovid), Health Management Information Consortium (HMIC) (Ovid) and Cumulative Index to Nursing and Allied Health Literature (CINAHL) (EBSCOhost) from 1980 to December 2009. In addition, NHS Economic Evaluation Database (NHS EED) and Database of Abstracts of Reviews of Effects (DARE) were searched for information on cost-effectiveness and modelling for the same period. Reference lists of included studies and of relevant systematic reviews were examined to identify further potentially relevant studies. Research registries of ongoing studies including National Institute for Health Research (NIHR) Clinical Research Network Portfolio Database, Current Controlled Trials and ClinicalTrials.gov were also searched, and further information was sought from contacts with experts. Randomised controlled trials (RCTs) and quasi-RCTs evaluating smoking cessation programmes that utilise computer, internet, mobile telephone or other electronic aids in adult smokers were included in the effectiveness review. Relevant studies of other design were included in the cost-effectiveness review and supplementary review. Pair-wise meta-analyses using both random- and fixed-effects models were carried out. Bayesian mixed-treatment comparisons (MTCs) were also performed. A de novo decision-analytical model was constructed for estimating the cost-effectiveness of interventions. Expected value of perfect information (EVPI) was calculated. Narrative synthesis of key themes and issues that may influence the acceptability and usability of electronic aids was provided in the supplementary review. This effectiveness review included 60 RCTs/quasi-RCTs reported in 77 publications. Pooled estimate for prolonged abstinence [relative risk (RR) = 1.32, 95% confidence interval (CI) 1.21 to 1.45] and point prevalence abstinence (RR = 1.14, 95% CI 1.07 to 1.22) suggested that computer and other electronic aids increase the likelihood of cessation compared with no intervention or generic self-help materials. There was no significant difference in effect sizes between aid to cessation studies (which provide support to smokers who are ready to quit) and cessation induction studies (which attempt to encourage a cessation attempt in smokers who are not yet ready to quit). Results from MTC also showed small but significant intervention effect (time to relapse, mean hazard ratio 0.87, 95% credible interval 0.83 to 0.92). Cost-threshold analyses indicated some form of electronic intervention is likely to be cost-effective when added to non-electronic behavioural support, but there is substantial uncertainty with regard to what the most effective (thus most cost-effective) type of electronic intervention is, which warrants further research. EVPI calculations suggested the upper limit for the benefit of this research is around £ 2000-3000 per person. The review focuses on smoking cessation programmes in the adult population, but does not cover smoking cessation in adolescents. Most available evidence relates to interventions with a single tailored component, while evidence for different modes of delivery (e.g. e-mail, text messaging) is limited. Therefore, the findings of lack of sufficient evidence for proving or refuting effectiveness should not be regarded as evidence of ineffectiveness. We have examined only a small number of factors that could potentially influence the effectiveness of the interventions. A comprehensive evaluation of potential effect modifiers at study level in a systematic review of complex interventions remains challenging. Information presented in published papers is often insufficient to allow accurate coding of each intervention or comparator. A limitation of the cost-effectiveness analysis, shared with several previous cost-effectiveness analyses of smoking cessation interventions, is that intervention benefit is restricted to the first quit attempt. Exploring the impact of interventions on subsequent attempts requires more detailed information on patient event histories than is available from current evidence. Our effectiveness review concluded that computer and other electronic aids increase the likelihood of cessation compared with no intervention or generic self-help materials, but the effect is small. The effectiveness does not appear to vary with respect to mode of delivery and concurrent non-electronic co-interventions. Our cost-effectiveness review suggests that making some form of electronic support available to smokers actively seeking to quit is highly likely to be cost-effective. This is true whether the electronic intervention is delivered alongside brief advice or more intensive counselling. The key source of uncertainty is that around the comparative effectiveness of different types of electronic interventions. Our review suggests that further research is needed on the relative benefits of different forms of delivery for electronic aids, the content of delivery, and the acceptability of these technologies for smoking cessation with subpopulations of smokers, particularly disadvantaged groups. More evidence is also required on the relationship between involving users in the design of interventions and the impact this has on effectiveness, and finally on how electronic aids developed and tested in research settings are applied in routine practice and in the community.

[Smoking abstinence rate and its associated factors between abrupt and gradual smoking cessation].

PubMed

Hao, R; Zhou, J P; Ni, L; Li, Q Y; Shi, G C

2017-12-12

Objective: To analyze and compare the abstinence rate of smoking quitting methods and its associated factors between abrupt and gradual smoking cessation in smokers with drug-based therapy. Methods: A prospective clinical study was conducted in patients undergoing quitting smoking intervention in Ruijin Hospital smoking cessation clinic between June 2013 and May 2016. All the subjects were randomized in a 1∶1 ratio into the abrupt smoking cessation group (smoking as usual over 3 weeks before a planned quit day, and then stopping smoking abruptly) and the gradual smoking cessation group (gradually reducing tobacco use over 3 weeks before a planned quit day, and then stopping smoking totally). The primary outcome was the complete abstinence rate, and the secondary outcomes included 1-month, 3-month and 6 month 7-day point prevalence of abstinence rates and 3 month sustained abstinence rates. Changes of body weight and drug adverse events were also compared. Results: A total of 314 moderate to severe nicotine-dependent patients were admitted in the study, including 157 patients in the abrupt smoking cessation and 157 patients in the gradual smoking cessation group. Fourteen patients fell off during the follow-up. For the complete abstinence rate, the gradual smoking cessation group was higher than the abrupt smoking cessation group(55.0% vs . 36.9%, χ(2)=9.841, P =0.002) .For 7-d smoking abstinence rate in the 1st, 3rd, 6th month, there was no significant difference between the 2 groups (all P >0.05). As for the 3-month sustained abstinence rate, a higher smoking quitting rate was seen in the gradual smoking cessation group compared to the abrupt smoking cessation group in the 6-month follow-up (17.9% vs .8.7%, χ(2)=5.441, P =0.020). The adverse drug reaction incidence was higher in the abrupt smoking cessation group than the gradual smoking cessation group (Gastrointestinal discomfort: 39.2% vs . 17.7%, χ(2)=12.336, P =0.000; Dreaminess: 40.2% vs . 13.3%, χ(2)=20.172, P =0.000). Conclusions: For moderate to severe nicotine-dependent patients, the gradual smoking cessation could serve to enhance the abstinence rate and mitigate the withdrawal symptoms.

Free smoking cessation mobile apps available in Australia: a quality review and content analysis.

PubMed

Thornton, Louise; Quinn, Catherine; Birrell, Louise; Guillaumier, Ashleigh; Shaw, Brad; Forbes, Erin; Deady, Mark; Kay-Lambkin, Frances

2017-12-01

This review aimed to identify free, high-quality, smoking cessation mobile applications (apps) that adhere to Australian smoking cessation treatment guidelines. A systematic search of smoking cessation apps was conducted using Google. The technical quality of relevant apps was rated using the Mobile Application Rating Scale. The content of apps identified as high quality was assessed for adherence to smoking cessation treatment guidelines. 112 relevant apps were identified. The majority were of poor technical quality and only six 'high-quality' apps were identified. These apps adhered to Australian treatment guidelines in part. The efficacy of two apps had been previously evaluated. In lieu of more substantial research in this area, it is suggested that the high-quality apps identified in this review may be more likely than other available apps to encourage smoking cessation. Implications for public health: Smoking cessation apps have the potential to address many barriers that prevent smoking cessation support being provided; however few high-quality smoking cessation apps are currently available in Australia, very few have been evaluated and the app market is extremely volatile. More research to evaluate smoking cessation apps, and sustained funding for evidence-based apps, is needed. © 2017 The Authors.

Proactive tobacco treatment offering free nicotine replacement therapy and telephone counselling for socioeconomically disadvantaged smokers: a randomised clinical trial

PubMed Central

Fu, Steven S; van Ryn, Michelle; Nelson, David; Burgess, Diana J; Thomas, Janet L; Saul, Jessie; Clothier, Barbara; Nyman, John A; Hammett, Patrick; Joseph, Anne M

2016-01-01

Background Evidenced-based tobacco cessation treatments are underused, especially by socioeconomically disadvantaged smokers. This contributes to widening socioeconomic disparities in tobacco-related morbidity and mortality. Methods The Offering Proactive Treatment Intervention trial tested the effects of a proactive outreach tobacco treatment intervention on population-level smoking abstinence and tobacco treatment use among a population-based sample of socioeconomically disadvantaged smokers. Current smokers (n=2406), regardless of interest in quitting, who were enrolled in the Minnesota Health Care Programs, the state's publicly funded healthcare programmes for low-income populations, were randomly assigned to proactive outreach or usual care. The intervention comprised proactive outreach (tailored mailings and telephone calls) and free cessation treatment (nicotine replacement therapy and intensive, telephone counselling). Usual care comprised access to a primary care physician, insurance coverage of Food and Drug Administration-approved smoking cessation medications, and the state's telephone quitline. The primary outcome was self-reported 6-month prolonged smoking abstinence at 1 year and was assessed by follow-up survey. Findings The proactive intervention group had a higher prolonged abstinence rate at 1 year than usual care (16.5% vs 12.1%, OR 1.47, 95% CI 1.12 to 1.93). The effect of the proactive intervention on prolonged abstinence persisted in selection models accounting for non-response. In analysis of secondary outcomes, use of evidence-based tobacco cessation treatments were significantly greater among proactive outreach participants compared with usual care, particularly combination counselling and medications (17.4% vs 3.6%, OR 5.69, 95% CI 3.85 to 8.40). Interpretation Population-based proactive tobacco treatment increases engagement in evidence-based treatment and is effective in long-term smoking cessation among socioeconomically disadvantaged smokers. Findings suggest that dissemination of population-based proactive treatment approaches is an effective strategy to reduce the prevalence of smoking and socioeconomic disparities in tobacco use. Trial registration number NCT01123967. PMID:26931362

The association of environmental, individual factors, and dopamine pathway gene variation with smoking cessation.

PubMed

Li, Suyun; Wang, Qiang; Pan, Lulu; Yang, Xiaorong; Li, Huijie; Jiang, Fan; Zhang, Nan; Han, Mingkui; Jia, Chongqi

2017-09-01

This study aimed to examine whether dopamine (DA) pathway gene variation were associated with smoking cessation, and compare the relative importance of infulence factors on smoking cessation. Participants were recruited from 17 villages of Shandong Province, China. Twenty-five single nucleotide polymorphisms in 8 DA pathway genes were genotyped. Weighted gene score of each gene was used to analyze the whole gene effect. Logistic regression was used to calculate odds ratios (OR) of the total gene score for smoking cessation. Dominance analysis was employed to compare the relative importance of individual, heaviness of smoking, psychological and genetic factors on smoking cessation. 415 successful spontaneous smoking quitters served as the cases, and 404 unsuccessful quitters served as the controls. A significant negative association of total DA pathway gene score and smoking cessation was observed (p < 0.001, OR: 0.25, 95% CI 0.16-0.38). Dominance analysis showed that the most important predictor for smoking cessation was heaviness of smoking score (42%), following by individual (40%), genetic (10%) and psychological score (8%). In conclusion, although the DA pathway gene variation was significantly associated with successful smoking cessation, heaviness of smoking and individual factors had bigger effect than genetic factors on smoking cessation.

Applying a new theory to smoking cessation: case of multi-theory model (MTM) for health behavior change.

PubMed

Sharma, Manoj; Khubchandani, Jagdish; Nahar, Vinayak K

2017-01-01

Background: Smoking continues to be a public health problem worldwide. Smoking and tobacco use are associated with cardiovascular diseases that include coronary heart disease, atherosclerosis, cerebrovascular disease, and abdominal aortic aneurysm. Programs for quitting smoking have played a significant role in reduction of smoking in the United States. The smoking cessation interventions include counseling, nicotine replacement therapy, buproprion therapy, and varenicline therapy. The success rates with each of these approaches vary with clear need for improvement. Moreover, there is a need for a robust theory that can guide smoking cessation counseling interventions and increase the success rates. A fourth generation approach using multi-theory model (MTM) of health behavior change is introduced in this article for smoking cessation. An approach for developing and evaluating an intervention for smoking cessation is presented along with a measurement tool. Methods: A literature review reifying the MTM of health behavior change for smoking cessation has been presented. An instrument designed to measure constructs of MTM and associated smoking cessation behavior has been developed. Results: The instrument developed is available for validation, reliability and prediction study pertaining to smoking cessation. The intervention is available for testing in a randomized control trial involving smokers. Conclusion: MTM is a robust theory that holds promise for testing and application to smoking cessation.

Proactive and Brief Smoking Cessation Intervention for Smokers at Outdoor Smoking "Hotspots" in Hong Kong.

PubMed

Chan, Sophia Siu Chee; Cheung, Yee Tak Derek; Wan, Zoe; Wang, Man Ping; Lam, Tai-Hing

2018-04-01

Increased outdoor smoking is a common phenomenon after indoor smoking bans were in place. A series of observational studies were conducted to evaluate a novel, proactive, and brief smoking cessation intervention at outdoor smoking "hotspots," i.e., outdoor public areas where ashtrays were available and smokers clustered to smoke. The number of smokers at 26 selected hotspots were observed and counted for two consecutive days. Further observations of the smokers' characteristics and brief smoking cessation intervention were conducted at ten of the hotspots with the greatest number of smokers. Responses of the smokers to the brief intervention, including a leaflet and brief smoking cessation advice using AWAR protocol delivered by trained smoking cessation ambassadors, were assessed. A total of 24,034 smokers were observed within 464 h, which equals 51.8 smokers per hour. Of the 5070 pedestrians observed at the ten hotspots during the intervention sessions, 1228 (24.2 %) were smokers. In the 1228 smokers who were approached during our intervention sessions, about two thirds were willing to receive the self-help leaflet on smoking cessation whereas about half received the brief smoking cessation advice. Recruiting smokers and delivering brief smoking cessation interventions at smoking hotspots are feasible and likely effective to reach large numbers of smokers. Studies to evaluate the effectiveness of using this approach for smoking cessation are warranted.

Cessation-related weight concern among homeless male and female smokers.

PubMed

Pinsker, Erika Ashley; Hennrikus, Deborah Jane; Erickson, Darin J; Call, Kathleen Thiede; Forster, Jean Lois; Okuyemi, Kolawole Stephen

2017-09-01

Concern about post-cessation weight gain is a barrier to making attempts to quit smoking; however, its effect on smoking cessation is unclear. In this study we examine cessation-related weight concern among the homeless, which hasn't been studied. Homeless males (n = 320) and females (n = 110) participating in a smoking cessation RCT in the Twin Cities, Minnesota from 2009 to 2011 completed surveys on cessation-related weight concern, smoking status, and components from the Behavioral Model for Vulnerable Populations. Generalized estimating equations were used to examine baseline predictors of cessation-related weight concern at baseline, the end of treatment, and 26-weeks follow-up. Logistic regression models were used to examine the relationship between cessation-related weight concern and smoking status at the end of treatment and follow-up. Females had higher cessation-related weight concern than males. Among males, older age, Black race, higher BMI, depression, and having health insurance were associated with higher cessation-related weight concern. Among females, nicotine dependence, greater cigarette consumption, indicating quitting is more important, older age of smoking initiation, and less support to quit from family were associated with higher cessation-related weight concern. In multivariate analyses, cessation-related weight concern decreased over time among females. Cessation-related weight concern wasn't associated with smoking cessation. Although several types of characteristics predicted cessation-related weight concern among males, only smoking characteristics predicted cessation-related weight concern among females. Given the small proportion of quitters in this study (8% of males and 5% of females), further research on the impact of cessation-related weight concern on smoking cessation among the homeless is warranted.

Exercise to Enhance Smoking Cessation: the Getting Physical on Cigarette Randomized Control Trial.

PubMed

Prapavessis, Harry; De Jesus, Stefanie; Fitzgeorge, Lindsay; Faulkner, Guy; Maddison, Ralph; Batten, Sandra

2016-06-01

Exercise has been proposed as a useful smoking cessation aid. The purpose of the present study is to determine the effect of an exercise-aided smoking cessation intervention program, with built-in maintenance components, on post-intervention 14-, 26- and 56-week cessation rates. Female cigarette smokers (n = 413) participating in a supervised exercise and nicotine replacement therapy (NRT) smoking cessation program were randomized to one of four conditions: exercise + smoking cessation maintenance, exercise maintenance + contact control, smoking cessation maintenance + contact control or contact control. The primary outcome was continuous smoking abstinence. Abstinence differences were found between the exercise and equal contact non-exercise maintenance groups at weeks 14 (57 vs 43 %), 26 (27 vs 21 %) and 56 (26 vs 23.5 %), respectively. Only the week 14 difference approached significance, p = 0.08. An exercise-aided NRT smoking cessation program with built-in maintenance components enhances post-intervention cessation rates at week 14 but not at weeks 26 and 56.

Addressing Heavy Drinking in Smoking Cessation Treatment: A Randomized Clinical Trial

ERIC Educational Resources Information Center

Kahler, Christopher W.; Metrik, Jane; LaChance, Heather R.; Ramsey, Susan E.; Abrams, David B.; Monti, Peter M.; Brown, Richard A.

2008-01-01

Heavy alcohol use frequently co-occurs with cigarette smoking and may impede smoking cessation. This clinical trial examined whether smoking cessation treatment that incorporates brief alcohol intervention can improve smoking cessation outcomes (7-day verified point prevalence abstinence) and reduce drinks consumed per week. Heavy drinkers seeking…

Happy ending: a randomized controlled trial of a digital multi-media smoking cessation intervention.

PubMed

Brendryen, Håvar; Kraft, Pål

2008-03-01

To assess the long-term efficacy of a fully automated digital multi-media smoking cessation intervention. Two-arm randomized control trial (RCT). Setting World Wide Web (WWW) study based in Norway. Subjects (n = 396) were recruited via internet advertisements and assigned randomly to conditions. Inclusion criteria were willingness to quit smoking and being aged 18 years or older. The treatment group received the internet- and cell-phone-based Happy Ending intervention. The intervention programme lasted 54 weeks and consisted of more than 400 contacts by e-mail, web-pages, interactive voice response (IVR) and short message service (SMS) technology. The control group received a self-help booklet. Additionally, both groups were offered free nicotine replacement therapy (NRT). Abstinence was defined as 'not even a puff of smoke, for the last 7 days', and assessed by means of internet surveys or telephone interviews. The main outcome was repeated point abstinence at 1, 3, 6 and 12 months following cessation. Participants in the treatment group reported clinically and statistically significantly higher repeated point abstinence rates than control participants [22.3% versus 13.1%; odds ratio (OR) = 1.91, 95% confidence interval (CI): 1.12-3.26, P = 0.02; intent-to-treat). Improved adherence to NRT and a higher level of post-cessation self-efficacy were observed in the treatment group compared with the control group. As the first RCT documenting the long-term treatment effects of such an intervention, this study adds to the promise of digital media in supporting behaviour change.

Exercise-based smoking cessation interventions among women

PubMed Central

Linke, Sarah E; Ciccolo, Joseph T; Ussher, Michael; Marcus, Bess H

2017-01-01

Although smoking rates are lower among women than men, women are less likely to quit smoking in cessation trials. This is in part due to their tendency to smoke to help prevent or mitigate negative mood/affect, depression and/or postcessation weight gain. Exercise helps to alleviate women’s fear of postcessation weight gain and reduces their cessation-related mood symptoms, making it a theoretically ideal smoking cessation intervention for women. In addition, short bouts of exercise decrease cigarette cravings and withdrawal symptoms among temporarily abstinent smokers. However, results from exercise-based smoking cessation interventions to date have been mostly nonsignificant. This paper describes the theoretical mechanisms (psychological, behavioral, physiological and neurobiological) and practical reasons underlying our belief that exercise-based smoking cessation interventions should not yet be abandoned despite their current paucity of supporting evidence. It also presents ideas for modifying future exercise-based smoking cessation interventions to increase adherence and, as a result, more accurately evaluate the effect of exercise on smoking cessation. PMID:23241156

Exercise-based smoking cessation interventions among women.

PubMed

Linke, Sarah E; Ciccolo, Joseph T; Ussher, Michael; Marcus, Bess H

2013-01-01

Although smoking rates are lower among women than men, women are less likely to quit smoking in cessation trials. This is in part due to their tendency to smoke to help prevent or mitigate negative mood/affect, depression and/or postcessation weight gain. Exercise helps to alleviate women's fear of postcessation weight gain and reduces their cessation-related mood symptoms, making it a theoretically ideal smoking cessation intervention for women. In addition, short bouts of exercise decrease cigarette cravings and withdrawal symptoms among temporarily abstinent smokers. However, results from exercise-based smoking cessation interventions to date have been mostly nonsignificant. This paper describes the theoretical mechanisms (psychological, behavioral, physiological and neurobiological) and practical reasons underlying our belief that exercise-based smoking cessation interventions should not yet be abandoned despite their current paucity of supporting evidence. It also presents ideas for modifying future exercise-based smoking cessation interventions to increase adherence and, as a result, more accurately evaluate the effect of exercise on smoking cessation.

Tobacco health warning messages on plain cigarette packs and in television campaigns: a qualitative study with Australian socioeconomically disadvantaged smokers.

PubMed

Guillaumier, Ashleigh; Bonevski, Billie; Paul, Christine

2015-02-01

Television advertisements, packaging regulations and health warning labels (HWLs) are designed to communicate anti-smoking messages to large number of smokers. However, only a few studies have examined how high smoking prevalence groups respond to these warnings. This study explored how socioeconomically disadvantaged smokers engage with health risk and cessation benefit messages. Six focus groups were conducted over September 2012-April 2013 with adult clients of welfare organizations in regional New South Wales, Australia who were current smokers (n = 51). Participants discussed HWLs, plain packaging and anti-smoking television advertisements. Discussions were audio-taped, transcribed verbatim and analysed using thematic analysis. Highly emotive warnings delivering messages of negative health effects were most likely to capture the attention of the study participants; however, these warning messages did not prompt quit attempts and participants were sceptical about the effectiveness of cessation programmes such as telephone quitlines. Active avoidance of health warning messages was common, and many expressed false and self-exempting beliefs towards the harms of tobacco. Careful consideration of message content and medium is required to communicate the anti-smoking message to disadvantaged smokers who consider themselves desensitized to warnings. Health communication strategies should continue to address false beliefs about smoking and educate on cessation services that are currently underutilized. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

The Prevalence and Predictors of Cigarette Smoking among Secondary School Students in Nigeria.

PubMed

Odeyemi, K A; Osibogun, A; Akinsete, A O; Sadiq, L

2009-03-01

This study was carried out to determine the prevalence of smoking among secondary school students and identify factors that influence smoking amongst them. This descriptive and explorative study was conducted among 1,183 secondary school students, selected by multistage sampling from each of the 6 geopolitical zones in Nigeria. Data was collected by using interviewer administered structured questionnaires. This study recorded a lifetime smoking prevalence of 26.4% and current smoking prevalence of 17.1% among secondary school students in Nigeria. Most (82%) of the students had seen warnings against smoking and most of them were aware that it is possible for cigarette smoking to damage body organs. Unfortunately, however, seeing such warnings had no significant effect on their decision to smoke or not. The students who smoke were introduced to smoking mainly by their friends (67.4 %), and the television (13.4%). Smoking habits of the respondents were influenced by parents' educational status (p<0.05), having friends who smoke (p<0.05) and living with a smoker (p<0.05). Over a quarter of secondary school students had ever smoked. Peer pressure was the main reason cited by respondents for initiating smoking. It is suggested that our smoking prevention programmes be reviewed and appropriate health education and smoking cessation programmes be developed and implemented in order to prevent and control smoking among Nigerian students.

Predicting the future prevalence of cigarette smoking in Italy over the next three decades.

PubMed

Carreras, Giulia; Gorini, Giuseppe; Gallus, Silvano; Iannucci, Laura; Levy, David T

2012-10-01

Smoking prevalence in Italy decreased by 37% from 1980 to now. This is due to changes in smoking initiation and cessation rates and is in part attributable to the development of tobacco control policies. This work aims to estimate the age- and sex-specific smoking initiation and cessation probabilities for different time periods and to predict the future smoking prevalence in Italy, assuming different scenarios. A dynamic model describing the evolution of current, former and never smokers was developed. Cessation and relapse rates were estimated by fitting the model with smoking prevalence in Italy, 1986-2009. The estimated parameters were used to predict prevalence, according to scenarios: (1) 2000-09 initiation/cessation; (2) half initiation; (3) double cessation; (4) Scenarios 2+3; (5) triple cessation; and (6) Scenarios 2+5. Maintaining the 2000-09 initiation/cessation, the 10% goal will not be achieved within next three decades: prevalence will stabilize at 12.1% for women and 20.3% for men. The goal could be rapidly achieved for women by halving initiation and tripling cessation (9.9%, 2016), or tripling cessation only (10.4%, 2017); for men halving initiation and tripling cessation (10.8%, 2024), or doubling cessation and halving initiation (10.5%, 2033), or tripling cessation only (10.8%, 2033). The 10% goal will be achieved within the next few decades, mainly by increasing smoking cessation. Policies to reach this goal would include increasing cigarette taxes, introducing total reimbursement of smoking cessation treatment, with a further development of quitlines and smoking cessation services. These measures are not yet fully implemented in Italy.

Would vaccination against nicotine be a cost-effective way to prevent smoking uptake in adolescents?

PubMed

Gartner, Coral E; Barendregt, Jan J; Wallace, Angela; Hall, Wayne D

2012-04-01

We used epidemiological modelling to assess whether nicotine vaccines would be a cost-effective way of preventing smoking uptake in adolescents. We built an epidemiological model using Australian data on age-specific smoking prevalence; smoking cessation and relapse rates; life-time sex-specific disability-adjusted life years lived for cohorts of 100,000 smokers and non-smokers; government data on the costs of delivering a vaccination programme by general practitioners; and a range of plausible and optimistic estimates of vaccine cost, efficacy and immune response rates based on clinical trial results. We first estimated the smoking uptake rates for Australians aged 12-19 years. We then used these estimates to predict the expected smoking prevalence in a birth cohort aged 12 in 2003 by age 20 under (i) current policy and (ii) different vaccination scenarios that varied in cost, initial vaccination uptake, yearly re-vaccination rates, efficacy and a favourable vaccine immune response rate. Under the most optimistic assumptions, the cost to avert a smoker at age 20 was $44,431 [95% confidence interval (CI) $40,023-49,250]. This increased to $296,019 (95% CI $252,307-$355,930) under more plausible scenarios. The vaccine programme was not cost-effective under any scenario. A preventive nicotine vaccination programme is unlikely to be cost-effective. The total cost of a universal vaccination programme would be high and its impact on population smoking prevalence negligible. For these reasons, such a programme is unlikely to be publicly funded in Australia or any other developed country. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

Do Smoking Cessation Websites Meet the Needs of Smokers with Severe Mental Illnesses?

ERIC Educational Resources Information Center

Brunette, Mary F.; Ferron, Joelle C.; Devitt, Timothy; Geiger, Pamela; Martin, Wendy M.; Pratt, Sarah; Santos, Meghan; McHugo, Gregory J.

2012-01-01

Many people learn about smoking cessation through information on the Internet. Whether people with severe mental illnesses, who have very high rates of smoking, are able to use currently available websites about smoking cessation is unknown. The study reported here assessed whether four smoking cessation websites met usability guidelines and…

The relationship between self-efficacy and reductions in smoking in a contingency management procedure.

PubMed

Romanowich, Paul; Mintz, Jim; Lamb, R J

2009-06-01

Social--cognitive and behavioral theories of change disagree on what the relevant controlling variables for initiating behavior change are. Correlations between baseline smoking cessation self-efficacy and the changes in breath carbon monoxide (CO) and the reduction in breath CO and increases in smoking cessation self-efficacy from baseline were obtained from a contingency management smoking cessation procedure. A test of the difference between the cross-lag correlations suggested a nonspurious causal relationship between smoking cessation self-efficacy and changes in breath CO. Path analyses showed that decreases in breath CO (reductions in smoking) predicted later increases in smoking cessation self-efficacy. Baseline self-reports of smoking cessation self-efficacy were not significantly correlated with subsequent changes in breath CO. Rather, significant correlations were found between reductions in breath CO and later increases in smoking cessation self-efficacy. These results suggest that self-efficacy may be a cognitive response to one's own behavior, and are inconsistent with a social--cognitive view of self-efficacy's role in behavior change. Implications for the development of smoking cessation programs and health-promoting behavior changes in general are discussed.

Study protocol of a pragmatic, randomised controlled pilot trial: clinical effectiveness on smoking cessation of traditional and complementary medicine interventions, including acupuncture and aromatherapy, in combination with nicotine replacement therapy

PubMed Central

Jang, Soobin; Park, Sunju; Jang, Bo-Hyoung; Park, Yu Lee; Lee, Ju Ah; Cho, Chung-Sik; Go, Ho-Yeon; Shin, Yong Cheol; Ko, Seong-Gyu

2017-01-01

Introduction Nicotine dependence is a disease, and tobacco use is related to 6 million deaths annually worldwide. Recently, in many countries, there has been growing interest in the use of traditional and complementary medicine (T&CM) methods, especially acupuncture, as therapeutic interventions for smoking cessation. The aim of this pilot study is to investigate the effectiveness of T&CM interventions on smoking cessation. Methods and analysis The STOP (Stop Tobacco Programme using traditional Korean medicine) study is designed to be a pragmatic, open-label, randomised pilot trial. This trial will evaluate whether adding T&CM methods (ie, ear and body acupuncture, aromatherapy) to conventional cessation methods (ie, nicotine replacement therapy (NRT), counselling) increases smoking cessation rates. Forty participants over 19 years old who are capable of communicating in Korean will be recruited. They will be current smokers who meet one of the following criteria: (1) smoke more than 10 cigarettes a day, (2) smoke less than 10 cigarettes a day and previously failed to cease smoking, or (3) smoke fewer than 10 cigarettes a day and have a nicotine dependence score (Fagerstrom Test for Nicotine Dependence) of 4 points or more. The trial will consist of 4 weeks of treatment and a 20 week follow-up period. A statistician will perform the statistical analyses for both the intention-to-treat (all randomly assigned participants) and per-protocol (participants who completed the trial without any protocol deviations) data using SAS 9.1.3. Ethics and dissemination This study has been approved by the Institutional Review Board (IRB) of the Dunsan Korean Medicine Hospital of Daejeon University (IRB reference no: DJDSKH-15-BM-11–1, Protocol No. version 4.1.).The protocol will be reapproved by IRB if it requires amendment. The trial will be conducted according to the Declaration of Helsinki, 7th version (2013). This study is designed to minimise the risk to participants, and the investigators will explain the study to the participants in detail. As an ethical clinical trial, the control group will also be given conventional cessation treatments, including NRT and counselling. Participants will be screened and provided with a registration number to protect their personal information. Informed consent will be obtained from the participants prior to enrolling them in the trial. Participants will be allowed to withdraw at anytime without penalty. Trial registration number ClinicalTrials.gov (NCT02768025); pre-results. PMID:28576892

Positive smoking cessation-related interactions with HIV care providers increase the likelihood of interest in cessation among HIV-positive cigarette smokers.

PubMed

Pacek, Lauren R; Rass, Olga; Johnson, Matthew W

2017-10-01

Smoking cessation has proven to be a challenge for HIV-positive smokers. Patient and provider characteristics may provide barriers to smoking cessation. We aimed to identify characteristics associated with interest in cessation as well as characterize use of, current interest in, and provider recommendations for smoking cessation modalities. Data came from 275 HIV-positive smokers recruited online. Half (49.1%) of the sample was interested in quitting; daily smoking was associated with decreased likelihood of interest in cessation, whereas making a lifetime quit attempt, receiving encouragement to quit from an HIV care provider, and greater frequency of discussions regarding cessation with HIV care providers were associated with increased likelihood of interest in cessation. Nicotine replacement therapy was the most commonly used (42.9%), generated the most interest (59.1%), and was the most commonly clinician-recommended (70.7%) cessation modality. Findings emphasize the importance of the healthcare provider-patient relationship for smoking cessation promotion in HIV-positive smokers.

Patient navigation to promote smoking cessation among low-income primary care patients: a pilot randomized controlled trial.

PubMed

Lasser, Karen E; Kenst, Karey S; Quintiliani, Lisa M; Wiener, Renda Soylemez; Murillo, Jennifer; Pbert, Lori; Xuan, Ziming; Bowen, Deborah J

2013-01-01

We conducted a pilot randomized controlled trial to determine the feasibility and acceptability of a patient navigation intervention. Forty-seven smokers from one safety-net hospital were randomized to either a control group, in which they received a smoking cessation brochure and a list of smoking cessation resources, or a navigation group, in which they received the smoking cessation brochure, a list of smoking cessation resources, and patient navigation. Follow-up data were obtained for 33 participants. Nine (47.4%) of 19 of navigation group participants had engaged in smoking cessation treatment by 3 months versus 6 (42.9%) of 14 control group participants (chi-square p = ns). Patient navigation to promote engagement in smoking cessation treatment was feasible and acceptable to participants.

Smoking behavior, attitudes, and cessation counseling among healthcare professionals in Armenia.

PubMed

Movsisyan, Narine K; Varduhi, Petrosyan; Arusyak, Harutyunyan; Diana, Petrosyan; Armen, Muradyan; Frances, Stillman A

2012-11-24

Smoking cessation counseling by health professionals has been effective in increasing cessation rates. However, little is known about smoking cessation training and practices in transition countries with high smoking prevalence such as Armenia. This study identified smoking-related attitudes and behavior of physicians and nurses in a 500-bed hospital in Yerevan, Armenia, the largest cancer hospital in the country, and explored barriers to their effective participation in smoking cessation interventions. This study used mixed quantitative and qualitative methods. Trained interviewers conducted a survey with physicians and nurses using a 42-item self-administered questionnaire that assessed their smoking-related attitudes and behavior and smoking cessation counseling training. Four focus group discussions with hospital physicians and nurses explored barriers to effective smoking cessation interventions. The focus group sessions were audio-taped, transcribed, and analyzed. The survey response rate was 58.5% (93/159) for physicians and 72.2% (122/169) for nurses. Smoking prevalence was almost five times higher in physicians compared to nurses (31.2% vs. 6.6%, p < 0.001). Non-smokers and ex-smokers had more positive attitudes toward the hospital's smoke-free policy compared to smokers (90.1% and 88.2% vs. 73.0%). About 42.6% of nurses and 26.9% of physicians reported having had formal training on smoking cessation methods. While both groups showed high support for routinely assisting patients to quit smoking, nurses more often than physicians considered health professionals as role models for patients. This study was the first to explore differences in smoking-related attitudes and behavior among hospital physicians and nurses in Yerevan, Armenia. The study found substantial behavioral and attitudinal differences in these two groups. The study revealed a critical need for integrating cessation counseling training into Armenia's medical education. As nurses had more positive attitudes toward cessation counseling compared to physicians, and more often reported having cessation training, they are an untapped resource that could be more actively engaged in smoking cessation interventions in healthcare settings.

Pharmaceutical care in smoking cessation

PubMed Central

Marín Armero, Alicia; Calleja Hernandez, Miguel A; Perez-Vicente, Sabina; Martinez-Martinez, Fernando

2015-01-01

As a determining factor in various diseases and the leading known cause of preventable mortality and morbidity, tobacco use is the number one public health problem in developed countries. Facing this health problem requires authorities and health professionals to promote, via specific programs, health campaigns that improve patients’ access to smoking cessation services. Pharmaceutical care has a number of specific characteristics that enable the pharmacist, as a health professional, to play an active role in dealing with smoking and deliver positive smoking cessation interventions. The objectives of the study were to assess the efficacy of a smoking cessation campaign carried out at a pharmaceutical care center and to evaluate the effects of pharmaceutical care on patients who decide to try to stop smoking. The methodology was an open, analytical, pre–post intervention, quasi-experimental clinical study performed with one patient cohort. The results of the study were that the promotional campaign for the smoking cessation program increased the number of patients from one to 22, and after 12 months into the study, 43.48% of the total number of patients achieved total smoking cessation. We can conclude that advertising of a smoking cessation program in a pharmacy increases the number of patients who use the pharmacy’s smoking cessation services, and pharmaceutical care is an effective means of achieving smoking cessation. PMID:25678779

Pharmaceutical care in smoking cessation.

PubMed

Marín Armero, Alicia; Calleja Hernandez, Miguel A; Perez-Vicente, Sabina; Martinez-Martinez, Fernando

2015-01-01

As a determining factor in various diseases and the leading known cause of preventable mortality and morbidity, tobacco use is the number one public health problem in developed countries. Facing this health problem requires authorities and health professionals to promote, via specific programs, health campaigns that improve patients' access to smoking cessation services. Pharmaceutical care has a number of specific characteristics that enable the pharmacist, as a health professional, to play an active role in dealing with smoking and deliver positive smoking cessation interventions. The objectives of the study were to assess the efficacy of a smoking cessation campaign carried out at a pharmaceutical care center and to evaluate the effects of pharmaceutical care on patients who decide to try to stop smoking. The methodology was an open, analytical, pre-post intervention, quasi-experimental clinical study performed with one patient cohort. The results of the study were that the promotional campaign for the smoking cessation program increased the number of patients from one to 22, and after 12 months into the study, 43.48% of the total number of patients achieved total smoking cessation. We can conclude that advertising of a smoking cessation program in a pharmacy increases the number of patients who use the pharmacy's smoking cessation services, and pharmaceutical care is an effective means of achieving smoking cessation.

Electronic Cigarette Use and Smoking Abstinence in Japan: A Cross-Sectional Study of Quitting Methods.

PubMed

Hirano, Tomoyasu; Tabuchi, Takahiro; Nakahara, Rika; Kunugita, Naoki; Mochizuki-Kobayashi, Yumiko

2017-02-17

The benefit of electronic cigarettes (e-cigarettes) in smoking cessation remains controversial. Recently, e-cigarettes have been gaining popularity in Japan, without evidence of efficacy on quitting cigarettes. We conducted an online survey to collect information on tobacco use, difficulties in smoking cessation, socio-demographic factors, and health-related factors in Japan. Among the total participants (n = 9055), 798 eligible persons aged 20-69 years who smoked within the previous five years were analyzed to assess the relationship between the outcome of smoking cessation and quitting methods used, including e-cigarettes, smoking cessation therapy, and unassisted. E-cigarette use was negatively associated with smoking cessation (odds ratio (OR) = 0.632; 95% confidence interval (CI) = 0.414-0.964) after adjusting for gender, age, health-related factors, and other quitting methods. Conversely, smoking cessation therapy (i.e., varenicline) was significantly associated with smoking cessation (OR = 1.885; 95% CI = 1.018-3.492) in the same model. For effective smoking cessation, e-cigarette use appears to have low efficacy among smokers in Japan. Allowing for the fact that this study is limited by its cross-sectional design, follow-up studies are needed to assess the prospective association between e-cigarette use and smoking cessation.

Promoting smoking cessation among parents: effects on smoking-related cognitions and smoking initiation in children.

PubMed

Schuck, Kathrin; Otten, Roy; Kleinjan, Marloes; Bricker, Jonathan B; Engels, Rutger C M E

2015-01-01

Parental smoking is associated with an increased risk of smoking among youth. Epidemiological research has shown that parental smoking cessation can attenuate this risk. This study examined whether telephone counselling for parents and subsequent parental smoking cessation affect smoking-related cognitions and smoking initiation among children of smoking parents. Data of a two-arm randomized controlled trial were used in which 512 smoking parents were recruited into cessation support through their children's primary schools. After the baseline assessment, smoking parents were randomly assigned to tailored telephone counselling or a standard self-help brochure. Parental cessation was measured as 6-month prolonged abstinence at the 12-month follow-up. Children's smoking-related cognitions and smoking initiation were examined at 3-month, 12-month, and 30-month follow-up. No statistical evidence was found that children of parents who received telephone counselling tailored to smoking parents or children of parents who achieved prolonged abstinence differ in smoking-related cognitions (i.e., smoking outcome expectancies, perceived safety of smoking, self-efficacy to refrain from smoking, susceptibility to smoking) or smoking initiation rate on any follow-up assessment. This study is the first to examine the effects of an evidence-based smoking cessation treatment for parents and treatment-induced parental smoking cessation on cognitive and behavioural outcomes among children. Although descriptive statistics showed lower smoking initiation rates among children of parents who achieved prolonged abstinence, there was no statistical evidence that telephone counselling tailored to parents or treatment-induced parental smoking cessation affects precursors of smoking or smoking initiation among youth. Copyright © 2014 Elsevier Ltd. All rights reserved.

A Qualitative Study on Unassisted Smoking Cessation Among Chinese Canadian Immigrants.

PubMed

Mao, Aimei; Bottorff, Joan L

2017-11-01

It is well-known that majority of smokers worldwide quit smoking without any assistance. This is even more evident among Chinese smokers. The aim of this qualitative study was to explore how Chinese Canadian immigrant men who smoked cigarettes perceived smoking cessation aids and services and how they used any form of the smoking cessation assistance to help them quit smoking. The study was conducted in British Columbia, Canada. Twenty-two Chinese immigrants were recruited by internet advertisement and through connections with local Chinese communities. Ten of the 22 participants were current smokers and the other 12 had quit smoking in the past 5 years. Data were collected using semistructured interviews. Although all participants, including both the ex-smokers and current smokers, had made more than one quit attempt, they rarely used cessation aids or services even after they had immigrated to Canada. The barriers to seeking the cessation assistance were grouped into two categories: practical barriers and cultural barriers. The practical barriers included "Lack of available information on smoking cessation assistance" and "Difficulty in accessing smoking cessation assistance," while cultural barriers included "Denial of physiological addiction to nicotine," "Mistrust in the effectiveness of smoking cessation assistance," "Tendency of self-reliance in solving problems," and "Concern of privacy revelation related to utilization of smoking cessation assistance." The findings revealed Chinese immigrants' unwillingness to use smoking cessation assistance as the result of vulnerability as immigrants and culturally cultivated masculinities of self-control and self-reliance.

Reducing alcohol consumption to minimize weight gain and facilitate smoking cessation among military beneficiaries.

PubMed

Sobell, Mark B; Peterson, Alan L; Sobell, Linda Carter; Brundige, Antoinette; Hunter, Christopher M; Hunter, Christine M; Goodie, Jeffrey L; Agrawal, Sangeeta; Hrysko-Mullen, Ann S; Isler, William C

2017-12-01

Smoking cessation-related weight gain can have significant negative health and career consequences for military personnel. Alcohol reduction combined with smoking cessation may decrease weight gain and relapse. A randomized clinical trial of military beneficiaries compared a standard smoking cessation (i.e., brief informational) intervention (N=159), with a brief motivational smoking cessation intervention that emphasized reduced drinking to lessen caloric intake and minimize weight gain (N=158). Participants who received the motivational intervention were significantly more likely to quit smoking at the 3-month follow-up (p=0.02), but the differences were not maintained at 6 (p=0.18) or 12months (p=0.16). Neither weight change nor alcohol reduction distinguished the 2 groups. Smoking cessation rates at 12months (motivational group=32.91%, informational group=25.79%) were comparable to previous studies, but successful cessation was not mediated by reduced drinking. Alcohol reduction combined with smoking cessation did not result in decreased weight gain or improved outcomes. Copyright © 2017. Published by Elsevier Ltd.

"I miss the care even though I know it's just a machine": an explorative study of the relationship between an Internet-based smoking cessation intervention and its participants.

PubMed

Brandt, Caroline L; Dalum, Peter; Thomsen, Tine T

2013-09-01

This study aimed to investigate how users perceive the different elements of an internet based smoking cessation intervention and to see if the program meet needs and expectations of people in a smoking cessation process. Nine semi-structured interviews were conducted in February 2010. Participants were recruited via the homepage of the smoking cessation program Dit Digitale Stopprogram (Your Digital Quit Program) operated by the Danish Cancer Society. The main result was that participants established a relationship to the program which influenced their smoking cessation process. Participants perceived the program as caring and found it supportive. However, the program also created feelings of frustration, disappointment and anger. Some participants in the last phase of cessation experienced text messages from the program as smoking cues. The study concluded that individual interpretations of the different elements in an Internet-based smoking cessation intervention can have both positive and negative impact on the smoking cessation process of participants.

Predictors of Smoking Cessation in Old–Old Age

PubMed Central

2016-01-01

Introduction: There is a dearth of knowledge on smoking cessation in older adults. This study examined predictors of smoking cessation in persons over age 75. Methods: This study is a secondary analysis of a prospective longitudinal study. A sample of 619 older persons aged 75–94 was drawn from a representative cohort of older persons in Israel and was examined longitudinally. By means of interviews, we assessed smoking, health, Activities of Daily Living (ADL), Instrumental ADL, cognitive dysfunction, and well-being. Results: Continuing smokers tended to be lonelier. Participants who quit smoking took more medications and had greater cognitive dysfunction compared to those who continued smoking. Conclusions: Greater cognitive dysfunction and high medication use or the physical causes for high medication use may precipitate smoking cessation in persons aged 75–94, potentially through a greater influence of caregivers on one’s lifestyle. Implications: Cognitive dysfunction and high medication use predicted smoking cessation. Smoking cessation for long time smokers may be influenced by greater ill health. Influence of caregivers may augment smoking cessation. Given these findings, for persistent smokers into old age, smoking cessation may occur at the time of physical and functional decline during the end of life period. PMID:26783294

Employee characteristics and health belief variables related to smoking cessation engagement attitudes.

PubMed

Street, Tamara D; Lacey, Sarah J

2018-05-01

Workplace smoking cessation programs can effectively assist employees to quit smoking. However, little is known about employees' attitudes towards engagement in workplace smoking cessation programs. This study aimed to address the limited understanding of the interaction between employee characteristics and their health beliefs toward engaging in a workplace smoking cessation program. Self-report data was collected from 897 employees of a mining company operating in two remote towns in Australia. The majority of participants were male (73%), the mean age was 36.9 years (SD = 11.5). Chi square tests of independence were used to analyze relationships between employee characteristics and smoking cessation engagement attitudes. Engagement attitudes included: A desire to cease smoking; desire for assistance with the smoking cessation process; and intention to participate in a workplace smoking intervention. The findings from this study indicated that attitudes towards engagement in smoking cessation programs varied for mining employees according to gender, age, perceived severity, perceived self-efficacy, and stage of readiness to change. These findings provide insights that health promotion practitioners may apply to inform the design and marketing of effective workplace smoking cessation programs for similar employees.

Perceived Barriers to Smoking Cessation among Adults with Substance Use Disorders

PubMed Central

McHugh, R. Kathryn; Votaw, Victoria R.; Fulciniti, Francesca; Connery, Hilary S.; Griffin, Margaret L.; Monti, Peter M.; Weiss, Roger D.

2017-01-01

The majority of adults seeking substance use disorder treatment also smoke. Smoking is associated with greater substance use disorder severity, poorer treatment outcome, and increased mortality among those with substance use disorders. Yet, engaging this population in smoking cessation treatment is a significant challenge. The aim of this study was to examine perceived barriers to smoking cessation among treatment-seeking adults with alcohol or opioid use disorder. Additionally, we examined whether anxiety sensitivity--a known risk factor for barriers to smoking cessation in the general population--was associated with more barriers to smoking cessation in this sample. A sample of 208 adults was recruited for a one-time study and completed self-report measures of anxiety sensitivity and perceived barriers to smoking cessation. Results indicated that the most common barriers were anxiety (82% of the sample), tension/irritability (76%), and concerns about the ability to maintain sobriety from their primary substance of abuse (64%). Those who reported more barriers also reported lower confidence in the ability to change their smoking behavior. Higher anxiety sensitivity was associated with more perceived barriers to smoking cessation, even when controlling for nicotine dependence severity. These results suggest that there are several perceived barriers to smoking cessation among treatment-seeking adults with substance use disorders. In addition to psychoeducational interventions aimed to modify negative beliefs about smoking cessation, anxiety sensitivity may be a promising therapeutic target in this population. PMID:28132700

Neural correlates of message tailoring and self-relatedness in smoking cessation programming.

PubMed

Chua, Hannah Faye; Liberzon, Israel; Welsh, Robert C; Strecher, Victor J

2009-01-15

Smoking leads to illnesses including addiction, cancer, and cardiovascular and respiratory diseases. Different intervention programs have become available. In the past decade, providing tailored smoking cessation messages has been shown to be more effective in inducing smoking cessation than one-size-fits-all interventions. However, little is known about the brain responses of smokers when they receive tailored smoking cessation messages. A neuroimaging study using blocked and event-related designs examined neural activity in 24 smokers exposed to high-tailored and low-tailored smoking cessation messages. In both blocked and event-related conditions, rostral medial prefrontal cortex and precuneus/posterior cingulate were engaged more during the processing of high-tailored smoking cessation messages than low-tailored smoking cessation messages. The activation patterns of smokers to tailored cessation messages show involvement of brain areas commonly implicated in self-related processing. Results seem to add support to the suggested role of self-relevance in tailored cessation programs, where previous studies have shown a potential mediating role of self-relevance on smoking abstinence. The findings are relevant to understanding the cognitive mechanisms underlying tailored message processing and might point to new directions for testing response to health communications programming.

Neural correlates of message tailoring and self-relatedness in smoking cessation programming

PubMed Central

Chua, Hannah Faye; Liberzon, Israel; Welsh, Robert C.; Strecher, Victor J.

2011-01-01

BACKGROUND Smoking leads to illnesses including addiction, cancer, and cardiovascular and respiratory diseases. Different intervention programs have become available. In the past decade, providing tailored smoking cessation messages has been shown to be more effective in inducing smoking cessation than one-size-fits-all interventions. However, little is known about the brain responses of smokers when they receive tailored smoking cessation messages. METHODS A neuroimaging study using blocked and event-related designs examined neural activity in 24 smokers exposed to high-tailored and low-tailored smoking cessation messages. RESULTS: In both blocked and event-related conditions, rostral medial prefrontal cortex and precuneus/posterior cingulate were engaged more during the processing of high-tailored smoking cessation messages than low-tailored smoking cessation messages. CONCLUSION The activation patterns of smokers to tailored cessation messages show involvement of brain areas commonly implicated in self-related processing. Results seem to add support to the suggested role of self-relevance in tailored cessation programs, where previous studies have shown a potential mediating role of self-relevance on smoking abstinence. The findings are relevant to understanding the cognitive mechanisms underlying tailored message processing and may point to new directions for testing response to health communications programming. PMID:18926523

Medicaid Coverage of Smoking Cessation Counseling and Medication Is Underutilized for Pregnant Women.

PubMed

Scheuermann, Taneisha S; Richter, Kimber P; Jacobson, Lisette T; Shireman, Theresa I

2017-05-01

Policies to promote smoking cessation among Medicaid-insured pregnant women have the potential to assist a significant proportion of pregnant smokers. In 2010, Kansas Medicaid began covering smoking cessation counseling for pregnant smokers. Our aim was to evaluate the use of smoking cessation benefits provided to pregnant women as a result of the Kansas Medicaid policy change that provided reimbursement for physician-provided smoking cessation counseling. We examined Kansas Medicaid claims data to estimate rates of delivery of smoking cessation treatment to Medicaid-insured pregnant women in Kansas from fiscal year 2010 through 2013. We analyzed the number of pregnant women who received physician-provided smoking cessation counseling indicated by procedure billing codes (ie, G0436 and G0437) and medication (ie, nicotine replacement therapy, bupropion, or varenicline) located in outpatient managed care encounter and fee-for-service claims data. We estimated the number of Medicaid-insured pregnant smokers using the national smoking prevalence (14%) in this population and the number of live births reported in Kansas. Annually from 2010 to 2013, approximately 27.2%-31.6% of pregnant smokers had claims for nicotine replacement therapy, bupropion, or varenicline. Excluding claims for bupropion, a medication commonly prescribed to treat depression, claims ranged from 9.3% to 11.1%. Following implementation of Medicaid coverage for smoking cessation counseling, less than 1% of estimated smokers had claims for counseling. This low claims rate suggests that simply changing policy is not sufficient to ensure use of newly implemented benefits, and that there probably remain critical gaps in smoking cessation treatment. This study evaluates the use of Medicaid reimbursement for smoking cessation counseling among low-income pregnant women in Kansas. We describe the Medicaid claims rates of physician-provided smoking cessation counseling for pregnant women, an evidence-based and universally recommended treatment approach for smoking cessation in this population. Our findings show that claims rates for smoking cessation benefits in this population are very low, even after policy changes to support provision of cessation assistance were implemented. Additional studies are needed to determine whether reimbursement is functioning as intended and identify potential gaps between policy and implementation of evidence-based smoking cessation treatment. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Long-term effectiveness of the preoperative smoking cessation programme at Western Health.

PubMed

Taylor, Hugh; Karahalios, Amalia; Bramley, David

2017-09-01

Smoking is associated with adverse effects in the perioperative period, including elevated risk of death. The perioperative period provides an opportunity to engage with patients who are smokers to encourage smoking cessation, often referred to as a 'teachable moment'. We developed a smoking intervention model for the pre-admission clinic (PAC) at Western Health, Victoria, Australia. This case series aimed to assess the impact of the smoking intervention model, which is standard of care, on the participant's smoking habits over four time points. We enrolled 50 consecutive participants for elective surgery who were smokers and had attended PAC at Western Health, Footscray. All smokers were offered a standard intervention package to address their smoking. Participants underwent a brief interview to elicit their current smoking behaviour on their day of surgery, 3 and 12 months post-operatively. We found a reduction at each time point post-intervention in the average number of cigarettes smoked per day by all participants with a 43% reduction at 12 months compared with PAC. We found that the number of participants who had quit increased at each time point, with 29% abstinent at 12 months post-operatively. At 12 months, we found 71% of participants had either quit or reduced the number of cigarettes smoked compared with the amount reported at PAC. This study adds to the evidence that a simple intervention preoperatively can contribute to long-term changes in smoking behaviour. © 2017 Royal Australasian College of Surgeons.

[Establishment of a practical training program in smoking cessation for use by pharmacists using cognitive-behavioral therapy and the motivational interview method].

PubMed

Saito, Moemi; Nodate, Yoshitada; Maruyama, Keiji; Tsuchiya, Masao; Watanabe, Machiko; Niwa, Sin-ichi

2012-01-01

We established a practical training program to nurture pharmacists who can give smoking cessation instructions. The program was provided to 85 interns (45 males and 40 females) in Teikyo University Hospital. The one-day practical training was provided to groups comprised of five members each. The training consisted of studies on the adverse effects of smoking, general outlines of the outpatient smoking cessation service, experiencing Smokerlyzer, studies about smoking-cessation drugs, studies about a smoking cessation therapy using cognitive-behavioral therapy and motivational interviewing, and case studies applying role-playing. Before and after the practical training, we conducted a questionnaire survey consisting of The Kano Test for Social Nicotine Dependence (KTSND) and the assessment of the smoking status, changes in attitudes to smoking, and willingness and confidence to give smoking cessation instructions. The overall KTSND score significantly dropped from 14.1±4.8 before the training to 8.9±4.8 after the training. The confidence to give smoking cessation instructions significantly increased from 3.4±1.9 to 6.2±1.3. Regarding the correlation between the smoking status and willingness and confidence to give smoking cessation instructions, the willingness and confidence were lower among the group of interns who either smoked or had smoked previously, suggesting that smoking had an adverse effect. A total of 88.2% of the interns answered that their attitudes to smoking had "changed slightly" or "changed" as a result of the training, indicating changes in their attitudes to smoking. Given the above, we believe that our newly-established smoking cessation instruction training is a useful educational tool.

Mining twitter to understand the smoking cessation barriers.

PubMed

Krittanawong, Chayakrit; Wang, Zhen

2017-10-26

Smoking cessation is challenging and lack of positive support is a known major barrier to quitting cigarettes. Previous studies have suggested that social influences might increase smokers' awareness of social norms for appropriate behavior, which might lead to smoking cessation. Although social media use is increasing among young adults in the United States, research on the relationship between social media use and smoking cessation is lacking. Twitter has provided a rich source of information for researchers, but no overview exists as to how the field uses Twitter in smoking cessation research. To the best of our knowledge, this study conducted a data mining analysis of Twitter to assess barriers to smoking cessation. In conclusion, Twitter is a cost-effective tool with the potential to disseminate information on the benefits of smoking cessation and updated research to the Twitter community on a global scale.

Providing smoking cessation programs to homeless youth: the perspective of service providers.

PubMed

Shadel, William G; Tucker, Joan S; Mullins, Leslie; Staplefoote, Lynette

2014-10-01

There is almost no information available on cigarette smoking among homeless youth, whether they are currently receiving services for smoking cessation, and how to best help them quit. This paper presents data collected from a series of semi-structured telephone interviews with service providers from 23 shelters and drop-in centers serving homeless youth in Los Angeles County about their current smoking cessation programming, interest in providing smoking cessation services to their clients, potential barriers to providing this service, and ways to overcome these barriers. Results indicated that 84% of facilities did not offer smoking cessation services, although nearly all (91%) were interested in doing so. Barriers to implementing formal smoking cessation programs on site included lack of resources (e.g., money, personnel) to support the programs, staff training, and concern that smoking cessation may not be a high priority for homeless youth themselves. Overall, service providers seemed to prefer a less intensive smoking cessation program that could be delivered at their site by existing staff. Data from this formative needs assessment will be useful for developing and evaluating a smoking cessation treatment that could be integrated into the busy, complex environment that characterizes agencies that serve homeless youth. Copyright © 2014 Elsevier Inc. All rights reserved.

Helping Smokers Quit: New Partners and New Strategies from the University of California, San Francisco Smoking Cessation Leadership Center.

PubMed

Schroeder, Steven A; Clark, Brian; Cheng, Christine; Saucedo, Catherine B

2018-01-01

The Smoking Cessation Leadership Center (SCLC) was established in 2003 to increase the rate of smoking cessation attempts and the likelihood those efforts would succeed. Although smoking remains the number one cause of preventable death and disability, clinicians underperform in smoking cessation. Furthermore, many clinical organizations, governmental agencies, and advocacy groups put little effort into smoking cessation. Initially targeted at increasing the efforts of primary care physicians, SCLC efforts expanded to include many other medical and non-physician disciplines, ultimately engaging 21 separate specialties. Most clinicians and their organizations are daunted by efforts required to become cessation experts. A compromise solution, Ask, Advise, Refer (to telephone quitlines), was crafted. SCLC also stimulated smoking cessation projects in governmental, not-for-profit, and industry groups, including the Veterans Administration, the Health Resources Services Administration, Los Angeles County, and the Joint Commission. SCLC helped CVS pharmacies to stop selling tobacco products and other pharmacies to increase smoking cessation efforts, provided multiple educational offerings, and distributed $6.4 million in industry-supported smoking cessation grants to 55 organizations plus $4 million in direct SCLC grants. Nevertheless, smoking still causes 540,000 annual deaths in the US. SCLC's work in the field of behavioral health is described in a companion article.

Effects of active non-smoking programmes on smoking behaviour in oral precancer patients.

PubMed

Hamadah, O; Hepburn, S; Thomson, P J

2007-08-01

Smoking is the commonest risk factor for oral cancer and precancer. The objective of this study was to characterize smoking behaviour and attitude in a cohort of oral precancer patients in Newcastle upon Tyne, UK, and to determine changes in behaviour during diagnosis, treatment and follow-up. Twenty-seven consecutive, smoking patients with dysplastic oral lesions were recruited to the study and a detailed smoking history obtained, quantifying types and numbers of cigarettes smoked, length of smoking history, and changes in smoking behaviour during treatment episodes and long-term follow-up. All patients underwent an interventional management protocol comprising risk-factor education, histopathological diagnosis by incisional biopsy and laser excision of lesions. Patients were followed up for 5 years. Whilst there was a significant decrease in the number of cigarettes smoked at patients' most recent follow-up compared with initial presentation (p<0.001), 74% continued to smoke. Patients received advice from a smoking cessation adviser on support available to them from the local NHS (National Health Service) Stop Smoking services. Six out of 10 patients who set a 'quit date' and attended a programme had quit at the 4-week follow-up but only 5 remained non-smokers. Smoking remains a considerable problem in oral precancer patients even after interventional treatment, with the risk of further precancerous lesions and malignant transformation.

Factors influencing European GPs' engagement in smoking cessation: a multi-country literature review.

PubMed

Stead, Martine; Angus, Kathryn; Holme, Ingrid; Cohen, David; Tait, Gayle

2009-09-01

Smoking cessation advice by GPs is an effective and cost-effective intervention, but is not implemented as widely as it could be. This wide-ranging Europe-wide literature review, part of the European Union (EU) PESCE (General Practitioners and the Economics of Smoking Cessation in Europe) project, explored the extent of GPs' engagement in smoking cessation and the factors that influence their engagement. Two searches were conducted, one for grey literature, across all European countries, and one for academic studies. Data from eligible studies published from 1990 onwards were synthesised and reported under four categories of influencing factors: GP characteristics, patient characteristics, structural factors, and cessation-specific knowledge and skills. The literature showed that most GPs in Europe question the smoking status of all new patients but fewer routinely ask this of regular patients, or advise smokers to quit. The proportion offering intensive interventions or prescribing treatments is lower still. Factors influencing GPs' engagement in smoking cessation include GPs' own smoking status and their attitudes towards giving smoking cessation advice; whether patients present with smoking-related symptoms, are pregnant, or heavy smokers; time, training, and reimbursement are important structural factors; and some GPs lack knowledge and skills regarding the use of specific cessation methods and treatments, or have limited awareness of specialist cessation services. No single factor or category of factors explains the variations in GPs' engagement in smoking cessation. Strategies to improve the frequency and quality of GPs' engagement in smoking cessation need to address the multifaceted influences on GPs' practice and to reflect the widely differing contexts across Europe.

Smoking behaviours and cessation services among male physicians in China: evidence from a structural equation model.

PubMed

Huang, Cheng; Guo, Chaoran; Yu, Shaohua; Feng, Yan; Song, Julia; Eriksen, Michael; Redmon, Pam; Koplan, Jeffrey

2013-09-01

To investigate smoking prevalence and cessation services provided by male physicians in hospitals in three Chinese cities. Data were collected from a survey of male physicians employed at 33 hospitals in Changsha, Qingdao and Wuxi City (n=720). Exploratory factor analysis was performed to identify latent variables, and confirmatory structural equation modelling analysis was performed to test the relationships between predictor variables and smoking in male physicians, and their provision of cessation services. Of the sampled male physicians, 25.7% were current smokers, and 54.0% provided cessation services by counselling (18.8%), distributing self-help materials (17.1%), and providing traditional remedies or medication (18.2%). Factors that predicted smoking included peer smoking (OR 1.14 95% CI 1.03 to 1.26) and uncommon knowledge (OR 0.94 95% CI 0.89 to 0.99), a variable measuring awareness of the association of smoking with stroke, heart attack, premature ageing and impotence in male adults as well as the role of passive smoking in heart attack. Factors that predicted whether physicians provided smoking cessation services included peer smoking (OR 0.82 95% CI 0.76 to 0.89), physicians' own smoking (OR 0.87 95% CI 0.81 to 0.93), training in cessation (OR 1.36 95% CI 1.27 to 1.45) and access to smoking cessation resources (OR 1.69 95% CI 1.58 to 1.82). The smoke-free policy is not strictly implemented at healthcare facilities, and smoking remains a public health problem among male physicians. A holistic approach, including a stricter implementation of the smoke-free policy, comprehensive education on the hazards of smoking, training in standard smoking-cessation techniques and provision of cessation resources, is needed to curb the smoking epidemic among male physicians and to promote smoking cessation services in China.

Projecting the effects of tobacco control policies in the USA through microsimulation: a study protocol.

PubMed

Tam, Jamie; Levy, David T; Jeon, Jihyoun; Clarke, John; Gilkeson, Scott; Hall, Tim; Feuer, Eric J; Holford, Theodore R; Meza, Rafael

2018-03-23

Smoking remains the leading cause of preventable death in the USA but can be reduced through policy interventions. Computational models of smoking can provide estimates of the projected impact of tobacco control policies and can be used to inform public health decision making. We outline a protocol for simulating the effects of tobacco policies on population health outcomes. We extend the Smoking History Generator (SHG), a microsimulation model based on data from the National Health Interview Surveys, to evaluate the effects of tobacco control policies on projections of smoking prevalence and mortality in the USA. The SHG simulates individual life trajectories including smoking initiation, cessation and mortality. We illustrate the application of the SHG policy module for four types of tobacco control policies at the national and state levels: smoke-free air laws, cigarette taxes, increasing tobacco control programme expenditures and raising the minimum age of legal access to tobacco. Smoking initiation and cessation rates are modified by age, birth cohort, gender and years since policy implementation. Initiation and cessation rate modifiers are adjusted for differences across age groups and the level of existing policy coverage. Smoking prevalence, the number of population deaths avoided, and life-years gained are calculated for each policy scenario at the national and state levels. The model only considers direct individual benefits through reduced smoking and does not consider benefits through reduced exposure to secondhand smoke. A web-based interface is being developed to integrate the results of the simulations into a format that allows the user to explore the projected effects of tobacco control policies in the USA. Usability testing is being conducted in which experts provide feedback on the interface. Development of this tool is under way, and a publicly accessible website is available at http://www.tobaccopolicyeffects.org. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Projecting the effects of tobacco control policies in the USA through microsimulation: a study protocol

PubMed Central

Levy, David T; Jeon, Jihyoun; Clarke, John; Gilkeson, Scott; Hall, Tim; Holford, Theodore R; Meza, Rafael

2018-01-01

Introduction Smoking remains the leading cause of preventable death in the USA but can be reduced through policy interventions. Computational models of smoking can provide estimates of the projected impact of tobacco control policies and can be used to inform public health decision making. We outline a protocol for simulating the effects of tobacco policies on population health outcomes. Methods and analysis We extend the Smoking History Generator (SHG), a microsimulation model based on data from the National Health Interview Surveys, to evaluate the effects of tobacco control policies on projections of smoking prevalence and mortality in the USA. The SHG simulates individual life trajectories including smoking initiation, cessation and mortality. We illustrate the application of the SHG policy module for four types of tobacco control policies at the national and state levels: smoke-free air laws, cigarette taxes, increasing tobacco control programme expenditures and raising the minimum age of legal access to tobacco. Smoking initiation and cessation rates are modified by age, birth cohort, gender and years since policy implementation. Initiation and cessation rate modifiers are adjusted for differences across age groups and the level of existing policy coverage. Smoking prevalence, the number of population deaths avoided, and life-years gained are calculated for each policy scenario at the national and state levels. The model only considers direct individual benefits through reduced smoking and does not consider benefits through reduced exposure to secondhand smoke. Ethics and dissemination A web-based interface is being developed to integrate the results of the simulations into a format that allows the user to explore the projected effects of tobacco control policies in the USA. Usability testing is being conducted in which experts provide feedback on the interface. Development of this tool is under way, and a publicly accessible website is available at http://www.tobaccopolicyeffects.org. PMID:29574440

Factors associated with smoking cessation success in Lebanon

PubMed Central

2018-01-01

Objective: The objective is to assess factors associated with the success rate of smoking cessation among Lebanese smokers in a smoking cessation center. Methods: A cross-sectional data study, conducted between March 2014 and March 2016 in an outpatient smoking cessation center with 156 enrolled patients. The patient’s nicotine dependence and motivation to quit smoking were evaluated according to the Fagerstrom Test for Nicotine Dependence and Richmond tests respectively. Results: The number of packs smoked per year decreased the odds of smoking cessation success (p=0.004, ORa=0.982, CI 0.97-0.994), while the compliance with the offered treatment increased the odds of success by 7.68 times (p<0.001, ORa=7.68, CI 3.438-17.187). Highly dependent and highly motivated smokers had more success in the quitting process compared to those with a lower dependence and motivation respectively. Conclusion: Our findings showed that many factors can influence smoking cessation, an experience described as difficult, most significantly the number of packs per year and compliance with the smoking cessation treatment. Moreover, although these outcomes are not representative of the entire Lebanese population, we believe that health authorities could utilize these results when implementing upcoming smoking cessations programs. All attempts at cessation should have a goal of reducing the number of packs smoked per year to improve the chances of ceasing into the future. PMID:29619139

A Qualitative Study on Unassisted Smoking Cessation Among Chinese Canadian Immigrants

PubMed Central

Mao, Aimei; Bottorff, Joan L.

2016-01-01

It is well-known that majority of smokers worldwide quit smoking without any assistance. This is even more evident among Chinese smokers. The aim of this qualitative study was to explore how Chinese Canadian immigrant men who smoked cigarettes perceived smoking cessation aids and services and how they used any form of the smoking cessation assistance to help them quit smoking. The study was conducted in British Columbia, Canada. Twenty-two Chinese immigrants were recruited by internet advertisement and through connections with local Chinese communities. Ten of the 22 participants were current smokers and the other 12 had quit smoking in the past 5 years. Data were collected using semistructured interviews. Although all participants, including both the ex-smokers and current smokers, had made more than one quit attempt, they rarely used cessation aids or services even after they had immigrated to Canada. The barriers to seeking the cessation assistance were grouped into two categories: practical barriers and cultural barriers. The practical barriers included “Lack of available information on smoking cessation assistance” and “Difficulty in accessing smoking cessation assistance,” while cultural barriers included “Denial of physiological addiction to nicotine,” “Mistrust in the effectiveness of smoking cessation assistance,” “Tendency of self-reliance in solving problems,” and “Concern of privacy revelation related to utilization of smoking cessation assistance.” The findings revealed Chinese immigrants’ unwillingness to use smoking cessation assistance as the result of vulnerability as immigrants and culturally cultivated masculinities of self-control and self-reliance. PMID:26819181

Are Chinese pediatricians missing the opportunity to help parents quit smoking?

