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Foshee, James P., Anita Oh, Adam Luginbuhl, Joseph Curry, William Keane, and David Cognetti. "Prospective, Randomized, Controlled Trial Using Best-Selling Smoking-Cessation Book." Ear, Nose & Throat Journal 96, no. 7 (July 2017): 258–63. http://dx.doi.org/10.1177/014556131709600701.
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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.
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Foshee, James P., Anita Oh, Adam Luginbuhl, Joseph Curry, William Keane, and David Cognetti. "Prospective, Randomized, Controlled Trial using Best-Selling Smoking-Cessation Book." Ear, Nose & Throat Journal 96, no. 7 (July 2017): 258–62. http://dx.doi.org/10.1177/014556131709600719.
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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.
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Harvey, Philip D., Shelley Cotroneo, and Tracy Schoales. "Quit4Life: A Health Canada Tobacco Cessation Program." Social Marketing Quarterly 5, no. 3 (September 1999): 103–7. http://dx.doi.org/10.1080/15245004.1999.9961072.
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The Quit4Life cessation program was developed in 1993. it was designed to give teenage smokers the tools they need to quit smoking. The idea for the Quit4Life program stemmed from Health Canada's belief that an informational, easy-to-obtain kit could benefit teenagers who are motivated to quit smoking.
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K.A, Nurulfarahin, Nina S.A, Lailati S., Raisah Z., Izzuddin A. A., and Sabariah Abd Hamid. "Challenges to Quit Smoking among Smokers in Bandar Baru Salak Tinggi, Sepang, Selangor, Malaysia." International Journal of Public Health Science (IJPHS) 7, no. 1 (March 1, 2018): 65. http://dx.doi.org/10.11591/ijphs.v7i1.10759.
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Cigarette smoking is the largest preventable risk factor for morbidity and mortality in developed countries. The prevalence of smoking is increasing in Malaysia. Over the years, we have accumulated the knowledge of the risks and dangers of smoking towards health and had used these as interventions to motivate smokers to quit smoking. However, quitting smoking is hard as people who stop smoking often start again because of weight gain, stress and withdrawal symptoms. Therefore, this study aimed to identify the challenges to quit smoking among smokers in Bandar Baru Salak Tinggi, Sepang, Selangor. A cross-sectional study was conducted with a combination of stratified and simple random sampling. The study was conducted via a face-to-face interview using a standardized questionnaire. The data was analyzed using SPSS (Statistical Package for Social Sciences) Version 20.0. Easy availability of cigarettes was the most challenging factor (86%) followed by seeing things that reminded the respondents of smoking (58%), feeling lost without smoking (53%) and withdrawal symptoms (47%). To combat these challenges, it is imperative to strengthen the enforcement on regulations advertisement and display of cigarettes and develop more activities on motivation among smokers and their families, which may be organized by government or non-government organizations. Other than that, another important aspect in the promoting smoking cessation program is to encourage smoke-free homes.
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Kendzor, Darla E., Michael S. Businelle, Joseph J. C. Waring, Ashley J. Mathews, Daryl W. Geller, Jocelyn M. Barton, Adam C. Alexander, Emily T. Hébert, Chaelin K. Ra, and Damon J. Vidrine. "Automated Mobile Delivery of Financial Incentives for Smoking Cessation Among Socioeconomically Disadvantaged Adults: Feasibility Study." JMIR mHealth and uHealth 8, no. 4 (April 15, 2020): e15960. http://dx.doi.org/10.2196/15960.
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Background Socioeconomic disadvantage is associated with a reduced likelihood of smoking cessation. Smartphone ownership is increasing rapidly, including among low-income adults, and smartphone interventions for smoking cessation may increase access to smoking cessation treatment among socioeconomically disadvantaged adults. Objective This study aimed to evaluate the feasibility of an automated smartphone-based approach to delivering financial incentives for smoking cessation. Methods Socioeconomically disadvantaged adults initiating tobacco cessation treatment were followed from 1 week before a scheduled quit attempt through 26 weeks after the quit date. Participants received telephone counseling and nicotine replacement therapy. Smoking cessation was verified 5 times per week via smartphone prompts to self-report smoking status and submit a breath sample via a portable carbon monoxide (CO) monitor that was connected with participants’ smartphones. Identity was verified during smoking status assessments using smartphone-based facial recognition software. When smoking abstinence and identity were verified, an automated credit card payment was triggered. Participants were incentivized for abstinence on the quit date and up to five days per week during the first 4 weeks after the scheduled quit date, with additional incentives offered during postquit weeks 8 and 12. In total, participants had the opportunity to earn up to US $250 in abstinence-contingent incentives over the first 12 weeks of the quit attempt. Results Participants (N=16) were predominantly female (12/16, 75%) and non-Hispanic white (11/16, 69%), black (4/16, 25%), or Hispanic of any race (1/16, 6%). Most participants (9/16, 56%) reported an annual household income of <US $11,000. During the first 4 weeks after the scheduled quit date, participants completed a median of 16 (out of 21; range 1-21) mobile smoking status assessments, and they earned a median of US $28 in abstinence-contingent incentives (out of a possible US $150; range US $0-US $135). Median earnings did not change during the 8- and 12-week incentivized follow-up periods (total median earnings over 12 weeks=US $28; range US $0-US $167). During the first 4 weeks after the scheduled quit date, participants abstained from smoking on a median of 5 (out of 21) assessment days (range 0-20). At the in-person follow-up visits, the expired CO-confirmed 7-day point prevalence abstinence rates were 19% (3/16) and 13% (2/16) at 12 and 26 weeks postquit, respectively. Overall, most participants reported that the system was easy to use and that they would recommend this treatment to their friends and family. Conclusions Preliminary data suggest that this smartphone-based approach to verifying identity and smoking status and automating the delivery of abstinence-contingent incentives to a credit card is feasible for use among socioeconomically disadvantaged adults. However, continued refinement is warranted.
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Vogt, Florian, Andy McEwen, and Susan Michie. "What General Practitioners Can Do to Deliver More Brief Stop-Smoking Interventions: An Exploratory Study." Journal of Smoking Cessation 3, no. 2 (December 1, 2008): 110–16. http://dx.doi.org/10.1375/jsc.3.2.110.
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AbstractGuidelines recommend that general practitioners (GPs) should advise all smoking patients to quit and provide additional stop-smoking interventions as appropriate. This study aimed to improve our understanding of how this recommendation can be achieved. General practitioners (N = 26) from London completed a questionnaire about their stop-smoking interventions and psychological factors that might affect these. Thirty-one per cent of the patients recognised as smokers by GPs did not receive an intervention and two-thirds of these were judged to be inappropriate for receipt of an intervention. Psychological factors that predicted behaviour were perceptions that doing this was ‘normative’, making an effort to make it happen, and feeling that the behaviour was easy to enact. Strategies to improve guideline implementation may be more effective if they addressed the above psychological factors.
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Ajith, Aniruddh, Aaron Broun, Danielle A. Duarte, Bambi Jewett, Lilianna Phan, Erin L. Mead-Morse, Mignonne C. Guy, Kelvin Choi, and Julia Chen-Sankey. "Cigar-Smoking-Cessation Interest and Experience among Black Young Adults: A Semi-Structured In-Depth Interview Investigation." International Journal of Environmental Research and Public Health 18, no. 14 (July 8, 2021): 7309. http://dx.doi.org/10.3390/ijerph18147309.
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Although Black/African American populations have high cigar-smoking prevalence, little is known about cigar-smoking cessation among this group. This study explored the perceptions and experiences of cigar-smoking cessation and assistance received from healthcare providers among forty Black young-adult cigar smokers (ages 21–29). Semi-structured in-depth phone interviews were transcribed and coded. Qualitative data were analyzed by using thematic analysis. Participants mostly smoked cigarillos, large cigars, and blunts. Overall, many regular cigarillo smokers reported interest in quitting eventually, while large-cigar and blunt smokers shared less interest in quitting because they perceived low harm from smoking these products. The reasons for cigar-smoking cessation were health concerns and financial constraints. Most of the participants who attempted to quit cigars did not use any cessation aids. The reasons for relapse included nicotine withdrawal, stress, and easy access. Additionally, most participants reported their healthcare providers did not ask whether they smoked cigars, and even when they knew, little assistance for cigar-smoking cessation was provided. Informing Black cigar smokers of the harm of cigar smoking and encouraging healthcare providers to screen for and assist with cigar-smoking cessation may alleviate the health burden of cigar smoking in this population.
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Elmeguid, W. Abd, A. Kassem, R. Abdalla, and O. Moustafa. "Promoting Smoking Cessation Through New Media Tools Facebook, Instagram and WhatsApp." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 139s. http://dx.doi.org/10.1200/jgo.18.11500.
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Background and context: Tobacco use is a devastating problem all over the world and in the Middle East. In Egypt 20% of the adult populations are using any type of tobacco and the problem is increasing among youth especially waterpipe. Tobacco industry is targeting the youth through many ways and using indirect ways in drama and points of sale. Raising the awareness of the public about smoking hazards and benefits of quitting is one important strategy to control the epidemic. Providing support and help material is very important. Behavioral support and promoting change is very important using coaching strategies and using new tools is very helpful to reach youth. Aim: Motivating current smokers to quit through the effect of role model using new tools for behavioral support. Strategy/Tactics: Providing the message and support through new tools as WhatsApp, Instagram and Facebook where smokers who is able to quit provide information about their smoking experience and how they overcome it. Program/Policy process: Tobacco treatment specialist worked in collaboration with few young medical students to develop a Facebook page on the World No Tobacco Day 2016 and developed different posts about smoking problem and inviting viewers to add their inputs. During the early days of the campaign the team used the Facebook ads tool to promote for the page and this was sponsored by few supporters. The team who is in charge of managing the Facebook page then thought about new ideas to increase the reach and impact of the page where inviting smokers who was able to quit or take a selfie with a piece of paper writing how many days they were able to abide from smoking. The page during few months made a trend on social media. Outcomes: The reach of the page was 3 million and the reactions were 500 thousand engagement with 52 thousand members. About three thousand smokers were able to quit with following the stories sent on the page. What was learned: Using social media tools is very good way to reach out and mobilize the public to change the behavior.
