Full Text Available Background: Tobacco use is very common among Indian society. In fact, tobacco use is responsible for majority of morbidity and mortality in India and worldwide. Tobacco has been identified as “addictive” and tobacco dependence has been defined as a health problem in ICD-10. Aims & Objectives: This review article aims to emphasize the role of primary health care providers in tobacco cessation and to give recommendations after identifying barriers and exploring the present scenario. Material Methods: Several studies, journals and web-based articles have been referred to support the evidence that a brief tobacco cessation advice from physicians could help the patient quit. Result: Studies show that there is lack of participation from primary health care providers for tobacco cessation. Several barriers have been identified in many studies and also there exist some solutions to these barriers. Conclusion: It has been concluded in the article that primary health care providers should be trained and supported with all possible resources so that they can screen tobacco use in patients and could help them quit.
Ma, Laura; Donohue, Caitlin; DeNofrio, Tina; Vitale Pedulla, Lillian; Haddad, Robert I; Rabinowits, Guilherme
Despite receiving a cancer diagnosis, many patients continue to use tobacco during treatment, negatively affecting their outcomes. We hypothesized that limited tobacco cessation (TC) discussion among patients and providers was partially the result of providers' lack of awareness of current TC resources available. We surveyed the head and neck oncology providers (HNOPs) at Dana-Farber Cancer Institute to evaluate their awareness of existing TC resources within the community and performed a 6-month medical record review of active tobacco users (ATUs) to evaluate the frequency of documented TC discussions in clinic. We educated the HNOPs about available TC resources, developed a TC resource teaching sheet, placed a provider alert page in examination rooms as a reminder of TC discussions, and built a TC discussion template to ease documentation. Four weeks postintervention, we resurveyed providers and again performed medical record reviews of ATUs. Preintervention, 13% of HNOPs were aware of TC resources available, and TC discussion documentation was 28%. Postintervention, 100% of HNOPs became aware of the TC resources available, and documentations increased to 56% at 5 months. Identification of ATUs increased from six to 13 per month to 17 to 33 per month post intervention. Eighty-eight percent of HNOPs felt the intervention prompted TC discussions in clinic with their ATUs. The limited number of TC discussions among patients and providers was at least partially the result of unawareness of TC resources available within the community. Educating HNOPs and alerting them to ATUs at their clinic visits successfully prompted TC discussions in clinic. Copyright © 2015 by American Society of Clinical Oncology.
Pesko, Michael F; Bains, Jaskaran; Maclean, Johanna Catherine; Cook, Benjamin Lê
The Affordable Care Act (ACA) allowed employer plans in the small-group marketplace to charge tobacco users up to 50 percent more for premiums-known as tobacco surcharges-but only if the employer offered a tobacco cessation program and the employee in question failed to participate in it. Using 2016 survey data collected by the Henry J. Kaiser Family Foundation and Health Research and Educational Trust on 278 employers eligible for Small Business Health Options Program, we examined the prevalence of tobacco surcharges and tobacco cessation programs in the small-group market under this policy and found that 16.2 percent of small employers used tobacco surcharges. Overall, 47 percent of employers used tobacco surcharges but failed to offer tobacco cessation counseling. Wellness program prevalence was lower in states that allowed tobacco surcharges, and 10.8 percent of employers in these states were noncompliant with the ACA by charging tobacco users higher premiums without offering cessation programs. Efforts should be undertaken to improve the monitoring and enforcement of ACA tobacco rating rules.
Kruse, Gina R; Rigotti, Nancy A; Raw, Martin; McNeill, Ann; Murray, Rachael; Piné-Abata, Hembadoon; Bitton, Asaf; McEwen, Andy
There are limited existing data describing the training methods used to educate tobacco cessation treatment providers around the world. To measure the prevalence of tobacco cessation treatment content, skills training and teaching methods reported by tobacco treatment training programs across the world. Web-based survey in May-September 2013 among tobacco cessation training experts across six geographic regions and four World Bank income levels. Response rate was 73% (84 of 115 countries contacted). Of 104 individual programs from 84 countries, most reported teaching brief advice (78%) and one-to-one counseling (74%); telephone counseling was uncommon (33%). Overall, teaching of knowledge topics was more commonly reported than skills training. Programs in lower income countries less often reported teaching about medications, behavioral treatments and biomarkers and less often reported skills-based training about interviewing clients, medication management, biomarker measurement, assessing client outcomes, and assisting clients with co-morbidities. Programs reported a median 15 hours of training. Face-to-face training was common (85%); online programs were rare (19%). Almost half (47%) included no learner assessment. Only 35% offered continuing education. Nearly all programs reported teaching evidence-based treatment modalities in a face-to-face format. Few programs delivered training online or offered continuing education. Skills-based training was less common among low- and middle-income countries (LMICs). There is a large unmet need for tobacco treatment training protocols which emphasize practical skills, and which are more rapidly scalable than face-to-face training in LMICs.
Van T. Tong
Full Text Available The Affordable Care Act (ACA requires states to provide tobacco-cessation services without cost-sharing for pregnant traditional Medicaid-beneficiaries effective October 2010. It is unknown the extent to which obstetricians–gynecologists are aware of the Medicaid tobacco-cessation benefit. We sought to examine the awareness of the Medicaid tobacco-cessation benefit in a national sample of obstetricians–gynecologists and assessed whether reimbursement would influence their tobacco cessation practice. In 2012, a survey was administered to a national stratified-random sample of obstetricians–gynecologists (n = 252 regarding awareness of the Medicaid tobacco-cessation benefit. Results were stratified by the percentage of pregnant Medicaid patients. Chi-squared tests (p < 0.05 were used to assess significant associations. Analyses were conducted in 2014. Eighty-three percent of respondents were unaware of the benefit. Lack of awareness increased as the percentage of pregnant Medicaid patients in their practices decreased (range = 71.9%–96.8%; P = 0.02. One-third (36.1% of respondents serving pregnant Medicaid patients reported that reimbursement would influence them to increase their cessation services. Four out of five obstetricians–gynecologists surveyed in 2012 were unaware of the ACA provision that required states to provide tobacco cessation coverage for pregnant traditional Medicaid beneficiaries as of October 2010. Broad promotion of the Medicaid tobacco-cessation benefit could reduce treatment barriers.
Full Text Available Abstract Background Tobacco use adversely affects oral health. Clinical guidelines recommend that dental providers promote tobacco abstinence and provide patients who use tobacco with brief tobacco use cessation counselling. Research shows that these guidelines are seldom implemented, however. To improve guideline adherence and to develop effective interventions, it is essential to understand provider behaviour and challenges to implementation. This study aimed to develop a theoretically informed measure for assessing among dental providers implementation difficulties related to tobacco use prevention and cessation (TUPAC counselling guidelines, to evaluate those difficulties among a sample of dental providers, and to investigate a possible underlying structure of applied theoretical domains. Methods A 35-item questionnaire was developed based on key theoretical domains relevant to the implementation behaviours of healthcare providers. Specific items were drawn mostly from the literature on TUPAC counselling studies of healthcare providers. The data were collected from dentists (n = 73 and dental hygienists (n = 22 in 36 dental clinics in Finland using a web-based survey. Of 95 providers, 73 participated (76.8%. We used Cronbach's alpha to ascertain the internal consistency of the questionnaire. Mean domain scores were calculated to assess different aspects of implementation difficulties and exploratory factor analysis to assess the theoretical domain structure. The authors agreed on the labels assigned to the factors on the basis of their component domains and the broader behavioural and theoretical literature. Results Internal consistency values for theoretical domains varied from 0.50 ('emotion' to 0.71 ('environmental context and resources'. The domain environmental context and resources had the lowest mean score (21.3%; 95% confidence interval [CI], 17.2 to 25.4 and was identified as a potential implementation difficulty. The domain emotion
Amemori, Masamitsu; Michie, Susan; Korhonen, Tellervo; Murtomaa, Heikki; Kinnunen, Taru H
Tobacco use adversely affects oral health. Clinical guidelines recommend that dental providers promote tobacco abstinence and provide patients who use tobacco with brief tobacco use cessation counselling. Research shows that these guidelines are seldom implemented, however. To improve guideline adherence and to develop effective interventions, it is essential to understand provider behaviour and challenges to implementation. This study aimed to develop a theoretically informed measure for assessing among dental providers implementation difficulties related to tobacco use prevention and cessation (TUPAC) counselling guidelines, to evaluate those difficulties among a sample of dental providers, and to investigate a possible underlying structure of applied theoretical domains. A 35-item questionnaire was developed based on key theoretical domains relevant to the implementation behaviours of healthcare providers. Specific items were drawn mostly from the literature on TUPAC counselling studies of healthcare providers. The data were collected from dentists (n = 73) and dental hygienists (n = 22) in 36 dental clinics in Finland using a web-based survey. Of 95 providers, 73 participated (76.8%). We used Cronbach's alpha to ascertain the internal consistency of the questionnaire. Mean domain scores were calculated to assess different aspects of implementation difficulties and exploratory factor analysis to assess the theoretical domain structure. The authors agreed on the labels assigned to the factors on the basis of their component domains and the broader behavioural and theoretical literature. Internal consistency values for theoretical domains varied from 0.50 ('emotion') to 0.71 ('environmental context and resources'). The domain environmental context and resources had the lowest mean score (21.3%; 95% confidence interval [CI], 17.2 to 25.4) and was identified as a potential implementation difficulty. The domain emotion provided the highest mean score (60%; 95% CI, 55
Amemori, Masamitsu; Korhonen, Tellervo; Kinnunen, Taru; Michie, Susan; Murtomaa, Heikki
Tobacco use adversely affects oral health. Tobacco use prevention and cessation (TUPAC) counselling guidelines recommend that healthcare providers ask about each patient's tobacco use, assess the patient's readiness and willingness to stop, document tobacco use habits, advise the patient to stop, assist and help in quitting, and arrange monitoring of progress at follow-up appointments. Adherence to such guidelines, especially among dental providers, is poor. To improve guideline implementation, it is essential to understand factors influencing it and find effective ways to influence those factors. The aim of the present study protocol is to introduce a theory-based approach to diagnose implementation difficulties of TUPAC counselling guidelines among dental providers. Theories of behaviour change have been used to identify key theoretical domains relevant to the behaviours of healthcare providers involved in implementing clinical guidelines. These theoretical domains will inform the development of a questionnaire aimed at assessing the implementation of the TUPAC counselling guidelines among Finnish municipal dental providers. Specific items will be drawn from the guidelines and the literature on TUPAC studies. After identifying potential implementation difficulties, we will design two interventions using theories of behaviour change to link them with relevant behaviour change techniques aiming to improve guideline adherence. For assessing the implementation of TUPAC guidelines, the electronic dental record audit and self-reported questionnaires will be used. To improve guideline adherence, the theoretical-domains approach could provide a comprehensive basis for assessing implementation difficulties, as well as designing and evaluating interventions. After having identified implementation difficulties, we will design and test two interventions to enhance TUPAC guideline adherence. Using the cluster randomised controlled design, we aim to provide further evidence on
Full Text Available Abstract Background Tobacco use adversely affects oral health. Tobacco use prevention and cessation (TUPAC counselling guidelines recommend that healthcare providers ask about each patient's tobacco use, assess the patient's readiness and willingness to stop, document tobacco use habits, advise the patient to stop, assist and help in quitting, and arrange monitoring of progress at follow-up appointments. Adherence to such guidelines, especially among dental providers, is poor. To improve guideline implementation, it is essential to understand factors influencing it and find effective ways to influence those factors. The aim of the present study protocol is to introduce a theory-based approach to diagnose implementation difficulties of TUPAC counselling guidelines among dental providers. Methods Theories of behaviour change have been used to identify key theoretical domains relevant to the behaviours of healthcare providers involved in implementing clinical guidelines. These theoretical domains will inform the development of a questionnaire aimed at assessing the implementation of the TUPAC counselling guidelines among Finnish municipal dental providers. Specific items will be drawn from the guidelines and the literature on TUPAC studies. After identifying potential implementation difficulties, we will design two interventions using theories of behaviour change to link them with relevant behaviour change techniques aiming to improve guideline adherence. For assessing the implementation of TUPAC guidelines, the electronic dental record audit and self-reported questionnaires will be used. Discussion To improve guideline adherence, the theoretical-domains approach could provide a comprehensive basis for assessing implementation difficulties, as well as designing and evaluating interventions. After having identified implementation difficulties, we will design and test two interventions to enhance TUPAC guideline adherence. Using the cluster
McGoldrick, Daniel E; Boonn, Ann V
Tobacco use kills more than 400,000 Americans every year. For smokers, quitting is the biggest step they can take to improve their health, but it is a difficult step. Fortunately, policy-based interventions can both encourage smokers to quit and help them succeed. Evidence shows that tobacco tax increases encourage smokers to quit-recent state and federal increases have created dramatic surges in calls to quitlines. Similarly, smokefree workplace laws not only protect workers and patrons from secondhand smoke but also encourage smokers to quit, help them succeed, and create a social environment less conducive to smoking. The impact of policy changes can be amplified by promoting quitting around the date they are implemented. Outreach to health practitioners can alert them to encourage their patients to quit. Earned and paid media can also be used to motivate smokers to quit when policy changes are put into effect. Although these policies and efforts regarding them can generate great demand for evidence-based cessation services such as counseling and medication, it is important to make these resources available for those wanting to quit. Public and private health insurance plans should provide coverage for cessation services, and states should invest tobacco tax and/or tobacco settlement dollars in smoking-cessation programs as recommended by the CDC. Finally, the Family Smoking Prevention and Tobacco Control Act has given the U.S. Food and Drug Administration new authority to regulate tobacco products and marketing, and to prevent tobacco companies from deceptively marketing new products that discourage smokers from quitting and keep them addicted. 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Taha, Nur Akmar; Tee, Ooi Guat
Objectives: Tobacco cessation is the primary goal of tobacco control measures. Community pharmacists are possible providers of tobacco cessation counselling due to their close contact with the public and the availability of non-prescription nicotine replacement therapies in pharmacies. However, community pharmacists often do not provide tobacco…
Franks, Andrea S; Sando, Karen; McBane, Sarah
Tobacco use continues to be a major cause of morbidity and mortality. Even with behavioral and pharmacologic treatment, long-term tobacco cessation rates are low. Electronic nicotine delivery systems, commonly referred to as electronic cigarettes or e-cigarettes, are increasingly used for tobacco cessation. Because e-cigarettes are widely used in this setting, health care professionals need to know if they are safe and effective. The purpose of this article is to review literature regarding use of e-cigarettes as a tool for tobacco cessation in patients who are ready to quit, as well as those who are not ready to quit, along with some selected patient populations. The safety and clinical implications of e-cigarette use are also reviewed. Small, short-term studies assessing smokers' use of e-cigarettes suggest that e-cigarettes may be well tolerated and modestly effective in achieving abstinence. High-quality studies are lacking to support e-cigarettes use for cessation in patients with mental health issues. One small prospective cohort study concluded that patients with mental health issues reduced cigarette use with e-cigarette use. Although one study found that patients with cancer reported using e-cigarettes as a tobacco-cessation strategy, e-cigarettes were not effective in supporting abstinence 6 and 12 months later. Additional research is needed to evaluate the use of e-cigarettes for smoking cessation in patients with pulmonary diseases. No data exist to describe the efficacy of e-cigarettes for smoking cessation in pregnant women. Although study subjects report minimal adverse effects with e-cigarettes and the incidence of adverse effects decreases over time, long-term safety data are lacking. Health care providers should assess e-cigarette use in their patients as part of the tobacco cessation process. © 2018 Pharmacotherapy Publications, Inc.
Hiratsuka, Vanessa Y; Avey, Jaedon P; Trinidad, Susan B; Beans, Julie A; Robinson, Renee F
American Indian (AI) and Alaska Native (AN) communities confront some of the highest rates of tobacco use and its sequelae. This formative research project sought to identify the perspectives of 41 stakeholders (community members receiving care within the healthcare system, primary care providers, and tribal healthcare system leaders) surrounding the use of pharmacogenetics toward tobacco cessation treatment in the setting of an AI/AN owned and operated health system in south central Alaska. Interviews were held with 20 adult AI/AN current and former tobacco users, 12 healthcare providers, and 9 tribal leaders. An emergent theme from data analysis was that current tobacco screening and cessation efforts lack information on electronic cigarette (e-cigarette) use. Perceptions of the use of e-cigarettes role in tobacco cessation varied. Preventive screening for tobacco use and clinical cessation counseling should address e-cigarette use. Healthcare provider tobacco cessation messaging should similarly address e-cigarettes.
Godshall William T
Full Text Available Abstract According to the Centers for Disease Control and Prevention, about 45 million Americans continue to smoke, even after one of the most intense public health campaigns in history, now over 40 years old. Each year some 438,000 smokers die from smoking-related diseases, including lung and other cancers, cardiovascular disorders and pulmonary diseases. Many smokers are unable – or at least unwilling – to achieve cessation through complete nicotine and tobacco abstinence; they continue smoking despite the very real and obvious adverse health consequences. Conventional smoking cessation policies and programs generally present smokers with two unpleasant alternatives: quit, or die. A third approach to smoking cessation, tobacco harm reduction, involves the use of alternative sources of nicotine, including modern smokeless tobacco products. A substantial body of research, much of it produced over the past decade, establishes the scientific and medical foundation for tobacco harm reduction using smokeless tobacco products. This report provides a description of traditional and modern smokeless tobacco products, and of the prevalence of their use in the United States and Sweden. It reviews the epidemiologic evidence for low health risks associated with smokeless use, both in absolute terms and in comparison to the much higher risks of smoking. The report also describes evidence that smokeless tobacco has served as an effective substitute for cigarettes among Swedish men, who consequently have among the lowest smoking-related mortality rates in the developed world. The report documents the fact that extensive misinformation about ST products is widely available from ostensibly reputable sources, including governmental health agencies and major health organizations. The American Council on Science and Health believes that strong support of tobacco harm reduction is fully consistent with its mission to promote sound science in regulation and in
Carr, Alan B; Ebbert, Jon
smokeless tobacco (ST) users, and eight studies evaluated interventions among cigarette smokers, six of which involved adult smokers in dental practice settings. All studies employed behavioral interventions and only one required pharmacotherapy as an interventional component. All studies included an oral examination component. Pooling all 14 studies suggested that interventions conducted by oral health professionals can increase tobacco abstinence rates (odds ratio [OR] 1.71, 95% confidence interval [CI] 1.44 to 2.03) at six months or longer, but there was evidence of heterogeneity (I² = 61%). Within the subgroup of interventions for smokers, heterogeneity was smaller (I² = 51%), but was largely attributable to a large study showing no evidence of benefit. Within this subgroup there were five studies which involved adult smokers in dental practice settings. Pooling these showed clear evidence of benefit and minimal heterogeneity (OR 2.38, 95% CI 1.70 to 3.35, 5 studies, I² = 3%) but this was a posthoc subgroup analysis. Amongst the studies in smokeless tobacco users the heterogeneity was also attributable to a large study showing no sign of benefit, possibly due to intervention spillover to control colleges; the other five studies indicated that interventions for ST users were effective (OR 1.70; 95% CI 1.36 to 2.11). Available evidence suggests that behavioral interventions for tobacco cessation conducted by oral health professionals incorporating an oral examination component in the dental office or community setting may increase tobacco abstinence rates among both cigarette smokers and smokeless tobacco users. Differences between the studies limit the ability to make conclusive recommendations regarding the intervention components that should be incorporated into clinical practice, however, behavioral counselling (typically brief) in conjunction with an oral examination was a consistent intervention component that was also provided in some control groups.
Khan, Nasreen; Anderson, Joe R; Du, Juan; Tinker, Dale; Bachyrycz, Amy M; Namdar, Rocsanna
The New Mexico Pharmaceutical Care Foundation received funding through the Tobacco Use Prevention and Control Program (TUPAC) to provide support for pharmacist-delivered tobacco cessation services. The goal of the program was to increase the availability of tobacco cessation services to residents of New Mexico. Program outcomes are presented, using data from the first 2 fiscal years. To assess tobacco quit rates among smokers who participated in the community pharmacist-based program and identify the predictors of quitting at the end of a 6-month program. Pharmacists, who had received Rx for Change training, provided tobacco cessation services. Patients were scheduled for an initial visit and then were seen at regularly scheduled follow-up visits at 1 month, 3 months, and 6 months from the initial visit. Data collected at the initial visit included demographics, smoking history, and readiness for quitting. Smoking status was collected at each of the follow-up visits. Data were analyzed using SAS (SAS Institute) and STATA (StataCorp LP) statistical software. Tobacco quit rates were calculated at 1, 3, and 6 months. Multivariate regression analysis was performed to assess predictors of quitting. Standard errors were adjusted for repeated observation. Data were available for 346 participants. The average quit rate at the end of 6 months was 25%. Significant predictors of quitting were high confidence levels in quitting at baseline, individuals who had first cigarettes at least 30 minutes after waking up, first cessation attempt, and nonwhite patients. A smoking cessation program delivered through trained community pharmacists with prescriptive authority is an effective approach to reducing smoking. Further research should be conducted to compare the effectiveness of pharmacists with that of other providers of tobacco cessation services.
Squier, Christopher; Hesli, Vicki; Lowe, John; Ponamorenko, Victor; Medvedovskaya, Natalia
To examine the relationship between physicians' smoking behaviors and their attitudes toward tobacco use by their patients and tobacco control in the Ukraine, a 70-item questionnaire was administered to 799 general practitioners (287 men and 512 women) working in both rural (278 physicians) and urban (521 physicians) areas of three regions of Ukraine. In all, 13.9% of physicians were current smokers and 21.6% reported being past smokers, with significantly (Pnon-smoking as a norm and (2) the likelihood that a patient will be provided smoking cessation counseling increases.
Vanessa Y. Hiratsuka
Full Text Available Background: American Indian (AI and Alaska Native (AN communities confront some of the highest rates of tobacco use and its sequelae. Methods: This formative research project sought to identify the perspectives of 41 stakeholders (community members receiving care within the healthcare system, primary care providers, and tribal healthcare system leaders surrounding the use of pharmacogenetics toward tobacco cessation treatment in the setting of an AI/AN owned and operated health system in south central Alaska. Results: Interviews were held with 20 adult AI/AN current and former tobacco users, 12 healthcare providers, and 9 tribal leaders. An emergent theme from data analysis was that current tobacco screening and cessation efforts lack information on electronic cigarette (e-cigarette use. Perceptions of the use of e-cigarettes role in tobacco cessation varied. Conclusion: Preventive screening for tobacco use and clinical cessation counseling should address e-cigarette use. Healthcare provider tobacco cessation messaging should similarly address e-cigarettes.
Full Text Available BackgroundA total of 275 million tobacco users live throughout India and are in need of tobacco cessation services. However, the preparation of physicians to deliver this service at primary care health facilities remains unknown.AimsThe study aimed to examine the primary care physicians’ preparedness to deliver tobacco cessation services in two Indian states.MethodResearchers surveyed physicians working in primary care public health facilities, primarily in rural areas using a semistructured interview schedule. Physicians’ preparedness was defined in the study as those possessing knowledge of tobacco cessation methods and exhibiting a positive attitude towards the benefits of tobacco cessation counselling as well as being willing to be part of tobacco prevention or cessation program.ResultsOverall only 17% of physicians demonstrated adequate preparation to provide tobacco cessation services at primary care health facilities in both the States. The findings revealed minimal tobacco cessation training during formal medical education (21.3% and on-the-job training (18.9%. Factors, like sex and age of service provider, type of health facility, location of health facility and number of patients attended by the service provider, failed to show significance during bivariate and regression analysis. Preparedness was significantly predicted by state health system.ConclusionThe study highlights a lack of preparedness of primary care physicians to deliver tobacco cessation services. Both the curriculum in medical school and on-the-job training require an addition of a learning component on tobacco cessation. The addition of this component will enable existing primary care facilities to deliver tobacco cessation services.
Momin, Behnoosh; Neri, Antonio; Zhang, Lei; Kahende, Jennifer; Duke, Jennifer; Green, Sonya Goode; Malarcher, Ann; Stewart, Sherri L
The National Comprehensive Cancer Control Program (NCCCP) and National Tobacco Control Program (NTCP) are both well-positioned to promote the use of population-based tobacco cessation interventions, such as state quitlines and Web-based interventions. This paper outlines the methodology used to conduct a comparative effectiveness research study of traditional and Web-based tobacco cessation and quitline promotion approaches. A mixed-methods study with three components was designed to address the effect of promotional activities on service usage and the comparative effectiveness of population-based smoking cessation activities across multiple states. The cessation intervention component followed 7,902 smokers (4,307 quitline users and 3,595 Web intervention users) to ascertain prevalence of 30-day abstinence rates 7 months after registering for smoking cessation services. User characteristics and quit success was compared across the two modalities. In the promotions component, reach and use of traditional and innovative promotion strategies were assessed for 24 states, including online advertising, state Web sites, social media, mobile applications, and their effects on quitline call volume. The partnership intervention component studied the extent of collaboration among six selected NCCCPs and NTCPs. This study will guide program staff and clinicians with evidence-based recommendations and best practices for implementation of tobacco cessation within their patient and community populations and establish an evidence base that can be used for decision making.
Objectives. We investigated the frequency of alternative tobacco product use (loose leaf, moist snuff, snus, dissolvables, electronic cigarettes [e-cigarettes]) among smokers and the association with quit attempts and intentions. Methods. A nationally representative probability-based cross-sectional survey of 1836 current or recently former adult smokers was completed in November 2011. Multivariate logistic regressions evaluated associations between alternative tobacco product use and smoking cessation behaviors. Results. Of the smokers, 38% had tried an alternative tobacco product, most frequently e-cigarettes. Alternative tobacco product use was associated with having made a quit attempt, and those intending to quit were significantly more likely to have tried and to currently use the products than were smokers with no intentions to quit. Use was not associated with successful quit attempts. Interest in future use of alternative tobacco products was low, except for e-cigarettes. Conclusions. Alternative tobacco products are attractive to smokers who want to quit smoking, but these data did not indicate that alternative tobacco products promote cessation. Unsubstantiated overt and implied claims that alternative tobacco products aid smoking cessation should be prohibited. PMID:23488521
Sarma, Smitha; Harikrishnan, Sivadasanpillai; Baldridge, Abigail S; Devarajan, Raji; Mehta, Aashna; Selvaraj, Sakhtivel; Ali, Mohammed K; Mohanan, Padinhare P; Prabhakaran, Dorairaj; Huffman, Mark D
India is the world's second largest consumer of tobacco, but tobacco cessation remains uncommon due, at least in part, to underutilization of cessation pharmacotherapy. We evaluated the availability, sales, and affordability of nicotine replacement therapy, bupropion, and varenicline in the South Indian state of Kerala to understand potential reasons for underutilization. From November 2016 to April 2017, we collected data on availability, inventory, and pricing of cessation medication through a cross-sectional survey of 199 public, semiprivate (Karunya), and private pharmacies across 5 districts in Kerala using World Health Organization/Health Action International methodology. Revenue and sales data were obtained from the latest Pharmatrac medication database. We assessed affordability using individual- and household-level income and expenditure data collected from November 2014 to November 2016 through the Acute Coronary Syndrome Quality Improvement in Kerala randomized trial. Cessation medications were not available in public hospitals (0%, n=58) nor in public specialty centers (0%, n=10) including those designated to provide cessation services. At least 1 cessation medicine was available at 63% of private pharmacies (n=109) and 27% of Karunya (semiprivate) pharmacies (n=22). Among the 75 pharmacies that stocked cessation medications, 96% had nicotine replacement therapy, 28% had bupropion, and 1% had varenicline. No outlets had sufficient inventory for a patient to purchase a 12-week treatment regimen. There were an estimated 253 270 treatment regimens sold throughout India and 14 092 in Kerala in 2013 to 2014. Treatment regimens cost 1.9 to 13.0× the median amount spent on smoked tobacco and between 8% and 52% of nonsubsistence income. Tobacco cessation medications are unavailable in the Kerala public sector and have limited availability in the private and semiprivate sectors. When available, medications are unaffordable for most patients. Addition of tobacco
Muramoto, Myra L; Hall, John R; Nichter, Mark; Nichter, Mimi; Aickin, Mikel; Connolly, Tim; Matthews, Eva; Campbell, Jean Z; Lando, Harry A
To evaluate the effect of tobacco cessation brief-intervention (BI) training for lay "health influencers," on knowledge, self-efficacy and the proportion of participants reporting BI delivery post-training. Randomized, community-based study comparing In-person or Web-based training, with mailed materials. In-person and Web-training groups had significant post-training cessation knowledge and self-efficacy gains. All groups increased the proportion of individuals reporting BIs at follow-up, with no significant between-group differences. Irrespective of participants' prior intervention experience, 80%-86% reported BIs within the past 90 days; 71%-79% reported >1 in the past 30. Web and In-person training significantly increase health influencer cessation knowledge and self-efficacy. With minimal prompting and materials, even persons without BI experience can be activated to encourage tobacco cessation.
Aghi, Mira; Nagler, Eve; Lando, Harry; Pednekar, Mangesh; Gupta, Prakash; Sorensen, Glorian
Despite the rapidly increasing burden of tobacco-related morbidity and mortality in low- and middle-income countries, tobacco control initiatives - especially cessation - receive little emphasis. This is true despite low-cost methods that have potential for widespread dissemination. The purpose of this paper is to provide a case study example of how lay interventionists may be trained and supported to facilitate tobacco use cessation, based on the successful Tobacco Free Teachers-Tobacco Free Society program (TFT-TFS) implemented in Bihar, India. This school-based program included multiple components, with lay interventionists having a crucial role. The lay interventionists included health educators and lead teachers, both of whom were selected based on formative research, underwent extensive training and received continuing support. We emphasized encouraging and supporting teachers to quit tobacco use and engaging both tobacco users and nonusers to create a supportive environment for cessation. We also stressed that neither the health educators nor lead teachers were being trained as counselors or as cessation experts. We focused on the importance of respecting teachers as individuals and identifying locally relevant methods of cessation. Although we cannot isolate the precise contribution of the lay interventionists to the successful TFT-TFS intervention, the abstinence findings in favor of the intervention at follow up are highly encouraging. Teachers have been neglected as lay interventionists for tobacco cessation despite the fact that they tend to be highly respected and credible. The approach used for TFT-TFS could be disseminable in multiple low- and middle-income country contexts through train-the-trainer programs targeted to teachers.
Piper, Megan E.; Smith, Stevens S.; Schlam, Tanya R.; Fleming, Michael F.; Bittrich, Amy A.; Brown, Jennifer L.; Leitzke, Cathlyn J.; Zehner, Mark E.; Fiore, Michael C.; Baker, Timothy B.
Objective: The present research examined the relation of psychiatric disorders to tobacco dependence and cessation outcomes. Method: Data were collected from 1,504 smokers (58.2% women; 83.9% White; mean age = 44.67 years, SD = 11.08) making an aided smoking cessation attempt as part of a clinical trial. Psychiatric diagnoses were determined with…
Full Text Available Background: Training medical students in tobacco prevention and cessation skills is critical to have competent physicians who are prepared to address the grave levels of morbidity and mortality associated with tobacco use. However, in India, enough attention has not been given to elicit the active participation of physicians in tobacco control. Keeping this in view, a program was undertaken to develop the skills and competence of medical students with the objective of improving medical student inquiry into smoking and the delivery of advice accordingly for patients in their clinical year′s routine consultations. Methods: The targeted learners were 149 1 st -year medical and dental students of SCB Medical College, Cuttack, Orissa, India, who had appeared the second semester examination; 84 of the participants were male. Students were allowed to appear a test before the training session on knowledge of tobacco cessation and post test was done after 1.5 months of training. The knowledge score was evaluated to evaluate the learning outcome. Results: We observed that a curriculum on tobacco intervention could improve relevant knowledge, attitudes and self-confidence and be applied in students early clinical experiences. Conclusions: There is need of joint action by practicing clinicians, the medical faculty and the curriculum planners of the country to incorporate tobacco cessation into the curriculum.
Rebecca L. Collins
Full Text Available The objective was to assess the effectiveness of a smoking cessation educational program on pediatric residents' counseling. Residents were randomly selected to receive the intervention. Residents who were trained were compared to untrained residents. Self-reported surveys and patient chart reviews were used. Measures included changes in self-reported knowledge, attitudes and behaviors of residents, and differences in chart documentation and caretaker-reported physician counseling behaviors. The intervention was multidimensional including a didactic presentation, a problem-solving session, clinic reminders, and provision of patient education materials. Results showed that residents who were trained were more likely to ask about tobacco use in their patients' households. They were also more likely to advise caretakers to cut down on or to quit smoking, to help set a quit date, and to follow up on the advice given at a subsequent visit. Trained residents were more likely to record a history of passive tobacco exposure in the medical record. These residents also reported improved confidence in their counseling skills and documented that they had done such counseling more often than did untrained residents. Caretakers of pediatric patients who smoke seen by intervention residents were more likely to report that they had received tobacco counseling. Following this intervention, pediatric residents significantly improved their behaviors, attitudes, and confidence in providing smoking cessation counseling to parents of their pediatric patients.
Vanessa Y. Hiratsuka; Jaedon P. Avey; Susan B. Trinidad; Julie A. Beans; Renee F. Robinson
Background. American Indian (AI) and Alaska Native (AN) communities confront some of the highest rates of tobacco use and its sequelae.Methods. This formative research project sought to identify the perspectives of 41 stakeholders (community members receiving care within the healthcare system, primary care providers, and tribal healthcare system leaders) surrounding the use of pharmacogenetics toward tobacco cessation treatment in the setting of an AI/AN owned and operated health system in so...
Randah Ribhi Hamadeh
A high tobacco-quit rate among smokers seeking treatment at QTC is encouraging and indicates that the clinics contributed to tobacco cessation in Bahrain. Counselling sessions and more frequent visits to QTC helped participants to successfully quit tobacco.
Dotson, Jo Ann Walsh; Pineda, Rowena; Cylkowski, Hannah; Amiri, Solmaz
We describe the development and evaluation of an iPad application to promote knowledge of tobacco risk and cessation resources for pregnant women. Pregnant women completed a survey on tobacco use in pregnancy, and clinicians reviewed their tobacco cessation practices and resources. The women reported that content was easy to understand (98%) and helped them understand tobacco risks (94%). Tobacco users reported that the information helped them want to quit smoking (75%) and provided ideas on how to quit (58%). Clinicians reported themes that reflected ease of use, support of pregnant women, and use of electronic resources. We conclude that iPad applications and other electronic health education delivery methods are useful tools that can augment coordinated and consistent tobacco cessation efforts in clinical settings. © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.
Saud, Mohammed; Madhu, B; Srinath, K M; Ashok, N C; Renuka, M
Tobacco is a leading cause of disease and premature death. Most of the smokers visit a doctor for various health related ailments and thus such clinic visits provide many opportunities for interventions and professional tobacco cessation advice. The primary aim of the following study is to assess the physician practices, perspectives, resources, barriers and education relating to tobacco cessation and their perceived need for training for the same. The secondary aim is to compare the physician's cessation practices from patient's perspective. A descriptive study was conducted in a hospital attached to Medical College in Mysore city, Karnataka. Information about doctor's practices, perspectives and their perceived need for training in tobacco cessation were collected using pre-structured self-administered Questionnaire, which were distributed in person. Patient's practices and perspectives were assessed using a pre-structured Oral Questionnaire. Almost 95% of physicians said that they ask patients about their smoking status and 94% advise them to quit smoking, but only 50% assist the patient to quit smoking and only 28% arrange follow-up visits. Thus, they do not regularly provide assistance to help patients quit, even though 98% of the physicians believed that helping patients to quit was a part of their role. Only 18% and 35% of the physicians said that Undergraduate Medical Education and Post Graduate Medical Education respectively prepared them very well to participate in smoking cessation activities. Tobacco cessation requires repeated and regular assistance. Such assistance is not being provided to patients by attending doctors. Our medical education system is failing to impart the necessary skills to doctors, needed to help patients quit smoking. Reforms in education are needed so as to prepare the physician to effectively address this problem.
Full Text Available Background: The 5As approach is a clinic-based approach and has been developed for primary health care providers who are uniquely positioned to interact with tobacco users. The 5As stands for: Ask about tobacco use at every visit, advise tobacco users to quit, assess readiness to quit, assist quit attempts through counseling and pharmacotherapy and arrange follow-up to prevent relapse. The present study explores whether auxiliary nurse midwives (ANMs adhere to the 3As from the recommended 5As model for tobacco cessation. Materials and Methods: The study was a cross-sectional study conducted among 501 ANMs in the state of Gujarat and Andhra Pradesh. Descriptive analysis and chi-square test were employed to test the differences in knowledge levels and practices of ANMs. Bivariate logistic regression was used to examine the association between each predictor variable separately and the outcome variables after adjusting for age and location. Data was analyzed using SPSS version 17 software. Results: Majority of ANMs reported that they were aware of respiratory illnesses, tuberculosis, lung and oral cancer as conditions caused due to tobacco consumption. Awareness of adverse reproductive and child health effects associated with tobacco use was very low. Only about one third of respondents informed all patients about harmful effects. Only 16% of ANMs reported having ever received any on-job training related to tobacco control. ANMs who reported receiving training in tobacco control were about two times more likely to provide information on health effects of tobacco as compared to those who reported not being trained in tobacco control in the state of Gujarat. Conclusions: A majority of ANMs ask patients about tobacco use but provide advice only to patients suffering from specific diseases. A context-specific capacity building package needs to be designed to equip ANMs in recommended 5As approach in tobacco cessation.
David, Annette M.; Cruz, Peter J.; Mercado, Susan P.; Dan, Li
Tobacco control stakeholders in priority populations are searching for culturally appropriate cessation training models to strengthen cessation capacity and infrastructure. We adapted the University of Arizona model for Brief Tobacco Cessation Interventions (BTI) training for Pacific Islanders and pilot-tested it in four Pacific Islands - Palau, the Federated States of Micronesia, the Northern Mariana Islands and the Marshall Islands.