PubMed

Liao, Jing; Winickoff, Jonathan P; Nong, Guangmin; Huang, Kaiyong; Yang, Li; Zhang, Zhiyong; Abdullah, Abu S

2016-08-20

Secondhand smoke (SHS) exposure of children due to parental tobacco use is a particularly prevalent health issue and is associated with adverse health outcomes. Following the US Clinical Practice guidelines, pediatricians in the United States deliver 5A's (ask, advise, assess, assist, and arrange) counseling to smoking parents which has proven to be effective. We examined Chinese pediatricians' adherence to the clinical practice guidelines for smoking cessation (i.e. 5A's counseling practices) with smoking parents, and identified factors associated with these practices. A cross-sectional paper-and-pencil survey of pediatricians was conducted in twelve conveniently selected southern Chinese hospitals. Factors associated with any of the 5A's smoking cessation counseling practices were identified by logistic regression. Of respondents (504/550), only 26 % routinely provided 5A's smoking cessation counseling to smoking parents. More than 80 % of pediatricians didn't receive formal training in smoking cessation and had not read China smoking cessation guidelines; 24 % reported being "very confident" in discussing smoking or SHS reduction with parents. Pediatricians who had never smoked (OR: 2.29, CI:1.02-5.12), received training in smoking cessation (OR: 2.50, CI:1.40-4.48), had read China smoking cessation guidelines (OR: 2.17, CI:1.10-4.26), and felt very (OR: 7.12, CI:2.45-20.70) or somewhat (OR: 3.05, CI:1.11-8.37) confident in delivering cessation counseling were more likely to practice 5A's. Pediatricians who reported "it is hard to find a time to talk with parents" (OR: 0.32, CI: 0.11-0.92) or "lack of a standard of care requiring pediatricians to provide smoking cessation or SHS exposure reduction intervention" (OR: 0.45, CI: 0.21-0.98) as a barrier were less likely to follow the 5A's guidelines. Smoking cessation counseling to address parental smoking is infrequent among Chinese pediatricians. There is a need to develop and test intervention strategies to improve the delivery of 5A's smoking cessation counseling to parental smokers.

Motivations, challenges and coping strategies for smoking cessation: Based on multi-ethnic pregnant couples in far western China.

PubMed

Bai, Xue; Chen, Jiang-Yun; Fang, Zi; Zhang, Xiao-Yan; Wang, Fang; Pan, Zheng-Qiong; Fang, Peng-Qian

2017-06-01

The present study aimed to clarify the smoking cessation motivations, challenges and coping strategies among pregnant couples. A qualitative design using a grounded theory approach was applied. Data were collected by individual semi-structured interviews with 39 married individuals (21 non-smoking pregnant women and 18 smoking or ever-smoking men with a pregnant wife) and 3 imams in an ethnically diverse region of far western China. The most common theme for smoking cessation motivation was "embryo quality" (i.e., a healthier baby), followed by family's health. Most interviewees reported that husband's withdrawal symptoms were the greatest challenge to smoking cessation, followed by the Chinese tobacco culture. Coping strategies given by the pregnant women typically involved combining emotional, behavioral and social interventions. Social interventions showed advantages in helping to quit smoking. Pregnancy appears to be a positive stimulus for pregnant couples' smoking cessation. Our results suggest that pregnancy, a highly important life event, may help to reduce barriers to smoking cessation at the social level (e.g., limiting access to cigarettes, avoiding temptation to smoke), but does little to help with the withdrawal symptoms. Professional guidance for smoking cessation is still necessary.

Smoking cessation alters subgingival microbial recolonization.

PubMed

Fullmer, S C; Preshaw, P M; Heasman, P A; Kumar, P S

2009-06-01

Smoking cessation improves the clinical manifestations of periodontitis; however, its effect on the subgingival biofilm, the primary etiological agent of periodontitis, is unclear. The purpose of this study was to investigate, longitudinally, if smoking cessation altered the composition of the subgingival microbial community, by means of a quantitative, cultivation-independent assay for bacterial profiling. Subgingival plaque was collected at baseline, and 3, 6, and 12 months post-treatment from smokers who received root planing and smoking cessation counseling. The plaque was analyzed by terminal restriction fragment length polymorphism (t-RFLP). Microbial profiles differed significantly between smokers and quitters at 6 and 12 months following smoking cessation. The microbial community in smokers was similar to baseline, while quitters demonstrated significantly divergent profiles. Changes in bacterial levels contributed to this shift. These findings reveal a critical role for smoking cessation in altering the subgingival biofilm and suggest a mechanism for improved periodontal health associated with smoking cessation.

iPhone apps for smoking cessation: a content analysis.

PubMed

Abroms, Lorien C; Padmanabhan, Nalini; Thaweethai, Lalida; Phillips, Todd

2011-03-01

With the proliferation of smartphones such as the iPhone, mobile phones are being used in novel ways to promote smoking cessation. This study set out to examine the content of the 47 iPhone applications (apps) for smoking cessation that were distributed through the online iTunes store, as of June 24, 2009. Each app was independently coded by two reviewers for its (1) approach to smoking cessation and (2) adherence to the U.S. Public Health Service's 2008 Clinical Practice Guidelines for Treating Tobacco Use and Dependence. Each app was also coded for its (3) frequency of downloads. Apps identified for smoking cessation were found to have low levels of adherence to key guidelines in the index. Few, if any, apps recommended or linked the user to proven treatments such as pharmacotherapy, counseling, and/or a quitline. iPhone apps for smoking cessation rarely adhere to established guidelines for smoking cessation. It is recommended that current apps be revised and future apps be developed around evidence-based practices for smoking cessation. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

iPhone Apps for Smoking Cessation

PubMed Central

Abroms, Lorien C.; Padmanabhan, Nalini; Thaweethai, Lalida; Phillips, Todd

2012-01-01

Background With the proliferation of smartphones such as the iPhone, mobile phones are being used in novel ways to promote smoking cessation. Purpose This study set out to examine the content of the 47 iPhone applications (apps) for smoking cessation that were distributed through the online iTunes store, as of June 24, 2009. Methods Each app was independently coded by two reviewers for their (1) approach to smoking cessation and their (2) adherence to the U.S. Public Health Service’s 2008 Clinical Practice Guidelines for Treating Tobacco Use and Dependence. Apps were also coded for their (3) frequency of downloads. Results Apps identified for smoking cessation were found to have low levels of adherence to key guidelines in the index. Few, if any, apps recommended or linked the user to proven treatments such as pharmacotherapy, counseling, and/or a quitline. Conclusions iPhone apps for smoking cessation rarely adhere to established guidelines for smoking cessation. It is recommended that current apps be revised and future apps be developed around evidence-based practices for smoking cessation. PMID:21335258

Determinants of physical activity promotion by smoking cessation advisors.

PubMed

Mas, Sébastien; Bernard, Paquito; Gourlan, Mathieu

2018-05-17

To investigate the cross-sectional association between personal physical activity (PA) level, Theory of Planned Behavior (TPB) constructs toward PA promotion, and PA promotion behavior among smoking cessation advisors. 149 smoking cessation advisors were invited to complete online questionnaires. Hypotheses were tested using Bayesian path analysis. Attitudes and perceived behavioral control (PBC) of smoking cessation advisors were related to PA promotion intentions; intentions were in turn related to PA promotion behaviors. Advisors' personal PA level was indirectly associated with PA promotion behaviors through PBC and PA promotion intentions. The TPB is a relevant theoretical framework with which to explore determinants of PA promotion behavior among smoking cessation advisors. The PA level of health care professionals may be linked to PA promotion behavior through some TPB constructs. Smoking cessation advisor training should include education on attitude development (e.g., PA benefits on smoking cessation), PBC (e.g., modality of PA prescription) and PA promotion intentions (e.g., goal setting). Smoking cessation advisors should also be encouraged to regularly practice PA in order to improve their PA promotion behaviors. Copyright © 2018 Elsevier B.V. All rights reserved.

Smoking behavior, attitudes, and cessation counseling among healthcare professionals in Armenia

PubMed Central

2012-01-01

Background Smoking cessation counseling by health professionals has been effective in increasing cessation rates. However, little is known about smoking cessation training and practices in transition countries with high smoking prevalence such as Armenia. This study identified smoking-related attitudes and behavior of physicians and nurses in a 500-bed hospital in Yerevan, Armenia, the largest cancer hospital in the country, and explored barriers to their effective participation in smoking cessation interventions. Methods This study used mixed quantitative and qualitative methods. Trained interviewers conducted a survey with physicians and nurses using a 42-item self-administered questionnaire that assessed their smoking-related attitudes and behavior and smoking cessation counseling training. Four focus group discussions with hospital physicians and nurses explored barriers to effective smoking cessation interventions. The focus group sessions were audio-taped, transcribed, and analyzed. Results The survey response rate was 58.5% (93/159) for physicians and 72.2% (122/169) for nurses. Smoking prevalence was almost five times higher in physicians compared to nurses (31.2% vs. 6.6%, p < 0.001). Non-smokers and ex-smokers had more positive attitudes toward the hospital’s smoke-free policy compared to smokers (90.1% and 88.2% vs. 73.0%). About 42.6% of nurses and 26.9% of physicians reported having had formal training on smoking cessation methods. While both groups showed high support for routinely assisting patients to quit smoking, nurses more often than physicians considered health professionals as role models for patients. Conclusions This study was the first to explore differences in smoking-related attitudes and behavior among hospital physicians and nurses in Yerevan, Armenia. The study found substantial behavioral and attitudinal differences in these two groups. The study revealed a critical need for integrating cessation counseling training into Armenia’s medical education. As nurses had more positive attitudes toward cessation counseling compared to physicians, and more often reported having cessation training, they are an untapped resource that could be more actively engaged in smoking cessation interventions in healthcare settings. PMID:23176746

Harm reduction and cessation efforts and interest in cessation resources among survivors of smoking-related cancers

PubMed Central

Berg, Carla J.; Carpenter, Matthew J.; Jardin, Bianca; Ostroff, Jamie S.

2013-01-01

Purpose Despite the well-established risks associated with persistent smoking, many cancer survivors who were active smokers at the time of cancer diagnosis continue to smoke. In order to guide the development of tobacco cessation interventions for cancer survivors, a better understanding is needed regarding post-diagnosis quitting efforts. Thus, we examined quitting and reduction efforts and interest in cessation resources among cancer survivors who self-identified as current smokers at the time of diagnosis. Methods We conducted analyses of survey participants (n=54) who were current smokers at the time of cancer diagnosis and were continued smokers at the time of assessment. We also conducted semi-structured interviews (n=21) among a subset of those who either continued to smoke or quit smoking post cancer diagnosis. Results Among our survey participants, 22.2% had ever used behavioral cessation resources and 66.7% had use pharmacotherapy, while 62.8% had interest in future use of behavioral cessation resources and 75.0% had interest in pharmacotherapy. The majority reported some quitting efforts including making quit attempts, using cessation medications, and reducing their daily cigarette consumption. Semi-structured interview data revealed various strategies used to aid in smoking reduction and cessation as well as variability in preferences for cessation resources. Conclusions Cancer patients who smoke following diagnosis often engage in smoking reduction and cessation-related behaviors, which may reflect their motivation to reduce their smoking-related risks. They also report high interest in cessation resources. Thus, it is important to explore the acceptability and effectiveness of different cessation intervention components among this group. PMID:23307036

Factors influencing European GPs' engagement in smoking cessation: a multi-country literature review

PubMed Central

Stead, Martine; Angus, Kathryn; Holme, Ingrid; Cohen, David; Tait, Gayle

2009-01-01

Background Smoking cessation advice by GPs is an effective and cost-effective intervention, but is not implemented as widely as it could be. Aim This wide-ranging Europe-wide literature review, part of the European Union (EU) PESCE (General Practitioners and the Economics of Smoking Cessation in Europe) project, explored the extent of GPs' engagement in smoking cessation and the factors that influence their engagement. Method Two searches were conducted, one for grey literature, across all European countries, and one for academic studies. Data from eligible studies published from 1990 onwards were synthesised and reported under four categories of influencing factors: GP characteristics, patient characteristics, structural factors, and cessation-specific knowledge and skills. Results The literature showed that most GPs in Europe question the smoking status of all new patients but fewer routinely ask this of regular patients, or advise smokers to quit. The proportion offering intensive interventions or prescribing treatments is lower still. Factors influencing GPs' engagement in smoking cessation include GPs' own smoking status and their attitudes towards giving smoking cessation advice; whether patients present with smoking-related symptoms, are pregnant, or heavy smokers; time, training, and reimbursement are important structural factors; and some GPs lack knowledge and skills regarding the use of specific cessation methods and treatments, or have limited awareness of specialist cessation services. No single factor or category of factors explains the variations in GPs' engagement in smoking cessation. Conclusion Strategies to improve the frequency and quality of GPs' engagement in smoking cessation need to address the multifaceted influences on GPs' practice and to reflect the widely differing contexts across Europe. PMID:19674514

Smoking cessation medications

MedlinePlus

Smoking cessation - medications; Smokeless tobacco - medications; Medications for stopping tobacco ... Smoking cessation medicines can: Help with the craving for tobacco. Help you with withdrawal symptoms. Keep you ...

Prevalence and characteristics of young adult smokers in the U.S. in the precontemplation stage of smoking cessation.

PubMed

Andrews, Mary E; Sabado, Melanie; Choi, Kelvin

2018-09-01

The precontemplation stage of smoking cessation refers to having no intention to quit smoking in the next six months. We aimed to estimate the prevalence of and characteristics associated with the precontemplation stage of smoking cessation among U.S. young adult smokers to inform the development of targeted interventions. We analyzed data in 2017 from the 2013-2014 National Adult Tobacco Survey. Young adult (18-29 years old) daily and non-daily smokers were included (n = 1809). We applied weighted multiple logistic regression models to examine the associations between demographics, tobacco use behaviors, exposure to pro- and anti-tobacco messages, and the precontemplation stage of smoking cessation. 59.0% of U.S. young adult smokers are in the precontemplation stage of smoking cessation. Unemployment was positively associated with being in the precontemplation stage of smoking cessation (AOR = 1.42 95% CI = 1.05, 1.91). Smoking every day (vs. some days), more cigarettes smoked per day, using roll-your-own cigarettes (vs. manufactured cigarettes only), currently smoking cigars, and signing up for promotional offers were positively associated with being in the precontemplation stage of smoking cessation (p < 0.05). Non-Hispanic Black was negatively associated with precontemplation stage (AOR = 0.40, 95% CI = 0.27, 0.59). Not smoking after viewing a health warning on a cigarette pack was negatively associated with the precontemplation stage of smoking cessation (AOR = 0.36, 95% CI = 0.25, 0.51). Many U.S. young adult smokers classify as being in the precontemplation stage of smoking cessation. Interventions to motivate these smokers to quit smoking with considerations of their specific characteristics (e.g., being unemployed) are warranted. Copyright © 2018 Elsevier Ltd. All rights reserved.

E-cigarette Use and Cigarette Smoking Cessation among Texas College Students.

PubMed

Mantey, Dale S; Cooper, Maria R; Loukas, Alexandra; Perry, Cheryl L

2017-11-01

We examined the relationships between e-cigarette use and subsequent cigarette smoking behaviors at 6- and 12-month follow-ups among young adults. Participants were 18-29 year-old current and former cigarette smokers (N = 627) at 24 Texas colleges, participating in a 3-wave study. Multi-level, multivariable logistic regression models, accounting for school clustering, examined the impact of self-reported use of e-cigarettes on cigarette smoking status at 6- and 12-month follow-ups. Two mutually-exclusive groups of e-cigarette users were examined: those that used for cigarette smoking cessation and those that used for reasons other than cessation. Baseline covariates included socio-demographics, past quit attempts, nicotine dependence, cigarettes per day, and other tobacco use. Use of e-cigarettes for cigarette smoking cessation was associated with increased odds of cigarette smoking cessation at 6- and 12-month follow-ups, while using e-cigarettes for other reasons was not, when adjusting for covariates. Use of e-cigarettes for cigarette smoking cessation may reduce cigarette smoking rates in young adult college students. Additional research is needed examining e-cigarettes as a complement to evidence-based cessation resources that are associated with cigarette smoking cessation among young adults.

Attitudes to smoking and smoking cessation among nurses.

PubMed

Chandrakumar, Sreejith; Adams, John

2015-10-28

This article presents a literature review on smoking rates among nurses and the nursing role in promoting smoking cessation worldwide. Findings included wide variations between countries in smoking rates among nurses, and the important influence of peers and family members on smoking behaviours. Several studies indicated that nurses would value more education on techniques to promote smoking cessation.

Long term follow-up of a tobacco prevention and cessation program in cystic fibrosis patients

PubMed Central

Ortega-García, Juan Antonio; Perales, Joseph E.; Cárceles-Álvarez, Alberto; Sánchez-Sauco, Miguel Felipe; Villalona, Seiichi; Mondejar-López, Pedro; Pastor-Vivero, María Dolores; Escolano, Pilar Mira; Jaimes-Vega, Diana Carolina; Sánchez-Solís, Manuel

2016-01-01

This study evaluates the impact over time of a telephone-based intervention in tobacco cessation and prevention targeting patients with cystic fibrosis (CF) in the Mediterranean region of Murcia, Spain. We conducted an experimental prospective study with a cohort of CF patients using an integrative smoking cessation programme, between 2008 and 2013. The target population included family members and patients from the Regional CF unit. The study included an initial tobacco exposure questionnaire, measurement of lung function, urinary cotinine levels, anthropomorphic measures and the administered intervention at specific time intervals. Of the 88 patients tracked through follow-up, active smoking rates were reduced from 10.23% to 4.55% (p = 0.06). Environmental tobacco exposure was reduced in non-smoker patients from 62.03% to 36.90% (p < 0.01) during the five year follow-up. Significant reductions in the gradient of household tobacco smoke exposure were also observed with a decrease of 12.60%, from 31.65% (n = 25/79) to 19.05% (n = 16/84) in 2013 (p = <0.01). Cotinine was significantly correlated with both active and passive exposure (p<0.01) with a significant reduction of cotinine levels from 63.13 (28.58–97.69) to 20.56 (0.86–40.27) ng/ml (p<0.01). The intervention to significantly increase the likelihood of family quitting (smoke-free home) was 1.26 (1.05–1.54). Telephone based interventions for tobacco cessation and prevention is a useful tool when applied over time. Trained intervention professionals in this area are needed in the environmental health approach for the treatment of CF. PMID:26990263

Long term follow-up of a tobacco prevention and cessation program in cystic fibrosis patients.

PubMed

Ortega-García, Juan Antonio; Perales, Joseph E; Cárceles-Álvarez, Alberto; Sánchez-Sauco, Miguel Felipe; Villalona, Seiichi; Mondejar-López, Pedro; Pastor-Vivero, María Dolores; Mira Escolano, Pilar; James-Vega, Diana Carolina; Sánchez-Solís, Manuel

2016-03-02

This study evaluates the impact over time of a telephone-based intervention in tobacco cessation and prevention targeting patients with cystic fibrosis (CF) in the Mediterranean region of Murcia, Spain. We conducted an experimental prospective study with a cohort of CF patients using an integrative smoking cessation programme, between 2008 and 2013. The target population included family members and patients from the Regional CF unit. The study included an initial tobacco exposure questionnaire, measurement of lung function, urinary cotinine levels, anthropomorphic measures and the administered intervention at specific time intervals. Of the 88 patients tracked through follow-up, active smoking rates were reduced from 10.23% to 4.55% (p = 0.06). Environmental tobacco exposure was reduced in non-smoker patients from 62.03% to 36.90% (p < 0.01) during the five year follow-up. Significant reductions in the gradient of household tobacco smoke exposure were also observed with a decrease of 12.60%, from 31.65% (n = 25/79) to 19.05% (n = 16/84) in 2013 (p = <0.01). Cotinine was significantly correlated with both active and passive exposure (p<0.01) with a significant reduction of cotinine levels from 63.13 (28.58-97.69) to 20.56 (0.86-40.27) ng/ml (p<0.01). The intervention to significantly increase the likelihood of family quitting (smoke-free home) was 1.26 (1.05-1.54). Telephone based interventions for tobacco cessation and prevention is a useful tool when applied over time. Trained intervention professionals in this area are needed in the environmental health approach for the treatment of CF.

E-cigarettes as smoking cessation aids: a survey among practitioners in Italy.

PubMed

Lazuras, Lambros; Muzi, Milena; Grano, Caterina; Lucidi, Fabio

2016-03-01

To describe experiences with and beliefs about e-cigarettes as safe and useful aids for smoking cessation among healthcare professionals providing smoking cessation services. Using a cross-sectional design, anonymous structured questionnaires were completed by 179 healthcare professionals in public smoking cessation clinics across 20 regions in Italy. Service providers reported that considerably more smokers made inquiries about e-cigarettes in 2014 than in 2013. The most frequent inquiries concerned the ingredients, safety and effectiveness of e-cigarettes as smoking cessation aids. Clients used e-cigarettes to quit smoking, cut down the number of conventional cigarettes smoked, have a safe alternative to smoking, and protect their health while continuing to smoke. More than 60 % of service providers reported favourable beliefs about the safety and effectiveness of e-cigarettes, and believed that e-cigarettes are as effective as other smoking cessation aids, including pharmacotherapy. Despite limited empirical evidence, service providers in Italy viewed e-cigarettes, as safe and effective smoking cessation aids. More concerted efforts are needed to improve knowledge about e-cigarettes among service providers, to guide their clinical practice and decision-making with respect to e-cigarettes.

Association of the DBH Polymorphism rs3025343 With Smoking Cessation in a Large Population-Based Sample.

PubMed

Hirvonen, Katariina; Korhonen, Tellervo; Salomaa, Veikko; Männistö, Satu; Kaprio, Jaakko

2017-09-01

Genetic variations in DBH-gene and its surroundings have been shown to associate with smoking behavior including smoking cessation in several studies. In this study we replicate and measure the effect size for association between DBH polymorphism rs3025343 and smoking cessation in a large population-based sample while examining environmental factors that could relate to the association. We studied 11 926 adult subjects from four surveys of the National FINRISK Study. The analysis was restricted to either current or former smokers. Logistic and linear regression analyses were conducted to investigate the relationships of the single nucleotide polymorphism (SNP), covariates, smoking cessation, and smoking severity (cotinine, CPD). Gene-environment interactions were tested by likelihood-ratio test. The association between rs3025343 and smoking cessation (prevalence odds ratio, OR = 1.12, p = .094, 95%CI = 0.98-1.30) was replicated identically with the GWAS study of The Tobacco and Genetics Consortium (OR = 1.12, 95%CI = 1.08-1.18). None of our tested phenotypes significantly influenced the association between rs3025343 and smoking cessation. Overall, marital status, education, depression, alcohol use, self-rated health, and chronic obstructive pulmonary disease (COPD) showed phenotypic associations with smoking cessation, but the association of various phenotypes with smoking cessation did not vary by genotype. The current study replicates the effect size for the association between rs3025343 and smoking cessation despite lack of overall significance due to smaller sample size. We could not show environmental influences on the association of rs3025343 with smoking cessation. Our study replicates the direction and strength of the association of DBH polymorphism rs3025343 with smoking cessation. We could not detect environmental influences on the strength of the association of rs3025343 with smoking cessation, but the limited power of our analysis needs to be taken into account. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Smoking cessation following admission to a coronary care unit.

PubMed

Rigotti, N A; Singer, D E; Mulley, A G; Thibault, G E

1991-01-01

To determine the impact of an episode of serious cardiovascular disease on smoking behavior and to identify factors associated with smoking cessation in this setting. Prospective observational study in which smokers admitted to a coronary care unit (CCU) were followed for one year after hospital discharge to determine subsequent smoking behavior. Coronary care unit of a teaching hospital. Preadmission smoking status was assessed in all 828 patients admitted to the CCU during one year. The 310 smokers surviving to hospital discharge were followed and their smoking behaviors assessed by self-report at six and 12 months. None. Six months after discharge, 32% of survivors were not smoking; the rate of sustained cessation at one year was 25%. Smokers with a new diagnosis of coronary heart disease (CHD) made during hospitalization had the highest cessation rate (53% vs. 31%, p = 0.01). On multivariate analysis, smoking cessation was more likely if patients were discharged with a diagnosis of CHD, had no prior history of CHD, were lighter smokers (less than 1 pack/day), and had congestive heart failure during hospitalization. Among smokers admitted because of suspected myocardial infarction (MI), cessation was more likely if the diagnosis was CHD than if it was noncoronary (37% vs. 19%, p less than 0.05), but a diagnosis of MI led to no more smoking cessation than did coronary insufficiency. Hospitalization in a CCU is a stimulus to long-term smoking cessation, especially for lighter smokers and those with a new diagnosis of CHD. Admission to a CCU may represent a time when smoking habits are particularly susceptible to intervention. Smoking cessation in this setting should improve patient outcomes because cessation reduces cardiovascular mortality, even when quitting occurs after the onset of CHD.

Long-Term Benefits of Smoking Cessation on Gastroesophageal Reflux Disease and Health-Related Quality of Life

PubMed Central

Kohata, Yukie; Fujiwara, Yasuhiro; Watanabe, Takanori; Kobayashi, Masanori; Takemoto, Yasuhiko; Kamata, Noriko; Yamagami, Hirokazu; Tanigawa, Tetsuya; Shiba, Masatsugu; Watanabe, Toshio; Tominaga, Kazunari; Shuto, Taichi; Arakawa, Tetsuo

2016-01-01

Objective Smoking is associated with gastroesophageal reflux disease (GERD). Varenicline, a nicotinic receptor partial agonist, is used to aid smoking cessation. The purpose of this study was to prospectively examine the long-term benefits of smoking cessation on GERD and health-related quality of life (HR-QOL). Methods Patients treated with varenicline were asked to fill out a self-report questionnaire about their smoking habits, gastrointestinal symptoms, and HR-QOL before and 1 year after smoking cessation. The prevalence of GERD, frequency of symptoms, and HR-QOL scores were compared. We also investigated associations between clinical factors and newly-developed GERD. Results A total of 141 patients achieved smoking cessation (success group) and 50 did not (failure group) at 1 year after the treatment. The GERD improvement in the success group (43.9%) was significantly higher than that in the failure group (18.2%). The frequency of reflux symptoms significantly decreased only in the success group. There were no significant associations between newly developed GERD and clinical factors including increased body mass index and successful smoking cessation. HR-QOL significantly improved only in the success group. Conclusions Smoking cessation improved both GERD and HR-QOL. Smoking cessation should be recommended for GERD patients. PMID:26845761

Global Reach of an Internet Smoking Cessation Intervention among Spanish- and English-Speaking Smokers from 157 Countries

PubMed Central

Barrera, Alinne Z.; Pérez-Stable, Eliseo J.; Delucchi, Kevin L.; Muñoz, Ricardo F.

2009-01-01

This investigation is a secondary analysis of demographic, smoking, and depression information in a global sample of Spanish- and English-speaking smokers who participated in a series of randomized controlled smoking cessation trials conducted via the Internet. The final sample consisted of 17,579 smokers from 157 countries. Smoking profiles were similar across languages and world regions and consistent with characteristics of participants in traditional smoking cessation studies. Participants were predominantly Spanish-speakers, evenly divided between men and women and relatively few indicated using traditional smoking cessation methods (e.g., groups or medication). This study demonstrates that substantial numbers of smokers from numerous countries seek Web-based smoking cessation resources and adds to the growing support for Web-assisted tobacco interventions as an additional tool to address the need for global smoking cessation efforts. PMID:19440423

Assessing the effectiveness of a pharmacist-delivered smoking cessation program in the State of Qatar: study protocol for a randomized controlled trial.

PubMed

El Hajj, Maguy Saffouh; Kheir, Nadir; Al Mulla, Ahmad Mohd; Al-Badriyeh, Daoud; Al Kaddour, Ahmad; Mahfoud, Ziyad R; Salehi, Mohammad; Fanous, Nadia

2015-02-26

It had been reported that up to 37% of the adult male population smokes cigarettes in Qatar. The Global Youth Tobacco Survey also stated that 13.4% of male school students aged 13 to 15 years in Qatar smoke cigarettes. Smoking cessation is key to reducing smoking-related diseases and deaths. Healthcare providers are in an ideal position to encourage smoking cessation. Pharmacists are the most accessible healthcare providers and are uniquely situated to initiate behavior change among patients. Many studies have shown that pharmacists can be successful in helping patients quit smoking. Studies demonstrating the effectiveness of pharmacist-delivered smoking cessation programs are lacking in Qatar. This proposal aims to test the effect of a structured smoking cessation program delivered by trained ambulatory pharmacists in Qatar. A prospective, randomized, controlled trial is conducted at eight ambulatory pharmacies in Qatar. Participants are randomly assigned to receive an at least four-session face-to-face structured patient-specific smoking cessation program conducted by the pharmacist or 5 to 10 min of unstructured brief smoking cessation advice (emulating current practice) given by the pharmacist. Both groups are offered nicotine replacement therapy if feasible. The primary outcome of smoking cessation will be confirmed by an exhaled carbon monoxide test at 12 months. Secondary outcomes constitute quality-of-life adjustment as well as cost analysis of program resources consumed, including per case and patient outcome. If proven to be effective, this smoking cessation program will be considered as a model that Qatar and the region can apply to decrease the smoking burden. Clinical Trials NCT02123329 .

Smoking cessation at the workplace. Results of a randomised controlled intervention study

PubMed Central

Lang, T; Nicaud, V; Slama, K; Hirsch, A; Imbernon, E; Goldberg, M; Calvel, L; Desobry, P; Favre-Trosson, J; Lhopital, C; Mathevon, P; Miara, D; Miliani, A; Panthier, F; Pons, G; Roitg, C; Thoores, M; the, w

2000-01-01

OBJECTIVES—To compare the effects of a worksite intervention by the occupational physician offering simple advice of smoking cessation with a more active strategy of advice including a "quit date" and extra support.
POPULATION—Employees of an electrical and gas company seen at the annual visit by their occupational physicians.
CRITERIA END POINTS—Smoking point prevalence defined as the percentage of smokers who were non-smokers at one year. Secondary criteria were the percentage of smokers who stopped smoking for more than six months and the difference in prevalence of smoking in both groups.
METHODS—Randomised controlled trial. The unit of randomisation was the work site physician and a random sample of the employees of whom he or she was in charge. The length of the follow up was one year. Each of 30 work site physicians included in the study 100 to 150 employees.
RESULTS—Among 504 subjects classified as smokers at baseline receiving simple advice (group A) and 591 the more active programme (group B), 68 (13.5%) in group A and 109 (18.4%) were non-smokers one year later (p=0.03; p=0.01 taking the occupational physician as the statistical unit and using a non-parametric test). Twenty three subjects (4.6%) in group A and 36 (6.1%) in group B (p=0.26) declared abstinence of six months or more. Among non-smokers at baseline, 3.4% in both groups were smokers after one year follow up. The prevalence of smokers did not differ significantly at baseline (32.9% and 32.4%, p=0.75). After the intervention the prevalence of smoking was 30.8% in group A and 28.7% in group B (p=0.19). An increase of the mean symptoms score for depression in those who quit was observed during this period.
CONCLUSIONS—A simple cessation intervention strategy during a mandatory annual examination, targeting a population of smokers independently of their motivation to stop smoking or their health status, showed a 36% relative increase of the proportion of smokers who quit smoking as compared with what can be achieved through simple advice.


Keywords: tobacco smoking; smoking cessation; randomised controlled trial; work site PMID:10814655

Prospective, randomized, controlled trial using best-selling smoking-cessation book.

PubMed

Foshee, James P; Oh, Anita; Luginbuhl, Adam; Curry, Joseph; Keane, William; Cognetti, David

2017-07-01

Our prospective, randomized, controlled trial aimed to evaluate the efficacy of the self-help book, The Easy Way to Stop Smoking, by Allen Carr, in promoting smoking cessation in patients with head and neck cancer. We assessed active smokers for their willingness to read a smoking cessation book. Participants were randomized to either receive the book from our department or recommended to purchase the book. All patients received smoking cessation counseling at recruitment. Phone surveys were conducted at short- and long-term intervals to determine if the patients had purchased and/or read the book and whether they were still smoking. One hundred twelve patients were recruited, 52 of whom completed follow-up surveys. Those who received the book for free were more likely to read the book (p = 0.05). Reading the book did not correlate with successful smoking cessation (p = 0.81). Some 26% of the 27 patients who received the book quit smoking compared with 32% of the 25 patients who were recommended the book (p = 0.76). Patients who indicated motivation to quit smoking were more likely to succeed. In our study, smoking cessation did not appear to be influenced by reading The Easy Way to Stop Smoking. Despite 80.8% of the cohort indicating at least a readiness to quit smoking at recruitment, only 28.8% of patients managed to achieve successful smoking cessation at long-term follow-up. Patient motivation remains an important factor in achieving long-term smoking abstinence. Quitting smoking remains a daunting challenge for patients, with multiple interventions likely needed to achieve cessation.

Predictors of smoking cessation and relapse in older adults.

PubMed Central

Salive, M E; Cornoni-Huntley, J; LaCroix, A Z; Ostfeld, A M; Wallace, R B; Hennekens, C H

1992-01-01

We examined longitudinal changes in smoking behavior among older adults in three community cohorts of the Established Populations for Epidemiologic Studies of the Elderly. Smoking prevalence declined from 15% at baseline to 9% during 6 years of follow-up. Annual smoking cessation and relapse rates were 10% and less than 1%, respectively. Interval diagnosis of myocardial infarction, stroke, or cancer increased subsequent smoking cessation but not relapse. Although smoking cessation around diagnosis is increased, primary prevention could yield greater benefits. PMID:1503170

Better Off Alone Than With a Smoker: The Influence of Partner’s Smoking Behavior in Later Life

PubMed Central

Wright, Laura

2016-01-01

Objectives: We examine how the likelihood of smoking cessation among smokers and patterns of adherence to smoking cessation differ by partnership status, partnership changes, and partners’ smoking behavior. The data are a nationally representative sample of smokers in middle and older age from the Health and Retirement Study (1992–2010). Method: We use multivariate logistic regression models to analyze the likelihood of smoking cessation among smokers and then estimate adherence to smoking cessation using discrete-time event history models. Results: Those partnered with smokers and those whose partners relapse into smoking are much less likely than the unpartnered to quit smoking and adhere to smoking cessation. Respondents partnered with non-smokers and those whose partners quit smoking are more likely to quit smoking than the unpartnered. Those recently widowed, divorced, and repartnered have similar smoking changes to the consistently unpartnered. Discussion: Being partnered does not always mean healthier behavior changes. Rather, the association between partnership status and smoking changes depends greatly on the health behavior changes of the partner. The partnership context at the time of smoking cessation sets the stage for longer term patterns of adherence, shaping health in older age. PMID:25693998

Evaluating the effectiveness of smoking cessation in the management of COPD.

PubMed

Temitayo Orisasami, Isimat; Ojo, Omorogieva

2016-07-28

The aim of this literature review is to assess the effectiveness of smoking cessation in managing patients with chronic obstructive pulmonary disease (COPD). COPD is the fifth leading cause of death in the world and smoking leads to COPD in more than 80% of cases. Smoking cessation aids are considered the most effective intervention to improve quality of life and prevent further deterioration in COPD. Evidence based on the use of pharmacotherapies, patient support and motivation as part of smoking cessation strategies were evaluated and discussed. The findings demonstrate that pharmacotherapies, support and counselling in smoking cessation help reduce hospital stay and hospitalisation and improve symptoms and quality of life. In addition, nurses need more education on how to use open-ended questions and motivation when giving advice on smoking cessation to patients with COPD.

WIC providers' perspectives on offering smoking cessation interventions.

PubMed

Aquilino, Mary Lober; Goody, Cynthia M; Lowe, John B

2003-01-01

To examine the perspectives of WIC clinic providers on offering smoking cessation interventions for pregnant women. Four focus groups consisting of WIC nurses, dietitians, and social workers (N = 25) were conducted at WIC clinics in eastern Iowa. Researchers developed discussion guidelines to determine how WIC providers currently approached pregnant women who smoke cigarettes and what they considered barriers to providing effective smoking cessation interventions. Code mapping was used to analyze focus group discussions. Factors influencing the ability of WIC staff to provide a smoking cessation intervention for pregnant women included available time, clinic priorities, staff approaches to clients, and staff training. In addition, providers expressed concerns about educational materials for clients as well as additional client issues that prevented smoking cessation. The absence of mechanisms to track clinic outcomes related to smoking cessation was also noted. WIC providers have time limitations that may necessitate minimal or low-intensity interventions for smoking cessation, but did not know that such approaches are actually effective. WIC providers require more education about the entire issue of smoking cessation in order to become more proactive in their attempts to help pregnant women quit. Training that enhances self-efficacy and understanding of the impact of smoking on mothers, infants, and children should be initiated to motivate staff to intervene. Another strategy to motivate WIC staff in this regard could be tracking clinic outcomes in helping women to quit smoking or prevent relapse.

Quit Smoking >

Cancer.gov

Quit smoking; Stop smoking; Quit smoking women; Stop smoking women easy way for women to stop smoking; Smoking effects on women; effects of smoking on women; effects of smoking in women; smoking side effects for women; quit smoking cigarettes; smoking cessation; smoking cessation women

Is the use of electronic cigarettes while smoking associated with smoking cessation attempts, cessation and reduced cigarette consumption? A survey with a 1‐year follow‐up

PubMed Central

Hitchman, Sara C.; Brown, Jamie; West, Robert; McNeill, Ann

2015-01-01

Abstract Aims To use a unique longitudinal data set to assess the association between e‐cigarette use while smoking with smoking cessation attempts, cessation and substantial reduction, taking into account frequency of use and key potential confounders. Design Web‐based survey, baseline November/December 2012, 1‐year follow‐up in December 2013. Setting Great Britain. Participants National general population sample of 4064 adult smokers, with 1759 (43%) followed‐up. Measurements Main outcome measures were cessation attempt, cessation and substantial reduction (≥50% from baseline to follow‐up) of cigarettes per day (CPD). In logistic regression models, cessation attempt in the last year (analysis n = 1473) and smoking status (n = 1656) at follow‐up were regressed on to baseline e‐cigarette use (none, non‐daily, daily) while adjusting for baseline socio‐demographics, dependence and nicotine replacement (NRT) use. Substantial reduction (n = 1042) was regressed on to follow‐up e‐cigarette use while adjusting for baseline socio‐demographics and dependence and follow‐up NRT use. Findings Compared with non‐use, daily e‐cigarette use at baseline was associated with increased cessation attempts [odds ratio (OR) = 2.11, 95% confidence interval (CI) = 1.24–3.58, P = 0.006], but not with cessation at follow‐up (OR = 0.62, 95% CI = 0.28–1.37, P = 0.24). Non‐daily use was not associated with cessation attempts or cessation. Daily e‐cigarette use at follow‐up was associated with increased odds of substantial reduction (OR = 2.49, 95% CI = 1.14–5.45, P = 0.02), non‐daily use was not. Conclusions Daily use of e‐cigarettes while smoking appears to be associated with subsequent increases in rates of attempting to stop smoking and reducing smoking, but not with smoking cessation. Non‐daily use of e‐cigarettes while smoking does not appear to be associated with cessation attempts, cessation or reduced smoking. PMID:25900312

Is the use of electronic cigarettes while smoking associated with smoking cessation attempts, cessation and reduced cigarette consumption? A survey with a 1-year follow-up.

PubMed

Brose, Leonie S; Hitchman, Sara C; Brown, Jamie; West, Robert; McNeill, Ann

2015-07-01

To use a unique longitudinal data set to assess the association between e-cigarette use while smoking with smoking cessation attempts, cessation and substantial reduction, taking into account frequency of use and key potential confounders. Web-based survey, baseline November/December 2012, 1-year follow-up in December 2013. Great Britain. National general population sample of 4064 adult smokers, with 1759 (43%) followed-up. Main outcome measures were cessation attempt, cessation and substantial reduction (≥50% from baseline to follow-up) of cigarettes per day (CPD). In logistic regression models, cessation attempt in the last year (analysis n = 1473) and smoking status (n = 1656) at follow-up were regressed on to baseline e-cigarette use (none, non-daily, daily) while adjusting for baseline socio-demographics, dependence and nicotine replacement (NRT) use. Substantial reduction (n = 1042) was regressed on to follow-up e-cigarette use while adjusting for baseline socio-demographics and dependence and follow-up NRT use. Compared with non-use, daily e-cigarette use at baseline was associated with increased cessation attempts [odds ratio (OR) = 2.11, 95% confidence interval (CI) = 1.24-3.58, P = 0.006], but not with cessation at follow-up (OR = 0.62, 95% CI = 0.28-1.37, P = 0.24). Non-daily use was not associated with cessation attempts or cessation. Daily e-cigarette use at follow-up was associated with increased odds of substantial reduction (OR = 2.49, 95% CI = 1.14-5.45, P = 0.02), non-daily use was not. Daily use of e-cigarettes while smoking appears to be associated with subsequent increases in rates of attempting to stop smoking and reducing smoking, but not with smoking cessation. Non-daily use of e-cigarettes while smoking does not appear to be associated with cessation attempts, cessation or reduced smoking. © 2015 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

Harm reduction and cessation efforts and interest in cessation resources among survivors of smoking-related cancers.

PubMed

Berg, Carla J; Carpenter, Matthew J; Jardin, Bianca; Ostroff, Jamie S

2013-03-01

Despite the well-established risks associated with persistent smoking, many cancer survivors who were active smokers at the time of cancer diagnosis continue to smoke. In order to guide the development of tobacco cessation interventions for cancer survivors, a better understanding is needed regarding post-diagnosis quitting efforts. Thus, we examined quitting and reduction efforts and interest in cessation resources among cancer survivors who self-identified as current smokers at the time of diagnosis. We conducted analyses of survey participants (n = 54) who were current smokers at the time of cancer diagnosis and were continued smokers at the time of assessment. We also conducted semi-structured interviews (n = 21) among a subset of those who either continued to smoke or quit smoking post-cancer diagnosis. Among our survey participants, 22.2 % had ever used behavioral cessation resources and 66.7 % had use pharmacotherapy, while 62.8 % had interest in future use of behavioral cessation resources and 75.0 % had interest in pharmacotherapy. The majority reported some quitting efforts including making quit attempts, using cessation medications, and reducing their daily cigarette consumption. Semi-structured interview data revealed various strategies used to aid in smoking reduction and cessation as well as variability in preferences for cessation resources. Cancer patients who smoke following diagnosis often engage in smoking reduction and cessation-related behaviors, which may reflect their motivation to reduce their smoking-related risks. They also report high interest in cessation resources. Thus, it is important to explore the acceptability and effectiveness of different cessation intervention components among this group. Cancer survivors who smoke demonstrate actions toward harm reduction and cessation. They should inquire about potential resources that might facilitate their efforts among their healthcare providers and enlist support and advice from others around them to bolster their efforts.

A comparison of time-varying covariates in two smoking cessation interventions for cardiac patients.

PubMed

Prenger, Rilana; Pieterse, Marcel E; Braakman-Jansen, Louise M A; Bolman, Catherine; de Vries, Hein; Wiggers, Loes C W

2013-04-01

The aim of the study was to explore the time-varying contribution of social cognitive determinants of smoking cessation following an intervention on cessation. Secondary analyses were performed on data from two comparable randomized controlled trials on brief smoking cessation interventions for cardiac in- and outpatients. Cox regression with time-varying covariates was applied to examine the predictive cognitions for smoking cessation over time. Both samples showed self-efficacy and intention-to-quit to be strong time-varying indicators of smoking cessation during the full 1-year follow-up period, and during the post-treatment phase in particular. Less consistently, time-varying cons of quitting and social influence were also found to be associated with smoking cessation, depending on the sample and type of intervention. Self-efficacy and intention-to-quit were the major covariates and positively related to smoking cessation over time among cardiac patients, in line with social-cognitive theories. Interestingly, both cognitive constructs appeared to act with some delay. Apparently, smoking cessation is a lengthy process in which the interplay between self-efficacy (and intention indirectly) and quitting behavior will largely determine long-term maintenance of abstinence. The presented time-varying analyses seem a valid and feasible way to underpin trajectories of cognitions in datasets with a limited number of time intervals.

Effects of preoperative smoking cessation on the incidence and risk of intraoperative and postoperative complications in adult smokers: a systematic review.

PubMed

Theadom, Alice; Cropley, Mark

2006-10-01

To establish the effect of preoperative smoking cessation on the risk of postoperative complications, and to identify the effect of the timing of preoperative cessation. The Cochrane Library Database, PsycINFO, EMBASE, Medline, and CINAHL databases were searched, using the terms: "smoking", "smoking-cessation", "tobacco-use", "tobacco-abstinence", "cigarett$", "complication$", "postoperative-complication$", "preoperative", "perioperative" and "surg$". Further articles were obtained from reference lists. The search was limited to articles on adults, written in English and published up to November 2005. Prospective cohort designs exploring the effects of preoperative smoking cessation on postoperative complications were included. Two reviewers independently scanned abstracts of relevant articles to determine eligibility. Lack of agreement was resolved through discussion and consensus. Twelve studies met the inclusion criteria. Methodological quality was assessed by both reviewers, exploring validation of smoking status, clear definition of the period of smoking cessation, control for confounding variables and length of follow-up. Only four of the studies specified the exact period of smoking cessation, with six studies specifying the length of the follow-up period. Five studies revealed a lower risk or incidence of postoperative complications in past smokers than current smokers or reported that there was no significant difference between past smokers and non-smokers. Longer periods of smoking cessation appear to be more effective in reducing the incidence/risk of postoperative complications; there was no increased risk in postoperative complications from short term cessation. An optimal period of preoperative smoking cessation could not be identified from the available evidence.

A Pilot Study of Tobacco Screening and Referral for Smoking Cessation Program among HIV-Infected Patients in France.

PubMed

Parienti, Jean-Jacques; Merzougui, Zine; de la Blanchardière, Arnaud; Dargère, Sylvie; Feret, Philippe; Le Maitre, Béatrice; Verdon, Renaud

The prevalence of tobacco smoking is high among patients living with HIV, supporting the need for effective targeted interventions. All current smokers at our outpatient HIV clinic were invited to participate in a smoking cessation program. Of the 716 patients living with HIV, 280 (39%) reported active smoking and were younger, more recently HIV infected and more frequently infected due to intravenous drug use (IDU). One hundred forty-seven (53%) smokers agreed to participate in the smoking cessation program and had a higher Fagerström score and were less likely IDU. During follow-up, 41 (28%) smokers withdrew from the program. After 6 months, 60 (57%) of the 106 smokers who completed the intervention had stopped tobacco smoking and were more likely to use varenicline, adjusting for a history of depression. Our smoking cessation program was feasible. However, strategies to reach and retain in smoking cessation program specific groups such as IDU are needed to improve the smoking cessation cascade.

Benefits of Incentives for Breastfeeding and Smoking cessation in pregnancy (BIBS): a mixed-methods study to inform trial design.

PubMed

Morgan, Heather; Hoddinott, Pat; Thomson, Gill; Crossland, Nicola; Farrar, Shelley; Yi, Deokhee; Hislop, Jenni; Moran, Victoria Hall; MacLennan, Graeme; Dombrowski, Stephan U; Rothnie, Kieran; Stewart, Fiona; Bauld, Linda; Ludbrook, Anne; Dykes, Fiona; Sniehotta, Falko F; Tappin, David; Campbell, Marion

2015-04-01

Smoking in pregnancy and/or not breastfeeding have considerable negative health outcomes for mother and baby. To understand incentive mechanisms of action for smoking cessation in pregnancy and breastfeeding, develop a taxonomy and identify promising, acceptable and feasible interventions to inform trial design. Evidence syntheses, primary qualitative survey, and discrete choice experiment (DCE) research using multidisciplinary, mixed methods. Two mother-and-baby groups in disadvantaged areas collaborated throughout. UK. The qualitative study included 88 pregnant women/recent mothers/partners, 53 service providers, 24 experts/decision-makers and 63 conference attendees. The surveys included 1144 members of the general public and 497 health professionals. The DCE study included 320 women with a history of smoking. (1) Evidence syntheses: incentive effectiveness (including meta-analysis and effect size estimates), delivery processes, barriers to and facilitators of smoking cessation in pregnancy and/or breastfeeding, scoping review of incentives for lifestyle behaviours; (2) qualitative research: grounded theory to understand incentive mechanisms of action and a framework approach for trial design; (3) survey: multivariable ordered logit models; (4) DCE: conditional logit regression and the log-likelihood ratio test. Out of 1469 smoking cessation and 5408 breastfeeding multicomponent studies identified, 23 smoking cessation and 19 breastfeeding studies were included in the review. Vouchers contingent on biochemically proven smoking cessation in pregnancy were effective, with a relative risk of 2.58 (95% confidence interval 1.63 to 4.07) compared with non-contingent incentives for participation (four studies, 344 participants). Effects continued until 3 months post partum. Inconclusive effects were found for breastfeeding incentives compared with no/smaller incentives (13 studies) but provider commitment contracts for breastfeeding show promise. Intervention intensity is a possible confounder. The acceptability of seven promising incentives was mixed. Women (for vouchers) and those with a lower level of education (except for breastfeeding incentives) were more likely to disagree. Those aged ≤ 44 years and ethnic minority groups were more likely to agree. Agreement was greatest for a free breast pump and least for vouchers for breastfeeding. Universal incentives were preferred to those targeting low-income women. Initial daily text/telephone support, a quitting pal, vouchers for > £20.00 per month and values up to £80.00 increase the likelihood of smoking cessation. Doctors disagreed with provider incentives. A 'ladder' logic model emerged through data synthesis and had face validity with service users. It combined an incentive typology and behaviour change taxonomy. Autonomy and well-being matter. Personal difficulties, emotions, socialising and attitudes of others are challenges to climbing a metaphorical 'ladder' towards smoking cessation and breastfeeding. Incentive interventions provide opportunity 'rungs' to help, including regular skilled flexible support, a pal, setting goals, monitoring and outcome verification. Individually tailored and non-judgemental continuity of care can bolster women's capabilities to succeed. Rigid, prescriptive interventions placing the onus on women to behave 'healthily' risk them feeling pressurised and failing. To avoid 'losing face', women may disengage. Included studies were heterogeneous and of variable quality, limiting the assessment of incentive effectiveness. No cost-effectiveness data were reported. In surveys, selection bias and confounding are possible. The validity and utility of the ladder logic model requires evaluation with more diverse samples of the target population. Incentives provided with other tailored components show promise but reach is a concern. Formal evaluation is recommended. Collaborative service-user involvement is important. This study is registered as PROSPERO CRD42012001980. The National Institute for Health Research Health Technology Assessment programme.

Effect of Medicaid coverage of tobacco-dependence treatments on smoking cessation.

PubMed

Liu, Feng

2009-12-01

Smoking cessation aids (nicotine replacement products and anti-depressant medication) have been proven to double quitting rates compared to placebo in several randomized controlled trials. But the high initial cost of cessation aids might create a financial barrier to cessation for low-income smokers. In the U.S., Medicaid provides health insurance coverage to low-income people, and in some states covers smoking cessation products. This paper uses nationally representative data of the U.S. to examine how the Medicaid coverage of cessation aids affect smoking behavior. The results indicate the Medicaid coverage of cessation products is positively associated with successful quitting among women aged 18-44.

Predictors of long-term smoking cessation: results from the global adult tobacco survey in Poland (2009–2010)

PubMed Central

2012-01-01

Background Expanding the information on determinants of smoking cessation is crucial for developing and implementing more effective tobacco control measures at the national as well as European levels. Data on smoking cessation and its social correlates among adults from middle-income countries of Central and Eastern Europe are still poorly reported in the literature. The aim of the study was to analyze the association of socio-demographic indicators with long term tobacco smoking cessation (quit smoking for at least one year prior to interview) among adults. Moreover, we evaluated motives for giving up smoking from former smokers. Methods Data on former as well as current smokers’ socio-demographic and smoking-related characteristics were derived from the Global Adult Tobacco Survey (GATS). GATS is a cross-sectional, nationally representative household survey implemented in Poland between 2009 and 2010. GATS collected data on a representative sample of 7,840 individuals including 1,206 individuals who met the criteria of long-term smoking cessation and 2,233 current smokers. Smoking cessation rate was calculated as the number of former smokers divided by the number of ever smokers. Logistic regression analyses were used to obtain odds ratios (ORs) and 95% confidence interval (CI) of the broad number of variables on successful cessation of smoking. Results Among females the quit rate was 30.4% compared to 37.9% in males (p < 0.01). Former smokers declared concerns about the health hazard of smoking (60.8%) and the high price of cigarettes (11.6%) as primary reasons for smoking cessation. Older age, high education attainment, awareness of smoking health consequences was associated with long-term quitting among both genders. Also employed males had over twice the probability of giving up smoking compared with unemployed, and being religious did not contribute to successful smoking cessation. Conclusion Results indicated that smoking cessation policies focused on younger age groups are vital for curbing tobacco epidemic in Poland and should become a public health main concern. There is also the need for interventions to raise awareness on smoking health risks and quitting benefits are crucial to increase cessation potential among adult smokers. Nevertheless further effort needs to be done to prevent smoking uptake. PMID:23173904

Predictors of long-term smoking cessation: results from the global adult tobacco survey in Poland (2009-2010).

PubMed

Kaleta, Dorota; Korytkowski, Przemysław; Makowiec-Dąbrowska, Teresa; Usidame, Bukola; Bąk-Romaniszyn, Leokadia; Fronczak, Adam

2012-11-22

Expanding the information on determinants of smoking cessation is crucial for developing and implementing more effective tobacco control measures at the national as well as European levels. Data on smoking cessation and its social correlates among adults from middle-income countries of Central and Eastern Europe are still poorly reported in the literature. The aim of the study was to analyze the association of socio-demographic indicators with long term tobacco smoking cessation (quit smoking for at least one year prior to interview) among adults. Moreover, we evaluated motives for giving up smoking from former smokers. Data on former as well as current smokers' socio-demographic and smoking-related characteristics were derived from the Global Adult Tobacco Survey (GATS). GATS is a cross-sectional, nationally representative household survey implemented in Poland between 2009 and 2010. GATS collected data on a representative sample of 7,840 individuals including 1,206 individuals who met the criteria of long-term smoking cessation and 2,233 current smokers. Smoking cessation rate was calculated as the number of former smokers divided by the number of ever smokers. Logistic regression analyses were used to obtain odds ratios (ORs) and 95% confidence interval (CI) of the broad number of variables on successful cessation of smoking. Among females the quit rate was 30.4% compared to 37.9% in males (p < 0.01). Former smokers declared concerns about the health hazard of smoking (60.8%) and the high price of cigarettes (11.6%) as primary reasons for smoking cessation. Older age, high education attainment, awareness of smoking health consequences was associated with long-term quitting among both genders. Also employed males had over twice the probability of giving up smoking compared with unemployed, and being religious did not contribute to successful smoking cessation. Results indicated that smoking cessation policies focused on younger age groups are vital for curbing tobacco epidemic in Poland and should become a public health main concern. There is also the need for interventions to raise awareness on smoking health risks and quitting benefits are crucial to increase cessation potential among adult smokers. Nevertheless further effort needs to be done to prevent smoking uptake.

The SNAP trial: a randomised placebo-controlled trial of nicotine replacement therapy in pregnancy--clinical effectiveness and safety until 2 years after delivery, with economic evaluation.

PubMed

Cooper, Sue; Lewis, Sarah; Thornton, James G; Marlow, Neil; Watts, Kim; Britton, John; Grainge, Matthew J; Taggar, Jaspal; Essex, Holly; Parrott, Steve; Dickinson, Anne; Whitemore, Rachel; Coleman, Tim

2014-08-01

Smoking during pregnancy causes many adverse pregnancy and birth outcomes. Nicotine replacement therapy (NRT) is effective for cessation outside pregnancy but efficacy and safety in pregnancy are unknown. We hypothesised that NRT would increase smoking cessation in pregnancy without adversely affecting infants. To compare (1) at delivery, the clinical effectiveness and cost-effectiveness for achieving biochemically validated smoking cessation of NRT patches with placebo patches in pregnancy and (2) in infants at 2 years of age, the effects of maternal NRT patch use with placebo patch use in pregnancy on behaviour, development and disability. Randomised, placebo-controlled, parallel-group trial and economic evaluation with follow-up at 4 weeks after randomisation, delivery and until infants were 2 years old. Randomisation was stratified by centre and a computer-generated sequence was used to allocate participants using a 1 : 1 ratio. Participants, site pharmacies and all study staff were blind to treatment allocation. Seven antenatal hospitals in the Midlands and north-west England. Women between 12 and 24 weeks' gestation who smoked ≥ 10 cigarettes a day before and ≥ 5 during pregnancy, with an exhaled carbon monoxide (CO) reading of ≥ 8 parts per million (p.p.m.). NRT patches (15 mg per 16 hours) or matched placebo as an 8-week course issued in two equal batches. A second batch was dispensed at 4 weeks to those abstinent from smoking. self-reported, prolonged abstinence from smoking between a quit date and childbirth, validated at delivery by CO measurement and/or salivary cotinine (COT) (primary outcome). Infants, at 2 years: absence of impairment, defined as no disability or problems with behaviour and development. Economic: cost per 'quitter'. One thousand and fifty women enrolled (521 NRT, 529 placebo). There were 1010 live singleton births and 12 participants had live twins, while there were 14 fetal deaths and no birth data for 14 participants. Numbers of adverse pregnancy and birth outcomes were similar in trial groups, except for a greater number of caesarean deliveries in the NRT group. Smoking: all participants were included in the intention-to-treat (ITT) analyses; those lost to follow-up (7% for primary outcome) were assumed to be smoking. At 1 month after randomisation, the validated cessation rate was higher in the NRT group {21.3% vs. 11.7%, odds ratio [OR], [95% confidence interval (CI)] for cessation with NRT, 2.05 [1.46 to 2.88]}. At delivery, there was no difference between groups' smoking cessation rates: 9.4% in the NRT and 7.6% in the placebo group [OR (95% CI), 1.26 (0.82 to 1.96)]. Infants: at 2 years, analyses were based on data from 888 out of 1010 (87.9%) singleton infants (including four postnatal infant deaths) [445/503 (88.5%) NRT, 443/507 (87.4%) placebo] and used multiple imputation. In the NRT group, 72.6% (323/445) had no impairment compared with 65.5% (290/443) in placebo (OR 1.40, 95% CI 1.05 to 1.86). The incremental cost-effectiveness ratio for NRT use was £4156 per quitter (£4926 including twins), but there was substantial uncertainty around these estimates. Nicotine replacement therapy patches had no enduring, significant effect on smoking in pregnancy; however, 2-year-olds born to women who used NRT were more likely to have survived without any developmental impairment. Further studies should investigate the clinical effectiveness and safety of higher doses of NRT. Current Controlled Trials ISRCTN07249128. This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 18, No. 54. See the NIHR Journals Library programme website for further project information.

Cost-effectiveness of intensive smoking cessation therapy among patients with small abdominal aortic aneurysms.

PubMed

Mani, Kevin; Wanhainen, Anders; Lundkvist, Jonas; Lindström, David

2011-09-01

Smoking cessation is one of the few available strategies to decrease the risk for expansion and rupture of small abdominal aortic aneurysms (AAAs). The cost-effectiveness of an intensive smoking cessation therapy in patients with small AAAs identified at screening was evaluated. A Markov cohort simulation model was used to compare an 8-week smoking cessation intervention with adjuvant pharmacotherapy and annual revisits vs nonintervention among 65-year-old male smokers with a small AAA identified at screening. The smoking cessation rate was tested in one-way sensitivity analyses in the intervention group (range, 22%-57%) and in the nonintervention group (range, 3%-30%). Literature data on the effect of smoking on AAA expansion and rupture was factored into the model. The intervention was cost-effective in all tested scenarios and sensitivity analyses. The smoking cessation intervention was cost-effective due to a decreased need for AAA repair and decreased rupture rate even when disregarding the positive effects of smoking cessation on long-term survival. The incremental cost/effectiveness ratio reached the willingness-to-pay threshold value of €25,000 per life-year gained when assuming an intervention cost of > €3250 or an effect of ≤ 1% difference in long-term smoking cessation between the intervention and nonintervention groups. Smoking cessation resulted in a relative risk reduction for elective AAA repair by 9% and for rupture by 38% over 10 years of follow-up. An adequate smoking cessation intervention in patients with small AAAs identified at screening can cost-effectively increase long-term survival and decrease the need for AAA repair. Copyright © 2011 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

Post-quit stress mediates the relation between social support and smoking cessation among socioeconomically disadvantaged adults.

PubMed

Bandiera, Frank C; Atem, Folefac; Ma, Ping; Businelle, Michael S; Kendzor, Darla E

2016-06-01

Social support interventions have demonstrated limited effectiveness for preventing smoking relapse. The stress-buffering hypothesis may be a useful framework by which to understand social support in smoking cessation interventions. The current study evaluated the interrelations among social support, stress, and smoking cessation in both moderation and mediation models. Participants (N=139) were enrolled in a smoking cessation study at the safety-net hospital in Dallas, Texas. During the week prior to a scheduled quit attempt, general social support was measured using the Interpersonal Support Evaluation List (ISEL) questionnaire and smoking-specific social support was measured via repeated smartphone-based ecological momentary assessments (EMA). Post-quit stress was repeatedly assessed via smartphone. Logistic regression analyses evaluated potential interaction effects of pre-quit social support and post-quit stress on the likelihood of achieving biochemically-verified 7-day point prevalence abstinence at 4 weeks post-quit. Mediation models were evaluated to determine if post-quit stress mediated the association between pre-quit social support and smoking cessation. Participants were predominantly Black (63.3%) and female (57.6%); and 55% reported an annual household income of <$12,000. Analyses indicated that pre-quit social support did not significantly interact with post-quit stress to influence smoking cessation. However, post-quit stress did mediate associations between social support variables and smoking cessation. Findings indicated that social support impacts smoking cessation through its influence on post-quit stress among socioeconomically disadvantaged adults participating in cessation treatment. Increasing social support for the specific purpose of reducing stress during a quit attempt may improve smoking cessation rates in disadvantaged populations. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Pairing Smoking-Cessation Services With Lung Cancer Screening: A Clinical Guideline From the Association for the Treatment of Tobacco Use and Dependence and the Society for Research on Nicotine and Tobacco

PubMed Central

Fucito, Lisa M.; Czabafy, Sharon; Hendricks, Peter S.; Kotsen, Chris; Richardson, Donna; Toll, Benjamin A.

2016-01-01

Smoking cessation is crucial for reducing cancer risk and premature mortality. The US Preventive Services Task Force (USPSTF) has recommended annual lung cancer screening with low-dose computed tomography (LDCT), and the Center for Medicare and Medicaid Services recently approved lung screening as a benefit for patients ages 55 to 77 years who have a 30 pack-year history. The Society for Research on Nicotine and Tobacco (SRNT) and the Association for the Treatment of Tobacco Use and Dependence (ATTUD) developed the guideline described in this commentary based on an illustrative literature review to present the evidence for smoking-cessation health benefits in this high-risk group and to provide clinical recommendations for integrating evidence-based smoking-cessation treatment with lung cancer screening. Unfortunately, extant data on lung cancer screening participants were scarce at the time this guideline was written. However, in this review, the authors summarize the sufficient evidence on the benefits of smoking cessation and the efficacy of smoking-cessation interventions for smokers ages 55 to 77 years to provide smoking-cessation interventions for smokers who seek lung cancer screening. It is concluded that smokers who present for lung cancer screening should be encouraged to quit smoking at each visit. Access to evidence-based smoking-cessation interventions should be provided to all smokers regardless of scan results, and motivation to quit should not be a necessary precondition for treatment. Follow-up contacts to support smoking-cessation efforts should be arranged for smokers. Evidence-based behavioral strategies should be used at each visit to motivate smokers who are unwilling to try quitting/reducing smoking or to try evidence-based treatments that may lead to eventual cessation. PMID:26916412

Adolescents’ and Young Adults’ Perceptions of Electronic Cigarettes for Smoking Cessation: A Focus Group Study

PubMed Central

Camenga, Deepa R.; Cavallo, Dana A.; Kong, Grace; Morean, Meghan E.; Connell, Christian M.; Simon, Patricia; Bulmer, Sandra M.

2015-01-01

Introduction: Research has shown that adults perceive that electronic cigarettes (e-cigarettes) are effective for smoking cessation, yet little is known about adolescents and young adults’ perceptions of e-cigarettes for quitting cigarette smoking. This study describes middle, high school, and college students’ beliefs about, and experiences with, e-cigarettes for cigarette smoking cessation. Methods: We conducted 18 focus groups (n = 127) with male and female cigarette smokers and nonsmokers in 2 public colleges, 2 high schools, and 1 middle school in Connecticut between November 2012 and April 2013. Participants discussed cigarette smoking cessation in relation to e-cigarettes. Verbatim transcripts were analyzed using thematic analysis. Results: All participants, regardless of age and smoking status, were aware that e-cigarettes could be used for smoking cessation. College and high school participants described different methods of how e-cigarettes could be used for smoking cessation: (a) nicotine reduction followed by cessation; (b) cigarette reduction/dual use; and (c) long-term exclusive e-cigarette use. However, overall, participants did not perceive that e-cigarette use led to successful quitting experiences. Participants described positive attributes (maintenance of smoking actions, “healthier” alternative to cigarettes, and parental approval) and negative attributes (persistence of craving, maintenance of addiction) of e-cigarettes for cessation. Some college students expressed distrust of marketing of e-cigarettes for smoking cessation. Conclusions: Adolescent and young adult smokers and nonsmokers perceive that there are several methods of using e-cigarettes for quitting and are aware of both positive and negative aspects of the product. Future research is needed to determine the role of e-cigarettes for smoking cessation in this population. PMID:25646346

Chinese and Vietnamese adult male smokers' perspectives regarding facilitators of tobacco cessation behavior.

PubMed

Spigner, Clarence; Yip, Mei-Po; Huang, Bu; Tu, Shin Ping

2007-01-01

National surveys show a low prevalence of tobacco cigarette smoking within the Asian American/Pacific Islander population. However, smoking rates loom higher when data is disaggregated by ethnicity and gender. Nevertheless, few data are available on how smokers in this population quit smoking. The aim of this study was to collect first-hand perspectives from adult male Chinese and Vietnamese current and former smokers who were patients at a community clinic in Seattle, Washington, in order to understand the facilitators toward smoking cessation and the methods that they might use to quit smoking. A telephone survey was administered to age-eligible male Chinese and Vietnamese clinic patients who were current or former smokers. A total of 196 Chinese and 198 Vietnamese (N=394) adult male current and former smokers were contacted from a pool culled from the clinic database. Descriptive analysis using SPSS software revealed ethnicity-specific differences between current and former smokers regarding influences on smoking cessation behavior as well as uptake and endorsement of cessation methods. Family encouragement and physician recommendations were significant facilitators on the cessation process. Will power and self-determination were frequently mentioned by both Vietnamese and Chinese smokers as helpful methods to quit smoking. Vietnamese smokers were more resourceful than Chinese smokers in their use of smoking cessation methods. Even with access to cessation classes at a health clinic, half of current smokers indicated that they had no intention to quit. Such attitudes underscore the need for promotion of effective smoking cessation programs as well as successful strategies for reaching smokers. These conclusions are particularly important for Chinese smokers, who were comparatively less resourceful in their use of smoking cessation methods. Future studies should explore integrating the concept of will power with current mainstream state-of-the-art smoking cessation programs.

Proactive tobacco treatment offering free nicotine replacement therapy and telephone counselling for socioeconomically disadvantaged smokers: a randomised clinical trial.

PubMed

Fu, Steven S; van Ryn, Michelle; Nelson, David; Burgess, Diana J; Thomas, Janet L; Saul, Jessie; Clothier, Barbara; Nyman, John A; Hammett, Patrick; Joseph, Anne M

2016-05-01

Evidenced-based tobacco cessation treatments are underused, especially by socioeconomically disadvantaged smokers. This contributes to widening socioeconomic disparities in tobacco-related morbidity and mortality. The Offering Proactive Treatment Intervention trial tested the effects of a proactive outreach tobacco treatment intervention on population-level smoking abstinence and tobacco treatment use among a population-based sample of socioeconomically disadvantaged smokers. Current smokers (n=2406), regardless of interest in quitting, who were enrolled in the Minnesota Health Care Programs, the state's publicly funded healthcare programmes for low-income populations, were randomly assigned to proactive outreach or usual care. The intervention comprised proactive outreach (tailored mailings and telephone calls) and free cessation treatment (nicotine replacement therapy and intensive, telephone counselling). Usual care comprised access to a primary care physician, insurance coverage of Food and Drug Administration-approved smoking cessation medications, and the state's telephone quitline. The primary outcome was self-reported 6-month prolonged smoking abstinence at 1 year and was assessed by follow-up survey. The proactive intervention group had a higher prolonged abstinence rate at 1 year than usual care (16.5% vs 12.1%, OR 1.47, 95% CI 1.12 to 1.93). The effect of the proactive intervention on prolonged abstinence persisted in selection models accounting for non-response. In analysis of secondary outcomes, use of evidence-based tobacco cessation treatments were significantly greater among proactive outreach participants compared with usual care, particularly combination counselling and medications (17.4% vs 3.6%, OR 5.69, 95% CI 3.85 to 8.40). Population-based proactive tobacco treatment increases engagement in evidence-based treatment and is effective in long-term smoking cessation among socioeconomically disadvantaged smokers. Findings suggest that dissemination of population-based proactive treatment approaches is an effective strategy to reduce the prevalence of smoking and socioeconomic disparities in tobacco use. NCT01123967. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

"It doesn't seem to make sense for a company that sells cigarettes to help smokers stop using them": A case study of Philip Morris's involvement in smoking cessation.