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Sadek, Joseph, Husein Moloo, Priscilla Belanger, Kara Nadeau, Debbie Aitken, Kris Foss, Terry Zwiep, et al. "Implementation of a systematic tobacco treatment protocol in a surgical outpatient setting: a feasibility study." Canadian Journal of Surgery 64, no. 1 (February 2021): E51—E58. http://dx.doi.org/10.1503/cjs.009919.
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Background: Smoking cessation programs started as late as 4 weeks before surgery reduce perioperative morbidity and death, yet outpatient clinic interventions are rarely provided. Our aim was to evaluate the feasibility of implementing a tobacco treatment protocol designed for an outpatient surgical setting. Methods: We completed a pre–post feasibility study of the implementation of a systematic, evidence-based tobacco treatment protocol in an outpatient colorectal surgery clinic. Outcomes included smoking prevalence, pre- and postimplementation smoker identification and intervention rates, recruitment, retention, smoking cessation and provider satisfaction. Results: Preimplementation, 15.5% of 116 surveyed patients were smokers. Fewer than 10% of urveyed patients reported being asked about smoking, and none were offered any cessation intervention. Over a 16-month postimplementation period, 1198 patients were seen on 2103 visits. Of these, 950 (79.3%) patients were asked smoking status on first visit and 1030 (86.0%) were asked on at least 1 visit. Of 169 identified smokers, 99 (58.6%) were referred to follow-up support using an opt-out approach. At 1-, 3- and 6-month follow-up, intention-to-quit rates among 78 enrolled patients were 24.4%, 22.9% and 19.2%, respectively. Postimplementation staff surveys reported that the protocol was easy to use, that staff would use it again and that it had positive patient responses. Conclusion: Implementation of our smoking cessation protocol in an outpatient surgical clinic was found to be feasible and used minimal clinic resources. This protocol could lead to increases in identification and documentation of smoking status, delivery of smoking cessation interventions and rates of smoking reduction and cessation.
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Joshi, Vibha, Sourabh Chakraborty, Nitin Kumar Joshi, Komal Bajaj, Bhawana Sati, and Anil Purohit. "Smokeless tobacco and its dependence among the urban-slum population of Jodhpur city." International Journal Of Community Medicine And Public Health 8, no. 3 (February 24, 2021): 1186. http://dx.doi.org/10.18203/2394-6040.ijcmph20210797.
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Background: Socio-economic status can be an important determinant for patterns of tobacco consumption and its related health risks. Easy availability and affordable price may lead to the indulgence of smokeless tobacco; this deprived the section of society towards addiction of smokeless tobacco. Therefore, this study was conducted to ascertain smokeless tobacco use and its dependence in urban slum population of Jodhpur city.Methods: A cross-sectional survey was conducted in the urban-slum population of Jodhpur in 2019. A cluster sampling strategy was used to collect data from 1200 participants in different slums of Jodhpur city. The semi-structured questionnaire was used to obtain information on tobacco usage and willingness to quit.Results: Out of surveyed 1200 participants, 48.5% were males and 51.4% were females. 65.7% of the tobacco users reported in study population. Among tobacco user’s majority were using smokeless tobacco (75.4%), followed by 14.8% dual tobacco users and 9.8% were smoking tobacco. Out of female and male tobacco users, 95% females and 86.3% males were using smokeless forms of tobacco respectively. The frequency of daily tobacco use, time of tobacco chewing, duration of tobacco use was significantly associated with gender. No significant association was found between willingness to quit and gender.Conclusions: Smokeless tobacco was prevalent as compared to smoking form in urban-slums of Jodhpur city. Younger population and women were more attracted towards smokeless tobacco and willingness to quit tobacco was equally prevalent among males and females. An effective health education strategy for tobacco cessation should be designed according to age and gender of urban-slums.
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Fergie, Libby, Tim Coleman, Michael Ussher, Sue Cooper, and Katarzyna A. Campbell. "Pregnant Smokers’ Experiences and Opinions of Techniques Aimed to Address Barriers and Facilitators to Smoking Cessation: A Qualitative Study." International Journal of Environmental Research and Public Health 16, no. 15 (August 2, 2019): 2772. http://dx.doi.org/10.3390/ijerph16152772.
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Pregnant women experience certain barriers and facilitators (B&Fs) when trying to quit smoking. This study aimed to elicit women’s views on techniques that could help overcome or enhance these. Semi-structured interviews were conducted with 12 pregnant women who had experience of smoking during pregnancy. Participants were prompted to discuss experiences of B&Fs and give suggestions of techniques that could address these appropriately. A thematic analysis was conducted using the one sheet of paper method. Four themes relating to suggested techniques were identified: accessing professional help, nicotine replacement therapy (NRT), distraction, and social interactions. Experiences of accessing professional help were generally positive, especially if there was a good rapport with, and easy access to a practitioner. Most women were aware of NRT, those who had used it reported both negative and positive experiences. Praise and encouragement from others towards cessation attempts appeared motivating; peer support groups were deemed useful. Women reported experiencing B&Fs which fell under four themes: influence of others, internal motivation, cues to smoke, and health. Overall, accessing professional support generated positive changes in smoking habits. Establishing ways of how to encourage more women to seek help and raising awareness of different types of support available would seem beneficial.
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Tracy, Derek K., Dan W. Joyce, and Sukhwinder S. Shergill. "Kaleidoscope." British Journal of Psychiatry 210, no. 4 (April 2017): 307–8. http://dx.doi.org/10.1192/bjp.210.4.307.
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Quitting smoking isn't easy, even with the advent of e-cigarettes. The NHS Stop Smoking Services (SSSs) were established in 2000, and have shown superior results to nicotine replacement alone, but are characterised by low, and dropping, attendance rates. Beneath the highlight figure of a halving of UK smoking prevalence over the past 40 years lies a direct £6 billion cost to the NHS and 80000 deaths each year, as well as recent concern that clinical commissioning groups are not renewing service funding. Given that the ‘health belief model’ is based upon a trigger changing behaviour, what will encourage attendance at SSSs, especially with evidence that smokers underestimate their own personal risk? Gilbert et al randomised over 4000 smokers across almost 100 general practices to receive either a standard generic advertisement of the SSS clinic, or an individually tailored risk letter and invitation to a no-commitment introductory SSS session. The hosting general practitioners (GPs) and SSS advisors were masked to the allocation. The personalised letter more than doubled the odds of attending the SSS, showing that a more proactive approach can help engagement. Interestingly, the intervention was more effective with men, who are typically less likely to attend and set quit dates.
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Steinberg, Marc L., Benjamin Billingsley, Rachel Rosen, Elizabeth E. Epstein, Shou-En Lu, Nicole Weickert, and Jill M. Williams. "Persistence targeted smoking cessation for smokers with schizophrenia or schizoaffective disorder: a feasibility study." Journal of Smoking Cessation 15, no. 3 (July 9, 2020): 157–62. http://dx.doi.org/10.1017/jsc.2020.19.
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AbstractIntroductionIndividuals with schizophrenia are more likely to smoke and less likely to quit smoking than those without schizophrenia. Because task persistence is lower in smokers with than without schizophrenia, it is possible that lower levels of task persistence may contribute to greater difficulties in quitting smoking observed among smokers with schizophrenia.AimsTo develop a feasible and acceptable intervention for smokers with schizophrenia.MethodsParticipants (N = 24) attended eight weekly individual cognitive behavioral therapy sessions for tobacco use disorder with a focus on increasing task persistence and received 10 weeks of nicotine patch.ResultsIn total, 93.8% of participants rated the intervention as at least a 6 out of 7 regarding how ‘easy to understand’ it was and 81.3% rated the treatment as at least a 6 out of 7 regarding how helpful it was to them. A total of 62.5% attended at least six of the eight sessions and session attendance was positively related to nicotine dependence and age and negatively related to self-efficacy for quitting.DiscussionThis intervention was feasible and acceptable to smokers with schizophrenia. Future research will examine questions appropriate for later stages of therapy development such as initial efficacy of the intervention and task persistence as a mediator of treatment outcome.
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Murray, Rachael L., Kate Brain, John Britton, Harriet D. Quinn-Scoggins, Sarah Lewis, Grace M. McCutchan, Samantha L. Quaife, et al. "Yorkshire Enhanced Stop Smoking (YESS) study: a protocol for a randomised controlled trial to evaluate the effect of adding a personalised smoking cessation intervention to a lung cancer screening programme." BMJ Open 10, no. 9 (September 2020): e037086. http://dx.doi.org/10.1136/bmjopen-2020-037086.