Sidhu, Anupreet Kaur; Sussman, Steve; Tewari, Abha; Bassi, Shalini; Arora, Monika
Tobacco use experimentation is most frequent between the ages of 15–24 in India. Therefore, programming to counteract tobacco use among adolescents is needed. There is a lack of evidence-based teen tobacco use prevention and cessation programs. The current study provides an outcome evaluation of the Project EX tobacco use prevention and cessation program among Indian adolescents (16–18 years). An eight-session classroom-based curriculum was adapted to the Indian context and translated from English to Hindi (local language). Next, it was tested using a quasi-experimental design with 624 Indian students at baseline, involving two program and two control schools, with a three-month post-program follow-up. Project EX involves motivation enhancement (e.g., talk shows and games) and coping skills (e.g., complementary and alternative medicine) components. Program participants rated complementary and alternative medicine (CAM) activities like meditation, yoga and healthy breathing higher than talk shows and games. Compared to the standard care control condition, the program condition revealed a prevention effect, but not a cessation effect. Implications for prevention/cessation programming among Indian teens are discussed. This study was approved by the Independent Ethics Committee, Mumbai.
Full Text Available Romanian expertise in tobacco control and cessation is relatively young, as it has effectively started in the early ‘90’s. Ever since, smoking prevalence in the general population has decreased from 36.1% (48% B/25%F in 2000 to 26.7% (37.4% B/16.7% F in 2012, but it is still high and needs further efforts from the Romanian tobacco control community. Romania has ratified FCTC in May 2003 and has signed it in June 2004. A recent achievement we are all proud of consists of the new law to ban smoking in public places, applied from March 2016, a much stronger law than the past one. However, the future challenges will be to implement and ensure respect of this new law, to avoid its future amendments which already arise at the horizon, but also to introduce new regulation about taxation, illegal cigarettes traffic and e-cigarettes brands. A good point is the national Stop Smoking program that is still running since 2007 in over 50 Romanian smoking cessation centers to almost fully reimburse costs of pharmacotherapy and counselling. The constant preoccupation for education and expertise development inside the Romanian Society of Pulmonologists, in particular through its Tobaccology section established in 2007 is another plus of the Romanian tobacco control society, as well as its numerous alliances with other national and international professionals. This was fructified in various networks that have contributed to producing national smoking cessation guidelines, to creating many partnerships in tobacco control projects and in the newly successful anti-tobacco legislation.
Wyman, Jodi; Price, James H; Jordan, Timothy R; Dake, Joseph A; Telljohann, Susan K
The purpose of this study was to examine Ohio parents' perceptions of the role of schools in smoking prevention, cessation, and anti-tobacco policy for their children. A 46-item questionnaire was based on the CDC Guidelines for School Health Programs to Prevent Tobacco Use and Addiction. Surveys (n = 800) were sent to a stratified random sample of parents of junior high and high school aged students and 57% responded. Parents were supportive of smoking prevention activities, but almost two-thirds believed their child's school should get parents' input. Furthermore, mothers/step-mothers were more likely than fathers/step-fathers to agree that the school had a role in smoking prevention activities. The majority of parents were also supportive of smoking cessation activities. However, only 8% of parent respondents supported schools providing nicotine gum or patches to students trying to quit smoking. Overall, the majority of parents were supportive of the seven recommendations developed by the CDC as guidelines for school health programs to prevent tobacco use and addiction. Schools have the opportunity to impact student smoking through prevention and cessation activities. Schools need to know that parents are supportive of these activities and want to be included in the process of implementing effective prevention or cessation programs.
Gómez-Coronado, Nieves; Walker, Adam J; Berk, Michael; Dodd, Seetal
Tobacco use disorder is a chronic illness. With its high comorbidity rate, it is a major cause of years of life lost or years lived with disability; however, it is also considered the most preventable cause of death in developed countries. Since the development of nicotine replacement therapy (NRT) in 1978, treatment options have continued to evolve and expand. Despite this, currently available treatments remain insufficient, with less than 25% of smokers remaining abstinent 1 year after treatment. In this article, we review existing and emerging smoking cessation pharmacotherapies, with a special emphasis on the most promising agents that are currently being investigated. A search of the Cochrane Database of Systematic Reviews and the PubMed, Ovid, and ClinicalTrials.gov databases (August 2 to September 1, 2017) was undertaken for articles on smoking cessation pharmacotherapies, applying no language restrictions. More than 40 pharmacotherapies were reviewed including conventional pharmacotherapies-NRT, bupropion, and varenicline (all approved by the U.S. Food and Drug Administration as first-line treatment of smoking cessation)-and novel therapies: cytisine, N-acetylcysteine, cycloserine, memantine, baclofen, topiramate, galantamine, and bromocriptine. Studies of combination NRT and varenicline showed the greatest smoking cessation rates. Clonidine and nortriptyline are second-line treatments used when first-line treatments fail or are contraindicated, or by patient preference. Some novel therapies, especially acetylcholinesterase inhibitors, cytisine, and N-acetylcysteine, display promising results. Because the results of randomized clinical trials were reported using varied end points and outcome measures, direct comparisons between different pharmacotherapies cannot easily be evaluated. Additional high-quality randomized double-blind placebo-controlled trials with long-term follow-up, using validated sustained abstinence measures, are needed to find more
Moorhouse, Michael D.; Pomeranz, Jamie L.; Barnett, Tracey E.; Yu, Nami S.; Curbow, Barbara A.
People with disabilities (PWD) are 50% more likely to smoke compared with the general population, yet interventions tailored to the needs of PWD remain limited. The authors surveyed directors from a leading disability service organization to assess their delivery of tobacco cessation interventions. Although tobacco cessation was identified as a…
Chen, Timothy C.; Hamlett-Berry, Kim W.; Watanabe, Jonathan H.; Bounthavong, Mark; Zillich, Alan J.; Christofferson, Dana E.; Myers, Mark G.; Himstreet, Julianne E.; Belperio, Pamela S.; Hudmon, Karen Suchanek
Background: Health care professionals can have a dramatic impact by assisting patients with tobacco cessation but most have limited training. Purpose: To evaluate the effectiveness of a 4-hour tobacco cessation training program. Methods: A team of multidisciplinary health care professionals created a veteran-specific tailored version of the Rx for…
Harris, Jeffrey E; Balsa, Ana Inés; Triunfo, Patricia
We analyzed a nationwide registry of all pregnancies in Uruguay during 2007-2013 to assess the impact of three types of tobacco control policies: (1) provider-level interventions aimed at the treatment of nicotine dependence, (2) national-level increases in cigarette taxes, and (3) national-level non-price regulation of cigarette packaging and marketing. We estimated models of smoking cessation during pregnancy at the individual, provider and national levels. The rate of smoking cessation during pregnancy increased from 15.4% in 2007 to 42.7% in 2013. National-level non-price policies had the largest estimated impact on cessation. The price response of the tobacco industry attenuated the effects of tax increases. While provider-level interventions had a significant effect, they were adopted by relatively few health centers. Quitting during pregnancy increased birth weight by an estimated 188 g. Tobacco control measures had no effect on the birth weight of newborns of non-smoking women. Copyright © 2015 Elsevier B.V. All rights reserved.
Sreeramareddy, Chandrashekhar T; Ramakrishnareddy, N; Rahman, Mahbubur; Mir, Imtiyaz Ali
Health professionals play an important role in providing advice to their patients about tobacco prevention and cessation. Health professionals who use tobacco may be deterred from providing cessation advice and counselling to their patients. We aimed to provide prevalence estimates of tobacco use among student health professionals and describe their attitudes towards tobacco cessation training. Country-wise aggregate data from the Global Health Professions Student Survey on 'c urrent cigarette smoking' (smoking cigarettes on 1 or more days during the past 30 days), and ' curren t use of tobacco products other than cigarettes' (chewing tobacco, snuff, bidis, cigars or pipes, 1 or more days during the past 30 days) were analysed. For each WHO region, we estimated mean prevalence rates of tobacco use weighted by the population of the sampling frame and aggregate proportions for ' health professionals' role' and ' cessation training' indicators using ' metaprop ' command on Stata V.11. A total of 107 527 student health professionals participated in 236 surveys done in four health profession disciplines spanning 70 countries with response rates ranging from 40% to 100%. Overall, prevalence of smoking was highest in European countries (20% medical and 40% dental students) and the Americas (13% pharmacy to 23% dental students). Other tobacco use was higher in eastern Mediterranean (10%-23%) and European countries (7%-13%). In most WHO regions, ≥70% of the students agreed that health professionals are role models, and have a role in advising about smoking cessation to their patients and the public. Only ≤33% of all student health professionals in most WHO regions (except 80% dental students in the Eastern Mediterranean region) had received formal training on smoking cessation approaches and ≥80% of all students agreed that they should receive formal cessation training. Tobacco control should take place together with medical educators to discourage tobacco use among
Smith Patricia M
Full Text Available Abstract Background This study was a pre-program evaluation of hospital-based nurses' tobacco intervention beliefs, confidence, training, practice, and perceived intervention barriers and facilitators. It was designed to identify relevant information prior to implementing tobacco cessation guidelines across a large northern rural region, home to 1 urban and 12 rural hospitals. Methods This cross-sectional survey was distributed by nurse managers to nurses in the 13 hospitals and returned by nurses (N = 269 via mail to the researchers. Results Nurses were somewhat confident providing cessation interventions, agreed they should educate patients about tobacco, and 94% perceived tobacco counselling as part of their role. Although only 11% had received cessation training, the majority reported intervening, even if seldom--91% asked about tobacco-use, 96% advised quitting, 89% assessed readiness to quit, 88% assisted with quitting, and 61% arranged post-discharge follow-up. Few performed any of these steps frequently, and among those who intervened, the majority spent Conclusions The findings showed nurses' willingness to engage in tobacco interventions. What the majority were doing maps onto the recommended minimum of 1-3 minutes but intervention frequency and follow-up were suboptimal. The rural-urban differences suggest a need for more research to explore the strengths of rural practice which could potentially inform approaches to smoking cessation in urban hospitals.
Ramseier, Christoph A; Warnakulasuriya, Saman; Needleman, Ian G; Gallagher, Jennifer E; Lahtinen, Aira; Ainamo, Anja; Alajbeg, Ivan; Albert, David; Al-Hazmi, Nadia; Antohé, Magda Ecaterina; Beck-Mannagetta, Johann; Benzian, Habib; Bergström, Jan; Binnie, Viv; Bornstein, Michael; Büchler, Silvia; Carr, Alan; Carrassi, Antonio; Casals Peidró, Elias; Chapple, Ian; Compton, Sharon; Crail, Jon; Crews, Karen; Davis, Joan Mary; Dietrich, Thomas; Enmark, Birgitta; Fine, Jared; Gallagher, Jennifer; Jenner, Tony; Forna, Doriana; Fundak, Angela; Gyenes, Monika; Hovius, Marjolijn; Jacobs, Annelies; Kinnunen, Taru; Knevel, Ron; Koerber, Anne; Labella, Roberto; Lulic, Martina; Mattheos, Nikos; McEwen, Andy; Ohrn, Kerstin; Polychronopoulou, Argy; Preshaw, Philip; Radley, Nicki; Rosseel, Josine; Schoonheim-Klein, Meta; Suvan, Jean; Ulbricht, Sabina; Verstappen, Petra; Walter, Clemens; Warnakulasuriya, Saman; Wennström, Jan; Wickholm, Seppo; Zoitopoulos, Liana
Tobacco use has been identified as a major risk factor for oral disorders such as cancer and periodontal disease. Tobacco use cessation (TUC) is associated with the potential for reversal of precancer, enhanced outcomes following periodontal treatment, and better periodontal status compared to patients who continue to smoke. Consequently, helping tobacco users to quit has become a part of both the responsibility of oral health professionals and the general practice of dentistry. TUC should consist of behavioural support, and if accompanied by pharmacotherapy, is more likely to be successful. It is widely accepted that appropriate compensation of TUC counselling would give oral health professionals greater incentives to provide these measures. Therefore, TUC-related compensation should be made accessible to all dental professionals and be in appropriate relation to other therapeutic interventions. International and national associations for oral health professionals are urged to act as advocates to promote population, community and individual initiatives in support of tobacco use prevention and cessation (TUPAC) counselling, including integration in undergraduate and graduate dental curricula. In order to facilitate the adoption of TUPAC strategies by oral health professionals, we propose a level of care model which includes 1) basic care: brief interventions for all patients in the dental practice to identify tobacco users, assess readiness to quit, and request permission to re-address at a subsequent visit, 2) intermediate care: interventions consisting of (brief) motivational interviewing sessions to build on readiness to quit, enlist resources to support change, and to include cessation medications, and 3) advanced care: intensive interventions to develop a detailed quit plan including the use of suitable pharmacotherapy. To ensure that the delivery of effective TUC becomes part of standard care, continuing education courses and updates should be implemented and
Ali, S.; Naqvi, A.
Background: Tobacco is the single leading and most preventable cause of death in today's worlds and responsible for six of the eight leading mortality causes in the world. Diseases related to tobacco use are known to cause about 5.4 million deaths every year, 80% of which are contributed by the developing world, and this toll is estimated to increase up to 8 million deaths per year by 2030. This study was conducted to determine the number of women who were offered counselling regarding cessation of tobacco use by all health care providers (medical and alternate), in rural Sindh, Pakistan. Methods: This cross-sectional survey was conducted during January to March, 2008 in District Khairpur, Sindh, Pakistan. A validated, pre-tested, translated questionnaire was used to collect the data from 502, adult women (aged between 18-60 years). These women were asked about the type of health provider they visited in the past 12 months and practices of provider regarding tobacco control including cessation and advice. Results: A large majority of women (nearly 71%) were illiterate, and 44% of women were in the age group 18-24 years. High prevalence (10%) of adult women were smokers. Only 12% of the total women who visited physicians during this time period were asked about their smoking status as compared to 7% who visited hakims and 13% who were approached by lady health visitors. Conclusion: A very small segment of the women users of health care system is enquired and counselled about tobacco use in any form by the health providers in Rural Sindh. Revisiting practices for health care professionals is urgently needed to address inevitable tobacco use in the region. (author)
Full Text Available This article systematically reviews 91 smoking cessation and tobacco prevention studies tailored for Indigenous populations around the world, with a particular focus on Aboriginal and Torres Strait Islander populations in Australia. We identified several components of effective interventions, including the use of multifaceted programs that simultaneously address the behavioural, psychological and biochemical aspects of addiction, using resources culturally tailored for the needs of individual Indigenous populations. Pharmacotherapy for smoking cessation was effective when combined with culturally tailored behavioural interventions and health professional support, though it is generally underused in clinical practice. From a policy perspective, interventions of greater intensity, with more components, were more likely to be effective than those of lower intensity and shorter duration. For any new policy it is important to consider community capacity building, development of knowledge, and sustainability of the policy beyond guided implementation. Future research should address how the intervention can be supported into standard practice, policy, or translation into the front-line of clinical care. Investigations are also required to determine the efficacy of emerging therapies (such as e-cigarettes and the use of social media to tackle youth smoking, and under-researched interventions that hold promise based on non-Indigenous studies, such as the use of Champix. We conclude that more methodologically rigorous investigations are required to determine components of the less-successful interventions to aid future policy, practice and research initiatives.
paucity of cessation clinics in India. Women are reluctant and fear the stigma of approaching cessation clinics. Proactive measures must be used to motivate women to go through the cessation follow up.
Campbell, Jean; Mays, Mary Z; Yuan, Nicole P; Muramoto, Myra L
To describe characteristics of health influencers (HIs) prior to training in brief tobacco cessation interventions (BI). HIs (n=910) in Arizona were recruited for a randomized controlled trial comparing training modalities. Typically middle-aged (M=43, SD=14), non-Hispanic white (68%), female (77%), non-tobacco users (93%), most identified personal (89%) rather than job-related (3%) motivators for becoming cessation interveners. Confidence about intervention ability was high (93%); knowledge scores, however, were low (M=55%, SD=13%). HIs exhibiting high motivation to intervene but lacking knowledge about BI strategies may be an untapped resource for tobacco cessation and a variety of other health promotion interventions.
Aquilino, Mary Lober; Goody, Cynthia M; Lowe, John B
To examine the perspectives of WIC clinic providers on offering smoking cessation interventions for pregnant women. Four focus groups consisting of WIC nurses, dietitians, and social workers (N = 25) were conducted at WIC clinics in eastern Iowa. Researchers developed discussion guidelines to determine how WIC providers currently approached pregnant women who smoke cigarettes and what they considered barriers to providing effective smoking cessation interventions. Code mapping was used to analyze focus group discussions. Factors influencing the ability of WIC staff to provide a smoking cessation intervention for pregnant women included available time, clinic priorities, staff approaches to clients, and staff training. In addition, providers expressed concerns about educational materials for clients as well as additional client issues that prevented smoking cessation. The absence of mechanisms to track clinic outcomes related to smoking cessation was also noted. WIC providers have time limitations that may necessitate minimal or low-intensity interventions for smoking cessation, but did not know that such approaches are actually effective. WIC providers require more education about the entire issue of smoking cessation in order to become more proactive in their attempts to help pregnant women quit. Training that enhances self-efficacy and understanding of the impact of smoking on mothers, infants, and children should be initiated to motivate staff to intervene. Another strategy to motivate WIC staff in this regard could be tracking clinic outcomes in helping women to quit smoking or prevent relapse.
Eaves, Emery R; Howerter, Amy; Nichter, Mark; Floden, Lysbeth; Gordon, Judith S; Ritenbaugh, Cheryl; Muramoto, Myra L
This article presents findings from qualitative interviews conducted as part of a research study that trained Acupuncture, Massage, and Chiropractic practitioners' in Arizona, US, to implement evidence-based tobacco cessation brief interventions (BI) in their routine practice. The qualitative phase of the overall study aimed to assess: the impact of tailored training in evidence-based tobacco cessation BI on complementary and alternative medicine (CAM) practitioners' knowledge and willingness to implement BIs in their routine practice; and their patients' responses to cessation intervention in CAM context. To evaluate the implementation of skills learned from a tailored training program, we conducted semi-structured qualitative interviews with 54 CAM practitioners in Southern Arizona and 38 of their patients. Interview questions focused on reactions to the implementation of tobacco cessation BIs in CAM practice. After participating in a tailored BI training, CAM practitioners reported increased confidence, knowledge, and motivation to address tobacco in their routine practice. Patients were open to being approached by CAM practitioners about tobacco use and viewed BIs as an expected part of wellness care. Tailored training motivated CAM practitioners in this study to implement evidence-based tobacco cessation BIs in their routine practice. Results suggest that CAM practitioners can be a valuable point of contact and should be included in tobacco cessation efforts.
Castañeda, Heide; Nichter, Mark; Nichter, Mimi; Muramoto, Myra
The authors present findings from a community-based tobacco cessation project that trained lay health influencers to conduct brief interventions. They outline four major lessons regarding sustainability. First, participants were concerned about the impact that promoting cessation might have on social relationships. "Social risk" must be addressed during training to ensure long-term sustainability. Second, formal training provided participants with an increased sense of self-efficacy, allowed them to embrace a health influencer identity, and aided in further reducing social risk. Third, material resources functioned to mediate social tensions during health intervention conversations. A variety of resources should be made available to health influencers to accommodate type of relationship, timing, and location of the interaction. Finally, project design must be attentive to the creation of a "community of practice" among health influencers as an integral part of project sustainability. These lessons have broad implications for successful health promotion beyond tobacco cessation.
Schauer, Gillian L; King, Brian A; McAfee, Timothy A
Approximately 70% of current (past 30-day) adult marijuana users are current tobacco users, which may complicate tobacco cessation. We assessed prevalence and trends in tobacco cessation among adult ever tobacco users, by marijuana use status. Data came from the National Survey on Drug Use and Health, a cross-sectional, nationally representative, household survey of U.S. civilians. Analyses included current, former, and never marijuana users aged≥18 reporting ever tobacco use (cigarette, cigar, chew/snuff). We computed weighted estimates (2013-2014) of current tobacco use, recent tobacco cessation (quit 30days to 12months), and sustained tobacco cessation (quit>12months) and adjusted trends in tobacco use and cessation (2005-2014) by marijuana use status. We also assessed the association between marijuana and tobacco use status. In 2013-2014, among current adult marijuana users reporting ever tobacco use, 69.1% were current tobacco users (vs. 38.5% of former marijuana users, pusers, pusers, pusers, pusers, pusers, pusers who ever used tobacco had double the prevalence (vs. never-marijuana users) of current tobacco use, and significantly lower sustained abstinence. Interventions addressing tobacco cessation in the context of use of marijuana and other substances may be warranted. Copyright © 2017 Elsevier Ltd. All rights reserved.
Davis, Joan M; Ramseier, Christoph A; Mattheos, Nikos; Schoonheim-Klein, Meta; Compton, Sharon; Al-Hazmi, Nadia; Polychronopoulou, Argy; Suvan, Jean; Antohé, Magda E; Forna, Doriana; Radley, Nicki
The use of tobacco continues to be a substantial risk factor in the development and progression of oral cancer, periodontitis, implant failure and poor wound healing. Dental and dental hygiene education providers have made great advances towards the incorporation of tobacco education into their curricula in recent years. Unfortunately, however, both medical and dental education research has consistently reported schools providing only basic knowledge-based curricula that rarely incorporate more effective, behaviourally-based components affecting long-term change. The limited training of oral healthcare students, at least in part, is reflected in practising dental professionals continuing to report offering incomplete tobacco interventions. In order to prepare the next generation of oral healthcare providers, this paper proposes a paradigm shift in how tobacco use prevention and cessation (TUPAC) may be incorporated into existing curricula. It is suggested that schools should carefully consider: to what level of competency should TUPAC be trained in dental and dental hygiene schools; the importance of establishing rapport through good communication skills; the core knowledge level for TUPAC; suggested instructional and assessment strategies; the importance of continuing professional education for the enhancement of TUPAC.
Abraham, Amanda J; Bagwell-Adams, Grace; Jayawardhana, Jayani
Given the high prevalence of smoking among substance use disorder (SUD) patients, the specialty SUD treatment system is an important target for adoption and implementation of tobacco cessation (TC) services. While research has addressed the impact of tobacco control on individual tobacco consumption, largely overlooked in the literature is the potential impact of state tobacco control policies on availability of services for tobacco cessation. This paper examines the association between state tobacco control policy and availability of TC services in SUD treatment programs in the United States. State tobacco control and state demographic data (n=51) were merged with treatment program data from the 2012 National Survey of Substance Abuse Treatment Services (n=10.413) to examine availability of TC screening, counseling and pharmacotherapy services in SUD treatment programs using multivariate logistic regression models clustered at the state-level. Approximately 60% of SUD treatment programs offered TC screening services, 41% offered TC counseling services and 26% offered TC pharmacotherapy services. Results of multivariate logistic regression showed the odds of offering TC services were greater for SUD treatment programs located in states with higher cigarette excise taxes and greater spending on tobacco prevention and control. Findings indicate cigarette excise taxes and recommended funding levels may be effective policy tools for increasing access to TC services in SUD treatment programs. Coupled with changes to insurance coverage for TC under the Affordable Care Act, state tobacco control policy tools may further reduce tobacco use in the United States. Published by Elsevier Ltd.
Full Text Available Smokers keep smoking despite knowing that tobacco claims many lives, including their own and others’. What makes it hard for them to quit smoking nonetheless? Tobacco companies insist that smokers choose to smoke, according to their right to self-determination. Moreover, they insist that with motivation and willpower to quit smoking, smokers can easily stop smoking. Against this backdrop, this paper aims to discuss the addictive disease called tobacco use disorder, with an assessment of the addictiveness of tobacco and the reasons why smoking cessation is challenging, based on neuroscientific research. Nicotine that enters the body via smoking is rapidly transmitted to the central nervous system and causes various effects, including an arousal response. The changes in the nicotine receptors in the brain due to continuous smoking lead to addiction symptoms such as tolerance, craving, and withdrawal. Compared with other addictive substances, including alcohol and opioids, tobacco is more likely to cause dependence in smokers, and smokers are less likely to recover from their dependence. Moreover, the thinning of the cerebral cortex and the decrease in cognitive functions that occur with aging accelerate with smoking. Such changes occur in the structure and functions of the brain in proportion to the amount and period of smoking. In particular, abnormalities in the neural circuits that control cognition and decision-making cause loss of the ability to exert self-control and autonomy. This initiates nicotine dependence and the continuation of addictive behaviors. Therefore, smoking is considered to be a behavior that is repeated due to dependence on an addictive substance, nicotine, instead of one’s choice by free will.
Jannat-Khah, Deanna P; McNeely, Jennifer; Pereyra, Margaret R; Parish, Carrigan; Pollack, Harold A; Ostroff, Jamie; Metsch, Lisa; Shelley, Donna R
Dental visits represent an opportunity to identify and help patients quit smoking, yet dental settings remain an untapped venue for treatment of tobacco dependence. The purpose of this analysis was to assess factors that may influence patterns of tobacco-use-related practice among a national sample of dental providers. We surveyed a representative sample of general dentists practicing in the United States (N = 1,802). Multivariable analysis was used to assess correlates of adherence to tobacco use treatment guidelines and to analyze factors that influence providers' willingness to offer tobacco cessation assistance if reimbursed for this service. More than 90% of dental providers reported that they routinely ask patients about tobacco use, 76% counsel patients, and 45% routinely offer cessation assistance, defined as referring patients for cessation counseling, providing a cessation prescription, or both. Results from multivariable analysis indicated that cessation assistance was associated with having a practice with 1 or more hygienists, having a chart system that includes a tobacco use question, having received training on treating tobacco dependence, and having positive attitudes toward treating tobacco use. Providers who did not offer assistance but who reported that they would change their practice patterns if sufficiently reimbursed were more likely to be in a group practice, treat patients insured through Medicaid, and have positive attitudes toward treating tobacco dependence. Findings indicate the potential benefit of increasing training opportunities and promoting system changes to increase involvement of dental providers in conducting tobacco use treatment. Reimbursement models should be tested to assess the effect on dental provider practice patterns.
Danhauer, Suzanne C.; Tooze, Janet A.; Blackstock, A. William; Spangler, John; Thomas, Leslie; Sutfin, Erin L.
Purpose. Many cancer patients continue to smoke after diagnosis, increasing their risk for treatment complications, reduced treatment efficacy, secondary cancers, and reduced survival. Outpatient oncology providers may not be using the “teachable moment” of cancer diagnosis to provide smoking cessation assistance. Providers and Methods. Physicians and midlevel providers (n = 74) who provide outpatient oncology services completed an online survey regarding smoking cessation counseling behaviors, beliefs, and perceived barriers. Outpatient medical records for 120 breast, lung, head and neck, colon, prostate, and acute leukemia cancer patients were reviewed to assess current smoking cessation assessment and intervention documentation practices. Results. Providers reported commonly assessing smoking in new patients (82.4% frequently or always), but rates declined at subsequent visits for both current smokers and recent quitters. Rates of advising patients to quit smoking were also high (86.5% frequently or always), but oncology setting. PMID:22334454
Stevens, Victor J; Solberg, Leif I; Quinn, Virginia P; Rigotti, Nancy A; Hollis, Jack A; Smith, K Sabina; Zapka, Jane G; France, Eric; Vogt, Thomas; Gordon, Nancy; Fishman, Paul; Boyle, Raymond G
This project examined tobacco policies and delivery of cessation services in nonprofit HMOs that collectively provide comprehensive medical care to more than 8 million members. Three annual surveys with health plan managers showed that all of these health plans had written tobacco control guidelines that became more comprehensive over the span of this study. We also surveyed a random sample of 4207 current smokers who had attended a primary care visit in the past year (399-528 at each of nine health plans). Of these smokers, 71% reported advice to quit, 56% were asked about their willingness to quit, 49% were provided some assistance in quitting (mostly self-help material or information about classes or counseling), and 9% were offered some kind of follow-up. Smokers receiving assistance in quitting reported higher satisfaction with their care. In general, health plans with the most comprehensive policies also showed higher rates of implementing tobacco treatment programs in primary care. Compared with tobacco control efforts of a decade or more ago, considerable progress has been made. However, there is still room for improvement in the proportion of smokers who receive the most effective forms of assistance in quitting.
Johnson, Joy L; Oliffe, John L; Kelly, Mary T; Bottorff, Joan L; LeBeau, Karen
The purpose of this qualitative study was to examine how new fathers decode image-based anti-smoking messages and uncover the extent to which ideals of masculinity might influence men to take up and/or disregard smoking cessation messages. The authors analyzed 5 images that had been used to promote smoking cessation and arrived at a consensus about the dominant discourse encoded by each image. During face-to-face interviews, new fathers were invited to discuss the images; these interview data were coded and analyzed using a social constructionist gender analysis. The study findings highlight how most men negotiated or opposed dominant discourses of health that communicated the dangers of smoking by reproducing dominant ideals of masculinity, including explicit disregard for self-health. They accepted dominant social discourses of fathering that reproduced traditional notions of masculinity, such as the protector and provider. The authors conclude that tobacco interventions targeted to new fathers must (a) develop more awareness of the ability of audiences to select discourses that empower their own interpretive positioning with regard to media, and (b) deconstruct and engage with context and age-specific masculine ideals to avoid providing rationales for continued tobacco use.
Namjuntra, Pisit; Suriyaprom, Kanjana
Compare tobacco use, exposure to second-hand smoke, and smoking cessation training among third-year medical technology students in Thailand between 2006 and 2011. The medical technology student survey was carried out with Global Health Professions Student Survey (GHPSS) between October and November 2011. The population of the present study was all students in nine medical technology schools. There were 773 students enrolled in this study yielding a response rate of 95.1%. The prevalence of current cigarette smokers had decreased from 2006 to 2011 (4.8% to 1.4%, respectively). Rates of exposure to second-hand smoke at home were 36.3% in 2006 and 39.7% in 2011, while rates of exposure to second-hand smoke in other places did not change. Most students recognized that they should give patients counseling to quit smoking, but only 20.6% in 2006 and 28.4% in 2011 of them had received formal training in tobacco cessation counseling. There were low percentages of current cigarette smoking but high percentages of exposure to second-hand smoke among medical technology students. The percentage of cessation training was still low among students. Therefore, medical technology schools should provide formal training in tobacco cessation for all students to help improve their ability in providing advice to patients.
Prabandari, Yayi Suryo; Nichter, Mark; Nichter, Mimi; Padmawathi, Retna Siwi; Muramoto, Myra
This paper describes a pioneering effort to introduce smoking cessation into Indonesia's medical school curriculum, and the first ever attempt to fully integrate tobacco control in all four years of medical school anywhere in Southeast Asia. The development, pretesting, and piloting of an innovative modular tobacco curriculum are discussed as well as the challenges that face implementation. In-depth interviews were conducted with medical school administrators and faculty in four medical colleges to determine interest in and willingness to fully integrate tobacco cessation into the college curriculum. A tobacco focused curriculum review, student focus groups, and a survey of medical students (n = 579) assessed current exposure to information about tobacco and interest in learning cessation skills. A modular tobacco curriculum was developed and was pretested, modified, piloted, and evaluated. Qualitative research was conducted to identify potential challenges to future curriculum implementation. Fifteen modules were successfully developed focusing on the relationship between tobacco and specific organ systems, diseases related to smoking, the impact of tobacco on medication effectiveness, and information on how to explain to patients about effects of tobacco on their health condition. Lecturers and students positively evaluated the curriculum as increasing their competency to support cessation during illness as a teachable moment. Systemic challenges to implementing the curriculum were identified including shifts in pedagogy, decentralized curriculum decision-making, and frequent lecturer turnover. A fully integrated tobacco curriculum for medical schools was piloted and is now freely available online. An important lesson learned in Indonesia was that a tobacco curriculum must be flexible enough to be adjusted when shifts in medical education take place. The curriculum is a resource for medical colleges and expert committees in Southeast Asia deliberating how best to
Smoking cessation - medications; Smokeless tobacco - medications; Medications for stopping tobacco ... Smoking cessation medicines can: Help with the craving for tobacco. Help you with withdrawal symptoms. Keep you ...
Boccio, Mindy; Sanna, Rashel S.; Adams, Sara R.; Goler, Nancy C.; Brown, Susan D.; Neugebauer, Romain S.; Ferrara, Assiamira; Wiley, Deanne M.; Bellamy, David J.; Schmittdiel, Julie A.
Purpose Many Americans continue to smoke, increasing their risk of disease and premature death. Both telephone-based counseling and in-person tobacco cessation classes may improve access for smokers seeking convenient support to quit. Little research has assessed whether such programs are effective in real-world clinical populations. Design Retrospective cohort study comparing wellness coaching participants with two groups of controls. Setting Kaiser Permanente, Northern California (KPNC), a large integrated health care delivery system. Subjects 241 patients who participated in telephonic tobacco cessation coaching from 1/1/2011–3/31/2012, and two control groups: propensity-score matched controls, and controls who participated in a tobacco cessation class during the same period. Wellness coaching participants received an average of two motivational interviewing based coaching sessions that engage the patient, evoke their reason to consider quitting and help them establish a quit plan. Measures Self-reported quitting of tobacco and fills of tobacco cessation medications within 12 months of follow-up. Analysis Logistic regressions adjusting for age, gender, race/ethnicity, and primary language. Results After adjusting for confounders, tobacco quit rates were higher among coaching participants vs. matched controls (31% vs. 23%, PCoaching participants and class attendees filled tobacco-cessation prescriptions at a higher rate (47% for both) than matched controls (6%, Pcoaching was as effective as in-person classes and was associated with higher rates of quitting compared to no treatment. The telephonic modality may increase convenience and scalability for health care systems looking to reduce tobacco use and improve health. PMID:26559720
DiGiulio, Anne; Haddix, Meredith; Jump, Zach; Babb, Stephen; Schecter, Anna; Williams, Kisha-Ann S; Asman, Kat; Armour, Brian S
In 2015, 27.8% of adult Medicaid enrollees were current cigarette smokers, compared with 11.1% of adults with private health insurance, placing Medicaid enrollees at increased risk for smoking-related disease and death (1). In addition, smoking-related diseases are a major contributor to Medicaid costs, accounting for about 15% (>$39 billion) of annual Medicaid spending during 2006-2010 (2). Individual, group, and telephone counseling and seven Food and Drug Administration (FDA)-approved medications are effective treatments for helping tobacco users quit (3). Insurance coverage for tobacco cessation treatments is associated with increased quit attempts, use of cessation treatments, and successful smoking cessation (3); this coverage has the potential to reduce Medicaid costs (4). However, barriers such as requiring copayments and prior authorization for treatment can impede access to cessation treatments (3,5). As of July 1, 2016, 32 states (including the District of Columbia) have expanded Medicaid eligibility through the Patient Protection and Affordable Care Act (ACA),* ,† which has increased access to health care services, including cessation treatments (5). CDC used data from the Centers for Medicare and Medicaid Services (CMS) Medicaid Budget and Expenditure System (MBES) and the Behavioral Risk Factor Surveillance System (BRFSS) to estimate the number of adult smokers enrolled in Medicaid expansion coverage. To assess cessation coverage among Medicaid expansion enrollees, the American Lung Association collected data on coverage of, and barriers to accessing, evidence-based cessation treatments. As of December 2015, approximately 2.3 million adult smokers were newly enrolled in Medicaid because of Medicaid expansion. As of July 1, 2016, all 32 states that have expanded Medicaid eligibility under ACA covered some cessation treatments for all Medicaid expansion enrollees, with nine states covering all nine cessation treatments for all Medicaid expansion
Nagelhout, Gera E.; Crone, Matty R.; van den Putte, Bas; Willemsen, Marc C.; Fong, Geoffrey T.; de Vries, Hein
This study aimed to examine age and educational inequalities in smoking cessation due to the implementation of a tobacco tax increase, smoke-free legislation and a cessation campaign. Longitudinal data from 962 smokers aged 15 years and older were used from three survey waves of the International Tobacco Control (ITC) Netherlands Survey. The 2008…
Tamí-Maury, Irene; Aigner, Carrie J; Hong, Judy; Strom, Sara; Chambers, Mark S; Gritz, Ellen R
Rates of tobacco use are increasing in the regions of Latin America and the Caribbean (LAC). Unfortunately, tobacco cessation education is not a standard component of the dental curriculum in LAC dental schools. The objective of this study was to identify the perceptions of LAC dental faculty members regarding the tobacco use prevention and cessation (TUPAC) competencies that should be addressed in the dental curricula. Dental deans and faculty completed a web-based questionnaire in Spanish, Portuguese, French, or English. The questionnaire contained 32 competencies grouped into the five A's (Ask, Advise, Assess, Assist, and Arrange) of tobacco cessation and six supplementary questions for identifying barriers to providing TUPAC education to dental students. Respondents indicated the degree to which they believed each competency should be incorporated into the dental curricula using a five-point Likert scale ("1" = strongly disagree to "5" = strongly agree). Responses were obtained from 390 faculty members (66 % South America, 18 % Mexico/Central America, 16 % the Caribbean). Of the respondents, 2, 12, and 83 % reported that smoking was allowed in clinical environments, other indoor environments, and outdoor environments of their dental schools, respectively. Mean importance ratings for each of the competencies were as follows: Ask (4.71), Advise (4.54), Assess (4.41), Assist (4.07), and Arrange (4.01). Overall, LAC dental educators agree that TUPAC training should be incorporated into the dental curricula. Assist and Arrange competencies were rated lower, relative to other competencies. Tobacco use among dental educators and high rates of on-campus smoking could potentially pose barriers to promoting cessation interventions in the LAC dental schools.