PubMed

McDaniel, Patricia A; Lown, E Anne; Malone, Ruth E

2017-01-01

In the late 1990s, American tobacco companies began offering limited cessation assistance to smokers by posting links on their company websites to government-sponsored smoking cessation resources. Philip Morris USA (PM) went further, funding youth cessation programs and creating its own online cessation program, QuitAssist. We explore why PM entered the cessation arena, and describe the variety of options considered and how PM-supported cessation programs were evaluated and promoted. We retrieved and analyzed archival PM documents from 1998-2005. We supplemented information from the documents with scholarly articles assessing QuitAssist and archived versions of the PM and QuitAssist websites. PM's Youth Smoking Prevention department began funding youth cessation projects and programs soon after its creation in 1998, motivated by the same issue that drove its interest in youth smoking prevention: regulatory threats posed by public and policymaker concern about youth smoking. The department took a similar approach to youth smoking cessation as it did with prevention, rejecting curricula with "anti-industry" themes. In 2002, a "cessation exploration team" examined a variety of rationales for and approaches to company support for adult smoking cessation. Ultimately, PM chose QuitAssist, a limited and less expensive option that nonetheless provided opportunities for engagement with a variety of public health and government officials. Independent research indicates that QuitAssist is not an effective cessation tool. While the transformation of ambitious plans into a mundane final product is a recurring theme with PM's corporate responsibility efforts, it would be inappropriate to dismiss PM's smoking cessation endeavors as half-hearted attempts to appear responsible. Such endeavors have the potential to inflict real harm by competing with more effective programs and by helping to maintain a tobacco-favorable policy environment. If PM truly wanted to support cessation, it could drop legal and other challenges to public policies that discourage smoking.

Accuracy of self-reported smoking cessation during pregnancy.

PubMed

Tong, Van T; Althabe, Fernando; Alemán, Alicia; Johnson, Carolyn C; Dietz, Patricia M; Berrueta, Mabel; Morello, Paola; Colomar, Mercedes; Buekens, Pierre; Sosnoff, Connie S; Farr, Sherry L; Mazzoni, Agustina; Ciganda, Alvaro; Becú, Ana; Bittar Gonzalez, Maria G; Llambi, Laura; Gibbons, Luz; Smith, Ruben A; Belizán, José M

2015-01-01

Evidence of bias of self-reported smoking cessation during pregnancy is reported in high-income countries but not elsewhere. We sought to evaluate self-reported smoking cessation during pregnancy using biochemical verification and to compare characteristics of women with and without biochemically confirmed cessation in Argentina and Uruguay. In a cross-sectional study from October 2011 to May 2012, women who attended one of 21 prenatal clinics and delivered at selected hospitals in Buenos Aires, Argentina and Montevideo, Uruguay, were surveyed about their smoking cessation during pregnancy. We tested saliva collected from women <12 h after delivery for cotinine to evaluate self-reported smoking cessation during pregnancy. Overall, 10.0% (44/441) of women who self-reported smoking cessation during pregnancy had biochemical evidence of continued smoking. Women who reported quitting later in pregnancy had a higher percentage of nondisclosure (17.2%) than women who reported quitting when learning of their pregnancy (6.4%). © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

Use of Smoking Cessation Interventions by Physicians in Argentina

PubMed Central

Schoj, Veronica; Mejia, Raul; Alderete, Mariela; Kaplan, Celia P.; Peña, Lorena; Gregorich, Steven E.; Alderete, Ethel; Pérez-Stable, Eliseo J.

2015-01-01

Background Physician-implemented interventions for smoking cessation are effective but infrequently used. We evaluated smoking cessation practices among physicians in Argentina. Methods A self-administered survey of physicians from six clinical systems asked about smoking cessation counselling practices, barriers to tobacco use counselling and perceived quality of training received in smoking cessation practices. Results Of 254 physicians, 52.3% were women, 11.8% were current smokers and 52% never smoked. Perceived quality of training in tobacco cessation counselling was rated as very good or good by 41.8% and as poor/very poor by 58.2%. Most physicians (90%) reported asking and recording smoking status, 89% advised patients to quit smoking but only 37% asked them to set a quit date and 44% prescribed medications. Multivariate analyses showed that Physicians’ perceived quality of their training in smoking cessation methods was associated with greater use of evidence-based cessation interventions. (OR = 6.5; 95% CI = 2.2–19.1); motivating patients to quit (OR: 7.9 CI 3.44–18.5), assisting patients to quit (OR = 9.9; 95% CI = 4.0–24.2) prescribing medications (OR = 9.6; 95% CI = 3.5–26.7), and setting up follow-up (OR = 13.0; 95% CI = 4.4–38.5). Conclusions Perceived quality of training in smoking cessation was associated with using evidence-based interventions and among physicians from Argentina. Medical training programs should enhance the quality of this curriculum. PMID:27594922

Service and sales workers, are they vulnerable to smoking cessation?

PubMed

Cho, Youn-Mo; Myong, Jun-Pyo; Kim, Hyoung-Ryoul; Lee, HyeEun; Koo, Jung-Wan

2017-10-07

The aim of the present study was to evaluate the association between failed smoking cessation and occupation by age stratification among Korean males and provide quantitative evidence of factors associated with failed smoking cessation. The study comprised 3,127 male workers who had attempted smoking cessation during their life time. Data were obtained from the Korea National Health and Nutrition Examination Survey from 2010 to 2012. Participants were stratified by age into two subgroups comprising a younger group (19-40 yr) and an older group (41-60 yr). Multiple logistic regression analyses were used to estimate odds ratios (ORs) for failed smoking cessation. In the younger group, failed smoking cessation was related to the occupational fields "service and sales" and "manual work" compared to "office work" (OR: 2.10, 95% confidence interval (CI): 1.34-3.29; and OR: 1.47, 95% CI: 1.02-2.12, respectively). In the older group, the ORs of failed smoking cessation occupational categories "service and sales" and "manual work" [ref: office workers] were 0.58 (0.40-0.85) and 0.90 (0.66-1.24), respectively. Failed smoking cessation is associated with occupational categories and age stratification. Policy makers need to create tailored anti-smoking policy considering the occupation and the age of the subjects.

Smoking, cessation and expenditure in low income Chinese: cross sectional survey.

PubMed

Hesketh, Therese; Lu, Li; Jun, Ye Xue; Mei, Wang Hong

2007-03-04

This study was carried-out to explore smoking behaviour and smoking expenditure among low income workers in Eastern China to inform tobacco control policy. A self-completion questionnaire was administered to 1958 urban workers, 1909 rural workers and 3248 migrant workers in Zhejiang Province, Eastern China in 2004. Overall 54% of the men and 1.8% of all women were current smokers (at least 1 cigarette per day). Smoking was least common in migrant men (51%), compared with 58% of urban workers and 64% rural inhabitants (P < 0.0001). Forty-nine percent of rural males smoke more than 10 cigarettes/day, and 22% over 20/day. The prevalence of smoking increased with age. Overall 9% of the males had successfully quit smoking. Reasons for quitting were to prevent future illness (58%), current illness (31%), family pressures (20%) and financial considerations (20%). Thirteen percent of current smokers had ever tried to quit (cessation for at least one week) while 22% intended to quit, with migrants most likely to intend to quit. Almost all (96%) were aware that smoking was harmful to health, though only 25% were aware of the dangers of passive smoking. A mean of 11% of personal monthly income is spent on smoking rising to a mean of 15.4% in rural smokers. This expenditure was found to have major opportunity costs, including in terms of healthcare access. The prevalence of smoking and successful quitting suggest that smoking prevalence in low income groups in Eastern China may have peaked. Tobacco control should focus on support for quitters, on workplace/public place smoking restrictions and should develop specific programmes in rural areas. Health education messages should emphasise the opportunity costs of smoking and the dangers of passive smoking.

A rural Appalachian faith-placed smoking cessation intervention.

PubMed

Schoenberg, Nancy E; Bundy, Henry E; Baeker Bispo, Jordan A; Studts, Christina R; Shelton, Brent J; Fields, Nell

2015-04-01

Although health promotion programming in faith institutions is promising, most faith-based or placed health projects focus on diet, exercise, or cancer screening and many have been located in urban environments. This article addresses the notable absence of faith programming for smoking cessation among underserved rural US residents who experience tobacco-related health inequities. In this article, we describe our faith-oriented smoking cessation program in rural Appalachia, involving 590 smokers in 26 rural churches randomized to early and delayed intervention groups. We present three main themes that account for participants' positive evaluation of the program; the program's ability to leverage social connections; the program's convenience orientation; and the program's financial support for smoking cessation. We also present themes on the roles of faith and church in smoking cessation programming, including some mixed perceptions on smoking stigma and comfort in church settings; challenges in faith-placed smoking cessation recruitment; and the positive perception of such programming by church leaders. We conclude that faith-placed smoking cessation programs offer great potential, although they must be administered with great sensitivity to individual and community norms.

A Rural Appalachian Faith-Placed Smoking Cessation Intervention

PubMed Central

Schoenberg, Nancy E.; Bundy, Henry E.; Baeker Bispo, Jordan A.; Studts, Christina R.; Shelton, Brent J.; Fields, Nell

2014-01-01

Although health promotion programming in faith institutions is promising, most faith-based or placed health projects focus on diet, exercise, or cancer screening and many have been located in urban environments. This article addresses the notable absence of faith programming for smoking cessation among underserved rural US residents who experience tobacco-related health inequities. In this article, we describe our faith-oriented smoking cessation program in rural Appalachia, involving 590 smokers in 26 rural churches randomized to early and delayed intervention groups. We present three main themes that account for participants’ positive evaluation of the program; the program’s ability to leverage social connections; the program’s convenience orientation; and the program’s financial support for smoking cessation. We also present themes on the roles of faith and church in smoking cessation programming, including some mixed perceptions on smoking stigma and comfort in church settings; challenges in faith-placed smoking cessation recruitment; and the positive perception of such programming by church leaders. We conclude that faith-placed smoking cessation program offer great potential, although they must be administered with great sensitivity to individual and community norms. PMID:24691565

Physician smoking status, attitudes toward smoking, and cessation advice to patients: an international survey.

PubMed

Pipe, Andrew; Sorensen, Michelle; Reid, Robert

2009-01-01

The smoking status of physicians can impact interactions with patients about smoking. The 'Smoking: The Opinions of Physicians' (STOP) survey examined whether an association existed between physician smoking status and beliefs about smoking and cessation and a physician's clinical interactions with patients relevant to smoking cessation, and perceptions of barriers to assisting with quitting. General and family practitioners across 16 countries were surveyed via telephone or face-to-face interviews using a convenience-sample methodology. Physician smoking status was self-reported. Of 4473 physicians invited, 2836 (63%) participated in the survey, 1200 (42%) of whom were smokers. Significantly fewer smoking than non-smoking physicians volunteered that smoking was a harmful activity (64% vs 77%; P<0.001). More non-smokers agreed that smoking cessation was the single biggest step to improving health (88% vs 82%; P<0.001) and discussed smoking at every visit (45% vs 34%; P<0.001). Although more non-smoking physicians identified willpower (37% vs 32%; P<0.001) and lack of interest (28% vs 22%; P<0.001) as barriers to quitting, more smoking physicians saw stress as a barrier (16% vs 10%; P<0.001). Smoking physicians are less likely to initiate cessation interventions. There is a need for specific strategies to encourage smoking physicians to quit, and to motivate all practitioners to adopt systematic approaches to assisting with smoking cessation.

Behavioral Interventions Associated with Smoking Cessation in the Treatment of Tobacco Use

PubMed Central

Roberts, Nicola J.; Kerr, Susan M.; Smith, Sheree M.S.

2013-01-01

Tobacco smoke is the leading cause of preventable premature death worldwide. While the majority of smokers would like to stop, the habitual and addictive nature of smoking makes cessation difficult. Clinical guidelines suggest that smoking cessation interventions should include both behavioural support and pharmacotherapy (e.g. nicotine replacement therapy). This commentary paper focuses on the important role of behavioural interventions in encouraging and supporting smoking cessation attempts. Recent developments in the field are discussed, including ‘cut-down to quit’, the behaviour change techniques taxonomy (BCTT) and very brief advice (VBA) on smoking. The paper concludes with a discussion of the important role that health professionals can and should play in the delivery of smoking cessation interventions. PMID:25114563

A lifetime Markov model for the economic evaluation of chronic obstructive pulmonary disease.

PubMed

Menn, Petra; Leidl, Reiner; Holle, Rolf

2012-09-01

Chronic obstructive pulmonary disease (COPD) is currently the fourth leading cause of death worldwide. It has serious health effects and causes substantial costs for society. The aim of the present paper was to develop a state-of-the-art decision-analytic model of COPD whereby the cost effectiveness of interventions in Germany can be estimated. To demonstrate the applicability of the model, a smoking cessation programme was evaluated against usual care. A seven-stage Markov model (disease stages I to IV according to the GOLD [Global Initiative for Chronic Obstructive Lung Disease] classification, states after lung-volume reduction surgery and lung transplantation, death) was developed to conduct a cost-utility analysis from the societal perspective over a time horizon of 10, 40 and 60 years. Patients entered the cohort model at the age of 45 with mild COPD. Exacerbations were classified into three levels: mild, moderate and severe. Estimation of stage-specific probabilities (for smokers and quitters), utilities and costs was based on German data where possible. Data on effectiveness of the intervention was retrieved from the literature. A discount rate of 3% was applied to costs and effects. Probabilistic sensitivity analysis was used to assess the robustness of the results. The smoking cessation programme was the dominant strategy compared with usual care, and the intervention resulted in an increase in health effects of 0.54 QALYs and a cost reduction of &U20AC;1115 per patient (year 2007 prices) after 60 years. In the probabilistic analysis, the intervention dominated in about 95% of the simulations. Sensitivity analyses showed that uncertainty primarily originated from data on disease progression and treatment cost in the early stages of disease. The model developed allows the long-term cost effectiveness of interventions to be estimated, and has been adapted to Germany. The model suggests that the smoking cessation programme evaluated was more effective than usual care as well as being cost-saving. Most patients had mild or moderate COPD, stages for which parameter uncertainty was found to be high. This raises the need to improve data on the early stages of COPD.

Health‐care interventions to promote and assist tobacco cessation: a review of efficacy, effectiveness and affordability for use in national guideline development

PubMed Central

Raw, Martin; McNeill, Ann; Stead, Lindsay; Aveyard, Paul; Bitton, John; Stapleton, John; McRobbie, Hayden; Pokhrel, Subhash; Lester‐George, Adam; Borland, Ron

2015-01-01

Abstract Aims This paper provides a concise review of the efficacy, effectiveness and affordability of health‐care interventions to promote and assist tobacco cessation, in order to inform national guideline development and assist countries in planning their provision of tobacco cessation support. Methods Cochrane reviews of randomized controlled trials (RCTs) of major health‐care tobacco cessation interventions were used to derive efficacy estimates in terms of percentage‐point increases relative to comparison conditions in 6–12‐month continuous abstinence rates. This was combined with analysis and evidence from ‘real world’ studies to form a judgement on the probable effectiveness of each intervention in different settings. The affordability of each intervention was assessed for exemplar countries in each World Bank income category (low, lower middle, upper middle, high). Based on World Health Organization (WHO) criteria, an intervention was judged as affordable for a given income category if the estimated extra cost of saving a life‐year was less than or equal to the per‐capita gross domestic product for that category of country. Results Brief advice from a health‐care worker given opportunistically to smokers attending health‐care services can promote smoking cessation, and is affordable for countries in all World Bank income categories (i.e. globally). Proactive telephone support, automated text messaging programmes and printed self‐help materials can assist smokers wanting help with a quit attempt and are affordable globally. Multi‐session, face‐to‐face behavioural support can increase quit success for cigarettes and smokeless tobacco and is affordable in middle‐ and high‐income countries. Nicotine replacement therapy, bupropion, nortriptyline, varenicline and cytisine can all aid quitting smoking when given with at least some behavioural support; of these, cytisine and nortriptyline are affordable globally. Conclusions Brief advice from a health‐care worker, telephone helplines, automated text messaging, printed self‐help materials, cytisine and nortriptyline are globally affordable health‐care interventions to promote and assist smoking cessation. Evidence on smokeless tobacco cessation suggests that face‐to‐face behavioural support and varenicline can promote cessation. PMID:26031929

Awareness, practices, and barriers regarding smoking cessation treatment among physicians in Saudi Arabia.

PubMed

Jradi, Hoda

2017-01-01

Smoking cessation counseling and therapy provided by physicians play an important role in helping smokers quit. Awareness and practices of the clinical practice guidelines for tobacco dependence (in particular the 5A's: Ask, Assist, Assess, Advise, and Arrange) among physicians and perceived barriers for their implementation is needed to improve care for individuals who smoke/use tobacco products in Saudi Arabia. A cross-sectional self-administered survey was conducted among 124 general and family practitioners in primary health care clinics belonging to 2 major medical centers in Riyadh city, Saudi Arabia. Descriptive statistics were reported for all survey variables. Logistic regression was used to examine the predictors of physicians' use of the 5A's for smoking cessation counseling and therapy. Among the 216 contacted physicians, 124 responded (57.4%). The majority (63.7%) were males, between the ages of 40 and 49 years (52.4%), practicing full-time (95.2%), and had not received smoking cessation training during medical school education or residency training (68.6%). Approximately 85.5% reported some experience with the guidelines (heard, read, or used). Asking (71.8%) and advising (87.9%) were the most implemented for smoking cessation, while assisting (15.3%) and arranging for follow-up (17.7%) were the least implemented. Most (96.0%) did not prescribe pharmacotherapy and 53.2% reported documenting the patient's smoking status. Reported barriers were mostly lack of time (72.6%) and lack of training (66.9%). Awareness of the guidelines, physician's smoking status, perceived competence in ability to provide smoking cessation counseling and therapy, reporting the ineffectiveness of smoking cessation therapy as a barrier, and the perceived benefit of reducing patient's physical symptoms were independently statistically significant predictors of the implementation of the 5A's for smoking cessation therapy. This preliminary study showed that smoking cessation delivery, according to the clinical practice guidelines recommendation, in Saudi Arabia is inadequate. Barriers were identified regarding the delivery of smoking cessation therapy and counseling for the first time. Physician training is likely to improve compliance with implementing smoking cessation counseling and therapy.

A randomized trial of nicotine-replacement therapy patches in pregnancy.

PubMed

Coleman, Tim; Cooper, Sue; Thornton, James G; Grainge, Matthew J; Watts, Kim; Britton, John; Lewis, Sarah

2012-03-01

Nicotine-replacement therapy is effective for smoking cessation outside pregnancy and its use is widely recommended during pregnancy. We investigated the efficacy and safety of nicotine patches during pregnancy. We recruited participants from seven hospitals in England who were 16 to 50 years of age with pregnancies of 12 to 24 weeks' gestation and who smoked five or more cigarettes per day. Participants received behavioral cessation support and were randomly assigned to 8 weeks of treatment with active nicotine patches (15 mg per 16 hours) or matched placebo patches. The primary outcome was abstinence from the date of smoking cessation until delivery, as validated by measurement of exhaled carbon monoxide or salivary cotinine. Safety was assessed by monitoring for adverse pregnancy and birth outcomes. Of 1050 participants, 521 were randomly assigned to nicotine-replacement therapy and 529 to placebo. There was no significant difference in the rate of abstinence from the quit date until delivery between the nicotine-replacement and placebo groups (9.4% and 7.6%, respectively; unadjusted odds ratio with nicotine-replacement therapy, 1.26; 95% confidence interval, 0.82 to 1.96), although the rate was higher at 1 month in the nicotine-replacement group than in the placebo group (21.3% vs. 11.7%). Compliance was low; only 7.2% of women assigned to nicotine-replacement therapy and 2.8% assigned to placebo used patches for more than 1 month. Rates of adverse pregnancy and birth outcomes were similar in the two groups. Adding a nicotine patch (15 mg per 16 hours) to behavioral cessation support for women who smoked during pregnancy did not significantly increase the rate of abstinence from smoking until delivery or the risk of adverse pregnancy or birth outcomes. However, low compliance rates substantially limited the assessment of safety. (Funded by the National Institute for Health Research Health Technology Assessment Programme; Current Controlled Trials number, ISRCTN07249128.).

Qualitative analysis of social network influences on quitting smoking among individuals with serious mental illness.

PubMed

Aschbrenner, Kelly A; Naslund, John A; Gill, Lydia; Hughes, Terence; O'Malley, Alistair J; Bartels, Stephen J; Brunette, Mary F

2017-07-04

The prevalence of cigarette smoking among adults with serious mental illness (SMI) remains high in the United States despite the availability of effective smoking cessation treatment. Identifying social influences on smoking and smoking cessation may help enhance intervention strategies to help smokers with SMI quit. The objective of this qualitative study was to explore social network influences on efforts to quit smoking among adults with SMI enrolled in a cessation treatment program. Participants were 41 individuals with SMI enrolled in a Medicaid Demonstration Project of smoking cessation at community mental health centers. A convenience sampling strategy was used to recruit participants for social network interviews exploring the influence of family, friends, peers, and significant others on quitting smoking. A team-based analysis of qualitative data involved descriptive coding, grouping coded data into categories, and identifying themes across the data. Social barriers to quitting smoking included pro-smoking social norms, attitudes, and behaviors of social network members, and negative interactions with network members, either specific to smoking or that triggered smoking. Social facilitators to quitting included quitting with network members, having cessation role models, and social support for quitting from network members. Similar to the general population, social factors appear to influence efforts to quit smoking among individuals with SMI enrolled in cessation treatment. Interventions that leverage positive social influences on smoking cessation have the potential to enhance strategies to help individuals with SMI quit smoking.

Teen smoking cessation help via the Internet: a survey of search engines.

PubMed

Edwards, Christine C; Elliott, Sean P; Conway, Terry L; Woodruff, Susan I

2003-07-01

The objective of this study was to assess Web sites related to teen smoking cessation on the Internet. Seven Internet search engines were searched using the keywords teen quit smoking. The top 20 hits from each search engine were reviewed and categorized. The keywords teen quit smoking produced between 35 and 400,000 hits depending on the search engine. Of 140 potential hits, 62% were active, unique sites; 85% were listed by only one search engine; and 40% focused on cessation. Findings suggest that legitimate on-line smoking cessation help for teens is constrained by search engine choice and the amount of time teens spend looking through potential sites. Resource listings should be updated regularly. Smoking cessation Web sites need to be picked up on multiple search engine searches. Further evaluation of smoking cessation Web sites need to be conducted to identify the most effective help for teens.

Health Care Workers in the Dominican Republic: Self-perceived role in smoking cessation

PubMed Central

Ossip-Klein, Deborah J.; Diaz, Sergio; Sierra, Essie; Quiñones, Zahira; Armstrong, Latoya; Chin, Nancy P.; McIntosh, Scott

2013-01-01

A Dominican Republic (DR) based multi-community trial of smoking cessation viewed health care workers (HCWs) as potential interventionists. Effectively engaging them, requires a clear understanding of their attitudes and practices regarding smoking. A Rapid Assessment Procedure, conducted among HCWs in six economically disadvantaged communities, included physicians, nurses, other health professionals, paraprofessionals and lay workers. Attitudes and practices about smoking were consistent across the 82 HCWs and mostly reflected community views. HCWs lacked proactiveness related to smoking cessation and had a limited view of their role, attributing clients’ quitting successes to personal will. Prior cessation training was limited although interest was generally high. Material resources about smoking cessation were virtually absent. DR HCWs’ views represented features both distinct from and common to HCWs elsewhere. Any intervention with HCWs must first raise awareness before addressing their role in smoking cessation, discussing implementation barriers and include training and materials about risks and effective interventions. PMID:19448160

Developing smoking cessation programs for chronically ill teens: lessons learned from research with healthy adolescent smokers.

PubMed

Robinson, Leslie A; Emmons, Karen M; Moolchan, Eric T; Ostroff, Jamie S

2008-03-01

Medically fragile teens who smoke need access to smoking cessation programs, because they are at even higher risk than their healthy peers for smoking-related complications. To date, no studies on the outcome of smoking cessation programs for medically ill teens have been conducted. To suggest directions for future research, we turn to the literature on smoking cessation in the general population of teens and occasionally to the literature on adult smokers. Four areas are explored: (a) the prevalence of unaided cessation in healthy teens; (b) the outcomes of various treatments for smoking cessation in healthy adolescents; (c) special issues that should be considered when designing programs for medically ill teens; and (d) lessons learned from previous research. Medically ill teens face a number of medical, emotional, social, and developmental challenges that can affect the quitting process. Research is sorely needed to address the unique needs of this population.

Effect of exercise type on smoking cessation: a meta-analysis of randomized controlled trials.

PubMed

Klinsophon, Thaniya; Thaveeratitham, Premtip; Sitthipornvorakul, Ekalak; Janwantanakul, Prawit

2017-09-06

Exercise is one choice of additional treatment for smoking cessation by relieving nicotine withdrawal symptoms and smoking craving. The possible mechanism of the effect of exercise on relieving nicotine withdrawal symptoms and smoking craving is including affect, biological, and cognitive hypotheses. Evidence suggests that different types of exercise have different effects on these mechanisms. Therefore, type of exercise might have effect on smoking cessation. The purpose of this study is to systematically review randomized controlled trials to gain insight into which types of exercise are effective for smoking cessation. Publications were systemically searched up to November 2016 in several databases (PubMed, ScienceDirect, PEDro, Web of Science, Scopus and Cochrane Library), using the following keywords: "physical activity", "exercise", "smoking", "tobacco" and "cigarette". The methodological quality was assessed independently by two authors. Meta-analysis was conducted to examine the effectiveness of the type of exercise on smoking cessation. The quality of the evidence was assessed and rated according to the GRADE approach. 20 articles on 19 studies were judged to meet the selection criteria (seven low-risk of bias RCTs and 12 high-risk of bias RCTs). The findings revealed low quality evidence for the effectiveness of yoga for smoking cessation at the end of the treatment. The evidence found for no effect of aerobic exercise, resisted exercise, and a combined aerobic and resisted exercise program on smoking cessation was of low to moderate quality. Furthermore, very low to low quality evidence was found for no effect of physical activity on smoking cessation. There was no effect of aerobic exercise, resisted exercise, physical activity and combined aerobic and resisted exercise on smoking cessation. There was a positive effect on smoking cessation at the end of treatment in the program where yoga plus cognitive-behavioral therapy (CBT) was used. However, which of the two work is still to be studied.

[Assessment of the impact over one year of a workplace health promotion programme in the province of Bergamo].

PubMed

Cremaschini, Marco; Moretti, Roberto; Brembilla, Giovanni; Valoti, Marinella; Sarnataro, Francesco; Spada, Pierangelo; Mologni, Graziella; Franchin, D; Antonioli, Lucia; Parodi, Daniela; Barbaglio, Giorgio; Masanotti, Giuseppe; Fiandri, Roberto

2015-05-04

To estimate short-term effects of integrated health promotion in the workplace within the framework of the Bergamo WHP (Workplace Health Promotion) network, which involves 94 companies and about 21,000 workers. A controlled non-randomized, before-after evaluation was carried out. Data were collected through anonymous questionnaires before (t0) and after participation in a 12-month health promotion programme (t1). The "control" group consisted of workers of companies participating in the programme who had not yet undertaken any interventions in the theme areas covered by the assessment. In the workers participating in the programme, positive early effects (after 12 months) were related to intake of food providing protection (fruit and vegetables) and increased rates of smoking cessation. The effects were more evident in males and in white collars. The physical activity and alcohol consumption trends went in the desired direction and with more effects than in the non-participating group, but without statistical significance. In the short term, no evident changes in events of road injury risk or in the quality of personal relationships were seen, probably due to the small size of the sample involved in these study areas. The results, although within the methodological limitations of the study, showed that after 12 months there was a reduction in some important risk factors for chronic diseases in workers participating in the programme, particularly for fruit and vegetable intake and smoking cessation. It will be important to monitor the effects of the programme on other risk factors in the medium and long term, and also the impact of employment status and gender so as to adjust the programme interventions accordingly. Cooperation with occupational/authorized physicians with use of their data collected from health surveillance, together with a limited set of general risk factor indicators, would be a desirable development for further studies.

Using the Web To Promote Smoking Cessation and Health for College-Aged Women.

ERIC Educational Resources Information Center

Col, Nananda F.; Fortin, Jennifer M.; Weber, Griffin; Braithwaite, R. Scott; Bowman, Stacie A.; Kim, Jung A.; Lyons, Jennifer L.; Dibble, Emily

Smoking among college students is on the rise, particularly among women and minorities. This paper explores smoking among college women, reviews different types of smoking cessation interventions, and describes a newly developed interactive Web site that combines tailored smoking cessation information with other health information in an attempt to…

Changes in Energy Balance Following Smoking Cessation and Resumption of Smoking in Women.

ERIC Educational Resources Information Center

Perkins, Kenneth A.; And Others

1990-01-01

Prospectively examined caloric intake, resting metabolic rate (RMR), leisure time physical activity, and sensitivity and preference for sweet taste in seven female smokers during normal smoking, complete cessation, and resumption of smoking. Findings suggest that smoking cessation may cause rapid change in energy balance which is quickly reversed…

The meanings of smoking to women and their implications for cessation.

PubMed

Greaves, Lorraine

2015-01-27

Smoking cigarettes is a gendered activity with sex- and gender-specific uptake trends and cessation patterns. While global male smoking rates have peaked, female rates are set to escalate in the 21st century, especially in low and middle income countries. Hence, smoking cessation for women will be an ongoing issue and requires refreshed attention. Public health and health promotion messages are being challenged to be increasingly tailored, taking gender into account. Women-centred approaches that include harm-reduction, motivational interviewing and trauma-informed elements are the new frontiers in interventions to encourage smoking cessation for women. Such approaches are linked to the meanings of smoking to women, the adaptive function of, and the overall role of smoking cigarettes in the context of women's lives. These approaches respect gender and sex-related factors that affect smoking and smoking cessation and respond to these issues, not by reinforcing destructive or negative gender norms, but with insight. This article discusses a women-centred approach to smoking cessation that could underpin initiatives in clinical, community or public health settings and could inform campaigns and messaging.

The Meanings of Smoking to Women and Their Implications for Cessation

PubMed Central

Greaves, Lorraine

2015-01-01

Smoking cigarettes is a gendered activity with sex- and gender-specific uptake trends and cessation patterns. While global male smoking rates have peaked, female rates are set to escalate in the 21st century, especially in low and middle income countries. Hence, smoking cessation for women will be an ongoing issue and requires refreshed attention. Public health and health promotion messages are being challenged to be increasingly tailored, taking gender into account. Women-centred approaches that include harm-reduction, motivational interviewing and trauma-informed elements are the new frontiers in interventions to encourage smoking cessation for women. Such approaches are linked to the meanings of smoking to women, the adaptive function of, and the overall role of smoking cigarettes in the context of women’s lives. These approaches respect gender and sex-related factors that affect smoking and smoking cessation and respond to these issues, not by reinforcing destructive or negative gender norms, but with insight. This article discusses a women-centred approach to smoking cessation that could underpin initiatives in clinical, community or public health settings and could inform campaigns and messaging. PMID:25633033

Efficacy of a technology-based, integrated smoking cessation and alcohol intervention for smoking cessation in adolescents: Results of a cluster-randomised controlled trial.

PubMed

Haug, Severin; Paz Castro, Raquel; Kowatsch, Tobias; Filler, Andreas; Schaub, Michael P

2017-11-01

To test the efficacy of a technology-based integrated smoking cessation and alcohol intervention versus a smoking cessation only intervention in adolescents. This was a two-arm, parallel-group, cluster-randomised controlled trial with assessments at baseline and six months follow-up. Subjects in both groups received tailored mobile phone text messages to support smoking cessation for 3months, and the option of registering for a program incorporating strategies for smoking cessation centred around a self-defined quit date. Subjects in the integrated intervention group also received tailored feedback regarding their consumption of alcohol and, for binge drinkers, tailored mobile phone text messages encouraging them to maintain their drinking within low-risk limits over a 3-month period. Primary outcome measures were the 7-day point prevalence of smoking abstinence and change in cigarette consumption. In 360 Swiss vocational and upper secondary school classes, 2127 students who smoked tobacco regularly and owned a mobile phone were invited to participate in the study. Of these, 1471 (69.2%) participated and 6-month follow-up data were obtained for 1116 (75.9%). No significant group differences were observed for any of the primary or secondary outcomes. Moderator analyses revealed beneficial intervention effects concerning 7-day smoking abstinence in participants with higher versus lower alcohol consumption. Overall, the integrated smoking cessation and alcohol intervention exhibited no advantages over a smoking cessation only intervention, but it might be more effective for the subgroup of adolescent smokers with higher alcohol consumption. Providing a combined smoking cessation and alcohol intervention might be recommended for adolescent smokers with higher-level alcohol consumption. Copyright © 2017 Elsevier Inc. All rights reserved.

Do cravings predict smoking cessation in smokers calling a national quit line: secondary analyses from a randomised trial for the utility of 'urges to smoke' measures.

PubMed

Taggar, Jaspal S; Lewis, Sarah; Docherty, Graeme; Bauld, Linda; McEwen, Andy; Coleman, Tim

2015-04-14

Single-item urges to smoke measures have been contemplated as important measures of nicotine dependence This study aimed to prospectively determine the relationships between measures of craving to smoke and smoking cessation, and compare their ability to predict cessation with the Heaviness of Smoking Index, an established measure of nicotine dependence. We conducted a secondary analysis of data from the randomised controlled PORTSSS trial. Measures of nicotine dependence, ascertained before making a quit attempt, were the HSI, frequency of urges to smoke (FUTS) and strength of urges to smoke (SUTS). Self-reported abstinence at six months after quitting was the primary outcome measure. Multivariate logistic regression and Receiver Operating Characteristic (ROC) analysis were used to assess associations and abilities of the nicotine dependence measures to predict smoking cessation. Of 2,535 participants, 53.5% were female; the median (Interquartile range) age was 38 (28-50) years. Both FUTS and HSI were inversely associated with abstinence six months after quitting; for each point increase in HSI score, participants were 16% less likely to have stopped smoking (OR 0.84, 95% C.I 0.78-0.89, p < 0.0001). Compared to participants with the lowest possible FUTS scores, those with greater scores had generally lower odds of cessation (p across frequency of urges categories=0.0026). SUTS was not associated with smoking cessation. ROC analysis suggested the HSI and FUTS had similar predictive validity for cessation. Higher FUTS and HSI scores were inversely associated with successful smoking cessation six months after quit attempts began and both had similar validity for predicting cessation.

The long-term cost-effectiveness of varenicline (12-week standard course and 12 + 12-week extended course) vs. other smoking cessation strategies in Canada.

PubMed

von Wartburg, M; Raymond, V; Paradis, P E

2014-05-01

Smoking is the leading risk factor for preventable morbidity and mortality as a result of heart and lung diseases and various forms of cancer. Reimbursement coverage for smoking cessation therapies remains limited in Canada and the United States despite the health and economic benefits of smoking cessation. This study aimed to evaluate the long-term cost-effectiveness of varenicline compared with other smoking cessation interventions in Canada using the Benefits of Smoking Cessation on Outcomes (BENESCO) model. Efficacy rates of the standard course (12 weeks) varenicline, extended course (12 + 12 weeks) varenicline, bupropion, nicotine replacement therapy and unaided intervention were derived based on a published mixed treatment comparison methodology and analysed within a Markov cohort model to estimate their cost-effectiveness over the lifetime cycle. Study cohort, smoking rates and prevalence, incidence and mortality of smoking-related diseases were calibrated to represent the Canadian population. Over the subjects' lifetime, both the standard and the extended course of varenicline are shown to dominate (e.g. less costly and more effective) all other alternative smoking cessation interventions considered. Compared with the standard varenicline treatment course, the extended course is highly cost-effective with an incremental cost-effectiveness ratio (ICER) less than $4000 per quality-adjusted life year. Including indirect cost and benefits of smoking cessation interventions further strengthens the result with the extended course of varenicline dominating all other alternatives considered. Evidence from complex smoking cessation models requiring numerous inputs and assumptions should be assessed in conjunction with evidence from other methodologies. The standard and extended courses of varenicline are decidedly cost-effective treatment regimes compared with alternative smoking cessation interventions and can provide significant cost savings to the healthcare system. © 2014 John Wiley & Sons Ltd.

Predictors of perceiving smoking cessation counselling as a midwife's role: a survey of Dutch midwives.

PubMed

Bakker, Martijntje J; de Vries, Hein; Mullen, Patricia Dolan; Kok, Gerjo

2005-02-01

Smoking during pregnancy can have many serious consequences. As the usual providers of pregnancy care in the Netherlands, midwives could serve as effective counsellors to pregnant women about cigarette smoking. The aim of the present study was to identify relevant factors that hamper or promote the provision of effective smoking cessation advice and counselling. Questionnaires were mailed to midwives; 237 (64.4%) were returned. Questions were asked about advantages and disadvantages of giving smoking cessation advice, perceived health benefits for mother and child, smoking behaviour and normative beliefs of colleagues, self-efficacy and role definition of midwives with regard to giving smoking cessation advice. Midwives who have a more positive role definition regarding giving smoking cessation advice are more convinced of the advantages of giving advice, the advantages of quitting for their clients and perceive more support from their colleagues with regard to giving advice. In general, midwives were motivated to provide their clients with smoking cessation advice. They were less comfortable with guiding women through the cessation process. Therefore, effective materials and training should be developed to facilitate and stimulate midwives in their role as effective counsellors.

Smoking-Related Behaviors and Effectiveness of Smoking Cessation Therapy Among Prisoners and Prison Staff.

PubMed

Turan, Onur; Turan, Pakize Ayse

2016-04-01

Smoking is a serious problem in prisons. This work aimed to assess smoking-related behaviors and the effectiveness of tobacco cessation therapy in prison. This study includes four visits to a prison in Bolvadin-Afyon, Turkey. Pharmacologic options for tobacco cessation were offered to the participants who wanted to quit smoking. One hundred seventy-nine subjects (109 prisoners and 70 prison staff) with 68.7% current smokers were included. There was an increase of cigarette smoking in 41.8% (the most common reason was stress) and decrease in 18.7% (the most common reason was health problems) of the participants after incarceration. Fifty-nine participants accepted the offered tobacco cessation treatment. Only 2 participants started their planned medications, but they could not quit smoking. The most common reason for failed attempts to quit was the high prices of cessation therapies. Factors like stress and being in prison may provoke smoking. A smoking ban does not seem to be a total solution for preventing tobacco use in prisons. Tobacco cessation programs may be a better option. Cost-free cessation medications may increase quitting rates among prisoners and prison staff. Copyright © 2016 by Daedalus Enterprises.

Smoking cessation programs in occupational settings

PubMed Central

Danaher, Brian G.

1980-01-01

For reasons of health and economics, the business community is displaying a growing interest in providing smoking cessation programs for employees. An examination of the current research on smoking cessation methods has revealed a number of promising directions that smoking cessation programs can take, for example, aversive smoking approaches combined with self-control strategies. A review of current smoking cessation programs in occupational settings revealed some emphasis on physician counseling, but a relatively greater emphasis on use of consultants (especially in proprietary programs) or of contingency programs to encourage nonsmoking. The smoking cessation programs in businesses can move in a number of innovative directions, including (a) increased use of inhouse programs with a variety of smoking cessation strategies; (b) greater emphasis on the training of program participants in nonsmoking behavioral skills, combined with contingency or incentive programs for smoking control; (c) vastly improved research methods, including complete followup assessments of program participants and chemical tests to validate their self-reported abstinence; (d) greater concern about the need for empirically tested procedures for recruitment of participants for the programs; and (e) expanded interchange among behavioral scientists (especially behavioral psychologists), health professionals in occupational health and medicine, union and employee groups, and management. PMID:7360872

Estimated Budget Impact of Adopting the Affordable Care Act's Required Smoking Cessation Coverage on United States Healthcare Payers.

PubMed

Baker, Christine L; Ferrufino, Cheryl P; Bruno, Marianna; Kowal, Stacey

2017-01-01

Despite abundant information on the negative impacts of smoking, more than 40 million adult Americans continue to smoke. The Affordable Care Act (ACA) requires tobacco cessation as a preventive service with no patient cost share for all FDA-approved cessation medications. Health plans have a vital role in supporting smoking cessation by managing medication access, but uncertainty remains on the gaps between smoking cessation requirements and what is actually occurring in practice. This study presents current cessation patterns, real-world drug costs and plan benefit design data, and estimates the 1- to 5-year pharmacy budget impact of providing ACA-required coverage for smoking cessation products to understand the fiscal impact to a US healthcare plan. A closed cohort budget impact model was developed in Microsoft Excel ® to estimate current and projected costs for US payers (commercial, Medicare, Medicaid) covering smoking cessation medicines, with assumptions for coverage and smoking cessation product utilization based on current, real-world national and state-level trends for hypothetical commercial, Medicare, and Medicaid plans with 1 million covered lives. A Markov methodology with five health states captures quit attempt and relapse patterns. Results include the number of smokers attempting to quit, number of successful quitters, annual costs, and cost per-member per-month (PMPM). The projected PMPM cost of providing coverage for smoking cessation medications is $0.10 for commercial, $0.06 for Medicare, and $0.07 for Medicaid plans, reflecting a low incremental PMPM impact of covering two attempts ranging from $0.01 for Medicaid to $0.02 for commercial and Medicare payers. The projected PMPM impact of covering two quit attempts with access to all seven cessation medications at no patient cost share remains low. Results of this study reinforce that the impact of adopting the ACA requirements for smoking cessation coverage will have a limited near-term impact on health plan's budgets. Pfizer Inc.

E-cigarettes and smoking cessation: evidence from a systematic review and meta-analysis.

PubMed

Rahman, Muhammad Aziz; Hann, Nicholas; Wilson, Andrew; Mnatzaganian, George; Worrall-Carter, Linda

2015-01-01

E-cigarettes are currently being debated regarding their possible role in smoking cessation and as they are becoming increasingly popular, the research to date requires investigation. To investigate whether the use of e-cigarettes is associated with smoking cessation or reduction, and whether there is any difference in efficacy of e-cigarettes with and without nicotine on smoking cessation. A systematic review of articles with no limit on publication date was conducted by searching PubMed, Web of Knowledge and Scopus databases. Published studies, those reported smoking abstinence or reduction in cigarette consumption after the use of e-cigarettes, were included. Studies were systematically reviewed, and meta-analyses were conducted using Mantel-Haenszel fixed-effect and random-effects models. Degree of heterogeneity among studies and quality of the selected studies were evaluated. Six studies were included involving 7,551 participants. Meta-analyses included 1,242 participants who had complete data on smoking cessation. Nicotine filled e-cigarettes were more effective for cessation than those without nicotine (pooled Risk Ratio 2.29, 95%CI 1.05-4.97). Amongst 1,242 smokers, 224 (18%) reported smoking cessation after using nicotine-enriched e-cigarettes for a minimum period of six months. Use of such e-cigarettes was positively associated with smoking cessation with a pooled Effect Size of 0.20 (95%CI 0.11-0.28). Use of e-cigarettes was also associated with a reduction in the number of cigarettes used. Included studies were heterogeneous, due to different study designs and gender variation. Whilst we were able to comment on the efficacy of nicotine vs. non-nicotine e-cigarettes for smoking cessation, we were unable to comment on the efficacy of e-cigarettes vs. other interventions for cessation, given the lack of comparator groups in the studies included in this meta-analysis. Use of e-cigarettes is associated with smoking cessation and reduction. More randomised controlled trials are needed to assess effectiveness against other cessation methods.

Randomized controlled trial to evaluate tooth stain reduction with nicotine replacement gum during a smoking cessation program.

PubMed

Whelton, Helen; Kingston, Rose; O'Mullane, Denis; Nilsson, Frederick

2012-06-13

In addition to its general and periodontal health effects smoking causes tooth staining. Smoking cessation support interventions with an added stain removal or tooth whitening effect may increase motivation to quit smoking. Oral health professionals are well placed to provide smoking cessation advice and support to patients. The objective of the present study was to evaluate the effect of Nicorette(®) Freshmint Gum used in a smoking cessation programme administered in a dental setting, on extrinsic stain and tooth shade among smokers. An evaluator-blinded, randomized, 12-week parallel-group controlled trial was conducted among 200 daily smokers motivated to quit smoking. Participants were randomised to use either the Nicorette(®) Freshmint Gum or Nicorette(®) Microtab (tablet). Tooth staining and shade were rated using the modified Lobene Stain Index and the Vita(®) Shade Guide at baseline, weeks 2, 6 and 12. To maintain consistency with other whitening studies, the primary end-point was the mean change in stain index between baseline and week 6. Secondary variables included changes in stain measurements and tooth shade at the other time points the number of gums or tablets used per day and throughout the trial period; and the number of cigarettes smoked per day. Treatments were compared using analysis of covariance (ANCOVA), using treatment and nicotine dependence as factors and the corresponding baseline measurement as a covariate. Each comparison (modified intention-to-treat) was tested at the 0.05 level, two-sided. Within-treatment changes from baseline were compared using a paired t-test. At week 6, the gum-group experienced a reduction in mean stain scores whilst the tablet-group experienced an increase with mean changes of -0.14 and +0.12 respectively, (p = 0.005, ANCOVA). The change in mean tooth shade scores was statistically significantly greater in the gum-group than in the tablet group at 2 (p = 0.015), 6 (p = 0.011) and 12 weeks (p = 0.003) with greater lightening in the gum-group at each examination period. These results support the efficacy of the tested nicotine replacement gum in stain reduction and shade lightening. These findings may help dentists to motivate those wishing to quit smoking using a nicotine replacement gum. NCT01440985.

Understanding Smoking Cessation in Rural Communities

ERIC Educational Resources Information Center

Hutcheson, Tresza D.; Greiner, K. Allen; Ellerbeck, Edward F.; Jeffries, Shawn K.; Mussulman, Laura M.; Casey, Genevieve N.

2008-01-01

Context: Rural communities are adversely impacted by increased rates of tobacco use. Rural residents may be exposed to unique communal norms and other factors that influence smoking cessation. Purpose: This study explored facilitating factors and barriers to cessation and the role of rural health care systems in the smoking-cessation process.…

Smoking Cessation Ameliorates Microalbuminuria With Reduction of Blood Pressure and Pulse Rate in Patients With Already Diagnosed Diabetes Mellitus.

PubMed

Hieshima, Kunio; Suzuki, Tomoko; Sugiyama, Seigo; Kurinami, Noboru; Yoshida, Akira; Miyamoto, Fumio; Kajiwara, Keizo; Jinnouchi, Tomio; Jinnouchi, Hideaki

2018-06-01

Smoking cessation in newly diagnosed type 2 diabetes patients is reported to be associated with amelioration of metabolic parameters and blood pressure (BP), and the reduction of microalbuminuria. The aim of this study is to demonstrate changes in BP, pulse rate (PR), and microalbuminuria in already diagnosed diabetes patients who quit smoking. We retrospectively evaluated diabetes outpatients who were habitual smokers, and who visited to our smoking cessation clinic. Patients were divided into two groups based on their smoking status at the termination of a 3-month smoking cessation program (smoking cessation group and smoking group), and analyzed systolic and diastolic BPs, PR, HbA1c, and body weight at the start date, and at 1, 3, 6, and 12 months thereafter. The urinary albumin-to-creatinine ratio was also measured at the start date and at 12 months. Thirty-five patients met our criteria. Mean diabetes duration was 12 years. Eighteen patients (52%) quit smoking. Success or failure of smoking cessation depended on nicotine dependence rather than good or bad glycemic control. Both BP and PR decreased significantly after 1 month or later in the smoking cessation group without worsening HbA1c, while both parameters did not show any changes in the smoking group. Microalbuminuria was also ameliorated significantly at 12 months compared with that at the start date in the smoking cessation group (95.8 ± 92.9 mg/gCr vs. 75.5 ± 96.3 mg/gCr, P = 0.0059), while it did not show a significant change in the smoking group. (61.9 ± 43.5 mg/gCr vs. 97.7 ± 90.4 mg/gCr, P = 0.1039). Smoking cessation might cause a reduction in chronic kidney disease progression through ameliorating microalbuminuria without metabolic adverse effects in patients already diagnosed with diabetes mellitus.

Smoking cessation results in a clinical lung cancer screening program.

PubMed

Borondy Kitts, Andrea K; McKee, Andrea B; Regis, Shawn M; Wald, Christoph; Flacke, Sebastian; McKee, Brady J

2016-07-01

Lung cancer screening may provide a "teachable moment" for promoting smoking cessation. This study assessed smoking cessation and relapse rates among individuals undergoing follow-up low-dose chest computed tomography (CT) in a clinical CT lung screening program and assessed the influence of initial screening results on smoking behavior. Self-reported smoking status for individuals enrolled in a clinical CT lung screening program undergoing a follow-up CT lung screening exam between 1st February, 2014 and 31st March, 2015 was retrospectively reviewed and compared to self-reported smoking status using a standardized questionnaire at program entry. Point prevalence smoking cessation and relapse rates were calculated across the entire population and compared with exam results. All individuals undergoing screening fulfilled the National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Lung Cancer Screening v1.2012(®) high-risk criteria and had an order for CT lung screening. A total of 1,483 individuals underwent a follow-up CT lung screening exam during the study interval. Smoking status at time of follow-up exam was available for 1,461/1,483 (98.5%). A total of 46% (678/1,461) were active smokers at program entry. The overall point prevalence smoking cessation and relapse rates were 20.8% and 9.3%, respectively. Prior positive screening exam results were not predictive of smoking cessation (OR 1.092; 95% CI, 0.715-1.693) but were predictive of reduced relapse among former smokers who had stopped smoking for 2 years or less (OR 0.330; 95% CI, 0.143-0.710). Duration of program enrollment was predictive of smoking cessation (OR 0.647; 95% CI, 0.477-0.877). Smoking cessation and relapse rates in a clinical CT lung screening program rates are more favorable than those observed in the general population. Duration of participation in the screening program correlated with increased smoking cessation rates. A positive exam result correlated with reduced relapse rates among smokers recently quit smoking.

Anxiety Sensitivity and Pre-Cessation Smoking Processes: Testing the Independent and Combined Mediating Effects of Negative Affect–Reduction Expectancies and Motives

PubMed Central

Farris, Samantha G.; Leventhal, Adam M.; Schmidt, Norman B.; Zvolensky, Michael J.

2015-01-01

Objective: Anxiety sensitivity appears to be relevant in understanding the nature of emotional symptoms and disorders associated with smoking. Negative-reinforcement smoking expectancies and motives are implicated as core regulatory processes that may explain, in part, the anxiety sensitivity–smoking interrelations; however, these pathways have received little empirical attention. Method: Participants (N = 471) were adult treatment-seeking daily smokers assessed for a smoking-cessation trial who provided baseline data; 157 participants provided within-treatment (pre-cessation) data. Anxiety sensitivity was examined as a cross-sectional predictor of several baseline smoking processes (nicotine dependence, perceived barriers to cessation, severity of prior withdrawal-related quit problems) and pre-cessation processes including nicotine withdrawal and smoking urges (assessed during 3 weeks before the quit day). Baseline negative-reinforcement smoking expectancies and motives were tested as simultaneous mediators via parallel multiple mediator models. Results: Higher levels of anxiety sensitivity were related to higher levels of nicotine dependence, greater perceived barriers to smoking cessation, more severe withdrawal-related problems during prior quit attempts, and greater average withdrawal before the quit day; effects were indirectly explained by the combination of both mediators. Higher levels of anxiety sensitivity were not directly related to pre-cessation smoking urges but were indirectly related through the independent and combined effects of the mediators. Conclusions: These empirical findings bolster theoretical models of anxiety sensitivity and smoking and identify targets for nicotine dependence etiology research and cessation interventions. PMID:25785807

User-Centered Design of Learn to Quit, a Smoking Cessation Smartphone App for People With Serious Mental Illness

PubMed Central

Rizo, Javier; Zeng, Emily; Kientz, Julie A; Ries, Richard; Otis, Chad; Hernandez, Kayla

2018-01-01

Background Smoking rates in the United States have been reduced in the past decades to 15% of the general population. However, up to 88% of people with psychiatric symptoms still smoke, leading to high rates of disease and mortality. Therefore, there is a great need to develop smoking cessation interventions that have adequate levels of usability and can reach this population. Objective The objective of this study was to report the rationale, ideation, design, user research, and final specifications of a novel smoking cessation app for people with serious mental illness (SMI) that will be tested in a feasibility trial. Methods We used a variety of user-centered design methods and materials to develop the tailored smoking cessation app. This included expert panel guidance, a set of design principles and theory-based smoking cessation content, development of personas and paper prototyping, usability testing of the app prototype, establishment of app’s core vision and design specification, and collaboration with a software development company. Results We developed Learn to Quit, a smoking cessation app designed and tailored to individuals with SMI that incorporates the following: (1) evidence-based smoking cessation content from Acceptance and Commitment Therapy and US Clinical Practice Guidelines for smoking cessation aimed at providing skills for quitting while addressing mental health symptoms, (2) a set of behavioral principles to increase retention and comprehension of smoking cessation content, (3) a gamification component to encourage and sustain app engagement during a 14-day period, (4) an app structure and layout designed to minimize usability errors in people with SMI, and (5) a set of stories and visuals that communicate smoking cessation concepts and skills in simple terms. Conclusions Despite its increasing importance, the design and development of mHealth technology is typically underreported, hampering scientific innovation. This report describes the systematic development of the first smoking cessation app tailored to people with SMI, a population with very high rates of nicotine addiction, and offers new design strategies to engage this population. mHealth developers in smoking cessation and related fields could benefit from a design strategy that capitalizes on the role visual engagement, storytelling, and the systematic application of behavior analytic principles to deliver evidence-based content. PMID:29339346

Medicaid Coverage Expansions and Cigarette Smoking Cessation Among Low-income Adults.

PubMed

Koma, Jonathan W; Donohue, Julie M; Barry, Colleen L; Huskamp, Haiden A; Jarlenski, Marian

2017-12-01

Expanding Medicaid coverage to low-income adults may have increased smoking cessation through improved access to evidence-based treatments. Our study sought to determine if states' decisions to expand Medicaid increased recent smoking cessation. Using pooled cross-sectional data from the Behavioral Risk Factor Surveillance Survey for the years 2011-2015, we examined the association between state Medicaid coverage and the probability of recent smoking cessation among low-income adults without dependent children who were current or former smokers (n=36,083). We used difference-in-differences estimation to examine the effects of Medicaid coverage on smoking cessation, comparing low-income adult smokers in states with Medicaid coverage to comparable adults in states without Medicaid coverage, with ages 18-64 years to those ages 65 years and above. Analyses were conducted for the full sample and stratified by sex. Residence in a state with Medicaid coverage among low-income adult smokers ages 18-64 years was associated with an increase in recent smoking cessation of 2.1 percentage points (95% confidence interval, 0.25-3.9). In the comparison group of individuals ages 65 years and above, residence in a state with Medicaid coverage expansion was not associated with a change in recent smoking cessation (-0.1 percentage point, 95% confidence interval, -2.1 to 1.8). Similar increases in smoking cessation among those ages 18-64 years were estimated for females and males (1.9 and 2.2 percentage point, respectively). Findings are consistent with the hypothesis that Medicaid coverage expansions may have increased smoking cessation among low-income adults without dependent children via greater access to preventive health care services, including evidence-based smoking cessation services.

Advice as a smoking cessation strategy: a systematic review and implications for physical therapists.

PubMed

Bodner, Michael E; Dean, Elizabeth

2009-07-01

Although identified as a clinical priority, smoking cessation has been addressed minimally in the literature in the context of physical therapy practice. Smoking cessation advice delivered by a health professional can help smokers quit. The salient components of such advice however warranted elucidation to enable physical therapists to integrate this clinical competence into their practices. Therefore, we conducted a systematic review to elucidate the effectiveness of advice by a health professional and its components to optimize smoking cessation instituted in the context of physical therapy practice. Thirty source articles were identified. A random-effects model meta-analysis was used to assess the effectiveness of the advice parameters. Risk ratios (RRs) were used to estimate pooled treatment effects. RRs for brief, intermediate, and intensive advice were 1.74 (95% CI=1.37, 2.22), 1.71 (95% CI=1.39, 2.09), and 1.60 (95% CI=1.13, 2.27), respectively. Self-help materials, follow-up, and interventions based on psychological or motivational frameworks were particularly effective components of intermediate and intensive advice interventions. Advice can be readily integrated into physical therapy practice and used to initiate or support ongoing smoking cessation in clients irrespective of reason for referral. Incorporating smoking cessation as a physical therapy goal is consistent with the contemporary definition of the profession and the mandates of physical therapy professional associations to promote health and wellness, including smoking cessation for both primary health benefit and to minimize secondary effects (e.g., delayed healing and recovery, and medical and surgical complications). Thus, advice is an evidence-based strategy to effect smoking cessation that can be exploited in physical therapy practice. Further research to refine how best to assess smokers and, in turn, individualize brief smoking cessation advice could augment positive smoking cessation outcomes.

Patient navigation and financial incentives to promote smoking cessation in an underserved primary care population: A randomized controlled trial protocol.

PubMed

Quintiliani, Lisa M; Russinova, Zlatka L; Bloch, Philippe P; Truong, Ve; Xuan, Ziming; Pbert, Lori; Lasser, Karen E

2015-11-01

Despite the high risk of tobacco-related morbidity and mortality among low-income persons, few studies have connected low-income smokers to evidence-based treatments. We will examine a smoking cessation intervention integrated into primary care. To begin, we completed qualitative formative research to refine an intervention utilizing the services of a patient navigator trained to promote smoking cessation. Next, we will conduct a randomized controlled trial combining two interventions: patient navigation and financial incentives. The goal of the intervention is to promote smoking cessation among patients who receive primary care in a large urban safety-net hospital. Our intervention will encourage patients to utilize existing smoking cessation resources (e.g., quit lines, smoking cessation groups, discussing smoking cessation with their primary care providers). To test our intervention, we will conduct a randomized controlled trial, randomizing 352 patients to the intervention condition (patient navigation and financial incentives) or an enhanced traditional care control condition. We will perform follow-up at 6, 12, and 18 months following the start of the intervention. Evaluation of the intervention will target several implementation variables: reach (participation rate and representativeness), effectiveness (smoking cessation at 12 months [primary outcome]), unintended consequences (e.g., purchase of illicit substances with incentive money), adoption (use of intervention across primary care suites), implementation (delivery of intervention), and maintenance (smoking cessation after conclusion of intervention). Improving the implementation of smoking cessation interventions in primary care settings serving large underserved populations could have substantial public health impact, reducing cancer-related morbidity/mortality and associated health disparities. Copyright © 2015 Elsevier Inc. All rights reserved.

Helping Poor Smokers Quit

ClinicalTrials.gov

2017-07-06

Smoking Cessation; Smoking, Tobacco; Smoking, Cigarette; Smoking, Pipe; Smoking (Tobacco) Addiction; Smoking; Tobacco Use; Tobacco Dependence; Tobacco Use Cessation; Tobacco Smoking; Tobacco; Use, Rehabilitation; Nicotine Dependence; Nicotine Use Disorder; Nicotine Dependence, Cigarettes; Nicotine Dependence Tobacco Product

The Impact of Quitting Smoking on Weight Among Women Prisoners Participating in a Smoking Cessation Intervention

PubMed Central

McClure, Leslie A.; Jackson, Dorothy O.; Villalobos, Gabrielle C.; Weaver, Michael F.; Stitzer, Maxine L.

2010-01-01

Objectives. We examined the impact of smoking cessation on weight change in a population of women prisoners. Methods. Women prisoners (n = 360) enrolled in a smoking cessation intervention; 250 received a 10-week group intervention plus transdermal nicotine replacement. Results. Women who quit smoking had significant weight gain at 3- and 6-month follow-ups, with a net difference of 10 pounds between smokers and abstainers at 6 months. By the 12-month follow-up, weight gain decreased among abstainers. Conclusions. We are the first, to our knowledge, to demonstrate weight gain associated with smoking cessation among women prisoners. Smoking cessation interventions that address postcessation weight gain as a preventative measure may be beneficial in improving health and reducing the high prevalence of smoking in prisoner populations. PMID:20558806

Factors affecting smoking cessation efforts of people with severe mental illness: a qualitative study.

PubMed

Rae, Jennifer; Pettey, Donna; Aubry, Tim; Stol, Jacqueline

2015-01-01

People with severe mental illness are much more likely to smoke than are members of the general population. Smoking cessation interventions that combine counseling and medication have been shown to be moderately effective, but quit rates remain low and little is known about the experiences of people with severe mental illness in smoking cessation interventions. To address this gap in knowledge, we conducted a qualitative study to investigate factors that help or hinder the smoking cessation efforts of people with severe mental illness. We recruited 16 people with severe mental illness who had participated in a clinical trial of two different smoking cessation interventions, one involving nicotine replacement therapy only and the other nicotine replacement therapy combined with motivational interviewing and a peer support group. We conducted open-ended, semi-structured interviews with participants, who ranged in age from 20 to 56 years old, were equally distributed by gender (eight men and eight women), and were predominantly Caucasian (n = 13, 81%). Primary mental illness diagnoses included schizophrenia/schizoaffective disorder (n = 6, 38%), depression (n = 5, 31%), bipolar disorder (n = 4, 25%), and anxiety disorder (n = 1, 6%). At entry into the clinical trial, participants smoked an average of 22.6 cigarettes per day (SD = 13.0). RESULTS indicated that people with mental illness have a diverse range of experiences in the same smoking cessation intervention. Smoking cessation experiences were influenced by factors related to the intervention itself (such as presence of smoking cessation aids, group supports, and emphasis on individual choice and needs), as well as individual factors (such as mental health, physical health, and substance use), and social-environmental factors (such as difficult life events and social relationships). An improved understanding of the smoking cessation experiences of people with severe mental illness can inform the delivery of future smoking cessation interventions for this population. The results of this study suggest the importance of smoking cessation interventions that offer a variety of treatment options, incorporating choice and flexibility, so as to be responsive to the evolving needs and preferences of individual clients.

Payroll contracting for smoking cessation: a worksite pilot study.

PubMed

Jeffery, R W; Pheley, A M; Forster, J L; Kramer, F M; Snell, M K

1988-01-01

Twenty-one men and 38 women participated in a worksite smoking cessation/smoking reduction program that combined financial contracts, organized through payroll deduction, and biweekly group treatment sessions. At the end of the program the smoking cessation rate was 51%, validated by expired air carbon monoxide. Six months later the validated cessation rate was 12%. We conclude that payroll incentives may be effective in helping workers quit smoking and offer suggestions for ways to promote better maintenance of this important behavior change.

Factors Correlated with Success Rate of Outpatient Smoking Cessation Services in Taiwan.

PubMed

Huang, Wei-Hsin; Hsu, Hsin-Yin; Chang, Betty Chia-Chen; Chang, Fong-Ching

2018-06-10

Smoking is the leading cause of preventable death. The purpose of this study was to explore the patient’s and physician’s factors that are correlated with smoking cessation success rate. A total of 877 smokers who visited the outpatient smoking cessation services at a medical center in Northern Taiwan were recruited for the study. Phone interviews were carried out six months after the initial visit to evaluate the success rate of smoking cessation. The result showed that the abstinence rate at six-month was 37.7%. By the multivariate logistic regression model, the predictive factors of abstinence were smokers who had a lower Fagerström test for cigarette dependence (FTCD), lower exhaled carbon monoxide (CO) concentration, or who smoked less than 20 cigarettes per day at the first visit. Smokers who had more than one smoking cessation outpatient visit or seen by physicians who, on average, delivered more than one smoking cessation consultations per week also led to a higher success rate. Therefore, we suggest that physicians should put more efforts and encourage follow-up visits for some smokers by knowing their characteristics at the first visit. Furthermore, physicians with more experience in smoking cessation consultation seemed to be more likely to help patients to quit smoking successfully.

Smoking Cessation in a Chronic Pancreatitis Population

PubMed Central

Han, Samuel; Kheder, Joan; Bocelli, Lisa; Fahed, Julien; Wachholtz, Amy; Seward, Gregory; Wassef, Wahid

2016-01-01

Objectives Smoking is a known risk factor for developing chronic pancreatitis and accelerates disease progression. Smoking cessation remains an important treatment recommendation, but little is known about its effects. This study evaluated smoking cessation in this population and its impact on quality of life. Methods 27 smokers with chronic pancreatitis participated in a smoking cessation program incorporating the QuitWorks program and individual counseling. Their smoking cessation rates were compared with a control population (n=200) consisting of in-patients without chronic pancreatitis who smoked. Smokers were also compared with non-smokers (n=25) with chronic pancreatitis in terms of quality of life indicators. Results 0/27 patients had quit smoking at 6 months, 1/27 at 12 months, and 0/27 patients at 18 months. There was a 19% quit rate in the control population at the 6-month period. Smokers had a worse quality of life, higher rates of depression and anxiety, and worse coping skills than non-smokers. Conclusions Smoking cessation in the chronic pancreatitis population is extremely challenging, as shown by our 0% quit rate after 18 months. Given that smokers with chronic pancreatitis also experience a worse quality of life, it becomes even more important to stress the importance of smoking cessation in these patients. PMID:27101574

Do social characteristics influence smoking uptake and cessation during young adulthood?

PubMed

Steinmetz-Wood, Madeleine; Gagné, Thierry; Sylvestre, Marie-Pierre; Frohlich, Katherine

2018-01-01

This study uses a Bourdieusian approach to assess young adults' resources and examines their association with smoking initiation and cessation. Data were drawn from 1450 young adults participating in the Interdisciplinary Study of Inequalities in Smoking, a cohort study in Montreal, Canada. We used logistic regression models to examine the association between young adults' income, education, and peer smoking at baseline and smoking onset and cessation. Young adults where most or all of their friends smoked had greater odds of smoking onset. Young adults that had completed pre-university postsecondary education also had higher odds of smoking onset after controlling for social support, employment status, and lacking money to pay for expenses. Income and the sociodemographic variables age and sex were not associated with smoking onset. Young adults where half of their friends smoked or where most to all of their friends smoked had lowers odds of smoking cessation. Men were more likely to cease smoking than women. Education, income and age were not associated with cessation. Interventions focusing on peer smoking may present promising avenues for tobacco prevention in young adults.

Tobacco Price Increase and Smoking Cessation in Japan, a Developed Country With Affordable Tobacco: A National Population-Based Observational Study.

PubMed

Tabuchi, Takahiro; Nakamura, Masakazu; Nakayama, Tomio; Miyashiro, Isao; Mori, Jun-Ichiro; Tsukuma, Hideaki

2016-01-01

Longitudinal assessment of the impact of tobacco price on smoking cessation is scarce. Our objective was to investigate the effect of a price increase in October 2010 on cessation rates according to gender, age, socioeconomic status, and level of tobacco dependence in Japan. We used longitudinal data linkage of two nationally representative studies and followed 2702 smokers for assessment of their cessation status. The odds ratios (ORs) for cessation were calculated using logistic regression. To estimate the impact of the 2010 tobacco price increase on cessation, data from 2007 were used as a reference category. Overall cessation rates significantly increased from 2007 to 2010, from 3.7% to 10.7% for men and from 9.9% to 16.3% for women. Cessation rates were 9.3% for men who smoked 1-10 cigarettes per day, 2.7% for men who smoked 11-20 cigarettes per day, and 2.0% for men who smoked more than 20 cigarettes per day in 2007. These rates increased to 15.5%, 10.0%, and 8.0%, respectively, in 2010. The impact was stronger among subjects who smoked more than 11 cigarettes per day than those who smoked 1-10 cigarettes per day in both sexes: ORs for 2010 were 4.04 for those smoking 11-20 cigarettes per day, 4.26 for those smoking more than 20 cigarettes per day, and 1.80 for those smoking 1-10 cigarettes per day in the main model in men. There were no obvious differences in the relationship between tobacco price increase and smoking cessation across age and household expenditure groups. The tobacco price increase in Japan had a significant impact on smoking cessation in both sexes, especially among heavy smokers, with no clear difference in effect by socio-demographic status.

Development of Novel Pharmacotherapeutics for Tobacco Dependence: Progress and Future Directions

PubMed Central

Kenny, Paul J.

2012-01-01

Introduction: The vast majority of tobacco smokers seeking to quit will relapse within the first month of abstinence. Currently available smoking cessation agents have limited utility in increasing rates of smoking cessation and in some cases there are notable safety concerns related to their use. Hence, there is a pressing need to develop safer and more efficacious smoking cessation medications. Methods: Here, we provide an overview of current efforts to develop new pharmacotherapeutic agents to facilitate smoking cessation, identified from ongoing clinical trials and published reports. Results: Nicotine is considered the major addictive agent in tobacco smoke, and the vast majority of currently available smoking cessation agents act by modulating nicotinic acetylcholine receptor (nAChR) signaling. Accordingly, there is much effort directed toward developing novel small molecule therapeutics and biological agents such as nicotine vaccines for smoking cessation that act by modulating nAChR activity. Our increasing knowledge of the neurobiology of nicotine addiction has revealed new targets for novel smoking cessation therapeutics. Indeed, we highlight many examples of novel small molecule drug development around non-nAChR targets. Finally, there is a growing appreciation that medications already approved for other disease indications could show promise as smoking cessation agents, and we consider examples of such repurposing efforts. Conclusion: Ongoing clinical assessment of potential smoking cessation agents offers the promise of new effective medications. Nevertheless, much of our current knowledge of molecular mechanisms of nicotine addiction derived from preclinical studies has not yet been leveraged for medications development. PMID:23024249

Support for smoking cessation interventions in physician organizations: results from a national study.

PubMed

McMenamin, Sara B; Schauffler, Helen Halpin; Shortell, Stephen M; Rundall, Thomas G; Gillies, Robin R

2003-12-01

To document the extent to which physician organizations, defined as medical groups and independent practice associations, are providing support for smoking cessation interventions and to identify external incentives and organizational characteristics associated with this support. This research uses data from the National Study of Physician Organizations and the Management of Chronic Illness, conducted by the University of California at Berkeley, to document the extent to which physician organizations provide support for smoking cessation interventions. Of 1587 physician organizations nationally with 20 or more physicians, 1104 participated, for a response rate of 70%. Overall, 70% of physician organizations offered some support for smoking cessation interventions. Specifically, 17% require physicians to provide interventions, 15% evaluate interventions, 39% of physician organizations offer smoking health promotion programs, 25% provide nicotine replacement therapy starter kits, and materials are provided on pharmacotherapy (39%), counseling (37%), and self-help (58%). Factors positively associated with organizational support include income or public recognition for quality measures, financial incentives to promote smoking cessation interventions, requirements to report HEDIS (Health Plan Employer Data and Information Set) scores, awareness of the 1996 Clinical Practice Guideline on Smoking Cessation, being a medical group, organizational size, percentage of primary care physicians, and hospital/HMO ownership of the organization. Physician organizations are providing support for smoking cessation interventions, yet the level of support might be improved with more extensive use of external incentives. Financial incentives targeted specifically at promoting smoking cessation interventions need to be explored further. Additionally, emphasis on quality measures should continue, including an expansion of HEDIS smoking cessation measures.

