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DUNAWAY, ANGELA. "Q: How can I quit smoking?" Journal of the American Academy of Physician Assistants 21, no. 11 (November 2008): 53. http://dx.doi.org/10.1097/01720610-200811000-00014.
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&NA;. "Q: How can I quit smoking?" Journal of the American Academy of Physician Assistants 21, no. 11 (November 2008): 54. http://dx.doi.org/10.1097/01720610-200811000-00015.
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Waterall, Jamie. "Stoptober: How you can help more people quit smoking." Practice Nursing 29, no. 10 (October 2, 2018): 479. http://dx.doi.org/10.12968/pnur.2018.29.10.479.
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Davidson, S. M., G. Boldt, and A. V. Louie. "How Can We Better Help Cancer Patients Quit Smoking?" International Journal of Radiation Oncology*Biology*Physics 99, no. 2 (October 2017): E393. http://dx.doi.org/10.1016/j.ijrobp.2017.06.1543.
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West, Oliver, Hayden McRobbie, and Peter Hajek. "How Addictive Can Cigarettes Be? Two Case Reports." Journal of Smoking Cessation 5, no. 1 (June 1, 2010): 102–5. http://dx.doi.org/10.1375/jsc.5.1.102.
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AbstractThe addiction literature contains numerous case reports of individuals dependent on a range of chemical substances, but strong dependence on cigarettes has not been similarly documented. This report attempts to fill this gap by describing two exceptionally dependent smokers. Both suffer with a smoking-related disease and have a very strong motivation to quit. Despite receiving intensive behavioural and pharmacological treatments to help them stop smoking, they have been unable to maintain even a short period of abstinence. The two cases provide reference examples for the assertion that while not all smokers are hopelessly hooked, some are. Such illustrative cases may stimulate research into the area of individual differences in cigarette dependence.
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Davidson, S. M., R. G. Boldt, and A. V. Louie. "How can we better help cancer patients quit smoking? The London Regional Cancer Program experience with smoking cessation." Current Oncology 25, no. 3 (June 27, 2018): 226. http://dx.doi.org/10.3747/co.25.3921.
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Background Because continued cigarette smoking after a cancer diagnosis is associated with detrimental outcomes, supporting cancer patients with smoking cessation is imperative. We evaluated the effect of the Smoking Cessation Program at the London Regional Cancer Program (lrcp) over a 2-year period.Methods The Smoking Cessation Program at the lrcp began in March 2014. New patients are screened for tobacco use. Tobacco users are counselled about the benefits of cessation and are offered referral to the program. If a patient accepts, a smoking cessation champion offers additional counselling. Follow-up is provided by interactive voice response (ivr) telephone system. Accrual data were collected monthly from January 2015 to December 2016 and were evaluated.Results During 2015–2016, 10,341 patients were screened for tobacco use, and 18% identified themselves as current or recent tobacco users. In 2015, 84% of tobacco users were offered referral, but only 13% accepted, and 3% enrolled in ivr follow-up. At the lrcp in 2016, 77% of tobacco users were offered referral to the program, but only 9% of smokers accepted, and only 2% enrolled in ivr follow-up.Conclusions The Smoking Cessation Program at the lrcp has had modest success, because multiple factors influence a patient’s success with cessation. Limitations of the program include challenges in referral and counselling, limited access to nicotine replacement therapy (nrt), and minimal follow-up. To mitigate some of those challenges, a pilot project was launched in January 2017 in which patients receive free nrt and referral to the local health unit.
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Cope, Graham. "Smoking cessation and serious mental illness." Independent Nurse 2021, no. 5 (May 2, 2021): 11–13. http://dx.doi.org/10.12968/indn.2021.5.11.
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Abidi, Fizzah B., Libby Laing, Sue Cooper, Tim Coleman, and Katarzyna A. Campbell. "Experts’ Views on Behaviour Change Techniques for Smoking Cessation in Pregnancy: A Qualitative Study." International Journal of Environmental Research and Public Health 17, no. 21 (October 22, 2020): 7729. http://dx.doi.org/10.3390/ijerph17217729.
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Smoking during pregnancy is a global health problem which has devastating health implications. Behavioural support is an important part of smoking cessation support for pregnant women. Research has identified barriers and facilitators (B&Fs) and effective behaviour change techniques (BCTs) to aid women’s quit attempts. However, the extent to which and how these BCTs are used in practice is unclear. The research aimed to establish experts’ views on how behavioural support can be optimised and techniques operationalised in clinical practice, by identifying ways to address known B&Fs for smoking cessation in pregnancy. A focus group discussion took place with six experts, which highlighted how BCTs can be used in practice to support women in their quit attempts. A thematic analysis was conducted to elicit overarching themes. Five themes were found: involving the family, empowering women, using incentives to boost motivation, using practical techniques to help women with their quit attempts and managing expectations about nicotine replacement therapy. Empowering women to make their own decisions and encouraging small positive changes in smoking habits, using visual aids (e.g., growth charts) to inform women of the harms of smoking to the baby and treating families holistically were deemed important.
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Tran, Binh Thang, Dinh Trung Tran, Khac Minh Nguyen, Xuan Trinh Thi Nguyen, Min Kyung Lim, Sung-il Cho, and Jin-Kyoung Oh. "How Much Is Too Much? Estimating Effective Price-Hikes to Affect Smoking Behavior in Vietnam." Nicotine & Tobacco Research 21, no. 12 (February 9, 2019): 1721–26. http://dx.doi.org/10.1093/ntr/ntz017.
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Abstract Introduction Raising the price of cigarettes is one of the most effective strategies to reduce cigarette smoking. The Vietnamese government is working toward the tobacco control goal of a 10% reduction in smoking prevalence by 2020. However, cigarette prices in Vietnam have not increased in the last two decades. The aim of this study was to estimate what cigarette prices would make smokers attempt to quit smoking, and to identify predictors of the price to quit and the intention to quit. Methods A cross-sectional survey was conducted with 822 male current smokers in Da Nang, Vietnam. A structured questionnaire was adapted from the International Tobacco Control project survey. Bayesian quantile regression was applied to predict factors associated with expected cigarette price. Results Fifty-six percent of smokers suggested a price to quit. Their median suggested price to quit per pack, 62 000 VND (2.8 USD), was 2.8 times higher than the actual current price, 22 000 VND (1.01 USD). Suggesting a lower price to quit was significantly associated with awareness of warning labels and smoke-free policies. In contrast, being a heavy smoker was significantly associated with a higher suggested price to quit across all quantiles. Conclusions There may be sufficient room to increase cigarette prices in Vietnam. The price to quit is associated with various factors, including non-pricing policies. Implications Evidence suggests that a steep increase in cigarette prices, setting a high minimum tax, and introducing a large specific tax, which are policy-induced price increases that can raise prices substantially in Vietnam, are preferable strategies. In addition to increasing price and taxes, the government should also strengthen non-pricing policies.
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Amrein, Melanie A., Janina Lüscher, Corina Berli, Theda Radtke, and Urte Scholz. "Do Daily Compensatory Health Beliefs Predict Intention to Quit and Smoking Behavior? A Daily Diary Study during Smoking Cessation." International Journal of Environmental Research and Public Health 17, no. 17 (September 3, 2020): 6419. http://dx.doi.org/10.3390/ijerph17176419.
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Compensatory health beliefs (CHBs) are a means to cope with motivational conflicts between intended health goals and the temptation for an unhealthy behavior. As CHBs can fluctuate on a daily basis, this study examined how daily CHBs are associated with daily intention to quit smoking and daily number of cigarettes smoked before and after a quit date at the between- and within-person level. The study comprised a prospective longitudinal design and investigated 83 women and 83 men for 32 consecutive days during an ongoing joint self-set quit attempt. Daily CHBs varied from day to day and between individuals. At the between-person level, higher women’s mean CHBs were associated with lower intention (b = −0.23, p = 0.04) and at the 10% level with more cigarettes smoked after the quit date (rate ratio (RR) = 1.92, p = 0.07). At the within-person level, women’s higher than usual CHBs were unrelated to intention to quit, but were related to less smoking before (RR = 0.96, p = 0.03) and at the 10% level after the quit date (RR = 0.91, p = 0.09). A marginally positive association between daily CHBs and smoking at the within-person level emerged for men. The negative effect of daily CHBs at the between-person level on smoking seems to unfold after the quit attempt and for women only.
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Shi, Yu, Chunhua Yu, Ailun Luo, Yuguang Huang, and David O. Warner. "Perioperative Tobacco Interventions by Chinese Anesthesiologists." Anesthesiology 112, no. 2 (February 1, 2010): 338–46. http://dx.doi.org/10.1097/aln.0b013e3181c91ee7.
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Background The prevalence of cigarette smoking in China is high. Surgery provides an excellent opportunity for patients to quit smoking, and anesthesiologists can play an important role in tobacco control. However, little is known about the practices, knowledge, and attitudes of Chinese anesthesiologists regarding perioperative tobacco interventions. Methods Chinese anesthesiologists were surveyed at a national meeting in 2009, with written questionnaires distributed to 800 practicing anesthesiologists. Results The survey response rate was 60.3%, and 10% of respondents themselves smoked cigarettes. Most (73%) of them frequently or almost always asked about smoking status; 51% advised about the health risk of tobacco use; and 60% advised patients to quit. Compared with nonsmokers, smokers were significantly less likely to advise about the health risks of smoking and quitting. A high proportion of respondents had accurate perceptions of perioperative and long-term health risks of smoking. Although most respondents agreed that advising patients to quit is the responsibility of anesthesiologists and the perioperative period is a good time to help patients quit smoking, few knew how to counsel about smoking or help patients get the help they needed to quit. Nonetheless, most of the respondents were willing to learn about perioperative interventions and spend an extra 5 min to help patients quit smoking. Conclusions Given their adequate knowledge of health risks of smoking, strong perception of responsibilities, and willingness to participate in tobacco control, Chinese anesthesiologists are poised to play a significant role in tobacco control in China that could improve perioperative outcomes and promote long-term health.
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Lee, Stella J., Ashley Sanders-Jackson, and Andy S. L. Tan. "Effects of Current and Enhanced Tobacco Corrective Messages on Smokers’ Intention to Quit Smoking and Intention to Purchase Cigarettes." Nicotine & Tobacco Research 22, no. 4 (May 2, 2019): 569–75. http://dx.doi.org/10.1093/ntr/ntz063.