David, Annette M; Cruz, Peter J; Mercado, Susan P; Li, Dan
Tobacco control stakeholders in priority populations are searching for culturally appropriate cessation training models to strengthen cessation capacity and infrastructure. We adapted the University of Arizona model for Brief Tobacco Cessation Interventions training for Pacific Islanders and pilot-tested it in four Pacific Islands-Palau, the Federated States of Micronesia, the Northern Mariana Islands and the Marshall Islands. All participants completed a posttraining knowledge assessment exam, pre- and posttraining confidence assessments, and a quality improvement evaluation. Of 70 participants, 65 (93%) completed the training. Forty-one (63%) passed the posttraining knowledge assessment exam at the first attempt; an additional 9 (14%) successfully passed on their second attempt, for a total pass rate of 77%. The pre- and posttraining confidence surveys demonstrated a statistically significant increase in confidence across all competency areas for delivering brief advice. The quality improvement survey revealed high acceptance and approval for the content and delivery of the locally adapted training model. As Pacific Island communities enact tobacco control policies, cessation demand is growing. The Guam cessation training model used culturally relevant data, materials, and training approaches and appeared effective in four different Pacific island countries. This underscores the importance of culturally competent adaptation of cessation training for priority populations such as Pacific Islanders.
Crail, Jon; Lahtinen, Aira; Beck-Mannagetta, Johann; Benzian, Habib; Enmarks, Birgitta; Jenner, Tony; Knevel, Ron; Lulic, Martina; Wickholm, Seppo
Appropriate compensation of tobacco use prevention and cessation (TUPAC) would give oral health professionals better incentives to provide TUPAC, which is considered part of their professional and ethical responsibility and improves quality of care. Barriers for compensation are that tobacco addiction is not recognised as a chronic disease but rather as a behavioural disorder or merely as a risk factor for other diseases. TUPAC-related compensation should be available to oral health professionals, be in appropriate relation to other dental therapeutic interventions and should not be funded from existing oral health care budgets alone. We recommend modifying existing treatment and billing codes or creating new codes for TUPAC. Furthermore, we suggest a four-staged model for TUPAC compensation. Stages 1 and 2 are basic care, stage 3 is intermediate care and stage 4 is advanced care. Proceeding from stage 1 to other stages may happen immediately or over many years. Stage 1: Identification and documentation of tobacco use is part of each patient's medical history and included into oral examination with no extra compensation. Stage 2: Brief intervention consists of a motivational interview and providing information about existing support. This stage should be coded/reimbursed as a short preventive intervention similar to other advice for oral care. Stage 3: Intermediate care consists of a motivational interview, assessment of tobacco dependency, informing about possible support and pharmacotherapy, if appropriate. This stage should be coded as preventive intervention similar to an oral hygiene instruction. Stage 4: Advanced care. Treatment codes should be created for advanced interventions by oral health professionals with adequate qualification. Interventions should follow established guidelines and use the most cost-effective approaches.
Yzer, Marco; Weisman, Susan; Mejia, Nicole; Hennrikus, Deborah; Choi, Kelvin; DeSimone, Susan
Blue-collar workers typically have high rates of tobacco use but low rates of using tobacco cessation resources available through their health benefits. Interventions to motivate blue-collar tobacco users to use effective cessation support are needed. Reasoned action theory is useful in this regard as it can identify the beliefs that shape tobacco cessation benefit use intentions. However, conventional reasoned action research cannot speak to how those beliefs can best be translated into intervention messages. In the present work, we expand the reasoned action approach by adding additional qualitative inquiry to better understand blue-collar smokers' beliefs about cessation benefit use. Across three samples of unionized blue-collar tobacco users, we identified (1) the 35 attitudinal, normative, and control beliefs that represented tobacco users' belief structure about cessation benefit use; (2) instrumental attitude as most important in explaining cessation intention; (3) attitudinal beliefs about treatment options' efficacy, health effects, and monetary implications of using benefits as candidates for message design; (4) multiple interpretations of cessation beliefs (e.g., short and long-term health effects); and (5) clear implications of these interpretations for creative message design. Taken together, the findings demonstrate how a mixed-method reasoned action approach can inform interventions that promote the use of tobacco cessation health benefits.
DiGiulio, Anne; Jump, Zach; Yu, Annie; Babb, Stephen; Schecter, Anna; Williams, Kisha-Ann S; Yembra, Debbie; Armour, Brian S
Cigarette smoking prevalence among Medicaid enrollees (25.3%) is approximately twice that of privately insured Americans (11.8%), placing Medicaid enrollees at increased risk for smoking-related disease and death (1). Medicaid spends approximately $39 billion annually on treating smoking-related diseases (2). Individual, group, and telephone counseling and seven Food and Drug Administration (FDA)-approved medications* are effective in helping tobacco users quit (3). Although state Medicaid coverage of tobacco cessation treatments improved during 2014-2015, coverage was still limited in most states (4). To monitor recent changes in state Medicaid cessation coverage for traditional (i.e., nonexpansion) Medicaid enrollees, the American Lung Association collected data on coverage of a total of nine cessation treatments: individual counseling, group counseling, and seven FDA-approved cessation medications † in state Medicaid programs during July 1, 2015-June 30, 2017. The American Lung Association also collected data on seven barriers to accessing covered treatments, such as copayments and prior authorization. As of June 30, 2017, 10 states covered all nine of these treatments for all enrollees, up from nine states as of June 30, 2015; of these 10 states, Missouri was the only state to have removed all seven barriers to accessing these cessation treatments. State Medicaid programs that cover all evidence-based cessation treatments, remove barriers to accessing these treatments, and promote covered treatments to Medicaid enrollees and health care providers would be expected to reduce smoking, smoking-related disease, and smoking-attributable federal and state health care expenditures (5-7).
Pearce, Jamie; Rind, Esther; Shortt, Niamh; Tisch, Catherine; Mitchell, Richard
Many neighborhood characteristics may constrain or enable smoking. This study investigated whether the neighborhood tobacco retail environment was associated with individual-level smoking and cessation in Scottish adults, and whether inequalities in smoking status were related to tobacco retailing. Tobacco outlet density measures were developed for neighborhoods across Scotland using the September 2012 Scottish Tobacco Retailers Register. The outlet data were cleaned and geocoded (n = 10,161) using a Geographic Information System. Kernel density estimation was used to calculate an outlet density measure for each postcode. The kernel density estimation measures were then appended to data on individuals included in the 2008-2011 Scottish Health Surveys (n = 28,751 adults aged ≥16), via their postcode. Two-level logistic regression models examined whether neighborhood density of tobacco retailing was associated with current smoking status and smoking cessation and whether there were differences in the relationship between household income and smoking status, by tobacco outlet density. After adjustment for individual- and area-level confounders, compared to residents of areas with the lowest outlet densities, those living in areas with the highest outlet densities had a 6% higher chance of being a current smoker, and a 5% lower chance of being an ex-smoker. There was little evidence to suggest that inequalities in either current smoking or cessation were narrower in areas with lower availability of tobacco retailing. The findings suggest that residents of environments with a greater availability of tobacco outlets are more likely to start and/or sustain smoking, and less likely to quit. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: email@example.com.
6 Department of Pulmonology and Critical Care, School of Clinical Medicine, Nelson R Mandela College of .... and strength of supporting data are presented and expert opinion was ... of discussions with patients around smoking, counselling and referral .... Varenicline is an effective smoking cessation therapy (Grade A).
Blankers, Matthijs; Buisman, Renate; Hopman, Petra; van Gool, Ronald; van Laar, Margriet
Tobacco use prevalence is elevated among people with mental illnesses, leading to elevated rates of premature smoking-related mortality. Opportunities to encourage smoking cessation among them are currently underused by mental health professionals. In this paper, we aim to explore mechanisms to invigorate professionals' intentions to help patients stop smoking. Data stem from a recent staff survey on the provision of smoking cessation support to patients with mental illnesses in the Netherlands. Items and underlying constructs were based on the theory of planned behaviour and literature on habitual behaviour. Data were weighted and only data from staff members with regular patient contact (n = 506) were included. Descriptive statistics of the survey items are presented and in a second step using structural equation modelling (SEM), we regressed the latent variables attitudes, subjective norms (SN), perceived behavioural control (PBC), past cessation support behaviour (PB) and current smoking behaviour on intentions to provide support. In optimisation steps, models comprising a subset of this initial model were evaluated. A sample of 506 mental health workers who had direct contact with patients completed the survey. The majority of them were females (70.0 %), respondents had an average age of 42.5 years (SD = 12.0). Seventy-five percent had at least a BSc educational background. Of the respondents, 76 % indicated that patients should be encouraged more to quit smoking. Respondents were supportive to train their direct colleagues to provide cessation support more often (71 %) and also supported the involvement of mental health care facilities in providing cessation support to patients (69 %). The majority of the respondents feels capable to provide cessation support (66 %). Two thirds of the respondents wants to provide support, however only a minority (35 %) intends to actually do so during the coming year. Next, using SEM an acceptable fit was
Cantrell, Jennifer; Anesetti-Rothermel, Andrew; Pearson, Jennifer L; Xiao, Haijun; Vallone, Donna; Kirchner, Thomas R
This study examined the impact of tobacco retail outlets on cessation outcomes over time among non-treatment-seeking smokers and assessed differences by neighborhood poverty and individual factors. Observational longitudinal cohort study using geospatial data. We used generalized estimating equations to examine cessation outcomes in relation to the proximity and density of tobacco retail outlets near the home. Eight large Designated Media Areas across the United States. A total of 2377 baseline smokers followed over three waves from 2008 to 2010. Outlet addresses were identified through North American Industry Classification System codes and proximity and density measures were constructed for each participant at each wave. Outcomes included past 30-day abstinence and pro-cessation attitudes. Smokers in high poverty census tracts living between 500 m and 1.9 km from an outlet were over two times more likely to be abstinent than those living fewer than 500 m from an outlet (P < 0.05). Density within 500 m of home was associated with reduced abstinence [odds ratio (OR) = 0.94; confidence interval (CI) = 0.90, 0.98) and lower pro-cessation attitudes (Coeff = -0.07, CI = -0.10, -0.03) only in high poverty areas. In low poverty areas, density within 500 m was associated with greater pro-cessation attitudes (OR = 0.06; CI = 0.01, 0.12). Gender, education and heaviness of smoking did not moderate the impact of outlet proximity and density on cessation outcomes. In the United States, density of tobacco outlets within 500 m of the home residence appears to be negatively associated with smoking abstinence and pro-cessation attitudes only in poor areas. © 2014 Society for the Study of Addiction.
... (chewing tobacco and snuff) has not been a focus of medical services or research, Epidemiological data suggest that while smoking has continued to decline both in the general population and within the military, the use...
Pai, Anuradha; Prasad, Shesha
Tobacco use is a global health care problem. Repetitive exposure to nicotine produces neuroadaptation resulting in nicotine dependence. Smoking is associated with a range of diseases, causing high levels of morbidity and mortality and is one of the leading causes of preventable deaths, with more than 4.6 million smokers worldwide dying each year from smoking related illnesses. Stopping smoking has major health benefits. Quitting at any age provides both short and long term benefits. 45 patients attending the outpatient department at the Oxford Dental College, Bangalore, were randomly allocated to three groups of interventions namely placebo, counseling and nicotine replacement therapy (NRT). Initially each one was assessed for carbon monoxide levels using a breath analyser (pico smokerlyser bedfont UK). They were followed up for six months and the carbon monoxide levels were again assessed using the same instrument. The paired t test was used to compare the results before and after the intervention. The scores before the initiation of intervention and after treatment were compared and all three interventions were found to be statistically significant after six months. It was noticed that patients with very low or low dependence followed by high dependence had good response in the placebo group (68% and 47.6% respectively), in the counseling group maximum response was seen in the medium followed by the very low group (61% and 59% respectively), and maximum response was seen in very high followed by the very low group with NRT (78.7% and 60.5% respectively). The inference that can be drawn from the present study is that non-invasive, non pharmacological methods like placebo and counseling are effective in low to medium groups, and NRT is effective with higher nicotine dependence.
Full Text Available Abstract Background The prevalence of tobacco smoking in Germany is high (~27%. Monitoring of national patterns of smoking behaviour and data on the “real-world” effectiveness of cessation methods are needed to inform policies and develop campaigns aimed at reducing tobacco-related harm. In England, the Smoking Toolkit Study (STS has been tracking such indicators since 2006, resulting in the adaptation of tobacco control policies. However, findings cannot be directly transferred into the German health policy context. The German Study on Tobacco Use (DEBRA: “Deutsche Befragung zum Rauchverhalten” aims to provide such nationally representative data. Methods/Design In June 2016, the study started collecting data from computer-assisted, face-to-face household interviews in people aged 14 years and older. Over a period of 3 years, a total of ~36,000 respondents will complete the survey with a new sample of ~2000 respondents every 2 months (=18 waves. This sample will report data on demographics and the use of tobacco and electronic (e-cigarettes. Per wave, about 500–600 people are expected to be current or recent ex-smokers (<12 months since quitting. This sample will answer detailed questions about smoking behaviour, quit attempts, exposure to health professionals’ advice on quitting, and use of cessation aids. Six-month follow-up data will be collected by telephone. Discussion The DEBRA study will be an important source of data for tobacco control policies, health strategies, and future research. The methodology is closely aligned to the STS, which will allow comparisons with data from England, a country with one of the lowest smoking prevalence rates in Europe (18%. Trial registration This study has been registered at the German Clinical Trials Register ( DRKS00011322 on 25th November 2016.
Yuan, Nicole P.; Castaneda, Heide; Nichter, Mark; Nichter, Mimi; Wind, Steven; Carruth, Lauren; Muramoto, Myra
Interventions tailored to individual smoker characteristics have increasingly received attention in the tobacco control literature. The majority of tailored interventions are generated by computers and administered with printed materials or web-based programs. The purpose of this study was to examine the tailoring activities of community lay…
Lee, Joseph G. L.; Matthews, Alicia K.; McCullen, Cramer A.; Melvin, Cathy L.
Context Lesbian, gay, bisexual, and transgender (LGBT) people are at increased risk for the adverse effects of tobacco use given their high prevalence of use, especially smoking. Evidence regarding cessation is limited. To determine if efficacious interventions are available and to aid the development of interventions, a systematic review was conducted of gray and peer-reviewed literature describing clinical, community, and policy interventions as well as knowledge, attitudes, and behaviors regarding tobacco use cessation among LGBT people. Evidence acquisition Eight databases for articles from 1987 to April 23, 2014 were searched. In February–November 2013, authors and researchers were contacted to identify gray literature. Evidence synthesis The search identified 57 records, of which 51 were relevant and 22 were from the gray literature; these were abstracted into evidence tables, and a narrative synthesis was conducted in October–May 2014. Group cessation curricula tailored for LGBT populations were found feasible to implement and show evidence of effectiveness. Community interventions have been implemented by and for LGBT communities; although these interventions showed feasibility, no rigorous outcome evaluations exist. Clinical interventions show little difference between LGBT and heterosexual people. Focus groups suggest that care is needed in selecting messaging used in media campaigns. Conclusions LGBT-serving organizations should implement existing evidence-based tobacco dependence treatment and clinical systems to support treatment of tobacco use. A clear commitment from government and funders is needed to investigate whether sexual orientation and gender identity moderate the impacts of policy interventions, media campaigns, and clinical interventions. PMID:25455123
Syed Sulaiman Syed Azhar
Full Text Available Abstract Background There is substantial evidence to support the association between tuberculosis (TB and tobacco smoking and that the smoking-related immunological abnormalities in TB are reversible within six weeks of cessation. Therefore, connecting TB and tobacco cessation interventions may produce significant benefits and positively impact TB treatment outcomes. However, no study has extensively documented the evidence of benefits of such integration. SCIDOTS Project is a study from the context of a developing nation aimed to determine this. Methods An integrated TB-tobacco intervention was provided by trained TB directly observed therapy short-course (DOTS providers at five chest clinics in Malaysia. The study was a prospective non-randomized controlled intervention using quasi-experimental design. Using Transtheoretical Model approach, 120 eligible participants who were current smokers at the time of TB diagnosis were assigned to either of two treatment groups: conventional TB DOTS plus smoking cessation intervention (integrated intervention or SCIDOTS group or conventional TB DOTS alone (comparison or DOTS group. At baseline, newly diagnosed TB patients considering quitting smoking within the next 30 days were placed in the integrated intervention group, while those who were contemplating quitting were assigned to the comparison group. Eleven sessions of individualized cognitive behavioral therapy with or without nicotine replacement therapy were provided to each participant in the integrated intervention group. The impacts of the novel approach on biochemically validated smoking cessation and TB treatment outcomes were measured periodically as appropriate. Results A linear effect on both 7-day point prevalence abstinence and continuous abstinence was observed over time in the intervention group. At the end of 6 months, patients who received the integrated intervention had significantly higher rate of success in quitting smoking when
Pendharkar, Bhagyashree; Levy, Steven M; McQuistan, Michelle R; Qian, Fang; Squier, Christopher A; Slach, Nancy A; Aquilino, Mary L
In order to facilitate effective tobacco cessation services within dental school clinics, it is necessary to understand the perceived barriers encountered by dental students while providing these services. The aim of this study was to identify which factors fourth-year dental students perceive to be associated with barriers to providing tobacco intervention services. A written survey was developed and completed by incoming fourth-year dental students (a convenience sample of seventy students) at the University of Iowa College of Dentistry in 2008. The survey assessed the perceived barriers to providing tobacco intervention services and related factors. Descriptive, bivariate, and linear regression analyses were conducted. The response rate was 97 percent. The most frequently reported barriers were patients' resistance to tobacco intervention services (96 percent), inadequate time available for tobacco intervention services (96 percent), and forgetting to give tobacco intervention advice (91 percent). The following variables were significantly (p<0.05) related to greater perceived barriers in providing tobacco intervention services: lower "adequacy of tobacco intervention curriculum coverage of specific topics covered over the previous three years" and greater "perceived importance of incorporating objective structured clinical examination teaching method for learning tobacco intervention." Students probably could benefit from additional didactic training, but most important may be enhanced clinical experiences and faculty reinforcement to facilitate effective practical student learning and adaptation for future delivery of intervention services in private practice settings.
Awaisu, Ahmed; Nik Mohamed, Mohamad Haniki; Mohamad Noordin, Noorliza; Abd Aziz, Noorizan; Syed Sulaiman, Syed Azhar; Muttalif, Abdul Razak; Ahmad Mahayiddin, Aziah
There is substantial evidence to support the association between tuberculosis (TB) and tobacco smoking and that the smoking-related immunological abnormalities in TB are reversible within six weeks of cessation. Therefore, connecting TB and tobacco cessation interventions may produce significant benefits and positively impact TB treatment outcomes. However, no study has extensively documented the evidence of benefits of such integration. SCIDOTS Project is a study from the context of a developing nation aimed to determine this. An integrated TB-tobacco intervention was provided by trained TB directly observed therapy short-course (DOTS) providers at five chest clinics in Malaysia. The study was a prospective non-randomized controlled intervention using quasi-experimental design. Using Transtheoretical Model approach, 120 eligible participants who were current smokers at the time of TB diagnosis were assigned to either of two treatment groups: conventional TB DOTS plus smoking cessation intervention (integrated intervention or SCIDOTS group) or conventional TB DOTS alone (comparison or DOTS group). At baseline, newly diagnosed TB patients considering quitting smoking within the next 30 days were placed in the integrated intervention group, while those who were contemplating quitting were assigned to the comparison group. Eleven sessions of individualized cognitive behavioral therapy with or without nicotine replacement therapy were provided to each participant in the integrated intervention group. The impacts of the novel approach on biochemically validated smoking cessation and TB treatment outcomes were measured periodically as appropriate. A linear effect on both 7-day point prevalence abstinence and continuous abstinence was observed over time in the intervention group. At the end of 6 months, patients who received the integrated intervention had significantly higher rate of success in quitting smoking when compared with those who received the conventional TB
Nagelhout, G.E.; Crone, M.R.; van den Putte, B.; Willemsen, M.C.; Fong, G.T.; de Vries, H.
This study aimed to examine age and educational inequalities in smoking cessation due to the implementation of a tobacco tax increase, smoke-free legislation and a cessation campaign. Longitudinal data from 962 smokers aged 15 years and older were used from three survey waves of the International
Sussman, Steve; Arriaza, Bridget; Grigsby, Timothy J.
Background: Relative to youth in regular high schools, alternative high school (AHS) youth are at high risk for alcohol, tobacco, and other drug (ATOD) misuse. Prevention and cessation efforts are needed for this population. Methods: A systematic, exhaustive literature search was completed to identify ATOD misuse prevention and cessation research…
N. Bruce Baskerville
This scoping review identified a large research gap in the area of prevention and cessation interventions for LGBTQ youth and young adults. There is a need for effective, community-informed, and engaged interventions specific to LGBTQ+ youth and young adults for the prevention and cessation of tobacco.
Kastaun, Sabrina; Brown, Jamie; Brose, Leonie S; Ratschen, Elena; Raupach, Tobias; Nowak, Dennis; Cholmakow-Bodechtel, Constanze; Shahab, Lion; West, Robert; Kotz, Daniel
The prevalence of tobacco smoking in Germany is high (~27%). Monitoring of national patterns of smoking behaviour and data on the "real-world" effectiveness of cessation methods are needed to inform policies and develop campaigns aimed at reducing tobacco-related harm. In England, the Smoking Toolkit Study (STS) has been tracking such indicators since 2006, resulting in the adaptation of tobacco control policies. However, findings cannot be directly transferred into the German health policy context. The German Study on Tobacco Use (DEBRA: "Deutsche Befragung zum Rauchverhalten") aims to provide such nationally representative data. In June 2016, the study started collecting data from computer-assisted, face-to-face household interviews in people aged 14 years and older. Over a period of 3 years, a total of ~36,000 respondents will complete the survey with a new sample of ~2000 respondents every 2 months (=18 waves). This sample will report data on demographics and the use of tobacco and electronic (e-)cigarettes. Per wave, about 500-600 people are expected to be current or recent ex-smokers (German Clinical Trials Register ( DRKS00011322 ) on 25th November 2016.
Momin, Behnoosh; Neri, Antonio; McCausland, Kristen; Duke, Jennifer; Hansen, Heather; Kahende, Jennifer; Zhang, Lei; Stewart, Sherri L
An estimated 43.5 million American adults currently smoke cigarettes. Well-designed tobacco education campaigns with adequate reach increase cessation and reduce tobacco use. Smokers report great interest in quitting but few use effective treatments including quitlines (QLs). This review examined traditional (TV, radio, print ads) versus innovative tobacco cessation (internet, social media) promotions for QL services. Between November 2011 and January 2012, searches were conducted on EBSCO, PubMed, Wilson, OCLC, CQ Press, Google Scholar, Gale, LexisNexis, and JSTOR. Existing literature shows that the amount of radio and print advertising, and promotion of free cessation medications increases QL call volume. Television advertising volume seems to be the best predictor of QL service awareness. Much of the literature on Internet advertising compares the characteristics of participants recruited for studies through various channels. The majority of the papers indicated that Internet-recruited participants were younger; this was the only demographic characteristic with high agreement across studies. Traditional media was only studied within mass media campaigns with TV ads having a consistent impact on increasing calls to QLs, therefore, it is hard to distinguish the impact of traditional media as an independent QL promotion intervention. With innovative media, while many QL services have a presence on social media sites, there is no literature on evaluating the effectiveness of these channels for quitline promotion.
Ford Daniel E
Full Text Available Abstract Background Although screening for tobacco use is increasing with electronic health records and standard protocols, other tobacco-control activities, such as referral of patients to cessation resources, is quite low. In the QUIT-PRIMO study, an online referral portal will allow providers to enter smokers' email addresses into the system. Upon returning home, the smokers will receive automated emails providing education about tobacco cessation and encouragement to use the patient smoking cessation website (with interactive tools, educational resources, motivational email messages, secure messaging with a tobacco treatment specialist, and online support group. Methods The informatics system will be evaluated in a comparative effectiveness trial of 160 community-based primary care practices, cluster-randomized at the practice level. In the QUIT-PRIMO intervention, patients will be provided a paper information-prescription referral and then "e-referred" to the system. In the comparison group, patients will receive only the paper-based information-prescription referral with the website address. Once patients go to the website, they are subsequently randomized within practices to either a standard patient smoking cessation website or an augmented version with access to a tobacco treatment specialist online, motivational emails, and an online support group. We will compare intervention and control practice participation (referral rates and patient participation (proportion referred who go to the website. We will then compare the effectiveness of the standard and augmented patient websites. Discussion Our goal is to evaluate an integrated informatics solution to increase access to web-delivered smoking cessation support. We will analyze the impact of this integrated system in terms of process (provider e-referral and patient login and patient outcomes (six-month smoking cessation. Trial Registration Web-delivered Provider Intervention for
Ortega-García, Juan Antonio; Perales, Joseph E; Cárceles-Álvarez, Alberto; Sánchez-Sauco, Miguel Felipe; Villalona, Seiichi; Mondejar-López, Pedro; Pastor-Vivero, María Dolores; Mira Escolano, Pilar; James-Vega, Diana Carolina; Sánchez-Solís, Manuel
This study evaluates the impact over time of a telephone-based intervention in tobacco cessation and prevention targeting patients with cystic fibrosis (CF) in the Mediterranean region of Murcia, Spain. We conducted an experimental prospective study with a cohort of CF patients using an integrative smoking cessation programme, between 2008 and 2013. The target population included family members and patients from the Regional CF unit. The study included an initial tobacco exposure questionnaire, measurement of lung function, urinary cotinine levels, anthropomorphic measures and the administered intervention at specific time intervals. Of the 88 patients tracked through follow-up, active smoking rates were reduced from 10.23% to 4.55% (p = 0.06). Environmental tobacco exposure was reduced in non-smoker patients from 62.03% to 36.90% (p < 0.01) during the five year follow-up. Significant reductions in the gradient of household tobacco smoke exposure were also observed with a decrease of 12.60%, from 31.65% (n = 25/79) to 19.05% (n = 16/84) in 2013 (p = <0.01). Cotinine was significantly correlated with both active and passive exposure (p<0.01) with a significant reduction of cotinine levels from 63.13 (28.58-97.69) to 20.56 (0.86-40.27) ng/ml (p<0.01). The intervention to significantly increase the likelihood of family quitting (smoke-free home) was 1.26 (1.05-1.54). Telephone based interventions for tobacco cessation and prevention is a useful tool when applied over time. Trained intervention professionals in this area are needed in the environmental health approach for the treatment of CF.
Brian G. Danaher
Conclusions: Consistent with previous research, the MyLastDip Web-based tobacco cessation intervention encouraged long-term levels of tobacco and smokeless tobacco abstinence. The addition of nicotine lozenges significantly improved both participant engagement and self-reported 7-day point prevalence tobacco abstinence at 3 months and when considering 3- and 6-month repeated point prevalence tobacco abstinence.
Tabuchi, Takahiro; Nakamura, Masakazu; Nakayama, Tomio; Miyashiro, Isao; Mori, Jun-Ichiro; Tsukuma, Hideaki
Longitudinal assessment of the impact of tobacco price on smoking cessation is scarce. Our objective was to investigate the effect of a price increase in October 2010 on cessation rates according to gender, age, socioeconomic status, and level of tobacco dependence in Japan. We used longitudinal data linkage of two nationally representative studies and followed 2702 smokers for assessment of their cessation status. The odds ratios (ORs) for cessation were calculated using logistic regression. To estimate the impact of the 2010 tobacco price increase on cessation, data from 2007 were used as a reference category. Overall cessation rates significantly increased from 2007 to 2010, from 3.7% to 10.7% for men and from 9.9% to 16.3% for women. Cessation rates were 9.3% for men who smoked 1-10 cigarettes per day, 2.7% for men who smoked 11-20 cigarettes per day, and 2.0% for men who smoked more than 20 cigarettes per day in 2007. These rates increased to 15.5%, 10.0%, and 8.0%, respectively, in 2010. The impact was stronger among subjects who smoked more than 11 cigarettes per day than those who smoked 1-10 cigarettes per day in both sexes: ORs for 2010 were 4.04 for those smoking 11-20 cigarettes per day, 4.26 for those smoking more than 20 cigarettes per day, and 1.80 for those smoking 1-10 cigarettes per day in the main model in men. There were no obvious differences in the relationship between tobacco price increase and smoking cessation across age and household expenditure groups. The tobacco price increase in Japan had a significant impact on smoking cessation in both sexes, especially among heavy smokers, with no clear difference in effect by socio-demographic status.
Full Text Available Background: Health systems play key roles in identifying tobacco users and providing evidence-based care to help them quit. This treatment includes different methods such as simple medical consultation, medication, and telephone counseling. To assess different quit smoking methods selected by patients in tobacco cessation centers in Iran in order to identify those that are most appropriate for the country health system. Methods: In this cross-sectional and descriptive study, a random sample of all quit centers at the country level was used to obtain a representative sample. Patients completed the self-administered questionnaire which contained 10 questions regarding the quality, cost, effect, side effects and the results of quitting methods using a 5-point Likert-type scale. Percentages, frequencies, mean, T-test, and variance analyses were computed for all study variables. Results: A total of 1063 smokers returned completed survey questionnaires. The most frequently used methods were Nicotine Replacement Therapy (NRT and combination therapy (NRT and Counseling with 228 and 163 individuals reporting these respectively. The least used methods were hypnotism (n = 8 and the quit and win (n = 17. The methods which gained the maximum scores were respectively the combined method, personal and Champix with means of 21.4, 20.4 and 18.4. The minimum scores were for e-cigarettes, hypnotism and education with means of 12.8, 11 and 10.8, respectively. There were significant differences in mean scores based on different cities and different methods. Conclusions: According to smokers′ selection the combined therapy, personal methods and Champix are the most effective methods for quit smoking and these methods could be much more considered in the country health system.
Troelstra, Sigrid A.; Bosdriesz, Jizzo R.; de Boer, Michiel R.; Kunst, Anton E.
Background The impact of tobacco control policies on measures of smoking cessation behaviour has often been studied, yet there is little information on their precise magnitude and duration. This study aims to measure the magnitude and timing of the impact of Dutch tobacco control policies on the
Troelstra, Sigrid A; Bosdriesz, Jizzo R; de Boer, Michiel R; Kunst, Anton E
BACKGROUND: The impact of tobacco control policies on measures of smoking cessation behaviour has often been studied, yet there is little information on their precise magnitude and duration. This study aims to measure the magnitude and timing of the impact of Dutch tobacco control policies on the
Warren, Charles W; Sinha, Dhirendra N; Lee, Juliette; Lea, Veronica; Jones, Nathan; Asma, Samira
The Global Health Professions Student Survey (GHPSS) has been conducted among third-year dental students in schools in forty-four countries, the Gaza Strip/West Bank, and three cities (Baghdad, Rio de Janeiro, and Havana) (all called "sites" in this article). In more than half the sites, over 20 percent of the students currently smoked cigarettes, with males having higher rates than females in thirty sites. Over 60 percent of students reported having been exposed to secondhand smoke in public places in thirty-seven of forty-eight sites. The majority of students recognized that they are role models in society and believed they should receive training on counseling patients to quit using tobacco, but few reported receiving formal training. Tobacco control efforts must discourage tobacco use among dentists, promote smoke-free workplaces, and implement programs that train dentists in effective cessation-counseling techniques.
Lee, Joseph G L; Matthews, Alicia K; McCullen, Cramer A; Melvin, Cathy L
Lesbian, gay, bisexual, and transgender (LGBT) people are at increased risk for the adverse effects of tobacco use, given their high prevalence of use, especially smoking. Evidence regarding cessation is limited. To determine if efficacious interventions are available and to aid the development of interventions, a systematic review was conducted of grey and peer-reviewed literature describing clinical, community, and policy interventions, as well as knowledge, attitudes, and behaviors regarding tobacco use cessation among LGBT people. Eight databases for articles from 1987 to April 23, 2014, were searched. In February-November 2013, authors and researchers were contacted to identify grey literature. The search identified 57 records, of which 51 were included and 22 were from the grey literature; these were abstracted into evidence tables, and a narrative synthesis was conducted in October 2013-May 2014. Group cessation curricula tailored for LGBT populations were found feasible to implement and show evidence of effectiveness. Community interventions have been implemented by and for LGBT communities, although these interventions showed feasibility, no rigorous outcome evaluations exist. Clinical interventions show little difference between LGBT and heterosexual people. Focus groups suggest that care is needed in selecting the messaging used in media campaigns. LGBT-serving organizations should implement existing evidence-based tobacco-dependence treatment and clinical systems to support treatment of tobacco use. A clear commitment from government and funders is needed to investigate whether sexual orientation and gender identity moderate the impacts of policy interventions, media campaigns, and clinical interventions. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Phillips Carl V
Full Text Available Abstract Background Although smokeless tobacco (ST use has played a major role in the low smoking prevalence among Swedish men, there is little information at the population level about ST as a smoking cessation aid in the U.S. Methods We used the 2000 National Health Interview Survey to derive population estimates for the number of smokers who had tried twelve methods in their most recent quit attempt, and for the numbers and proportions who were former or current smokers at the time of the survey. Results An estimated 359,000 men switched to smokeless tobacco in their most recent quit attempt. This method had the highest proportion of successes among those attempting it (73%, representing 261,000 successful quitters (switchers. In comparison, the nicotine patch was used by an estimated 2.9 million men in their most recent quit attempt, and almost one million (35% were former smokers at the time of the survey. Of the 964,000 men using nicotine gum, about 323,000 (34% became former smokers. Of the 98,000 men who used the nicotine inhaler, 27,000 quit successfully (28%. None of the estimated 14,000 men who tried the nicotine nasal spray became former smokers. Forty-two percent of switchers also reported quitting smoking all at once, which was higher than among former smokers who used medications (8–19%. Although 40% of switchers quit smoking less than 5 years before the survey, 21% quit over 20 years earlier. Forty-six percent of switchers were current ST users at the time of the survey. Conclusion Switching to ST compares very favorably with pharmaceutical nicotine as a quit-smoking aid among American men, despite the fact that few smokers know that the switch provides almost all of the health benefits of complete tobacco abstinence. The results of this study show that tobacco harm reduction is a viable cessation option for American smokers.
Jadhav, Kiran; Singh, Dhanpal
In India most of the tobacco cessation centers are concentrating only on urban population, whereas, literature reveals that it is rural population, which shows high frequency of consumption of tobacco. It is well known that high frequency of tobacco consumption is associated with psychological dependence. This study aimed at identifying, which form of tobacco consumption (smoking or smokeless) is associated with psychological dependence and is associated with which particular age group in rural population. It was a questionnaire based survey where 200 subjects were enrolled. Revised version of standard Fagerstrom Test for Nicotine dependence (FTND) was given to each subject to answer. The collected data was statistically analyzed by using Karl Pearson Correlation (r) test and Student's t-test. Study showed that subjects above 40 years of age are psychologically highly dependent on tobacco smoking as compared to tobacco chewing. Tobacco chewing is more prevalent among the younger population (20-30 years of age) and type of habit does not have any influence over psychological dependence below 40 years of age. A positive correlation was observed between duration of habit and psychological dependence in all age groups irrespective of type of the habit of tobacco consumption. This study attempts at creating a new avenue for the tobacco cessation centers where they can target their efforts towards rural population particularly people above 40 years of age with a tobacco smoking habit so that they can actually reduce the burden of a number of people at risk for developing tobacco associated oral cancer.
Weiss, Stephanie M; Smith-Simone, Stephanie Y
Tobacco-cessation product packaging and instruction materials may not be appropriate for some smokers and may contribute to the underuse and misuse of evidence-based treatments. The dual goals of this project are to analyze literacy levels of Food and Drug Administration (FDA)-approved and non-approved tobacco-cessation product packaging, directions, and claims, and to identify and categorize claims found on product packaging. The Campaign for Tobacco Free Kids (CTFK) maintains the Quitting and Reducing Tobacco Use Inventory of Products (QuiTIP) database, which catalogs products marketed and sold to consumers to reduce or quit use of tobacco products. It also includes all medications approved by the FDA for tobacco cessation as well as a sample of non-approved products such as homeopathic, herbal, nutritional, or dietary supplements commonly marketed as either cessation aids or alternative tobacco/nicotine products. This paper assesses the reading levels required to understand product packaging, labeling, and instructions using the Simple Measure of Gobbledygook (SMOG) and identifies claims on the product package labels using standard qualitative methods. Key findings show that the average reading levels needed to understand instructions for both FDA-approved and non-approved cessation products are above the reading levels recommended to ensure maximum comprehension. Improving the packaging and directions of evidence-based tobacco-cessation products so that they are preferably at or below a fifth-grade reading level, along with using consumer-based design principles to develop packaging, may help smokers take advantage of and correctly use products that will greatly increase their chances of successful quitting. 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Blankers, Matthijs; Buisman, Renate; Hopman, Petra; van Gool, Ronald; van Laar, Margriet
Tobacco use prevalence is elevated among people with mental illnesses, leading to elevated rates of premature smoking-related mortality. Opportunities to encourage smoking cessation among them are currently underused by mental health professionals. In this paper, we aim to explore mechanisms to
Yuan, Nicole P.; Wind, Steven; Nichter, Mimi; Nichter, Mark; Castañeda, Heide; Carruth, Lauren; Muramoto, Myra L.
Objective To identify types of health influencers in tobacco cessation based on the frequency and characteristics of brief intervention activities. Methods Longitudinal qualitative interviews were completed with 28 individuals post-training. Results Four individuals were categorized as Rarely Active, 5 as Active with Family and Friends, 9 as Active in the Workplace, and 10 as Proactive in Multiple Settings. Unique motivators, intervention behaviors, and barriers were documented. Some individuals displayed high levels of self-efficacy necessary for expanding the reach of community-based interventions. Conclusion Training programs need to address the impact of contextual factors on initiating and sustaining intervention activities. PMID:20524890
Yuan, Nicole P; Wind, Steven; Nichter, Mimi; Nichter, Mark; Castañeda, Heide; Carruth, Lauren; Muramoto, Myra
To identify types of health influencers in tobacco cessation based on the frequency and characteristics of brief intervention activities. Longitudinal qualitative interviews were completed with 28 individuals posttraining. Four individuals were categorized as Rarely Active, 5 as Active With Family and Friends, 9 as Active in the Workplace, and 10 as Proactive in Multiple Settings. Unique motivators, intervention behaviors, and barriers were documented. Some individuals displayed high levels of self-efficacy necessary for expanding the reach of community-based interventions. Training programs need to address the impact of contextual factors on initiating and sustaining intervention activities.