Perioperative and Long-Term Smoking Behaviors in Cosmetic Surgery Patients.

PubMed

Van Slyke, Aaron C; Carr, Michael; Knox, Aaron D C; Genoway, Krista; Carr, Nicholas J

2017-09-01

Many plastic surgeons advocate smoking cessation before patients undergo cosmetic surgery with extensive soft-tissue dissection. Smoking cessation rates after cosmetic surgery are unknown. The preoperative consultation may be an opportunity to promote long-term smoking cessation. This is a retrospective, cross-sectional cohort study. All patients over an 8-year study period who smoked before their preoperative consultation; who quit 2 weeks before surgery; and who subsequently underwent rhytidectomy, abdominoplasty, or mastopexy were included. Patients were asked to complete a Web-based survey at long-term follow-up. Eighty-five smokers were included, and 47 patients completed the survey, for a response rate of 55.3 percent. Average follow-up was 63.3 months. Five respondents were social smokers and thus excluded. Of the 42 daily smokers, 17 patients (40.5 percent) were no longer smoking cigarettes on a daily basis at long-term follow-up. Of these 17 patients, 10 (23.8 percent) had not smoked since their operation. A total of 24 patients (57.1 percent) had reduced their cigarette consumption by any amount, and 70.8 percent (17 of 24) of these patients agreed that discussing adverse surgical outcomes related to smoking influenced their ability to quit/reduce. Twenty-one of 42 patients (50.0 percent) admitted that they were not compliant with the preoperative smoking cessation instructions. This is the first report to investigate long-term smoking cessation from a cosmetic surgery practice. The authors have shown a positive association between smoking cessation and cosmetic surgery. Requesting a period of cessation before cosmetic surgery may promote long-lasting smoking cessation.

Implicit and Explicit Attitudes Predict Smoking Cessation: Moderating Effects of Experienced Failure to Control Smoking and Plans to Quit

PubMed Central

Chassin, Laurie; Presson, Clark C.; Sherman, Steven J.; Seo, Dong-Chul; Macy, Jon

2010-01-01

The current study tested implicit and explicit attitudes as prospective predictors of smoking cessation in a Midwestern community sample of smokers. Results showed that the effects of attitudes significantly varied with levels of experienced failure to control smoking and plans to quit. Explicit attitudes significantly predicted later cessation among those with low (but not high or average) levels of experienced failure to control smoking. Conversely, however, implicit attitudes significantly predicted later cessation among those with high levels of experienced failure to control smoking, but only if they had a plan to quit. Because smoking cessation involves both controlled and automatic processes, interventions may need to consider attitude change interventions that focus on both implicit and explicit attitudes. PMID:21198227

Smoking Cessation in Cardiac Patients: The Influence of Action Plans, Coping Plans and Self-Efficacy on Quitting Smoking

ERIC Educational Resources Information Center

de Hoog, Natascha; Bolman, Catherine; Berndt, Nadine; Kers, Esther; Mudde, Aart; de Vries, Hein; Lechner, Lilian

2016-01-01

Smoking cessation is the most effective action for cardiac patients who smoke to improve their prognosis, yet more than one-half of cardiac patients continue to smoke after hospital admission. This study examined the influence of action plans, coping plans and self-efficacy on intention to quit and smoking cessation in cardiac patients. Cardiac…

Are Optimism and Cynical Hostility Associated with Smoking Cessation in Older Women?

PubMed

Progovac, Ana M; Chang, Yue-Fang; Chang, Chung-Chou H; Matthews, Karen A; Donohue, Julie M; Scheier, Michael F; Habermann, Elizabeth B; Kuller, Lewis H; Goveas, Joseph S; Chapman, Benjamin P; Duberstein, Paul R; Messina, Catherine R; Weaver, Kathryn E; Saquib, Nazmus; Wallace, Robert B; Kaplan, Robert C; Calhoun, Darren; Smith, J Carson; Tindle, Hilary A

2017-08-01

Optimism and cynical hostility independently predict morbidity and mortality in Women's Health Initiative (WHI) participants and are associated with current smoking. However, their association with smoking cessation in older women is unknown. The purpose of this study is to test whether optimism (positive future expectations) or cynical hostility (mistrust of others) predicts smoking cessation in older women. Self-reported smoking status was assessed at years 1, 3, and 6 after study entry for WHI baseline smokers who were not missing optimism or cynical hostility scores (n = 10,242). Questionnaires at study entry assessed optimism (Life Orientation Test-Revised) and cynical hostility (Cook-Medley, cynical hostility subscale). Generalized linear mixed models adjusted for sociodemographics, lifestyle factors, and medical and psychosocial characteristics including depressive symptoms. After full covariate adjustment, optimism was not related to smoking cessation. Each 1-point increase in baseline cynical hostility score was associated with 5% lower odds of cessation over 6 years (OR = 0.95, CI = 0.92-0.98, p = 0.0017). In aging postmenopausal women, greater cynical hostility predicts lower smoking cessation over time. Future studies should examine whether individuals with this trait may benefit from more intensive cessation resources or whether attempting to mitigate cynical hostility itself may aid smoking cessation.

Patient demand for smoking cessation advice in dentist offices after introduction of graphic health warnings in Australia.

PubMed

Afifah, Rm; Schwarz, E

2008-09-01

The effectiveness of smoking cessation intervention by dentists has not been conclusively established. This study aimed to investigate whether the inclusion of graphic health warning pictures (including mouth and throat cancer) as part of the Australian National Tobacco Campaign strategy would elicit measurably increased demand for smoking cessation advice in dental practices. A cross-sectional survey of private dental practices in New South Wales, Australia. Separate questionnaires were answered by dentists and patients from their practice. Questions comprised smoking practices and attitudes toward smoking cessation activities in dental practice. The majority of dentists (85.7 per cent; n = 29) and dental patients (92.4 per cent; n = 800) recalled seeing the graphic health warnings, with mouth and throat cancer the most commonly observed. Television was the main medium. Nineteen per cent of dental patients (n = 152) reported themselves as current smokers. Half of them were planning to quit within six months (49.7 per cent) and agreed that graphic health warnings made them more likely to quit (47.7 per cent). Dentists showed positive attitudes toward cessation activities but believed many patients lacked motivation to quit smoking; a perception that was seen to be the main barrier in offering smoking cessation advice. Forty per cent of smokers would try to quit if asked by their dentists, but only 28.4 per cent preferred a dentist for cessation advice. In general, dentists found no change in demand for smoking cessation advice since the launch of the National Tobacco Campaign in 2006. Health warning pictures seemed to increase the patients' awareness and intention to quit smoking, however it did not appear to generate more demand for smoking cessation advice from their dentists. Dentists had low expectations about their patients' motivation to stop smoking.

Association between use of contraband tobacco and smoking cessation outcomes: a population-based cohort study

PubMed Central

Mecredy, Graham C.; Diemert, Lori M.; Callaghan, Russell C.; Cohen, Joanna E.

2013-01-01

Background: High tobacco prices, typically achieved through taxation, are an evidence-based strategy to reduce tobacco use. However, the presence of inexpensive contraband tobacco could undermine this effective intervention by providing an accessible alternative to quitting. We assessed whether the use of contraband tobacco negatively affects smoking cessation outcomes. Methods: We evaluated data from 2786 people who smoked, aged 18 years or older, who participated in the population-based longitudinal Ontario Tobacco Survey. We analyzed associations between use of contraband tobacco and smoking cessation outcomes (attempting to quit, 30-d cessation and long-term cessation at 1 yr follow-up). Results: Compared with people who smoked premium or discount cigarettes, people who reported usually smoking contraband cigarettes at baseline were heavier smokers, perceived greater addiction, identified more barriers to quitting and were more likely to have used pharmacotherapy for smoking cessation. People who smoked contraband cigarettes were less likely to report a period of 30-day cessation during the subsequent 6 months (adjusted relative risk [RR] 0.23, 95% confidence interval [CI] 0.09–0.61) and 1 year (adjusted RR 0.30, 95% CI 0.14–0.61), but they did not differ significantly from other people who smoked regarding attempts to quit (at 6 mo, adjusted RR 0.74, 95% CI 0.43–1.20) or long-term cessation (adjusted RR 0.24, 95% CI 0.04–1.34). Interpretation: Smoking contraband cigarettes was negatively associated with short-term smoking cessation. Access to contraband tobacco may therefore undermine public health efforts to reduce the use of tobacco at the population level. PMID:23460630

Smoking cessation treatment by Dutch respiratory nurses: reported practice, attitudes and perceived effectiveness.

PubMed

Kotz, D; van Litsenburg, W; van Duurling, R; van Schayck, C P; Wesseling, G J

2008-01-01

To describe Dutch respiratory nurses' current smoking cessation practices, attitudes and beliefs, and to compare these with a survey from the year 2000, before the national introduction of a protocol for the treatment of nicotine and tobacco addiction (the L-MIS protocol). Questionnaire survey among all 413 registered respiratory nurses in the Netherlands in 2006. The response rate was 62%. Seventy-seven percent of the respondents reported to have "fairly good" or "good" knowledge of all steps of the L-MIS protocol. Seven out of 10 behavioural techniques for smoking cessation from the protocol were used by more than 94% of the respondents. Seventy-four percent of the respiratory nurses recommended the use of either nicotine replacement therapy (70%) or bupropion (44%). Almost two-thirds (65% of 254) perceived lack of patient's motivation as the most important barrier for smoking cessation treatment; a four-fold increase compared to the year 2000. We conclude that respiratory nurses are compliant with the L-MIS protocol. They offer intensive support and use behavioural techniques for smoking cessation more frequently than evidence-based pharmacological aids for smoking cessation. Perceived lack of patient's motivation forms the most important threat to respiratory nurses' future smoking cessation activities. International guidelines acknowledge that respiratory patients have a more urgent need to stop smoking but have more difficulty doing so. They should be offered the most intensive smoking cessation counselling in combination with pharmacotherapy. This kind of counselling may be more feasible for respiratory nurses than for physicians who often lack time. Their efforts could be increased by reimbursing pharmacological aids for smoking cessation and by developing simple tools to systematically assess motivation to quit and psychiatric co-morbidity in smoking patients.

Respiratory, cardiovascular and other physiological consequences of smoking cessation.

PubMed

Gratziou, Christina

2009-02-01

Smoking cessation is associated with substantial reductions in tobacco-related morbidity and mortality. Based on the current literature, the beneficial effects of quitting are particularly evident on pulmonary and cardiovascular function, but the negative physiological effects of cessation are less well documented. The objective of this article was to review systematically data on the physiological effects of smoking cessation. Articles based upon clinical trials, randomised controlled trials and meta-analyses were selected from titles and abstracts obtained via a MEDLINE search (May 2003-May 2008). Additional studies were identified from the bibliographies of reviewed literature. Smoking cessation is associated with improved lung function and a reduction in the presence and severity of respiratory symptoms. These changes, apparent within months of quitting, are sustained with long-term abstinence. The underlying pathophysiologies of smoking-induced airway inflammation and endothelial dysfunction are partially reversed following cessation in healthy ex-smokers, but not in those with chronic obstructive pulmonary disease. Smoking cessation is also associated with substantially improved cardiovascular function and reduced risk of primary and secondary cardiovascular morbidity and mortality. Although the overall long-term health benefits are unquestionable, smoking cessation is also associated with other possible undesirable short-term physiological effects such as weight gain, hypertension, constipation and mouth ulcers; and altered activity of the enzyme cytochrome P450 1A2 (CYP1A2), which metabolises many commonly used drugs. The negative physiological effects of smoking cessation may adversely affect a smoker's attempt to quit, and physicians should provide their smoking patients with motivation and regular encouragement and support when attempting to quit, whilst educating them on the health benefits of abstinence. Additionally, since cigarette smoke is a potent inducer of CYP1A2, patients attempting to quit smoking should have their dosages of drugs metabolised by this enzyme closely monitored.

Effects of brief smoking cessation education with expiratory carbon monoxide measurement on level of motivation to quit smoking.

PubMed

Choi, Won-Young; Kim, Cheol-Hwan; Lee, Ok-Gyu

2013-05-01

Smoking rates among Korean adult males is still high despite multifaceted efforts to reduce it. In Korea, there have been several studies on the effectiveness of smoking cessation education for inpatients, health check-ups, and smoking cessation clinics. However, there haven't been any studies on the effectiveness of smoking cessation education conducted outside the hospital. This study investigated effectiveness of brief education on smoking cessation with an expiratory carbon monoxide (CO) measurement outside the hospital among adult male office-workers in Korea. From April 1st to May 10th, 2012, we conducted a controlled trial among 95 adult male office workers over the age of 19 who smoke outside, in a public place in Seoul by cluster sampling. For the education group, we provided smoking cessation education for about 5 to 10 minutes, measured the expiratory CO level, and made the subjects complete questionnaires, while only self-help materials on quitting smoking were given to the control group. After 4 weeks, we evaluated the change in the level of motivation or success to quit smoking in both groups via e-mail or mobile phone. In the education group, the level of motivation to quit smoking was improved significantly. A multiple logistic regression analysis showed that the odds ratio of improved motivation to quit smoking in the education group was 28.10 times higher than that of the control group. Brief education on smoking cessation with expiratory CO measurement conducted outside the hospital could enhance the level of motivation to quit smoking.

Nicotine craving: ERPs correlates after VR exposure to smoking cues.

PubMed

Gamito, Pedro; Oliveira, Jorge; Baptista, André; Morais, Diogo; Lopes, Paulo; Saraiva, Tomaz; Rosa, Pedro; Santos, Nuno; Soares, Fábio; Sottomayor, Catarina; Barata, Filipa

2012-01-01

Even though it is diminishing in Europe, smoking is still a serious health problem. The craving of Nicotine is one of the hardest behaviours to tackle when a smoking cessation programme is implemented. Following on previous work [1], which aimed at evaluating the possibility of inducing smoking craving in smokers using a VR platform, the present study was devised to assess the role of craving in cognitive processing through event related potentials (ERP). From an initial sample of 89 university students (smokers and non-smokers), which was randomly exposed to VR smoking cues and VR non-smoking cue scenarios, a subsample of 13 smokers and non-smokers was drawn. This subsample (M = 23.08; SD = 4.39), which had previously been immersed in the VR smoking cues environment, was presented to a rapid (1 sec) serial of smoking and neutral images. Data on brain activity was recorded through an EEG during this task to further estimate ERPs. When compared to non-smokers, smokers showed higher frontal activation when watching smoking related images.

Vape, quit, tweet? Electronic cigarettes and smoking cessation on Twitter.

PubMed

van der Tempel, Jan; Noormohamed, Aliya; Schwartz, Robert; Norman, Cameron; Malas, Muhannad; Zawertailo, Laurie

2016-03-01

Individuals seeking information about electronic cigarettes are increasingly turning to social media networks like Twitter. We surveyed dominant Twitter communications about e-cigarettes and smoking cessation, examining message sources, themes, and attitudes. Tweets from 2014 were searched for mentions of e-cigarettes and smoking cessation. A purposive sample was subjected to mixed-methods analysis. Twitter communication about e-cigarettes increased fivefold since 2012. In a sample of 300 tweets from high-authority users, attitudes about e-cigarettes as smoking cessation aids were favorable across user types (industry, press, public figures, fake accounts, and personal users), except for public health professionals, who lacked consensus and contributed negligibly to the conversation. The most prevalent message themes were marketing, news, and first-person experiences with e-cigarettes as smoking cessation aids. We identified several industry strategies to reach Twitter users. Our findings show that Twitter users are overwhelmingly exposed to messages that favor e-cigarettes as smoking cessation aids, even when disregarding commercial activity. This underlines the need for effective public health engagement with social media to provide reliable information about e-cigarettes and smoking cessation online.

Exploring Smoking Cessation Attitudes, Beliefs, and Practices in Occupational Health Nursing.

PubMed

Ganz, Ollie; Fortuna, Grace; Weinsier, Stephanie; Campbell, Kay; Cantrell, Jennifer; Furmanski, William L

2015-07-01

The purpose of this study was to explore occupational health nurses' attitudes, beliefs, and practices regarding the delivery of smoking cessation services to workers. The study included 707 members of the American Association of Occupational Health Nurses (AAOHN) who completed a one-time survey during the fall of 2012. Results indicated that occupational health nurses believed that evidence-based treatments are at least somewhat effective and that they should provide smoking cessation services to their workers; however, a majority of occupational health nurses reported that they did not have appropriate smoking cessation training or guidelines in their workplaces. Occupational health nurses would benefit from training in the use of smoking cessation guidelines and evidence-based smoking cessation interventions, which could be used in their clinical practice. Employers should ensure that workplace policies, such as providing coverage for cessation services, facilitate smokers' efforts to quit. Employers can benefit from many of these policies through cost savings via reduced health care costs and absenteeism. © 2015 The Author(s).

[Side Effects of Smoking Cessation].

PubMed

Braun, Raffael; Huwiler, Bernhard

2018-06-01

Side Effects of Smoking Cessation Abstract. We present the case of a clozapine intoxication associated with aspiration pneumonia due to smoking cessation. Clozapine is mainly metabolized by CYP1A2. CYP1A2 is induced by cigarette smoking, which may change the plasma level of clozapine, especially if consuming habits change.

Smoking Cessation Failure among Korean Adolescents

ERIC Educational Resources Information Center

Kim, Sung Reul; Kim, Hyun Kyung; Kim, Ji Young; Kim, Hye Young; Ko, Sung Hee; Park, Minyoung

2016-01-01

The aim of this study was to identify smoking cessation failure subgroups among Korean adolescents. Participants were 379 smoking adolescents who joined a smoking cessation program. A questionnaire and a cotinine urine test were administered before the program began. Three months after the program ended, the cotinine urine test was repeated. A…

Rapid fall in lung density following smoking cessation in COPD.

PubMed

Shaker, Saher B; Stavngaard, Trine; Laursen, Lars Christian; Stoel, Berend C; Dirksen, Asger

2011-02-01

Whether smoking-induced lung inflammation subsides after smoking cessation is currently a matter of debate. We used computed tomography (CT) to evaluate the effect of smoking cessation on lung density in patients with COPD. Thirty-six patients quit smoking out of 254 current smokers with COPD who were followed with annual CT and lung function tests (LFT) for 2?4 years as part of a randomised placebo-controlled trial of the effect of inhaled budesonide on CT-lung density. Lung density was expressed as the 15th percentile density (PD15) and relative area of emphysema below -910 HU (RA-910). From the time-trends in the budesonide and placebo groups the expected CT-lung densities at the first visit after smoking cessation were calculated by linear regression and compared to the observed densities. Following smoking cessation RA-910 increased by 2.6% (p = 0.003) and PD15 decreased by -4.9 HU (p = 0.0002). Furthermore, changes were larger in the budesonide group than the placebo group (PD15: -7.1 vs -2.8 HU. RA-910 3.7% vs 1.7%). These differences were, however, not statistically significant. The LFT parameters (FEV(1) and diffusion capacity) were not significantly influenced by smoking cessation. Inflammation partly masks the presence of emphysema on CT and smoking cessation results in a paradoxical fall in lung density, which resembles rapid progression of emphysema. This fall in density is probably due to an anti-inflammatory effect of smoking cessation.

Distress Intolerance during Smoking Cessation Treatment

PubMed Central

Farris, Samantha G.; Leyro, Teresa M.; Allan, Nicholas P.; Øverup, Camilla S.; Schmidt, Norman B.; Zvolensky, Michael J.

2016-01-01

Distress intolerance is a key vulnerability factor implicated in the maintenance and relapse of cigarette smoking. Yet, past work has not examined changes in these processes during smoking cessation treatment or their relation to smoking cessation outcomes. The aim of the present study was to examine the effect of two smoking cessation interventions on changes in self-report and behavioral distress intolerance indices during treatment, and whether these changes are associated with smoking cessation outcomes. Treatment-seeking smokers (N = 384) were randomly assigned to one of two 4-session smoking cessation treatment programs: Standard Cessation Program (SCP) or Smoking Treatment and Anxiety Management Program (STAMP). Quit dates were scheduled to coincide with the final treatment session. Physical domains of distress intolerance were assessed at baseline and at each weekly session, via the Discomfort Intolerance Scale (DIS; higher scores indicate more intolerance for discomfort) and Breath Holding Duration Task (shorter durations indicate more intolerance for respiratory distress). The STAMP condition produced a greater rate of reduction in DIS scores than did the SCP condition. Changes in DIS scores during treatment mediated the effect of STAMP treatment on 7-day point prevalence abstinence at Month 3 post-quit attempt. There were no treatment conditions differences in changes in Breath-Holding duration. Data suggest self-reported distress intolerance is malleable in the context of stress sensitivity reduction treatment, but not standard smoking cessation treatment, and such reductions may result in promotion of smoking abstinence. PMID:27565398

Smoking Cessation in COPD Causes a Transient Improvement in Spirometry and Decreases Micronodules on High-Resolution CT Imaging

PubMed Central

Dhariwal, Jaideep; Tennant, Rachel C.; Hansell, David M.; Westwick, John; Walker, Christoph; Ward, Simon P.; Pride, Neil; Barnes, Peter J.; Kon, Onn Min

2014-01-01

Background: Smoking cessation is of major importance for all smokers; however, in patients with COPD, little information exists on how smoking cessation influences lung function and high-resolution CT (HRCT) scan appearances. Methods: In this single-center study, we performed screening spirometry in a group of heavy smokers aged 40 to 80 years (N = 358). We then studied the effects of smoking cessation in two groups of selected subjects: smokers with COPD (n = 38) and smokers with normal spirometry (n = 55). In parallel to subjects undergoing smoking cessation, we studied a control group of nonsmokers (n = 19). Results: Subjects with COPD who quit smoking had a marked, but transient improvement in FEV1 at 6 weeks (184 mL, n = 17, P < .01) that was still present at 12 weeks (81 mL, n = 17, P < .05) and only partially maintained at 1 year. In contrast, we saw improvement in the transfer factor of lung for carbon monoxide at 6 weeks in both subjects with COPD who quit smoking (0.47 mmol/min/kPa, n = 17, P < .01) and subjects who quit smoking with normal spirometry (0.40 mmol/min/kPa, n = 35, P < .01). An upper-zone single HRCT image slice reliably identified emphysema at baseline in 74% of smokers with COPD (28 of 38) and 29% of healthy smokers (16 of 55). Smoking cessation had no significant effect on the appearances of emphysema but decreased the presence of micronodules on HRCT imaging. Conclusions: Cigarette smoking causes extensive lung function and HRCT image abnormalities, even in patients with normal spirometry. Smoking cessation has differential effects on lung function (FEV1 and gas transfer) and features on HRCT images (emphysema and micronodules). Cessation of smoking in patients with COPD causes a transient improvement in FEV1 and decreases the presence of micronodules, offering an opportunity for concomitant therapy during smoking cessation to augment these effects. Smoking cessation at the earliest possible opportunity is vital to minimize permanent damage to the lungs. PMID:24522562

[Medical students' smoking habits and attitudes about cessation].

PubMed

Rinfel, József; Oberling, János; Tóth, Ildikó; Prugberger, László; Nagy, Lajos

2011-03-20

Medical years are very important in shaping the attitudes of future doctors. It is proven that doctors who smoke do not advise their patient to stop smoking. We have to know the students' smoking habits and attitudes about smoking cessation to make them interested in the fight against tobacco. To investigate medical students' smoking habits and attitudes about cessation. We applied the Hungarian translation of the Global Health Professionals Student Survey. Medical students from the first and fifth year filled in the survey anonymously during the seminars. Statistical analysis was performed with SPSS. In both years 245 students filled in the questionnaire. In the first year 30.8%, in the fifth year 38.9% of the students were defined as smokers. During the academic study the number of daily smokers and the number of smoked cigarettes increases. Students require training about smoking cessation, however they would entrust it to a specialist. Based on our data we need a teaching block in the curricula about smoking and smoking cessation.

Smoking cessation in women: findings from qualitative research.

PubMed

Puskar, M

1995-11-01

The purpose of this descriptive exploratory study is to describe the experience of successful smoking cessation in adult women. The convenience sample included 10 women, ages 25 to 42, who had abstained from smoking for at least 6 months but not longer than 3 years. A semistructured interview format was used to elicit descriptions of the experience of successful smoking cessation from these subjects. The interview format explored the experience, including initial contemplation, the process of quitting, and maintenance of smoking abstinence. Interviews were audiotaped, transcribed, and then analyzed using methods outlined by Miles and Huberman [1]. Four themes emerged from the data: evolving commitment to health and personal growth, being stigmatized, changing conceptualization of smoking, and smoking cessation as a relational phenomenon. These findings were consistent with Pender's Health Promotion Model and have implications for nurse practitioners who counsel women on smoking cessation.

“It doesn’t seem to make sense for a company that sells cigarettes to help smokers stop using them”: A case study of Philip Morris’s involvement in smoking cessation

PubMed Central

Lown, E. Anne; Malone, Ruth E.

2017-01-01

Background In the late 1990s, American tobacco companies began offering limited cessation assistance to smokers by posting links on their company websites to government-sponsored smoking cessation resources. Philip Morris USA (PM) went further, funding youth cessation programs and creating its own online cessation program, QuitAssist. We explore why PM entered the cessation arena, and describe the variety of options considered and how PM-supported cessation programs were evaluated and promoted. Methods We retrieved and analyzed archival PM documents from 1998–2005. We supplemented information from the documents with scholarly articles assessing QuitAssist and archived versions of the PM and QuitAssist websites. Results PM’s Youth Smoking Prevention department began funding youth cessation projects and programs soon after its creation in 1998, motivated by the same issue that drove its interest in youth smoking prevention: regulatory threats posed by public and policymaker concern about youth smoking. The department took a similar approach to youth smoking cessation as it did with prevention, rejecting curricula with “anti-industry” themes. In 2002, a “cessation exploration team” examined a variety of rationales for and approaches to company support for adult smoking cessation. Ultimately, PM chose QuitAssist, a limited and less expensive option that nonetheless provided opportunities for engagement with a variety of public health and government officials. Independent research indicates that QuitAssist is not an effective cessation tool. Conclusions While the transformation of ambitious plans into a mundane final product is a recurring theme with PM’s corporate responsibility efforts, it would be inappropriate to dismiss PM’s smoking cessation endeavors as half-hearted attempts to appear responsible. Such endeavors have the potential to inflict real harm by competing with more effective programs and by helping to maintain a tobacco-favorable policy environment. If PM truly wanted to support cessation, it could drop legal and other challenges to public policies that discourage smoking. PMID:28846738

Smoking cessation and bone healing: optimal cessation timing.

PubMed

Truntzer, Jeremy; Vopat, Bryan; Feldstein, Michael; Matityahu, Amir

2015-02-01

Smoking is a worldwide epidemic. Complications related to smoking behavior generate an economic loss around $193 billion annually. In addition to impacting chronic health conditions, smoking is linked to increased perioperative complications in those with current or previous smoking history. Numerous studies have demonstrated more frequent surgical complications including higher rates of infection, poor wound healing, heightened pain complaints, and increased pulmonary morbidities in patients with a smoking history. Longer preoperative cessation periods also seem to correlate with reduced rates. At roughly 4 weeks of cessation prior to surgery, complication rates more closely reflect individuals without a smoking history in comparison with those that smoke within 4 weeks of surgery. In the musculoskeletal system, a similar trend has been observed in smokers with higher rates of fractures, nonunions, malunions, infections, osteomyelitis, and lower functional scores compared to non-smoking patients. Unfortunately, the present literature lacks robust data suggesting a temporal relationship between smoking cessation and bone healing. In our review, we analyze pseudoarthrosis rates following spinal fusion to suggest that bone healing in the context of smoking behavior follows a similar time sequence as observed in wound healing. We also discuss the implications for further clarity on bone healing and smoking cessation within orthopedics including improved risk stratification and better identification of circumstances where adjunct therapy is appropriate.

Teaching smoking-cessation counseling to medical students using simulated patients.

PubMed

Eyler, A E; Dicken, L L; Fitzgerald, J T; Oh, M S; Wolf, F M; Zweifler, A J

1997-01-01

Our objective was to evaluate the effectiveness of using simulated patient instructors and the Ockene method to instruct third-year medical students in smoking-cessation counseling techniques. We used a clinical exercise with self-study preparation and simulated patient instructors. One hundred fifty-nine students participated in a smoking-cessation counseling session in which cognitive and behavioral endpoints were assessed by simulated patient instructors and the students themselves. Student performance in the cognitive and behavioral components of model smoking-cessation counseling was acceptable. Specific areas of weakness, such as the tendency of students to underemphasize the personal and social benefits of smoking cessation, and to overestimate their competence on a number of skill items, were identified. Student evaluation of the exercise was positive. Smoking-cessation counseling can be taught effectively to third-year medical students by simulated patient instructors during a clinical clerkship.

Efficacy of electronic cigarettes for smoking cessation.

PubMed

Orr, Katherine Kelly; Asal, Nicole J

2014-11-01

To review data demonstrating effective smoking cessation with electronic cigarettes (e-cigarettes). A literature search of MEDLINE/PubMed (1946-March 2014) was performed using the search terms e-cigarettes, electronic cigarettes, and smoking cessation. Additional references were identified from a review of literature citations. All English-language clinical studies assessing efficacy of e-cigarettes compared with baseline, placebo, or other pharmacological methods to aid in withdrawal symptoms, smoking reduction, or cessation were evaluated. A total of 6 clinical studies were included in the review. In small studies, e-cigarettes significantly decreased desire to smoke, number of cigarettes smoked per day, and exhaled carbon monoxide levels. Symptoms of nicotine withdrawal and adverse effects were variable. The most common adverse effects were nausea, headache, cough, and mouth/throat irritation. Compared with nicotine patches, e-cigarettes were associated with fewer adverse effects and higher adherence. Most studies showed a significant decrease in cigarette use acutely; however, long-term cessation was not sustained at 6 months. There is limited evidence for the effectiveness of e-cigarettes in smoking cessation; however, there may be a place in therapy to help modify smoking habits or reduce the number of cigarettes smoked. Studies available provided different administration patterns such as use while smoking, instead of smoking, or as needed. Short-term studies reviewed were small and did not necessarily evaluate cessation with a focus on parameters associated with cessation withdrawal symptoms. Though long-term safety is unknown, concerns regarding increased poisoning exposures among adults in comparison with cigarettes are alarming. © The Author(s) 2014.

Ethnic and Gender Differences in Smoking and Smoking Cessation in a Population of Young Adult Air Force Recruits.

ERIC Educational Resources Information Center

Ward, Kenneth D.; Vander Weg, Mark W.; Kovach, Kristen Wood; Klesges, Robert C.; DeBon, Margaret W.; Haddock, C. Keith; Talcott, G. Wayne; Lando, Harry A.

2002-01-01

Investigated gender and ethnic differences in smoking and smoking cessation among young adult military recruits. Surveys administered at the start of basic training indicated that whites (especially white females) and Native Americans were more likely to smoke than other ethnic groups. Gender differences were not observed in cessation rates, which…

Impact of A Smoking Prevention Interactive Experience (ASPIRE), an interactive, multimedia smoking prevention and cessation curriculum for culturally diverse high-school students.

PubMed

Prokhorov, Alexander V; Kelder, Steven H; Shegog, Ross; Murray, Nancy; Peters, Ronald; Agurcia-Parker, Carolyn; Cinciripini, Paul M; de Moor, Carl; Conroy, Jennifer L; Hudmon, Karen Suchanek; Ford, Kentya H; Marani, Salma

2008-09-01

Few studies have examined the long-term efficacy of computer-based smoking prevention and cessation programs. We analyzed the long-term impact of A Smoking Prevention Interactive Experience (ASPIRE), a theoretically sound computer-based smoking prevention and cessation curriculum for high school students. Sixteen predominantly minority, inner-city high schools were randomly assigned to receive the ASPIRE curriculum or standard care (receipt of the National Cancer Institute's Clearing the Air self-help booklet). A total of 1160 students, 1098 of whom were nonsmokers and 62 smokers at baseline, were included. At 18-month follow-up, among baseline nonsmokers, smoking initiation rates were significantly lower in the ASPIRE condition (1.9% vs. 5.8%, p < .05). Students receiving ASPIRE also demonstrated significantly higher decisional balance against smoking and decreased temptations to smoke. Differences between groups in self-efficacy and resistance skills were not significant. There was a nonsignificant trend toward improved smoking cessation with ASPIRE, but low recruitment of smokers precluded conclusions with respect to cessation. ASPIRE demonstrated the potential for an interactive multimedia program to promote smoking prevention. Further studies are required to determine ASPIRE's effects on cessation.

Factors associated with smoking cessation

PubMed Central

França, Samires Avelino de Souza; Neves, Ana Ligian Feitosa das; de Souza, Tatiane Andressa Santos; Martins, Nandara Celana Negreiros; Carneiro, Saul Rassy; Sarges, Edilene do Socorro Nascimento Falcão; de Souza, Maria de Fátima Amine Houat

2015-01-01

OBJECTIVE To analyze the prevalence and factors associated with smoking abstinence among patients who were treated in a reference unit for smoking cessation. METHODS This cross-sectional study examined the medical records of 532 patients treated in a reference unit for smoking cessation in Belém, PA, Northern Brazil, between January 2010 and June 2012. Sociodemographic variables and those related to smoking history and treatment were analyzed. Statistical significance was set at p < 0.05. RESULTS The mean age of the participants was 50 years; 57.0% of the patients were women. The mean tobacco load was 30 packs/year, and the mean smoking duration was approximately 32 years. Most patients remained in treatment for four months. The rate of smoking abstinence was 75.0%. Regression analysis indicated that maintenance therapy, absence of relapse triggers, and lower chemical dependence were significantly associated with smoking cessation. CONCLUSIONS The smoking abstinence rate observed was 75.0%. The cessation process was associated with several aspects, including the degree of chemical dependence, symptoms of withdrawal, and period of patient follow-up in a multidisciplinary treatment program. Studies of this nature contribute to the collection of consistent epidemiological data and are essential for the implementation of effective smoking prevention and cessation strategies. PMID:25741649

Effects of E-cigarette Advertising Messages and Cues on Cessation Outcomes.

PubMed

Jo, Catherine L; Golden, Shelley D; Noar, Seth M; Rini, Christine; Ribisl, Kurt M

2018-01-01

We examined effects of e-cigarette ad messages and visual cues on outcomes related to combustible cigarette smoking cessation: smoking cessation intention, smoking urges, and immediate smoking behavior. US adult smokers (N = 3293) were recruited through Amazon Mechanical Turk and randomized to condition in a 3 (message: e-cigarette use anywhere, harm reduction, control) × 2 (e-cigarette cue presence or absence) between-subjects experiment. Stimuli were print ads for cigarette-like e-cigarettes ("cigalikes") that were manipulated for the experimental conditions. We conducted ANOVA and logistic regression analyses to investigate effects of the manipulations. Message effects on cessation intention and smoking urges were not statistically significant. There was no evidence of cue effects or message × cue interactions across outcomes. Contrary to expectations, e-cigarette use anywhere and harm reduction messages were associated with lower odds of immediate smoking than the control message (AOR EUA = 0.75, 95%CI = 0.58, 0.97, p = .026; AOR HR = 0.72, 95%CI = 0.55, 0.93, p = .013). E-cigarette use anywhere and harm reduction messages may encourage smoking cessation, given the observed reduction in immediate smoking. E-cigarette cues may not influence smoking cessation outcomes. Future studies should investigate whether message effects are a result of smokers believing e-cigarettes to be effective cessation aids.

Adolescents' and Young Adults' Perceptions of Electronic Cigarettes for Smoking Cessation: A Focus Group Study.

PubMed

Camenga, Deepa R; Cavallo, Dana A; Kong, Grace; Morean, Meghan E; Connell, Christian M; Simon, Patricia; Bulmer, Sandra M; Krishnan-Sarin, Suchitra

2015-10-01

Research has shown that adults perceive that electronic cigarettes (e-cigarettes) are effective for smoking cessation, yet little is known about adolescents and young adults' perceptions of e-cigarettes for quitting cigarette smoking. This study describes middle, high school, and college students' beliefs about, and experiences with, e-cigarettes for cigarette smoking cessation. We conducted 18 focus groups (n = 127) with male and female cigarette smokers and nonsmokers in 2 public colleges, 2 high schools, and 1 middle school in Connecticut between November 2012 and April 2013. Participants discussed cigarette smoking cessation in relation to e-cigarettes. Verbatim transcripts were analyzed using thematic analysis. All participants, regardless of age and smoking status, were aware that e-cigarettes could be used for smoking cessation. College and high school participants described different methods of how e-cigarettes could be used for smoking cessation: (a) nicotine reduction followed by cessation; (b) cigarette reduction/dual use; and (c) long-term exclusive e-cigarette use. However, overall, participants did not perceive that e-cigarette use led to successful quitting experiences. Participants described positive attributes (maintenance of smoking actions, "healthier" alternative to cigarettes, and parental approval) and negative attributes (persistence of craving, maintenance of addiction) of e-cigarettes for cessation. Some college students expressed distrust of marketing of e-cigarettes for smoking cessation. Adolescent and young adult smokers and nonsmokers perceive that there are several methods of using e-cigarettes for quitting and are aware of both positive and negative aspects of the product. Future research is needed to determine the role of e-cigarettes for smoking cessation in this population. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

THE ROLE OF EMPLOYERS IN FACILITATING SMOKING CESSATION AMONG STAFF: PERSPECTIVE OF DRIVERS IN A NIGERIAN UNIVERSITY.

PubMed

Olumide, A O; Owoaje, Eme T

2017-12-01

Several interventions have been instituted to encourage smoking cessation among smokers. Many adults are currently working and spend several hours a day at work. Employers thus have a role to play in encouraging staff who smoke to quit. This study investigated the perception of drivers employed in the University of Ibadan, Nigeria on the role of their employers in facilitating smoking cessation among staff who smoke. All 176 drivers employed by the University and who were available on the days of the interviews were interviewed. A semi-structured questionnaire was used to obtain information on drivers' opinion on the role of employers in facilitating smoking cessation among staff. All the drivers were male and had a mean age of 51.2 ± 5.8 years. Five (2.8%) drivers were current smokers. One hundred and thirty-six (77.3%) drivers were of the opinion that their employers had a role to play in encouraging smoking cessation among staff who smoke. They felt this could be done by organizing workshops to sensitize staff on the dangers of smoking 73 (53.7%), educating staff about the health effects of smoking 26 (19.1%) and arresting staff caught smoking during official hours 20 (14.7%). Many of the drivers felt that their employers had a role to play in encouraging smoking cessation among staff. The University authorities should build on this and take specific steps to institute a comprehensive workplace antitobacco policy which includes smoking cessation interventions to assist staff who smoke to quit.

Effectiveness of a Culturally-Tailored Smoking Cessation Intervention for Arab-American Men

PubMed Central

Haddad, Linda G.; Al-Bashaireh, Ahmad M.; Ferrell, Anastasiya V.; Ghadban, Roula

2017-01-01

To date, no smoking cessation programs are available for Arab American (ARA) men, who are a vulnerable population with high rates of smoking. Thus, the primary aim of this one group pre-test/post-test study was to assess the effectiveness of Sehatack—a culturally and linguistically tailored smoking cessation program for ARA men. The study sample was 79 ARA men with a mean age of 43 years who smoked between 5 and 40 cigarettes (mean = 19.75, SD = 9.1) per day (98.7%). All of the participants reported more interest in smoking cessation post-intervention and many of the participants in the baseline (38.5%) and post-intervention phases (47.7%) wanted to quit smoking ”very much”. For daily smokers who completed the smoking cessation program, the median number of cigarettes smoked daily was significantly lower than those in the post-intervention phase (Z = −6.915, p < 0.001). Results of this preliminary study indicate that: (a) Sehatack may be a promising way for ARA men to quit smoking, and (b) culturally relevant smoking cessation counselors can be trained to recruit and retain ARA smokers in an intensive group smoking cessation program. Strengths of this study were community engagement and rapport between three faith organizations and the University of Florida College of Nursing. However, a larger trial is needed to address study limitations and to confirm benefits in this population. PMID:28406462

The effect of successful and unsuccessful smoking cessation on short-term anxiety, depression, and suicidality

PubMed Central

Capron, Daniel W.; Allan, Nicholas P.; Norr, Aaron M.; Zvolensky, Michael J.; Schmidt, Norman B.

2014-01-01

Research on the mental health effects of quitting smoking is limited. Smokers with mental illness appear to be at a higher risk of unsuccessful smoking cessation. Recent work suggests they are at elevated risk for post-cessation increases in anxiety, depression and suicidal ideation. The current study tested the effects of successful and unsuccessful smoking cessation on short-term psychopathology in 192 community participants. Smoking cessation outcomes were classified using expired carbon monoxide levels that were taken at quit week, 1 and 2 week follow-up and 1 month follow-up. We found no psychopathology increases in participants who successfully quit smoking. For individuals struggling to quit our results partially supported a recently proposed struggling quitters hypothesis. However, the vast majority of individuals posited to be vulnerable by the struggling quitters hypothesis did not experience clinically significant increases in psychopathology. These findings have implications for clinicians whose clients are interested in smoking cessation. PMID:24457901

Parental Influence on Adolescent Smoking Cessation: Is there a Gender Difference?

PubMed Central

Kong, Grace; Camenga, Deepa; Krishnan-Sarin, Suchitra

2011-01-01

We examined the association of parental disapproval of adolescent smoking and parental smoking status, with past smoking quit behaviors among daily-smoking, high school-aged adolescents, and also tested whether these associations differ for boys and girls. Adolescent regular smokers (N = 253) completed questions on smoking behaviors, past smoking cessation behaviors, parental disapproval of smoking, and parental smoking. Past smoking cessation behaviors were defined as “the number of quit attempts that lasted longer than 24 hours” and “the longest number of days of abstinence”. Logistic regression analyses showed that for all adolescents, even having one smoking parent was associated with decreased odds of being abstinent for longer than 2 days. However, for girls, not having any smoking parents was associated with greater duration of abstinence (> 2 weeks). Having both parents, compared with not having any parents disapprove of smoking, was associated with greater number of quit attempts in boys, but this effect was not found in girls. The results indicate that parents have a salient role in adolescent smoking cessation behaviors, and this association appears to be gender-specific. However, further research is needed to understand the mechanisms that explain gender differences in parental influence on adolescent smoking cessation behaviors. PMID:22070852

Implicit and explicit attitudes predict smoking cessation: moderating effects of experienced failure to control smoking and plans to quit.

PubMed

Chassin, Laurie; Presson, Clark C; Sherman, Steven J; Seo, Dong-Chul; Macy, Jonathan T

2010-12-01

The current study tested implicit and explicit attitudes as prospective predictors of smoking cessation in a Midwestern community sample of smokers. Results showed that the effects of attitudes significantly varied with levels of experienced failure to control smoking and plans to quit. Explicit attitudes significantly predicted later cessation among those with low (but not high or average) levels of experienced failure to control smoking. Conversely, however, implicit attitudes significantly predicted later cessation among those with high levels of experienced failure to control smoking, but only if they had a plan to quit. Because smoking cessation involves both controlled and automatic processes, interventions may need to consider attitude change interventions that focus on both implicit and explicit attitudes. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

[Association between smoking/smoking cessation and glycemic control in male patients with type 2 diabetes].

PubMed

Su, J; Qin, Y; Shen, C; Gao, Y; Pan, E C; Pan, X Q; Tao, R; Zhang, Y Q; Wu, M

2017-11-10

Objective: To explore the association of smoking and smoking cessation with glycemic control in male patients with type 2 diabetes. Methods: From December 2013 to January 2014, a total of 7 763 male patients with type 2 diabetes, who received national basic public health service in Changshu county of Suzhou city, Huai'an and Qinghe districts of Huai'an city, Jiangsu province, were recruited by cluster sampling. Questionnaire survey and anthropometric measurements were conducted, and fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) levels were measured. Multiple linear regression model was used to evaluate the association of smoking and smoking cessation with glycemic control. Results: The prevalence of current smoking was 45.5% in male patients with type 2 diabetes. The levels of FPG and HbA1c increased with number of cigarettes smoked per day compared with non-smokers ( P <0.001). Among patients with drug treatment, the average increase of HbA1c level in current smokers with smoking duration ≥30 years and smoking index ≥40 pack-years were 0.27% (95 %CI : 0.05%-0.49%) and 0.38% (95 %CI : 0.23%-0.53%), respectively. FPG and HbA1c level decreased obviously with smoking cessation years among former smokers ( P <0.05). Among the patients receiving no drug treatment, no dose-response relationships were observed between smoking duration, smoking cessation years and levels of FPG and HbA1c. Conclusion: Cigarette smoking was negatively related with glycemic control in male type 2 diabetes patients, especially in patients with drug treatment. Smoking cessation may be beneficial for glycemic control. Smoking cessation should be encouraged for diabetes patients as early as possible.

Adaptation and uptake evaluation of an SMS text message smoking cessation programme (MiQuit) for use in antenatal care

PubMed Central

Naughton, Felix; Cooper, Sue; Bowker, Katharine; Campbell, Katarzyna; Sutton, Stephen; Leonardi-Bee, Jo; Sloan, Melanie; Coleman, Tim

2015-01-01

Objectives To adapt a tailored short message service (SMS) text message smoking cessation intervention (MiQuit) for use without active health professional endorsement in routine antenatal care settings, to estimate ‘real-world’ uptake and test the feasibility of its use. Design Single-site service evaluation. Setting A Nottinghamshire (UK) antenatal clinic. Participants Pregnant women accessing the antenatal clinic (N=1750) over 6 months. Intervention A single-sheet A5 leaflet provided in the women's maternity notes folder describing the MiQuit text service. Similar materials were left on clinic desks and noticeboards. Outcome measures MiQuit activation requests and system interactions were logged for two time frames: 6 months (strict) and 8 months (extended). Local hospital data were used to estimate the denominator of pregnant smokers exposed to the materials. Results During the strict and extended time frames, 13 and 25 activation requests were received, representing 3% (95% CI 2% to 5%) and 4% (95% CI 3% to 6%) of estimated smokers, respectively. Only 11 (44%) of the 25 requesting activation sent a correctly formatted initiation text. Of those activating MiQuit, and invited to complete tailoring questions (used to tailor support), 6 (67%) completed all 12 questions by text or website and 5 (56%) texted a quit date to the system. Of the 11 activating MiQuit, 5 (45%, 95% CI 21% to 72%) stopped the programme prematurely. Conclusions A low-intensity, cheap cessation intervention promoted at very low cost, resulted in a small but potentially impactful uptake rate by pregnant smokers. PMID:26493459

Nicotine replacement therapy, professional therapy, snuff use and tobacco smoking: a study of smoking cessation strategies in southern Sweden.

PubMed

Lindström, Martin

2007-12-01

The strategies used to support smoking cessation among quitters were investigated according to year of smoking cessation and sociodemographic characteristics. The 2004 public health survey in Skåne, Sweden, is a cross-sectional study. A total of 27,757 people aged 18-80 answered a postal questionnaire. The participation rate was 59%. Different strategies to support smoking cessation--that is, no therapy, nicotine replacement (NRT), professional therapy and snus (snuff) use, were investigated among quitters according to year of smoking cessation, and demographic and socioeconomic characteristics. 14.9% of the men and 18.1% of the women were daily smokers. The prevalence of daily snus use was 19.5% among men but only 2.3% among women. Stratifying the data according to year of smoking cessation (1938-2004) revealed a significant increase in active smoking cessation strategies such as NRT, professional therapy and snus use. NRT was more common among women (23.6%) than men (14.8%) among smokers who quit in 2000-4, but snus use was more common among men (30.4% versus 8.7%). No replacement or other therapy at all was significantly more common among women (63.6%) than men (52.1%). People aged 35-80 years used more nicotine replacement than people aged 18-34, while men aged 18-34 used snus to quit smoking significantly more than men aged 55-80. Snus is used commonly among men as a support for smoking cessation in Sweden. Women use pharmacological NRT to a greater extent, but this can probably not compensate for the much higher extent of snuff use as a cessation strategy among men.

Minority Stress, Smoking Patterns, and Cessation Attempts: Findings From a Community-Sample of Transgender Women in the San Francisco Bay Area

PubMed Central

Mereish, Ethan H.; Manning, David; Iwamoto, Mariko; Operario, Don; Nemoto, Tooru

2016-01-01

Introduction: Research has demonstrated associations between reports of minority stressors and smoking behaviors among lesbian, gay, and bisexual populations; however, little is known about how minority stressors are related to smoking behaviors and cessation attempts among transgender women. The purpose of this study was twofold: (1) to examine the associations between transgender-based discrimination and smoking patterns among a sample of transgender women; and (2) to identify barriers to smoking cessation in a sample of transgender women with a history of smoking. Methods: A community sample of 241 transgender women completed a one-time survey. Binary and multinomial logistic regression models examined associations between minority stressors and (1) smoking behaviors and (2) cessation attempts. Both models adjusted for income, education, race/ethnicity, recent sex work, HIV status, depression, alcohol use, and current hormone use. Results: Overall, 83% of participants indicated that they had smoked a cigarette in the last month. Of these women, 62.3% reported daily smoking and 51.7% reported an unsuccessful quit attempt. Discrimination was positively associated with currently smoking (adjusted odds ratio [AOR] = 1.04, 95% confidence interval [CI]: 1.01, 1.08). Discrimination was positively associated with unsuccessful cessation (AOR = 1.03, 95% CI: 1.01, 1.18) and never attempting (AOR = 1.04, 95% CI: 1.01, 1.11) compared to successful cessation. Discrimination was also positively associated with never attempting compared to unsuccessful cessation (AOR = 1.01, 95% CI: 1.00, 1.03). Conclusions: Smoking cessation may be driven by unique transgender-related minority stressors, such as discrimination. Future research is warranted to address unique stigmatizing contexts when understanding and providing tailored intervention addressing smoking among transgender women. PMID:25782458

Quality of life after quitting smoking and initiating aerobic exercise.

PubMed

Bloom, Erika Litvin; Minami, Haruka; Brown, Richard A; Strong, David R; Riebe, Deborah; Abrantes, Ana M

2017-10-01

Quitting smoking and aerobic exercise each improve health. Although smokers may be concerned that quitting smoking will reduce their quality of life (QOL), recent research has shown that cessation is associated with QOL benefits. Elements of smoking cessation interventions, such as exercise, may contribute to changes in QOL. However, it is unknown whether initiating exercise in the context of smoking cessation is associated with greater or different effects on QOL than smoking cessation alone. The current study is a secondary analysis of data from a randomized trial (n = 61) of an exercise intervention for smoking cessation. We hypothesized that smoking abstinence and engagement in exercise would have positive, additive effects on QOL at end-of-treatment, 6- and, 12-month follow-ups. Sedentary adult smokers were randomized to the exercise intervention or a health education control (HEC) group. Additionally, all participants received smoking cessation counseling and nicotine patches. Data were analyzed using actual engagement in exercise, rather than group assignment as a proxy for exercise engagement, because some HEC participants also began exercising. Abstinence was positively associated with higher total and physical health QOL at follow-up. Exercise was not associated with total QOL and only marginally associated with physical health QOL, but was positively related to overall sense of well-being. Emphasizing that smoking cessation is associated with higher QOL may help motivate smokers to initiate quit attempts.

Are digital interventions for smoking cessation in pregnancy effective? A systematic review protocol.

PubMed

Griffiths, Sarah Ellen; Brown, Katherine E; Fulton, Emily Anne; Tombor, Ildiko; Naughton, Felix

2016-12-01

Behavioural support for smoking cessation in pregnancy can be effective; however, many pregnant women face barriers to seeking support to stop smoking. Some digital interventions have been found to be effective for smoking cessation in the general population and may be effective for supporting cessation in pregnancy due to their flexibility and the potential for personalisation. To date, there is limited evidence of the effectiveness of digital interventions for smoking cessation in pregnancy. This review aims to assess the following: (1) whether digital interventions are effective at promoting smoking cessation among pregnant women; (2) which behaviour change techniques (BCTs) or combinations of BCTs are associated with the effectiveness of digital interventions for smoking cessation in pregnancy; and (3) whether the number of BCTs used is associated with the effectiveness of digital interventions for smoking cessation in pregnancy. This review will include digital interventions delivered largely through computer (PC or laptop), video/DVD, mobile phone (including smartphones) or portable handheld device (e.g. tablet, iPad) and include websites, mobile or tablet applications and SMS text messages. Interventions must be randomised or quasi-randomised controlled trials aimed at women who smoke in pregnancy, with smoking cessation as a measured outcome (preferably the latest available point prevalence smoking status measure taken during pregnancy, biochemically verified if available). Electronic bibliographic databases will be searched to identify suitable studies indexed in the following: Academic Search Complete, ASSIA, CINAHL, The Cochrane Library, EMBASE, Medline, PsycINFO, Scopus, and Web of Science. The search strategy will include key words and database-specific subject headings relating to 'pregnancy' and 'smoking' and synonyms for the terms 'digital' and 'randomised controlled trial'. Where required and where possible, the first and second authors will independently code interventions and control groups for BCTs. If data allows, meta-analyses will be used to assess intervention effectiveness and the effectiveness of BCTs. This systematic review will provide a detailed synthesis of the effectiveness of current research using digital interventions for smoking cessation in pregnancy, to build on the evidence base and guide the development of future research in this area. PROSPERO CRD42016036201.

Mass Media for Smoking Cessation in Adolescents

ERIC Educational Resources Information Center

Solomon, Laura J.; Bunn, Janice Y.; Flynn, Brian S.; Pirie, Phyllis L.; Worden, John K.; Ashikaga, Takamaru

2009-01-01

Theory-driven, mass media interventions prevent smoking among youth. This study examined effects of a media campaign on adolescent smoking cessation. Four matched pairs of media markets in four states were randomized to receive or not receive a 3-year television/radio campaign aimed at adolescent smoking cessation based on social cognitive theory.…

Randomized Controlled Trial of Behavioral Activation Smoking Cessation Treatment for Smokers with Elevated Depressive Symptoms

ERIC Educational Resources Information Center

MacPherson, Laura; Tull, Matthew T.; Matusiewicz, Alexis K.; Rodman, Samantha; Strong, David R.; Kahler, Christopher W.; Hopko, Derek R.; Zvolensky, Michael J.; Brown, Richard A.; Lejuez, C. W.

2010-01-01

Objective: Depressive symptoms are associated with poor smoking cessation outcomes, and there remains continued interest in behavioral interventions that simultaneously target smoking and depressive symptomatology. In this pilot study, we examined whether a behavioral activation treatment for smoking (BATS) can enhance cessation outcomes. Method:…

What Factors Are Important in Smoking Cessation Amongst Deprived Communities?: A Qualitative Study

ERIC Educational Resources Information Center

Henderson, Hazel J.; Memon, Anjum; Lawson, Kate; Jacobs, Barbara; Koutsogeorgou, Eleni

2011-01-01

Objective: There is limited evidence regarding effective smoking cessation interventions in deprived communities. This study explored what factors are considered most important in smoking cessation, from the perspective of a group of NHS Stop Smoking Service users from a deprived community. Design: A qualitative study. Setting: A deprived…

You can't pay me to quit: the failure of financial incentives for smoking cessation in head and neck cancer patients.

PubMed

Ghosh, A; Philiponis, G; Bewley, A; Ransom, E R; Mirza, N

2016-03-01

A prospective randomised study was conducted at a tertiary care hospital to evaluate the effects of financial incentives for smoking cessation targeted at a high-risk population. Patients with a past history of head and neck cancer were voluntarily enrolled over a two-year period. They were randomised to a cash incentives or no incentive group. Subjects were offered enrolment in smoking cessation courses. Smoking by-product levels were assessed at 30 days, 3 months and 6 months. Subjects in the incentive group received $150 if smoking cessation was confirmed. Over 2 years, 114 patients with an established diagnosis of head and neck cancer were offered enrolment. Twenty-four enrolled and 14 attended the smoking cessation classes. Only two successfully quit smoking at six months. Both these patients were in the financially incentivised group and received $150 at each test visit. Providing a financial incentive for smoking cessation to a population already carrying a diagnosis of head and neck cancer in order to promote a positive behaviour change was unsuccessful.

User-Centered Design of Learn to Quit, a Smoking Cessation Smartphone App for People With Serious Mental Illness.

PubMed

Vilardaga, Roger; Rizo, Javier; Zeng, Emily; Kientz, Julie A; Ries, Richard; Otis, Chad; Hernandez, Kayla

2018-01-16

Smoking rates in the United States have been reduced in the past decades to 15% of the general population. However, up to 88% of people with psychiatric symptoms still smoke, leading to high rates of disease and mortality. Therefore, there is a great need to develop smoking cessation interventions that have adequate levels of usability and can reach this population. The objective of this study was to report the rationale, ideation, design, user research, and final specifications of a novel smoking cessation app for people with serious mental illness (SMI) that will be tested in a feasibility trial. We used a variety of user-centered design methods and materials to develop the tailored smoking cessation app. This included expert panel guidance, a set of design principles and theory-based smoking cessation content, development of personas and paper prototyping, usability testing of the app prototype, establishment of app's core vision and design specification, and collaboration with a software development company. We developed Learn to Quit, a smoking cessation app designed and tailored to individuals with SMI that incorporates the following: (1) evidence-based smoking cessation content from Acceptance and Commitment Therapy and US Clinical Practice Guidelines for smoking cessation aimed at providing skills for quitting while addressing mental health symptoms, (2) a set of behavioral principles to increase retention and comprehension of smoking cessation content, (3) a gamification component to encourage and sustain app engagement during a 14-day period, (4) an app structure and layout designed to minimize usability errors in people with SMI, and (5) a set of stories and visuals that communicate smoking cessation concepts and skills in simple terms. Despite its increasing importance, the design and development of mHealth technology is typically underreported, hampering scientific innovation. This report describes the systematic development of the first smoking cessation app tailored to people with SMI, a population with very high rates of nicotine addiction, and offers new design strategies to engage this population. mHealth developers in smoking cessation and related fields could benefit from a design strategy that capitalizes on the role visual engagement, storytelling, and the systematic application of behavior analytic principles to deliver evidence-based content. ©Roger Vilardaga, Javier Rizo, Emily Zeng, Julie A Kientz, Richard Ries, Chad Otis, Kayla Hernandez. Originally published in JMIR Serious Games (http://games.jmir.org), 16.01.2018.

Attitudes and behaviours in smoking cessation among general practitioners in Finland 2001.

PubMed

Barengo, Noël C; Sandström, H Patrick; Jormanainen, Vesa J; Myllykangas, Markku T

2005-01-01

To investigate whether smoking by general practitioners (GPs) and gender influence smoking cessation advice. A self-administered questionnaire, originally developed by the WHO and modified according to the Finnish health care system was sent by mail to physicians who were members of the Finnish Medical Association (FMA). Participants were restricted to those who were living in Finland and were younger than 65 years. Numbers of participants was 3,057 and the response rate 69%. Smoking male GPs gave less smoking cessation advice only to patients with a stomach ulcer or patients using oral contraceptive pills compared with their non-smoking colleagues. Male GPs gave less smoking cessation advice to pregnant patients or patients using contraceptive pills than female GPs. Female smoking GPs less likely advised patients who were pregnant or who were using oral contraceptive pills to stop smoking than non-smoking female GPs (p <0.001). The percentage of GPs who have never distributed smoking cessation information was lower in men (41%) than in women (45%; p-value: 0.052). Minor differences in anti-smoking advice to patients between smoking and non-smoking general practitioners were found. The little involvement of GPs in health promotion activities regarding tobacco control is of concern.

E-Cigarettes and Smoking Cessation: Evidence from a Systematic Review and Meta-Analysis

PubMed Central

Rahman, Muhammad Aziz; Hann, Nicholas; Wilson, Andrew; Mnatzaganian, George; Worrall-Carter, Linda

2015-01-01

Background E-cigarettes are currently being debated regarding their possible role in smoking cessation and as they are becoming increasingly popular, the research to date requires investigation. Objectives To investigate whether the use of e-cigarettes is associated with smoking cessation or reduction, and whether there is any difference in efficacy of e-cigarettes with and without nicotine on smoking cessation. Data Sources A systematic review of articles with no limit on publication date was conducted by searching PubMed, Web of Knowledge and Scopus databases. Methods Published studies, those reported smoking abstinence or reduction in cigarette consumption after the use of e-cigarettes, were included. Studies were systematically reviewed, and meta-analyses were conducted using Mantel-Haenszel fixed-effect and random-effects models. Degree of heterogeneity among studies and quality of the selected studies were evaluated. Results Six studies were included involving 7,551 participants. Meta-analyses included 1,242 participants who had complete data on smoking cessation. Nicotine filled e-cigarettes were more effective for cessation than those without nicotine (pooled Risk Ratio 2.29, 95%CI 1.05-4.97). Amongst 1,242 smokers, 224 (18%) reported smoking cessation after using nicotine-enriched e-cigarettes for a minimum period of six months. Use of such e-cigarettes was positively associated with smoking cessation with a pooled Effect Size of 0.20 (95%CI 0.11-0.28). Use of e-cigarettes was also associated with a reduction in the number of cigarettes used. Limitations Included studies were heterogeneous, due to different study designs and gender variation. Whilst we were able to comment on the efficacy of nicotine vs. non-nicotine e-cigarettes for smoking cessation, we were unable to comment on the efficacy of e-cigarettes vs. other interventions for cessation, given the lack of comparator groups in the studies included in this meta-analysis. Conclusions Use of e-cigarettes is associated with smoking cessation and reduction. More randomised controlled trials are needed to assess effectiveness against other cessation methods. PMID:25822251

A mixed-method systematic review and meta-analysis of mental health professionals' attitudes toward smoking and smoking cessation among people with mental illnesses.

PubMed

Sheals, Kate; Tombor, Ildiko; McNeill, Ann; Shahab, Lion

2016-09-01

People with mental illnesses and substance abuse disorders are important targets for smoking cessation interventions. Mental health professionals (MHPs) are ideally placed to deliver interventions, but their attitudes may prevent this. This systematic review therefore aimed to identify and estimate quantitatively MHPs attitudes towards smoking and main barriers for providing smoking cessation support and to explore these attitudes in-depth through qualitative synthesis. The online databases AMED, EMBASE, Medline, PsychINFO, HMIC and CINAHL were searched in March 2015 using terms relating to three concepts: 'attitudes', 'mental health professionals' and 'smoking cessation'. Quantitative or qualitative studies of any type were included. Proportions of MHPs' attitudes towards smoking and smoking cessation were pooled across studies using random effects meta-analysis. Qualitative findings were evaluated using thematic synthesis. Thirty-eight studies including 16 369 participants were eligible for inclusion. Pooled proportions revealed that 42.2% [95% confidence interval (CI) = 35.7-48.8] of MHPs reported perceived barriers to smoking cessation interventions, 40.5% (95% CI = 30.4-51.0) negative attitudes towards smoking cessation and 45.0% (95% CI = 31.9-58.4) permissive attitudes towards smoking. The most commonly held beliefs were that patients are not interested in quitting (51.4%, 95% CI = 33.4-69.2) and that quitting smoking is too much for patients to take on (38%, 95% CI = 16.4-62.6). Qualitative findings were consistent with quantitative results, revealing a culture of smoking as 'the norm' and a perception of cigarettes as a useful tool for patients and staff. A significant proportion of mental health professionals hold attitudes and misconceptions that may undermine the delivery of smoking cessation interventions; many report a lack of time, training and confidence as main barriers to addressing smoking in their patients. © 2016 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

A review of smoking cessation services in women attending colposcopy clinics in Scotland.

PubMed

Rumbles, A U; Nicholson, S C; Court, S J

2012-02-01

The most common reason for women being referred to colposcopy clinics is an abnormal smear suggesting pre-cancerous change within the cervix. It has been demonstrated that in women with low-grade lesions, smoking cessation led to a reduction in size of the cervical lesion over a 6-month period. Smoking is also recognised as an independent risk factor for treatment failure of cervical intraepithelial neoplasia. As 'stop smoking' services have become an integral part of the colposcopy clinic at St John's Hospital, Livingston, a national survey was undertaken. The aim of the survey was to establish what smoking cessation information, advice and support is available in colposcopy clinics throughout Scotland, and if staff had attended standardised training on raising the issue of smoking. The study demonstrated that 52% of colposcopy clinics in Scotland always establish smoking status but only 37% of clinics discuss the benefits of smoking cessation in relation to abnormal cervical smears. There was inaccurate and inconsistent written and verbal advice given on the benefits of cessation and whether women should cut down or stop smoking completely. The majority of staff had not attended standardised training on how to raise the issue of smoking and very few clinics have established referral pathways for smoking cessation support.

Nurses' smoking behaviour related to cessation practice.

PubMed

Slater, Paul; McElwee, Gerard; Fleming, Paul; McKenna, Hugh

To examine the smoking behaviour, knowledge and attitudes of nurses, their willingness to provide smoking cessation support to patients, the accessibility of training in this area and their willingness to undertake future training in this area. A randomised sample of qualified nurses (n = 1,074) in statutory, private and voluntary sectors and across a variety of specialties were surveyed by postal questionnaire. Four focus groups were conducted in various settings before and after the survey. Of those who took part in the survey, 55% had never smoked, 19% were ex-smokers and 26% were smokers. Most agreed that nurses have a responsibility to help those who want to quit smoking. However, nurses who smoked rated their ability to help patients and their effectiveness as a role model lower than nurses who were ex-smokers or non-smokers. Smoking prevalence among nurses is no greater than in the general female population. Nurses who smoke are less motivated to provide cessation support for patients, have less positive attitudes to the value of smoking cessation, are less likely to have received smoking cessation training and are less likely to want further training. These results have implications for nurses' own smoking status, as well as their attitudes to cessation training, health promotion practice and future research.

Treating Nicotine Dependence and Preventing Smoking Relapse in Cancer Patients

PubMed Central

Chang, Eun Hae Estelle; Braith, Andrew; Hitsman, Brian; Schnoll, Robert A.

2017-01-01

Introduction Despite the well-documented harmful effects of smoking, many cancer patients continue to smoke. Smoking cessation is critical to address in this population given the associated increase in treatment toxicity, risk of second primary tumors, decrease in treatment response and higher disease-specific and all-cause mortality with continued smoking following a cancer diagnosis. This review seeks to summarize the latest recommendations and guidelines on smoking cessation treatment for patients diagnosed with cancer, and the evidence behind those recommendations. Areas covered We reviewed the latest evidence for smoking cessation treatments for cancer patients and the clinical guidelines and recommendation available for oncologists and health care providers. The unique aspects of nicotine dependence among patients diagnosed with cancer, and key challenges and barriers that cancer survivors and health care providers experience when considering smoking cessation treatments, and available clinical resources, are also discussed. Lastly, the authors summarize future directions in the field of smoking cessation treatment for cancer patients. Expert commentary While there are areas of improvement in research of smoking cessation treatment for cancer patients, critical under-explored areas remain. Nonetheless, providers should adhere to the NCCN guidelines and offer a brief counseling intervention to motivate patients to quit smoking when appropriate resources are not available. PMID:28808692

Determining Smoking Cessation Related Information, Motivation, and Behavioral Skills among Opiate Dependent Smokers in Methadone Treatment.

PubMed

Cooperman, Nina A; Richter, Kimber P; Bernstein, Steven L; Steinberg, Marc L; Williams, Jill M

2015-04-01

Over 80% of people in methadone treatment smoke cigarettes, and existing smoking cessation interventions have been minimally effective. To develop an Information-Motivation-Behavioral Skills (IMB) Model of behavior change based smoking cessation intervention for methadone maintained smokers, we examined smoking cessation related IMB factors in this population. Current or former smokers in methadone treatment (n = 35) participated in focus groups. Ten methadone clinic counselors participated in an individual interview. A content analysis was conducted using deductive and inductive approaches. Commonly known IMB factors related to smoking cessation were described. These factors included: the health effects of smoking and treatment options for quitting (information); pregnancy and cost of cigarettes (motivators); and coping with emotions, finding social support, and pharmacotherapy adherence (behavioral skills). IMB factors specific to methadone maintained smokers were also described. These factors included: the relationship between quitting smoking and drug relapse (information), the belief that smoking is the same as using drugs (motivator); and coping with methadone clinic culture and applying skills used to quit drugs to quitting smoking (behavioral skills). IMB strengths and deficits varied by individual. Methadone maintained smokers could benefit from research on an IMB Model based smoking cessation intervention that is individualized, addresses IMB factors common among all smokers, and also addresses IMB factors unique to this population.

Smoking, cessation, and cessation counseling in patients with cancer: A population-based analysis.

PubMed

Ramaswamy, Apoorva T; Toll, Benjamin A; Chagpar, Anees B; Judson, Benjamin L

2016-04-15

Smoking is known to be carcinogenic and an important factor in the outcome of cancer treatment. However, to the authors' knowledge, smoking habits and smoking cessation counseling in patients with cancer have been poorly studied. The authors sought to analyze smoking habits among Americans diagnosed with cancer in a nationally representative dataset. The cancer supplement of the National Health Interview Survey (NHIS) in 2010 was used to obtain information regarding self-reported smoking behavior in a representative sample of the US population. Cancer history, smoking history, quitting behavior, cessation counseling, cessation approaches, and sociodemographic variables were analyzed. A total of 27,157 individuals were interviewed for the NHIS in 2010, representing 216,052,891 individuals, 7,058,135 of whom had ever smoked and 13,188,875 of whom had been told that they had cancer. Approximately 51.7% of individuals diagnosed with cancer and who were active smokers reported being counseled to quit smoking by a health professional within the previous 12 months. Cancer survivors were no more likely to quit smoking than individuals in the general population. Those diagnosed with a tobacco-related cancer were found to be no more likely to report quitting smoking than those with other types of cancers. Rates of quitting did not appear to vary based on the type of smoking cessation method used (P = .50). Patients with cancer, including those diagnosed with a tobacco-related cancer, do not appear to be more likely to quit smoking than the general population. Only approximately one-half of patients with cancer who smoke are counseled to quit. Smoking cessation in patients with cancer is an important area for intervention and investigation. © 2016 American Cancer Society.

