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.

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

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.

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.

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.

[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.

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…

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

Comparing Two Web-Based Smoking Cessation Programs: Randomized Controlled Trial

PubMed Central

McKay, H Garth; Seeley, John R; Lichtenstein, Edward; Gau, Jeff M

2008-01-01

Background Smoking cessation remains a significant public health problem. Innovative interventions that use the Internet have begun to emerge that offer great promise in reaching large numbers of participants and encouraging widespread behavior change. To date, the relatively few controlled trials of Web-based smoking cessation programs have been limited by short follow-up intervals. Objective We describe the 6-month follow-up results of a randomized controlled trial in which participants recruited online were randomly assigned to either a Web-based smoking cessation program (Quit Smoking Network; QSN) or a Web-based exercise enhancement program (Active Lives) adapted somewhat to encourage smoking cessation. Methods The study was a two-arm randomized controlled trial that compared two Web-based smoking cessation programs: (1) the QSN intervention condition presented cognitive-behavioral strategies, and (2) the Active Lives control condition provided participants with guidance in developing a physical activity program to assist them with quitting. The QSN condition provided smoking cessation information and behavior change strategies while the Active Lives condition provided participants with physical activity recommendations and goal setting. The QSN condition was designed to be more engaging (eg, it included multimedia components) and to present much greater content than is typically found in smoking cessation programs. Results Contrary to our hypotheses, no between-condition differences in smoking abstinence were found at 3- and 6-month follow-up assessments. While participants in the QSN intervention condition spent more time than controls visiting the online program, the median number of 1.0 visit in each condition and the substantial attrition (60.8% at the 6-month follow-up) indicate that participants were not as engaged as we had expected. Conclusions Contrary to our hypothesis, our test of two Web-based smoking cessation conditions, an intervention and an attention placebo control, failed to show differences at 3- and 6-month assessments. We explored possible reasons for this finding, including limited engagement of participants and simplifying program content and architecture. Future research needs to address methods to improve participant engagement in online smoking cessation programs. Possible approaches in this regard can include new informed consent procedures that better explain the roles and responsibilities of being a research participant, new program designs that add more vitality (changing content from visit to visit), and new types of reminders pushed out to participants to encourage return visits. Simplifying program content through a combination of enhanced tailoring and information architecture also merits further research attention. PMID:19017582

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

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

Funding a smoking cessation program for Crohn's disease: an economic evaluation.

PubMed

Coward, Stephanie; Heitman, Steven J; Clement, Fiona; Negron, Maria; Panaccione, Remo; Ghosh, Subrata; Barkema, Herman W; Seow, Cynthia; Leung, Yvette P Y; Kaplan, Gilaad G

2015-03-01

Patients with Crohn's disease (CD) who smoke are at a higher risk of flaring and requiring surgery. Cost-effectiveness studies of funding smoking cessation programs are lacking. Thus, we performed a cost-utility analysis of funding smoking cessation programs for CD. A cost-utility analysis was performed comparing five smoking cessation strategies: No Program, Counseling, Nicotine Replacement Therapy (NRT), NRT+Counseling, and Varenicline. The time horizon for the Markov model was 5 years. The health states included medical remission (azathioprine or antitumor necrosis factor (anti-TNF), dose escalation of an anti-TNF, second anti-TNF, surgery, and death. Probabilities were taken from peer-reviewed literature, and costs (CAN$) for surgery, medications, and smoking cessation programs were estimated locally. The primary outcome was the cost per quality-adjusted life year (QALY) gained associated with each smoking cessation strategy. Threshold, three-way sensitivity, probabilistic sensitivity analysis (PSA), and budget impact analysis (BIA) were carried out. All strategies dominated No Program. Strategies from most to least cost effective were as follows: Varenicline (cost: $55,614, QALY: 3.70), NRT+Counseling (cost: $58,878, QALY: 3.69), NRT (cost: $59,540, QALY: 3.69), Counseling (cost: $61,029, QALY: 3.68), and No Program (cost: $63,601, QALY: 3.67). Three-way sensitivity analysis demonstrated that No Program was only more cost effective when every strategy's cost exceeded approximately 10 times their estimated costs. The PSA showed that No Program was the most cost-effective <1% of the time. The BIA showed that any strategy saved the health-care system money over No Program. Health-care systems should consider funding smoking cessation programs for CD, as they improve health outcomes and reduce costs.

“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

Interest in technology-based and traditional smoking cessation programs among adult smokers in Ankara, Turkey

PubMed Central

2011-01-01

Background Little is known about the demand for smoking cessation services in settings with high smoking prevalence rates. Furthermore, acceptability of text messaging and Internet as delivery mechanisms for smoking cessation programs in non-developed countries is under-reported. Given the cost effectiveness of technology-based programs, these may be more feasible to roll out in settings with limited public health resources relative to in-person programs. Findings 148 adult smokers took part in a community-based survey in Ankara, Turkey. Two in five (43%) respondents reported typically smoking their first cigarette within 30 minutes of waking. Many participants expressed a desire to quit smoking: 27% reported seriously thinking about quitting in the next 30 days; 53% reported at least one quit attempt in the past year. Two in five smokers wanting to quit reported they were somewhat or extremely like to try a smoking cessation program if it were accessible via text messaging (45%) or online (43%). Conclusions Opportunities for low-cost, high-reach, technology-based smoking cessation programs are under-utilized. Findings support the development and testing of these types of interventions for adult smokers in Turkey. PMID:21806793

Estimation of the break-even point for smoking cessation programs in pregnancy.

PubMed Central

Shipp, M; Croughan-Minihane, M S; Petitti, D B; Washington, A E

1992-01-01

BACKGROUND. Successful programs to help pregnant women quit smoking have been developed and evaluated, but formal smoking cessation programs are not a part of care at most prenatal sites. The cost of such programs may be an issue. Considering the costs of adverse maternal and infant outcomes resulting from smoking, we estimated there would be an amount of money a prenatal program could invest in smoking cessation and still "break even" economically. METHODS. A model was developed and published data, along with 1989 hospital charge data, were used to arrive at a break-even point for smoking cessation programs in pregnancy. RESULTS. Using overall United States data, we arrived at a break-even cost of $32 per pregnant woman. When these data were varied to fit specific US populations, the break-even costs varied from $10 to $237, with the incidence of preterm low birth weight having the most impact on the cost. CONCLUSIONS. It may be advisable to invest greater amounts of money in a prenatal smoking cessation program for some populations. However, for every population there is an amount that can be invested while still breaking even. PMID:1536354

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…

A 5-year evaluation of a smoking cessation incentive program for chemical employees.

PubMed

Olsen, G W; Lacy, S E; Sprafka, J M; Arceneaux, T G; Potts, T A; Kravat, B A; Gondek, M R; Bond, G G

1991-11-01

This 5-year study of the Dow Chemical Texas Operations 1984-1985 Smoking Cessation Incentive Program (SCIP) evaluated the smoking habits of 1,097 participants and 1,174 nonparticipants. We observed, via questionnaire and saliva cotinine data, that participants were 2.3 times more likely to be long-term (greater than or equal to 5 years) nonusers of tobacco than nonparticipants (10.2% vs 4.4%, P less than or equal to 0.01). However, smoking cessation rates for 3-4 years, 1-2 years, and less than 1 year were similar for participants who remained smokers at the conclusion of SCIP and nonparticipants. Age and the interaction between the management job category and having quit smoking for at least 30 days sometime prior to the worksite program were important predictors of smoking cessation among participants. Thirty-six percent of the participants who were considered exsmokers of 6 months duration at the conclusion of the program in 1985 remained long-term quitters 5 years later. Stress and enjoyment of smoking were the two most important reasons provided by participants for recidivism. The results of this 5-year evaluation demonstrate the heterogeneity of employee participation and success with a worksite smoking cessation program.

Experience of a smoking cessation program among high school students in Taiwan.

PubMed

Chang, Chi-Ping; Lee, Ting-Ting; Mills, Mary Etta

2014-01-01

In Taiwan, the prevalence of smoking among teenagers has led to a required smoking cessation program in schools. Students caught smoking in school are required to participate in a weekly smoking cessation class. The purpose of this study was to explore the experience of high school students in a smoking cessation program. Fifteen adolescents participated in a one-on-one in-depth semistructured interview, and the content was analyzed for patterns based on the methods of Miles and Huberman. In addition, Lewin's change theory of drive forces and restraining forces was used to describe the change in behavior as a result of the program. Five major themes were identified: the onset of smoking-change influenced by families and friends; intention to quit smoking-driving force; the irresistible temptation to smoke-restraining force; limited change effects-more attention and assistance needed; and change in attitude rather than behavior-smoking remained unchanged. Changes were seen in the perceptions and attitudes of these students toward smoking at the end of the program; however, none of them were able to really quit. Most participants revealed that they used improper means to pass the carbon monoxide test requirement that was used as a measure of not smoking. Alternative future intervention strategies for further study include change in health policy to support nicotine replacement methods for heavy adolescent smoker, use of teacher support, and exercise programs to support students going through the smoking cessation period.

Feasibility and Acceptability of a Text Message-Based Smoking Cessation Program for Young Adults in Lima, Peru: Pilot Study

PubMed Central

Zevallos, Karine; Samolski, M Reuven; Requena, David; Velarde, Chaska; Briceño, Patricia; Piazza, Marina; Ybarra, Michele L

2017-01-01

Background In Peru’s urban communities, tobacco smoking generally starts during adolescence and smoking prevalence is highest among young adults. Each year, many attempt to quit, but access to smoking cessation programs is limited. Evidence-based text messaging smoking cessation programs are an alternative that has been successfully implemented in high-income countries, but not yet in middle- and low-income countries with limited tobacco control policies. Objective The objective was to assess the feasibility and acceptability of an short message service (SMS) text message-based cognitive behavioral smoking cessation program for young adults in Lima, Peru. Methods Recruitment included using flyers and social media ads to direct young adults interested in quitting smoking to a website where interested participants completed a Google Drive survey. Inclusion criteria were being between ages 18 and 25 years, smoking at least four cigarettes per day at least 6 days per week, willing to quit in the next 30 days, owning a mobile phone, using SMS text messaging at least once in past year, and residing in Lima. Participants joined one of three phases: (1) focus groups and in-depth interviews whose feedback was used to develop the SMS text messages, (2) validating the SMS text messages, and (3) a pilot of the SMS text message-based smoking cessation program to test its feasibility and acceptability among young adults in Lima. The outcome measures included adherence to the SMS text message-based program, acceptability of content, and smoking abstinence self-report on days 2, 7, and 30 after quitting. Results Of 639 participants who completed initial online surveys, 42 met the inclusion criteria and 35 agreed to participate (focus groups and interviews: n=12; validate SMS text messages: n=8; program pilot: n=15). Common quit practices and beliefs emerged from participants in the focus groups and interviews informed the content, tone, and delivery schedule of the messages used in the SMS text message smoking cessation program. A small randomized controlled pilot trial was performed to test the program’s feasibility and acceptability; nine smokers were assigned to the SMS text message smoking cessation program and six to a SMS text message nutrition program. Participant retention was high: 93% (14/15) remained until day 30 after quit day. In all, 56% of participants (5/9) in the SMS text message smoking cessation program reported remaining smoke-free until day 30 after quit day and 17% of participants (1/6) in the SMS text message nutrition program reported remaining smoke-free during the entire program. The 14 participants who completed the pilot reported that they received valuable health information and approved the delivery schedule of the SMS text messages. Conclusions This study provides initial evidence that a SMS text message smoking cessation program is feasible and acceptable for young adults residing in Lima. PMID:28778850

Developing a smoking cessation program for Turkish-speaking migrants in Switzerland: novel findings and promising effects.

PubMed

Schnoz, Domenic; Schaub, Michael; Schwappach, David L; Salis Gross, Corina

2011-02-01

Recent studies show that smoking prevalence in the Turkish-speaking migrant population in Switzerland is substantially higher than in the general population. A specific group treatment for Turkish-speaking migrants was developed and tested in order to provide the migrant population with equal access to smoking cessation programs and to improve the migration-sensitive quality of such programs by sociocultural targeting. The evaluation of the program included quantitative (questionnaires t1 and t2 and follow-up by telephone) and qualitative methods (participant observation and semi-structured interviews). The results showed that 37.7% of the 61 participants were smoke free at the 12-month follow-up. The factors of being in a partnership and using nicotine replacement products during the program were positively associated with successful cessation. We also demonstrated the importance of "strong ties" (strong relationships between participants) and the sensitivity of the program to sociocultural (e.g., social aspects of smoking in Turkish culture, which were addressed in relapse prevention), socioeconomic (e.g., low financial resources, which were addressed by providing the course for free), and migration-specific (e.g., underdeveloped access to smoking cessation programs, which was addressed using outreach strategy for recruiting) issues. Overall, the smoking cessation program was successfully tested and is now becoming implemented as a regular service of the Swiss Public Health Program for Tobacco Prevention (by the Swiss Association for Smoking Prevention).

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

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.

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

Intermittent exercise in response to cigarette cravings in the context of an Internet-based smoking cessation program

PubMed Central

Linke, Sarah E.; Rutledge, Thomas; Myers, Mark G.

2013-01-01

Background Interventions using sustained aerobic exercise programs to aid smoking cessation have resulted in modest, short-term cessation rates comparable to conventional cessation methods. No smoking cessation trial to date has prescribed intermittent bouts of exercise in response to nicotine cravings. Objectives This pilot randomized controlled trial examined the feasibility and efficacy of an Internet-based smoking cessation program alone (CON) vs. the same Internet-based program + intermittent exercise in response to cigarette cravings (EX). Study population Participants (N = 38; mean age = 43.6 [SD = 11.5]; 60.5% women) were generally healthy, inactive adult smokers who desired to quit. Results The overall retention rate was 60.5% (n = 23), and no significant retention rate differences were found between groups (EX vs. CON). Although retained participants achieved a higher cessation rate (26.1%) than all enrolled participants (15.8%), adjusted intent-to-treat and per-protocol binary logistic regression analyses revealed no significant cessation rate differences between EX and CON groups. Linear regression results indicated that additional days of self-reported exercise on the study website during the intervention phase predicted significantly higher reduction rates among EX group participants, F(2, 16) = 31.08, p < .001. Conclusions Results were mixed with regard to the incremental benefit of exercise in the presence of the apparently valuable Internet-based smoking cessation program. The results support findings from related research and underscore the need for additional investigation into both the mechanisms underlying the effect of exercise on cigarette cravings and the challenges of poor adherence in the context of exercise-based smoking cessation interventions. PMID:23956792

[Effects of a smoking cessation program including telephone counseling and text messaging using stages of change for outpatients after a myocardial infarction].

PubMed

Kong, Jung-Hyeon; Ha, Yeongmi

2013-08-01

This study was done to identify effects of a smoking cessation program including telephone counseling and text messaging using stages of change for outpatients who have had a myocardial infarction (MI). This research was a quasi-experimental design with a nonequivalent control group pretest-posttest. The participants were 48 outpatients (experimental group=24, control group=24) recruited from one university hospital. They were randomly assigned to one of two groups: (a) an experimental group with telephone counseling (once a week) and text messaging (five times a week) using stages of change, and (b) a control group with traditional telephone counseling (once a month). Efficacy of the intervention was measured by comparing the two groups on smoking-related variables at 3 weeks and 12 weeks. At the 3-week and 12-week measurements, there were significant differences between the experimental and control groups on smoking cessation self-efficacy (p<.001), nicotine dependence (p<.001), CO levels (p<.001), and smoking cessation rates (p<.001). The results indicate that the smoking cessation program including telephone counseling and text messaging using stages of change is effective for outpatients after a MI. Further attention should be paid to the intensity of the smoking cessation program and periods for long-term follow-up.

[Effectiveness of smoking cessation in group-based behavioral treatment in association to health status and motivation of participants--own research findings].

PubMed

Broszkiewicz, Marzenna; Drygas, Wojciech

2009-01-01

The efficacy and cost-effectiveness of behavioral treatments compare favorably with the pharmacotherapies and community-based interventions. Group-based behavioral programs have been scientifically proven as the effective smoking cessation intervention. Aim of the study was identifying predictors of the efficacy of smoking cessation in health factors: health status and motivation and doctor's advice. Program is a multicomponent group-based behavioral intervention with the elements recommended by the US Public Health Service as the most effective. 517 smokers were included into the program in the outpatient clinic setting in years 2001-2007. A point prevalence abstinence (PPA) was estimated by self-reported smoking cessation. Three homogeneous groups of patients according to their status health were established: participants with tobacco-related diseases n = 182, with psychiatric disorders n = 101 and healthy ones n = 150. 59.6% of participants stopped smoking during four-week program. Program was effective in smoking cessation both for sick and healthy participants. Motivational factors, among others health motivation did not distinguish for whole population as well as for participants with tobacco-related diseases. Lack of doctor's advice increased efficacy of smoking cessation both for the whole population and for group with tobacco-related diseases. Nor health status and motivation neither doctor's advice were predictors of behavioral group-based treatment for tobacco smokers.

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

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.

The impact of including incentives and competition in a workplace smoking cessation program on quit rates.

PubMed

Koffman, D M; Lee, J W; Hopp, J W; Emont, S L

1998-01-01

To determine the effectiveness of a multicomponent smoking cessation program supplemented by incentives and team competition. A quasi-experimental design was employed to compare the effectiveness of three different smoking cessation programs, each assigned to separate worksite. The study was conducted from 1990 to 1991 at three aerospace industry worksites in California. All employees who were current, regular tobacco users were eligible to participate in the program offered at their site. The multicomponent program included a self-help package, telephone counseling, and other elements. The incentive-competition program included the multicomponent program plus cash incentives and team competition for the first 5 months of the program. The traditional program offered a standard smoking cessation program. Self-reported questionnaires and carbon monoxide tests of tobacco use or abstinence were used over a 12-month period. The incentive-competition program had an abstinence rate of 41% at 6 months (n = 68), which was significantly better than the multicomponent program (23%, n = 81) or the traditional program (8%, n = 36). At 12 months, the quit rates for the incentive and multicomponent-programs were statistically indistinguishable (37% vs. 30%), but remained higher than the traditional program (11%). Chi-square tests, t-tests, and logistic regression were used to compare smoking abstinence across the three programs. Offering a multicomponent program with telephone counseling may be just as effective for long-term smoking cessation as such a program plus incentives and competition, and more effective than a traditional program.

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

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.

Beliefs and perceived norms concerning smoking cessation program recruitment among African American teen smokers: what appeals to youth and what turns them away.

PubMed

Peters, Ronald J; Meshack, Angela; Kelder, Steven H; Springer, Andrew; Agurcia, Carolyn

2011-01-01

A qualitative approach was used to investigate the beliefs and perceived norms about participation in smoking cessation programs among a sample of African American alternative school students (N = 53), aged 14 to 18 years old, in the United States who were current smokers. The authors found that the majority of participants felt that smoking cessation programs were not effective, caused smoking, or lacked activities. Both boys and girls believed that communication sources that provided direct messages in real situations were the best motivators or incentives for African American youth recruitment into smoking cessation programs. These findings support research that African Americans are more attentive to communications that involve direct personal stimuli. In addition, African Americans place heavy emphasis on source and message style to determine credibility of the intervention strategy.

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.

Smoking-related health behaviors of employees and readiness to quit: basis for health promotion interventions.

PubMed

Ott, Carol H; Plach, Sandra K; Hewitt, Jeanne Beauchamp; Cashin, Susan E; Kelber, Sheryl; Cisler, Ron A; Weis, Jo M

2005-06-01

This report describes patterns of cigarette smoking and interest in smoking cessation programs among employees in a public worksite (n = 6,000) and a private worksite (n = 14,000). Of the 622 employees who attended an employee assistance program (EAP) orientation, 110 (18%) were current smokers. A significantly greater proportion of public employees smoked cigarettes, smoked more heavily, and evaluated their health more poorly compared to private employees. Smokers in both sites were over-represented in unskilled positions. Regardless of worksite, respondents who smoked had similar desires to quit or cut down and were annoyed by the comments of others, felt guilty about smoking, awakened with a desire to smoke, and felt they had a smoking problem. Overall, more than one third of individuals were interested in joining a smoking cessation program. Occupational health nurses may use these findings to design and implement smoking cessation interventions in their workplaces.

Culturally-Tailored Smoking Cessation for American Indians: Study protocol for a randomized controlled trial

PubMed Central

2011-01-01

Background Cigarette smoking is the number one cause of preventable death among American Indian and Alaska Natives, AI/ANs. Two out of every five AI/AN will die from tobacco-related diseases if the current smoking rates of AI/ANs (40.8%) persist. Currently, there is no proven, effective culturally-tailored smoking cessation program designed specifically for a heterogeneous population of AI. The primary aim of this group randomized clinical trial is to test the efficacy of "All Nations Breath of Life" (ANBL) program compared to a non-tailored "Current Best Practices" smoking cessation program among AI smokers. Methods We will randomize 56 groups (8 smokers per group) to the tailored program or non-tailored program for a total sample size of 448 American Indian smokers. All participants in the proposed study will be offered pharmacotherapy, regardless of group assignment. This study is the first controlled trial to examine the efficacy of a culturally-tailored smoking cessation program for American Indians. If the intervention is successful, the potential health impact is significant because the prevalence of smoking is the highest in this population. Trial Registration ClinicalTrials.gov: NCT01106456 PMID:21592347

[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

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.

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.

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…

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

Comparison of cigarette smoking knowledge, attitudes, and practices among staff in perinatal and other substance abuse treatment settings.

PubMed

Miller-Thomas, Tonya; Leoutsakos, Jeannie-Marie S; Terplan, Mishka; Brigham, Emily P; Chisolm, Margaret S

2014-01-01

Despite the high prevalence and known morbidity and mortality caused by cigarette smoking, 60% to 70% of substance abuse treatment programs lack smoking cessation counseling or fail to offer pharmacotherapy for smoking cessation, including those programs designed to meet the needs of drug-dependent pregnant patients. Previous studies of staff knowledge, attitudes, and practices (S-KAP) at general substance abuse/HIV treatment programs have suggested that staff may contribute to the deficiency in smoking cessation treatment in these settings. It is not known whether similar deficiencies exist at perinatal substance abuse treatment programs. This study compared cigarette S-KAP in perinatal substance abuse (n = 41) and general substance abuse/HIV treatment (Veterans Affairs [VA] medical center, hospital-, and community-based) workforce samples (n = 335). Significant differences were seen between the 2 groups on all measures, but perinatal staff compared favorably to general staff only on measures of barriers to smoking cessation services. Perinatal staff compared unfavorably on all other measures: knowledge, beliefs/attitudes, self-efficacy, and smoking cessation practices. Pair-wise comparisons of knowledge and beliefs/attitudes revealed a significant difference between perinatal and VA staff; of self-efficacy, between perinatal and staff at all other settings; and of smoking cessation practices, between perinatal and VA and community-based staff. These results-showing deficiencies of perinatal staff on most S-KAP measures-are concerning and suggest that identifying gaps in and improving S-KAP in perinatal substance abuse programs is urgently needed, for which the VA may provide an efficacious model.

User preferences for a text message-based smoking cessation intervention.

PubMed

Bock, Beth C; Heron, Kristin E; Jennings, Ernestine G; Magee, Joshua C; Morrow, Kathleen M

2013-04-01

Younger adults are more likely to smoke and less likely to seek treatment than older smokers. They are also frequent users of communication technology. In the current study, we conducted focus groups to obtain feedback about preferences for a text message-based smoking cessation program from potential users. Participants (N = 21, M age = 25.6 years, age range = 20-33 years) were current or recently quit smokers (M cigarettes/day = 12.8) who used text messaging. Participants completed questionnaires and participated in a 2-hour focus group. Focus groups were conducted using an a priori semistructured interview guide to promote discussion of the content and functionality of the intervention. Major themes from analysis of the focus groups included support for the acceptability of a text-based cessation program, suggestions for a more technologically broad-based program, and adjustments to the program structure. Participants recommended including social networking functions, user control of program output through an online profile, and text message features to promote interaction with the system. Interestingly, many participants suggested the program should begin on individuals' identified quit day, challenging the procedures used in most cessation programs, which begin by preparing participants for a future quit date. Overall, younger adult smokers appear to be interested in participating in a smoking cessation program that uses text messages and web-based elements. Qualitative feedback regarding the perceived optimal features and structure of a technology-based intervention challenged traditional methods of implementing smoking cessation interventions and will inform the development of future programs.

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…

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)

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.

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…

Smoking cessation and its predictors: results from a community-based pharmacy tobacco cessation program in New Mexico.

PubMed

Khan, Nasreen; Anderson, Joe R; Du, Juan; Tinker, Dale; Bachyrycz, Amy M; Namdar, Rocsanna

2012-09-01

The New Mexico Pharmaceutical Care Foundation received funding through the Tobacco Use Prevention and Control Program (TUPAC) to provide support for pharmacist-delivered tobacco cessation services. The goal of the program was to increase the availability of tobacco cessation services to residents of New Mexico. Program outcomes are presented, using data from the first 2 fiscal years. To assess tobacco quit rates among smokers who participated in the community pharmacist-based program and identify the predictors of quitting at the end of a 6-month program. Pharmacists, who had received Rx for Change training, provided tobacco cessation services. Patients were scheduled for an initial visit and then were seen at regularly scheduled follow-up visits at 1 month, 3 months, and 6 months from the initial visit. Data collected at the initial visit included demographics, smoking history, and readiness for quitting. Smoking status was collected at each of the follow-up visits. Data were analyzed using SAS (SAS Institute) and STATA (StataCorp LP) statistical software. Tobacco quit rates were calculated at 1, 3, and 6 months. Multivariate regression analysis was performed to assess predictors of quitting. Standard errors were adjusted for repeated observation. Data were available for 346 participants. The average quit rate at the end of 6 months was 25%. Significant predictors of quitting were high confidence levels in quitting at baseline, individuals who had first cigarettes at least 30 minutes after waking up, first cessation attempt, and nonwhite patients. A smoking cessation program delivered through trained community pharmacists with prescriptive authority is an effective approach to reducing smoking. Further research should be conducted to compare the effectiveness of pharmacists with that of other providers of tobacco cessation services.

LGBTQ Youth and Young Adult Perspectives on a Culturally Tailored Group Smoking Cessation Program.

PubMed

Baskerville, Neill Bruce; Shuh, Alanna; Wong-Francq, Katy; Dash, Darly; Abramowicz, Aneta

2017-08-01

The prevalence of smoking among LGBTQ youth and young adults (YYAs) is much higher than that of non-LGBTQ young people. The current study explored LGBTQ YYA perceptions of a culturally tailored group smoking cessation counselling program, along with how the intervention could be improved. We conducted focus groups (n = 24) with 204 LGBTQ YYAs in Toronto and Ottawa, Canada. Open-ended questions focused on their feelings, likes and dislikes, concerns and additional ideas for a culturally tailored group cessation counselling intervention. Focus group transcripts were coded thematically and analyzed. Overall, YYAs were ambivalent towards the concept of a culturally tailored, group cessation counselling program. Although several participants were attracted to the LGBTQ friendly and social benefits of such a program (eg, good support system), many also had concerns. Particularly, the possibility that other group members might trigger them to smoke was a frequently stated issue. Focus group members also noted lack of motivation to attend the group, and that the group program may be inaccessible depending on where and when the program was offered. Several suggestions were made as to how to ameliorate the expressed issues related to inaccessibility or lack of attractiveness. This study is among the first to gain the perspectives of LGBTQ YYAs on culturally tailored group cessation strategies in Canada. We identified components of group cessation programs that are both favored and not favored among LGBTQ YYAs, as well as suggestions as to how to make group cessation programs more appealing. This study is particularly relevant as smoking cessation programs are one of the most commonly offered and published cessation interventions for the LGBTQ community, yet little is understood in terms of preferences of LGBTQ YYA smokers. Given the disparity in the prevalence of smoking among LGBTQ young people compared to their non-LGBTQ peers, research on effective intervention strategies for this population is needed. Findings from this study can assist practitioners and researchers in designing interventions. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco.

LGBTQ Youth and Young Adult Perspectives on a Culturally Tailored Group Smoking Cessation Program

PubMed Central

Baskerville, Neill Bruce; Shuh, Alanna; Wong-Francq, Katy; Dash, Darly; Abramowicz, Aneta

2017-01-01

Abstract Introduction The prevalence of smoking among LGBTQ youth and young adults (YYAs) is much higher than that of non-LGBTQ young people. The current study explored LGBTQ YYA perceptions of a culturally tailored group smoking cessation counselling program, along with how the intervention could be improved. Methods We conducted focus groups (n = 24) with 204 LGBTQ YYAs in Toronto and Ottawa, Canada. Open-ended questions focused on their feelings, likes and dislikes, concerns and additional ideas for a culturally tailored group cessation counselling intervention. Focus group transcripts were coded thematically and analyzed. Results Overall, YYAs were ambivalent towards the concept of a culturally tailored, group cessation counselling program. Although several participants were attracted to the LGBTQ friendly and social benefits of such a program (eg, good support system), many also had concerns. Particularly, the possibility that other group members might trigger them to smoke was a frequently stated issue. Focus group members also noted lack of motivation to attend the group, and that the group program may be inaccessible depending on where and when the program was offered. Several suggestions were made as to how to ameliorate the expressed issues related to inaccessibility or lack of attractiveness. Conclusions This study is among the first to gain the perspectives of LGBTQ YYAs on culturally tailored group cessation strategies in Canada. We identified components of group cessation programs that are both favored and not favored among LGBTQ YYAs, as well as suggestions as to how to make group cessation programs more appealing. Implications This study is particularly relevant as smoking cessation programs are one of the most commonly offered and published cessation interventions for the LGBTQ community, yet little is understood in terms of preferences of LGBTQ YYA smokers. Given the disparity in the prevalence of smoking among LGBTQ young people compared to their non-LGBTQ peers, research on effective intervention strategies for this population is needed. Findings from this study can assist practitioners and researchers in designing interventions. PMID:28339649

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.

Barriers and facilitators to tobacco cessation in a nationwide sample of addiction treatment programs

PubMed Central

Pagano, Anna; Tajima, Barbara; Guydish, Joseph

2016-01-01

Introduction Smoking rates among addiction treatment clients are 3–4 times higher than those of the general population. Recent studies indicate that ceasing tobacco use during treatment may improve recovery outcomes. Across the United States, publicly funded addiction treatment programs vary widely in terms of their tobacco policies and tobacco cessation services offered to clients. Methods The study reported here is the qualitative component of a larger study. Twenty-four programs were recruited from a random sample of publicly funded programs participating in the NIDA Clinical Trials Network. Semistructured interviews were administered by phone to program directors. ATLAS.ti software was used to facilitate thematic analysis of interview transcripts. Findings While all directors expressed interest in helping clients to quit smoking, they cited numerous barriers to implementing tobacco policies and services. These included smoking culture, client resistance, lack of resources, staff smoking, and environmental barriers. Directors also cited several factors that they believed would support tobacco cessation. These included financial support, enhanced leadership, and state mandates against smoking in addiction treatment programs. Conclusion Addiction treatment programs are beginning to place more emphasis on tobacco cessation during treatment. However, furthering this goal requires substantial infrastructural and cultural change. These qualitative study findings may help to inform Single State Agencies (SSAs) to support publicly funded addiction treatment programs in their tobacco cessation efforts. In order to maximize effectiveness, state-level policies regarding tobacco cessation during treatment should be informed by ongoing dialogue between service providers and SSAs. PMID:27296658

Smoking cessation support for pregnant women: role of mobile technology

PubMed Central

Heminger, Christina L; Schindler-Ruwisch, Jennifer M; Abroms, Lorien C

2016-01-01

Background Smoking during pregnancy has deleterious health effects for the fetus and mother. Given the high risks associated with smoking in pregnancy, smoking cessation programs that are designed specifically for pregnant smokers are needed. This paper summarizes the current landscape of mHealth cessation programs aimed at pregnant smokers and where available reviews evidence to support their use. Methods A search strategy was conducted in June–August 2015 to identify mHealth programs with at least one component or activity that was explicitly directed at smoking cessation assistance for pregnant women. The search for text messaging programs and applications included keyword searches within public health and medical databases of peer-reviewed literature, Google Play/iTunes stores, and gray literature via Google. Results Five unique short message service programs and two mobile applications were identified and reviewed. Little evidence was identified to support their use. Common tools and features identified included the ability to set your quit date, ability to track smoking status, ability to get help during cravings, referral to quitline, and tailored content for the individual participant. The theoretical approach utilized was varied, and approximately half of the programs included pregnancy-related content, in addition to cessation content. With one exception, the mHealth programs identified were found to have low enrollment. Conclusion Globally, there are a handful of applications and text-based mHealth programs available for pregnant smokers. Future studies are needed that examine the efficacy of such programs, as well as strategies to best promote enrollment. PMID:27110146

Tobacco industry research on smoking cessation. Recapturing young adults and other recent quitters.

PubMed

Ling, Pamela M; Glantz, Stanton A

2004-05-01

Smoking rates are declining in the United States, except for young adults (age 18 to 24). Few organized programs target smoking cessation specifically for young adults, except programs for pregnant women. In contrast, the tobacco industry has invested much time and money studying young adult smoking patterns. Some of these data are now available in documents released through litigation. Review tobacco industry marketing research on smoking cessation to guide new interventions and improve clinical practice, particularly to address young adult smokers' needs. Analysis of previously secret tobacco industry documents. Compared to their share of the smoking population, young adult smokers have the highest spontaneous quitting rates. About 10% to 30% of smokers want to quit; light smokers and brand switchers are more likely to try. Tobacco companies attempted to deter quitting by developing products that appeared to be less addictive or more socially acceptable. Contrary to consumer expectations, "ultra low tar" cigarette smokers were actually less likely to quit. Tobacco industry views of young adult quitting behavior contrast with clinical practice. Tobacco marketers concentrate on recapturing young quitters, while organized smoking cessation programs are primarily used by older smokers. As young people have both the greatest propensity to quit and the greatest potential benefits from smoking cessation, targeted programs for young adults are needed. Tobacco marketing data suggest that aspirational messages that decrease the social acceptability of smoking and support smoke-free environments resonate best with young adult smokers' motivations.

Tobacco Industry Research on Smoking Cessation

PubMed Central

Ling, Pamela M; Glantz, Stanton A

2004-01-01

BACKGROUND Smoking rates are declining in the United States, except for young adults (age 18 to 24). Few organized programs target smoking cessation specifically for young adults, except programs for pregnant women. In contrast, the tobacco industry has invested much time and money studying young adult smoking patterns. Some of these data are now available in documents released through litigation. OBJECTIVE Review tobacco industry marketing research on smoking cessation to guide new interventions and improve clinical practice, particularly to address young adult smokers’ needs. METHODS Analysis of previously secret tobacco industry documents. RESULTS Compared to their share of the smoking population, young adult smokers have the highest spontaneous quitting rates. About 10% to 30% of smokers want to quit; light smokers and brand switchers are more likely to try. Tobacco companies attempted to deter quitting by developing products that appeared to be less addictive or more socially acceptable. Contrary to consumer expectations, “ultra low tar” cigarette smokers were actually less likely to quit. CONCLUSIONS Tobacco industry views of young adult quitting behavior contrast with clinical practice. Tobacco marketers concentrate on recapturing young quitters, while organized smoking cessation programs are primarily used by older smokers. As young people have both the greatest propensity to quit and the greatest potential benefits from smoking cessation, targeted programs for young adults are needed. Tobacco marketing data suggest that aspirational messages that decrease the social acceptability of smoking and support smoke-free environments resonate best with young adult smokers’ motivations. PMID:15109339

Assessing the feasibility, acceptability and potential effectiveness of an integrated approach to smoking cessation for new and expectant fathers: The Dads in Gear study protocol.

PubMed

Bottorff, Joan L; Oliffe, John L; Sarbit, Gayl; Caperchione, Cristina; Clark, Marianne; Anand, Anima; Howay, Kym

2017-03-01

Evidence related to the effects of tobacco exposure in pregnancy and on infant and child health have focused on women's smoking cessation. Less often addressed is men's smoking, which when continued in fatherhood, reduces the chances of female partners' cessation and can negatively impact children's health as well as men's health. Dads in Gear (DIG) is an innovative program designed specifically for new fathers who want to reduce and quit smoking that includes three components: smoking cessation, fathering, and physical activity. The over-arching purpose of this study is to evaluate the feasibility of the DIG program and provide estimates of program efficacy. The purpose of this article is to describe the rationale and protocol for evaluating the DIG program's feasibility, acceptability and potential effectiveness. Using a prospective, non-comparative design, the DIG program will be implemented and evaluated in six communities. The program will be offered by trained facilitators to fathers who currently smoke and want to quit. The RE-AIM framework will guide the evaluation. Open-ended questions in participant surveys, and semi-structured interviews and weekly telephone de-briefs with facilitators will provide data for a process evaluation. Estimates of effectiveness include smoking behavior, fathering and physical activity measures at baseline, end of program, and 3-month follow up. The DIG program could support positive changes with respect to smoking cessation, physical activity and overall health for men. These effects could also promote family health. The program might also provide an effective model for engaging men in other health behavior change. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

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.

A randomized evaluation of smoking cessation interventions for pregnant women at a WIC clinic.

PubMed Central

Mayer, J P; Hawkins, B; Todd, R

1990-01-01

Pregnant smokers attending a local health department WIC clinic were randomly assigned to one of two self-help smoking cessation programs or usual care. The multiple component program resulted in larger quit rates than usual care during the last month of pregnancy (11 percent vs 3 percent) and postpartum (7 percent vs 0 percent). Achieving quit rates in WIC similar to those in studies conducted at prenatal care settings, suggests that smoking cessation programs for low-income pregnant WIC clients are feasible. PMID:2293809

Effects of a Mindfulness-Based Smoking Cessation Program for an Adult with Mild Intellectual Disability

ERIC Educational Resources Information Center

Singh, Nirbhay N.; Lancioni, Giulio E.; Winton, Alan S. W.; Singh, Ashvind N. A.; Singh, Judy; Singh, Angela D. A.

2011-01-01

Smoking is a major risk factor for a number of health conditions and many smokers find it difficult to quit smoking without specific interventions. We developed and used a mindfulness-based smoking cessation program with a 31-year-old man with mild intellectual disabilities who had been a smoker for 17 years. The mindfulness-based smoking…

Workplace tobacco interventions.

PubMed

Perry, G

1996-01-01

Health promotion programs are becoming an integral part of work site activities. Recent data from Indiana businesses suggest that smoking is a leading concern. An objective has been adopted by the Indiana Chamber of Commerce that states that the number of employers with work site smoking cessation policies should increase. Smoking control and cessation programs implemented in industry have contributed to a decrease in the number of smokers and in the health risks of nonsmokers exposed to environmental tobacco smoke. This report describes the effectiveness of work site smoking control programs.

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…

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…

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.

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.

Quitting Smoking During Substance Use Disorders Treatment: Patient and Treatment-related Variables

PubMed Central

Campbell, Barbara K.; Le, Thao; Tajima, Barbara; Guydish, Joseph

2016-01-01

Although individuals in substance use disorders (SUD) treatment continue to smoke at high rates, regulatory, policy and programming changes promoting tobacco cessation are being implemented and some patients quit successfully. We examined associations of smoking patterns, tobacco advertising receptivity, anti-tobacco message awareness, health risk perception, attitudes towards addressing smoking and availability of smoking cessation services with quitting smoking during SUD treatment. Surveys were completed by 1127 patients in 24 programs chosen randomly, stratified by program type (residential, methadone maintenance, outpatient), from among publicly funded, adult treatment programs within the National Drug Abuse Treatment Clinical Trials Network. Among respondents who had been in SUD treatment for at least one month, there were 631 current smokers and 52 former smokers who reported quitting smoking during treatment for at least one month prior to survey completion; these respondents comprised our sample (N=683). Results showed that participants who reported health concerns as a reason for quitting were 1.27 times more likely to have quit during treatment (p=.015) than those reporting health concerns affected quitting a little or not at all. Additionally, participants who reported that smoking cessation was part of their personal treatment plan during SUD treatment were 1.08 times more likely to have quit during treatment (p<.001). Participants in methadone treatment were 49% less likely to report successfully quitting during treatment than those in outpatient treatment (95%CI: 0. 35-0.75, p<.001). Leveraging health concerns about smoking and including smoking cessation in an individualized treatment plan may help increase smoking cessation during SUD treatment. PMID:28017183

Woman focused smoking cessation programming: a qualitative study.

PubMed

Minian, Nadia; Penner, Jessica; Voci, Sabrina; Selby, Peter

2016-03-12

Several studies of smoking cessation programs in clinical settings have revealed poorer outcomes for women compared to men, including counselling alone or in combination with pharmacotherapy. The objective of the current study was to explore treatment and program structure needs and preferences among female clients in a specialized smoking cessation clinic in an academic mental health and addiction health science centre in order to inform program design so that it meets the needs of female clients. Four focus groups were conducted with current and former female clients (n = 23, mode age range = 50-59 years old, 56.5% were still smoking and 43.5% had quit) who had registered for outpatient smoking cessation treatment. Questions were designed to examine what aspects of the services were helpful and what changes they would like to see to better assist them and other women with quitting smoking. A thematic analysis of the raw data (audio recordings and notes taken during the focus groups) was conducted using a phenomenological theoretical framework. Themes that emerged indicated that females trying to quit smoking are best supported if they have choice from a variety of services so that treatment can be individualized to meet their specific needs; psychosocial support is provided both one-one-one with health care professionals and by peers in support groups; free pharmacotherapy is available to eliminate financial barriers to use; women-specific educational topics and support groups are offered; the clinic is accessible with evening/weekend hours, options to attend a local clinic, and childcare availability; and communication about clinic services and operation are clear, readily available, and regularly updated. An ideal smoking cessation program for women includes a women's centred approach with sufficient variety and choice, free pharmacotherapy, non-judgmental support, accessible services and clear communication of program options and changes. Findings may suggest an actionable list of adaptations that can be adopted by other clinics providing smoking cessation services to women.

Integrating smoking cessation into substance use disorder treatment for military veterans: measurement and treatment engagement efforts.

PubMed

Shealy, Suzanne E; Winn, Jaime L

2014-02-01

Military personnel and veterans smoke at higher rates than the general population, compromising physical performance readiness and health (Committee on Smoking Cessation in Military and Veteran Populations & Institute of Medicine, 2009). While efforts are being made within both the Department of Defense and the Veterans' Administration (VA) hospitals to prevent onset, change the smoking culture, and promote smoking cessation; smoking rates are increasing among combat deployed service members, and smoking rates are particularly high among veterans with mental health and other substance use disorders (McFall, 2006). Recent research supports making smoking cessation widely available and integrated with other forms of care (Gierisch et al., 2012; McFall et al., 2010). This paper describes the efforts of one VA substance use disorder (SUD) treatment program to integrate smoking cessation in routine care, including assessment of tobacco use and motivation and intention to quit via the proposed Nic-BAM assessment. Our team was 100% successful in incorporating the Nic-BAM into our regular assessment of treatment program participants. This suggests that staff members are amenable to assessing for tobacco addiction alongside other substance addictions. Although smoking did not decrease according to the Nic-BAM, an increase in the use of nicotine-replacement products suggests that participants are willing to initiate a quit attempt during SUD treatment. The availability of new evidence-based approaches for integration of tobacco cessation with mental health and SUD treatment may help to enhance programmatic efforts. Environmental changes are needed to fully incorporate tobacco recovery into SUD programming, and additional resources may include peer support specialists. © 2013.

A multimedia mobile phone-based youth smoking cessation intervention: findings from content development and piloting studies.

PubMed

Whittaker, Robyn; Maddison, Ralph; McRobbie, Hayden; Bullen, Chris; Denny, Simon; Dorey, Enid; Ellis-Pegler, Mary; van Rooyen, Jaco; Rodgers, Anthony

2008-11-25

While most young people who smoke want to quit, few access cessation support services. Mobile phone-based cessation programs are ideal for young people: mobile phones are the most common means of peer communication, and messages can be delivered in an anonymous manner, anywhere, anytime. Following the success of our text messaging smoking cessation program, we developed an innovative multimedia mobile phone smoking cessation intervention. The aim of the study was to develop and pilot test a youth-oriented multimedia smoking cessation intervention delivered solely by mobile phone. Development included creating content and building the technology platform. Content development was overseen by an expert group who advised on youth development principles, observational learning (from social cognitive theory), effective smoking cessation interventions, and social marketing. Young people participated in three content development phases (consultation via focus groups and an online survey, content pre-testing, and selection of role models). Video and text messages were then developed, incorporating the findings from this research. Information technology systems were established to support the delivery of the multimedia messages by mobile phone. A pilot study using an abbreviated 4-week program of video and text content tested the reliability of the systems and the acceptability of the intervention. Approximately 180 young people participated in the consultation phase. There was a high priority placed on music for relaxation (75%) and an interest in interacting with others in the program (40% would read messages, 36% would read a blog). Findings from the pre-testing phase (n = 41) included the importance of selecting "real" and "honest" role models with believable stories, and an interest in animations (37%). Of the 15 participants who took part in the pilot study, 13 (87%) were available for follow-up interviews at 4 weeks: 12 participants liked the program or liked it most of the time and found the role model to be believable; 7 liked the role model video messages (5 were unsure); 8 used the extra assistance for cravings; and 9 were happy with two messages per day. Nine participants (60%) stopped smoking during the program. Some technical challenges were encountered during the pilot study. A multimedia mobile phone smoking cessation program is technically feasible, and the content developed is appropriate for this medium and is acceptable to our target population. These results have informed the design of a 6-month intervention currently being evaluated for its effectiveness in increasing smoking cessation rates in young people.

A Multimedia Mobile Phone–Based Youth Smoking Cessation Intervention: Findings From Content Development and Piloting Studies

PubMed Central

Maddison, Ralph; McRobbie, Hayden; Bullen, Chris; Denny, Simon; Dorey, Enid; Ellis-Pegler, Mary; van Rooyen, Jaco; Rodgers, Anthony

2008-01-01

Background While most young people who smoke want to quit, few access cessation support services. Mobile phone–based cessation programs are ideal for young people: mobile phones are the most common means of peer communication, and messages can be delivered in an anonymous manner, anywhere, anytime. Following the success of our text messaging smoking cessation program, we developed an innovative multimedia mobile phone smoking cessation intervention. Objective The aim of the study was to develop and pilot test a youth-oriented multimedia smoking cessation intervention delivered solely by mobile phone. Methods Development included creating content and building the technology platform. Content development was overseen by an expert group who advised on youth development principles, observational learning (from social cognitive theory), effective smoking cessation interventions, and social marketing. Young people participated in three content development phases (consultation via focus groups and an online survey, content pre-testing, and selection of role models). Video and text messages were then developed, incorporating the findings from this research. Information technology systems were established to support the delivery of the multimedia messages by mobile phone. A pilot study using an abbreviated 4-week program of video and text content tested the reliability of the systems and the acceptability of the intervention. Results Approximately 180 young people participated in the consultation phase. There was a high priority placed on music for relaxation (75%) and an interest in interacting with others in the program (40% would read messages, 36% would read a blog). Findings from the pre-testing phase (n = 41) included the importance of selecting “real” and “honest” role models with believable stories, and an interest in animations (37%). Of the 15 participants who took part in the pilot study, 13 (87%) were available for follow-up interviews at 4 weeks: 12 participants liked the program or liked it most of the time and found the role model to be believable; 7 liked the role model video messages (5 were unsure); 8 used the extra assistance for cravings; and 9 were happy with two messages per day. Nine participants (60%) stopped smoking during the program. Some technical challenges were encountered during the pilot study. Conclusions A multimedia mobile phone smoking cessation program is technically feasible, and the content developed is appropriate for this medium and is acceptable to our target population. These results have informed the design of a 6-month intervention currently being evaluated for its effectiveness in increasing smoking cessation rates in young people. PMID:19033148

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.

Costs of the Smoking Cessation Program in Brazil

PubMed Central

Mendes, Andréa Cristina Rosa; Toscano, Cristiana Maria; Barcellos, Rosilene Marques de Souza; Ribeiro, Alvaro Luis Pereira; Ritzel, Jonas Bohn; Cunha, Valéria de Souza; Duncan, Bruce Bartholow

2016-01-01

ABSTRACT OBJECTIVE To assess the costs of the Smoking Cessation Program in the Brazilian Unified Health System and estimate the cost of its full implementation in a Brazilian municipality. METHODS The intensive behavioral therapy and treatment for smoking cessation includes consultations, cognitive-behavioral group therapy sessions, and use of medicines. The costs of care and management of the program were estimated using micro-costing methods. The full implementation of the program in the municipality of Goiania, Goias was set as its expansion to meet the demand of all smokers motivated to quit in the municipality that would seek care at Brazilian Unified Health System. We considered direct medical and non-medical costs: human resources, medicines, consumables, general expenses, transport, travels, events, and capital costs. We included costs of federal, state, and municipal levels. The perspective of the analysis was that from the Brazilian Unified Health System. Sensitivity analysis was performed by varying parameters concerning the amount of activities and resources used. Data sources included a sample of primary care health units, municipal and state secretariats of health, and the Brazilian Ministry of Health. The costs were estimated in Brazilian Real (R$) for the year of 2010. RESULTS The cost of the program in Goiania was R$429,079, with 78.0% regarding behavioral therapy and treatment of smoking. The cost per patient was R$534, and, per quitter, R$1,435. The full implementation of the program in the municipality of Goiania would generate a cost of R$20.28 million to attend 35,323 smokers. CONCLUSIONS The Smoking Cessation Program has good performance in terms of cost per patient that quit smoking. In view of the burden of smoking in Brazil, the treatment for smoking cessation must be considered as a priority in allocating health resources. PMID:27849293

Internet-Based Programs Incorporating Behavior Change Techniques Are Associated With Increased Smoking Cessation in the General Population: A Systematic Review and Meta-analysis.

PubMed

McCrabb, Sam; Baker, Amanda L; Attia, John; Skelton, Eliza; Twyman, Laura; Palazzi, Kerrin; McCarter, Kristen; Ku, Dominic; Bonevski, Billie

2018-05-10

This study aims to (i) examine the effectiveness of internet-based smoking cessation programs; (ii) describe the number and type of behavior change techniques (BCTs) employed; and (iii) explore whether BCTs included in internet-based smoking cessation programs are related to program effectiveness. MEDLINE, CINAHL, EMBASE, PsycINFO, and CENTRAL databases were searched. Randomized controlled trials were included if they described the study of a smoking cessation program delivered via the internet; included current adult tobacco smokers from the general population; and were written in English. Random effects meta-analyses and meta-regressions were used to examine program effectiveness (pooled odds ratios, by outcome measure, i.e., 7 day point prevalence abstinence [PPA], 30 day PPA, other abstinence measure) in short- and long-term outcomes, and examine the associations between BCT number and type (individual BCTs and BCT domain) and program effectiveness. Results from 45 studies were included (n = 65,736). Intervention effectiveness was found in the short term for all outcome measures (OR = 1.29, 95% CI 1.12, 1.50, p = .001), for "prolonged abstinence" (OR = 1.43, 95% CI 1.09, 1.87, p = .009), and "30 day PPA" (OR = 1.75, 95% CI 1.13, 2.72, p = .013). Internet-based programs were effective in the long term for all outcome measures (OR = 1.19, 95% CI = 1.06, 1.35, p = .004) and for "prolonged abstinence" (OR = 1.40, 95% CI 1.19, 1.63, p < .001). On average, interventions used more BCTs than comparison groups (6.6 vs. 3.1, p = .0002). The impact of specific individual BCTs and BCT domains on effectiveness was examined and is reported. Internet-based smoking cessation interventions increased the odds of cessation by 29 per cent in the short term and by 19 per cent in the long term. Internet-based smoking cessation intervention development should incorporate BCTs to increase effectiveness. CRD42015014676.

Barriers and Facilitators to Tobacco Cessation in a Nationwide Sample of Addiction Treatment Programs.

PubMed

Pagano, Anna; Tajima, Barbara; Guydish, Joseph

2016-08-01

Smoking rates among addiction treatment clients are 3-4 times higher than those of the general population. Recent studies indicate that ceasing tobacco use during treatment may improve recovery outcomes. Across the United States, publicly funded addiction treatment programs vary widely in terms of their tobacco policies and tobacco cessation services offered to clients. The study reported here is the qualitative component of a larger study. Twenty-four programs were recruited from a random sample of publicly funded programs participating in the NIDA Clinical Trials Network. Semi-structured interviews were administered by phone to program directors. ATLAS.ti software was used to facilitate thematic analysis of interview transcripts. While all directors expressed interest in helping clients to quit smoking, they cited numerous barriers to implementing tobacco policies and services. These included smoking culture, client resistance, lack of resources, staff smoking, and environmental barriers. Directors also cited several factors that they believed would support tobacco cessation. These included financial support, enhanced leadership, and state mandates against smoking in addiction treatment programs. Addiction treatment programs are beginning to place more emphasis on tobacco cessation during treatment. However, furthering this goal requires substantial infrastructural and cultural change. These qualitative study findings may help to inform Single State Agencies (SSAs) to support publicly funded addiction treatment programs in their tobacco cessation efforts. In order to maximize effectiveness, state-level policies regarding tobacco cessation during treatment should be informed by ongoing dialogue between service providers and SSAs. Copyright © 2016 Elsevier Inc. All rights reserved.