Palipudi, Krishna M.; Nelson-Blutcher, Glenda; Murty, Komanduri S.; Asma, Samira
We analyzed data from the Global Adult Tobacco Survey (GATS) from 21 countries to categorize smokers by stages of cessation and highlight interventions that could be tailored to each stage. GATS is a nationally representative household survey that measures tobacco use and other key indicators by using a standardized protocol. The distribution of smokers into precontemplation, contemplation, and preparation stages varied by country. Using the stages of change model, each country can design and implement effective interventions suitable to its cultural, social, and economic situations to help smokers advance successfully through the stages of cessation. PMID:26378897
Mbulo, Lazarous; Palipudi, Krishna M; Nelson-Blutcher, Glenda; Murty, Komanduri S; Asma, Samira
We analyzed data from the Global Adult Tobacco Survey (GATS) from 21 countries to categorize smokers by stages of cessation and highlight interventions that could be tailored to each stage. GATS is a nationally representative household survey that measures tobacco use and other key indicators by using a standardized protocol. The distribution of smokers into precontemplation, contemplation, and preparation stages varied by country. Using the stages of change model, each country can design and implement effective interventions suitable to its cultural, social, and economic situations to help smokers advance successfully through the stages of cessation.
Full Text Available Abstract Background Expanding the information on determinants of smoking cessation is crucial for developing and implementing more effective tobacco control measures at the national as well as European levels. Data on smoking cessation and its social correlates among adults from middle-income countries of Central and Eastern Europe are still poorly reported in the literature. The aim of the study was to analyze the association of socio-demographic indicators with long term tobacco smoking cessation (quit smoking for at least one year prior to interview among adults. Moreover, we evaluated motives for giving up smoking from former smokers. Methods Data on former as well as current smokers’ socio-demographic and smoking-related characteristics were derived from the Global Adult Tobacco Survey (GATS. GATS is a cross-sectional, nationally representative household survey implemented in Poland between 2009 and 2010. GATS collected data on a representative sample of 7,840 individuals including 1,206 individuals who met the criteria of long-term smoking cessation and 2,233 current smokers. Smoking cessation rate was calculated as the number of former smokers divided by the number of ever smokers. Logistic regression analyses were used to obtain odds ratios (ORs and 95% confidence interval (CI of the broad number of variables on successful cessation of smoking. Results Among females the quit rate was 30.4% compared to 37.9% in males (p Conclusion Results indicated that smoking cessation policies focused on younger age groups are vital for curbing tobacco epidemic in Poland and should become a public health main concern. There is also the need for interventions to raise awareness on smoking health risks and quitting benefits are crucial to increase cessation potential among adult smokers. Nevertheless further effort needs to be done to prevent smoking uptake.
Lisa M. Wilson
Full Text Available Background. Policymakers need estimates of the impact of tobacco control (TC policies to set priorities and targets for reducing tobacco use. We systematically reviewed the independent effects of TC policies on smoking behavior. Methods. We searched MEDLINE (through January 2012 and EMBASE and other databases through February 2009, looking for studies published after 1989 in any language that assessed the effects of each TC intervention on smoking prevalence, initiation, cessation, or price participation elasticity. Paired reviewers extracted data from studies that isolated the impact of a single TC intervention. Findings. We included 84 studies. The strength of evidence quantifying the independent effect on smoking prevalence was high for increasing tobacco prices and moderate for smoking bans in public places and antitobacco mass media campaigns. Limited direct evidence was available to quantify the effects of health warning labels and bans on advertising and sponsorship. Studies were too heterogeneous to pool effect estimates. Interpretations. We found evidence of an independent effect for several TC policies on smoking prevalence. However, we could not derive precise estimates of the effects across different settings because of variability in the characteristics of the intervention, level of policy enforcement, and underlying tobacco control environment.
Clattenburg, Eben J; Elf, Jessica L; Apelberg, Benjamin J
In the USA, tobacco marketing expenditure is increasingly concentrated at the point of sale (POS). Previous studies have demonstrated an association between exposure to tobacco POS advertising and increased smoking initiation, but limited evidence is available on adult smokers' decisions and behaviours. An immediate post-cigarette purchase survey was administered to 301 cigarette purchasers outside of two grocery stores in Vermont to assess the prevalence of unplanned purchases and opinions about POS tobacco advertising and displays. In total, 11.3% of purchases were reported as unplanned. Certain groups were more likely to make unplanned purchases including: 18-24-year-olds (OR: 2.1, 95% CI 1.0 to 4.4), less than daily smokers (OR: 5.6, 95% CI 1.9 to 16.9), smokers who made 3+ quit attempts in the previous year (OR: 2.4, 95% CI 0.9 to 6.0), those who plan to quit in the next month (OR: 3.7, 95% CI 1.6 to 9.0), and those who agreed that tobacco POS advertising makes quitting smoking harder (OR: 2.3, 95% CI 1.1 to 4.8). Overall, 31.2% of participants agreed that tobacco POS advertising makes quitting smoking harder. Individuals who intended to quit within the next month, made 3+ quit attempts in the last year, or made an unplanned cigarette purchase were the most likely to agree. Young adults and individuals making multiple quit attempts or planning to quit in the next month are more likely to make unplanned cigarette purchases. Reducing unplanned purchases prompted by tobacco POS advertising could improve the likelihood of successful cessation among smokers.
Brantley, Erin; Bysshe, Tyler; Steinmetz, Erika; Bruen, Brian K.
Introduction State Medicaid programs can cover tobacco cessation therapies for millions of low-income smokers in the United States, but use of this benefit is low and varies widely by state. This article assesses the effects of changes in Medicaid benefit policies, general tobacco policies, smoking norms, and public health programs on the use of cessation therapy among Medicaid smokers. Methods We used longitudinal panel analysis, using 2-way fixed effects models, to examine the effects of changes in state policies and characteristics on state-level use of Medicaid tobacco cessation medications from 2010 through 2014. Results Medicaid policies that require patients to obtain counseling to get medications reduced the use of cessation medications by approximately one-quarter to one-third; states that cover all types of cessation medications increased usage by approximately one-quarter to one-third. Non-Medicaid policies did not have significant effects on use levels. Conclusions States could increase efforts to quit by developing more comprehensive coverage and reducing barriers to coverage. Reductions in barriers could bolster smoking cessation rates, and the costs would be small compared with the costs of treating smoking-related diseases. Innovative initiatives to help smokers quit could improve health and reduce health care costs. PMID:27788063
Malone, V; Harrison, R; Daker-White, G
WHAT IS KNOWN ON THE SUBJECT?: There are high rates of tobacco smoking in people living with mental illness, and rates are much higher than the general population. People living with mental illness experience high rates of cardiovascular disease and other physical health problems as a result of tobacco smoking. There is a lack of evidence on successful interventions for reducing the rates of smoking in people living with mental illness. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: A meta-synthesis of data from a number of studies to support mental health nurses to access data quickly and support the translation of findings into practice. Studies found staff working in mental health services expressed they did not have the confidence to adequately address smoking cessation for people living with mental illness. People living with mental illness would like support and encouragement support to help them achieve successful smoking cessation. People living with mental illness want support from mental health service staff to increase their confidence in smoking cessation rather than mainstream smoking cessation services. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Existing evidence-based interventions for smoking cessation has had limited impact on the smoking rates of people living with mental illness. Research is needed into innovative smoking cessation interventions and the service delivery of these interventions for people living with mental illness. Interventions to support people living with mental illness in smoking cessation could be part of mainstream mental health service delivery. Opportunities for smoking cessation training for mental health service staff could be provided. Introduction People with mental illness are up to three times more likely to smoke and experience greater challenges and less success when trying to quit and therefore have higher risk of smoking-related morbidity and mortality. There is a lack of evidence on successful interventions to
Davis, J.M.; Ramseier, C.A.; Mattheos, N.; Schoonheim-Klein, M.; Compton, S.; Al-Hazmi, N.; Polychronopoulou, A.; Suvan, J.; Forna, D.; Radley, N.
The use of tobacco continues to be a substantial risk factor in the development and progression of oral cancer, periodontitis, implant failure and poor wound healing. Dental and dental hygiene education providers have made great advances towards the incorporation of tobacco education into their
Sharma, Ratika; Meurk, Carla; Bell, Stephanie; Ford, Pauline; Gartner, Coral
Reducing the burden of physical illness among people living with severe mental illnesses (SMI) is a key priority. Smoking is strongly associated with SMIs resulting in excessive smoking related morbidity and mortality in smokers with SMI. Smoking cessation advice and assistance from mental health practitioners would assist with reducing smoking and smoking-related harms in this group. This study examined the attitudes and practices of Australian mental health practitioners towards smoking cessation and tobacco harm reduction for smokers with SMI, including adherence to the 5As (ask, assess, advise, assist and arrange follow up) of smoking cessation. We surveyed 267 Australian mental health practitioners using a cross-sectional, online survey. Most practitioners (77.5%) asked their clients about smoking and provided health education (66.7%) but fewer provided direct assistance (31.1-39.7%). Most believed that tobacco harm reduction strategies are effective for reducing smoking related risks (88.4%) and that abstinence from all nicotine should not be the only goal discussed with smokers with SMI (77.9%). Many respondents were unsure about the safety (56.9%) and efficacy (39.3%) of e-cigarettes. Practitioners trained in smoking cessation were more likely (OR: 2.9, CI: 1.5-5.9) to help their clients to stop smoking. Community mental health practitioners (OR: 0.3, CI: 0.1-0.9) and practitioners who were current smokers (OR: 0.3, CI: 0.1-0.9) were less likely to adhere to the 5As of smoking cessation intervention. The results of this study emphasize the importance and need for providing smoking cessation training to mental health practitioners especially community mental health practitioners. © 2017 Australian College of Mental Health Nurses Inc.
Huang, Jidong; Kim, Yoonsang; Vera, Lisa; Emery, Sherry L
The electronic cigarette (e-cigarette) market has evolved rapidly in recent years, with exploding growth in brands and product types; however, e-cigarette use among priority (sexual minority and low-income) populations and its relationship with smoking-cessation and tobacco control policies have yet to be fully characterized. The authors conducted a nationally representative online survey of 17,522 U.S. adults in 2013. Participants were drawn from GfK's KnowledgePanel. Logistic regression models were used to analyze relationships between e-cigarettes (awareness, ever use, current use) and cigarette smoking and cessation behaviors, tobacco control policies, and demographics. Analyses were conducted in 2014. Approximately 15% of participants reported ever use of e-cigarettes, 5.1% reported current use, and 34.5% of ever users reported current use. E-cigarette awareness was lower among women, minorities, and those with low education. Ever and current use of e-cigarettes was higher among current cigarette smokers, young adults, and those with low SES; both ever use and current use were correlated with current cigarette smoking status, particularly when combined with quit intentions or attempts. Lesbian/gay/bisexual/transgender respondents had higher rates of ever use and current use. Ever use was lower in states with comprehensive smoking bans. No significant relationship between cigarette price and e-cigarette use was detected. Ongoing surveillance of e-cigarette use among subpopulation groups and monitoring their use for combustible cigarette cessation are needed. Important variations in the patterns and correlates of e-cigarette awareness and use exist among priority populations. These findings have implications for future e-cigarette policy decisions. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Rosenthal, Lisa; Carroll-Scott, Amy; Earnshaw, Valerie A; Sackey, Naa; O'Malley, Stephanie S; Santilli, Alycia; Ickovics, Jeannette R
Many people continue to smoke tobacco products despite known negative health consequences, including increased risk of chronic disease and death. Disparities exist in rates of smoking and chronic disease, underscoring the importance of understanding the barriers and motivations to smoking cessation among vulnerable populations, such as socioeconomically disadvantaged people of color. This study uses data from a cross-sectional randomized household survey conducted in six low-income neighborhoods in New Haven, Connecticut, USA (N=1205). The objectives were to examine barriers and motivations to quitting smoking among daily tobacco smokers (31.6% of respondents) and sociodemographic differences in endorsement of barriers and motivations. The two most common barriers to quitting were perceiving it to be too difficult and not wanting to quit. Financial costs, social support, and social influence were themes endorsed highly across both barriers and motivations to quitting. Sociodemographic differences were found, such as women and Black participants being more likely to be interested in a free quitline or quit website; women and Latinos being more likely to be afraid of gaining weight; and women, participants with less education, and older participants being more likely to be concerned about the cost of cessation products. Understanding barriers and motivations to quitting among disadvantaged populations is crucial. Financial issues, social support, and social norms should be targeted in promoting cessation among disadvantaged, urban populations. Programs, interventions, and policies can also use research about specific barriers and motivations for sociodemographic sub-groups to be tailored, targeted, and more effective. Copyright © 2012 Elsevier Ltd. All rights reserved.
Johnson, Matthew W; Garcia-Romeu, Albert; Johnson, Patrick S; Griffiths, Roland R
Data suggest psychedelics such as psilocybin and lysergic acid diethylamide (LSD) may hold therapeutic potential in the treatment of addictions, including tobacco dependence. This retrospective cross-sectional anonymous online survey characterized 358 individuals (52 females) who reported having quit or reduced smoking after ingesting a psychedelic in a non-laboratory setting ⩾1 year ago. On average, participants smoked 14 cigarettes/day for 8 years, and had five previous quit attempts before their psychedelic experience. Of the 358 participants, 38% reported continuous smoking cessation after psychedelic use (quitters). Among quitters, 74% reported >2 years' abstinence. Of the 358 participants, 28% reported a persisting reduction in smoking (reducers), from a mode of 300 cigarettes/month before, to a mode of 1 cigarette/month after the experience. Among reducers, 62% reported >2 years of reduced smoking. Finally, 34% of the 358 participants (relapsers) reported a temporary smoking reduction before returning to baseline smoking levels, with a mode time range to relapse of 3-6 months. Relapsers rated their psychedelic experience significantly lower in personal meaning and spiritual significance than both other groups. Participants across all groups reported less severe affective withdrawal symptoms (e.g. depression, craving) after psychedelic use compared with previous quit attempts, suggesting a potential mechanism of action for psychedelic-associated smoking cessation/reduction. Changes in life priorities/values were endorsed as the most important psychological factor associated with smoking cessation/reduction. Results suggest psychedelics may hold promise in treating tobacco addiction as potentially mediated by spiritual experience, changed priorities/values, and improved emotional regulation.
Huang, Li-Ling; Kowitt, Sarah D; Sutfin, Erin L; Patel, Tanha; Ranney, Leah M; Goldstein, Adam O
Although adolescent cigarette use continues to decline in the United States, electronic cigarette (e‑cigarette) use among adolescents has escalated rapidly. This study assessed trends and patterns of e‑cigarette use and concurrent cigarette smoking and the relationships between e-cigarette use and smoking cessation intentions and behaviors among high school students in North Carolina. Data came from high school students who completed the school-based, cross-sectional North Carolina Youth Tobacco Survey in 2011 (n = 4,791) and 2013 (n = 4,092). This study assessed changes in prevalence of e-cigarette and cigarette use from 2011 through 2013, and cessation-related factors associated with those students' current and past use of e‑cigarettes in 2013. The prevalence of current e-cigarette use (use in the past 30 days) significantly increased from 1.7% (95% CI, 1.3%-2.2%) in 2011 to 7.7% (95% CI, 5.9%-10.0%) in 2013. Among dual users, current e-cigarette use was negatively associated with intention to quit cigarette smoking for good (relative risk ratio [RRR] = 0.51; 95% CI, 0.29-0.87) and with attempts to quit cigarette smoking in the past 12 months (RRR = 0.69; 95% CI, 0.49-0.97). Current e-cigarette smokers were less likely than those who only smoked cigarettes to have ever abstained from cigarette smoking for 6 months (RRR = 0.42; 95% CI, 0.21-0.82) or 1 year (RRR = 0.21; 95% CI, 0.09-0.51) and to have used any kind of aids for smoking cessation (RRR = 0.46; 95% CI, 0.29-0.74). Public health practitioners and cessation clinic service providers should educate adolescents about the risks of using any nicotine-containing products, including e-cigarettes, and provide adequate tobacco cessation resources and counseling to adolescent tobacco users.
Abu S. Abdullah
Full Text Available Physicians have a key role to play in combating tobacco use and reducing the tobacco induced harm to health. However, there is a paucity of information about tobacco-use and cessation among physicians in developing countries. To assess the need for and nature of smoking cessation services among physicians in developing countries, a detailed literature review of studies published in English, between 1987 and 2010 was carried out. The electronic databases Medline and Pub Med were searched for published studies. The findings show that there are regional variations in the current smoking prevalence, quitting intentions, and cessation services among physicians. Smoking prevalence (median was highest in Central/Eastern Europe (37%, followed by Africa (29%, Central and South America (25% and Asia (17.5%. There were significant gender differences in smoking prevalence across studies, with higher prevalence among males than females. Smoking at work or in front of patients was commonly practiced by physicians in some countries. Asking about smoking status or advising patients to quit smoking was not common practice among the physicians, especially among smoker physicians. Organized smoking cessation programs for physicians did not exist in all of these regions. This review suggests that while smoking of physicians varies across different developing regions; prevalence rates tend to be higher than among physicians in developed countries. Quitting rates were low among the physicians, and the delivery of advice on quitting smoking was not common across the studies. To promote tobacco control and increase cessation in populations, there is a need to build physicians’ capacity so that they can engage in tobacco use prevention and cessation activities.
Tobacco use is the leading cause of preventable mortality in the world. Article 14 of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) states that countries should promote cessation of tobacco use and adequate treatment for tobacco dependence. Health-care providers asking all patients about their tobacco use and advising tobacco users to quit are evidence-based strategies that increase tobacco abstinence. This report examines the proportion of tobacco smokers in 17 countries responding to the Global Adult Tobacco Survey (GATS) who saw a health-care provider in the past year and who reported that a health-care provider asked them about smoking and advised them to quit. Respondents were tobacco smokers aged ≥15 years surveyed during 2008-2011 in Bangladesh, Brazil, China, Egypt, India, Indonesia, Malaysia, Mexico, Philippines, Poland, Romania, Russia, Thailand, Turkey, Ukraine, Uruguay, and Vietnam. The proportion of smokers who had visited a health-care provider during the previous 12 months ranged from 21.6% in Egypt to 62.3% in Poland. Among these, the proportion reporting that a health-care provider asked if they smoked ranged from 34.9% in Vietnam to 82.1% in Romania. Among those screened for tobacco use, those who reported their health-care providers advised them to quit ranged from 17.3% in Mexico to 67.3% in Romania. In most countries, persons aged ≥45 years were more likely to report being screened and advised to quit than were persons aged ≤24 years. Health-care providers should identify smokers and provide advice and assistance in quitting at each visit as an adjunct to effective community interventions (e.g., increased price of tobacco products; smoke-free policies, mass media campaigns, and tobacco quitlines).
El-Bastawissi, Ay; McAfee, T; Zbikowski, S M; Hollis, J; Stark, M; Wassum, K; Clark, N; Barwinski, R; Broughton, E
To describe the experience of uninsured and Medicaid Oregon tobacco users who registered in Free & Clear (F&C), a telephone based cessation programme including five scheduled outbound calls. Using a retrospective cohort design, 1334 (423 uninsured, 806 Medicaid, and 105 commercially insured) Oregon tobacco users who registered in F&C between 18 November 1998 and 28 February 2000 were identified and followed for 12 months post-registration; 648 (48.6%) were successfully contacted at 12 months. Information was collected from the F&C database. Unconditional logistic regression, adjusted for race and education, was used. The seven day quit rate at 12 months, assuming non-respondents were smokers, was 14.8% (95% confidence interval (CI) 13.0 to 16.9). This rate was significantly higher among commercially insured participants (v Medicaid but not uninsured) and among participants who completed > or = 5 calls (v or = 5 calls were 60% more likely to quit tobacco (odds ratio (OR) 1.6, 95% CI 0.9 to 3.1), and uninsured respondents who completed > or = 5 calls were 70% more likely to quit tobacco (OR 1.7, 95% CI 0.9 to 3.5), relative to those who completed < 5 calls, but the difference was not significant. The quit rates are similar to those reported in efficacy trials. The observed variation in quitting tobacco for respondents by number of calls completed and by insurance merits further investigation concentrating on increasing compliance with the call schedule, particularly for the uninsured.
Rennen, E.; Nagelhout, G.E.; van den Putte, B.; Janssen, E.; Mons, U.; Guignard, R.; Beck, F.; de Vries, H.; Thrasher, J.F.; Willemsen, M.C.
This study examined whether awareness of tobacco control policies was associated with social unacceptability of smoking and whether social unacceptability had an effect on smoking cessation in three European countries. Representative samples (n = 3865) of adult smokers in France, the Netherlands and
Schillo Barbara A
Full Text Available Abstract Background This observational study assessed the relation between mass media campaigns and service volume for a statewide tobacco cessation quitline and stand-alone web-based cessation program. Methods Multivariate regression analysis was used to identify how weekly calls to a cessation quitline and weekly registrations to a web-based cessation program are related to levels of broadcast media, media campaigns, and media types, controlling for the impact of external and earned media events. Results There was a positive relation between weekly broadcast targeted rating points and the number of weekly calls to a cessation quitline and the number of weekly registrations to a web-based cessation program. Additionally, print secondhand smoke ads and online cessation ads were positively related to weekly quitline calls. Television and radio cessation ads and radio smoke-free law ads were positively related to web program registration levels. There was a positive relation between the number of web registrations and the number of calls to the cessation quitline, with increases in registrations to the web in 1 week corresponding to increases in calls to the quitline in the subsequent week. Web program registration levels were more highly influenced by earned media and other external events than were quitline call volumes. Conclusion Overall, broadcast advertising had a greater impact on registrations for the web program than calls to the quitline. Furthermore, registrations for the web program influenced calls to the quitline. These two findings suggest the evolving roles of web-based cessation programs and Internet-use practices should be considered when creating cessation programs and media campaigns to promote them. Additionally, because different types of media and campaigns were positively associated with calls to the quitline and web registrations, developing mass media campaigns that offer a variety of messages and communicate through
Full Text Available Background: In India most of the tobacco cessation centers are concentrating only on urban population, whereas, literature reveals that it is rural population, which shows high frequency of consumption of tobacco. It is well known that high frequency of tobacco consumption is associated with psychological dependence. This study aimed at identifying, which form of tobacco consumption (smoking or smokeless is associated with psychological dependence and is associated with which particular age group in rural population. Materials and Methods: It was a questionnaire based survey where 200 subjects were enrolled. Revised version of standard Fagerstrom Test for Nicotine dependence (FTND was given to each subject to answer. The collected data was statistically analyzed by using Karl Pearson Correlation (r test and Student′s t-test. Results: Study showed that subjects above 40 years of age are psychologically highly dependent on tobacco smoking as compared to tobacco chewing. Tobacco chewing is more prevalent among the younger population (20-30 years of age and type of habit does not have any influence over psychological dependence below 40 years of age. A positive correlation was observed between duration of habit and psychological dependence in all age groups irrespective of type of the habit of tobacco consumption. Conclusion: This study attempts at creating a new avenue for the tobacco cessation centers where they can target their efforts towards rural population particularly people above 40 years of age with a tobacco smoking habit so that they can actually reduce the burden of a number of people at risk for developing tobacco associated oral cancer.
Schaap, M. M.; Kunst, A. E.; Leinsalu, M.; Regidor, E.; Ekholm, O.; Dzurova, D.; Helmert, U.; Klumbiene, J.; Santana, P.; Mackenbach, J. P.
BACKGROUND: Recently a scale was introduced to quantify the implementation of tobacco control policies at country level. Our study used this scale to examine the potential impact of these policies on quit ratios in European countries. Special attention was given to smoking cessation among lower
Kuschner, Ware G; Reddy, Sunayana; Mehrotra, Nidhi; Paintal, Harman S
PRIMARY CARE PROVIDERS SHOULD BE AWARE OF TWO NEW DEVELOPMENTS IN NICOTINE ADDICTION AND SMOKING CESSATION: 1) the emergence of a novel nicotine delivery system known as the electronic (e-) cigarette; and 2) new reports of residual environmental nicotine and other biopersistent toxicants found in cigarette smoke, recently described as "thirdhand smoke". The purpose of this article is to provide a clinician-friendly introduction to these two emerging issues so that clinicians are well prepared to counsel smokers about newly recognized health concerns relevant to tobacco use. E-cigarettes are battery powered devices that convert nicotine into a vapor that can be inhaled. The World Health Organization has termed these devices electronic nicotine delivery systems (ENDS). The vapors from ENDS are complex mixtures of chemicals, not pure nicotine. It is unknown whether inhalation of the complex mixture of chemicals found in ENDS vapors is safe. There is no evidence that e-cigarettes are effective treatment for nicotine addiction. ENDS are not approved as smoking cessation devices. Primary care givers should anticipate being questioned by patients about the advisability of using e-cigarettes as a smoking cessation device. The term thirdhand smoke first appeared in the medical literature in 2009 when investigators introduced the term to describe residual tobacco smoke contamination that remains after the cigarette is extinguished. Thirdhand smoke is a hazardous exposure resulting from cigarette smoke residue that accumulates in cars, homes, and other indoor spaces. Tobacco-derived toxicants can react to form potent cancer causing compounds. Exposure to thirdhand smoke can occur through the skin, by breathing, and by ingestion long after smoke has cleared from a room. Counseling patients about the hazards of thirdhand smoke may provide additional motivation to quit smoking.
Sarkar, Bidyut K; Shahab, Lion; Arora, Monika; Lorencatto, Fabiana; Reddy, K Srinath; West, Robert
India has 275 million adult tobacco users and tobacco use is estimated to contribute to more than a million deaths in the country each year. There is an urgent need to develop and evaluate affordable, practicable and scalable interventions to promote cessation of tobacco use. Because tobacco use is so harmful, an increase of as little as 1 percentage point in long-term quit success rates can have an important public health impact. This protocol paper describes the rationale and methods of a large randomized controlled trial which aims to evaluate the effectiveness of a brief scalable smoking cessation intervention delivered by trained health professionals as an outreach programme in poor urban communities in India. This is a pragmatic, two-arm, community-based cluster randomized controlled trial focused on tobacco users in low-income communities. The treatment arm is a brief intervention comprising brief advice including training in craving control using simple yogic breathing exercises (BA-YBA) and the control arm is very brief advice (VBA). Of a total of 32 clusters, 16 will be allocated to the intervention arm and 16 to the control arm. Each cluster will have 31 participants, making a total of 992 participants. The primary outcome measure will follow the Russell Standard: self-report of sustained abstinence for at least 6 months following the intervention confirmed at the final follow-up by salivary cotinine. This trial will inform national and international policy on delivery of scalable and affordable brief outreach interventions to promote tobacco use cessation in low resource settings where tobacco users have limited access to physicians and medications. © 2014 Society for the Study of Addiction.
Vickerman, Katrina A; Kellogg, Elizabeth S; Zbikowski, Susan M
Background Phone-based tobacco cessation program effectiveness has been established and randomized controlled trials have provided some support for Web-based services. Relatively little is known about who selects different treatment modalities and how they engage with treatments in a real-world setting. Objective This paper describes the characteristics, Web utilization patterns, and return rates of tobacco users who self-selected into a Web-based (Web-Only) versus integrated phone/Web (Phone/Web) cessation program. Methods We examined the demographics, baseline tobacco use, Web utilization patterns, and return rates of 141,429 adult tobacco users who self-selected into a Web-Only or integrated Phone/Web cessation program through 1 of 10 state quitlines from August 2012 through July 2013. For each state, registrants were only included from the timeframe in which both programs were offered to all enrollees. Utilization data were limited to site interactions occurring within 6 months after registration. Results Most participants selected the Phone/Web program (113,019/141,429, 79.91%). After enrollment in Web services, Web-Only were more likely to log in compared to Phone/Web (21,832/28,410, 76.85% vs 23,920/56,892, 42.04%; PPhone/Web were also more likely to return if they had completed a coaching call, identified as white non-Hispanic or “other” race, or were commercially insured (all Pphone. The interactive Tobacco Tracker, Cost Savings Calculator, and Quitting Plan were the most widely used features overall. Web-Only were more likely than Phone/Web to use most key features (all PPhone/Web and Web-Only, Web-Only were less likely to have received quitline NRT. Conclusions This paper adds to our understanding of who selects different cessation treatment modalities and how they engage with the program in a real-world setting. Web-Only were younger, healthier smokers of higher socioeconomic status who interacted more intensely with services in a single session
Pacek, Lauren R; Rass, Olga; Johnson, Matthew W
Smoking cessation has proven to be a challenge for HIV-positive smokers. Patient and provider characteristics may provide barriers to smoking cessation. We aimed to identify characteristics associated with interest in cessation as well as characterize use of, current interest in, and provider recommendations for smoking cessation modalities. Data came from 275 HIV-positive smokers recruited online. Half (49.1%) of the sample was interested in quitting; daily smoking was associated with decreased likelihood of interest in cessation, whereas making a lifetime quit attempt, receiving encouragement to quit from an HIV care provider, and greater frequency of discussions regarding cessation with HIV care providers were associated with increased likelihood of interest in cessation. Nicotine replacement therapy was the most commonly used (42.9%), generated the most interest (59.1%), and was the most commonly clinician-recommended (70.7%) cessation modality. Findings emphasize the importance of the healthcare provider-patient relationship for smoking cessation promotion in HIV-positive smokers.
Full Text Available Objectives: The main objective of this study was to investigate the effectiveness of an interactive smoking cessation program when first implemented in a naïve population of Romanian adolescents. The secondary objective was to assess youngsters’ attitudes and beliefs towards tobacco dependence, their compliance to smoking cessation interventions and success rate of a standard smoking cessation pilot program.Materials and methods: A total of 231 subjects 14-19 years old participated in the Adolescent Smoking Cessation (ASC pilot program in Romania in 2005. Subjects were evaluated based on the ASC questionnaire, a validated set of questions about smoking and cessation profile, whether current smoker or not. Smoking status was validated by carbon monoxide determination in exhaled air. Participants were delivered 6 interactive ASC sessions about smoking hazards and methods to quit smoking. A final evaluation was done to assess overall program’s impact and to reward quitters and reducers by prizes.Results: Study population was made of 52.4% every day smokers, 10.4% at least once/week but not every day smokers, 6% less than once/week smokers, 23.4% never smokers and 7.8% ex-smokers. Cessation rate was 12.3% in every day smokers and 16.6 % in at least once a week but not every day smokers. Also, 4.1% every day smokers and 30 % at least once/week not every day smokers reduced number of cigarettes smoked/day. The program registered a high attendance rate/sessions as 85.2 % of subjects were present in all sessions. Also, significant changes occurred in participant’s beliefs about smoking and cessation.Conclusions: Pilot ASC was an efficient program with 12.3% of daily smokers to quit smoking and its positive impact on personal smoking and cessation beliefs in 90 % of participants. J Clin Exp Invest 2010; 1(3: 150-155
Haines-Saah, Rebecca J; Kelly, Mary T; Oliffe, John L; Bottorff, Joan L
Young adults have high rates of tobacco use compared to other subpopulations, yet there are relatively few tobacco interventions specifically targeted to this group. Picture Me Smokefree is an online tobacco reduction and cessation intervention for young adults that uses digital photography and social networking. The main goal of the project was to determine the feasibility of engaging young adults in participating in user-driven, online forums intended to provide peer support and motivate critical reflection about tobacco use and cessation among this high-use, hard-to-reach population. A related aim was to explore the influence of gender-related factors on participation, in order to determine the need for online interventions to be tailored to the specific gender preferences reflecting young men and women's participation styles. A total of 60 young adults ages 19-24 years who self-identified as current cigarette smokers or who had quit within the last year were recruited from across British Columbia, Canada, and participated in an online photo group on Facebook over a period of 12 consecutive weeks. A variety of data collection methods were used including tracking online activity, a brief online follow-up survey, and qualitative interviews with study participants. Data analysis involved descriptive statistics on recruitment, retention, and participation and qualitative (eg, narrative analysis, synthesis of feedback) feedback about participant engagement. Findings from this study suggest good potential for Facebook as an accessible, low-cost platform for engaging young adults to reflect on the reasons for their tobacco use, the benefits of quitting or reducing, and the best strategies for tobacco reduction. Young adults' frequent use of mobile phones and other mobile devices to access social networking permitted ease of access and facilitated real-time peer-to-peer support across a diverse group of participants. However, our experience of conducting the study
Troelstra, Sigrid A; Bosdriesz, Jizzo R; de Boer, Michiel R; Kunst, Anton E
The impact of tobacco control policies on measures of smoking cessation behaviour has often been studied, yet there is little information on their precise magnitude and duration. This study aims to measure the magnitude and timing of the impact of Dutch tobacco control policies on the rate of searching for information on smoking cessation, using Google Trends search query data. An interrupted time series analysis was used to examine the effect of two types of policies (smoke-free legislation and reimbursement of smoking cessation support (SCS)) on Google searches for 'quit smoking'. Google Trends data were seasonally adjusted and analysed using autoregressive integrated moving average (ARIMA) modelling. Multiple effect periods were modelled as dummy variables and analysed simultaneously to examine the magnitude and duration of the effect of each intervention. The same analysis was repeated with Belgian search query data as a control group, since Belgium is the country most comparable to the Netherlands in terms of geography, language, history and culture. A significant increase in relative search volume (RSV) was found from one to four weeks (21-41%) after the introduction of the smoking ban in restaurants and bars in the Netherlands in 2008. The introduction of SCS reimbursement in 2011 was associated with a significant increase of RSV (16-22%) in the Netherlands after 3 to 52 weeks. The reintroduction of SCS in 2013 was associated with a significant increase of RSV (9-21%) in the Netherlands from 3 to 32 weeks after the intervention. No effects were found in the Belgian control group for the smoking ban and the reintroduction of SCS in 2013, but there was a significant increase in RSV shortly before and after the introduction of SCS in 2011. These findings suggest that these tobacco control policies have short-term or medium-term effects on the rate of searching for information on smoking cessation, and therefore potentially on smoking cessation rates.
Williams, Geoffrey C; McGregor, Holly A; Sharp, Daryl; Levesque, Chantal; Kouides, Ruth W; Ryan, Richard M; Deci, Edward L
A longitudinal randomized trial tested the self-determination theory (SDT) intervention and process model of health behavior change for tobacco cessation (N = 1006). Adult smokers were recruited for a study of smokers' health and were assigned to intensive treatment or community care. Participants were relatively poor and undereducated. Intervention patients perceived greater autonomy support and reported greater autonomous and competence motivations than did control patients. They also reported greater medication use and significantly greater abstinence. Structural equation modeling analyses confirmed the SDT process model in which perceived autonomy support led to increases in autonomous and competence motivations, which in turn led to greater cessation. The causal role of autonomy support in the internalization of autonomous motivation, perceived competence, and smoking cessation was supported. Copyright 2006 APA, all rights reserved.
Peltier, MacKenzie R; Roys, Melanie R; Waters, Aaron F; Vinci, Christine; Waldo, Krystal M; Stewart, Shelby A; Toups, Robert C; Jones, Louis; Copeland, Amy L
Despite considerable health risks due to lower levels of estrogen production and the compounding antiestrogenic effects of nicotine, postmenopausal females continue to smoke. These females face significant barriers to cessation, including negative affect, weight concerns, and menopausal symptom severity. The current pilot study explored the effect of negative affect, weight concerns, and menopausal symptom severity on motivation and readiness to quit smoking. Eighteen postmenopausal smokers were randomized to receive brief motivational interviewing (B-MI; n = 8) or control treatment (i.e., a 1-hour video, n = 10). Participants completed measures of negative affect, weight concerns, and menopausal symptoms, as well as measures of motivation and readiness to quit. Motivation and readiness to quit were reassessed one week following treatment. At baseline, weight concerns, specifically surrounding smoking to prevent overeating, were identified as related to increased motivation to quit smoking. Menopausal symptom severity, specifically somatic symptoms, assessed at baseline, was associated with increased readiness for cessation. B-MI did not increase motivation or readiness to quit; however, results indicate that cigarettes per day decreased from baseline to follow-up by approximately 20-30%. These results provide valuable insight into enhancing engagement in a cessation treatment among this population. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Regidor, Enrique; Pascual, Cruz; Giráldez-García, Carolina; Galindo, Silvia; Martínez, David; Kunst, Anton E.