Smoking cessation results in a clinical lung cancer screening program

PubMed Central

McKee, Andrea B.; Regis, Shawn M.; Wald, Christoph; Flacke, Sebastian; McKee, Brady J.

2016-01-01

Background Lung cancer screening may provide a “teachable moment” for promoting smoking cessation. This study assessed smoking cessation and relapse rates among individuals undergoing follow-up low-dose chest computed tomography (CT) in a clinical CT lung screening program and assessed the influence of initial screening results on smoking behavior. Methods Self-reported smoking status for individuals enrolled in a clinical CT lung screening program undergoing a follow-up CT lung screening exam between 1st February, 2014 and 31st March, 2015 was retrospectively reviewed and compared to self-reported smoking status using a standardized questionnaire at program entry. Point prevalence smoking cessation and relapse rates were calculated across the entire population and compared with exam results. All individuals undergoing screening fulfilled the National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Lung Cancer Screening v1.2012® high-risk criteria and had an order for CT lung screening. Results A total of 1,483 individuals underwent a follow-up CT lung screening exam during the study interval. Smoking status at time of follow-up exam was available for 1,461/1,483 (98.5%). A total of 46% (678/1,461) were active smokers at program entry. The overall point prevalence smoking cessation and relapse rates were 20.8% and 9.3%, respectively. Prior positive screening exam results were not predictive of smoking cessation (OR 1.092; 95% CI, 0.715–1.693) but were predictive of reduced relapse among former smokers who had stopped smoking for 2 years or less (OR 0.330; 95% CI, 0.143–0.710). Duration of program enrollment was predictive of smoking cessation (OR 0.647; 95% CI, 0.477–0.877). Conclusions Smoking cessation and relapse rates in a clinical CT lung screening program rates are more favorable than those observed in the general population. Duration of participation in the screening program correlated with increased smoking cessation rates. A positive exam result correlated with reduced relapse rates among smokers recently quit smoking. PMID:27606076

The Effect of Positive Group Psychotherapy and Motivational Interviewing on Smoking Cessation: A Qualitative Descriptive Study.

PubMed

Lee, Eun Jin

The purpose of this study was to describe the process and evaluate the effect of positive group psychotherapy and motivational interviewing as an intervention for smoking cessation. A qualitative descriptive study was conducted at a university in South Korea. Positive group psychotherapy and motivational interviewing were attended by 36 smokers for 1 hour once a week, for 6 hours. A recorded exit interview was conducted after the intervention. The resulting transcripts were analyzed with content analysis and thematic analysis. Among the 36 study participants, the importance of stopping smoking was rated higher in the successful cessation (defined as those who ceased smoking for at least 3 months; hereafter, success group) group (8.6 ± 0.4, n = 10) than in the failed cessation (defined as those who did not cease smoking for at least 3 months; hereafter, failure group) group (7.75 ± 0.3, n = 26; p < .01). The confidence to stop smoking was rated higher by the successes (8.4 ± 0.3) than by the failures (5.5 ± 0.4; p < .01). More successes wanted to stop smoking for the sake of their loved ones (60%) and health (50%), whereas more failures wanted to stop smoking for saving money (45.5%). Failures had more cross-addiction than successes (three to four addictions: 31.5% vs. 20%). When participants were asked to find 10 personality merits, 78% of the successes and 47% of the failures found their 10 merits. The therapeutic process was described as "sharing the smoking cessation process with others," "detailed guidance for stress management and smoking cessation," and "compliments about efforts for smoking cessation." The importance of and confidence in smoking cessation were predictors for successful cessation for 3-6 months. Motivational interviewing increased motivations, whereas positive group psychotherapy increased positive thoughts and confidence.

Smoking Cessation Awareness and Utilization Among Lesbian, Gay, Bisexual, and Transgender Adults: An Analysis of the 2009–2010 National Adult Tobacco Survey

PubMed Central

Lee, Youn Ok; Bennett, Keisa; Goodin, Amie

2016-01-01

Introduction: Each year, there are more than 480 000 deaths in the United States attributed to smoking. Lesbian, gay, bisexual and transgender (LGBT) adults are a vulnerable population that smokes at higher rates than heterosexuals. Methods: We used data collected from the National Adult Tobacco Survey 2009–2010, a large, nationally representative study using a randomized, national sample of US landline and cellular telephone listings, (N = 118 590). We compared LGBT adults to their heterosexual counterparts with regard to exposure to advertisements promoting smoking cessation, and awareness and use of tobacco treatment services, including quitlines, smoking cessation classes, health professional counseling, nicotine replacement therapy, and medications. Results: Fewer GBT men, compared to heterosexual men, were aware of the quitline. However, LGBT individuals have similar exposure to tobacco cessation advertising, as well as similar awareness of and use of evidence based cessation methods as compared to heterosexual peers. Conclusions: The similarly of awareness and use of cessation support indicates a need for LGBT-specific efforts to reduce smoking disparities. Potential interventions would include: improving awareness of, access to and acceptability of current cessation methods for LGBT patients, developing tailored cessation interventions, and denormalizing smoking in LGBT community spaces. PMID:26014455

Smoking Cessation Induces Profound Changes in the Composition of the Intestinal Microbiota in Humans

PubMed Central

Biedermann, Luc; Zeitz, Jonas; Mwinyi, Jessica; Sutter-Minder, Eveline; Rehman, Ateequr; Ott, Stephan J.; Steurer-Stey, Claudia; Frei, Anja; Frei, Pascal; Scharl, Michael; Loessner, Martin J.; Vavricka, Stephan R.; Fried, Michael; Schreiber, Stefan; Schuppler, Markus; Rogler, Gerhard

2013-01-01

Background The human intestinal microbiota is a crucial factor in the pathogenesis of various diseases, such as metabolic syndrome or inflammatory bowel disease (IBD). Yet, knowledge about the role of environmental factors such as smoking (which is known to influence theses aforementioned disease states) on the complex microbial composition is sparse. We aimed to investigate the role of smoking cessation on intestinal microbial composition in 10 healthy smoking subjects undergoing controlled smoking cessation. Methods During the observational period of 9 weeks repetitive stool samples were collected. Based on abundance of 16S rRNA genes bacterial composition was analysed and compared to 10 control subjects (5 continuing smokers and 5 non-smokers) by means of Terminal Restriction Fragment Length Polymorphism analysis and high-throughput sequencing. Results Profound shifts in the microbial composition after smoking cessation were observed with an increase of Firmicutes and Actinobacteria and a lower proportion of Bacteroidetes and Proteobacteria on the phylum level. In addition, after smoking cessation there was an increase in microbial diversity. Conclusions These results indicate that smoking is an environmental factor modulating the composition of human gut microbiota. The observed changes after smoking cessation revealed to be similar to the previously reported differences in obese compared to lean humans and mice respectively, suggesting a potential pathogenetic link between weight gain and smoking cessation. In addition they give rise to a potential association of smoking status and the course of IBD. PMID:23516617

Tobacco use among Iraq- and Afghanistan-era veterans: a qualitative study of barriers, facilitators, and treatment preferences.

PubMed

Gierisch, Jennifer M; Straits-Tröster, Kristy; Calhoun, Patrick S; Beckham, Jean C; Acheson, Shawn; Hamlett-Berry, Kim

2012-01-01

Military service and combat exposure are risk factors for smoking. Although evidence suggests that veterans are interested in tobacco use cessation, little is known about their reasons for quitting, treatment preferences, and perceived barriers to effective tobacco use cessation treatment. Our study objective was to elicit perspectives of Iraq- and Afghanistan-era veterans who had not yet quit smoking postdeployment to inform the development of smoking cessation services for this veteran cohort. We conducted 3 focus groups among 20 participants in October 2006 at the Durham Veterans Affairs Medical Center to explore issues on tobacco use and smoking cessation for Iraq- and Afghanistan-era veterans who continued to smoke postdeployment. We used qualitative content analysis to identify major themes and organize data. Veterans expressed the belief that smoking was a normalized part of military life and described multiple perceived benefits of smoking. Although veterans expressed a high level of interest in quitting, they listed several behavioral, situational, and environmental triggers that derailed smoking cessation. They expressed interest in such cessation treatment features as flexible scheduling, free nicotine replacement therapy, peer support, and family inclusion in treatment. Our results indicate that the newest cohort of veterans perceives smoking as endemic in military service. However, they want to quit smoking and identified several personal and environmental obstacles that make smoking cessation difficult. Our findings may inform programmatic efforts to increase successful quit attempts in this unique veteran population.

Engaging nurses in smoking cessation: Challenges and opportunities in Turkey.

PubMed

Nichter, Mimi; Çarkoğlu, Aslı; Nichter, Mark; Özcan, Şeyda; Uysal, M Atilla

2018-02-01

This paper discusses the training of nurses in smoking cessation as part of routine patient care in Turkey. Formative research was carried out prior to training to identify challenges faced by smokers when trying to quit. Site visits to government hospitals and cessation clinics were conducted to observe health care provider-patient interactions involving behavior change. Four culturally sensitive cessation training workshops for nurses (n = 54) were conducted in Istanbul. Following training, nurses were debriefed on their experiences delivering cessation advice. Challenges to cessation counseling included lack of time and incentives for nurse involvement; lack of skills to deliver information about the harm of smoking and benefits of quitting; the medicalization of cessation through the use of pharmaceuticals; and hospital policy which devalues time spent on cessation activities. The pay-for-performance model currently adopted in hospitals has de-incentivized doctor participation in cessation clinics. Nurses play an important role in smoking cessation in many countries. In Turkey, hospital policy will require change so that cessation counseling can become a routine part of nursing practice, incentives for providing cessation are put in place, and task sharing between nurses and doctors is clarified. Nurses and doctors need to receive training in both the systemic harms of smoking and cessation counseling skills. Opportunities, challenges and lessons learned are highlighted. Copyright © 2017 Elsevier B.V. All rights reserved.

Predictors of Utilization of a Novel Smoking Cessation Smartphone App

PubMed Central

Zeng, Emily Y.; Vilardaga, Roger; Heffner, Jaimee L.; Mull, Kristin E.

2015-01-01

Abstract Background: Understanding the characteristics of high and low utilizers of smartphone applications (apps) for smoking cessation would inform development of more engaging and effective apps, yet no studies to date have addressed this critical question. Informed by prior research on predictors of cessation Web site utilization, this study examines the degree to which baseline demographic factors (gender, age, and education), smoking-related factors (smoking level and friends' smoking), and psychological factors (depression and anxiety) are predictive of utilization of a smartphone app for smoking cessation called SmartQuit. Materials and Methods: Data came from 98 participants randomized to SmartQuit as part of a pilot trial from March to May 2013. We used negative binomial count regressions to examine the relationship between user characteristics and utilization of the app over an 8-week treatment period. Results: Lower education (risk ratio [RR]=0.492; p=0.021), heavier smoking (RR=0.613; p=0.033), and depression (RR=0.958; p=0.017) prospectively predicted lower app utilization. Women (RR=0.320; p=0.022), those with lower education (RR=0.491; p=0.013), and heavier smokers (RR=0.418; p=0.039) had lower utilization of app features known to predict smoking cessation. Conclusions: Many of the predictors of utilization of smoking cessation apps are the same as those of cessation Web sites. App-delivered smoking cessation treatment effectiveness could be enhanced by focusing on increasing engagement of women, those with lower education, heavy smokers, and those with current depressive symptoms. PMID:26171733

Smoking behaviour and preferences for cessation support among clients of an Indigenous community-controlled health service.

PubMed

Cockburn, Nicole; Gartner, Coral; Ford, Pauline J

2018-03-02

Reducing smoking prevalence among Indigenous Australians is a vital part of closing the health gap between Indigenous and non-Indigenous Australians. Community-controlled health clinics are an important setting for delivering smoking cessation advice and assistance. This study measured tobacco and e-cigarette use, knowledge of smoking-related health effects, motivations to quit and interest in cessation aids. Clients of Aboriginal & Torres Strait Islander Community Health Service dental clinics in Southeast Queensland (n = 421) completed a brief written questionnaire while in the waiting room. Nearly half (n = 184, 47%) of the participants currently smoked daily, of which 9% (n = 7) currently used e-cigarettes. Few smokers (8%, n = 13) had no intention to quit smoking. For current smokers, previously used quit methods were abrupt cessation (42%, n = 78), nicotine replacement therapies (NRT; 25%, n = 45), prescription medications (23%, n = 43), e-cigarettes (9%, n = 17) and other methods (3%, n = 6). Current smokers were most interested in cutting down (85%, n = 110), abrupt cessation (75%, n = 98) and free NRT (72%, n = 101). Fewer (34%, n = 36) were interested in purchasing NRT for smoking cessation. Our study found there was interest in accessing smoking cessation aids among the clients of this community-controlled health clinic, particularly if provided free of charge. Embedding smoking cessation advice and assistance into a range of community-controlled health clinics could provide opportunities for addressing the high smoking prevalence among Indigenous Australians. © 2018 Australasian Professional Society on Alcohol and other Drugs.

Increasing Pediatricians' Smoking Cessation Promotion and Knowledge of the Smoking Cessation Trust.

PubMed

Thomas, Katharine E H; Kisely, Steve; Urrego, Fernando

2017-05-01

The link between second hand smoke exposure (SHSe) and health issues in children has been well established. The objective of this study was to determine if a short intervention implemented among pediatricians promotes improvement in the promotion of smoking cessation to caregivers and increase pediatricians' awareness of the Smoking Cessation Trust (SCT). Pediatricians from 6 clinics were randomly assigned to the control or intervention group. All pediatricians received a survey to assess baseline knowledge, confidence and behaviors in smoking cessation promotion and utilization of the SCT. Pediatricians in intervention group received an educational lecture delivered by a physician. Two months post intervention, pediatricians in the control and intervention group received a survey to assess changes from baseline. Out of 36 general pediatricians, 27 completed the surveys for use in the analysis of this study (75%). Intervention group made more referrals to the SCT, compared to controls (p=0.048) and to baseline (p=0.0065). Pediatricians in the intervention group were more confident in recommending the use of NRT (0.040) and schedule a follow up to discuss smoking cessation (p=0.029) after the intervention. The intervention group was more likely to refer caregivers to smoking cessation programs (p=0.027), discuss a child's health risk from SHSe (0.031) and recommending the use of NRT to help quit (p=0.047) post intervention. The results from this study indicate that a short intervention can increase confidence and behavior in various parameters of smoking cessation promotion and significantly improve the rate in which pediatricians refer smoking caregivers to the SCT.

The effectiveness of smoking cessation interventions prior to surgery: a systematic review.

PubMed

Cropley, Mark; Theadom, Alice; Pravettoni, Gabriella; Webb, Gemma

2008-03-01

The objective of this review was to evaluate the effectiveness of smoking cessation interventions prior to surgery and examine smoking cessation rates at 6 months follow-up. The Cochrane Library Database, PsycINFO, EMBASE, Medline, and Cinahl databases were searched using the terms: smok$, smoking cessation, tobacco, cigar$, preop$, operati$, surg$, randomi*ed control$ trial, intervention, program$, cessation, abstinen$, quit. Further articles were obtained from reference lists. The search was limited to articles on adults, written in English and published up to December 2006. Only randomized control trials (RCTs) that incorporated smoking cessation interventions to patients awaiting elective surgery were included. Seven studies met the inclusion criteria. Methodological quality was assessed by all the authors. The findings revealed that short-term quit rates (or a reduction by more than half of normal daily rate) ranged from 18% to 93% in patients receiving a smoking intervention (mean 55%), compared with a range of 2%-65% of controls (mean = 27.7%). Two studies examined smoking status at 6 months but these revealed no significant difference in abstinence rates between patients who had received an intervention and those that had not. Studies that incorporated counseling in addition to nicotine replacement therapy appeared to show greater benefits. It is concluded that smoking cessation interventions prior to surgery are effective in helping patients to quit smoking. However, such effects appear to be short-lived. Future research needs to examine intervention and patient factors to see whether tailoring the smoking cessation intervention specifically to the patient improves overall abstinence rates.

Correlates of Cessation Success among Romanian Adults

PubMed Central

Dziankowska-Zaborszczyk, Elżbieta; Makowiec-Dąbrowska, Teresa

2014-01-01

Background. Tobacco smoking and its consequences are a serious public health problem in Romania. Evidence-based data on factors associated with successful smoking cessation are crucial to optimize tobacco control. The aim of the study was to determine the sociodemographic and other factors associated with smoking cessation success among adults. Materials and Methods. Data was from a sample of 4,517 individuals derived from the Global Adult Tobacco Survey (GATS). GATS is a cross-sectional, nationally representative household survey implemented in Romania in 2011. Data was analyzed with logistic regression. Results. Among females, the quit rate was 26.3% compared with 33.1% in males (P < 0.02). We found disparities in cessation success among the analyzed groups of respondents. Being economically active, being aged 40 and above, and having an awareness of smoking health consequences were associated with long-term quitting smoking among men, while initiating smoking at a later age increased the odds of quitting smoking among women. However, cohabitation with nonsmokers was the strongest predictor of successful cessation among both genders. Conclusion. Programs increasing quit rates and encourage cessation among groups less likely to quit, adopting voluntary smoke-free homes, and increasing the awareness of smoking and tobacco pollution risks are needed. PMID:24995319

Correlates of cessation success among Romanian adults.

PubMed

Kaleta, Dorota; Usidame, Bukola; Dziankowska-Zaborszczyk, Elżbieta; Makowiec-Dąbrowska, Teresa

2014-01-01

Tobacco smoking and its consequences are a serious public health problem in Romania. Evidence-based data on factors associated with successful smoking cessation are crucial to optimize tobacco control. The aim of the study was to determine the sociodemographic and other factors associated with smoking cessation success among adults. Data was from a sample of 4,517 individuals derived from the Global Adult Tobacco Survey (GATS). GATS is a cross-sectional, nationally representative household survey implemented in Romania in 2011. Data was analyzed with logistic regression. Among females, the quit rate was 26.3% compared with 33.1% in males (P < 0.02). We found disparities in cessation success among the analyzed groups of respondents. Being economically active, being aged 40 and above, and having an awareness of smoking health consequences were associated with long-term quitting smoking among men, while initiating smoking at a later age increased the odds of quitting smoking among women. However, cohabitation with nonsmokers was the strongest predictor of successful cessation among both genders. Programs increasing quit rates and encourage cessation among groups less likely to quit, adopting voluntary smoke-free homes, and increasing the awareness of smoking and tobacco pollution risks are needed.

Implementation of Workplace-Based Smoking Cessation Support Activities and Smoking Cessation Among Employees: The Finnish Public Sector Study

PubMed Central

Kivimäki, Mika; Oksanen, Tuula; Pentti, Jaana; Heponiemi, Tarja; Väänänen, Ari; Virtanen, Marianna; Vahtera, Jussi

2012-01-01

Objectives. We investigated the relationship between implementation of workplace smoking cessation support activities and employee smoking cessation. Methods. In 2 cohort studies, participants were 6179 Finnish public-sector employees who self-reported as smokers at baseline in 2004 (study 1) or 2008 (study 2) and responded to follow-up surveys in 2008 (study 1; n = 3298; response rate = 71%) or 2010 (study 2; n = 2881; response rate = 83%). Supervisors’ reports were used to assess workplace smoking cessation support activities. We conducted multilevel logistic regression analyses to examine changes in smoking status. Results. After adjustment for sociodemographic characteristics, number of cigarettes smoked per day, work unit size, shift work, type of job contract, health status, and health behaviors, baseline smokers whose supervisors reported that the employing agency had offered pharmacological treatments or financial incentives were more likely than those in workplaces that did not offer such support to have quit smoking. In general, associations were stronger among moderate or heavy smokers (≥ 10 cigarettes/day) than among light smokers (< 10 cigarettes/day). Conclusions. Cessation activities offered by employers may encourage smokers, particularly moderate or heavy smokers, to quit smoking. PMID:22594722

Smoking cessation behavioural therapy in disadvantaged neighbourhoods: an explorative analysis of recruitment channels.

PubMed

Benson, Fiona E; Nierkens, Vera; Willemsen, Marc C; Stronks, Karien

2015-07-31

The optimum channel(s) used to recruit smokers living in disadvantaged neighbourhoods for smoking cessation behavioural therapy (SCBT) is unknown. This paper examines the channels through which smokers participating in a free, multi-session SCBT programme heard about and were referred to this service in a disadvantaged neighbourhood, and compares participants' characteristics and attendance between channels. 109 participants, recruited from free SCBT courses in disadvantaged areas of two cities in the Netherlands, underwent repeated surveys. Participants were asked how they heard about the SCBT and who referred them. Participant characteristics were compared between five channels, including the General Practitioner (GP), a community organisation, word of mouth, another health professional, and media or self-referred. Whether the channels through which people heard about or were referred to the service predicted attendance of ≥4 sessions was investigated with logistic regression analysis. Over a quarter of the participants had no or primary education only, and more than half belonged to ethnic minority populations. Most participants heard through a single channel. More participants heard about (49%) and were referred to (60%) the SCBT by the (GP) than by any other channel. Factors influencing quit success, including psychosocial factors and nicotine dependence, did not differ significantly between channel through which participants heard about the SCBT. No channel significantly predicted attendance. The GP was the single most important source to both hear about and be referred to smoking cessation behavioural therapy in a disadvantaged neighbourhood. A majority of participants of low socioeconomic or ethnic minority status heard about the programme through this channel. Neither the channel through which participants heard about or were referred to the therapy influenced attendance. As such, concentrating on the channel which makes use of the existing infrastructure and which is highest yielding, the GP, would be an appropriate strategy if recruitment resources were scarce.

Characterizing smoking, cessation services, and quit interest across outpatient substance abuse treatment modalities

PubMed Central

McClure, Erin A.; Acquavita, Shauna P.; Dunn, Kelly E.; Stoller, Kenneth B.; Stitzer, Maxine L.

2013-01-01

The majority of individuals seeking treatment for substance use disorders are cigarette smokers, yet smoking cessation is rarely addressed during treatment. Conducting a detailed smoking-related characterization of substance abuse treatment patients across treatment modalities may facilitate the development of tailored treatment strategies. This study administered a battery of self-report instruments to compare tobacco use, quit attempts, smoking knowledge and attitudes, program services, and interest in quitting among smoking patients enrolled in opioid replacement therapy (ORT) vs. non-opioid replacement (non-ORT). ORT compared with non-ORT participants smoked more heavily, had greater tobacco dependence, and endorsed greater exposure to smoking cessation services at their treatment programs. Favorable attitudes towards cessation during treatment were found within both groups. These data identify several potential clinical targets, most notably including confidence in abstaining and attitudes toward cessation pharmacotherapies that may be addressed by substance abuse treatment clinics. PMID:23988192

Profile of women who carried out smoking cessation treatment: a systematic review

PubMed Central

Pereira, Caroline Figueira; de Vargas, Divane

2015-01-01

OBJECTIVE Analyze the profile of women, in health services, who carry out treatment for smoking cessation. METHODS Systematic review that used the following sources of information: Cummulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, Biblioteca Virtual em Saúde (BVS), Scopus and Web of Science. We included quantitative studies that addressed the characterization of women, in health services, who carried out treatment for smoking cessation, resulting in 12 articles for analysis. The assessment of the methodological quality of the studies was performed using the instrument MAStARI from Joanna Briggs Institute. RESULTS The predominant profile of women who carried out treatment for smoking cessation in health services was composed of white, married, employed, and highly level educated women. Women who carried out the treatment for smoking cessation in specialized services had a more advanced age, were white, were married and had a diagnosis of depression. The quality level of most studies was moderate. CONCLUSIONS The profile of women who carry out treatment for smoking cessation, either in general or specialized health services, is composed of white, married, and highly level educated women. Publications about smoking women are scarce and the lack of Brazilian studies characterizing the profile of women who start treatment for smoking cessation shows the need for studies that explore this subject. PMID:26247386

Profile of women who carried out smoking cessation treatment: a systematic review.

PubMed

Pereira, Caroline Figueira; de Vargas, Divane

2015-01-01

OBJECTIVE Analyze the profile of women, in health services, who carry out treatment for smoking cessation. METHODS Systematic review that used the following sources of information: Cummulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, Biblioteca Virtual em Saúde (BVS), Scopus and Web of Science. We included quantitative studies that addressed the characterization of women, in health services, who carried out treatment for smoking cessation, resulting in 12 articles for analysis. The assessment of the methodological quality of the studies was performed using the instrument MAStARI from Joanna Briggs Institute. RESULTS The predominant profile of women who carried out treatment for smoking cessation in health services was composed of white, married, employed, and highly level educated women. Women who carried out the treatment for smoking cessation in specialized services had a more advanced age, were white, were married and had a diagnosis of depression. The quality level of most studies was moderate. CONCLUSIONS The profile of women who carry out treatment for smoking cessation, either in general or specialized health services, is composed of white, married, and highly level educated women. Publications about smoking women are scarce and the lack of Brazilian studies characterizing the profile of women who start treatment for smoking cessation shows the need for studies that explore this subject.

Craving and nicotine withdrawal in a Spanish smoking cessation sample.

PubMed

Piñeiro, Bárbara; López-Durán, Ana; Fernández del Río, Elena; Martínez, Úrsula; Brandon, Thomas H; Becoña, Elisardo

2014-01-01

Craving and nicotine withdrawal syndrome (NWS) are components of the tobacco use disorder in DSM-5. They both appear after smoking cessation or an abrupt reduction in tobacco use, and they are associated with both short and long-term smoking-cessation outcomes. The aim of the present study was to examine the association of craving and withdrawal with smoking cessation at the end of the treatment and relapse at 3 months follow-up in a Spanish sample of smokers. The sample comprised 342 smokers (37.7% men; 62.3% women) receiving a cognitive-behavioral treatment for smoking cessation. The assessments of craving and withdrawal were conducted using the Minnesota Nicotine Withdrawal Scale. Abstainers at the end of the treatment, compared to non abstainers, showed significantly lower post-treatment withdrawal, and post-treatment craving. Furthermore, they had lower scores in pre-treatment nicotine dependence. Among abstainers, craving decreased significantly from pre-cessation levels, while in those participants who did not quit smoking it remained on the same levels. High nicotine dependence was a predictor of smoking at the end of the treatment, whereas high nicotine withdrawal predicted relapse at 3 months. Findings support the robust role of craving and NWS in smoking cessation and relapse, although they differ in their specific patterns of change over time.

Predictors of medication adherence and smoking cessation among smokers under community corrections supervision.

PubMed

Cropsey, Karen L; Clark, C Brendan; Stevens, Erin N; Schiavon, Samantha; Lahti, Adrienne C; Hendricks, Peter S

2017-02-01

Individuals in the U.S. criminal justice system now represent over 12% of all current U.S. smokers. With smoking banned in most U.S. jails and prisons, the cessation focus for this population has shifted to individuals who are under community correction supervision (e.g., probation, parole). The aim of this study was to examine predictors of successful smoking cessation among criminal justice individuals supervised in the community. Five hundred participants under community corrections supervision were randomized to receive either four sessions of smoking cessation counseling or no counseling in conjunction with 12weeks of bupropion treatment plus brief physician advice to quit. Logistic regression analyses examined associations of smoking variables with medication adherence and successful abstinence. Mediation analysis evaluated the indirect effects of medication adherence on smoking abstinence. The strongest associate of medication adherence was previous use of bupropion, while the strongest associate of smoking abstinence was medication adherence. Mediation analysis indicated that previous use of bupropion indirectly increased cessation rates through the pathway of increased medication adherence. These results highlight the importance of medication adherence for smoking cessation among community corrections smokers. Providing exposure to medication may be a promising intervention to increase medication adherence and subsequent cessation rates in this population. Copyright © 2016 Elsevier Ltd. All rights reserved.

Comparative effectiveness of post-discharge interventions for hospitalized smokers: study protocol for a randomized controlled trial

PubMed Central

2012-01-01

Background A hospital admission offers smokers an opportunity to quit. Smoking cessation counseling provided in the hospital is effective, but only if it continues for more than one month after discharge. Providing smoking cessation medication at discharge may add benefit to counseling. A major barrier to translating this research into clinical practice is sustaining treatment during the transition to outpatient care. An evidence-based, practical, cost-effective model that facilitates the continuation of tobacco treatment after discharge is needed. This paper describes the design of a comparative effectiveness trial testing a hospital-initiated intervention against standard care. Methods/design A two-arm randomized controlled trial compares the effectiveness of standard post-discharge care with a multi-component smoking cessation intervention provided for three months after discharge. Current smokers admitted to Massachusetts General Hospital who receive bedside smoking cessation counseling, intend to quit after discharge and are willing to consider smoking cessation medication are eligible. Study participants are recruited following the hospital counseling visit and randomly assigned to receive Standard Care or Extended Care after hospital discharge. Standard Care includes a recommendation for a smoking cessation medication and information about community resources. Extended Care includes up to three months of free FDA-approved smoking cessation medication and five proactive computerized telephone calls that use interactive voice response technology to provide tailored motivational messages, offer additional live telephone counseling calls from a smoking cessation counselor, and facilitate medication refills. Outcomes are assessed at one, three, and six months after hospital discharge. The primary outcomes are self-reported and validated seven-day point prevalence tobacco abstinence at six months. Other outcomes include short-term and sustained smoking cessation, post-discharge utilization of smoking cessation treatment, hospital readmissions and emergency room visits, and program cost per quit. Discussion This study tests a disseminable smoking intervention model for hospitalized smokers. If effective and widely adopted, it could help to reduce population smoking rates and thereby reduce tobacco-related mortality, morbidity, and health care costs. Trial registration United States Clinical Trials Registry NCT01177176. PMID:22852832

Smoking, mental illness and socioeconomic disadvantage: analysis of the Australian National Survey of Mental Health and Wellbeing

PubMed Central

2013-01-01

Background High rates of smoking and lower rates of smoking cessation are known to be associated with common mental disorders such as anxiety and depression, and with individual and community measures of socioeconomic status. It is not known to what extent mental illness and socioeconomic status might be jointly associated with smoking behaviour. We set out to examine the relationship between mental illness, measures of socioeconomic disadvantage and both current smoking and smoking cessation rates. Methods We used data from the 2007 Australian National Survey of Mental Health and Wellbeing to examine the relationship between mental illness, socioeconomic status and both current smoking and smoking cessation. We used cross-classified tables and logistic regression to examine the relationship between psychosocial and sociodemographic predictors and current smoking. We also used proportional hazards regression to examine the relationship between the factors and smoking cessation. Results Both mental illness and socioeconomic status were independently associated with current smoking and with lower likelihood of smoking cessation, with gradients in smoking by mental health status being observed within levels of socioeconomic indicators and vice versa. Having a mental illness in the past 12 months was the most prevalent factor strongly associated with smoking, affecting 20.0% of the population, associated with increased current smoking (OR 2.43; 95% CI: 1.97-3.01) and reduced likelihood of smoking cessation (HR: 0.77; 95% CI: 0.65-0.91). Conclusions The association between mental illness and smoking is not explained by the association between mental illness and socioeconomic status. There are strong socioeconomic and psychosocial gradients in both current smoking and smoking cessation. Incorporating knowledge of the other adverse factors in smokers’ lives may increase the penetration of tobacco control interventions in population groups that have historically benefitted less from these activities. PMID:23663362

DENTAL PATIENT KNOWLEDGE ABOUT THE EFFECTS OF SMOKING AND ATTITUDES ABOUT THE ROLE OF DENTISTS IN SMOKING CESSATION.

PubMed

Yahya, Nurul Asyikin; Saub, Roslan; Nor, Mariani Md; Yusoff, Noriah

2017-03-01

Dentists can offer their patients who smoke tobacco assistance with smoking cessation. We conducted this study to assess dental patient knowledge about the effects of smoking and perceptions and attitudes regarding the role of dentists in smoking cessation counselling. We conducted this study to inform tobacco cessation programs that could potentially include dentists. We conducted a cross-sectional study using a self-administered questionnaire among 375 patients. The mean age of subjects was 33.4 years; females comprised 51.5%. Participants were divided into 3 groups: those who never smoked (n = 263, 70.7%), smokers (n = 92, 24.7%), and ex-smokers (n = 17, 4.5%). Significantly more participants (p = 0.046) who never smoked (92.9%) knew smoking can cause bad breath than smokers (86.9%). Significantly more participants (p = 0.002) who never smoked (74.8%) knew smoking can cause periodontal disease than smokers (57.6%). Significantly more participants (p < 0.001) who never smoked (84.5%) knew smoking can cause oral cancer than smokers (66.7%). Significantly more participants (p < 0.001) who never smoked (86.7%) knew smoking can cause lung cancer than smokers (69.7%). Significantly more participants who never smoked (85.5%) felt dentists should be interested in the smoking status of their patients (p = 0.004) than smokers (72.6%). Significantly more participants (p = 0.08) who never smoked (69.6%) stated dentists should give smoking cessation advice than smokers/ex-smokers (59.0%). Smoker/ ex-smokers had less knowledge about the effects of smoking on oral and general health than non-smokers. Both smokers/ex-smokers and non-smokers felt dentists should provide smoking cessation advice.

Smoking prevalence and beliefs on smoking cessation among members of the Japanese Cancer Association in 2006 and 2010.

PubMed

Kumiko, Saika; Tomotaka, Sobue; Masakazu, Nakamura; Akira, Oshima; Keiji, Wakabayashi; Nobuyuki, Hamajima; Yumiko, Mochizuki; Rie, Yamaguchi; Kazuo, Tajima

2012-08-01

Smoking is a significant contributing factor to disease-related deaths worldwide. Members of the Japanese Cancer Association (JCA) can play a leading role in helping people to live tobacco-free through social action. In 2010, this study assessed smoking prevalence among JCA members and their attitudes toward smoking, smoking cessation, and their responsibilities. Results of the 2010 survey were compared with those of a 2006 survey. Final response rates were 60.8% in the 2006 survey and 47.4% in the 2010 survey, and the current smoking rates were 9.0% and 5.3%, respectively. Regarding concern by current smokers over smoking cessation, the percentage of smokers who were ready to quit smoking within the next month increased from 4.9% to 6.3% between 2006 and 2010. Most JCA members agreed with antismoking actions such as smoking bans in all workplaces, public places, or while walking in the street, regulation restricting the sale and distribution of tobacco to children, tobacco education at school, use of tobacco tax for health, provision of information on tobacco, and smoking cessation support. Approximately 30% of responders disagreed on actions to raise the price of tobacco, regulations restricting the sale of tobacco, health warnings on tobacco packaging, bans on tobacco advertisement, and antismoking campaigns. Barriers to smoking cessation interventions identified were physician's time required to provide interventions, resistance of patients to smoking cessation advice, and lack of education on tobacco control. Not only antismoking actions but also support of smokers by health professionals through adequate education on smoking cessation treatment is needed in the future. © 2012 Japanese Cancer Association.

Beliefs of Turkish and Moroccan Immigrants in The Netherlands about Smoking Cessation: Implications for Prevention

ERIC Educational Resources Information Center

Nierkens, Vera; Stronks, Karien; van Oel, Clarine J.; de Vries, Hein

2005-01-01

Tobacco smoking is a very important preventable cause of mortality and morbidity, and this is also the case in immigrant populations. Therefore, smoking cessation interventions need to take these groups into account. Insight into the applicability of behavioral smoking cessation interventions for non-Western populations is necessary. The objective…

The Effect of a Multiple Treatment Program and Maintenance Procedures on Smoking Cessation.

ERIC Educational Resources Information Center

Powell, Don R.

The efficacy of a multiple treatment smoking cessation program and three maintenance strategies was evaluated. Phases I and II of the study involved 51 subjects who participated in a five-day smoking cessation project consisting of lectures, demonstrations, practice exercises, negative smoking, and the teaching of self-control procedures. At the…

Smoking cessation in pregnancy: psychosocial interventions and patient-focused perspectives

PubMed Central

Miyazaki, Yukiko; Hayashi, Kunihiko; Imazeki, Setsuko

2015-01-01

Background Smoking during pregnancy causes obstetric and fetal complications, and smoking cessation may have great benefits for the mother and the child. However, some pregnant women continue smoking even in pregnancy. Objective To review the literature addressing the prevalence of smoking during pregnancy, explore psychosocial factors associated with smoking, and review the evidence of psychosocial interventions for smoking cessation during pregnancy in recent years. Literature review Computerized Internet search results in PubMed for the years spanning from 2004 to 2014, as well as references cited in articles, were reviewed. A search for the keywords “smoking cessation pregnancy” and “intervention” and “clinical trials” yielded 52 citations. Thirty-five citations were identified as useful to this review for the evidence of psychosocial interventions for smoking cessation during pregnancy. Results The prevalence of smoking during pregnancy differs by country, reflecting the countries’ social, cultural, and ethnic backgrounds. Women who had socioeconomic disadvantages, problems in their interpersonal relationships, higher stress, depression, less social support, and who engaged in health-risk behaviors were more prone to smoking during pregnancy. Psychosocial interventions, such as counseling, are effective methods for increasing smoking cessation. Conclusion Smokers may have various psychosocial problems in addition to health problems. It is important to understand each individual’s social situation or psychosocial characteristics, and a psychosocial intervention focused on the characteristics of the individual is required. PMID:25960677

Electronic Cigarettes for Smoking Cessation.

PubMed

Orellana-Barrios, Menfil A; Payne, Drew; Medrano-Juarez, Rita M; Yang, Shengping; Nugent, Kenneth

2016-10-01

The use of electronic cigarettes (e-cigarettes) is increasing, but their use as a smoking-cessation aid is controversial. The reporting of e-cigarette studies on cessation is variable and inconsistent. To date, only 1 randomized clinical trial has included an arm with other cessation methods (nicotine patches). The cessation rates for available clinical trials are difficult to compare given differing follow-up periods and broad ranges (4% at 12 months with non-nicotine e-cigarettes to 68% at 4 weeks with concomitant nicotine e-cigarettes and other cessation methods). The average combined abstinence rate for included prospective studies was 29.1% (combination of 6-18 months׳ rates). There are few comparable clinical trials and prospective studies related to e-cigarettes use for smoking cessation, despite an increasing number of citations. Larger randomized clinical trials are essential to determine whether e-cigarettes are effective smoking-cessation devices. Copyright © 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

Effects of E-cigarette Advertising Messages and Cues on Cessation Outcomes

PubMed Central

Jo, Catherine L.; Golden, Shelley D.; Noar, Seth M.; Rini, Christine; Ribisl, Kurt M.

2017-01-01

Objectives We examined effects of e-cigarette ad messages and visual cues on outcomes related to combustible cigarette smoking cessation: smoking cessation intention, smoking urges, and immediate smoking behavior. Methods US adult smokers (N = 3293) were recruited through Amazon Mechanical Turk and randomized to condition in a 3 (message: e-cigarette use anywhere, harm reduction, control) × 2 (e-cigarette cue presence or absence) between-subjects experiment. Stimuli were print ads for cigarette-like e-cigarettes (“cigalikes”) that were manipulated for the experimental conditions. We conducted ANOVA and logistic regression analyses to investigate effects of the manipulations. Results Message effects on cessation intention and smoking urges were not statistically significant. There was no evidence of cue effects or message × cue interactions across outcomes. Contrary to expectations, e-cigarette use anywhere and harm reduction messages were associated with lower odds of immediate smoking than the control message (AOREUA = 0.75, 95%CI = 0.58, 0.97, p = .026; AORHR = 0.72, 95%CI = 0.55, 0.93, p = .013). Conclusions E-cigarette use anywhere and harm reduction messages may encourage smoking cessation, given the observed reduction in immediate smoking. E-cigarette cues may not influence smoking cessation outcomes. Future studies should investigate whether message effects are a result of smokers believing e-cigarettes to be effective cessation aids. PMID:29242819

Postcessation weight gain concern as a barrier to smoking cessation: Assessment considerations and future directions.

PubMed

Germeroth, Lisa J; Levine, Michele D

2018-01-01

Concern about postcessation weight gain may be one potential barrier to quitting smoking. In this 'mini-review' of recent literature, we summarize findings on the relationship between postcessation weight gain concern and smoking cessation, and evaluate varied use of postcessation weight gain concern assessments and potential moderators of the postcessation weight gain concern-cessation association. We conducted a search using the terms "smoking" OR "smoking cessation" AND "weight concern" for articles published between January 1, 2011 and December 31, 2016. We identified 17 studies assessing postcessation weight gain concern, seven of which evaluated the postcessation weight gain concern-cessation association. The relationship between postcessation weight gain concern and smoking cessation was mixed. Recent studies varied in their assessments of postcessation weight gain concern, many of which were not validated and assessed correlates of this construct. Studies varied in their adjustment of demographic (e.g., sex), smoking-specific (e.g., smoking level), and weight-specific (e.g., body mass index) variables. The use of non-validated assessments and variability in testing covariates/moderators may contribute to conflicting results regarding the postcessation weight gain concern-cessation relationship. We recommend validating an assessment of postcessation weight gain concern, maintaining vigilance in testing and reporting covariates/moderators, and investigating trajectories of this construct over time and by smoking status to inform future assessment and intervention efforts. Copyright © 2017 Elsevier Ltd. All rights reserved.

Integrating smoking control policies into employee benefits: a survey of large California corporations.

PubMed Central

Schauffler, H H

1993-01-01

OBJECTIVES. Public health policy promotes the use of risk-rating health insurance and payment for smoking cessation as economic incentives to encourage smoking cessation. This study was undertaken to learn more about the adoption of these policies in large corporations. METHODS. A random sample survey of 280 private California corporations with more than 500 employees was undertaken to document the prevalence of policies integrating smoking control into employee benefit designs. RESULTS. Only 8.6% of large corporations had ever considered risk-rating health insurance premiums using smoking status and only 2.15% had implemented a risk-rating policy. Nearly 20% of the companies offered health insurance plans that covered smoking cessation services. Subsidization or payment for smoking cessation outside health insurance was provided by over 37% of the companies surveyed, and 87% had adopted formal work-site smoking policies. CONCLUSION. Benefit policies that provide financial support to smokers to participate in smoking cessation services are much more prevalent and are viewed more positively by the benefits managers in large corporations than are policies to risk-rate health insurance premiums on the basis of smoking. PMID:8362996

Financial strain indirectly influences smoking cessation through withdrawal symptom severity.

PubMed

Kendzor, Darla E; Businelle, Michael S; Waters, Aaron F; Frank, Summer G; Hébert, Emily T

2018-02-01

Financial strain has an adverse impact on smoking cessation. However, the mechanisms through which financial strain influences cessation remain unclear. The purpose of the current study was to determine whether financial strain indirectly influenced smoking cessation through withdrawal symptom severity. Participants (N=139) were primarily Black (63.3%) and female (57.6%) adults enrolled in a smoking cessation program at a safety-net hospital. A self-report financial strain questionnaire was completed one week prior to the scheduled quit date, and the Wisconsin Smoking Withdrawal Scale (WSWS) was completed on the day after the scheduled quit date. Biochemically-verified 7-day point prevalence abstinence was assessed four weeks after the scheduled quit date. Adjusted mediation analyses were conducted using the PROCESS macro for SPSS to evaluate the indirect effects of financial strain on smoking cessation via post-quit withdrawal symptom severity. Analyses indicated a significant indirect effect of financial strain on smoking cessation through total withdrawal symptom severity, B=0.027; 95% CI (0.003, 0.066); and specifically anger, B=0.035; 95% CI (0.008, 0.074), anxiety, B=0.021; 95% CI (0.001, 0.051), and sleep symptoms, B=0.015; 95% CI (0.005, 0.043). Greater pre-quit financial strain was associated with greater post-quit withdrawal symptom severity, which increased the likelihood of non-abstinence 4 weeks after the scheduled quit attempt. The direct effect of financial strain on smoking cessation was not significant in any of the mediation models. Findings: suggest that withdrawal severity is an underlying mechanism through which financial strain influences smoking cessation. Copyright © 2017 Elsevier B.V. All rights reserved.

Family and carer smoking control programmes for reducing children's exposure to environmental tobacco smoke.

PubMed

Behbod, Behrooz; Sharma, Mohit; Baxi, Ruchi; Roseby, Robert; Webster, Premila

2018-01-31

Children's exposure to other people's tobacco smoke (environmental tobacco smoke, or ETS) is associated with a range of adverse health outcomes for children. Parental smoking is a common source of children's exposure to ETS. Older children in child care or educational settings are also at risk of exposure to ETS. Preventing exposure to ETS during infancy and childhood has significant potential to improve children's health worldwide. To determine the effectiveness of interventions designed to reduce exposure of children to environmental tobacco smoke, or ETS. We searched the Cochrane Tobacco Addiction Group Specialised Register and conducted additional searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PsycINFO, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Education Resource Information Center (ERIC), and the Social Science Citation Index & Science Citation Index (Web of Knowledge). We conducted the most recent search in February 2017. We included controlled trials, with or without random allocation, that enrolled participants (parents and other family members, child care workers, and teachers) involved in the care and education of infants and young children (from birth to 12 years of age). All mechanisms for reducing children's ETS exposure were eligible, including smoking prevention, cessation, and control programmes. These include health promotion, social-behavioural therapies, technology, education, and clinical interventions. Two review authors independently assessed studies and extracted data. Due to heterogeneity of methods and outcome measures, we did not pool results but instead synthesised study findings narratively. Seventy-eight studies met the inclusion criteria, and we assessed all evidence to be of low or very low quality based on GRADE assessment. We judged nine studies to be at low risk of bias, 35 to have unclear overall risk of bias, and 34 to have high risk of bias. Twenty-one interventions targeted populations or community settings, 27 studies were conducted in the well-child healthcare setting and 26 in the ill-child healthcare setting. Two further studies conducted in paediatric clinics did not make clear whether visits were made to well- or ill-children, and another included visits to both well- and ill-children. Forty-five studies were reported from North America, 22 from other high-income countries, and 11 from low- or middle-income countries. Only 26 of the 78 studies reported a beneficial intervention effect for reduction of child ETS exposure, 24 of which were statistically significant. Of these 24 studies, 13 used objective measures of children's ETS exposure. We were unable to pinpoint what made these programmes effective. Studies showing a significant effect used a range of interventions: nine used in-person counselling or motivational interviewing; another study used telephone counselling, and one used a combination of in-person and telephone counselling; three used multi-component counselling-based interventions; two used multi-component education-based interventions; one used a school-based strategy; four used educational interventions, including one that used picture books; one used a smoking cessation intervention; one used a brief intervention; and another did not describe the intervention. Of the 52 studies that did not show a significant reduction in child ETS exposure, 19 used more intensive counselling approaches, including motivational interviewing, education, coaching, and smoking cessation brief advice. Other interventions consisted of brief advice or counselling (10 studies), feedback of a biological measure of children's ETS exposure (six studies), nicotine replacement therapy (two studies), feedback of maternal cotinine (one study), computerised risk assessment (one study), telephone smoking cessation support (two studies), educational home visits (eight studies), group sessions (one study), educational materials (three studies), and school-based policy and health promotion (one study). Some studies employed more than one intervention. 35 of the 78 studies reported a reduction in ETS exposure for children, irrespective of assignment to intervention and comparison groups. One study did not aim to reduce children's tobacco smoke exposure but rather sought to reduce symptoms of asthma, and found a significant reduction in symptoms among the group exposed to motivational interviewing. We found little evidence of difference in effectiveness of interventions between the well infant, child respiratory illness, and other child illness settings as contexts for parental smoking cessation interventions. A minority of interventions have been shown to reduce children's exposure to environmental tobacco smoke and improve children's health, but the features that differentiate the effective interventions from those without clear evidence of effectiveness remain unclear. The evidence was judged to be of low or very low quality, as many of the trials are at a high risk of bias, are small and inadequately powered, with heterogeneous interventions and populations.

Smoking habits and smoking cessation among North Carolina nurses.

PubMed

Swenson, I E

1989-01-01

A 1987 questionnaire survey of a 1% random sample (n = 356) of registered nurses in North Carolina provided data on the smoking habits and smoking cessation. Fifty-six percent were never smokers; 19% were current smokers. Among the ever smokers, 31% had quit smoking for at least one year. Twenty-two percent of the former smokers had smoked less than 5 years and 39% less than 10 years before quitting. Anecdotal notes from never smokers suggested that their major deterrent to smoking was their own parents smoking. Concerns about the addictive smoking behavior and health effects of smoking observed in their parents as well as concerns about potential health risks to themselves deterred them from smoking. Concerns about the adverse consequences of smoking was the most influential factor influencing smoking cessation and reduction of cigarette smoking. Friends' and family's encouragement to stop smoking was the most influential external factor motivating nurses to quit or reduce cigarette consumption. Fifty-seven percent of the former smokers quit smoking after one or two attempts while 53 of the current smokers had tried to quit 3 or more times - 90% had tried at least once to quit smoking; however, only 18% of the current smokers had abstained for more than one year during any of their attempts to quit. Implications of the results include: (1) smoking cessation programs for nurses in the workplace may have considerable impact since the majority of nurses who smoke are tying to quit; (2) relapse prevention strategies need to be an integral part of such smoking cessation programs including involvement of family and friends to support the smokers in their cessation efforts.

Barriers and Promoters of an Evidenced-Based Smoking Cessation Counseling During Prenatal Care in Argentina and Uruguay

PubMed Central

Tong, Van T.; Morello, Paola; Farr, Sherry L.; Lawsin, Catalina; Dietz, Patricia M.; Aleman, Alicia; Berrueta, Mabel; Mazzoni, Agustina; Becu, Ana; Buekens, Pierre; Belizán, José; Althabe, Fernando

2015-01-01

In Argentina and Uruguay, 10.3 and 18.3 %, respectively, of pregnant women smoked in 2005. Brief cessation counseling, based on the 5A’s model, has been effective in different settings. This qualitative study aims to improve the understanding of factors influencing the provision of smoking cessation counseling during pregnancy in Argentina and Uruguay. In 2010, we obtained prenatal care providers’, clinic directors’, and pregnant smokers’ opinions regarding barriers and promoters to brief smoking cessation counseling in publicly-funded prenatal care clinics in Buenos Aires, Argentina and Montevideo, Uruguay. We interviewed six prenatal clinic directors, conducted focus groups with 46 health professionals and 24 pregnant smokers. Themes emerged from three issue areas: health professionals, health system, and patients. Health professional barriers to cessation counseling included inadequate knowledge and motivation, perceived low self-efficacy, and concerns about inadequate time and large workload. They expressed interest in obtaining a counseling script. Health system barriers included low prioritization of smoking cessation and a lack of clinic protocols to implement interventions. Pregnant smokers lacked information on the risks of prenatal smoking and underestimated the difficulty of smoking cessation. Having access to written materials and receiving cessation services during clinic waiting times were mentioned as promoters for the intervention. Women also were receptive to non-physician office staff delivering intervention components. Implementing smoking cessation counseling in publicly-funded prenatal care clinics in Argentina and Uruguay may require integrating counseling into routine prenatal care and educating and training providers on best-practices approaches. PMID:25500989

Cessation support for smokers with mental health problems: a survey of resources and training needs.

PubMed

Simonavicius, Erikas; Robson, Debbie; McEwen, Andy; Brose, Leonie S

2017-09-01

Around thirty percent of smokers have a mental health problem. Smoking cessation has been associated with mental health benefits, but smoking prevalence remains high in populations with mental health problems. This study aimed to assess mental health related knowledge, practice, and training needs of practitioners supporting smoking cessation. UK stop smoking practitioners (n=717) recruited via a database of a national provider of smoking cessation training in June 2016 sufficiently completed an online survey about available resources, knowledge, confidence, and training needs related to smoking cessation and mental health. Responses were described and compared between practitioners with a mental health lead and those without such a lead in their service using chi-square statistics and t-tests. A considerable proportion agreed (37%) or were undecided (28.9%) that smoking helped people with mental health problems feel better and agreed (17.2%) or were undecided (30.2%) that cessation would exacerbate mental health symptoms. Only 11.6% said their service had designated funding for smokers with mental health problems and 26.5% were or had a staff member who was a dedicated lead practitioner for mental health work. Practitioners from services that had a dedicated mental health lead were more confident in supporting smokers with different mental health problems and using different pharmacotherapies (all p<0.001) and were more likely to disagree that cessation was detrimental (p=0.001). A majority of practitioners were interested in training, particularly about smoking cessation effects on psychiatric medication (84.3% of n=632) and how to tailor stop smoking support to clients with mental health problems (82.4%). Practitioners who support smoking cessation have limited knowledge about mental health and smoking but are willing to learn and improve. However, they are hindered by a lack of resources. Copyright © 2017. Published by Elsevier Inc.

What are the main sources of smoking cessation support used by adolescent smokers in England? A cross-sectional study.

PubMed

Shaikh, Wasif; Nugawela, Manjula D; Szatkowski, Lisa

2015-06-19

Adolescent smoking is a worldwide public health concern. Whilst various support measures are available to help young smokers quit, their utilization of cessation support remains unknown. A cross-sectional study was conducted using data from the 2012 Smoking, Drinking and Drug Use among Young People survey to quantify the use of seven different types of cessation support by adolescents aged 11-16 in England who reported current smoking and having tried to quit, or ex-smoking. Logistic regression was used to calculate odds ratios and 95% confidence intervals for the associations between participant characteristics and reported use of cessation support. Amongst 617 current and ex-smokers, 67.3% (95% CI 63.0-71.2) reported use of at least one cessation support measure. Not spending time with friends who smoke was the most commonly-used measure, reported by 45.4% of participants (95% CI 41.1-49.8), followed by seeking smoking cessation advice from family or friends (27.4%, 95% CI 23.7-31.5) and using nicotine products (15.4%, 95% CI 12.6-18.7). Support services provided by the National Health Service (NHS) were infrequently utilized. Having received lessons on smoking was significantly associated with reported use of cessation support (adjusted OR 1.55, 95% CI 1.02-2.34) and not spending time with friends who smoked (adjusted OR 1.98, 95% CI 1.33-2.95). Students with family members who smoked were more likely to report asking family or friends for help to quit (adjusted OR 1.74, 95% CI 1.07-2.81). Respondents who smoked fewer cigarettes per week were generally less likely to report use of cessation support measures. The majority of young smokers reported supported attempts to quit, though the support they used tended to be informal rather than formal. Evidence is needed to quantify the effectiveness of cessation support mechanisms which are acceptable to and used by young smokers.

[Helping smoking cessation in COPD, asthma, lung cancer, operated smokers].

PubMed

Perriot, J; Underner, M; Peiffer, G; Dautzenberg, B

2018-06-01

Smoking is the cause of addictive behavior. Tobacco addiction is a chronic disease that makes difficult to stop smoking and leads to further use. Smoking is a risk factor for COPD, asthma and lung cancer; it may be the cause of severe perioperative complications. This finding justifies that smokers benefit from advice of stopping smoking and smoking cessation assistance. Helping patients to stop smoking increases the chances of quitting, improves the prognosis of tobacco-related diseases, the effectiveness of their treatments and the quality of life of the patients. This article updates the modalities of smoking cessation assistance in smokers with COPD, asthma and lung cancer in operated patients. The goal of the management must be the complete cessation of tobacco smoke intoxication, which alone reduces tobacco mortality. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Masculinity and Fatherhood

PubMed Central

Oliffe, John L.; Bottorff, Joan L.; Kelly, Mary T.

2015-01-01

Health promotion initiatives to reduce smoking among parents have focused almost exclusively on women to support their cessation during pregnancy and postpartum, while overlooking the importance of fathers’ smoking cessation. This study was a secondary analysis of in-depth interviews with 20 new and expectant fathers to identify how they perceived their female partners’ efforts to assist them to reduce or quit smoking. Social constructionist gender frameworks were used to theorize and develop the findings. Three key themes were identified: support and autonomy in men’s smoking cessation, perception of challenging men’s freedom to smoke, and contempt for men’s continued smoking. The findings suggest that shifts in masculinities as men take up fathering should be considered in designing smoking cessation interventions for fathers. PMID:25106653

Nicotine dependence and smoking habits in patients with head and neck cancer*

PubMed Central

de Almeida, Adriana Ávila; Bandeira, Celso Muller; Gonçalves, Antonio José; Araújo, Alberto José

2014-01-01

Objective: To assess smoking habits and nicotine dependence (ND) in patients with head and neck cancer Methods: This study involved 71 smokers or former smokers with squamous cell carcinoma in the oral cavity, pharynx, or larynx who were treated at a university hospital in the city of São Paulo between January and May of 2010. We used the Fagerström Test for Nicotine Dependence to evaluate smoking habits and ND in the sample. Data regarding cancer treatment were collected from medical records. Depending on the variables studied, we used the chi-square test, Fisher's exact test, Student's t-test, or Spearman's correlation test. Results: Of the 71 patients, 47 (66.2%) presented with high or very high ND, 40 (56.3%) smoked more than 20 cigarettes/day, and 32 (45.1%) smoked their first cigarette within 5 min of awakening. Advanced disease stage correlated significantly with the number of cigarettes smoked per day (p = 0.011) and with smoking history (p = 0.047). We found that ND did not correlate significantly with gender, disease stage, smoking cessation, or number of smoking cessation attempts, nor did the number of cigarettes smoked per day correlate with smoking cessation or gender. Treatment for smoking cessation was not routinely offered. Conclusions: In most of the patients studied, the level of ND was high or very high. The prevalence of heavy smoking for long periods was high in our sample. A diagnosis of cancer is a motivating factor for smoking cessation. However, intensive smoking cessation treatment is not routinely offered to smoking patients diagnosed with cancer. PMID:25029652

Models of smoking cessation brief interventions in oral health.

PubMed

Dawson, Greer M; Noller, Jennifer M; Skinner, John C

2013-12-01

The links between tobacco smoking, and periodontal disease and oral cancer make the inclusion of smoking cessation interventions at dental visits an important prevention strategy in oral health services. The 5As (Ask, Advise, Assess, Assist, Arrange), which utilises a stages of change model, is the most commonly recognised framework for the provision of smoking cessation brief interventions and is advocated widely. While the popularity of the 5As continues, increasingly evidence suggests that staged-based interventions in smoking cessation may not be the best approach. Lack of time and expertise are also cited by health professionals as barriers to undertaking brief interventions and thus abbreviated forms of the 5As have been advocated. In 2009, NSW Health introduced a mandatory policy for public dental services in NSW to conduct smoking cessation brief interventions at the chairside based on a three-step approach, which is currently being evaluated. Given the debate and the pending evaluation results, this paper reviews models of smoking cessation brief interventions, to contribute to achieving a best practice model for public oral health in NSW.

A novel recruitment message to increase enrollment into a smoking cessation treatment program: preliminary results from a randomized trial.

PubMed

Schnoll, Robert A; Cappella, Joseph; Lerman, Caryn; Pinto, Angela; Patterson, Freda; Wileyto, E Paul; Bigman, Cabral; Leone, Frank

2011-12-01

Most smokers do not utilize approved interventions for nicotine dependence, reducing the probability of cessation. Smoking cessation programs typically use recruitment messages emphasizing the health threats of smoking. Augmenting this threat message by describing the genetic aspects of nicotine addiction may enhance enrollment into a cessation program. During telephone recruitment, 125 treatment-seeking smokers were randomized to receive by phone either a standard threat message or a threat plus genetic prime message and were offered open-label varenicline and counseling. There was a greater rate of enrollment into the cessation program for the threat plus genetic prime participants (51.7%) versus the threat-only participants (37.7%; p = .03). Smokers who self-identified from racial/ethnic minority groups were less likely to enroll in the cessation program (p = .01) versus smokers who self-identified as Caucasian. These preliminary data suggest that a simple, affordable, and transportable communication approach enhances enrollment of smokers into a smoking cessation program. A larger clinical trial to evaluate a genetic prime message for improving recruitment into smoking cessation programs is warranted.

Design and study protocol of the maternal smoking cessation during pregnancy study, (M-SCOPE).

PubMed

Loukopoulou, Andriani N; Vardavas, Constantine I; Farmakides, George; Rossolymos, Christos; Chrelias, Charalambos; Tzatzarakis, Manolis N; Tsatsakis, Aristidis; Lymberi, Maria; Connolly, Gregory N; Behrakis, Panagiotis K

2011-12-06

Maternal smoking is the most significant cause of preventable complications during pregnancy, with smoking cessation during pregnancy shown to increase birth weight and reduce preterm birth among pregnant women who quit smoking. Taking into account the fact that the number of women who smoke in Greece has increased steadily throughout the previous decade and that the prevalence of smoking among Greek females is one of the highest in the world, smoking cessation should be a top priority among Greek health care professionals. The Maternal Smoking Cessation during Pregnancy Study (M-SCOPE), is a Randomized Control Trial (RCT) that aims to test whether offering Greek pregnant smokers a high intensity intervention increases smoking cessation during the third trimester of pregnancy, when compared to a low intensity intervention. Prospective participants will be pregnant smokers of more than 5 cigarettes per week, recruited up to the second trimester of pregnancy. Urine samples for biomarker analysis of cotinine will be collected at three time points: at baseline, at around the 32nd week of gestation and at six months post partum. The control group/low intensity intervention will include: brief advice for 5 minutes and a short leaflet, while the experimental group/intensive intervention will include: 30 minutes of individualized cognitive-behavioural intervention provided by a trained health professional and a self-help manual especially tailored for smoking cessation during pregnancy, while counselling will be based on the ''5 As.'' After childbirth, the infants' birth weight, gestational age and any other health related complications during pregnancy will be recorded. A six months post-partum a follow up will be performed in order to re-assess the quitters smoking status. If offering pregnant smokers a high intensity intervention for smoking cessation increases the rate of smoking cessation in comparison to a usual care low intensity intervention in Greek pregnant smokers, such a scheme if beneficial could be implemented successfully within clinical practice in Greece. ClinicalTrials.gov Identifier NCT01210118.

Web-Based Smoking-Cessation Program

PubMed Central

Strecher, Victor J.; McClure, Jennifer B.; Alexander, Gwen L.; Chakraborty, Bibhas; Nair, Vijay N.; Konkel, Janine M.; Greene, Sarah M.; Collins, Linda M.; Carlier, Carola C.; Wiese, Cheryl J.; Little, Roderick J.; Pomerleau, Cynthia S.; Pomerleau, Ovide F.

2009-01-01

Background Initial trials of web-based smoking-cessation programs have generally been promising. The active components of these programs, however, are not well understood. This study aimed to (1) identify active psychosocial and communication components of a web-based smoking-cessation intervention and (2) examine the impact of increasing the tailoring depth on smoking cessation. Design Randomized fractional factorial design. Setting Two HMOs: Group Health in Washington State and Henry Ford Health System in Michigan. Participants 1866 smokers. Intervention A web-based smoking-cessation program plus nicotine patch. Five components of the intervention were randomized using a fractional factorial design: high- versus low-depth tailored success story, outcome expectation, and efficacy expectation messages; high- versus low-personalized source; and multiple versus single exposure to the intervention components. Measurements Primary outcome was 7 day point-prevalence abstinence at the 6-month follow-up. Findings Abstinence was most influenced by high-depth tailored success stories and a high-personalized message source. The cumulative assignment of the three tailoring depth factors also resulted in increasing the rates of 6-month cessation, demonstrating an effect of tailoring depth. Conclusions The study identified relevant components of smoking-cessation interventions that should be generalizable to other cessation interventions. The study also demonstrated the importance of higher-depth tailoring in smoking-cessation programs. Finally, the use of a novel fractional factorial design allowed efficient examination of the study aims. The rapidly changing interfaces, software, and capabilities of eHealth are likely to require such dynamic experimental approaches to intervention discovery. PMID:18407003

Motivations toward smoking cessation, reasons for relapse, and modes of quitting: results from a qualitative study among former and current smokers

PubMed Central

Buczkowski, Krzysztof; Marcinowicz, Ludmila; Czachowski, Slawomir; Piszczek, Elwira

2014-01-01

Background Smoking cessation plays a crucial role in reducing preventable morbidity and mortality and is a recognized public-health-policy issue in many countries. Two of the most important factors that affect the efficacy of quitting smoking are motivation and the ability to cope with situations causing relapse. Aim The objective of the study reported here was to investigate former and current smokers’ motivations for smoking cessation, reasons for relapse, and modes of quitting. Methods We arranged four focus groups with 24 participants (twelve current and twelve former smokers) and eleven semi-structured interviews (five current and six former smokers) with a view to understanding and categorizing their opinions on motivations and the course and process of smoking cessation. The data were next analyzed using descriptive qualitative methods. Results Three main themes were identified: (1) motivations to quit smoking, (2) reasons why smokers sometimes relapse, and (3) modes of quitting smoking. Within the first theme, the following six subthemes surfaced: (1) a smoking ban at home and at work due to other people’s wishes and rules, (2) the high cost of cigarettes, (3) the unpleasant smell, (4) health concern, (5) pregnancy and breastfeeding, and (6) a variety of other factors. The second theme encompassed the following subthemes: (1) stress and the need to lessen it by smoking a cigarette, (2) the need to experience the pleasure connected with smoking, and (3) the smoking environment both at home and at work. Participants presented different smoking-cessation modes, but mainly they were unplanned attempts. Conclusion Two very important motivations for smoking cessation were a smoking ban at home and at work due to other people’s wishes and rules, and the high cost of cigarettes. The most common smoking-cessation mode was a spontaneous decision to quit, caused by a particular trigger factor. Relapse causes encompassed, most notably: stress, lack of the pleasure previously obtained from smoking, and the smoking environment. PMID:25336926

Mindfulness predicts lower affective volatility among African Americans during smoking cessation.

PubMed

Adams, Claire E; Chen, Minxing; Guo, Lin; Lam, Cho Y; Stewart, Diana W; Correa-Fernández, Virmarie; Cano, Miguel A; Heppner, Whitney L; Vidrine, Jennifer Irvin; Li, Yisheng; Ahluwalia, Jasjit S; Cinciripini, Paul M; Wetter, David W

2014-06-01

Recent research suggests that mindfulness benefits emotion regulation and smoking cessation. However, the mechanisms by which mindfulness affects emotional and behavioral functioning are unclear. One potential mechanism, lower affective volatility, has not been empirically tested during smoking cessation. This study examined longitudinal associations among mindfulness and emotional responding over the course of smoking cessation treatment among predominantly low-socioeconomic status (SES) African American smokers, who are at high risk for relapse to smoking and tobacco-related health disparities. Participants (N = 399, 51% female, mean age = 42, 48% with annual income <$10,000) completed a baseline measure of trait mindfulness. Negative affect, positive affect, and depressive symptoms were assessed at five time points during smoking cessation treatment (up to 31 days postquit). Volatility indices were calculated to quantify within-person instability of emotional symptoms over time. Over and above demographic characteristics, nicotine dependence, and abstinence status, greater baseline trait mindfulness predicted lower volatility of negative affect and depressive symptoms surrounding the quit attempt and up to 1 month postquit, ps < 0.05. Although volatility did not mediate the association between greater mindfulness and smoking cessation, these results are the first to show that mindfulness is linked to lower affective volatility (or greater stability) of negative emotions during the course of smoking cessation. The present study suggests that mindfulness is linked to greater emotional stability and augments the study of mindfulness in diverse populations. Future studies should examine the effects of mindfulness-based interventions on volatility and whether lower volatility explains effects of mindfulness-based treatments on smoking cessation.

Increasing access to smoking cessation treatment in a low-income, HIV-positive population: the feasibility of using cellular telephones.

PubMed

Lazev, Amy; Vidrine, Damon; Arduino, Roberto; Gritz, Ellen

2004-04-01

This study examined the feasibility of using cellular telephones to improve access to smoking cessation counseling in a low-income, HIV-positive population. Two pilot studies were conducted: (a). A survey of interest and barriers in participating in a smoking cessation intervention (n=49) and (b). a cellular telephone smoking cessation intervention in which participants were provided with free cellular telephones and received six telephone counseling sessions over a 2-week period (n=20). A primary care clinic serving a multiethnic, medically indigent, HIV-positive population served as the setting. Demographics and smoking status were assessed by self-report and expired-air carbon monoxide testing. In study 1, participants reported multiple barriers to participating in a smoking cessation intervention, including transportation, transience, and telephone availability. However, they also reported a high level of interest in participating in a smoking cessation intervention, with the greatest interest in a cellular telephone intervention. In study 2, 19 of the 20 participants successfully completed 2 weeks of smoking cessation counseling with a 93% (106 of 114 calls) contact rate. A total of 19 participants made a quit attempt, and the 2-week end of treatment point-prevalence abstinence rate was 75%. The provision of cellular telephones allowed for the implementation of a proactive telephone smoking cessation intervention providing an underserved population with access to care. Cellular telephones also may provide unique benefits because of the intensity of counseling and support provided as well as the ability to provide counseling in real-world, real-time situations (in vivo counseling).

Applying anthropology to eliminate tobacco-related health disparities.

PubMed

Goldade, Kate; Burgess, Diana; Olayinka, Abimbola; Whembolua, Guy Lucien S; Okuyemi, Kolawole S

2012-06-01

Disparities in tobacco's harm persist. Declines in smoking among the general population have not been experienced to the same extent by vulnerable populations. Innovative strategies are required to diminish disparities in tobacco's harm. As novel tools, anthropological concepts and methods may be applied to improve the design and outcomes of tobacco cessation interventions. We reviewed over 60 articles published in peer-reviewed journals since 1995 for content on anthropology and smoking cessation. The specific questions framing the review were: (a) "How can lessons learned from anthropological studies of smoking improve the design and effectiveness of smoking cessation interventions?" (b) How can anthropology be applied to diminish disparities in smoking cessation? and (c) How can qualitative methods be used most effectively in smoking cessation intervention research? Three specific disciplinary tools were identified and examined: (a) culture, (b) reflexivity, and (c) qualitative methods. Examining culture as a dynamic influence and understanding the utilities of smoking in a particular group is a precursor to promoting cessation. Reflexivity enables a deeper understanding of how smokers perceive quitting and smoking beyond addiction and individual health consequences. Qualitative methods may be used to elicit in-depth perspectives on quitting, insights to inform existing community-based strategies for making behavior changes, and detailed preferences for cessation treatment or programs. Anthropological tools can be used to improve the effectiveness of intervention research studies targeting individuals from vulnerable groups. Synthesized applications of anthropological concepts can be used to facilitate translation of findings into clinical practice for providers addressing tobacco cessation in vulnerable populations.