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Abstract Introduction A federal court has ordered tobacco companies to issue corrective messages to address tobacco-related misperceptions. This study examined the effects of viewing current versus two enhanced versions of tobacco corrective messages on smokers’ intention to quit smoking and intention to purchase cigarettes. Methods US adult smokers (N = 803) were randomly assigned to view (1) two current tobacco corrective messages (Current), (2) two corrective messages that include an industry deception statement (Industry Deception), or (3) two corrective messages with an industry deception statement and testimonials of people harmed by smoking (Industry Deception + Testimonial). Outcomes were pretest–posttest change in intentions to quit smoking and posttest intention to purchase cigarette measures. Results Intention to quit smoking increased significantly after viewing the Current corrective messages versus baseline. In addition, viewing the Industry Deception + Testimonial messages increased intention to quit smoking compared with the Current corrective condition and the Industry Deception condition. Hispanic smokers had increased intention to quit smoking and decreased intention to purchase cigarettes to a greater degree than non-Hispanic smokers in response to Industry Deception + Testimonial messages. There was no significant difference in intention to purchase cigarettes across conditions. Conclusions Enhancing the current corrective statements by including an industry deception statement and testimonials may strengthen effects and contribute to remedying the effects of tobacco misinformation. Implications Previous research has found that draft or proposed versions of tobacco industry corrective messages are effective in correcting beliefs and knowledge. However, studies have not examined how the current court-ordered corrective messages could change intention to quit smoking and intention to purchase cigarettes nor whether enhanced messages could perform better. Study findings suggest that the current corrective messages can increase smokers’ intention to quit smoking beyond their baseline intention. More importantly, enhancing corrective messages by including an industry deception statement and testimonial was found to be more effective than current corrective messages. Findings can inform future iterations of tobacco correctives and strategies to reverse the effects of tobacco misinformation.
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Glover, Marewa, and Anette Kira. "Pregnant Māori Smokers’ Perception of Cessation Support and How It Can Be More Helpful." Journal of Smoking Cessation 7, no. 2 (October 12, 2012): 65–71. http://dx.doi.org/10.1017/jsc.2012.13.
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This study aimed to investigate the perception of smoking cessation services and products by pregnant Māori (New Zealand's Indigenous people) smokers and identify how these can be improved. Semi-structured face-to-face interviews were conducted with 60 pregnant Māori smokers. Most of the women (82%) had been advised to stop smoking, but few (21%) felt influenced by the advice. In addition, the women in this study felt that health provider support needed to be more encouraging, understanding and more readily available. Many (78%) had come across smokefree pamphlets, but few had read them. Only four women had been given a booklet specifically aimed at pregnant Māori women. Several women thought that the promotion of smokefree pregnancies needed to be aimed at the whole whānau (extended family). The main conclusions were that motivation to quit could be enhanced by delivery of a clear, consistent and repeated message from multiple sources, backed up with effective, supportive and encouraging services and education resources about risks and smoking cessation options. Primary health care interventions delivering a range of services need to be flexible – for example, by visiting pregnant women in their home – and need to target the whole expectant whānau, instead of focusing on pregnant women in isolation.
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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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Alam., Dr Sheikh Mahabub. "Second-hand Tobacco Smoke (ETS) – Findings of an Australian Case Study and How Dhaka can reap the Benefit from the Research Outcome." International Journal of Social Sciences and Humanities Invention 5, no. 9 (September 2, 2018): 4959–68. http://dx.doi.org/10.18535/ijsshi/v5i9.01.
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Smoking / ETS kills, prime reason for cancer, asthma, other lung diseases and other deadly diseases. It is diagnosed as the greatest silent killer on earth. Smoking has no positive contribution to human health or to the environment. It affects almost all organs of the body, leading to carcinogenic diseases and ending in premature mortality. Infants and children are most at risk. Although the overall smoking trend is slowly declining but smoking rate among students and young adults (both men and women) are disturbingly increasing in Australia despite strong collaborative efforts of public and private sector to curb tobacco smoking. Exposure to smoking is a violation of the right of all individuals to breathe clean air. Although people can’t be forced to quit smoking, but regulation can be tightened, and strict enforcement of law would be a good deterrent for smokers. Australia has banned tobacco smoking in all public places and Bangladesh government could follow that noble initiative. In addition, community engagement, awareness building through education, accompanied by punishing smoking / ETS producers with hefty fines. Bangladesh unfortunately belongs among the top five smoking nation on earth. About 43% of people smokes and in the long run it will bring catastrophic consequences. Currently there are about 1.5 million cancer patients and about 3 30 million kidney patients and growing. A major contributor is tobacco and ETS. Unless urgent measures are taken the country will be flooded with patients with incurable diseases, a burden the country can’t afford to handle.
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Marck, Claudia H., Roshan das Nair, Lisa B. Grech, Ron Borland, and Cris S. Constantinescu. "Modifiable risk factors for poor health outcomes in multiple sclerosis: The urgent need for research to maximise smoking cessation success." Multiple Sclerosis Journal 26, no. 3 (June 20, 2019): 266–71. http://dx.doi.org/10.1177/1352458519858730.
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Tobacco smoking is a well-established risk factor for multiple sclerosis (MS) onset, progression and poor health outcomes in people with MS. Despite smoking being a modifiable risk factor, no research has been undertaken to understand how, or who is best placed, to assess or understand smoking behaviour in people with MS, or how healthcare professionals can best assist people with MS to quit. People with MS may have unique motivators to continue smoking, or unique barriers to smoking cessation, that are not addressed by existing cessation tools. Research is urgently needed in this area if the aim is to maximise health outcomes for all people with MS.
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Shiffman, Saul, and John R. Hughes. "Improving on the Proven: Increased Efficacy and Reach With Innovations in Use of Therapeutic Nicotine." Journal of Smoking Cessation 4, S2 (December 1, 2009): 1–21. http://dx.doi.org/10.1375/jsc.4.supp.1.
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AbstractTherapeutic nicotine (TN) has been a mainstay of evidence-based smoking cessation treatment for many years, with established patterns of application. Yet recent research and practice indicates that innovations in how TN is used and applied to new populations can substantially enhance its efficacy and reach, improving upon established approaches to TN use. In this article, we address innovations how TN is used, discussing evidence that starting treatment before the quit day, combining patch with acute TN forms, and continuing TN treatment after a lapse, all substantially improve treatment outcomes compared to current TN practices, with effects sizes in the same range as the basic effect of TN versus placebo. We also review the use of TN in populations interested in smoking reduction as a path to quitting, discussing evidence that TN improves success rates in quitting by gradual reduction, and can also be used for reduction among smokers who are not yet ready to quit, leading to increased cessation rates. The evidence suggests that innovations in how TN is used can have substantial effects on the efficacy and reach of smoking cessation treatment.
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Rajani, Nikita B., Nikolaos Mastellos, and Filippos T. Filippidis. "Self-Efficacy and Motivation to Quit of Smokers Seeking to Quit: Quantitative Assessment of Smoking Cessation Mobile Apps." JMIR mHealth and uHealth 9, no. 4 (April 30, 2021): e25030. http://dx.doi.org/10.2196/25030.
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Background Decreasing trends in the number of individuals accessing face-to-face support are leaving a significant gap in the treatment options for smokers seeking to quit. Face-to-face behavioral support and other interventions attempt to target psychological factors such as the self-efficacy and motivation to quit of smokers, as these factors are associated with an increased likelihood of making quit attempts and successfully quitting. Although digital interventions, such as smoking cessation mobile apps, could provide a promising avenue to bridge the growing treatment gap, little is known about their impact on psychological factors that are vital for smoking cessation. Objective This study aims to better understand the possible impact of smoking cessation mobile apps on important factors for successful cessation, such as self-efficacy and motivation to quit. Our aim is to assess the self-efficacy and motivation to quit levels of smokers before and after the use of smoking cessation mobile apps. Methods Smokers seeking to quit were recruited to participate in a 4-week app-based study. After screening, eligible participants were asked to use a mobile app (Kwit or Quit Genius). The smoking self-efficacy questionnaire and the motivation to stop smoking scale were used to measure the self-efficacy and motivation to quit, respectively. Both were assessed at baseline (before app use), midstudy (2 weeks after app use), and end-study (4 weeks after app use). Paired sample two-tailed t tests were used to investigate whether differences in self-efficacy and motivation between study time points were statistically significant. Linear regression models investigated associations between change in self-efficacy and change in motivation to quit before and after app use with age, gender, and nicotine dependence. Results A total of 116 participants completed the study, with the majority being male (71/116, 61.2%), employed (76/116, 65.6%), single (77/116, 66.4%), and highly educated (87/116, 75.0%). A large proportion of participants had a low to moderate dependence on nicotine (107/116, 92.2%). A statistically significant increase of 5.09 points (95% CI 1.83-8.34) from 37.38 points at baseline in self-efficacy was found at the end of the study. Statistically significant increases were also found for the subcomponents of self-efficacy (intrinsic and extrinsic self-efficacies). Similarly, a statistically significant increase of 0.38 points (95% CI 0.06-0.70) from 5.94 points at baseline in motivation to quit was found at the end of the study. Gender, age, and nicotine dependence were not statistically significantly associated with changes in self-efficacy and motivation to quit. Conclusions The assessed mobile apps positively impacted the self-efficacy and motivation to quit of smokers making quit attempts. This has important implications on the possible future use of digitalized interventions and how they could influence important psychological factors for quitting such as self-efficacy and motivation. However, further research is needed to assess whether digital interventions can supplement or replace traditional forms of therapy.
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Schwaninger, Philipp, Corina Berli, Urte Scholz, and Janina Lüscher. "Effectiveness of a Dyadic Buddy App for Smoking Cessation: Randomized Controlled Trial." Journal of Medical Internet Research 23, no. 9 (September 9, 2021): e27162. http://dx.doi.org/10.2196/27162.