To evaluate the effect of tobacco prices and the implementation of smoke-free legislation on smoking cessation in Spain, by educational level, across the period 1993-2012. National Health Surveys data for the above two decades were used to calculate smoking cessation in people aged 25-64 years. The
Au-Yeung, Caroline M; Weisman, Susan R; Hennrikus, Deborah J; Forster, Jean L; Skoog, Rodney; Luneburg, Wade; Hesse, Bernie
An estimated one fifth of all U.S. adult smokers receive health benefits through insurance plans administered by Taft-Hartley Health and Welfare Funds. Most funds do not offer comprehensive tobacco-cessation services to fund participants despite evidence that doing so would be cost effective and save lives. This paper examines the decision-making processes of Minnesota-based fund trustees and advisors to identify factors that influence decisions about modifications to benefits. Formative data about the process by which funds make health benefit modifications were collected in 2007-2008 from 25 in-depth key informant interviews with fund trustees and a cross-section of fund advisors, including administrators, attorneys, and healthcare business consultants. Analyses were performed using a general inductive approach to identify conceptual themes, employing qualitative data analysis software. The most commonly cited factors influencing trustees' decisions about health plan benefit modifications-including modifications regarding tobacco-cessation benefits-were benefit costs, participants' demand for services, and safeguarding participants' health. Barriers included information gaps, concerns about participants' response, and difficulty projecting benefit utilization and success. Advisors wielded considerable influence in decision-making processes. Trustees relied on a small pool of business, legal, and administrative advisors to provide guidance and recommendations about possible health plan benefit modifications. Providing advisors with evidence-based information and resources about benefit design, cost/return-on-investment (ROI), effectiveness, and promotion may be an effective means to influence funds to provide comprehensive tobacco-cessation benefits. Copyright © 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Ribot, Blanca; Isern, Rosanna; Hernández-Martínez, Carmen; Canals, Josefa; Aranda, Núria; Arija, Victoria
Tobacco during pregnancy affects the health of the newborn. The aim was to assess the effect of maternal exposure to active and passive tobacco and of smoking cessation on the risk of preterm deliveries and birth weight, taking into account other risk factors. Longitudinal study conducted in 282 healthy pregnant women. General, obstetrical and hematological data were collected as it was the smoking habit during pregnancy. Pregnant women were classified as "exposed to smoke" (active smoker and passive smoker) and "unexposed to smoke" (non-smokers and women who quitted smoking during pregnancy). A percentage of 59.2 were non-smokers, 18.4% active smokers, 8.5% second-hand smokers and 13.8% had stopped smoking. Unexposed pregnant women who stopped smoking had the same risk of premature deliveries and children with similar birth weight as non-smoker women. Active and second-hand smokers were at higher risk of preterm deliveries than non-smokers (odds ratio [OR] 6.5, 95% confidence interval [95% CI] 1.4-30.8 and OR 6.2, 95% CI 1.0-38.9, respectively); however, higher levels of hemoglobin in the 1st and 3rd trimester exerted a protective effect (OR 0.9, 95% CI 0.8-0.9). Active and second-hand smokers had babies weighing less than non-smokers (around 129 and 178g less, respectively). Active or passive exposure to smoke during pregnancy and lower hemoglobin levels are associated with an increased risk of premature deliveries and lower birth weight. Stopping smoking during pregnancy prevents these detrimental effects. Copyright © 2013 Elsevier España, S.L. All rights reserved.
Full Text Available Ware G Kuschner, Sunayana Reddy, Nidhi Mehrotra, Harman S PaintalDivision of Pulmonary and Critical Care Medicine, Stanford University School of Medicine, Palo Alto, CA, USAAbstract: Primary care providers should be aware of two new developments in nicotine addiction and smoking cessation: 1 the emergence of a novel nicotine delivery system known as the electronic (e- cigarette; and 2 new reports of residual environmental nicotine and other biopersistent toxicants found in cigarette smoke, recently described as “thirdhand smoke”. The purpose of this article is to provide a clinician-friendly introduction to these two emerging issues so that clinicians are well prepared to counsel smokers about newly recognized health concerns relevant to tobacco use. E-cigarettes are battery powered devices that convert nicotine into a vapor that can be inhaled. The World Health Organization has termed these devices electronic nicotine delivery systems (ENDS. The vapors from ENDS are complex mixtures of chemicals, not pure nicotine. It is unknown whether inhalation of the complex mixture of chemicals found in ENDS vapors is safe. There is no evidence that e-cigarettes are effective treatment for nicotine addiction. ENDS are not approved as smoking cessation devices. Primary care givers should anticipate being questioned by patients about the advisability of using e-cigarettes as a smoking cessation device. The term thirdhand smoke first appeared in the medical literature in 2009 when investigators introduced the term to describe residual tobacco smoke contamination that remains after the cigarette is extinguished. Thirdhand smoke is a hazardous exposure resulting from cigarette smoke residue that accumulates in cars, homes, and other indoor spaces. Tobacco-derived toxicants can react to form potent cancer causing compounds. Exposure to thirdhand smoke can occur through the skin, by breathing, and by ingestion long after smoke has cleared from a room
Park, Elyse R; Gareen, Ilana F; Japuntich, Sandra; Lennes, Inga; Hyland, Kelly; DeMello, Sarah; Sicks, JoRean D; Rigotti, Nancy A
The National Lung Screening Trial (NLST) found a reduction in lung cancer mortality among participants screened with low-dose computed tomography vs chest radiography. In February 2015, Medicare announced its decision to cover annual lung screening for patients with a significant smoking history. These guidelines promote smoking cessation treatment as an adjunct to screening, but the frequency and effectiveness of clinician-delivered smoking cessation interventions delivered after lung screening are unknown. To determine the association between the reported clinician-delivered 5As (ask, advise, assess, assist [talk about quitting or recommend stop-smoking medications or recommend counseling], and arrange follow-up) after lung screening and smoking behavior changes. A matched case-control study (cases were quitters and controls were continued smokers) of 3336 NLST participants who were smokers at enrollment examined participants' rates and patterns of 5A delivery after a lung screen and reported smoking cessation behaviors. Prevalence of the clinician-delivered 5As and associated smoking cessation after lung screening. Delivery of the 5As 1 year after screening were as follows: ask, 77.2%; advise, 75.6%; assess, 63.4%; assist, 56.4%; and arrange follow-up, 10.4%. Receipt of ask, advise, and assess was not significantly associated with quitting in multivariate models that adjusted for sociodemographic characteristics, medical history, screening results, nicotine dependence, and motivation to quit. Assist was associated with a 40% increase in the odds of quitting (odds ratio, 1.40; 95% CI, 1.21-1.63), and arrange was associated with a 46% increase in the odds of quitting (odds ratio, 1.46; 95% CI, 1.19-1.79). Assist and arrange follow-up delivered by primary care providers to smokers who were participating in the NLST were associated with increased quitting; less intensive interventions (ask, advise, and assess) were not. However, rates of assist and arrange
Licht, Andrea S; Hyland, Andrew J; O'Connor, Richard J; Chaloupka, Frank J; Borland, Ron; Fong, Geoffrey T; Nargis, Nigar; Cummings, K Michael
This paper examines how price minimizing behaviors impact efforts to stop smoking. Data on 4,988 participants from the International Tobacco Control Policy Evaluation (ITC) Four-Country Survey who were smokers at baseline (wave 5) and interviewed at a 1 year follow-up were used. We examined whether price minimizing behaviors at baseline predicted: (1) cessation, (2) quit attempts, and (3) successful quit attempts at one year follow up using multivariate logistic regression modeling. A subset analysis included 3,387 participants who were current smokers at waves 5 and 6 and were followed through wave 7 to explore effects of changing purchase patterns on cessation. Statistical tests for interaction were performed to examine the joint effect of SES and price/tax avoidance behaviors on cessation outcomes. Smokers who engaged in any price/tax avoidance behaviors were 28% less likely to report cessation. Persons using low/untaxed sources were less likely to quit at follow up, those purchasing cartons were less likely to make quit attempts and quit, and those using discount cigarettes were less likely to succeed, conditional on making attempts. Respondents who utilized multiple behaviors simultaneously were less likely to make quit attempts and to succeed. SES did not modify the effects of price minimizing behaviors on cessation outcomes. The data from this paper indicate that the availability of lower priced cigarette alternatives may attenuate public health efforts aimed at to reduce reducing smoking prevalence through price and tax increases among all SES groups.
Licht, Andrea S.; Hyland, Andrew J.; O’Connor, Richard J.; Chaloupka, Frank J.; Borland, Ron; Fong, Geoffrey T.; Nargis, Nigar; Cummings, K. Michael
This paper examines how price minimizing behaviors impact efforts to stop smoking. Data on 4,988 participants from the International Tobacco Control Policy Evaluation (ITC) Four-Country Survey who were smokers at baseline (wave 5) and interviewed at a 1 year follow-up were used. We examined whether price minimizing behaviors at baseline predicted: (1) cessation, (2) quit attempts, and (3) successful quit attempts at one year follow up using multivariate logistic regression modeling. A subset analysis included 3,387 participants who were current smokers at waves 5 and 6 and were followed through wave 7 to explore effects of changing purchase patterns on cessation. Statistical tests for interaction were performed to examine the joint effect of SES and price/tax avoidance behaviors on cessation outcomes. Smokers who engaged in any price/tax avoidance behaviors were 28% less likely to report cessation. Persons using low/untaxed sources were less likely to quit at follow up, those purchasing cartons were less likely to make quit attempts and quit, and those using discount cigarettes were less likely to succeed, conditional on making attempts. Respondents who utilized multiple behaviors simultaneously were less likely to make quit attempts and to succeed. SES did not modify the effects of price minimizing behaviors on cessation outcomes. The data from this paper indicate that the availability of lower priced cigarette alternatives may attenuate public health efforts aimed at to reduce reducing smoking prevalence through price and tax increases among all SES groups. PMID:21655144
Tabuchi, Takahiro; Fukui, Keisuke; Gallus, Silvano
Tobacco price increases can generate increased public interest in smoking cessation, but it is not clear how long this interest lasts. Our objective was to evaluate the duration of the impact of cigarette price increase in Japan using Google search data. Monthly or daily aggregated Google search volume for smoking cessation in Japan from 2004 to 2016 was collected in terms of relative search volume (RSV) ranging from 0-100. Using monthly RSV data, we evaluated possible relationships between the RSVs and tobacco control measures in Japan. Time periods within which the impact of search volume significantly increased were identified by cluster detection test, using daily RSV data. A spike in RSV preceding the enforcement of a cigarette price increase revealed an anticipation effect. Between 2004 and 2016 the three highest monthly RSV spikes were observed in July 2006 (RSV=66), when cigarette prices increased by 11%, and in September (RSV=90) and October 2010 (RSV=100), when cigarette prices increased by 37%. Regarding daily RSV, the detected cluster size around the price increase in 2010 (52 days) was longer than that in 2006 (17 days). In 2010, a cluster period of 25 days before the date of the price increase was observed, suggesting an anticipation effect. After the onset of the price increase, a cluster of 27 days was detected. When the cigarette price increased due to consumption tax in April 2014, almost no anticipation effect was observed. The population impact of tobacco price increases on smoking cessation may be assessed using Google Trends data. The cluster indicates that a higher cigarette price increase had a higher and longer-lasting effect on population interest in cessation, but the impact may continue for a relatively short time. To examine the duration of the impact of cigarette price increases on population interest in smoking cessation in Japan, Google search data for smoking cessation was analyzed. Between 2004 and 2016 the three highest spikes of
Joseph R. DiFranza
Full Text Available Abstract Within the field of addiction research, individuals tend to operate within silos of knowledge focused on specific drug classes. The discovery that tobacco dependence develops in a progression of stages and that the latency to the onset of withdrawal symptoms after the last use of tobacco changes over time have provided insights into how tobacco dependence develops that might be applied to the study of other drugs. As physical dependence on tobacco develops, it progresses through previously unrecognized clinical stages of wanting, craving and needing. The latency to withdrawal is a measure of the asymptomatic phase of withdrawal, extending from the last use of tobacco to the emergence of withdrawal symptoms. Symptomatic withdrawal is characterized by a wanting phase, a craving phase, and a needing phase. The intensity of the desire to smoke that is triggered by withdrawal correlates with brain activity in addiction circuits. With repeated tobacco use, the latency to withdrawal shrinks from as long as several weeks to as short as several minutes. The shortening of the asymptomatic phase of withdrawal drives an escalation of smoking, first in terms of the number of smoking days/month until daily smoking commences, then in terms of cigarettes smoked/day. The discoveries of the stages of physical dependence and the latency to withdrawal raises the question, does physical dependence develop in stages with other drugs? Is the latency to withdrawal for other substances measured in weeks at the onset of dependence? Does it shorten over time? The research methods that uncovered how tobacco dependence emerges might be fruitfully applied to the investigation of other addictions.
El Dib, Regina; Suzumura, Erica A; Akl, Elie A; Gomaa, Huda; Agarwal, Arnav; Chang, Yaping; Prasad, Manya; Ashoorion, Vahid; Heels-Ansdell, Diane; Maziak, Wasim; Guyatt, Gordon
A systematic review and meta-analysis to investigate the impact of electronic nicotine delivery systems (ENDS) and/or electronic non-nicotine delivery systems (ENNDS) versus no smoking cessation aid, or alternative smoking cessation aids, in cigarette smokers on long-term tobacco use. Searches of MEDLINE, EMBASE, PsycInfo, CINAHL, CENTRAL and Web of Science up to December 2015. Randomised controlled trials (RCTs) and prospective cohort studies. Three pairs of reviewers independently screened potentially eligible articles, extracted data from included studies on populations, interventions and outcomes and assessed their risk of bias. We used the Grading of Recommendations Assessment, Development and Evaluation approach to rate overall certainty of the evidence by outcome. Three randomised trials including 1007 participants and nine cohorts including 13 115 participants proved eligible. Results provided by only two RCTs suggest a possible increase in tobacco smoking cessation with ENDS in comparison with ENNDS (RR 2.03, 95% CI 0.94 to 4.38; p=0.07; I 2 =0%, risk difference (RD) 64/1000 over 6 to 12 months, low-certainty evidence). Results from cohort studies suggested a possible reduction in quit rates with use of ENDS compared with no use of ENDS (OR 0.74, 95% CI 0.55 to 1.00; p=0.051; I 2 =56%, very low certainty). There is very limited evidence regarding the impact of ENDS or ENNDS on tobacco smoking cessation, reduction or adverse effects: data from RCTs are of low certainty and observational studies of very low certainty. The limitations of the cohort studies led us to a rating of very low-certainty evidence from which no credible inferences can be drawn. Lack of usefulness with regard to address the question of e-cigarettes' efficacy on smoking reduction and cessation was largely due to poor reporting. This review underlines the need to conduct well-designed trials measuring biochemically validated outcomes and adverse effects. Published by the BMJ
Reports an error in "Psychiatric disorders in smokers seeking treatment for tobacco dependence: Relations with tobacco dependence and cessation" by Megan E. Piper, Stevens S. Smith, Tanya R. Schlam, Michael F. Fleming, Amy A. Bittrich, Jennifer L. Brown, Cathlyn J. Leitzke, Mark E. Zehner, Michael C. Fiore and Timothy B. Baker ( Journal of Consulting and Clinical Psychology , 2010[Feb], Vol 78, 13-23). There was an error in the Method section in the World Mental Health Survey Initiative version of the CIDI subsection. The authors characterized one of the anxiety conditions analyzed as "panic disorder". However, this should have been labeled as "panic attacks", consequently making the occurrence rates and relations the authors reported actually pertain to panic attacks, social phobia, and generalized anxiety disorder. (The following abstract of the original article appeared in record 2010-00910-005.) Objective: The present research examined the relation of psychiatric disorders to tobacco dependence and cessation outcomes. Data were collected from 1,504 smokers (58.2% women; 83.9% White; mean age = 44.67 years, SD = 11.08) making an aided smoking cessation attempt as part of a clinical trial. Psychiatric diagnoses were determined with the Composite International Diagnostic Interview structured clinical interview. Tobacco dependence was assessed with the Fagerström Test of Nicotine Dependence (FTND) and the Wisconsin Inventory of Smoking Dependence Motives (WISDM). Diagnostic groups included those who were never diagnosed, those who had ever been diagnosed (at any time, including in the past year), and those with past-year diagnoses (with or without prior diagnosis). Some diagnostic groups had lower follow-up abstinence rates than did the never diagnosed group ( ps < .05). At 8 weeks after quitting, strong associations were found between cessation outcome and both past-year mood disorder and ever diagnosed anxiety disorder. At 6 months after quitting, those ever
Chapman, Simon; Wakefield, Melanie A
In the 50 years since the twentieth century's smoking epidemic began to decline from the beginning of the 1960s, hundreds of millions of smokers around the world have stopped smoking permanently. Overwhelmingly, most stopped without any formal assistance in the form of medication or professional assistance, including many millions of former heavy smokers. Nascent discussion about national and global tobacco endgame scenarios is dominated by an assumption that transitioning from cigarettes to alternative forms of potent, consumer-acceptable forms of nicotine will be essential to the success of endgames. This appears to uncritically assume (1) the hardening hypothesis: that as smoking prevalence moves toward and below 10%, the remaining smokers will be mostly deeply addicted, and will be largely unable to stop smoking unless they are able to move to other forms of 'clean' nicotine addiction such as e-cigarettes and more potent forms of nicotine replacement; and (2) an overly medicalised view of smoking cessation that sees unassisted cessation as both inefficient and inhumane. In this paper, we question these assumptions. We also note that some vanguard nations which continue to experience declining smoking prevalence have long banned smokeless tobacco and non-therapeutic forms of nicotine delivery. We argue that there are potentially risky consequences of unravelling such bans when history suggests that large-scale cessation is demonstrably possible.
Chapman, Simon; Wakefield, Melanie A
In the 50 years since the twentieth century's smoking epidemic began to decline from the beginning of the 1960s, hundreds of millions of smokers around the world have stopped smoking permanently. Overwhelmingly, most stopped without any formal assistance in the form of medication or professional assistance, including many millions of former heavy smokers. Nascent discussion about national and global tobacco endgame scenarios is dominated by an assumption that transitioning from cigarettes to alternative forms of potent, consumer-acceptable forms of nicotine will be essential to the success of endgames. This appears to uncritically assume (1) the hardening hypothesis: that as smoking prevalence moves toward and below 10%, the remaining smokers will be mostly deeply addicted, and will be largely unable to stop smoking unless they are able to move to other forms of ‘clean’ nicotine addiction such as e-cigarettes and more potent forms of nicotine replacement; and (2) an overly medicalised view of smoking cessation that sees unassisted cessation as both inefficient and inhumane. In this paper, we question these assumptions. We also note that some vanguard nations which continue to experience declining smoking prevalence have long banned smokeless tobacco and non-therapeutic forms of nicotine delivery. We argue that there are potentially risky consequences of unravelling such bans when history suggests that large-scale cessation is demonstrably possible. PMID:23591504
Rabin, Rachel A; Ashare, Rebecca L; Schnoll, Robert A; Cinciripini, Paul M; Hawk, Larry W; Lerman, Caryn; Tyndale, Rachel F; George, Tony P
Tobacco and cannabis are frequently used in combination and cannabis co-use may lead to poor tobacco cessation outcomes. Therefore, it is important to explore if cannabis co-use is associated with a reduced likelihood of achieving successful tobacco abstinence among treatment-seeking tobacco smokers. The present study examined whether current cannabis use moderated tobacco cessation outcomes after 12 weeks of pharmacological treatment (varenicline vs. nicotine patch vs. placebo) with adjunctive behavioral counseling. Treatment-seeking tobacco smokers (N = 1,246) were enrolled in an intent-to-treat study, of which 220 were current cannabis users. Individuals were randomly assigned to 12 weeks of placebo (placebo pill plus placebo patch), nicotine patch (active patch plus placebo pill), or varenicline (active pill plus placebo patch), plus behavioral counseling. The primary endpoint was biochemically verified 7-day point prevalence abstinence at the end of treatment. Controlling for rate of nicotine metabolism, treatment arm, age, sex, alcohol, and level of nicotine dependence, cannabis users were as successful at achieving biochemically verified 7-day point prevalence abstinence compared to tobacco-only smokers. Findings suggest that cannabis use does not hinder the ability to quit tobacco smoking. Future tobacco cessation studies should employ prospective, longitudinal designs investigating cannabis co-use over time and at different severity levels. (Am J Addict 2016;25:291-296). © 2016 American Academy of Addiction Psychiatry.
Kennedy, Ryan David; Behm, Ilan; Craig, Lorraine; Thompson, Mary E; Fong, Geoffrey T; Guignard, Romain; Beck, Francois
Smoking cessation advice from health care providers (HCP) is well-known to be associated with increased quitting. This study sought to understand the extent to which smokers in France who visited a HCP around the time of the implementation of the national ban on smoking received encouragement to quit from a HCP and what kinds of intervention were provided. HCP may have a unique opportunity during the implementation phase of smoke-free laws to address their patients' smoking behaviours to increase the likelihood of success at a time when smokers' readiness and interest in quitting may be higher. Telephone interviews were conducted among adult smokers (n = 1067) before and after the two-phase (2007 and 2008) national ban on indoor smoking as part of the International Tobacco Control (ITC) France Survey. In the survey, smokers were asked whether they had visited a HCP in the past 6 months and, if so, whether they had received cessation encouragement, and/or other interventions to support quitting such as prescriptions for stop-smoking medication. Most smokers (61%) reported visiting a HCP in the 6 months prior to the first phase of the national smoke-free ban, and 58% after the time of the hospitality ban. Of these, most reported they did not receive any assistance from a HCP before (54%) or after (64%) the smoke-free law. Among those who reported an intervention, the most common were only encouragement to quit (58% in Wave 1 and 49% in Wave 2), or receiving both encouragement and a pamphlet (31% in both Wave 1 and 2). The combination of prescriptions for stop-smoking medicine and encouragement to quit increased from 8% in 2007 to 22% in 2008. The smokers who received an intervention were more likely (OR 1.9, 95% CI: 1.2-2.9) to report that they were thinking about quitting. This study demonstrates that HCP in France are well positioned to provide smoking cessation encouragement and other interventions to a majority of smokers and thus the importance of taking
Torabi, Mohammad R; Tao, Ran; Jay, Stephen J; Olcott, Courtney
Chronic diseases are currently the major cause of death and disability worldwide. Addressing the main causes of chronic diseases from a preventive perspective is imperative for half ing a continual increase in premature deaths. Physicians occupy a unique position to assist individuals with chronic disease prevention. Hence, medical school is an opportunity to prepare physicians for preventive interventions with patients at risk for developing chronic diseases. This study asserts that education on chronic disease prevention that targets tobacco cessation/prevention, nutrition/ diet, and exercise physiology/fitness is a key aspect of medical school curricula. However, many US medical schools do not include all 3 components in their curricula. This study investigates the extent to which medical school curricula include the above 3 areas. Two methods were utilized for the study: (1) a cross-sectional survey was given to the associate dean of academic affairs of 129 US medical schools and (2) relevant data were retrieved from the Association of American Medical Colleges. Findings support the notion that medical schools are in need of increased curricula covering tobacco prevention/cessation, nutrition/diet, and exercise physiology/fitness. Results indicate that exercise physiology/fitness was the area receiving the least attention in medical schools. Ultimately, this study's purpose was to provide a basis for determining whether inclusion of these 3 subjects in medical school curricula has any significant effect on training future doctors to meet the needs of growing numbers of individuals with chronic disease.
Cook, Jessica W.; Fucito, Lisa M.; Piasecki, Thomas M.; Piper, Megan E.; Schlam, Tanya R.; Berg, Kristin M.; Baker, Timothy B.
Objective: Alcohol consumption is associated with smoking cessation failure in both community and clinical research. However, little is known about the relation between alcohol consumption and smoking cessation milestones (i.e., achieving initial abstinence, avoiding lapses and relapse). Our objective in this research was to examine the relations…
Full Text Available This paper examines how price minimizing behaviors impact efforts to stop smoking. Data on 4,988 participants from the International Tobacco Control Policy Evaluation (ITC Four-Country Survey who were smokers at baseline (wave 5 and interviewed at a 1 year follow-up were used. We examined whether price minimizing behaviors at baseline predicted: (1 cessation, (2 quit attempts, and (3 successful quit attempts at one year follow up using multivariate logistic regression modeling. A subset analysis included 3,387 participants who were current smokers at waves 5 and 6 and were followed through wave 7 to explore effects of changing purchase patterns on cessation. Statistical tests for interaction were performed to examine the joint effect of SES and price/tax avoidance behaviors on cessation outcomes. Smokers who engaged in any price/tax avoidance behaviors were 28% less likely to report cessation. Persons using low/untaxed sources were less likely to quit at follow up, those purchasing cartons were less likely to make quit attempts and quit, and those using discount cigarettes were less likely to succeed, conditional on making attempts. Respondents who utilized multiple behaviors simultaneously were less likely to make quit attempts and to succeed. SES did not modify the effects of price minimizing behaviors on cessation outcomes. The data from this paper indicate that the availability of lower priced cigarette alternatives may attenuate public health efforts aimed at to reduce reducing smoking prevalence through price and tax increases among all SES groups. This paper examines how price minimizing behaviors impact efforts to stop smoking. Data on 4,988 participants from the International Tobacco Control Policy Evaluation (ITC Four-Country Survey who were smokers at baseline (wave 5 and interviewed at a 1 year follow-up were used. We examined whether price minimizing behaviors at baseline predicted: (1 cessation, (2 quit attempts, and (3 successful
Conclusion: Participants at the intervention worksite increased their knowledge regarding the dangers of tobacco use and secondhand smoke exposure. Among current tobacco users, the intervention appeared to increase family rules regarding secondhand smoke exposure in their homes and vehicles.
Full Text Available Physicians are rated the most trustworthy source of information for smokers and thus play an increasing role in disseminating information on e-cigarettes to patients. Therefore, it is important to understand what is currently being communicated about e-cigarettes between physicians and patients. This study explored the knowledge, beliefs, communication, and recommendation of e-cigarettes among physicians of various specialties. Semi-structured interviews were conducted in early 2016 with 35 physicians across five different specialties. Interviews were transcribed and coded for the following deductive themes: (1 tobacco cessation recommendation practices, (2 knowledge of e-cigarettes, (3 communication of e-cigarettes with patients, (4 recommendation of e-cigarettes, and (5 general beliefs about e-cigarettes. Physicians across all specialties reported having conversations with patients about e-cigarettes. Conversations were generally prompted by the patient inquiring about e-cigarettes as a cessation method. Overall, physicians felt there was a lack of information on the efficacy and long term health effects but despite lack of evidence, generally did not discourage patients from trying e-cigarettes as a cessation device. Although physicians did not currently recommend e-cigarettes over traditional cessation methods, they were open to recommending e-cigarettes in the future if adequate data became available suggesting effectiveness. Patients are inquiring about e-cigarettes with physicians across various specialties. Future research should continue to study physicians' perceptions/practices given their potential to impact patient behavior and the possibility that such perceptions may change over time in response to the evidence-base on e-cigarettes. Keywords: E-cigarette, Harm reduction, Smoking cessation, Physicians, Qualitative
Meghan E. Morean
Full Text Available Behavioral incentives have been used to encourage smoking cessation in older adolescents, but the acceptability of incentives to promote a smoke-free lifestyle in younger adolescents is unknown. To inform the development of novel, effective, school-based interventions for youth, we assessed middle school students’ interest in participating in an incentive-based tobacco abstinence program. We surveyed 988 students (grades 6–8 attending three Connecticut middle schools to determine whether interest in program participation varied as a function of (1 intrapersonal factors (i.e., demographic characteristics (sex, age, race, smoking history, and trait impulsivity and/or (2 aspects of program design (i.e., prize type, value, and reward frequency. Primary analyses were conducted using multiple regression. A majority of students (61.8% reported interest in program participation. Interest did not vary by gender, smoking risk status, or offering cash prizes. However, younger students, non-Caucasian students, behaviorally impulsive students, and students with higher levels of self-regulation were more likely to report interest. Inexpensive awards (e.g., video games offered monthly motivated program interest. In sum, middle school students reported high levels of interest in an incentive-based program to encourage a tobacco-free lifestyle. These formative data can inform the design of effective, incentive-based smoking cessation and prevention programs in middle schools.
Morean, Meghan E; Camenga, Deepa R; Kong, Grace; Cavallo, Dana A; Schepis, Ty S; Krishnan-Sarin, Suchitra
Behavioral incentives have been used to encourage smoking cessation in older adolescents, but the acceptability of incentives to promote a smoke-free lifestyle in younger adolescents is unknown. To inform the development of novel, effective, school-based interventions for youth, we assessed middle school students' interest in participating in an incentive-based tobacco abstinence program. We surveyed 988 students (grades 6-8) attending three Connecticut middle schools to determine whether interest in program participation varied as a function of (1) intrapersonal factors (i.e., demographic characteristics (sex, age, race), smoking history, and trait impulsivity) and/or (2) aspects of program design (i.e., prize type, value, and reward frequency). Primary analyses were conducted using multiple regression. A majority of students (61.8%) reported interest in program participation. Interest did not vary by gender, smoking risk status, or offering cash prizes. However, younger students, non-Caucasian students, behaviorally impulsive students, and students with higher levels of self-regulation were more likely to report interest. Inexpensive awards (e.g., video games) offered monthly motivated program interest. In sum, middle school students reported high levels of interest in an incentive-based program to encourage a tobacco-free lifestyle. These formative data can inform the design of effective, incentive-based smoking cessation and prevention programs in middle schools.
Yunis, Kalid; Beydoun, Hind; Nakad, Pascale; Khogali, Mustafa; Shatila, Faysal; Tamim, Hala
To describe patterns of cigarette and narghile (hubble-bubble or water-pipe) smoking before and during pregnancy and identify predictors of successful smoking cessation. A survey was conducted on 4660 pregnant women who delivered single live births between September 1st, 2001 and December 31st, 2002 at five hospitals in Beirut, Lebanon. Women were classified into four groups according to patterns of tobacco use before and during pregnancy: 1) consistent non-users, 2) successful quitters, 3) unsuccessful quitters and 4) consistent users. High education (OR = 2.03, 95% CI: 0.99-4.15), adequate prenatal care (OR = 1.72, 95% CI: 1.02-2.91) and mild smoking at baseline (OR = 2.35, 95% CI: 1.36-4.09) were main determinants of successful cigarette smoking cessation, whereas successful quitters of narghile use were more likely to be nulliparous (OR = 1.80, 95% CI: 1.08-2.99) or to have a nonsmoking partner (OR = 7.57, 95 % CI: 2.31-24.78). Different populations should be targeted when designing smoking cessation interventions for cigarette and narghile users.
Borland, Ron; Li, Lin; Driezen, Pete; Wilson, Nick; Hammond, David; Thompson, Mary E; Fong, Geoffrey T; Mons, Ute; Willemsen, Marc C; McNeill, Ann; Thrasher, James F; Cummings, K Michael
To describe some of the variability across the world in levels of quit smoking attempts and use of various forms of cessation support. Use of the International Tobacco Control Policy Evaluation Project surveys of smokers, using the 2007 survey wave (or later, where necessary). Australia, Canada, China, France, Germany, Ireland, Malaysia, Mexico, the Netherlands, New Zealand, South Korea, Thailand, United Kingdom, Uruguay and United States. Samples of smokers from 15 countries. Self-report on use of cessation aids and on visits to health professionals and provision of cessation advice during the visits. Prevalence of quit attempts in the last year varied from less than 20% to more than 50% across countries. Similarly, smokers varied greatly in reporting visiting health professionals in the last year (<20% to over 70%), and among those who did, provision of advice to quit also varied greatly. There was also marked variability in the levels and types of help reported. Use of medication was generally more common than use of behavioural support, except where medications are not readily available. There is wide variation across countries in rates of attempts to stop smoking and use of assistance with higher overall use of medication than behavioural support. There is also wide variation in the provision of brief advice to stop by health professionals. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.
Fleischer, Nancy L; Lozano, Paula; Wu, Yun-Hsuan; Hardin, James W; Meng, Gang; Liese, Angela D; Fong, Geoffrey T; Thrasher, James F
To examine how point-of-sale (POS) display bans, tobacco retailer density and tobacco retailer proximity were associated with smoking cessation and relapse in a cohort of smokers in Canada, where provincial POS bans were implemented differentially over time from 2004 to 2010. Data from the 2005 to 2011 administrations of the International Tobacco Control (ITC) Canada Survey, a nationally representative cohort of adult smokers, were linked via residential geocoding with tobacco retailer data to derive for each smoker a measure of retailer density and proximity. An indicator variable identified whether the smoker's province banned POS displays at the time of the interview. Outcomes included cessation for at least 1 month at follow-up among smokers from the previous wave and relapse at follow-up among smokers who had quit at the previous wave. Logistic generalised estimating equation models were used to determine the relationship between living in a province with a POS display ban, tobacco retailer density and tobacco retailer proximity with cessation (n=4388) and relapse (n=866). Provincial POS display bans were not associated with cessation. In adjusted models, POS display bans were associated with lower odds of relapse which strengthened after adjusting for retailer density and proximity, although results were not statistically significant (OR 0.66, 95% CI 0.41 to 1.07, p=0.089). Neither tobacco retailer density nor proximity was associated with cessation or relapse. Banning POS retail displays shows promise as an additional tool to prevent relapse, although these results need to be confirmed in larger longitudinal studies. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Conclusions: Results of this review indicate that the scientific papers in the most recent decade recommend the use of NRT and Champix in combination with educational interventions. Additional research is needed to compare qualitative and quantitative studies for smoking cessation.
Fellows Jeffrey L
Full Text Available Abstract Background Extended smoking cessation follow-up after hospital discharge significantly increases abstinence. Hospital smoke-free policies create a period of ‘forced abstinence’ for smokers, thus providing an opportunity to integrate tobacco dependence treatment, and to support post-discharge maintenance of hospital-acquired abstinence. This study is funded by the National Heart, Lung, and Blood Institute (1U01HL1053231. Methods/Design The Inpatient Technology-Supported Assisted Referral study is a multi-center, randomized clinical effectiveness trial being conducted at Kaiser Permanente Northwest (KPNW and at Oregon Health & Science University (OHSU hospitals in Portland, Oregon. The study assesses the effectiveness and cost-effectiveness of linking a practical inpatient assisted referral to outpatient cessation services plus interactive voice recognition (AR + IVR follow-up calls, compared to usual care inpatient counseling (UC. In November 2011, we began recruiting 900 hospital patients age ≥18 years who smoked ≥1 cigarettes in the past 30 days, willing to remain abstinent postdischarge, have a working phone, live within 50 miles of the hospital, speak English, and have no health-related barriers to participation. Each site will randomize 450 patients to AR + IVR or UC using a 2:1 assignment strategy. Participants in the AR + IVR arm will receive a brief inpatient cessation consult plus a referral to available outpatient cessation programs and medications, and four IVR follow-up calls over seven weeks postdischarge. Participants do not have to accept the referral. At KPNW, UC participants will receive brief inpatient counseling and encouragement to self-enroll in available outpatient services. The primary outcome is self-reported thirty-day smoking abstinence at six months postrandomization for AR + IVR participants compared to usual care. Additional outcomes include self-reported and biochemically confirmed
Fellows, Jeffrey L; Mularski, Richard; Waiwaiole, Lisa; Funkhouser, Kim; Mitchell, Julie; Arnold, Kathleen; Luke, Sabrina
Extended smoking cessation follow-up after hospital discharge significantly increases abstinence. Hospital smoke-free policies create a period of 'forced abstinence' for smokers, thus providing an opportunity to integrate tobacco dependence treatment, and to support post-discharge maintenance of hospital-acquired abstinence. This study is funded by the National Heart, Lung, and Blood Institute (1U01HL1053231). The Inpatient Technology-Supported Assisted Referral study is a multi-center, randomized clinical effectiveness trial being conducted at Kaiser Permanente Northwest (KPNW) and at Oregon Health & Science University (OHSU) hospitals in Portland, Oregon. The study assesses the effectiveness and cost-effectiveness of linking a practical inpatient assisted referral to outpatient cessation services plus interactive voice recognition (AR + IVR) follow-up calls, compared to usual care inpatient counseling (UC). In November 2011, we began recruiting 900 hospital patients age ≥18 years who smoked ≥1 cigarettes in the past 30 days, willing to remain abstinent postdischarge, have a working phone, live within 50 miles of the hospital, speak English, and have no health-related barriers to participation. Each site will randomize 450 patients to AR + IVR or UC using a 2:1 assignment strategy. Participants in the AR + IVR arm will receive a brief inpatient cessation consult plus a referral to available outpatient cessation programs and medications, and four IVR follow-up calls over seven weeks postdischarge. Participants do not have to accept the referral. At KPNW, UC participants will receive brief inpatient counseling and encouragement to self-enroll in available outpatient services. The primary outcome is self-reported thirty-day smoking abstinence at six months postrandomization for AR + IVR participants compared to usual care. Additional outcomes include self-reported and biochemically confirmed seven-day abstinence at six months, self-reported seven
Singh, Binu; Hrywna, Mary; Wackowski, Olivia A; Delnevo, Cristine D; Jane Lewis, M; Steinberg, Michael B
Physicians are rated the most trustworthy source of information for smokers and thus play an increasing role in disseminating information on e-cigarettes to patients. Therefore, it is important to understand what is currently being communicated about e-cigarettes between physicians and patients. This study explored the knowledge, beliefs, communication, and recommendation of e-cigarettes among physicians of various specialties. Semi-structured interviews were conducted in early 2016 with 35 physicians across five different specialties. Interviews were transcribed and coded for the following deductive themes: (1) tobacco cessation recommendation practices, (2) knowledge of e-cigarettes, (3) communication of e-cigarettes with patients, (4) recommendation of e-cigarettes, and (5) general beliefs about e-cigarettes. Physicians across all specialties reported having conversations with patients about e-cigarettes. Conversations were generally prompted by the patient inquiring about e-cigarettes as a cessation method. Overall, physicians felt there was a lack of information on the efficacy and long term health effects but despite lack of evidence, generally did not discourage patients from trying e-cigarettes as a cessation device. Although physicians did not currently recommend e-cigarettes over traditional cessation methods, they were open to recommending e-cigarettes in the future if adequate data became available suggesting effectiveness. Patients are inquiring about e-cigarettes with physicians across various specialties. Future research should continue to study physicians' perceptions/practices given their potential to impact patient behavior and the possibility that such perceptions may change over time in response to the evidence-base on e-cigarettes.