Engaging African Americans in Smoking Cessation Programs

ERIC Educational Resources Information Center

Wallen, Jacqueline; Randolph, Suzanne; Carter-Pokras, Olivia; Feldman, Robert; Kanamori-Nishimura, Mariano

2014-01-01

Background: African Americans are disproportionately exposed to and targeted by prosmoking advertisements, particularly menthol cigarette ads. Though African Americans begin smoking later than whites, they are less likely to quit smoking than whites. Purpose: This study was designed to explore African American smoking cessation attitudes,…

Web-based computer-tailoring for practice nurses aimed to improve smoking cessation guideline adherence: A study protocol for a randomized controlled effectiveness trial.

PubMed

de Ruijter, D; Smit, E S; de Vries, H; Hoving, C

2016-05-01

Dutch practice nurses sub-optimally adhere to evidence-based smoking cessation guidelines. Web-based computer-tailoring could be effective in improving their guideline adherence. Therefore, this paper aims to describe the development of a web-based computer-tailored program and the design of a randomized controlled trial testing its (cost-)effectiveness. Theoretically grounded in the I-Change Model and Self-Determination Theory, and based on the results of a qualitative needs assessment among practice nurses, a web-based computer-tailored program was developed including three modules with tailored advice, an online forum, modules with up-to-date information about smoking cessation, Frequently Asked Questions (FAQs) and project information, and a counseling checklist. The program's effects are assessed by comparing an intervention group (access to all modules) with a control group (access to FAQs, project information and counseling checklist only). Smoking cessation guideline adherence and behavioral predictors (i.e. intention, knowledge, attitude, self-efficacy, social influence, action and coping planning) are measured at baseline and at 6- and 12-month follow-up. Additionally, the program's indirect effects on smokers' quit rates and the number of quit attempts are assessed after 6 and 12months. This paper describes the development of a web-based computer-tailored adherence support program for practice nurses and the study design of a randomized controlled trial testing its (cost-)effectiveness. This program potentially contributes to improving the quality of smoking cessation care in Dutch general practices. If proven effective, the program could be adapted for use by other healthcare professionals, increasing the public health benefits of improved smoking cessation counseling for smokers. Copyright © 2016 Elsevier Inc. All rights reserved.

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.

Corporate smoking cessation on Long Island.

PubMed

Mulligan, Peter

2010-03-01

Tobacco addiction is a treatable health care problem. Employers are experiencing major annual increases in the cost of providing health insurance benefits. The expenditures due to smoking-related diseases are a major contributor to the escalating cost of employer-sponsored health and life benefit plans. An initiative that employers have adopted to help control increases in health care costs as well as improve the lifestyle of employees is the establishment of corporate wellness programs. Programs that promote healthy lifestyles and wellness are connected to the principle that a happy and healthy worker will be more effective and productive. Another dividend of corporate wellness programs is higher employee retention and better employee morale. An earlier study investigated the impact of wellness programs for Long Island employers. One of the major findings of that research was the confirmation of the prevalence of smoking cessation initiatives as components of the successful wellness programs. This article, through analysis of a follow-up survey, confirms that corporate smoking cessation programs have a significant return on investment. Further, the analysis identifies the components of the cessation programs and measures the relative impact of each element.

The Goetz Plan: A Practical Smoking Cessation Program for College Students

ERIC Educational Resources Information Center

Krohn, Franklin B.; Goetz, Kristin M.

2005-01-01

Tobacco smoking is responsible for approximately 434,000 deaths per year in the United States (Fact Sheet, 1993). College students represent a large portion of the smoking public. Roughly 70% of college students have tried smoking (Everett & Husten, 1999). There are various methods available to assist in smoking cessation, some being, nicotine…

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.

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

Quitting smoking during substance use disorders treatment: Patient and treatment-related variables.

PubMed

Campbell, Barbara K; Le, Thao; Tajima, Barbara; Guydish, Joseph

2017-02-01

Although individuals in substance use disorders (SUD) treatment continue to smoke at high rates, regulatory, policy and programming changes promoting tobacco cessation are being implemented and some patients quit successfully. We examined associations of smoking patterns, tobacco advertising receptivity, anti-tobacco message awareness, health risk perception, attitudes towards addressing smoking and availability of smoking cessation services with quitting smoking during SUD treatment. Surveys were completed by 1127 patients in 24 programs chosen randomly, stratified by program type (residential, methadone maintenance, outpatient), from among publicly funded, adult treatment programs within the National Drug Abuse Treatment Clinical Trials Network. Among respondents who had been in SUD treatment for at least one month, there were 631 current smokers and 52 former smokers who reported quitting smoking during treatment for at least one month prior to survey completion; these respondents comprised our sample (N=683). Results showed that participants who reported health concerns as a reason for quitting were 1.27 times more likely to have quit during treatment (p=0.015) than those reporting health concerns affected quitting a little or not at all. Additionally, participants who reported that smoking cessation was part of their personal treatment plan during SUD treatment were 1.08 times more likely to have quit during treatment (p<0.001). Participants in methadone treatment were 49% less likely to report successfully quitting during treatment than those in outpatient treatment (95%CI: 0. 35-0.75, p<0.001). Leveraging health concerns about smoking and including smoking cessation in an individualized treatment plan may help increase smoking cessation during SUD treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

Overcoming limitations in previous research on exercise as a smoking cessation treatment: rationale and design of the "Quit for Health" trial.

PubMed

Williams, David M; Ussher, Michael; Dunsiger, Shira; Miranda, Robert; Gwaltney, Chad J; Monti, Peter M; Emerson, Jessica

2014-01-01

Aerobic exercise has been proposed as a stand-alone or adjunct smoking cessation treatment, but findings have been mixed. Laboratory studies have shown that individual exercise sessions lead to decreases in withdrawal symptoms and cigarette cravings, but findings are limited by lack of follow-up and artificial settings. On the other hand, smoking cessation treatment RCTs have generally failed to show positive effects of exercise on smoking cessation, but have been plagued by poor and/or unverified compliance with exercise programs. This paper describes the rationale and design for Quit for Health (QFH)--an RCT designed to determine the efficacy of aerobic exercise as an adjunct smoking cessation treatment among women. To overcome limitations of previous research, compliance with the exercise (and wellness contact control) program is incentivized and directly observed, and ecological momentary assessment is used to examine change over time in withdrawal symptoms and cigarette cravings in participants' natural environments. Copyright © 2013 Elsevier Inc. All rights reserved.

Overcoming Limitations in Previous Research on Exercise as a Smoking Cessation Treatment: Rationale and Design of the “Quit for Health” Trial

PubMed Central

Williams, David M.; Ussher, Michael; Dunsiger, Shira; Miranda, Robert; Gwaltney, Chad J.; Monti, Peter M.; Emerson, Jessica

2013-01-01

Aerobic exercise has been proposed as a stand-alone or adjunct smoking cessation treatment, but findings have been mixed. Laboratory studies have shown that individual exercise sessions lead to decreases in withdrawal symptoms and cigarette cravings, but findings are limited by lack of follow-up and artificial settings. On the other hand, smoking cessation treatment RCTs have generally failed to show positive effects of exercise on smoking cessation, but have been plagued by poor and/or unverified compliance with exercise programs. This paper describes the rationale and design for Quit for Health (QFH)—an RCT designed to determine the efficacy of aerobic exercise as an adjunct smoking cessation treatment among women. To overcome limitations of previous research, compliance with the exercise (and wellness contact control) program is incentivized and directly observed, and ecological momentary assessment is used to examine change over time in withdrawal symptoms and cigarette cravings in participants’ natural environments. PMID:24246818

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.

Structural and cultural barriers to the adoption of smoking cessation services in addiction treatment organizations.

PubMed

Knudsen, Hannah K; Studts, Jamie L; Boyd, Sara; Roman, Paul M

2010-07-01

Few studies have examined associations between the availability of smoking cessation services in addiction treatment organizations and specific cultural, staffing, and resource barriers. Telephone interviews were conducted with administrators of 897 addiction treatment organizations in the United States. These data revealed that few programs had adopted the full bundle of five recommended tobacco-related intake procedures, and that less than half of programs offered any smoking cessation services. Barriers to adoption of the intake bundle and availability of services included organizational culture and low levels of staff skills. Adoption of cessation services was associated with center type, location in a hospital setting, levels of care, and organizational size. Although a substantial proportion of organizations offer smoking cessation services, expansion of these services and greater adoption of tobacco-related intake procedures are needed to address the needs of nicotine-dependent individuals in addiction treatment.

Feasibility and Acceptability of a Text Messaging Program for Smoking Cessation in Israel.

PubMed

Abroms, Lorien; Hershcovitz, Ronit; Boal, Ashley; Levine, Hagai

2015-08-01

Text messaging programs on mobile phones have been shown to promote smoking cessation. This study investigated whether a text-messaging program for smoking cessation, adapted from QuitNowTXT, is feasible in Israel and acceptable to Israeli smokers. Participants (N = 38) were given a baseline assessment, enrolled in the adapted text messaging program, and followed-up with at 2 weeks and 4 weeks after their quit date. The authors used an intent-to-treat analysis and found that 23.7% of participants reported having quit smoking at the 4-week follow-up. Participants sent an average of 12.9 text replies during the study period, and the majority reported reading most or all of the texts. However, 34.2% of participants had unsubscribed by the 4-week follow-up. Moderate levels of satisfaction were reported; more than half agreed that they would recommend the program. Suggestions for improvement included adding advice by an expert counselor, website support, and increased customization. Results indicate that a text messaging smoking cessation program developed by modifying the content of QuitNowTXT is feasible and could be acceptable to smokers in Israel. The experience adapting and pilot testing the program can serve as a model for using QuitNowTXT to develop and implement such programs in other countries.

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.

A Comparison of Mandated Versus Volunteer Adolescent Participants in Youth Tobacco Cessation Programs

PubMed Central

Houser-Marko, Linda; Curry, Susan J.; Mermelstein, Robin J.; Emery, Sherry; Pugach, Oksana

2012-01-01

A national evaluation of community-based youth cessation programs delivered in group format provided the opportunity to compare mandated and volunteer program participants on demographics, smoking patterns, other health behaviors and motivation to quit. A total of 857 youth participants completed surveys prior to the start of their treatment program. Mandated youth comprised 24% of the sample (n=202). Both bivariate and multivariate comparisons were conducted. Mandated participants reported lower levels of stress, higher extrinsic motivation and lower intrinsic motivation to quit, and were more likely to be in the earlier (precontemplation) stage of readiness to quit. Mandated and volunteer smokers did not differ in their smoking patterns, school-related smoking behaviors, or binge drinking. Rates of smoking, school problems, and binge drinking were higher among cessation program participants than in general samples of youth. Programs with mixed voluntary-mandatory participation may benefit from extra attention to motivational issues. PMID:21550728

Effectiveness of a pharmacist-delivered smoking cessation program in the State of Qatar: a randomized controlled trial.

PubMed

El Hajj, Maguy Saffouh; Kheir, Nadir; Al Mulla, Ahmad Mohd; Shami, Rula; Fanous, Nadia; Mahfoud, Ziyad R

2017-02-20

Cigarette smoking is one of the major preventable causes of death and diseases in Qatar. The study objective was to test the effect of a structured smoking cessation program delivered by trained pharmacists on smoking cessation rates in Qatar. A prospective randomized controlled trial was conducted in eight ambulatory pharmacies in Qatar. Eligible participants were smokers 18 years and older who smoked one or more cigarettes daily for 7 days, were motivated to quit, able to communicate in Arabic or English, and attend the program sessions. Intervention group participants met with the pharmacists four times at 2 to 4 week intervals. Participants in the control group received unstructured brief smoking cessation counseling. The primary study outcome was self-reported continuous abstinence at 12 months. Analysis was made utilizing data from only those who responded and also using intent-to-treat principle. A multinomial logistic regression model was fitted to assess the predictors of smoking at 12 months. Analysis was conducted using IBM-SPSS® version 23 and STATA® version 12. A total of 314 smokers were randomized into two groups: intervention (n = 167) and control (n = 147). Smoking cessation rates were higher in the intervention group at 12 months; however this difference was not statistically significant (23.9% vs. 16.9% p = 0.257). Similar results were observed but with smaller differences in the intent to treat analysis (12.6% vs. 9.5%, p = 0.391). Nevertheless, the daily number of cigarettes smoked for those who relapsed was significantly lower (by 4.7 and 5.6 cigarettes at 3 and 6 months respectively) in the intervention group as compared to the control group (p = 0.041 and p = 0.018 respectively). At 12 months, the difference was 3.2 cigarettes in favor of the intervention group but was not statistically significant (p = 0.246). Years of smoking and daily number of cigarettes were the only predictors of smoking as opposed to quitting at 12 months (p = 0.005; p = 0.027 respectively). There was no statistically significant difference in the smoking cessation rate at 12 months between the groups. However, the smoking cessation program led to higher (albeit non-significant) smoking cessation rates compared with usual care. More research should be conducted to identify factors that might improve abstinence. Clinical Trials NCT02123329 . Registration date 20 April 2014.

Essential elements of self-help/minimal intervention strategies for smoking cessation.

PubMed

Glynn, T J; Boyd, G M; Gruman, J C

1990-01-01

Two decades of research suggest that self-help/minimal intervention strategies for smoking cessation may be the preferred means by which smokers stop and can produce success rates approximating those of more formal programs, at lower cost and with greater access to relevant populations. In order to make the best possible use of these self-help/minimal intervention approaches, the National Cancer Institute (NCI) supported a series of randomized, controlled intervention trials and, in June of 1988, convened an Expert Advisory Panel to address the question "What are the essential elements of self-help/minimal intervention strategies for smoking cessation?". The panel's recommendations were that: (1) Intervention efforts should focus on increasing smokers' motivations to make serious quit attempts; (2) Delivery of programs be broadened to include all smokers; (3) Programs be targeted to stages of cessation and specific populations; (4) All programs include (a) elements focused on health and social consequences of smoking, and (b) strategies and exercises aimed at quitting, maintenance of nonsmoking, relapse prevention, and recycling; (5) Materials and programs be made widely available rather than "fine tuning" existing programs or developing new ones; and (6) Programs make use of specific adjunctive strategies. In this way, a reacceleration of the decline in smoking prevalence may be realized in the 1990s and significantly contribute to the NCI's Year 2000 goals and the Surgeon General's aim of a smoke-free society.

Comparing Tailored and Untailored Text Messages for Smoking Cessation: A Randomized Controlled Trial among Adolescent and Young Adult Smokers

ERIC Educational Resources Information Center

Skov-Ettrup, L. S.; Ringgaard, L. W.; Dalum, P.; Flensborg-Madsen, T.; Thygesen, L. C.; Tolstrup, J. S.

2014-01-01

The aim was to compare the effectiveness of untailored text messages for smoking cessation to tailored text messages delivered at a higher frequency. From February 2007 to August 2009, 2030 users of an internet-based smoking cessation program with optional text message support aged 15-25 years were consecutively randomized to versions of the…

Engagement Within a Mobile Phone-Based Smoking Cessation Intervention for Adolescents and its Association With Participant Characteristics and Outcomes.

PubMed

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

2017-11-01

Although mobile phone-delivered smoking cessation programs are a promising way to promote smoking cessation among adolescents, little is known about how adolescents might actually use them. The aim of this study was to determine adolescents' trajectories of engagement with a mobile phone-delivered smoking cessation program over time and the associations these trajectories have with baseline characteristics and treatment outcomes. We performed secondary data analysis on a dataset from a study that compared a mobile phone-delivered integrated smoking cessation and alcohol intervention with a smoking cessation only intervention for adolescents recruited in vocational and upper secondary school classes (N=1418). Throughout the 3-month intervention, participants in both intervention groups received one text message prompt per week that either assessed smoking-related target behaviors or encouraged participation in a quiz or a message contest. Sequence analyses were performed to identify engagement trajectories. Analyses were conducted to identify predictors of engagement trajectory and associations between engagement trajectories and treatment outcomes. Three engagement trajectories emerged: (1) stable engagement (646/1418, 45.56%), (2) decreasing engagement (501/1418, 35.33%), and (3) stable nonengagement (271/1418, 19.11%). Adolescents who were younger, had no immigrant background, perceived more benefits of quitting smoking, and reported binge drinking preceding the baseline assessment were more likely to exhibit stable engagement. Due to different reach of more engaged and less engaged participants at follow-up, three statistical models (complete-cases, last-observation-carried-forward, and multiple imputation) for the associations of engagement trajectory and smoking outcome were tested. For 7-point smoking abstinence, no association was revealed to be statistically significant over all three models. However, decreasing engagement with the program was associated over all three models, with greater reductions in daily tobacco use than nonengagement. The majority of tobacco-smoking adolescents engaged extensively with a mobile phone-based smoking cessation program. However, not only stable engagement but also decreasing engagement with a program might be an indicator of behavioral change. Measures to avoid nonengagement among adolescents appear especially necessary for older smokers with an immigrant background who do not drink excessively. In addition, future studies should not only examine the use of specific program components but also users' engagement trajectories to better understand the mechanisms behind behavioral change. ©Raquel Paz Castro, Severin Haug, Andreas Filler, Tobias Kowatsch, Michael P Schaub. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 01.11.2017.

Parents' perceptions of the role of schools in tobacco use prevention and cessation for youth.

PubMed

Wyman, Jodi; Price, James H; Jordan, Timothy R; Dake, Joseph A; Telljohann, Susan K

2006-06-01

The purpose of this study was to examine Ohio parents' perceptions of the role of schools in smoking prevention, cessation, and anti-tobacco policy for their children. A 46-item questionnaire was based on the CDC Guidelines for School Health Programs to Prevent Tobacco Use and Addiction. Surveys (n = 800) were sent to a stratified random sample of parents of junior high and high school aged students and 57% responded. Parents were supportive of smoking prevention activities, but almost two-thirds believed their child's school should get parents' input. Furthermore, mothers/step-mothers were more likely than fathers/step-fathers to agree that the school had a role in smoking prevention activities. The majority of parents were also supportive of smoking cessation activities. However, only 8% of parent respondents supported schools providing nicotine gum or patches to students trying to quit smoking. Overall, the majority of parents were supportive of the seven recommendations developed by the CDC as guidelines for school health programs to prevent tobacco use and addiction. Schools have the opportunity to impact student smoking through prevention and cessation activities. Schools need to know that parents are supportive of these activities and want to be included in the process of implementing effective prevention or cessation programs.

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.

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.

[Predictors of outcome of a smoking cessation treatment by gender].

PubMed

Marqueta, Adriana; Nerín, Isabel; Jiménez-Muro, Adriana; Gargallo, Pilar; Beamonte, Asunción

2013-01-01

To identify factors predictive of the outcome of a smoking cessation program by gender. A cross-sectional study of smokers starting treatment in a smoking cessation clinic from 2002 to 2007 was conducted. The variables consisted of data on sociodemographic factors, smoking habits, the social context of smoking and psychiatric comorbidity prior to or during the smoking cessation process. All patients received multicomponent treatment consisting of psychological and pharmacological interventions. Success was defined as self-reported continuous abstinence confirmed by cooximetry (CO ≤10 ppm). Logistic regression was used to analyze the factors predictive of success. A total of 1302 persons (52.1% men and 47.9% women), with a mean age of 43.4 (10.2) years, were included. The mean number of cigarettes smoked per day was 25.3 (10.4) and the mean Fagerström test score was 6.2 (2.2) points. The success rate was 41.3% (538) with no differences by gender. Positive predictors were lower nicotine dependence and having a non-smoking partner in men and older age, smoking fewer cigarettes per day, having fewer smoking friends and not experiencing depression or anxiety during the treatment in women. Men and women have similar tobacco abstinence outcomes although gender factors play a role in determining abstinence. The gender perspective should be incorporated in smoking prevention and cessation programs. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

A phone-counseling smoking-cessation intervention for male Chinese restaurant workers.

PubMed

Burton, Dee; Zeng, Xin X; Chiu, Cynthia H; Sun, Junmian; Sze, Nga L; Chen, Yilin; Chin, Margaret S

2010-12-01

We sought to develop a smoking-cessation intervention for male Chinese restaurant workers in New York City that required no seeking out by participants; provided support over a relatively long period of time; and was responsive to participants' cultural backgrounds and daily lives. The resulting intervention consisted of a minimum of 9 proactive phone counseling sessions within a 6-month period for each participant recruited at his worksite. All activities were conducted in Chinese languages. The efficacy of this proactive phone-counseling intervention was assessed in a pretest/posttest design comparing baseline smoking with smoking 6 months after the intervention ended. Of 137 male employees recruited at their restaurants, 101 (median age 40.5) participated in the phone-counseling intervention in 2007-2008, with 75 completing the program with at least 9 counseling calls. We found a linear increase in smoking cessation from 0% at Call 1 to 50.7% at Call 9 for 75 men who completed the program, and we found for all 101 participants a 32.7% intent-to-treat cessation rate for 6 months post-end of program, adjusted to 30.8% by saliva cotinine assessments. The results indicate that combining field outreach with phone counseling over an extended period of time can facilitate smoking cessation for population groups whose environments do not support efforts to quit smoking.

Smoking cessation interventions in the pre-admission clinic: assessing two approaches.

PubMed

Sachs, Robyn; Wild, T Cameron; Thomas, Laura; Hammal, Fadi; Finegan, Barry A

2012-07-01

Brief intervention (BI) to encourage patients who smoke to quit is effective and should occur at every patient interaction. If smokers receive a motivational interview in addition to BI and are offered pharmacotherapy to treat nicotine withdrawal, cessation rates may be improved. We compared the uptake, implementation, and effectiveness of these two approaches in the delivery of a smoking cessation intervention during assessments in a pre-admission clinic (PAC). The study was performed in the PAC at two tertiary care hospitals. At both hospitals, PAC patients were screened for smoking status, and current smokers were offered the opportunity to participate in a cessation program. Those who agreed were asked to consent to participate in an evaluation of program effectiveness that included a telephone interview about smoking status six months after hospital discharge. A cohort design was used to compare cessation outcomes across PACs during a one-year period of patient recruitment. The primary outcome measure was a self-reported continuous quit rate six months following hospitalization. Secondary outcomes included the number of patients willing to participate and the completeness of the delivery of program components. A BI delivered at one PAC consisted of brief advice and self-help materials, including handing the patient a business card with an available 1-800 Quit line (a telephone smoking cessation help line). The other PAC offered an intensive intervention (II) that included augmenting the BI with an in-hospital and post-discharge motivational interview and access to nicotine replacement therapy (NRT) during admission. At follow-up, we were able to contact 147 of the 288 smokers who agreed to participate in the evaluation of the program, and the self-reported quit rates for the BI and II interventions were 11.4% and 19.5%, respectively. More than 1,200 current smokers were identified and approached at both PACs during the 12-month patient recruitment period, and 60% of those were willing to accept the offered smoking cessation intervention (either BI or II). Implementation of II was uneven, particularly the delivery of the in-hospital motivational interview and prescription of NRT. Uptake of the 1-800 Quit service after discharge was inadequate. The PAC is a feasible location to identify smokers and offer a cessation intervention. There are considerable logistical barriers to the development of an II intervention program as described. A program that incorporates elements of BI and II could offer a practical approach to the implementation of a hospital-wide smoking cessation intervention.

Affordable Care Act Impact on Medicaid Coverage of Smoking-Cessation Treatments.

PubMed

McMenamin, Sara B; Yoeun, Sara W; Halpin, Helen A

2018-04-01

Four sections of the Affordable Care Act address the expansion of Medicaid coverage for recommended smoking-cessation treatments for: (1) pregnant women (Section 4107), (2) all enrollees through a financial incentive (1% Federal Medical Assistance Percentage increase) to offer comprehensive coverage (Section 4106), (3) all enrollees through Medicaid formulary requirements (Section 2502), and (4) Medicaid expansion enrollees (Section 2001). The purpose of this study is to document changes in Medicaid coverage for smoking-cessation treatments since the passage of the Affordable Care Act and to assess how implementation has differentially affected Medicaid coverage policies for: pregnant women, enrollees in traditional Medicaid, and Medicaid expansion enrollees. From January through June 2017, data were collected and analyzed from 51 Medicaid programs (50 states plus the District of Columbia) through a web-based survey and review of benefits documents to assess coverage policies for smoking-cessation treatments. Forty-seven Medicaid programs have increased coverage for smoking-cessation treatments post-implementation of the Affordable Care Act by adopting one or more of the four smoking-cessation treatment provisions. Coverage for pregnant women increased in 37 states, coverage for newly eligible expansion enrollees increased in 32 states, and 15 states added coverage and/or removed copayments in order to apply for a 1% increase in the Federal Medical Assistance Percentage. Coverage for all recommended pharmacotherapy and group and individual counseling increased from seven states in 2009 to 28 states in 2017. The Affordable Care Act was successful in improving and expanding state Medicaid coverage of effective smoking-cessation treatments. Many programs are not fully compliant with the law, and additional guidance and clarification from the Centers for Medicare and Medicaid Services may be needed. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Targeting Body Image Schema for Smoking Cessation among College Females: Rationale, Program Description, and Pilot Study Results

ERIC Educational Resources Information Center

Napolitano, Melissa A.; Lloyd-Richardson, Elizabeth E.; Fava, Joseph L.; Marcus, Bess H.

2011-01-01

Smoking among young adults is a significant public health problem. Despite the negative health effects, many young women smoke for weight and body image reasons. Understanding the factors that prompt young women to initiate and continue smoking is important for designing smoking cessation interventions. The aim of the current article is to outline…

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.

The Systematic Development of an Internet-Based Smoking Cessation Intervention for Adults.

PubMed

Dalum, Peter; Brandt, Caroline Lyng; Skov-Ettrup, Lise; Tolstrup, Janne; Kok, Gerjo

2016-07-01

Objectives The objective of this project was to determine whether intervention mapping is a suitable strategy for developing an Internet- and text message-based smoking cessation intervention. Method We used the Intervention Mapping framework for planning health promotion programs. After a needs assessment, we identified important changeable determinants of cessation behavior, specified objectives for the intervention, selected theoretical methods for meeting our objectives, and operationalized change methods into practical intervention strategies. Results We found that "social cognitive theory," the "transtheoretical model/stages of change," "self-regulation theory," and "appreciative inquiry" were relevant theories for smoking cessation interventions. From these theories, we selected modeling/behavioral journalism, feedback, planning coping responses/if-then statements, gain frame/positive imaging, consciousness-raising, helping relationships, stimulus control, and goal-setting as suitable methods for an Internet- and text-based adult smoking cessation program. Furthermore, we identified computer tailoring as a useful strategy for adapting the intervention to individual users. Conclusion The Intervention Mapping method, with a clear link between behavioral goals, theoretical methods, and practical strategies and materials, proved useful for systematic development of a digital smoking cessation intervention for adults. © 2016 Society for Public Health Education.

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.

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

Perceptions Toward a Smoking Cessation App Targeting LGBTQ+ Youth and Young Adults: A Qualitative Framework Analysis of Focus Groups

PubMed Central

Dash, Darly; Wong, Katy; Shuh, Alanna; Abramowicz, Aneta

2016-01-01

Background The prevalence of smoking among lesbian, gay, bisexual, trans, queer, and other sexual minority (LGBTQ+) youth and young adults (YYA) is significantly higher compared with that among non-LGBTQ+ persons. However, in the past, interventions were primarily group cessation classes that targeted LGBTQ+ persons of all ages. mHealth interventions offer an alternate and modern intervention platform for this subpopulation and may be of particular interest for young LGBTQ+ persons. Objective This study explored LGBTQ+ YYA (the potential users’) perceptions of a culturally tailored mobile app for smoking cessation. Specifically, we sought to understand what LGBTQ+ YYA like and dislike about this potential cessation tool, along with how such interventions could be improved. Methods We conducted 24 focus groups with 204 LGBTQ+ YYA (aged 16-29 years) in Toronto and Ottawa, Canada. Participants reflected on how an app might support LGBTQ+ persons with smoking cessation. Participants indicated their feelings, likes and dislikes, concerns, and additional ideas for culturally tailored smoking cessation apps. Framework analysis was used to code transcripts and identify the overarching themes. Results Study findings suggested that LGBTQ+ YYA were eager about using culturally tailored mobile apps for smoking cessation. Accessibility, monitoring and tracking, connecting with community members, tailoring, connecting with social networks, and personalization were key reasons that were valued for a mobile app cessation program. However, concerns were raised about individual privacy and that not all individuals had access to a mobile phone, users might lose interest quickly, an app would need to be marketed effectively, and app users might cheat and lie about progress to themselves. Participants highlighted that the addition of distractions, rewards, notifications, and Web-based and print versions of the app would be extremely useful to mitigate some of their concerns. Conclusions This study provided insight into the perspectives of LGBTQ+ YYA on a smoking cessation intervention delivered through a mobile app. The findings suggested a number of components of a mobile app that were valued and those that were concerning, as well as suggestions on how to make a mobile app cessation program successful. App development for this subpopulation should take into consideration the opinions of the intended users and involve them in the development and evaluation of mobile-based smoking cessation programs. PMID:27864164

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 a smoking cessation education on smoking cessation, endothelial function, and serum carboxyhemoglobin in male patients with variant angina].

PubMed

Cho, Sook Hee

2012-04-01

The aim of this study was to evaluate the effects of a smoking cessation education on endothelial function and carboxyhemoglobin levels in smokers with variant angina. A nonequivalent control group pretest-posttest design was used. Participants were 60 male smokers with variant angina admitted to one hospital: the control group (30) between September and December, 2009, and the experimental group (30) between February and May, 2010. Endothelial function, as defined by flow-mediated vasodilation (FMD) of the brachial artery, and serum carboxyhemoglobin (COHb) were determined at baseline and at 3 months after the initiation of education in both groups. Three months after the program, smoking cessation was successful in 22 of the 30 smokers in the experimental group, but only in 4 of 30 smokers in the control group (p<.001). After the education, the experimental group showed a significant increase in FMD, and a significant decreased in serum COHb compared with the control group. The findings indicate that this smoking cessation education program is effective for hospitalized smokers with variant angina.

Internet and Cell Phone Based Smoking Cessation Programs among Adolescents

ERIC Educational Resources Information Center

Mehta, Purvi; Sharma, Manoj

2010-01-01

Smoking cessation among adolescents is a salient public health issue, as it can prevent the adoption of risky health behaviors and reduce negative impacts on health. Self-efficacy, household and social support systems, and perceived benefits are some important cessation determinants. With the popular use of the Internet and cell phone usage among…

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.

The Primary Results of the Treating Adult Smokers at Risk for Weight Gain with Interactive Technology (TARGIT) Study.

PubMed

Johnson, Karen C; Thomas, Fridtjof; Richey, Phyllis; Tran, Quynh T; Tylavsky, Fran; Miro, Danielle; Coday, Mace

2017-10-01

To evaluate whether a behavioral weight management program combined with a smoking cessation program delivered via interactive technology could prevent postcessation weight gain. Three hundred and thirty young adult smokers, age 18 to 35 years, were randomized to a smoking cessation program alone (comparison group), which included behavioral counseling and nicotine replacement, or to a behavioral weight management program adapted from the Look AHEAD trial plus the same smoking cessation program (intervention group). The Treating Adult Smokers at Risk for Weight Gain with Interactive Technology study randomized 164 participants to the comparison group and 166 participants to the intervention group. On average, the participants gained 0.91 kg after 24 months in the trial (comparison group + 1.45 kg and intervention group + 0.32; P = 0.157). The only variable systematically affecting weight change over time was smoking abstinence, in which those who were abstinent, on average, gained 0.14 kg more per month compared with those who continued to smoke (P < 0.001). In exploratory analyses, the intervention participants who were abstinent at 6 months had numerically smaller weight gains compared with abstinent participants in the comparison group, but these differences were not statistically significant. Providing an intensive weight gain prevention program combined with a smoking cessation program via interactive technology was not associated with greater long-term weight gain prevention. © 2017 The Obesity Society.

Cell Phone-Based Expert Systems for Smoking Cessation

DTIC Science & Technology

2011-09-01

computerized tailored intervention (CTI) with feedback messages delivered via cell phone . CTIs have shown increasing promise as useful behavior change programs...behaviors. This will be the first study to adapt a smoking cessation Internet-based CTI to provide personalized feedback on a cell phone to reduce smoking behaviors in military veterans.

A comparison of mandated versus volunteer adolescent participants in youth tobacco cessation programs.

PubMed

Houser-Marko, Linda; Curry, Susan J; Mermelstein, Robin J; Emery, Sherry; Pugach, Oksana

2011-09-01

A national evaluation of community-based youth cessation programs delivered in group format provided the opportunity to compare mandated and volunteer program participants on demographics, smoking patterns, other health behaviors and motivation to quit. A total of 857 youth participants completed surveys prior to the start of their treatment program. Mandated youth comprised 24% of the sample (n=202). Both bivariate and multivariate comparisons were conducted. Mandated participants reported lower levels of stress, higher extrinsic motivation and lower intrinsic motivation to quit, and were more likely to be in the earlier (precontemplation) stage of readiness to quit. Mandated and volunteer smokers did not differ in their smoking patterns, school-related smoking behaviors, or binge drinking. Rates of smoking, school problems, and binge drinking were higher among cessation program participants than in general samples of youth. Programs with mixed voluntary-mandatory participation may benefit from extra attention to motivational issues. Copyright © 2011 Elsevier Ltd. All rights reserved.

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.

Moderate intensity exercise as an adjunct to standard smoking cessation treatment for women: a pilot study.

PubMed

Williams, David M; Whiteley, Jessica A; Dunsiger, Shira; Jennings, Ernestine G; Albrecht, Anna E; Ussher, Michael H; Ciccolo, Joseph T; Parisi, Alfred F; Marcus, Bess H

2010-06-01

Previous randomized controlled trials have not supported moderate intensity exercise as an efficacious adjunct to smoking cessation treatments for women; however, compliance with exercise programs in these studies has been poor. The purpose of this pilot study was to estimate the effects of moderate intensity exercise on smoking cessation outcomes under optimal conditions for exercise program compliance. Sixty previously sedentary, healthy, female smokers were randomized to an 8-week program consisting of brief baseline smoking cessation counseling and the nicotine patch plus either 150 min/week of moderate intensity exercise or contact control. Participants attended a median of 86.4% and 95.5% of prescribed exercise/control sessions, respectively. There was a moderate, though statistically nonsignificant, effect of exercise at post-treatment for objectively verified 7-day point prevalence abstinence (48.3% vs. 23.3%; OR = 3.07, 95% CI: 0.89-11.07) and prolonged abstinence (34.5% vs. 20.0%; OR = 2.11, 95% CI: 0.56-8.32). Effects were attenuated when controlling for potential confounders, and after a 1-month, no-treatment period. The findings provide a preliminary indication that, given adequate compliance, moderate intensity exercise may enhance short-term smoking cessation outcomes for women; however, a larger trial is warranted. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

[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.

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.

Evaluation of Intrinsic and Extrinsic Motivation Interventions with a Self-Help Smoking Cessation Program.

ERIC Educational Resources Information Center

Curry, Susan J.; And Others

1991-01-01

Evaluated personalized feedback and financial incentives as adjuncts to self-help materials for smoking cessation among subjects (n=1,217) randomized to 4 treatment groups and followed up at 3 and 12 months. Financial incentive increased self-help material use, did not increase cessation rates, and was associated with higher relapse rates.…

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.

A cost-benefit analysis of the outpatient smoking cessation services in Taiwan from a societal viewpoint.

PubMed

Chen, Pei-Ching; Lee, Yue-Chune; Tsai, Shih-Tzu; Lai, Chih-Kuan

2012-05-01

This study applied a cost-benefit analysis from a societal viewpoint to evaluate the Outpatient Smoking Cessation Services (OSCS) program. The costs measured in this study include the cost to the health sector, non-health sectors, the patients and their family, as well as the loss of productivity as a result of smoking. The benefits measured the medical costs savings and the earnings due to the increased life expectancy of a person that has stopped smoking for 15 years. Data were obtained from the primary data of a telephone survey, the literatures and reports from the Outpatient Smoking Cessation Management Center and government. Sensitivity analyses were conducted to verify the robustness of the results. There were 169,761 cases that participated in the outpatient smoking cessation program in the years 2007 and 2008, of those cases, 8,282 successfully stopped smoking. The total cost of the OSCS program was 18 million USD. The total benefits of the program were 215 million USD with a 3% discount rate; the net benefit to society was 196 million USD. After conducting sensitivity analyses on the different abstinence, relapse, and discount rates, from a societal perspective, the benefits still far exceeded the costs, while from a health care perspective, there was only a net benefit when the respondent's abstinence rate was used. From a societal perspective, the OSCS program in Taiwan is cost-beneficial. This study provides partial support for the policy makers to increase the budget and expand the OSCS program.

Creating and Testing a Deaf-Friendly, Stop-Smoking Web Site Intervention

ERIC Educational Resources Information Center

Jones, Elaine G.; Goldsmith, Melissa; Effken, Judith; Button, Kevin; Crago, Michael

2010-01-01

Deaf adults' access to smoking cessation programs is limited due to cultural, linguistic, and geographic barriers. Web-based stop-smoking interventions have demonstrated cessation rates comparable to other interventions. The Internet is widely used by Deaf adults, but difficulties with online English text remain. We found no published accounts of…

Psychosocial Factors and Enrollment in a Televised Smoking Cessation Program.

ERIC Educational Resources Information Center

Kviz, Frederick J.; And Others

1991-01-01

Interviews with random samples of 641 registrants for a smoking cessation program on Chicago television news and 2,398 smokers who regularly viewed the news determined that registration was associated with (1) recognition of the need to change behavior; (2) high expectation for quitting; (3) concern about the burden of lung cancer on significant…

Computer-Assisted, Counselor-Delivered Smoking Cessation Counseling for Community College Students: Intervention Approach and Sample Characteristics

ERIC Educational Resources Information Center

Prokhorov, Alexander V.; Fouladi, Rachel T.; de Moor, Carl; Warneke, Carla L.; Luca, Mario; Jones, Mary Mullin; Rosenblum, Carol; Emmons, Karen M.; Hudmon, Karen Suchanek; Yost, Tracey E.; Gritz, Ellen R.

2007-01-01

This report presents the experimental approach and baseline findings from "Look at Your Health," an ongoing study to develop and evaluate a computer-assisted, counselor-delivered smoking cessation program for community college students. It describes the expert system software program used for data collection and for provision of tailored feedback,…

Media campaign effectiveness in promoting a smoking-cessation program.

PubMed

Czarnecki, Karen Davis; Vichinsky, Laura E; Ellis, Jennifer A; Perl, Sarah B

2010-03-01

Little is known about the perceived barriers among smokers who do not utilize phone-based, population-level smoking-cessation services. The purpose of this study was to improve understanding of a media campaign's impact in promoting a phone-based, time-limited smoking-cessation program as measured by smoker awareness of the program, untapped interest in the program, perceived barriers to use of the program, and suggested methods for enhanced outreach. A random telephone survey of New York City smokers (n=1000) was conducted in 2006 in order to assess awareness of, interest in, and barriers to using the 2006 Nicotine Patch Program. Analyses were conducted in 2006 and 2007. The level of program awareness was high (60% overall), although it varied by demographic subgroup. The level of program interest among smokers unaware of the program was also encouragingly high (54%). Analysis of barriers to program use indicates that enrollment may be increased by addressing hesitance about using patches, developing messages for smokers who do not self-identify as smokers, and clarifying application procedures. Specific outreach strategies suggested by smokers include promotion through direct mail and advertising on public transportation. These data suggest that the use of mass media is an effective method for informing smokers about cessation services and that enrollment could be improved by modifying public messages to address barriers as well as expanding outreach to specific demographic groups. Improved outreach to smokers may be feasible using the strategies suggested by smokers in this survey. These findings can aid smoking-cessation services in expanding their reach and impact. Published by Elsevier Inc.

Simulation-based estimates of effectiveness and cost-effectiveness of smoking cessation in patients with chronic obstructive pulmonary disease.

PubMed

Atsou, Kokuvi; Chouaid, Christos; Hejblum, Gilles

2011-01-01

The medico-economic impact of smoking cessation considering a smoking patient with chronic obstructive pulmonary disease (COPD) is poorly documented. Here, considering a COPD smoking patient, the specific burden of continuous smoking was estimated, as well as the effectiveness and the cost-effectiveness of smoking cessation. A multi-state Markov model adopting society's perspective was developed. Simulated cohorts of English COPD patients who are active smokers (all severity stages combined or patients with the same initial severity stage) were compared to identical cohorts of patients who quit smoking at cohort initialization. Life expectancy, quality adjusted life-years (QALY), disease-related costs, and incremental cost-effectiveness ratio (ICER: £/QALY) were estimated, considering smoking cessation programs with various possible scenarios of success rates and costs. Sensitivity analyses included the variation of model key parameters. At the horizon of a smoking COPD patient's remaining lifetime, smoking cessation at cohort intitialization, relapses being allowed as observed in practice, would result in gains (mean) of 1.27 life-years and 0.68 QALY, and induce savings of -1824 £/patient in the disease-related costs. The corresponding ICER was -2686 £/QALY. Smoking cessation resulted in 0.72, 0.69, 0.64 and 0.42 QALY respectively gained per mild, moderate, severe, and very severe COPD patient, but was nevertheless cost-effective for mild to severe COPD patients in most scenarios, even when hypothesizing expensive smoking cessation intervention programmes associated with low success rates. Considering a ten-year time horizon, the burden of continuous smoking in English COPD patients was estimated to cost a total of 1657 M£ while 452516 QALY would be simultaneously lost. The study results are a useful support for the setting of smoking cessation programmes specifically targeted to COPD patients.

Weight gain as a barrier to smoking cessation among military personnel.

PubMed

Russ, C R; Fonseca, V P; Peterson, A L; Blackman, L R; Robbins, A S

2001-01-01

To assess the relationships between active-duty military status, military weight standards, concern about weight gain, and anticipated relapse after smoking cessation. Cross-sectional study. Hospital-based tobacco cessation program. Two hundred fifty-two enrollees, of 253 eligible, to a tobacco cessation program in 1999 (135 men, 117 women; 43% on active duty in the military). Independent variables included gender, body mass index (weight/height2), and military status. Dependent variables included about weight gain with smoking cessation and anticipated relapse. In multivariate regression analyses that controlled for gender and body mass index, active-duty military status was associated with an elevated level of concern about weight gain (1.9-point increase on a 10-point scale; 95% confidence interval [CI], 1.0- to 2.8-point increase), as well as higher anticipated relapse (odds ratio [OR] = 3.6; 95% CI, 1.3 to 9.8). Among subjects who were close to or over the U.S. Air Force maximum allowable weight for height, the analogous OR for active-duty military status was 6.9 (p = .02). Occupational weight standards or expectations may pose additional barriers for individuals contemplating or attempting smoking cessation, as they do among active-duty military personnel. These barriers are likely to hinder efforts to decrease smoking prevalence in certain groups.

Evaluation of intrinsic and extrinsic motivation interventions with a self-help smoking cessation program.

PubMed

Curry, S J; Wagner, E H; Grothaus, L C

1991-04-01

Personalized feedback and a financial incentive, developed from an intrinsic/extrinsic motivation framework, were evaluated as adjuncts to self-help materials for smoking cessation. Ss (N = 1,217) were randomized to 4 treatment groups and were followed up at 3 and 12 months. Consistent with hypotheses derived from the motivation framework, the financial incentive increased the use of self-help materials, did not increase cessation rates among program users, and was associated with higher relapse rates among those who did manage to quit. The personalized feedback increased both smoking cessation and use of the materials 3 months after distribution of the materials. Continuous abstinence (abstinence at 3 and 12 months) in the group that received the personalized feedback alone was twice the rate of the other groups.

Suitability of a Group Behavioural Therapy Module for Workplace Smoking Cessation Programs in Malaysia: a Pilot Study.

PubMed

Maarof, Muhammad Faizal; Ali, Adliah Mhd; Amit, Noh; Bakry, Mohd Makmor; Taha, Nur Akmar

2016-01-01

In Malaysia, data on components suitability the established smoking cessation module is limited. This exploratory study aimed to evaluate the suitability of the components developed in the module for group behavioural therapy in workplace smoking cessation programs. Twenty staff were identified but only eight individuals were selected according to the study criteria during the recruitment period in May 2014. Focus group discussion was conducted to identify themes relevant to the behavioural issues among smokers. Thematic analysis yielded seven major themes which were reasons for regular smoking, reasons for quitting, comprehending smoking characteristics, quit attempt experiences, support and encouragement, learning new skills and behaviour, and preparing for lapse/relapse or difficult situations. As a result, the developed module was found to be relevant and suitable for use based on these themes.

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.

Tobacco interventions for Indigenous Australians: a review of current evidence.

PubMed

Power, Jennifer; Grealy, Claire; Rintoul, Duncan

2009-12-01

This paper reviewed effective interventions for increasing smoking cessation among Indigenous Australians and identified gaps in evidence regarding smoking cessation interventions for Indigenous Australians. A systematic review of academic literature and reports from government and non-government agencies published between 2001 and 2007 was conducted in early 2008. Initial findings from the review were tested using 16 in-depth interviews and two half-day workshops with practitioners and researchers working in the area of Indigenous health. Seven Australian programs for which there had been well-designed, rigorous evaluations were identified. A further four programs were identified that had limited evaluation information available. These studies provide evidence that face-to-face counselling or quit support used in conjunction with nicotine replacement therapy (NRT) is likely to increase quit rates among Indigenous people. Training Aboriginal Health Workers to provide brief smoking cessation intervention with patients is also likely to contribute to increased quit rates. Evidence regarding other interventions is more limited. Evidence indicates that smoking cessation strategies targeted at individuals, such as NRT and/ or counselling, may be effective smoking cessation aids for Indigenous Australians. However, there is no evidence regarding interventions likely to be effective in encouraging more Indigenous Australians to access these quit support strategies.

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.

Development of targeted messages to promote smoking cessation among construction trade workers

PubMed Central

Strickland, J. R.; Smock, N.; Casey, C.; Poor, T.; Kreuter, M. W.; Evanoff, B. A.

2015-01-01

Blue-collar workers, particularly those in the construction trades, are more likely to smoke and have less success in quitting when compared with white-collar workers. Little is known about health communication strategies that might influence this priority population. This article describes our formative work to develop targeted messages to increase participation in an existing smoking cessation program among construction workers. Using an iterative and sequential mixed-methods approach, we explored the culture, health attitudes and smoking behaviors of unionized construction workers. We used focus group and survey data to inform message development, and applied audience segmentation methods to identify potential subgroups. Among 144 current smokers, 65% reported wanting to quit smoking in the next 6 months and only 15% had heard of a union-sponsored smoking cessation program, despite widespread advertising. We tested 12 message concepts and 26 images with the target audience to evaluate perceived relevance and effectiveness. Participants responded most favorably to messages and images that emphasized family and work, although responses varied by audience segments based on age and parental status. This study is an important step towards integrating the culture of a high-risk group into targeted messages to increase participation in smoking cessation activities. PMID:25231165

Perceptions Toward a Smoking Cessation App Targeting LGBTQ+ Youth and Young Adults: A Qualitative Framework Analysis of Focus Groups.

PubMed

Baskerville, N Bruce; Dash, Darly; Wong, Katy; Shuh, Alanna; Abramowicz, Aneta

2016-11-18

The prevalence of smoking among lesbian, gay, bisexual, trans, queer, and other sexual minority (LGBTQ+) youth and young adults (YYA) is significantly higher compared with that among non-LGBTQ+ persons. However, in the past, interventions were primarily group cessation classes that targeted LGBTQ+ persons of all ages. mHealth interventions offer an alternate and modern intervention platform for this subpopulation and may be of particular interest for young LGBTQ+ persons. This study explored LGBTQ+ YYA (the potential users') perceptions of a culturally tailored mobile app for smoking cessation. Specifically, we sought to understand what LGBTQ+ YYA like and dislike about this potential cessation tool, along with how such interventions could be improved. We conducted 24 focus groups with 204 LGBTQ+ YYA (aged 16-29 years) in Toronto and Ottawa, Canada. Participants reflected on how an app might support LGBTQ+ persons with smoking cessation. Participants indicated their feelings, likes and dislikes, concerns, and additional ideas for culturally tailored smoking cessation apps. Framework analysis was used to code transcripts and identify the overarching themes. Study findings suggested that LGBTQ+ YYA were eager about using culturally tailored mobile apps for smoking cessation. Accessibility, monitoring and tracking, connecting with community members, tailoring, connecting with social networks, and personalization were key reasons that were valued for a mobile app cessation program. However, concerns were raised about individual privacy and that not all individuals had access to a mobile phone, users might lose interest quickly, an app would need to be marketed effectively, and app users might cheat and lie about progress to themselves. Participants highlighted that the addition of distractions, rewards, notifications, and Web-based and print versions of the app would be extremely useful to mitigate some of their concerns. This study provided insight into the perspectives of LGBTQ+ YYA on a smoking cessation intervention delivered through a mobile app. The findings suggested a number of components of a mobile app that were valued and those that were concerning, as well as suggestions on how to make a mobile app cessation program successful. App development for this subpopulation should take into consideration the opinions of the intended users and involve them in the development and evaluation of mobile-based smoking cessation programs. ©N Bruce Baskerville, Darly Dash, Katy Wong, Alanna Shuh, Aneta Abramowicz. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 18.11.2016.

Perceived difficulty quitting predicts enrollment in a smoking-cessation program for patients with head and neck cancer.

PubMed

Duffy, Sonia A; Scheumann, Angela L; Fowler, Karen E; Darling-Fisher, Cynthia; Terrell, Jeffrey E

2010-05-01

To determine the predictors of participation in a smoking-cessation program among patients with head and neck cancer. This cross-sectional study is a substudy of a larger, randomized trial of patients with head and neck cancer that determined the predictors of smokers' participation in a cessation intervention. Otolaryngology clinics at three Veterans Affairs medical centers (Ann Arbor, MI, Gainesville, FL, and Dallas, TX), and the University of Michigan Hospital in Ann Arbor. 286 patients who had smoked within six months of the screening survey were eligible for a smoking-cessation intervention. Descriptive statistics and bivariate and multivariate logistic regression were used to determine the independent predictors of smokers' participation in an intervention study. Perceived difficulty quitting (as a construct of self-efficacy), health behaviors (i.e., smoking and problem drinking), clinical characteristics (i.e., depression and cancer site and stage), and demographic variables. Forty-eight percent of those eligible participated. High perceived difficulty quitting was the only statistically significant predictor of participation, whereas problem drinking, lower depressive symptoms, and laryngeal cancer site approached significance. Special outreach may be needed to reach patients with head and neck cancer who are overly confident in quitting, problem drinkers, and patients with laryngeal cancer. Oncology nurses are in an opportune position to assess patients' perceived difficulty quitting smoking and motivate them to enroll in cessation programs, ultimately improving quality of life, reducing risk of recurrence, and increasing survival for this population.

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.

User Preferences for a Text Message-Based Smoking Cessation Intervention

ERIC Educational Resources Information Center

Bock, Beth C.; Heron, Kristin E.; Jennings, Ernestine G.; Magee, Joshua C.; Morrow, Kathleen M.

2013-01-01

Younger adults are more likely to smoke and less likely to seek treatment than older smokers. They are also frequent users of communication technology. In the current study, we conducted focus groups to obtain feedback about preferences for a text message-based smoking cessation program from potential users. Participants ("N" = 21, "M" age = 25.6…

Coping Strategies Used by Adolescents during Smoking Cessation

ERIC Educational Resources Information Center

Jannone, Laura; O'Connell, Kathleen A.

2007-01-01

The purpose of this study was to examine coping strategies used by teens as they attempted to quit smoking. The teens were attending a school-based cessation program titled "Quit 2 Win" that was offered in four high schools. This study examined situations in which teens were tempted to smoke. The study compares coping strategies teens reported in…

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.

State Medicaid Coverage for Tobacco Cessation Treatments and Barriers to Accessing Treatments - United States, 2015-2017.