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IntroductionIntegration of smoking cessation (SC) into lung cancer screening is essential to optimise clinical and cost effectiveness. The most effective way to use this ‘teachable moment’ is unclear. The Yorkshire Enhanced Stop Smoking study will measure the effectiveness of an SC service integrated within the Yorkshire Lung Screening Trial (YLST) and will test the efficacy of a personalised SC intervention, incorporating incidental findings detected on the low-dose CT scan performed as part of YLST.Methods and analysisUnless explicitly declined, all smokers enrolled in YLST will see an SC practitioner at baseline and receive SC support over 4 weeks comprising behavioural support, pharmacotherapy and/or a commercially available e-cigarette. Eligible smokers will be randomised (1:1 in permuted blocks of random size up to size 6) to receive either an enhanced, personalised SC support package, including CT scan images, or continued standard best practice. Anticipated recruitment is 1040 smokers (January 2019–December 2020). The primary objective is to measure 7-day point prevalent carbon monoxide (CO) validated SC after 3 months. Secondary outcomes include CO validated cessation at 4 weeks and 12 months, self-reported continuous cessation at 4 weeks, 3 months and 12 months, attempts to quit smoking and changes in psychological variables, including perceived risk of lung cancer, motivation to quit smoking tobacco, confidence and efficacy beliefs (self and response) at all follow-up points. A process evaluation will explore under which circumstances and on which groups the intervention works best, test intervention fidelity and theory test the mechanisms of intervention impact.Ethics and disseminationThis study has been approved by the East Midlands-Derby Research Ethics Committee (18/EM/0199) and the Health Research Authority/Health and Care Research Wales. Results will be disseminated through publication in peer-reviewed scientific journals, presentation at conferences and via the YLST website.Trial registration numbersISRCTN63825779, NCT03750110.
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Sullman, Mark J. M., Maria-Eugenia Gras, Antonios Kagialis, Ioulia Papageorgi, and Sílvia Font-Mayolas. "Cigarette, E-Cigarette and Waterpipe Use among Young Adults: Differential Cognitions about These Three Forms of Smoking." International Journal of Environmental Research and Public Health 17, no. 11 (May 27, 2020): 3787. http://dx.doi.org/10.3390/ijerph17113787.
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Background: Polytobacco use is common among young adults. The purpose of the present study was to investigate a number of cognitions related to the use of three tobacco products (cigarettes, e-cigarettes and waterpipes) among young adults. Methods: Participants (n = 799, 59.4% women) aged 18–25 years old (M = 21.8, SD = 1.7) completed an online tobacco cognitions questionnaire. Results: For all three tobacco products, there was significantly more agreement with the cognition “I would smoke if my best friend offered” among tobacco users (used one or more tobacco products) than among non-users. For e-cigarettes and waterpipes, there was significantly more agreement with the cognition “It would be easy to quit these products” than was reported by non-users. Polytobacco users (three tobacco products) endorsed the cognitions scale (the six cognition items were combined to form a single cognitions scale for each tobacco product) significantly more than non-users for cigarettes and e-cigarettes. Furthermore, waterpipe users, polytobacco users, dual users and single users all endorsed the combined cognitions scales more strongly than non-users. Conclusions: Efforts to prevent polytobacco use should ensure that young adults have the necessary self-efficacy to resist peer pressure and provide them with clear information about the health risks associated with using alternative tobacco products.
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Singh, Prashant Kumar, Amit Yadav, Pranay Lal, Dhirendra N. Sinha, Prakash C. Gupta, Leimapokpam Swasticharan, Shalini Singh, and Ravi Mehrotra. "Dual Burden of Smoked and Smokeless Tobacco Use in India, 2009–2017: A Repeated Cross-Sectional Analysis Based on Global Adult Tobacco Survey." Nicotine & Tobacco Research 22, no. 12 (February 8, 2020): 2196–202. http://dx.doi.org/10.1093/ntr/ntaa033.
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Abstract Introduction The dual use of smoked and smokeless tobacco (SLT) poses a serious challenge to tobacco control efforts. This article examines the trends and patterns of this usage in India during the period 2009–2010 and 2016–2017. Methods Data from two rounds of nationally representative cross-sectional Global Adult Tobacco Survey (GATS) conducted in 2009–2010 and 2016–2017 have been used. Dual use was assessed based on current smokers and SLT users in both rounds. Results Findings reveal that dual use in India has dropped from 5.3% during 2009–2010 to 3.4% during 2016–2017, a decline of nearly 10 million dual users. However, some states have added nearly 4.6 million new dual users during this period. While dual use continues to remain high in rural areas, there has been a manifold increase in urban areas. Findings revealed that intention to quit tobacco was lower among dual tobacco users as compared to single users with considerable difference between urban and rural areas. Conclusion Easy availability and affordability of SLT products compared to smoking products and restrictions on smoking in public places may have pushed current smokers and dual users to take to or intensify their SLT consumption. Measures relating to awareness, pricing, taxation, and enforcement of tobacco control laws should focus on all forms of tobacco, especially targeting high dual burden in rural and urban settings. Implications Dual form of tobacco users represent 12% of all tobacco users in the country. The study reveals that intention to quit tobacco among dual users is significantly lower than that among single tobacco product users. This requires improving public awareness about the morbidity and mortality that arises from the use of all forms of tobacco products. Efforts to restrict the availability of tobacco products should focus on licensing the sale of all tobacco products. Reduction in dual tobacco use will not only result in multiplied health benefits but also help in achieving the Non-Communicable Diseases targets under the United Nations Sustainable Development Goals.
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Sreevani, R. "Quit smoking holistic way." Indian Journal of Psychiatric Nursing 7, no. 1 (2014): 52. http://dx.doi.org/10.4103/2231-1505.262267.
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Heffner, Jaimee L., Noreen L. Watson, Edit Serfozo, Megan M. Kelly, Erin D. Reilly, Daniella Kim, Kelsey Baker, N. F. N. Scout, and Maria Karekla. "An Avatar-Led Digital Smoking Cessation Program for Sexual and Gender Minority Young Adults: Intervention Development and Results of a Single-Arm Pilot Trial." JMIR Formative Research 5, no. 7 (July 30, 2021): e30241. http://dx.doi.org/10.2196/30241.
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Background Sexual and gender minority young adults have a high prevalence of smoking and unique barriers to accessing tobacco treatment. Objective To address these challenges as well as their preferences for sexual and gender minority–targeted interventions and digital programs, we developed and evaluated the acceptability, preliminary efficacy, and impact on theory-based change processes of an acceptance and commitment therapy–based digital program called Empowered, Queer, Quitting, and Living (EQQUAL). Methods Participants (n=22) of a single-arm trial conducted to evaluate the program were young adults, age 18 to 30 years, who self-identified as sexual and gender minority individuals and smoked at least one cigarette per day. All participants received access to the EQQUAL program. Participants completed web-based surveys at baseline and at a follow-up 2 months after enrollment. We verified self-reported smoking abstinence with biochemical testing; missing data were counted as smoking or using tobacco. Results For young adults who logged in at least once (n=18), the mean number of log-ins was 5.5 (SD 3.6), mean number of sessions completed was 3.1 (SD 2.6), and 39% (7/18) completed all 6 sessions. Overall, 93% of participants (14/15) were satisfied with the EQQUAL program, 100% (15/15) found it easy to use, and 100% (15/15) said it helped them be clearer about how to quit. Abstinence from smoking or using tobacco was confirmed with biochemical testing for 23% of participants (5/22). Both quantitative and qualitative results suggested a positive overall response to the avatar guide, with areas for future improvement largely centered on the avatar’s appearance and movements. Conclusions Treatment acceptability of EQQUAL was very promising. The rate of abstinence, which was biochemically confirmed, was 3 times higher than that of the only other digital program to date that has targeted sexual and gender minority young adults and 6 to 13 times higher than those of nontargeted digital smoking interventions among sexual and gender minority young adults. Planned improvements for the next iteration of the program include making the avatar’s movements more natural; offering multiple avatar guides with different on characteristics such as race, ethnicity, and gender identity from which to choose; and providing a support forum for users to connect anonymously with peers.
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Mazur, Rafał, Sebastian Masternak, Michał Pająk, Nikodem Skoczeń, Ewelina Soroka, and Marcin Olajossy. "Can the use of varenicline improve the efficacy of pharmacotherapy for nicotine addiction?" Current Problems of Psychiatry 20, no. 1 (March 1, 2019): 21–34. http://dx.doi.org/10.2478/cpp-2019-0002.
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Abstract Introduction: Smoking is a huge medical and social problem in Poland, with as many as about 24% of Poles being addicted to nicotine. Approximately 6 million people worldwide die every year from conditions that are closely related to tobacco addiction, such as cancer and cardiovascular, metabolic or lung diseases. The difficulty in combatting nicotine dependence is largely due to the complex mechanism of this addiction. The motivation of a patient to quit smoking is of great importance in the difficult withdrawal process. Strengthening this motivation is one of the most important tasks of physicians and addiction therapists. Overview of literature: Nicotine replacement therapy (NRT) has been the most widely known way to break away from smoking addiction for many years now. It involves delivering nicotine to the body in ways that are less harmful than through tobacco smoke. As a consequence, the cravings for nicotine are reduced, making it easier for the patient to break with the addiction. Clinical trials have shown that the use of NRT is associated with a 50-70% increased chance of maintaining abstinence from smoking compared to placebo. There are many NRT products, including nicotine chewing gum, nicotine patches, lozenges, dissolvable nicotine sticks, or inhalers. Bupropion is a selective dopamine–noradrenaline reuptake inhibitor. This drug is one of the most commonly used in the pharmacotherapy of depression in the United States. At the same time, it has been found to have a positive effect on people trying to break up with the habit of smoking cigarettes. The mechanism of action remains unknown in this case, but studies clearly indicate the efficacy of bupropion, which is comparable to the efficacy of NRT. Varenicline is a partial agonist selective for α4β2 nicotinic acetylcholine receptors. It has a higher affinity for these receptors than nicotine. By stimulating them, it causes an increase in dopamine secretion (but to a lesser extent than cigarette smoking), helping in this way ease withdrawal symptoms. Conclusions: Varenicline has higher efficacy than bupropion and NRTs. Simultaneous use of two NRT forms increases the effectiveness of this method to a level comparable to varenicline. Contrary to previous reports, it seems that varenicline does not increase self-aggressive behaviour and the risk of suicide. The effectiveness of antinicotinic drugs depends on the sex of the patient. For both sexes, the most effective drug is varenicline. It is slightly more effective in women than in men. By contrast, NRT and bupropion show greater therapeutic potential in men.