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Background Tobacco smoking is one of the biggest public health threats. Smartphone apps offer new promising opportunities for supporting smoking cessation in real time. This randomized controlled trial investigated the effectiveness of an app that encourages individuals to quit smoking with the help of a social network member (buddy) in daily life. Objective The objective of this study is to test the effectiveness of the SmokeFree buddy app compared with a control group with self-reported smoking abstinence and carbon monoxide (CO)–verified smoking abstinence as primary outcomes and self-reports of smoked cigarettes per day (CPD) as a secondary outcome. Methods A total of 162 adults who smoked participated in this single-blind, two-arm, parallel-group, intensive longitudinal randomized controlled trial. Around a self-set quit date (ie, 7 days before the self-set quit date and 20 days after) and 6 months later, participants of the intervention and control groups reported on daily smoking abstinence and CPD in end-of-day diaries. Daily smoking abstinence was verified via daily exhaled CO assessments. This assessment was administered via an app displaying results of exhaled CO, thus addressing self-monitoring in both groups. In addition, participants in the intervention group used the SmokeFree buddy app, a multicomponent app that facilitates social support from a buddy of choice. Results A significant reduction in CPD from baseline to the 6-month follow-up was observed among participants in both groups. Multilevel analyses revealed no significant intervention effect on self-reported and CO-verified daily smoking abstinence at the quit date and 3 weeks later. However, CPD was lower at the quit date and 3 weeks later in the intervention group than in the control group. No significant differences between groups were found for any outcome measures 6 months after the quit date. Overall, low app engagement and low perceived usefulness were observed. Conclusions Despite some encouraging short-term findings on the amount of smoking, the SmokeFree buddy app did not have beneficial effects on smoking abstinence over and above the self-monitoring control condition. Future studies should examine whether and what support processes can be effectively stimulated and how app use can be improved to better achieve this goal. Trial Registration ISRCTN Registry 11154315; https://www.isrctn.com/ISRCTN11154315 International Registered Report Identifier (IRRID) RR2-10.1186/s12889-019-7723-z
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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.
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Clemens, Kelly J., Angela Stuart, and Stuart G. Ferguson. "Pre-quit nicotine decreases nicotine self-administration and attenuates cue- and drug-induced reinstatement." Journal of Psychopharmacology 33, no. 3 (January 30, 2019): 364–71. http://dx.doi.org/10.1177/0269881118822074.
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Background: Administration of smoking cessation medications in anticipation of a nominated quit date can promote abstinence. How this occurs is not widely understood, but may be due to the disruption of contingencies between smoking behaviour and acute drug effects. Aims: The aim of this study was to explore this relationship, we examined the effect of pre-quit nicotine replacement therapy on susceptibility to relapse in an animal model of nicotine dependence. Methods: Rats were trained to intravenously self-administer nicotine across 20 days. Continuous low-dose nicotine was administered via a mini-osmotic pump either across the last 7 days of self-administration and across 6 days of extinction, or across extinction only. Cue- and drug-induced reinstatements of responding were then measured with mini-pumps retained, the day after mini-pump removal or one week later. Results: Pre-quit nicotine administration markedly reduced self-administration across the last days of training as the response, and its associated cues, no longer reliably predicted an acute drug effect. Pre-quit, but not post-quit, nicotine administration significantly attenuated cue-induced reinstatement once mini-pumps were removed, indicating that the contingency disruption across training reduced the conditioned reinforcing properties of the cue at test. Both pre-quit and post-quit nicotine attenuated nicotine-primed reinstatement. Conclusions: Together these results suggest that administration of a nicotine replacement prior to a nominated quit date may enhance resistance to relapse via disruption of the contingency between a response, its associated cues, and a rewarding nicotine effect.
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Smith, Andrea L., Stacy M. Carter, Sally M. Dunlop, Becky Freeman, and Simon Chapman. "Revealing the complexity of quitting smoking: a qualitative grounded theory study of the natural history of quitting in Australian ex-smokers." Tobacco Control 27, no. 5 (November 23, 2017): 568–76. http://dx.doi.org/10.1136/tobaccocontrol-2017-053919.
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ObjectiveTo explore the quitting histories of Australian ex-smokers in order to develop an understanding of the varied contribution of smoking cessation assistance (either pharmacotherapy or professionally mediated behavioural support) to the process of quitting.DesignQualitative grounded theory study; in-depth interviews.Participants37 Australian adult ex-smokers (24–68 years; 15 men, 22 women) who quit in the past 6–24 months.ResultsAlthough participants’ individual quitting histories and their overall experiences of quitting were unique, when the 37 quitting histories were compared it was clear two experiences were common to almost all participants: almost no one quit at their first quit attempt and almost everyone started out quitting unassisted. Furthermore, distinct patterns existed in the timing and use of assistance, in particular the age at which assistance was first used, how some participants were resolutely uninterested in assistance, and how assistance might have contributed to the process of successful quitting even if not used on the final quit attempt. Importantly, three patterns in use of assistance were identified: (1) only ever tried to quit unassisted (n=13); (2) started unassisted, tried assistance but reverted back to unassisted (n=13); (3) started unassisted, tried assistance and quit with assistance (n=11). For most participants, insight into what quitting would require was only gained through prior quitting experiences with and without assistance. For a number of participants, interest in assistance was at its lowest when the participant was most ready to quit.ConclusionQuitting should be viewed as a process drawing on elements of assisted and unassisted quitting rather than a stand-alone event that can be labelled as strictly assisted or unassisted.
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Warner, Kenneth E. "How to Think—Not Feel—about Tobacco Harm Reduction." Nicotine & Tobacco Research 21, no. 10 (April 30, 2018): 1299–309. http://dx.doi.org/10.1093/ntr/nty084.
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Abstract Introduction The debate over tobacco harm reduction (THR) has divided the tobacco control community into two camps, one expressing serious reservations about THR whereas the other believes that reduced-risk products like e-cigarettes will disrupt the cigarette market. The often emotional debate would benefit from dispassionate data-based evaluation of evidence. Methods After briefly discussing harm reduction in public health and specifically in tobacco control, this paper identifies major issues concerning e-cigarettes and reviews relevant evidence. Issues include: e-cigarettes’ risks compared to cigarette smoking; the effect of vaping on youth smoking; vaping’s impact on adult smoking cessation; the net long-term public health implications of vaping; and differences in views on policy issues. The intent is to provide a broad overview of issues and evidence, directing readers to more detailed reviews of specific issues. Findings Principal findings include the following: (1) while longitudinal studies suggest that vaping increases never-smoking young people’s odds of trying smoking, national survey data indicate that adolescents’ 30-day smoking prevalence decreased at an unprecedented rate precisely whereas vaping increased. Use of all other tobacco products also declined. (2) Recent population-level studies add evidence that vaping is increasing adult smoking cessation. (3) Vaping is likely to make a positive contribution to public health. Conclusions THR can be a complement to, not a substitute for, evidenced-based tobacco control interventions. Tobacco control professionals need to focus on objective assessment of and discussion about the potential costs and benefits of THR. Implications Participants on both sides of the divisive THR debate need to examine the complicated issues and evidence more objectively. This entails considering both the potential benefits and costs associated with reduced-risk products like e-cigarettes. Furthermore, it requires examining different kinds of evidence when considering specific issues. For example, those concerned by longitudinal study findings that vaping increases students’ trial of cigarettes should consider US national survey evidence that youth smoking has decreased at an unprecedented rate. A review of the major issues suggests that the potential of vaping to assist adult smokers to quit outweighs the potential negatives.
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Gaikwad, Rahul, Rahul Bhowate, Payal Bajad, and Shailesh Gondivkar. "Potential Predictor of Tobacco Cessation among Factory Workers: A Baseline Data of Worksite Tobacco Cessation Programs in the Central Part of India." Journal of Contemporary Dental Practice 18, no. 11 (2017): 1071–77. http://dx.doi.org/10.5005/jp-journals-10024-2178.
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ABSTRACT Aim Our study aimed to evaluate the prevalence of tobacco use among factory workers and identify the predicting factors for quitting tobacco use. Materials and methods In this cross-sectional study, a total of 640 factory workers were included and divided into the quitter group and who had never quit the tobacco habit in the past. Data were collected by standardized and validated questionnaire pro forma, which comprised the demographic profile, smoking history, and Fagerström scale to check the nicotine dependence. Data were analyzed using descriptive analysis and Chi-squares test, whereas logistic regression was used to predict the factor for quitting the tobacco habit. All tests were applied using Statistical Package for the Social Sciences (SPSS) version 17.0. Results The mean age among the quitters was comparatively low than the never-quit group. Out of 640 participants, the majority of quitters and those who never quit were found to consume smokeless tobacco (232 [93.5]; 288 [73.5]). As per logistic regression analysis, gender of participants, age of starting tobacco use, and frequency of tobacco use can be considered as good predictors to quit smoking/chewing tobacco. Conclusion The present study found that participants in the quitter group were less dependent on tobacco, and these participants were more likely to quit smoking if behavioral support was provided at the early days of the quitting attempt. Clinical significance This study's result provides valuable insight into the current tobacco usage and potential predicting factors for quitting tobacco use among factory workers in India. These data can help in developing a policy for the implementation of tobacco cessation programs at the worksite. How to cite this article Gaikwad R, Bhowate R, Bajad P, Gadbail AR, Gondivkar S, Sarode SC, Sarode GS, Patil S. Potential Predictor of Tobacco Cessation among Factory Workers: A Baseline Data of Worksite Tobacco Cessation Programs in the Central Part of India. J Contemp Dent Pract 2017;18(11):1071-1077.
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Abo-Tabik, Maryam, Yael Benn, and Nicholas Costen. "Are Machine Learning Methods the Future for Smoking Cessation Apps?" Sensors 21, no. 13 (June 22, 2021): 4254. http://dx.doi.org/10.3390/s21134254.
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Smoking cessation apps provide efficient, low-cost and accessible support to smokers who are trying to quit smoking. This article focuses on how up-to-date machine learning algorithms, combined with the improvement of mobile phone technology, can enhance our understanding of smoking behaviour and support the development of advanced smoking cessation apps. In particular, we focus on the pros and cons of existing approaches that have been used in the design of smoking cessation apps to date, highlighting the need to improve the performance of these apps by minimizing reliance on self-reporting of environmental conditions (e.g., location), craving status and/or smoking events as a method of data collection. Lastly, we propose that making use of more advanced machine learning methods while enabling the processing of information about the user’s circumstances in real time is likely to result in dramatic improvement in our understanding of smoking behaviour, while also increasing the effectiveness and ease-of-use of smoking cessation apps, by enabling the provision of timely, targeted and personalised intervention.