PubMed

DiGiulio, Anne; Jump, Zach; Yu, Annie; Babb, Stephen; Schecter, Anna; Williams, Kisha-Ann S; Yembra, Debbie; Armour, Brian S

2018-04-06

Cigarette smoking prevalence among Medicaid enrollees (25.3%) is approximately twice that of privately insured Americans (11.8%), placing Medicaid enrollees at increased risk for smoking-related disease and death (1). Medicaid spends approximately $39 billion annually on treating smoking-related diseases (2). Individual, group, and telephone counseling and seven Food and Drug Administration (FDA)-approved medications* are effective in helping tobacco users quit (3). Although state Medicaid coverage of tobacco cessation treatments improved during 2014-2015, coverage was still limited in most states (4). To monitor recent changes in state Medicaid cessation coverage for traditional (i.e., nonexpansion) Medicaid enrollees, the American Lung Association collected data on coverage of a total of nine cessation treatments: individual counseling, group counseling, and seven FDA-approved cessation medications † in state Medicaid programs during July 1, 2015-June 30, 2017. The American Lung Association also collected data on seven barriers to accessing covered treatments, such as copayments and prior authorization. As of June 30, 2017, 10 states covered all nine of these treatments for all enrollees, up from nine states as of June 30, 2015; of these 10 states, Missouri was the only state to have removed all seven barriers to accessing these cessation treatments. State Medicaid programs that cover all evidence-based cessation treatments, remove barriers to accessing these treatments, and promote covered treatments to Medicaid enrollees and health care providers would be expected to reduce smoking, smoking-related disease, and smoking-attributable federal and state health care expenditures (5-7).

Helping Smokers Quit: The Smoking Cessation Leadership Center Engages Behavioral Health by Challenging Old Myths and Traditions.

PubMed

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

2018-01-01

Smoking is much more common among persons with behavioral health conditions (mental illnesses and/or substance use disorders). Persons with these disorders are more likely to die from smoking-related causes than any other reason. Studies have shown that stopping smoking can improve mental health function, as well as improve outcomes for substance use disorders. Yet, for a variety of reasons, smoking cessation has not been integrated into the treatment of behavioral health conditions, and in many instances tobacco use was not only condoned but encouraged. Beginning in 2007, the Smoking Cessation Leadership Center (SCLC) began engaging relevant agencies in an attempt to stimulate more vigorous smoking cessation activities. Partners included the federal Substance Abuse and Mental Health Services Administration, advocacy organizations such as the National Alliance on Mental Illness and Community Anti-Drug Coalitions of America, and clinical groups such as the American Psychiatric Nurses Association, the American Psychiatric Association, American Psychological Association, National Council on Behavioral Health, and National Association of State Mental Health Program Directors. A signature program featured 16 individual state summits involving agencies and groups from multiple sectors, all aiming to lower smoking rates in behavioral health populations. These activities mark an evolving culture change within behavioral health.

Process of smoking cessation. Implications for clinicians.

PubMed

Prochaska, J O; Goldstein, M G

1991-12-01

The process of smoking cessation involves progression through five stages of change: precontemplation, contemplation, preparation, action, and maintenance. Most patients are not prepared to take action on their smoking, yet most smoking cessation programs are designed for smokers who are so prepared. Small percentages of smokers register for action-oriented cessation programs. How much progress patients make after an intervention is directly related to what stage they are in prior to intervention. The stages of change can be quickly assessed with four questions. Physicians can then be more effective with a broader range of patients by matching their interventions to the patients' stage of change. Helping patients progress just one stage can double their chances of not smoking 6 months later. Providing personalized information about the cons of smoking, asking affect-arousing questions, and encouraging patients to re-evaluate themselves as smokers are interventions physicians can use to help patients who are not prepared to quit smoking. Behavioral interventions, such as providing substitutes like nicotine gum and removing or altering cues for smoking, are most helpful for patients who are ready to take action. The use of a stage-matched, patient-centered counseling intervention can help physicians to feel less frustrated and more effective in their efforts to help a broad range of their patients.

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.

[Quality and effectiveness of smoking cessation interventions in workplaces sites].

PubMed

Iwanowicz, Eliza

2008-01-01

According to the survey carried out by the National Centre for Workplace Health Promotion at the Nofer Institute of Occupational Medicine, the level and quality of smoking cessation interventions implemented in Polish enterprises are insufficient. Therefore, the dissemination of good practices in this field is needed. The paper presents (on the basis of the literature review) chosen outcomes of the research focused on the effectiveness of workplace smoking cessation interventions. These are mostly methods influencing the turnout in such programs as well as reduction of smoking in the workplace. According to the papers in question, partnership relationships between the organizers of the program and its participants as well as ensuring the employees in the process of quitting various forms of social support are factors, which may contribute to effective reduction of smoking in the workplace. It seems necessary to increase awareness of this issue among Polish managers.

Community smoking cessation contests: an effective public health strategy.

PubMed

Leinweber, C E; Macdonald, J M; Campbell, H S

1994-01-01

This report describes the follow-up of a community-sponsored smoking cessation contest. The aims of the evaluation were to describe the characteristics of contestants and the quit rates at six weeks, six months and one year. The "Quit to Win" contest was held as part of a larger cancer prevention program in Medicine Hat, Alberta. In order to be eligible for prizes, contestants were required to be smoke-free for six weeks and have their smoking status verified by a "Buddy". Contestants were contacted by telephone at the end of the contest and again at six months and one year. Seventy-five individuals entered the contest. The quit rates, 56%, 27% and 21% at six weeks, six months and one year respectively, compare favourably with other smoking cessation interventions. This study demonstrates that a community-based program can reach a variety of smokers with a relatively simple intervention.

Improving Adherence to Smoking Cessation Treatment: Intervention Effects in a Web-Based Randomized Trial.

PubMed

Graham, Amanda L; Papandonatos, George D; Cha, Sarah; Erar, Bahar; Amato, Michael S; Cobb, Nathan K; Niaura, Raymond S; Abrams, David B

2017-03-01

Web-based smoking cessation interventions can deliver evidence-based treatments to a wide swath of the population, but effectiveness is often limited by insufficient adherence to proven treatment components. This study evaluated the impact of a social network (SN) intervention and free nicotine replacement therapy (NRT) on adherence to evidence-based components of smoking cessation treatment in the context of a Web-based intervention. A sample of adult U.S. smokers (N = 5290) was recruited via BecomeAnEX.org, a free smoking cessation Web site. Smokers were randomized to one of four arms: (1) an interactive, evidence-based smoking cessation Web site (WEB) alone; (2) WEB in conjunction with an SN intervention designed to integrate participants into the online community (WEB+SN); (3) WEB plus free NRT (WEB+NRT); and (4) the combination of all treatments (WEB+SN+NRT). Adherence outcomes assessed at 3-month follow-up were as follows: Web site utilization metrics, use of skills training components, intratreatment social support, and pharmacotherapy use. WEB+SN+NRT outperformed all others on Web site utilization metrics, use of practical counseling tools, intratreatment social support, and NRT use. It was the only intervention to promote the sending of private messages and the viewing of community pages over WEB alone. Both social network arms outperformed WEB on most metrics of online community engagement. Both NRT arms showed higher medication use compared to WEB alone. This study demonstrated the effectiveness of two approaches for improving adherence to evidence-based components of smoking cessation treatment. Integrated approaches to medication provision and social network engagement can enhance adherence to components known to improve cessation. This study demonstrated that an integrated approach to medication provision and social network integration, when delivered through an online program, can enhance adherence across all three recommended components of an evidence-based smoking cessation program (skills training, social support, and pharmacotherapy use). Nicotine replacement therapy-when provided as part of an integrated program-increases adherence to other program elements, which in turn augment its own therapeutic effects. An explicit focus on approaches to improve treatment adherence is an important first step to identifying leverage points for optimizing intervention effectiveness. © The Author 2016. 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 National Survey of Tobacco Cessation Programs for Youths

PubMed Central

Curry, Susan J.; Emery, Sherry; Sporer, Amy K.; Mermelstein, Robin; Flay, Brian R.; Berbaum, Michael; Warnecke, Richard B.; Johnson, Timothy; Mowery, Paul; Parsons, Jennifer; Harmon, Lori; Hund, Lisa; Wells, Henry

2007-01-01

Objectives. We collected data on a national sample of existing community-based tobacco cessation programs for youths to understand their prevalence and overall characteristics. Methods. We employed a 2-stage sampling design with US counties as the first-stage probability sampling units. We then used snowball sampling in selected counties to identify administrators of tobacco cessation programs for youths. We collected data on cessation programs when programs were identified. Results. We profiled 591 programs in 408 counties. Programs were more numerous in urban counties; fewer programs were found in low-income counties. State-level measures of smoking prevalence and tobacco control expenditures were not associated with program availability. Most programs were multisession, school-based group programs serving 50 or fewer youths per year. Program content included cognitive-behavioral components found in adult programs along with content specific to adolescence. The median annual budget was $2000. Few programs (9%) reported only mandatory enrollment, 35% reported mixed mandatory and voluntary enrollment, and 56% reported only voluntary enrollment. Conclusions. There is considerable homogeneity among community-based tobacco cessation programs for youths. Programs are least prevalent in the types of communities for which national data show increases in youths’ smoking prevalence. PMID:17138932

Smoking cessation after 12 months with multi-component therapy.

PubMed

Raich, Antònia; Martínez-Sánchez, Jose Maria; Marquilles, Emili; Rubio, Lídia; Fu, Marcela; Fernández, Esteve

2015-03-01

Smoking is one of the most important causes of morbidity and mortality in developed countries. One of the priorities of public health programmes is the reduction of its prevalence, which would involve millions of people quitting smoking, but cessation programs often have modest results, especially within certain population groups. The aim of this study was to analyze the variables determining the success of a multicomponent therapy programme for smoking cessation. We conducted the study in the Smoking Addiction Unit at the Hospital of Manresa, with 314 patients (91.4% of whom had medium or high-level dependency). We observed that higher educational level, not living with a smoker, following a multimodal programme or smoking cessation with psychological therapy, and pharmacological treatment are relevant factors for quitting smoking. Abstinence rates are not associated with other factors, such as sex, age, smoking behaviour characteristics or psychiatric history. The combination of pharmacological and psychological treatment increased success rates in multicomponent therapy. Psychological therapy only also obtained positive results, though somewhat more modest.

Health risk behaviors in smoking and non-smoking young women.

PubMed

Kelley, Frances J; Thomas, Sue Ann; Friedmann, Erika

2003-04-01

To compare the health, health risk behaviors and stress levels of college female smokers and non-smokers. Forty-one college women, ages 18-21 years, participated in an interview and completed a health survey and the Derogatis Stress Profile. The smokers perceived themselves to be more overweight (Chi square, p = < .001). Smokers used more marijuana (Chi square, p = < .003) and had higher scores on depression [t (39) = 2.29, p = .028], hostility [t (39) = 2.562, p = .014] and perceived quality of health [t (39) = 2.72, p = .01]. In the interview, smokers identified social situations involving alcohol as the time they would most likely smoke. Smokers did not smoke when ill and all were interested in quitting. The non-smoking women support smoking cessation for their peers. College alcohol and substance use prevention and treatment programs should address tobacco cessation. The majority of college women are not smokers and could be resources to encourage smoking cessation among their peers. Smoking cessation at this age has dramatic implications for future health.

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.

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.

Tobacco control recommendations identified by LGBT Atlantans in a community-based participatory research project.

PubMed

Bryant, Lawrence; Damarin, Amanda K; Marshall, Zack

2014-01-01

Lesbian, gay, bisexual, and transgender (LGBT) people are increasingly aware that disproportionately high smoking rates severely impact the health of their communities. Motivated to make a change, a group of LGBT community members, policymakers, and researchers from Atlanta carried out a community-based participatory research (CBPR) project. This formative research study sought to identify recommendations for culturally relevant smoking prevention and cessation interventions that could improve the health of Atlanta's LGBT communities. Data presented here come from four focus groups with 36 participants and a community meeting with 30 participants. Among study participants, the most favored interventions were providing LGBT-specific cessation programs, raising awareness about LGBT smoking rates, and getting community venues to go smoke-free. Participants also suggested providing reduced-cost cessation products for low-income individuals, using LGBT "role models" to promote cessation, and ensuring that interventions reach all parts of the community. Findings reinforce insights from community-based research with other marginalized groups. Similarities include the importance of tailoring cessation programs for specific communities, the need to acknowledge differences within communities, and the significance of community spaces in shaping discussions of cessation. Further, this study highlights the need for heightened awareness. The Atlanta LGBT community is largely unaware that high smoking rates affect its health, and is unlikely to take collective action to address this problem until it is understood.

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.

Smoking cessation intervention within the framework of a lung cancer screening program: preliminary results and clinical perspectives from the "Cosmos-II" Trial.

PubMed

Filippo, Lococo; Principe, Rosastella; Cesario, Alfredo; Apolone, Giovanni; Carleo, Francesco; Ialongo, Pasquale; Veronesi, Giulia; Cardillo, Giuseppe

2015-02-01

Data coming from the literature investigating the effectiveness and interaction between smoking cessation (SC) and lung cancer screening (LCScr) are still sparse and inconsistent. Herein, we report the preliminary results from the ongoing lung cancer screening trial ("Cosmos-II") focusing our analysis on the inter-relationship between the SC program and the LCScr.

A Pragmatic Randomized Trial Comparing Telephone-Based Enhanced Pharmacy Care and Usual Care to Support Smoking Cessation.

PubMed

Gong, Jason; Baker, Christine L; Zou, Kelly H; Bruno, Marianna; Jumadilova, Zhanna; Lawrence, David; Wilson, Beth; Ewel, Cynthia

2016-12-01

Smoking is the leading preventable cause of death, and tobacco control professionals continue to make progress in cessation efforts. Pharmacists can assist smokers seeking to quit by offering counseling on smoking cessation pharmacotherapies. Pragmatic randomized trials are useful for investigating practical questions about an intervention's risks, benefits, and costs in routine clinical practice. To evaluate an enhanced pharmacy care (EPC) program involving personalized pharmacist-provided telephone counseling for supporting prescription smoking cessation medications compared with usual care (UC). Cigarette smokers filling a newly prescribed smoking cessation pharmacotherapy and with pharmacy benefits managed by Express Scripts were recruited. Qualified subjects were randomized 1:1 to EPC and UC. Subjects in EPC received 3 telephone-counseling sessions from specialist pharmacists during the early course of the study, while subjects in UC did not receive any counseling sessions. Study outcomes were collected through telephone contact and using the Express Scripts prescription database. The primary outcome assessed the 1-week point prevalence (PP) of smoking abstinence at the end of the trial (week 12). Secondary outcomes included 4-week PP at week 12 and adherence, evaluated by proportion of days covered (PDC), to prescribed smoking cessation pharmacotherapies. There were 1,017 randomized subjects. Among them, 1,002 subjects were included in the analysis, and 513 were randomized into EPC and 489 into UC. Baseline demographics, smoking history, and prescribed smoking cessation pharmacotherapies were comparable. Varenicline and nicotine replacement therapy (NRT) were most frequently prescribed for smoking cessation. In EPC, 46.0% received all 3 counseling sessions; 29.4% received 2 sessions; and 14.6% received 1 session. Overall, 353 subjects in EPC and 383 subjects in UC completed the week 12 assessment. In the analysis for 1-week PP of smoking abstinence at week 12, the percentage of abstainers in EPC was numerically higher than in UC (42.3% vs. 38.2%) with OR = 1.24, 95% CI = 0.96-1.61. It was not statistically significant. Adherence to prescription smoking cessation medication was significantly higher in EPC versus UC (49.7% vs. 45.6%; P = 0.033). This study evaluated whether a telephone-based pharmacy care program, provided by pharmacists and designed to support attempted quitters, improved quitting and increased adherence over usual care. The findings suggest that an enhanced program may benefit smokers by increasing prescription smoking cessation medication adherence. Future research should explore this program's effect on smokers who are compliant, based on insights on quitting provided by the post hoc analyses and limitations of the current study design. This study was sponsored by Pfizer. Gong, Baker, Zou, Bruno, Jumadilova, and Lawrence are employees and stockholders of Pfizer. Wilson and Ewel are employees of United BioSource Corporation, which received funding from Pfizer for conducting this study and for the development of this manuscript. Study concept and design were contributed by Gong, Bruno, and Ewel, with assistance from Jumadilova, Lawrence, and Zou. Gong, Jumadilova, Lawrence, and Ewel collected the data. Data interpretation was performed by Baker, Zou, and Wilson, assisted by Gong, Lawrence, and Ewel. The manuscript was written by Baker, Ewel, and Gong, with assistance from the other authors, and revised by Baker, Wilson, Zou, and Gong, with assistance from Bruno and Jumadilova.

A randomized controlled trial of smartphone-based mindfulness training for smoking cessation: a study protocol.

PubMed

Garrison, Kathleen A; Pal, Prasanta; Rojiani, Rahil; Dallery, Jesse; O'Malley, Stephanie S; Brewer, Judson A

2015-04-14

Tobacco use is responsible for the death of about 1 in 10 individuals worldwide. Mindfulness training has shown preliminary efficacy as a behavioral treatment for smoking cessation. Recent advances in mobile health suggest advantages to smartphone-based smoking cessation treatment including smartphone-based mindfulness training. This study evaluates the efficacy of a smartphone app-based mindfulness training program for improving smoking cessation rates at 6-months follow-up. A two-group parallel-randomized clinical trial with allocation concealment will be conducted. Group assignment will be concealed from study researchers through to follow-up. The study will be conducted by smartphone and online. Daily smokers who are interested in quitting smoking and own a smartphone (n = 140) will be recruited through study advertisements posted online. After completion of a baseline survey, participants will be allocated randomly to the control or intervention group. Participants in both groups will receive a 22-day smartphone-based treatment program for smoking. Participants in the intervention group will receive mobile mindfulness training plus experience sampling. Participants in the control group will receive experience sampling-only. The primary outcome measure will be one-week point prevalence abstinence from smoking (at 6-months follow-up) assessed using carbon monoxide breath monitoring, which will be validated through smartphone-based video chat. This is the first intervention study to evaluate smartphone-based delivery of mindfulness training for smoking cessation. Such an intervention may provide treatment in-hand, in real-world contexts, to help individuals quit smoking. Clinicaltrials.gov NCT02134509 . Registered 7 May 2014.

Exploring the adequacy of smoking cessation support for pregnant and postpartum women

PubMed Central

2013-01-01

Background Smoking in pregnancy exemplifies the relationship between tobacco use and health inequalities. While difficulty reaching and engaging this population in cessation support is often highlighted in the literature, there is limited research that explores the factors that shape the provision and use of support by this subpopulation. Using Ontario, Canada, as a case study, this study examines how the use of cessation support by women is encouraged or discouraged by cessation policy, programming and practice; how geographical and sociocultural factors influence provision and uptake of support; and how barriers and challenges can be addressed through a comprehensive approach. Methods Semi-structured, in-depth interviews with key informants (31) and pregnant or postpartum women (29) were conducted to examine the cessation needs of this subpopulation, barriers to the provision and uptake of cessation support and directions for policy, service provision and programming. Results Key barriers included: the absence of a provincial cessation strategy and funding, capacity and engagement/accessibility issues. Geographical features presented additional challenges to provision/uptake, as did the absence of resources tailored to Aboriginal women and adolescents. Key informants recommended a comprehensive cessation strategy to facilitate coordination of cessation resources provincially and locally and elucidated the need for capacity building within tobacco control and within reproductive, child and maternal health. Participants also highlighted the need to further develop tobacco control policies and target the social determinants of health through poverty reduction, housing and education support. The provision of incentives, transportation, childcare and meals/snacks; adoption of woman-centred, harm-reduction and stigma reduction approaches; and promotion of programs through a variety of local venues were recommended by participants to address engagement and accessibility issues. Conclusions The current cessation system in Ontario is not equipped to adequately reduce smoking among pregnant and postpartum women. A comprehensive, multi-sector strategy designed to provide tailored and sustainable support through different system entry points is needed. A cultural shift in practice is also necessary to eliminate mixed messaging, strengthen practice and encourage open channels of communication about smoking between women and their providers. The study highlights the need to address smoking among women in a more holistic manner and for capacity building strategies that focus on strengthening providers’ competency and confidence in practice. Future research should explore: capacity building strategies, especially among rural and remote communities; the smoking and cessation experiences of different subpopulations of pregnant and postpartum women; the effectiveness of tailored strategies; and interventions that address smoking among partners and other family members. PMID:23672201

Pilot clinic study of Project EX for smoking cessation with Spanish adolescents.

PubMed

Espada, José P; Gonzálvez, María T; Orgilés, Mireia; Guillén-Riquelme, Alejandro; Soto, Daniel; Sussman, Steve

2015-06-01

Despite efforts to prevent smoking, the prevalence of smoking in Spanish adolescents remains high. So far, there are no evidence-based smoking cessation programs for adolescents in Spain. This study describes the evaluation of Project EX, an eight-session school-based clinic smoking cessation program, with Spanish cigarette smokers 13-19 years of age, from 9 schools (four program condition schools and five control condition schools). A group-randomized controlled trial was used. There were 211 smokers at baseline (112 program group, and 99 control group). Evaluation involved an immediate pretest and posttest survey (administered five-weeks later) and six-month follow-up (after the immediate posttest). At immediate posttest, Project EX significantly reduced future nicotine dependence scores (mFTQ; p<.001), and increased intention to quit smoking (p<.001), and led to a higher previous day (prior to assessment) quit rate (p<.03). At the six-month follow-up, the percentage of quitters in the program group was 14.28%, whereas no smokers quit smoking in the control group (p<.04), and Project EX had a significant influence on future smoking expectation (p=.006) and overall level of 30-day smoking. Results for the Project EX school-based clinic are promising for adolescent smokers in Spain, although difficulties in recruitment and high attrition are of concern. Findings and limitations are discussed and suggestions for future research are suggested. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effectiveness of a Web-based multiple tailored smoking cessation program: a randomized controlled trial among Dutch adult smokers.

PubMed

Smit, Eline Suzanne; de Vries, Hein; Hoving, Ciska

2012-06-11

Distributing a multiple computer-tailored smoking cessation intervention through the Internet has several advantages for both provider and receiver. Most important, a large audience of smokers can be reached while a highly individualized and personal form of feedback can be maintained. However, such a smoking cessation program has yet to be developed and implemented in The Netherlands. To investigate the effects of a Web-based multiple computer-tailored smoking cessation program on smoking cessation outcomes in a sample of Dutch adult smokers. Smokers were recruited from December 2009 to June 2010 by advertising our study in the mass media and on the Internet. Those interested and motivated to quit smoking within 6 months (N = 1123) were randomly assigned to either the experimental (n = 552) or control group (n = 571). Respondents in the experimental group received the fully automated Web-based smoking cessation program, while respondents in the control group received no intervention. After 6 weeks and after 6 months, we assessed the effect of the intervention on self-reported 24-hour point prevalence abstinence, 7-day point prevalence abstinence, and prolonged abstinence using logistic regression analyses. Of the 1123 respondents, 449 (40.0%) completed the 6-week follow-up questionnaire and 291 (25.9%) completed the 6-month follow-up questionnaire. We used a negative scenario to replace missing values. That is, we considered respondents lost to follow-up to still be smoking. The computer-tailored program appeared to have significantly increased 24-hour point prevalence abstinence (odds ratio [OR] 1.85, 95% confidence interval [CI] 1.30-2.65), 7-day point prevalence abstinence (OR 2.17, 95% CI 1.44-3.27), and prolonged abstinence (OR 1.99, 95% CI 1.28-3.09) rates reported after 6 weeks. After 6 months, however, no intervention effects could be identified. Results from complete-case analyses were similar. The results presented suggest that the Web-based computer-tailored smoking cessation program had a significant effect on abstinence reported after a 6-week period. At the 6-month follow-up, however, no intervention effects could be identified. This might be explained by the replacement of missing values on the primary outcome measures due to attrition using a negative scenario. While results were similar when using a less conservative scenario (ie, complete-case analyses), the results should still be interpreted with caution. Further research should aim at identifying strategies that will prevent high attrition in the first place and, subsequently, to identify the best strategies for dealing with missing data when studies have high attrition rates. Dutch Trial Register NTR1351; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1351 (Archived by WebCite at http://www.webcitation.org/67egSTWrz).

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

Public Health Clinical Demonstration Project for Smoking Cessation in Veterans with Posttraumatic Stress Disorder

PubMed Central

Dedert, Eric A.; Wilson, Sarah M.; Calhoun, Patrick S.; Moore, Scott D.; Hamlett-Berry, Kim W.; Beckham, Jean C.

2009-01-01

Veterans with posttraumatic stress disorder are at high risk for smoking and experience difficulty with smoking cessation. We designed this clinical demonstration project to provide a low-cost, feasibly implemented smoking cessation intervention that would maximize the number of smokers who accessed the intervention. Five hundred eighty-four veteran smokers were contacted by invitational letters. Interested veterans received follow-up telephone calls using standardized scripts offering three intervention resources: 1) a referral to the National Cancer Institute’s Smoking Quitline, 2) web-based counseling, and 3) local Veteran Affairs pharmacologic treatment for smoking cessation. Twenty-three percent of survey recipients participated in the clinical program. Two months after these resources were offered by phone, follow-up phone calls indicated that 25% of participants providing follow-up information reported maintaining smoking abstinence. This clinical demonstration project was associated with a 2.6% impact (i.e., reach [31.1% of smokers accessed intervention] by efficacy [8.4% of those accessing intervention quit]), meaning that 2.6% of the total number of targeted smokers reported 8 week abstinence. Results suggested that this brief, low-cost intervention was feasible and promoted smoking cessation in veterans with posttraumatic stress disorder. PMID:19737675

Perceived Difficulty Quitting Predicts Enrollment in a Smoking-Cessation Program for Patients With Head and Neck Cancer

PubMed Central

Duffy, Sonia A.; Scheumann, Angela L.; Fowler, Karen E.; Darling-Fisher, Cynthia; Terrell, Jeffrey E.

2013-01-01

Purpose/Objectives To determine the predictors of participation in a smoking-cessation program among patients with head and neck cancer. Design This cross-sectional study is a substudy of a larger, randomized trial of patients with head and neck cancer that determined the predictors of smokers’ participation in a cessation intervention. Setting Otolaryngology clinics at three Veterans Affairs medical centers (Ann Arbor, MI, Gainesville, FL, and Dallas, TX), and the University of Michigan Hospital in Ann Arbor. Sample 286 patients who had smoked within six months of the screening survey were eligible for a smoking-cessation intervention. Methods Descriptive statistics and bivariate and multivariate logistic regression were used to determine the independent predictors of smokers’ participation in an intervention study. Main Research Variables Perceived difficulty quitting (as a construct of self-efficacy), health behaviors (i.e., smoking and problem drinking), clinical characteristics (i.e., depression and cancer site and stage), and demographic variables. Findings Forty-eight percent of those eligible participated. High perceived difficulty quitting was the only statistically significant predictor of participation, whereas problem drinking, lower depressive symptoms, and laryngeal cancer site approached significance. Conclusions Special outreach may be needed to reach patients with head and neck cancer who are overly confident in quitting, problem drinkers, and patients with laryngeal cancer. Implications for Nursing Oncology nurses are in an opportune position to assess patients’ perceived difficulty quitting smoking and motivate them to enroll in cessation programs, ultimately improving quality of life, reducing risk of recurrence, and increasing survival for this population. PMID:20439219

[Counseling interventions for smoking cessation: systematic review].

PubMed

Alba, Luz Helena; Murillo, Raúl; Castillo, Juan Sebastián

2013-04-01

A systematic review on efficacy and safety of smoking cessation counseling was developed. The ADAPTE methodology was used with a search of Clinical Practice Guidelines (CPG) in Medline, EMBASE, CINAHL, LILACS, and Cochrane. DELBI was used to select CPG with score over 60 in methodological rigor and applicability to the Colombian health system. Smoking cessation rates at 6 months were assessed according to counseling provider, model, and format. In total 5 CPG out of 925 references were selected comprising 44 systematic reviews and meta-analyses. Physician brief counseling and trained health professionals' intensive counseling (individual, group, proactive telephone) are effective with abstinence rates between 2.1% and 17.4%. Only practical counseling and motivational interview were found effective intensive interventions. The clinical effect of smoking cessation counseling is low and long term cessation rates uncertain. Cost-effectiveness analyses are recommended for the implementation of counseling in public health programs.

Aboriginal health workers experience multilevel barriers to quitting smoking: a qualitative study.

PubMed

Dawson, Anna P; Cargo, Margaret; Stewart, Harold; Chong, Alwin; Daniel, Mark

2012-05-23

Long-term measures to reduce tobacco consumption in Australia have had differential effects in the population. The prevalence of smoking in Aboriginal peoples is currently more than double that of the non-Aboriginal population. Aboriginal Health Workers are responsible for providing primary health care to Aboriginal clients including smoking cessation programs. However, Aboriginal Health Workers are frequently smokers themselves, and their smoking undermines the smoking cessation services they deliver to Aboriginal clients. An understanding of the barriers to quitting smoking experienced by Aboriginal Health Workers is needed to design culturally relevant smoking cessation programs. Once smoking is reduced in Aboriginal Health Workers, they may then be able to support Aboriginal clients to quit smoking. We undertook a fundamental qualitative description study underpinned by social ecological theory. The research was participatory, and academic researchers worked in partnership with personnel from the local Aboriginal health council. The barriers Aboriginal Health Workers experience in relation to quitting smoking were explored in 34 semi-structured interviews (with 23 Aboriginal Health Workers and 11 other health staff) and 3 focus groups (n = 17 participants) with key informants. Content analysis was performed on transcribed text and interview notes. Aboriginal Health Workers spoke of burdensome stress and grief which made them unable to prioritise quitting smoking. They lacked knowledge about quitting and access to culturally relevant quitting resources. Interpersonal obstacles included a social pressure to smoke, social exclusion when quitting, and few role models. In many workplaces, smoking was part of organisational culture and there were challenges to implementation of Smokefree policy. Respondents identified inadequate funding of tobacco programs and a lack of Smokefree public spaces as policy level barriers. The normalisation of smoking in Aboriginal society was an overarching challenge to quitting. Aboriginal Health Workers experience multilevel barriers to quitting smoking that include personal, social, cultural and environmental factors. Multidimensional smoking cessation programs are needed that reduce the stress and burden for Aboriginal Health Workers; provide access to culturally relevant quitting resources; and address the prevailing normalisation of smoking in the family, workplace and community.

Aboriginal Health Workers experience multilevel barriers to quitting smoking: a qualitative study

PubMed Central

2012-01-01

Introduction Long-term measures to reduce tobacco consumption in Australia have had differential effects in the population. The prevalence of smoking in Aboriginal peoples is currently more than double that of the non-Aboriginal population. Aboriginal Health Workers are responsible for providing primary health care to Aboriginal clients including smoking cessation programs. However, Aboriginal Health Workers are frequently smokers themselves, and their smoking undermines the smoking cessation services they deliver to Aboriginal clients. An understanding of the barriers to quitting smoking experienced by Aboriginal Health Workers is needed to design culturally relevant smoking cessation programs. Once smoking is reduced in Aboriginal Health Workers, they may then be able to support Aboriginal clients to quit smoking. Methods We undertook a fundamental qualitative description study underpinned by social ecological theory. The research was participatory, and academic researchers worked in partnership with personnel from the local Aboriginal health council. The barriers Aboriginal Health Workers experience in relation to quitting smoking were explored in 34 semi-structured interviews (with 23 Aboriginal Health Workers and 11 other health staff) and 3 focus groups (n = 17 participants) with key informants. Content analysis was performed on transcribed text and interview notes. Results Aboriginal Health Workers spoke of burdensome stress and grief which made them unable to prioritise quitting smoking. They lacked knowledge about quitting and access to culturally relevant quitting resources. Interpersonal obstacles included a social pressure to smoke, social exclusion when quitting, and few role models. In many workplaces, smoking was part of organisational culture and there were challenges to implementation of Smokefree policy. Respondents identified inadequate funding of tobacco programs and a lack of Smokefree public spaces as policy level barriers. The normalisation of smoking in Aboriginal society was an overarching challenge to quitting. Conclusions Aboriginal Health Workers experience multilevel barriers to quitting smoking that include personal, social, cultural and environmental factors. Multidimensional smoking cessation programs are needed that reduce the stress and burden for Aboriginal Health Workers; provide access to culturally relevant quitting resources; and address the prevailing normalisation of smoking in the family, workplace and community. PMID:22621767

Impact of educational outreach visits on smoking cessation activities performed by specialist physicians: a randomized trial.

PubMed

Etter, Jean-François

2006-07-01

To find out whether educational visits by a nurse to specialist physicians improved their self-reporting of smoking cessation activities; whether these visits increased the percentage of physicians who were aware of and recommended a computer-tailored smoking cessation program and who participated in a training workshop on tobacco dependency treatment. Specialist private practice physicians (n = 523) working in Geneva, Switzerland were randomly assigned to either receiving (n = 261) or not receiving (n = 262) a single 40-minute visit by a trained nurse in 2003. The physicians answered a postal questionnaire 5 months after the visits indicating the percentage of their patients they counselled or treated for tobacco dependency and we recorded whether physicians took part in the workshop. Only half (53%) of the physicians agreed to receive a visit. At follow-up more physicians in the intervention group than in the control group were aware of the computer-tailored program (73% vs. 39%, p < 0.001) and more physicians in the intervention group said they recommended the use of this program to more patients (20% vs. 10%, p = 0.009). Among non-smoking physicians only, the proportion of patients who were advised to quit smoking was higher in the intervention than in the control group (69% vs. 54%, p = 0.019, as reported by physicians). The intervention had no impact on physicians' participation in the workshop. Visits by a nurse increased the proportion of physicians who recommended to their patients the use of a computer-tailored smoking cessation program. Among non-smoking physicians only, the intervention increased the proportion of patients who received the advice to quit smoking, as reported by physicians.

Addressing Smoking in Supported Residential Facilities for People with Severe Mental Illness: Has Any Progress Been Achieved?

PubMed Central

Lawn, Sharon; Lucas, Teri

2016-01-01

Background: Smoking rates for people with severe mental illness have remained high despite significant declines in smoking rates in the general population, particularly for residents of community supported residential facilities (SRFs) where smoking has been largely neglected and institutionalized. Methods: Two studies undertaken 10 years apart (2000 and 2010) with SRFs in Adelaide, Australia looked at historical trends to determine whether any progress has been made to address smoking for this population. The first study was ethnographic and involved narrative description and analysis of the social milieu of smoking following multiple observations of smoking behaviours in two SRFs. The second study involved an eight-week smoking cessation group program providing tailored support and free nicotine replacement therapy to residents across six SRFs. Changes in smoking behaviours were measured using pre and post surveys with residents, with outcomes verified by also seeking SRF staff and smoking cessation group facilitator qualitative feedback and reflection on their observations of residents and the setting. Results: The culture of smoking in mental health SRFs is a complex part of the social milieu of these settings. There appears to have been little change in smoking behaviours of residents and attitudes and support responses by staff of SRFs since 2000 despite smoking rates declining in the general community. Tailored smoking cessation group programs for this population were well received and did help SRF residents to quit or cut down their smoking. They did challenge staff negative attitudes to residents’ capacity to smoke less or quit. Conclusions: A more systematic approach that addresses SRF regulations, smoke-free policies, staff attitudes and training, and consistent smoking cessation support to residents is needed. PMID:27735881

Association of Smoking Cessation With Financial Stress and Material Well-Being: Results From a Prospective Study of a Population-Based National Survey

PubMed Central

Siahpush, Mohammad; Spittal, Matt; Singh, Gopal K

2007-01-01

Objectives. We used 4 waves of prospective data to examine the association of smoking cessation with financial stress and material well-being. Methods. Data (n = 5699 at baseline) came from 4 consecutive waves (2001–2005) of the Household Income and Labour Dynamics in Australia survey. We used mixed models to examine the participant-specific association of smoking cessation with financial stress and material well-being. Results. On average, a smoker who quits is expected to have a 25% reduction (P<.001; odds ratio [OR]=0.75; 95% confidence interaval [CI]=0.69, 0.81) in the odds of financial stress. Similarly, the data provided strong evidence (P<.001) that a smoker who quits is likely to experience an enhanced level of material well-being. Conclusions. Our findings indicate that interventions to encourage smoking cessation are likely to improve standards of living and reduce deprivation. The findings provide grounds for encouraging the social services sector to incorporate smoking cessation efforts into their programs to enhance the material or financial conditions of disadvantaged groups. The findings also provide additional incentives for smokers to stop smoking and as such can be used in antismoking campaigns and by smoking cessation services. PMID:17971550

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

Is Weight Gain after Smoking Cessation Inevitable?

ERIC Educational Resources Information Center

Talcott, Gerald W.; And Others

1995-01-01

Studied weight gain after smoking cessation in a naturalistic setting where all smokers quit and risk factors for postcessation weight gain were modified. Results showed no significant weight changes for smokers who quit. Suggests that an intensive program featuring dietary guidelines and increased physical activity can attenuate weight gain. (RJM)

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.

Smoking Cessation and Relapse Prevention among Undergraduate Students: A Pilot Demonstration Project.

ERIC Educational Resources Information Center

Ramsay, Jim; Hoffmann, Anne

2004-01-01

The prevalence of college students' tobacco use is widely recognized, but successful cessation and relapse-prevention programs for these smokers have drawn little attention. The authors, who explored the feasibility of training peers to lead cessation and relapse-prevention programs for undergraduates, found a quit rate of 88.2%, suggesting that…

Smoking Cessation Program for Inpatients with Substance Use Disorder: A Quasi-Randomized Controlled Trial of Feasibility and Efficacy.

PubMed

Rüther, Tobias; Ruderer, Amelie; Wirth, Christina; Schuler, Veronika; Lang, Verena; Linhardt, Andrea; Kröger, Christoph B; Pogarell, Oliver

2016-01-01

The present study investigated the feasibility, acceptance and efficacy of a newly developed cognitive behavioral program for smoking cessation/reduction ('Rethink your Smoking' program, RSP) in inpatients with substance use disorder (SUD). One hundred ninety-nine inpatients with SUD were randomly assigned to either the RSP (n = 101) or a minimal intervention (MI) program (n = 98). In addition, participants were offered optional nicotine replacement therapy. Data from a group of patients with SUD without any intervention (control group, n = 78) were included in the analyses for comparison. Assessments were performed at admission, discharge and follow-up after 3 and 6 months. RSP proved to be feasible and was well accepted by participants. Patients in both interventions showed lower scores for physical nicotine dependence and number of cigarettes smoked per day and higher scores for various motivational parameters at discharge and 3 months later. Both interventions were superior to no intervention, but no differences were found between the RSP and MI. A smoking cessation/reduction program is feasible for substance-dependent in-patients undergoing detoxification. Although the RSP appears to be effective in terms of harm reduction in in-patients with SUD, more cost- and time-efficient programs might also be suitable for this population. © 2016 S. Karger AG, Basel.

[Passive smoking at work: proposal for a smokeless company policy].

PubMed

Lombardi, C C

2007-01-01

Tobacco smoke contains about 4000 chemical substances, among which cancer agents (benzene, formaldehyde, polonium-210). There is sufficient evidence that inhalation of tobacco passive smoke causes human risks (cancer, cardio-vascular and respiratory system diseases). With the no-smoking act, issued by minister Sirchia in 2003, smoke is forbidden in indoor space in Italy, but much has still to be done in practice. Difficulties in application depend on the facts that smokers psychologically and hardly oppose and sanctions are complicated to apply. In this work we will argue the following problems and purpose respective alternatives: 1) To consider passive smoking risk in the 626/94 act into a specific section. 2) To transform administrative sanctions into a fund finalized to smoke cessation programs. 3) Increase formation-information smoke cessation programs, especially focused on positive effects from stop smoking.

Promoting Tobacco Cessation and Smoke-Free Workplaces Through Community Outreach Partnerships in Puerto Rico

PubMed Central

Díaz-Toro, Elba C.; Fernández, Maria E.; Correa-Fernández, Virmarie; Calo, William A.; Ortiz, Ana Patricia; Mejía, Luz M.; Mazas, Carlos A.; Santos-Ortiz, María del Carmen; Wetter, David W.

2014-01-01

Background Puerto Rico (PR) has a lower smoking prevalence than the United States (14.8% vs. 21.2%, respectively); nevertheless, the five leading causes of death are associated with smoking. There is a need to implement evidence-based tobacco control strategies in PR. Objectives The Outreach Pilot Program (OPP) was designed to engage communities, health professionals, and researchers in a network to advance health promotion activities and research to increase the use of the PR Quitline (PRQ) among smokers and promoting policies in support of smoke-free workplaces. Methods Using community-based participatory research (CBPR) methods, the OPP mobilized a network of community and academic partners to implement smoking cessation activities including referrals to the PRQ, adoption of evidence-based smoking cessation programs, and promotion of smoke-free legislation. Results Eighty organizations participated in the OPP. Collaborators implemented activities that supported the promotion of the PRQ and smoke-free workplaces policy and sponsored yearly trainings, including tobacco control conferences. From 2005 to 2008, physician referrals to the PRQ increased from 2.6% to 7.2%. The number of annual smokers receiving cessation services through the PRQ also increased from 703 to 1,086. The OPP shepherded a rigorous smoke-free law through participation in the development, promotion, and implementation of the smoke-free workplaces legislation as well as the creation of the PR Tobacco Control Strategic Plan, launched in 2006. Conclusions This project demonstrates the feasibility of developing a successful and sustainable community-based outreach program model that enlists the participation of academic researchers, community organizations, and health care providers as partners to promote tobacco control. PMID:25152097

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

Tobacco use and motivation to stop smoking among long-term smokers who are ineligible for lung cancer screening.

PubMed

Taghizadeh, Niloofar; Taylor, Kathryn L; MacEachern, Paul; Koetzler, Rommy; Dickinson, James A; Gillson, Ashley; Yang, Huiming; Tammemagi, Martin C; Penz, Erika; Pendharkar, Sachin R; Lam, Stephen C; Graham, Andrew; Culling, Jessica; Burrowes, Paul; Bédard, Eric L R; Tremblay, Alain

2017-09-01

The importance of smoking cessation interventions in lung cancer screening participants has been highlighted. This study aimed to describe the smoking habits of individuals who were ineligible for lung cancer screening and to investigate whether this encounter may represent an opportunity to reduce tobacco use. Ever smokers between the ages of 55 and 80 and ≥1.5% lung cancer risk over 6 years or having smoked ≥30 pack-years and with no more than 15 years of smoking abstinence were eligible to participate in the Alberta Lung Cancer Screening Program (ALCSP). A baseline questionnaire exploring tobacco use was administered to all interested individuals as part of the eligibility determination for the program. Among 504 individuals, 254 (50.4%) met the criteria for the ALCSP and 250 (49.6%) were non-eligible for screening. Non-eligible individuals were slightly younger (mean=60.2 vs. 63.1 years, p-value <0.001), and less likely to be current smokers (26.0% vs. 48.8%, p-value <0.001). Non-eligible smokers had a lower degree of addiction compared to eligible group, as measured by the Fagerström Test of Nicotine Dependence (Median=4.0 vs 6.0, p-value=0.001), but still in the "moderately dependent" range for this test. There were no significant differences in motivation to quit (98.5% vs. 97.6%, p-value=0.689), or motivation to receive help with their quit attempt (89.2% vs. 90.3%, p-value=0.813) between these two groups. Only 7.7% of non-eligible and 2.4% of eligible current smokers were currently in a smoking cessation program. A significant proportion of individuals applying to, but not qualifying for a lung cancer screening program are active smokers with significant nicotine dependence. Very few are currently participating in active smoking cessation programs but almost all are interested in quitting and in receiving help with quit attempts. Future studies need to investigate the most effective approaches for smoking cessation in this substantial group of older, long-term smokers, capitalizing on their motivation to receive cessation assistance. Copyright © 2017 Elsevier B.V. All rights reserved.

Creating and testing a deaf-friendly, stop-smoking web site intervention.

PubMed

Jones, Elaine G; Goldsmith, Melissa; Effken, Judith; Button, Kevin; Crago, Michael

2010-01-01

Deaf adults' access to smoking cessation programs is limited due to cultural, linguistic, and geographic barriers. Web-based stop-smoking interventions have demonstrated cessation rates comparable to other interventions. The Internet is widely used by Deaf adults, but difficulties with online English text remain. We found no published accounts of Internet interventions promoting smoking cessation among Deaf individuals. The purpose of our project was to create and pilot test a prototype interactive Web site that provides users with information in American Sign Language related to smoking cessation. We utilized web cams to create real-time "video chat rooms" for virtual support groups and had an "ask the experts" feature. Deaf community members participated in all phases of development and testing, and a Deaf former smoker served as the moderator for the site. Evaluations were positive, with emphasis on interactive and visual aspects of the site.

Impact of a statewide Internet-based tobacco cessation intervention.

PubMed

Saul, Jessie E; Schillo, Barbara A; Evered, Sharrilyn; Luxenberg, Michael G; Kavanaugh, Annette; Cobb, Nathan; An, Lawrence C

2007-09-30

An increasing number of people have access to the Internet, and more people are seeking tobacco cessation resources online every year. Despite the proliferation of various online interventions and their evident acceptance and reach, little research has addressed their impact in the real world. Typically, low response rates to Internet-based follow-up surveys generate unrepresentative samples and large confidence intervals when reporting results. The aim of this study was to achieve a high response rate on follow-up evaluation in order to better determine the impact of an Internet-based tobacco cessation intervention provided to tobacco users in Minnesota, United States. Participants included 607 men and women aged 18 and over residing in Minnesota who self-reported current tobacco use when registering for an Internet-based tobacco cessation program between February 2 and April 13, 2004. Participants were given access to an interactive website with features including social support, expert systems, proactive email, chat sessions, and online counselors. Mixed-mode follow-up (online survey with telephone survey for online nonrespondents) occurred 6 months after registration. Of the study participants, 77.6% (471/607) responded to the 6-month follow-up survey (39.4% online and 38.2% by telephone). Among respondents, 17.0% (80/471, 95% CI = 13.6%-20.4%) reported that they had not smoked in the past 7 days (observed rate). Assuming all nonrespondents were still smoking (missing=smoking rate), the quit rate was 13.2% (80/607, 95% CI = 10.5%-15.9%). This mixed-mode follow-up survey of an online smoking cessation program achieved a high response rate and provides a more accurate estimate of long-term cessation rates than has been previously reported. Quit rates for the Internet-based tobacco cessation program were higher than those expected for unassisted quit attempts and are comparable to other evidence-based behavioral interventions. The similarities between quit rates demonstrates that an Internet-based cessation program may have as great an impact as, and can have wider reach than, other cessation programs such as those delivered by telephone. With over 100000 people having visited the website and over 23000 having registered, a 6-month self-reported quit rate of 13.2% suggests that the quitplan.com program helped over 3000 Minnesotans remain tobacco free for at least 6 months. Results of this study suggest that an Internet-based cessation program is a useful tool in states' efforts to provide comprehensive cessation tools for smokers.

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

Predictors of Middle School Students' Interest in Participating in an Incentive-Based Tobacco Prevention and Cessation Program in Connecticut

PubMed Central

Morean, Meghan E.; Camenga, Deepa R.; Kong, Grace; Cavallo, Dana A.; Schepis, Ty S.

2014-01-01

Behavioral incentives have been used to encourage smoking cessation in older adolescents, but the acceptability of incentives to promote a smoke-free lifestyle in younger adolescents is unknown. To inform the development of novel, effective, school-based interventions for youth, we assessed middle school students' interest in participating in an incentive-based tobacco abstinence program. We surveyed 988 students (grades 6–8) attending three Connecticut middle schools to determine whether interest in program participation varied as a function of (1) intrapersonal factors (i.e., demographic characteristics (sex, age, race), smoking history, and trait impulsivity) and/or (2) aspects of program design (i.e., prize type, value, and reward frequency). Primary analyses were conducted using multiple regression. A majority of students (61.8%) reported interest in program participation. Interest did not vary by gender, smoking risk status, or offering cash prizes. However, younger students, non-Caucasian students, behaviorally impulsive students, and students with higher levels of self-regulation were more likely to report interest. Inexpensive awards (e.g., video games) offered monthly motivated program interest. In sum, middle school students reported high levels of interest in an incentive-based program to encourage a tobacco-free lifestyle. These formative data can inform the design of effective, incentive-based smoking cessation and prevention programs in middle schools. PMID:25147747

Examining sustainability in a hospital setting: case of smoking cessation.

PubMed

Campbell, Sharon; Pieters, Karen; Mullen, Kerri-Anne; Reece, Robin; Reid, Robert D

2011-09-14

The Ottawa Model of Smoking Cessation (OMSC) is a hospital-based smoking cessation program that is expanding across Canada. While the short-term effectiveness of hospital cessation programs has been documented, less is known about long-term sustainability. The purpose of this exploratory study was to understand how hospitals using the OMSC were addressing sustainability and determine if there were critical factors or issues that should be addressed as the program expanded. Six hospitals that differed on OMSC program activities (identify and document smokers, advise quitting, provide medication, and offer follow-up) were intentionally selected, and two key informants per hospital were interviewed using a semi-structured interview guide. Key informants were asked to reflect on the initial decision to implement the OMSC, the current implementation process, and perceived sustainability of the program. Qualitative analysis of the interview transcripts was conducted and themes related to problem definition, stakeholder influence, and program features emerged. Sustainability was operationalized as higher performance of OMSC activities than at baseline. Factors identified in the literature as important for sustainability, such as program design, differences in implementation, organizational characteristics, and the community environment did not explain differences in program sustainability. Instead, key informants identified factors that reflected the interaction between how the health problem was defined by stakeholders, how priorities and concerns were addressed, features of the program itself, and fit within the hospital context and resources as being influential to the sustainability of the program. Applying a sustainability model to a hospital smoking cessation program allowed for an examination of how decisions made during implementation may impact sustainability. Examining these factors during implementation may provide insight into issues affecting program sustainability, and foster development of a sustainability plan. Based on this study, we suggest that sustainability plans should focus on enhancing interactions between the health problem, program features, and stakeholder influence.

Examining sustainability in a hospital setting: Case of smoking cessation

PubMed Central

2011-01-01

Background The Ottawa Model of Smoking Cessation (OMSC) is a hospital-based smoking cessation program that is expanding across Canada. While the short-term effectiveness of hospital cessation programs has been documented, less is known about long-term sustainability. The purpose of this exploratory study was to understand how hospitals using the OMSC were addressing sustainability and determine if there were critical factors or issues that should be addressed as the program expanded. Methods Six hospitals that differed on OMSC program activities (identify and document smokers, advise quitting, provide medication, and offer follow-up) were intentionally selected, and two key informants per hospital were interviewed using a semi-structured interview guide. Key informants were asked to reflect on the initial decision to implement the OMSC, the current implementation process, and perceived sustainability of the program. Qualitative analysis of the interview transcripts was conducted and themes related to problem definition, stakeholder influence, and program features emerged. Results Sustainability was operationalized as higher performance of OMSC activities than at baseline. Factors identified in the literature as important for sustainability, such as program design, differences in implementation, organizational characteristics, and the community environment did not explain differences in program sustainability. Instead, key informants identified factors that reflected the interaction between how the health problem was defined by stakeholders, how priorities and concerns were addressed, features of the program itself, and fit within the hospital context and resources as being influential to the sustainability of the program. Conclusions Applying a sustainability model to a hospital smoking cessation program allowed for an examination of how decisions made during implementation may impact sustainability. Examining these factors during implementation may provide insight into issues affecting program sustainability, and foster development of a sustainability plan. Based on this study, we suggest that sustainability plans should focus on enhancing interactions between the health problem, program features, and stakeholder influence. PMID:21917156

Randomized Trial of Four Financial-Incentive Programs for Smoking Cessation

PubMed Central

Halpern, Scott D.; French, Benjamin; Small, Dylan S.; Saulsgiver, Kathryn; Harhay, Michael O.; Audrain-McGovern, Janet; Loewenstein, George; Brennan, Troyen A.; Asch, David A.; Volpp, Kevin G.

2015-01-01

BACKGROUND Financial incentives promote many health behaviors, but effective ways to deliver health incentives remain uncertain. METHODS We randomly assigned CVS Caremark employees and their relatives and friends to one of four incentive programs or to usual care for smoking cessation. Two of the incentive programs targeted individuals, and two targeted groups of six participants. One of the individual-oriented programs and one of the group-oriented programs entailed rewards of approximately $800 for smoking cessation; the others entailed refundable deposits of $150 plus $650 in reward payments for successful participants. Usual care included informational resources and free smoking-cessation aids. RESULTS Overall, 2538 participants were enrolled. Of those assigned to reward-based programs, 90.0% accepted the assignment, as compared with 13.7% of those assigned to deposit-based programs (P<0.001). In intention-to-treat analyses, rates of sustained abstinence from smoking through 6 months were higher with each of the four incentive programs (range, 9.4 to 16.0%) than with usual care (6.0%) (P<0.05 for all comparisons); the superiority of reward-based programs was sustained through 12 months. Group-oriented and individual-oriented programs were associated with similar 6-month abstinence rates (13.7% and 12.1%, respectively; P = 0.29). Reward-based programs were associated with higher abstinence rates than deposit-based programs (15.7% vs. 10.2%, P<0.001). However, in instrumental-variable analyses that accounted for differential acceptance, the rate of abstinence at 6 months was 13.2 percentage points (95% confidence interval, 3.1 to 22.8) higher in the deposit-based programs than in the reward-based programs among the estimated 13.7% of the participants who would accept participation in either type of program. CONCLUSIONS Reward-based programs were much more commonly accepted than deposit-based programs, leading to higher rates of sustained abstinence from smoking. Group-oriented incentive programs were no more effective than individual-oriented programs. (Funded by the National Institutes of Health and CVS Caremark; ClinicalTrials.gov number, NCT01526265.) PMID:25970009

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.