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Bower, B. "Smoking out the Best Way to Quit Smoking." Science News 136, no. 23 (December 2, 1989): 358. http://dx.doi.org/10.2307/3973762.
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Wen, Si, Helle Larsen, Marilisa Boffo, Raoul P. P. P. Grasman, Thomas Pronk, Joeri B. G. van Wijngaarden, and Reinout W. Wiers. "Combining Web-Based Attentional Bias Modification and Approach Bias Modification as a Self-Help Smoking Intervention for Adult Smokers Seeking Online Help: Double-Blind Randomized Controlled Trial." JMIR Mental Health 7, no. 5 (May 8, 2020): e16342. http://dx.doi.org/10.2196/16342.
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Background Automatically activated cognitive motivational processes such as the tendency to attend to or approach smoking-related stimuli (ie, attentional and approach bias) have been related to smoking behaviors. Therefore, these cognitive biases are thought to play a role in maintaining smoking behaviors. Cognitive biases can be modified with cognitive bias modification (CBM), which holds promise as an easy-access and low-cost online intervention. However, little is known about the effectiveness of online interventions combining two varieties of CBM. Targeting multiple cognitive biases may improve treatment outcomes because these biases have been shown to be relatively independent. Objective This study aimed to test the individual and combined effects of two web-based CBM varieties—attentional bias modification (AtBM) and approach bias modification (ApBM)—in a double-blind randomized controlled trial (RCT) with a 2 (AtBM: active versus sham) × 2 (ApBM: active versus sham) factorial design. Methods A total of 504 adult smokers seeking online help to quit smoking were randomly assigned to 1 of 4 experimental conditions to receive 11 fully automated CBM training sessions. To increase participants’ intrinsic motivation to change their smoking behaviors, all participants first received brief, automated, tailored feedback. The primary outcome was point prevalence abstinence during the study period. Secondary outcomes included daily cigarette use and attentional and approach bias. All outcomes were repeatedly self-assessed online from baseline to the 3-month follow-up. For the examination of training effects on outcome changes, an intention-to-treat analysis with a multilevel modeling (MLM) approach was adopted. Results Only 10.7% (54/504) of the participants completed all 11 training sessions, and 8.3% (42/504) of the participants reached the 3-month follow-up assessment. MLM showed that over time, neither AtBM or ApBM nor a combination of both differed from their respective sham training in point prevalence abstinence rates (P=.17, P=.56, and P=.14, respectively), and in changes in daily cigarette use (P=.26, P=.08, and P=.13, respectively), attentional bias (P=.07, P=.81, and P=.15, respectively), and approach bias (P=.57, P=.22, and P=.40, respectively), while daily cigarette use decreased over time across conditions for all participants (P<.001). Conclusions This RCT provides no support for the effectiveness of combining AtBM and ApBM in a self-help web-based smoking cessation intervention. However, this study had a very high dropout rate and a very low frequency of training usage, indicating an overall low acceptability of the intervention, which precludes any definite conclusion on its efficacy. We discuss how this study can inform future designs and settings of online CBM interventions. Trial Registration Netherlands Trial Register NTR4678; https://www.trialregister.nl/trial/4678
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Slomski, Anita. "Best Way to Quit Smoking: Cold Turkey." JAMA 315, no. 20 (May 24, 2016): 2159. http://dx.doi.org/10.1001/jama.2016.6211.
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Faiza, Bashir, Hassan Mehmood, Sumera Naz, and Saima Naz. "Prevalence and Determinants of Substance Abuse Among Slum Dwellers in Islamabad- Pakistan." International Journal of Translational Medical Research and Public Health 3, no. 2 (December 14, 2019): 107–13. http://dx.doi.org/10.21106/ijtmrph.85.
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Background: The slums are illegal settlements and are always left out in health surveys. However, studies around the world show that substance or drug abuse is higher among slum dwellers and may have different patterns and determinants which need to be studied in order to frame targeted programs and policies. The present study was aimed at estimating the magnitude as well as determinants of substance/drug abuse among slum dwellers in Islamabad, the capital city of Pakistan.
Methodology: This community-based cross-sectional study was conducted among the residents of slums/nomadic settlements of Islamabad. A total of 207 statistically calculated sample size comprised of adults from both genders aged 15 years and above, consenting to participate from the randomly selected 9 clusters in Islamabad was needed for the study. From each cluster, 23 households, and from each household one individual was randomly selected for estimating the prevalence. All those who were abusing substances were counted as cases and others as controls for case-control analysis. A structured questionnaire was used to gather information on demographics, trends, types of substances abused, risk factors for getting engaged in substance abuse, whether they had tried to quit at any stage and what difficulties they faced when trying to quit. Results were entered and analyzed using Epi-info version 7.2.
Results: A total of 204 participants were enrolled in this study. Among these 68 (33%) were substance or drug abusers. For the case-control study, substance/drug users were considered as cases 68 and rest as controls. Bivariate analysis of the risk factors indicated that easy of availability of drugs in slum areas (OR: 20.3, p= 0.000); exposure to tobacco smoking (OR: 8.8, p= 0.000); and being a working child (OR: 6.0, p= 0.000) were the strong predictors of high substance abuse. Education (OR: 0.2, p= 0.000) and living with own parents during childhood (OR: 0.7 p= 0.2) had protective effects against substance abuse.
Conclusion and Implications for Translation: The study concludes that the following were the determinants of substance/drug abuse among the slum dwellers in the study: easy availability due to unregulated sales of drugs, high rate of tobacco consumption, poverty, low level of literacy, and being a working-child. Specific policies and plans focused on law enforcement for curbing the illegal drug sales and reduction of child labor along with the provision of education should be devised and implemented to help these neglected communities and modify the determinants.
Key words: • Substance abuse • Drug abuse • Slum dwellers • Case-control • Islamabad • Pakistan
Copyright © 2019 Faiza et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Richards, Clive. "Online orders quickest way to receive quit smoking book." Nursing Standard 21, no. 16 (January 2, 2007): 33. http://dx.doi.org/10.7748/ns.21.16.33.s62.
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Quisenberry, Amanda J., Shreya Shaw, Amy K. Ferketich, and Jay R. Corrigan. "Going Once, Going Twice: Using Willingness-to-Accept Auctions to Promote Smoking Cessation." Nicotine & Tobacco Research 22, no. 9 (April 18, 2020): 1632–35. http://dx.doi.org/10.1093/ntr/ntaa065.
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Abstract Introduction Incentive-based smoking cessation interventions increase quit rates. The optimal incentive, however, is unknown. We used a willingness-to-accept (WTA) auction where smokers submitted bids indicating the incentive they would need to receive for 1 week of smoking cessation. Aims and Methods Smokers ready to quit (n = 35) participated in a WTA auction, naming the amount they needed to be paid to quit for 1 week. Auction winners received an incentive if they successfully quit. All smokers received nicotine replacement therapy and self-help cessation materials. Carbon monoxide concentrations were monitored remotely three times during the week and in person at the final session. Results Participants who smoked their first cigarette within 5 min of waking demanded a significantly larger incentive in exchange for quitting than those who waited (p < .05). About 45% of auction winners quit smoking compared to 20% of nonwinners (p < .05). The cost per quit was $466 among auction winners compared to $894 among nonwinners. Conclusions WTA auctions may be an effective way to determine the amount smokers need to be paid to quit, which would allow researchers to estimate the most cost-effective payment to offer as part of incentive-based smoking cessation programs. Replication evaluating longer-term cessation outcomes with larger samples is warranted. Implications Incentive-based smoking cessation interventions increase quit rates. However, the optimal incentive is unknown. We found that a WTA auction is a feasible technique for estimating the amount smokers need to be paid to quit. Incentives are a surprisingly cost-effective way to facilitate smoking cessation because they are only paid to those who successfully quit. WTA auctions are a promising tool for determining the incentive that strikes the optimal balance between being large enough to motivate cessation, but small enough that it can be offered to the largest possible population of smokers for a given program budget.
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Sweeney-Magee, M., D. Kale, A. Hamill, and H. Gilbert. "‘I Sat Filling in This Form While Smoking and It Was Divine’. An Analysis of Free-Text Comments from Smokers Who Report They Have No Intention of Quitting in the Next Six Months." Journal of Smoking Cessation 11, no. 4 (December 16, 2014): 219–28. http://dx.doi.org/10.1017/jsc.2014.29.
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Introduction: Smokers unmotivated to quit are neglected by smoking cessation research. Free-text comment analysis is a potentially useful way to gain insight into this group's beliefs.Aims: To analyse the free-text comments provided by smokers unmotivated to quit as part of a randomized controlled trial of computer-tailored feedback for smoking cessation.Method: A random sample of 58,660 smokers were sent a smoking behaviour questionnaire (SBQ). The responses and follow-up outcomes of those providing free-text comments were compared to those who did not to assess the representativeness of the former group of smokers. The comments of participants unmotivated to quit (631) were thematically analysed.Results: Those who provided a comment differed from those who did not on variables including education level and quit attempts at six-month follow-up. Emergent themes included; justification of smoking and restricting smoking instead of quitting.Conclusions: The findings illustrate the value of free-text comments in identifying issues important to respondents. The identified themes highlight areas for future research in smokers unmotivated to quit including cutting down as a path to quitting and explicit messages regarding the inability of positive health behaviours to balance out the negative impact of smoking on health.Trial registration: Current Controlled Trials ISRCTN05385712.