Duke, Jennifer C; Hansen, Heather; Kim, Annice E; Curry, Laurel; Allen, Jane
The promotion of evidence-based cessation services through social media sites may increase their utilization by smokers. Data on social media adoption and use within tobacco control programs (TCPs) have not been reported. This study examines TCP use of and activity levels on social media, the reach of TCP sites, and the level of engagement with the content on sites. A cross-sectional descriptive study of state TCP social media sites and their content was conducted. In 2013, 60% (30/50) of TCPs were using social media. Approximately one-quarter (26%, 13/50) of all TCPs used 3 or more social media sites, 24% (12/50) used 2, and 10% (5/50) used 1 site. Overall, 60% (30/50) had a Facebook page, 36% (18/50) had a Twitter page, and 40% (20/50) had a YouTube channel. The reach of social media was different across each site and varied widely by state. Among TCPs with a Facebook page, 73% (22/30) had less than 100 likes per 100,000 adults in the state, and 13% (4/30) had more than 400 likes per 100,000 adults. Among TCPs with a Twitter page, 61% (11/18) had less than 10 followers per 100,000 adults, and just 1 state had more than 100 followers per 100,000 adults. Seven states (23%, 7/30) updated their social media sites daily. The most frequent social media activities focused on the dissemination of information rather than interaction with site users. Social media resources from a national cessation media campaign were promoted infrequently. The current reach of state TCP social media sites is low and most TCPs are not promoting existing cessation services or capitalizing on social media's interactive potential. TCPs should create an online environment that increases participation and 2-way communication with smokers to promote free cessation services.
de Korte, D.; van Schayck, O.C.P.; van Spiegel, P.; Kaptein, A.A.; Sachs, A.; Rutten-van Mölken, M.; Chavannes, N.; Tromp-Beelen, T.; Bes, R.; Allard, R.; Peeters, G.; Kliphuis, L.; Schouten, J.W.; van Gennip, L.; van Ommen, R.; Asin, J.
Despite ongoing efforts to reduce tobacco smoking, the smoking prevalence in many countries has remained stable for years. This may be a consequence of either lack of knowledge about effective ways to reduce smoking, or failing treatment of tobacco addiction in healthcare. This study explored gaps
Nagelhout, G.E.; de Vries, H.; Fong, G.T.; Candel, M.J.J.M.; Thrasher, J.F.; van den Putte, B.; Thompson, M.E.; Cummings, K.M.; Willemsen, M.C.
Introduction: This study aims to test the pathways of change from individual exposure to smoke-free legislation on smoking cessation, as hypothesized in the International Tobacco Control (ITC) Conceptual Model. Methods: A nationally representative sample of Dutch smokers aged 15 years and older was
Klumbiene, Jurate; Sakyte, Edita; Petkeviciene, Janina; Prattala, Ritva; Kunst, Anton E.
Background: This study aimed to evaluate the association between tobacco control policies and trends in smoking cessation according to gender, age and educational level in Lithuania in 1994-2010. Methods: The data were obtained from nine cross-sectional postal surveys conducted biennially within the
Sadasivam, Rajani S; Cutrona, Sarah L; Luger, Tana M; Volz, Erik; Kinney, Rebecca; Rao, Sowmya R; Allison, Jeroan J; Houston, Thomas K
Although technology-assisted tobacco interventions (TATIs) are effective, they are underused due to recruitment challenges. We tested whether we could successfully recruit smokers to a TATI using peer marketing through a social network (Facebook). We recruited smokers on Facebook using online advertisements. These recruited smokers (seeds) and subsequent waves of smokers (peer recruits) were provided the Share2Quit peer recruitment Facebook app and other tools. Smokers were incentivized for up to seven successful peer recruitments and had 30 days to recruit from date of registration. Successful peer recruitment was defined as a peer recruited smoker completing the registration on the TATI following a referral. Our primary questions were (1) whether smokers would recruit other smokers and (2) whether peer recruitment would extend the reach of the intervention to harder-to-reach groups, including those not ready to quit and minority smokers. Overall, 759 smokers were recruited (seeds: 190; peer recruits: 569). Fifteen percent (n = 117) of smokers successfully recruited their peers (seeds: 24.7%; peer recruits: 7.7%) leading to four recruitment waves. Compared to seeds, peer recruits were less likely to be ready to quit (peer recruits 74.2% vs. seeds 95.1%), more likely to be male (67.1% vs. 32.9%), and more likely to be African American (23.8% vs. 10.8%) (p marketing quadrupled our engaged smokers and enriched the sample with not-ready-to-quit and African American smokers. Peer recruitment is promising, and our study uncovered several important challenges for future research. This study demonstrates the successful recruitment of smokers to a TATI using a Facebook-based peer marketing strategy. Smokers on Facebook were willing and able to recruit other smokers to a TATI, yielding a large and diverse population of smokers. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For
Malchy Leslie A
Full Text Available Abstract Background The prevalence of tobacco use among individuals with mental illness remains a serious public health concern. Tobacco control has received little attention in community mental health despite the fact that many individuals with mental illness are heavy smokers and experience undue tobacco-related health consequences. Methods This qualitative study used methods of discourse analysis to examine the perceptions of health care providers, both professionals and paraprofessionals, in relation to their roles in tobacco control in the community mental health system. Tobacco control is best conceptualised as a suite of policies and practices directed at supporting smoke free premises, smoking cessation counselling and limiting access to tobacco products. The study took place following the establishment of a new policy that restricted tobacco smoking inside all mental health facilities and on their grounds. Ninety one health care providers participated in open-ended interviews in which they described their role in tobacco control. The interview data were analyzed discursively by asking questions such as: what assumptions underlie what is being said about tobacco? Results Five separate yet overlapping discursive frames were identified in which providers described their roles. Managing a smoke free environment emphasised the need to police and monitor the smoke free environment. Tobacco is therapeutic was a discourse that underscored the putative value of smoking for clients. Tobacco use is an individual choice located the decision to smoke with individual clients thereby negating a role in tobacco control for providers. It's someone else's role was a discourse that placed responsibility for tobacco control with others. Finally, the discourse of tobacco control as health promotion located tobacco control in a range of activities that are used to support the health of clients. Conclusions This study provides insights into the complex
López Zubizarreta, Marco; Hernández Mezquita, Miguel Ángel; Miralles García, José Manuel; Barrueco Ferrero, Miguel
Smoking is, together with diabetes mellitus, one of the main risk factors for cardiovascular disease. Diabetic patients have unique features and characteristics, some of which are not well known, that cause smoking to aggravate the effects of diabetes and impose difficulties in the smoking cessation process, for which a specificand more intensive approach with stricter controls is required. This review details all aspects with a known influence on the interaction between smoking and diabetes, both as regards the increased risk of macrovascular and microvascular complications of diabetes and the factors with an impact on the results of smoking cessation programs. The treatment guidelines for these smokers, including the algorithms and drug treatment patterns which have proved most useful based on scientific evidence, are also discussed. Copyright © 2017 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.
McClure, Jennifer B; Bush, Terry; Anderson, Melissa L; Blasi, Paula; Thompson, Ella; Nelson, Jennifer; Catz, Sheryl L
To assess the effects of a novel oral health promotion program (Oral Health 4 Life; OH4L) delivered through state-funded tobacco quitlines. Using a semipragmatic design to balance experimental control and generalizability, we randomized US quitline callers (n = 718) to standard care or standard care plus OH4L. We followed participants for 6 months to assess effects on professional dental care and smoking abstinence. We collected data between 2015 and 2017. Participants were racially diverse (42% non-White) and socioeconomically disadvantaged. Most (71%) reported fair or poor oral health, and all were overdue for routine dental care. At 6 months, professional dental care and abstinence did not significantly differ between arms, but abstinence favored the experimental arm and was significantly higher among experimental participants at 2 months in a complete case sensitivity analysis. OH4L was not effective for promoting dental care, but integrating oral health counseling with quitline counseling may offer some advantage for smoking cessation. Public Health Implications. We offer a model for conducting semipragmatic trials and partnering with tobacco quitlines to evaluate population-level public health interventions.
Sudhakar, Knv; Pathi, Jugajyothi; Avinash, J; Raju, P V Krishnam; Sureshan, Vinay; Vidya, K C
The aim of the study was (1) to explore the baseline beliefs and practices of accredited social health activist (ASHA) workers of Khurda district of Orissa with respect to tobacco cessation and (2) to assess whether a brief intervention will be effective in improving the beliefs and practices of ASHA workers. The results of this study could be utilized by policy makers for framing important strategies for tobacco cessation in rural areas utilizing ASHA workers. A quasi-experimental study (before and after comparison) was performed in Khurda district of Orissa to find out whether a brief intervention could improve the beliefs and practices of ASHA workers related to antitobacco counseling in rural areas. A 14-item structured, interviewer-administered questionnaire, written in English (translated in Odiya), was used. The final sample size was estimated as 135. Data were entered into Statistical Package for the Social Sciences (version 21) for analysis. All the mean belief items, practice items, degree of preparedness, and interest in training scores of study population increased significantly from baseline to postintervention. The study population showed a statistically significant improvement in postintervention composite belief and composite practices score. The majority of ASHA workers had positive beliefs and favorable practices after attending a brief intervention toward smoking cessation in their community. After attending the intervention, nearly half of the respondents felt themselves either somewhat or very well prepared for tobacco cessation. Most of them showed their interest toward getting further training in the field. Training programs and regular tobacco cessation activities should be planned in the primary health-care delivery system of India.
Receipt of evidence-based brief cessation interventions by health professionals and use of cessation assisted treatments among current adult cigarette-only smokers: National Adult Tobacco Survey, 2009–2010
Full Text Available Abstract Background Helping tobacco smokers to quit during a medical visit is a clinical and public health priority. Research suggests that most health professionals engage their patients in at least some of the ‘5 A’s’ of the brief cessation intervention recommended in the U.S. Public Health Service Clinical Practice Guideline, but information on the extent to which patients act on this intervention is uncertain. We assessed current cigarette-only smokers’ self-reported receipt of the 5 A’s to determine the odds of using optimal cessation assisted treatments (a combination of counseling and medication. Methods Data came from the 2009–2010 National Adult Tobacco Survey (NATS, a nationally representative landline and mobile phone survey of adults aged ≥18 years. Among current cigarette-only smokers who visited a health professional in the past 12 months, we assessed patients’ self-reported receipt of the 5 A’s, use of the combination of counseling and medication for smoking cessation, and use of other cessation treatments. We used logistic regression to examine whether receipt of the 5 A’s during a recent clinic visit was associated with use of cessation treatments (counseling, medication, or a combination of counseling and medication among current cigarette-only smokers. Results In this large sample (N = 10,801 of current cigarette-only smokers who visited a health professional in the past 12 months, 6.3 % reported use of both counseling and medication for smoking cessation within the past year. Other assisted cessation treatments used to quit were: medication (19.6 %; class or program (3.8 %; one-on-one counseling (3.7 %; and telephone quitline (2.6 %. Current cigarette-only smokers who reported receiving all 5 A’s during a recent clinic visit were more likely to use counseling (odds ratio [OR]: 11.2, 95 % confidence interval [CI]: 7.1–17.5, medication (OR: 6.2, 95 % CI: 4.3–9.0, or a combination of
Schaap, Maartje M; Kunst, Anton E; Leinsalu, Mall
BACKGROUND: Recently a scale was introduced to quantify the implementation of tobacco control policies at country level. Our study used this scale to examine the potential impact of these policies on quit ratios in European countries. Special attention was given to smoking cessation among lower......-smokers divided by total ever-smokers. In regression analyses we explored the correlation between national quit ratios and the national score on the Tobacco Control Scale. RESULTS: Quit ratios were especially high (>45%) in Sweden, England, Netherlands, Belgium and France, and relatively low (... quit ratios than countries with less developed tobacco control policies. High and low educated smokers benefit about equally from the nation-wide tobacco control policies....
Olsen, Céline E J L Brassart
to women and young people. They also show that, when combined with large pictorial health warnings, plain-packaging measures increase awareness about the risks related to tobacco consumption, encouraging more people to quit and fewer to start. In that these measures merely regulate the use of logos...... or colours for public health purposes, they are in compliance with international trade and intellectual property law....
Kirchner, Thomas R; Cantrell, Jennifer; Anesetti-Rothermel, Andrew; Ganz, Ollie; Vallone, Donna M; Abrams, David B
Little is known about the factors that drive the association between point-of-sale marketing and behavior, because methods that directly link individual-level use outcomes to real-world point-of-sale exposure are only now beginning to be developed. Daily outcomes during smoking cessation were examined as a function of both real-time geospatial exposure to point-of-sale tobacco (POST) and subjective craving to smoke. Continuous individual geospatial location data collected over the first month of a smoking-cessation attempt in 2010-2012 (N=475) were overlaid on a POST outlet geodatabase (N=1060). Participants' mobility data were used to quantify the number of times they came into contact with a POST outlet. Participants recorded real-time craving levels and smoking status via ecological momentary assessment (EMA) on cellular telephones. The final data set spanned a total of 12,871 days of EMA and geospatial tracking. Lapsing was significantly more likely on days with any POST contact (OR=1.19, 95% CI=1.18, 1.20), and increasingly likely as the number of daily POST contacts increased (OR=1.07, 95% CI=1.06, 1.08). Overall, daily POST exposure was significantly associated with lapsing when craving was low (OR=1.22, 95% CI=1.20, 1.23); high levels of craving were more directly associated with lapse outcomes. These data shed light on the way mobility patterns drive a dynamic interaction between individuals and the POST environment, demonstrating that quantification of individuals' exposure to POST marketing can be used to identify previously unrecognized patterns of association among individual mobility, the built environment, and behavioral outcomes. © 2013 American Journal of Preventive Medicine.
Assessing the adaptation and implementation fidelity of an Online Tobacco Cessation Training Program for Healthcare Professionals in three Spanish-speaking Latin American countries: The Fruitful Study
This study has been funded by Global Bridges Mayo Clinic (Pfizer Medical Group; GB-13520139: Development and Dissemination of a Tobacco Cessation Training Program for Healthcare Professionals in Spanish-speaking Countries. Moreover, CM and EF are also funded by the Spanish Government (Instituto de Salut Carlos III, grant PI15-00875 and the Catalan Government (Xarxa Catalana d’Hospitals sense fum, Agència de Salut Pública de Catalunya, contracte Nº 2015VAR171
Hung, Dorothy Y; Leidig, Robynn; Shelley, Donna R
Organizational culture is an important but underinvestigated feature of the work environment that can impact provider behavior, including adherence to clinical practice guidelines. There is substantial evidence that physician assistance to smokers can produce significant reductions in tobacco use. However, this evidence has not been well translated into practice, as only a small proportion of smokers receive recommended treatment during medical visits. This study examines organizational culture as a contextual feature of primary care clinics and its impact on adherence to evidence-based guidelines for treating tobacco use. Cross-sectional survey data were collected from 500 primary care providers in 60 community clinics located in New York City. Relationships between provider adherence to "5A" clinical guidelines, as recommended by the U.S. Public Health Service, and both provider and organizational covariates were described. We used hierarchical linear modeling to examine the associations between clinic culture and provider treatment patterns. Providers in clinics with stronger "group/clan," "hierarchical," and "rational" culture types, as compared with a "developmental" culture, reported greater adherence to 5A guidelines (p organizational culture can influence provider adherence to cessation treatment guidelines, even when controlling for other factors known to affect practice patterns. Specifically, cultures that emphasize human resources and performance standards are conducive to integrating 5A guidelines into routine practice. Understanding the role of organizational culture enables healthcare managers and practitioners to be strategic when implementing, and also sustaining, use of evidence-based guidelines.
Ramo, Danielle E; Thrul, Johannes; Chavez, Kathryn; Delucchi, Kevin L; Prochaska, Judith J
Young adult smokers are a challenging group to engage in smoking cessation interventions. With wide reach and engagement among users, Facebook offers opportunity to engage young people in socially supportive communities for quitting smoking and sustaining abstinence. We developed and tested initial efficacy, engagement, and acceptability of the Tobacco Status Project, a smoking cessation intervention for young adults delivered within Facebook. The intervention was based on the US Public Health Service Clinical Practice Guidelines and the Transtheoretical Model and enrolled participants into study-run 3-month secret Facebook groups matched on readiness to quit smoking. Cigarette smokers (N=79) aged 18-25, who used Facebook on most days, were recruited via Facebook. All participants received the intervention and were randomized to one of three monetary incentive groups tied to engagement (commenting in groups). Assessments were completed at baseline, 3-, 6-, and 12-months follow-up. Analyses examined retention, smoking outcomes over 12 months (7-day point prevalence abstinence, ≥50% reduction in cigarettes smoked, quit attempts and strategies used, readiness to quit), engagement, and satisfaction with the intervention. Retention was 82% (65/79) at 6 months and 72% (57/79) at 12 months. From baseline to 12-months follow-up, there was a significant increase in the proportion prepared to quit (10/79, 13%; 36/79, 46%, Pused a nicotine replacement therapy approved by the Food and Drug Administration, while 18% (14/79) used an electronic nicotine delivery system to quit (eg, electronic cigarette). A majority (48/79, 61%) commented on at least one Facebook post, with more commenting among those with biochemically verified abstinence at 3 months (P=.036) and those randomized to receive a personal monetary incentive (P=.015). Over a third of participants (28/79, 35%) reported reading most or all of the Facebook posts. Highest acceptability ratings of the intervention were
Full Text Available Abstract Background People of South Asian-origin are responsible for more than three-quarters of all the smokeless tobacco (SLT consumption worldwide; yet there is little evidence on the effect of SLT cessation interventions in this population. South Asians use highly addictive and hazardous SLT products that have a strong socio-cultural dimension. We designed a bespoke behaviour change intervention (BCI to support South Asians in quitting SLT and then evaluated its feasibility in Pakistan and in the UK. Methods We conducted two literature reviews to identify determinants of SLT use among South Asians and behaviour change techniques (BCTs likely to modify these, respectively. Iterative consensus development workshops helped in selecting potent BCTs for BCI and designing activities and materials to deliver these. We piloted the BCI in 32 SLT users. All BCI sessions were audiotaped and analysed for adherence to intervention content and the quality of interaction (fidelity index. In-depth interviews with16 participants and five advisors assessed acceptability and feasibility of delivering the BCI, respectively. Quit success was assessed at 6 months by saliva/urine cotinine. Results The BCI included 23 activities and an interactive pictorial resource that supported these. Activities included raising awareness of the harms of SLT use and benefits of quitting, boosting clients’ motivation and self-efficacy, and developing strategies to manage their triggers, withdrawal symptoms, and relapse should that occur. Betel quid and Guthka were the common forms of SLT used. Pakistani clients were more SLT dependent than those in the UK. Out of 32, four participants had undetectable cotinine at 6 months. Fidelity scores for each site varied between 11.2 and 42.6 for adherence to content – maximum score achievable 44; and between 1.4 and 14 for the quality of interaction - maximum score achievable was 14. Interviews with advisors highlighted the need for
João Maurício Castaldelli-Maia
Full Text Available Objective: To analyze the predictors of smoking cessation treatment outcomes in a sample with a high rate of medical and psychiatric disorders and addictions. Methods: Analysis of predictors of success of a 6-week treatment provided by an addiction care unit (CAPS-AD to 367 smokers in Brazil from 2007 to 2010. Forty variables were collected at baseline. Success was defined as abstinence from smoking for a period of at least 14 consecutive days, including the last day of treatment. Twenty variables were selected for the logistic regression model. Results: The only condition correlated with successful treatment after logistic regression was smoking one's first cigarette 5 minutes or more after waking (beta = 1.85, 95% confidence interval [95%CI] = 1.11-3.10, p = 0.018. Subjects with hypertension and alcohol use disorders and those who were undergoing psychiatric treatment showed success rates comparable to or greater than the average success rate of the sample (34.2-44.4%. Conclusions: These findings support the importance of the variable time to first cigarette in treatment outcomes for a sample with a high rate of clinical and psychiatric disorders. Good success rates were observed for pharmacological treatment, which was combined with group therapy based on cognitive-behavioral concepts and integrated into ongoing treatment of other addictions and psychiatric disorders.
Keller, Paula A; Greenseid, Lija O; Christenson, Matthew; Boyle, Raymond G; Schillo, Barbara A
Tobacco tax increases are associated with increases in quitline calls and reductions in smoking prevalence. In 2013, ClearWay Minnesota(SM) conducted a six-week media campaign promoting QUITPLAN® Services (QUITPLAN Helpline and quitplan.com) to leverage the state's tax increase. The purpose of this study was to ascertain the association of the tax increase and media campaign on call volumes, web visits, and enrollments in QUITPLAN Services. In this observational study, call volume, web visits, enrollments, and participant characteristics were analyzed for the periods June-August 2012 and June-August 2013. Enrollment data and information about media campaigns were analyzed using multivariate regression analysis to determine the association of the tax increase on QUITPLAN Services while controlling for media. There was a 160% increase in total combined calls and web visits, and an 81% increase in enrollments in QUITPLAN Services. Helpline call volumes and enrollments declined back to prior year levels approximately six weeks after the tax increase. Visits to and enrollments in quitplan.com also declined, but increased again in mid-August. The tax increase and media explained over 70% of variation in enrollments in the QUITPLAN Helpline, with media explaining 34% of the variance and the tax increase explaining an additional 36.1% of this variance. However, media explained 64% of the variance in quitplan.com enrollments, and the tax increase explained an additional 7.6% of this variance. Since tax increases occur infrequently, these policy changes must be fully leveraged as quickly as possible to help reduce prevalence.
Chen, Min-Li; Chou, Li-Na; Zheng, Ya-Cheng
Cigarette smoking not only damages the health of adolescents, but also contributes to air pollution. The Tobacco Hazards Prevention Act in Taiwan stipulates that cigarettes should not be sold to persons younger than 18 years. Therefore, schools should actively educate students and raise awareness of the Tobacco Hazards Prevention Act to reduce the level of damage to the health of adolescents and maintain good air quality. This study had two main goals: (1) to evaluate the stipulation that no person shall provide tobacco products to persons under the age of 18 and the effects of counseling strategies on store managers confirming customer ages before tobacco sale in southern Taiwan; and (2) to evaluate the situation of tobacco hazard prevention education conducted by school in southern Taiwan. A cross-sectional design was adopted for this study. Study I: The investigation involved an analysis of 234 retailers including convenience stores (n = 70), grocery stores (n = 83), and betel nut stalls (n = 81). The results indicated that among the 234 retailers, 171 (73.1%) of them routinely failed to confirm the buyers' ages before allowing them to purchase tobacco. The number of retailers who exhibited failure to confirm customer ages before selling tobacco products had decreased from 171 (73.1%) to 59 (25.2%) and that of those who confirmed customer ages before selling tobacco products had increased from 63 (26.9%) to 175 (74.8%) after counseling strategies had been provided, thereby revealing statistical significance (χ² = 11.26, p selling tobacco products to minors. Schools should pay close attention to tobacco hazard prevention education for junior high school students to ensure that such students are adequately educated about tobacco hazard prevention.
Gonzálvez, María T; Morales, Alexandra; Orgilés, Mireia; Sussman, Steve; Espada, José P
Although some school-based tobacco cessation and prevention programs have been proven to be effective, there remains a lack of understanding of how these programs succeed. This longitudinal study aimed to test smoking intention as a mediator of Project EX's intervention efficacy to reduce tobacco use. Using a computerized random number generator, six high schools located in the Mediterranean coast were randomly selected to participate in the program condition (Spanish version of Project EX) or the waiting-list control group with baseline, immediate-posttest, and 12-month follow-up assessments. At baseline, 685 adolescents aged 14-20 years (mean age: 14.87; SD = 0.92; 47.4% were females) were evaluated using self-administered tests of tobacco, and smoking intention. A biomarker of smoke inhalation, a measurement of exhaled carbon monoxide (ECM), was used. Mediation analyses were conducted using the PROCESS v2.12 macro for Windows. Project EX had a significant effect on smoking intention. Indirect effects indicated that Project EX reduced the ECM level, and number of cigarettes used. This is the first Spanish study that explored intention as a mediator of the long-term efficacy of Project EX to reduce tobacco use in adolescents. Results suggested that interventions that reduce consumption intention at short-term are more likely to be successful in decreasing tobacco use in the long-term. Copyright © 2018 Elsevier Ltd. All rights reserved.
Full Text Available Cigarette smoking not only damages the health of adolescents, but also contributes to air pollution. The Tobacco Hazards Prevention Act in Taiwan stipulates that cigarettes should not be sold to persons younger than 18 years. Therefore, schools should actively educate students and raise awareness of the Tobacco Hazards Prevention Act to reduce the level of damage to the health of adolescents and maintain good air quality. This study had two main goals: (1 to evaluate the stipulation that no person shall provide tobacco products to persons under the age of 18 and the effects of counseling strategies on store managers confirming customer ages before tobacco sale in southern Taiwan; and (2 to evaluate the situation of tobacco hazard prevention education conducted by school in southern Taiwan. A cross-sectional design was adopted for this study. Study I: The investigation involved an analysis of 234 retailers including convenience stores (n = 70, grocery stores (n = 83, and betel nut stalls (n = 81. The results indicated that among the 234 retailers, 171 (73.1% of them routinely failed to confirm the buyers’ ages before allowing them to purchase tobacco. The number of retailers who exhibited failure to confirm customer ages before selling tobacco products had decreased from 171 (73.1% to 59 (25.2% and that of those who confirmed customer ages before selling tobacco products had increased from 63 (26.9% to 175 (74.8% after counseling strategies had been provided, thereby revealing statistical significance (χ2 = 11.26, p < 0.001. Study II: A total of 476 (89.1% participants had received tobacco hazards prevention education and 58 (10.9% had not. Among the various residential areas, the highest percentage of participants that did not received tobacco hazards prevention education located in the plane regions (8.4%. The government organizations should continue to adopt counseling strategies to reduce the rate of disobedience of the Tobacco Hazards
Zawertailo, Laurie; Pavlov, Dmytro; Ivanova, Anna; Ng, Ginnie; Baliunas, Dolly; Selby, Peter
Electronic cigarettes (e-cigarettes) are being used as cessation aids by many smokers despite a lack of empirical evidence regarding their safety and efficacy. We analyzed the association of e-cigarette use and smoking abstinence in a population of smokers accessing standard smoking cessation treatment (nicotine replacement therapy [NRT] plus behavioral counseling) through primary care clinics in Ontario, Canada. Participants were recruited through 187 primary care clinics across Ontario, Canada and were eligible for up to 26 weeks of brief behavioral counseling and individualized dosing of NRT at no cost. Adjusted logistic regression models were used to examine the association between concurrent e-cigarette use and smoking abstinence at 3- and 6-month follow-ups. Of the 6526 participants who completed a 3-month follow-up, 18.1% reported using an e-cigarette while in treatment. The majority of e-cigarette users (78.2%) reported using an e-cigarette for smoking cessation. At 3-month follow-up, e-cigarette use was negatively associated with abstinence after controlling for confounders (adjusted odds ratio [AOR] = 0.706, p E-cigarette use was also negatively associated with abstinence at 6-month follow-up (AOR = 0.502, p E-cigarette use was negatively associated with successful quitting in this large community sample of smokers accessing standard evidence-based smoking cessation treatment through primary care clinics, even after adjusting for covariates such as severity of tobacco dependence, gender, and age. The findings suggest that concurrent use of e-cigarettes with NRT may harm cessation attempts. This study confirms previous findings from observational studies regarding the negative association between e-cigarette use and smoking cessation, but in a large cohort of smokers enrolled in an evidence-based treatment program. The implications of these findings are that concurrent use of e-cigarettes during a quit attempt utilizing cost-free evidence-based treatment
Cosh, Suzanne; Hawkins, Kimberley; Skaczkowski, Gemma; Copley, David; Bowden, Jacqueline
Smoking prevalence among Aboriginal Australian young people greatly exceeds the prevalence in the broader population of Australian young people, yet limited research has explored the social context in which young Aboriginal Australians smoke. Four focus groups were conducted in 2009 with South Australian Aboriginal smokers aged 15-29 years residing in urban areas (n = 32) to examine attitudes and experiences surrounding smoking and quitting. The primary reasons for smoking initiation and maintenance among Aboriginal Australian young people were identified as stress, social influence and boredom. Motivators for quitting were identified as pregnancy and/or children, sporting performance (males only), cost issues and, to a lesser extent, health reasons. The barriers to cessation were identified as social influence, the perception of quitting as a distant event and reluctance to access cessation support. However, it appears that social influences and stress were particularly salient contributors to smoking maintenance among Aboriginal Australian young people. Smoking cessation interventions targeted at young urban Aboriginal Australian smokers should aim to build motivation to quit by utilising the motivators of pregnancy and/or children, sporting performance (males only), cost issues and, to a lesser extent, health reasons, while acknowledging the pertinent role of social influence and stress in the lives of young urban Aboriginal Australian smokers.
Mass media campaigns and telephone quitlines are effective in increasing cessation rates among cigarette smokers. During March 19-June 10, 2012, CDC aired Tips from Former Smokers (TIPS), the first federally funded, nationwide, paid-media tobacco education campaign in the United States. The TIPS campaign featured former smokers talking about their experiences living with diseases caused by smoking. The campaign was primarily intended to encourage adult smokers aged 18-54 years to quit by making them aware of the health damage caused by smoking and letting them know that they could call the telephone quitline portal 1-800-QUIT-NOW or visit the National Cancer Institute (NCI) smoking cessation website (http://www.smokefree.gov) if they needed free help to quit. The campaign included advertising on national and local cable television, local radio, online media, and billboards, and in movie theaters, transit venues, and print media. To determine the effects of the TIPS campaign on weekly quitline call volume and weekly unique visitors to the cessation website, CDC analyzed call and visitor data immediately before, during, and immediately after the campaign period and compared them with data from the corresponding weeks in 2011. This report summarizes the results of that analysis, which found that the number of weekly calls to the quitline from the 50 states, the District of Columbia, Guam, and Puerto Rico increased 132% (207,519 additional calls) during the TIPS campaign, and the number of unique visitors to the cessation website increased 428% (510,571 additional unique visitors). These results indicate that many smokers are interested in quitting and learning more about cessation assistance, and will respond to motivational messages that include an offer of help.
Regidor, Enrique; Pascual, Cruz; Giráldez-García, Carolina; Galindo, Silvia; Martínez, David; Kunst, Anton E
To evaluate the effect of tobacco prices and the implementation of smoke-free legislation on smoking cessation in Spain, by educational level, across the period 1993-2012. National Health Surveys data for the above two decades were used to calculate smoking cessation in people aged 25-64 years. The relationship between tobacco prices and smoking quit-ratio was estimated using multiple linear regression adjusted for time and the presence of smoke-free legislation. The immediate as well as the longer-term impact of the 2006 smoke-free law on quit-ratio was estimated using segmented linear regression analysis. The analyses were performed separately in men and women with high and low education, respectively. No relationship was observed between tobacco prices and smoking quit-ratio, except in women having a low educational level, among whom a rise in price was associated with a decrease in quit-ratio. The smoke-free law altered the smoking quit-ratio in the short term and altered also pre-existing trends. Smoking quit-ratio increased immediately after the ban - though this increase was significant only among women with a low educational level - and then decreased in subsequent years except among men with a high educational level. A clear relationship between tobacco prices and smoking quit-ratio was not observed in a recent period. After the implementation of smoke-free legislation the trend in the quit ratio in most of the socio-economic groups was different from the trend observed before implementation, so existing inequalities in smoking quit-ratio were not widened or narrowed. Copyright © 2015 Elsevier B.V. All rights reserved.
... Second-hand smoke is the smoke that fills restaurants, offices or other enclosed spaces when people burn ... as smuggling, illicit manufacturing and counterfeiting. The tobacco industry and others often argue that high tobacco product ...
Berry, Kaitlyn M; Reynolds, Lindsay M; Collins, Jason M; Siegel, Michael B; Fetterman, Jessica L; Hamburg, Naomi M; Bhatnagar, Aruni; Benjamin, Emelia J; Stokes, Andrew
The role of electronic cigarettes (e-cigarettes) in product transitions has been debated. We used nationally representative data from the Population Assessment of Tobacco and Health Study waves 1 (2013-2014) and 2 (2014-2015) to investigate the associations between e-cigarette initiation and cigarette cessation/reduction in the USA. We limited the sample to current cigarette smokers aged 25+ years who were not current e-cigarette users at wave 1. We modelled 30-day cigarette cessation and substantial reduction in cigarette consumption as a function of e-cigarette initiation between surveys using multivariable logistic regression. Between waves 1 and 2, 6.9% of cigarette smokers who were not current e-cigarette users transitioned to former smokers. After adjusting for covariates, cigarette smokers who initiated e-cigarette use between waves and reported they used e-cigarettes daily at wave 2 had 7.88 (95% CI 4.45 to 13.95) times the odds of 30-day cigarette cessation compared with non-users of e-cigarettes at wave 2. Cigarette smokers who began using e-cigarettes every day and did not achieve cessation had 5.70 (95% CI 3.47 to 9.35) times the odds of reducing their average daily cigarette use by at least 50% between waves 1 and 2 compared with e-cigarette non-users. Daily e-cigarette initiators were more likely to have quit smoking cigarettes or reduced use compared with non-users. However, less frequent e-cigarette use was not associated with cigarette cessation/reduction. These results suggest incorporating frequency of e-cigarette use is important for developing a more thorough understanding of the association between e-cigarette use and cigarette cessation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Biener, Lois; Leischow, Scott J.; Zeller, Mitch R.
Introduction: Tobacco product testing is a critical component of the Family Smoking Prevention and Tobacco Control Act (FSPTCA), which grants the Food and Drug Administration the authority to regulate tobacco products. The availability of methods and measures that can provide accurate data on the relative health risks across types of tobacco products, brands, and subbrands of tobacco products on the validity of any health claims associated with a product, and on how consumers perceive information on products toxicity or risks is crucial for making decisions on the product's potential impact on public health. These tools are also necessary for making assessments of the impact of new indications for medicinal products (other than cessation) but more importantly of tobacco products that may in the future be marketed as cessation tools. Objective: To identify research opportunities to develop empirically based and comprehensive methods and measures for testing tobacco and other nicotine-containing products so that the best science is available when decisions are made about products or policies. Methods: Literature was reviewed to address sections of the FSPTCA relevant to tobacco product evaluation; research questions were generated and then reviewed by a committee of research experts. Results: A research agenda was developed for tobacco product evaluation in the general areas of toxicity and health risks, abuse liability, consumer perception, and population effects. Conclusion: A cohesive, systematic, and comprehensive assessment of tobacco products is important and will require building consensus and addressing some crucial research questions. PMID:21460383
Krause, 1995; Pender & Pender , 1987; Sparics, 1995). For successful patient education to occur, motivational factors of the patient related to...cessation intervention could be explained by Nola Pender’s theoiy identifying health promoting behaviors integral to the individual’s lifestyle... Pender described cognitive-perceptual factors which act as primary motivational mechanisms influencing health promotion activities ( Pender et al., 1987
Aquilino, M Lober; Lowe, J B
Tobacco production, distribution, and use are international issues with significant health and economic implications. This paper provides an overview of the effective approaches to tobacco control including decreasing demand for tobacco products through taxation, consumer education, research, bans on advertising and promotion, warning labels, and restrictions on public smoking. The effectiveness of reducing the supply of tobacco products through prohibition, restrictions on youth access, crop substitution, trade restrictions, and control of smuggling, will also be discussed. Decreasing smoking, particularly among young people, by preventing or delaying initiation, preventing regular use, and increasing cessation through behavioural approaches for all ages is reviewed. Cessation methods including pharmacological approaches, 'quitlines', Internet programmes, and the targeting of specific populations are discussed. Internet availability of tobacco products and sustainability of current efforts are presented as continuing challenges to tobacco control.
A Leena Selvamary
Full Text Available Introduction: Tobacco use continues to be the leading global cause of preventable death. Dental health professionals play a significant role in the intervention of the tobacco-related epidemic. Aim: The aim of this study was to compare the effectiveness of health education (HE alone and HE with cognitive behavior therapy (CBT at a dental tertiary referral unit of South India. Materials and Methods: Self-reported quit attempt was assessed and the sample size was estimated at 194. Tobacco users who met the inclusion criteria were randomly assigned to one of the two groups - HE only and HE with CBT. Age, sex, socioeconomic status, form of tobacco usage, alcohol usage, addiction and stage of motivation, knowledge, attitude, and behavior regarding tobacco use, and ill effects were assessed at baseline. Follow-up was for 6 months (2nd, 6th, 12th, and 24th weeks to assess reduced use, quit attempt, point prevalence abstinence, continuous abstinence, lapse, relapse, and attrition rates in each visit. The self-reported quit rates were validated using the standardized cotinine test. Pearson's Chi-square test was used to determine the effectiveness of intervention. Results: Continuous abstinence was significantly high in CBT. Reduced use and point prevalence abstinence were significantly higher in HE. Quit attempt in both the groups was equal showing no statistical significance. Attrition was significantly higher in HE compared to CBT. Conclusion: CBT plays a vital role in achieving continuous abstinence, overcoming social factors, and reducing lapse among the tobacco users.
Viteri, Ernesto; Barnoya, Joaquin; Hudmon, Karen Suchanek; Solorzano, Pedro J
Guatemala, a party to the Framework Convention on Tobacco Control (FCTC), is obliged to promote the wider availability of smoking cessation treatment and to restrict tobacco advertising. Pharmacies are fundamental in providing smoking cessation medications but also might increase the availability of cigarettes. To assess availability of cessation medications and cigarettes and their corresponding advertising in Guatemala pharmacies. In Guatemala City a representative sample was selected from a list of registered pharmacies classified by type (non-profit, chain, independent). In addition, all pharmacies in the neighbouring town of Antigua were included for comparison. Trained surveyors used a checklist to characterise each pharmacy with respect to availability and advertising of cessation medications and cigarettes. A total of 505 pharmacies were evaluated. Cessation medications were available in 115 (22.8%), while cigarettes were available in 29 (5.7%) pharmacies. When available, medications were advertised in 1.7% (2) and cigarettes in 72.4% (21) of pharmacies. Chain pharmacies were significantly more likely to sell cessation medications and cigarettes, and to advertise cigarettes than were non-profit and independent pharmacies. Most pharmacies in Guatemala do not stock cessation medications or cigarettes. Cigarette advertising was more prevalent than advertising for cessation medications. FCTC provisions have not been implemented in Guatemala pharmacies.