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.

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.

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: the value of a comprehensive carved-in benefit.

PubMed

Johnston, Stephen S; Mark, Tami L; Dirani, Riad

2008-01-01

This qualitative narrative review examines the potential returns from providing smoking cessation treatments (SCTs) through an insurance plan's standard benefit package versus through an optional supplementary wellness ('rider') program. Research indicates most employers offer SCTs as part of a rider available for purchase. Studies demonstrate that the higher the cost of SCTs, the lower the SCT participation rates; when employees receive SCTs, smoking cessation rates increase, effecting lower employee healthcare costs and improved productivity. Employers may receive a considerable return on the investment of offering SCTs as part of comprehensive insurance benefit for their employees as opposed to a rider.

Formative Evaluation of a Practice-Based Smoking Cessation Program for Diverse Populations

ERIC Educational Resources Information Center

Mahoney, Martin C.; Erwin, Deborah O.; Widman, Christy; Masucci Twarozek, Annamaria; Saad-Harfouche, Frances G.; Underwood, Willie, III.; Fox, Chester H.

2014-01-01

Background. Smoking rates are higher among those living at or below poverty and among persons with lower levels of education. We report on a formative research project examining patient perceptions of tobacco cessation strategies among diverse, low socioeconomic, urban smokers cared for in community-based primary care medical offices. Method. We…

Single-arm trial of the second version of an acceptance & commitment therapy smartphone application for smoking cessation.

PubMed

Bricker, Jonathan B; Copeland, Wade; Mull, Kristin E; Zeng, Emily Y; Watson, Noreen L; Akioka, Katrina J; Heffner, Jaimee L

2017-01-01

The first randomized trial of a smartphone application (app) for adult smoking cessation (SmartQuit 1.0) revealed key features that predict cessation. These findings guided the revision of this Acceptance & Commitment Therapy (ACT)-based application (SmartQuit 2.0), which was primarily tested to examine participant receptivity, short-term cessation and reduction, and the relationship between program completion, smoking cessation and reduction. Secondarily, outcomes were descriptively compared with the SmartQuit1.0 trial. Adult participants (78% female, 25% with high school or less education, 30% unemployed) were recruited into the single-arm pilot trial (N=99) of SmartQuit 2.0 with a two-month follow-up (85% retention). Regarding receptivity, 84% of participants were satisfied with SmartQuit 2.0 (vs. 59% for SmartQuit1.0), 73% would recommend it to a friend (vs. 48% for SmartQuit1.0), 81% found the ACT exercises useful for quitting (vs. 44% for SmartQuit1.0). At the 2-month follow-up, the quit rates were 21% for 7-day point prevalence (vs. 23% for SmartQuit1.0), 11% for 30-day point prevalence (vs. 13% for SmartQuit1.0), and 75% of participants reduced their smoking frequency (vs. 57% for SmartQuit1.0). Among program completers (24% of total sample), the quit rates were 33% for 7-day point prevalence, 28% for 30-day point prevalence, and 88% of participants reduced their smoking frequency. The revised app had high user receptivity, modest quit rates, and high smoking reduction rates. Program completion may be key to boosting the app's effectiveness. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Reaching Spanish-speaking smokers online: a 10-year worldwide research program

PubMed Central

Muñoz, Ricardo Felipe; Chen, Ken; Bunge, Eduardo Liniers; Bravin, Julia Isabela; Shaughnessy, Elizabeth Annelly; Pérez-Stable, Eliseo Joaquín

2014-01-01

Objective To describe a 10-year proof-of-concept smoking cessation research program evaluating the reach of online health interventions throughout the Americas. Methods Recruitment occurred from 2002–2011, primarily using Google.com AdWords. Over 6 million smokers from the Americas entered keywords related to smoking cessation; 57 882 smokers (15 912 English speakers and 41 970 Spanish speakers) were recruited into online self-help automated intervention studies. To examine disparities in utilization of methods to quit smoking, cessation aids used by English speakers and Spanish speakers were compared. To determine whether online interventions reduce disparities, abstinence rates were also compared. Finally, the reach of the intervention was illustrated for three large Spanish-speaking countries of the Americas—Argentina, Mexico, and Peru—and the United States of America. Results Few participants had utilized other methods to stop smoking before coming to the Internet site; most reported using no previous smoking cessation aids: 69.2% of Spanish speakers versus 51.8% of English speakers (P < 0.01). The most used method was nicotine gum, 13.9%. Nicotine dependence levels were similar to those reported for in-person smoking cessation trials. Overall observed quit rate for English speakers was 38.1% and for Spanish speakers, 37.0%; quit rates in which participants with missing data were considered to be smoking were 11.1% and 10.6%, respectively. Neither comparison was significantly different. Conclusions The systematic use of evidence-based Internet interventions for health problems could have a broad impact throughout the Americas, at little or no cost to individuals or to ministries of health. PMID:25211569

Effectiveness of a Web-Based Multiple Tailored Smoking Cessation Program: A Randomized Controlled Trial Among Dutch Adult Smokers

PubMed Central

de Vries, Hein; Hoving, Ciska

2012-01-01

Background Distributing a multiple computer-tailored smoking cessation intervention through the Internet has several advantages for both provider and receiver. Most important, a large audience of smokers can be reached while a highly individualized and personal form of feedback can be maintained. However, such a smoking cessation program has yet to be developed and implemented in the Netherlands. Objective To investigate the effects of a Web-based multiple computer-tailored smoking cessation program on smoking cessation outcomes in a sample of Dutch adult smokers. Methods Smokers were recruited from December 2009 to June 2010 by advertising our study in the mass media and on the Internet. Those interested and motivated to quit smoking within 6 months (N = 1123) were randomly assigned to either the experimental (n = 552) or control group (n = 571). Respondents in the experimental group received the fully automated Web-based smoking cessation program, while respondents in the control group received no intervention. After 6 weeks and after 6 months, we assessed the effect of the intervention on self-reported 24-hour point prevalence abstinence, 7-day point prevalence abstinence, and prolonged abstinence using logistic regression analyses. Results Of the 1123 respondents, 449 (40.0%) completed the 6-week follow-up questionnaire and 291 (25.9%) completed the 6-month follow-up questionnaire. We used a negative scenario to replace missing values. That is, we considered respondents lost to follow-up to still be smoking. The computer-tailored program appeared to have significantly increased 24-hour point prevalence abstinence (odds ratio [OR] 1.85, 95% confidence interval [CI] 1.30–2.65), 7-day point prevalence abstinence (OR 2.17, 95% CI 1.44–3.27), and prolonged abstinence (OR 1.99, 95% CI 1.28–3.09) rates reported after 6 weeks. After 6 months, however, no intervention effects could be identified. Results from complete-case analyses were similar. Conclusions The results presented suggest that the Web-based computer-tailored smoking cessation program had a significant effect on abstinence reported after a 6-week period. At the 6-month follow-up, however, no intervention effects could be identified. This might be explained by the replacement of missing values on the primary outcome measures due to attrition using a negative scenario. While results were similar when using a less conservative scenario (ie, complete-case analyses), the results should still be interpreted with caution. Further research should aim at identifying strategies that will prevent high attrition in the first place and, subsequently, to identify the best strategies for dealing with missing data when studies have high attrition rates. Trial Registration Dutch Trial Register NTR1351; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1351 (Archived by WebCite at http://www.webcitation.org/67egSTWrz) PMID:22687887

Development of targeted messages to promote smoking cessation among construction trade workers.

PubMed

Strickland, J R; Smock, N; Casey, C; Poor, T; Kreuter, M W; Evanoff, B A

2015-02-01

Blue-collar workers, particularly those in the construction trades, are more likely to smoke and have less success in quitting when compared with white-collar workers. Little is known about health communication strategies that might influence this priority population. This article describes our formative work to develop targeted messages to increase participation in an existing smoking cessation program among construction workers. Using an iterative and sequential mixed-methods approach, we explored the culture, health attitudes and smoking behaviors of unionized construction workers. We used focus group and survey data to inform message development, and applied audience segmentation methods to identify potential subgroups. Among 144 current smokers, 65% reported wanting to quit smoking in the next 6 months and only 15% had heard of a union-sponsored smoking cessation program, despite widespread advertising. We tested 12 message concepts and 26 images with the target audience to evaluate perceived relevance and effectiveness. Participants responded most favorably to messages and images that emphasized family and work, although responses varied by audience segments based on age and parental status. This study is an important step towards integrating the culture of a high-risk group into targeted messages to increase participation in smoking cessation activities. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Results from a Community-Based Smoking Cessation Treatment Program for LGBT Smokers

PubMed Central

Matthews, Alicia K.; Li, Chien-Ching; Kuhns, Lisa M.; Tasker, Timothy B.; Cesario, John A.

2013-01-01

Introduction. Little is known about lesbian, gay, bisexual, and transgender (LGBT) people's response to smoking cessation interventions. This descriptive study examined the benefits of a community-based, culturally tailored smoking cessation treatment program for LGBT smokers. Methods. A total of N = 198 LGBT individuals recruited from clinical practice and community outreach participated in group-based treatment. Sessions were based on the American Lung Association's “Freedom from Smoking Program” (ALA-FFS) and were tailored to LGBT smokers' needs. Seven-day smoking point prevalence abstinence served as the primary outcome. Results. Participants (M age = 40.5) were mostly White (70.4%) and male (60.5%) and had at least a college degree (58.4%). Forty-four percent scored in the moderate range on the Fagerström Test for Nicotine Dependence pretreatment, and 42.4% completed treatment (≥75% sessions). Higher educational attainment and use of nicotine replacement therapy (NRT) were associated with treatment completion. Self-reported quit rates were 32.3% at posttreatment assessment. Treatment attendance (OR = 2.45), use of NRT (OR = 4.24), and lower nicotine dependency (OR = 0.73) were positively associated with quitting smoking. Conclusions. Results suggest the benefits of offering LGBT smokers culturally tailored smoking cessation treatments. Future research could improve outcomes by encouraging treatment attendance and promoting NRT uptake. PMID:23840237

[Efficiency and risk factors in the cognitive-behavioural treatment for smoking cessation in pregnancy].

PubMed

Godá, Teresa; Marcos, Teodor; Corominas, Josep; Núñez, Laura; Salamero, Manel

2007-11-03

The aim of this study is to quantify the efficiency of the cognitive-behavioural treatment for smoking cessation in pregnancy and to evaluate the risk factors of success or failure for the abstinence before the childbirth. We studied 74 pregnant smoking women who, between January 2003 and January 2004, came to their obstetric regular control in the Hospital Casa Maternitat-Hospital Clínic i Provincial de Barcelona, and who voluntarily acceded to the cognitive-behavioural treatment without replacement of nicotine for the smoking cessation that they were offered. 44% of women who made the program of visits came abstinent to the childbirth, and of them, 93.1% was abstinent during the quarantine. 51.5% reduced the consumption and 4.5% didn't change or increased the consumption. The fact that someone smokes at home (p = 0.006), the degree of dependence to the nicotine (p = 0.015) and a consumption of coffee superior to 3 daily cups (p = 0.039), in an equation of logistic regression, classified both groups (abstinence/not abstinence). The efficiency of a program based on cognitive-behavioural therapy, without replacement of nicotine, for the smoking cessation in the pregnancy is confirmed in our sample. We propose to consider risk factors of treatment failure the fact that someone smokes at home and a daily high consumption of coffee.

Factors affecting commencement and cessation of smoking behaviour in Malaysian adults

PubMed Central

2012-01-01

Background Tobacco consumption peak in developed countries has passed, however, it is on the increase in many developing countries. Apart from cigarettes, consumption of local hand-rolled cigarettes such as bidi and rokok daun are prevalent in specific communities. Although factors associated with smoking initiation and cessation has been investigated elsewhere, the only available data for Malaysia is on prevalence. This study aims to investigate factors associated with smoking initiation and cessation which is imperative in designing intervention programs. Methods Data were collected from 11,697 adults by trained recording clerks on sociodemographic characteristics, practice of other risk habit and details of smoking such as type, duration and frequency. Smoking commencement and cessation were analyzed using the Kaplan-Meier estimates and log-rank tests. Univariate and multivariate Cox proportional hazard regression models were used to calculate the hazard rate ratios. Results Males had a much higher prevalence of the habit (61.7%) as compared to females (5.8%). Cessation was found to be most common among the Chinese and those regularly consuming alcoholic beverages. Kaplan-Meier plot shows that although males are more likely to start smoking, females are found to be less likely to stop. History of betel quid chewing and alcohol consumption significantly increase the likelihood of commencement (p < 0.0001), while cessation was least likely among Indians, current quid chewers and kretek users (p < 0.01). Conclusions Gender, ethnicity, history of quid chewing and alcohol consumption have been found to be important factors in smoking commencement; while ethnicity, betel quid chewing and type of tobacco smoked influences cessation. PMID:22429627

Self-Determination Theory With Application to Employee Health Settings.

PubMed

Ross, Brenda M; Barnes, Donelle M

2018-01-01

Occupational health nurses motivate employees to engage in healthy behaviors. Both clinicians and researchers need strong theories on which to base decisions for health programs (e.g., healthy diet) and experimental interventions (e.g., workplace walking). The self-determination theory could be useful as it includes concepts of individual autonomy, competence to perform healthy behaviors, and relationships as predictors of health behaviors and outcomes. In this article, the self-determination theory is described and evaluated using Walker and Avant's criteria. The theory is applied to a population of federal employees who smoke. By increasing employees' ability to autonomously choose smoking cessation programs, support their competence to stop smoking, and improve their relationships with both others who smoke and employee health services, smoking cessation should increase.

How Medicaid and Other Public Policies Affect Use of Tobacco Cessation Therapy, United States, 2010–2014

PubMed Central

Brantley, Erin; Bysshe, Tyler; Steinmetz, Erika; Bruen, Brian K.

2016-01-01

Introduction State Medicaid programs can cover tobacco cessation therapies for millions of low-income smokers in the United States, but use of this benefit is low and varies widely by state. This article assesses the effects of changes in Medicaid benefit policies, general tobacco policies, smoking norms, and public health programs on the use of cessation therapy among Medicaid smokers. Methods We used longitudinal panel analysis, using 2-way fixed effects models, to examine the effects of changes in state policies and characteristics on state-level use of Medicaid tobacco cessation medications from 2010 through 2014. Results Medicaid policies that require patients to obtain counseling to get medications reduced the use of cessation medications by approximately one-quarter to one-third; states that cover all types of cessation medications increased usage by approximately one-quarter to one-third. Non-Medicaid policies did not have significant effects on use levels. Conclusions States could increase efforts to quit by developing more comprehensive coverage and reducing barriers to coverage. Reductions in barriers could bolster smoking cessation rates, and the costs would be small compared with the costs of treating smoking-related diseases. Innovative initiatives to help smokers quit could improve health and reduce health care costs. PMID:27788063

Children with Chronic Lung Disease: Facilitating Smoking Cessation for their Caregivers.

PubMed

Bacewicz, Aleksandra; Wang, Wei; Ashouri, Judy; ElMallah, Mai K

2015-06-01

Through a QI project at a tertiary referral pediatric pulmonary center, our objective was to establish a methodical approach to identify and engage smoking parents of children with chronic lung disease in a smoking cessation program. We hypothesized that smoking caregivers of children with chronic lung disease would be more motivated to enroll in a smoking cessation program when referred from tertiary pediatric pulmonary center. We assessed smoking habits and interest in quitting of parents with surveys. Parents ready to quit within 30 days were referred to the Florida Quitline from clinic. Pulmonary function tests, exacerbations, hospitalizations and need for prednisone or antibiotics were obtained from the patient charts and surveys. Follow-up two to 6 months later assessed the quit rate and child's clinical well-being and lung function. A standard mechanism to identify caregivers who smoked was established by engaging our medical assistants through a prompt in our EMR system. Out of those caregivers who were identified as smokers and accompanied their children to clinic, 52% were interested in a referral to the Florida Quitline. Out of those, only 12% successfully completed the program and ceased to smoke. The Florida Quitline was unable to reach the majority of parents who were referred to them. The majority of those referred to the Ouitline were not successfully contacted or enrolled in the program. The current procedure for referring and enrolling individuals to the Quitline is not effective for our population, but compares to the national average.

So You Want Your Employees to Quit Smoking?

ERIC Educational Resources Information Center

Taylor, G. Stephen; Holmes, Horace, Jr.

1990-01-01

Efforts of corporations to limit or ban smoking in the workplace have been generally unsuccessful. This article reviews the most common antismoking programs, including education, counseling and incentives, and proscriptive rules and policies. A multidimensional, broad-based smoking cessation program is then described. (Author/TE)

Modifying Risk Factors for Total Joint Arthroplasty: Strategies That Work Nicotine.

PubMed

Springer, Bryan D

2016-08-01

Smoking and nicotine use remain a major health care crisis in the United States. Although rates have dropped dramatically over the last 50 years, approximately 18% of the US adult population still smokes. The musculoskeletal effects of nicotine and other byproducts of smoking place patients at increased risk for perioperative complications including medical complication, wound healing problems, infection, and death. A comprehensive behavioral modification program with or without the use of nicotine replacement therapy has been shown to be most effective at smoking cessation around the time of planned surgery. Although literature suggests that smoking cessation 4-6 weeks before surgery can diminish risk, both current and former smokers are at increased risk for perioperative complications compared with those that have never smoked. Cotinine, a metabolite of nicotine, can be used to monitor smoking cessation before surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

Effects of smoking cessation on heart rate variability among long-term male smokers.

PubMed

Harte, Christopher B; Meston, Cindy M

2014-04-01

Cigarette smoking has been shown to adversely affect heart rate variability (HRV), suggesting dysregulation of cardiac autonomic function. Conversely, smoking cessation is posited to improve cardiac regulation. The aim of the present study was to examine the effects of smoking cessation on HRV among a community sample of chronic smokers. Sixty-two healthy male smokers enrolled in an 8-week smoking cessation program involving a nicotine transdermal patch treatment. Participants were assessed at baseline (while smoking regularly), at mid-treatment (while using a high-dose patch), and at follow-up, 4 weeks after patch discontinuation. Both time-domain (standard deviation of normal-to-normal (NN) intervals (SDNN), square root of the mean squared difference of successive NN intervals (RMSSD), and percent of NN intervals for which successive heartbeat intervals differed by at least 50 ms (pNN50)) and frequency-domain (low frequency (LF), high frequency (HF), LF/HF ratio) parameters of HRV were assessed at each visit. Successful quitters (n = 20), compared to those who relapsed (n = 42), displayed significantly higher SDNN, RMSSD, pNN50, LF, and HF at follow-up, when both nicotine and smoke free. Smoking cessation significantly enhances HRV in chronic male smokers, indicating improved autonomic modulation of the heart. Results suggest that these findings may be primarily attributable to nicotine discontinuation rather than tobacco smoke discontinuation alone.

Adolescent romantic relationships and change in smoking status.

PubMed

Kennedy, David P; Tucker, Joan S; Pollard, Michael S; Go, Myong-Hyun; Green, Harold D

2011-04-01

Although smoking rates have decreased, smoking among adolescents continues to be a problem. Previous research has shown the importance of peer influences on adolescent smoking behavior but has mostly neglected the impact of adolescent romantic relationships. This study examines the influence of romantic relationships with smokers and non-smokers on smoking initiation and cessation over a one-year period using data from the National Longitudinal Study of Adolescent Health (Add Health). For initial non-smokers, we examined whether the total length of time in romantic relationships with smokers and non-smokers at Wave I, as well as amount of exposure to smoking through romantic partners, predicted smoking initiation at Wave II. Among initial regular smokers, we examined whether these same relationship characteristics predicted smoking cessation at Wave II. These analyses were conducted separately for respondents in any type of romantic relationship, as well as just those respondents in close romantic relationships. Results indicated that, for close romantic relationships, cessation was more likely among smokers with more time in relationships with non-smoking partners. Greater exposure to smoking through romantic partners at Wave I significantly decreased the likelihood of cessation among initial smokers and increased the likelihood of initiation among initial non-smokers. For all relationships, greater exposure to smoking through romantic partners at Wave I significantly reduced the likelihood of cessation. These associations held when controlling for best friend smoking, as well as demographic factors and school-level smoking, suggesting that peer-based smoking programs aimed at adolescents should incorporate a focus on romantic relationships. Copyright © 2010 Elsevier B.V. All rights reserved.

Anxiety and smoking cessation outcomes in alcohol-dependent smokers.

PubMed

Kelly, Megan M; Grant, Christoffer; Cooper, Sharon; Cooney, Judith L

2013-02-01

Anxiety-related characteristics, including anxiety sensitivity and trait anxiety, are elevated in individuals with alcohol and nicotine dependence and associated with greater difficulties with quitting smoking. However, little is known about how anxiety-related characteristics are related to smoking cessation outcomes in alcohol-dependent smokers. The present study, part of a larger smoking cessation clinical trial, examined associations between anxiety sensitivity, trait anxiety, nicotine withdrawal symptoms, smoking urges, and smoking cessation outcomes in a sample of 83 alcohol-dependent smokers. Participants were enrolled in concurrent alcohol and tobacco treatment as part of a substance-abuse intensive outpatient program. Smoking cessation treatment was administered in a 3-week cognitive-behavioral format that included 8 weeks of open-label nicotine patch treatment. Information on nicotine withdrawal, smoking urges, and CO-confirmed smoking consumption rates was collected at baseline, quit date, end of behavioral treatment, and at a 1-month follow-up. Higher levels of anxiety sensitivity were associated with more smoking urges due to anticipation of negative affect relief at quit date. Higher levels of trait anxiety were associated with more smoking urges due to positive reinforcement and anticipation of relief of negative affect at quit date, as well as more severe nicotine withdrawal symptoms at the end of treatment. Levels of anxiety sensitivity and trait anxiety were not associated with Cox regression survival times to relapse. These results indicate that for alcohol-dependent smokers, levels of anxiety sensitivity and trait anxiety are important to consider in the assessment and treatment of nicotine dependence.

Factors Associated with Use of Automated Smoking Cessation Interventions: Findings from the eQuit Study

ERIC Educational Resources Information Center

Balmford, James; Borland, Ron; Benda, Peter; Howard, Steve

2013-01-01

The aim was to better understand structural factors associated with uptake of automated tailored interventions for smoking cessation. In a prospective randomized controlled trial with interventions only offered, not mandated, participants were randomized based on the following: web-based expert system (QuitCoach); text messaging program (onQ);…

Feasibility of a Text-Based Smoking Cessation Intervention in Rural Older Adults

ERIC Educational Resources Information Center

Noonan, D.; Silva, S.; Njuru, J.; Bishop, T.; Fish, L. J.; Simmons, L. A.; Choi, S. H.; Pollak, K. I.

2018-01-01

Text-based interventions are effective for smoking cessation, but have not been tested in rural older adults. The purpose of this study was to compare the feasibility, acceptability and preliminary efficacy of a text-based Scheduled Gradual Reduction (SGR) program to a non-SGR text messaging support condition among rural older adults. Adults over…

Randomized Controlled Trial Examining the Effectiveness of a Tailored Self-Help Smoking-Cessation Intervention for Postsecondary Smokers

ERIC Educational Resources Information Center

Travis, Heather E.; Lawrance, Kelli-an G.

2009-01-01

Objective: Between September 2002 and February 2003, the authors assessed the effectiveness of a new, age-tailored, self-help smoking-cessation program for college students. Participants: College student smokers (N = 216) from 6 Ontario universities participated. Methods: The researchers used a randomized controlled trial with a 3-month telephone…

Medical and sociodemographic factors predict persistent smoking after coronary events.

PubMed

Sverre, Elise; Otterstad, Jan Erik; Gjertsen, Erik; Gullestad, Lars; Husebye, Einar; Dammen, Toril; Moum, Torbjørn; Munkhaugen, John

2017-09-06

Understanding the determinants of persistent smoking after a coronary event constitutes the basis of modelling interventions of smoking cessation in secondary prevention programs. We aim to identify the potentially modifiable medical, sociodemographic and psychosocial factors, comprising the study factors, associated with unfavourable risk factor control after CHD events. A cross-sectional explorative study used logistic regression analysis to investigate the association between study factors and smoking status in 1083 patients hospitalized with myocardial infarction and/or coronary revascularization. Hospital record data, a self-report questionnaire, clinical examination and blood samples were applied. At the index hospitalization, 390 patients were smoking and at follow-up after 2-36 months 167 (43%) of these had quit, while 230 reported persistent smoking. In adjusted analyses, unemployed or disability benefits (Odds ratio (OR) 4.1), low education (OR 3.5), longer smoking duration (OR 2.3) and not having ST-elevation myocardial infarction (STEMI) as index event (OR 2.3) were significantly associated with persistent smoking. Psychosocial factors at follow-up were not associated with persistent smoking. Smokers reported high motivation for cessation, with 68% wanting help to quit. Only 42% had been offered nicotine replacement therapy or other cessation aids. Smokers rated use of tobacco as the most important cause of their coronary disease (6.8 on a 1-10 Likert scale). Low socioeconomic status, prior duration of smoking, and not having STEMI as index event were associated with persisting smoking. Persistent smokers in this study seem to have an acceptable risk perception and were motivated to cease smoking, but needed assistance through cessation programs including prescription of pharmacological aids. Registered at ClinicalTrials.gov: NCT02309255 , registered retrospectively.

Finding needles in a haystack: a methodology for identifying and sampling community-based youth smoking cessation programs.

PubMed

Emery, Sherry; Lee, Jungwha; Curry, Susan J; Johnson, Tim; Sporer, Amy K; Mermelstein, Robin; Flay, Brian; Warnecke, Richard

2010-02-01

Surveys of community-based programs are difficult to conduct when there is virtually no information about the number or locations of the programs of interest. This article describes the methodology used by the Helping Young Smokers Quit (HYSQ) initiative to identify and profile community-based youth smoking cessation programs in the absence of a defined sample frame. We developed a two-stage sampling design, with counties as the first-stage probability sampling units. The second stage used snowball sampling to saturation, to identify individuals who administered youth smoking cessation programs across three economic sectors in each county. Multivariate analyses modeled the relationship between program screening, eligibility, and response rates and economic sector and stratification criteria. Cumulative logit models analyzed the relationship between the number of contacts in a county and the number of programs screened, eligible, or profiled in a county. The snowball process yielded 9,983 unique and traceable contacts. Urban and high-income counties yielded significantly more screened program administrators; urban counties produced significantly more eligible programs, but there was no significant association between the county characteristics and program response rate. There is a positive relationship between the number of informants initially located and the number of programs screened, eligible, and profiled in a county. Our strategy to identify youth tobacco cessation programs could be used to create a sample frame for other nonprofit organizations that are difficult to identify due to a lack of existing directories, lists, or other traditional sample frames.

Utilizing Patient E-learning in an Intervention Study on Preoperative Smoking Cessation.

PubMed

Wong, Jean; Raveendran, Raviraj; Chuang, Junior; Friedman, Zeev; Singh, Mandeep; Patras, Jayadeep; Wong, David T; Chung, Frances

2018-05-01

Patients who smoke put themselves at increased risk for serious surgical complications, yet it is not currently routine practice to educate patients about the risk of complications due to smoking. Computer-based smoking cessation programs are increasingly being utilized in the general population and may overcome some of the barriers such as lack of time, knowledge, and training to provide interventions. Our objective was to develop and implement a patient e-learning program designed for surgical patients as part of a multifaceted program aimed at assisting them to quit smoking and to determine the factors cross-sectionally and longitudinally associated with abstinence. In this prospective multicenter study, smokers undergoing elective noncardiac surgery participated in a preoperative smoking cessation program consisting of a patient e-learning program, brief advice, educational pamphlet, tobacco quitline referral, letter to the primary care physician, and pharmacotherapy. The patient e-learning program described (1) the benefits of quitting smoking before surgery; (2) how to quit smoking; and (3) how to cope while quitting. The 7-day point prevalence (PP) abstinence on the day of surgery and at 1, 3 and 6 six months after surgery was separately assessed, and factors most associated with abstinence were identified using multivariable logistic regression analysis. Generalized estimating equation methods were used to estimate effect of the factors associated with abstinence longitudinally. The reach of the program was assessed with the number of smokers who participated in the program versus the number of patients who were referred to the program. A total of 459 patients (68.9% of eligible patients) participated. The 7-day PP abstinence at day of surgery, 1 month, 3 months, and 6 months was 22%, 29%, 25%, and 22%, respectively. The variables predicting abstinence at 6 months were use of pharmacotherapy (odds ratio [OR], 7.32; 95% confidence interval [CI], 3.71-14.44; P < .0001) and number of contacts with a tobacco quitline (OR, 1.60; 95% CI, 1.35-1.90; P < .0001). Presence of other smokers in the household (OR, 0.39; 95% CI, 0.21-0.72; P = .0030) and amount spent on cigarettes weekly at baseline (per $10 increase) (OR, 0.73; 95% CI, 0.61-0.87; P = .0004) were barriers to abstinence. Our preoperative smoking cessation program resulted in a 7-day PP abstinence of 22% at 6 months. A multifaceted intervention including a patient e-learning program may be a valuable tool to overcome some of the barriers to help surgical patients quit smoking.

A low-cost, practical method for increasing smokers' interest in smoking cessation programs.

PubMed

McDonald, Paul W

2004-01-01

Low participation rates reduce the public health impact of smoking cessation programs. Two barriers for improving participation are the cost of media campaigns and the proportion of smokers motivated to quit smoking. The objective of this study was to examine the feasibility of using classified newspaper ads and messages aimed at each stage of change to enhance participation in smoking cessation programs. Three classified ads were run concurrently in a local daily newspaper for five consecutive days. The ads were designed to engage smokers in each of Prochaska's five stages of change. Each ad invited smokers or former smokers to call the local health department to participate in a paid focus group to design a new health department program. Calls were received from 181 eligible smokers, including 124 who provided data for the study. Thirty-seven, 34, and 29 percent of smoking respondents were in precontemplation, contemplation and preparation respectively. Half of ex-smokers were in the action stage. Ads cost 174 dollars (Cdn), thus the cost per recruit was less than a dollar. Classified ads can recruit smokers from all stages of change. Compared to traditional mass media, classified ads may also be a highly cost-efficient promotional strategy. Results provide justification for further research.

"I know it's bad for me and yet I do it": exploring the factors that perpetuate smoking in Aboriginal Health Workers--a qualitative study.

PubMed

Dawson, Anna P; Cargo, Margaret; Stewart, Harold; Chong, Alwin; Daniel, Mark

2012-07-11

Aboriginal Health Workers (AHWs) have a mandate to deliver smoking cessation support to Aboriginal people. However, a high proportion of AHWs are smokers and this undermines their delivery of smoking cessation programs. Smoking tobacco is the leading contributor to the burden of disease in Aboriginal Australians and must be prevented. Little is known about how to enable AHWs to quit smoking. An understanding of the factors that perpetuate smoking in AHWs is needed to inform the development of culturally relevant programs that enable AHWs to quit smoking. A reduction of smoking in AHWs is important to promote their health and also optimise the delivery of smoking cessation support to Aboriginal clients. We conducted a fundamental qualitative description study that was nested within a larger mixed method participatory research project. The individual and contextual factors that directly or indirectly promote (i.e. perpetuate) smoking behaviours in AHWs were explored in 34 interviews and 3 focus groups. AHWs, other health service staff and tobacco control personnel shared their perspectives. Data analysis was performed using a qualitative content analysis approach with collective member checking by AHW representatives. AHWs were highly stressed, burdened by their responsibilities, felt powerless and undervalued, and used smoking to cope with and support a sense of social connectedness in their lives. Factors directly and indirectly associated with smoking were reported at six levels of behavioural influence: personal factors (e.g. stress, nicotine addiction), family (e.g. breakdown of family dynamics, grief and loss), interpersonal processes (e.g. socialisation and connection, domestic disputes), the health service (e.g. job insecurity and financial insecurity, demanding work), the community (e.g. racism, social disadvantage) and policy (e.g. short term and insecure funding). An extensive array of factors perpetuated smoking in AHWs. The multitude of personal, social and environmental stressors faced by AHWs and the accepted use of communal smoking to facilitate socialisation and connection were primary drivers of smoking in AHWs in addition to nicotine dependence. Culturally sensitive multidimensional smoking cessation programs that address these factors and can be tailored to local needs are indicated.

The efficacy of mobile phone-based text message interventions ('Happy Quit') for smoking cessation in China.

PubMed

Liao, Yanhui; Wu, Qiuxia; Tang, Jinsong; Zhang, Fengyu; Wang, Xuyi; Qi, Chang; He, Haoyu; Long, Jiang; Kelly, Brian C; Cohen, Joanna

2016-08-19

Considering the extreme shortage of smoking cessation services in China, and the acceptability, feasibility and efficacy of mobile phone-based text message interventions for quitting smoking in other countries, here we propose a study of "the efficacy of mobile phone-based text message interventions ('Happy Quit') for smoking cessation in China". The primary objective of this proposed project is to assess whether a program of widely accessed mobile phone-based text message interventions ('Happy Quit') will be effective at helping people in China who smoke, to quit. Based on the efficacy of previous studies in smoking cessation, we hypothesize that 'Happy Quit' will be an effective, feasible and affordable smoking cessation program in China. In this single-blind, randomized trial, undertaken in China, about 2000 smokers willing to make a quit attempt will be randomly allocated, using an independent telephone randomization system that includes a minimization algorithm balancing for sex (male, female), age (19-34 or >34 years), educational level (≤ or >12 years), and Fagerstrom score for nicotine addiction (≤5, >5), to 'Happy Quit', comprising motivational messages and behavioral-change support, or to a control group that receives text messages unrelated to quitting. Messages will be developed to be suitable for Chinese. A pilot study will be conducted before the intervention to modify the library of messages and interventions. The primary outcome will be self-reported continuous smoking abstinence. A secondary outcome will be point prevalence of abstinence. Abstinence will be assessed at six time points (4, 8, 12, 16, 20 and 24 weeks post-intervention). A third outcome will be reductions in number of cigarettes smoked per day. The results will provide valuable insights into bridging the gap between need and services received for smoking cessation interventions and tobacco use prevention in China. It will also serve as mHealth model for extending the public health significance of other interventions, such as mental health interventions. NCT02693626 (Registration data April 11, 2016).

Interest in an online smoking cessation program and effective recruitment strategies: results from Project Quit.

PubMed

McClure, Jennifer B; Greene, Sarah M; Wiese, Cheryl; Johnson, Karin E; Alexander, Gwen; Strecher, Victor

2006-08-22

The Internet is a promising venue for delivering smoking cessation treatment, either as a stand-alone program or as an adjunct to pharmacotherapy. However, there is little data to indicate what percent of smokers are interested in receiving online smoking cessation services or how best to recruit smokers to Internet-based programs. Using a defined recruitment sample, this study aimed to identify the percentage of smokers who expressed interest in or enrolled in Project Quit, a tailored, online, cognitive-behavioral support program offered with adjunctive nicotine replacement therapy patches. In addition, we examined the effectiveness of several individual-level versus population-level recruitment strategies. Members from two large health care organizations in the United States were invited to participate in Project Quit. Recruitment efforts included proactive invitation letters mailed to 34533 likely smokers and reactive population-level study advertisements targeted to all health plan members (> 560000 adults, including an estimated 98000 smokers across both health care organizations). An estimated 1.6% and 2.5% of adult smokers from each health care organization enrolled in Project Quit. Among likely smokers who received proactive study invitations, 7% visited the Project Quit website (n = 2260) and 4% (n = 1273) were eligible and enrolled. Response rates were similar across sites, despite using different sources to assemble the invitation mailing list. Proactive individual-level recruitment was more effective than other forms of recruitment, accounting for 69% of website visitors and 68% of enrollees. Smokers were interested in receiving online smoking cessation support, even though they had access to other forms of treatment through their health insurance. Uptake rates for this program were comparable to those seen when smokers are advised to quit and are referred to other forms of smoking cessation treatment. In this sample, proactive mailings were the best method for recruiting smokers to Project Quit.

The relation between media promotions and service volume for a statewide tobacco quitline and a web-based cessation program

PubMed Central

2011-01-01

Background This observational study assessed the relation between mass media campaigns and service volume for a statewide tobacco cessation quitline and stand-alone web-based cessation program. Methods Multivariate regression analysis was used to identify how weekly calls to a cessation quitline and weekly registrations to a web-based cessation program are related to levels of broadcast media, media campaigns, and media types, controlling for the impact of external and earned media events. Results There was a positive relation between weekly broadcast targeted rating points and the number of weekly calls to a cessation quitline and the number of weekly registrations to a web-based cessation program. Additionally, print secondhand smoke ads and online cessation ads were positively related to weekly quitline calls. Television and radio cessation ads and radio smoke-free law ads were positively related to web program registration levels. There was a positive relation between the number of web registrations and the number of calls to the cessation quitline, with increases in registrations to the web in 1 week corresponding to increases in calls to the quitline in the subsequent week. Web program registration levels were more highly influenced by earned media and other external events than were quitline call volumes. Conclusion Overall, broadcast advertising had a greater impact on registrations for the web program than calls to the quitline. Furthermore, registrations for the web program influenced calls to the quitline. These two findings suggest the evolving roles of web-based cessation programs and Internet-use practices should be considered when creating cessation programs and media campaigns to promote them. Additionally, because different types of media and campaigns were positively associated with calls to the quitline and web registrations, developing mass media campaigns that offer a variety of messages and communicate through different types of media to motivate tobacco users to seek services appears important to reach tobacco users. Further research is needed to better understand the complexities and opportunities involved in simultaneous promotion of quitline and web-based cessation services. PMID:22177237

The relation between media promotions and service volume for a statewide tobacco quitline and a web-based cessation program.

PubMed

Schillo, Barbara A; Mowery, Andrea; Greenseid, Lija O; Luxenberg, Michael G; Zieffler, Andrew; Christenson, Matthew; Boyle, Raymond G

2011-12-16

This observational study assessed the relation between mass media campaigns and service volume for a statewide tobacco cessation quitline and stand-alone web-based cessation program. Multivariate regression analysis was used to identify how weekly calls to a cessation quitline and weekly registrations to a web-based cessation program are related to levels of broadcast media, media campaigns, and media types, controlling for the impact of external and earned media events. There was a positive relation between weekly broadcast targeted rating points and the number of weekly calls to a cessation quitline and the number of weekly registrations to a web-based cessation program. Additionally, print secondhand smoke ads and online cessation ads were positively related to weekly quitline calls. Television and radio cessation ads and radio smoke-free law ads were positively related to web program registration levels. There was a positive relation between the number of web registrations and the number of calls to the cessation quitline, with increases in registrations to the web in 1 week corresponding to increases in calls to the quitline in the subsequent week. Web program registration levels were more highly influenced by earned media and other external events than were quitline call volumes. Overall, broadcast advertising had a greater impact on registrations for the web program than calls to the quitline. Furthermore, registrations for the web program influenced calls to the quitline. These two findings suggest the evolving roles of web-based cessation programs and Internet-use practices should be considered when creating cessation programs and media campaigns to promote them. Additionally, because different types of media and campaigns were positively associated with calls to the quitline and web registrations, developing mass media campaigns that offer a variety of messages and communicate through different types of media to motivate tobacco users to seek services appears important to reach tobacco users. Further research is needed to better understand the complexities and opportunities involved in simultaneous promotion of quitline and web-based cessation services.

The use of peer mentors to enhance a smoking cessation intervention for persons with serious mental illnesses.

PubMed

Dickerson, Faith B; Savage, Christina L G; Schweinfurth, Lucy A B; Medoff, Deborah R; Goldberg, Richard W; Bennett, Melanie; Lucksted, Alicia; Chinman, Matthew; Daumit, Gail; Dixon, Lisa; DiClemente, Carlo

2016-03-01

We evaluated a well-specified peer mentor program that enhanced a professionally led smoking cessation group for persons with serious mental illnesses. Participants were 8 peer mentors, persons with serious mental illnesses who had successfully quit smoking, and 30 program participants, persons with serious mental illnesses enrolled in a 6-month intervention. Peer mentors were trained and then helped to deliver a smoking cessation group and met with program participants individually. We assessed the mentors' skills after training, their fidelity to the model, and the program's feasibility and acceptability. We also measured the smoking outcomes of the program participants including change in exhaled carbon monoxide, a measure of recent smoking, and aspects of the peer mentor-program participant relationship. Peer mentors attained a mean score of 13.6/14 on role play assessments after training and delivered the intervention with fidelity as assessed by adherence and competence ratings (mean scores of 97% and 93%, respectively). The feasibility and acceptability of the intervention was demonstrated in that 28/30 participants met with their peer mentors regularly and only 1 participant and no peer mentor discontinued in the study. Both parties rated the interpersonal alliance highly, mean of 5.9/7. The program participants had a decline in carbon monoxide levels and number of cigarettes smoked per day (repeated measures ANOVA F = 6.04, p = .008; F = 15.87, p < .001, respectively). A total of 22/30 (73%) made a quit attempt but only 3 (10%) achieved sustained abstinence. Our study adds to the growing literature about peer-delivered interventions. (c) 2016 APA, all rights reserved).

Immediate and Six-month Effects of Project EX Russia: A Smoking Cessation Intervention Pilot Program

PubMed Central

Sun, Ping; Akhmadeeva, Leila; Arpawong, Thalida Em; Kukhareva, Polina

2013-01-01

This study evaluates the performance of the Project EX tobacco use cessation program in Russian summer recreational camps. An eight-session clinic-based tobacco use cessation program for adolescents was tested during the summer of 2011 in an experimental pilot trial that involved different youth that rotated through camps. Conditions were nested within camps. Two rotations of unique subject groups of smokers (program and standard care control) through each of five camps provided the means of controlling for campsite by condition. Assignment of condition by rotation was random (by a flip of a coin), achieving reasonable baseline comparability (total n=164 smokers at baseline, 76 program group, 88 standard care control group). Evaluation involved an immediate pretest and posttest and a six-month telephone follow-up. At immediate posttest, Project EX was moderately well-received, significantly reduced future smoking expectation (46% reduction in EX Program Condition versus 8% in Control, p<.0001), decreased intention to not quit smoking (−5.2% in EX versus +1.4% in Control, p<.05), and increased motivation to quit smoking (0.72 versus −0.04, p<.0001). At the six-month follow-up, program subjects reported a higher intent-to-treat quit rate during the last 30 days (7.5% versus 0.1%, p<.05). For the subjects who remained monthly smokers at the six-month follow-up, Project EX reduced subjects’ level of nicotine dependence (−0.53 versus +0.15, p<.001). The results were quite promising for this program, which included motivation enhancement, coping skill, and alternative medicine material. However, further research on teen tobacco use cessation programming in Russia with larger sample sizes, involving other locations of the country, and with stronger research designs is needed. PMID:23639851

A Randomized Trial of Contingency Management for Smoking Cessation During Intensive Outpatient Alcohol Treatment.

PubMed

Cooney, Judith L; Cooper, Sharon; Grant, Christoffer; Sevarino, Kevin; Krishnan-Sarin, Suchitra; Gutierrez, Ian A; Cooney, Ned L

2017-01-01

This randomized clinical trial was designed to evaluate the efficacy of contingency management (CM) for smoking cessation for smokers with alcohol abuse or dependence delivered concurrently with intensive outpatient alcohol treatment. The study also explored the indirect effects of CM smoking treatment and smoking cessation on alcohol and drug use outcomes. Alcohol abuse/dependent smokers were randomized to cognitive behavioral therapy plus nicotine replacement therapy plus contingency management (CBT+NRT+CM) or to cognitive behavior therapy plus nicotine replacement therapy (CBT+NRT) delivered concurrent with a three-week intensive outpatient alcohol treatment program. Participants in the CBT+NRT+CM condition were significantly more likely to be cigarette abstinent at the end of treatment (χ 2 (1)=8.48, p=.004) with approximately double the carbon monoxide confirmed quit rate (60%) compared with the CBT+NRT condition (29%). At the one-month and six-month time-points there were nonsignificant differences in smoking abstinence outcomes by condition. Smoking treatment condition did not directly affect alcohol abstinence outcomes, but we observed an indirect effect of smoking treatment on alcohol and drug abstinence at one-month follow-up that was mediated by smoking cessation at the end of treatment. Adding CM to an evidence-based smoking cessation treatment that included medication and behavioral counseling doubled the quit rate at the end of treatment. This finding provides strong evidence for the efficacy of CM for helping alcohol dependent smokers reach the milestone of initial smoking abstinence. Published by Elsevier Inc.

Attitudes Toward Smoking Cessation Among Sheltered Homeless Parents.

PubMed

Stewart, Holly C; Stevenson, Terrell N; Bruce, Janine S; Greenberg, Brian; Chamberlain, Lisa J

2015-12-01

The prevalence of smoking among homeless adults is approximately 70 %. Cessation programs designed for family shelters should be a high priority given the dangers cigarette smoke poses to children. However, the unique nature of smoking in the family shelter setting remains unstudied. We aimed to assess attitudes toward smoking cessation, and unique barriers and motivators among homeless parents living in family shelters in Northern California. Six focus groups and one interview were conducted (N = 33, ages 23-54). The focus groups and interviews were audiorecorded, transcribed verbatim, and a representative team performed qualitative theme analysis. Eight males and 25 females participated. The following major themes emerged: (1) Most participants intended to quit eventually, citing concern for their children as their primary motivation. (2) Significant barriers to quitting included the ubiquity of cigarette smoking, its central role in social interactions in the family shelter setting, and its importance as a coping mechanism. (3) Participants expressed interest in quitting "cold turkey" and in e-cigarettes, but were skeptical of the patch and pharmacotherapy. (4) Feelings were mixed regarding whether individual, group or family counseling would be most effective. Homeless parents may be uniquely motivated to quit because of their children, but still face significant shelter-based social and environmental barriers to quitting. Successful cessation programs in family shelters must be designed with the unique motivations and barriers of this population in mind.

Tobacco and diabetes: clinical relevance and approach to smoking cessation in diabetic smokers.

PubMed

López Zubizarreta, Marco; Hernández Mezquita, Miguel Ángel; Miralles García, José Manuel; Barrueco Ferrero, Miguel

2017-04-01

Smoking is, together with diabetes mellitus, one of the main risk factors for cardiovascular disease. Diabetic patients have unique features and characteristics, some of which are not well known, that cause smoking to aggravate the effects of diabetes and impose difficulties in the smoking cessation process, for which a specificand more intensive approach with stricter controls is required. This review details all aspects with a known influence on the interaction between smoking and diabetes, both as regards the increased risk of macrovascular and microvascular complications of diabetes and the factors with an impact on the results of smoking cessation programs. The treatment guidelines for these smokers, including the algorithms and drug treatment patterns which have proved most useful based on scientific evidence, are also discussed. Copyright © 2017 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

Proactive telephone counseling for adolescent smokers: Comparing regular smokers with infrequent and occasional smokers on treatment receptivity, engagement, and outcomes.

PubMed

Heffner, Jaimee L; Kealey, Kathleen A; Marek, Patrick M; Bricker, Jonathan B; Ludman, Evette J; Peterson, Arthur V

2016-08-01

Adolescent smoking cessation efforts to date have tended to focus on regular smokers. Consequently, infrequent and occasional smokers' receptivity and response to smoking cessation interventions is unknown. To address this gap, this study examines data from the Hutchinson Study of High School Smoking-a randomized trial that examined the effectiveness of a telephone-delivered smoking cessation intervention for a large, population-based cohort of adolescent smokers proactively recruited in an educational setting. The study population included 1837 proactively identified high school smokers. Intervention receptivity, engagement, and outcomes were examined among adolescent infrequent (1-4days/month) and occasional (5-19days/month) smokers and compared with regular smokers (20 or more days/month). With regard to treatment receptivity, intervention recruitment did not differ by smoking frequency. For engagement, intervention completion rates were higher for infrequent smokers (80.5%) compared with occasional (63.8%) and regular smokers (61.5%, p<0.01). Intervention effect sizes were not statistically different across groups. Adolescent infrequent and occasional smokers are at least as receptive to a proactively delivered smoking cessation intervention as regular smokers and can benefit just as much from it. Including these adolescent smokers in cessation programs and research-with the goal of interrupting progression of smoking before young adulthood-should help reduce the high smoking prevalence among young adults. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Smoking behavior and motivation to quit among chronic pain patients initiating multidisciplinary pain treatment: a prospective study.

PubMed

Unrod, Marina; Gironda, Ronald J; Clark, Michael E; White, Kristi E; Simmons, Vani N; Sutton, Steven K; Brandon, Thomas H

2014-08-01

The primary aim of this study was to assess smoking characteristics and cessation motivation prior to and after initiation of multidisciplinary chronic pain treatment. A secondary aim was to identify predictors of cessation motivation among smokers initiating treatment for chronic pain. We used a prospective, nonrandomized, repeated measures design. The study was conducted in a multidisciplinary specialty pain treatment program at a veterans hospital. Smokers (N = 90) referred to a multidisciplinary pain program for the treatment of chronic pain. Patients completed questionnaires assessing pain-related and smoking-related factors prior to (baseline) and 8 weeks post (follow-up) specialty pain treatment initiation. Primary outcome measures were the Contemplation Ladder and the Stages of Change (SOC) algorithm. At baseline, patients reported moderate levels of cessation motivation, and 69% were in the contemplation stage or higher on the SOC. Motivation to quit smoking was higher at follow-up compared with baseline on both continuous, t(89) = 2.11, P < 0.05, and stage-based, z = 3.69, P < 0.01, measures. At follow-up, participants reported greater interest in receiving cessation interventions, and 7.8% of patients had quit smoking. Pain-related predictors of motivation (e.g., pain intensity) were subsumed by more general predictors (e.g., nicotine dependence). Patients in this sample were more motivated to quit smoking a few weeks after, as compared with before initiating specialty pain treatment. Future research into pain-specific predictors of cessation motivation is warranted to inform the development of interventions that address pain patients' unique needs. Wiley Periodicals, Inc.