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Khudhir, Karwan Mahmood, Kochr Ali Mahmood, Kochar Khasro Saleh, and Mosharaf Hossain. "A cross sectional study to determine the prevalence and risk factors of low back pain among public technical institute staff in Kurdistan Region, Iraq." F1000Research 6 (February 23, 2017): 182. http://dx.doi.org/10.12688/f1000research.10806.1.
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There is a lack of quantitative data regarding exposure response relationships between low back pain (LBP) and associated risk factors among institute staff in Kurdistan Region, Iraq. This study explored such associations in an analytic cross-sectional study. Data collection was carried out with a self-administered questionnaire. A total of 70 (90%) institute staff from Koya Technical Institute (KTI) participated in this study. The findings indicated that 61.4% of KTI staff report LBP. Independent variables significantly associated with reporting LBP (P value <0.05) during past 12 months were smoking (OR=10.882; 95%CI=1.301-90.995) and job tenure (OR=3.159; 95% CI=1.072-9.312). In conclusion, LBP is significantly associated with smoking and years worked; therefore, workers should be educated on the effects of smoking not only as it relates to LBP, but also how it affects the whole body and how to quit it. This can be done through health promotion campaigns and programs sponsored by the university.
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Allem, Jon-Patrick, Allison Dormanesh, Anuja Majmundar, Jennifer B. Unger, Matthew G. Kirkpatrick, Akshat Choube, Aneesh Aithal, Emilio Ferrara, and Tess Boley Cruz. "Topics of Nicotine-Related Discussions on Twitter: Infoveillance Study." Journal of Medical Internet Research 23, no. 6 (June 7, 2021): e25579. http://dx.doi.org/10.2196/25579.
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Background Cultural trends in the United States, the nicotine consumer marketplace, and tobacco policies are changing. Objective The goal of this study was to identify and describe nicotine-related topics of conversation authored by the public and social bots on Twitter, including any misinformation or misconceptions that health education campaigns could potentially correct. Methods Twitter posts containing the term “nicotine” were obtained from September 30, 2018 to October 1, 2019. Methods were used to distinguish between posts from social bots and nonbots. Text classifiers were used to identify topics in posts (n=300,360). Results Prevalent topics of posts included vaping, smoking, addiction, withdrawal, nicotine health risks, and quit nicotine, with mentions of going “cold turkey” and needing help in quitting. Cessation was a common topic, with mentions of quitting and stopping smoking. Social bots discussed unsubstantiated health claims including how hypnotherapy, acupuncture, magnets worn on the ears, and time spent in the sauna can help in smoking cessation. Conclusions Health education efforts are needed to correct unsubstantiated health claims on Twitter and ultimately direct individuals who want to quit smoking to evidence-based cessation strategies. Future interventions could be designed to follow these topics of discussions on Twitter and engage with members of the public about evidence-based cessation methods in near real time when people are contemplating cessation.
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Sumodhee, Dayyanah, Rachel Povey, and Nikolas Pontikos. "‘It's a bit of a grey area’: challenges faced by stop smoking practitioners when advising on e-cigarettes." Journal of Smoking Cessation 15, no. 1 (December 16, 2019): 44–49. http://dx.doi.org/10.1017/jsc.2019.25.
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AbstractIntroductionAccording to UK guidelines, stop smoking practitioners are expected to be open and supportive towards e-cigarette users. As adequate support from practitioners can be instrumental for smokers to successfully quit smoking, it is crucial to explore the challenges that stop smoking practitioners face when advising on e-cigarette use.AimThis qualitative study explores the challenges that stop smoking practitioners face when advising patients on e-cigarettes.MethodsA qualitative study was conducted with semi-structured interviews with 10 stop smoking practitioners from four stop smoking services in London. Face to face interviews were recorded and transcribed verbatim. Inductive thematic analysis was conducted to explore practitioners' experiences when advising on e-cigarettes.FindingsTwo themes were noted: practitioners' concerns and practitioner–patient interactions. Practitioners were particularly concerned regarding the lack of information, safety issues and the maintenance of addiction linked with e-cigarettes. They emphasised the difficulty of advising on a product that they cannot prescribe. Overall, practitioners expressed the lack of confidence when advising on e-cigarettes since they were often unprepared and not able to answer patients' questions on e-cigarettes.ConclusionsStop smoking practitioners' lack of confidence and limited knowledge regarding e-cigarettes emphasises the necessity for training and guidance on e-cigarettes to improve their interactions with patients on this subject. In particular, practitioners need to be provided with clear guidance on how to counsel patients about how and where to buy e-cigarettes.
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Heath, Janie, Sara Young, Sharon Bennett, Mary Beth Ginn, and Geoffrey Cox. "Evidence-Based Smoking Cessation Interventions for Patients With Acute Respiratory Disorders." Annual Review of Nursing Research 27, no. 1 (December 2009): 273–96. http://dx.doi.org/10.1891/0739-6686.27.273.
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Worldwide, tobacco use continues to be the most significant preventable cause of death and hospital admissions, particularly related to respiratory diseases. Acute respiratory illnesses requiring hospitalization provide an opportunity for nurses to intervene and help smokers quit. Of the three top hospital admissions related to respiratory diseases, chronic obstructive pulmonary disease (COPD) is the one that continues to have increased mortality whereas community acquired pneumonia and asthma have decreased over the past 5 years. The course of all three can be caused or exacerbated by continued smoking. This review describes the state of the science of nursing research focused on tobacco cessation interventions for hospitalized patients with COPD, asthma, or community acquired pneumonia. Additionally, we describe two evidence-based, nurse-driven, hospital protocols to treat tobacco dependence that can serve as models of care. Recommendations are made as to how to effectively promote nursing interventions for tobacco cessation in the acute care setting.
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Peckham, Emily, Catherine Arundel, Della Bailey, Suzanne Crosland, Caroline Fairhurst, Paul Heron, Catherine Hewitt, et al. "A bespoke smoking cessation service compared with treatment as usual for people with severe mental ill health: the SCIMITAR+ RCT." Health Technology Assessment 23, no. 50 (September 2019): 1–116. http://dx.doi.org/10.3310/hta23500.
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Background There is a high prevalence of smoking among people with severe mental ill health (SMI). Helping people with SMI to quit smoking could improve their health and longevity, and reduce health inequalities. However, those with SMI are less likely to access and engage with routine smoking cessation services than the general population. Objectives To compare the clinical effectiveness and cost-effectiveness of a bespoke smoking cessation (BSC) intervention with usual stop smoking services for people with SMI. Design A pragmatic, two-arm, individually randomised controlled trial. Setting Primary care and secondary care mental health services in England. Participants Smokers aged ≥ 18 years with SMI who would like to cut down on or quit smoking. Interventions A BSC intervention delivered by mental health specialists trained to deliver evidence-supported smoking cessation interventions compared with usual care. Main outcome measures The primary outcome was self-reported, CO-verified smoking cessation at 12 months. Smoking-related secondary outcomes were self-reported smoking cessation, the number of cigarettes smoked per day, the Fagerström Test for Nicotine Dependence and the Motivation to Quit questionnaire. Other secondary outcomes were Patient Health Questionnaire-9 items, Generalised Anxiety Disorder Assessment-7 items and 12-Item Short-Form Health Survey, to assess mental health and body mass index measured at 6 and 12 months post randomisation. Results The trial randomised 526 people (265 to the intervention group, 261 to the usual-care group) aged 19 to 72 years (mean 46 years). About 60% of participants were male. Participants smoked between 3 and 100 cigarettes per day (mean 25 cigarettes per day) at baseline. The intervention group had a higher rate of exhaled CO-verified smoking cessation at 6 and 12 months than the usual-care group [adjusted odds ratio (OR) 12 months: 1.6, 95% confidence interval (CI) 0.9 to 2.8; adjusted OR 6 months: 2.4, 95% CI 1.2 to 4.7]. This was not statistically significant at 12 months (p = 0.12) but was statistically significant at 6 months (p = 0.01). In total, 111 serious adverse events were reported (69 in the BSC group and 42 in the usual-care group); the majority were unplanned hospitalisations due to a deterioration in mental health (n = 98). The intervention is likely (57%) to be less costly but more effective than usual care; however, this result was not necessarily associated with participants’ smoking status. Limitations Follow-up was not blind to treatment allocation. However, the primary outcome included a biochemically verified end point, less susceptible to observer biases. Some participants experienced difficulties in accessing nicotine replacement therapy because of changes in service provision. Efforts were made to help participants access nicotine replacement therapy, but this may have affected participants’ quit attempt. Conclusions People with SMI who received the intervention were more likely to have stopped smoking at 6 months. Although more people who received the intervention had stopped smoking at 12 months, this was not statistically significant. Future work Further research is needed to establish how quitting can be sustained among people with SMI. Trial registration Current Controlled Trials ISRCTN72955454. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 50. See the NIHR Journals Library website for further project information.
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Aveyard, Paul, Nicola Lindson, Sarah Tearne, Rachel Adams, Khaled Ahmed, Rhona Alekna, Miriam Banting, et al. "Nicotine preloading for smoking cessation: the Preloading RCT." Health Technology Assessment 22, no. 41 (August 2018): 1–84. http://dx.doi.org/10.3310/hta22410.