Confirming the Structure of the "Why Do You Smoke?" Questionnaire: A Community Resource for Adolescent Tobacco Cessation

ERIC Educational Resources Information Center

Smith, Dennis W.; Lee, Jay T.; Colwell, Brian; Stevens-Manser, Stacey

2008-01-01

In response to the problem of adolescent smoking and limited appropriate cessation resources, this study examined the pattern and structure of the American Lung Association, Why Do You Smoke? (WDS) to determine its appropriateness for use in youth smoking cessation programs. The WDS is used to help smokers identify primary motivations for using…

A randomized trial of concurrent smoking-cessation and substance use disorder treatment in stimulant-dependent smokers.

PubMed

Winhusen, Theresa M; Brigham, Gregory S; Kropp, Frankie; Lindblad, Robert; Gardin, John G; Penn, Pat; Hodgkins, Candace; Kelly, Thomas M; Douaihy, Antoine; McCann, Michael; Love, Lee D; DeGravelles, Eliot; Bachrach, Ken; Sonne, Susan C; Hiott, Bob; Haynes, Louise; Sharma, Gaurav; Lewis, Daniel F; VanVeldhuisen, Paul; Theobald, Jeff; Ghitza, Udi

2014-04-01

To evaluate the impact of concurrent treatments for substance use disorder and nicotine-dependence for stimulant-dependent patients. A randomized, 10-week trial with follow-up at 3 and 6 months after smoking quit date conducted at 12 substance use disorder treatment programs between February 2010 and July 2012. Adults meeting DSM-IV-TR criteria for cocaine and/or methamphetamine dependence and interested in quitting smoking were randomized to treatment as usual (n = 271) or treatment as usual with smoking-cessation treatment (n = 267). All participants received treatment as usual for substance use disorder treatment. Participants assigned to treatment as usual with concurrent smoking-cessation treatment received weekly individual smoking cessation counseling and extended-release bupropion (300 mg/d) during weeks 1-10. During post-quit treatment (weeks 4-10), participants assigned to treatment as usual with smoking-cessation treatment received a nicotine inhaler and contingency management for smoking abstinence. Weekly proportion of stimulant-abstinent participants during the treatment phase, as assessed by urine drug screens and self-report, was the primary outcome. Secondary measures included other substance/nicotine use outcomes and treatment attendance. There were no significant treatment effects on stimulant-use outcomes, as measured by the primary outcome and stimulant-free days, on drug-abstinence, or on attendance. Participants assigned to treatment as usual with smoking-cessation treatment, relative to those assigned to treatment as usual, had significantly better outcomes for drug-free days at 6-month follow-up (χ(2)(1) = 4.09, P <.05), with a decrease in drug-free days from baseline of -1.3% in treatment as usual with smoking-cessation treatment and of -7.6% in treatment as usual. Participants receiving treatment as usual with smoking-cessation treatment, relative to those receiving treatment as usual, had significantly better outcomes on smoking point-prevalence abstinence (25.5% vs 2.2%; χ(2)(1) = 44.69, P < .001; OR =18.2). These results suggest that providing smoking-cessation treatment to illicit stimulant-dependent patients in outpatient substance use disorder treatment will not worsen, and may enhance, abstinence from nonnicotine substance use. ClinicalTrials.gov identifier: NCT01077024. © Copyright 2013 Physicians Postgraduate Press, Inc.

Influence of Psychiatric and Personality Disorders on Smoking Cessation among Individuals in Opiate Dependence Treatment

PubMed Central

Cooperman, Nina A.; Lu, Shou-En; Richter, Kimber P.; Bernstein, Steven L.; Williams, Jill M.

2016-01-01

Objective We aimed to evaluate how psychiatric and personality disorders influence smoking cessation goals and attempts among people with opiate dependence who smoke. This information could aid the development of more effective cessation interventions for these individuals. Methods Participants (N=116) were recruited from two methadone clinics, completed the Millon Clinical Multiaxial Inventory–III, and were asked about their smoking behavior and quitting goals. We used the Least Absolute Shrinkage and Selection Operator (LASSO) method, a technique commonly used for studies with small sample sizes and large number of predictors, to develop models predicting having a smoking cessation goal, among those currently smoking daily, and ever making a quit attempt, among those who ever smoked. Results Almost all participants reported ever smoking (n = 115, 99%); 70% (n = 80) had made a serious quit attempt in the past; 89% (n = 103) reported current daily smoking; and, 59% (n = 61) had a goal of quitting smoking and staying off cigarettes. Almost all (n = 112, 97%) had clinically significant characteristics of a psychiatric or personality disorder. White race, anxiety, and a negativistic personality facet (expressively resentful) were negative predictors of having a cessation goal. Overall narcissistic personality pattern and a dependent personality facet (interpersonally submissive) were positive predictors of having a cessation goal. Somatoform disorder, overall borderline personality pattern, and a depressive personality facet (cognitively fatalistic) were negative predictors of ever making a quit attempt. Individual histrionic (gregarious self-image), antisocial (acting out mechanism), paranoid (expressively defensive), and sadistic (pernicious representations) personality disorder facets were positive predictors of ever making a quit attempt. Each model provided good discrimination for having a smoking cessation goal or not (C-statistic of .76, 95% CI[0.66, 0.85]) and ever making a quit attempt or not (C-statistic of .79, 95% CI[0.70, 0.88]). Conclusions Compared to existing treatments, smoking cessation treatments that can be tailored to address the individual needs of people with specific psychiatric disorders or personality disorder traits may better help those in opiate dependence treatment to set a cessation goal, attempt to quit, and eventually quit smoking. PMID:27064523

Systematic review: internet-based program for youth smoking prevention and cessation.

PubMed

Park, Eunhee; Drake, Emily

2015-01-01

To review the characteristics and effects Internet-based youth smoking prevention and cessation programs. Systematic review of published articles in peer-reviewed journals in the past 10 years, focused on Internet-based youth smoking prevention and cessation programs. Twelve articles were selected based on the following criteria: studies reporting the outcomes of Internet-based smoking cessation or prevention intervention programs for adolescents who are younger than 24 years. The components of youth Internet-based smoking intervention programs are analyzed based on study features (i.e., sample, design, theoretical basis, analysis, outcome measures) and program characteristics (i.e., focus, setting, frequency, duration, intensity, and different components) that make the programs effective. The most common components of effective Internet-based programs are identified as the following: the use of multimedia, tailored approaches, personalized feedback, and interactive features. The characteristics and effects of the programs vary, but most programs show positive results in youth smoking prevention and cessation in spite of the studies' limitations. The evidence from this review provides useful information of recent efforts related to Internet-based youth smoking prevention and cessation programs, which can have significant clinical implications in developing future innovative youth smoking prevention and intervention programs. © 2014 Sigma Theta Tau International.

Smoking Cessation Counseling Beliefs and Behaviors of Outpatient Oncology Providers

PubMed Central

Danhauer, Suzanne C.; Tooze, Janet A.; Blackstock, A. William; Spangler, John; Thomas, Leslie; Sutfin, Erin L.

2012-01-01

Purpose. Many cancer patients continue to smoke after diagnosis, increasing their risk for treatment complications, reduced treatment efficacy, secondary cancers, and reduced survival. Outpatient oncology providers may not be using the “teachable moment” of cancer diagnosis to provide smoking cessation assistance. Providers and Methods. Physicians and midlevel providers (n = 74) who provide outpatient oncology services completed an online survey regarding smoking cessation counseling behaviors, beliefs, and perceived barriers. Outpatient medical records for 120 breast, lung, head and neck, colon, prostate, and acute leukemia cancer patients were reviewed to assess current smoking cessation assessment and intervention documentation practices. Results. Providers reported commonly assessing smoking in new patients (82.4% frequently or always), but rates declined at subsequent visits for both current smokers and recent quitters. Rates of advising patients to quit smoking were also high (86.5% frequently or always), but <30% of providers reported frequently or always providing intervention to smoking patients (e.g., nicotine replacement therapy or other medications, self-help materials, and/or referrals). Only 30% of providers reported that they frequently or always followed up with patients to assess progress with quitting. Few providers (18.1%) reported high levels of confidence in their ability to counsel smoking patients. Patients' lack of motivation was identified as the most important barrier to smoking cessation. Conclusions. Although beliefs about providing cessation services to smoking patients were generally positive, few providers reported commonly providing interventions beyond advice to quit. Additional training and clinic-based interventions may improve adherence to tobacco cessation practice guidelines in the outpatient oncology setting. PMID:22334454

Brief smoking cessation intervention: a prospective trial in the urology setting.

PubMed

Bjurlin, Marc A; Cohn, Matthew R; Kim, Dae Y; Freeman, Vincent L; Lombardo, Lindsay; Hurley, Stephen D; Hollowell, Courtney M P

2013-05-01

Urologists have an important role in the treatment of tobacco related diseases, such as kidney and bladder cancer. Despite this role, urologists receive little training in promoting tobacco cessation. We prospectively evaluated a brief smoking cessation intervention offered by a urologist at an outpatient clinic. Between 2009 and 2011 adult smokers from a single institution urology clinic were enrolled in a prospective, brief intervention trial or in usual care as controls. All patients were assessed by the validated Fagerström test for nicotine dependence and the readiness to quit questionnaire. Trial patients received a 5-minute brief smoking cessation intervention. The primary outcome was abstinence at 1 year and the secondary outcome was the number of attempts to quit. Multivariate logistic regression was used to identify factors associated with the quit rate and quit attempts. A total of 179 patients were enrolled in the study, including 100 in the brief smoking cessation intervention, 41 in the brief smoking cessation intervention plus nicotine replacement therapy and 38 usual care controls. Of the participants 81.0% were 40 years old or older with a mean ± SD 11.26 ± 7.23 pack-year smoking history. Mean readiness to quit and tobacco dependence scores were similar in the 2 arms (p = 0.25 and 0.92, respectively). The 1-year quit rate in the brief smoking cessation intervention group was 12.1% vs 2.6% in the usual care group (OR 4.44, p = 0.163) Adding nicotine replacement therapy increased the quit rate to 19.5% (vs usual care OR 9.91, p = 0.039). Patients who received the brief smoking cessation intervention were significantly more likely to attempt to quit (OR 2.31, p = 0.038). Increased readiness scores were associated with an increased quit rate and increased quit attempts. Urologists can successfully implement a brief smoking cessation intervention program. Our study highlights the role of the urologist in providing smoking cessation assistance and the significant impact of brief, simple advice about quitting smoking on the smoker quit rate. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Positive Psychotherapy for Smoking Cessation: A Pilot Randomized Controlled Trial.

PubMed

Kahler, Christopher W; Spillane, Nichea S; Day, Anne M; Cioe, Patricia A; Parks, Acacia; Leventhal, Adam M; Brown, Richard A

2015-11-01

Greater depressive symptoms and low positive affect (PA) are associated with poor smoking cessation outcomes. Smoking cessation approaches that incorporate a focus on PA may benefit smokers trying to quit. The purpose of this study was to conduct a pilot randomized clinical trial to compare standard smoking cessation treatment (ST) with smoking cessation treatment that targets positive affect, termed positive psychotherapy for smoking cessation (PPT-S). Smokers who were seeking smoking cessation treatment were assigned by urn randomization to receive, along with 8 weeks of nicotine replacement therapy, either ST (n = 31) or PPT-S (n = 35). Seven-day point prevalence smoking abstinence was biochemically confirmed at 8, 16, and 26 weeks. Compared to ST, a greater percentage of participants in PPT-S were abstinent at 8 weeks, 16 weeks, and 26 weeks, but these differences were nonsignificant. In a more statistically powerful longitudinal model, participants in PPT-S had a significantly higher odds of abstinence (adjusted odds ratio [AOR] = 2.75; 95% CI = 1.02, 7.42; p = .046) across follow-ups compared to those in ST. The positive effect of PPT-S was stronger for those higher in PA (OR = 6.69, 95% CI = 1.16, 38.47, p = .03). Greater use of PPT-S strategies during the initial 8 weeks of quitting was associated with a less steep decline in smoking abstinence rates over time (OR = 2.64, 95% CI = 1.06, 6.56, p =.04). This trial suggests substantial promise for incorporating PPT into smoking cessation treatment. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Nicotine replacement therapy, professional therapy, snuff use and tobacco smoking: a study of smoking cessation strategies in southern Sweden

PubMed Central

Lindström, Martin

2007-01-01

Objectives The strategies used to support smoking cessation among quitters were investigated according to year of smoking cessation and sociodemographic characteristics. Methods The 2004 public health survey in Skåne, Sweden, is a cross‐sectional study. A total of 27 757 people aged 18–80 answered a postal questionnaire. The participation rate was 59%. Different strategies to support smoking cessation—that is, no therapy, nicotine replacement (NRT), professional therapy and snus (snuff) use, were investigated among quitters according to year of smoking cessation, and demographic and socioeconomic characteristics. Results 14.9% of the men and 18.1% of the women were daily smokers. The prevalence of daily snus use was 19.5% among men but only 2.3% among women. Stratifying the data according to year of smoking cessation (1938–2004) revealed a significant increase in active smoking cessation strategies such as NRT, professional therapy and snus use. NRT was more common among women (23.6%) than men (14.8%) among smokers who quit in 2000–4, but snus use was more common among men (30.4% versus 8.7%). No replacement or other therapy at all was significantly more common among women (63.6%) than men (52.1%). People aged 35–80 years used more nicotine replacement than people aged 18–34, while men aged 18–34 used snus to quit smoking significantly more than men aged 55–80. Conclusions Snus is used commonly among men as a support for smoking cessation in Sweden. Women use pharmacological NRT to a greater extent, but this can probably not compensate for the much higher extent of snuff use as a cessation strategy among men. PMID:18048619

Cost-Effectiveness of Integrating Tobacco Cessation Into Post-Traumatic Stress Disorder Treatment.

PubMed

Barnett, Paul G; Jeffers, Abra; Smith, Mark W; Chow, Bruce K; McFall, Miles; Saxon, Andrew J

2016-03-01

We examined the cost-effectiveness of smoking cessation integrated with treatment for post-traumatic stress disorder (PTSD). Smoking veterans receiving care for PTSD (N = 943) were randomized to care integrated with smoking cessation versus referral to a smoking cessation clinic. Smoking cessation services, health care cost and utilization, quality of life, and biochemically-verified abstinence from cigarettes were assessed over 18-months of follow-up. Clinical outcomes were combined with literature on changes in smoking status and the effect of smoking on health care cost, mortality, and quality of life in a Markov model of cost-effectiveness over a lifetime horizon. We discounted cost and outcomes at 3% per year and report costs in 2010 US dollars. The mean of smoking cessation services cost was $1286 in those randomized to integrated care and $551 in those receiving standard care (P < .001). There were no significant differences in the cost of mental health services or other care. After 12 months, prolonged biochemically verified abstinence was observed in 8.9% of those randomized to integrated care and 4.5% of those randomized to standard care (P = .004). The model projected that Integrated Care added $836 in lifetime cost and generated 0.0259 quality adjusted life years (QALYs), an incremental cost-effectiveness ratio of $32 257 per QALY. It was 86.0% likely to be cost-effective compared to a threshold of $100 000/QALY. Smoking cessation integrated with treatment for PTSD was cost-effective, within a broad confidence region, but less cost-effective than most other smoking cessation programs reported in the literature. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Cost-Effectiveness of Integrating Tobacco Cessation Into Post-Traumatic Stress Disorder Treatment

PubMed Central

Jeffers, Abra; Smith, Mark W.; Chow, Bruce K.; McFall, Miles; Saxon, Andrew J.

2016-01-01

Abstract Introduction: We examined the cost-effectiveness of smoking cessation integrated with treatment for post-traumatic stress disorder (PTSD). Methods: Smoking veterans receiving care for PTSD ( N = 943) were randomized to care integrated with smoking cessation versus referral to a smoking cessation clinic. Smoking cessation services, health care cost and utilization, quality of life, and biochemically-verified abstinence from cigarettes were assessed over 18-months of follow-up. Clinical outcomes were combined with literature on changes in smoking status and the effect of smoking on health care cost, mortality, and quality of life in a Markov model of cost-effectiveness over a lifetime horizon. We discounted cost and outcomes at 3% per year and report costs in 2010 US dollars. Results: The mean of smoking cessation services cost was $1286 in those randomized to integrated care and $551 in those receiving standard care ( P < .001). There were no significant differences in the cost of mental health services or other care. After 12 months, prolonged biochemically verified abstinence was observed in 8.9% of those randomized to integrated care and 4.5% of those randomized to standard care ( P = .004). The model projected that Integrated Care added $836 in lifetime cost and generated 0.0259 quality adjusted life years (QALYs), an incremental cost-effectiveness ratio of $32 257 per QALY. It was 86.0% likely to be cost-effective compared to a threshold of $100 000/QALY. Conclusions: Smoking cessation integrated with treatment for PTSD was cost-effective, within a broad confidence region, but less cost-effective than most other smoking cessation programs reported in the literature. PMID:25943761

Knowledge, attitudes and preferences regarding genetic testing for smoking cessation. A cross-sectional survey among Dutch smokers

PubMed Central

Smerecnik, Chris; van Schooten, Frederik J; de Vries, Hein; van Schayck, Constant P

2012-01-01

Objectives Recent research strongly suggests that genetic variation influences smokers' ability to stop. Therefore, the use of (pharmaco) genetic testing may increase cessation rates. This study aims to assess the intention of smokers concerning undergoing genetic testing for smoking cessation and their knowledge, attitudes and preferences about this subject. Design Online cross-sectional survey. Setting Database internet research company of which every inhabitant of the Netherlands of ≥12 years with an email address and capable of understanding Dutch can become a member. Participants 587 of 711 Dutch smokers aged ≥18 years, daily smokers for ≥5 years and smoke on average ≥10 cigarettes/day (response rate=83%). Primary and secondary outcome measures Smokers' knowledge, attitudes and preferences and their intention to undergo genetic testing for smoking cessation. Results Knowledge on the influence of genetic factors in smoking addiction and cessation was found to be low. Smokers underestimated their chances of having a genetic predisposition and the influence of this on smoking cessation. Participants perceived few disadvantages, some advantages and showed moderate self-efficacy towards undergoing a genetic test and dealing with the results. Smokers were mildly interested in receiving information and participating in genetic testing, especially when offered by their general practitioner (GP). Conclusions For successful implementation of genetic testing for smoking in general practice, several issues should be addressed, such as the knowledge on smoking cessation, genetics and genetic testing (including advantages and disadvantages) and the influence of genetics on smoking addiction and cessation. Furthermore, smokers allocate their GPs a crucial role in the provision of information and the delivery of a genetic test for smoking; however, it is unclear whether GPs will be able and willing to take on this role. PMID:22223839

News media coverage of smoking and health is associated with changes in population rates of smoking cessation but not initiation

PubMed Central

Pierce, J.; Gilpin, E.

2001-01-01

OBJECTIVE—To determine whether changes in news media coverage of smoking and health issues are associated with changes in smoking behaviour in the USA.
DESIGN AND MAIN OUTCOME MEASURES—Issue importance in the US news media is assessed by the number of articles published annually in major magazines indexed in The Reader's Guide to Periodical Literature. Annual incidence rates for cessation and initiation in the USA were computed from the large, representative National Health Interview Surveys (1965-1992). Patterns in cessation incidence were considered for ages 20-34 years and 35-50 years. Initiation incidence was examined for adolescents (14-17 years) and young adults (18-21 years) of both sexes.
RESULTS—From 1950 to the early 1980s, the annual incidence of cessation in the USA mirrored the pattern of news media coverage of smoking and health, particularly for middle aged smokers. Cessation rates in younger adults increased considerably when secondhand smoke concerns started to increase in the US population. Incidence of initiation in young adults did not start to decline until the beginning of the public health campaign against smoking in the 1960s. Among adolescents, incidence rates did not start to decline until the 1970s, after the broadcast ban on cigarette advertising.
CONCLUSIONS—The level of coverage of smoking and health in the news media may play an important role in determining the rate of population smoking cessation, but not initiation. In countries where cessation has lagged, advocates should work to increase the newsworthiness of smoking and health issues.


Keywords: initiation; cessation; health; mass media PMID:11387535

Knowledge, attitudes and other factors associated with assessment of tobacco smoking among pregnant Aboriginal women by health care providers: a cross-sectional survey

PubMed Central

2012-01-01

Background As with many Indigenous peoples, smoking rates among Aboriginal Australians are considerably higher than those of the non-Indigenous population. Approximately 50% of Indigenous women smoke during pregnancy, a time when women are more motivated to quit. Antenatal care providers are potentially important change agents for reducing the harms associated with smoking, yet little is known about their knowledge, attitudes or skills, or the factors associated with providing smoking cessation advice. Methods This paper aimed to explore the knowledge and attitudes of health care providers caring for pregnant Australian Aboriginal women with regard to smoking risks and cessation; and to identify factors associated with self-reported assessment of smoking. A cross-sectional survey was undertaken with 127 staff providing antenatal care to Aboriginal women from two jurisdictions: the Northern Territory and New South Wales, Australia. Measures included respondents' estimate of the prevalence of smoking among pregnant women; optimal and actual assessment of smoking status; knowledge of risks associated with antenatal smoking; knowledge of smoking cessation; attitudes to providing cessation advice to pregnant women; and perceived barriers and motivators for cessation for pregnant women. Results The median provider estimate of the smoking prevalence was 69% (95%CI: 60,70). The majority of respondents considered assessment of smoking status to be integral to antenatal care and a professional responsibility. Most (79%) indicated that they assess smoking status in 100% of clients. Knowledge of risks was generally good, but knowledge of cessation was poor. Factors independently associated with assessing smoking status among all women were: employer service type (p = 0.025); cessation knowledge score (p = 0.011); and disagreeing with the statement that giving advice is not worth it given the low level of success (p = 0.011). Conclusions Addressing knowledge of smoking risks and cessation counselling is a priority and should improve both confidence and ability, and increase the frequency and effectiveness of counselling. The health system must provide supports to providers through appropriate policy and resourcing, to enable them to address this issue. PMID:22397580

Knowledge, attitudes and other factors associated with assessment of tobacco smoking among pregnant Aboriginal women by health care providers: a cross-sectional survey.

PubMed

Passey, Megan E; D'Este, Catherine A; Sanson-Fisher, Robert W

2012-03-07

As with many Indigenous peoples, smoking rates among Aboriginal Australians are considerably higher than those of the non-Indigenous population. Approximately 50% of Indigenous women smoke during pregnancy, a time when women are more motivated to quit. Antenatal care providers are potentially important change agents for reducing the harms associated with smoking, yet little is known about their knowledge, attitudes or skills, or the factors associated with providing smoking cessation advice. This paper aimed to explore the knowledge and attitudes of health care providers caring for pregnant Australian Aboriginal women with regard to smoking risks and cessation; and to identify factors associated with self-reported assessment of smoking. A cross-sectional survey was undertaken with 127 staff providing antenatal care to Aboriginal women from two jurisdictions: the Northern Territory and New South Wales, Australia. Measures included respondents' estimate of the prevalence of smoking among pregnant women; optimal and actual assessment of smoking status; knowledge of risks associated with antenatal smoking; knowledge of smoking cessation; attitudes to providing cessation advice to pregnant women; and perceived barriers and motivators for cessation for pregnant women. The median provider estimate of the smoking prevalence was 69% (95%CI: 60,70). The majority of respondents considered assessment of smoking status to be integral to antenatal care and a professional responsibility. Most (79%) indicated that they assess smoking status in 100% of clients. Knowledge of risks was generally good, but knowledge of cessation was poor. Factors independently associated with assessing smoking status among all women were: employer service type (p = 0.025); cessation knowledge score (p = 0.011); and disagreeing with the statement that giving advice is not worth it given the low level of success (p = 0.011). Addressing knowledge of smoking risks and cessation counselling is a priority and should improve both confidence and ability, and increase the frequency and effectiveness of counselling. The health system must provide supports to providers through appropriate policy and resourcing, to enable them to address this issue.

Factors Influencing Smoking Cessation in Patients with Coronary Artery Disease.

ERIC Educational Resources Information Center

McKenna, Kryss; Higgins, Helen

1997-01-01

Ten sociodemographic, clinical, and psychological characteristics considered predictors of difficulty with smoking cessation in patients with coronary artery disease are reviewed. The compounding effects of nicotine addiction are discussed. Consideration of these factors may result in individualized programs for smoking cessation. A brief overview…

The efficacy of vigorous-intensity exercise as an aid to smoking cessation in adults with elevated anxiety sensitivity: study protocol for a randomized controlled trial

PubMed Central

2012-01-01

Background Although cigarette smoking is a leading cause of death and disability in the United States (US), over 40 million adults in the US currently smoke. Quitting smoking is particularly difficult for smokers with certain types of psychological vulnerability. Researchers have frequently called attention to the relation between smoking and anxiety-related states and disorders, and evidence suggests that panic and related anxiety vulnerability factors, specifically anxiety sensitivity (AS or fear of somatic arousal), negatively impact cessation. Accordingly, there is merit to targeting AS among smokers to improve cessation outcome. Aerobic exercise has emerged as a promising aid for smoking cessation for this high-risk (for relapse) group because exercise can effectively reduce AS and other factors predicting smoking relapse (for example, withdrawal, depressed mood, anxiety), and it has shown initial efficacy for smoking cessation. The current manuscript presents the rationale, study design and procedures, and design considerations of the Smoking Termination Enhancement Project (STEP). Methods STEP is a randomized clinical trial that compares a vigorous-intensity exercise intervention to a health and wellness education intervention as an aid for smoking cessation in adults with elevated AS. One hundred and fifty eligible participants will receive standard treatment (ST) for smoking cessation that includes cognitive behavioral therapy (CBT) and nicotine replacement therapy (NRT). In addition, participants will be randomly assigned to either an exercise intervention (ST+EX) or a health and wellness education intervention (ST+CTRL). Participants in both arms will meet 3 times a week for 15 weeks, receiving CBT once a week for the first 7 weeks, and 3 supervised exercise or health and wellness education sessions (depending on randomization) per week for the full 15-week intervention. Participants will be asked to set a quit date for 6 weeks after the baseline visit, and smoking cessation outcomes as well as putative mediator variables will be measured up to 6 months following the quit date. Discussion The primary objective of STEP is to evaluate whether vigorous-intensity exercise can aid smoking cessation in anxiety vulnerable adults. If effective, the use of vigorous-intensity exercise as a component of smoking cessation interventions would have a significant public health impact. Specifically, in addition to improving smoking cessation treatment outcome, exercise is expected to offer benefits to overall health, which may be particularly important for smokers. The study is also designed to test putative mediators of the intervention effects and therefore has the potential to advance the understanding of exercise-anxiety-smoking relations and guide future research on this topic. Clinical trials registry ClinicalTrials.gov, NCT01065506, http://clinicaltrials.gov/ct2/show/NCT01065506 PMID:23148822

The efficacy of vigorous-intensity exercise as an aid to smoking cessation in adults with elevated anxiety sensitivity: study protocol for a randomized controlled trial.

PubMed

Smits, Jasper A J; Zvolensky, Michael J; Rosenfield, David; Marcus, Bess H; Church, Timothy S; Frierson, Georita M; Powers, Mark B; Otto, Michael W; Davis, Michelle L; DeBoer, Lindsey B; Briceno, Nicole F

2012-11-13

Although cigarette smoking is a leading cause of death and disability in the United States (US), over 40 million adults in the US currently smoke. Quitting smoking is particularly difficult for smokers with certain types of psychological vulnerability. Researchers have frequently called attention to the relation between smoking and anxiety-related states and disorders, and evidence suggests that panic and related anxiety vulnerability factors, specifically anxiety sensitivity (AS or fear of somatic arousal), negatively impact cessation. Accordingly, there is merit to targeting AS among smokers to improve cessation outcome. Aerobic exercise has emerged as a promising aid for smoking cessation for this high-risk (for relapse) group because exercise can effectively reduce AS and other factors predicting smoking relapse (for example, withdrawal, depressed mood, anxiety), and it has shown initial efficacy for smoking cessation. The current manuscript presents the rationale, study design and procedures, and design considerations of the Smoking Termination Enhancement Project (STEP). STEP is a randomized clinical trial that compares a vigorous-intensity exercise intervention to a health and wellness education intervention as an aid for smoking cessation in adults with elevated AS. One hundred and fifty eligible participants will receive standard treatment (ST) for smoking cessation that includes cognitive behavioral therapy (CBT) and nicotine replacement therapy (NRT). In addition, participants will be randomly assigned to either an exercise intervention (ST+EX) or a health and wellness education intervention (ST+CTRL). Participants in both arms will meet 3 times a week for 15 weeks, receiving CBT once a week for the first 7 weeks, and 3 supervised exercise or health and wellness education sessions (depending on randomization) per week for the full 15-week intervention. Participants will be asked to set a quit date for 6 weeks after the baseline visit, and smoking cessation outcomes as well as putative mediator variables will be measured up to 6 months following the quit date. The primary objective of STEP is to evaluate whether vigorous-intensity exercise can aid smoking cessation in anxiety vulnerable adults. If effective, the use of vigorous-intensity exercise as a component of smoking cessation interventions would have a significant public health impact. Specifically, in addition to improving smoking cessation treatment outcome, exercise is expected to offer benefits to overall health, which may be particularly important for smokers. The study is also designed to test putative mediators of the intervention effects and therefore has the potential to advance the understanding of exercise-anxiety-smoking relations and guide future research on this topic. ClinicalTrials.gov, NCT01065506, http://clinicaltrials.gov/ct2/show/NCT01065506.

Treatment Attrition: Associations with Negative Affect Smoking Motives and Barriers to Quitting Among Treatment-Seeking Smokers

PubMed Central

Garey, Lorra; Kauffman, Brooke Y.; Neighbors, Clayton; Schmidt, Norman B.; Zvolensky, Michael J.

2016-01-01

Introduction Pre-treatment attrition and perceived barriers for quitting are clinically important processes involved in early phases of quitting smoking. However, less is known about the constructs that may contribute to these processes such as negative affect reduction smoking motives. Method The current study sought to evaluate the relation between negative affect reduction smoking motives with pre-treatment attrition and perceived barriers for quitting in a sample of 425 treatment-seeking smokers (48.5% female; Mage = 37.69; SD = 13.61) enrolled in a smoking cessation study examining the efficacy of a transdiagnostic panic-smoking cessation treatment relative to a standard smoking cessation treatment. Results Results indicated that greater negative affect reduction smoking motives was associated with an increased likelihood of treatment initiation (Odds Ratio = 1.49, CI: 1.09, 2.04). Additionally, negative affect reduction smoking motives was associated with greater perceived barriers for cessation among pre-treatment drop-outs and treatment initiators. Conclusions This initial investigation provides evidence for the possible clinical utility in addressing negative affect reduction smoking motives during early stages of quitting. Additionally, such findings could potentially inform the development of personalized, early stages of quitting interventions for smoking cessation. PMID:27518764

Higher levels of salivary alpha-amylase predict failure of cessation efforts in male smokers.

PubMed

Dušková, M; Simůnková, K; Hill, M; Hruškovičová, H; Hoskovcová, P; Králíková, E; Stárka, L

2010-01-01

The ability to predict the success or failure of smoking cessation efforts will be useful for clinical practice. Stress response is regulated by two primary neuroendocrine systems. Salivary cortisol has been used as a marker for the hypothalamus-pituitary-adrenocortical axis and salivary alpha-amylase as a marker for the sympathetic adrenomedullary system. We studied 62 chronic smokers (34 women and 28 men with an average age of 45.2+/-12.9 years). The levels of salivary cortisol and salivary alpha-amylase were measured during the period of active smoking, and 6 weeks and 24 weeks after quitting. We analyzed the men separately from the women. The men who were unsuccessful in cessation showed significantly higher levels of salivary alpha-amylase over the entire course of the cessation attempt. Before stopping smoking, salivary cortisol levels were higher among the men who were unsuccessful in smoking cessation. After quitting, there were no differences between this group and the men who were successful in cessation. In women we found no differences between groups of successful and unsuccessful ex-smokers during cessation. In conclusions, increased levels of salivary alpha-amylase before and during smoking cessation may predict failure to quit in men. On the other hand, no advantage was found in predicting the failure to quit in women. The results of our study support previously described gender differences in smoking cessation.

Determining counselling communication strategies associated with successful quits in the National Health Service community pharmacy Stop Smoking programme in East London: a focused ethnography using recorded consultations.

PubMed

Rivas, Carol; Sohanpal, Ratna; MacNeill, Virginia; Steed, Liz; Edwards, Elizabeth; Antao, Laurence; Griffiths, Chris; Eldridge, Sandra; Taylor, Stephanie; Walton, Robert

2017-10-27

To determine communication strategies associated with smoking cessation in the National Health Service community pharmacy Stop Smoking programme. 11 community pharmacies in three inner east London boroughs. 9 stop smoking advisers and 16 pairs of smokers who either quit or did not quit at 4 weeks, matched on gender, ethnicity, age and smoking intensity. 1-3 audio-recorded consultations between an adviser and each pair member over 5-6 weeks were analysed using a mixed-method approach. First a content analysis was based on deductive coding drawn from a theme-oriented discourse analysis approach and the Roter Interaction Analysis System. Core themes were identified through this quantification to explore in detail the qualitative differences and similarities between quitters and non-quitters. Quantitative analysis revealed advisers used a core set of counselling strategies that privileged the 'voice of medicine' and often omitted explicit motivational interviewing. Smokers tended to quit when these core strategies were augmented by supportive talk, clear permission for smokers to seek additional support from the adviser between consultations, encouragement for smokers to use willpower. The thematic analysis highlighted the choices made by advisers as to which strategies to adopt and the impacts on smokers. The first theme 'Negotiating the smoker-adviser relationship' referred to adviser judgements about the likelihood the smoker would quit. The second theme, 'Roles of the adviser and smoker in the quit attempt', focused on advisers' counselling strategies, while the third theme, 'Smoker and adviser misalignment on reasons for smoking, relapsing and quitting', concerned inconsistencies in the implementation of National Centre for Smoking Cessation and Training recommendations. Advisers in community pharmacies should use the advantages of their familiarity with smokers to ensure appropriate delivery of patient-centred counselling strategies and reflect on the impact on their counselling of early judgements of smoker success. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[Tobacco and plastic surgery: An absolute contraindication?

PubMed

Matusiak, C; De Runz, A; Maschino, H; Brix, M; Simon, E; Claudot, F

2017-08-01

Smoking increases perioperative risk regarding wound healing, infection rate and failure of microsurgical procedures. There is no present consensus about plastic and aesthetic surgical indications concerning smoking patients. The aim of our study is to analyze French plastic surgeons practices concerning smokers. A questionnaire was send by e-mail to French plastic surgeons in order to evaluate their own operative indications: patient information about smoking dangers, pre- and postoperative delay of smoking cessation, type of intervention carried out, smoking cessation supports, use of screening test and smoking limit associated to surgery refusing were studied. Statistical tests were used to compare results according to practitioner activity (liberal or public), own smoking habits and time of installation. In 148 questionnaires, only one surgeon did not explain smoking risk. Of the surgeons, 49.3% proposed smoking-cessation supports, more frequently with public practice (P=0.019). In total, 85.4% of surgeons did not use screening tests. Years of installation affected operative indication with smoking patients (P=0.02). Pre- and postoperative smoking cessation delay were on average respectively 4 and 3 weeks in accordance with literature. Potential improvements could be proposed to smoking patients' care: smoking cessation assistance, screening tests, absolute contraindication of some procedures or level of consumption to determine. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Minority Stress, Smoking Patterns, and Cessation Attempts: Findings From a Community-Sample of Transgender Women in the San Francisco Bay Area.

PubMed

Gamarel, Kristi E; Mereish, Ethan H; Manning, David; Iwamoto, Mariko; Operario, Don; Nemoto, Tooru

2016-03-01

Research has demonstrated associations between reports of minority stressors and smoking behaviors among lesbian, gay, and bisexual populations; however, little is known about how minority stressors are related to smoking behaviors and cessation attempts among transgender women. The purpose of this study was twofold: (1) to examine the associations between transgender-based discrimination and smoking patterns among a sample of transgender women; and (2) to identify barriers to smoking cessation in a sample of transgender women with a history of smoking. A community sample of 241 transgender women completed a one-time survey. Binary and multinomial logistic regression models examined associations between minority stressors and (1) smoking behaviors and (2) cessation attempts. Both models adjusted for income, education, race/ethnicity, recent sex work, HIV status, depression, alcohol use, and current hormone use. Overall, 83% of participants indicated that they had smoked a cigarette in the last month. Of these women, 62.3% reported daily smoking and 51.7% reported an unsuccessful quit attempt. Discrimination was positively associated with currently smoking (adjusted odds ratio [AOR] = 1.04, 95% confidence interval [CI]: 1.01, 1.08). Discrimination was positively associated with unsuccessful cessation (AOR = 1.03, 95% CI: 1.01, 1.18) and never attempting (AOR = 1.04, 95% CI: 1.01, 1.11) compared to successful cessation. Discrimination was also positively associated with never attempting compared to unsuccessful cessation (AOR = 1.01, 95% CI: 1.00, 1.03). Smoking cessation may be driven by unique transgender-related minority stressors, such as discrimination. Future research is warranted to address unique stigmatizing contexts when understanding and providing tailored intervention addressing smoking among transgender women. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Individual- and Area-level Unemployment Influence Smoking Cessation Among African Americans Participating in a Randomized Clinical Trial

PubMed Central

Kendzor, Darla E.; Reitzel, Lorraine R.; Mazas, Carlos A.; Cofta-Woerpel, Ludmila M.; Cao, Yumei; Ji, Lingyun; Costello, Tracy J.; Vidrine, Jennifer Irvin; Businelle, Michael S.; Li, Yisheng; Castro, Yessenia; Ahluwalia, Jasjit S.; Cinciripini, Paul M.; Wetter, David W.

2012-01-01

African Americans suffer disproportionately from the adverse health consequences of smoking, and also report substantially lower socioeconomic status than Whites and other racial/ethnic groups in the U.S. Although socioeconomic disadvantage is known to have a negative influence on smoking cessation rates and overall health, little is known about the influence of socioeconomic status on smoking cessation specifically among African Americans. Thus, the purpose of the current study was to characterize the impact of several individual- and area-level indicators of socioeconomic status on smoking cessation among African Americans. Data were collected as part of a smoking cessation intervention study for African American smokers (N = 379) recruited from the Houston, Texas, metropolitan area, who participated in the study between 2005 and 2007. The separate and combined influences of individual-level (insurance status, unemployment, education, and income) and area-level (neighborhood unemployment, education, income, and poverty) indicators of socioeconomic status on continuous smoking abstinence were examined across time intervals using continuation ratio logit modeling. Individual-level analyses indicated that unemployment was significantly associated with reduced odds of smoking abstinence, while higher income was associated with greater odds of abstinence. However, only unemployment remained a significant predictor of abstinence when unemployment and income were included in the model together. Area-level analyses indicated that greater neighborhood unemployment and poverty were associated with reduced odds of smoking abstinence, while greater neighborhood education was associated with higher odds of abstinence. However, only neighborhood unemployment remained significantly associated with abstinence status when individual-level income and unemployment were included in the model. Overall, findings suggest that individual- and area-level unemployment have a negative impact on smoking cessation among African Americans. Addressing unemployment through public policy and within smoking cessation interventions, and providing smoking cessation treatment for the unemployed may have a beneficial impact on tobacco-related health disparities. PMID:22405506

Individual- and area-level unemployment influence smoking cessation among African Americans participating in a randomized clinical trial.

PubMed

Kendzor, Darla E; Reitzel, Lorraine R; Mazas, Carlos A; Cofta-Woerpel, Ludmila M; Cao, Yumei; Ji, Lingyun; Costello, Tracy J; Vidrine, Jennifer Irvin; Businelle, Michael S; Li, Yisheng; Castro, Yessenia; Ahluwalia, Jasjit S; Cinciripini, Paul M; Wetter, David W

2012-05-01

African Americans suffer disproportionately from the adverse health consequences of smoking, and also report substantially lower socioeconomic status than Whites and other racial/ethnic groups in the U.S. Although socioeconomic disadvantage is known to have a negative influence on smoking cessation rates and overall health, little is known about the influence of socioeconomic status on smoking cessation specifically among African Americans. Thus, the purpose of the current study was to characterize the impact of several individual- and area-level indicators of socioeconomic status on smoking cessation among African Americans. Data were collected as part of a smoking cessation intervention study for African American smokers (N = 379) recruited from the Houston, Texas, metropolitan area, who participated in the study between 2005 and 2007. The separate and combined influences of individual-level (insurance status, unemployment, education, and income) and area-level (neighborhood unemployment, education, income, and poverty) indicators of socioeconomic status on continuous smoking abstinence were examined across time intervals using continuation ratio logit modeling. Individual-level analyses indicated that unemployment was significantly associated with reduced odds of smoking abstinence, while higher income was associated with greater odds of abstinence. However, only unemployment remained a significant predictor of abstinence when unemployment and income were included in the model together. Area-level analyses indicated that greater neighborhood unemployment and poverty were associated with reduced odds of smoking abstinence, while greater neighborhood education was associated with higher odds of abstinence. However, only neighborhood unemployment remained significantly associated with abstinence status when individual-level income and unemployment were included in the model. Overall, findings suggest that individual- and area-level unemployment have a negative impact on smoking cessation among African Americans. Addressing unemployment through public policy and within smoking cessation interventions, and providing smoking cessation treatment for the unemployed may have a beneficial impact on tobacco-related health disparities. Copyright © 2012 Elsevier Ltd. All rights reserved.

The association between anxiety sensitivity and motivation to quit smoking among women and men in residential substance use treatment.

PubMed

Dahne, Jennifer; Hoffman, Elana M; MacPherson, Laura

2015-01-01

Smoking-attributed mortality is the leading cause of death among individuals in residential substance use treatment. As such, identifying factors that influence smoking cessation is highly relevant and important for this group. Motivation to quit (MTQ) smoking is one such factor that is related to smoking cessation. In the present study we examine the relationship between Anxiety Sensitivity (AS) and MTQ among individuals enrolled in a residential substance use treatment center in Washington, DC. In light of gender differences in smoking cessation as well as factors that contribute to cessation, we examined this relationship by gender in men and women using multiple group path analysis. Participants (n = 472) completed a measure of MTQ, the structured clinical interview for DSM-IV (SCID-IV-TR), a measure of AS, and self-reported their number of cigarettes smoked per day prior to entering a restricted environment. RESULTS indicated that AS was significantly related to MTQ in women (standardized path estimate = 0.21, p = .01), but was not significantly related to MTQ in men. Conclusions/Importance: Findings suggest the importance of considering AS as a factor in MTQ for women and subsequent smoking cessation among individuals in residential substance use treatment. RESULTS of this study contribute to the extant literature on predictors of MTQ and highlight the need for tailored cessation interventions with AS as one potential cessation treatment target.

Relations of Alcohol Consumption with Smoking Cessation Milestones and Tobacco Dependence

ERIC Educational Resources Information Center

Cook, Jessica W.; Fucito, Lisa M.; Piasecki, Thomas M.; Piper, Megan E.; Schlam, Tanya R.; Berg, Kristin M.; Baker, Timothy B.

2012-01-01

Objective: Alcohol consumption is associated with smoking cessation failure in both community and clinical research. However, little is known about the relation between alcohol consumption and smoking cessation milestones (i.e., achieving initial abstinence, avoiding lapses and relapse). Our objective in this research was to examine the relations…

Functional Health Literacy and Smoking Cessation Outcomes

ERIC Educational Resources Information Center

Varekojis, Sarah M.; Miller, Larry; Schiller, M. Rosita; Stein, David

2011-01-01

Purpose: This paper aims to describe the relationship between functional health literacy level and smoking cessation outcomes. Design/methodology/approach: Participants in an inpatient smoking cessation program in a mid-western city in the USA were enrolled and the Short Test of Functional Health Literacy in Adults was administered while the…

Smoking Cessation Delivered by Medical Students Is Helpful to Homeless Population

ERIC Educational Resources Information Center

Spector, Andrew; Alpert, Hilary; Karam-Hage, Maher

2007-01-01

Objective: The authors pilot a smoking-cessation outreach for the homeless that extends medical students' tobacco cessation education. Method: In this prospective study, second-year medical students administered cognitive behavior therapy or unstructured support to homeless subjects to help them quit smoking. Self-report and biological measures…

Efficacy of Incorporating Experiencing Exercises into a Smoking Cessation Curriculum.

ERIC Educational Resources Information Center

Watt, Celia A.; Manaster, Guy

2003-01-01

Examines the impact of experiential exercises, combined with a traditional smoking cessation intervention, on quit rates and social learning theory variables known to impact smoking cessation. Measures of self-efficacy and locus of control did not significantly differ between the experimental and control conditions. Quit rates did not differ…

Training Malaysian Pharmacy Undergraduates with Knowledge and Skills on Smoking Cessation

PubMed Central

Brewster, Joan M.; Nik Mohamed, Mohamad Haniki

2015-01-01

Objective. To evaluate the feasibility of an online training module, Certified Smoking Cessation Service Provider (CSCSP), developed for practicing pharmacists to equip pharmacy students with knowledge necessary for smoking cessation counseling and to assess the changes in student knowledge and skills regarding smoking cessation following training. Design. Sixty third-year and 80 fourth-year pharmacy undergraduates (N=140) were given access to an online module, the main intervention in the study. Two linkable questionnaires were administered to assess students’ preintervention and postintervention knowledge. For the third-year students, an additional role-play training component was incorporated, and student skills were assessed during week 14 with an Objective Structured Clinical Examination (OSCE). Assessment. Preintervention and postintervention knowledge assessments were completed by 130 (92.8%) students. Sixty-six students scored above 50% for the knowledge component postintervention, compared to 13 at preintervention, demonstrating significant improvement (x2(1, N=130)=32, p=0.003). All third-year students completed the intervention, and 66.7% were able to counsel excellently for smoking cessation, scoring more than 80%. Conclusion. The CSCSP online module developed for practicing professionals was found suitable for equipping pharmacy undergraduates with knowledge on smoking cessation topics. The module, along with role-play training, also equipped students with knowledge and skills to provide smoking cessation counseling. PMID:26246620

Mind-body practices: an alternative, drug-free treatment for smoking cessation? A systematic review of the literature.

PubMed

Carim-Todd, Laura; Mitchell, Suzanne H; Oken, Barry S

2013-10-01

The limited success of current smoking cessation therapies encourages research into new treatment strategies. Mind-body practices such as yoga and meditation have the potential to aid smoking cessation and become an alternative drug-free treatment option. The aim of this article is to assess the efficacy of yoga and other meditation-based interventions for smoking cessation, to identify the challenges of clinical trials applying mind-body treatments, and to outline directions for future research on these types of therapies to assist in smoking cessation. A systematic review of the scientific literature. Fourteen clinical trials met the inclusion criteria defined for this review. Each article was reviewed thoroughly, and evaluated for quality, design, and methodology. Although primary outcomes differed between studies, the fourteen articles, most with limitations, reported promising effects supporting further investigation of the use of these practices to improve smoking cessation. The literature supports yoga and meditation-based therapies as candidates to assist smoking cessation. However, the small number of studies available and associated methodological problems require more clinical trials with larger sample sizes and carefully monitored interventions to determine rigorously if yoga and meditation are effective treatments. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Mind-body practices: an alternative, drug-free treatment for smoking cessation? A systematic review of the literature

PubMed Central

Carim-Todd, Laura; Mitchell, Suzanne H.; Oken, Barry S.

2013-01-01

Objective The limited success of current smoking cessation therapies encourages research into new treatment strategies. Mind-body practices such as yoga and meditation have the potential to aid smoking cessation and become an alternative drug-free treatment option. The aim of this article is to assess the efficacy of yoga and other meditation-based interventions for smoking cessation, to identify the challenges of clinical trials applying mind-body treatments, and to outline directions for future research on these types of mind-body therapies to assist in smoking cessation. Method A systematic review of the scientific literature. Results Fourteen clinical trials met the inclusion criteria defined for this review. Each article was reviewed thoroughly, and evaluated for quality, design, and methodology. Although primary outcomes differed between studies, the fourteen articles, most with some limitations, reported promising effects supporting further investigation of the use of these practices to improve smoking cessation. Conclusions The literature supports yoga and meditation-based therapies as candidates to assist smoking cessation. However, the small number of studies available and associated methodological problems require more clinical trials with larger sample sizes and carefully monitored interventions to determine rigorously if yoga and meditation are effective treatments. PMID:23664122

[Pharmacogenetics in the treatment of tobacco addiction].

PubMed

Quaak, M; van Schooten, F J; van Schayck, C P

2013-01-01

Smokers vary in their genetic susceptibility to become addicted to smoking and probably also in their reaction to smoking cessation pharmacotherapies. To provide an overview of the developments on the pharmacogenetics of the treatment of tobacco addiction. Review article describing the biological processes associated with tobacco addiction, and the influence of genetic variants on smoking behavior and the efficacy of smoking cessation therapies. Several (combinations of) genetic variants in smoking-related genes influence nicotine dependence. Moreover, several genetic variants in smoking- and treatment-related genes seem to influence the efficacy of smoking cessation therapies which are distinctive for the different forms of pharmacotherapy, especially when they have a different mechanism-of-action. Much progress has been made in unraveling the (pharmaco)genetics of tobacco addiction, but much still remains to be done before genetically tailored smoking cessation therapy can be implemented in clinical practice.

Masculinity and Fatherhood: New Fathers' Perceptions of Their Female Partners' Efforts to Assist Them to Reduce or Quit Smoking.

PubMed

Kwon, Jae-Yung; Oliffe, John L; Bottorff, Joan L; Kelly, Mary T

2015-07-01

Health promotion initiatives to reduce smoking among parents have focused almost exclusively on women to support their cessation during pregnancy and postpartum, while overlooking the importance of fathers' smoking cessation. This study was a secondary analysis of in-depth interviews with 20 new and expectant fathers to identify how they perceived their female partners' efforts to assist them to reduce or quit smoking. Social constructionist gender frameworks were used to theorize and develop the findings. Three key themes were identified: support and autonomy in men's smoking cessation, perception of challenging men's freedom to smoke, and contempt for men's continued smoking. The findings suggest that shifts in masculinities as men take up fathering should be considered in designing smoking cessation interventions for fathers. © The Author(s) 2014.

General and smoking cessation weight concern in a Hispanic sample of light and intermittent smokers.

PubMed

Landrau-Cribbs, Erica; Cabriales, José Alonso; Cooper, Theodore V

2015-02-01

This study assessed general and cessation related weight concerns in a Hispanic sample of light (≤10 cigarettes per day) and intermittent (non-daily smoking) smokers (LITS) participating in a brief smoking cessation intervention. Three hundred and fifty-four Hispanic LITS (Mage=34.2, SD=14; 51.1% male; 57.9% Mexican American; 59.0% daily light, 41.0% intermittent) completed baseline measures assessing demographics, tobacco use/history, stage of change (SOC), general weight concern, and cessation related weight concern. Three multiple logistic regression models examined potential predictors (i.e., age, gender, SOC, cigarettes per month, smoking status [daily vs non-daily], weight, cessation related weight concern, general weight concern) of general weight concern, cessation related weight concern, and past 30day abstinence (controlling for the intervention). Study results indicated that a majority of participants reported general weight concern (59.6%), and slightly more than a third (35.6%) reported post cessation weight gain concern (mean and median weight tolerated before relapse were within the 10-12lb range). Lower weight and endorsing general weight concern were associated with cessation related weight concern. Female gender, higher weight, and endorsing cessation related weight concern were associated with general weight concern. Monthly cigarette use was associated with smoking cessation at the three-month follow-up. The results indicate a substantial prevalence of general weight concern and non-trivial rates of cessation related weight concern in Hispanic LITS attempting to quit, and greater success in quitting among those who reported lower rates of cigarettes smoked per month. Copyright © 2014 Elsevier Ltd. All rights reserved.

Smoke and mirrors: how Massachusetts diverted millions in tobacco tax revenues.

PubMed

Ritch, Wendy A; Begay, Michael E

2002-07-01

This study examines the politics of appropriating Question 1 tobacco tax revenues in the first budget year after Massachusetts voters passed the ballot initiative in 1992. The initiative increased the tobacco tax on cigarettes by 25 cents per pack and on smokeless tobacco by 25% of the wholesale price. Data were collected from newspapers, letters, memoranda, budgets, press releases, legislative floor debates, government documents, legislative journals, personal interviews, and tobacco industry documents that were downloaded from the Tobacco Archives internet site. During the first budget year, programmes mentioned by the initiative that were not exclusively tobacco related accounted for 27% of total Question 1 expenditures, while 50% of the revenues were allocated for programmes that were neither mentioned by the initiative nor provided any tobacco education, prevention, and cessation services. Only 23% of Question 1 funds were appropriated for programmes that provided exclusively tobacco education, prevention, and cessation services. Question 1 revenues were also used to supplant funding for pre-existing programmes, which was explicitly prohibited by the initiative. The first budget year became the template for Question 1 appropriations in subsequent fiscal years. Politics did not end after voters passed Question 1. Public health advocates lacked a strategy and budget plan to influence the appropriation of Question 1 funds after the passage of this ballot initiative.

Smoke and mirrors: how Massachusetts diverted millions in tobacco tax revenues.

PubMed

Ritch, W A; Begay, M E

2001-12-01

This study examines the politics of appropriating Question 1 tobacco tax revenues in the first budget year after Massachusetts voters passed the ballot initiative in 1992. The initiative increased the tobacco tax on cigarettes by 25 cents per pack and on smokeless tobacco by 25% of the wholesale price. Data were collected from newspapers, letters, memoranda, budgets, press releases, legislative floor debates, government documents, legislative journals, personal interviews, and tobacco industry documents that were downloaded from the Tobacco Archives internet site. During the first budget year, programmes mentioned by the initiative that were not exclusively tobacco related accounted for 27% of total Question 1 expenditures, while 50% of the revenues were allocated for programmes that were neither mentioned by the initiative nor provided any tobacco education, prevention, and cessation services. Only 23% of Question 1 funds were appropriated for programmes that provided exclusively tobacco education, prevention, and cessation services. Question 1 revenues were also used to supplant funding for pre-existing programmes, which was explicitly prohibited by the initiative. The first budget year became the template for Question 1 appropriations in subsequent fiscal years. Politics did not end after voters passed Question 1. Public health advocates lacked a strategy and budget plan to influence the appropriation of Question 1 funds after the passage of this ballot initiative.

An Online Survey of Family Members' Beliefs and Attitudes About Smoking and Mental Illness.

PubMed

Aschbrenner, Kelly A; Dixon, Lisa B; Naslund, John A; Bienvenida, John Carlo M; McManus, Kinsey L; Bartels, Stephen J; Brunette, Mary F

2017-01-01

Family beliefs about smoking and cessation may influence whether individuals with mental illness who smoke use effective cessation treatment. We surveyed family members online regarding beliefs about smoking and cessation among people with mental illness. Method: Two hundred fifty-six family members of individuals with mental illness completed an online survey. Responses were summarized and t tests were used to compare responses based on the family member's smoking status. One-quarter of respondents agreed that people with mental illness must smoke to manage mental health symptoms, nearly half (48%) expressed uncertainty about the whether nicotine replacement therapy is harmful for this population, and 69% believed that family members do not have the skills to help an individual with mental illness quit smoking. Misconceptions about smoking and mental illness and uncertainty about the safety of cessation treatment may interfere with family support for quitting smoking among people with mental illness.

Associations between health literacy and established predictors of smoking cessation.

PubMed

Stewart, Diana W; Adams, Claire E; Cano, Miguel A; Correa-Fernández, Virmarie; Li, Yisheng; Waters, Andrew J; Wetter, David W; Vidrine, Jennifer Irvin

2013-07-01

We examined associations between health literacy and predictors of smoking cessation among 402 low-socioeconomic status (SES), racially/ethnically diverse smokers. Data were collected as part of a larger study evaluating smoking health risk messages. We conducted multiple linear regression analyses to examine relations between health literacy and predictors of smoking cessation (i.e., nicotine dependence, smoking outcome expectancies, smoking risk perceptions and knowledge, self-efficacy, intentions to quit or reduce smoking). Lower health literacy was associated with higher nicotine dependence, more positive and less negative smoking outcome expectancies, less knowledge about smoking health risks, and lower risk perceptions. Associations remained significant (P < .05) after controlling for demographics and SES-related factors. These results provide the first evidence that low health literacy may serve as a critical and independent risk factor for poor cessation outcomes among low-socioeconomic status, racially/ethnically diverse smokers. Research is needed to investigate potential mechanisms underlying this relationship.

Have guidelines about smoking cessation support in pregnancy changed practice in Victoria, Australia?

PubMed

Perlen, Susan; Brown, Stephanie J; Yelland, Jane

2013-06-01

Antenatal smoking cessation guidelines have been available in Victoria, Australia, for the past decade. The objective of this study was to assess to what extent introduction of smoking cessation guidelines in pregnancy changed practice in Victorian public hospitals. Two population-based postal surveys of women giving birth in the state of Victoria, conducted in 2000 and 2008 before and after implementation of smoking cessation guidelines. Self-administered questionnaires were distributed by hospitals and home birth practitioners to women 5-6 months postpartum. Surveys were completed and returned by 67 percent of eligible women (1,616/2,412) in 2000 and 51% (2,900/5,681) in 2008. Compared with the 2000 survey, women in the 2008 survey attending public sector care were more likely: to receive advice on how to stop smoking (Adjusted Odds Ratio: 2.2, 95% CI 1.5-3.2); to be given written information (Adj OR: 2.7, 95% CI 1.8-4.0); to be referred to stop smoking programs (Adj OR: 6.1, 95% CI 3.1-11.7); and to have discussed smoking cessation at more than one visit (Adj OR: 1.5, 95% CI 1.0-2.2). While the majority of women in both surveys were asked about smoking in early pregnancy, about half of those smoking did not receive advice on how to stop or cut down; were not given written information; were not told about/referred to stop smoking programs and were not asked again about smoking at subsequent visits. The significant shift in women's reports of receiving smoking cessation advice and support between the two surveys occurred predominantly at public hospitals where women received all or some antenatal care. Smoking cessation guidelines in Victorian public hospitals have increased the extent to which pregnant women receive advice and support to stop or reduce smoking. However, half of smokers did not receive the full complement of advice and support according to state guidelines, with marked variability according to where and from whom women received antenatal care. Further efforts are needed to implement smoking cessation advice and support in clinical practice. © 2013, Copyright the Authors, Journal compilation © 2013, Wiley Periodicals, Inc.

SMOKING CESSATION INTERVENTIONS FOR HOSPITALIZED SMOKERS: A SYSTEMATIC REVIEW

PubMed Central

Rigotti, Nancy A.; Munafo, Marcus R.; Stead, Lindsay F.

2009-01-01

Background A hospital admission provides an opportunity to help people stop smoking. Providing smoking cessation advice, counselling, or medication is now a quality-of-care measure for U.S. hospitals. We assessed the effectiveness of smoking cessation interventions initiated during a hospital stay. Methods We searched the Cochrane Tobacco Addiction Review Group's register for randomized and quasi-randomized controlled trials of smoking cessation interventions (behavioral counselling and/or pharmacotherapy) that began during hospitalization and had a minimum of 6 months follow-up. Two authors independently extracted data from each paper, with disagreements resolved by consensus. Results 33 trials met inclusion criteria. Smoking counselling that began during hospitalization and included supportive contacts for >1 month after discharge increased smoking cessation rates at 6-12 months (pooled OR 1.65, 95% CI 1.44-1.90). No benefit was found for interventions with less post-discharge contact. Counselling was effective when offered to all hospitalized smokers and to the subset admitted for cardiovascular disease. Adding nicotine replacement therapy to counselling produced a trend toward efficacy over counseling alone (OR 1.47, 95% CI 0.92-2.35). One study added bupropion to counselling. It had a nonsignificant result (OR 1.56, 95% CI 0.79-3.06). Conclusions Offering smoking cessation counselling to all hospitalized smokers is effective as long as supportive contacts continue for >1 month after discharge. Adding NRT to counselling may further increase smoking cessation rates and should be offered when clinically indicated, especially to hospitalized smokers with nicotine withdrawal symptoms. PMID:18852395

ASPO Joseph W. Cullen Memorial Award Lecture. Bridging the clinical and public health perspectives in tobacco treatment research: scenes from a tobacco treatment research career.

PubMed

Curry, S J

2001-04-01

This paper, delivered as the 2000 Joseph W. Cullen Memorial Award Lecture, reviews smoking cessation treatment research conducted over the past 15 years at the Center for Health Studies, Group Health COOPERATIVE: The research program includes assessment, treatment, and health services research that addressed four main questions: (a) What motivates people to quit smoking? (b) Are self-help interventions effective? (c) Can health care benefits impact the utilization of smoking cessation services? and (d) Does smoking cessation impact health care utilization and costs? In the area of motivation for smoking cessation, an intrinsic-extrinsic model of type of motivation for smoking cessation was used to develop and validate a reasons for quitting scale. Results from administration of the scale across different samples of smokers show that higher levels of intrinsic relative to extrinsic motivation predicts successful cessation. A series of five randomized trials of self-help interventions indicate that self-help interventions accompanied by motivational feedback and/or outreach telephone counseling can be effective. However, the same interventions did not improve long-term abstinence rates in non-volunteer samples of smokers. With regard to health care benefits, we find that full coverage of smoking cessation services improves the reach of proven interventions into the general population of smokers with no significant reductions in effectiveness. Furthermore, studies of smoking cessation and health care utilization find that, although quitters have higher initial costs, their costs go down at the same time that those of continuing smokers' begin to accelerate. Cessation appears to reverse a trajectory of higher health care costs.

Effects of preoperative smoking cessation on the incidence and risk of intraoperative and postoperative complications in adult smokers: a systematic review

PubMed Central

Theadom, Alice; Cropley, Mark

2006-01-01

Objectives To establish the effect of preoperative smoking cessation on the risk of postoperative complications, and to identify the effect of the timing of preoperative cessation. Data sources The Cochrane Library Database, PsycINFO, EMBASE, Medline, and CINAHL databases were searched, using the terms: “smoking”, “smoking‐cessation”, “tobacco‐use”, “tobacco‐abstinence”, “cigarett$”, “complication$”, “postoperative‐complication$”, “preoperative”, “perioperative” and “surg$”. Further articles were obtained from reference lists. The search was limited to articles on adults, written in English and published up to November 2005. Study selection Prospective cohort designs exploring the effects of preoperative smoking cessation on postoperative complications were included. Two reviewers independently scanned abstracts of relevant articles to determine eligibility. Lack of agreement was resolved through discussion and consensus. Twelve studies met the inclusion criteria. Data extraction Methodological quality was assessed by both reviewers, exploring validation of smoking status, clear definition of the period of smoking cessation, control for confounding variables and length of follow‐up. Data synthesis Only four of the studies specified the exact period of smoking cessation, with six studies specifying the length of the follow‐up period. Five studies revealed a lower risk or incidence of postoperative complications in past smokers than current smokers or reported that there was no significant difference between past smokers and non‐smokers. Conclusions Longer periods of smoking cessation appear to be more effective in reducing the incidence/risk of postoperative complications; there was no increased risk in postoperative complications from short term cessation. An optimal period of preoperative smoking cessation could not be identified from the available evidence. PMID:16998168

Reasons for smoking cessation attempts among Japanese male smokers vary by nicotine dependence level: a cross-sectional study after the 2010 tobacco tax increase

PubMed Central

Tanihara, Shinichi; Momose, Yoshito

2015-01-01

Objectives To examine the association between smoking cessation attempts during the previous 12 months, motivators to quit smoking and nicotine dependence levels among current male smokers after Japan's massive 2010 tobacco tax increase. Design Cross-sectional study. Setting A self-reported questionnaire about smoking habits, nicotine dependence levels and factors identified as motivators to quit smoking was administered to 9378 employees working at a company located in Fukuoka Prefecture in Japan (as of 1 October 2011). Participants A total of 2251 male current smokers 20–69 years old. Primary and secondary outcome measures Nicotine dependence level assessed by Fagerström Test for Cigarette Dependence (FTCD), smoking cessation attempts during the previous 12 months and motivators for smoking cessation. Results The proportion of current smokers who had attempted to quit smoking within the previous 12 months was 40.6%. Nicotine dependence level of current smokers was negatively associated with cessation attempts during the previous 12 months. Motivators for smoking cessation differed by nicotine dependence levels. ‘The rise in cigarette prices since October 2010’ as a smoking cessation motivator increased significantly at the medium nicotine dependence level (OR 1.44, 95% CI 1.09 to 1.90); however, this association was not statistically significant for individuals with high nicotine dependence (OR 1.24, 95% CI 0.80 to 1.92). ‘Feeling unhealthy’ was significantly negatively associated for medium (OR 0.42, 95% CI 0.27 to 0.65) and high (OR 0.31, 95% CI 0.14 to 0.71) nicotine dependence levels. Trend associations assessed by assigning ordinal numbers to total FTCD score for those two motivators were statistically significant. Conclusions The efficacy of smoking cessation strategies can be improved by considering the target group's nicotine dependence level. For smokers with medium and high nicotine dependence levels, more effective strategies aimed at encouraging smoking cessation, such as policy interventions including increasing tobacco taxes, are needed. PMID:25795690

Reasons for smoking cessation attempts among Japanese male smokers vary by nicotine dependence level: a cross-sectional study after the 2010 tobacco tax increase.

PubMed

Tanihara, Shinichi; Momose, Yoshito

2015-03-20

To examine the association between smoking cessation attempts during the previous 12 months, motivators to quit smoking and nicotine dependence levels among current male smokers after Japan's massive 2010 tobacco tax increase. Cross-sectional study. A self-reported questionnaire about smoking habits, nicotine dependence levels and factors identified as motivators to quit smoking was administered to 9378 employees working at a company located in Fukuoka Prefecture in Japan (as of 1 October 2011). A total of 2251 male current smokers 20-69 years old. Nicotine dependence level assessed by Fagerström Test for Cigarette Dependence (FTCD), smoking cessation attempts during the previous 12 months and motivators for smoking cessation. The proportion of current smokers who had attempted to quit smoking within the previous 12 months was 40.6%. Nicotine dependence level of current smokers was negatively associated with cessation attempts during the previous 12 months. Motivators for smoking cessation differed by nicotine dependence levels. 'The rise in cigarette prices since October 2010' as a smoking cessation motivator increased significantly at the medium nicotine dependence level (OR 1.44, 95% CI 1.09 to 1.90); however, this association was not statistically significant for individuals with high nicotine dependence (OR 1.24, 95% CI 0.80 to 1.92). 'Feeling unhealthy' was significantly negatively associated for medium (OR 0.42, 95% CI 0.27 to 0.65) and high (OR 0.31, 95% CI 0.14 to 0.71) nicotine dependence levels. Trend associations assessed by assigning ordinal numbers to total FTCD score for those two motivators were statistically significant. The efficacy of smoking cessation strategies can be improved by considering the target group's nicotine dependence level. For smokers with medium and high nicotine dependence levels, more effective strategies aimed at encouraging smoking cessation, such as policy interventions including increasing tobacco taxes, are needed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

An Evaluation of a Therapist-Administered Bibliotherapy and Spouse Smoking Habits on Smoking Behavior.

ERIC Educational Resources Information Center

Seibel, Barbara L.

1979-01-01

Attempted to evaluate a readily available comprehensive bibliothearpy smoking cessation program and the impact of smoking and nonsmoking behavior of a spouse on the individual to stop smoking. Results suggest that motivation is an important variable in smoking cessation. (Author)

Socioeconomic Inequalities in Smoking and Smoking Cessation Due to a Smoking Ban: General Population-Based Cross-Sectional Study in Luxembourg.

PubMed

Tchicaya, Anastase; Lorentz, Nathalie; Demarest, Stefaan

2016-01-01

This study aimed to measure changes in socioeconomic inequalities in smoking and smoking cessation due to the 2006 smoking ban in Luxembourg. Data were derived from the PSELL3/EU-SILC (Panel Socio-Economique Liewen Zu Letzebuerg/European Union--Statistic on Income and Living Conditions) survey, which was a representative survey of the general population aged ≥16 years conducted in Luxembourg in 2005, 2007, and 2008. Smoking prevalence and smoking cessation due to the 2006 smoking ban were used as the main smoking outcomes. Two inequality measures were calculated to assess the magnitude and temporal trends of socioeconomic inequalities in smoking: the prevalence ratio and the disparity index. Smoking cessation due to the smoking ban was considered as a positive outcome. Three multiple logistic regression models were used to assess social inequalities in smoking cessation due to the 2006 smoking ban. Education level, income, and employment status served as proxies for socioeconomic status. The prevalence of smoking decreased by 22.5% between 2005 and 2008 (from 23.1% in 2005 to 17.9% in 2008), but socioeconomic inequalities in smoking persisted. Smoking prevalence decreased by 24.2% and 20.2% in men and women, respectively; this difference was not statistically significant. Smoking cessation in daily smokers due to the 2006 smoking ban was associated with education level, employment status, and income, with higher percentages of quitters among those with a lower socioeconomic status. The decrease in smoking prevalence after the 2006 law was also associated with a reduction in socioeconomic inequalities, including differences in education level, income, and employment status. Although the smoking ban contributed to a reduction of such inequalities, they still persist, indicating the need for a more targeted approach of smoke-free policies directed toward lower socioeconomic groups.