Depression, anxiety, stress, and motivation over the course of smoking cessation treatment

PubMed Central

Pawlina, Maritza Muzzi Cardozo; Rondina, Regina de Cássia; Espinosa, Mariano Martinez; Botelho, Clóvis

2015-01-01

Objective: To evaluate changes in the levels of patient anxiety, depression, motivation, and stress over the course of smoking cessation treatment. Methods: This cohort study involved patients enrolled in a smoking cessation program in Cuiabá, Brazil. We selected patients who completed the program in six months or less (n = 142). Patient evaluations were conducted at enrollment (evaluation 1 [E1]); after 45 days of treatment with medication and cognitive-behavioral therapy (E2); and at the end of the six-month study period (E3). Patients were evaluated with a standardized questionnaire (to collect sociodemographic data and determine smoking status), as well as with the University of Rhode Island Change Assessment scale, Beck Anxiety Inventory, Beck Depression Inventory, and Lipp Inventory of Stress Symptoms for Adults. The data were analyzed with the nonparametric Wilcoxon test for paired comparisons. To compare treatment success (smoking cessation) with treatment failure, the test for two proportions was used. Results: Among the 142 patients evaluated, there were improvements, in terms of the levels of anxiety, depression, motivation, and stress, between E1 and E2, as well as between E1 and E3. In addition, treatment success correlated significantly with the levels of motivation and anxiety throughout the study period, whereas it correlated significantly with the level of depression only at E2 and E3. Conclusions: We conclude that there are in fact changes in the levels of patient anxiety, depression, motivation, and stress over the course of smoking cessation treatment. Those changes appear to be more pronounced in patients in whom the treatment succeeded. PMID:26578135

Predictors of adherence to pharmacological and behavioral treatment in a cessation trial among smokers in Aleppo, Syria

PubMed Central

Ben Taleb, Ziyad; Ward, Kenneth D; Asfar, Taghrid; Bahelah, Raed; Maziak, Wasim

2015-01-01

Introduction The development of evidence-based smoking cessation programs is in its infancy in developing countries, which continue to bear the main brunt of the tobacco epidemic. Adherence to treatment recommendations is an important determinant of the success of smoking cessation programs, but little is known about factors influencing adherence to either pharmacological or behavioral treatment in developing countries settings. Our study represents the first attempt to examine the predictors of adherence to cessation treatment in a low-income developing country. Methods Predictors of adherence to pharmacological and behavioral treatment were identified by analyzing data from a multi-site, two-group, parallel-arm, double-blind, randomized, placebo-controlled smoking cessation trial in primary care clinics in Aleppo, Syria. Participants received 3 in-person behavioral counseling sessions plus 5 brief follow-up phone counseling sessions, and were randomized to either 6 weeks of nicotine or placebo patch. Results Of the 269 participants, 68% adhered to pharmacological treatment, while 70% adhered to behavioral counseling. In logistic regression modeling, lower adherence to pharmacological and behavioral treatment was associated with higher daily smoking at baseline, greater withdrawal symptoms, and perception of receiving placebo instead of active nicotine patch. Women showed lower adherence than men to behavioral treatment, while being assigned to placebo condition and baseline waterpipe use were associated with lower adherence to pharmacological treatment. Conclusion Adherence to cessation treatment for cigarette smokers in low-income countries such as Syria may benefit from integrated cessation components that provide intensive treatment for subjects with higher nicotine dependence, and address concurrent waterpipe use at all stages. PMID:26077603

Design Considerations in Developing a Text Messaging Program Aimed at Smoking Cessation

PubMed Central

Holtrop, Jodi Summers; Bağci Bosi, A Tülay; Emri, Salih

2012-01-01

Background Cell phone text messaging is gaining increasing recognition as an important tool that can be harnessed for prevention and intervention programs across a wide variety of health research applications. Despite the growing body of literature reporting positive outcomes, very little is available about the design decisions that scaffold the development of text messaging-based health interventions. What seems to be missing is documentation of the thought process of investigators in the initial stages of protocol and content development. This omission is of particular concern because many researchers seem to view text messaging as the intervention itself instead of simply a delivery mechanism. Certainly, aspects of this technology may increase participant engagement. Like other interventions, however, the content is a central driver of the behavior change. Objective To address this noted gap in the literature, we discuss the protocol decisions and content development for SMS Turkey (or Cebiniz birakin diyor in Turkish), a smoking cessation text messaging program for adult smokers in Turkey. Methods Content was developed in English and translated into Turkish. Efforts were made to ensure that the protocol and content were grounded in evidence-based smoking cessation theory, while also reflective of the cultural aspects of smoking and quitting in Turkey. Results Methodological considerations included whether to provide cell phones and whether to reimburse participants for texting costs; whether to include supplementary intervention resources (eg, personal contact); and whether to utilize unidirectional versus bidirectional messaging. Program design considerations included how messages were tailored to the quitting curve and one’s smoking status after one’s quit date, the number of messages participants received per day, and over what period of time the intervention lasted. Conclusion The content and methods of effective smoking cessation quitline programs were a useful guide in developing SMS Turkey. Proposed guidelines in developing text messaging-based behavior change programs are offered. PMID:22832182

Factors associated with stage of change in smoker in relation to smoking cessation based on the Korean National Health and Nutrition Examination Survey II-V

PubMed Central

Leem, Ah Young; Han, Chang Hoon; Ahn, Chul Min; Lee, Sang Haak; Kim, Jae Yeol; Chun, Eun Mi; Yoo, Kwang Ha

2017-01-01

Despite a decrease in incidence, smoking remains the most serious public health problem worldwide. Identification of the factors contributing to changes in willingness to quit smoking may aid the development of strategies that encourage smoking cessation. Pooled cross-sectional data from 11,924 smokers from the Korean National Health and Nutrition Examination Survey II–V were analyzed. The stages of change in smoking cessation were categorized as pre-contemplation, contemplation, and preparation. Baseline characteristics, socioeconomic factors, quality of life, psychological status, and smoking-related factors were compared between groups. The smokers were grouped as follows: 32.4% pre-contemplation, 54.4% contemplation, and 13.1% preparation. The proportion of smokers in the pre-contemplation group decreased (from 37.4% to 28.4%) from 2001 to 2012, while the proportion in the preparation group increased (from 6.4% to 18.1%). Compared with the preparation group, after adjusting for confounding factors, the pre-contemplation group was older [≥65 years-old; odds ratio (OR) = 1.40], more often single (OR = 1.38), less educated (elementary school or lower; OR = 1.93), less physically active in terms of walking (OR = 1.38) or performing strengthening exercises (OR = 1.61), smoked more heavily (≥20 cigarettes per day; OR = 4.75), and had a lower prevalence of chronic disease (OR = 0.76). Moreover, smokers who had never received education on smoking cessation were less willing to quit than those who had (OR = 0.44). In Korean smokers, the stages of change for smoking cessation were associated with age, education, marital status, chronic diseases, physical activity, and participation in smoking cessation programs. PMID:28472051

Utilization of smoking cessation medication benefits among medicaid fee-for-service enrollees 1999–2008

PubMed Central

Kahende, Jennifer; England, Lucinda; Zhang, Lei; Mowery, Paul; Xu, Xin; Sevilimedu, Varadan; Rolle, Italia

2017-01-01

Objective To assess state coverage and utilization of Medicaid smoking cessation medication benefits among fee-for-service enrollees who smoked cigarettes. Methods 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. Results 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. Conclusions 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. PMID:28207744

Patterns and predictors of smoking cessation among users of a telephone hotline.

PubMed Central

Jaén, C R; Cummings, K M; Zielezny, M; O'Shea, R

1993-01-01

Most former cigarette smokers in the United States have stopped without formal assistance. However, a large proportion of smokers desire and seek help other than by attending formal programs. It is important to recognize what factors are likely to influence the effectiveness of smoking cessation attempts among these persons. The authors report results of a prospective cohort study of 1,552 smokers who called a stop smoking hotline to request self-help smoking cessation information. The participants were classified into three groups based on reports at the 6-month followup: 242 quitters, 497 recidivists, and 813 nonquitters. Baseline and followup data were used to evaluate three comparisons: quitters versus nonquitters, quitters versus recidivists, and recidivists versus nonquitters. Nonquitters appear to be less motivated and more doubtful of their abilities to quit successfully compared with the other two groups. Quitters appear to live in a supportive environment for smoking cessation. Heavier smokers are more hesitant to try to quit, but once they make an attempt they are as likely to succeed as lighter smokers, when other factors are kept constant. Efforts to promote environments supportive of smoking cessation are likely to result in a larger number of successful quitters. Similarly, efforts to strengthen motivation and belief in personal ability to quit are likely to encourage more nonquitters to attempt to stop smoking. Finally, it appears that some smokers need a previous quit attempt before they are able to maintain cessation successfully. PMID:8265763

African-American teen smokers: issues to consider for cessation treatment.

PubMed Central

Moolchan, E. T.; Berlin, I.; Robinson, M. L.; Cadet, J. L.

2000-01-01

Previous reports have indicated ethnic differences in both tobacco-related morbidity and treatment outcome for smoking cessation among adults. We assessed smoking-related characteristics in African-American and non-African American teenagers applying to a cessation trial. 115 teens (15.9 +/- 1.8 years, 68% females, 27% African-American) responded via telephone to media ads. Self-reported sociodemographic, medical and smoking-related data were obtained to determine pre-eligibility for a full intake screen prior to trial participation. Compared to non-African American, African American teen applicants were older (16.4 +/- 1.7 years versus 15.6 +/- 1.6; p = 0.015), had lower Fagerström Test for Nicotine Dependence (FTND) scores (5.3 +/- 2.3 versus 6.1 +/- 1.8; p = 0.018, ANOVA controlling for age) and smoked fewer cigarettes on the weekend (27 +/- 16 versus 38 +/- 17; p = 0.001). African American teens reported similar duration of smoking (3.3 +/- 1.4 versus 3.1 +/- 1.5 years) and time elapsed between first cigarette ever smoked and daily smoking (0.7 +/- 0.9 versus 0.6 +/- 0.7 years). African American and non-African American teens had similar motivation to quit scores and frequency of reported health problems (e.g., asthma, psychiatric conditions). These data suggest that cessation treatment programs designed for African American youth should include lower Fagerstrom-defined levels, and possibly other criteria for tobacco dependence. These observations also highlight the importance of ethnocultural issues in treatment research programs. PMID:11202758

Opportunities for youth smoking cessation: findings from a national focus group study.

PubMed

Balch, George I; Tworek, Cindy; Barker, Dianne C; Sasso, Barbara; Mermelstein, Robin; Giovino, Gary A

2004-02-01

To identify opportunities for smoking cessation among adolescents, we conducted six computer-assisted telephone focus groups with 48 male and female high school student smokers and former smokers from six states across the United States, all aged 15-17 years, in two groups each of "established smokers," "late experimenters," and "quitters." These adolescents considered addiction to cigarettes real, powerful, stealthy, insidious, harmful, and avoidable. They considered quitting smoking achievable and desirable. Many of the established smokers and some experimenters would not consider quitting until an indefinite future, when they expected adult responsibilities to help them quit. Quitters had been encouraged by friends who did not smoke around them or offer them cigarettes; they also associated more with nonsmoking friends. Some adolescents, especially quitters, reported that parents had tried to help them quit; some smokers reported that parents had provided them with cigarettes. Some adolescents reported school rules and enforcement that made it hard to smoke; others reported school rules and enforcement that made it easy and tempting to smoke. These adolescents were not aware of the availability of professional help or interested in it. Many did not consider smoking urgent or "intense" enough for professional help. Perceptions of cessation programs were nonexistent or negative. Participants were aware of nicotine replacement therapies but less so of prescription medications. These findings suggest that it is critical to educate adolescents about what good cessation programming is and is not, why it is needed, how it might help, and where it is offered.

Efficacy of a Tailored Tobacco Control Program on Long-Term Use in a Population of U.S. Military Troops

ERIC Educational Resources Information Center

Klesges, Robert C.; DeBon, Margaret; Vander Weg, Mark W.; Haddock, C. Keith; Lando, Harry A.; Relyea, George E.; Peterson, Alan L.; Talcott, G. Wayne

2006-01-01

The authors evaluated the effect of a brief tailored smoking control intervention delivered during basic military training on tobacco use in a population of military personnel (N = 33,215). Participants were randomized to either a tobacco use intervention (smoking cessation, smokeless tobacco use cessation, or prevention depending on tobacco…

Attitude and practices among dentists and senior dental students in iran toward tobacco cessation as an effort to prevent oral cancer.

PubMed

Razavi, Sayed Mohammad; Zolfaghari, Behzad; Doost, Mostafa Emami; Tahani, Bahareh

2015-01-01

Oral health professionals are responsible in Iran for providing a brief tobacco cessation program to smoker patients. The aim of this study was to assess Iranian dental student and dentist practice, knowledge and attitudes toward smoking cessation programs. A valid and reliable self-administered questionnaire was designed and distributed to 150 dentists working in Isfahan-Iran and 60 dental students. Some questions were developed based on the expected 5A tobacco cessation protocol. Statements on attitudes focused on professional responsibility towards smoking cessation and its effectiveness. Chi-square, ANOVA, and t test were used for statistical analysis. The cessation program in dental settings covers a small group of patients (18%). Some 69.1% (n=96) of dentists reported asking their patients about tobacco use, 64% (n=83) advising their patients to quit, 33.8% (n=47) assessing their patients willingness to quit and 20% (n=28) reported helping their patients in changing their behavior. A far lower percentage reported active involvement in arranging assistance for smokers to quit (4.3%, n=5). Some 22% of students and 26% of dentists disagreed that the tobacco cessation programs should be as part of dentists' professional responsibility and 70% of them were willing to follow the protocol of tobacco cessation for patients. Iranian dentist performance regarding tobacco cessation is weak. Dentists and students indicated their lack of knowledge as the major reason for non-adherence to the protocol. Therefore, planning to encourage dentist to follow the protocol needs continuous educational programs.

Smoking Behaviors and Attitudes Among Clients and Staff at New York Addiction Treatment Programs Following a Smoking Ban: Findings After 5 Years.

PubMed

Pagano, Anna; Guydish, Joseph; Le, Thao; Tajima, Barbara; Passalacqua, Emma; Soto-Nevarez, Arturo; Brown, Lawrence S; Delucchi, Kevin L

2016-05-01

Addiction treatment clients are more likely to die of tobacco-related diseases than of alcohol or illicit drug-related causes. We aimed to assess smoking behavior, and smoking-related attitudes and services, in New York addiction treatment programs before a statewide smoking ban in treatment facilities was implemented (2008), 1 year (2009) and 5 years after implementation (2013). We conducted surveys at each time point with clients (N = 329, 341, and 353, respectively) and staff (N = 202, 203, and 166, respectively) from five residential and two methadone maintenance programs in New York State. At each data collection wave, questionnaires measured smoking behavior as well as smoking-related knowledge, attitudes, and experiences with tobacco cessation services as part of addiction treatment. Staff smoking prevalence decreased from 35.2% in 2008 to 21.8% in 2013 (P = .005) while client smoking prevalence over the same period was unchanged (68.1% vs. 66.0%, P = .564). Among clients who smoked, mean cigarettes per day decreased from 13.7 (SD = 8.38) to 10.2 (SD = 4.44; P < .001). There were significant time-by-treatment-type interactions for client tobacco-related attitudes and cessation services received; and for staff self-efficacy and cessation services provided. In residential programs, scores for most items decreased (became less positive) in 2009 followed by a partial rebound in 2013. Methadone program scores tended to rise (become more positive) throughout the study period. Staff and clients may respond differentially to tobacco-free policies depending on type of treatment program, and this finding may help to inform the implementation of tobacco-free policies in other statewide addiction treatment systems. © 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.

Examining the Effects of Art Therapy on Reoccurring Tobacco Use in a Taiwanese Youth Population: A Mixed-Method Study.

PubMed

Hong, Rei-Mei; Guo, Su-Er; Huang, Chun-Sheng; Yin, Cheng

2018-03-21

Cigarette smoking is a primary risk factor affecting mental and physical health worldwide. Many chronic diseases are closely related to smoking. Adolescents in Taiwan are increasingly using tobacco, especially in rural areas. This research project used a mixed-method study to examine the effects of art therapy on smoking cessation in rural Taiwanese youth smokers. Participants from years 10-11, were drawn from three senior high schools in Taiwan. The experimental group participated in a six-week smoking cessation intervention using art therapy. The comparison group participated in typical courses on smoking cessation. Quantitative measures included need for smoking, nicotine dependence, self-esteem, self-efficacy, and smoking cessation status. Qualitative analysis was based on phenomenology. A total of 66 students (n = 40 experimental group; n = 26 comparison group) were the subjects of quantitative analysis. No differences were noted in baseline characteristics of groups. Generalized estimating equation analyses suggested significant between-group differences in change from pre- to follow-up test scores in the "social domain" (B = -5.12, p < 0.05). Qualitative data (n = 17 experimental group; n = 10 control group) suggested three domains: effects of art therapy on smoking prevention, benefits of art therapy on other outcome measures, and comparison between art therapy and traditional smoking cessation programs. Conclusions/importance: The findings of this study can potentially contribute significantly to existing knowledge regarding the perceptions of art therapy on reoccurring tobacco use in Taiwanese youth.

The Use of Peer Mentors to Enhance a Smoking Cessation Intervention for Persons with Serious Mental Illnesses

PubMed Central

Dickerson, Faith B.; Savage, Christina L.G.; Schweinfurth, Lucy A.B.; Medoff, Deborah R.; Goldberg, Richard W.; Bennett, Melanie; Lucksted, Alicia; Chinman, Matthew; Daumit, Gail; Dixon, Lisa; DiClemente, Carlo

2015-01-01

Objective We evaluated a well-specified peer mentor program that enhanced a professionally-led smoking cessation group for persons with serious mental illnesses. Methods Participants were 8 peer mentors, persons with serious mental illnesses who had successfully quit smoking, and 30 program participants, persons with serious mental illnesses enrolled in a 6 month intervention. Peer mentors were trained and then helped to deliver a smoking cessation group and met with program participants individually. We assessed the mentors’ skills after training, their fidelity to the model, and the program’s feasibility and acceptability. We also measured the smoking outcomes of the program participants including change in exhaled carbon monoxide, a measure of recent smoking, and aspects of the peer mentor-program participant relationship. Results Peer mentors attained a mean score of 13.6/14 on role play assessments after training and delivered the intervention with fidelity as assessed by adherence and competence ratings (mean scores of 97% and 93%, respectively). The feasibility and acceptability of the intervention was demonstrated in that 28/30 participants met with their peer mentors regularly and only 1 participant and no peer mentor discontinued in the study. Both parties rated the interpersonal alliance highly, mean of 5.9/7. The program participants had a decline in carbon monoxide levels and number of cigarettes smoked per day (repeated measures ANOVA F=6.04, p=.008; F=15.87, p<.001, respectively). A total of 22/30 (73%) made a quit attempt but only 3 (10%) achieved sustained abstinence. Conclusions and Implications for Practice Our study adds to the growing literature about peer-delivered interventions. PMID:26461436

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.

Building Evidence-Based Tobacco Treatment in the Eastern Mediterranean Region: Lessons Learned by the Syrian Center for Tobacco Studies

PubMed Central

Asfar, Taghrid; Ward, Kenneth D.; Al-Ali, Radwan; Maziak, Wasim

2016-01-01

The tobacco epidemic in Syria is characterized by high rates of cigarettes smoking in men and dramatic reemergence of waterpipe smoking, especially among youths and women. The Syrian Center for Tobacco Studies (SCTS), an NIH-funded pioneer research and capacity building institution, has developed a research infrastructure and conducted three randomized clinical trials to develop and rigorously test culturally-appropriate tobacco treatment programs integrated into primary healthcare (PHC) centers. This review aimed to discuss challenges and lessons learned from the Syrian experience. Addressing these challenges may inform future cessation research activities in Syria and other developing countries. To develop a research infrastructure, the SCTS has established Syria’s first IRB and trained physicians/medical students in both tobacco treatment and research methods. Main challenges to conduct the cessation trials were difficulties of coordination between the local and international collaborators; high Smoking Rates among PHC providers; lack of pharmacological agents used in tobacco treatment; and difficulties of conducting research in a politically volatile region. Strategies to overcome these challenges were ensuring an active and regular involvement of all investigator; and advocating for a national smoking-cessation plan that involves training health care providers in smoking cessation treatment and make pharmacological agents used in smoking cessation available. PMID:27563356

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

Motivation and Reasons to Quit: Predictive Validity among Adolescent Smokers

ERIC Educational Resources Information Center

Turner, Lindsey R.; Mermelstein, Robin

2004-01-01

Objectives : To examine reasons to quit among adolescents in a smoking cessation program, and whether reasons were associated with subsequent cessation. Methods : Participants were 351 adolescents. At baseline, adolescents reported motivation, reasons to quit, and stage of change for cessation. Quit status was assessed at end of treatment. Results…

Motivating Latino caregivers of children with asthma to quit smoking: a randomized trial.

PubMed

Borrelli, Belinda; McQuaid, Elizabeth L; Novak, Scott P; Hammond, S Katharine; Becker, Bruce

2010-02-01

Secondhand smoke exposure is associated with asthma onset and exacerbation. Latino children have higher rates of asthma morbidity than other groups. The current study compared the effectiveness of a newly developed smoking cessation treatment with existing clinical guidelines for smoking cessation. Latino caregivers who smoked (N = 133; 72.9% female; mean age = 36.8 years) and had a child with asthma were randomly assigned to receive 1 of 2 smoking cessation counseling interventions during a home-based asthma program: (a) behavioral action model (BAM; modeled on clinical guidelines for smoking cessation) or (b) precaution adoption model (PAM; feedback on the caregiver's carbon monoxide level and child's secondhand smoke exposure using Motivational Interviewing). Counseling was delivered by a bilingual Latina health educator, and the content was tailored to Latino values and culture. It was not necessary for smokers to want to quit smoking to participate. Smoking cessation was biochemically verified and secondhand smoke exposure was objectively measured through passive nicotine monitors. Intent-to-treat analyses showed that 20.5% of participants in the PAM condition and 9.1% of those in the BAM condition were continuously abstinent at 2 months posttreatment (OR = 2.54; 95% CI = 0.91-7.10), whereas 19.1% of participants in the PAM condition and 12.3% of those in BAM condition were continuously abstinent at 3 months posttreatment (OR = 1.68; 95% CI = 0.64-4.37). Secondhand smoke exposure decreased only in the BAM condition (p < .001), an effect due to less smoking around the child among nonquitters in this condition. Asthma morbidity showed significant decreases in the posttreatment period for the PAM group only (p < .001). Results provide support for targeting specific populations with theory-based interventions.

Preventing Relapse to Cigarette Smoking by Behavioral Skill Training.

ERIC Educational Resources Information Center

Hall, Sharon M.; And Others

Although smoking cessation techniques have been effective, few programs have long term results. To investigate the effectiveness of a tobacco dependence relapse prevention program, 123 adult smokers (51 male, 72 female) voluntarily participated in one of four small group treatment conditions (6 or 30 second aversive smoking plus skill training, or…

Social Psychological Factors in Adolescent Cigarette Smoking.

ERIC Educational Resources Information Center

Sherman, Steven J.; And Others

Results emanating from smoking cessation programs suggest the necessity for a greater commitment to research for primary smoking prevention. Because of the early onset of smoking, more research must focus on adolescents and preadolescents who have not yet begun to smoke regularly. Three areas of concentrated study are proposed: (1) the initiation…

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.

Nicotine Dependence and Cost-Effectiveness of Individualized Support for Smoking Cessation: Evidence from Practice at a Worksite in Japan

PubMed Central

Nakamura, Koshi; Sakurai, Masaru; Miura, Katsuyuki; Morikawa, Yuko; Nagasawa, Shin-ya; Ishizaki, Masao; Kido, Teruhiko; Naruse, Yuchi; Suwazono, Yasushi; Nakagawa, Hideaki

2013-01-01

Given the lack of economic studies evaluating the outcomes of smoking cessation programs from the viewpoint of program sponsors, we conducted a case study to provide relevant information for worksites. The present study was carried out between 2006 and 2008 at a manufacturing factory in the Toyama Prefecture of Japan and included subjects who voluntarily entered a smoking cessation program. The program included face-to-face counselling followed by weekly contact to provide encouragement over six months using e-mail or inter-office mail. Nicotine patches were available if required. All 151 participants stopped smoking immediately. Over the 24-month study period, self-report showed 49.7% abstained continuously from smoking. The rate of 24-month consecutive abstinence was higher in participants with lower Fagerström Test scores for Nicotine Dependence at baseline than in those with higher scores (63.6% for 0–2 points vs. 46.5% for 3–6 points vs. 43.8% for 7–10 points; chi-square test p = 0.19). A logistic regression model showed a significant linear trend for the association between the score and abstinence status after adjustment for possible confounding factors (p = 0.03). The crude incremental cost for one individual to successfully quit smoking due to the support program was ¥46,379 (i.e., ¥100 = $1.28, £0.83, or €1.03 at foreign exchange rates). The corresponding costs for the three categories of the Fagerström Test score for Nicotine Dependence were ¥31,953, ¥47,450 and ¥64,956, respectively. When a sensitivity analysis was conducted based on the 95% confidence interval of the success rate, the variance in the corresponding costs was ¥25,514–45,034 for 0–2 points, ¥38,344–61,824 for 3–6 points, and ¥45,698–108,260 for 7–10 points. The degree of nicotine dependence may therefore be an important determinant of the cost-effectiveness of smoking cessation programs. PMID:23383289

Nicotine dependence and cost-effectiveness of individualized support for smoking cessation: evidence from practice at a worksite in Japan.

PubMed

Nakamura, Koshi; Sakurai, Masaru; Miura, Katsuyuki; Morikawa, Yuko; Nagasawa, Shin-ya; Ishizaki, Masao; Kido, Teruhiko; Naruse, Yuchi; Suwazono, Yasushi; Nakagawa, Hideaki

2013-01-01

Given the lack of economic studies evaluating the outcomes of smoking cessation programs from the viewpoint of program sponsors, we conducted a case study to provide relevant information for worksites. The present study was carried out between 2006 and 2008 at a manufacturing factory in the Toyama Prefecture of Japan and included subjects who voluntarily entered a smoking cessation program. The program included face-to-face counselling followed by weekly contact to provide encouragement over six months using e-mail or inter-office mail. Nicotine patches were available if required. All 151 participants stopped smoking immediately. Over the 24-month study period, self-report showed 49.7% abstained continuously from smoking. The rate of 24-month consecutive abstinence was higher in participants with lower Fagerström Test scores for Nicotine Dependence at baseline than in those with higher scores (63.6% for 0-2 points vs. 46.5% for 3-6 points vs. 43.8% for 7-10 points; chi-square test p = 0.19). A logistic regression model showed a significant linear trend for the association between the score and abstinence status after adjustment for possible confounding factors (p = 0.03). The crude incremental cost for one individual to successfully quit smoking due to the support program was ¥46,379 (i.e., ¥100 = $1.28, £0.83, or €1.03 at foreign exchange rates). The corresponding costs for the three categories of the Fagerström Test score for Nicotine Dependence were ¥31,953, ¥47,450 and ¥64,956, respectively. When a sensitivity analysis was conducted based on the 95% confidence interval of the success rate, the variance in the corresponding costs was ¥25,514-45,034 for 0-2 points, ¥38,344-61,824 for 3-6 points, and ¥45,698-108,260 for 7-10 points. The degree of nicotine dependence may therefore be an important determinant of the cost-effectiveness of smoking cessation programs.

Smoking Cessation Support by Text Message During Pregnancy: A Qualitative Study of Views and Experiences of the MiQuit Intervention

PubMed Central

Hopewell, Sarah; Coleman, Tim; Cooper, Sue; Naughton, Felix

2017-01-01

Abstract Introduction: SMS text messaging is increasingly used for delivering smoking cessation support and pilot studies suggest this may also be useful in pregnancy. This study explores the views of women who received a tailored text messaging cessation intervention (MiQuit) during pregnancy, focusing on acceptability, perceived impact, and suggestions for improvements. Methods: Semi-structured interviews were undertaken with 15 purposively sampled women who had received the MiQuit intervention during pregnancy as part of a randomized controlled trial. Data were analyzed thematically. Results: Three main themes were identified: “impact”, “approach,” and “optimization.” Participants described an immediate, yet often short-lived, impact from the texts that distracted and delayed them from smoking and they perceived that texts focusing on the development of and risk to the baby generated more enduring emotional impacts. Most women found receiving support by text preferable to face-to-face cessation support, with participants citing the greater regularity, convenience, and non-judgmental style as particular advantages. Participants would have preferred a longer support program with increased tailoring, greater customization of text timings and consideration of cutting down as an alternative/precursor to quitting. Conclusion: Pregnancy-specific cessation support by text message was well received and participants considered the support increased their motivation to stop smoking. The focus on the developing baby, the regularity of contact and the provision of gentle, encouraging messages were highlighted as particularly important elements of the program. Implications: This study adds further evidence to the acceptability and perceived positive impact of text-messaging programs in aiding smoking cessation in pregnancy. The findings indicate that for some women, this type of support is preferable to face-to-face methods and could be utilized by health professionals, either in addition to current methods or as an alternative. This study is also relevant to researchers developing health-related text programs to consider participants’ desire for greater tailoring. Further research is required into adapting and continuing text support for women postpartum. PMID:28403457

Smoking Cessation Support by Text Message During Pregnancy: A Qualitative Study of Views and Experiences of the MiQuit Intervention.

PubMed

Sloan, Melanie; Hopewell, Sarah; Coleman, Tim; Cooper, Sue; Naughton, Felix

2017-05-01

SMS text messaging is increasingly used for delivering smoking cessation support and pilot studies suggest this may also be useful in pregnancy. This study explores the views of women who received a tailored text messaging cessation intervention (MiQuit) during pregnancy, focusing on acceptability, perceived impact, and suggestions for improvements. Semi-structured interviews were undertaken with 15 purposively sampled women who had received the MiQuit intervention during pregnancy as part of a randomized controlled trial. Data were analyzed thematically. Three main themes were identified: "impact", "approach," and "optimization." Participants described an immediate, yet often short-lived, impact from the texts that distracted and delayed them from smoking and they perceived that texts focusing on the development of and risk to the baby generated more enduring emotional impacts. Most women found receiving support by text preferable to face-to-face cessation support, with participants citing the greater regularity, convenience, and non-judgmental style as particular advantages. Participants would have preferred a longer support program with increased tailoring, greater customization of text timings and consideration of cutting down as an alternative/precursor to quitting. Pregnancy-specific cessation support by text message was well received and participants considered the support increased their motivation to stop smoking. The focus on the developing baby, the regularity of contact and the provision of gentle, encouraging messages were highlighted as particularly important elements of the program. This study adds further evidence to the acceptability and perceived positive impact of text-messaging programs in aiding smoking cessation in pregnancy. The findings indicate that for some women, this type of support is preferable to face-to-face methods and could be utilized by health professionals, either in addition to current methods or as an alternative. This study is also relevant to researchers developing health-related text programs to consider participants' desire for greater tailoring. Further research is required into adapting and continuing text support for women postpartum. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco.

Proactive recruitment of cancer patients’ social networks into a smoking cessation trial

PubMed Central

Bastian, Lori A.; Fish, Laura J.; Peterson, Bercedis L.; Biddle, Andrea K.; Garst, Jennifer; Lyna, Pauline; Molner, Stephanie; Bepler, Gerold; Kelley, Mike; Keefe, Francis J.; McBride, Colleen M.

2011-01-01

Background This report describes the characteristics associated with successful enrollment of smokers in the social networks (i.e., family and close friends) of patients with lung cancer into a smoking cessation intervention. Methods Lung cancer patients from four clinical sites were asked to complete a survey enumerating their family members and close friends who smoke, and provide permission to contact these potential participants. Family members and close friends identified as smokers were interviewed and offered participation in a smoking cessation intervention. Repeated measures logistic regression model examined characteristics associated with enrollment. Results A total of 1,062 eligible lung cancer patients were identified and 516 patients consented and completed the survey. These patients identified 1,325 potentially eligible family and close friends. Of these, 496 consented and enrolled in the smoking cessation program. Network enrollment was highest among patients who were white and had late-stage disease. Social network members enrolled were most likely to be female, a birth family, immediate family, or close friend, and live in close geographic proximity to the patient. Conclusions Proactive recruitment of smokers in the social networks of lung cancer patients is challenging. In this study, the majority of family members and friends declined to participate. Enlisting immediate female family members and friends, who live close to the patient as agents to proactively recruit other network members into smoking cessation trials could be used to extend reach of cessation interventions to patients’ social networks. Moreover, further consideration should be given to the appropriate timing of approaching network smokers to consider cessation. PMID:21382509

Mixed-Methods for Comparing Tobacco Cessation Interventions.

PubMed

Momin, Behnoosh; Neri, Antonio; Zhang, Lei; Kahende, Jennifer; Duke, Jennifer; Green, Sonya Goode; Malarcher, Ann; Stewart, Sherri L

2017-03-01

The National Comprehensive Cancer Control Program (NCCCP) and National Tobacco Control Program (NTCP) are both well-positioned to promote the use of population-based tobacco cessation interventions, such as state quitlines and Web-based interventions. This paper outlines the methodology used to conduct a comparative effectiveness research study of traditional and Web-based tobacco cessation and quitline promotion approaches. A mixed-methods study with three components was designed to address the effect of promotional activities on service usage and the comparative effectiveness of population-based smoking cessation activities across multiple states. The cessation intervention component followed 7,902 smokers (4,307 quitline users and 3,595 Web intervention users) to ascertain prevalence of 30-day abstinence rates 7 months after registering for smoking cessation services. User characteristics and quit success was compared across the two modalities. In the promotions component, reach and use of traditional and innovative promotion strategies were assessed for 24 states, including online advertising, state Web sites, social media, mobile applications, and their effects on quitline call volume. The partnership intervention component studied the extent of collaboration among six selected NCCCPs and NTCPs. This study will guide program staff and clinicians with evidence-based recommendations and best practices for implementation of tobacco cessation within their patient and community populations and establish an evidence base that can be used for decision making.

Smoking Cessation After Acute Myocardial Infarction in Relation to Depression and Personality Factors.

PubMed

Schlyter, Mona; Leosdottir, Margrét; Engström, Gunnar; André-Petersson, Lena; Tydén, Patrik; Östman, Margareta

2016-04-01

Smoking is an important cardiovascular risk factor and smoking cessation should be a primary target in secondary prevention after a myocardial infarction (MI). The purpose of this study was to examine whether personality, coping and depression were related to smoking cessation after an MI. MI patients ≤70 years (n = 323, 73 % men, 58.7 ± 8.3 years), participating in the Secondary Prevention and Compliance following Acute Myocardial Infarction study in Malmö, Sweden, between 2002 and 2005, were interviewed by a psychologist to assess coping strategies and completed Beck Depression and NEO Personality Inventories, in close proximity to the acute event. Correlation between smoking status (current, former and never), personality factors, coping and depression was assessed at baseline and 24 months after the MI using logistic regression and in a multivariate analysis, adjusting for age and sex. Of the participating patients, 46 % were current smokers. Two years after the event, 44 % of these were still smoking. At baseline, current smokers scored higher on the depression and neuroticism scales and had lower agreeableness scores. Patients who continued to smoke after 2 years had higher scores on being confrontational (i.e. confrontative coping style) compared to those who had managed to quit. Patients who continued to smoke had significantly lower agreeableness and were more often living alone. Personality, coping strategies and psychosocial circumstances are associated with smoking cessation rates in patients with MI. Considering personality factors and coping strategies to better individualise smoking cessation programs in MI patients might be of importance.

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.

Examining smoking and cessation during pregnancy among an Appalachian sample: a preliminary view

PubMed Central

Cottrell, Lesley; Gibson, Mark; Harris, Carole; Rai, Alia; Sobhan, Sabera; Berry, Traci; Stanton, Bonita

2007-01-01

Background Several transitions that a woman experiences prenatally may influence her desire or ability to discontinue smoking. This study explores the role of smoking for young, Appalachian, nulliparous pregnant women and their plans for smoking during their pregnancies. Results The reports of women and their male partners were taken from baseline interviews conducted during the first trimester of pregnancy. Cigarette smoking appeared to be more than an isolated addictive activity; rather, smoking was interwoven in women's social and personal realms, often changing as their perceptions of self changed. Women and their partners who continued to smoke appeared to be depressed, reject authority, and perceived little control over issues related to being pregnant. Conclusion These findings support the argument that standard substance use treatments and polices based on stages-of-change theories may not be effective for all individuals particularly those experiencing significant developmental changes in their lives. Greater success might be obtained from treatment programs designed to recognize the impact of these transitions as it relates to the substance use. The changing experiences of pregnant women in terms of their identity development, views of others, and their relationships have not been adequately addressed in existing cessation programs. Empirically-based interventions targeting these lifestyle characteristics may lead to increased cessation success among pregnant women. PMID:17484783

Using incentives to encourage smoking abstinence among pregnant indigenous women? A feasibility study.

PubMed

Glover, Marewa; Kira, Anette; Walker, Natalie; Bauld, Linda

2015-06-01

Smoking during pregnancy increases the risk of many adverse health outcomes for both the mother and the unborn child (Morton et al. 2010). Indigenous people often have a higher smoking prevalence during pregnancy than non-Indigenous populations. In New Zealand (NZ), the smoking rates among Indigenous Māori women who are pregnant have reduced since 1991 (68 %) but still remains high in 2007 (34 %) (Morton et al. 2010). The success rate of most smoking cessation interventions for pregnant smokers is low at <6 % (Lumley et al. 2009). In other populations of pregnant women, financial incentives have been shown to increase the attractiveness of smoking cessation programs and increase the number of quit attempts. A feasibility study was undertaken to determine the likely effectiveness of an incentives-based cessation trial among pregnant Māori women that smoked. Pregnant smokers, aged 16 years and older, who self-identified as Māori, were 2-30 weeks pregnant, and currently smoked, were recruited through health practitioners, print media, and radio adverts in Auckland, NZ. Participants were randomised to (1) usual cessation support, including information about different cessation products and services, and access to nicotine replacement therapy (control), (2) usual cessation support plus a retail voucher to the value of NZ$25 for each 'abstinent from smoking' week for 8 weeks (voucher), or (3) usual cessation support plus product to the value of NZ$25 for each 'abstinent from smoking' week for 8 weeks (product). Outcomes measures included weekly self-reported and monthly biochemically verified smoking status, and acceptability. Of the 74 referred women, 50 declined involvement in the study and 24 consented and were randomised (eight control, eight voucher and eight to product). The mean age of participants was 25 years old (±2.25). Overall 21 % (n = 5) of the women were abstinent from smoking for at least 6 weeks of the eight, one from the control, six from the product and three from the voucher. Our findings suggest that incentives, in particular a choice of products, may be an effective addition to usual care to increase smoking cessation among pregnant Māori women, which has the potential to improve health outcomes for both the mother and child.

A qualitative exploration of the reasons for the discontinuation of smoking cessation treatment among Quit Smoking Clinics' defaulters and health care providers in Malaysia.

PubMed

Lee, Mei Lin; Hassali, Mohamed Azmi; Shafie, Asrul Akmal

2013-01-01

Treatment default among the smokers hinders the effectiveness of the delivery of cessation services. While many studies have predicted the defaulters' characteristics, the reasons why these smokers dropped out and continued smoking are seldom explored. This study examined the barriers encountered by such smokers and their respective health care providers (HCPs) in relation to the discontinuation of cessation treatment. From May 2010 to March 2011, 15 current adult smokers and 9 HCPs from 2 Quit Smoking Clinics (QSCs) in the Melaka Tengah District, Malacca, Malaysia were interviewed on smoking, cessation, and the QSC. Interviews were audio recorded and transcribed verbatim. The transcripts were subsequently translated into English and analyzed using thematic analysis. The barriers encountered were categorized as Individual- and Clinic-level. Both smokers and HCPs acknowledged that the smokers' low intrinsic motivation was the individual-level barrier. The clinic-level barriers were the mismatched perceptions of smokers and HCPs regarding the HCPs' roles, skills, and attitudes, as well as the availability and efficacy of smoking cessation aids (SCAs). While the smokers viewed the program as not helpful, the HCPs cited the lack of organizational support as their main barrier. The reasons for treatment default centered on the overall dissatisfaction with the treatment (due to the program, HCP, and SCA factors) combined with the smokers' low intrinsic motivation. Optimizing the interplay of the extrinsic motivational cues, such as the HCP and SCA factors, would complement the smoker's low intrinsic motivation and thus encourage treatment retention. However, it is necessary to strike a balance between the individual smoker's needs and the availability of organizational support. Copyright © 2013 Elsevier Inc. All rights reserved.

Usage and Effectiveness of a Fully Automated, Open-Access, Spanish Web-Based Smoking Cessation Program: Randomized Controlled Trial

PubMed Central

2014-01-01

Background The Internet is an optimal setting to provide massive access to tobacco treatments. To evaluate open-access Web-based smoking cessation programs in a real-world setting, adherence and retention data should be taken into account as much as abstinence rate. Objective The objective was to analyze the usage and effectiveness of a fully automated, open-access, Web-based smoking cessation program by comparing interactive versus noninteractive versions. Methods Participants were randomly assigned either to the interactive or noninteractive version of the program, both with identical content divided into 4 interdependent modules. At baseline, we collected demographic, psychological, and smoking characteristics of the smokers self-enrolled in the Web-based program of Universidad Nacional de Educación a Distancia (National Distance Education University; UNED) in Madrid, Spain. The following questionnaires were administered: the anxiety and depression subscales from the Symptom Checklist-90-Revised, the 4-item Perceived Stress Scale, and the Heaviness of Smoking Index. At 3 months, we analyzed dropout rates, module completion, user satisfaction, follow-up response rate, and self-assessed smoking abstinence. Results A total of 23,213 smokers were registered, 50.06% (11,620/23,213) women and 49.94% (11,593/23,213) men, with a mean age of 39.5 years (SD 10.3). Of these, 46.10% (10,701/23,213) were married and 34.43% (7992/23,213) were single, 46.03% (10,686/23,213) had university education, and 78.73% (18,275/23,213) were employed. Participants smoked an average of 19.4 cigarettes per day (SD 10.3). Of the 11,861 smokers randomly assigned to the interactive version, 2720 (22.93%) completed the first module, 1052 (8.87%) the second, 624 (5.26%) the third, and 355 (2.99%) the fourth. Completion data was not available for the noninteractive version (no way to record it automatically). The 3-month follow-up questionnaire was completed by 1085 of 23,213 enrolled smokers (4.67%). Among them, 406 (37.42%) self-reported not smoking. No difference between groups was found. Assuming missing respondents continued to smoke, the abstinence rate was 1.74% (406/23,213), in which 22,678 were missing respondents. Among follow-up respondents, completing the 4 modules of the intervention increased the chances of smoking cessation (OR 1.95, 95% CI 1.27-2.97, P<.001), as did smoking 30 minutes (OR 1.58, 95% CI 1.04-2.39, P=.003) or 1 hour after waking (OR 1.93, 95% CI 1.27-2.93, P<.001) compared to smoking within the first 5 minutes after waking. Conclusions The findings suggest that the UNED Web-based smoking cessation program was very accessible, but a high level of attrition was confirmed. This could be related to the ease of enrollment, its free character, and the absence of direct contact with professionals. It is concluded that, in practice, the greater the accessibility to the program, the lower the adherence and retention. Professional support from health services and the payment of a reimbursable fee could prevent high rates of attrition. PMID:24760951

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.

Pathways to health: a cluster randomized trial of nicotine gum and motivational interviewing for smoking cessation in low-income housing.

PubMed

Okuyemi, Kolawole S; James, Aimee S; Mayo, Matthew S; Nollen, Nicole; Catley, Delwyn; Choi, Won S; Ahluwalia, Jasjit S

2007-02-01

Despite high smoking rates among those living in poverty, few cessation studies are conducted in these populations. This cluster-randomized trial tested nicotine gum plus motivational interviewing (MI) for smoking cessation in 20 low-income housing developments (HDs). Intervention participants (10 HDs, n = 66) received educational materials, 8 weeks of 4 mg nicotine gum, and 5 MI sessions on quitting smoking. Comparison participants (10 HDs, n = 107) received 5 MI sessions and educational materials addressing fruit and vegetable consumption. Participants had a mean age of 46.3 years and were predominantly female (70%) and African American (83%). Biochemically-verified 7-day abstinence rates at 8 weeks were 6.1% and 5.6% in the intervention and comparison arms, respectively (p = ns); and at 26 weeks were 7.6% and 9.3%, respectively (p = ns). Results suggest that nicotine gum plus MI were not effective for smoking cessation in low-income housing. Programs are needed to enhance the effectiveness of pharmacotherapy and counseling in underserved populations.

Predictors of adherence to pharmacological and behavioral treatment in a cessation trial among smokers in Aleppo, Syria.

PubMed

Ben Taleb, Ziyad; Ward, Kenneth D; Asfar, Taghrid; Bahelah, Raed; Maziak, Wasim

2015-08-01

The development of evidence-based smoking cessation programs is in its infancy in developing countries, which continue to bear the main brunt of the tobacco epidemic. Adherence to treatment recommendations is an important determinant of the success of smoking cessation programs, but little is known about factors influencing adherence to either pharmacological or behavioral treatment in developing countries settings. Our study represents the first attempt to examine the predictors of adherence to cessation treatment in a low-income developing country. Predictors of adherence to pharmacological and behavioral treatment were identified by analyzing data from a multi-site, two-group, parallel-arm, double-blind, randomized, placebo-controlled smoking cessation trial in primary care clinics in Aleppo, Syria. Participants received 3 in-person behavioral counseling sessions plus 5 brief follow-up phone counseling sessions, and were randomized to either 6 weeks of nicotine or placebo patch. Of the 269 participants, 68% adhered to pharmacological treatment, while 70% adhered to behavioral counseling. In logistic regression modeling, lower adherence to pharmacological and behavioral treatment was associated with higher daily smoking at baseline, greater withdrawal symptoms, and perception of receiving placebo instead of active nicotine patch. Women showed lower adherence than men to behavioral treatment, while being assigned to placebo condition and baseline waterpipe use were associated with lower adherence to pharmacological treatment. Adherence to cessation treatment for cigarette smokers in low-income countries such as Syria may benefit from integrated cessation components that provide intensive treatment for subjects with higher nicotine dependence, and address concurrent waterpipe use at all stages. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Impact of smoking cessation training for community pharmacists in Indonesia.

PubMed

Kristina, Susi Ari; Thavorncharoensap, Montarat; Pongcharoensuk, Petcharat; Prabandari, Yayi Suryo

2015-01-01

Community pharmacists play an important role in tobacco control and adequate training on smoking cessation is essential. A quasi-experimental pre-test/post-test design was used. A one-day workshop on smoking cessation organized by Indonesian Pharmacists Association as part of PCE program was offered to 133 community pharmacists. The workshop consisted of a 3-hour lecture and a 3-hour role-play session. Pre-training and post-training surveys assessed the impact of training on parameters including knowledge, perceived role and self-efficacy with respect to smoking cessation counseling practices. Intention and ability to perform counseling using the 5A framework was assessed after training only. After PCE, knowledge score significantly increased from 24.9±2.58 to 35.7±3.54 (p<0.001). Perceived role and self-efficacy in smoking cessation counseling also significantly increased from 25.8±2.73 to 28.7±2.24, and 27.6±4.44 to 32.6±3.63, respectively (p<0.001). After the workshop, most participants were willing to ask, advise, and assess patients who ready to quit, but were still less likely to assist in quitting plans and arranging follow up counseling. More than 75% pharmacists were able to perform cessation counseling and 65% of them can completely perform a 5A brief intervention. PCE can enhance pharmacists' knowledge, perceived role, self-efficacy in cessation counseling practices, and create willingness and ability to perform cessation counseling. Future training is recommended to improve skills in assisting quitting plans and arranging follow up.

Cost-effective primary care-based strategies to improve smoking cessation: more value for money.

PubMed

Salize, Hans Joachim; Merkel, Silke; Reinhard, Iris; Twardella, Dorothee; Mann, Karl; Brenner, Hermann

2009-02-09

Evidence from cost-effective smoking cessation programs is scarce. This study determined the cost-effectiveness of 3 smoking cessation strategies as provided by general practitioners (GPs) in Germany. In a cluster-randomized smoking cessation trial, rates and intervention costs for 577 smoking patients of 82 GPs were followed up for 12 months. Three smoking cessation treatments were tested: (1) GP training plus GP remuneration for each abstinent patient, (2) GP training plus cost-free nicotine replacement medication and/or bupropion hydrochloride for the patient, and (3) a combination of both strategies. Smoking abstinence at 12 months was the primary outcome used to calculate incremental cost-effectiveness ratios and net monetary benefits. Intervention 1 was not effective compared with treatment as usual (TAU). Interventions 2 and 3 each proved to be cost-effective compared separately with TAU. When applying a 95% level of certainty of cost-effectiveness against TAU, euro 9.80 or euro 6.96, respectively, had to be paid for each additional 1% of patients abstinent at 12 months (maximum willingness to pay). That means that in intervention 2, euro 92.12 per patient in the program must be invested to gain 1 additional quitter (as opposed to euro 39.10 paid per patient during the trial). In intervention 2, the cost was euro 82.82, as opposed to euro 50.04. Neither of these 2 cost-effective treatments proved to be superior to the other. The cost-effectiveness of both treatments was stable against TAU in sensitivity analyses. (The exchange rate from October 1, 2003, was used; euro1 = $1.17.) Both treatments have a high potential to reduce smoking-related morbidity at a low cost. It is highly recommended that they be implemented as a routine service offered by GPs because in many countries, health insurance plans currently do not fund nicotine replacement therapy.

Supporting Aboriginal Women to Quit Smoking: Antenatal and Postnatal Care Providers' Confidence, Attitudes, and Practices.

PubMed

Tzelepis, Flora; Daly, Justine; Dowe, Sarah; Bourke, Alex; Gillham, Karen; Freund, Megan

2017-05-01

Tobacco use during pregnancy is substantially higher among Aboriginal women compared to non-Aboriginal women in Australia. However, no studies have investigated the amount or type of smoking cessation care that staff from Aboriginal antenatal and postnatal services provide to clients who smoke or staff confidence to do so. This study examined Aboriginal antenatal and postnatal staff confidence, perceived role and delivery of smoking cessation care to Aboriginal women and characteristics associated with provision of such care. Staff from 11 Aboriginal Maternal and Infant Health Services and eight Aboriginal Child and Family Health services in the Hunter New England Local Health District in Australia completed a cross-sectional self-reported survey (n = 67, response rate = 97.1%). Most staff reported they assessed clients' smoking status most or all of the time (92.2%). However, only a minority reported they offered a quitline referral (42.2%), provided follow-up support (28.6%) or provided nicotine replacement therapy (4.7%) to most or all clients who smoked. Few staff felt confident in motivating clients to quit smoking (19.7%) and advising clients about using nicotine replacement therapy (15.6%). Staff confident with talking to clients about how smoking affected their health had significantly higher odds of offering a quitline referral [OR = 4.9 (1.7-14.5)] and quitting assistance [OR = 3.9 (1.3-11.6)] to clients who smoke. Antenatal and postnatal staff delivery of smoking cessation care to pregnant Aboriginal women or mothers with young Aboriginal children could be improved. Programs that support Aboriginal antenatal and postnatal providers to deliver smoking cessation care to clients are needed. Aboriginal antenatal and postnatal service staff have multiple opportunities to assist Aboriginal women to quit smoking during pregnancy and postpartum. However, staff confidence and practices of offering various forms of smoking cessation support to pregnant Aboriginal women is unexplored. This is the first study to examine the amount and type of smoking cessation support Aboriginal antenatal and postnatal service staff provide to Aboriginal women, staff confidence and their perceived role in delivering smoking cessation care. This information is valuable for developing strategies that assist antenatal and postnatal staff to improve their delivery of smoking cessation care to Aboriginal women. © 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.

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.

“I know it’s bad for me and yet I do it”: exploring the factors that perpetuate smoking in Aboriginal Health Workers - a qualitative study

PubMed Central

2012-01-01

Background Aboriginal Health Workers (AHWs) have a mandate to deliver smoking cessation support to Aboriginal people. However, a high proportion of AHWs are smokers and this undermines their delivery of smoking cessation programs. Smoking tobacco is the leading contributor to the burden of disease in Aboriginal Australians and must be prevented. Little is known about how to enable AHWs to quit smoking. An understanding of the factors that perpetuate smoking in AHWs is needed to inform the development of culturally relevant programs that enable AHWs to quit smoking. A reduction of smoking in AHWs is important to promote their health and also optimise the delivery of smoking cessation support to Aboriginal clients. Methods We conducted a fundamental qualitative description study that was nested within a larger mixed method participatory research project. The individual and contextual factors that directly or indirectly promote (i.e. perpetuate) smoking behaviours in AHWs were explored in 34 interviews and 3 focus groups. AHWs, other health service staff and tobacco control personnel shared their perspectives. Data analysis was performed using a qualitative content analysis approach with collective member checking by AHW representatives. Results AHWs were highly stressed, burdened by their responsibilities, felt powerless and undervalued, and used smoking to cope with and support a sense of social connectedness in their lives. Factors directly and indirectly associated with smoking were reported at six levels of behavioural influence: personal factors (e.g. stress, nicotine addiction), family (e.g. breakdown of family dynamics, grief and loss), interpersonal processes (e.g. socialisation and connection, domestic disputes), the health service (e.g. job insecurity and financial insecurity, demanding work), the community (e.g. racism, social disadvantage) and policy (e.g. short term and insecure funding). Conclusions An extensive array of factors perpetuated smoking in AHWs. The multitude of personal, social and environmental stressors faced by AHWs and the accepted use of communal smoking to facilitate socialisation and connection were primary drivers of smoking in AHWs in addition to nicotine dependence. Culturally sensitive multidimensional smoking cessation programs that address these factors and can be tailored to local needs are indicated. PMID:22533609

Do respiratory therapists receive training and education in smoking cessation? A national study of post-secondary training programs.

PubMed

Jordan, Timothy R; Khubchandani, Jagdish; Wiblishauser, Michael; Glassman, Tavis; Thompson, Amy

2011-10-01

To assess the tobacco-related education provided by post-secondary respiratory therapy training programs in the United States. A cross-sectional research design was used to survey the entire population of program directors of post-secondary, respiratory therapy training programs in the United States. A valid and reliable questionnaire was developed and mailed using a 2-wave mailing technique (73% return rate). Internal reliability coefficients (Cronbach alpha) for the various components of the questionnaire ranged from 0.78 to 0.91. More than half of programs (56%) offered no teaching on the 5R's. Nearly half (47%) offered no teaching on the 5A's. Of the 13 tobacco-related topics listed in the basic science and clinical science sections of the questionnaire, only one topic (i.e., diseases linked to tobacco use) received 3h or more of instruction by approximately a third of programs (35.8%). The majority of programs (>90%) spent no time teaching students about the socio-political aspects of tobacco use cessation. Moreover, 41% of programs did not formally evaluate students' competence in providing smoking cessation counseling to patients. Tobacco-related education is a very minor component of the education and training received by respiratory therapy students in the United States. Respiratory therapy training programs in the United States have great potential to strengthen the tobacco-related education that they provide to students. Practicing respiratory therapists would likely benefit from continuing medical education focused on how to use evidence-based smoking cessation counseling techniques with patients. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

The role of public policies in reducing smoking: the Minnesota SimSmoke tobacco policy model.