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Guo, Jong-Long, Hsiao-Pei Hsu, Mei-Hsun Lin, Cheng-Yu Lin, and Chiu-Mieh Huang. "Testing the Usability of Digital Educational Games for Encouraging Smoking Cessation." International Journal of Environmental Research and Public Health 17, no. 8 (April 14, 2020): 2695. http://dx.doi.org/10.3390/ijerph17082695.
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This study, using an observational design, assessed the effect of digital educational games on students’ intention to quit smoking. Specifically, a series of digital games were developed to encourage smoking cessation and enhance students’ engagement with the material. Three determinants of engagement were tested: perceived ease of use, perceived usefulness, and perceived satisfaction. Usability assessments were performed using a structured questionnaire and usability-testing software (Morae). Most students reported that the games were easy to use (73.3–93.3%), useful (60.0–83.3%) and satisfactory (66.7–70.0%). After using the games, approximately half (46.7–53.3%) reported that they intended to quit smoking. After controlling for gender and age, multiple regression analysis revealed that only perceived usefulness statistically significantly contributed to intention to quit (β = 2.38, p < 0.05). ‘Taiko Drumming’ showed the highest number of mouse clicks (67.23), and the lowest time between inputs (7.88 s). It also received the most positive feedback (17 marks). These findings show that integrating learners’ experiences into the development of learning material can improve learning effectiveness.
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YablonsKY, Peter K., and olga a. suKhovsKaYa. "ElEctronic cigarEttEs — «way of smoking» or quit smoking dEvicEs? commEntary articlE on v .d. mEndElEvich." Bulletin of Contemporary Clinical Medicine 8, no. 3 (2015): 72–74. http://dx.doi.org/10.20969/vskm.2015.8(3).72-74.
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Maybrey, Rhys. "There is an easy way to stop smoking." Nursing Standard 16, no. 23 (February 20, 2002): 30. http://dx.doi.org/10.7748/ns.16.23.30.s47.
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Glasby, Angela. "The old fashioned way to quit smoking was the best for me." Nursing Standard 22, no. 7 (October 24, 2007): 32–33. http://dx.doi.org/10.7748/ns.22.7.32.s41.
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Ganhão, I., E. Gonçalves, A. Paixão, and M. Trigo. "Tobacco Smoking and Motivation to Quit in Psychiatric Patients." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)70653-4.
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Introduction:Smoking is a major health risk in the population in general with significantly increased morbility/mortality with severe consequences on the quality of life and tremendous economic burden on society. It is well known that psychiatric patients have an even higher prevalence of smoking, of heavy smokers and of other risk factors that contribute to the same illnesses.Non-smoking campaigns/smoking restrictions have flourished and it appears that more people are quitting or seriously contemplating the idea. When once, many non-smokers tolerated smokers, today the stigma associated with smoking is undeniable. Psychiatric patients, already greatly stigmatized, risk even becoming more so. Furthermore, smoking cessation programs and interventions frequently are not available, exclude many psychiatric patients and/or are ill-adapted to the special needs in this patient population.Aim:To establish the prevalence of smoking, quantity of tobacco smoked, other factors of dependence by psychiatric diagnosis in a portuguese psychiatric hospital.Establish the motivation of these patients to seek help by professionals and motivation to quit.Methods:Application of questionnaires including Fagerstrom's Modified Questionnaire to patients under care by one team of a Psychaitric hospital in Lisbon, Portugal (CHPL - Sector A).Discussion and conclusions:The study is under way therefore, there are no valid conclusions yet.Certainly it will be possible to confirm high levels of smoking tobacco in this patient population. Hopefully, we may also conclude that there is the desire to change smoking habits making cessation programs a needed and welcomed intervention in psychiatric settings.
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Ljaljević, Agima, Elvir Zvrko, and Marija Stojiljković. "Tobacco Use Among Youth: Findings from the Global Youth Tobacco Survey in Montenegro." Archives of Industrial Hygiene and Toxicology 59, no. 3 (September 1, 2008): 183–89. http://dx.doi.org/10.2478/10004-1254-59-2008-1874.
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Tobacco Use Among Youth: Findings from the Global Youth Tobacco Survey in MontenegroSmoking is a burning healthcare and economy issue, especially in underdeveloped countries. The aim of this study was to determine the number of smokers among elementary school students in Montenegro and to assess the correlates of tobacco use. The study was done in 2003 using the World Health Organization Global Youth Tobacco Survey. Our data showed that children as young as ten years smoked. There were 3.6 % permanent smokers and one in three students (30.6 %) experimented with smoking. More than two thirds who smoked agreed that they should quit smoking, and three fourths tried to quit. This study has also shown that children talk too little about smoking in schools and are exposed to passive smoking at home and elsewhere. Activities to solve the elementary school smoking problem should include preventive programs to be introduced into regular school curricula because this is the only way to address the issue properly. In addition, legislation prohibiting indoor tobacco smoking should be implemented rigorously to protect children from passive smoking in public places.
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V., Manikanta K., Harish B. R., Sudhir Gowda, and Charan Amogh Raj. "Relationship between personality traits and tobacco smoking behaviour in outpatients of a tertiary care hospital, Mandya." International Journal Of Community Medicine And Public Health 8, no. 9 (August 27, 2021): 4492. http://dx.doi.org/10.18203/2394-6040.ijcmph20213558.
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Background: This study was conducted on 168 patients to assess nicotine dependence in tobacco smokers and to compare their personality profiles with non-smokers. Methods: The patients were grouped into nicotine dependent and non-nicotine dependent based on the DSM IV-TR, Personality profile assessed with the big five personality test. informed consent was taken before collecting the data. The test of significance used was independent sample t-test and one way ANOVA.Results: A total of 168 participants were included in this study, comprised of 84 smokers (50%) and 84 non-smokers (50%). Smokers revealed a higher score in neuroticism compared to non-smokers (25.19+4.33 vs. 24.07+3.99), higher extroversion (19.02+4.67 vs. 18.64+6.18) lower Conscientiousness (20.30+6.64 vs. 21.37+5.18) and lower openness to experience (22.14+6.24 vs. 22.75+5.25). mean score of neuroticism is significantly more in moderate (26.12+5.50) level nicotine dependence, openness to experience showed significantly high (28.4+2.31) level nicotine dependence. 41.6% of smokers belong to low to moderate level ND, 30.9% moderate level ND, 22.6% high-level ND, and 0.04% low-level ND. Neuroticism showed health concerns as the reason to quit smoking than those who did not. Conclusions: 39.2% of the participants did not even attempt to quit smoking and the most common reason to quit smoking was health concerns and social factors so it is important to educate these individuals and motivate them to quit smoking. Major causes of relapse were social factors and media/advertisement. Hence strict rules against the display of smoking can help to prevent relapse
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Verplaetse, Terril L., MacKenzie R. Peltier, Walter Roberts, Kelly E. Moore, Brian P. Pittman, and Sherry A. McKee. "Associations Between Nicotine Metabolite Ratio and Gender With Transitions in Cigarette Smoking Status and E-Cigarette Use: Findings Across Waves 1 and 2 of the Population Assessment of Tobacco and Health (PATH) Study." Nicotine & Tobacco Research 22, no. 8 (March 9, 2020): 1316–21. http://dx.doi.org/10.1093/ntr/ntaa022.
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Abstract Introduction Nicotine metabolite ratio (NMR), the ratio of trans 3′-hydroxycotinine to cotinine, is a biomarker of nicotine metabolism. Discrepant findings among clinical trials and population-based studies warrant replication on whether higher NMR, or faster nicotine metabolism, is associated with quitting cigarette smoking. Associations of NMR and e-cigarette use are largely unknown, as well as the relationship between NMR and gender on quitting cigarette smoking or e-cigarette use. Methods The Population Assessment of Tobacco and Health (PATH) Study is a nationally representative, longitudinal cohort study assessing tobacco use in the US population. In the current study, the PATH (waves 1 and 2; adult interviews) was used to evaluate longitudinal predictions in relationships among NMR and gender and their association with transitions (quit vs. current stable) in cigarette smoking status and e-cigarette use status across waves 1 and 2 of the PATH study. Results NMR and gender were not significantly associated with quit behavior for combustible cigarettes. Regarding e-cigarettes, a significant two-way interaction demonstrated that women with higher NMR were less likely to quit e-cigarette use compared to women with lower NMR (odds ratio [OR] = 0.10, 95% confidence interval [CI] = 0.02–0.57; p = .01). Conclusions Findings identify that women with faster nicotine metabolism were 10 times less likely to quit e-cigarettes compared to women with slower nicotine metabolism across waves 1 and 2 of the PATH study. Results suggest that NMR may be used as a biomarker for transitions in e-cigarette quit behavior for women. Implications Findings identify that women with faster nicotine metabolism were 10 times less likely to quit e-cigarettes compared to women with slower nicotine metabolism. Results suggest that NMR may be used as a biomarker for transitions in e-cigarette quit behavior for women. Establishing parameters for NMR collection and for the use of NMR as a biomarker for cigarette smoking behavior and e-cigarette use is an important next step, and may have implications for early intervention and treatment for cessation.
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Moodie, Crawford S., Rosemary Hiscock, Jim Thrasher, and Garth Reid. "Perceptions of cigarette pack inserts promoting cessation and dissuasive cigarettes among young adult smokers in the UK: a cross-sectional online survey." BMJ Open 8, no. 9 (September 2018): e019662. http://dx.doi.org/10.1136/bmjopen-2017-019662.