Socioeconomic Inequalities in Smoking and Smoking Cessation Due to a Smoking Ban: General Population-Based Cross-Sectional Study in Luxembourg

PubMed Central

Tchicaya, Anastase; Lorentz, Nathalie; Demarest, Stefaan

2016-01-01

This study aimed to measure changes in socioeconomic inequalities in smoking and smoking cessation due to the 2006 smoking ban in Luxembourg. Data were derived from the PSELL3/EU-SILC (Panel Socio-Economique Liewen Zu Letzebuerg/European Union—Statistic on Income and Living Conditions) survey, which was a representative survey of the general population aged ≥16 years conducted in Luxembourg in 2005, 2007, and 2008. Smoking prevalence and smoking cessation due to the 2006 smoking ban were used as the main smoking outcomes. Two inequality measures were calculated to assess the magnitude and temporal trends of socioeconomic inequalities in smoking: the prevalence ratio and the disparity index. Smoking cessation due to the smoking ban was considered as a positive outcome. Three multiple logistic regression models were used to assess social inequalities in smoking cessation due to the 2006 smoking ban. Education level, income, and employment status served as proxies for socioeconomic status. The prevalence of smoking decreased by 22.5% between 2005 and 2008 (from 23.1% in 2005 to 17.9% in 2008), but socioeconomic inequalities in smoking persisted. Smoking prevalence decreased by 24.2% and 20.2% in men and women, respectively; this difference was not statistically significant. Smoking cessation in daily smokers due to the 2006 smoking ban was associated with education level, employment status, and income, with higher percentages of quitters among those with a lower socioeconomic status. The decrease in smoking prevalence after the 2006 law was also associated with a reduction in socioeconomic inequalities, including differences in education level, income, and employment status. Although the smoking ban contributed to a reduction of such inequalities, they still persist, indicating the need for a more targeted approach of smoke-free policies directed toward lower socioeconomic groups. PMID:27100293

The second Chicago televised smoking cessation program: a 24-month follow-up.

PubMed Central

Warnecke, R B; Langenberg, P; Wong, S C; Flay, B R; Cook, T D

1992-01-01

OBJECTIVES. As smoking decreases in the population, the remaining smoking population will change, and cessation initiatives will have to incorporate strategies designed for these smokers. METHODS. To study patterns of response to a cessation intervention composed of 20 televised segments and the American Lung Association Freedom from Smoking in 20 Days manual, this study compared cessation rates over 24 months in a cohort of smokers who registered for a cessation program with those in a cohort selected from the smoking population at large. RESULTS. At post intervention, multiple point prevalence of cessation among participants, adjusted for baseline smoking, was 14% among registrants and 6% in the population; at 24 months the adjusted rates were 6% and 2%, respectively. Heavy smokers benefited more than light smokers, and there was a consistent dose-response relationship between extent of exposure to the intervention and cessation. CONCLUSION. The effects of the intervention were strongest for those who read the manual and watched the programs daily. Manual use was important, and those who did not read it did not appear to benefit. Compared to the population and given full participation, heavy smokers benefited more than lighter smokers. PMID:1585964

A mixed‐method systematic review and meta‐analysis of mental health professionals' attitudes toward smoking and smoking cessation among people with mental illnesses

PubMed Central

Sheals, Kate; Tombor, Ildiko; McNeill, Ann

2016-01-01

Abstract Background and aims People with mental illnesses and substance abuse disorders are important targets for smoking cessation interventions. Mental health professionals (MHPs) are ideally placed to deliver interventions, but their attitudes may prevent this. This systematic review therefore aimed to identify and estimate quantitatively MHPs attitudes towards smoking and main barriers for providing smoking cessation support and to explore these attitudes in‐depth through qualitative synthesis. Methods The online databases AMED, EMBASE, Medline, PsychINFO, HMIC and CINAHL were searched in March 2015 using terms relating to three concepts: ‘attitudes’, ‘mental health professionals’ and ‘smoking cessation’. Quantitative or qualitative studies of any type were included. Proportions of MHPs' attitudes towards smoking and smoking cessation were pooled across studies using random effects meta‐analysis. Qualitative findings were evaluated using thematic synthesis. Results Thirty‐eight studies including 16 369 participants were eligible for inclusion. Pooled proportions revealed that 42.2% [95% confidence interval (CI) = 35.7–48.8] of MHPs reported perceived barriers to smoking cessation interventions, 40.5% (95% CI = 30.4–51.0) negative attitudes towards smoking cessation and 45.0% (95% CI = 31.9–58.4) permissive attitudes towards smoking. The most commonly held beliefs were that patients are not interested in quitting (51.4%, 95% CI = 33.4–69.2) and that quitting smoking is too much for patients to take on (38%, 95% CI = 16.4–62.6). Qualitative findings were consistent with quantitative results, revealing a culture of smoking as ‘the norm’ and a perception of cigarettes as a useful tool for patients and staff. Conclusions A significant proportion of mental health professionals hold attitudes and misconceptions that may undermine the delivery of smoking cessation interventions; many report a lack of time, training and confidence as main barriers to addressing smoking in their patients. PMID:27003925

Interpersonal communication as an indirect pathway for the effect of antismoking media content on smoking cessation.

PubMed

van den Putte, Bas; Yzer, Marco; Southwell, Brian G; de Bruijn, Gert-Jan; Willemsen, Marc C

2011-05-01

In the context of health campaigns, interpersonal communication can serve at least 2 functions: (a) to stimulate change through social interaction and (b) in a secondary diffusion process, to further disseminate message content. In a 3-wave prospective study of 1,079 smokers, the authors demonstrate that mass media messages (antismoking campaigns and news coverage relevant to smoking cessation) have an indirect effect on smoking cessation intention and behavior via interpersonal communication. Exposure to campaigns and news coverage prompts discussion about the campaigns, and, in turn, about smoking cessation. Interpersonal communication regarding smoking cessation then influences intention to quit smoking and attempts to quit smoking. The study finds evidence not only for the social interaction function of interpersonal communication, but also for the secondary diffusion function. A substantial number of smokers who are not directly exposed to the antismoking campaigns are nevertheless indirectly exposed via communication with people who have seen these campaigns. These results imply that encouragement of interpersonal communication can be an important campaign objective.

Fiscal Impact of Smoking Cessation in Thailand: A Government Perspective Cost-Benefit Analysis.

PubMed

Connolly, Mark P; Kotsopoulos, Nikolaos; Suthipinijtham, Pichaya; Rungruanghiranya, Suthat

2018-04-01

We evaluate the broader public economic consequences of investments in smoking cessation that change lifetime productivity, which can influence future government tax revenue and social transfer costs and health care spending. The analysis applies a government perspective framework for assessing the intergenerational relationships between morbidity and mortality and lifetime tax revenue and social transfers received. Applying smoking prevalence in Thailand, a cohort model was developed for smoker and former smokers to estimate impact on lifetime direct taxes and tobacco taxes paid. Age-specific earnings for males and wage appropriate tax rates were applied to estimate net taxes for smokers and former smokers. Introducing smoking cessation leads to lifetime public economic benefits of THB13 998 to THB43 356 per person depending on the age of introducing smoking cessation. Factoring in the costs of smoking cessation therapy, an average return on investment of 1.35 was obtained indicating fiscal surplus generated for government from the combined effect of increased tax revenues and of averting smoking-attributable health care costs.

Hospital Smoke-Free Policy: Compliance, Enforcement, and Practices. A Staff Survey in Two Large Public Hospitals in Australia.

PubMed

McCrabb, Sam; Baker, Amanda L; Attia, John; Balogh, Zsolt J; Lott, Natalie; Palazzi, Kerrin; Naylor, Justine; Harris, Ian A; Doran, Christopher M; George, Johnson; Wolfenden, Luke; Skelton, Eliza; Bonevski, Billie

2017-11-08

Background: Smoke-free hospital policies are becoming increasingly common to promote good health and quit attempts among patients who smoke. This study aims to assess: staff perceived enforcement and compliance with smoke-free policy; the current provision of smoking cessation care; and the characteristics of staff most likely to report provision of care to patients. Methods: An online cross-sectional survey of medical, nursing, and allied staff from two Australian public hospitals was conducted. Staff report of: patient and staff compliance with smoke-free policy; perceived policy enforcement; the provision of the 5As for smoking cessation (Ask, Assess, Advise, Assist, and Arrange follow-up); and the provision of stop-smoking medication are described. Logistic regressions were used to determine respondent characteristics related to the provision of the 5As and stop-smoking medication use during hospital admission. Results: A total of 805 respondents participated. Self-reported enforcement of smoke-free policy was low (60.9%), together with compliance for both patients (12.9%) and staff (23.6%). The provision of smoking cessation care was variable, with the delivery of the 5As ranging from 74.7% (ask) to 18.1% (arrange follow-up). Medical staff (odds ratio (OR) = 2.09, CI = 1.13, 3.85, p = 0.018) and full time employees (OR = 2.03, CI = 1.06, 3.89, p = 0.033) were more likely to provide smoking cessation care always/most of the time. Stop-smoking medication provision decreased with increasing age of staff (OR = 0.98, CI = 0.96, 0.99, p = 0.008). Conclusions: Smoke-free policy enforcement and compliance and the provision of smoking cessation care remains low in hospitals. Efforts to improve smoking cessation delivery by clinical staff are warranted.

Community-based youth tobacco control interventions: cost effectiveness of the Full Court Press project.

PubMed

Ross, Hana; Powell, Lisa M; Bauer, Joseph E; Levy, David T; Peck, Richard M; Lee, Hye-Ryeon

2006-01-01

We evaluated the impact of a community-based tobacco control project that was implemented in the city of Tucson, Arizona, USA, between 1996 and 2001. The project's goal was to reduce the prevalence of youth smoking through change in social norms at schools and in communities and workplaces. As is often the case, these community-based health promotion interventions were implemented in conjunction with other broader programmes, in this case implemented on the state level. Taking into account state level interventions as well as changes in sociodemographic and economic environment over the course of the project (e.g. increases in cigarette prices), we measure the net effect of the intervention in terms of the number of people who quit or did not initiate smoking and by the discounted life-years gained. To establish the value of investing into community-based intervention, we calculated the real discounted cost per quit and per life-year gained of 3789 US dollars and 3942 US dollars, respectively. These compare favourably with the real cost per quit of 4270 US dollars when implementing the 1996 US Clinical Practice Guideline for smoking cessation but exceed the real cost of 2923 US dollars per discounted life-year gained when following the guideline. A sensitivity analysis that assumed 5% programme persistence (i.e. 5% of the programme's impact would last forever in the absence of future funding for the programme), one-third would relapse and that one-third of those who quit may have quit smoking even without the programme, suggested a lower cost per discounted life-year saved of 3476 US dollars. The cost effectiveness of this project compares favourably with other tobacco control interventions. Despite its relatively small target group, this community-based intervention was cost effective.

Impact of Lung Cancer Screening Results on Smoking Cessation

PubMed Central

Berg, Christine D.; Riley, Thomas L.; Cunningham, Christopher R.; Taylor, Kathryn L.

2014-01-01

Background Lung cancer screening programs may provide opportunities to reduce smoking rates among participants. This study evaluates the impact of lung cancer screening results on smoking cessation. Methods Data from Lung Screening Study participants in the National Lung Screening Trial (NLST; 2002–2009) were used to prepare multivariable longitudinal regression models predicting annual smoking cessation in those who were current smokers at study entry (n = 15489, excluding those developing lung cancer in follow-up). The associations of lung cancer screening results on smoking cessation over the trial period were analyzed. All hypothesis testing used two sided P values. Results In adjusted analyses, smoking cessation was strongly associated with the amount of abnormality observed in the previous year’s screening (P < .0001). Compared with those with a normal screen, individuals were less likely to be smokers if their previous year’s screen had a major abnormality that was not suspicious for lung cancer (odds ratio [OR] = 0.811; 95% confidence interval [CI] = 0.722 to 0.912; P < .001), was suspicious for lung cancer but stable from previous screens (OR = 0.785; 95% CI = 0.706 to 0.872; P < .001), or was suspicious for lung cancer and was new or changed from the previous screen (OR = 0.663; 95% CI = 0.607 to 0.724; P < .001). Differences in smoking prevalence were present up to 5 years after the last screen. Conclusions Smoking cessation is statistically significantly associated with screen-detected abnormality. Integration of effective smoking cessation programs within screening programs should lead to further reduction in smoking-related morbidity and mortality. PMID:24872540

News media coverage of smoking and health is associated with changes in population rates of smoking cessation but not initiation.

PubMed

Pierce, J P; Gilpin, E A

2001-06-01

To determine whether changes in news media coverage of smoking and health issues are associated with changes in smoking behaviour in the USA. Issue importance in the US news media is assessed by the number of articles published annually in major magazines indexed in The Reader's Guide to Periodical Literature. Annual incidence rates for cessation and initiation in the USA were computed from the large, representative National Health Interview Surveys (1965-1992). Patterns in cessation incidence were considered for ages 20-34 years and 35-50 years. Initiation incidence was examined for adolescents (14-17 years) and young adults (18-21 years) of both sexes. From 1950 to the early 1980s, the annual incidence of cessation in the USA mirrored the pattern of news media coverage of smoking and health, particularly for middle aged smokers. Cessation rates in younger adults increased considerably when second hand smoke concerns started to increase in the US population. Incidence of initiation in young adults did not start to decline until the beginning of the public health campaign against smoking in the 1960s. Among adolescents, incidence rates did not start to decline until the 1970s, after the broadcast ban on cigarette advertising. The level of coverage of smoking and health in the news media may play an important role in determining the rate of population smoking cessation, but not initiation. In countries where cessation has lagged, advocates should work to increase the newsworthiness of smoking and health issues.

Translating guidelines to practice: findings from a multidisciplinary preventive cardiology programme in the west of Ireland.

PubMed

Gibson, Irene; Flaherty, Gerard; Cormican, Sarah; Jones, Jennifer; Kerins, Claire; Walsh, Anne Marie; Costello, Caroline; Windle, Jane; Connolly, Susan; Crowley, James

2014-03-01

The aim of this observational, descriptive study is to evaluate the impact of an intensive, evidence-based preventive cardiology programme on medical and lifestyle risk factors in patients at high risk of developing cardiovascular disease (CVD). Increased CVD risk patients and their family members/partners were invited to attend a 16-week programme consisting of a professional multidisciplinary lifestyle intervention, with appropriate risk factor and therapeutic management in a community setting. Smoking, dietary habits, physical activity levels, waist circumference and body mass index, and medical risk factors were measured at initial assessment, at end of programme, and at 1-year follow up. Adherence to the programme was high, with 375 (87.2%) participants and 181 (84.6%) partners having completed the programme, with 1-year data being obtained from 235 (93.6%) patients and 107 (90.7%) partners. There were statistically significant improvements in both lifestyle (body mass index, waist circumference, physical activity, Mediterranean diet score, fish, fruit, and vegetable consumption, smoking cessation rates), psychosocial (anxiety and depression scales and quality of life indices), and medical risk factors (blood pressure, lipid and glycaemic targets) between baseline and end of programme, with these improvements being sustained at 1-year follow up. These findings demonstrate how a holistic model of CVD prevention can improve cardiovascular risk factors by achieving healthier lifestyles and optimal medical management.

Utilization of smoking cessation medication benefits among medicaid fee-for-service enrollees 1999-2008.

PubMed

Kahende, Jennifer; Malarcher, Ann; England, Lucinda; Zhang, Lei; Mowery, Paul; Xu, Xin; Sevilimedu, Varadan; Rolle, Italia

2017-01-01

To assess state coverage and utilization of Medicaid smoking cessation medication benefits among fee-for-service enrollees who smoked cigarettes. We used the linked National Health Interview Survey (survey years 1995, 1997-2005) and the Medicaid Analytic eXtract files (1999-2008) to assess utilization of smoking cessation medication benefits among 5,982 cigarette smokers aged 18-64 years enrolled in Medicaid fee-for-service whose state Medicaid insurance covered at least one cessation medication. We excluded visits during pregnancy, and those covered by managed care or under dual enrollment (Medicaid and Medicare). Multivariate logistic regression was used to determine correlates of cessation medication benefit utilization among Medicaid fee-for-service enrollees, including measures of drug coverage (comprehensive cessation medication coverage, number of medications in state benefit, varenicline coverage), individual-level demographics at NHIS interview, age at Medicaid enrollment, and state-level cigarette excise taxes, statewide smoke-free laws, and per-capita tobacco control funding. In 1999, the percent of smokers with ≥1 medication claims was 5.7% in the 30 states that covered at least one Food and Drug Administration (FDA)-approved cessation medication; this increased to 9.9% in 2008 in the 44 states that covered at least one FDA-approved medication (p<0.01). Cessation medication utilization was greater among older individuals (≥ 25 years), females, non-Hispanic whites, and those with higher educational attainment. Comprehensive coverage, the number of smoking cessation medications covered and varenicline coverage were all positively associated with utilization; cigarette excise tax and per-capita tobacco control funding were also positively associated with utilization. Utilization of medication benefits among fee-for-service Medicaid enrollees increased from 1999-2008 and varied by individual and state-level characteristics. Given that the Affordable Care Act bars state Medicaid programs from excluding any FDA-approved cessation medications from coverage as of January 2014, monitoring Medicaid cessation medication claims may be beneficial for informing efforts to increase utilization and maximize smoking cessation.

The role of Facebook in Crush the Crave, a mobile- and social media-based smoking cessation intervention: qualitative framework analysis of posts.

PubMed

Struik, Laura Louise; Baskerville, Neill Bruce

2014-07-11

Social networking sites, particularly Facebook, are increasingly included in contemporary smoking cessation interventions directed toward young adults. Little is known about the role of Facebook in smoking cessation interventions directed toward this age demographic. The aim of this study was to characterize the content of posts on the Facebook page of Crush the Crave, an evidence-informed smoking cessation intervention directed toward young adults aged 19 to 29 years. Crush the Crave Facebook posts between October 10, 2012 and June 12, 2013 were collected for analysis, representing page activity during the pilot phase of Crush the Crave. Of the 399 posts included for analysis, 121 were original posts, whereas the remaining 278 were reply posts. Posts were coded according to themes using framework analysis. We found that the original Crush the Crave Facebook posts served two main purposes: to support smoking cessation and to market Crush the Crave. Most of the original posts (86/121, 71.1%) conveyed support of smoking cessation through the following 7 subthemes: encouraging cessation, group stimulation, management of cravings, promoting social support, denormalizing smoking, providing health information, and exposing tobacco industry tactics. The remaining original posts (35/121, 28.9%) aimed to market Crush the Crave through 2 subthemes: Crush the Crave promotion and iPhone 5 contest promotion. Most of the reply posts (214/278, 77.0%) were in response to the supporting smoking cessation posts and the remaining 64 (23.0%) were in response to the marketing Crush the Crave posts. The most common response to both the supporting smoking cessation and marketing Crush the Crave posts was user engagement with the images associated with each post at 40.2% (86/214) and 45% (29/64), respectively. The second most common response consisted of users sharing their smoking-related experiences. More users shared their smoking-related experiences in response to the supporting smoking cessation posts (81/214, 37.9%) compared to the marketing Crush the Crave posts (11/64, 17%). With the exception of 4 posts, a moderator posted all the original posts. In addition, although 56.00% (18,937/33,815) of Crush the Crave Facebook page users were men, only 19.8% (55/278) of the reply posts were made by men. Finally, men were found to be more likely to express sarcasm or make strong assertions about quitting smoking and Crush the Crave than women. The CTC Facebook page presents as a unique platform for supporting young adult smoking cessation at all stages of the cessation process. The findings of this study indicate that social networking sites, especially Facebook, warrant inclusion in tobacco control efforts directed towards young adults. Research on effectiveness of the Facebook page for quitting smoking is needed.

The Role of Facebook in Crush the Crave, a Mobile- and Social Media-Based Smoking Cessation Intervention: Qualitative Framework Analysis of Posts

PubMed Central

2014-01-01

Background Social networking sites, particularly Facebook, are increasingly included in contemporary smoking cessation interventions directed toward young adults. Little is known about the role of Facebook in smoking cessation interventions directed toward this age demographic. Objective The aim of this study was to characterize the content of posts on the Facebook page of Crush the Crave, an evidence-informed smoking cessation intervention directed toward young adults aged 19 to 29 years. Methods Crush the Crave Facebook posts between October 10, 2012 and June 12, 2013 were collected for analysis, representing page activity during the pilot phase of Crush the Crave. Of the 399 posts included for analysis, 121 were original posts, whereas the remaining 278 were reply posts. Posts were coded according to themes using framework analysis. Results We found that the original Crush the Crave Facebook posts served two main purposes: to support smoking cessation and to market Crush the Crave. Most of the original posts (86/121, 71.1%) conveyed support of smoking cessation through the following 7 subthemes: encouraging cessation, group stimulation, management of cravings, promoting social support, denormalizing smoking, providing health information, and exposing tobacco industry tactics. The remaining original posts (35/121, 28.9%) aimed to market Crush the Crave through 2 subthemes: Crush the Crave promotion and iPhone 5 contest promotion. Most of the reply posts (214/278, 77.0%) were in response to the supporting smoking cessation posts and the remaining 64 (23.0%) were in response to the marketing Crush the Crave posts. The most common response to both the supporting smoking cessation and marketing Crush the Crave posts was user engagement with the images associated with each post at 40.2% (86/214) and 45% (29/64), respectively. The second most common response consisted of users sharing their smoking-related experiences. More users shared their smoking-related experiences in response to the supporting smoking cessation posts (81/214, 37.9%) compared to the marketing Crush the Crave posts (11/64, 17%). With the exception of 4 posts, a moderator posted all the original posts. In addition, although 56.00% (18,937/33,815) of Crush the Crave Facebook page users were men, only 19.8% (55/278) of the reply posts were made by men. Finally, men were found to be more likely to express sarcasm or make strong assertions about quitting smoking and Crush the Crave than women. Conclusions The CTC Facebook page presents as a unique platform for supporting young adult smoking cessation at all stages of the cessation process. The findings of this study indicate that social networking sites, especially Facebook, warrant inclusion in tobacco control efforts directed towards young adults. Research on effectiveness of the Facebook page for quitting smoking is needed. PMID:25016998

Differences in spousal influence on smoking cessation by gender and education among Japanese couples.

PubMed

Takagi, Daisuke; Kondo, Naoki; Takada, Misato; Hashimoto, Hideki

2014-11-19

Previous studies have reported that spousal non-smoking has a spillover effect on the partner's cessation. However, discussion is lacking on the factors modifying that association. We examined whether the spillover effect of spousal non-smoking was associated with the couple's educational attainment. We used paired marital data from the Japanese Study on Stratification, Health, Income, and Neighborhood (J-SHINE), which targeted residents aged 25-50 years in four Japanese municipalities. We selected a spouse smoker at the time of marriage (target respondent), and set his/her smoking status change (continued or quit smoking after marriage) as an outcome, regressed on the counterpart's smoking status (continued smoking or non-smoking) and combinations of each couple's educational attainment as explanatory variables using log-binomial regression models (n =1001 targets; 708 men and 293 women). Regression results showed that a counterpart who previously quit smoking or was a never-smoker was associated with the target male spouse's subsequent cessation. However, for women, the association between husband's non-smoking and their own cessation was significant only for couples in which both spouses were highly educated. Our findings suggest that a spouse's smoking status is important for smoking cessation interventions in men. For women, however, a couple's combined educational attainment may matter in the interventions.

Design of effective interventions for smoking cessation through financial and non-financial incentives.

PubMed

Balderrama, Fanor; Longo, Christopher J

2017-11-01

Smoking has a tremendous negative impact on the Canadian economy and contributes to growing costs in the healthcare system. Efforts to reduce smoking rates may therefore reduce strain on the healthcare system and free up scarce resources. Academic literature on economic smoking cessation incentives presents a countless variety of interventions that have met with varying degrees of success. This study reviews six different variables used in the design of incentives in smoking cessation interventions: direction, form, magnitude, certainty, recipient grouping, and target demographic. The purpose of this study is to provide analysis and recommendations about the contribution of each variable into the overall effectiveness of smoking cessation programs and help health leaders design better interventions according to their specific needs.

Ethnic differences in smoking rate, nicotine dependence, and cessation-related variables among adult smokers in Hawaii.

PubMed

Herzog, Thaddeus A; Pokhrel, Pallav

2012-12-01

This study tests hypotheses concerning ethnic disparities in daily cigarette smoking rates, nicotine dependence, cessation motivation, and knowledge and past use of cessation methods (e.g., counseling) and products (e.g., nicotine patch) in a multiethnic sample of smokers in Hawaii. Previous research has revealed significant differences in smoking prevalence among Native Hawaiians, Filipinos, Japanese, and Caucasians in Hawaii. However, no study has examined differences in dependence and cessation-related knowledge and practices among smokers representing these ethnic groups. Participants were recruited through newspaper advertisement as part of a larger smoking cessation intervention study. Participants (N = 919; M age = 45.6, SD = 12.7; 48 % women) eligible to participate provided self-report data through mail and telephone. Participants included 271 self-identified Native Hawaiians, 63 Filipinos, 316 Caucasians, 145 "East Asians" (e.g., Japanese, Chinese), and 124 "other" (e.g., Hispanic, African-American). Pair-wise comparisons of means, controlling for age, gender, income, education, and marital status, indicated that Native Hawaiian smokers reported significantly higher daily smoking rates and higher levels of nicotine dependence compared to East Asians. Native Hawaiian smokers reported significantly lower motivation to quit smoking than Caucasians. Further, Filipino and Native Hawaiian smokers reported lesser knowledge of cessation methods and products, and less frequent use of these methods and products than Caucasians. The results suggest that Native Hawaiian and Filipino smokers could be underserved with regard to receiving cessation-related advice, and may lack adequate access to smoking cessation products and services. In addition, cessation interventions tailored for Native Hawaiian smokers could benefit from a motivational enhancement component.

Cost effectiveness of a smoking cessation program in patients admitted for coronary heart disease.

PubMed

Quist-Paulsen, Petter; Lydersen, Stian; Bakke, Per S; Gallefoss, Frode

2006-04-01

Smoking cessation is probably the most important action to reduce mortality after a coronary event. Smoking cessation programs are not widely implemented in patients with coronary heart disease, however, possibly because they are thought not to be worth their costs. Our objectives were to estimate the cost effectiveness of a smoking cessation program, and to compare it with other treatment modalities in cardiovascular medicine. A cost-effectiveness analysis was performed on the basis of a recently conducted randomized smoking cessation intervention trial in patients admitted for coronary heart disease. The cost per life year gained by the smoking cessation program was derived from the resources necessary to implement the program, the number needed to treat to get one additional quitter from the program, and the years of life gained if quitting smoking. The cost effectiveness was estimated in a low-risk group (i.e. patients with stable coronary heart disease) and a high-risk group (i.e. patients after myocardial infarction or unstable angina), using survival data from previously published investigations, and with life-time extrapolation of the survival curves by survival function modeling. In a lifetime perspective, the incremental cost per year of life gained by the smoking cessation program was euro 280 and euro 110 in the low and high-risk group, respectively (2000 prices). These costs compare favorably to other treatment modalities in patients with coronary heart disease, being approximately 1/25 the cost of both statins in the low-risk group and angiotensin-converting enzyme inhibitors in the high-risk group. In a sensitivity analysis, the costs remained low in a wide range of assumptions. A nurse-led smoking cessation program with several months of intervention is very cost-effective compared with other treatment modalities in patients with coronary heart disease.

Spirometry as a motivational tool to improve smoking cessation rates: a systematic review of the literature.

PubMed

Wilt, Timothy J; Niewoehner, Dennis; Kane, Robert L; MacDonald, Roderick; Joseph, Anne M

2007-01-01

Obtaining spirometric testing and providing those results to individuals who smoke has been advocated as a motivational tool to improve smoking cessation. However, its effectiveness is not known. We conducted a systematic review to determine if this approach improves rates of smoking cessation. Data sources included MEDLINE (1966 to October 2005), the Cochrane Library, and experts in the field. Eligible randomized controlled trials (RCTs) enrolled at least 25 smokers per arm, evaluated spirometry with associated counseling or in combination with other treatments, followed subjects at least 6 months, and provided smoking abstinence rates. Results from nonrandomized studies also were summarized. The primary outcome was patient-reported long-term (at least 6 months) sustained abstinence with biological validation. Additional outcomes included self-reported abstinence and point-prevalence abstinence. Seven RCTs (N = 6,052 subjects) met eligibility criteria. Follow-up duration ranged from 9 to 36 months. In six trials, the intervention group received concomitant treatments previously demonstrated to increase cessation independently. The range of abstinence was 3%-14% for control subjects and 7%-39% among intervention groups, statistically significantly in favor of intervention in four studies. The only RCT that assessed the independent contribution of spirometry in combination with counseling demonstrated a nonsignificant 1% improvement in patient-reported point-prevalence abstinence at 12 months in the group that received spirometry plus counseling versus counseling alone (6.5% versus 5.5%). Findings from observational studies were mixed, and the lack of controls makes interpretation problematic. Available evidence is insufficient to determine whether obtaining spirometric values and providing that information to patients improves smoking cessation compared with other smoking cessation methods. Spirometric values are of limited benefit as a predictor of smoking cessation or as a tool to "customize" smoking cessation strategies.

Dental vs. Medical Students' Comfort with Smoking Cessation Counseling: Implications for Dental Education.

PubMed

Allen, Staci Robinson; Kritz-Silverstein, Donna

2016-08-01

The aim of this study was to determine if dental and medical students have similar feelings of professional responsibility, comfort, and confidence with counseling patients about smoking cessation during their clinical years. All third- and fourth-year osteopathic medical (N=580) and dental students (N=144) at Western University of Health Sciences were invited to participate in a survey in April-July 2014, either electronically or in person, regarding their perceived professional responsibility, comfort, and confidence in counseling smokers about quitting and major constraints against counseling smokers about quitting. Respondents' demographic characteristics, smoking history, and history of living with a smoker were also assessed. Response rates were 21% (124/580) for medical and 82% (118/144) for dental students. Most of the responding medical (99.2%) and dental (94.9%) students reported feeling it was their professional responsibility to counsel patients about smoking cessation. Medical student respondents were significantly more comfortable and confident counseling patients about smoking cessation than dental student respondents (p<0.001). Students in the third year were just as comfortable and confident counseling patients about smoking cessation as students in the fourth year (p>0.10). There were no differences by age, but students who were former smokers were significantly more comfortable and confident counseling about smoking cessation than were nonsmokers (p=0.001). While almost all of the responding students reported feeling responsible for counseling patients about smoking cessation, the medical students and former smokers were more comfortable and confident performing this counseling. These results suggest the need for additional training in counseling techniques for dental students and nonsmokers. Future studies should assess the impact of medical and dental students' smoking cessation counseling.

Financial strain and smoking cessation among men and women within a self-guided quit attempt.

PubMed

Reitzel, Lorraine R; Langdon, Kirsten J; Nguyen, Nga T; Zvolensky, Michael J

2015-08-01

Financial strain, defined as an unfavorable asset-to-needs ratio, has been associated with reduced odds of smoking cessation in the context of a structured clinical study providing cessation assistance. This study reports on a secondary data analysis that assessed the association of financial strain and biochemically-verified smoking abstinence within a structured clinical study of smokers making a self-guided cessation attempt. Participants (N=58; 65.5% men) were enrolled in a study about anxiety sensitivity and smoking cessation whereby they were instructed to initiate a self-guided quit attempt. Relations between financial strain and biochemically-verified smoking abstinence on the quit day and at Days 3, 7, 14, 28, and 90 post-quit were assessed using generalized estimating equations controlling for age, sex, race, education, partner status, pre-quit cigarettes smoked per day, and time. Associations between financial strain and abstinence in the whole sample were marginal (aOR=.94, 95% CI=.87-1.01, observations=293; p=.07). However, sex was a significant moderator: greater financial strain was associated with lower odds of abstinence for men (aOR=.90, 95% CI=.80-1.00, observations=201; p=.05), but not women (aOR=1.05, 95% CI=.91-1.21, observations=92; p=.48). Results indicated that financial strain was associated with lower odds of cessation among men undergoing a self-guided quit attempt in the context of a structured clinical study. These data suggest that financial strain may be an important socioeconomic determinant of smoking cessation and support its relevance for better understanding socioeconomic-based smoking-related health disparities. Future work may benefit by exploring sex-specific models of financial strain in the context of smoking cessation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Financial Strain and Smoking Cessation among Men and Women within a Self-Guided Quit Attempt

PubMed Central

Reitzel, Lorraine R.; Langdon, Kirsten J.; Nguyen, Nga T.; Zvolensky, Michael J.

2015-01-01

Financial strain, defined as an unfavorable asset-to-needs ratio, has been associated with reduced odds of smoking cessation in the context of a structured clinical study providing cessation assistance. This study reports on a secondary data analysis that assessed the association of financial strain and biochemically-verified smoking abstinence within a structured clinical study of smokers making a self-guided cessation attempt. Participants (N=58; 65.5% men) were enrolled in a study about anxiety sensitivity and smoking cessation whereby they were instructed to initiate a self-guided quit attempt. Relations between financial strain and biochemically-verified smoking abstinence on the quit day and at Days 3, 7, 14, 28, and 90 post-quit were assessed using generalized estimating equations controlling for age, sex, race, education, partner status, pre-quit cigarettes smoked per day, and time. Associations between financial strain and abstinence in the whole sample were marginal (aOR=.94, 95% CI=.87-1.01, observations=293; p=.07). However, sex was a significant moderator: greater financial strain was associated with lower odds of abstinence for men (aOR=.90, 95% CI= .80-1.00, observations=201; p=.05), but not women (aOR=1.05, 95% CI= .91-1.21, observations=92; p=.48). Results indicated that financial strain was associated with lower odds of cessation among men undergoing a self-guided quit attempt in the context of a structured clinical study. These data suggest financial strain may be an important socioeconomic determinant of smoking cessation and support its relevance for better understanding socioeconomic-based smoking-related health disparities. Future work may benefit by exploring sex-specific models of financial strain in the context of smoking cessation. PMID:25879712

Registered nurses' perception of self-efficacy and competence in smoking cessation after participating in a web-based learning activity.

PubMed

Rosvall, Annica; Carlson, Elisabeth

2017-12-01

To describe how registered nurses having undergone a web-based learning activity perceive their self-efficacy and competence to support patients with smoking cessation in connection with surgery. Smoking cessation in connection with surgery reduces postoperative complications, and the support patients get from registered nurses may be important in helping them become smoke-free in connection with their surgery. Therefore, registered nurses are in need of enhanced understanding about which kind of counselling is the most effective for smoking cessation. Educating large groups of registered nurses in a digital environment appears to be a flexible and cost-effective way. A convergent mixed-method design with data collection was done using questionnaires (n = 47) and semistructured interviews (n = 11). Inclusion criteria were registered nurses in surgical wards. The samples were nonprobability and modified nested. Descriptive statistics and content analysis were used for data analysis. After completing the web-based learning activity, the registered nurses perception was that of good self-efficacy and increased competence in supporting patients with smoking cessation in connection with surgery. They improved their understanding of how to talk about smoking cessation with patients in dialogue using open-ended questions. Nevertheless, the registered nurses requested opportunities for dialogue and interaction with colleagues or topic experts. The results indicate that registered nurses can enhance their competence in supporting patients to embrace smoking cessation by learning in a digital environment. Self-efficacy and understanding of the topic seems to motivate registered nurses to counsel patients about smoking cessation. Findings from this study will be of particular interest to educators in healthcare settings who can devise further development of web-based learning activities. © 2017 John Wiley & Sons Ltd.

User Experience Evaluation of a Smoking Cessation App in People With Serious Mental Illness

PubMed Central

Rizo, Javier; Kientz, Julie A.; McDonell, Michael G.; Ries, Richard K.; Sobel, Kiley

2016-01-01

Introduction: Smoking rates among people with serious mental illness are 3 to 4 times higher than the general population, yet currently there are no smoking cessation apps specifically designed to address this need. We report the results of a User Experience (UX) evaluation of a National Cancer Institute smoking cessation app, QuitPal, and provide user centered design data that can be used to tailor smoking cessation apps for this population. Methods: Two hundred forty hours of field experience with QuitPal, 10 hours of recorded interviews and task performances, usage logs and a self-reported usability scale, informed the results of our study. Participants were five individuals recruited from a community mental health clinic with a reported serious mental illness history. Performance, self-reports, usage logs and interview data were triangulated to identify critical usability errors and UX themes emerging from this population. Results: Data suggests QuitPal has below average levels of usability, elevated time on task performances and required considerable amounts of guidance. UX themes provided critical information to tailor smoking cessation apps for this population, such as the importance of breaking down “cessation” into smaller steps and use of a reward system. Conclusions: This is the first study to examine the UX of a smoking cessation app among people with serious mental illness. Data from this study will inform future research efforts to expand the effectiveness and reach of smoking cessation apps for this highly nicotine dependent yet under-served population. Implications: Data from this study will inform future research efforts to expand the effectiveness and reach of smoking cessation apps for people with serious mental illness, a highly nicotine dependent yet under-served population. PMID:26581430

Applying Anthropology to Eliminate Tobacco-Related Health Disparities

PubMed Central

Burgess, Diana; Olayinka, Abimbola; Whembolua, Guy Lucien S.; Okuyemi, Kolawole S.

2012-01-01

Introduction: Disparities in tobacco’s harm persist. Declines in smoking among the general population have not been experienced to the same extent by vulnerable populations. Innovative strategies are required to diminish disparities in tobacco’s harm. As novel tools, anthropological concepts and methods may be applied to improve the design and outcomes of tobacco cessation interventions. Methods: We reviewed over 60 articles published in peer-reviewed journals since 1995 for content on anthropology and smoking cessation. The specific questions framing the review were: (a) “How can lessons learned from anthropological studies of smoking improve the design and effectiveness of smoking cessation interventions?” (b) How can anthropology be applied to diminish disparities in smoking cessation? and (c) How can qualitative methods be used most effectively in smoking cessation intervention research? Results: Three specific disciplinary tools were identified and examined: (a) culture, (b) reflexivity, and (c) qualitative methods. Examining culture as a dynamic influence and understanding the utilities of smoking in a particular group is a precursor to promoting cessation. Reflexivity enables a deeper understanding of how smokers perceive quitting and smoking beyond addiction and individual health consequences. Qualitative methods may be used to elicit in-depth perspectives on quitting, insights to inform existing community-based strategies for making behavior changes, and detailed preferences for cessation treatment or programs. Conclusions: Anthropological tools can be used to improve the effectiveness of intervention research studies targeting individuals from vulnerable groups. Synthesized applications of anthropological concepts can be used to facilitate translation of findings into clinical practice for providers addressing tobacco cessation in vulnerable populations. PMID:22271609

Disadvantaged Former Miners' Perspectives on Smoking Cessation: A Qualitative Study

ERIC Educational Resources Information Center

White, Simon; Baird, Wendy

2013-01-01

Objective: To explore disadvantaged former miners' perspectives in north Derbyshire, United Kingdom (UK) on smoking and smoking cessation. Methods: In-depth, audiotaped interviews with 16 disadvantaged former miners who smoked or had stopped smoking within six months. Results: Perceptions of being able to stop smoking with minimal difficulty and…

Social capital, political trust and daily smoking and smoking cessation: a population-based study in southern Sweden.

PubMed

Lindström, M

2009-07-01

To investigate the associations between vertical (institutional) political trust in the Riksdag and daily smoking and smoking cessation. Cross-sectional study. In total, 27,757 individuals aged 18-80 years answered a postal questionnaire, which represents 59% of the random sample. A logistic regression model was used to investigate the associations between political trust in the Riksdag and daily smoking and smoking cessation. A multivariate analysis was performed to investigate the importance of possible confounders on the differences in daily smoking and smoking cessation according to political trust. In total, 14.9% of the men and 18.1% of the women were daily smokers. Middle-aged respondents were significantly more likely to be daily smokers than the young. The proportion of ever smokers who had quit smoking increased with age. Respondents with low generalized trust in other people [odds ratio (OR) 1.6, 95% confidence interval (CI) 1.5-1.8 among men; OR 1.7, 95% CI 1.5-1.8 among women] and not high political trust/no political trust at all (OR 1.6, 95% CI 1.4-1.8 among men; OR 1.8, 95% CI 1.6-2.0 among women) had significantly higher ORs of daily smoking. Men and women with not particularly high political trust/no political trust at all and no opinion of the Riksdag had significantly lower ORs of smoking cessation than people with very high/high political trust. These associations remained significant after multiple adjustments. The results suggest that political trust is independently associated with both daily smoking and smoking cessation.

Cigarette smoking, nicotine dependence, and motivation for smoking cessation in psychiatric inpatients.

PubMed

Solty, Heidi; Crockford, David; White, William D; Currie, Shawn

2009-01-01

Cigarette smoking is the leading preventable cause of death and disease in Canada, and is disproportionately more frequent among psychiatric patients. Smoking cessation interventions can be successfully implemented with psychiatric patients, yet no Canadian studies have evaluated smoking prevalence, nicotine dependence, and motivation for smoking cessation in psychiatric inpatients. Our study did so to help plan appropriate interventions for these patients. All inpatients aged 18 years or older admitted to acute-care psychiatry units at the Foothills Medical Centre in Calgary, Alberta, during a 6-month period completed a survey involving questions from the Canadian Tobacco Use Monitoring Survey, the Fagerstrom Test for Nicotine Dependence (FTND), the Readiness to Quit Ladder, and the Decisional Balance for Cigarette Smoking. Responses were analyzed for correlation with discharge diagnoses, age, and sex. Among the total inpatients (n = 342), 211 (62%) completed the survey. Among those, 55% were current cigarette smokers and 17.5% were former smokers. Nicotine dependence (FTND > or = 6) was reported in 45.2% of smokers. Smoking prevalence and nicotine dependence severity was greatest in the substance use disorders (SUD) and psychotic disorders groups. Current smokers endorsed more negative than positive attributes of smoking. Regarding smoking cessation, 51% of patients were precontemplative, 12.7% contemplative, and 36.2% preparatory or action-oriented, despite few receiving advice to quit. Cigarette smoking and nicotine dependence are highly prevalent in psychiatric inpatients. However, self-reported motivation for smoking cessation is noteworthy, emphasizing that cessation advice and appropriate follow-up care should be provided to psychiatric inpatients who smoke.

[Social deprivation and time perception, the impact on smoking cessation].

PubMed

Merson, Frédéric; Perriot, Jean

2011-01-01

Smoking addiction and smoking behaviour are closely related to social deprivation. The aim of this study was to evaluate the impact of social deprivation and time perspective on smoking cessation in order to improve the support provided to socially deprived persons seeking to quit smoking. The study examined the impact of social disadvantages and time perspective on smoking cessation. 192 patients (including 45% of socially disadvantaged people) participated in the study. Social deprivation was measured using the EPICES scale, while time perspective was measured using the short version of the Zimbardo Time Perspective Inventory. Data relating to individuals' characteristics, smoking addiction, behaviour and smoking cessation were collected as part of this research. Compared to the rest of the population, socially disadvantaged people were found to be more likely to stop smoking for financial reasons (p < 0.0001). The study also found that their attempts to quit smoking are more likely to fail (p = 0,006). In addition, socially disadvantaged people suffer more frequently from anxio-depressive disorders (p < 0.0001) and are also prone to a higher level of nicotine dependence (p < 0.0001). The 'Past-Negative' and ?Present-Fatalistic' dimensions of time perspective, toward which socially disadvantaged people are more likely to lean (p < 0.0001), are associated with failed smoking cessation. The ?Future' dimension, in which socially disadvantaged people are less likely to project themselves (p < 0.0002), is a predictive factor of smoking cessation. The results highlight the importance of taking into account social deprivation and time perspective in helping socially disadvantaged patients to quit smoking.

Characterizing Internet Searchers of Smoking Cessation Information

PubMed Central

Graham, Amanda L

2006-01-01

Background The Internet is a viable channel to deliver evidence-based smoking cessation treatment that has the potential to make a large population impact on reducing smoking prevalence. There is high demand for smoking cessation information and support on the Internet. Approximately 7% (10.2 million) of adult American Internet users have searched for information on quitting smoking. Little is known about these individuals, their smoking status, what type of cessation services they are seeking on the Internet, or how frequently these searches for cessation information are conducted. Objective The primary goal of this study was to characterize individuals who search for smoking cessation information on the Internet to determine appropriate triage and treatment strategies. The secondary goal was to estimate the incidence of searches for cessation information using publicly available search engine data. Methods We recruited individuals who clicked on a link to a leading smoking cessation website (QuitNet) from within the results of a search engine query. Individuals were “intercepted” before seeing the QuitNet home page and were invited to participate in the study. Those accepting the invitation were routed to an online survey about demographics, smoking characteristics, preferences for specific cessation services, and Internet search patterns. To determine the generalizability of our sample, national datasets on search engine usage patterns, market share, and keyword rankings were examined. These datasets were then used to estimate the number of queries for smoking cessation information each year. Results During the 10-day study period, 2265 individuals were recruited and 29% (N = 655) responded. Of these, 59% were female and overall tended to be younger than the previously characterized general Internet population. Most (76%) respondents were current smokers; 17% had quit within the last 7 days, and 7% had quit more than 7 days ago. Slightly more than half of active smokers (53%) indicated that they were planning to quit in the next 30 days. Smokers were more likely to seek information on how to quit and on medications; former smokers were more interested in how to cope with withdrawal. All participants rated withdrawal information and individually tailored information as being more useful, while displaying little interest in telephone counseling, expert support, or peer support. Publicly available data from large search engines suggest that 4 million Americans search for resources on smoking cessation each year. Conclusions This study adds to the limited data available on individuals who search for smoking cessation information on the Internet, supports the prior estimates of the size of the population, and indicates that these individuals are in appropriate stages for both active cessation interventions and aggressive relapse prevention efforts. Continued development and evaluation of online interventions is warranted, and organizations seeking to promote cessation should carefully evaluate the Internet as a possible modality for treatment and as a gateway to other traditional programs. PMID:17032633

Tobacco Use and Smoking Cessation Practices among Physicians in Developing Countries: A Literature Review (1987–2010)

PubMed Central

Abdullah, Abu S.; Stillman, Frances A.; Yang, Li; Luo, Hongye; Zhang, Zhiyong; Samet, Jonathan M.

2013-01-01

Physicians have a key role to play in combating tobacco use and reducing the tobacco induced harm to health. However, there is a paucity of information about tobacco-use and cessation among physicians in developing countries. To assess the need for and nature of smoking cessation services among physicians in developing countries, a detailed literature review of studies published in English, between 1987 and 2010 was carried out. The electronic databases Medline and Pub Med were searched for published studies. The findings show that there are regional variations in the current smoking prevalence, quitting intentions, and cessation services among physicians. Smoking prevalence (median) was highest in Central/Eastern Europe (37%), followed by Africa (29%), Central and South America (25%) and Asia (17.5%). There were significant gender differences in smoking prevalence across studies, with higher prevalence among males than females. Smoking at work or in front of patients was commonly practiced by physicians in some countries. Asking about smoking status or advising patients to quit smoking was not common practice among the physicians, especially among smoker physicians. Organized smoking cessation programs for physicians did not exist in all of these regions. This review suggests that while smoking of physicians varies across different developing regions; prevalence rates tend to be higher than among physicians in developed countries. Quitting rates were low among the physicians, and the delivery of advice on quitting smoking was not common across the studies. To promote tobacco control and increase cessation in populations, there is a need to build physicians’ capacity so that they can engage in tobacco use prevention and cessation activities. PMID:24380976

Smoking cessation at the workplace. Results of a randomised controlled intervention study. Worksite physicians from the AIREL group.

PubMed

Lang, T; Nicaud, V; Slama, K; Hirsch, A; Imbernon, E; Goldberg, M; Calvel, L; Desobry, P; Favre-Trosson, J P; Lhopital, C; Mathevon, P; Miara, D; Miliani, A; Panthier, F; Pons, G; Roitg, C; Thoores, M

2000-05-01

To compare the effects of a worksite intervention by the occupational physician offering simple advice of smoking cessation with a more active strategy of advice including a "quit date" and extra support. Employees of an electrical and gas company seen at the annual visit by their occupational physicians. CRITERIA END POINTS: Smoking point prevalence defined as the percentage of smokers who were non-smokers at one year. Secondary criteria were the percentage of smokers who stopped smoking for more than six months and the difference in prevalence of smoking in both groups. Randomised controlled trial. The unit of randomisation was the work site physician and a random sample of the employees of whom he or she was in charge. The length of the follow up was one year. Each of 30 work site physicians included in the study 100 to 150 employees. Among 504 subjects classified as smokers at baseline receiving simple advice (group A) and 591 the more active programme (group B), 68 (13.5%) in group A and 109 (18. 4%) were non-smokers one year later (p=0.03; p=0.01 taking the occupational physician as the statistical unit and using a non-parametric test). Twenty three subjects (4.6%) in group A and 36 (6.1%) in group B (p=0.26) declared abstinence of six months or more. Among non-smokers at baseline, 3.4% in both groups were smokers after one year follow up. The prevalence of smokers did not differ significantly at baseline (32.9% and 32.4%, p=0.75). After the intervention the prevalence of smoking was 30.8% in group A and 28. 7% in group B (p=0.19). An increase of the mean symptoms score for depression in those who quit was observed during this period. A simple cessation intervention strategy during a mandatory annual examination, targeting a population of smokers independently of their motivation to stop smoking or their health status, showed a 36% relative increase of the proportion of smokers who quit smoking as compared with what can be achieved through simple advice.

Age and educational inequalities in smoking cessation due to three population-level tobacco control interventions: findings from the International Tobacco Control (ITC) Netherlands Survey.

PubMed

Nagelhout, Gera E; Crone, Matty R; van den Putte, Bas; Willemsen, Marc C; Fong, Geoffrey T; de Vries, Hein

2013-02-01

This study aimed to examine age and educational inequalities in smoking cessation due to the implementation of a tobacco tax increase, smoke-free legislation and a cessation campaign. Longitudinal data from 962 smokers aged 15 years and older were used from three survey waves of the International Tobacco Control (ITC) Netherlands Survey. The 2008 survey was performed before the implementation of the interventions and the 2009 and 2010 surveys were performed after the implementation. No significant age and educational differences in successful smoking cessation were found after the implementation of the three tobacco control interventions, although smokers aged 15-39 years were more likely to attempt to quit. Of the three population-level tobacco control interventions that were implemented simultaneously in the Netherlands, only the smoke-free legislation seemed to have increased quit attempts. The price increase of cigarettes may have been only effective in stimulating smoking cessation among younger smokers. Larger tax increases, stronger smoke-free legislation and media campaigns about the dangers of (second-hand) smoking are needed in the Netherlands.

Smoking cessation, depression, and exercise: empirical evidence, clinical needs, and mechanisms.

PubMed

Bernard, Paquito; Ninot, Gregory; Moullec, Gregory; Guillaume, Sebastien; Courtet, Philippe; Quantin, Xavier

2013-10-01

Smoking is significantly more common among persons with major depressive disorders (MDDs). Furthermore, smokers with MDD report more difficulties when they quit smoking (greater withdrawal symptoms, higher probability of relapse). The aim of this narrative review is to describe research on exercise and depression and exercise and smoking cessation. We have critically reviewed various smoking cessation intervention programs for depressive smokers examining (a) the protective effect of exercise against relapse for smokers with MDD and (b) the benefits of exercise for treating withdrawal symptoms. We have also reviewed the current literature investigating the mechanisms between exercise-depression and exercise-smoking. This review suggests that exercise may reduce depressive symptoms following cessation and provide a useful strategy for managing withdrawal symptoms in smokers with MDD. Various psychological, biological, and genetic hypotheses have been tested (e.g., distraction hypothesis, expectations hypothesis, cortisol hypothesis) and few have obtained significant results. It might be beneficial for health professionals to recommend physical activity and promote supervised exercise sessions for smokers with MDD during smoking cessation. Future research needs to examine relationships between exercise, smoking, and depression with transdisciplinary and ecological momentary assessment.

Determining Smoking Cessation Related Information, Motivation, and Behavioral Skills among Opiate Dependent Smokers in Methadone Treatment

PubMed Central

Cooperman, Nina A.; Richter, Kimber P.; Bernstein, Steven L.; Steinberg, Marc L.; Williams, Jill M.

2015-01-01

Background Over 80% of people in methadone treatment smoke cigarettes, and existing smoking cessation interventions have been minimally effective. Objective To develop an Information-Motivation-Behavioral Skills (IMB) Model of behavior change based smoking cessation intervention for methadone maintained smokers, we examined smoking cessation related information, motivation, and behavioral skills in this population. Methods Current or former smokers in methadone treatment (n=35) participated in focus groups. Ten methadone clinic counselors participated in an individual interview. A content analysis was conducted using deductive and inductive approaches. Results Commonly known information, motivation, and behavioral skills factors related to smoking cessation were described. These factors included: the health effects of smoking and treatment options for quitting (information); pregnancy and cost of cigarettes (motivators); and coping with emotions, finding social support, and pharmacotherapy adherence (behavioral skills). Information, motivation, and behavioral skills factors specific to methadone maintained smokers were also described. These factors included: the relationship between quitting smoking and drug relapse (information), the belief that smoking is the same as using drugs (motivator); and coping with methadone clinic culture and applying skills used to quit drugs to quitting smoking (behavioral skills). Information, motivation, and behavioral skills strengths and deficits varied by individual. Conclusions Methadone maintained smokers could benefit from research on an IMB Model based smoking cessation intervention that is individualized, addresses IMB factors common among all smokers, and also addresses IMB factors unique to this population. PMID:25559697

An exploration of health beliefs and attitudes of smokers with vascular disease who participate in or decline a smoking cessation program.

PubMed

Clarke, Kim E; Aish, Arlene

2002-09-01

The descriptive cross-sectional aspect of this study compared a group of smokers with peripheral arterial disease who chose to participate in a smoking intervention with a group of smokers with peripheral arterial disease who declined to participate. The longitudinal aspect of this study used Ajzen and Fishbein's(1) Theory of Reasoned Action, Keeney's(2) Expected Utility Decision Theory, and Prochaska and DiClemente's(3) Transtheoretical Model of Change to describe the influence of this smoking cessation program on the beliefs and attitudes about smoking in group 1. Smokers completed a smoking beliefs questionnaire with vascular disease at baseline and after 13 weeks of smoking cessation intervention. Smokers who did not want to participate in the smoking cessation program also completed this questionnaire for comparison. Statistically significant differences were found to differentiate people who enrolled in the smoking cessation program from those who did not. Subjects in group 2 smoked less per day, were less educated, were less often diagnosed as having peripheral arterial disease, were found to be more in the precontemplation stage of change in smoking cessation, cared more about what their physician and family thought they should do, and perceived themselves to be at less risk for developing more severe circulatory problems if they did not quit smoking. After 13 weeks, participants in both groups 1 and 2 were found to smoke significantly less per day. No support was found for the expectation that the smoking intervention would influence stage of change in smoking behavior or attitudes and beliefs about the risks of smoking to the participants' health after 13 weeks.

Do counselor techniques predict quitting during smoking cessation treatment? A component analysis of telephone-delivered Acceptance and Commitment Therapy

PubMed Central

Vilardaga, Roger; Heffner, Jaimee L.; Mercer, Laina D.; Bricker, Jonathan

2014-01-01

No studies to date have examined the effect of counselor techniques on smoking cessation over the course of treatment. To address this gap, we examined the degree to which the use of specific Acceptance and Commitment Therapy (ACT) counseling techniques in a given session predicted smoking cessation reported at the next session. The data came from the ACT arm of a randomized controlled trial of a telephone-delivered smoking cessation intervention. Trained raters coded 139 counseling sessions across 44 participants. The openness, awareness and activation components of the ACT model were rated for each telephone counseling session. Multilevel logistic regression models were used to estimate the predictive relationship between each component during any given telephone session and smoking cessation at the following telephone session. For every 1-unit increase in counselors’ use of openness and awareness techniques there were 42% and 52% decreases in the odds of smoking at the next counseling session, respectively. However, there was no significant predictive relationship between counselors’ use of activation techniques and smoking cessation. Overall, results highlight the theoretical and clinical value of examining therapists’ techniques as predictors of outcome during the course of treatment. PMID:25156397

Tobacco training in clinical social work graduate programs.

PubMed

Kleinfelder, JoAnn; Price, James H; Dake, Joseph A; Jordan, Timothy R; Price, Joy A

2013-08-01

The leading cause of preventable death, in the most vulnerable segments of society, whom social workers often counsel, is cigarette smoking. The purpose of this study was to assess tobacco smoking cessation training in clinical social work programs. A valid 21-item questionnaire was sent to the entire population of 189 clinical graduate social work programs identified by the Council on Social Work Education. A three-wave mailing process was used to maximize the return rate. Directors from 112 clinical social work programs returned completed questionnaires (61 percent). The majority (91 percent) of directors reported having never thought about offering formal smoking cessation training, and only nine of the programs (8 percent) currently provided formal smoking cessation education. The three leading barriers to offering smoking cessation education were as follows: not a priority (60 percent), not enough time (55 percent), and not required by the accrediting body (41 percent). These findings indicate that clinical social work students are not receiving standardized smoking cessation education to assist in improving the well-being of their clients. The national accrediting body for graduate clinical social work programs should consider implementing guidelines for smoking cessation training in the curriculums.

Financial strain and smoking cessation among racially/ethnically diverse smokers.

PubMed

Kendzor, Darla E; Businelle, Michael S; Costello, Tracy J; Castro, Yessenia; Reitzel, Lorraine R; Cofta-Woerpel, Ludmila M; Li, Yisheng; Mazas, Carlos A; Vidrine, Jennifer Irvin; Cinciripini, Paul M; Greisinger, Anthony J; Wetter, David W

2010-04-01

We evaluated the influence of financial strain on smoking cessation among Latino, African American, and Caucasian smokers of predominantly low socioeconomic status. Smokers enrolled in a smoking cessation study (N = 424) were followed from 1 week prequit through 26 weeks postquit. We conducted a logistic regression analysis to evaluate the association between baseline financial strain and smoking abstinence at 26 weeks postquit after control for age, gender, race/ethnicity, educational level, annual household income, marital status, number of cigarettes smoked per day, and time to first cigarette of the day. Greater financial strain at baseline was significantly associated with reduced odds of abstinence at 26 weeks postquit among those who completed the study (odds ratio [OR] = 0.77; 95% confidence interval [CI] = 0.62, 0.94; P = .01). There was a significant association as well in analyses that included those who completed the study in addition to those lost to follow-up who were categorized as smokers (OR = 0.78; 95% CI = 0.64, 0.96; P = .02). Greater financial strain predicted lower cessation rates among racially/ethnically diverse smokers. Our findings highlight the impact of economic concerns on smoking cessation and the need to address financial strain in smoking cessation interventions.

Treating Tobacco Dependence: Development of a Smoking Cessation Treatment Program for Outpatient Mental Health Clinics

ERIC Educational Resources Information Center

Gulliver, Suzy Bird; Wolfsdorf, Barbara A.; Morissette, Sandra Baker

2004-01-01

Response to smoking cessation treatment programs sharply decreases when applied to smokers with psychiatric comorbidities. Consequently, the development of smoking cessation treatments that address the needs of psychiatric patients is greatly needed. The primary purpose of this article is to detail the process of development of an empirically…

Preliminary Examination of Adolescent Spending in a Contingency Management-Based Smoking-Cessation Program

ERIC Educational Resources Information Center

Cavallo, Dana A.; Nich, Charla; Schepis, Ty S.; Smith, Anne E.; Liss, Thomas B.; McFetridge, Amanda K.; Krishnan-Sarin, Suchitra

2010-01-01

Contingency management (CM) utilizing monetary incentives is efficacious in enhancing abstinence in an adolescent smoking-cessation program, but how adolescents spend their money has not been examined. We assessed spending habits of 38 adolescent smokers in a CM-based smoking-cessation project prior to quitting and during treatment using a…

Behavioral Treatment Approaches to Prevent Weight Gain Following Smoking Cessation.

ERIC Educational Resources Information Center

Grinstead, Olga A.

Personality and physiological, cognitive, and environmental factors have all been suggested as critical variables in smoking cessation and relapse. Weight gain and the fear of weight gain after smoking cessation may also prevent many smokers from quitting. A sample of 45 adult smokers participated in a study in which three levels of preventive…

Predictors of Retention in Smoking Cessation Treatment among Latino Smokers in the Northeast United States

ERIC Educational Resources Information Center

Lee, Christina S.; Hayes, Rashelle B.; McQuaid, Elizabeth L.; Borrelli, Belinda

2010-01-01

Introduction. Only one previous study on minority retention in smoking cessation treatment has been conducted (Nevid JS, Javier RA, Moulton JL III. "Factors predicting participant attrition in a community-based, culturally specific smoking cessation program for Hispanic smokers." "Health Psychol" 1996; 15: 226-29). We investigated predictors of…

Evaluation of a Pharmacist and Nurse Practitioner Smoking Cessation Program.

PubMed

Afzal, Zubair; Pogge, Elizabeth; Boomershine, Virginia

2017-08-01

To evaluate the efficacy of a smoking cessation program led by a pharmacist and a nurse practitioner. During a 6-month period, patients attended 7 one-on-one face-to-face smoking cessation counseling sessions with a pharmacist and 1 to 2 one-on-one face-to-face smoking cessation counseling sessions with a nurse practitioner. The primary outcome was smoking cessation point prevalence rates at months 1, 3, and 5 post-quit date. Secondary outcomes included medication adherence rates at months 1, 3, and 5 post-quit date, nicotine dependence at baseline versus program end, and patient satisfaction. Nine (47%) of 19 total participants completed the program. Seven of the 9 patients who completed the program were smoke-free upon study completion. Point prevalence rates at months 1, 3, and 5 post-quit date were 66%, 77%, and 77%, respectively, based on patients who completed the program. Medication adherence rates were 88.6%, 54.6%, and 75% at months 1, 3, and 5 post-quit date, respectively. Based on the Fagerstrom test, nicotine dependence decreased from baseline to the end of the study, 4.89 to 0.33 ( P < .001). Overall, participants rated the program highly. A joint pharmacist and nurse practitioner smoking cessation program can assist patients in becoming smoke-free.

Identifying multi-level culturally appropriate smoking cessation strategies for Aboriginal health staff: a concept mapping approach.

PubMed

Dawson, Anna P; Cargo, Margaret; Stewart, Harold; Chong, Alwin; Daniel, Mark

2013-02-01

Aboriginal Australians, including Aboriginal Health Workers (AHWs), smoke at rates double the non-Aboriginal population. This study utilized concept mapping methodology to identify and prioritize culturally relevant strategies to promote smoking cessation in AHWs. Stakeholder participants included AHWs, other health service employees and tobacco control personnel. Smoking cessation strategies (n = 74) were brainstormed using 34 interviews, 3 focus groups and a stakeholder workshop. Stakeholders sorted strategies into meaningful groups and rated them on perceived importance and feasibility. A concept map was developed using multi-dimensional scaling and hierarchical cluster analyses. Ten unique clusters of smoking cessation strategies were depicted that targeted individuals, family and peers, community, workplace and public policy. Smoking cessation resources and services were represented in addition to broader strategies addressing social and environmental stressors that perpetuate smoking and make quitting difficult. The perceived importance and feasibility of clusters were rated differently by participants working in health services that were government-coordinated compared with community-controlled. For health service workers within vulnerable populations, these findings clearly implicate a need for contextualized strategies that mitigate social and environmental stressors in addition to conventional strategies for tobacco control. The concept map is being applied in knowledge translation to guide development of smoking cessation programs for AHWs.

From the Sidelines to the Frontline: How the Substance Abuse and Mental Health Services Administration Embraced Smoking Cessation

PubMed Central

Santhosh, Lekshmi; Meriwether, Margaret; Saucedo, Catherine; Reyes, Reason; Cheng, Christine; Clark, Brian; Tipperman, Doug

2014-01-01

Smoking is a major contributor to premature mortality among people with mental illness and substance abuse. Historically, the Substance Abuse and Mental Health Services Administration (SAMHSA) did not include smoking cessation in its mission. We describe the development of a unique partnership between SAMHSA and the University of California, San Francisco’s Smoking Cessation Leadership Center. Starting with an educational summit in Virginia in 2007, it progressed to a jointly sponsored “100 Pioneers for Smoking Cessation” campaign that provided grants and technical assistance to organizations promoting cessation. By 2013, the partnership established 7 “Leadership Academies,” state-level multidisciplinary collaboratives of organizations focused on cessation. This academic–public partnership increased tobacco quit attempts, improved collaboration across multiple agencies, and raised awareness about tobacco use in vulnerable populations. PMID:24625143

Trait hostility and hostile interpretation biases in daily smokers: associations with reasons for smoking, motivation to quit, and early smoking lapse.

PubMed

Cougle, Jesse R; Hawkins, Kirsten A; Macatee, Richard J; Zvolensky, Michael J; Sarawgi, Shivali

2014-09-01

Hostility has emerged as an important predictor of smoking cessation difficulties, though the mechanisms underlying the hostility and smoking relationship are poorly understood. Further, research has yet to explore relations between hostile interpretation biases and different aspects of smoking behavior. In the present study, current daily smokers (N = 106) were administered measures of smoking characteristics, smoking motivation, reasons for quitting, hostility, and hostile interpretation bias. Neither trait hostility nor hostile interpretation bias were uniquely associated with motivation to quit, reasons for quitting, nicotine dependence, or problematic symptoms following past cessation attempts. However, hostility and hostile interpretation biases were uniquely associated with different reasons for smoking. Additionally, greater hostile interpretation bias (but not hostility) was uniquely associated with early relapse following past cessation attempts. The current findings add uniquely to the growing, but still relatively small, literature on hostility and smoking and implicate hostile interpretation bias as a potential treatment target in smoking cessation interventions.

User Experience Evaluation of a Smoking Cessation App in People With Serious Mental Illness.

PubMed

Vilardaga, Roger; Rizo, Javier; Kientz, Julie A; McDonell, Michael G; Ries, Richard K; Sobel, Kiley

2016-05-01

Smoking rates among people with serious mental illness are 3 to 4 times higher than the general population, yet currently there are no smoking cessation apps specifically designed to address this need. We report the results of a User Experience (UX) evaluation of a National Cancer Institute smoking cessation app, QuitPal, and provide user centered design data that can be used to tailor smoking cessation apps for this population. Two hundred forty hours of field experience with QuitPal, 10 hours of recorded interviews and task performances, usage logs and a self-reported usability scale, informed the results of our study. Participants were five individuals recruited from a community mental health clinic with a reported serious mental illness history. Performance, self-reports, usage logs and interview data were triangulated to identify critical usability errors and UX themes emerging from this population. Data suggests QuitPal has below average levels of usability, elevated time on task performances and required considerable amounts of guidance. UX themes provided critical information to tailor smoking cessation apps for this population, such as the importance of breaking down "cessation" into smaller steps and use of a reward system. This is the first study to examine the UX of a smoking cessation app among people with serious mental illness. Data from this study will inform future research efforts to expand the effectiveness and reach of smoking cessation apps for this highly nicotine dependent yet under-served population. Data from this study will inform future research efforts to expand the effectiveness and reach of smoking cessation apps for people with serious mental illness, a highly nicotine dependent yet under-served population. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Effect of financial incentives on ethnic disparities in smoking cessation interventions in primary care: cross-sectional study.

PubMed

Hamilton, F L; Laverty, A A; Vamos, E P; Majeed, A; Millett, C

2013-03-01

Smoking cessation interventions are underprovided in primary care. Financial incentives may help address this. However, few studies in the UK have examined their impact on disparities in the delivery of smoking cessation interventions. Cross-sectional study using 2007 data from 29 general practices in Wandsworth, London, UK. We used logistic regression to examine associations between disease group [cardiovascular disease (CVD), respiratory disease, depression or none of these diseases], ethnicity and smoking outcomes following the introduction of the Quality and Outcomes Framework in 2004. Significantly, more CVD patients had smoking status ascertained compared with those with respiratory disease (89 versus 72%), but both groups received similar levels of cessation advice (93 and 89%). Patients with depression or none of the diseases were less likely to have smoking status ascertained (60% for both groups) or to receive advice (80 and 75%). Smoking prevalence was high, especially for patients with depression (44%). White British patients had higher rates of smoking than most ethnic groups, but black Caribbean men with depression had the highest smoking prevalence (62%). Smoking rates remain high, particularly for white British and black Caribbean patients. Extending financial incentives to include recording of ethnicity and rewarding quit rates may further improve smoking cessation outcomes in primary care.

Treatment attrition: Associations with negative affect smoking motives and barriers to quitting among treatment-seeking smokers.

PubMed

Garey, Lorra; Kauffman, Brooke Y; Neighbors, Clayton; Schmidt, Norman B; Zvolensky, Michael J

2016-12-01

Pre-treatment attrition and perceived barriers for quitting are clinically important processes involved in early phases of quitting smoking. However, less is known about the constructs that may contribute to these processes such as negative affect reduction smoking motives. The current study sought to evaluate the relation between negative affect reduction smoking motives and pre-treatment attrition and perceived barriers for quitting in a sample of 425 treatment-seeking smokers (48.5% female; Mage=37.69 years; SD=13.61) enrolled in a smoking cessation study examining the efficacy of a transdiagnostic panic-smoking cessation treatment relative to a standard smoking cessation treatment. Results indicated that greater negative affect reduction smoking motives was associated with an increased likelihood of treatment initiation (odds ratio=1.49, CI: 1.09, 2.04). Additionally, negative affect reduction smoking motives was associated with greater perceived barriers for cessation among pre-treatment drop-outs and treatment initiators. This initial investigation provides evidence for the possible clinical utility in addressing negative affect reduction smoking motives during early stages of quitting. Additionally, such findings could potentially inform the development of personalized, early stages of quitting interventions for smoking cessation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Preventing postpartum smoking relapse: an opportunity for neonatal nurses.