PubMed

Levy, David T; Boyle, Raymond G; Abrams, David B

2012-11-01

Following the landmark lawsuit and settlement with the tobacco industry, Minnesota pursued the implementation of stricter tobacco control policies, including tax increases, mass media campaigns, smokefree air laws, and cessation treatment policies. Modeling is used to examine policy effects on smoking prevalence and smoking-attributable deaths. To estimate the effect of tobacco control policies in Minnesota on smoking prevalence and smoking-attributable deaths using the SimSmoke simulation model. Minnesota data starting in 1993 are applied to SimSmoke, a simulation model used to examine the effect of tobacco control policies over time on smoking initiation and cessation. Upon validating the model against smoking prevalence, SimSmoke is used to distinguish the effect of policies implemented since 1993 on smoking prevalence. Using standard attribution methods, SimSmoke also estimates deaths averted as a result of the policies. SimSmoke predicts smoking prevalence accurately between 1993 and 2011. Since 1993, a relative reduction in smoking rates of 29% by 2011 and of 41% by 2041 can be attributed to tobacco control policies, mainly tax increases, smokefree air laws, media campaigns, and cessation treatment programs. Moreover, 48,000 smoking-attributable deaths will be averted by 2041. Minnesota SimSmoke demonstrates that tobacco control policies, especially taxes, have substantially reduced smoking prevalence and smoking-attributable deaths. Taxes, smokefree air laws, mass media, cessation treatment policies, and youth-access enforcement contributed to the decline in prevalence and deaths averted, with the strongest component being taxes. With stronger policies, for example, increasing cigarette taxes to $4.00 per pack, Minnesota's smoking rate could be reduced by another 13%, and 7200 deaths could be averted by 2041. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Evaluating Nicotine Craving, Withdrawal, and Substance Use as Mediators of Smoking Cessation in Cocaine- and Methamphetamine-Dependent Patients

PubMed Central

Lewis, Daniel F.; Winhusen, Theresa

2016-01-01

Abstract Introduction: Smoking is highly prevalent in substance dependence, but smoking-cessation treatment (SCT) is more challenging in this population. To increase the success of smoking cessation services, it is important to understand potential therapeutic targets like nicotine craving that have meaningful but highly variable relationships with smoking outcomes. This study characterized the presence, magnitude, and specificity of nicotine craving as a mediator of the relationship between SCT and smoking abstinence in the context of stimulant-dependence treatment. Methods: This study was a secondary analysis of a randomized, 10-week trial conducted at 12 outpatient SUD treatment programs. Adults with cocaine and/or methamphetamine dependence ( N = 538) were randomized to SUD treatment as usual (TAU) or TAU+SCT. Participants reported nicotine craving, nicotine withdrawal symptoms, and substance use in the week following a uniform quit attempt of the TAU+SCT group, and self-reported smoking 7-day point prevalence abstinence (verified by carbon monoxide) at end-of-treatment. Results: Bootstrapped regression models indicated that, as expected, nicotine craving following a quit attempt mediated the relationship between SCT and end-of-treatment smoking point prevalence abstinence (mediation effect = 0.09, 95% CI = 0.04% to 0.14%, P < .05, 14% of total effect). Nicotine withdrawal symptoms and substance use were not significant mediators ( P s > .05, <1% of total effect). This pattern held for separate examinations of cocaine and methamphetamine dependence. Conclusions: Nicotine craving accounts for a small but meaningful portion of the relationship between smoking-cessation treatment and smoking abstinence during SUD treatment. Nicotine craving following a quit attempt may be a useful therapeutic target for increasing the effectiveness of smoking-cessation treatment in substance dependence. PMID:26048168

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.

Adolescents' smoking behavior and its relationships with psychological constructs based on transtheoretical model: a cross-sectional survey.

PubMed

Kim, Young-Ho

2006-05-01

Korean adolescents' smoking is currently being considered as a crucial factor determining the health status of adolescents and an important public health and social issue. The purpose of the study was to test the applicability of the Transtheoretical model to gain an understanding of smoking behavior change. A total of 706 adolescents who participated in the smoking cessation programs administered by the Korea Quit Smoking Association or Korean Association of Smoking & Health in 2003 were recruited. Four Korean-version questionnaires were used to identify the stages of smoking behavior and psychological attributes: Stage of Smoking Behavior Change Scale, Processes of Change Scale for Smoking, Decision Balance Scale for Smoking, and Self-efficacy Scale to avoid smoking. Korean adolescents' smoking behavior was differed according to gender. In addition, the findings revealed that behavioral and cognitive processes of change, self-efficacy, and positives differed across the stages of smoking behavior, and that psychological constructs of the transtheoretical model had a statistically significant impact on smoking behavior change. This research could spawn the development of theory-based and empirically supported smoking cessation intervention strategies and programs directed toward adolescents in the health care and nursing areas.

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…

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.

The Role of Public Policies in Reducing Smoking

PubMed Central

Levy, David T.; Boyle, Raymond G.; Abrams, David B.

2015-01-01

Background Following the landmark lawsuit and settlement with the tobacco industry, Minnesota pursued the implementation of stricter tobacco control policies, including tax increases, mass media campaigns, smokefree air laws, and cessation treatment policies. Modeling is used to examine policy effects on smoking prevalence and smoking-attributable deaths. Purpose To estimate the effect of tobacco control policies in Minnesota on smoking prevalence and smoking-attributable deaths using the SimSmoke simulation model. Methods Minnesota data starting in 1993 are applied to SimSmoke, a simulation model used to examine the effect of tobacco control policies over time on smoking initiation and cessation. Upon validating the model against smoking prevalence, SimSmoke is used to distinguish the effect of policies implemented since 1993 on smoking prevalence. Using standard attribution methods, SimSmoke also estimates deaths averted as a result of the policies. Results SimSmoke predicts smoking prevalence accurately between 1993 and 2011. Since 1993, a relative reduction in smoking rates of 29% by 2011 and of 41% by 2041 can be attributed to tobacco control policies, mainly tax increases, smokefree air laws, media campaigns, and cessation treatment programs. Moreover, 48,000 smoking-attributable deaths will be averted by 2041. Conclusions Minnesota SimSmoke demonstrates that tobacco control policies, especially taxes, have substantially reduced smoking prevalence and smoking-attributable deaths. Taxes, smokefree air laws, mass media, cessation treatment policies, and youth-access enforcement contributed to the decline in prevalence and deaths averted, with the strongest component being taxes. With stronger policies, for example, increasing cigarette taxes to $4.00 per pack, Minnesota’s smoking rate could be reduced by another 13%, and 7200 deaths could be averted by 2041. PMID:23079215

Influence of Recruitment Strategy on the Reach and Effect of a Web-Based Multiple Tailored Smoking Cessation Intervention among Dutch Adult Smokers

ERIC Educational Resources Information Center

Smit, Eline Suzanne; Hoving, Ciska; Cox, Vincent Cornelis Maria; de Vries, Hein

2012-01-01

This study investigated the influence of two different recruitment strategies on the reach and effect of a web-based multiple tailored smoking cessation program. From May 2009 until June 2010, Dutch adult smokers were recruited via mass media or general practices. Those who completed the baseline questionnaire were followed up during 6 weeks (two…

College Smoking-Cessation Using Cell Phone Text Messaging.

ERIC Educational Resources Information Center

Obermayer, Jami L.; Riley, William T.; Jean-Mary, Jersino

2004-01-01

Although rates of smoking among college-aged students continue to rise, few interventions that focus on college smokers' unique motivations and episodic smoking patterns exist. The authors developed and evaluated a prototype program targeting college students that integrates Web and cell phone technologies to deliver a smoking-cessation…

Are primary health care providers prepared to implement an anti-smoking program in Syria?

PubMed

Asfar, Taghrid; Al-Ali, Radwan; Ward, Kenneth D; Vander Weg, Mark W; Maziak, Wasim

2011-11-01

To document primary health care (PHC) providers' tobacco use, and how this influences their smoking cessation practices and attitudes towards tobacco-control policies. Anonymous questionnaires were distributed to PHC providers in 7 randomly selected PHC centers in Aleppo, Syria. All PHC providers completed the questionnaires (100% response rate). A quarter of these providers smoke cigarettes and more than 10% smoke waterpipes. Physicians who smoke were less likely to advise patients to quit (OR=0.29; 95% CI, 0.09-0.95), assess their motivation to quit (OR=0.13, 95% CI=0.02-0.72), or assist them in quitting (OR=0.24, 95% CI=0.06-0.99). PHC providers who smoke were less likely to support a ban on smoking in PHC settings (68.2% vs. 89.1%) and in enclosed public places (68.2% vs. 86.1%) or increases in the price of tobacco products (43.2% vs. 77.4%) (P<0.01 for all comparisons). Smoking, including waterpipe, continues to be widespread among PHC providers in Syria and will negatively influence implementation of anti-smoking program in PHC settings. Smoking awareness and cessation interventions targeted to PHC providers, and training programs to build providers' competency in addressing their patients' smoking is crucial in Syria. Published by Elsevier Ireland Ltd.

Respiratory problems and anxiety sensitivity in smoking lapse among treatment seeking smokers.

PubMed

Zvolensky, Michael J; Rodríguez-Cano, Rubén; Paulus, Daniel J; Kotov, Roman; Bromet, Evelyn; Gonzalez, Adam; Manning, Kara; Luft, Benjamin J

2017-12-01

The current study examined whether the interaction of lower respiratory symptoms and anxiety sensitivity is related to smoking lapse in the context of smoking cessation. Participants were adult daily smokers (N=60) exposed to the World Trade Center (WTC) disaster who were in a smoking cessation treatment program (75.0% male, 50.6years old [SD=9.2], and current smoking rate was 17.6 cigarettes per day (SD=10.6). Results indicated that the interaction between lower respiratory symptoms and anxiety sensitivity was a significant predictor of greater risk for lapse (i.e., lower survival time; B=0.005, OR=1.01, p=0.039). Follow-up analysis showed that greater respiratory symptoms were a significant predictor of lapse risk among those with high (B=0.116, OR=1.12, p=0.025), but not those with low (B=-0.048, OR=0.95, p=0.322), levels of anxiety sensitivity. The findings from the current study suggest that smokers with greater respiratory symptoms and higher levels of anxiety sensitivity may be associated with early lapse to smoking following smoking cessation treatment. Future work has the potential to inform the development of tailored cessation interventions for smokers who experience varying levels of lower respiratory symptoms and anxiety sensitivity. Copyright © 2017 Elsevier Ltd. All rights reserved.

Smoking history, knowledge, and attitudes among older residents of a long-term care facility.

PubMed

Carosella, Ann Marie; Ossip-Klein, Deborah J; Watt, Celia A; Podgorski, Carol

2002-05-01

In the absence of empirical literature from the resident perspective, this study provided a first assessment of smoking history, knowledge of the risks of smoking, the risks of environmental tobacco exposure, and the benefits of quitting among older (age 50+) nursing home unit residents, as well as readiness to quit, barriers to quitting, frequency of cessation advice by healthcare givers, and quit-attempt history of residents who smoke. Subjects were 25 smokers and 70 non-smokers housed on long-term nursing home units in a county hospital. Results indicated that smoking status for the majority of residents was similar to when they were admitted, although smokers smoked fewer cigarettes (M = 11.6, SD = 9.2) than prior to admission (M = 18.6, SD = 11.8). Smokers were less likely than non-smokers to agree that smoking is harmful to their health. Both smokers and non-smokers were not well informed of the dangers of passive smoke exposure. The majority of smokers were in precontemplation (no interest in quitting within the next 6 months). Fewer than half of residents who smoked reported receiving cessation advice from physicians (40%) or nurses (36%), and no in-house cessation programs were available. These results suggest gaps in knowledge and resources for smoking cessation in this setting and an opportunity for intervention. This study begins to build an evidence base from the residents' perspective that can be used by healthcare providers, administrators, and policy makers in addressing smoking in the nursing home.

The head start tobacco cessation initiative: using systems change to support staff identification and intervention for tobacco use in low-income families.

PubMed

Moody-Thomas, Sarah; Sparks, Michael; Hamasaka, Laura; Ross-Viles, Sarah; Bullock, Amber

2014-08-01

Tobacco use continues to be the leading cause of preventable illness and death in the United States. Remarkably, more than nine million preschool-aged children are exposed to secondhand smoke, resulting in increased rates of morbidity and mortality. Even more disturbing is that tobacco use is highest among people with the lowest levels of income and education. Thus, reaching these populations is a challenge facing tobacco control programs. This report describes an innovative pilot project implementing a systems change model that involves multiple stakeholders in integrating evidence-based cessation strategies into federal Head Start programs, which serve low-income adults and their children. The Tobacco Cessation Initiative was developed through a partnership between the American Legacy Foundation, the Mailman School of Public Health at Columbia University, and the Louisiana State University Health Sciences Center School of Public Health. The partnership developed guidelines to fit into the overall mission of Head Start by enabling participating sites to incorporate tobacco cessation identification and referral protocols into their existing infrastructures. This program allowed Head Start sites to incorporate, into their existing family services, protocols for user identification and referral; build partnerships with groups supporting tobacco cessation; link families to cessation services; and educate families about risks associated with exposure to secondhand smoke. Applying system strategies in non-clinical settings such as Head Start offers a way to improve the health and quality of life of preschool children at the highest risk for exposure to secondhand smoke.

The effects of smoking and smoking cessation on nasal mucociliary clearance, mucus properties and inflammation

PubMed Central

Utiyama, Daniela Mitiyo Odagiri; Yoshida, Carolina Tieko; Goto, Danielle Miyuki; de Santana Carvalho, Tômas; de Paula Santos, Ubiratan; Koczulla, Andreas Rembert; Saldiva, Paulo Hilário Nascimento; Nakagawa, Naomi Kondo

2016-01-01

OBJECTIVE: The aim of the present study was to assess nasal mucociliary clearance, mucus properties and inflammation in smokers and subjects enrolled in a Smoking Cessation Program (referred to as quitters). METHOD: A total of 33 subjects with a median (IQR) smoking history of 34 (20-58) pack years were examined for nasal mucociliary clearance using a saccharine transit test, mucus properties using contact angle and sneeze clearability tests, and quantification of inflammatory and epithelial cells, IL-6 and IL-8 concentrations in nasal lavage fluid. Twenty quitters (mean age: 51 years, 9 male) were assessed at baseline, 1 month, 3 months and 12 months after smoking cessation, and 13 smokers (mean age: 52 years, 6 male) were assessed at baseline and after 12 months. Clinicaltrials.gov: NCT02136550. RESULTS: Smokers and quitters showed similar demographic characteristics and morbidities. At baseline, all subjects showed impaired nasal mucociliary clearance (mean 17.6 min), although 63% and 85% of the quitters demonstrated significant nasal mucociliary clearance improvement at 1 month and 12 months, respectively. At 12 months, quitters also showed mucus sneeze clearability improvement (∼26%), an increased number of macrophages (2-fold) and no changes in mucus contact angle or cytokine concentrations. CONCLUSION: This study showed that smoking cessation induced early improvements in nasal mucociliary clearance independent of mucus properties and inflammation. Changes in mucus properties were observed after only 12 months of smoking cessation. PMID:27438569

Smoking habits of relatives of patients with cancer: cancer diagnosis in the family is an important teachable moment for smoking cessation.

PubMed

Hayran, Mutlu; Kilickap, Saadettin; Elkiran, Tamer; Akbulut, Hakan; Abali, Huseyin; Yuce, Deniz; Kilic, Diclehan; Turhal, Serdar

2013-01-01

In this study we aimed to determine the rate and habitual patterns of smoking, intentions of cessation, dependence levels and sociodemographic characteristics of relatives of patients with a diagnosis of cancer. This study was designed by the Turkish Oncology Group, Epidemiology and Prevention Subgroup. The relatives of cancer patients were asked to fill a questionnaire and Fagerstrom test of nicotine dependence. The median ages of those with lower and higher Fagerstrom scores were 40 years and 42 years, respectively. We found no evidence of variation between the two groups for the remaining sociodemographic variables, including the subject's medical status, gender, living in the same house with the patient, their educational status, their family income, closeness to their cancer patients or spending time with them or getting any help or wanting to get some help. Only 2% of the subjects started smoking after cancer was diagnosed in their loved ones and almost 20% of subjects had quit smoking during the previous year. The Fagerstrom score is helpful in determining who would be the most likely to benefit from a cigarette smoking cessation program. Identification of these people with proper screening methods might help us to pinpoint who would benefit most from these programs.

[Use of a retail sales tax on tobacco to fund drug therapy for smoking cessation].

PubMed

Antoñanzas Villar, Fernando; Rodríguez Ibeas, Roberto; Juárez Castelló, Carmelo; Ramírez Esquibel, Manuel; Lorente Antoñanzas, Reyes; Ginestal Gómez, Jaime

2006-12-01

To analyze the revenue-generating potential of a new retail sales tax on tobacco and its effects on public health if the tax revenues were allocated to finance smoking cessation programs. We provide an extensive review of the legislation on the authority of autonomous communities to order the levy and collection of special taxes and describe the new tobacco retail sales tax. We calculated collected tax revenues with a simulation model of indirect taxation -the SINDIEF (Simulador de Imposición Indirecta del Instituto de Estudios Fiscales) model- and determined the potential number of smokers who would quit smoking. Epidemiological and clinical variables from existing pharmacological therapies were used to obtain the results. For the highest tax rate (20 eurocents per pack), we found that 1,078,000 smokers yearly would give up smoking, suggesting that the new tax could be considered as a way to promote pharmacotherapy in smoking behavior. Fiscal corresponsability to finance smoking cessation programs could be based on a tobacco retailing sales tax, similar to that levied on hydrocarbons. Simulations for different tax rates show the huge potential of the tax to yield revenues, as the tax is levied yearly on 4.6 billion cigarette packs each year.

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.

Facebook Apps for Smoking Cessation: A Review of Content and Adherence to Evidence-Based Guidelines

PubMed Central

2014-01-01

Background Facebook is the most popular social network site, with over 1 billion users globally. There are millions of apps available within Facebook, many of which address health and health behavior change. Facebook may represent a promising channel to reach smokers with cessation interventions via apps. To date, there have been no published reports about Facebook apps for smoking cessation. Objective The purpose of this study was to review the features and functionality of Facebook apps for smoking cessation and to determine the extent to which they adhere to evidence-based guidelines for tobacco dependence treatment. Methods In August 2013, we searched Facebook and three top Internet search engines using smoking cessation keywords to identify relevant Facebook apps. Resultant apps were screened for eligibility (smoking cessation-related, English language, and functioning). Eligible apps were reviewed by 2 independent coders using a standardized coding scheme. Coding included content features (interactive, informational, and social) and adherence to an established 20-item index (possible score 0-40) derived from the US Public Health Service’s Clinical Practice Guidelines for Treating Tobacco Use and Dependence. Results We screened 22 apps for eligibility; of these, 12 underwent full coding. Only 9 apps were available on Facebook. Facebook apps fell into three broad categories: public pledge to quit (n=3), quit-date–based calculator/tracker (n=4), or a multicomponent quit smoking program (n=2). All apps incorporated interactive, informational, and social features except for two quit-date–based calculator/trackers apps (lacked informational component). All apps allowed app-related posting within Facebook (ie, on self/other Facebook profile), and four had a within-app “community” feature to enable app users to communicate with each other. Adherence index summary scores among Facebook apps were low overall (mean 15.1, SD 7.8, range 7-30), with multicomponent apps scoring the highest. Conclusions There are few smoking cessation apps available within Facebook. Among those available, adherence to cessation treatment guidelines was low. Smoking cessation interventions provided via the Facebook platform are a unique and as yet untapped treatment strategy that can harness existing social support and social networks for quitting. Research is needed to examine whether apps that adhere to clinical practice guidelines for tobacco dependence treatment are more effective in promoting cessation than those that do not. PMID:25205129

Facebook apps for smoking cessation: a review of content and adherence to evidence-based guidelines.

PubMed

Jacobs, Megan A; Cobb, Caroline O; Abroms, Lorien; Graham, Amanda L

2014-09-09

Facebook is the most popular social network site, with over 1 billion users globally. There are millions of apps available within Facebook, many of which address health and health behavior change. Facebook may represent a promising channel to reach smokers with cessation interventions via apps. To date, there have been no published reports about Facebook apps for smoking cessation. The purpose of this study was to review the features and functionality of Facebook apps for smoking cessation and to determine the extent to which they adhere to evidence-based guidelines for tobacco dependence treatment. In August 2013, we searched Facebook and three top Internet search engines using smoking cessation keywords to identify relevant Facebook apps. Resultant apps were screened for eligibility (smoking cessation-related, English language, and functioning). Eligible apps were reviewed by 2 independent coders using a standardized coding scheme. Coding included content features (interactive, informational, and social) and adherence to an established 20-item index (possible score 0-40) derived from the US Public Health Service's Clinical Practice Guidelines for Treating Tobacco Use and Dependence. We screened 22 apps for eligibility; of these, 12 underwent full coding. Only 9 apps were available on Facebook. Facebook apps fell into three broad categories: public pledge to quit (n=3), quit-date-based calculator/tracker (n=4), or a multicomponent quit smoking program (n=2). All apps incorporated interactive, informational, and social features except for two quit-date-based calculator/trackers apps (lacked informational component). All apps allowed app-related posting within Facebook (ie, on self/other Facebook profile), and four had a within-app "community" feature to enable app users to communicate with each other. Adherence index summary scores among Facebook apps were low overall (mean 15.1, SD 7.8, range 7-30), with multicomponent apps scoring the highest. There are few smoking cessation apps available within Facebook. Among those available, adherence to cessation treatment guidelines was low. Smoking cessation interventions provided via the Facebook platform are a unique and as yet untapped treatment strategy that can harness existing social support and social networks for quitting. Research is needed to examine whether apps that adhere to clinical practice guidelines for tobacco dependence treatment are more effective in promoting cessation than those that do not.

Preliminary evaluation of a telephone-based smoking cessation intervention in the lung cancer screening setting: A randomized clinical trial.

PubMed

Taylor, Kathryn L; Hagerman, Charlotte J; Luta, George; Bellini, Paula G; Stanton, Cassandra; Abrams, David B; Kramer, Jenna A; Anderson, Eric; Regis, Shawn; McKee, Andrea; McKee, Brady; Niaura, Ray; Harper, Harry; Ramsaier, Michael

2017-06-01

Incorporating effective smoking cessation interventions into lung cancer screening (LCS) programs will be essential to realizing the full benefit of screening. We conducted a pilot randomized trial to determine the feasibility and efficacy of a telephone-counseling (TC) smoking cessation intervention vs. usual care (UC) in the LCS setting. In collaboration with 3 geographically diverse LCS programs, we enrolled current smokers (61.5% participation rate) who were: registered to undergo LCS, 50-77 years old, and had a 20+ pack-year smoking history. Eligibility was not based on readiness to quit. Participants completed pre-LCS (T0) and post-LCS (T1) telephone assessments, were randomized to TC (N=46) vs. UC (N=46), and completed a final 3-month telephone assessment (T2). Both study arms received a list of evidence-based cessation resources. TC participants also received up to 6 brief counseling calls with a trained cessation counselor. Counseling calls incorporated motivational interviewing and utilized the screening result as a motivator for quitting. The outcome was biochemically verified 7-day point prevalence cessation at 3-months post-randomization. Participants (56.5% female) were 60.2 (SD=5.4) years old and reported 47.1 (SD=22.2) pack years; 30% were ready to stop smoking in the next 30 days. TC participants completed an average of 4.4 (SD=2.3) sessions. Using intent-to-treat analyses, biochemically verified quit rates were 17.4% (TC) vs. 4.3% (UC), p<.05. This study provides preliminary evidence that telephone-based cessation counseling is feasible and efficacious in the LCS setting. As millions of current smokers are now eligible for lung cancer screening, this setting represents an important opportunity to exert a large public health impact on cessation among smokers who are at very high risk for multiple tobacco-related diseases. If this evidence-based, brief, and scalable intervention is replicated, TC could help to improve the overall cost-effectiveness of LCS. NCT02267096, https://clinicaltrials.gov. Copyright © 2017 Elsevier B.V. All rights reserved.

Acute post cessation smoking. A strong predictive factor for metabolic syndrome among adult Saudis.

PubMed

Al-Daghri, Nasser M

2009-02-01

To determine the influence of tobacco exposure in the development of metabolic syndrome (MS) in the adult Saudi population. Six hundred and sixty-four adults (305 males and 359 females) aged 25-70 years were included in this cross-sectional study conducted at the King Abdul-Aziz University Hospital, between June 2006 and May 2007. We classified the participants into non-smokers, smokers, and ex-smokers (defined as complete cessation for 1-2 years). All subjects were screened for the presence of MS using the modified American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI), International Diabetes Federation (IDF) and World Health Organization (WHO) definitions. Metabolic syndrome was highest among ex-smokers regardless of definition used. Relative risk for ex-smokers (95% CI: 2.23, 1.06-4.73) was more than twice in harboring MS as compared to non-smokers (95% CI: 2.78, 1.57-4.92) (p=0.009). Acute post-cessation smoking is a strong predictor for MS among male and female Arabs. Smoking cessation programs should include a disciplined lifestyle and dietary intervention to counteract the MS-augmenting side-effect of smoking cessation.

[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.

Tobacco Use Cessation and Youth. Issue Brief. August 1999.

ERIC Educational Resources Information Center

Wojciak, Alison

This issue brief discusses the importance of tobacco use cessation efforts for youth. Section 1 discusses the need for tobacco cessation for youth, explaining that despite increased attention to the prevention of tobacco use among youth, there has been little attention to youth who already smoke, and few programs for youth have proven successful.…

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.

Smoking Behaviors Among Urban and Rural Pregnant Women Enrolled in the Kansas WIC Program.

PubMed

Jacobson, Lisette T; Dong, Frank; Scheuermann, Taneisha S; Redmond, Michelle L; Collins, Tracie C

2015-10-01

Smoking during pregnancy is associated with poor birth outcomes. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a public nutritional assistance program for low-income pregnant women and their children up to age five. This study examined differences in smoking behavior among women enrolled in the Kansas WIC program. A secondary analysis was conducted using the Pregnancy Nutrition Surveillance System dataset of enrolled women between 2005 and 2011. Geographic residency status was obtained through application of the Census tract-based rural-urban commuting area codes. Chi square tests of association were used to assess differences. Multi-variable binary logistic regression was used to assess maternal characteristics and smoking 3 months prior to pregnancy. Total sample size averaged 21,650 women for years 2005 through 2011. Low-income, rural pregnant women smoked at significantly higher rates before, during, and after pregnancy. High smoking rates have remained unchanged since 2008. The following characteristics were associated with reduced odds of smoking 3 months prior to pregnancy: being 17 years old or younger, Hispanic, a high school graduate, urban location, normal body mass index, no live births prior to current pregnancy, and using multi-vitamins. Results from this study indicate that the WIC population in rural areas may have different needs regarding smoking cessation programming than the urban WIC population. Findings help inform WIC program administrators and assist in enhancing current smoking cessation services to the Kansas WIC population.

Efficacy of team-based financial incentives for smoking cessation in the workplace.

PubMed

Yeo, Chang Dong; Lee, Hea Yeon; Ha, Jick Hwan; Kang, Hyeon Hui; Kang, Ji Young; Kim, Sung Kyoung; Kim, Myung Sook; Moon, Hwa Sik; Lee, Sang Haak

2015-01-01

Worksite smoking cessation programs offer accessibility of the target population, availability of occupational health support, and the potential for peer pressure and peer support. The purpose of this study was to identify the efficacy of the financial incentives given to various teams in the workplace. St. Paul's Hospital's employees were enrolled. Each team of employees consisted of smoking participants and non-smoking fellow workers from the same department. The financial incentive of 50000 won (about $45) was rewarded to the team for each successful participant-not to individual members-after the first week and then after one month. If the smokers in the team remained abstinent for a longer time period, the team was given an incentive of 100000 won for each successful participant after 3 and 6 months. A total 28 smoking participants and 6 teams were enrolled. Self-reported abstinence rates validated by urinary cotinine test at 3, 6, and 12 months after the initial cessation were 61%, 54%, and 50%, respectively. Smokers with high nicotine dependence scores or those who began participation 1 month after enrollment initiation had a lower abstinence rate at 3 months, but not at 6 and 12 months. Participants who succeeded at smoking cessation at 12 months were more likely to be older and have a longer smoking duration history. The financial incentives given to teams could be promising and effective to improve long-term rates of smoking cessation. This approach could use peer pressure and peer support in the workplace over a longer period.

Mixed-Methods for Comparing Tobacco Cessation Interventions

PubMed Central

Momin, Behnoosh; Neri, Antonio; Zhang, Lei; Kahende, Jennifer; Duke, Jennifer; Green, Sonya Goode; Malarcher, Ann; Stewart, Sherri L.

2017-01-01

Introduction The National Comprehensive Cancer Control Program (NCCCP) and National Tobacco Control Program (NTCP) are both well-positioned to promote the use of population-based tobacco cessation interventions, such as state quitlines and Web-based interventions. Aims This paper outlines the methodology used to conduct a comparative effectiveness research study of traditional and Web-based tobacco cessation and quitline promotion approaches. Methods A mixed-methods study with three components was designed to address the effect of promotional activities on service usage and the comparative effectiveness of population-based smoking cessation activities across multiple states. Results/Findings The cessation intervention component followed 7,902 smokers (4,307 quitline users and 3,595 Web intervention users) to ascertain prevalence of 30-day abstinence rates 7 months after registering for smoking cessation services. User characteristics and quit success was compared across the two modalities. In the promotions component, reach and use of traditional and innovative promotion strategies were assessed for 24 states, including online advertising, state Web sites, social media, mobile applications, and their effects on quitline call volume. The partnership intervention component studied the extent of collaboration among six selected NCCCPs and NTCPs. Conclusions This study will guide program staff and clinicians with evidence-based recommendations and best practices for implementation of tobacco cessation within their patient and community populations and establish an evidence base that can be used for decision making. PMID:28243318

Smoking risk and the likelihood of quitting among African-American female light and heavy smokers.

PubMed

Fernander, Anita; Schumacher, Mitzi; Wei, Xiaochen; Crooks, Peter; Wedlund, Peter

2008-10-01

While African-American females are more likely to be light smokers compared to their counterparts of other racially classified social groups (RCSGs), they are more likely to carry a heavier burden of smoking-related morbidity and mortality. Thus, it is critical that African-American female light smokers are targeted to engage in smoking cessation. Research has revealed that African-American women are less likely to have a successful quit attempt following a cessation intervention than females from other RCSGs. It has been postulated that the low smoking cessation rates among African-American female light smokers may be due to the lack of appropriate psychosocioculturally tailored cessation interventions that address issues of stress and coping that explain why they smoke and continue to smoke that may differ from their heavy smoker counterparts. The purpose of this study was to ascertain whether African-American female light smokers differed from their heavy smoker counterparts on psychosociocultural stress and coping factors. Findings revealed no differences in the sociodemographic variables of age, income, education and BMI; in the psychosociocultural measures of acculturative stress, race-related stress and coping; or in the smoking characteristics of menthol smoking status, cotinine level and CYP2A6 metabolic functioning between light and heavy smokers. However, the study found that African-American female light smokers take longer to smoke their first cigarette of the day, have a lower smoking risk, are more likely to quit, and exhibit lower carbon monoxide levels than African-American female heavy smokers. The current study suggests that other than the obvious factors of greater likelihood of quitting, lower smoking risk, longer latency to smoke and lower carbon monoxide levels, specific smoking cessation programs may not need to be differentially psychosocio-culturally tailored for African-American female light smokers compared to their heavy-smoking counterparts.

The maximum willingness to pay for smoking cessation method among adult smokers in Mexico.

PubMed

Heredia-Pi, Ileana B; Servan-Mori, Edson; Reynales-Shigematsu, Luz Myriam; Bautista-Arredondo, Sergio

2012-01-01

To estimate the maximum willingness to pay (WTP) for an effective smoking cessation treatment among smokers in Mexico and to identify the environmental, demographic, and socioeconomic factors associated with the WTP. A cross-sectional study was conducted. The sample contained 777 smokers (willingness to quit using a WTP of >0) who had responded to the 2009 Global Adult Tobacco Survey conducted in Mexico. Statistical associations and descriptive analyses were conducted to describe smokers and their WTP by using tobacco-related environmental, socioeconomic, and demographic variables. Overall, 74.4% of the smokers were men and 51.4% were daily smokers. On average, the smokers had been consuming tobacco for more than 15 years, 58.6% had made cessation attempts in the past, and around 10.0% knew about the existence of centers to aid in smoking cessation. The average WTP for an effective cessation method was US $191. Among men, the WTP was US $152 lower than among women. In all the estimated models, the higher an individual's education and socioeconomic level, the higher his or her WTP. This study suggests that Mexican smokers interested in quitting smoking attribute a high monetary value to an effective cessation method. Male smokers demonstrated less altruistic behavior than did female smokers. Mexico requires the implementation of more policies designed to support smoking cessation and to limit tobacco addiction. Expanding the availability of cessation programs and access to pharmacological treatments may contribute to reaching universal coverage by integrating new pharmacological alternatives into the health sector's medicine formulary. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

A Mobile Game to Support Smoking Cessation: Prototype Assessment

PubMed Central

Fortugno, Nicholas; Scherlis, Daniel R

2018-01-01

Background Cigarette smoking results in an estimated seven million deaths annually. Almost half of all smokers attempt to quit each year, yet only approximately 6% are successful. Although there are multiple effective interventions that can increase these odds, substantial room remains for improvement. One effective approach to helping smokers quit is contingency management, where quitting is incentivized with the delivery of monetary rewards in exchange for objective evidence (eg, exhaled carbon monoxide levels) of abstinence. Objective We assessed the feasibility and promise of Inspired, a contingency management mobile app for smoking cessation that uses game-based rewards to incentivize abstinence from smoking instead of the monetary (or material) rewards typically used. We sought participant feedback and limited objective data on: the features and design of Inspired, interest in using Inspired when it becomes available, the likelihood of Inspired being an effective cessation aid, and the rank order preference of Inspired relative to other familiar smoking cessation aids. Methods Twenty-eight treatment-seeking smokers participated in this study. Participants attended a single one-hour session in which they received an overview of the goals of the Inspired mobile game, practiced submitting breath carbon monoxide (CO) samples, and played representative levels of the game. Participants were then told that they could play an extra level, or they could stop, complete an outcome survey, receive payment, and be dismissed. A sign-up sheet requesting personal contact information was available for those who wished to be notified when the full version of Inspired becomes available. Results Using binary criteria for endorsement, participants indicated that, assuming it was currently available and fully developed, they would be more likely to use Inspired than: any other smoking cessation aid (21/28, 75%), the nicotine patch (23/28, 82%), a drug designed to reduce smoking cravings (23/28, 82%), or a program involving attendance in training sessions or support group meetings (27/28, 96%). In the questionnaire, participants indicated that both the Inspired program (26/28, 93%) and the Inspired game would be “Fun” (28/28, 100%), and 71% (20/28) reported that the program would help them personally quit smoking. Fifty-eight percent of participants (15/26) chose to continue playing the game rather than immediately collecting payment for participation and leaving. Eighty-two percent of participants (23/28) signed up to be notified when the full version of Inspired becomes available. Conclusions This was the first study to evaluate a game-based contingency management app that uses game-based virtual goods as rewards for smoking abstinence. The outcomes suggest that the completed app has potential to be an effective smoking cessation aid that would be widely adopted by smokers wishing to quit. PMID:29880466

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.

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.

Combining community participatory research with a randomized clinical trial: the Protecting the Hood Against Tobacco (PHAT) smoking cessation study.

PubMed

Froelicher, Erika Sivarajan; Doolan, Daniel; Yerger, Valerie B; McGruder, Carol O; Malone, Ruth E

2010-01-01

This article describes the process and results of a smoking cessation intervention randomized clinical trial (RCT) that was conducted as a community-based participatory research project. This RCT tested whether outcomes are improved by adding social justice and tobacco industry targeting messages to a smoking cessation program conducted among African American adults within a low-income community in San Francisco, California. This study provides lessons for future similar research projects that focus on urban low-income populations. Participants were randomly allocated to receive a smoking-cessation program (control group [CG]) or CG care plus tobacco industry and media (IAM) messages. Primary interventions were behavioral. At intake, participants reporting severe withdrawal or smoking > or = 25 cigarettes daily were offered free nicotine replacement therapy. Baseline data were from an in-person interview. Outcome measures included self-reported smoking status; validation of quitting was by salivary cotinine assays. Of 87 participants providing baseline data, 31% (27) did not join the RCT. Proportions quitting in the CG and IAM group were 11.5% and 13.6% at 6 months and 5.3% and 15.8% at 12 months, respectively. African Americans in underserved inner-city neighborhoods can be recruited into RCTs with community participatory approaches. Differences between the CG and IAM in proportions who quit were 2.1% and 10.5% at 6 and 12 months, respectively. More than 3 years with adequate funding, high staffing ratios, and intense outreach and follow-up schedules are needed to achieve recruitment and study goals. 2010 Elsevier Inc. All rights reserved.

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…

State medicaid coverage for tobacco cessation treatments and barriers to coverage - United States, 2008-2014.

PubMed

Singleterry, Jennifer; Jump, Zach; Lancet, Elizabeth; Babb, Stephen; MacNeil, Allison; Zhang, Lei

2014-03-28

Medicaid enrollees have a higher smoking prevalence than the general population (30.1% of adult Medicaid enrollees aged <65 years smoke, compared with 18.1% of U.S. adults of all ages), and smoking-related disease is a major contributor to increasing Medicaid costs. Evidence-based cessation treatments exist, including individual, group, and telephone counseling and seven Food and Drug Administration (FDA)-approved medications. A Healthy People 2020 objective (TU-8) calls for all state Medicaid programs to adopt comprehensive coverage of these treatments. However, most states do not provide such coverage. To monitor trends in state Medicaid cessation coverage, the American Lung Association collected data on coverage of all evidence-based cessation treatments except telephone counseling by state Medicaid programs (for a total of nine treatments), as well as data on barriers to accessing these treatments (such as charging copayments or limiting the number of covered quit attempts) from December 31, 2008, to January 31, 2014. As of 2014, all 50 states and the District of Columbia cover some cessation treatments for at least some Medicaid enrollees, but only seven states cover all nine treatments for all enrollees. Common barriers in 2014 include duration limits (40 states for at least some populations or plans), annual limits (37 states), prior authorization requirements (36 states), and copayments (35 states). Comparing 2008 with 2014, 33 states added treatments to coverage, and 22 states removed treatments from coverage; 26 states removed barriers to accessing treatments, and 29 states added new barriers. The evidence from previous analyses suggests that states could reduce smoking-related morbidity and health-care costs among Medicaid enrollees by providing Medicaid coverage for all evidence-based cessation treatments, removing all barriers to accessing these treatments, promoting the coverage, and monitoring its use.

Poly-Tobacco Use Among HIV-Positive Smokers: Implications for Smoking Cessation Efforts

PubMed Central

2013-01-01

Introduction: Poly-tobacco use is defined as cigarette and other tobacco consumption with either product used daily or nondaily. While concurrent use of different types of tobacco has been documented within the general population, less is known about poly-tobacco use among HIV-positive smokers and its impact on smoking cessation efforts. Objective: To characterize the profile of poly-tobacco users (PTU) in a sample of HIV-positive smokers participating in a cessation program. Methods: The study sample consisted of 474 HIV-positive smokers enrolled in a 2-group randomized controlled trial of cigarette smoking cessation comparing a cell phone–based intervention to usual care. Prevalence was determined, and risk factors for poly-tobacco use were evaluated using logistic regression. Results: In this cohort of HIV-positive cigarette smokers, 21.6% of participants were PTU, with cigars (73.4%) the most common tobacco product consumed. Among PTU, 73.5% used other form(s) of tobacco some days, and 26.5% use them every day. Perceived discrimination and unemployment were significantly associated with poly-tobacco use after adjusting for other demographic, behavioral, and psychosocial factors. Analysis showed that participants in the cell phone group (vs. usual care) were more likely to report 24-hr abstinence, both among monocigarette users (16.6% vs. 6.3%, p < .001) and PTU (18.5% vs. 0%, p < .001). Conclusion: Poly-tobacco use prevalence among adult HIV-positive smokers was considerably higher than in the general population. Special attention must be placed on concurrent use of cigarettes and cigars among HIV-positive smokers. Because PTU are a unique population less likely to succeed in brief smoking cessation interventions, effective cessation programs are needed. PMID:23907506

Crossing Boundaries

PubMed Central

Steinmetz, Erika; Bysshe, Tyler; Bruen, Brian K.

2017-01-01

Objectives: Previous state interagency collaborations have led to successful tobacco cessation initiatives. The objective of this study was to assess the roles and interaction of state Medicaid and public health agency efforts to support tobacco cessation for low-income Medicaid beneficiaries. Methods: We interviewed Medicaid and state public health agency officials in 8 states in September and October 2015 about collaborations in policy development and implementation for Medicaid tobacco cessation, including Medicaid coverage policies, quitlines, and monitoring. Results: Collaboration between Medicaid and public health agencies was limited. Smoking cessation quitlines were the most common area of collaboration cited. Public health officials were typically not involved in developing Medicaid coverage policies. States covered a range of US Food and Drug Administration–approved tobacco cessation medications, but 7 of the 8 states imposed limitations, such as charging copayments or requiring previous authorization. States generally lacked data to monitor implementation of tobacco cessation efforts and had little ability to determine the effectiveness of their policies. Conclusions: To strengthen efforts to reduce smoking and tobacco-related health burdens and to monitor the effectiveness of policies and programs, Medicaid and public health agencies should prioritize tobacco cessation and develop and analyze data about smoking and cessation efforts among Medicaid beneficiaries. Recent multistate initiatives from the Centers for Disease Control and Prevention and the Centers for Medicare & Medicaid Services seek to promote stronger collaborations in clinical prevention activities, including tobacco cessation. PMID:28192676

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.

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.

Predictors of early versus late smoking abstinence within a 24-month disease management program.

PubMed

Cox, Lisa Sanderson; Wick, Jo A; Nazir, Niaman; Cupertino, A Paula; Mussulman, Laura M; Ahluwalia, Jasjit S; Ellerbeck, Edward F

2011-03-01

Standard smoking cessation treatment studies have been limited to 6- to 12-month follow-up, and examination of predictors of abstinence has been restricted to this timeframe. The KanQuit study enrolled 750 rural smokers across all stages of readiness to stop smoking and provided pharmacotherapy management and/or disease management, including motivational interviewing (MI) counseling every 6 months over 2 years. This paper examines differences in predictors of abstinence following initial (6-month) and extended (24-month) intervention. Baseline variables were analyzed as potential predictors of self-reported smoking abstinence at Month 6 and at Month 24. Chi-square tests, 2-sample t tests, and multiple logistic regression analyses were used to identify predictors of abstinence among 592 participants who completed assessment at baseline and Months 6 and 24. Controlling for treatment group, the final regression models showed that male gender and lower baseline cigarettes per day predicted abstinence at both 6 and 24 months. While remaining significant, the relative advantage of being male decreased over time. Global motivation to stop smoking, controlled motivation, and self-efficacy predicted abstinence at 6 months but did not predict abstinence at Month 24. In contrast, stage of change was strongly predictive of 24-month smoking status. While the importance of some predictors of successful smoking cessation appeared to diminish over time, initial lack of interest in cessation and number of cigarettes per day strongly predicted continued smoking following a 2-year program.

An Exploration of Smoking Among People Attending Residential Substance Abuse Treatment: Prevalence and Outcomes at Three Months Post-Discharge.

PubMed

Ingram, Isabella; Kelly, Peter J; Deane, Frank P; Baker, Amanda L; Lyons, Geoff; Blackman, Russell

2017-01-01

Smoking continues to be a major health concern for people with a history of alcohol or other substance use problems. The current research is aimed to (1) describe the prevalence of smoking in residential addictions treatment services and (2) compare characteristics of people who had or had not quit smoking. Participants were attending residential substance abuse treatment provided by the Australian Salvation Army. These programs are up to 10 months in length and offer a range of low-intensity smoking cessation supports. Measures of smoking, substance use, and clinical characteristics were collected from 2008 to 2015 at baseline and three months post-discharge from treatment (N = 702). At baseline, 86% of people were smokers (n = 606). At follow-up, only 48 participants who were smokers at baseline (7%) had quit smoking. Participants who had quit smoking at follow-up also reported higher rates of abstinence from alcohol or other substances at follow-up (72%) than people who had not quit smoking (46%; OR = 2.95, 95% CI [1.52, 5.74]). There is potential for smoking cessation to be better addressed as part of routine care in substance abuse treatment settings. Future research should evaluate the provision of more systematic smoking cessation interventions within these settings.

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…

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.

[E-Cigarettes – Friend or Foe?].

PubMed

Russi, Erich W

2015-07-01

Not nicotine, but an abundant amount of toxic chemicals produced by the combustion of tobacco are the cause of well-known health problems. E-cigarette vapor contains no or only minimal quantities of potentially harmful substances. Hence it can be assumed that vaping in adults is much less harmful than smoking of cigarettes. Furthermore, no data exist that e-cigarettes will encourage youngsters to become cigarette smokers. E-cigarette vaping has the potential to reduce the daily number of cigarettes smoked or facilitates cessation of smoking in heavily nicotine-dependent smokers, who keep on smoking despite a structured smoking cessation program. Health professionals should be aware of this type of nicotine substitution, since the controversial discussion is often emotional and not evidence-based.

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.

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.

Are Primary Health Care Providers Prepared to Implement an Anti-smoking Program in Syria?

PubMed Central

Asfar, Taghrid; Al-Ali, Radwan; Ward, Kenneth D.; Vander Weg, Mark W.; Maziak, Wasim

2010-01-01

Objective To document primary health care (PHC) providers’ tobacco use, and how this influences their smoking cessation practices and attitudes towards tobacco-control policies. Methods Anonymous questionnaires were distributed to PHC providers in 7 randomly selected PHC centers in Aleppo, Syria. Results All PHC providers completed the questionnaires (100% response rate). A quarter of these providers smoke cigarettes and more than 10% smoke waterpipes. Physicians who smoke were less likely to advise patients to quit (OR = 0.29; 95% CI, 0.09–0.95), assess their motivation to quit (OR = 0.13, 95% CI = 0.02–0.72), or assist them in quitting (OR = 0.24, 95% CI = 0.06–0.99). PHC providers who smoke were less likely to support a ban on smoking in PHC settings (68.2% vs. 89.1%) and in enclosed public places (68.2% vs. 86.1%) or increases in the price of tobacco products (43.2% vs. 77.4%) (P < 0.01 for all comparisons). Conclusions Smoking, including waterpipe, continues to be widespread among PHC providers in Syria and will negatively influence implementation of anti-smoking program in PHC settings. Practice implications Smoking awareness and cessation interventions targeted to PHC providers, and training programs to build providers’ competency in addressing their patients’ smoking is crucial in Syria. PMID:21168300

Smoking Cessation and Changes in Body Mass Index: Findings From the First Randomized Cessation Trial in a Low-Income Country Setting.

PubMed

Ben Taleb, Ziyad; Ward, Kenneth D; Asfar, Taghrid; Jaber, Rana; Bahelah, Raed; Maziak, Wasim

2017-03-01

In high-income countries, quitting cigarette smoking is associated with weight gain, which can reduce motivation to abstain. Whether smoking cessation is associated with weight gain in a low-income country context has never been investigated. We aimed to determine the post-cessation changes in body mass index (BMI) and its predictors among smokers who received a smoking cessation intervention in a low-income country setting. We performed post hoc analyses of data from 269 smokers who participated in a two-group, parallel-arm, double-blind, placebo-controlled randomized trial of combined nicotine replacement therapy (NRT) and behavioral counseling in primary care clinics in Aleppo, Syria. We used generalized estimating equation modeling to identify predictors of changes in BMI at 6 weeks and 6- and 12-month follow-ups after quit date. The mean pre-cessation BMI of the sample was 27.9kg/m2 (SD = 5.2). Over 12 months of follow-up, BMI of smoking abstainers averaged 1.8 BMI units (approximately 4.8kg) greater than non-abstainers (p = .012). Throughout the study, greater BMI was associated with being female (p = .048), reporting smoking to control weight (p < .001) and having previously failed to quit due to weight gain (p = .036). Similar to findings from high-income countries, smoking cessation in Syria is associated with weight gain, particularly among women and those who have weight concerns prior to quitting. This group of smokers may benefit from tailored cessation interventions with integrated body weight management elements that take into consideration the prevailing local and cultural influences on diet and levels of physical activity. This study provides the first evidence regarding post-cessation changes in BMI among smokers who attempt to quit in a low-income country setting. Our findings advance knowledge regarding post-cessation weight gain and offers insight for researchers and clinicians to identify smokers at higher risk of post-cessation weight gain. This information will help in delivering interventions that take into account the prevailing cultural influence on diet and physical activity and will ultimately help in designing future tailored cessation programs in Syria and other low-income countries with similar cultural background and level of development. © The Author 2016. 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.

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.

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

Financial incentives for smoking cessation in low-income smokers: study protocol for a randomized controlled trial

PubMed Central

2012-01-01

Background Tobacco smoking is the leading avoidable cause of death in high-income countries. The smoking-related disease burden is borne primarily by the least educated and least affluent groups. Thus, there is a need for effective smoking cessation interventions that reach to, and are effective in this group. Research suggests that modest financial incentives are not very effective in helping smokers quit. What is not known is whether large financial incentives can enhance longer-term (1 year) smoking cessation rates, outside clinical and workplace settings. Trial design A randomized, parallel groups, controlled trial. Methods Participants: Eight hundred low-income smokers in Switzerland (the less affluent third of the population, based on fiscal taxation). Intervention: A smoking cessation program including: (a) financial incentives given during 6 months; and (b) Internet-based counseling. Financial rewards will be offered for biochemically verified smoking abstinence after 1, 2, and 3 weeks and 1, 3, and 6 months, for a maximum of 1,500 CHF (1,250 EUR, 1,500 USD) for those abstinent at all time-points. All participants, including controls, will receive Internet-based, individually-tailored, smoking cessation counseling and self-help booklets, but there will be no in-person or telephone counseling, and participants will not receive medications. The control group will not receive financial incentives. Objective: To increase smoking cessation rates. Outcome: Smoking abstinence after 6 and 18 months, not contradicted by biochemical tests. We will assess relapse after the end of the intervention, to test whether 6-month effects translate into sustained abstinence 12 months after the incentives are withdrawn. Randomization: Will be done using sealed envelopes drawn by participants. Blinding: Is not possible in this context. Discussion Smoking prevention policies and interventions have been least effective in the least educated, low-income groups. Combining financial incentives and Internet-based counseling is an innovative approach that, if proven acceptable and effective, could be later implemented on a large scale at a reasonable cost, decrease health disparities, and save many lives. Trial registration Current Controlled Trials ISRCTN04019434. PMID:22721577

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

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.

Treating Depressed and Anxious Smokers in Smoking Cessation Programs

ERIC Educational Resources Information Center

Richards, C. Steven; Cohen, Lee M.; Morrell, Holly E. R.; Watson, Noreen L.; Low, Blakely E.

2013-01-01

Objective: Cigarette smoking is the leading cause of preventable death in the United States. In addition, smoking rates among depressed and anxious smokers are higher than in the population at large. Furthermore, treating depressed and anxious smokers effectively is particularly challenging because of their significant negative affect,…

78 FR 13236 - TRICARE: Smoking Cessation Program

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-27

... National Community Pharmacists Association felt that since some retail pharmacists provide smoking... and Medicaid Services (CMS), pharmacists are not recognized as authorized TRICARE independent... individual pharmacist is not recognized as an independent provider. Therefore, pharmacist counseling services...