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ObjectivesTo explore young adult smokers’ perceptions of cigarette pack inserts promoting cessation and cigarettes designed to be dissuasive.DesignCross-sectional online survey.SettingUK.ParticipantsThe final sample was 1766 young adult smokers, with 50.3% male and 71.6% white British. To meet the inclusion criteria, participants had to be 16–34 years old and smoke factory-made cigarettes.Primary and secondary outcome measuresSalience of inserts, perceptions of inserts as information provision, perceptions of inserts on quitting, support for inserts and perceived appeal, harm and trial of three cigarettes (a standard cigarette, a standard cigarette displaying the warning ‘Smoking kills’ and a green cigarette).ResultsHalf the sample indicated that they would read inserts with three-fifths indicating that they are a good way to provide information about quitting (61%). Just over half indicated that inserts would make them think more about quitting (53%), help if they decided to quit (52%), are an effective way of encouraging smokers to quit (53%) and supported having them in all packs (55%). Participants who smoked factory-made cigarettes and other tobacco products (compared with exclusive factory-made cigarette smokers), had made a quit attempt within the last 6 months (compared with those that had never made a quit attempt) or were likely to make a successful quit attempt in the next 6 months (compared with those unlikely to make a quit attempt in the next 6 months) were more likely to indicate that inserts could assist with cessation. Multivariable logistic regression modelling suggested that compared with the standard cigarette, the cigarette with warning (adjusted OR=17.71; 95% CI 13.75 to 22.80) and green cigarette (adjusted OR=30.88; 95% CI 23.98 to 39.76) were much less desirable (less appealing, more harmful and less likely to be tried).ConclusionsInserts and dissuasive cigarettes offer policy makers additional ways of using the pack to reduce smoking.
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Chaiton, Michael, Joanna E. Cohen, Sue J. Bondy, Peter Selby, K. Stephen Brown, Roberta Ferrence, and John M. Garcia. "Perceived Addiction as a Predictor of Smoking Cessation Among Occasional Smokers." Journal of Smoking Cessation 12, no. 3 (January 21, 2016): 165–72. http://dx.doi.org/10.1017/jsc.2015.19.
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Introduction: Common short screening measures of dependence that use number of cigarettes per day may not be appropriate for use in populations of occasional smokers.Aims: In this study, we investigate whether perceived addiction (PA) predicts quit attempts and successful cessation among occasional smokers.Methods: Current occasional smokers (18+) in the Ontario Tobacco Survey (OTS) longitudinal cohort study followed up every six months for up to three years. Respondents rated their self-perceived level of addiction (very vs. somewhat or not very addicted). Generalised Estimating Equation models and proportional hazard models were used to test the predictive ability of PA.Results/Findings: Occasional smokers with very high PA had a higher likelihood of reporting a quit attempt (RR: 2.49; 95% CI: 1.88, 3.30) after adjusting for demographics. Given an incident quit attempt, occasional smokers who reported being very addicted were 2.93 times more likely to relapse (95%: 2.01, 4.28). The effect of PA was independent of other predictors of smoking behaviour.Conclusions: For some, occasional smokers, smoking cessation is a difficult process that may require significant support. Asking occasional smokers about PA is an effective way to predict likely success in quitting smokers that may be easily assessed in population based, as well as in community and clinical, settings.
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Penberthy, J. Kim, J. Morgan Penberthy, Marcus R. Harris, Sonali Nanda, Jennifer Ahn, Caridad Ponce Martinez, Apule O. Osika, et al. "Are Smoking Cessation Treatments Associated with Suicidality Risk? An Overview." Substance Abuse: Research and Treatment 10 (January 2016): SART.S33389. http://dx.doi.org/10.4137/sart.s33389.
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Risk of suicidality during smoking cessation treatment is an important, but often overlooked, aspect of nicotine addiction research and treatment. We explore the relationship between smoking cessation interventions and suicidality and explore common treatments, their associated risks, and effectiveness in promoting smoking reduction and abstinence. Although active smokers have been reported to have twofold to threefold increased risk of suicidality when compared to nonsmokers, 1 4 research regarding the safest way to stop smoking does not always provide clear guidelines for practitioners wishing to advise their patients regarding smoking cessation strategies. In this article, we review pharmacological and cognitive behavioral therapy (CBT) options that are available for people seeking to quit smoking, focusing on the relationship between the ability of these therapies to reduce smoking behavior and promote abstinence and suicidality risks as assessed by reported suicidality on validated measures, reports of suicidal ideation, behaviors, actual attempts, or completed suicides. Pharmacotherapies such as varenicline, bupropion, and nicotine replacement, and CBTs, including contextual CBT interventions, have been found to help reduce smoking rates and promote and maintain abstinence. Suicidality risks, while present when trying to quit smoking, do not appear to demonstrate a consistent or significant rise associated with use of any particular smoking cessation pharmacotherapy or CBT/contextual CBT intervention reviewed.
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Lindson, Nicola, Susan Michie, and Paul Aveyard. "Exploratory Analyses of the Popularity and Efficacy of Four Behavioral Methods of Gradual Smoking Cessation." Nicotine & Tobacco Research 22, no. 12 (July 1, 2020): 2257–61. http://dx.doi.org/10.1093/ntr/ntaa123.
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Abstract Introduction Around half of smokers attempt to stop by cutting-down first. Evidence suggests that this results in similar quit rates to abrupt quitting. Evidence for the effectiveness and popularity of different gradual cessation methods is sparse. Methods Secondary, exploratory, analyses of a randomized trial of gradual versus abrupt smoking cessation. Gradual participants (N = 342) chose between four methods of cutting-down over 2 weeks: cutting-out the easiest cigarettes first (HR-E); cutting-out the most difficult cigarettes first (HR-D); smoking on an increasing time schedule (SR); and not smoking during particular periods (SFP). Nicotine replacement therapy and behavioral support were provided before and after quit day. We used logistic and linear regression modeling to test whether the method chosen was associated with smoking reduction, quit attempts, and abstinence, while adjusting for potential confounders. Results Participants were on average 49 years old, smoked 20 cigarettes per day, and had a Fagerstrom Test for Cigarette Dependence score of 6. 14.9% (51/342) chose HR-E, 2.1% (7/342) HR-D, 46.2% (158/342) SFP, and 36.8% (126/342) SR. We found no evidence of adjusted or unadjusted associations between method and successful 75% reduction in cigarette consumption, reduction in percentage cigarettes per day or exhaled carbon monoxide, quit attempts, or abstinence at 4-week or 6-month follow-up. Conclusions Future research and practice could focus more heavily on the SR and SFP methods as these appeared notably more popular than HR. There was substantial imprecision in the efficacy data, which should be treated with caution; however, none of the gradual cessation methods showed clear evidence of being more efficacious than others. Implications There is evidence that people who would like to quit smoking gradually should be supported to do so. However, as this is relatively new thinking and there is large potential for variation in methods, guidance on the best way to offer support is sparse. This article is an exploratory analysis of the popularity and efficacy of various methods in an attempt to move the topic forward and inform the implementation of gradual smoking cessation methods in practice. The identified popularity of some methods over others signposts directions for future research.
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Morriscey, Carol, Aaron Shephard, Anouk van Houdt, David Kerr, and Sean P. Barrett. "Using ‘Smart’ Technology to Aid in Cigarette Smoking Cessation: Examining an Innovative Way to Monitor and Improve Quit Attempt Outcomes." Journal of Smoking Cessation 14, no. 3 (September 25, 2018): 149–54. http://dx.doi.org/10.1017/jsc.2018.33.
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AbstractIntroductionRecently, smartphone applications (apps) have been used as smoking cessation aids. Interactive apps appear to more effective than non-interactive apps. SmokeBeat, a smartphone app used in conjunction with a smartwatch, aims to detect smoking events, interact with the user as they occur and potentially stop smoking events before they occur in the future.AimsThe purpose of this feasibility study was to determine the sensitivity and specificity of SmokeBeat in detecting smoking events.MethodsThe feasibility of using the app as a smoking cessation aid was tested over a 2-week period by daily, dependent smokers. SmokeBeat's cigarette detection rate was measured in laboratory sessions both before and after the 2-week period. Fisher's exact test was used to compare detection rates from each session.Results/FindingsThe detection rate was 22.5% during session 1 and 41.7% during session 2. Once technological issues were controlled for (i.e., signal loss between smartphone and smartwatch), SmokeBeat's detection rate improved over the 2-week period, resulting in a 100% detection rate.ConclusionsApps which can detect smoking events in real time present an opportunity for a proactive and interactive smoking cessation aid – a potentially useful tool for individuals attempting to quit smoking.
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Fagerström, Karl O. "Can Reduced Smoking Be a Way for Smokers Not Interested in Quitting to Actually Quit?" Respiration 72, no. 2 (2005): 216–20. http://dx.doi.org/10.1159/000084057.
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Mel'nichenko, G. A., S. A. Butrova, and A. A. Larina. "Vliyanie tabakokureniya na zdorov'e i massu telacheloveka." Obesity and metabolism 7, no. 1 (March 15, 2010): 15–19. http://dx.doi.org/10.14341/2071-8713-5273.
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Tobacco smoking causes a lot of human deseases and is one of the main reasons of premature death. Smoking cessation is very important for the patient's health but difficult for them due to development of nicotine dependence. Tobacco dependence is a chronic disease. Smoking Cessation Clinical Practice Guideline, published in 2008, emphasize the dire health consequences of tobacco dependence, regulate the way of treating patients who want to quit smoking, recommending the use of effective treatments, including counseling and medications. Seven first-line medications (5 nicotine and 2 non-nicotine, including Varenicline) that reliably increase long-term smoking abstinence rates are now available. Smoking cessation is accompanied by a moderate weigh gain. And its a strong motivational factor to continue smoking, espcially for women. Сounseling, healthy food and physical activity are recommended for such patients.