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BackgroundNicotine preloading means using nicotine replacement therapy prior to a quit date while smoking normally. The aim is to reduce the drive to smoke, thereby reducing cravings for smoking after quit day, which are the main cause of early relapse. A prior systematic review showed inconclusive and heterogeneous evidence that preloading was effective and little evidence of the mechanism of action, with no cost-effectiveness data.ObjectivesTo assess (1) the effectiveness, safety and tolerability of nicotine preloading in a routine NHS setting relative to usual care, (2) the mechanisms of the action of preloading and (3) the cost-effectiveness of preloading.DesignOpen-label randomised controlled trial with examination of mediation and a cost-effectiveness analysis.SettingNHS smoking cessation clinics.ParticipantsPeople seeking help to stop smoking.InterventionsNicotine preloading comprised wearing a 21 mg/24 hour nicotine patch for 4 weeks prior to quit date. In addition, minimal behavioural support was provided to explain the intervention rationale and to support adherence. In the comparator group, participants received equivalent behavioural support. Randomisation was stratified by centre and concealed from investigators.Main outcome measuresThe primary outcome was 6-month prolonged abstinence assessed using the Russell Standard. The secondary outcomes were 4-week and 12-month abstinence. Adverse events (AEs) were assessed from baseline to 1 week after quit day. In a planned analysis, we adjusted for the use of varenicline (Champix®; Pfizer Inc., New York, NY, USA) as post-cessation medication. Cost-effectiveness analysis took a health-service perspective. The within-trial analysis assessed health-service costs during the 13 months of trial enrolment relative to the previous 6 months comparing trial arms. The base case was based on multiple imputation for missing cost data. We modelled long-term health outcomes of smoking-related diseases using the European-study on Quantifying Utility of Investment in Protection from Tobacco (EQUIPT) model.ResultsIn total, 1792 people were eligible and were enrolled in the study, with 893 randomised to the control group and 899 randomised to the intervention group. In the intervention group, 49 (5.5%) people discontinued preloading prematurely and most others used it daily. The primary outcome, biochemically validated 6-month abstinence, was achieved by 157 (17.5%) people in the intervention group and 129 (14.4%) people in the control group, a difference of 3.02 percentage points [95% confidence interval (CI) –0.37 to 6.41 percentage points; odds ratio (OR) 1.25, 95% CI 0.97 to 1.62;p = 0.081]. Adjusted for use of post-quit day varenicline, the OR was 1.34 (95% CI 1.03 to 1.73;p = 0.028). Secondary abstinence outcomes were similar. The OR for the occurrence of serious AEs was 1.12 (95% CI 0.42 to 3.03). Moderate-severity nausea occurred in an additional 4% of the preloading group compared with the control group. There was evidence that reduced urges to smoke and reduced smoke inhalation mediated the effect of preloading on abstinence. The incremental cost-effectiveness ratio at the 6-month follow-up for preloading relative to control was £710 (95% CI –£13,674 to £23,205), but preloading was dominant at 12 months and in the long term, with an 80% probability that it is cost saving.LimitationsThe open-label design could partially account for the mediation results. Outcome assessment could not be blinded but was biochemically verified.ConclusionsUse of nicotine-patch preloading for 4 weeks prior to attempting to stop smoking can increase the proportion of people who stop successfully, but its benefit is undermined because it reduces the use of varenicline after preloading. If this latter effect could be overcome, then nicotine preloading appears to improve health and reduce health-service costs in the long term. Future work should determine how to ensure that people using nicotine preloading opt to use varenicline as cessation medication.Trial registrationCurrent Controlled Trials ISRCTN33031001.FundingThis project was funded by the NIHR Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 22, No. 41. See the NIHR Journals Library website for further project information.
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Glasser, Allison M., Alexis Barton, Jessica Rath, Bethany Simard, Shyanika W. Rose, Elizabeth Hair, and Donna Vallone. "Perceptions of Use Patterns and Health Consequences Associated With Mentholated Cigarettes Among U.S. Adults." Health Education & Behavior 47, no. 2 (January 31, 2020): 284–92. http://dx.doi.org/10.1177/1090198119897608.
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Despite declines in overall cigarette smoking in the United States, menthol cigarette smoking prevalence has increased among young adults (18-25 years) and remains constant among older adults (26 years and older). Disparities in menthol cigarette use exist, with higher prevalence among younger adult smokers and among racial/ethnic minority populations. Menthol in cigarettes has been shown to play a role in increasing smoking initiation and making it more difficult to quit smoking. Little research focuses on perceptions of the addictive potential and health consequences of menthol cigarette use. This analysis uses data from a national panel of U.S. adults ( n = 1,303) surveyed in 2016. Participants were asked to what extent they agreed with various statements regarding menthol use among demographic and tobacco use subgroups. These data reveal disparities in perceptions of the impact of menthol use, with Black, non-Hispanic, and Hispanic adults and adults with lower income and less education misperceiving the health effects and addiction potential of menthol in cigarettes. Determining how and to what extent population subgroups understand the effect of menthol cigarette use can inform public education strategies and, in turn, policy efforts to ban or restrict menthol cigarette availability.
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Kim, Jihyun, Hayeon Song, Kelly Merrill Jr, Younbo Jung, and Remi Junghuem Kwon. "Using Serious Games for Antismoking Health Campaigns: Experimental Study." JMIR Serious Games 8, no. 4 (December 2, 2020): e18528. http://dx.doi.org/10.2196/18528.
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Background Serious games for health have been gaining in popularity among scholars and practitioners. However, there remain a few questions to be addressed. Objective This study tests the effects of a serious game and fear appeals on smoking-related outcomes. More specifically, this research aims to understand how serious games function as a more effective vehicle for a health campaign than a traditional medium, such as a print-based pamphlet. Further, while serious games utilize a variety of persuasive strategies in the game’s content, it is not clear whether fear appeals, which are widely used persuasive-message strategies for health, can be an effective strategy in serious games. Thus, we are testing the effect of fear appeals in a serious game. Methods We created a computer game and a print brochure to educate participants about the risks of smoking. More specifically, a flash-based single-player game was developed in which players were asked to avoid cigarettes in the gameplay context. We also developed an online brochure based on existing smoking-related brochures at a university health center; antismoking messages on the computer game and in the brochure were comparable. Then, an experiment using a 2 (media type: game vs. print) x 2 (fearful image: fear vs. no-fear) between-subjects design was conducted. The study recruitment was announced to undergraduate students enrolled in a large, public Midwestern university in the United States. After a screening test, a total of 72 smokers, who reported smoking in the past 30 days, participated in the experiment. Results Overall, gameplay, when compared to print-based pamphlets, had greater impacts on attitudes toward smoking and the intention to quit smoking. Further, the game’s persuasive effects were especially pronounced when messages contained fear appeals. When fearful images were presented, participants in the game condition reported significantly more negative attitudes toward social smoking than those in the print condition [F(1,67)=7.28; P=.009; ηp2=0.10]. However, in the no-fear condition, there was no significant difference between the conditions [F(1,67)=0.25; P=.620]. Similarly, the intention to quit smoking [F(1,67)=4.64; P=.035; ηp2=0.07] and susceptibility [F(1,67)=6.92; P=.011; ηp2=0.09] were also significantly different between the conditions, but only when fear appeals were used. Conclusions This study extends fear appeal research by investigating the effects of different media types. It offers empirical evidence that a serious game can be an effective vehicle for fear appeals.
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Thomas, Kristin, Marcus Bendtsen, Catharina Linderoth, and Preben Bendtsen. "Implementing Facilitated Access to a Text Messaging, Smoking Cessation Intervention Among Swedish Patients Having Elective Surgery: Qualitative Study of Patients’ and Health Care Professionals’ Perspectives." JMIR mHealth and uHealth 8, no. 9 (September 18, 2020): e17563. http://dx.doi.org/10.2196/17563.
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Background There is strong evidence that short-term smoking cessation before surgery can reduce postoperative morbidity. There are, however, several structural problems in health care systems concerning how to implement smoking cessation interventions in routine practice for preoperative patients. Objective This study aimed to analyze the implementation of a text messaging, smoking cessation intervention targeting patients having elective surgery. Implementation of facilitated access (ie, referral from practitioners) and the perceived usefulness among patients were investigated. Elective surgery is defined as scheduled, nonacute surgery. Methods A qualitative study was carried out at two medium-sized hospitals in the south of Sweden. The implementation of facilitated access was investigated during a 12-month period from April 2018 to April 2019. Facilitated access was conceptualized as specialists recommending the text messaging intervention to patients having elective surgery. Implementation was explored in terms of perceptions about the intervention and behaviors associated with implementation; that is, how patients used the intervention and how specialists behaved in facilitating usage among patients. Two focus groups with smoking cessation specialists and 10 individual interviews with patients were carried out. Qualitative content analysis was used to analyze the data. Results Two main categories were identified from the focus group data with smoking cessation specialists: implementation approach and perceptions about the intervention. The first category, implementation approach, referred to how specialists adapted their efforts to situational factors and to the needs and preferences of patients, and how building of trust with patients was prioritized. The second category, perceptions about the intervention, showed that specialists thought the content and structure of the text messaging intervention felt familiar and worked well as a complement to current practice. Two categories were identified from the patient interview data: incorporating new means of support from health care and determinants of use. The first category referred to how patients adopted and incorporated the intervention into their smoking cessation journey. Patients were receptive, shared the text messages with friends and family, humanized the text messages, and used the messages as a complement to other strategies to quit smoking. The second category, determinants of use, referred to aspects that influenced how and when patients used the intervention and included the following: timing of the intervention and text messages, motivation to change, and perceptions of the mobile phone medium. Conclusions Smoking cessation specialists adopted an active role in implementing the intervention by adapting their approach and fitting the intervention into existing routines. Patients showed strong motivation to change and openness to incorporate the intervention into their behavior change journey; however, the timing of the intervention and messages were important in optimizing the support. A text messaging, smoking cessation intervention can be a valuable and feasible way to reach smoking patients having elective surgery.
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Sohlberg, Tove, and Peter Wennberg. "Developmental pathways to smoking cessation." Drugs and Alcohol Today 14, no. 2 (May 27, 2014): 96–106. http://dx.doi.org/10.1108/dat-11-2013-0046.
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Purpose – To a great extent research about smoking cessation has focussed on effects from different support programs and means, in spite of that several studies have shown that over 90 percent quit smoking without such help. Factors that are important for the individual in the process from being a smoker to becoming smoke-free is less examined and also how these factors interact. The purpose of this paper is to describe typical careers or pathways that end up with a successful smoking cessation. Design/methodology/approach – Respondents were recruited during Oct 2009-May 2010 via screening-questions in the so-called Monitor – project. By the turn of each month 1,500 individuals, aged 16-84, from a representative sample in the Swedish population, were interviewed via telephone. Respondents who stated being previous daily smokers, but smoke-free for at least 12 months, and agreed to participate were asked to answer a postal survey (n=1,683) concerning their process to a smoke-free life. The analyses of data included the linking of individuals between different states in the stages toward becoming smoke-free. Findings – Several typical pathways were described and respondents with more severe smoking habits followed different pathways than individuals with milder problems. Nicotine replacement therapys or Swedish smoke-free tobacco was not found to be a component in any of the typical pathways. Originality/value – Smoking cessation is a heterogeneous phenomenon and individuals can follow several pathways to become smoke-free, therefore this study adds to a more nuanced picture of smoking cessation and also expands the knowledge concerning smoking cessation in individual long-term processes.