Game On? Smoking Cessation Through the Gamification of mHealth: A Longitudinal Qualitative Study

PubMed Central

Eisingerich, Andreas B

2016-01-01

Background Finding ways to increase and sustain engagement with mHealth interventions has become a challenge during application development. While gamification shows promise and has proven effective in many fields, critical questions remain concerning how to use gamification to modify health behavior. Objective The objective of this study is to investigate how the gamification of mHealth interventions leads to a change in health behavior, specifically with respect to smoking cessation. Methods We conducted a qualitative longitudinal study using a sample of 16 smokers divided into 2 cohorts (one used a gamified intervention and the other used a nongamified intervention). Each participant underwent 4 semistructured interviews over a period of 5 weeks. Semistructured interviews were also conducted with 4 experts in gamification, mHealth, and smoking cessation. Interviews were transcribed verbatim and thematic analysis undertaken. Results Results indicated perceived behavioral control and intrinsic motivation acted as positive drivers to game engagement and consequently positive health behavior. Importantly, external social influences exerted a negative effect. We identified 3 critical factors, whose presence was necessary for game engagement: purpose (explicit purpose known by the user), user alignment (congruency of game and user objectives), and functional utility (a well-designed game). We summarize these findings in a framework to guide the future development of gamified mHealth interventions. Conclusions Gamification holds the potential for a low-cost, highly effective mHealth solution that may replace or supplement the behavioral support component found in current smoking cessation programs. The framework reported here has been built on evidence specific to smoking cessation, however it can be adapted to health interventions in other disease categories. Future research is required to evaluate the generalizability and effectiveness of the framework, directly against current behavioral support therapy interventions in smoking cessation and beyond. PMID:27777216

Game On? Smoking Cessation Through the Gamification of mHealth: A Longitudinal Qualitative Study.

PubMed

El-Hilly, Abdulrahman Abdulla; Iqbal, Sheeraz Syed; Ahmed, Maroof; Sherwani, Yusuf; Muntasir, Mohammed; Siddiqui, Sarim; Al-Fagih, Zaid; Usmani, Omar; Eisingerich, Andreas B

2016-10-24

Finding ways to increase and sustain engagement with mHealth interventions has become a challenge during application development. While gamification shows promise and has proven effective in many fields, critical questions remain concerning how to use gamification to modify health behavior. The objective of this study is to investigate how the gamification of mHealth interventions leads to a change in health behavior, specifically with respect to smoking cessation. We conducted a qualitative longitudinal study using a sample of 16 smokers divided into 2 cohorts (one used a gamified intervention and the other used a nongamified intervention). Each participant underwent 4 semistructured interviews over a period of 5 weeks. Semistructured interviews were also conducted with 4 experts in gamification, mHealth, and smoking cessation. Interviews were transcribed verbatim and thematic analysis undertaken. Results indicated perceived behavioral control and intrinsic motivation acted as positive drivers to game engagement and consequently positive health behavior. Importantly, external social influences exerted a negative effect. We identified 3 critical factors, whose presence was necessary for game engagement: purpose (explicit purpose known by the user), user alignment (congruency of game and user objectives), and functional utility (a well-designed game). We summarize these findings in a framework to guide the future development of gamified mHealth interventions. Gamification holds the potential for a low-cost, highly effective mHealth solution that may replace or supplement the behavioral support component found in current smoking cessation programs. The framework reported here has been built on evidence specific to smoking cessation, however it can be adapted to health interventions in other disease categories. Future research is required to evaluate the generalizability and effectiveness of the framework, directly against current behavioral support therapy interventions in smoking cessation and beyond.

Web-Based Information on the Treatment of Tobacco Dependence for Oral Health Professionals: Analysis of English-Written Websites

PubMed Central

2017-01-01

Background Studies have been conducted on the content and quality of Web-based information for patients who are interested in smoking cessation advice and for health care practitioners regarding the content of e-learning programs about tobacco cessation. However, to the best of our knowledge, there is no such information about the quality of Web-based learning resources regarding smoking cessation dedicated to oral health professionals. Objective The aim of this study was to identify and evaluate the quality of the content of webpages providing information about smoking cessation for oral health care professionals. Methods Websites were identified using Google and Health on Net (HON) search engines using the terms: smoking cessation OR quit smoking OR stop smoking OR 3As OR 5As OR tobacco counselling AND dentistry OR dental clinic OR dentist OR dental hygienist OR oral health professionals. The first 100 consecutive results of the 2 search engines were considered for the study. Quality assessment was rated using the DISCERN questionnaire, the Journal of the American Medical Association (JAMA) benchmarks, and the HON seal. In addition, smoking cessation content on each site was assessed using an abbreviated version of the Smoke Treatment Scale (STS-C) and the Smoking Treatment Scale-Rating (STS-R). To assess legibility of the selected websites, the Flesch Reading Ease (FRES) and the Flesch-Kinkaid Reading Grade Level (FKRGL) were used. Websites were also classified into multimedia and nonmultimedia and friendly and nonfriendly usability. Results Of the first 200 sites selected (100 of Google and 100 of HON), only 11 met the inclusion criteria and mainly belonged to governmental institutions (n=8), with the others being prepared by Professional Associations (n=2) and nonprofit organizations (n=1). Only 3 were exclusively dedicated to smoking cessation. The average score obtained with the DISCERN was 3.0, and the average score in the FKRGL and FRES was 13.31 (standard deviation, SD 3.34) and 40.73 (SD 15.46), respectively. Of the 11 websites evaluated, none achieved all the four JAMA benchmarks. The mean score of STS-R among all the websites was 2.81 (SD 0.95) out of 5. A significant strong positive correlation was obtained between the DISCERN mean values and the STS-R (R=.89, P=.01). Conclusions The mean quality of webpages with information for oral health care professionals about smoking cessation is low and displayed a high heterogeneity. These webpages are also difficult to read and often lack multimedia resources, which further limits their usefulness. PMID:29054831

A smoking ban in public places increases the efficacy of bupropion and counseling on cessation outcomes at 1 year.

PubMed

Grassi, M Caterina; Enea, Domenico; Ferketich, Amy K; Lu, Bo; Nencini, Paolo

2009-09-01

Legal restrictions have contributed to the decline in smoking prevalence in several European countries. We investigated the impact of the Italian 2005 indoor smoking ban on the efficacy of counseling alone or in combination with bupropion for smoking cessation. Before and after the introduction of the ban (2001-2006), 550 smokers were enrolled in the smoking cessation program in Rome and were asked to choose between a 6-week group counseling therapy (GCT) given alone or in combination with 7 weeks of daily bupropion. Follow-up was completed 12, 26, and 52 weeks after the quit day. Due to the observational nature of the study, we used propensity scores to match 138 and 290 subjects (pre-/postban) in the bupropion- and GCT-only groups, respectively. Covariate balance in the two matched samples was adequate for all variables except "coffee consumption" in the GCT-only group. The regression adjusted odds ratios indicated that the introduction of the ban resulted in 52% reduced odds of continued smoking at 12 months among the GCT + bupropion group and 41% reduced odds in the GCT-only group. We observed that the ban was associated with both increased 12-month abstinence rates and motivation to quit. In a mediation analysis, we determined that the total effect of the smoking ban on the abstinence rate was reduced after controlling for motivation, which confirmed that motivation was a partial mediator. The introduction of an indoor smoking ban improved the efficacy of smoking cessation treatments by possibly providing a setting that increased the level of motivation to stop smoking.

Evaluating Nicotine Craving, Withdrawal, and Substance Use as Mediators of Smoking Cessation in Cocaine- and Methamphetamine-Dependent Patients.

PubMed

Magee, Joshua C; Lewis, Daniel F; Winhusen, Theresa

2016-05-01

Smoking is highly prevalent in substance dependence, but smoking-cessation treatment (SCT) is more challenging in this population. To increase the success of smoking cessation services, it is important to understand potential therapeutic targets like nicotine craving that have meaningful but highly variable relationships with smoking outcomes. This study characterized the presence, magnitude, and specificity of nicotine craving as a mediator of the relationship between SCT and smoking abstinence in the context of stimulant-dependence treatment. This study was a secondary analysis of a randomized, 10-week trial conducted at 12 outpatient SUD treatment programs. Adults with cocaine and/or methamphetamine dependence (N = 538) were randomized to SUD treatment as usual (TAU) or TAU+SCT. Participants reported nicotine craving, nicotine withdrawal symptoms, and substance use in the week following a uniform quit attempt of the TAU+SCT group, and self-reported smoking 7-day point prevalence abstinence (verified by carbon monoxide) at end-of-treatment. Bootstrapped regression models indicated that, as expected, nicotine craving following a quit attempt mediated the relationship between SCT and end-of-treatment smoking point prevalence abstinence (mediation effect = 0.09, 95% CI = 0.04% to 0.14%, P < .05, 14% of total effect). Nicotine withdrawal symptoms and substance use were not significant mediators (Ps > .05, <1% of total effect). This pattern held for separate examinations of cocaine and methamphetamine dependence. Nicotine craving accounts for a small but meaningful portion of the relationship between smoking-cessation treatment and smoking abstinence during SUD treatment. Nicotine craving following a quit attempt may be a useful therapeutic target for increasing the effectiveness of smoking-cessation treatment in substance dependence. © 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.

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.

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.

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.

Novel setting for addressing tobacco-related disparities: a survey of community welfare organization smoking policies, practices and attitudes.

PubMed

Bonevski, B; O'Brien, J; Frost, S; Yiow, L; Oakes, W; Barker, D

2013-02-01

Research in the United States and Australia acknowledges the potential of non-government social and community service organizations (SCSOs) for reaching socially disadvantaged smokers. This study aimed to describe SCSO smoking policies and practices, and attitudes of senior staff towards smoking and cessation. It also investigated factors associated with positive tobacco control attitudes. In 2009, a cross-sectional telephone survey was undertaken of senior staff in Australian SCSOs, 149 respondents representing 93 organizations completed the survey (response rate=65%; 93/142). Most service clients (60%) remained in programs for 6 months plus, and 77% attended at least weekly. Although 93% of respondents indicated they had an organizational smoking policy, it often did not include the provision of smoking cessation support. Most respondents indicated that client smoking status was not recorded on case notes (78%). Attitudes were mostly positive towards tobacco control in SCSOs, with a mean (standard deviation) score of 8.3 (2.9) of a possible 13. The practice of assessing clients' interest in quitting was the only statistically significant factor associated with high tobacco control attitude scores. The results suggest that SCSOs are appropriate settings for reaching socially disadvantaged smokers with cessation support. Although generally receptive to tobacco control, organizations require further support to integrate smoking cessation support into usual care. In particular, education, training and support for staff to enable them to help their clients quit smoking is important.

Novel setting for addressing tobacco-related disparities: a survey of community welfare organization smoking policies, practices and attitudes

PubMed Central

Bonevski, B.; O’Brien, J.; Frost, S.; Yiow, L.; Oakes, W.; Barker, D.

2013-01-01

Research in the United States and Australia acknowledges the potential of non-government social and community service organizations (SCSOs) for reaching socially disadvantaged smokers. This study aimed to describe SCSO smoking policies and practices, and attitudes of senior staff towards smoking and cessation. It also investigated factors associated with positive tobacco control attitudes. In 2009, a cross-sectional telephone survey was undertaken of senior staff in Australian SCSOs, 149 respondents representing 93 organizations completed the survey (response rate = 65%; 93/142). Most service clients (60%) remained in programs for 6 months plus, and 77% attended at least weekly. Although 93% of respondents indicated they had an organizational smoking policy, it often did not include the provision of smoking cessation support. Most respondents indicated that client smoking status was not recorded on case notes (78%). Attitudes were mostly positive towards tobacco control in SCSOs, with a mean (standard deviation) score of 8.3 (2.9) of a possible 13. The practice of assessing clients’ interest in quitting was the only statistically significant factor associated with high tobacco control attitude scores. The results suggest that SCSOs are appropriate settings for reaching socially disadvantaged smokers with cessation support. Although generally receptive to tobacco control, organizations require further support to integrate smoking cessation support into usual care. In particular, education, training and support for staff to enable them to help their clients quit smoking is important. PMID:22798564

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.

Proactive outreach smoking cessation program for Chinese employees in China.

PubMed

Wang, Man Ping; Suen, Yi Nam; Li, William Ho Cheung; Lau, Oi Sze; Lam, Tai Hing; Chan, Sophia Siu Chee

2018-03-04

We evaluated the first workplace intervention to help smokers quit in Hong Kong. Smoking employees (N = 642) received a 26-page self-help booklet and 15 fix SMS within 3 months and chose to receive cognitive behavioral workshop (N = 76), or face-to-face counseling (N = 11), or group health talk (N = 516), or telephone counseling (N = 39). Twenty participants were interviewed individually for their opinions about the interventions. By intention-to-treat, the overall self-reported past 7-day point prevalence quit rate was 31.0% and 32.9%, and reduction rate was 15.0% and 13.2% at 6 and 12-months, respectively. More than 20% of the unmotivated smokers at baseline (N = 399) quit in this program. Proactive outreach workplace smoking cessation programs with diverse intensity but without medications, chosen by smokers and supported by employers without further incentives, were feasible in busy working environment in Hong Kong.

Preferred smoking cessation methods for Asian or Pacific Islander household smokers who live with hospitalized children.

PubMed

Lee, Meta T; Bracamontes, Jennifer; Mosier, Evan; Davis, James; Maddock, Jay E

2011-03-01

A qualitative study was conducted to determine preferred smoking cessation methods among Asian or Pacific Islander (API) smokers who live with hospitalized children. This study occurred in a children's hospital where a new cessation program would be developed. Twenty-six API smokers who live with children admitted to the hospital were interviewed and tape-recorded. Responses to survey questions were transcribed, categorized, and analyzed. 73% were interested in quitting, 34% within the next 30 days. Few would independently use the quit-line (31%) or attend group classes (4%). However, if offered during their child's hospitalization, 52% would sign up for individualized counseling and 29% would attend group sessions. Respondents believed advice would be helpful from their physician (71%), child's pediatrician (65%, nurse (64%), respiratory therapist (65%), or smoking cessation counselor (75%). The majority of API smokers were interested in quitting and receptive to one-on-one counseling. Advice would be helpful from any healthcare professional. Hawaii Medical Journal Copyright 2011.

Improving clinic- and neighborhood-based smoking cessation services within federally qualified health centers serving low-income, minority neighborhoods.

PubMed

Fisher, Edwin; Musick, Judy; Scott, Catina; Miller, J Philip; Gram, Richard; Richardson, Veronica; Clark, Jane; Pachalla, Vani

2005-04-01

Within federally qualified health centers serving low-income, African American audiences, participatory approaches to system changes were organized through multidisciplinary committees that (a) drew on evidence-based guidelines, (b) guided system changes including the requirement of documenting smoking status and readiness to quit in encounter forms, (c) tested and refined practice improvements prior to their general adoption, and (d) guided development of neighborhood-based resources and supports for smoking cessation that were linked to clinic-based services. Documentation of smoking status or readiness to quit increased from 2% of encounter forms in the first 3 months to 94.3% in the last 3 months of the 24-month program. This rate remained over 90% throughout the following year. Exit interviews also indicated increased key clinic-based services, including "explained importance of quitting" (to 78% and 82% of interview respondents in the two intervention clinics in year 2), "tell you that you should quit" (to 80% in each), "tell you about nicotine gum...or other medications" (to 69% and 58%), "offer to help you quit" (to 61% and 64%), and "tell you about programs or help in your neighborhood" (to 51% and 56%). These rates exceeded those in one comparison clinic and equaled those in a second that also had launched a smoking cessation initiative. From exit interviews, improvements in neighborhood resources and support (e.g., people and activities that encourage nonsmoking) also exceeded those in comparison clinics. Thus, participatory approaches to system changes and quality improvement can enhance clinic- and neighborhood-based smoking cessation services within health centers serving low-income, minority populations.

Smoking, nicotine dependence, and motives to quit in Asian American versus Caucasian college students.

PubMed

Bowen, Sarah; Kurz, Andrew S

2012-10-01

Few smoking cessation programs are designed for college students, a unique population that may categorically differ from adolescents and adults, and thus may have different motivations to quit than the general adult population. Understanding college student motives may lead to better cessation interventions tailored to this population. Motivation to quit may differ, however, between racial groups. The current study is a secondary analysis examining primary motives in college student smokers, and differences between Asian American and Caucasian students in smoking frequency, nicotine dependence, and motives to quit. Participants (N = 97) listed personal motives to quit cigarette smoking, which were then coded into categories: health, personal relationships (e.g., friends, family, romantic partners), self-view (e.g., "addicted" or "not in control"), image in society, impact on others or the environment (e.g., second-hand smoke, pollution), and drain on personal resources (e.g., money, time). Mean number of motives were highest in the category of health, followed by personal relationships, drain on resources, self-view, image, and impact. Asian American students listed significantly fewer motives in the categories of health, self-view and image, and significantly more in the category of personal relationships than Caucasian students. Nicotine dependence was significantly higher for Asian American students. However, frequency of smoking did not differ between groups. Results may inform customization of smoking cessation programs for college students and address relevant culturally specific factors of different racial groups.

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

Assessing the National Cancer Institute's SmokefreeMOM Text-Messaging Program for Pregnant Smokers: Pilot Randomized Trial.

PubMed

Abroms, Lorien C; Chiang, Shawn; Macherelli, Laura; Leavitt, Leah; Montgomery, Margaret

2017-10-03

Automated text messages on mobile phones have been found to be effective for smoking cessation in adult smokers. This study aims to test the acceptability and feasibility of SmokefreeMOM, a national smoking cessation text-messaging program for pregnant smokers. Participants were recruited from prenatal care and randomized to receive SmokefreeMOM (n=55), an automated smoking cessation text-messaging program, or a control text message quitline referral (n=44). Participants were surveyed by phone at baseline and at 1 month and 3 months after enrollment. Results indicate that the SmokefreeMOM program was highly rated overall and rated more favorably than the control condition in its helpfulness at 3-month follow-up (P<.01) and in its frequency of messaging at both 1-month and 3-month follow-ups (P<.001, P<.01, respectively). Despite the presence of technical problems, the vast majority of intervention participants read all program messages, and few participants unsubscribed from the program. There were no significant differences between groups on the use of extra treatment resources or on smoking-related outcomes. However, at the 3-month follow-up, some outcomes favored the intervention group. SmokefreeMOM is acceptable for pregnant smokers. It is recommended that SmokefreeMOM be further refined and evaluated. Clinicaltrials.gov NCT02412956; https://clinicaltrials.gov/ct2/show/NCT02412956 (Archived by WebCite at http://www.webcitation.org/6tcmeRnbC). ©Lorien C Abroms, Shawn Chiang, Laura Macherelli, Leah Leavitt, Margaret Montgomery. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 03.10.2017.

Motivation and reasons to quit: predictive validity among adolescent smokers.

PubMed

Turner, Lindsey R; Mermelstein, Robin

2004-01-01

To examine reasons to quit among adolescents in a smoking cessation program, and whether reasons were associated with subsequent cessation. Participants were 351 adolescents. At baseline, adolescents reported motivation, reasons to quit, and stage of change for cessation. Quit status was assessed at end of treatment. Girls were more likely to endorse image and appearance reasons to quit. Cessation was more likely among adolescents with higher motivation and those wanting to quit because of friends. Different reasons to quit were associated with motivation and cessation. Baseline motivation strongly predicted cessation, suggesting the relative value of assessing global motivation.

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.

A Mobile Game to Support Smoking Cessation: Prototype Assessment.

PubMed

Raiff, Bethany R; Fortugno, Nicholas; Scherlis, Daniel R; Rapoza, Darion

2018-06-07

Cigarette smoking results in an estimated seven million deaths annually. Almost half of all smokers attempt to quit each year, yet only approximately 6% are successful. Although there are multiple effective interventions that can increase these odds, substantial room remains for improvement. One effective approach to helping smokers quit is contingency management, where quitting is incentivized with the delivery of monetary rewards in exchange for objective evidence (eg, exhaled carbon monoxide levels) of abstinence. We assessed the feasibility and promise of Inspired, a contingency management mobile app for smoking cessation that uses game-based rewards to incentivize abstinence from smoking instead of the monetary (or material) rewards typically used. We sought participant feedback and limited objective data on: the features and design of Inspired, interest in using Inspired when it becomes available, the likelihood of Inspired being an effective cessation aid, and the rank order preference of Inspired relative to other familiar smoking cessation aids. Twenty-eight treatment-seeking smokers participated in this study. Participants attended a single one-hour session in which they received an overview of the goals of the Inspired mobile game, practiced submitting breath carbon monoxide (CO) samples, and played representative levels of the game. Participants were then told that they could play an extra level, or they could stop, complete an outcome survey, receive payment, and be dismissed. A sign-up sheet requesting personal contact information was available for those who wished to be notified when the full version of Inspired becomes available. Using binary criteria for endorsement, participants indicated that, assuming it was currently available and fully developed, they would be more likely to use Inspired than: any other smoking cessation aid (21/28, 75%), the nicotine patch (23/28, 82%), a drug designed to reduce smoking cravings (23/28, 82%), or a program involving attendance in training sessions or support group meetings (27/28, 96%). In the questionnaire, participants indicated that both the Inspired program (26/28, 93%) and the Inspired game would be "Fun" (28/28, 100%), and 71% (20/28) reported that the program would help them personally quit smoking. Fifty-eight percent of participants (15/26) chose to continue playing the game rather than immediately collecting payment for participation and leaving. Eighty-two percent of participants (23/28) signed up to be notified when the full version of Inspired becomes available. This was the first study to evaluate a game-based contingency management app that uses game-based virtual goods as rewards for smoking abstinence. The outcomes suggest that the completed app has potential to be an effective smoking cessation aid that would be widely adopted by smokers wishing to quit. ©Bethany R Raiff, Nicholas Fortugno, Daniel R Scherlis, Darion Rapoza. Originally published in JMIR Serious Games (http://games.jmir.org), 07.06.2018.

Smoking Cessation Programs for Lesbian, Gay, Bisexual, Transgender, and Intersex People: A Content-Based Systematic Review.

PubMed

Berger, Israel; Mooney-Somers, Julie

2017-11-07

Tobacco use among lesbian, gay, bisexual, and transgender (LGBT) people is double the general population. Limited evidence suggests high smoking rates among intersex people. Lesbian, gay, bisexual, transgender, and intersex (LGBTI) people are a priority population in Australian health policy, particularly mental health and aging. Despite associations between smoking and noncommunicable diseases relevant to aging and mental health, LGBTI-targeted smoking cessation interventions in Australia have been limited to people living with HIV. Applying existing interventions to marginalized populations without modification and evaluation may fail and exacerbate inequities. To assess outcomes and characterize the populations served, cultural modifications, and behavior change techniques (BCTs) of interventions to reduce LGBTI smoking. We searched MEDLINE, six additional databases, and contacted authors to retrieve published and unpublished program evaluations. We retrieved 19 studies (3663 participants). None used control groups. Overall quit rate was 61.0% at the end of interventions and stabilized at 38.6% at 3-6 months. All studies included gay men, 13 included lesbians, 13 "LGBT," 12 bisexual people, five transgender people, and none included intersex people. Transgender people comprised 3% of participants. Of programs open to women, 27.8% of participants were women. Cultural modifications were used by 17 (89.5%) studies, commonly meeting in LGBT spaces, discussing social justice, and discussing LGBT-specific triggers. Common BCTs included providing normative information, boosting motivation/self-efficacy, relapse prevention, social support, action planning, and discussing consequences. Quit rates were high; using control groups would improve evaluation. Existing programs may fail to reach groups other than gay men. This review examines the evidence for LGBTI-targeted smoking cessation interventions. Populations within LGBTI are not proportionally represented in smoking cessation research, and no study addressed intersex smoking. Overall, LGBT-targeted interventions appear to be effective, and simply having an LGBT-specific group may be more effective than groups for the general population. More rigorous research is necessary to draw firm conclusions. Our study space analysis provides suggestions for areas of more targeted research on mechanisms underlying these complex interventions' success. © The Author 2016. 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 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.

Neural Correlates of Graphic Cigarette Warning Labels Predict Smoking Cessation Relapse

PubMed Central

Owens, Max M.; MacKillop, James; Gray, Joshua C.; Hawkshead, Brittany E.; Murphy, Cara M.; Sweet, Lawrence H.

2017-01-01

Exposure to graphic warning labels (GWLs) on cigarette packaging has been found to produce heightened activity in brain regions central to emotional processing and higher-order cognitive processes. The current study extends this literature by using functional magnetic resonance imaging (fMRI) to investigate neural activation in response to GWLs and use it to predict relapse in an evidence-based smoking cessation treatment program. Participants were 48 treatment-seeking nicotine-dependent smokers who completed an fMRI paradigm in which they were exposed to GWLs, text-only warning labels (TOLs), and matched control stimuli. Subsequently, they enrolled in smoking cessation treatment and their smoking behavior was monitored. Activation in bilateral amygdala, right dorsolateral prefrontal cortex, right inferior frontal gyrus, left medial temporal gyrus, bilateral occipital lobe, and bilateral fusiform gyrus was greater during GWLs than TOLs. Neural response in the ventromedial prefrontal cortex (vmPFC) during exposure to GWLs (relative to a visual control image) predicted relapse during treatment beyond baseline demographic and dependence severity, but response in the amygdala to GWLs did not. These findings suggest that neurocognitive processes in the vmPFC may be critical to understanding how GWL’s induce behavior change and may be useful as a predictor of smoking cessation treatment prognosis. PMID:28236714

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 Psilocybin-facilitated Smoking Cessation

PubMed Central

Johnson, Matthew W.; Garcia-Romeu, Albert; Griffiths, Roland R.

2017-01-01

Background A recent open-label pilot study (N=15) found that two to three moderate to high doses (20 and 30 mg/70 kg) of the serotonin 2A receptor agonist psilocybin, in combination with cognitive behavioral therapy (CBT) for smoking cessation, resulted in substantially higher 6-month smoking abstinence rates than are typically observed with other medications or CBT alone. Objectives To assess long-term effects of a psilocybin-facilitated smoking cessation program at ≥12 months after psilocybin administration. Methods The present report describes biologically verified smoking abstinence outcomes of the previous pilot study at ≥12 months, and related data on subjective effects of psilocybin. Results All 15 participants completed a 12-month follow-up, and 12 (80%) returned for a long-term (≥16 months) follow-up, with a mean interval of 30 months (range = 16 – 57 months) between target-quit date (i.e., first psilocybin session) and long-term follow-up. At 12-month follow-up, 10 participants (67%) were confirmed as smoking abstinent. At long-term follow-up, nine participants (60%) were confirmed as smoking abstinent. At 12-month follow-up 13 participants (86.7%) rated their psilocybin experiences among the 5 most personally meaningful and spiritually significant experiences of their lives. Conclusion These results suggest that in the context of a structured treatment program, psilocybin holds considerable promise in promoting long-term smoking abstinence. The present study adds to recent and historical evidence suggesting high success rates when using classic psychedelics in the treatment of addiction. Further research investigating psilocybin-facilitated treatment of substance use disorders is warranted. PMID:27441452

Long-term follow-up of psilocybin-facilitated smoking cessation.

PubMed

Johnson, Matthew W; Garcia-Romeu, Albert; Griffiths, Roland R

2017-01-01

A recent open-label pilot study (N = 15) found that two to three moderate to high doses (20 and 30 mg/70 kg) of the serotonin 2A receptor agonist, psilocybin, in combination with cognitive behavioral therapy (CBT) for smoking cessation, resulted in substantially higher 6-month smoking abstinence rates than are typically observed with other medications or CBT alone. To assess long-term effects of a psilocybin-facilitated smoking cessation program at ≥12 months after psilocybin administration. The present report describes biologically verified smoking abstinence outcomes of the previous pilot study at ≥12 months, and related data on subjective effects of psilocybin. All 15 participants completed a 12-month follow-up, and 12 (80%) returned for a long-term (≥16 months) follow-up, with a mean interval of 30 months (range = 16-57 months) between target-quit date (i.e., first psilocybin session) and long-term follow-up. At 12-month follow-up, 10 participants (67%) were confirmed as smoking abstinent. At long-term follow-up, nine participants (60%) were confirmed as smoking abstinent. At 12-month follow-up 13 participants (86.7%) rated their psilocybin experiences among the five most personally meaningful and spiritually significant experiences of their lives. These results suggest that in the context of a structured treatment program, psilocybin holds considerable promise in promoting long-term smoking abstinence. The present study adds to recent and historical evidence suggesting high success rates when using classic psychedelics in the treatment of addiction. Further research investigating psilocybin-facilitated treatment of substance use disorders is warranted.

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.

Inferring Smoking Status from User Generated Content in an Online Cessation Community.

PubMed

Amato, Michael S; Papandonatos, George D; Cha, Sarah; Wang, Xi; Zhao, Kang; Cohn, Amy M; Pearson, Jennifer L; Graham, Amanda L

2018-01-22

User generated content (UGC) is a valuable but underutilized source of information about individuals who participate in online cessation interventions. This study represents a first effort to passively detect smoking status among members of an online cessation program using UGC. Secondary data analysis was performed on data from 826 participants in a web-based smoking cessation randomized trial that included an online community. Domain experts from the online community reviewed each post and comment written by participants and attempted to infer the author's smoking status at the time it was written. Inferences from UGC were validated by comparison with self-reported 30-day point prevalence abstinence (PPA). Following validation, the impact of this method was evaluated across all individuals and timepoints in the study period. Of the 826 participants in the analytic sample, 719 had written at least one post from which content inference was possible. Among participants for whom unambiguous smoking status was inferred during the 30 days preceding their 3-month follow-up survey, concordance with self-report was almost perfect (kappa = 0.94). Posts indicating abstinence tended to be written shortly after enrollment (median = 14 days). Passive inference of smoking status from UGC in online cessation communities is possible and highly reliable for smokers who actively produce content. These results lay the groundwork for further development of observational research tools and intervention innovations. © The Author(s) 2018. 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 survey of managed care strategies for pregnant smokers.

PubMed

Barker, D C; Robinson, L A; Rosenthal, A C

2000-01-01

The purpose of this study was to measure the content and comprehensiveness of pregnancy specific smoking cessation strategies within managed care organisations (MCOs) responding affirmatively to the national 1997-98 Addressing Tobacco in Managed Care (ATMC) survey. This cross sectional follow up study consisted of a fax survey sent to medical directors and a 37 question telephone survey of program overseers about the smoking cessation strategy. 147 MCOs identifying a pregnancy specific smoking cessation strategy on the 1997-98 ATMC survey served as the initial sample; 88 MCOs of 128 eligible plans completed both components, with a response rate of 69%. Pregnancy specific smoking cessation strategies varied. 40% of respondents used the Agency for Health Care Policy and Research guidelines for clinical smoking cessation to design their strategy. Strategies included self help materials, quit classes, telephone support and brief counselling by providers, linkages to quality improvement efforts, and use of patient databases for outreach. Only 42% offered a postpartum relapse prevention element. Lack of patient interest, competing clinic priorities, and the lack of a smoker identification system were the most problematic barriers to implementing strategies, common to at least a quarter of respondents. A majority ranked best practice manuals and web site linkages as the most useful form of technical assistance, followed by peer-to-peer counselling, regional workshops, newsletters, on-site assistance, and national conferences. The survey provides the first profile of prenatal tobacco treatment strategies in managed care. While design limitations prevent generalisation of these results to all MCOs, such information can help guide technical assistance to plans interested in reducing smoking among pregnant women.

Initial evaluation of a real-world Internet smoking cessation system

PubMed Central

Cobb, Nathan K.; Graham, Amanda L.; Bock, Beth C.; Papandonatos, George; Abrams, David B.

2010-01-01

To significantly reduce smoking prevalence, treatments must balance reach, efficacy, and cost. The Internet can reach millions of smokers cost-effectively. Many cessation Web sites exist, but few have been evaluated. As a result, the potential impact of the Internet on smoking prevalence remains unknown. The present study reports the results, challenges, and limitations of a preliminary, large-scale evaluation of a broadly disseminated smoking cessation Web site used worldwide (QuitNet). Consecutive registrants (N=1,501) were surveyed 3 months after they registered on the Web site to assess 7-day point prevalence abstinence. Results must be interpreted cautiously because this is an uncontrolled study with a 25.6% response rate. Approximately 30% of those surveyed indicated they had already quit smoking at registration. Excluding these participants, an intention-to-treat analysis yielded 7% point prevalence abstinence (for the responders only, abstinence was 30%). A range of plausible cessation outcomes (9.8%–13.1%) among various subgroups is presented to illustrate the strengths and limitations of conducting Web-based evaluations, and the tensions between clinical and dissemination research methods. Process-to-outcome analyses indicated that sustained use of QuitNet, especially the use of social support, was associated with more than three times greater point prevalence abstinence and more than four times greater continuous abstinence. Despite its limitations, the present study provides useful information about the potential efficacy, challenging design and methodological issues, process-to-outcome mechanisms of action, and potential public health impact of Internet-based behavior change programs for smoking cessation. PMID:16036277

Evaluation of 'Stop Smoking in its Tracks': an intensive smoking cessation program for pregnant Aboriginal women incorporating contingency-based financial rewards.

PubMed

Passey, Megan E; Stirling, Janelle M

2018-06-14

Smoking during pregnancy is three times as common among Aboriginal women as non-Aboriginal women, with consequent higher rates of adverse health outcomes. Effective interventions to support Aboriginal women to quit smoking have not yet been identified. To assess the feasibility and acceptability of implementing a culturally tailored, intensive smoking cessation program, including contingency-based financial rewards (CBFR), for pregnant Aboriginal women. The structured program included frequent support with individually tailored counselling, free nicotine replacement therapy, engagement with household members, specially developed resources, CBFR and peer support groups. It was implemented by three rural Aboriginal Maternal and Infant Health Services sites. Women were eligible if they or their partner were Aboriginal; and if they were: current smokers or had quit since becoming pregnant; >=16 years old; at <20 weeks gestation; and locally resident. Data included demographics, obstetrics, initial smoking behaviour, program implementation and quitting behaviour. Self-reported quitting was confirmed by expired carbon monoxide (CO). Women and staff were interviewed about their experiences. Twenty-two of 38 eligible women (58%) enrolled in the program, with 19 (86% remaining at the end of their pregnancy. The program was highly acceptable to both women and providers. Feasibility issues included challenges providing twice-weekly visits for 3 weeks and running fortnightly support groups. Of the 19 women who completed the program, 15 (79%) reported a quit attempt lasting >=24 hours, and 8 (42%) were CO-confirmed as not smoking in late pregnancy. The rewards were perceived to help motivate women, but the key to successful quitting was considered to be the intensive support provided. 'Stop Smoking in its Tracks' was acceptable and is likely to be feasible to implement with some modifications. The program should be tested in a larger study.

The Effects of Noxious Subliminal Suggestion upon Smoking Attitudes and Behavior.

ERIC Educational Resources Information Center

Dutto, Franklin N.; Galli, Nicholas

The efforts of smoking cessation programs have met with various degrees of success and fresh approaches to the problem are needed. An innovative technique that interrupts the psychogenic drives of smokers was employed to determine the effect of noxious subliminal suggestion on smoking attitudes and behavior. Adult smokers (N=60) were shown…

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.

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

Self-determination, smoking, diet and health.

PubMed

Williams, Geoffrey C; Minicucci, Daryl S; Kouides, Ruth W; Levesque, Chantal S; Chirkov, Valery I; Ryan, Richard M; Deci, Edward L

2002-10-01

A Clinical Trial will test (1) a Self-Determination Theory (SDT) model of maintained smoking cessation and diet improvement, and (2) an SDT intervention, relative to usual care, for facilitating maintained behavior change and decreasing depressive symptoms for those who quit smoking. SDT is the only empirically derived theory which emphasizes patient autonomy and has a validated measure for each of its constructs, and this is the first trial to evaluate an SDT intervention. Adult smokers will be stratified for whether they are at National Cholesterol Education Program (1996) recommended goal for low-density lipoprotein cholesterol (LDL-C). Those with elevated LDL-C will be studied for diet improvement as well as smoking cessation. Six-month interventions involve a behavior-change counselor using principles of SDT to facilitate autonomous motivation and perceived competence for healthier behaving. Cotinine-validated smoking cessation and LDL-C-validated dietary recall of reduced fat intake, as well as depressive symptoms, will be assessed at 6 and 18 months. Structural equation modeling will test the model for both behaviors within the intervention and usual-care conditions.

Smoking cessation and the cardiovascular patient.

PubMed

Prochaska, Judith J; Benowitz, Neal L

2015-09-01

Smoking remains the leading cause of preventable morbidity and mortality. Our review highlights research from 2013 to 2015 on the treatment of cigarette smoking, with a focus on heart patients and cardiovascular outcomes. Seeking to maximize the reach and effectiveness of existing cessation medications, current tobacco control research has demonstrated the safety and efficacy of combination treatment, extended use, reduce-to-quit strategies, and personalized approaches to treatment matching. Further, cytisine has gained interest as a lower-cost strategy for addressing the global tobacco epidemic. On the harm reduction front, snus and electronic nicotine delivery systems are being widely distributed and promoted with major gaps in knowledge of the safety of long-term and dual use. Quitlines, comparable in outcome to in-person treatment, make cessation counseling available on a national scale, though use rates remain relatively low. Employee reward programs are gaining attention given the high costs of tobacco use to employers; sustaining quit rates postpayment, however, has proven challenging. Evidence-based cessation treatments exist. Broader dissemination, adoption, and implementation are key to addressing the tobacco epidemic. The cardiology team has a professional obligation to advance tobacco control efforts and can play an important role in achieving a smoke-free future.

Design strategy for a smoking cessation trial of survival.

PubMed

Shuster, Jonathan J

2015-04-01

Despite unequivocal evidence that smoking cessation is beneficial in terms of survival, there is at present no firm evidence that smoking cessation programs save lives. While they do increase quit rates, the collective evidence from randomized trials is inconclusive with respect to long-term survival. Withdrawal symptoms and the potential for harm when a subjects relapses after a prolonged period of cessation (e.g., 5+ years) might mitigate some or all of the benefits of the sustained quitters. This paper will review the key survival epidemiology and argue for a large randomized field trial of about 30,000 subjects, followed personally for 5 years and collectively for 15 years through the National Death Index. The intervention should be personalized, but reproducible through a treatment assignment algorithm. Personal coaching should be a major part of the intervention. Important short-term data on healthcare utilization should also be collected. Strong financial motivation for quitting (or prevention of smoking in the first place) is also presented. This paper is intended to motivate a large collective effort amongst the US Clinical and Translational Science Awardees to design the intervention and bring together the interested players to conduct the study. © 2013 Wiley Periodicals, Inc.

Effects of a guided web-based smoking cessation program with telephone counseling: a cluster randomized controlled trial.

PubMed

Mehring, Michael; Haag, Max; Linde, Klaus; Wagenpfeil, Stefan; Schneider, Antonius

2014-09-24

Preliminary findings suggest that Web-based interventions may be effective in achieving significant smoking cessation. To date, very few findings are available for primary care patients, and especially for the involvement of general practitioners. Our goal was to examine the short-term effectiveness of a fully automated Web-based coaching program in combination with accompanied telephone counseling in smoking cessation in a primary care setting. The study was an unblinded cluster-randomized trial with an observation period of 12 weeks. Individuals recruited by general practitioners randomized to the intervention group participated in a Web-based coaching program based on education, motivation, exercise guidance, daily short message service (SMS) reminding, weekly feedback through Internet, and active monitoring by general practitioners. All components of the program are fully automated. Participants in the control group received usual care and advice from their practitioner without the Web-based coaching program. The main outcome was the biochemically confirmed smoking status after 12 weeks. We recruited 168 participants (86 intervention group, 82 control group) into the study. For 51 participants from the intervention group and 70 participants from the control group, follow-up data were available both at baseline and 12 weeks. Very few patients (9.8%, 5/51) from the intervention group and from the control group (8.6%, 6/70) successfully managed smoking cessation (OR 0.86, 95% CI 0.25-3.0; P=.816). Similar results were found within the intent-to-treat analysis: 5.8% (5/86) of the intervention group and 7.3% (6/82) of the control group (OR 1.28, 95% CI 0.38-4.36; P=.694). The number of smoked cigarettes per day decreased on average by 9.3 in the intervention group and by 6.6 in the control group (2.7 mean difference; 95% CI -5.33 to -0.58; P=.045). After adjustment for the baseline value, age, gender, and height, this significance decreases (mean difference 2.2; 95% CI -4.7 to 0.3; P=.080). This trial did not show that the tested Web-based intervention was effective for achieving smoking cessation compared to usual care. The limited statistical power and the high drop-out rate may have reduced the study's ability to detect significant differences between the groups. Further randomized controlled trials are needed in larger populations and to investigate the long-term outcome. German Register for Clinical Trials, registration number DRKS00003067; http://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ ID=DRKS00003067 (Archived by WebCite at http://www.webcitation.org/6Sff1YZpx).

Baseline characteristics and recruitment strategies in a randomized clinical trial of African-American light smokers.

PubMed

Okuyemi, Kolawole S; Cox, Lisa Sanderson; Nollen, Nicole L; Snow, Tricia M; Kaur, Harsohena; Choi, Won; Nazir, Niaman; Mayo, Matthew S; Ahluwalia, Jasjit S

2007-01-01

This study describes the design, recruitment, and baseline data of the first smoking-cessation clinical trial for African-American light smokers, Kick It at Swope II (KIS-II). KIS-II was a randomized trial testing the efficacy of nicotine gum (vs. placebo gum) in combination with counseling (motivational interviewing or health education). This study was conducted at an urban community-based clinic serving predominantly lower-income African-Americans. African-Americans who smoked 1 to 10 cigarettes per day were eligible. Of 1933 individuals screened, 1012 (52%) were eligible and 755 (75%) were enrolled in the study. Baseline assessment included smoking history and psychometric measures. The majority of participants were women (67%) with a mean age of 45.1 years (SD = 10.7). Participants smoked on average 7.6 cigarettes (SD = 3.21) per day, had a mean exhaled carbon monoxide level of 13.9 ppm (SD = 8.9) and a mean serum cotinine level of 244.2 ng/mL (SD = 154.4), and reported high levels of motivation and confidence to quit smoking. African-American light smokers were motivated to stop smoking and to enroll in a smoking-cessation program. Characteristics of our sample suggest African-American light smokers are an appropriate group for inclusion in smoking-cessation interventions.

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

[Effectiveness of Varenicline with counseling programs on smoking cessation in a targeted clinical setting in China].

PubMed

Jiang, Bin; He, Yao; Zuo, Fang; Wu, Lei; Liu, Qinghui; Zhang, Li; Zhou, Changxi; Cheng, Kk; Chan, Sc; Lam, Th

2014-12-01

To evaluate the effectiveness of Varenicline for smoking cessation in a community-based smoking-cessation-clinic (SCC) in Chinese smokers. A prospective observational study was conducted in Beijing, China. 799 smokers (762 men and 37 women) were assessed on data gathered from structured questionnaires at baseline and follow up programs at 1, 3 and 6 months. Trained physician counselors provided free individual counseling and follow-up interviews with brief counseling for all the subjects. 272 subjects were additionally prescribed Varenicline according to their own choice and reported data were compared to those without Varenicline. Outcomes were self-reported, regarding the 7-day point prevalence on abstinence rate and continuous abstinence rates at 1, 3 and 6 month follow-up periods. At 6-month and by intention-to-treat, the 7-day point prevalence on abstinence rate with Varenicline and counseling, was significantly higher than the group with counseling only (34.6% versus 23.1%; OR = 1.75, 95% CI: 1.27-2.42;P < 0.001). The 3-month continuous abstinence rate at 6 month was higher in the group with Varenicline(31.3% versus 18.2% ;OR = 2.04, 95% CI:1.46-2.86;P < 0.001). Varenicline also showed better outcomes at 1 and 3 month follow-up. Varenicline prescription in the smoking cessation clinic appeared to be effective that doubled the rates of quitting among Chinese smokers in the practice at a community-based SCC.

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.

Relationship of occupational and non-occupational stress with smoking in automotive industry workers.

PubMed

Hassani, Somayeh; Yazdanparast, Taraneh; Seyedmehdi, Seyed Mohammad; Ghaffari, Mostafa; Attarchi, Mirsaeed; Bahadori, Baharak

2014-01-01

Tobacco use is the second cause of death and first cause of preventable mortality worldwide. Smoking in the workplace is particularly concerning. Smoking-free workplaces decrease the risk of exposure of non-smoking personnel to cigarette smoke. Recent studies have mostly focused on the effect of daily or non-occupational stressors (in comparison with occupational stress) on prevalence of smoking. Occupational stress is often evaluated in workplaces for smoking cessation or control programs, but the role of non-occupational stressors is often disregarded in this respect. This cross-sectional study was conducted in an automobile manufacturing company. The response of automotive industry workers to parts of the validated, reliable, Farsi version of Musculoskeletal Intervention Center (MUSIC)-Norrtalje questionnaire was evaluated. A total of 3,536 factory workers participated in this study. Data were analyzed using SPSS and P<0.05 was considered statistically significant. The correlation of smoking with demographic factors, occupational stressors and life events was evaluated. The results of logistic regression analysis showed that even after adjusting for the confounding factors, cigarette smoking was significantly correlated with age, sex, level of education, job control and life events (P<0.05). The results showed that of occupational and non-occupational stressors, only job control was correlated with cigarette smoking. Non-occupational stressors had greater effect on cigarette smoking. Consideration of both non-occupational and occupational stressors can enhance the success of smoking control programs. On the other hand, a combination of smoking control and stress (occupational and non-occupational) control programs can be more effective than smoking cessation interventions alone.

Maintenance of tobacco cessation programmes in public hospitals in Catalonia, Spain.

PubMed

Ballbè, Montse; Martínez, Cristina; Saltó, Esteve; Cabezas, Carmen; Riccobene, Anna; Valverde, Araceli; Gual, Antoni; Fernández, Esteve

2015-03-01

The provision of smoking cessation interventions in hospitals has been strongly recommended. The aim of this study is to determine the maintenance of smoking cessation programmes for inpatients and hospital workers in hospitals of Catalonia (Spain) seven years after the implementation of a Tobacco Cessation Programme. A cross-sectional survey was conducted in all hospitals that offer public service in Catalonia, Spain (n=73). An online questionnaire was sent to all coordinators of the smoke-free hospital project or managers of each hospital. The survey included questions about the type of hospital, type of programmes implemented and availability and source of smoking cessation drugs. Responses to the questionnaire were submitted by 58 hospitals (79.5%). 74% and 93.1% of the hospitals had smoking cessation programmes for inpatients and workers, respectively. Most of the hospitals maintained the programmes and started routinely buying smoking cessation drugs after a period of receiving them free-of-charge. However, 17.2% of the hospitals refused to buy these drugs and 24% never had these drugs available. Through a supportive Tobacco Cessation Programme, most hospitals have smoking cessation programmes for both patients and workers. Most of them have incorporated smoking cessation drugs as a regular resource in their services' portfolio. The lack of these resources may jeopardise the maintenance of well-established programmes in hospitals. Copyright © 2014 Elsevier Ltd. All rights reserved.

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.

Efficacy of an Experiential, Dissonance-Based Smoking Intervention for College Students Delivered via the Internet

PubMed Central

Simmons, Vani Nath; Heckman, Bryan W.; Fink, Angelina C.; Small, Brent J.; Brandon, Thomas H.

2015-01-01

Objective College represents a window of opportunity to reach the sizeable number of cigarette smokers who are vulnerable to lifelong smoking. The underutilization of typical cessation programs suggests the need for novel and more engaging approaches for reaching college smokers. The aim of the present study was to test the efficacy of a dissonance-enhancing, Web-based experiential intervention for increasing smoking cessation motivation and behavior. Method We used a 4-arm, randomized design to examine the efficacy of a Web-based, experiential smoking intervention (Web-Smoke). The control conditions included a didactic smoking intervention (Didactic), a group-based experiential intervention (Group), and a Web-based nutrition experiential intervention (Web-Nutrition). We recruited 341 college smokers. Primary outcomes were motivation to quit, assessed immediately postintervention, and smoking abstinence at 1 and 6 months following the intervention. Results As hypothesized, the Web-Smoke intervention was more effective than control groups in increasing motivation to quit. At 6-month follow-up, the Web-Smoke intervention produced higher rates of smoking cessation than the Web-Nutrition control intervention. Daily smoking moderated intervention outcomes. Among daily smokers, the Web-Smoke intervention produced greater abstinence rates than both the Web-Nutrition and Didactic control conditions. Conclusion Findings demonstrate the efficacy of a theory-based intervention delivered over the Internet for increasing motivation to quit and smoking abstinence among college smokers. The intervention has potential for translation and implementation as a secondary prevention strategy for college-aged smokers. PMID:23668667

Efficacy of an experiential, dissonance-based smoking intervention for college students delivered via the internet.

PubMed

Simmons, Vani Nath; Heckman, Bryan W; Fink, Angelina C; Small, Brent J; Brandon, Thomas H

2013-10-01

College represents a window of opportunity to reach the sizeable number of cigarette smokers who are vulnerable to lifelong smoking. The underutilization of typical cessation programs suggests the need for novel and more engaging approaches for reaching college smokers. The aim of the present study was to test the efficacy of a dissonance-enhancing, Web-based experiential intervention for increasing smoking cessation motivation and behavior. We used a 4-arm, randomized design to examine the efficacy of a Web-based, experiential smoking intervention (Web-Smoke). The control conditions included a didactic smoking intervention (Didactic), a group-based experiential intervention (Group), and a Web-based nutrition experiential intervention (Web-Nutrition). We recruited 341 college smokers. Primary outcomes were motivation to quit, assessed immediately postintervention, and smoking abstinence at 1 and 6 months following the intervention. As hypothesized, the Web-Smoke intervention was more effective than control groups in increasing motivation to quit. At 6-month follow-up, the Web-Smoke intervention produced higher rates of smoking cessation than the Web-Nutrition control intervention. Daily smoking moderated intervention outcomes. Among daily smokers, the Web-Smoke intervention produced greater abstinence rates than both the Web-Nutrition and Didactic control conditions. Findings demonstrate the efficacy of a theory-based intervention delivered over the Internet for increasing motivation to quit and smoking abstinence among college smokers. The intervention has potential for translation and implementation as a secondary prevention strategy for college-aged smokers. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

Sex Differences in Varenicline Efficacy for Smoking Cessation: A Meta-Analysis

PubMed Central

Smith, Philip H.; Kaufman, Mira; Mazure, Carolyn M.; Weinberger, Andrea H.

2016-01-01

Abstract Introduction: Women have lower rates of quitting than men with both bupropion and nicotine replacement. It is unknown whether varenicline demonstrates differential efficacy for men and women. The purpose of this study was to conduct the first comprehensive meta-analysis of clinical trial data examining sex differences in the efficacy of varenicline for smoking cessation. Methods: Searching MEDLINE, EMBASE, and PsychINFO, 17 of 43 clinical trials of varenicline for smoking cessation published through December 31, 2014 were low-bias randomized double-blind placebo-controlled trials. Data ( n = 6710 smokers, 34% female, n = 16 studies, 96% of available data) was analyzed with Metafor program in R. Outcome endpoints were 7-day point-prevalence (PP) and continuous-abstinence (CA) at week 12 (end of treatment), week 24 (6-month follow-up), and week 52 (12-month follow-up). Results: Using placebo, women were less likely than men to quit (PP-12, CA-24; P < .05 for sex). Using varenicline, similar rates of abstinence for men and women were demonstrated for all six outcomes (eg, PP-12 abstinence rates were 53% in both women and men). Varenicline versus placebo outcomes demonstrated that varenicline was more effective for women for short and intermediate outcomes (PP-12, CA-12, CA-24; P < .05 sex × medication interaction). For end-of-treatment PP, varenicline was 46% more effective for women. For continuous abstinence, varenicline was 34% (CA-12) and 31% (CA-24) more effective for women. Conclusions: Unlike other smoking cessation medications, varenicline demonstrated greater efficacy among women smokers for short and immediate-term outcomes and equal efficacy for 1-year outcomes. Varenicline may be particularly useful for reducing the sex disparity typically seen in rates of smoking cessation. Implications: Varenicline is currently the most effective FDA-approved smoking cessation medication and this is the first demonstration that women compared with men have a preferred therapeutic response for a smoking cessation medication when considering short-term outcomes. Importantly, this is also the first demonstration that women have similar rates of quitting to men when considering longer-term, 1-year outcomes. PMID:26446070

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.

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

Exercise counseling to enhance smoking cessation outcomes: the Fit2Quit randomized controlled trial.

PubMed

Maddison, Ralph; Roberts, Vaughan; McRobbie, Hayden; Bullen, Christopher; Prapavessis, Harry; Glover, Marewa; Jiang, Yannan; Brown, Paul; Leung, William; Taylor, Sue; Tsai, Midi

2014-10-01

Regular exercise has been proposed as a potential smoking cessation aid. This study aimed to determine the effects of an exercise counseling program on cigarette smoking abstinence at 24 weeks. A parallel, two-arm, randomized controlled trial was conducted. Adult cigarette smokers (n = 906) who were insufficiently active and interested in quitting were randomized to receive the Fit2Quit intervention (10 exercise telephone counseling sessions over 6 months) plus usual care (behavioral counseling and nicotine replacement therapy) or usual care alone. There were no significant group differences in 7-day point-prevalence and continuous abstinence at 6 months. The more intervention calls successfully delivered, the lower the probability of smoking (OR, 0.88; 95 % CI 0.81-0.97, p = 0.01) in the intervention group. A significant difference was observed for leisure time physical activity (difference = 219.11 MET-minutes/week; 95 % CI 52.65-385.58; p = 0.01). Telephone-delivered exercise counseling may not be sufficient to improve smoking abstinence rates over and above existing smoking cessation services. (Australasian Clinical Trials Registry Number: ACTRN12609000637246.).