PubMed

Forest, Sharron

2009-08-01

Smoking during pregnancy and exposure to environmental tobacco smoke have harmful and sometimes devastating effects on the health of the newborn. Although interventions for smoking cessation during pregnancy demonstrate effectiveness for increasing smoking abstinence, the majority of women relapse in the postpartum period. However, modifying contributing factors for relapse may improve the success of sustained abstinence. Many parents are eager to quit smoking and willing to participate in smoking cessation interventions. Through a population-based approach to healthcare, neonatal nurses are in an ideal position to prevent relapse and to promote smoking abstinence; they can coordinate and lead efforts for establishing smoking cessation strategies that integrate obstetric, newborn, and pediatric services.

mHealth for Smoking Cessation Programs: A Systematic Review.

PubMed

Ghorai, Koel; Akter, Shahriar; Khatun, Fatema; Ray, Pradeep

2014-07-18

mHealth transforms healthcare delivery around the world due to its affordability and right time availability. It has been used for delivery of various smoking cessation programs and interventions over the past decade. With the proliferation of smartphone usage around the world, many smartphone applications are being developed for curbing smoking among smokers. Various interventions like SMS, progress tracking, distractions, peer chats and others are being provided to users through smartphone applications. This paper presents a systematic review that analyses the applications of mobile phones in smoking cessations. The synthesis of the diverse concepts within the literature on smoking cessations using mobile phones provides deeper insights in the emerging mHealth landscape.

Aspects of physician-patient communication in the program of smoking cessation.

PubMed

Nemeş, Roxana-Maria; Postolache, Paraschiva; Tintilă, Adeline; Mihălţan, F D; Petrariu, F D

2015-01-01

The doctor-smoker patient communication is essential for smokers to realize the harmful effects of tobacco on health and the benefits of smoking cessation. Nicotine found in cigarettes is a powerful drug and a direct dependency generator, which makes smoking cessation difficult, the withdrawal syndrome being hard to overcome for many smokers. The doctor-smoker patient communication is a complex process of data, information and knowledge transmission, subjected to some semiotic rules. In the Counseling Center for Smoking Cessation (CCSC) from the Rehabilitation Clinical Hospital of Iasi the medical and psychological counseling and the pharmacologic therapy for smoking cessation is ensured by the qualified personnel. CCSC was founded in 2005, when the hospital was included in European Program: "European Network Smoke-Free Hospital", and experienced an important development in 2007 with the initiation "Stop Smoking" National Program of Ministry of Health. The doctor-smoker patient communication in the CCSC was conducted during the smoker's recruitment, therapeutic and post therapeutic period, a special place being occupied by the doctor-medical staff communication, including smoker medical students. The number of people who became nonsmokers after being counseled at our center was the evidence of the effectiveness of this communication. The obtained results determined us to join the global fight against smoking and to propose the introduction of the smoking cessation program in the curriculum of the medical education institutions.

Psychosocial correlates of smoking cessation among elderly ever-smokers in the United States.

PubMed

Honda, Keiko

2005-02-01

This study was conducted to identify the psychosocial factors associated with successful smoking cessation among ever-smokers aged 60 and older in the United States. Descriptive and multivariate analyses of the 2000 National Health Interview Survey (NHIS) were conducted. Controlling for sociodemographics and medical history of smoking-associated diseases, former smokers were less likely to have psychological distress (adjusted OR=0.71, 95% CI=0.58-0.88) and more likely to believe in the danger of second-hand smoke (adjusted OR=3.01, 95% CI=2.4-3.79) and the appropriateness of a smoking ban in indoor public places (adjusted OR=2.62, 95% CI=2.11-3.26). Having no regular source for care (adjusted OR=0.54, 95% CI=0.37-0.78) was an independent barrier to cessation, as were younger age, female, Hispanic race, being nonmarried and employed, and having lower income and education. This work contributes to a knowledge base for the development of interventions to maximize smoking cessation of elderly smokers. Findings suggest that strategies tailored to psychological distress and beliefs about smoking health harms and smoking restriction policies would aid in successful cessation. Specific measures reinforcing the importance of having a regular source for care may promote cessation. The extent to which these psychosocial factors affect elders' motivation to quit smoking remains to be explored.

Smoking history and motivation to quit in smokers with schizophrenia in a smoking cessation program.

PubMed

Mann-Wrobel, Monica C; Bennett, Melanie E; Weiner, Elaine E; Buchanan, Robert W; Ball, M Patricia

2011-03-01

The present study sought to better understand the relationships among smoking history, motivation to change, and smoking cessation outcomes in people with schizophrenia who smoke. We examined smoking and quit history, negative consequences due to smoking, readiness to change, smoking temptation, and confidence to quit in a sample of people diagnosed with schizophrenia or schizoaffective disorder according to DSM-IV criteria who were participating in a larger randomized trial of bupropion SR and a psychoeducational intervention for smoking cessation. Data were collected from June 2003 to May 2005. At baseline, participants reported high levels of nicotine dependence and daily smoking, as well as multiple recent and lifetime quit attempts that were generally brief in nature. Participants were most concerned about the health effects of smoking and endorsed reasons for smoking related to coping with negative affect and boredom. Most participants reported wanting to quit smoking, but the sample generally reported low levels of confidence in their ability to quit. During the course of participation in the intervention, self-efficacy to quit increased while temptation to smoke decreased; however readiness to quit remained unchanged. Smoking cessation programs for people with schizophrenia should focus on teaching coping skills for negative affect, boredom, and specific "high risk situations" for smoking in addition to education, medication, or nicotine replacement therapy. Further, cessation efforts may benefit from directly addressing low self-efficacy for quitting, rather than readiness for change alone, among people with schizophrenia. Published by Elsevier B.V.

Hypnosis, behavioral theory, and smoking cessation.

PubMed

Covino, N A; Bottari, M

2001-04-01

Although nicotine replacement and other pharmacological treatments head the list of popular interventions for smoking cessation, approaches based on psychology can also assist smokers. Hypnosis, suggestion, and behavior therapies have been offered to patients and studied experimentally for several decades. Although no single psychological approach has been found to be superior to others, psychological interventions contribute significantly to successful treatment outcome in smoking cessation. This article describes common hypnotic and behavioral approaches to smoking cessation and critically reviews some of the findings from clinical and experimental research studies. The authors also offer suggestions regarding treatment and future research.

Socioeconomic inequalities in smoking in The Netherlands before and during the Global Financial Crisis: a repeated cross-sectional study.

PubMed

Benson, Fiona E; Kuipers, Mirte A G; Nierkens, Vera; Bruggink, Jan-Willem; Stronks, Karien; Kunst, Anton E

2015-05-06

The Global Financial Crisis (GFC) increased levels of financial strain, especially in those of low socioeconomic status (SES). Financial strain can affect smoking behaviour. This study examines socioeconomic inequalities in current smoking and smoking cessation in The Netherlands before and during the Global Financial Crisis (GFC). Participants were 66,960 Dutch adults (≥ 18 years) who took part in the annual national Health Survey (2004-2011). Period was dichotomised: 'pre-' and 'during-GFC'. SES measures used were income, education and neighbourhood deprivation. Outcomes were current smoking rates (smokers/total population) and smoking cessation ratios (former smokers/ever smokers). Multilevel logistic regression models controlled for individual characteristics and tested for interaction between period and SES. In both periods, high SES respondents (in all indicators) had lower current smoking levels and higher cessation ratios than those of middle or low SES. Inequalities in current smoking increased significantly in poorly educated adults of 45-64 years of age (Odds Ratio (OR) low educational level compared with high: 2.00[1.79-2.23] compared to pre-GFC 1.67[1.50-1.86], p for interaction = 0.02). Smoking cessation inequalities by income in 18-30 year olds increased with borderline significance during the GFC (OR low income compared to high income: 0.73[0.58-0.91]) compared to pre-GFC (OR: 0.98[0.80-1.20]), p for interaction = 0.051). Overall, socioeconomic inequalities in current smoking and smoking cessation were unchanged during the GFC. However, current smoking inequalities by education, and smoking cessation inequalities by income, increased in specific age groups. Increased financial strain caused by the crisis may disproportionately affect smoking behaviour in some disadvantaged groups.

Association of intracranial aneurysm rupture with smoking duration, intensity, and cessation.

PubMed

Can, Anil; Castro, Victor M; Ozdemir, Yildirim H; Dagen, Sarajune; Yu, Sheng; Dligach, Dmitriy; Finan, Sean; Gainer, Vivian; Shadick, Nancy A; Murphy, Shawn; Cai, Tianxi; Savova, Guergana; Dammers, Ruben; Weiss, Scott T; Du, Rose

2017-09-26

Although smoking is a known risk factor for intracranial aneurysm (IA) rupture, the exact relationship between IA rupture and smoking intensity and duration, as well as duration of smoking cessation, remains unknown. In this case-control study, we analyzed 4,701 patients with 6,411 IAs diagnosed at the Brigham and Women's Hospital and Massachusetts General Hospital between 1990 and 2016. We divided individuals into patients with ruptured aneurysms and controls with unruptured aneurysms. We performed univariable and multivariable logistic regression analyses to determine the association between smoking status and ruptured IAs at presentation. In a subgroup analysis among former and current smokers, we assessed the association between ruptured aneurysms and number of packs per day, duration of smoking, and duration since smoking cessation. In multivariable analysis, current (odds ratio [OR] 2.21, 95% confidence interval [CI] 1.89-2.59) and former smoking status (OR 1.56, 95% CI 1.31-1.86) were associated with rupture status at presentation compared with never smokers. In a subgroup analysis among current and former smokers, years smoked (OR 1.02, 95% CI 1.01-1.03) and packs per day (OR 1.46, 95% CI 1.25-1.70) were significantly associated with ruptured aneurysms at presentation, whereas duration since cessation among former smokers was not significant (OR 1.00, 95% CI 0.99-1.02). Current cigarette smoking, smoking intensity, and smoking duration are significantly associated with ruptured IAs at presentation. However, the significantly increased risk persists after smoking cessation, and smoking cessation does not confer a reduced risk of aneurysmal subarachnoid hemorrhage beyond that of reducing the cumulative dose. © 2017 American Academy of Neurology.

Maintenance of Smoking Cessation: Effect of Follow-Up Letters, Smoking Motivation, Muscle Tension, and Health Locus of Control.

ERIC Educational Resources Information Center

Shipley, Robert H.

1981-01-01

Following smoking-cessation treatment, half of 44 subjects were sent supportive maintenance letters. Letters produced no main effect but reduced smoking in subjects who smoked from habit or received little pleasure from smoking. Letters increased smoking among opposite subject groups and those believing powerful others could not influence their…

Group hypnosis vs. relaxation for smoking cessation in adults: a cluster-randomised controlled trial.

PubMed

Dickson-Spillmann, Maria; Haug, Severin; Schaub, Michael P

2013-12-23

Despite the popularity of hypnotherapy for smoking cessation, the efficacy of this method is unclear. We aimed to investigate the efficacy of a single-session of group hypnotherapy for smoking cessation compared to relaxation in Swiss adult smokers. This was a cluster-randomised, parallel-group, controlled trial. A single session of hypnosis or relaxation for smoking cessation was delivered to groups of smokers (median size = 11). Participants were 223 smokers consuming ≥ 5 cigarettes per day, willing to quit and not using cessation aids (47.1% females, M = 37.5 years [SD = 11.8], 86.1% Swiss). Nicotine withdrawal, smoking abstinence self-efficacy, and adverse reactions were assessed at a 2-week follow-up. The main outcome, self-reported 30-day point prevalence of smoking abstinence, was assessed at a 6-month follow up. Abstinence was validated through salivary analysis. Secondary outcomes included number of cigarettes smoked per day, smoking abstinence self-efficacy, and nicotine withdrawal. At the 6-month follow up, 14.7% in the hypnosis group and 17.8% in the relaxation group were abstinent. The intervention had no effect on smoking status (p = .73) or on the number of cigarettes smoked per day (p = .56). Smoking abstinence self-efficacy did not differ between the interventions (p = .14) at the 2-week follow-up, but non-smokers in the hypnosis group experienced reduced withdrawal (p = .02). Both interventions produced few adverse reactions (p = .81). A single session of group hypnotherapy does not appear to be more effective for smoking cessation than a group relaxation session. Current Controlled Trials ISRCTN72839675.

[Acceptance of a total smoking ban in schools: students' attitudes].

PubMed

Morgenstern, M; Wiborg, G; Hanewinkel, R

2008-06-01

The purpose of this study was to measure students' attitudes towards a total smoking ban in schools and towards impositions in cases of violation. Cross-sectional survey of 1 738 students of 12 public schools in Schleswig-Holstein (grades 7-13, age 11-20 years). Data were collected by means of written questionnaires administered during class time. The following variables were assessed: attitude towards smoking ban, attitude towards impositions, age, sex, citizenship, perceived school climate, current smoking, lifetime smoking; for smokers, and additionally, the "Heaviness of Smoking Index". 76.5% of all students agreed with a total smoking ban, 66.4% agreed with the punishment of violations. Higher acceptance rates were found among girls, young students (11-15 years of age), for never-smokers, and for students who feel comfortable at school. Acceptance of the smoking ban is closely related to current smoking status: 93% of the non-smoking students, but only 14% of the daily smoking students agreed with the regulations. Refusal of the ban increased with increasing physical dependence. The intensification of the smoking ban in public schools meets approval by the majority of students. Smoking students should be more strongly involved in the implementation process, e.g., by supplemental cessation programmes.

The Association Between Anxiety Sensitivity and Motivation to Quit Smoking Among Women and Men in Residential Substance Use Treatment

PubMed Central

Dahne, Jennifer; Hoffman, Elana M.; MacPherson, Laura

2015-01-01

Background Smoking-attributed mortality is the leading cause of death among individuals in residential substance use treatment. As such, identifying factors that influence smoking cessation is highly relevant and important for this group. Motivation to quit (MTQ) smoking is one such factor that is related to smoking cessation. Objectives In the present study we examine the relationship between Anxiety Sensitivity (AS) and MTQ among individuals enrolled in a residential substance use treatment center in Washington, DC. In light of gender differences in smoking cessation as well as factors that contribute to cessation, we examined this relationship by gender in men and women using multiple group path analysis. Methods Participants (n = 472) completed a measure of MTQ, the structured clinical interview for DSM-IV (SCID-IV-TR), a measure of AS, and self-reported their number of cigarettes smoked per day prior to entering a restricted environment. Results Results indicated that AS was significantly related to MTQ in women (standardized path estimate = 0.21, p = .01), but was not significantly related to MTQ in men. Conclusions/Importance Findings suggest the importance of considering AS as a factor in MTQ for women and subsequent smoking cessation among individuals in residential substance use treatment. Results of this study contribute to the extant literature on predictors of MTQ and highlight the need for tailored cessation interventions with AS as one potential cessation treatment target. PMID:25265420

Smoking cessation and the Internet: a qualitative method examining online consumer behavior.

PubMed

Frisby, Genevieve; Bessell, Tracey L; Borland, Ron; Anderson, Jeremy N

2002-01-01

Smoking is a major preventable cause of disease and disability around the world. Smoking cessation support-including information, discussion groups, cognitive behavioral treatment, and self-help materials-can be delivered via the Internet. There is limited information about the reasons and methods consumers access smoking cessation information on the Internet. This study aims to determine the feasibility of a method to examine the online behavior of consumers seeking smoking cessation resources. In particular, we sought to identify the reasons and methods consumers use to access and assess the quality of these resources. Thirteen participants were recruited via the state-based Quit smoking cessation campaign, operated by the Victorian Cancer Council, in December 2001. Online behavior was evaluated using semi-structured interviews and Internet simulations where participants sought smoking cessation information and addressed set-case scenarios. Online interaction was tracked through pervasive logging with specialist software. Thirteen semi-structured interviews and 4 Internet simulations were conducted in January 2002. Participants sought online smoking cessation resources for reasons of convenience, timeliness, and anonymity-and because their current information needs were unmet. They employed simple search strategies and could not always find information in an efficient manner. Participants employed several different strategies to assess the quality of online health resources. Consumer online behavior can be studied using a combination of survey, observation, and online surveillance. However, further qualitative and observational research is required to harness the full potential of the Internet to deliver public health resources.

Effect of a brief smoking cessation intervention on adult tobacco smokers with pulmonary tuberculosis: A cluster randomized controlled trial from North India.

PubMed

Goel, Sonu; Kathiresan, Jeyashree; Singh, Preeti; Singh, Rana J

2017-09-01

An association between smoking and poor tuberculosis (TB) treatment outcomes has been globally established. Various smoking cessation interventions (SCIs) have been proven worldwide to curb smoking behavior. There is a need for evidence to assess if SCI increases the chance of successful treatment outcome among TB patients. To assess the effectiveness of a brief SCI; The Ask, Brief, Cessation support (ABC) package, on treatment outcomes and smoking cessation in smear-positive adult pulmonary TB patients. A cluster, randomized controlled trial was conducted wherein 17 designated microscopic centers of Chandigarh, India were randomly assigned using a computer-generated randomization sequence to receive SCI within directly observed treatment, short (DOTS) services, or existing standard of care. Eligible and consenting smokers (15 + years) registered as smear-positive pulmonary TB for DOTS (n = 156) between January and June 2013 were enrolled. Smoking cessation (self-reported) was assessed at intervals till the end of treatment. End TB treatment outcomes were extracted from patient records. Treatment success was lower in intervention arm (83.6%) as compared control arm (88.2%), but the difference was statistically insignificant (P = 0.427). Smoking cessation was higher in intervention arm (80.2%) compared to comparison arm (57.5%) (adjusted incidence risk ratio = 1.56; 95% confidence interval = 1.24-1.93; P < 0.0001). SCI is effective in inducing smoking cessation among TB patients. No association of SCI with TB treatment outcomes could be detected.

Qualitative exploration of a smoking cessation trial for people living with HIV in South Africa.

PubMed

Krishnan, Nandita; Gittelsohn, Joel; Ross, Alexandra; Elf, Jessica; Chon, Sandy; Niaura, Raymond; Martinson, Neil; Golub, Jonathan E

2017-06-16

In South Africa, people living with HIV (PLWH) have a high prevalence of smoking, which undermines the beneficial effects of antiretroviral therapy (ART). However, little is known about barriers to smoking cessation and what interventions work for PLWH in this setting. A randomized trial comparing intensive anti-smoking counseling versus counseling and nicotine replacement therapy (NRT) was recently concluded in Klerksdorp, South Africa. In a post-trial follow-up, 23 in-depth interviews with patients and one focus group discussion with counselors from the trial were conducted. A codebook was developed and codes were applied to the transcripts, which were analyzed using a thematic analysis. Barriers at the economic, social/interpersonal, and individual levels induced stress, which hindered smoking cessation. Economic stressors included unemployment and poverty. Social or interpersonal stressors were lack of social support for quitting smoking and lack of social support due to having HIV. Individual stressors were traumatic life events. Alcohol was used to cope with stress and frequently co-occurred with smoking. Managing cravings was a barrier unrelated to stress. Participants proposed income and employment opportunities, group counseling and more frequent counseling as solutions to address stressors at different levels. NRT was helpful to mitigate cravings. Future smoking cessation interventions need to target barriers at multiple levels. Increasing the supply and duration of NRT may increase its effectiveness. Other behavioral approaches such as group counseling or peer counseling could hold promise in this setting but need to be tested for efficacy through randomized controlled trials. To our knowledge, this is the first qualitative study examining barriers to smoking cessation for people living with HIV in South Africa. Smoking is highly prevalent among people with HIV in South Africa and cessation interventions are urgently needed. A better understanding of barriers to smoking cessation that people with HIV face will lead to the development of contextually appropriate interventions. This study also provides feedback on interventions from a recently concluded smoking cessation randomized trial and will help guide the design of future smoking cessation trials. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Facility-level, state, and financial factors associated with changes in the provision of smoking cessation services in US substance abuse treatment facilities: Results from the National Survey of Substance Abuse Treatment Services 2006 to 2012.

PubMed

Cohn, Amy; Elmasry, Hoda; Niaura, Ray

2017-06-01

Cigarette smoking is common among patients in substance abuse treatment. Tobacco control programs have advocated for integrated tobacco dependence treatment into behavioral healthcare, including within substance abuse treatment facilities (SATFs) to reduce the public health burden of tobacco use. This study used data from seven waves (2006 to 2012) of the National Survey of Substance Abuse Treatment Services (n=94,145) to examine state and annual changes in the provision of smoking cessation services within US SATFs and whether changes over time could be explained by facility-level (private vs public ownership, receipt of earmarks, facility admissions, acceptance of government insurance) and state-level factors (cigarette tax per pack, smoke free policies, and percent of CDC recommended tobacco prevention spending). Results showed that the prevalence of SATFs offering smoking cessation services increased over time, from 13% to 65%. The amount of tax per cigarette pack, accepting government insurance, government (vs private) ownership, facility admissions, and CDC recommended tobacco prevention spending (per state) were the strongest correlates of the provision of smoking cessation programs in SATFs. Facilities that received earmarks were less likely to provide cessation services. Adult smoking prevalence and state-level smoke free policies were not significant correlates of the provision of smoking cessation services over time. Policies aimed at increasing the distribution of tax revenues to cessation services in SATFs may offset tobacco-related burden among those with substance abuse problems. Copyright © 2017. Published by Elsevier Inc.

Maintenance of a smoking cessation program in public health clinics beyond the experimental evaluation period.

PubMed Central

Manfredi, C.; Crittenden, K.; Cho, Y. I.; Engler, J.; Warnecke, R.

2001-01-01

OBJECTIVES: As phase 3 of a study to evaluate a smoking cessation program in public health practice, the authors assess the maintenance and impact of the It's Time smoking cessation program in seven public maternal and child health clinics in Chicago. METHODS: The authors interviewed 404 clinic patients in the study's baseline phase (prior to introduction of the It's Time intervention program), and 610 in the program maintenance phase (in the year after experimental evaluation had ended) to assess exposure to smoking cessation interventions offered at the clinic, and smoking cessation outcomes (quit, actions toward quitting, scores on action, motivation, readiness, and confidence scales). The authors controlled for clustering of smokers within clinics, smokers' characteristics prior to clinic visit, and type of clinic service. They compared outcomes by study group (control or intervention) to which each clinic had been assigned in the earlier experimental phase. RESULTS: Compared to baseline, smokers in the maintenance phase had greater exposure to posters, provider advice and booklet, and better outcomes on seven of eight smoking cessation measures, including quitting. These improvements were larger for clinics with prior experience implementing It's Time. CONCLUSION: Participation in the experimental evaluation of the It's Time program prepared and possibly motivated the clinics to continue the program. Continuing the program resulted in greater delivery of interventions and improved smoking cessation outcomes for smokers in the clinics. PMID:11889280

Impact of Online Education on Nurses' Delivery of Smoking Cessation Interventions With Implications for Evidence-Based Practice.

PubMed

Bialous, Stella A; Sarna, Linda; Wells, Marjorie J; Brook, Jenny K; Kralikova, Eva; Pankova, Alexandra; Zatoński, Witold; Przewozniak, Krzysztof

2017-10-01

Tobacco use is the leading cause of preventable disease and death in Europe and worldwide. Nurses, if properly educated, can contribute to decreasing the burden of tobacco use in the region by helping smokers quit smoking. To assess: (a) the feasibility of an online program to educate nurses in Czech Republic and Poland on evidence-based smoking cessation interventions for patients and (b) self-reported changes in practices related to consistently (usually or always) providing smoking cessation interventions to smokers, before and 3 months after participation in the program. A prospective single-group pre-post design. A total of 280 nurses from Czech Republic and 156 from Poland completed baseline and follow-up surveys. At 3 months, nurses were significantly more likely to provide smoking cessation interventions to patients who smoke and refer patients for cessation services (p < .01). Nurses significantly improved their views about the importance of nursing involvement in tobacco control. Education about tobacco control can make a difference in clinical practice, but ongoing support is needed to maintain these changes. Health system changes can also facilitate the expectation that delivering evidence-based smoking cessation interventions should be routine nursing care. Educating nurses on cessation interventions and tobacco control is pivotal to decrease tobacco-related disparities, disease, and death. Online methods provide an accessible way to reach a large number of nurses. © 2017 Sigma Theta Tau International.

Program Strategies for Adolescent Smoking Cessation

ERIC Educational Resources Information Center

Fritz, Deborah J.; Wider, Lottchen Crane; Hardin, Sally B.; Horrocks, Michelle

2008-01-01

School nurses who work with adolescents are in an ideal position to promote smoking cessation. This opportunity is important because research suggests teens who smoke are likely to become habitual smokers. This study characterizes adolescents' patterns and levels of smoking, describes adolescents' perceptions toward smoking, and delineates quit…

Implementation of smoking cessation guidelines in the emergency department: a qualitative study of staff perceptions.

PubMed

Katz, David A; Paez, Monica W; Reisinger, Heather S; Gillette, Meghan T; Weg, Mark W Vander; Titler, Marita G; Nugent, Andrew S; Baker, Laurence J; Holman, John E; Ono, Sarah S

2014-01-24

The US Public Health Service smoking cessation practice guideline specifically recommends that physicians and nurses strongly advise their patients who use tobacco to quit, but the best approach for attaining this goal in the emergency department (ED) remains unknown. The aim of this study was to characterize emergency physicians' (EPs) and nurses' (ENs) perceptions of cessation counseling and to identify barriers and facilitators to implementation of the 5 A's framework (Ask-Advise-Assess-Assist-Arrange) in the ED. We conducted semi-structured, face-to-face interviews of 11 EPs and 19 ENs following a pre-post implementation trial of smoking cessation guidelines in two study EDs. We used purposeful sampling to target EPs and ENs with different attitudes toward cessation counseling, based on their responses to a written survey (Decisional Balance Questionnaire). Conventional content analysis was used to inductively characterize the issues raised by study participants and to construct a coding structure, which was then applied to study transcripts. The main findings of this study converged upon three overarching domains: 1) reactions to the intervention; 2) perceptions of patients' receptivity to cessation counseling; and 3) perspectives on ED cessation counseling and preventive care. ED staff expressed ambivalence toward the implementation of smoking cessation guidelines. Both ENs and EPs agreed that the delivery of smoking cessation counseling is important, but that it is not always practical in the ED on account of time constraints, the competing demands of acute care, and resistance from patients. Participants also called attention to the need for improved role clarity and teamwork when implementing the 5 A's in the ED. There are numerous challenges to the implementation of smoking cessation guidelines in the ED. ENs are generally willing to take the lead in offering brief cessation counseling, but their efforts need to be reinforced by EPs. ED systems need to address workflow, teamwork, and practice policies that facilitate prescription of smoking cessation medication, referral for cessation counseling, and follow-up in primary care. The results of this qualitative evaluation can be used to guide the design of future ED intervention studies. ClinicalTrials.gov registration number NCT00756704.

Continuous-time system identification of a smoking cessation intervention

NASA Astrophysics Data System (ADS)

Timms, Kevin P.; Rivera, Daniel E.; Collins, Linda M.; Piper, Megan E.

2014-07-01

Cigarette smoking is a major global public health issue and the leading cause of preventable death in the United States. Toward a goal of designing better smoking cessation treatments, system identification techniques are applied to intervention data to describe smoking cessation as a process of behaviour change. System identification problems that draw from two modelling paradigms in quantitative psychology (statistical mediation and self-regulation) are considered, consisting of a series of continuous-time estimation problems. A continuous-time dynamic modelling approach is employed to describe the response of craving and smoking rates during a quit attempt, as captured in data from a smoking cessation clinical trial. The use of continuous-time models provide benefits of parsimony, ease of interpretation, and the opportunity to work with uneven or missing data.

Do pharmacy staff recommend evidenced-based smoking cessation products? A pseudo patron study.

PubMed

Chiang, P P C; Chapman, S

2006-06-01

To determine whether pharmacy staff recommend evidence-based smoking cessation aids. Pseudo patron visit to 50 randomly selected Sydney pharmacies where the pseudo patron enquired about the 'best' way to quit smoking and about the efficacy of a non-evidence-based cessation product, NicoBloc. Nicotine replacement therapy was universally stocked and the first product recommended by 90% of pharmacies. After prompting, 60% of pharmacies, either also recommended NicoBloc or deferred to 'customer choice'. About 34% disparaged the product. Evidence-based smoking cessation advice in Sydney pharmacies is fragile and may be compromised by commercial concerns. Smokers should be provided with independent point-of-sale summaries of evidence of cessation product effectiveness and warned about unsubstantiated claims.

Smiling Instead of Smoking: Development of a Positive Psychology Smoking Cessation Smartphone App for Non-daily Smokers.

PubMed

Hoeppner, Bettina B; Hoeppner, Susanne S; Kelly, Lourah; Schick, Melissa; Kelly, John F

2017-10-01

The usefulness of mobile technology in supporting smoking cessation has been demonstrated, but little is known about how smartphone apps could best be leveraged. The purpose of this paper is to describe the program of research that led to the creation of a smoking cessation app for non-daily smokers, so as to stimulate further ideas to create "smart" smartphone apps to support health behavior change. Literature reviews to evaluate the appropriateness of the proposed app, content analyses of existing apps, and smoking cessation sessions with non-daily smokers (n = 38) to inform the design of the app. The literature reviews showed that (1) smoking cessation apps are sought after by smokers, (2) positive affect plays an important role in smoking cessation, (3) short, self-administered exercises consistently bring about enduring positive affect enhancements, and (4) low treatment-seeking rates of non-daily smokers despite high motivation to quit indicate a need for novel smoking cessation support. Directed content analyses of existing apps indicated that tailoring, two-way interactions, and proactive features are under-utilized in existing apps, despite the popularity of such features. Conventional content analyses of audio-recorded session tapes suggested that difficulty in quitting was generally linked to specific, readily identifiable occasions, and that social support was considered important but not consistently sought out. The "Smiling Instead of Smoking" (SIS) app is an Android app that is designed to act as a behavioral, in-the-pocket coach to enhance quitting success in non-daily smokers. It provides proactive, tailored behavioral coaching, interactive tools (e.g., enlisting social support), daily positive psychology exercises, and smoking self-monitoring.

A Qualitative Study of the Barriers to and Facilitators of Smoking Cessation Among Lesbian, Gay, Bisexual, and Transgender Smokers Who Are Interested in Quitting

PubMed Central

Cesario, John; Ruiz, Raymond; Ross, Natalie; King, Andrea

2017-01-01

Abstract Purpose: Lesbian, gay, bisexual, and transgender (LGBT) individuals are significantly more likely to smoke compared with their heterosexual and cisgender counterparts. The purpose of this study was to explore barriers to and facilitators of smoking cessation readiness among LGBT smokers. Methods: This descriptive study used a qualitative approach. Four 90-minute focus groups (eligibility criteria: age ≥21, self-identify as LGBT, current smoker, interest in quitting smoking) were conducted. Participants also completed a brief survey that measured additional demographic characteristics and smoking behaviors. Topics explored included quit experiences, attitudes and beliefs, barriers to and facilitators of cessation, and cultural factors related to smoking behaviors. Established qualitative methods were used to conduct the focus groups and data analysis. Results: The mean age of participants (N = 31) was 37.1 years with the majority identifying as male (58.1%). The sample group was racially diverse: 32% were African American, 39% were White, and 29% were more than one race. Interest in quitting was high (M = 9.0, range 0–10). Barriers to smoking cessation fell under the broad themes of individual-level factors, cultural factors, psychosocial factors, and access to treatment. Facilitators of smoking cessation included stage of readiness, health concerns, social stigma, a shift in social norms, financial costs, and improving dating prospects. Conclusions: Interest in smoking cessation was high in this sample of LGBT smokers and influenced by a range of facilitators. Nevertheless, several general and culturally specific barriers to smoking cessation readiness were identified. The study results have implications for future research and the development of outreach, prevention, and treatment programs. PMID:28068208

Smoking cessation alters intestinal microbiota: insights from quantitative investigations on human fecal samples using FISH.

PubMed

Biedermann, Luc; Brülisauer, Karin; Zeitz, Jonas; Frei, Pascal; Scharl, Michael; Vavricka, Stephan R; Fried, Michael; Loessner, Martin J; Rogler, Gerhard; Schuppler, Markus

2014-09-01

There has been a dramatic increase in investigations on the potential mechanistic role of the intestinal microbiota in various diseases and factors modulating intestinal microbial composition. We recently reported on intestinal microbial shifts after smoking cessation in humans. In this study, we aimed to conduct further microbial analyses and verify our previous results obtained by pyrosequencing using a direct quantitative microbial approach. Stool samples of healthy smoking human subjects undergoing controlled smoking cessation during a 9-week observational period were analyzed and compared with 2 control groups, ongoing smoking and nonsmoking subjects. Fluorescence in situ hybridization was applied to quantify specific bacterial groups. Intestinal microbiota composition was substantially altered after smoking cessation as characterized by an increase in key representatives from the phyla of Firmicutes (Clostridium coccoides, Eubacterium rectale, and Clostridium leptum subgroup) and Actinobacteria (HGC bacteria and Bifidobacteria) as well as a decrease in Bacteroidetes (Prevotella spp. and Bacteroides spp.) and Proteobacteria (β- and γ-subgroup of Proteobacteria). As determined by fluorescence in situ hybridization, an independent direct quantitative microbial approach, we could confirm that intestinal microbiota composition in humans is influenced by smoking. The characteristics of observed microbial shifts suggest a potential mechanistic association to alterations in body weight subsequent to smoking cessation. More importantly, regarding previously described microbial hallmarks of dysbiosis in inflammatory bowel diseases, a variety of observed microbial alterations after smoking cessation deserve further consideration in view of the divergent effect of smoking on the clinical course of Crohn's disease and ulcerative colitis.

Determinants of Smoking Cessation among Adolescents in South Africa

ERIC Educational Resources Information Center

Panday, Saadhna; Reddy, S. Priscilla; Ruiter, Robert A. C.; Bergstrom, Erik; de Vries, Hein

2005-01-01

Data is required on the motivational determinants of smoking cessation among a multi-ethnic sample of adolescents in South Africa. The I-Change Model was used to explore the determinants of smoking cessation among a sample of 1267 Black African, Colored and White Grade 9-11 monthly smokers and former smokers in the Southern Cape-Karoo region.…

[Comparison of insurance coverage of tobacco cessation pharmacotherapies in five countries from the Organisation for Economic Co-operation and Development].

PubMed

Le Faou, A-L; Scemama, O

2005-11-01

Reports in the literature demonstrate effectiveness and cost-effectiveness of tobacco treatments including drug and behavioral therapies. The health insurance coverage of smoking cessation treatments could lower financial barriers which limit the access to these services. The purpose of this paper was to compare health insurance coverage for pharmacotherapies for smoking cessation in five countries from the Organisation for Economic Co-operation and Development. A literature review was performed using Medline, official websites and Google. A grid was used to analyse articles and reports in order to identify: the public or private coverage of smoking cessation pharmacotherapies; the population groups who were covered; the extent and content of the insurance coverage as well as the practical ways to obtain it and the training and certification of the health staff to prescribe these treatments. Australia, Quebec, the United States, New Zealand and the United Kingdom provide financial coverage for some of the drugs prescribed to stop smoking. The financial coverage depends on the organization of the health care system: universal coverage in Australia, Quebec, New Zealand, and the United Kingdom and private coverage in the United States except for the Medicaid public program. In the United States as well as in the United Kingdom the first population group to benefit from financial coverage of smoking cessation therapy were socially precarious persons. Prescription schemes are recommended in the present programs and persons who receive the treatment are generally requested to attend follow-up visits. All countries studied encourage training of health professionals in tobacco cessation, but except for Australia and New Zealand there is no mandatory registration of physicians who prescribe smoking cessation drugs. The financial coverage of smoking cessation pharmacotherapies is often the result of a political decision. Taking into consideration the situation of developed countries, France should first consider the financial coverage of smoking cessation pharmacotherapies for socially precarious persons and populations with tobacco-related diseases. In addition, a population-based study should be conducted in France to measure the efficacy of financial coverage on smoking cessation.

Smoking habits, awareness of risks, and attitude towards tobacco control policies among medical students in Lagos, Nigeria.

PubMed

Dania, Michelle G; Ozoh, Obianuju B; Bandele, Emmanuel O

2015-01-01

This study aimed to assess the prevalence of cigarette smoking among medical students, and to determine their level of knowledge regarding risk associated with cigarette smoking and their attitude and behavior towards tobacco control strategies and policies. A stratified random sampling approach was used to select participants. A modified version of the the Global Health Professional Students Survey questionnaire was self-administered. Descriptive statistics were applied and comparisons were done using chi-square test. Multivariate logistic regression was used to obtain the significant determinants of smoking. A P < 0.05 was considered significant. A total of 250 students participated in the study with a response rate of 89.2%. The mean age (years) was 21.4 ± 3. Rate of ever smoking and current smoking was 9.6 and 1.2%, respectively. Age > 21, having a smoking father, and use of alcohol were significantly associated with ever smoking. Knowledge of smoking as a risk for emphysema was 72.8%, coronary artery disease 82.8%, stroke 68.8%, and low birth weight 76.4%. There were 103 (41.2%) students aware of antidepressant usage in smoking cessation. One hundred and ninety-five (78%) offered smoking cessation advice if a smoker had no smoking-related disease and did not seek their opinion about smoking, 68.8% affirmed to having adequate knowledge on smoking cessation, and 56.8% had received formal training on smoking cessation techniques. The ban on cigarette smoking in enclosed public places was supported by 92.4%. The prevalence of current cigarette smoking among medical students in Lagos is relatively low. Gaps exist in the level of knowledge of the students regarding risks of cigarette smoking, tobacco cessation strategies, and in their attitude and behavior towards offering tobacco cessation advice. There is need therefore to include formal training on tobacco control strategies at an early stage in the medical curriculum.

A Perioperative Smoking Cessation Intervention With Varenicline, Counseling, and Fax Referral to a Telephone Quitline Versus a Brief Intervention: A Randomized Controlled Trial.

PubMed

Wong, Jean; Abrishami, Amir; Riazi, Sheila; Siddiqui, Naveed; You-Ten, Eric; Korman, Jennifer; Islam, Sazzadul; Chen, Xin; Andrawes, Maged S M; Selby, Peter; Wong, David T; Chung, Frances

2017-08-01

The effectiveness of perioperative interventions to quit smoking with varenicline has not been compared with brief interventions. Our objective was to determine the efficacy of a comprehensive smoking cessation program versus a brief intervention for smoking cessation. In this prospective, multicenter study, 296 patients were randomized to participate in a smoking cessation program (one 10- to 15-minute counseling session, pharmacotherapy with varenicline, an educational pamphlet, and a fax referral to a telephone quitline); or brief advice and self-referral to a telephone quitline. The primary outcome was the 7-day point prevalence (PP) abstinence at 12 months after surgery. Secondary outcomes included abstinence at 1, 3, and 6 months. Multivariable generalized linear regression was used to identify independent variables related to abstinence. The 7-day PP abstinence for the smoking cessation program versus brief advice group was 42.4% vs 26.2% (relative risk [RR], 1.62; 95% confidence interval [CI], 1.16-2.25; P = .003) at 12 months. The 7-day PP abstinence at 1, 3, and 6 months was higher in the smoking cessation group versus the brief advice group: 45.7% vs 25.5% (RR, 1.79; 95% CI, 1.29-2.49; P < .001), 46.4% vs 26.9% (RR, 1.72; 95% CI, 1.25-2.37; P< .001), and 45.0% vs 26.2% (RR, 1.72; 95% CI, 1.24-2.38; P < .001), respectively. Participating in the smoking cessation group predicted abstinence at 12 months (RR, 1.58; 95% CI, 1.12-2.21; P = .0087). A perioperative smoking cessation program with counseling, pharmacotherapy with varenicline, an educational pamphlet, and a fax referral to a quitline increased abstinence from smoking 1, 3, 6, and 12 months after surgery versus a brief intervention.

Ethnic differences in smoking rate, nicotine dependence, and cessation-related variables among adult smokers in Hawaii

PubMed Central

Herzog, Thaddeus A; Pokhrel, Pallav

2012-01-01

This study tests hypotheses concerning ethnic disparities in daily cigarette smoking rates, nicotine dependence, cessation motivation, and knowledge and past use of cessation methods (e.g., counseling) and products (e.g., nicotine patch) in a multiethnic sample of smokers in Hawaii. Previous research has revealed significant differences in smoking prevalence among Native Hawaiians, Filipinos, Japanese, and Caucasians in Hawaii. However, no study has examined differences in dependence and cessation-related knowledge and practices among smokers representing these ethnic groups. Participants were recruited through newspaper advertisement as part of a larger smoking cessation intervention study. Participants (N=919; M age=45.6, SD=12.7; 48% Women) eligible to participate provided self-report data through mail and telephone. Participants included 271 self-identified Native Hawaiians, 63 Filipinos, 316 Caucasians, 145 “East Asians” (e.g., Japanese, Chinese), and 124 “Other” (e.g., Hispanic, African-American). Pair-wise comparisons of means, controlling for age, gender, income, education, and marital status, indicated that Native Hawaiian smokers reported significantly higher daily smoking rates and higher levels of nicotine dependence compared to East Asians. Native Hawaiian smokers reported significantly lower motivation to quit smoking than Caucasians. Further, Filipino and Native Hawaiian smokers reported lesser knowledge of cessation methods and products, and less frequent use of these methods and products than Caucasians. The results suggest that Native Hawaiian and Filipino smokers could be underserved with regard to receiving cessation-related advice, and may lack adequate access to smoking cessation products and services. In addition, cessation interventions tailored for Native Hawaiian smokers could benefit from a motivational enhancement component. PMID:22438074

Exposure to Point-of-Sale Marketing of Cigarettes and E-Cigarettes as Predictors of Smoking Cessation Behaviors.

PubMed

Mantey, Dale S; Pasch, Keryn E; Loukas, Alexandra; Perry, Cheryl L

2017-11-06

Cue-reactivity theory suggests smoking-related visual cues such as point-of-sale (POS) marketing (e.g., advertising, product displays) may undermine cessation attempts by causing an increase in nicotine cravings among users. This study examined the relationship between recall of exposure to POS marketing and subsequent cessation behaviors among young adult cigarette smokers. Participants included 813 18-29 year old (m=21.1, sd=2.70) current cigarette smokers attending 24 Texas colleges. Multivariable logistic regression models examined the impact of baseline self-reported exposure to cigarette and e-cigarette advertising and product displays, on using e-cigarettes for cessation and successful cigarette cessation at 6-month follow-up. Two-way interactions between product-specific advertising and between product-specific displays were examined to determine if the marketing of one product strengthened the cue-reactivity of the other. Baseline covariates included socio-demographic factors, past quit attempts, intentions to quit smoking, and nicotine dependence. Exposure to e-cigarette displays was associated with lower odds of cigarette smoking cessation, controlling for covariates and conventional cigarette display exposure. E-cigarette advertising was positively associated with use of e-cigarettes for cigarette cessation among participants exposed to low (i.e., at least one standard deviation below the mean) levels of cigarette advertising. Cigarette advertising was associated with use of e-cigarettes for cigarette cessation only among those exposed to low levels of e-cigarette advertising. Exposure to cigarette displays was not associated with either outcome. Smoking-related cues at POS may undermine successful cigarette cessation. Exposure to product displays decrease odds of cessation. Advertising exposure increased odds for using e-cigarettes for cessation attempts, but may have guided smokers towards an unproven cessation aid. By examining the interaction of conventional cigarette and e-cigarette marketing exposure, this study adds a unique insight into the impact of retail tobacco marketing on cigarette smoking cessation behavior among young adults. These findings suggest policies should be considered that balance encouraging cigarette smoking cessation while limiting marketing strategies, such as POS product displays, that may undermine successful cessation attempts. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A Pragmatic Trial of E-Cigarettes, Incentives, and Drugs for Smoking Cessation.

PubMed

Halpern, Scott D; Harhay, Michael O; Saulsgiver, Kathryn; Brophy, Christine; Troxel, Andrea B; Volpp, Kevin G

2018-06-14

Whether financial incentives, pharmacologic therapies, and electronic cigarettes (e-cigarettes) promote smoking cessation among unselected smokers is unknown. We randomly assigned smokers employed by 54 companies to one of four smoking-cessation interventions or to usual care. Usual care consisted of access to information regarding the benefits of smoking cessation and to a motivational text-messaging service. The four interventions consisted of usual care plus one of the following: free cessation aids (nicotine-replacement therapy or pharmacotherapy, with e-cigarettes if standard therapies failed); free e-cigarettes, without a requirement that standard therapies had been tried; free cessation aids plus $600 in rewards for sustained abstinence; or free cessation aids plus $600 in redeemable funds, deposited in a separate account for each participant, with money removed from the account if cessation milestones were not met. The primary outcome was sustained smoking abstinence for 6 months after the target quit date. Among 6131 smokers who were invited to enroll, 125 opted out and 6006 underwent randomization. Sustained abstinence rates through 6 months were 0.1% in the usual-care group, 0.5% in the free cessation aids group, 1.0% in the free e-cigarettes group, 2.0% in the rewards group, and 2.9% in the redeemable deposit group. With respect to sustained abstinence rates, redeemable deposits and rewards were superior to free cessation aids (P<0.001 and P=0.006, respectively, with significance levels adjusted for multiple comparisons). Redeemable deposits were superior to free e-cigarettes (P=0.008). Free e-cigarettes were not superior to usual care (P=0.20) or to free cessation aids (P=0.43). Among the 1191 employees (19.8%) who actively participated in the trial (the "engaged" cohort), sustained abstinence rates were four to six times as high as those among participants who did not actively engage in the trial, with similar relative effectiveness. In this pragmatic trial of smoking cessation, financial incentives added to free cessation aids resulted in a higher rate of sustained smoking abstinence than free cessation aids alone. Among smokers who received usual care (information and motivational text messages), the addition of free cessation aids or e-cigarettes did not provide a benefit. (Funded by the Vitality Institute; ClinicalTrials.gov number, NCT02328794 .).

Dispositional Mindfulness Predicts Enhanced Smoking Cessation and Smoking Lapse Recovery

PubMed Central

Heppner, Whitney L.; Spears, Claire Adams; Correa-Fernández, Virmarie; Castro, Yessenia; Li, Yisheng; Guo, Beibei; Reitzel, Lorraine R.; Vidrine, Jennifer Irvin; Mazas, Carlos A.; Cofta-Woerpel, Ludmila; Cinciripini, Paul M.; Ahluwalia, Jasjit S.; Wetter, David W.

2016-01-01

Background Although mindfulness has been hypothesized to promote health behaviors, no research has examined how dispositional mindfulness might influence the process of smoking cessation. Purpose The current study investigated dispositional mindfulness, smoking abstinence, and recovery from a lapse among African American smokers. Methods Participants were 399 African Americans seeking smoking cessation treatment (treatments did not include any components related to mindfulness). Dispositional mindfulness and other psychosocial measures were obtained pre-quit; smoking abstinence was assessed 3 days, 31 days, and 26 weeks post-quit. Results Individuals higher in dispositional mindfulness were more likely to quit smoking both initially and over time. Moreover, among individuals who had lapsed at day 3, those higher in mindfulness were more likely to recover abstinence by the later time points. The mindfulness-early abstinence association was mediated by lower negative affect, lower expectancies to regulate affect via smoking, and higher perceived social support. Conclusions Results suggest that mindfulness might enhance smoking cessation among African American smokers by operating on mechanisms posited by prominent models of addiction. PMID:26743533

The dissemination of smoking cessation methods for pregnant women: achieving the year 2000 objectives.

PubMed Central

Windsor, R A; Li, C Q; Lowe, J B; Perkins, L L; Ershoff, D; Glynn, T

1993-01-01

The smoking prevalence rate among adult women and pregnant women has decreased only 0.3 to 0.5% per year since 1969. Without a nationwide dissemination of efficacious smoking cessation methods based on these trends, by the year 2000 the smoking prevalence among pregnant women will be approximately 18%. This estimate is well above the US Department of Health and Human Services Year 2000 Objective of 10%. The US dissemination of tested smoking cessation methods could help an additional 12,900 to 155,000 pregnant smokers annually and 600,000 to 1,481,000 cumulatively to quit smoking during the 1990s. Dissemination could help achieve 31 to 78% of the Year 2000 Objectives for pregnancy smoking prevalence. (With dissemination, at best a 15% smoking prevalence during pregnancy, rather than the 10% objective, is likely to be observed.) Our results confirm a well-documented need for a national campaign to disseminate smoking cessation methods. PMID:8427318

Associations Between Health Literacy and Established Predictors of Smoking Cessation

PubMed Central

Adams, Claire E.; Cano, Miguel A.; Correa-Fernández, Virmarie; Waters, Andrew J.; Wetter, David W.; Vidrine, Jennifer Irvin

2013-01-01

Objectives. We examined associations between health literacy and predictors of smoking cessation among 402 low-socioeconomic status (SES), racially/ethnically diverse smokers. Methods. Data were collected as part of a larger study evaluating smoking health risk messages. We conducted multiple linear regression analyses to examine relations between health literacy and predictors of smoking cessation (i.e., nicotine dependence, smoking outcome expectancies, smoking risk perceptions and knowledge, self-efficacy, intentions to quit or reduce smoking). Results. Lower health literacy was associated with higher nicotine dependence, more positive and less negative smoking outcome expectancies, less knowledge about smoking health risks, and lower risk perceptions. Associations remained significant (P < .05) after controlling for demographics and SES-related factors. Conclusions. These results provide the first evidence that low health literacy may serve as a critical and independent risk factor for poor cessation outcomes among low-socioeconomic status, racially/ethnically diverse smokers. Research is needed to investigate potential mechanisms underlying this relationship. PMID:23678912

The Association Between Body Image and Smoking Cessation Among Individuals Living with HIV/AIDS

PubMed Central

Fingeret, Michelle Cororve; Vidrine, Damon J.; Arduino, Roberto C.; Gritz, Ellen R.

2007-01-01

Lower smoking cessation rates are associated with body image concerns in the general population. This relationship is particularly important to study in individuals living with HIV/AIDS due to alarmingly high smoking rates and considerable bodily changes experienced with HIV disease progression and treatment. The association between body image and smoking cessation rates was examined among individuals living with HIV/AIDS participating in a smoking cessation intervention. Body image concerns were significantly associated with depression, anxiety, stress, and social support, all variables known to affect cessation rates. However, reduced quit rates were found among individuals reporting elevated and low levels of body image concerns at the end of treatment. These findings suggest a unique relationship between smoking and body image among individuals living with HIV/AIDS. Further research is needed to examine these effects and whether moderate levels of body image concerns in this population reflect realistic body perceptions associated with positive mental health. PMID:18089265

Prevalence and Correlates of Smoking among Low-Income Adults Residing in New York City Public Housing Developments-2015.

PubMed

Feinberg, A; Lopez, P M; Wyka, K; Islam, N; Seidl, L; Drackett, E; Mata, A; Pinzon, J; Baker, M R; Lopez, J; Trinh-Shevrin, C; Shelley, D; Bailey, Z; Maybank, K A; Thorpe, L E

2017-08-01

To guide targeted cessation and prevention programming, this study assessed smoking prevalence and described sociodemographic, health, and healthcare use characteristics of adult smokers in public housing. Self-reported data were analyzed from a random sample of 1664 residents aged 35 and older in ten New York City public housing developments in East/Central Harlem. Smoking prevalence was 20.8%. Weighted log-binomial models identified to be having Medicaid, not having a personal doctor, and using health clinics for routine care were positively associated with smoking. Smokers without a personal doctor were less likely to receive provider quit advice. While most smokers in these public housing developments had health insurance, a personal doctor, and received provider cessation advice in the last year (72.4%), persistently high smoking rates suggest that such cessation advice may be insufficient. Efforts to eliminate differences in tobacco use should consider place-based smoking cessation interventions that extend cessation support beyond clinical settings.

Modelling a budgetary impact analysis for funding drug-based smoking cessation therapies for patients with major depressive disorder in Spain.

PubMed

Rejas-Gutiérrez, J; Bruguera, E; Cedillo, S

2017-09-01

Smoking is associated with high healthcare resource utilisation and cost to society. Patients with major depressive disorder (MDD) exhibit high susceptibility to nicotine dependence. Varenicline, bupropion and nicotine replacement therapy are all indicated for smoking cessation; however funding by the Spanish national health system (SNHS) is limited. We modelled a budgetary impact analysis (BIA) to estimate the impact of the SNHS funding drug-based therapies for smoking cessation in smokers with MDD. The BIA compared the current unfunded scenario versus a funded scenario (varenicline, bupropion, nicotine replacement therapy combined with medical follow-up and counselling) using the Spanish SNHS and societal perspectives. The BIA design was a hybrid model using a decision tree algorithm (population size: smokers with MDD) and Markov chains (smoking cessation attempts) over a 5-year horizon. Smoking cessation drug efficacy was derived from clinical trials, and smoking cessation costs avoided were taken from an analysis of the Spanish National Health Survey. Results were shown as incremental cost savings. Scenarios and threshold univariate sensitivity analyses tested model robustness. The funded scenario resulted in an increase of 43,478 cessation attempts and 8930 fewer smokers after 5 years compared to the unfunded scenario. The cost of funding was €25.3 million and costs avoided were €26.5 million. There was a cumulative 5-year incremental cost saving of €1.2 million to Spanish society. Results were robust using alternative scenarios. Funding smoking cessation drugs in patients with MDD is of economic benefit to Spain and could produce net savings from the third year of implementation. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Correlates of use of electronic cigarettes versus nicotine replacement therapy for help with smoking cessation.

PubMed

Pokhrel, Pallav; Little, Melissa A; Fagan, Pebbles; Kawamoto, Crissy T; Herzog, Thaddeus A

2014-12-01

Electronic- or e-cigarettes are nicotine-delivery devices commonly used by smokers to quit or reduce smoking. At present, not much is known about the characteristics of smokers who specifically try e-cigarettes to quit smoking compared to the nicotine replacement therapy (NRT) products approved by the U.S. Food and Drug Administration (FDA). Determining the characteristics of smokers who are likely to choose e-cigarettes as cessation aids would help develop strategies to impart valid information about e-cigarettes to such smokers as facts regarding the safety and utility of e-cigarettes emerge. This study is based on 834 daily smokers [mean age=45.8 (standard deviation=13)] from Hawaii. Demographic, smoking- and cessation-related variables were examined as correlates of ever use of e-cigarette only or any FDA-approved NRT product only or both as cessation aids. Results indicated that younger smokers, non-White smokers, and smokers reporting higher income, lower nicotine dependence, shorter smoking history, and higher lifetime quit attempts were more likely to have tried e-cigarettes but not NRT products for help with smoking cessation. Smokers who are attracted to use e-cigarettes but not FDA-approved NRT products may differ from smokers who are likely to have used NRT products but not e-cigarettes in terms of demographic (e.g., age, ethnicity) and smoking- or cessation-related characteristics (e.g., nicotine dependence, quit attempts). Given the lack of knowledge regarding the health effects of e-cigarettes and their efficacy as cessation aids, future research needs to continue characterizing smokers who are likely to use e-cigarettes for smoking cessation. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Gender and disparities: the example of tobacco smoking].

PubMed

Clair, Carole; De Kleijn, Miriam J J; Jaunin-Stalder, Nicole; Cornuz, Jacques

2015-06-10

Smoking prevalence is globally five times higher among men compared to women but this gap tends to decrease. Regarding health consequences of smoking, women tend to be more vulnerable than men. They are namely more at risk to present certain lung cancers and die of cardiovascular disease. While men are less prone to seek help for smoking cessation, women are less successful in their quit attempts and smoking cessation treatments are less effective among them. Interventions for smoking cessation and preventive measures tailored to gender specificities have the potential to improve management of smokers and decrease gender disparities in healthcare.

Barriers And Motivators for Smoking Cessation in Patients With Systemic Lupus Erythematosus (SLE).

PubMed

Terrell, Deirdra R; Stewart, Lauren M; Tolma, Eleni L; McClain, Rebekah; Vesely, Sara K; James, Judith A

2015-11-01

Although studies have shown that smoking is detrimental to the health of patients with systemic lupus erythematosus (SLE), studies regarding barriers and motivators for smoking cessation are lacking. The purpose of this study was to generate hypotheses regarding the barriers and motivators for smoking cessation in SLE patients. This study was based on the theoretical framework of the stages of change model. All participants met SLE classification criteria. Interviews were conducted with 16 current and 10 former smokers. Motivators included: medical reasons, readiness, and concern for others. Barriers included: enjoyment, coping mechanism, and an emotional connection. Participants were unsure of the impact of smoking on their medication and disease, and had mixed feelings regarding the impact on pain. The main motivator for cessation in this population was concern for one's health. Rheumatologists need to include disease specific harms and assess pain management strategies as part of cessation counseling.

Low-Burden Strategies to Promote Smoking Cessation Treatment Among Patients With Serious Mental Illness.

PubMed

Chen, Li-Shiun; Baker, Timothy B; Korpecki, Jeanette M; Johnson, Kelly E; Hook, Jaime P; Brownson, Ross C; Bierut, Laura J

2018-06-01

Patients with serious mental illness have high smoking prevalence and early mortality. Inadequate implementation of evidence-based smoking cessation treatment in community mental health centers (CMHCs) contributes to this disparity. This column describes a study of the effects of quality improvement strategies on treatment and cessation outcomes among patients with serious mental illness at four CMHCs. Two low-burden strategies, decision support and academic detailing with data-driven feedback, were implemented in the CMHCs' clinics from 2014 to 2016. Pre- and postimplementation data from pharmacy and medical records were analyzed. The percentage of patients receiving cessation medication increased from 5% to 18% (p≤.001), and smoking prevalence decreased from 57% to 54% (p≤.001). This quality improvement approach holds great potential for increasing the level of smoking cessation care for patients treated in CMHC settings. Decision support and academic detailing with feedback may be effective strategies to promote best practices.

Reactivity to negative affect in smokers: the role of implicit associations and distress tolerance in smoking cessation.

PubMed

Cameron, Amy; Reed, Kathleen Palm; Ninnemann, Andrew

2013-12-01

Avoidance of negative affect is one motivational factor that explains smoking cessation relapse during cessation attempts. This negative reinforcement model of smoking cessation and relapse has demonstrated the importance of one's ability to tolerate nicotine withdrawal symptoms, particularly negative affect states, in remaining abstinent from smoking. Distress tolerance and implicit associations are two individual constructs that may influence the strength of this relationship. In this pilot study the authors examined implicit associations related to avoidance and negative affect using a modified Implicit Association Test (IAT), a measure designed to examine implicit associations related to negative affect and avoidance, and the relationship of these associations to distress tolerance and smoking relapse. In total, 40 participants were recruited through community flyers as part of a larger smoking cessation study. Participants completed a brief smoking history, behavioral distress tolerance assessments, and the modified IAT. Smoking status was assessed via phone 3days and 6days post-quit date. Results from a Cox proportional hazard model revealed that implicit associations between avoidance and negative affect were significantly negatively correlated with time to relapse after a smoking cessation attempt, whereas the behavioral distress tolerance assessments did not predict time to relapse. This study provides novel information about the cognitive associations that may underlie avoidant behavior in smokers, and may be important for understanding smoking relapse when negative affect states are particularly difficult to tolerate. Authors discuss the importance of implicit associations in understanding smoking relapse and how they can be targeted in treatment. © 2013.

Knowledge, attitudes and practices regarding smoking cessation among Chinese affiliates of women's organisations in Hong Kong.

PubMed

Leung, Doris Y P; Chan, Sophia S C; Fu, Idy C Y; Lam, Tai-hing

2011-03-01

Volunteers and staff of women's organisations who are highly active in engaging and providing community service can be recruited to motivate female smokers to quit. We described the knowledge and attitudes regarding tobacco control and smoking cessation among these affiliates in Hong Kong and identified factors associated with the practices of cessation interventions. Eight of 14 women's organisations joining the Women Against Tobacco Taskforce agreed to participate. All staff, volunteers, and members of the eight organisations were invited to complete a self-administered anonymous questionnaire during July and August 2006. A total of 623 out of 771 (80.8%) affiliates responded. Their knowledge on smoking and health (mean = 3.91, SD = 1.44 on a range of 0-7), smoking related diseases (mean = 2.91, SD = 0.97 on a range of 0-4), and women-specific diseases (mean = 2.93, SD = 1.87 on a range of 0-6), was considered to be inadequate. They had positive attitudes towards tobacco control (mean = 3.31, SD = 0.55) and their own role in smoking cessation counselling (mean = 3.19, SD = 0.56) on a 4-point Likert scale and 39.3% reported had attempted to offer quitting advice. Logistic regression analysis found that participants having direct contact with smokers who had a positive attitude towards their own role in smoking cessation counselling (OR = 2.57; 95% CI = 1.67-3.95) and better knowledge of smoking and smoking-related diseases (OR = 1.35; 95% CI = 1.06-1.71) were more likely to provide cessation counselling after controlling for gender; knowledge on smoking and health, and women-specific diseases; attitude towards tobacco control, negative and positive attitudes towards female smokers, and perceived self-efficacy in smoking cessation counselling. Women's organisations showed limited support towards tobacco control and their affiliates had a limited knowledge on smoking and health but had positive attitudes. Appropriate training, capacity building and establishing rapport with women's organisations are needed to promote smoking cessation and to support tobacco control in the community. © 2010 Blackwell Publishing Ltd.

Pathways of Change Explaining the Effect of Smoke-Free Legislation on Smoking Cessation in the Netherlands. An Application of the International Tobacco Control Conceptual Model

PubMed Central

de Vries, Hein; Fong, Geoffrey T.; Candel, Math J. J. M.; Thrasher, James F.; van den Putte, Bas; Thompson, Mary E.; Cummings, K. Michael; Willemsen, Marc C.

2012-01-01

Introduction: This study aims to test the pathways of change from individual exposure to smoke-free legislation on smoking cessation, as hypothesized in the International Tobacco Control (ITC) Conceptual Model. Methods: A nationally representative sample of Dutch smokers aged 15 years and older was surveyed during 4 consecutive annual surveys. Of the 1,820 baseline smokers, 1,012 participated in the fourth survey. Structural Equation Modeling was employed to test a model of the effects of individual exposure to smoke-free legislation through policy-specific variables (support for smoke-free legislation and awareness of the harm of [secondhand] smoking) and psychosocial mediators (attitudes, subjective norm, self-efficacy, and intention to quit) on quit attempts and quit success. Results: The effect of individual exposure to smoke-free legislation on smoking cessation was mediated by 1 pathway via support for smoke-free legislation, attitudes about quitting, and intention to quit smoking. Exposure to smoke-free legislation also influenced awareness of the harm of (secondhand) smoking, which in turn influenced the subjective norm about quitting. However, only attitudes about quitting were significantly associated with intention to quit smoking, whereas subjective norm and self-efficacy for quitting were not. Intention to quit predicted quit attempts and quit success, and self-efficacy for quitting predicted quit success. Conclusions: Our findings support the ITC Conceptual Model, which hypothesized that policies influence smoking cessation through policy-specific variables and psychosocial mediators. Smoke-free legislation may increase smoking cessation, provided that it succeeds in influencing support for the legislation. PMID:22491892

Pathways of change explaining the effect of smoke-free legislation on smoking cessation in The Netherlands. An application of the international tobacco control conceptual model.

PubMed

Nagelhout, Gera E; de Vries, Hein; Fong, Geoffrey T; Candel, Math J J M; Thrasher, James F; van den Putte, Bas; Thompson, Mary E; Cummings, K Michael; Willemsen, Marc C

2012-12-01

This study aims to test the pathways of change from individual exposure to smoke-free legislation on smoking cessation, as hypothesized in the International Tobacco Control (ITC) Conceptual Model. A nationally representative sample of Dutch smokers aged 15 years and older was surveyed during 4 consecutive annual surveys. Of the 1,820 baseline smokers, 1,012 participated in the fourth survey. Structural Equation Modeling was employed to test a model of the effects of individual exposure to smoke-free legislation through policy-specific variables (support for smoke-free legislation and awareness of the harm of [secondhand] smoking) and psychosocial mediators (attitudes, subjective norm, self-efficacy, and intention to quit) on quit attempts and quit success. The effect of individual exposure to smoke-free legislation on smoking cessation was mediated by 1 pathway via support for smoke-free legislation, attitudes about quitting, and intention to quit smoking. Exposure to smoke-free legislation also influenced awareness of the harm of (secondhand) smoking, which in turn influenced the subjective norm about quitting. However, only attitudes about quitting were significantly associated with intention to quit smoking, whereas subjective norm and self-efficacy for quitting were not. Intention to quit predicted quit attempts and quit success, and self-efficacy for quitting predicted quit success. Our findings support the ITC Conceptual Model, which hypothesized that policies influence smoking cessation through policy-specific variables and psychosocial mediators. Smoke-free legislation may increase smoking cessation, provided that it succeeds in influencing support for the legislation.

Positive Psychotherapy for Smoking Cessation: Treatment Development, Feasibility and Preliminary Results

PubMed Central

Kahler, Christopher W.; Spillane, Nichea S.; Day, Anne; Clerkin, Elise; Parks, Acacia; Leventhal, Adam M.; Brown, Richard A.

2013-01-01

Low positive and high negative affect predict low rates of smoking abstinence among smokers making a quit attempt. Positive Psychotherapy can both increase positive affect and decrease negative affect and therefore may be a useful adjunct to behavioral smoking counseling. The purpose of the present study was to assess the feasibility and acceptability of a Positive Psychotherapy for Smoking Cessation (PPT-S) intervention that integrates standard smoking cessation counseling with nicotine patch and a package of positive psychology interventions. We delivered PPT-S to 19 smokers who were low in positive affect at baseline. Rates of session attendance and satisfaction with treatment were high, and most participants reported using and benefiting from the positive psychology interventions. Almost one-third of participants (31.6%) sustained smoking abstinence for 6 months after their quit date. Future studies to assess the relative efficacy of PPT-S compared to standard smoking cessation treatment are warranted. PMID:24683417

Positive Psychotherapy for Smoking Cessation: Treatment Development, Feasibility and Preliminary Results.

PubMed

Kahler, Christopher W; Spillane, Nichea S; Day, Anne; Clerkin, Elise; Parks, Acacia; Leventhal, Adam M; Brown, Richard A

2014-01-01

Low positive and high negative affect predict low rates of smoking abstinence among smokers making a quit attempt. Positive Psychotherapy can both increase positive affect and decrease negative affect and therefore may be a useful adjunct to behavioral smoking counseling. The purpose of the present study was to assess the feasibility and acceptability of a Positive Psychotherapy for Smoking Cessation (PPT-S) intervention that integrates standard smoking cessation counseling with nicotine patch and a package of positive psychology interventions. We delivered PPT-S to 19 smokers who were low in positive affect at baseline. Rates of session attendance and satisfaction with treatment were high, and most participants reported using and benefiting from the positive psychology interventions. Almost one-third of participants (31.6%) sustained smoking abstinence for 6 months after their quit date. Future studies to assess the relative efficacy of PPT-S compared to standard smoking cessation treatment are warranted.

Interventions for Tobacco Smoking

PubMed Central

Schlam, Tanya R.; Baker, Timothy B.

2017-01-01

Around 19% of U.S. adults smoke cigarettes, and smoking remains the leading avoidable cause of death in this country. Without treatment only ~5% of smokers who try to quit achieve long-term abstinence, but evidence-based cessation treatment increases this figure to 10-30%. The process of smoking cessation comprises different pragmatically defined phases, and these can help guide smoking treatment development and evaluation. This review evaluates the effectiveness of smoking interventions for smokers who are unwilling to make a quit attempt (Motivation Phase), who are willing to make a quit attempt (Cessation Phase), who have recently quit (Maintenance Phase), and who have recently relapsed (Relapse Recovery Phase). Multiple effective treatments exist for some phases (Cessation), but not others (Relapse Recovery). A chronic care approach to treating smoking requires effective interventions for every phase, especially interventions that exert complementary effects both within and across phases, and that can be disseminated broadly and cost-effectively. PMID:23297788

Topic Modeling of Smoking- and Cessation-Related Posts to the American Cancer Society's Cancer Survivor Network (CSN): Implications for Cessation Treatment for Cancer Survivors Who Smoke.

PubMed

Westmaas, J Lee; McDonald, Bennett R; Portier, Kenneth M

2017-08-01

Smoking is a risk factor in at least 18 cancers, and approximately two-thirds of cancer survivors continue smoking following diagnosis. Text mining of survivors' online posts related to smoking and quitting could inform strategies to reduce smoking in this vulnerable population. We identified posts containing smoking/cessation-related keywords from the Cancer Survivors Network (CSN), an online cancer survivor community of 166 000 members and over 468 000 posts since inception. Unsupervised topic model analysis of posts since 2000 using Latent Dirichlet Allocation extracted 70 latent topics which two subject experts inspected for themes based on representative terms. Posterior analysis assessed the distribution of topics within posts, and the range of themes discussed across posts. Less than 1% of posts (n = 3998) contained smoking/cessation-related terms, and covered topics related to cancer diagnoses, treatments, and coping. The most frequent smoking-related topics were quit smoking methods (5.4% of posts), and the environment for quitters (2.9% of posts), such as the stigma associated with being a smoker diagnosed with cancer and lack of empathy experienced compared to nonsmokers. Smoking as a risk factor for one's diagnosis was a primary topic in only 1.7% of smoking/cessation-related posts. The low frequency of smoking/cessation-related posts may be due to expected criticism/stigma for smoking but may also suggests a need for health care providers to address smoking and assist with quitting in the diagnostic and treatment process. Topic model analysis revealed potential barriers that should be addressed in devising clinical or population-level interventions for cancer survivors who smoke. Although smoking is a major risk factor for cancer, little is known about cancer patients' or survivors' views or concerns about smoking and quitting. This study used text mining of posts to an online community of cancer patients and survivors to investigate contexts in which smoking or quitting is discussed. Results indicated that smoking and quitting discussions were relatively rare, but nevertheless provide insight into barriers that may need to be addressed in cessation interventions for survivors. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.