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Gigliotti, Analice, and Ronaldo Laranjeira. "Habits, attitudes and beliefs of smokers in four Brazilian capitals." Revista Brasileira de Psiquiatria 27, no. 1 (March 2005): 37–44. http://dx.doi.org/10.1590/s1516-44462005000100010.
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Tobacco consumption is a major cause of death and disease, and quitting smoking is the most important thing smokers can do to benefit their health. As of the last census, 32.5% of the Brazilian population smoked, but little is known about how many wish to quit and which factors can influence them to make such a decision. OBJECTIVE: To analyze the habits, attitudes and believes of smokers in four major Brazilian cities and compare the results with data from 17 European countries. METHODS: A total of 800 smokers were interviewed. The interviews were conducted in person and individually, using a semi-structured questionnaire. Smokers were defined as individuals who smoke at least one cigarette per week. They were recruited by intentional sampling (confronted on the street and invited to answer the questionnaire) according to pre-established quotas based on social class, gender, occupation and age. Therefore, the number of interviews in a certain population stratum within the sample was determined according to the proportion of smokers generally represented by that stratum. RESULTS: The majority of smokers interviewed presented a low to moderate degree of dependence and wanted to stop smoking. The greater was the motivation to quit, the higher was the number of quitting attempts, as well as the probability of having received medical advice. Only 21% of the smokers had been advised to stop smoking by their doctors. The factor cited by smokers as the one that would most influence their future efforts to stop was "concern about exposing children, relatives and friends to tobacco smoke". The population of Brazil, in contrast to those of European countries, seems to have a high degree of consciousness regarding the fight against tobacco.
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Moodie, Crawford, Anne Marie MacKintosh, James F. Thrasher, Ann McNeill, and Sara Hitchman. "Use of Cigarettes With Flavor-Changing Capsules Among Smokers in the United Kingdom: An Online Survey." Nicotine & Tobacco Research 21, no. 11 (August 24, 2018): 1547–55. http://dx.doi.org/10.1093/ntr/nty173.
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Abstract Introduction Cigarettes with flavor-changing capsules in the filter have experienced phenomenal global growth in the last decade. We explore sociodemographic and smoking-related factors associated with using capsule cigarettes, how frequently users burst the capsule, and reasons for using them. Methods An online survey was conducted in the United Kingdom between April and May 2016 with 6234 factory-made and/or hand-rolled cigarette smokers. This analysis focuses on 3620 factory-made cigarette smokers, aged 18 years and over, who had smoked in the past month. Results Thirteen percent smoked capsule cigarettes, with younger smokers more likely than older smokers to do so. Capsule use was significantly more common among White non-British than White British and among those planning to quit in the next 6 months than those not planning to quit. Most capsule users who crushed the capsule did so always (51%) or most of the time (18%), with more frequent crushing of capsules more common among females, younger and middle-aged participants, White British, and those with a lower score on the Heaviness of Smoking Index. The most common reasons for using capsule cigarettes were that they taste better (52%), are smoother (41%), provide a choice of flavors (32%), and the enjoyment of clicking the capsule (25%). Capsule and noncapsule smokers did not differ significantly in their perceptions of the harmfulness of their brand relative to other brands. Conclusions Our study provides an insight into how and why smokers of capsule cigarettes use these products, with the key drivers of use being taste, flavor choice, and interactivity. Implications Cigarettes with capsules in the filter that can be burst to change the flavor have experienced remarkable growth since being introduced in 2007, but little is known about how and why smokers use these products. Thirteen percent of factory-made cigarette smokers in our sample smoked a brand with a capsule in the filter, with approximately two-thirds crushing the capsule all or most of the time. Capsule use was more likely among younger participants. The main reasons for smoking capsule cigarettes were related to how they taste, having a choice of flavors, and enjoyment of clicking the capsule (interactivity).
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Johnston, Robyn, Lydia Hearn, Donna Cross, Laura T. Thomas, and Sharon Bell. "Parent voices guide smoking intervention development." Health Education 115, no. 5 (August 3, 2015): 455–69. http://dx.doi.org/10.1108/he-03-2014-0024.
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Purpose – While parents’ influence on their children’s smoking behaviour is widely recognised, little is known about parents of four to eight year olds’ attitudes and beliefs around smoking cessation and how they communicate with their children about smoking. The purpose of this paper is to explore parents’ perceptions of quitting smoking and their beliefs and actions related to the use of parenting practices to discourage smoking by their children. Design/methodology/approach – Four focus groups and 17 interviews were conducted with parents (n=46) of four to eight year old children in Perth, Western Australia. Findings – Many parents indicated their children strongly influenced their quitting behaviours, however, some resented being made to feel guilty about their smoking because of their children. Parents were divided in their beliefs about the amount of influence they had on their children’s future smoking. Feelings of hypocrisy appear to influence the extent to which parents who smoked talked with their child about smoking. Parents recommended a variety of resource options to support quitting and talking with their child about smoking. Practical implications – Interventions aimed at parents who smoke and have young children should: reinforce parents’ importance as role models; highlight the importance of talking to children about smoking when they are young and provide strategies for maintaining ongoing communication; be supportive and avoid making parents feel guilty; and emphasise that quitting smoking is the best option for their child’s health (and their own), while also providing effective harm minimisation options for parents who have not yet quit. Originality/value – Parents of children of lower primary school age can be highly influential on their children’s later smoking behaviours, thus, effective interventions that address the current beliefs and practices of these parents may be particularly advantageous.
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Bendtsen, Marcus, Kristin Thomas, Catharina Linderoth, and Preben Bendtsen. "Effects of a Text Messaging Smoking Cessation Intervention Among Online Help Seekers and Primary Health Care Visitors in Sweden: Protocol for a Randomized Controlled Trial Using a Bayesian Group Sequential Design." JMIR Research Protocols 9, no. 12 (December 3, 2020): e23677. http://dx.doi.org/10.2196/23677.
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Background A steady decline of the smoking prevalence in Sweden has been recorded over the past decade; however, people still start and continue to smoke. There is a need for effective smoking cessation interventions that can scale to a national level and that are designed to reach individuals requiring smoking cessation support in the general population. Objective Previous randomized controlled trials of smoking cessation interventions among high school and university students in Sweden have found consistent evidence that text messaging interventions are effective in helping students quit smoking. However, there are no studies that investigate the effects of text messaging interventions in a more general population. The objective of this study is to estimate the effects of a text messaging intervention on individuals seeking help to quit online and individuals visiting primary health care units. Methods A 2-arm, parallel-group (1:1), randomized controlled trial will be employed to address the study objectives. The trial will follow a Bayesian group sequential design. Recruitment will be conducted using online advertisement (Google, Bing, and Facebook) and through health care professionals at primary health care units. All participants will receive treatment as usual; however, participants who are allocated to the intervention arm will also be given access to a 12-week text message smoking cessation intervention. Primary outcomes are 8-week prolonged abstinence and 4-week point prevalence, measured 3 months and 6 months postrandomization. Mediator variables (self-efficacy, importance, and know-how) will be measured to estimate causal mediation models. Results Recruitment commenced in September 2020 and will not exceed 24 months. This means that a complete dataset will be available at the latest towards the end of 2022. We expect to publish the findings from this trial by June 2023. Conclusions This trial will further our understanding of the effects of text messaging interventions among a more general population than has previously been studied. We also aim to learn about differential effects between those who seek support online and those who are given facilitated support at primary health care units. Trial recruitment is limited to the Swedish population; however, a strength of this study is the pragmatic way in which participants are recruited. Through online advertisements, individuals are recruited in reaction to their own interest in seeking help to quit. At primary health care units, individuals who were not necessarily looking for smoking cessation support are given information about the trial. This closely mimics the way the intervention would be disseminated in a real-world setting and may therefore strengthen the argument of generalizability of findings. Trial Registration ISRCTN 13455271; http://www.isrctn.com/ISRCTN13455271. International Registered Report Identifier (IRRID) PRR1-10.2196/23677
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Ehret, Phillip J., and David K. Sherman. "Public Policy and Health." Policy Insights from the Behavioral and Brain Sciences 1, no. 1 (October 2014): 222–30. http://dx.doi.org/10.1177/2372732214549472.
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Public policies designed to improve health and well-being are challenged by people’s resistance. A social psychological perspective reveals how health policies can pose a psychological threat to individuals and result in resistance to following health recommendations. Self-affirmation, a brief psychological intervention that has individuals focus on important personal values, can help reduce resistance to behavior change and help promote health and well-being in four health-policy domains: graphic cigarette warning labels designed to get people to quit smoking, community health programs targeted at high-risk populations, alcohol intervention and prevention programs targeted at problem drinkers, and adherence to medical recommendations and treatment regimens among people coping with disease. Using self-affirmation has important strengths and limitations as a tool to help policymakers and practitioners encourage better health choices.
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Neil, JM, SN Price, ER Friedman, C. Ponzani, JS Ostroff, A. Muzikansky, and ER Park. "Patient-Level Factors Associated with Oncology Provider-Delivered Brief Tobacco Treatment Among Recently Diagnosed Cancer Patients." Tobacco Use Insights 13 (January 2020): 1179173X2094927. http://dx.doi.org/10.1177/1179173x20949270.