[Previous abstinence time as a predictive factor at 12 months follow-up in a multi-component smoking cessation program].

PubMed

Moreno-Arnedillo, J J; Morante-Benadero, M E; Sánchez-Vegazo-Sánchez, E

2014-01-01

The objective of this study is to analyze the length of the longest period of previous abstinence time as a predictor of the results of a smoking cessation program at 12 months follow-up. A cross-sectional study was conducted on a sample of 475 smokers who had participated in a multi-component smoking cessation group therapy program. The independent variable is the longest abstinence time passed, measured in weeks, before the current treatment. Success was defined as self-reported abstinence. Bivariate analyses were applied to the independent variable and to other variables in order to determine the factors that would be part of a logistic regression model using contrasts Student t or χ(2) comparisons, as appropriate. Those that showed statistical significance were entered into a multivariate logistic regression model. Within the studied variables, previous abstinence time and sex were the only predictive variables of success at 12 month follow-up. The probability of being abstinent at 12 months follow-up was significantly associated with the length of the previous longest period of abstinence, and this is the best of the predictors considered. Successful cessation programs depend more on the relationship with the consumer biographical aspects than with biological factors. The history of previous attempts is a more valuable source of information for designing treatments than others traditionally considered. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

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.

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 advice: the self-reported attitudes and practice of primary health care physicians in a military community, central Saudi Arabia

PubMed Central

AlAteeq, Mohammed; Alrashoud, Abdulaziz M; Khair, Mohammed; Salam, Mahmoud

2016-01-01

Background Brief advice on smoking cessation from primary health care (PHC) physicians reduces smoking prevalence. However, few studies have investigated the provision of such advice by PHC physicians providing services to military communities. The aim of this study was to evaluate PHC physicians’ attitudes toward and practice of delivering smoking cessation advice to smokers in a military community in central Saudi Arabia. Methods A self-reported survey of PHC physicians was conducted in 2015 using a previously validated tool. The age, sex, educational level, job title, experience and previous smoking cessation training of each physician was recorded. Attitude (ten statements) and practice (six statements) were evaluated on a five-point Likert scale. Scoring system was applied and percentage mean scores (PMS) were calculated. Descriptive/statistical analyses were applied to identify factors that were significantly associated with a positive attitude and favorable practice (PMS >65 each). P-values <0.05 were considered to be significant. Results Response rate was 73/150 (48.6%), of which equal sex distribution (52%:48%) was observed, with a mean age of 35.3±9.6 years. General practitioners constituted 71.4%, followed by consultants (17.9%) and specialists (10.7%). Those with a postgraduate education formed 49.3%, while experience averaged 9.5±9.2 years. Approximately 56% had not attended a smoking cessation educational program in the previous year. Approximately 75% of physicians had a positive attitude (PMS =72.4±11.2), while 64.4% reported favorable practice (PMS =65.3±27.7). Higher education levels were significantly more associated with positive attitude than lower education levels (adj. odds ratio [OR] 95% confidence interval [CI] =17.9 [1.3–242.3]; adj. P=0.03). More experienced physicians (adj. OR [95% CI] =9.5 [1.6–54.6]) and those with positive attitude (adj. OR [95% CI] =6.1 [1.6–23.3]) were more likely to report a favorable practice, compared to the less experienced (adj. P=0.012) and physicians with a negative attitude (adj. P=0.008). Conclusion Provision of smoking cessation advice by primary health care physicians serving a military community is significantly associated with their attitude and years of experience. Patients who are seeking smoking cessation advice should be referred to physicians with higher levels of education. Routinely scheduled training on proper delivery of smoking cessation advice may increase physicians’ confidence; improve their attitude, and subsequently, their practice. PMID:27175065

Smoking cessation advice: the self-reported attitudes and practice of primary health care physicians in a military community, central Saudi Arabia.

PubMed

AlAteeq, Mohammed; Alrashoud, Abdulaziz M; Khair, Mohammed; Salam, Mahmoud

2016-01-01

Brief advice on smoking cessation from primary health care (PHC) physicians reduces smoking prevalence. However, few studies have investigated the provision of such advice by PHC physicians providing services to military communities. The aim of this study was to evaluate PHC physicians' attitudes toward and practice of delivering smoking cessation advice to smokers in a military community in central Saudi Arabia. A self-reported survey of PHC physicians was conducted in 2015 using a previously validated tool. The age, sex, educational level, job title, experience and previous smoking cessation training of each physician was recorded. Attitude (ten statements) and practice (six statements) were evaluated on a five-point Likert scale. Scoring system was applied and percentage mean scores (PMS) were calculated. Descriptive/statistical analyses were applied to identify factors that were significantly associated with a positive attitude and favorable practice (PMS >65 each). P-values <0.05 were considered to be significant. Response rate was 73/150 (48.6%), of which equal sex distribution (52%:48%) was observed, with a mean age of 35.3±9.6 years. General practitioners constituted 71.4%, followed by consultants (17.9%) and specialists (10.7%). Those with a postgraduate education formed 49.3%, while experience averaged 9.5±9.2 years. Approximately 56% had not attended a smoking cessation educational program in the previous year. Approximately 75% of physicians had a positive attitude (PMS =72.4±11.2), while 64.4% reported favorable practice (PMS =65.3±27.7). Higher education levels were significantly more associated with positive attitude than lower education levels (adj. odds ratio [OR] 95% confidence interval [CI] =17.9 [1.3-242.3]; adj. P=0.03). More experienced physicians (adj. OR [95% CI] =9.5 [1.6-54.6]) and those with positive attitude (adj. OR [95% CI] =6.1 [1.6-23.3]) were more likely to report a favorable practice, compared to the less experienced (adj. P=0.012) and physicians with a negative attitude (adj. P=0.008). Provision of smoking cessation advice by primary health care physicians serving a military community is significantly associated with their attitude and years of experience. Patients who are seeking smoking cessation advice should be referred to physicians with higher levels of education. Routinely scheduled training on proper delivery of smoking cessation advice may increase physicians' confidence; improve their attitude, and subsequently, their practice.

How do text-messaging smoking cessation interventions confer benefit? A multiple mediation analysis of Text2Quit.

PubMed

Hoeppner, Bettina B; Hoeppner, Susanne S; Abroms, Lorien C

2017-04-01

To determine the degree to which the observed benefit of Text2Quit was accounted for by psychosocial mechanisms derived from its quit smoking messaging versus from the use of extra-programmatic smoking cessation treatments and services. Prospective, multiple mediation model of a randomized controlled trial (RCT). United States nation-wide. A total of 409 adult daily smokers participated. Participants were, on average, 35 years of age, predominantly female (68%), white (79%), lacked a college degree (70%), had medium nicotine dependence (average Fagerström Nicotine Dependence Score score of 5.2) and more than half (62%) had made a previous quit attempt. Adult daily smokers browsing the web for smoking cessation support (n = 409; recruited 19 May2011-10 July 2012) were randomized to receive smoking cessation support via Text2Quit versus a smoking cessation material. Mediators (i.e. changes in psychosocial constructs of health behavior change, use of extra-programmatic treatment) were assessed at 1 month using single-item measures and outcome (i.e. self-reported 7-day point prevalence abstinence) at 6-month follow-up. Mediators accounted for 35% of the effect of Text2Quit on smoking cessation. Only psychosocial mechanisms had complete mediational paths, with increases in self-efficacy [b = 0.10 (0.06-0.15)], quitting know-how [b = 0.07 (0.03-0.11)] and the sense that someone cared [b = 0.06 (0.01-0.11)], partially explaining the conferred benefit of Text2Quit. Use of outside resources, including treatments promoted explicitly by Text2Quit, i.e. medication [b = 0.001 (-0.01 to 0.01), quitline [b = -0.002 (-0.01 to 0.04)], treatments and resources not promoted by Text2Quit, i.e. online forums [b = 0.01 (-0.01 to 0.04)] and self-help materials [b = -0.01 (-0.04 to 0.02)], did not have complete mediational paths. An interaction effect existed for medication use that suggested that for participants not using medication, Text2Quit conferred substantial benefit, but not for participants using medication. Text-messaging programs for smoking cessation appear primarily to confer benefit by promoting improvements in the psychosocial processes related to quitting rather than through the use of extra-programmatic smoking cessation treatments and services. © 2016 Society for the Study of Addiction.

[Relations between attitude and practice of smoking and the training program regarding tobacco control among community medical staff members in Hangzhou, Zhejiang province].

PubMed

Liu, Qing-Min; Ren, Yan-Jun; Cao, Cheng-Jian; Liu, Bing; Lv, Jun; Li, Li-Ming

2013-08-01

To investigate the relations between training and both the attitude and practice on smoking control among community medical staff members in Hangzhou, Zhejiang province. Three representative districts including Xiacheng, Gongshu and Westlake were chosen from Hangzhou city. Questionnaire survey was applied to collect information from the related community medical staff members. The survey mainly contained three aspects: knowledge, attitude and practice regarding smoking control involved in the community medical activities. Availability and application of the resources on smoking cessation were also studied. Logistic regression analysis was applied to explore the factors associated with the smoking control training programs. Differences of rates between groups were assessed with chi-square statistics. Wilcoxon rank sum test was used to study the relationships among knowledge, attitude and practice related to smoking control programs, targeted to the community medical staff members. Eight hundred forty-six community medical workers were involved. Sixty-five percent of the community medical staff members had learned related knowledge on smoking control. Proportion of the community medical staff who had taken lessons on smoking control with 3-10 working years was 1.77 times more than the ones with experience less than two years (OR = 1.77, 95% CI: 1.25-2.51). Eighty-eight point seven percent of the medical staff who had received smoking control training programs were identified with the consciousness that they should advise the patients to quit smoking, comparing to the proportion 81.60% (Z=-2.87, P=0.00) in the control group. In terms of the practice regarding smoking control, data showed that 21.62% of the medical staff who had received smoking control training programs would provide 'how to quit smoking' to more than 90% of the smoking patients, while the proportion in the control group was 10.65% (Z = -5.68, P = 0.00). The use of drugs, traditional Chinese medicine therapy and the smoking cessation hotline rate were all less than 30%. The training programs being used on smoking control seemed useful in improving the consciousness and practice towards the smoking control programs during their medical activities among the community medical staff members.

Electronic Nicotine Delivery Systems and Smoking Cessation in Arkansas, 2014

PubMed Central

Ekanem, Uwemedimbuk S.; Cen, Ruiqi; Simon, Wanda; Chedjieu, Irene P.; Woodward, Morgan; Delongchamp, Robert R.; Wheeler, J. Gary

2017-01-01

Objectives: As of October 2015, evidence needed to make a recommendation about the use of electronic nicotine delivery systems (ENDS) for smoking cessation was limited. We used the 2014 Arkansas Behavioral Risk Factor Surveillance System with additional state-specific questions to determine the prevalence of ENDS use, the impact of ENDS use on smoking cessation, and beliefs about ENDS use in Arkansas. Our objectives were to determine if (1) ENDS use was associated with lower odds of quitting smoking, (2) ENDS users believed that ENDS use was not harmful to their health, and (3) ENDS users believed that switching to ENDS reduced their tobacco-related health risks. Methods: We conducted a cross-sectional study of 4465 respondents to the Arkansas Behavioral Risk Factor Surveillance System and used weighted analyses to account for the complex survey design. We used a subset of records formed by (1) formers smokers who quitted smoking in the last 5 years and (2) current smokers to assess the odds of quitting. Results: In 2014, 6.1% (95% confidence interval [CI], 5.0%-7.4%) of Arkansas adults were currently using ENDS. Of the 1083 participants who were current smokers or had quit smoking within the past 5 years, 515 (54.1%) had used ENDS. Of the 515 ENDS users, 404 (80.3%) had continued smoking. ENDS use was significantly associated with reduced odds of quitting smoking (weighted odds ratio = 0.53; 95% CI, 0.34-0.83). Although 2437 of 3808 participants (62.5%) believed that it was harmful for nonsmokers to start using ENDS and 1793 of 3658 participants (47.0%) believed that switching to ENDS did not reduce tobacco-related health risks, only 80 of 165 (41.3%) and 50 of 168 (33.9%) ENDS users shared these same respective beliefs. Conclusions: Most smokers who indicated smoking in the past 5 years and who tried ENDS did not stop smoking. ENDS use was inversely associated with smoking cessation. Tobacco cessation programs should tell cigarette smokers that ENDS use may not help them quit smoking. PMID:28147209

Electronic Nicotine Delivery Systems and Smoking Cessation in Arkansas, 2014.

PubMed

Ekanem, Uwemedimbuk S; Cardenas, Victor M; Cen, Ruiqi; Simon, Wanda; Chedjieu, Irene P; Woodward, Morgan; Delongchamp, Robert R; Wheeler, J Gary

As of October 2015, evidence needed to make a recommendation about the use of electronic nicotine delivery systems (ENDS) for smoking cessation was limited. We used the 2014 Arkansas Behavioral Risk Factor Surveillance System with additional state-specific questions to determine the prevalence of ENDS use, the impact of ENDS use on smoking cessation, and beliefs about ENDS use in Arkansas. Our objectives were to determine if (1) ENDS use was associated with lower odds of quitting smoking, (2) ENDS users believed that ENDS use was not harmful to their health, and (3) ENDS users believed that switching to ENDS reduced their tobacco-related health risks. We conducted a cross-sectional study of 4465 respondents to the Arkansas Behavioral Risk Factor Surveillance System and used weighted analyses to account for the complex survey design. We used a subset of records formed by (1) formers smokers who quitted smoking in the last 5 years and (2) current smokers to assess the odds of quitting. In 2014, 6.1% (95% confidence interval [CI], 5.0%-7.4%) of Arkansas adults were currently using ENDS. Of the 1083 participants who were current smokers or had quit smoking within the past 5 years, 515 (54.1%) had used ENDS. Of the 515 ENDS users, 404 (80.3%) had continued smoking. ENDS use was significantly associated with reduced odds of quitting smoking (weighted odds ratio = 0.53; 95% CI, 0.34-0.83). Although 2437 of 3808 participants (62.5%) believed that it was harmful for nonsmokers to start using ENDS and 1793 of 3658 participants (47.0%) believed that switching to ENDS did not reduce tobacco-related health risks, only 80 of 165 (41.3%) and 50 of 168 (33.9%) ENDS users shared these same respective beliefs. Most smokers who indicated smoking in the past 5 years and who tried ENDS did not stop smoking. ENDS use was inversely associated with smoking cessation. Tobacco cessation programs should tell cigarette smokers that ENDS use may not help them quit smoking.

Cross-Cultural Adaptation of a Text Message-Based Program for Smoking Cessation in Buenos Aires, Argentina.

PubMed

Colantonio, Lisandro D; Peña, Lorena; Whittaker, Robyn; Mejia, Raul M

2016-03-01

Few individual-level nonpharmacological interventions are available in Argentina to support smokers who attempt to quit. We conducted a cross-cultural adaptation of Stop Smoking with Mobile Phones, an English text message-based tobacco cessation program, in Buenos Aires. The process included English-Spanish translation and back-translation, face validity checking by two local tobacco cessation experts, and a complete review using a structured questionnaire and discussion groups with potential users (current smokers who want to quit or former smokers who quit in the past 6 months). An editing group was responsible for analyzing information collected and preparing adapted messages. Readability of final messages was assessed. Tobacco cessation experts found translated messages suitable for the local setting, although mention of "mate" (a local infusion which can trigger cravings) was recommended. Review of messages by two potential users confirmed most of the messages would help smokers to quit and resulted in minor edits. Potential users who participated in two discussion groups (n = 17, 64.7% female, age range: 30-73) found the content of messages was relevant for cessation and related to their own experiences, although they suggested adding information regarding the negative consequences of smoking. Participants emphasized that messages should be formatted using voseo and informal style and provided feedback on specific words and expressions. Readability of final messages was easy/very easy (Fernández Huerta Index: 79.93). The cross-cultural adaptation of Stop Smoking with Mobile Phones resulted in relevant revisions for the study population, including tone, wording, and pertinent information (eg, smoking consequences). Local acceptability and effectiveness should be confirmed in future studies. © 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.

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

Electronic cigarette use among cancer patients: Characteristics of e-cigarette users and their smoking cessation outcomes

PubMed Central

Borderud, Sarah P.; Li, Yuelin; Burkhalter, Jack; Sheffer, Christine E.; Ostroff, Jamie S.

2017-01-01

Background Given that continued smoking after a cancer diagnosis increases the risk for adverse health outcomes, cancer patients are strongly advised to quit. Despite a current lack of evidence regarding their safety and effectiveness as a cessation tool, electronic cigarettes (e-cigarettes) are becoming increasingly popular. In order to guide oncologists’ communication with their patients about e-cigarette use, this paper provides the first published clinical data about e-cigarette use and cessation outcomes among cancer patients. Methods Participants (n=1074) included smokers (cancer patients) who recently enrolled in a tobacco treatment program at a comprehensive cancer center. Standard demographic, tobacco use history and follow-up cessation outcomes were assessed. Results A threefold increase in e-cigarette use was observed from 2012 to 2013 (10.6% vs. 38.5%). E-cigarette users were more nicotine dependent than non-users, had more prior quit attempts, and were more likely to be diagnosed with thoracic and head or neck cancers. Using a complete case analysis, e-cigarette users were as likely to be smoking at follow-up as non-users, (OR: 1.0; 95%CI 0.5–1.7). Using an intention to treat analysis, e-cigarette users were twice as likely to be smoking at follow-up as non-users, (OR: 2.0; 95%CI 1.2–3.3). Conclusions The high rate of e-cigarette use observed is consistent with recent papers highlighting increased e-cigarette use in the general population. Our longitudinal findings raise doubt about the utility of e-cigarettes for facilitating smoking cessation among cancer patients. Further research is needed to evaluate the safety and efficacy of e-cigarettes as a cessation treatment for cancer patients. PMID:25252116

Web-Based Information on the Treatment of Tobacco Dependence for Oral Health Professionals: Analysis of English-Written Websites.

PubMed

Diniz-Freitas, Márcio; Insua, Angel; Keat, Ross; Fricain, Jean Christophe; Catros, Sylvain; Monteiro, Luis; Silva, Luis; Lodi, Giovanni; Pispero, Alberto; Albuquerque, Rui

2017-10-20

Studies have been conducted on the content and quality of Web-based information for patients who are interested in smoking cessation advice and for health care practitioners regarding the content of e-learning programs about tobacco cessation. However, to the best of our knowledge, there is no such information about the quality of Web-based learning resources regarding smoking cessation dedicated to oral health professionals. The aim of this study was to identify and evaluate the quality of the content of webpages providing information about smoking cessation for oral health care professionals. Websites were identified using Google and Health on Net (HON) search engines using the terms: smoking cessation OR quit smoking OR stop smoking OR 3As OR 5As OR tobacco counselling AND dentistry OR dental clinic OR dentist OR dental hygienist OR oral health professionals. The first 100 consecutive results of the 2 search engines were considered for the study. Quality assessment was rated using the DISCERN questionnaire, the Journal of the American Medical Association (JAMA) benchmarks, and the HON seal. In addition, smoking cessation content on each site was assessed using an abbreviated version of the Smoke Treatment Scale (STS-C) and the Smoking Treatment Scale-Rating (STS-R). To assess legibility of the selected websites, the Flesch Reading Ease (FRES) and the Flesch-Kinkaid Reading Grade Level (FKRGL) were used. Websites were also classified into multimedia and nonmultimedia and friendly and nonfriendly usability. Of the first 200 sites selected (100 of Google and 100 of HON), only 11 met the inclusion criteria and mainly belonged to governmental institutions (n=8), with the others being prepared by Professional Associations (n=2) and nonprofit organizations (n=1). Only 3 were exclusively dedicated to smoking cessation. The average score obtained with the DISCERN was 3.0, and the average score in the FKRGL and FRES was 13.31 (standard deviation, SD 3.34) and 40.73 (SD 15.46), respectively. Of the 11 websites evaluated, none achieved all the four JAMA benchmarks. The mean score of STS-R among all the websites was 2.81 (SD 0.95) out of 5. A significant strong positive correlation was obtained between the DISCERN mean values and the STS-R (R=.89, P=.01). The mean quality of webpages with information for oral health care professionals about smoking cessation is low and displayed a high heterogeneity. These webpages are also difficult to read and often lack multimedia resources, which further limits their usefulness. ©Márcio Diniz-Freitas, Angel Insua, Ross Keat, Jean Christophe Fricain, Sylvain Catros, Luis Monteiro, Luis Silva, Giovanni Lodi, Alberto Pispero, Rui Albuquerque. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 20.10.2017.

The Stop Smoking Before Surgery Program

PubMed Central

Bottorff, Joan L.; Seaton, Cherisse L.; Viney, Nancy; Stolp, Sean; Krueckl, Sandra; Holm, Nikolai

2015-01-01

Objective: This study aimed to examine the impact of a Stop Smoking Before Surgery (SSBS) program in a health authority where responsibility for surgical services is shared by health professionals in regional centers and outlying communities. Methods: A between-subjects, pre-post mixed method program evaluation was conducted. Elective surgery patients at 2 Northern Canadian hospitals were recruited and surveyed at 2 time points: pre-SSBS implementation (n = 150) and 1 year post-SSBS implementation (n = 90). In addition, semistructured interviews were conducted with a purposeful sample of participants (n = 18). Results: Participants who received information about stopping smoking before surgery post-SSBS implementation were more likely than expected to have reduced their smoking, χ2(1, 89) = 10.62, P = .001, and had a significantly higher Awareness of Smoking-Related Perioperative Complications score than those that were advised to quit smoking prior to SSBS implementation (U = 1288.0, P < .001). Being advised by a health care professional was the second strongest predictor of whether or not participants reduced their smoking before surgery post-SSBS implementation. However, there was no significant change in the number of participants who reported being advised to quit smoking before surgery between groups. Conclusion: Providing surgery-specific resources to increase awareness of and support for surgery-specific smoking cessation had limited success in this rural context. Additional strategies are needed to ensure that every surgical patient who smokes receives information about the benefits of quitting for surgery and is aware of available cessation resources. PMID:26385995

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 longitudinal study of medicaid coverage for tobacco dependence treatments in Massachusetts and associated decreases in hospitalizations for cardiovascular disease.

PubMed

Land, Thomas; Rigotti, Nancy A; Levy, Douglas E; Paskowsky, Mark; Warner, Donna; Kwass, Jo-Ann; Wetherell, Leann; Keithly, Lois

2010-12-07

Insurance coverage of tobacco cessation medications increases their use and reduces smoking prevalence in a population. However, uncertainty about the impact of this coverage on health care utilization and costs is a barrier to the broader adoption of this policy, especially by publicly funded state Medicaid insurance programs. Whether a publicly funded tobacco cessation benefit leads to decreased medical claims for tobacco-related diseases has not been studied. We examined the experience of Massachusetts, whose Medicaid program adopted comprehensive coverage of tobacco cessation medications in July 2006. Over 75,000 Medicaid subscribers used the benefit in the first 2.5 years. On the basis of earlier secondary survey work, it was estimated that smoking prevalence declined among subscribers by 10% during this period. Using claims data, we compared the probability of hospitalization prior to use of the tobacco cessation pharmacotherapy benefit with the probability of hospitalization after benefit use among Massachusetts Medicaid beneficiaries, adjusting for demographics, comorbidities, seasonality, influenza cases, and the implementation of the statewide smoke-free air law using generalized estimating equations. Statistically significant annualized declines of 46% (95% confidence interval 2%-70%) and 49% (95% confidence interval 6%-72%) were observed in hospital admissions for acute myocardial infarction and other acute coronary heart disease diagnoses, respectively. There were no significant decreases in hospitalizations rates for respiratory diagnoses or seven other diagnostic groups evaluated. Among Massachusetts Medicaid subscribers, use of a comprehensive tobacco cessation pharmacotherapy benefit was associated with a significant decrease in claims for hospitalizations for acute myocardial infarction and acute coronary heart disease, but no significant change in hospital claims for other diagnoses. For low-income smokers, removing the barriers to the use of smoking cessation pharmacotherapy has the potential to decrease short-term utilization of hospital services.

A Longitudinal Study of Medicaid Coverage for Tobacco Dependence Treatments in Massachusetts and Associated Decreases in Hospitalizations for Cardiovascular Disease

PubMed Central

Land, Thomas; Rigotti, Nancy A.; Levy, Douglas E.; Paskowsky, Mark; Warner, Donna; Kwass, Jo-Ann; Wetherell, LeAnn; Keithly, Lois

2010-01-01

Background Insurance coverage of tobacco cessation medications increases their use and reduces smoking prevalence in a population. However, uncertainty about the impact of this coverage on health care utilization and costs is a barrier to the broader adoption of this policy, especially by publicly funded state Medicaid insurance programs. Whether a publicly funded tobacco cessation benefit leads to decreased medical claims for tobacco-related diseases has not been studied. We examined the experience of Massachusetts, whose Medicaid program adopted comprehensive coverage of tobacco cessation medications in July 2006. Over 75,000 Medicaid subscribers used the benefit in the first 2.5 years. On the basis of earlier secondary survey work, it was estimated that smoking prevalence declined among subscribers by 10% during this period. Methods and Findings Using claims data, we compared the probability of hospitalization prior to use of the tobacco cessation pharmacotherapy benefit with the probability of hospitalization after benefit use among Massachusetts Medicaid beneficiaries, adjusting for demographics, comorbidities, seasonality, influenza cases, and the implementation of the statewide smoke-free air law using generalized estimating equations. Statistically significant annualized declines of 46% (95% confidence interval 2%–70%) and 49% (95% confidence interval 6%–72%) were observed in hospital admissions for acute myocardial infarction and other acute coronary heart disease diagnoses, respectively. There were no significant decreases in hospitalizations rates for respiratory diagnoses or seven other diagnostic groups evaluated. Conclusions Among Massachusetts Medicaid subscribers, use of a comprehensive tobacco cessation pharmacotherapy benefit was associated with a significant decrease in claims for hospitalizations for acute myocardial infarction and acute coronary heart disease, but no significant change in hospital claims for other diagnoses. For low-income smokers, removing the barriers to the use of smoking cessation pharmacotherapy has the potential to decrease short-term utilization of hospital services. Please see later in the article for the Editors' Summary PMID:21170313

Randomized controlled trial of a web-based computer-tailored smoking cessation program as a supplement to nicotine patch therapy.

PubMed

Strecher, Victor J; Shiffman, Saul; West, Robert

2005-05-01

To assess the efficacy of World Wide Web-based tailored behavioral smoking cessation materials among nicotine patch users. Two-group randomized controlled trial. World Wide Web in England and Republic of Ireland. A total of 3971 subjects who purchased a particular brand of nicotine patch and logged-on to use a free web-based behavioral support program. Web-based tailored behavioral smoking cessation materials or web-based non-tailored materials. Twenty-eight-day continuous abstinence rates were assessed by internet-based survey at 6-week follow-up and 10-week continuous rates at 12-week follow-up. Using three approaches to the analyses of 6- and 12-week outcomes, participants in the tailored condition reported clinically and statistically significantly higher continuous abstinence rates than participants in the non-tailored condition. In our primary analyses using as a denominator all subjects who logged-on to the treatment site at least once, continuous abstinence rates at 6 weeks were 29.0% in the tailored condition versus 23.9% in the non-tailored condition (OR = 1.30; P = 0.0006); at 12 weeks continuous abstinence rates were 22.8% versus 18.1%, respectively (OR = 1.34; P = 0.0006). Moreover, satisfaction with the program was significantly higher in the tailored than in the non-tailored condition. The results of this study demonstrate a benefit of the web-based tailored behavioral support materials used in conjunction with nicotine replacement therapy. A web-based program that collects relevant information from users and tailors the intervention to their specific needs had significant advantages over a web-based non-tailored cessation program.

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

Smoking habits among physicians in Istanbul and their attitudes regarding anti-smoking legislation.

PubMed

Uysal, Mehmet Atilla; Dilmen, Nevit; Karasulu, Levent; Demir, Tunçalp

2007-01-01

The purpose of this study was to analyze smoking related beliefs, attitudes and knowledge on anti-smoking legislation among physicians practicing in Istanbul, Turkey. Questionnaires were sent to 18.000 physicians who were also members of Istanbul Chamber of Medicine. Three hundred-seventy and four physicians responded. Two hundred-fifty of the respondents were males (66.8%) and 124 were females (33.2%). Sixty out of 374 physicians were smokers. Eighteen of them (30%) were females, 42 of them (70%) were males. 91.5% of physicians who smoked tobacco and 98.4% of non-smoker physicians agreed that smoking is a serious health issue. 91.1% of nonsmoker physicians and 70.7% of smokers asked their patients about their smoking habits. The difference between smokers and non-smokers was statistically significant in both comparisons (p= 0.012 and p= 0.00, respectively). 25% of smoking physicians and 34.5% of non-smokers referred their patients to smoking cessation centers. 21.7% of smoking physicians and 28.8% of non-smokers believed in the success of pharmacological therapy. The difference between smokers and non-smokers was statistically non significant (p= 0.167 and p= 0.262, respectively). This results suggests that physicians have insufficient knowledge on smoking cessation therapies and the law regarding the use of tobacco and that smoking cessation techniques should be incorporated in the curriculum of the faculties and post graduation training programs.

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…

Web-based support as an adjunct to group-based smoking cessation for adolescents

PubMed Central

Mermelstein, Robin; Turner, Lindsey

2008-01-01

Although group-based programs remain the most common treatment approach for adolescent smoking cessation, success rates for these programs have been relatively modest, and their reach may be limited. Web-based adjuncts may be one way to boost the efficacy and reach of group-based approaches. The purpose of this study was to evaluate the effectiveness of enhancing the American Lung Association’s Not on Tobacco program (NOT) with a Web-based adjunct (NOT Plus). Twenty-nine high schools were randomly assigned to either the NOT program alone or to the NOT Plus condition, which included access to a specially designed Web site for teens, along with proactive phone calls from the group facilitator to the participant. Self-reported smoking behavior was obtained at end-of-program and at a 3-month follow-up. Using hierarchical linear modeling, accounting for the clustering of students in schools, and controlling for student gender, grade, race, and baseline smoking rate, there was a marginally significant (p = .06) condition effect at end-of-treatment and a significant effect at 3-month follow-up (p < .05) favoring the NOT Plus condition. Approximately 57% of adolescents reported visiting the Web site, and among the NOT Plus condition, use of the Web site was associated with cessation significantly at end-of-program (p < .05), but not at 3 months. Adolescents in urban schools were more likely to access the Web site than those in rural schools. Participants who visited the Web site rated it positively on several dimensions. Reasons for not using the Web site will be discussed, as well as its value as an adjunct. PMID:17491173

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

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.

The Effectiveness of a Computer-Tailored E-Learning Program for Practice Nurses to Improve Their Adherence to Smoking Cessation Counseling Guidelines: Randomized Controlled Trial.

PubMed

de Ruijter, Dennis; Candel, Math; Smit, Eline Suzanne; de Vries, Hein; Hoving, Ciska

2018-05-22

Improving practice nurses' (PN) adherence to smoking cessation counseling guidelines will benefit the quality of smoking cessation care and will potentially lead to higher smoking abstinence rates. However, support programs to aid PNs in improving their guideline uptake and adherence do not exist yet. The aim of this study was to assess the effects of a novel computer-tailored electronic learning (e-learning) program on PNs' smoking cessation guideline adherence. A Web-based randomized controlled trial (RCT) was conducted in which an intervention group (N=147) with full access to the e-learning program for 6 months was compared with a control group (N=122) without access. Data collection was fully automated at baseline and 6-month follow-up via online questionnaires, assessing PNs' demographics, work-related factors, potential behavioral predictors based on the I-Change model, and guideline adherence. PNs also completed counseling checklists to retrieve self-reported counseling activities for each consultation with a smoker (N=1175). To assess the program's effectiveness in improving PNs' guideline adherence (ie, overall adherence and adherence to individual counseling guideline steps), mixed linear and logistic regression analyses were conducted, thus accommodating for the smokers being nested within PNs. Potential effect moderation by work-related factors and behavioral predictors was also examined. After 6 months, 121 PNs in the intervention group (82.3%, 121/147) and 103 in the control group (84.4%, 103/122) completed the follow-up questionnaire. Mixed linear regression analysis revealed that counseling experience moderated the program's effect on PNs' overall guideline adherence (beta=.589; 95% CI 0.111-1.068; P Holm-Bonferroni =.048), indicating a positive program effect on adherence for PNs with a more than average level of counseling experience. Mixed logistic regression analyses regarding adherence to individual guideline steps revealed a trend toward moderating effects of baseline levels of behavioral predictors and counseling experience. More specifically, for PNs with less favorable scores on behavioral predictors (eg, low baseline self-efficacy) and high levels of counseling experience, the program significantly increased adherence. Results from our RCT showed that among PNs with more than average counseling experience, the e-learning program resulted in significantly better smoking cessation guideline adherence. Experienced PNs might have been better able to translate the content of our e-learning program into practically applicable counseling strategies compared with less experienced colleagues. Less favorable baseline levels of behavioral predictors among PNs possibly contributed to this effect, as there was more room for improvement by consulting the tailored content of the e-learning program. To further substantiate the effectiveness of e-learning programs on guideline adherence by health care professionals (HCPs), it is important to assess how to support a wider range of HCPs. Netherlands Trial Register NTR4436; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4436 (Archived by WebCite at http://www.webcitation.org/6zJQuSRq0). ©Dennis de Ruijter, Math Candel, Eline Suzanne Smit, Hein de Vries, Ciska Hoving. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 22.05.2018.

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.

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.

Examining mixing methods in an evaluation of a smoking cessation program.

PubMed

Betzner, Anne; Lawrenz, Frances P; Thao, Mao

2016-02-01

Three different methods were used in an evaluation of a smoking cessation study: surveys, focus groups, and phenomenological interviews. The results of each method were analyzed separately and then combined using both a pragmatic and dialectic stance to examine the effects of different approaches to mixing methods. Results show that the further apart the methods are philosophically, the more diverse the findings. Comparisons of decision maker opinions and costs of the different methods are provided along with recommendations for evaluators' uses of different methods. Copyright © 2015. Published by Elsevier Ltd.

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.…

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.

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.

Use of an online smoking cessation community promotes abstinence: Results of propensity score weighting.

PubMed

Graham, Amanda L; Papandonatos, George D; Erar, Bahar; Stanton, Cassandra A

2015-12-01

We estimated the causal effects of use of an online smoking cessation community on 30-day point prevalence abstinence at 3 months. Participants (N = 492) were adult current smokers in the enhanced Internet arm of The iQUITT Study, a randomized trial of Internet and telephone treatment for smoking cessation. All participants accessed a Web-based smoking-cessation program that included a large, established online community. Automated tracking metrics of passive (e.g., reading forum posts, viewing member profiles) and active (e.g., writing forum posts, sending private messages) community use were extracted from the site at 3 months. Self-selected community use defines the groups of interest: "None," "Passive," and "Both" (passive + active). Inverse probability of treatment weighting corrected for baseline imbalances on demographic, smoking, psychosocial, and medical history variables. Propensity weights estimated via generalized boosted models were used to calculate Average Treatment Effects (ATE) and Average Treatment effects on the Treated (ATT). Patterns of community use were: None = 198 (40.2%), Passive = 110 (22.4%), and Both = 184 (37.4%). ATE-weighted abstinence rates were: None = 4.2% (95% CI = 1.5-6.9); Passive = 15.1% (95% CI = 8.4-21.9); Both = 20.4% (95% CI = 13.9-26.8). ATT-weighted abstinence rates indicated even greater benefits of community use. Community users were more likely to quit smoking at 3 months than nonusers. The estimated benefit from use of online community resources was even larger among subjects with high propensity to use them. No differences in abstinence emerged between passive and passive/active users. Results suggest that lurking in online communities confers specific abstinence benefits. Implications of these findings for online cessation communities are discussed. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

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.

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.

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

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

Characteristics of COPD smokers and effectiveness and safety of smoking cessation medications.

PubMed

Jiménez Ruiz, Carlos A; Ramos Pinedo, Angela; Cicero Guerrero, Ana; Mayayo Ulibarri, Marisa; Cristobal Fernández, Maribel; Lopez Gonzalez, Gema

2012-09-01

Smoking is the main cause of chronic obstructive pulmonary disease (COPD), and smoking cessation is the only treatment shown to be effective in arresting the progression of COPD. Different epidemiological and population-based studies have shown smokers with COPD to have specific smoking characteristics that differentiate them from the rest of smokers and which complicate smoking cessation. The main objective of this study is to analyze the effectiveness and safety of drug treatments for smoking cessation in smokers with severe or very severe COPD. Smokers with severe or very severe COPD (Global Initiative for Chronic Obstructive Lung Disease stages III and IV) received treatment for smoking cessation. The treatment program consisted of a combination of behavioral therapy and drug treatment. Patients were followed up at 1, 2, 4, 6, 8, 10, 12, 18, and 24 weeks after the quit date. Four hundred seventy-two patients were seen, 65% were male, and their mean age was 58.3 (9.8). They smoked an average of 29.7 (13.4) cigarettes/day, and their mean Fagerström test for nicotine dependence score was 7.4 (2.1). Continuous abstinence rate from 9 to 24 weeks (CAR 9-24) was 48.5%. According to type of treatment used, CAR 9-24 for nicotine replacement therapy (NRT), bupropion, and varenicline were 38.2%, 55.6%, and 58.3%, respectively. Varenicline was more effective than nicotine patches: 61% versus 44.1% (odds ratio: 1.98; 95% CI: 1.25-3.12; p = .003). NRT was the treatment producing the fewest adverse effects. The onset of psychiatric symptoms due to medication was rare and evenly distributed across groups. This study shows that smokers with severe or very severe COPD are predominantly males with a high degree of physical dependence upon nicotine. CAR 9-24 was 48.5%. Varenicline and bupropion yielded higher abstinence rates than NRT. Varenicline was more effective than nicotine patches: all types of treatments were safe.

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…

Using social marketing to increase recruitment of pregnant smokers to smoking cessation service: a success story.

PubMed

Lowry, R J; Hardy, S; Jordan, C; Wayman, G

2004-06-01

To explore what it is like to be a pregnant smoker in Sunderland and to inform the development of a Smoking Cessation Programme; to use qualitative techniques to develop a cessation programme tailored to pregnant smokers. The intervention follows years of social marketing research and development in Sunderland, Wearside, UK. Information derived from nine focus groups (mainly with women from deprived areas, social class C2D and E) provided insights into the issues facing smoking pregnant women. This information was then used to overcome barriers to smoking cessation using the principles of social marketing. The number of women recruited into a specially designed smoking cessation support initiative was compared with women recruited into comparable groups in the North East. Recruitment of pregnant (and non-pregnant) smokers to the new NHS smoking cessation programme in Sunderland has increased during the intervention phase compared with neighbouring Primary Care Trust areas (in which different smoking cessation interventions targeted at pregnant women were being undertaken). This innovative intervention has been successful in generating ideas, guiding development of a customer-friendly service and encouraging women to come forward for smoking cessation support during their pregnancy. The target population have welcomed the approach, and health professionals have enjoyed and benefited from the role play with professional actors.

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.

Inpatient smoking cessation therapy: truth or dare?

PubMed

Boehm, Gabriela; Schroeder, Yvonne; Schoberberger, Rudolf

2015-10-01

This study aims to answer the question to which extent even very heavy nicotine-dependent smokers can benefit from a 3-week inpatient smoking cessation program. A particular focus lies on analyzing the positive effects, which go above and beyond normally anticipated health benefits. This is a descriptive study observing 270 patients over a 1-year period consisting of recruitment, therapy, and two post-therapy follow-up visits at 6-month interval. Gender differences, changes in body weight, and factors relating to addiction and the nicotine withdrawal process are analyzed. In comparing successful participants-post-therapy nonsmokers-with less successful ones, our analysis identifies benefits and advantages an inpatient smoking cessation therapy can bring to even the heaviest smokers. At the 12-month post-therapy follow-up visit, 42.6% of participants were identified as nonsmokers. A total of 34.0% of participants took up smoking again. No data is available on the remaining participants. Nonsmokers experienced significant reduction in nicotine craving and withdrawal symptoms. In terms of body weight, increases were found in both, men and women, nonsmokers and smokers. Successful quitters fail to report of an unbearable strong desire to smoke. Such unfounded fear should be communicated. Weight gain remains an undesired side effect. Hence, it is crucial to diagnose individuals more prone to weight gain and offer coping strategies thus reducing the risk of developing obesity. Nevertheless, the outcome of the study should be an encouragement to also heavy smokers and empower them to undertake smoking cessation.

Impact of smoking cessation aids and mass media among recent quitters.

PubMed

Biener, Lois; Reimer, Rebecca L; Wakefield, Melanie; Szczypka, Glen; Rigotti, Nancy A; Connolly, Gregory

2006-03-01

Although studies have addressed the effectiveness of conventional smoking aids such as quit-smoking programs and pharmaceutical therapy, few studies have assessed their likely impact on cessation at the population level relative to the impact of mass media anti-tobacco advertisements. A random digit dial telephone survey of 6739 Massachusetts residents conducted in 2001-2002 yielded a subsample of 787 individuals who had quit-smoking within the past 2 years. Measures included the types of cessation aids used and perceptions of their helpfulness. Rates of population impact were estimated. Multinomial logistic regression determined the predictors of being helped by conventional aids, by TV advertisements only, or having no help. Analyses conducted in 2004-2005 showed that advertisements were the most frequently mentioned source of help among recent quitters. Older more dependent smokers were most likely to find conventional aids helpful. Younger respondents and those who had remained abstinent for more than 6 months were most likely to report being helped by TV ads. The most helpful ads were those that depicted illness due to smoking or provided inspirational quit tips. Anti-tobacco media campaigns are a vital component of the National Action Plan for Tobacco Cessation. It is essential that such a campaign be implemented, both to support the National Quit Line and to provide assistance to those smokers who find no other form of aid helpful.

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.

Adaptation, Implementation Plan, and Evaluation of an Online Tobacco Cessation Training Program for Health Care Professionals in Three Spanish-Speaking Latin American Countries: Protocol of the Fruitful Study

PubMed Central

Company, Assumpta; Guillen, Olga; Margalef, Mercè; Arrien, Martha Alicia; Sánchez, Claudia; Cáceres de León, Paula

2017-01-01

Background Tobacco cessation training programs to treat tobacco dependence have measureable effects on patients’ smoking. Tobacco consumption in low- and middle-income countries (LMICs) is high and slowly decreasing, but these countries usually lack measures to face the epidemic, including tobacco cessation training programs for health professionals and organizations. Based on a previous online smoking cessation training program for hospital workers in Spain, the Fruitful Study aims to increase smoking cessation knowledge, attitudes, self-confidence, and performance interventions among health care professionals of three Spanish-speaking low- and middle-income Latin American and Caribbean (LAC) countries. Objective The purpose of this paper is to describe the methodology and evaluation strategy of the Fruitful Study intended to adapt, implement, and test the effectiveness of an online, evidence-based tobacco cessation training program addressed to health professionals from Bolivia, Guatemala, and Paraguay. Methods This study will use a mixed-methods design with a pre-post evaluation (quantitative approach) and in-depth interviews and focus groups (qualitative approach). The main outcomes will be (1) participants’ attitudes, knowledge, and behaviors before and after the training; and (2) the level of implementation of tobacco control policies within the hospitals before and after the training. Results To date, adaptation of the materials, study enrollment, and training activities have been completed. During the adaptation, the main mismatches were language background and content adaptation. Several aids were developed to enable students’ training enrollment, including access to computers, support from technicians, and reminders to correctly complete the course. Follow-up data collection is in progress. We have enrolled 281 hospital workers. Results are expected at the beginning of 2017 and will be reported in two follow-up papers: one about the formative evaluation and the other about the summative evaluation. Conclusions There is a need to learn more about the cultural and content elements that should be modified when an online tobacco cessation training program is adapted to new contexts. Special attention should be given to the personal and material resources that could make the implementation possible. Results from the Fruitful Study may offer a new approach to adapting programs to LMICs in order to offer education solutions with the use of emerging and growing communication technologies. ClinicalTrial Clinicaltrials.gov NCT02718872; https://clinicaltrials.gov/ct2/show/NCT02718872 (Archived by WebCite at http://www.webcitation.org/6mjihsgE2) PMID:28128731

Factors Associated with Cigarette Smoking and Motivation to Quit among Street Food Sellers in Vietnam

PubMed Central

Le, Xuan Thanh Thi; To, Lien Thi; Le, Huong Thi; Hoang, Hanh Duc; Do, Khanh Nam; Nguyen, Cuong Tat; Tran, Bach Xuan; Nguyen, Luong Thanh; Latkin, Carl A.; Zhang, Melvyn W. B.; Ho, Roger C. M.

2018-01-01

Since 2013, smoke-free signs in public places, including in restaurants and food stores, have been introduced in Vietnam, aiming to prevent passive smoking. Although extensive research has been carried out on second-hand smoking among clients in public places (e.g., hospitals, restaurants) in Vietnam, no single study exists which captures the current practice of smoking among street food outlets. This study aims to estimate the prevalence of smoking and identify factors associated with smoking status and cessation motivation amongst food sellers in Vietnam. A cross-sectional study involving 1733 food providers at outlets was conducted in 29 districts in Hanoi capital, Vietnam, in 2015. The prevalence of smoking amongst food sellers was determined to be 8.5% (25% for men and 0.8% for women). The enforcement of the smoke-free policy remains modest, since only 7.9% observed outlets complied with the law, providing a room designated for smokers. Although approximately 80% of the participants were aware of the indoor smoke-free regulations in public places, such as restaurants and food stores, 40.2% of smokers reported no intention of quitting smoking. A percentage of 37.6% of current smokers reported that despite having intentions to quit, they did not receive any form of support for smoking cessation. Being male and having hazardous drinking habits and a poor quality of life were all factors that were significantly associated with smoking status. Additionally, having awareness of smoking’s adverse effects and being frequently supervised by the authority were associated with a greater motivation to quit. This study highlights the importance of an accompanying education and smoking cessation program in addition to the frequent inspection and reinforcement of smoke-free policy in food stores. This research extends on our knowledge of smoking prevalence and its factors related to smoking events and motivation to quit among street food outlets. Overall, this study strengthens the idea that more government efforts towards preventing passive smoking and smoking cessation education are necessary in restaurants and other street food outlets. PMID:29382157

Patterns of use of a free nicotine patch program for Medicaid and uninsured patients.

PubMed Central

Jaén, C. R.; Cummings, K. M.; Shah, D.; Aungst, W.

1997-01-01

This study assessed the use and effectiveness of a free nicotine patch program among Medicaid and uninsured smokers. Patterns of patch use, associated behaviors with quit attempt, side effects, and self-reported abstinence from smoking for 6 months were evaluated prospectively among patients from five urban family practice offices and a nicotine dependence clinic located in a comprehensive cancer center in Western New York. Results indicated that the majority of participants used the program as intended, and 90% of the participants found the patch useful in their quit attempt. Fourteen percent of participants were abstinent for 6 months or more. We found no support for inappropriate use of transdermal nicotine patches among patients with no health insurance or those on Medicaid. Transdermal nicotine patches are an effective cessation aid for smokers. Given the tall of the consequences of smoking on health costs, barriers to access to effective treatment for smoking cessation among individuals covered by Medicaid for health insurance need to be eliminated. PMID:9170833

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.

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.

Rate of nicotine metabolism and smoking cessation outcomes in a community-based sample of treatment-seeking smokers.

PubMed

Kaufmann, Amanda; Hitsman, Brian; Goelz, Patricia M; Veluz-Wilkins, Anna; Blazekovic, Sonja; Powers, Lindsay; Leone, Frank T; Gariti, Peter; Tyndale, Rachel F; Schnoll, Robert A

2015-12-01

In samples from controlled randomized clinical trials, a smoker's rate of nicotine metabolism, measured by the 3-hydroxycotinine to cotinine ratio (NMR), predicts response to transdermal nicotine. Replication of this relationship in community-based samples of treatment-seeking smokers may help guide the implementation of the NMR for personalized treatment for nicotine dependence. Data from a community-based sample of treatment seeking smokers (N=499) who received 8weeks of transdermal nicotine and 4 behavioral counseling sessions were used to evaluate associations between the NMR and smoking cessation. Secondary outcomes included withdrawal and craving, depression and anxiety, side effects, and treatment adherence. The NMR was a significant predictor of abstinence (OR=.56, 95% CI: 0.33-0.95, p=.03), with faster metabolizers showing lower quit rates than slower metabolizers (24% vs. 33%). Faster nicotine metabolizers exhibited significantly higher levels of anxiety symptoms over time during treatment, vs. slower metabolizers (NMR x Time interaction: F[3,357]=3.29, p=.02). NMR was not associated with changes in withdrawal, craving, depression, side effects, and treatment adherence (p's>.05). In a community-based sample of treatment-seeking smokers, faster nicotine metabolizers were significantly less likely to quit smoking and showed higher rates of anxiety symptoms during a smoking cessation treatment program, vs. slower nicotine metabolizers. These results provide further evidence that transdermal nicotine is less effective for faster nicotine metabolizers and suggest the need to address cessation-induced anxiety symptoms among these smokers to increase the chances for successful smoking cessation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Effectiveness of a fully automated internet-based smoking cessation program: a randomized controlled trial (STAMP).

PubMed

Nguyen Thanh, Viet; Guignard, Romain; Lancrenon, Sylvie; Bertrand, Camille; Delva, Catherine; Berlin, Ivan; Pasquereau, Anne; Arwidson, Pierre

2018-01-23

The internet offers an interesting alternative to face-to-face and telephone-based support for smoking cessation. This study was designed to assess the effectiveness of a personalized and automated internet-based program. French current adult smokers willing to quit within 2 weeks were recruited for a randomized controlled trial. The intervention consisted of an automated program of 45 e-mails ("e-coaching") sent over a 3-month period. The control group received a PDF version of a booklet on smoking cessation. Self-reported 7-day point prevalence smoking abstinence was measured at 6 months (primary outcome), at 3 and 12 months of follow-up (secondary outcomes). 2,478 smokers were randomized (1,242 for e-coaching, 1,236 for the booklet). Cessation rate in the intention-to-treat population was not significantly different between the two groups at 6 and 12 months, but was higher in the e-coaching group at 3 months than in the control group (27.5% vs 23.5%, p=0.02, OR=1.24, CI=[1.03-1.49]). After adjustment for baseline conditions, the effect of the intervention in the per-protocol (PP) sample was significant at 3 months (aOR=1.72 [1.31-2.28], p<0.001, N=1042) and at 6 months (aOR=1.27 [1.00-1.60], p=0.05, N=1082). GLM repeated measure analyses showed significant group by time interaction in the ITT and a significant group effect in the PP population. Analyzed intention-to-treat, e-coaching was superior to a booklet at 3 months (end of intervention) but no more superior at 6 and 12 months follow up. Among those who actually followed the program, the effectiveness is also observed 3 months after the intervention is stopped. © The Author(s) 2018. 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.

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.

Process evaluation of a mHealth program: lessons learned from Stop My Smoking USA, a text messaging-based smoking cessation program for young adults.

PubMed

Ybarra, Michele L; Holtrop, Jodi Summers; Prescott, Tonya L; Strong, David

2014-11-01

Report lessons learned in an RCT of Stop My Smoking (SMS) USA, a mHealth smoking cessation program for young adult smokers. 164 18-24-year-olds were recruited nationally, online in 2011. Program evaluation data were provided at 12-week post-Quit Day. (1) Inviting participants to complete a brief text messaging survey and then asking them to complete a longer online survey resulted in the highest response rate (89%). (2) The positive tone of program messages was the most commonly noted program strength. (3) Suggested improvements included more social connectivity and additional assistance overcoming stressful situations. (4) Half of intervention participants moved through the program linearly and half went through various paths that reflected multiple relapses. Suggestions to use pharmacotherapy resulted in 22% of heavy smokers to utilize it. Participant feedback provided concrete ways in which this and other young adult-focused interventions can improve messaging and program features to be even more salient. Future young adult mHealth interventions could: Integrate models that are flexible to different "paths" of behavior change; address stressful life events directly and comprehensively; integrate proactive messaging that promotes pharmacotherapy options; and use text messaging as a gateway to longer online surveys. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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.

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