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Nosa, Vili, Kotalo Leau, and Natalie Walker. "Cytisine as an alternative smoking cessation product for Pacific smokers in New Zealand." Pacific Health Dialog 21, no. 2 (September 29, 2018): 89–95. http://dx.doi.org/10.26635/phd.2018.919.
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ABSTRACT
Introduction: Pacific people in New Zealand have one of the highest rates of smoking. Cytisine is a plant-based alkaloid that has proven efficacy, effectiveness and safety compared to a placebo and nicotine replacement therapy (NRT) for smoking cessation. Cytisine, like varenicline, is a partial agonist of nicotinic acetylcholine receptors, and blocks the rewarding effects of nicotine. Cytisine is naturally found in some plants in the Pacific region, and so may appeal to Pacific smokers wanting to quit. This paper investigates the acceptability of cytisine as a smoking cessation product for Pacific smokers in New Zealand, using a qualitative study design.
Methods: In December 2015, advertisements and snowball sampling was used to recruit four Pacific smokers and three Pacific smoking cessation specialists in Auckland, New Zealand. Semi-structured interviews where undertaken, whereby participants were asked about motivations to quit and their views on smoking cessation products, including cytisine (which is currently unavailable in New Zealand). Interviews were recorded and transcribed verbatim, with thematic analysis conducted manually.
Findings: Pacific smokers reported wanting to quit for loved ones and family, but did not find currently available smoking cessation products effective. Almost all participants had not previously heard of cytisine, but many of the Pacific smokers were keen to try it. Participants identified with cytisine on a cultural basis (given its natural status), but noted that their use would be determined by the efficacy of the medicine, its cost, side-effects, and accessibility. They were particularly interested in cytisine being made available in liquid form, which could be added to a “smoothie” or drunk as a “traditional tea”. Participants thought cytisine should be promoted in a culturally-appropriate way, with packaging and advertising designed to appeal to Pacific smokers.
Conclusions: Cytisine is more acceptable to Pacific smokers than other smoking cessation products, because of their cultural practices of traditional medicine and the natural product status of cytisine.
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Wynd, Christine A. "Personal Power Imagery and Relaxation Techniques Used in Smoking Cessation Programs." American Journal of Health Promotion 6, no. 3 (January 1992): 184–96. http://dx.doi.org/10.4278/0890-1171-6.3.184.
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Background. Theoretically-based interventions are necessary for enhancing the power of self-control behaviors in smokers attempting to quit smoking cigarettes. The purpose of this study was to examine the use of guided imagery and relaxation techniques as interventions for smoking cessation. The relationship of imagery and self-control was also examined. Methods. A convenience sample of 84 adult smokers participated in one of three treatment conditions: power imagery (n = 28), relaxation imagery (n =29), and “placebo” control (n = 27). Treatment group members were taught imagery during a six-session smoking cessation program, and the control group was provided imagery training upon study completion. Results. Smoking quit rates were 67% for the power imagery group, 69 % for the relaxation group, and 27% for the control group. At a three-month follow-up, the power imagery group had a continued abstinence rate of 52 % (relapse rate = 48 %), the relaxation group had an abstinence rate of 55% (relapse rate = 45 %), and the control group cessation rate remained at 27% (relapse rate = 73%). One-way and repeated measures MANOVAs demonstrated significant differences among the three groups at posttreatment, F (8, 158) = 13.92, p < .05, and revealed that the practice of imagery treatments over time produced changes in power test scores and smoking rates, F(3, 127) = 24.67, p < .05. Discussion. This study demonstrated that power and relaxation imagery treatments were equally effective in reducing smoking rates. Further investigations into the therapeutic uses of imagery are recommended.
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Keijsers, Merel, Maria Cecilia Vega-Corredor, Melanie Tomintz, and Simon Hoermann. "Virtual Reality Technology Use in Cigarette Craving and Smoking Interventions (I “Virtually” Quit): Systematic Review." Journal of Medical Internet Research 23, no. 9 (September 17, 2021): e24307. http://dx.doi.org/10.2196/24307.
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Background Over the last 2 decades, virtual reality technologies (VRTs) have been proposed as a way to enhance and improve smoking cessation therapy. Objective This systematic review aims to evaluate and summarize the current knowledge on the application of VRT in various smoking cessation therapies, as well as to explore potential directions for future research and intervention development. Methods A literature review of smoking interventions using VRT was conducted. Results Not all intervention studies included an alternative therapy or a placebo condition against which the effectiveness of the intervention could be benchmarked, or a follow-up measure to ensure that the effects were lasting. Virtual reality (VR) cue exposure therapy was the most extensively studied intervention, but its effect on long-term smoking behavior was inconsistent. Behavioral therapies such as a VR approach-avoidance task or gamified interventions were less common but reported positive results. Notably, only 1 study combined Electronic Nicotine Delivery Devices with VRT. Conclusions The inclusion of a behavioral component, as is done in the VR approach-avoidance task and gamified interventions, may be an interesting avenue for future research on smoking interventions. As Electronic Nicotine Delivery Devices are still the subject of much controversy, their potential to support smoking cessation remains unclear. For future research, behavioral or multicomponent interventions are promising avenues of exploration. Future studies should improve their validity by comparing their intervention group with at least 1 alternative or placebo control group, as well as incorporating follow-up measures.
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Rivas, Carol, Ratna Sohanpal, Virginia MacNeill, Liz Steed, Elizabeth Edwards, Laurence Antao, Chris Griffiths, Sandra Eldridge, Stephanie Taylor, and Robert Walton. "Determining counselling communication strategies associated with successful quits in the National Health Service community pharmacy Stop Smoking programme in East London: a focused ethnography using recorded consultations." BMJ Open 7, no. 10 (October 2017): e015664. http://dx.doi.org/10.1136/bmjopen-2016-015664.
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ObjectivesTo determine communication strategies associated with smoking cessation in the National Health Service community pharmacy Stop Smoking programme.Setting11 community pharmacies in three inner east London boroughs.Participants9 stop smoking advisers and 16 pairs of smokers who either quit or did not quit at 4 weeks, matched on gender, ethnicity, age and smoking intensity.Method1–3 audio-recorded consultations between an adviser and each pair member over 5–6 weeks were analysed using a mixed-method approach. First a content analysis was based on deductive coding drawn from a theme-oriented discourse analysis approach and the Roter Interaction Analysis System. Core themes were identified through this quantification to explore in detail the qualitative differences and similarities between quitters and non-quitters.ResultsQuantitative analysis revealed advisers used a core set of counselling strategies that privileged the ‘voice of medicine’ and often omitted explicit motivational interviewing. Smokers tended to quit when these core strategies were augmented by supportive talk, clear permission for smokers to seek additional support from the adviser between consultations, encouragement for smokers to use willpower. The thematic analysis highlighted the choices made by advisers as to which strategies to adopt and the impacts on smokers. The first theme ‘Negotiating the smoker–adviser relationship’ referred to adviser judgements about the likelihood the smoker would quit. The second theme, ‘Roles of the adviser and smoker in the quit attempt’, focused on advisers’ counselling strategies, while the third theme, ‘Smoker and adviser misalignment on reasons for smoking, relapsing and quitting’, concerned inconsistencies in the implementation of National Centre for Smoking Cessation and Training recommendations.DiscussionAdvisers in community pharmacies should use the advantages of their familiarity with smokers to ensure appropriate delivery of patient-centred counselling strategies and reflect on the impact on their counselling of early judgements of smoker success.
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Rajani, Nikita B., Nikolaos Mastellos, and Filippos T. Filippidis. "Impact of Gamification on the Self-Efficacy and Motivation to Quit of Smokers: Observational Study of Two Gamified Smoking Cessation Mobile Apps." JMIR Serious Games 9, no. 2 (April 27, 2021): e27290. http://dx.doi.org/10.2196/27290.
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Background The proportion of smokers making quit attempts and the proportion of smokers successfully quitting have been decreasing over the past few years. Previous studies have shown that smokers with high self-efficacy and motivation to quit have an increased likelihood of quitting and staying quit. Consequently, further research on strategies that can improve the self-efficacy and motivation of smokers seeking to quit could lead to substantially higher cessation rates. Some studies have found that gamification can positively impact the cognitive components of behavioral change, including self-efficacy and motivation. However, the impact of gamification in the context of smoking cessation and mobile health has been sparsely investigated. Objective This study aims to examine the association between perceived usefulness, perceived ease of use, and frequency of use of gamification features embedded in smoking cessation apps on self-efficacy and motivation to quit smoking. Methods Participants were assigned to use 1 of the 2 mobile apps for a duration of 4 weeks. App-based questionnaires were provided to participants before app use and 2 weeks and 4 weeks after they started using the app. Gamification was quantitatively operationalized based on the Cugelman gamification framework and concepts from the technology acceptance model. The mean values of perceived frequency, ease of use, and usefulness of gamification features were calculated at midstudy and end-study. Two linear regression models were used to investigate the impact of gamification on self-efficacy and motivation to quit. Results A total of 116 participants completed the study. The mean self-efficacy increased from 37.38 (SD 13.3) to 42.47 (SD 11.5) points and motivation to quit increased from 5.94 (SD 1.4) to 6.32 (SD 1.7) points after app use. Goal setting was perceived to be the most useful gamification feature, whereas sharing was perceived to be the least useful. Participants self-reported that they used the progress dashboards the most often, whereas they used the sharing feature the least often. The average perceived frequency of gamification features was statistically significantly associated with change in self-efficacy (β=3.35; 95% CI 0.31-6.40) and change in motivation to quit (β=.54; 95% CI 0.15-0.94) between baseline and end-study. Conclusions Gamification embedded in mobile apps can have positive effects on self-efficacy and motivation to quit smoking. The findings of this study can provide important insights for tobacco control policy makers, mobile app developers, and smokers seeking to quit.