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Background: A cancer diagnosis is seen as a “teachable moment” for patients to consider changing their behavioral risk factors, such as smoking. It also offers an opportunity for oncology providers to engage in a dialogue about how they can support patients changing their smoking behaviors. Brief, evidence-based tobacco cessation treatment delivered by oncology providers through the 5As (Ask, Advise, Assess, Assist Arrange) model is recommended, but provision to cancer patients remains suboptimal. Aim: Explore patient-level factors associated with 5As receipt among current smokers with a newly diagnosed cancer. Method: A total of 303 patients self-reported whether they received each of the 5As during their most recent oncology care visit. Multivariable regression analyses were conducted to identify patient-level factors associated with 5As receipt. Results: Oncology provider-delivered 5As rates ranged from 81.5% (Ask) to 30.7% (Arrange). 5As receipt was associated with: reporting lower illness-related stigma, diagnosis of a comorbid smoking-related disease, diagnosis of a smoking-related cancer, and diagnosis of a non-advanced cancer. Conclusion: Findings support previous literature in which smoking-related diagnoses were associated with greater receipt of 5As; however, disparities in the receipt of 5As existed for patients with more advanced cancer diagnoses and illness-related stigma. Inequities in the provision of quit assistance may further decrease treatment effectiveness and survival expectancy among certain patient populations. These findings are, therefore, important as they identify specific patient-level factors associated with lower 5As receipt among newly diagnosed cancer patients.
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Grabovac, Igor, Helmut Brath, Horst Schalk, Olaf Degen, and Thomas E. Dorner. "Clinical setting-based smoking cessation programme and the quality of life in people living with HIV in Austria and Germany." Quality of Life Research 26, no. 9 (April 20, 2017): 2387–95. http://dx.doi.org/10.1007/s11136-017-1580-y.
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Abstract Purpose To report on the global quality of life (QOL) in people living with HIV (PLWHIV) and how a smoking cessation intervention influences the changes in QOL. Methods Participants were asked to fill out a questionnaire during visits to their HIV outpatient clinic consisting of sociodemographic information, general health data and the WHOQOL HIV-Bref. Exhaled carbon monoxide measurements were used to confirm the smoking status, based on which participants classified as smokers received a short 5 min structured intervention and were offered participation in a full smoking cessation programme consisting of five sessions. Follow-up was done 8 months after the baseline. Results Overall 447 (mean age = 45.5) participants took part with 221 being classified as smokers. A total of 165 (74.6%) participants received a short intervention and 63 (29.4%) agreed to participate in the full program. At baseline, differences in QoL were observed, where smokers had lower QoL in domains of physical (M = 16.1 vs. 15.3, p = 0.009) and psychological (M = 15.3 vs. 14.6, p = 0.021) well-being, independency level (M = 16.1 vs. 15.2, p = 0.003) and environment (M = 16.5 vs. 16.0, p = 0.036). At study end, 27 (12.2%) participants quit smoking; 12 (19.0%) participants of the full programme and 15 (14.7%) that received the short intervention. There were no significant differences in QoL between those that continued to smoke and quitters at follow-up. Conclusion Quality of life results may be used to better understand the underlying motivation of PLWHIV who start cessation programs. In order to reduce the high prevalence and health burden that smoking causes in PLWHIV, it is necessary to introduce effective interventions that can be used in the clinical settings.
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Esbensen, B. A., I. K. Roelsgaard, S. K. Larsen, and T. Thomsen. "AB1326-HPR TOBACCO ADDICTION IN PEOPLE WITH RHEUMATOID ARTHRITIS – FROM THE PERSPECTIVE OF PATIENTS." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 1952.2–1952. http://dx.doi.org/10.1136/annrheumdis-2020-eular.965.
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Background:Smoking is one of the most significant modifiable exosomes risk factors for rheumatoid arthritis (RA) (1). Studies suggest that 25-30% of people with RA in Denmark smoke (2). This is almost twice as many as in the background population in Denmark. People with RA have a significant increased risk of severe comorbidity including cardiovascular disease. In addition, there are indications that smokers with RA have a poorer effect of the medical inflammatory treatment compared to non-smokers, and consequently more difficult to achieve remission of the disease activity (3). Tobacco addiction is complex and can be a challenge in smoking cessation. In addition to physiological dependence, habits and social and environmental factors may influence addiction. Tobacco smoking is associated with an addiction to nicotine and it is unexplored how this addiction appears in people with RA.Objectives:The aim of this study was to examine from the patient’s perspective how tobacco addiction appears in people with rheumatoid arthritis.Methods:We conducted a qualitative study based on a hermeneutics approach. People with RA who previously had participated in a randomized controlled study (4) about smoking cessation conducted at the Center for Rheumatology and Spine Diseases at Rigshospitalet, Denmark were recruited for semi-structured interviews.Results:In total, 12 people with RA (50% female) were included in the study. The median age was 62 years and median RA disease duration was 12 years. The degree of physical dependence measured by Fagerströms Test for Nicotine dependence (FTND) was on average: 4.9 (score: 0-10, 0=nonphysical dependence).Three categories of how tobacco addiction appeared emerged during the analysis: 1)It develops into ingrown habitsreferring to the fact that smoking already in adolescence contributes to the development of specific physical, mental and social smoking behavior. Not all individuals considered themselves addicted to nicotine as they did not necessarily connect the nicotine to the ingrown habits. 2)The body craves for nicotinereferring to nicotine proved calming, while a lacking or insufficient dose caused withdrawal symptoms. Furthermore, smoking became a habit where a craving for smoking occurred in certain situations. 3)Ambivalence – for and againstreferring to the physical dependence and smoking habits making a smoking cessation difficult. Dependency to nicotine and challenges to quit smoking led to a feeling of ambivalence and a lack of control.Conclusion:Tobacco addiction appeared as a physical dependence and a habit, which, during a smoking cessation, led to ambivalent feelings. Therefore, based on this study, there is still a need for health professionals to talk to patients about smoking. But also, a need to articulate the complexity of addiction in order to support for smoking cessations. Information should be strengthened in the clinical practice in relation to nicotine’s implication in tobacco addiction as well as the consequences of tobacco smoking for individuals with RA.References:[1]Scott DL, Wolfe F, Huizinga TW. Lancet. 2010 ###[2]Loppenthin K, Esbensen BA, Jennum P, Ostergaard M, Tolver A, Thomsen T, et al. Clin Rheumatol. 2015. ###[3]Roelsgaard IK, Ikdahl E, Rollefstad S, Wibetoe G, Esbensen BA, Kitas GD, et al. Rheumatology (Oxford). 2019. ###[4]Roelsgaard IK, Thomsen T, Ostergaard M, Christensen R, Hetland ML, Jacobsen S, et al. Trials. 2017;18(1):570.###Disclosure of Interests:None declared
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Perski, Olga, Noreen L. Watson, Kristin E. Mull, and Jonathan B. Bricker. "Identifying Content-Based Engagement Patterns in a Smoking Cessation Website and Associations With User Characteristics and Cessation Outcomes: A Sequence and Cluster Analysis." Nicotine & Tobacco Research 23, no. 7 (January 12, 2021): 1103–12. http://dx.doi.org/10.1093/ntr/ntab008.
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Abstract Introduction Using WebQuit as a case study, a smoking cessation website grounded in Acceptance and Commitment Therapy, we aimed to identify sequence clusters of content usage and examine their associations with baseline characteristics, change to a key mechanism of action, and smoking cessation. Methods Participants were adult smokers allocated to the WebQuit arm in a randomized controlled trial (n = 1,313). WebQuit contains theory-informed content including goal setting, self-monitoring and feedback, and values- and acceptance-based exercises. Sequence analysis was used to temporally order 30-s website usage segments for each participant. Similarities between sequences were assessed with the optimal matching distance algorithm and used as input in an agglomerative hierarchical clustering analysis. Associations between sequence clusters and baseline characteristics, acceptance of cravings at 3 months and self-reported 30-day point prevalence abstinence at 12 months were examined with linear and logistic regression. Results Three qualitatively different sequence clusters were identified. “Disengagers” (576/1,313) almost exclusively used the goal-setting feature. “Tryers” (375/1,313) used goal setting and two of the values- and acceptance-based components (“Be Aware,” “Be Willing”). “Committers” (362/1,313) primarily used two of the values- and acceptance-based components (“Be Willing,” “Be Inspired”), goal setting, and self-monitoring and feedback. Compared with Disengagers, Committers demonstrated greater increases in acceptance of cravings (p = .01) and 64% greater odds of quit success (ORadj = 1.64, 95% CI = 1.18, 2.29, p = .003). Discussion WebQuit users were categorized into Disengagers, Tryers, and Committers based on their qualitatively different content usage patterns. Committers saw increases in a key mechanism of action and greater odds of quit success. Implications This case study demonstrates how employing sequence and cluster analysis of usage data can help researchers and practitioners gain a better understanding of how users engage with a given eHealth intervention over time and use findings to test theory and/or to improve future iterations to the intervention. Future WebQuit users may benefit from being directed to the values- and acceptance-based and the self-monitoring and feedback components via reminders over the course of the program.
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Partos, Timea R., Rosemary Hiscock, Anna B. Gilmore, J. Robert Branston, Sara Hitchman, and Ann McNeill. "Impact of tobacco tax increases and industry pricing on smoking behaviours and inequalities: a mixed-methods study." Public Health Research 8, no. 6 (April 2020): 1–140. http://dx.doi.org/10.3310/phr08060.