Li, Lin; Borland, Ron; Yong, Hua-Hie; Fong, Geoffrey T; Bansal-Travers, Maansi; Quah, Anne C K; Sirirassamee, Buppha; Omar, Maizurah; Zanna, Mark P; Fotuhi, Omid
Limited longitudinal studies on smoking cessation have been reported in Asia, and it remains unclear whether determinants of quitting are similar to those found in Western countries. This study examined prospective predictors of smoking cessation among adult smokers in Thailand and Malaysia. Four thousand and four smokers were surveyed in Malaysia and Thailand in 2005. Of these, 2,426 smokers were followed up in 2006 (61% retention). Baseline measures of sociodemographics, dependence, and interest in quitting were used to predict both making quit attempts and point prevalence maintenance of cessation. More Thai than Malaysian smokers reported having made quit attempts between waves, but among those who tried, the rates of staying quit were not considerably different between Malaysians and Thais. Multivariate analyses showed that smoking fewer cigarettes per day, higher levels of self-efficacy, and more immediate quitting intentions were predictive of both making a quit attempt and staying quit in both countries. Previous shorter quit attempts and higher health concerns about smoking were only predictive of making an attempt, whereas prior abstinence for 6 months or more and older age were associated with maintenance. In Malaysia and Thailand, predictors of quitting activity appear to be similar. However, as in the West, predictors of making quit attempts are not all the same as those who predict maintenance. The actual predictors differ in potentially important ways from those found in the West. We need to determine the relative contributions of cultural factors and the shorter history of efforts to encourage quitting in Asia.
... 1 in 3 countries, representing 39% of the world's population, monitors tobacco use by repeating nationally representative youth ... 1.4 billion people, or 20% of the world's population, are protected by comprehensive national smoke-free laws. ...
Solway, Erica Singer
Even as the rate of smoking in the U.S. population overall has decreased dramatically during the last four decades, people with mental illness continue to use tobacco at alarmingly high rates. In the last two years, national initiatives have developed to address smoking within this population, yet there has not been an attempt to understand the…
Poureslami, Iraj M; Shum, Jessica; Cheng, Natalie; FitzGerald, J Mark
To explore cultural context for smoking cessation within Chinese communities in Vancouver, and identify opportunities to support development of culturally appropriate resources for cessation. Applied participatory approach involving community members, patients, and key-informants in the design and implementation of the research. Whereas many participants were motivated to quit, their perceptions of desire to do so were not supported by effective interventions and many attempts to quit were unsuccessful. Tobacco control clinics and care providers need to adopt culturally and linguistically relevant interventions to facilitate behavioral modifications and cessation in ethnic minority communities.
Borland, Ron; Yong, Hua-Hie; Fong, Geoffrey T.; Bansal-Travers, Maansi; Quah, Anne C. K.; Sirirassamee, Buppha; Omar, Maizurah; Zanna, Mark P.; Fotuhi, Omid
Introduction: Limited longitudinal studies on smoking cessation have been reported in Asia, and it remains unclear whether determinants of quitting are similar to those found in Western countries. This study examined prospective predictors of smoking cessation among adult smokers in Thailand and Malaysia. Methods: Four thousand and four smokers were surveyed in Malaysia and Thailand in 2005. Of these, 2,426 smokers were followed up in 2006 (61% retention). Baseline measures of sociodemographics, dependence, and interest in quitting were used to predict both making quit attempts and point prevalence maintenance of cessation. Results: More Thai than Malaysian smokers reported having made quit attempts between waves, but among those who tried, the rates of staying quit were not considerably different between Malaysians and Thais. Multivariate analyses showed that smoking fewer cigarettes per day, higher levels of self-efficacy, and more immediate quitting intentions were predictive of both making a quit attempt and staying quit in both countries. Previous shorter quit attempts and higher health concerns about smoking were only predictive of making an attempt, whereas prior abstinence for 6 months or more and older age were associated with maintenance. Discussion: In Malaysia and Thailand, predictors of quitting activity appear to be similar. However, as in the West, predictors of making quit attempts are not all the same as those who predict maintenance. The actual predictors differ in potentially important ways from those found in the West. We need to determine the relative contributions of cultural factors and the shorter history of efforts to encourage quitting in Asia. PMID:20889478
Das, Smita; Tonelli, Makenzie; Ziedonis, Douglas
Tobacco use disorders (TUDs) continue to be overly represented in patients treated in mental health and addiction treatment settings. It is the most common substance use disorder (SUD) and the leading cause of health disparities and increased morbidity/mortality amongst individuals with a psychiatric disorder. There are seven Food and Drug Administration (FDA) approved medications and excellent evidence-based psychosocial treatment interventions to use in TUD treatment. In the past few years, access to and use of other tobacco or nicotine emerging products are on the rise, including the highly publicized electronic cigarette (e-cigarette). There has also been a proliferation of technology-based interventions to support standard TUD treatment, including mobile apps and web-based interventions. These tools are easily accessed 24/7 to support outpatient treatment. This update will review the emerging products and counter-measure intervention technologies, including how clinicians can integrate these tools and other community-based resources into their practice.
Full Text Available Background: Smoking is the single most important public health challenge facing the National Health Service. The detrimental effects on the general health of tobacco smoking are well documented. Smoking is a primary risk factor for oral cancer and many oral diseases. Dental professional scan plays an important role in preventing adverse health effects by promoting smoking cessation. Objective: To assess the knowledge, attitude, and practice among clinical dental students in giving smoking cessation advice and to explore the barriers to this activity. Materials and Methods: A total of 262 clinical dental trainee of two dental colleges (College of Dental Sciences and Bapuji Dental College of Davangere city were included in the survey. A self-administered questionnaire was administered to assess the knowledge, attitude, and practice toward Tobacco Cessation Advise. Results: Among the 262 participants in the study, around 51% said they know about Nicotine Replacement Therapy, and among them, only 4.6% were aware of the options available in the market. When asked about 5A's of tobacco cessation, only 35.5% were aware of it. Similarly, when asked about 5R's of tobacco cessation, 48.5% were unaware of it. Conclusions: The respondents did not have sufficient knowledge regarding tobacco cessation advice. With patient's disinterest and lack of time being quoted as the important barriers in providing tobacco cessation advice, it is highly recommended that there is need to incorporate few chapters on tobacco, its effect and cessation of habit in the undergraduate dental curriculum with simultaneous application of the same in clinical practice.
Widome, Rachel; Joseph, Anne M; Polusny, Melissa A; Chlebeck, Bernadette; Brock, Betsy; Gulden, Ashley; Fu, Steven S
Our goal in this study was to examine beliefs and attitudes about tobacco use in the newest generation of combat veterans, those who served in Afghanistan (Operation Enduring Freedom [OEF]) and Iraq (Operation Iraqi Freedom [OIF]). We held 5 focus groups (n = 17) with Minnesota Army National Guard soldiers who had recently returned from combat deployment in support of OEF/OIF. Sessions were audiorecorded, transcribed, coded, and analyzed using a grounded theory approach. We found that it is common to use tobacco in the combat zone for stress and anger management and boredom relief. Tobacco was also a tool for staying alert, a way to socialize, and provided a chance to take breaks. Participants recognized the culture of tobacco use in the military. Stress, nicotine dependence, the tobacco environment at drill activities, and perceived inaccessibility of cessation tools perpetuated use at home and served as a barrier to cessation. Repeatedly, participants cited tobacco policies (such as increased taxes and smoke-free workspaces) as motivators for quitting. There are specific circumstances common to combat zones that promote tobacco use. Results suggest that environmental changes that address the prominence of tobacco in military culture, the acceptance of nonsmoking breaks, and cessation programs that address stress issues and make cessation aids available may be effective in reducing tobacco use.
Bialous, Stella A; Sarna, Linda; Wells, Marjorie J; Brook, Jenny K; Kralikova, Eva; Pankova, Alexandra; Zatoński, Witold; Przewozniak, Krzysztof
Tobacco use is the leading cause of preventable disease and death in Europe and worldwide. Nurses, if properly educated, can contribute to decreasing the burden of tobacco use in the region by helping smokers quit smoking. To assess: (a) the feasibility of an online program to educate nurses in Czech Republic and Poland on evidence-based smoking cessation interventions for patients and (b) self-reported changes in practices related to consistently (usually or always) providing smoking cessation interventions to smokers, before and 3 months after participation in the program. A prospective single-group pre-post design. A total of 280 nurses from Czech Republic and 156 from Poland completed baseline and follow-up surveys. At 3 months, nurses were significantly more likely to provide smoking cessation interventions to patients who smoke and refer patients for cessation services (p Nurses significantly improved their views about the importance of nursing involvement in tobacco control. Education about tobacco control can make a difference in clinical practice, but ongoing support is needed to maintain these changes. Health system changes can also facilitate the expectation that delivering evidence-based smoking cessation interventions should be routine nursing care. Educating nurses on cessation interventions and tobacco control is pivotal to decrease tobacco-related disparities, disease, and death. Online methods provide an accessible way to reach a large number of nurses. © 2017 Sigma Theta Tau International.
Bastos-Amador, P; Almendro-Delia, M; Muñoz-Calero, B; Blanco-Ponce, E; Recio-Mayoral, A; Reina-Toral, A; Cruz-Fernandez, J M; García-Alcántara, A; Hidalgo-Urbano, R; García-Rubira, J C
The tobacco paradox is a phenomenon insufficiently explained by previous studies. This study analyses the prognostic role of prior or active smoking in patients with acute coronary syndrome. We obtained data from the ARIAM registry, between 2001 and 2012. The study included 42,827 patients with acute coronary syndrome (mean age, 65±13 years; 26.4% women). The influence of smoking and that of being an ex-smoker on mortality was analysed using a multivariate analysis. The smokers were younger, were more often men, had less diabetes, hypertension and prior history of heart failure, stroke, arrhythmia and renal failure and more frequently had ST-elevation and a family history of smoking. The ex-smokers had more dyslipidaemia and history of angina, myocardial infarction, ischemic heart disease, peripheral vasculopathy and chronic bronchial disease. Smokers and ex-smokers less frequently developed cardiogenic shock (smokers 4.2%, ex-smokers 4.7% and nonsmokers 6.9%, P<.001). Hospital mortality was 7.8% for the nonsmokers, 4.9% for the ex-smokers and 3.1% for the smokers (P<.001). In the multivariate analysis, the smoker factor lost its influence in the prognosis (-0.26%, p=.52 using an inverse probability calculation; and+0.26%, P=.691 using a propensity analysis). However, the exsmoker factor showed a significant reduction in mortality in both tests (-2.4% in the inverse probability analysis, P<.001; and -1.5% in the propensity analysis, P=.005). The tobacco paradox is a finding that could be explained by other prognostic factors. Smoking cessation prior to hospitalization for acute coronary syndrome is associated with a better prognosis. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.
Albert, David A; Bruzelius, Emilie; Ward, Angela; Gordon, Judith S
The aims of this mixed-methods study were to assess tobacco treatment behaviors among residents and faculty in dental specialty postdoctoral programs and to explore factors in training and practice related to tobacco treatment education. Surveys and focus groups were conducted with a convenience sample of participants at three postdoctoral residency programs in New York City. Surveys assessed tobacco cessation training and behaviors. Focus groups explored barriers to implementing tobacco cessation treatment in educational settings. Data were collected between May and December 2013. Among the 160 faculty and residents identified as potentially eligible for the study, 60 were invited by program directors to participate, and 50 subsequently completed the survey and participated in a focus group (response rate of 31.3%). Survey results indicated high levels of asking patients about tobacco use and advising patients to quit. In contrast, specific tobacco cessation assistance and follow-up care occurred less frequently. There were statistically significant differences in tobacco cessation intervention across the specialties surveyed, but not between residents and faculty. Focus group comments were grouped into three broad areas: clinician factors, organizational support, and structural and contextual factors. Focus group results indicated that participants experienced significant organizational and structural barriers to learning about and providing tobacco treatment. Participants from each specialty indicated that multi-level barriers impeded their provision of evidence-based tobacco cessation interventions in postdoctoral educational settings. They suggested that didactic education should be reinforced by organizational- and systems-level changes to facilitate comprehensive tobacco education and effective cessation treatment in future dental practice.
Boudreaux, Edwin D; Bedek, Kristyna L; Byrne, Nelson J; Baumann, Brigitte M; Lord, Sherrill A; Grissom, Grant
Background Health care providers do not routinely carry out brief counseling for tobacco cessation despite the evidence for its effectiveness. For this intervention to be routinely used, it must be brief, be convenient, require little investment of resources, require little specialized training, and be perceived as efficacious by providers. Technological advances hold much potential for addressing the barriers preventing the integration of brief interventions for tobacco cessation into the he...
Full Text Available Background Quitting tobacco use can reduce smokers' risks for disease and premature death. We used the trans-theoretical behavior change model to examine temporal differences in readiness to quit smoking among adults in five countries. Methods We analyzed two independent samples from the Global Adult Tobacco Survey, a standardized national adult household survey of persons aged ≥15 years, for five countries: Mexico (2009, 2015, Philippines (2010, 2016, Thailand (2009, 2011, Turkey (2008, 2012, and Vietnam (2010, 2016. Response rates ranged 82.5%-96.3% and sample sizes ranged 8,996-20,606. Current smokers were defined as adults who smoked tobacco on a daily or non-daily basis. Using responses to questions assessing intention to quit cigarette smoking, we categorized current smokers into the following stages of change: pre-contemplation, contemplation, and preparation. Relative change was compared using z-tests ( p < 0.05. Results No significant change in smoking prevalence between wave 1 and 2 occurred for Mexico (15.9% to 16.4%, Thailand (23.7% to 24.0%, or Vietnam (23.8% to 22.5%. In contrast, smoking prevalence declined for Philippines (28.2% to 22.7% and Turkey (31.2% to 27.1%. There was an increase in the proportion of smokers in the pre-contemplation stage in Thailand (76.1% to 85.4% and Vietnam (70.8% to 82.3%, while a decline occurred in Turkey (31.2% to 27.1%; no significant change occurred in Mexico or Philippines. The proportion of smokers in the contemplation stage declined in Thailand (17.6% to 12.0% and Vietnam (21.6% to 14.1%, but increased in Turkey (21.2% to 26.9%; no significant change occurred in Mexico or Philippines. The proportion in the preparation stage declined in Thailand (6.3% to 2.6% and Vietnam (7.6% to 3.6%; no significant changes occurred in, Mexico, Philippines, or Turkey. Conclusions Using the stages of change model, smokers' readiness to quit varies by country. Tailored interventions towards specific stages of
Nathan R. Jones
Full Text Available The Nursing Global Health Professions Student Survey (GHPSS has been conducted in schools in 39 countries and the Gaza Strip/West Bank (identified as “sites” for the remainder of this paper. In half the sites, over 20% of the students currently smoked cigarettes, with males having higher rates than females in 22 sites. Over 60% of students reported having been exposed to secondhand smoke in public places in 23 of 39 sites. The majority of students recognized that they are role models in society, believed they should receive training on counseling patients to quit using tobacco, but few reported receiving any formal training. Tobacco control efforts must discourage tobacco use among health professionals, promote smoke free workplaces, and implement programs that train health professionals in effective cessation-counseling techniques.
Gould, Gillian S; Bar-Zeev, Yael; Bovill, Michelle; Atkins, Lou; Gruppetta, Maree; Clarke, Marilyn J; Bonevski, Billie
Indigenous smoking rates are up to 80% among pregnant women: prevalence among pregnant Australian Indigenous women was 45% in 2014, contributing significantly to the health gap for Indigenous Australians. We aimed to develop an implementation intervention to improve smoking cessation care (SCC) for pregnant Indigenous smokers, an outcome to be achieved by training health providers at Aboriginal Medical Services (AMS) in a culturally competent approach, developed collaboratively with AMS. The Behaviour Change Wheel (BCW), incorporating the COM-B model (capability, opportunity and motivation for behavioural interventions), provided a framework for the development of the Indigenous Counselling and Nicotine (ICAN) QUIT in Pregnancy implementation intervention at provider and patient levels. We identified evidence-practice gaps through (i) systematic literature reviews, (ii) a national survey of clinicians and (iii) a qualitative study of smoking and quitting with Aboriginal mothers. We followed the three stages recommended in Michie et al.'s "Behaviour Change Wheel" guide. Targets identified for health provider behaviour change included the following: capability (psychological capability, knowledge and skills) by training clinicians in pharmacotherapy to assist women to quit; motivation (optimism) by presenting evidence of effectiveness, and positive testimonials from patients and clinicians; and opportunity (environmental context and resources) by promoting a whole-of-service approach and structuring consultations using a flipchart and prompts. Education and training were selected as the main intervention functions. For health providers, the delivery mode was webinar, to accommodate time and location constraints, bringing the training to the services; for patients, face-to-face consultations were supported by a booklet embedded with videos to improve patients' capability, opportunity and motivation. The ICAN QUIT in Pregnancy was an intervention to train health
Tønnesen, Hanne; Faurschou, Pernille; Ralov, Helge
Daily smokers and hazardous drinkers are high-risk patients, developing 2-4 times more complications after surgery. Preoperative smoking and alcohol cessation for four to eight weeks prior to surgery halves this complication rate. The patients' preoperative contact with the surgical departments...
Adaptation, Implementation Plan, and Evaluation of an Online Tobacco Cessation Training Program for Health Care Professionals in Three Spanish-Speaking Latin American Countries: Protocol of the Fruitful Study.
Martínez, Cristina; Company, Assumpta; Guillen, Olga; Margalef, Mercè; Arrien, Martha Alicia; Sánchez, Claudia; Cáceres de León, Paula; Fernández, Esteve
Tobacco cessation training programs to treat tobacco dependence have measureable effects on patients' smoking. Tobacco consumption in low- and middle-income countries (LMICs) is high and slowly decreasing, but these countries usually lack measures to face the epidemic, including tobacco cessation training programs for health professionals and organizations. Based on a previous online smoking cessation training program for hospital workers in Spain, the Fruitful Study aims to increase smoking cessation knowledge, attitudes, self-confidence, and performance interventions among health care professionals of three Spanish-speaking low- and middle-income Latin American and Caribbean (LAC) countries. The purpose of this paper is to describe the methodology and evaluation strategy of the Fruitful Study intended to adapt, implement, and test the effectiveness of an online, evidence-based tobacco cessation training program addressed to health professionals from Bolivia, Guatemala, and Paraguay. This study will use a mixed-methods design with a pre-post evaluation (quantitative approach) and in-depth interviews and focus groups (qualitative approach). The main outcomes will be (1) participants' attitudes, knowledge, and behaviors before and after the training; and (2) the level of implementation of tobacco control policies within the hospitals before and after the training. To date, adaptation of the materials, study enrollment, and training activities have been completed. During the adaptation, the main mismatches were language background and content adaptation. Several aids were developed to enable students' training enrollment, including access to computers, support from technicians, and reminders to correctly complete the course. Follow-up data collection is in progress. We have enrolled 281 hospital workers. Results are expected at the beginning of 2017 and will be reported in two follow-up papers: one about the formative evaluation and the other about the summative
van der Mark, Marianne; Nijssen, Peter C G; Vlaanderen, Jelle; Huss, Anke; Mulleners, Wim M; Sas, Antonetta M G; van Laar, Teus; Kromhout, Hans; Vermeulen, Roel
The aim of this study was to investigate the possible reduced risk of Parkinson Disease (PD) due to coffee, alcohol, and/or cigarette consumption. In addition, we explored the potential effect modification by intensity, duration and time-since-cessation of smoking on the association between cumulative pack-years of cigarette smoking (total smoking) and PD risk. Data of a hospital based case-control study was used including 444 PD patients, diagnosed between 2006 and 2011, and 876 matched controls from 5 hospitals in the Netherlands. A novel modeling method was applied to derive unbiased estimates of the potential modifying effects of smoking intensity, duration, and time-since-cessation by conditioning on total exposure. We observed no reduced risk of PD by alcohol consumption and only a weak inverse association between coffee consumption and PD risk. However, a strong inverse association of total smoking with PD risk was observed (OR=0.27 (95%CI: 0.18-0.42) for never smokers versus highest quartile of tobacco use). The observed protective effect of total smoking was significantly modified by time-since-cessation with a diminishing protective effect after cessation of smoking. No effect modification by intensity or duration of smoking was observed indicating that both intensity and duration have an equal contribution to the reduced PD risk. Understanding the dynamics of the protective effect of smoking on PD risk aids in understanding PD etiology and may contribute to strategies for prevention and treatment.
Strasser Sheryl M
Full Text Available Abstract Background Tobacco use, particularly smoking, is the most preventable cause of death in the United States. More than 400,000 premature deaths are associated with its use and the health care costs are in the billions. All health care provider groups should be concerned with patients who continue to smoke and use tobacco. The US Preventive Services Taskforce and Health People 2010 guidelines encourage providers to counsel smokers on cessation. Current studies, though limited regarding chiropractic advising practices indicate a low engagement rate when it comes to providing cessation information. Objective To test a campaign regarding initial impact aimed at increasing chiropractic interns advising on cessation and delivery of information to smokers on cessation. Discussion Chiropractic interns do engage patients on smoking status and can be encouraged to provide more cessation messages and information to patients. The initial impact assessment of this campaign increased the provision of information to patients by about 25%. The prevalence of smoking among chiropractic patients, particularly at teaching clinics may be lower than the national averages. Conclusion Chiropractic interns can and should be encouraged to advise smokers about cessation. A systematic method of intake information on smoking status is needed and a standardized education protocol for chiropractic colleges is needed. Chiropractic colleges should assess the adequacy of their advising roles and implement changes to increase cessation messages to their patients as soon as possible.
research /demonstrat ion involves the study/evaluation of: (select all that apply) D Public benefit or service programs D D Procedures for obtaining...of payment for benefits or services under those programs Category 32 CFR 219.101(b)(6): This research is a taste and food quality evaluation and/or...age for other than obvious reasons (i.e., disease state: sickle cell anemia, breast cancer, prostate cancer), specific justification for exclusion of
Carlos A. Jimenez-Ruiz
Tobacco smoking is the main cause of COPD. Smoking cessation is the only therapeutic measure that can cure COPD and prevent this disorder from its chronic progression. Smoking cessation in COPD patients is difficult because most of these patients have specific characteristics that prevent them to quit. Recently, an ERS Task Force has developed a Consensus Document that contains recommendations for helping COPD smokers to quit.
Farber, Harold J; Pakhale, Smita; Neptune, Enid R
An important approach to reduce youth tobacco use is the adoption of regulations to prohibit tobacco product sale to individuals younger than 21 years, termed Tobacco 21. In the United States, close to 90% of current smokers started smoking before the age of 18 years, and 99% before age 26 years. Earlier age of tobacco use initiation is associated with lower rates of smoking cessation. Increasing minimum age to purchase has been shown to reduce tobacco product use among youth. The critical determinant is likely the loss of social sources of tobacco products. Enforcement activities are important for age-of-purchase laws to be effective. Raising the minimum legal age to purchase tobacco products to 21 years is highly supported among both the smoking and nonsmoking public. Tobacco sales to those younger than 21 years account for just 2% of total tobacco sales, yet produce 90% of new smokers. The short-term effect on small business of raising the minimum age to purchase would be minimal. Small businesses will have time to adapt to the decrease in tobacco sales as fewer youth grow up nicotine addicted. Raising the minimum age to purchase of tobacco and nicotine products to 21 years, combined with enforcement of those restrictions, will help protect future generations from a lifetime of tobacco dependence and associated morbidity. These regulations should apply to all tobacco products, including electronic nicotine delivery systems. Respiratory health care providers should educate their local, state, and federal policy makers on the importance of Tobacco 21.
Prochaska, Judith J; Fromont, Sebastien C; Wa, Christina; Matlow, Ryan; Ramo, Danielle E; Hall, Sharon M
Youth with psychiatric disorders are at increased risk of tobacco use. Outpatient mental health settings have received little investigation for delivering tobacco treatment. This study obtained formative data to guide development of a tobacco cessation program for transitional age youth with co-occurring psychiatric disorders with a focus on outpatient mental health settings. Applying qualitative methods, we analyzed transcripts from interviews with 14 mental health clients (aged 16-23) and 8 mental health providers. The youth identified internal (nicotine addiction and mood), social, parental, and media influences to their use of tobacco. Providers' viewed youth tobacco use as a normative developmental process, closely tied to management of psychiatric symptoms, supported by parents, and of lower priority relative to youth alcohol and illicit drug use. Youth and providers believed that clinicians can do more to address tobacco use in practice and emphasized nonjudgmental support and nondirective approaches. Top recommended quitting strategies, however, differed notably for the youth (cold turkey, support from friends, physical activity, hobbies) and providers (cessation pharmacotherapy, cessation groups, treatment referrals). Mental health providers' greater prioritization of other substances and view of youth smoking as developmentally normative and a coping strategy for psychopathology are likely contributing to the general lack of attention to tobacco use currently. Integrating care within mental health settings would serve to reach youth in an arena where clinical rapport is already established, and study findings suggest receptivity for system improvements. Of consideration, however, is the apparent disconnect between provider and youth recommended strategies for supporting cessation.
videogame , tobacco use, military. 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF RESPONSIBLE... videogame is theory-guided and uses animations, videos and interactive activities to provide facts about smoking and tobacco use, as well as provides...prevention and cessation interactive multimedia tool ( videogame ) among active Army personnel stationed at Fort Hood, Texas. Body Throughout the
McNeill, Ann; Gravely, Shannon; Hitchman, Sara C; Bauld, Linda; Hammond, David; Hartmann-Boyce, Jamie
Tobacco use is the largest single preventable cause of death and disease worldwide. Standardised tobacco packaging is an intervention intended to reduce the promotional appeal of packs and can be defined as packaging with a uniform colour (and in some cases shape and size) with no logos or branding, apart from health warnings and other government-mandated information, and the brand name in a prescribed uniform font, colour and size. Australia was the first country to implement standardised tobacco packaging between October and December 2012, France implemented standardised tobacco packaging on 1 January 2017 and several other countries are implementing, or intending to implement, standardised tobacco packaging. To assess the effect of standardised tobacco packaging on tobacco use uptake, cessation and reduction. We searched MEDLINE, Embase, PsycINFO and six other databases from 1980 to January 2016. We checked bibliographies and contacted study authors to identify additional peer-reviewed studies. Primary outcomes included changes in tobacco use prevalence incorporating tobacco use uptake, cessation, consumption and relapse prevention. Secondary outcomes covered intermediate outcomes that can be measured and are relevant to tobacco use uptake, cessation or reduction. We considered multiple study designs: randomised controlled trials, quasi-experimental and experimental studies, observational cross-sectional and cohort studies. The review focused on all populations and people of any age; to be included, studies had to be published in peer-reviewed journals. We examined studies that assessed the impact of changes in tobacco packaging such as colour, design, size and type of health warnings on the packs in relation to branded packaging. In experiments, the control condition was branded tobacco packaging but could include variations of standardised packaging. Screening and data extraction followed standard Cochrane methods. We used different 'Risk of bias' domains for
Ostroff, Jared L; Wolff, Marissa L; Andros, Christina; Nemec, Eric C
The purpose of this article is to describe a service learning experience involving tobacco prevention education and to measure the education's effect on the learners' knowledge of tobacco products. Student pharmacists planned and presented a 40-min tobacco prevention education program using the Tar Wars curriculum to fourth and fifth grade students at three suburban elementary schools in Western Massachusetts. Mean scores on a five-question assessment given to school age children before and after the presentation were compared. A total of 206 elementary school students in ten classrooms participated. The average survey score increased from 1.87 on the pre-survey to 3.72 out of a maximum of five on the post-survey (Peducation to three suburban elementary schools. The children demonstrated an increase in short-term knowledge regarding tobacco use. Tobacco prevention is a unique co-curricular opportunity for student pharmacists to get involved in their community. Copyright © 2017 Elsevier Inc. All rights reserved.
The internet can provide wide access to online smoking cessation programmes developed by highly qualified professionals. Compared with one-to-one counselling in smoking cessation clinics or on telephone quitlines, the mass-level dissemination of automatised, individualised counselling on the internet is comparable to the industrial revolution, when skilled craftsmen working in small shops were replaced by huge plants. Hundreds of websites provide information and advice on smoking cessation, but very few of them have been evaluated scientifically. Therefore, it is not yet known whether web-based smoking cessation interventions are effective in the long term, and which of their components are most effective for subgroups of smokers. Claims for efficacy found on some popular websites have not been evaluated. The internet is being used increasingly by tobacco companies to promote their products. The overall effect of internet smoking cessation programs on smoking prevalence is unknown. Greater efforts should be expended to improve the reach and efficacy of smoking cessation websites.
Ernster, V; Kaufman, N; Nichter, M; Samet, J; Yoon, S Y
A gender perspective contributes to a better understanding of the epidemiological trends, social marketing strategies, economic policies, and international actions relating to women and the tobacco epidemic. Evidence is provided in this article for the negative impact of tobacco use by women and of passive smoking on the health of women and children. Use of tobacco by women is increasing and this is related to the tobacco industry's aggressive advertising, sponsorship and promotion strategies. Policy directions are proposed in this article. At all levels, a multi-pronged strategy--including changes in legislation and fiscal policies, improvements in gender-sensitive health services, and cessation programmes--should be considered. Much more gender-specific research on tobacco use is needed, particularly in developing countries. Women's empowerment and leadership should be at the centre of all tobacco control efforts and are essential for the success of national programmes and the recently introduced Framework Convention on Tobacco Control.
Couch, Elizabeth T; Chaffee, Benjamin W; Gansky, Stuart A; Walsh, Margaret M
Tobacco products in the United States and the patterns of tobacco use are changing. Although cigarette smoking prevalence has declined, dental professionals are likely to encounter substantial numbers of patients who have tried and are continuing to use new and alternative tobacco products, including cigars, water pipes (hookahs), and electronic cigarettes, as well as conventional and new smokeless tobacco products. The authors reviewed conventional and new tobacco products in the United States, their adverse oral and systemic health effects, and their prevalence of use. Tobacco products other than cigarettes account for a substantial portion of tobacco use. For this reason, tobacco-use prevention and cessation counseling provided by dental health care professionals must address all tobacco products, including cigarettes, cigars, water pipes, and electronic cigarettes, as well as conventional and new smokeless tobacco products. Cigarette smoking and smokeless tobacco use are associated with immediate and long-term adverse health effects, including nicotine addiction, oral and systemic disease, and death. Novel products may attract new tobacco users, potentially leading to addiction that results in enduring tobacco product use and associated adverse health effects. This critical review of conventional, new, and emerging tobacco products presents information that dental professionals can use in providing tobacco-related counseling to patients who use or who are at risk for using tobacco products. It is essential that dental professionals are knowledgeable about tobacco products and are able to answer patients' questions and provide them with evidence-based tobacco-related counseling. This information may prevent patients from initiating use or help reduce or cease use to avoid immediate and long-term adverse health effects, including nicotine addiction, oral and systemic disease, and death. Copyright © 2016 American Dental Association. Published by Elsevier Inc
Newhall, Karina; Suckow, Bjoern; Spangler, Emily; Brooke, Benjamin S; Schanzer, Andres; Tan, Tze-Woei; Burnette, Mary; Edelen, Maria Orlando; Farber, Alik; Goodney, Philip
Despite the recognized benefits of smoking cessation, many clinicians question if a brief smoking cessation intervention can help dedicated smokers with peripheral arterial disease understand nicotine dependence and harms related to smoking. We investigated the impact and durability of a multimodal smoking cessation intervention on patient attitudes regarding nicotine dependence and the health effects of smoking. We conducted a pilot cluster-randomized trial of a brief smoking cessation intervention at 8 vascular surgery practices between September 1, 2014 and August 31, 2015. Compared with control sites, patients at intervention sites received protocolized brief cessation counseling, medications, and referrals to a quitline. After their clinic visit and again at 3 months, participants completed a brief survey about patient attitudes regarding nicotine dependence and the health effects of smoking. Responses to questions were analyzed using chi-squared test and Student's t-test. All trial participants (n = 156) complete the initial survey, and 75 (45%) participants completed the follow-up survey. Intervention and control patients both reported a greater than 30-pack-year history (80% vs. 90%, P = 0.07) and previous failed quit attempts (77% vs. 78%, P = 0.8). Compared with usual care, patients in the intervention group were more likely to describe hearing advice to quit from their surgeon (98% vs. 77%, P smoking (scaled score 56.6 vs. 50.6, P = 0.001). When resurveyed 3 months after intervention, patients in the intervention group had larger declines in nicotine dependence and health effect domains, suggesting durable impact of the intervention on patient attitudes regarding nicotine addiction and smoking harms. Brief smoking cessation counseling by a vascular surgeon increases patient interest in smoking cessation and awareness of smoking harms, and this effect was durable 3 months after intervention. This evidence suggests that even brief counseling
Nath, Manoj; Garg, Bharti; Sahoo, Ranjan Kumar; Tuteja, Narendra
Salinity stress negatively affects the crop productivity worldwide, including that of rice. Coping with these losses is a major concern for all countries. The pea DNA helicase, PDH45 is a unique member of helicase family involved in the salinity stress tolerance. However, the exact mechanism of the PDH45 in salinity stress tolerance is yet to be established. Therefore, the present study was conducted to investigate the mechanism of PDH45-mediated salinity stress tolerance in transgenic tobacco and rice lines along with wild type (WT) plants using CoroNa Green dye based sodium localization in root and shoot sections. The results showed that under salinity stress root and shoot of PDH45 overexpressing transgenic tobacco and rice accumulated less sodium (Na(+)) as compared to their respective WT. The present study also reports salinity tolerant (FL478) and salinity susceptible (Pusa-44) varieties of rice accumulated lowest and highest Na(+) level, respectively. All the varieties and transgenic lines of rice accumulate differential Na(+) ions in root and shoot. However, roots accumulate high Na(+) as compared to the shoots in both tobacco and rice transgenic lines suggesting that the Na(+) transport in shoot is somehow inhibited. It is proposed that the PDH45 is probably involved in the deposition of apoplastic hydrophobic barriers and consequently inhibit Na(+) transport to shoot and therefore confers salinity stress tolerance to PDH45 overexpressing transgenic lines. This study concludes that tobacco (dicot) and rice (monocot) transgenic plants probably share common salinity tolerance mechanism mediated by PDH45 gene.
Hall, Peter A; Fong, Geoffrey T; Meng, Gang
Future oriented time perspective predicts a number of important health behaviors and outcomes, including smoking cessation. However, it is not known how future orientation exerts its effects on such outcomes, and no large scale cross-national studies have examined the question prospectively. The aim of the current investigation was to examine the relationship between time perspective and success in smoking cessation, and social cognitive mediators of the association. The ITC-4 is a multi-wave, four country survey (Australia, Canada, United States, United Kingdom) of current smokers (N=9772); the survey includes baseline measurements of time perspective, intentions, quit attempts, and self-reported quit status at follow-up over 8 years. We examined the predictive power of time perspective for smoking cessation, as mediated through strength of quit intentions and prior history of quit attempts. Findings indicated that those smokers with a stronger future orientation at baseline were more likely to have successfully quit at follow-up. This effect was partially explained by intention-mediated effects of future orientation on quit attempts. Future orientation predicts smoking cessation across four English-speaking countries; the cessation-facilitating effects of future orientation may be primarily due to future oriented individuals' motivated and sustained involvement in the quit cycle over time. Copyright © 2014 Elsevier Ltd. All rights reserved.
Goldade, Kate; Burgess, Diana; Olayinka, Abimbola; Whembolua, Guy Lucien S; Okuyemi, Kolawole S
Disparities in tobacco's harm persist. Declines in smoking among the general population have not been experienced to the same extent by vulnerable populations. Innovative strategies are required to diminish disparities in tobacco's harm. As novel tools, anthropological concepts and methods may be applied to improve the design and outcomes of tobacco cessation interventions. We reviewed over 60 articles published in peer-reviewed journals since 1995 for content on anthropology and smoking cessation. The specific questions framing the review were: (a) "How can lessons learned from anthropological studies of smoking improve the design and effectiveness of smoking cessation interventions?" (b) How can anthropology be applied to diminish disparities in smoking cessation? and (c) How can qualitative methods be used most effectively in smoking cessation intervention research? Three specific disciplinary tools were identified and examined: (a) culture, (b) reflexivity, and (c) qualitative methods. Examining culture as a dynamic influence and understanding the utilities of smoking in a particular group is a precursor to promoting cessation. Reflexivity enables a deeper understanding of how smokers perceive quitting and smoking beyond addiction and individual health consequences. Qualitative methods may be used to elicit in-depth perspectives on quitting, insights to inform existing community-based strategies for making behavior changes, and detailed preferences for cessation treatment or programs. Anthropological tools can be used to improve the effectiveness of intervention research studies targeting individuals from vulnerable groups. Synthesized applications of anthropological concepts can be used to facilitate translation of findings into clinical practice for providers addressing tobacco cessation in vulnerable populations.
Lippert, Adam M.
Objective. To examine temporal changes in the correlates of experimental and current e-cigarette use and associations with tobacco quit attempts. Method. Repeated cross-sectional analyses of data from the 2011 (n = 17,741), 2012 (n = 23,194), and 2013 (n = 16,858) National Youth Tobacco Surveys--a nationally representative sample of U.S. middle…
Full Text Available Background: Legislation preventing smoking in public places was introduced in England in July 2007. Since then, smoke-free policies have been extended to the majority of hospitals including those providing cancer therapies. Whilst studies have been conducted on the impact and effectiveness of hospital smoke-free policy in the UK and other countries, there have not been any studies with a focus on cancer care providers. Cancer patients are a priority group for smoking cessation and support and this study aimed to examine implementation of the National Institute Clinical Excellence (NICE guidance (PH48 in acute cancer care trusts in the UK. Methods: Participants were recruited from UK radiotherapy and chemotherapy departments (total 80 sites, 65 organisations and asked to complete a 15 min online questionnaire exploring the implementation of NICE guidance at their hospital site. Results: Considerable variability in implementation of the NICE guidance was observed. A total of 79.1% trusts were smoke-free in theory; however, only 18.6% were described as smoke-free in practice. Areas of improvement were identified in information and support for patients and staff including in Nicotine Replacement Therapy (NRT provision, staff training and clarity on e-cigarette policies. Conclusions: While some trusts have effective smoke-free policies and provide valuable cessation support services for patients, improvements are required to ensure that all sites fully adopt the NICE guidance.