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Zhang, Li, Yanhan Chen, Yalan Lv, Xia Yang, Qianyu Yin, Li Bai, Yaling Luo, Manoj Sharma, and Yong Zhao. "The Perception and Intervention of Internship Nursing Students Helping Smokers to Quit: A Cross-Sectional Study in Chongqing, China." International Journal of Environmental Research and Public Health 16, no. 20 (October 13, 2019): 3882. http://dx.doi.org/10.3390/ijerph16203882.
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Background: Smoking is among the most preventable causes of death globally. Tobacco cessation can lessen the number of potential deaths. The China Tobacco Cessation Guidelines encourage medical staff to perform the 5As (Ask, Advise, Assess, Assist, Arrange) when delivering tobacco dependence treatments to patients. Nursing students will develop to be nurses in the future and they have to finish 9 months of clinical practicum study in the last year at hospitals or care centers. However, the frequency of behaviors used to help smokers quit among Chinese nursing internship students is unclear. This study analyzed the rate of nurse interns’ performance of the 5As and which demographic characteristics, perceptions of smoking and knowledge predicted higher performance of the 5As. Methods: The cluster sampling method was used to select 13 teaching hospitals among 29. All nursing intern students were expected to finish the questionnaire about their 5As behaviors to help patients quit smoking. Their 5As performances were scored from one to five with 5 being the best and scores were summed. A multivariate linear mixed-effect model was employed to test the differences between their 5As. Results: Participating in the survey were 1358 interns (62.4% response rate). The average scores were as follows—Ask—3.15, Advise—2.75, Assess—2.67, Assist—2.58 and Arrange—2.42. A total of 56.3% students perceived that medical staff should perform the 5As routinely to help patients quit smoking. On the other hand, 52.1% viewed clinical preceptors as role models of the 5As. School education regarding tobacco control, smoking dependence treatment, self-efficacy and positive intentions were predictors of higher performance of the 5As (p < 0.001). Conclusions: Nursing internship students seldom administered tobacco dependence treatments to patients. It is essential to improve the corresponding education, skills and self-efficacy of the 5As. Meanwhile, clinical preceptors should procure more training in the responsibilities and skills related to tobacco cessation. In this way, clinical preceptors can be role models of the 5As and impart positive influences on interns.
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Sucharitha, Sree T., Pradeep Rangasamy, Vaishikaa R, Balaji S.M, Bindu T, and Gunasekaran N. "Smart Phone Apps for Smoking Cessation - A Qualitative Study among Healthcare Providers in Chennai." Journal of Evidence Based Medicine and Healthcare 8, no. 21 (May 24, 2021): 1630–35. http://dx.doi.org/10.18410/jebmh/2021/308.
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BACKGROUND Majority of smokers are aware of health consequences due to smoking but reported inability to quit smoking in multiple studies. Reasons attributed to continued smoking include multiple causes like addiction, habit and stress, as well as face-valid causes such as disease, personality problems, weakness of character, etc. Tobacco cessation services promoted by World Health Organization (WHO) are typically to be initiated by the service provider and include brief opportunistic assessment for smoking cessation widely known as 5A’ and 5R’s for brief assessment. Health interventions are identified by WHO as an effective way to enhance the promotion of tobacco cessation as only three percent of smokers manage to quit without help of intervention. This study explored the awareness of smart phone apps for smoking cessation among private healthcare providers in Chennai. METHODS A qualitative, explorative study through one-on-one, personal interviews among 36 randomly approached and consenting healthcare providers primarily providing tobacco related health care services including dentists, psychiatrists, ear – nose - throat surgeons, general medicine, respiratory medicine, surgeons and obstetricians at six private teaching medical institutes was conducted from July 2020 to October 2020 in Chennai. RESULTS The results showed that majority of the healthcare providers lack awareness of smart phone-based apps for smoking cessation. However, a very small minority3 who were aware were limited by social determinants of health of the clients such as perceived poor digital literacy, unaffordability of internet packages to recommend them. CONCLUSIONS The healthcare providers from various fields lacked the awareness of smart phone apps aiding with smoking cessation with the exception of a minor few3 who acknowledged their existence but were engaged very minimally with these modalities. KEYWORDS Healthcare Providers’ Awareness, Smart Phone Based-Apps, Smoking Cessation Apps, Tobacco Clients, Personal Interviews
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Bindoff, Ivan, Tristan R. Ling, Peter Gee, Benjamin Geelan, Stuart G. Ferguson, and Gregory M. Peterson. "Effects of a Mobile App Called Quittr, Which Utilizes Premium Currency and Games Features, on Improving Engagement With Smoking Cessation Intervention: Pilot Randomized Controlled Trial." JMIR Serious Games 8, no. 4 (December 14, 2020): e23734. http://dx.doi.org/10.2196/23734.
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Background Numerous mobile health (mHealth) apps have been developed to support smokers attempting to quit smoking. Although these apps have been reported to be successful, only modest improvements in the quit rate have been measured. It has been proposed that efforts to improve user engagement and retention may improve the quit rate further. Owing to the high cost of smoking-related disease, it is considered worthwhile to pursue even small improvements. Objective The aim of this study was to test a novel smartphone app that leverages premium currency strategies developed by the mobile games industry in an attempt to improve engagement and retention with a smoking cessation intervention. Methods We designed and developed a smoking cessation app called “Quittr” in line with previously developed smoking cessation mHealth apps. In addition to this established framework, we added a stand-alone fully featured city-building clicker-style game called “Tappy Town,” and a premium virtual currency called “QuitCoins.” The user earns QuitCoins for using the app in a way that contributes positively toward their quit attempt, and they can redeem these coins in Tappy Town for bonuses. To establish whether these features improved engagement and retention, we ran a 5-month randomized controlled trial where the intervention group had the full app with the extra games features, while the control group had the standard app only. Recruitment was performed via web-based advertising. Participants (N=175) had no direct contact with the researchers or other support staff. Results No significant differences in terms of engagement, retention, or smoking outcomes were found between the control and intervention groups. However, survey data indicated that the majority of the participants valued Tappy Town (10/17, 59%) and the QuitCoins rewards system (13/17, 77%). Usage data also suggested that Tappy Town was widely played and was generally appealing to users (mean total time spent in app, control group: 797 seconds vs intervention group: 3502 seconds, P<.001). Analysis of the results suggests that users in the intervention group may have been negatively affected by the aspects of the chosen design, and some theories were explored to explain this unexpected outcome. Conclusions Although the novel features of the Quittr app failed to improve the key outcomes measured in this study, there were enough positive indications to warrant further exploration of the concept. Additional research will be required to identify and correct any design flaws that may have adversely affected our participants before a follow-up study can be completed. Trial Registration Australian and New Zealand Clinical Trials Register ACTRN12617000491369; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372661&isReview=true
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Tattan-Birch, Harry, Sarah E. Jackson, Charlotte Ide, Linda Bauld, and Lion Shahab. "Evaluation of the Impact of a Regional Educational Advertising Campaign on Harm Perceptions of E-Cigarettes, Prevalence of E-Cigarette Use, and Quit Attempts Among Smokers." Nicotine & Tobacco Research 22, no. 7 (December 14, 2019): 1148–54. http://dx.doi.org/10.1093/ntr/ntz236.
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Abstract Introduction We evaluated how effective an advertising campaign that was piloted by Cancer Research UK in January/February 2018 was at promoting quit attempts by increasing awareness of the relative harms of e-cigarettes compared with smoking. Methods Adults (≥16 years, n = 2217) living in Greater Manchester (campaign region), Yorkshire & Humber and the North East of England (control regions) completed cross-sectional surveys immediately before and after the campaign period. Surveys measured socio-demographics, perceptions and use of e-cigarettes, and motivation and attempts to quit smoking. We tested interactions between time (pre, post) and region (campaign, control). Results 36.7% (95% CI 33.0%–40.6%) of those in the intervention region recognized the campaign. In the general population, interactions were nonsignificant for all outcomes except for perception of e-cigarettes as effective cessation aids, with smaller increases from pre- to post-campaign in the campaign (49.9% to 54.0%) compared with the control region (40.5% to 55.0%; odds ratio [OR] = 0.66, 95% CI .45–0.98). Among smokers, motivation to quit increased in the intervention region (44.0% to 48.0%) but decreased in the control region (40.5% to 21.5%; OR = 2.97, 95% confidence interval [CI] 1.25–7.16), with no other significant differences between regions over time. Bayes factors confirmed that nonsignificant results were inconclusive. Conclusions Compared with the control region, the campaign was associated with an increase in smokers’ motivation to quit but a smaller increase in adults’ perception of e-cigarettes as an effective cessation aid. There was insufficient evidence to determine whether the campaign affected other outcomes. Implications Past extended mass media tobacco control campaigns have been shown to change public attitudes towards smoking, improve motivation to quit smoking, and reduce smoking prevalence. Much less is known about shorter, targeted campaigns. Here we show that using mass media to communicate accurate information about the relative harms of e-cigarettes compared with smoking may be an effective strategy in increasing smokers’ motivation to quit. Moreover, even when only run for a month, such campaigns can reach a large proportion of the targeted population. Further research is needed to evaluate effects on quit attempts and success.