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Background Increasing tobacco prices through taxation is very effective for reducing smoking prevalence and inequalities. For optimum effect, understanding how the tobacco industry and smokers respond is essential. Tobacco taxation changes occurred in the UK over the study period, including annual increases, a shift in structure from ad valorem to specific taxation and relatively higher increases on roll-your-own tobacco than on factory-made cigarettes. Objectives Understanding tobacco industry pricing strategies in response to tax changes and the impact of tax on smokers’ behaviour, including tax evasion and avoidance, as well as the effect on smoking inequalities. Synthesising findings to inform how taxation can be improved as a public health intervention. Design Qualitative analysis and evidence synthesis (commercial and Nielsen data) and longitudinal and aggregate cross-sectional analyses (International Tobacco Control Policy Evaluation Project data). Setting The UK, from 2002 to 2016. Data sources and participants Data were from the tobacco industry commercial literature and retail tobacco sales data (Nielsen, New York, NY, USA). Participants were a longitudinal cohort (with replenishment) of smokers and ex-smokers from 10 surveys of the International Tobacco Control Policy Evaluation Project (around 1500 participants per survey). Main outcome measures (1) Tobacco industry pricing strategies, (2) sales volumes and prices by segments over time and (3) smokers’ behaviours, including products purchased, sources, brands, consumption, quit attempts, success and sociodemographic differences. Review methods Tobacco industry commercial literature was searched for mentions of tobacco products and price segments, with 517 articles extracted. Results The tobacco industry increased prices on top of tax increases (overshifting), particularly on premium products, and, recently, the tobacco industry overshifted more on cheap roll-your-own tobacco than on factory-made cigarettes. Increasingly, price rises were from industry revenue generation rather than tax. The tobacco industry raised prices gradually to soften impact; this was less possible with larger tax increases. Budget measures to reduce cheap product availability failed due to new cheap factory-made products, price marking and small packs. In 2014, smokers could buy factory-made (roll-your-own tobacco) cigarettes at real prices similar to 2002. Exclusive roll-your-own tobacco and mixed factory-made cigarettes and roll-your-own tobacco use increased, whereas exclusive factory-made cigarette use decreased, alongside increased cheap product use, rather than quitting. Quitting behaviours were associated with higher taxes. Smokers consumed fewer factory-made cigarettes and reduced roll-your-own tobacco weight over time. Apparent illicit purchasing did not increase. Disadvantaged and dependent smokers struggled with tobacco affordability and were more likely to smoke cheaper products, but disadvantage did not affect quit success. Limitations Different for each data set; triangulation increased confidence. Conclusions The tobacco industry overshifted taxes and increased revenues, even when tax increases were high. Therefore, tobacco taxes can be further increased to reduce price differentials and recoup public health costs. Government strategies on illicit tobacco appear effective. Large, sudden tax increases would reduce the industry’s ability to manipulate prices, decrease affordability and increase quitting behaviours. More disadvantaged, and dependent, smokers need more help with quitting. Future work Assessing the impact of tax changes made since 2014; changing how tax changes are introduced (e.g. sudden intermittent or smaller continuous); and tax changes on tobacco initiation. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 6. See the NIHR Journals Library website for further project information.
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Watson, Noreen L., Jaimee L. Heffner, Kristin E. Mull, Jennifer B. McClure, and Jonathan B. Bricker. "Which Method of Assessing Depression and Anxiety Best Predicts Smoking Cessation: Screening Instruments or Self-Reported Conditions?" Nicotine & Tobacco Research 22, no. 10 (June 2, 2020): 1860–66. http://dx.doi.org/10.1093/ntr/ntaa099.
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Abstract Introduction Affective disorders and symptoms (ADS) are predictive of lower odds of quitting smoking. However, it is unknown which approach to assessing ADS best predicts cessation. This study compared a battery of ADS screening instruments with a single, self-report question on predicting cessation. Among those who self-reported ADS, we also examined if an additional question regarding whether participants believed the condition(s) might interfere with their ability to quit added predictive utility to the single-item question. Methods Participants (N = 2637) enrolled in a randomized controlled trial of web-based smoking treatments completed a battery of five ADS screening instruments and answered a single-item question about having ADS. Those with a positive self-report on the single-item question were also asked about their interference beliefs. The primary outcome was complete-case, self-reported 30-day point prevalence abstinence at 12 months. Results Both assessment approaches significantly predicted cessation. Screening positive for ≥ one ADS in the battery was associated with 23% lower odds of quitting than not screening positive for any (p = .023); those with a positive self-report on the single-item had 39% lower odds of quitting than self-reporting no mental health conditions (p < .001). Area under the receiver operating characteristic curve values for the two assessment approaches were similar (p = .136). Adding the interference belief question to the single-item assessment significantly increased the area under the receiver operating characteristic curve value (p = .042). Conclusions The single-item question assessing ADS had as much predictive validity, and possibly more, than the battery of screening instruments for identifying participants at risk for failing to quit smoking. Adding a question about interference beliefs significantly increased the predictive utility of the single-item question. Implications This is the first study to demonstrate that a single-item question assessing ADS has at least as much predictive validity, and possibly more, than a battery of validated screening instruments for identifying smokers at highest risk for cessation failure. This study also demonstrates adding a question about interference beliefs significantly adds to the predictive utility of a single, self-report question about mental health conditions. Findings from this study can be used to inform decisions regarding how to assess ADS in the context of tobacco treatment settings.
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Meacham, Meredith C., Erin A. Vogel, and Johannes Thrul. "Vaping-Related Mobile Apps Available in the Google Play Store After the Apple Ban: Content Review." Journal of Medical Internet Research 22, no. 11 (November 13, 2020): e20009. http://dx.doi.org/10.2196/20009.
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Background In response to health concerns about vaping devices (eg, youth nicotine use, lung injury), Apple removed 181 previously approved vaping-related apps from the App Store in November 2019. This policy change may lessen youth exposure to content that glamorizes vaping; however, it may also block important sources of information and vaping device control for adults seeking to use vaping devices safely. Objective Understanding the types of nicotine and cannabis vaping–related apps still available in the competing Google Play Store can shed light on how digital apps may reflect information available to consumers. Methods In December 2019, we searched the Google Play Store for vaping-related apps using the keywords "vape" and "vaping" and reviewed the first 100 apps presented in the results. We reviewed app titles, descriptions, screenshots, and metadata to categorize the intended substance (nicotine or cannabis/tetrahydrocannabinol) and the app’s purpose. The most installed apps in each purpose category were downloaded and evaluated for quality and usability with the Mobile App Rating Scale. Results Of the first 100 apps, 79 were related to vaping. Of these 79 apps, 43 (54%) were specific to nicotine, 3 (4%) were specific to cannabis, 1 (1%) was intended for either, and for the remaining 31 (39%), the intended substance was unclear. The most common purposes of the apps were making do-it-yourself e-liquids (28/79, 35%) or coils (25/79, 32%), games/entertainment (19/79, 24%), social networking (16/79, 20%), and shopping for vaping products (15/79, 19%). Of the 79 apps, at least 4 apps (5%) paired with vaping devices to control temperature or dose settings, 8 apps (10%) claimed to help people quit smoking using vaping, and 2 apps (3%) had the goal of helping people quit vaping. Conclusions The majority of vaping-related apps in the Google Play Store had features either to help users continue vaping, such as information for modifying devices, or to maintain interest in vaping. Few apps were for controlling device settings or assisting with quitting smoking or vaping. Assuming that these Google Play Store apps were similar in content to the Apple App Store apps that were removed, it appears that Apple’s ban would have a minimal effect on people who vape with the intention of quitting smoking or who are seeking information about safer vaping via mobile apps.
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Perka, Edward J. "Culture Change in Addictions Treatment." Health Promotion Practice 12, no. 6_suppl_2 (November 2011): 159S—165S. http://dx.doi.org/10.1177/1524839911414410.
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Targeted training and technical assistance can have a major impact on the attitudes and beliefs of addiction service providers with respect to the treatment of tobacco dependency. Major gains have been made with the general public since the mid-1960s with respect to the reduction of tobacco use behavior and tobacco-related diseases. Tobacco use continues to be a major public health problem, and tobacco control initiatives are significantly affecting public attitudes and norms regarding tobacco use. There is, however, a specific population that has not benefited from these gains and, in fact, has been encouraged to continue smoking rather than make an attempt to quit. Individuals with a substance use disorder and/or mental health disorder have a much higher percentage of tobacco use than the general population, resulting in major health disparities. The addiction treatment and recovery community has lagged behind the general public in addressing tobacco use. New York State’s project, “Integrating Tobacco Use Interventions Into Chemical Dependence Services,” is a model that demonstrates how innovative regulations, and training and technical assistance developed specifically for addiction service providers, can initiate culture change with respect to tobacco use within addiction treatment settings, resulting in improved treatment outcomes and longer term stable recovery.
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&NA;. "How to quit smoking—now." Nursing 35 (February 2005): 24. http://dx.doi.org/10.1097/00152193-200502001-00017.
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Gupta, D., K. Winckel, J. Burrows, J. Ross, and J. W. Upham. "Utilisation of Nicotine Replacement Therapy within a Hospital Pharmacist Initiated Smoking-Cessation Intervention – A Pragmatic Randomised Controlled Trial." Journal of Smoking Cessation 12, no. 1 (October 2, 2015): 45–54. http://dx.doi.org/10.1017/jsc.2015.14.
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Introduction:Hospital pharmacists currently play a limited role in the management of nicotine withdrawal and smoking-cessation. They have multiple tasks and limited time; a strong evidence base is required to determine importance of including smoking-cessation interventions into their routine practice.Aims:The aims of this study were to evaluate the effectiveness of a hospital pharmacist initiated smoking-cessation intervention (SCI) in increasing the utilisation of Nicotine Replacement Therapy (NRT) in hospitalised smokers, and in increasing quit rates post-discharge.Methods:This study was conducted in a tertiary referral hospital using a pragmatic randomised control design. After screening, 100 inpatient smokers were enrolled and randomised by the research pharmacist (RP) to either the intervention or usual care arm (n= 50 for both arms). Smoking-cessation advice was available to all smokers during their hospital stay under the smoking management policy, which represented usual care. However, this approach is often unstructured and provided on an ad-hoc basis. Those in the intervention arm received brief SCI from the RP, who also facilitated NRT prescribing if required. Prescribing rates of NRT in the hospital and on discharge in both the groups were compared. Participants were contacted by phone three-months after enrolment to assess their seven-day point prevalence of abstinence (PPA) from smoking and use of NRT post-discharge.Results:A significantly higher proportion of participants in the intervention arm used NRT in the hospital (82% vs. 24%,Χ2= 33.8,p< 0.001) and at discharge (68% vs. 12%,Χ2= 32.7,p< 0.0001) and significantly more participants who received SCI from the RP continued to use NRT after discharge (OR 3.1, CI 1.2 to 8.2). A similar number of participants in both the groups claimed seven-day PPA after three-months (18% usual-care vs. 15% intervention-arm, OR 0.8, CI 0.24 to 2.67).Conclusions:Hospital pharmacist led brief SCI can enhance the utilisation of NRT in hospital and after discharge; there was no clear effect on cessation rates at three months. There is a need to explore feasible options for a coordinated, multidisciplinary approach to smoking-cessation in hospital and across the continuum, which may have a greater impact on long term smoking-cessation rates.