Marín Armero, Alicia; Calleja Hernandez, Miguel A; Perez-Vicente, Sabina; Martinez-Martinez, Fernando
As a determining factor in various diseases and the leading known cause of preventable mortality and morbidity, tobacco use is the number one public health problem in developed countries. Facing this health problem requires authorities and health professionals to promote, via specific programs, health campaigns that improve patients' access to smoking cessation services. Pharmaceutical care has a number of specific characteristics that enable the pharmacist, as a health professional, to play an active role in dealing with smoking and deliver positive smoking cessation interventions. The objectives of the study were to assess the efficacy of a smoking cessation campaign carried out at a pharmaceutical care center and to evaluate the effects of pharmaceutical care on patients who decide to try to stop smoking. The methodology was an open, analytical, pre-post intervention, quasi-experimental clinical study performed with one patient cohort. The results of the study were that the promotional campaign for the smoking cessation program increased the number of patients from one to 22, and after 12 months into the study, 43.48% of the total number of patients achieved total smoking cessation. We can conclude that advertising of a smoking cessation program in a pharmacy increases the number of patients who use the pharmacy's smoking cessation services, and pharmaceutical care is an effective means of achieving smoking cessation.
Marín Armero A
Full Text Available Alicia Marín Armero,1 Miguel A Calleja Hernandez,2 Sabina Perez-Vicente,3 Fernando Martinez-Martinez4 1Community Pharmacy, Murcia, Spain; 2Hospital Pharmacy, University Hospital Virgen de las Nieves, Granada, Spain; 3Result Evaluation Unit, Institute of Biomedicine, Sevilla, Spain; 4Research Unit in Pharmaceutical Care, University of Granada, Granada, Spain Abstract: As a determining factor in various diseases and the leading known cause of preventable mortality and morbidity, tobacco use is the number one public health problem in developed countries. Facing this health problem requires authorities and health professionals to promote, via specific programs, health campaigns that improve patients’ access to smoking cessation services. Pharmaceutical care has a number of specific characteristics that enable the pharmacist, as a health professional, to play an active role in dealing with smoking and deliver positive smoking cessation interventions. The objectives of the study were to assess the efficacy of a smoking cessation campaign carried out at a pharmaceutical care center and to evaluate the effects of pharmaceutical care on patients who decide to try to stop smoking. The methodology was an open, analytical, pre–post intervention, quasi-experimental clinical study performed with one patient cohort. The results of the study were that the promotional campaign for the smoking cessation program increased the number of patients from one to 22, and after 12 months into the study, 43.48% of the total number of patients achieved total smoking cessation. We can conclude that advertising of a smoking cessation program in a pharmacy increases the number of patients who use the pharmacy’s smoking cessation services, and pharmaceutical care is an effective means of achieving smoking cessation. Keywords: community pharmacy, health campaign, tobacco cessation, nicotine replacement therapy
Yim Wah Mak
Full Text Available Previous studies have shown that nursing interventions are effective in helping people to stop smoking, but that the participation of nurses in tobacco control activities has been far from satisfactory. The primary objective of this study is to identify factors that encourage or discourage nurses from participating in providing smoking-cessation interventions to their clients, based on the 5 A’s (ask, advise, assess, assist, arrange framework. A cross-sectional survey was conducted among 4413 nurses in Hong Kong from different clinical specialties. A logistics regression analysis found that predictors for the practicing of all of the 5 A’s are nurses who want to receive training in smoking-cessation interventions, those who have received such training, and those who are primarily working in a medical unit or in ambulatory/outpatient settings. The regression model also showed that attitude towards smoking cessation was positively associated with all of the 5 A’s. The results indicate a need to encourage and provide nurses with opportunities to receive training on smoking-cessation interventions. Strategies to persuade nurses to provide smoking-cessation interventions are also important, since nurses are motivated to perform smoking-cessation interventions when they feel a stronger sense of mission to control tobacco use.
Facility-level, state, and financial factors associated with changes in the provision of smoking cessation services in US substance abuse treatment facilities: Results from the National Survey of Substance Abuse Treatment Services 2006 to 2012.
Cohn, Amy; Elmasry, Hoda; Niaura, Ray
Cigarette smoking is common among patients in substance abuse treatment. Tobacco control programs have advocated for integrated tobacco dependence treatment into behavioral healthcare, including within substance abuse treatment facilities (SATFs) to reduce the public health burden of tobacco use. This study used data from seven waves (2006 to 2012) of the National Survey of Substance Abuse Treatment Services (n=94,145) to examine state and annual changes in the provision of smoking cessation services within US SATFs and whether changes over time could be explained by facility-level (private vs public ownership, receipt of earmarks, facility admissions, acceptance of government insurance) and state-level factors (cigarette tax per pack, smoke free policies, and percent of CDC recommended tobacco prevention spending). Results showed that the prevalence of SATFs offering smoking cessation services increased over time, from 13% to 65%. The amount of tax per cigarette pack, accepting government insurance, government (vs private) ownership, facility admissions, and CDC recommended tobacco prevention spending (per state) were the strongest correlates of the provision of smoking cessation programs in SATFs. Facilities that received earmarks were less likely to provide cessation services. Adult smoking prevalence and state-level smoke free policies were not significant correlates of the provision of smoking cessation services over time. Policies aimed at increasing the distribution of tax revenues to cessation services in SATFs may offset tobacco-related burden among those with substance abuse problems. Copyright © 2017. Published by Elsevier Inc.
Ussher, Michael H; Taylor, Adrian H; Faulkner, Guy E J
Taking regular exercise may help people give up smoking by moderating nicotine withdrawal and cravings, and by helping to manage weight gain. To determine whether exercise-based interventions alone, or combined with a smoking cessation programme, are more effective than a smoking cessation intervention alone. We searched the Cochrane Tobacco Addiction Group Specialized Register in April 2014, and searched MEDLINE, EMBASE, PsycINFO, and CINAHL Plus in May 2014. We included randomized trials which compared an exercise programme alone, or an exercise programme as an adjunct to a cessation programme, with a cessation programme (which we considered the control in this review). Studies were required to recruit smokers or recent quitters and have a follow-up of six months or more. Studies that did not meet the full inclusion criteria because they only assessed the acute effects of exercise on smoking behaviour, or because the outcome was smoking reduction, are summarised but not formally included. We extracted data on study characteristics and smoking outcomes. Because of differences between studies in the characteristics of the interventions used we summarized the results narratively, making no attempt at meta-analysis. We assessed risk of selection and attrition bias using standard methodological procedures expected by The Cochrane Collaboration. We identified 20 trials with a total of 5,870 participants. The largest study was an internet trial with 2,318 participants, and eight trials had fewer than 30 people in each treatment arm. Studies varied in the timing and intensity of the smoking cessation and exercise programmes offered. Only one included study was judged to be at low risk of bias across all domains assessed. Four studies showed significantly higher abstinence rates in a physically active group versus a control group at end of treatment. One of these studies also showed a significant benefit for exercise versus control on abstinence at the three-month follow
This project was developed as an educational tool to increase awareness of tobacco related issues such as lifestyle choices, health risks, advertising, saying no, cessation, second hand smoke and smokeless tobacco...
Seidel, Sarah E; Metzger, Kristi; Guerra, Andrea; Patton-Levine, Jessie; Singh, Sandeepkumar; Wilson, William T; Huang, Philip
The adoption of tobacco-free policies in behavioral health settings is an important step in reducing staff tobacco use as well as the high rates of tobacco use among people with mental illness and behavioral disorders. Studies have demonstrated the importance of staff support when implementing tobacco-free workplace policies, but there is limited research examining tobacco use prevalence among staff and staff attitude before and after policy adoption. Integral Care, a local authority for behavioral health and developmental disabilities in Austin, Texas, and Austin Public Health embarked on a comprehensive planning process before implementing a 100% tobacco-free campus policy. The objectives were 1) assess staff tobacco use and attitudes toward a tobacco-free policy, 2) communicate policy to staff, 3) provide staff education and training, and 4) provide cessation resources. Integral Care and Austin Public Health conducted a web-based employee survey 6 months before and 6 and 12 months after implementation of the policy to measure tobacco use prevalence and attitudes among employees. Employees had significant improvements in tobacco use prevalence and attitudes toward the tobacco-free policy from pre-implementation to post-implementation. Tobacco use prevalence among staff decreased from 27.6% to 13.8%, and support for the policy increased from 60.6% to 80.3% at 12 months post-implementation. Adoption of 100% tobacco-free campus policies in behavioral health settings can result in significant reductions in staff tobacco use. Leadership should provide staff with education, training, and cessation support before adoption of tobacco-free work site policies to ensure success.
Goto, Rei; Nishimura, Shuzo; Ida, Takanori
In spite of gradual increases in tobacco price and the introduction of laws supporting various anti-tobacco measures, the proportion of smokers in Japan's population is still higher than in other developed nations. To understand what information and individual characteristics drive smokers to attempt to quit smoking. These determinants will help to realise effective tobacco control policy as a base for understanding of cessation behaviour. Discrete choice experiments on a total of 616 respondents registered at a consumer monitoring investigative company. The effect of price is greater on smokers with lower nicotine dependence. For smokers of moderate and low dependency, short term health risks and health risks caused by passive smoking have a strong impact, though the existence of penalties and long term health risks have little influence on smokers' decisions to quit. For highly dependent smokers, non-price attributes have little impact. Furthermore, the effects of age, sex and knowledge are also not uniform in accounting for smoking cessation. Determinants of smoking cessation vary among levels of nicotine dependency. Therefore, how and what information is provided needs to be carefully considered when counselling smokers to help them to quit.
Meltzer, Lauren R; Simmons, Vani N; Sutton, Steven K; Drobes, David J; Quinn, Gwendolyn P; Meade, Cathy D; Unrod, Marina; Brandon, Karen O; Harrell, Paul T; Eissenberg, Thomas; Bullen, Christopher R; Brandon, Thomas H
Electronic Nicotine Delivery Systems, also called electronic cigarettes or e-cigarettes, have been available for over a decade and use has been increasing dramatically. The primary reported reasons for use are to aid smoking cessation or reduction, yet a significant proportion appear to be long-term users of both products ("dual users"). Dual users may be motivated to quit smoking and might benefit from a behavioral intervention for smoking cessation. This paper describes the intervention development, as well as the design, methods, and data analysis plans for an ongoing randomized controlled trial (RCT). Formative research and learner verification were conducted to create a usable, understandable, and acceptable self-help intervention targeting dual users. The efficacy is being tested in an RCT with current dual users (N=2900) recruited nationally and randomized to one of three conditions. The Assessment Only (ASSESS) group only completes assessments. The Generic Self-Help (GENERIC) group receives non-targeted smoking cessation booklets and supplemental materials sent monthly over 18months. The e-cigarette Targeted Self-Help (eTARGET) group receives the newly developed intervention (targeted booklets and supplemental materials) sent over the same period. All participants complete self-report surveys every 3months over 2years. The primary study outcome is self-reported 7-day point prevalence abstinence. Cost-effectiveness metrics for the GENERIC and eTARGET interventions will also be calculated. Copyright © 2017 Elsevier Inc. All rights reserved.
Masters, Matthew N; Haardörfer, Regine; Windle, Michael; Berg, Carla
Limited research has examined psychosocial factors that differ among cigarette users, marijuana users, and co-users and influence their cessation efforts. We examined: 1) sociodemographic, mental health, and other substance use in relation to user category; and 2) associations among these factors in relation to recent quit attempts and readiness to quit among single product versus co-users. We used a cross-sectional design to study college students aged 18-25 from seven Georgia campuses, focusing on the 721 reporting cigarette and/or marijuana use in the past 4months (238 cigarette-only; 331 marijuana-only; 152 co-users). Multinomial logistic regression showed that correlates (p'susers were more likely to report readiness to quit and quit attempts of cigarettes versus marijuana (p'susers reported readiness to quit, 41.18% of cigarette-only and 21.75% of marijuana-only users reported recent quit attempts (p's<0.001). Binary logistic regressions indicated distinct correlates of readiness to quit and quit attempts of cigarettes and marijuana. Cessation efforts of the respective products must attend to co-use with the other product to better understand relative perceptions of importance and confidence in quitting and actual cessation efforts. Copyright © 2017 Elsevier Ltd. All rights reserved.
Dunn, L; Ogilvie, A; Pelkonen, M; Notkola, I; Tukiainen, H; Tervahauta, M; Tuomilehto, J; Nissinen, A
Kirandeep Kaur, Shivani Juneja, Sandeep KaushalDepartment of Pharmacology, Dayanand Medical College and Hospital, Ludhiana, Punjab, IndiaWith reference to the article published under the title "Pharmacologic agents for smoking cessation: A clinical review", we would like to add some information related to smoking cessation therapy among pregnant females. In that article, in the nicotine replacement therapy section, pregnancy has been considered as a contraindication...
Kelly, Bridget; Baur, Louise A; Bauman, Adrian E; King, Lesley
Determining children's exposure to food and beverage company sponsorship, and the effect of this exposure, is important in establishing the extent to which there may be health and societal consequences. This paper aimed to provide preliminary evidence on the scope and potential effects on children of unhealthy food and beverage sponsorship. A review of published literature and media and marketing reports was conducted to determine the types of food and beverage sponsorship campaigns that children are exposed to, and the effect of corporate sponsorship (including tobacco and alcohol) on children and adolescents. A large range of food and beverage sponsorship activities, in Australia and internationally, were identified for both school and sport settings. In particular, food and beverage companies have attempted to develop a marketing presence at all levels of professional and community sport. No information was identified measuring the effect of food and beverage company sponsorship on children and adolescents. However, empirical evidence from consumer studies relating to tobacco and alcohol sponsorship has repeatedly demonstrated that sponsorship has an impact on children's product recall and product-related attitudes and behavioural intentions. While there is no available research on the direct effect of food and beverage sponsorship, the demonstrated effects of tobacco and alcohol sponsorship on children's product awareness, preferences and consumption are likely to be applicable to food companies.
Dentists United to Extinguish Tobacco (DUET): a study protocol for a cluster randomized, controlled trial for enhancing implementation of clinical practice guidelines for treating tobacco dependence in dental care settings.
Ostroff, Jamie S; Li, Yuelin; Shelley, Donna R
Although dental care settings provide an exceptional opportunity to reach smokers and provide brief cessation advice and treatment to reduce oral and other tobacco-related health conditions, dental care providers demonstrate limited adherence to evidence-based guidelines for treatment of tobacco use and dependence. Guided by a multi-level, conceptual framework that emphasizes changes in provider beliefs and organizational characteristics as drivers of improvement in tobacco treatment delivery, the current protocol will use a cluster, randomized design and multiple data sources (patient exit interviews, provider surveys, site observations, chart audits, and semi-structured provider interviews) to study the process of implementing clinical practice guidelines for treating tobacco dependence in 18 public dental care clinics in New York City. The specific aims of this comparative-effectiveness research trial are to: compare the effectiveness of three promising strategies for implementation of tobacco use treatment guidelines-staff training and current best practices (CBP), CBP + provider performance feedback (PF), and CBP + PF + provider reimbursement for delivery of tobacco cessation treatment (pay-for-performance, or P4P); examine potential theory-driven mechanisms hypothesized to explain the comparative effectiveness of three strategies for implementation; and identify baseline organizational factors that influence the implementation of evidence-based tobacco use treatment practices in dental clinics. The primary outcome is change in providers' tobacco treatment practices and the secondary outcomes are cost per quit, use of tobacco cessation treatments, quit attempts, and smoking abstinence. We hypothesize that the value of these promising implementation strategies is additive and that incorporating all three strategies (CBP, PF, and P4P) will be superior to CBP alone and CBP + PF in improving delivery of cessation assistance to smokers. The findings
Passey, Megan E; D'Este, Catherine A; Sanson-Fisher, Robert W
As with many Indigenous peoples, smoking rates among Aboriginal Australians are considerably higher than those of the non-Indigenous population. Approximately 50% of Indigenous women smoke during pregnancy, a time when women are more motivated to quit. Antenatal care providers are potentially important change agents for reducing the harms associated with smoking, yet little is known about their knowledge, attitudes or skills, or the factors associated with providing smoking cessation advice. This paper aimed to explore the knowledge and attitudes of health care providers caring for pregnant Australian Aboriginal women with regard to smoking risks and cessation; and to identify factors associated with self-reported assessment of smoking. A cross-sectional survey was undertaken with 127 staff providing antenatal care to Aboriginal women from two jurisdictions: the Northern Territory and New South Wales, Australia. Measures included respondents' estimate of the prevalence of smoking among pregnant women; optimal and actual assessment of smoking status; knowledge of risks associated with antenatal smoking; knowledge of smoking cessation; attitudes to providing cessation advice to pregnant women; and perceived barriers and motivators for cessation for pregnant women. The median provider estimate of the smoking prevalence was 69% (95%CI: 60,70). The majority of respondents considered assessment of smoking status to be integral to antenatal care and a professional responsibility. Most (79%) indicated that they assess smoking status in 100% of clients. Knowledge of risks was generally good, but knowledge of cessation was poor. Factors independently associated with assessing smoking status among all women were: employer service type (p = 0.025); cessation knowledge score (p = 0.011); and disagreeing with the statement that giving advice is not worth it given the low level of success (p = 0.011). Addressing knowledge of smoking risks and cessation counselling is a priority
Passey Megan E
Full Text Available Abstract Background As with many Indigenous peoples, smoking rates among Aboriginal Australians are considerably higher than those of the non-Indigenous population. Approximately 50% of Indigenous women smoke during pregnancy, a time when women are more motivated to quit. Antenatal care providers are potentially important change agents for reducing the harms associated with smoking, yet little is known about their knowledge, attitudes or skills, or the factors associated with providing smoking cessation advice. Methods This paper aimed to explore the knowledge and attitudes of health care providers caring for pregnant Australian Aboriginal women with regard to smoking risks and cessation; and to identify factors associated with self-reported assessment of smoking. A cross-sectional survey was undertaken with 127 staff providing antenatal care to Aboriginal women from two jurisdictions: the Northern Territory and New South Wales, Australia. Measures included respondents' estimate of the prevalence of smoking among pregnant women; optimal and actual assessment of smoking status; knowledge of risks associated with antenatal smoking; knowledge of smoking cessation; attitudes to providing cessation advice to pregnant women; and perceived barriers and motivators for cessation for pregnant women. Results The median provider estimate of the smoking prevalence was 69% (95%CI: 60,70. The majority of respondents considered assessment of smoking status to be integral to antenatal care and a professional responsibility. Most (79% indicated that they assess smoking status in 100% of clients. Knowledge of risks was generally good, but knowledge of cessation was poor. Factors independently associated with assessing smoking status among all women were: employer service type (p = 0.025; cessation knowledge score (p = 0.011; and disagreeing with the statement that giving advice is not worth it given the low level of success (p = 0.011. Conclusions Addressing
Full Text Available Purpose: Homeless adults have a higher prevalence of smoking compared to the general population. Most tobacco cessation efforts have focused on the general population, with limited attention paid to this vulnerable population. In this study, homeless adults as well as shelter staff were interviewed to understand their attitudes and beliefs about smoking and smoking cessation, and receptiveness to smoking cessation interventions. Methods: Semi-structured, one-on-one interviews were audio recorded and transcribed for 13 homeless adult smokers and 9 staff recruited from a homeless shelter in Charleston, South Carolina. Transcripts were analyzed in a systematic manner by independent investigators trained in grounded theory. The constant comparison method was used to code, categorize and synthesize the qualitative data. Results: The majority of smokers interviewed expressed the desire to stop smoking, but felt that stress from being homeless was a barrier to quitting. When asked about different tobacco cessation methods, there was no preferred method and there was skepticism regarding actual effectiveness of different methods, since many had previously been unsuccessful when tried by these smokers. Shelter staff acknowledged that tobacco cessation was important, but did not see it as a priority for shelter residents. Even though cessation medications are available in the shelter clinic, very few of the smokers or shelter staff interviewed were aware of the availability of these medications. Conclusions: This study suggests that adult smokers in a homeless shelter are interested in quitting smoking and receptive toward assistance, but that lack of awareness and perceived importance of cessation among staff is a significant barrier. Providing training to staff and encouraging them to take a proactive approach to tobacco cessation may be an area to focus future cessation interventions.
Heffner, Jaimee L; Wyszynski, Christopher M; Comstock, Bryan; Mercer, Laina D; Bricker, Jonathan
Web-based behavioral interventions for substance use are being developed at a rapid pace, yet there is a dearth of information regarding the most effective methods for recruiting participants into web-based intervention trials. In this paper, we describe our successful recruitment of participants into a pilot trial of web-based Acceptance and Commitment Therapy (ACT) for smoking cessation and compare traditional and web-based methods of recruitment in terms of their effects on baseline participant characteristics, association with study retention and treatment outcome, yield, and cost-effectiveness. Over a 10-week period starting June 15, 2010, we recruited 222 smokers for a web-based smoking cessation study using a variety of recruitment methods. The largest portion of randomized participants were recruited through Google AdWords (36%), followed by medical Internet media (23%), standard media (14%), word of mouth (12%), broadcast emails (11%), and social media (6%). Recruitment source was not related to baseline participant characteristics, 3-month data retention, or 30-day point prevalence smoking abstinence at the 3-month outcome assessment. Cost per randomized participant ranged from $5.27/participant for word of mouth to $172.76/participant for social media, with a mean cost of $42.48/participant. Our diversified approach to recruitment, including both traditional and web-based methods, enabled timely enrollment of participants into the study. Because there was no evidence of a substantive difference in baseline characteristics, retention, or outcomes based on recruitment channel, the yield and cost-effectiveness of recruitment methods may be the more critical considerations in developing a feasible recruitment plan for a web-based smoking cessation intervention study. Copyright © 2013 Elsevier Ltd. All rights reserved.
The study investigated the impact of mindfulness training in fostering tobacco cessation among undergraduates in a Nigerian university. It also observed the moderating effect of self-efficacy on the causal link between mindfulness training and tobacco cessation. Participants were 57 students randomly assigned to ...
Cristina Mae Wood
Full Text Available Tobacco use is the first preventable cause of death. This is associated not only with physical illness and a shorter life expectancy, but also with different mental disorders such as anxiety disorders. Given the low risk perception of use, this paper reports a systematic review of the scientific literature on the relationship between anxiety and tobacco from an emotional perspective, including data on smoking prevalence, factors associated with the onset and maintenance of tobacco use, as well as those factors that hamper smoking cessation and increase relapse rates. The high rates of comorbidity between tobacco use and anxiety disorders make necessary the development of new and better tobacco cessation treatments, especially designed for those smokers with high state anxiety or anxiety sensitivity, with the aim of maximizing the efficacy.
Full Text Available Abstract Background Preventing an epidemic increase in smoking prevalence is a major challenge for developing countries. Ghana, has maintained a low smoking prevalence despite the presence of cigarette manufacturing for many decades. Some of this success may have been contributed by cultural factors and attitudes. We have studied public awareness of health risks, attitudes to smoke-free policy, tobacco advertising/promotion and other factors in a Ghanaian population sample. Methods We used two-stage cluster randomized sampling to study household members aged 14 and over in a representative household sample in the Ashanti Region of Ghana. Results 6258 people, 88% of those eligible, took part in the study. Knowledge of health risks of smoking and passive smoking was high; radio was the main source of such information. Most people work and/or spend time in places where smoking is permitted. There was very strong support (97% for comprehensive smoke-free legislation, particularly among Christians and Muslims. Despite the advertising ban, a third of respondents (35%, particularly in urban areas, had noticed advertising of tobacco or tobacco products, on the radio (72% and television (28%. Among smokers, 76% had attempted to quit in the last 6 months, with the main sources of advice being friends and spouses. Use of nicotine replacement therapy was very rare. Low levels of health awareness were seen in females compared with males (Adjusted Odds Ratio (AOR; 0.51, 95% CI 0.39-0.69, p Conclusion Awareness of health risks and support for smoke-free policy are high in Ghana. Exposure to tobacco advertising or promotion is limited and most smokers have tried to quit. Whether these findings are cause or effect of current low smoking prevalence is uncertain.
Menke J Michael
Education and Prevention has included the goal of identifying and eliminating tobacco related disparities for special populations, including low-income groups. Of importance, in 2008 the Arizona Health Care Cost Containment System was authorized to provide tobacco cessation pharmacotherapy as a covered benefit for its members.
Robertson, J.B.; Bray, J.T.
Using X-ray fluorescence spectrometry, 11 heavy elements at concentrations that are easily detectable have been identified in smokeless tobacco products. These concentrations were found to increase in cheek epithelium samples of the user after exposure to smokeless tobacco. This feasibility study suggests that the level of strontium in the cheek epithelium could be a valid measure of recent smokeless tobacco use. It also demonstrates that strontium levels become undetectable within several days of smokeless tobacco cessation. This absence of strontium could validate a self-report of abstinence from smokeless tobacco. Finally, the X-ray spectrum of heavy metal content of cheek epithelium from smokeless tobacco users could itself provide a visual stimulus to further motivate the user to terminate the use of smokeless tobacco products
Full Text Available Tobacco consumption is a major causative agent for various deadly diseases such as coronary artery disease and cancer. It is the largest avoidable health risk in the world, causing more problems than alcohol, drug use, high blood pressure, excess body weight or high cholesterol. As countries like Indonesia prepare to develop national policy guidelines for tobacco harm reduction, the scientific community can help by providing continuous ideas and a forum for sharing and distributing information, drafting guidelines, reviewing best practices, raising funds, and establishing partnerships. We propose several strategies for reducing tobacco consumption, including advertisement interference, cigarette pricing policy, adolescent smoking prevention policy, support for smoking cessation therapy, special informed consent for smokers, smoking prohibition in public spaces, career incentives, economic incentives, and advertisement incentives. We hope that these strategies would assist people to avoid starting smoking or in smoking cessation.
Thomsen, Thordis; Villebro, N.; Møller, Ann Merete
Background Smokers have a substantially increased risk of postoperative complications. Preoperative smoking intervention may be effective in decreasing this incidence, and surgery may constitute a unique opportunity for smoking cessation interventions. Objectives The objective of this review...... was to assess the effect of preoperative smoking intervention on smoking cessation at the time of surgery and 12 months postoperatively and on the incidence of postoperative complications. Search strategy The specialized register of the Cochrane Tobacco Addiction Group was searched using the free text...... and keywords (surgery) or (operation) or (anaesthesia) or (anesthesia). MEDLINE, EMBASE and CINAHL were also searched, combining tobacco- and surgery-related terms. Most recent search April 2010. Selection criteria Randomized controlled trials that recruited people who smoked prior to surgery, offered...
Chen, Joseph S; Nguyen, Austin Huy; Malesker, Mark A; Morrow, Lee E
Although tobacco practices and the effects of tobacco use among the general American population are well described, minimal data exist regarding tobacco use and barriers to smoking cessation among homeless individuals. Anonymous, voluntary surveys based on a previously implemented instrument were completed by 100 smoking individuals residing at a homeless shelter. These surveys assessed high-risk smoking behaviors and respondents' perceived barriers to long-term smoking cessation. Ninety percent of study participants reported engaging in at least one of the high-risk tobacco practices. Nicotine replacement therapy was perceived by respondents to be the most desired form of smoking cessation aid. Excessive stress with use of tobacco smoking to alleviate stress and anxiety was the most significant self-perceived barrier to smoking cessation. High-risk tobacco practices are remarkably common among smoking homeless individuals. Despite literature consistently showing that non-nicotine tobacco cessation pharmacotherapies (varenicline, buproprion) have higher smoking cessation rates, nicotine replacement monotherapy was perceived as more valuable by survey respondents. Although lack of financial resources was expected to be the biggest barrier to successful cessation, social stressors and the use of smoking to cope with homelessness were perceived as a greater obstacle in this cohort. Given the paucity of data on the long-term effects of the high-risk tobacco behaviors reported by these homeless smokers, this study highlights the need for further investigations regarding tobacco use and tobacco cessation in this vulnerable population. Copyright © 2016 by Daedalus Enterprises.
Thomsen, Thordis; Villebro, Nete; Møller, Ann Merete
BACKGROUND: Smokers have a substantially increased risk of postoperative complications. Preoperative smoking intervention may be effective in decreasing this incidence, and surgery may constitute a unique opportunity for smoking cessation interventions. OBJECTIVES: The objectives of this review...... are to assess the effect of preoperative smoking intervention on smoking cessation at the time of surgery and 12 months postoperatively, and on the incidence of postoperative complications. SEARCH METHODS: We searched the Cochrane Tobacco Addiction Group Specialized Register in January 2014. SELECTION CRITERIA......: Randomized controlled trials that recruited people who smoked prior to surgery, offered a smoking cessation intervention, and measured preoperative and long-term abstinence from smoking or the incidence of postoperative complications or both outcomes. DATA COLLECTION AND ANALYSIS: The review authors...
Barnes, Jo; Dong, Christine Y; McRobbie, Hayden; Walker, Natalie; Mehta, Monaz; Stead, Lindsay F
Hypnotherapy is widely promoted as a method for aiding smoking cessation. It is proposed to act on underlying impulses to weaken the desire to smoke or strengthen the will to stop. To evaluate the efficacy of hypnotherapy for smoking cessation. We searched the Cochrane Tobacco Addiction Group Specialized Register and the databases MEDLINE, EMBASE, AMED, SCI, SSCI using the terms smoking cessation and hypnotherapy or hypnosis. Date of most recent searches July 2010. There were no language restrictions. We considered randomized controlled trials of hypnotherapy which reported smoking cessation rates at least six months after the beginning of treatment. Three authors independently extracted data on participant characteristics, the type and duration of the hypnotherapy, the nature of the control group, smoking status, method of randomization, and completeness of follow up. They also independently assessed the quality of the included studies.The main outcome measure was abstinence from smoking after at least six months follow up. We used the most rigorous definition of abstinence in each trial, and biochemically validated rates where available. Those lost to follow up were considered to be smoking. We summarised effects as risk ratios (RR). Where possible, we performed meta-analysis using a fixed-effect model. We also noted any adverse events reported. Eleven studies compared hypnotherapy with 18 different control interventions. There was significant heterogeneity between the results of the individual studies, with conflicting results for the effectiveness of hypnotherapy compared to no treatment, or to advice, or psychological treatment. We did not attempt to calculate pooled risk ratios for the overall effect of hypnotherapy. There was no evidence of a greater effect of hypnotherapy when compared to rapid smoking or psychological treatment. Direct comparisons of hypnotherapy with cessation treatments considered to be effective had confidence intervals that were too
Baker, Christine L; Ferrufino, Cheryl P; Bruno, Marianna; Kowal, Stacey
Despite abundant information on the negative impacts of smoking, more than 40 million adult Americans continue to smoke. The Affordable Care Act (ACA) requires tobacco cessation as a preventive service with no patient cost share for all FDA-approved cessation medications. Health plans have a vital role in supporting smoking cessation by managing medication access, but uncertainty remains on the gaps between smoking cessation requirements and what is actually occurring in practice. This study presents current cessation patterns, real-world drug costs and plan benefit design data, and estimates the 1- to 5-year pharmacy budget impact of providing ACA-required coverage for smoking cessation products to understand the fiscal impact to a US healthcare plan. A closed cohort budget impact model was developed in Microsoft Excel ® to estimate current and projected costs for US payers (commercial, Medicare, Medicaid) covering smoking cessation medicines, with assumptions for coverage and smoking cessation product utilization based on current, real-world national and state-level trends for hypothetical commercial, Medicare, and Medicaid plans with 1 million covered lives. A Markov methodology with five health states captures quit attempt and relapse patterns. Results include the number of smokers attempting to quit, number of successful quitters, annual costs, and cost per-member per-month (PMPM). The projected PMPM cost of providing coverage for smoking cessation medications is $0.10 for commercial, $0.06 for Medicare, and $0.07 for Medicaid plans, reflecting a low incremental PMPM impact of covering two attempts ranging from $0.01 for Medicaid to $0.02 for commercial and Medicare payers. The projected PMPM impact of covering two quit attempts with access to all seven cessation medications at no patient cost share remains low. Results of this study reinforce that the impact of adopting the ACA requirements for smoking cessation coverage will have a limited near-term impact
Cesar Augusto Oviedo Tejada; Fernanda Ewerling; Anderson Moreira Aristides dos Santos; Andréa Dâmaso Bertoldi; Ana Maria Menezes
Tobacco has been identified as the drug with the highest addiction rate and the leading cause of avoidable deaths. The current study thus aimed to identify the determinants of smoking cessation in a Brazilian population sample based on data from the National Household Sample Survey for 2008. The study analyzed socioeconomic, residential, and health-related data as well as individual habits. Data analysis used Poisson regression. The following factors were associated with smoking cessation: ag...
Soneji, Samir; Yang, JaeWon; Knutzen, Kristin E; Moran, Meghan Bridgid; Tan, Andy S L; Sargent, James; Choi, Kelvin
Nearly 2.9 million US adolescents engaged with online tobacco marketing in 2013 to 2014. We assess whether engagement is a risk factor for tobacco use initiation, increased frequency of use, progression to poly-product use, and cessation. We analyzed data from 11 996 adolescents sampled in the nationally representative, longitudinal Population Assessment for Tobacco and Health study. At baseline (2013-2014), we ascertained respondents' engagement with online tobacco marketing. At follow-up (2014-2015), we determined if respondents had initiated tobacco use, increased frequency of use, progressed to poly-product use, or quit. Accounting for known risk factors, we fit a multivariable logistic regression model among never-users who engaged at baseline to predict initiation at follow-up. We fit similar models to predict increased frequency of use, progression to poly-product use, and cessation. Compared with adolescents who did not engage, those who engaged reported higher incidences of initiation (19.5% vs 11.9%), increased frequency of use (10.3% vs 4.4%), and progression to poly-product use (5.8% vs 2.4%), and lower incidence of cessation at follow-up (16.1% vs 21.5%). Accounting for other risk factors, engagement was positively associated with initiation (adjusted odds ratio [aOR] = 1.26; 95% confidence interval [CI]: 1.01-1.57), increased frequency of use (aOR = 1.58; 95% CI: 1.24-2.00), progression to poly-product use (aOR = 1.70; 95% CI: 1.20-2.43), and negatively associated with cessation (aOR = 0.71; 95% CI: 0.50-1.00). Engagement with online tobacco marketing represents a risk factor for adolescent tobacco use. FDA marketing regulation and cooperation of social-networking sites could limit engagement. Copyright © 2018 by the American Academy of Pediatrics.
Schroeder, Steven A; Clark, Brian; Cheng, Christine; Saucedo, Catherine B
The Smoking Cessation Leadership Center (SCLC) was established in 2003 to increase the rate of smoking cessation attempts and the likelihood those efforts would succeed. Although smoking remains the number one cause of preventable death and disability, clinicians underperform in smoking cessation. Furthermore, many clinical organizations, governmental agencies, and advocacy groups put little effort into smoking cessation. Initially targeted at increasing the efforts of primary care physicians, SCLC efforts expanded to include many other medical and non-physician disciplines, ultimately engaging 21 separate specialties. Most clinicians and their organizations are daunted by efforts required to become cessation experts. A compromise solution, Ask, Advise, Refer (to telephone quitlines), was crafted. SCLC also stimulated smoking cessation projects in governmental, not-for-profit, and industry groups, including the Veterans Administration, the Health Resources Services Administration, Los Angeles County, and the Joint Commission. SCLC helped CVS pharmacies to stop selling tobacco products and other pharmacies to increase smoking cessation efforts, provided multiple educational offerings, and distributed $6.4 million in industry-supported smoking cessation grants to 55 organizations plus $4 million in direct SCLC grants. Nevertheless, smoking still causes 540,000 annual deaths in the US. SCLC's work in the field of behavioral health is described in a companion article.
Full Text Available Background. Tobacco smoking and its consequences are a serious public health problem in Romania. Evidence-based data on factors associated with successful smoking cessation are crucial to optimize tobacco control. The aim of the study was to determine the sociodemographic and other factors associated with smoking cessation success among adults. Materials and Methods. Data was from a sample of 4,517 individuals derived from the Global Adult Tobacco Survey (GATS. GATS is a cross-sectional, nationally representative household survey implemented in Romania in 2011. Data was analyzed with logistic regression. Results. Among females, the quit rate was 26.3% compared with 33.1% in males (P<0.02. We found disparities in cessation success among the analyzed groups of respondents. Being economically active, being aged 40 and above, and having an awareness of smoking health consequences were associated with long-term quitting smoking among men, while initiating smoking at a later age increased the odds of quitting smoking among women. However, cohabitation with nonsmokers was the strongest predictor of successful cessation among both genders. Conclusion. Programs increasing quit rates and encourage cessation among groups less likely to quit, adopting voluntary smoke-free homes, and increasing the awareness of smoking and tobacco pollution risks are needed.
Lee, Youn Ok; Momin, Behnoosh; Hansen, Heather; Duke, Jennifer; Harms, Kristin; McCartney, Amanda; Neri, Antonio; Kahende, Jennifer; Zhang, Lei; Stewart, Sherri L
Digital media are often used to encourage smoking cessation by increasing quitline call volume through direct promotion to smokers or indirect promotion to smoker proxies. The documentation of a program's experiences utilizing digital media is necessary to develop both the knowledge base and a set of best practices. This case study highlights the use of digital media in a proxy-targeted campaign to promote the California Smokers' Helpline to health care professionals from October 2009 to September 2012. We describe the iterative development of the campaign's digital media activities and report campaign summaries of web metrics (website visits, webinar registrations, downloads of online materials, online orders for promotional materials) and media buy (gross impressions) tracking data. The campaign generated more than 2.7 million gross impressions from digital media sources over 3 years. Online orders for promotional materials increased almost 40% over the course of the campaign. A clearly defined campaign strategy ensured that there was a systematic approach in developing and implementing campaign activities and ensuring that lessons learned from previous years were incorporated. Discussion includes lessons learned and recommendations for future improvements reported by campaign staff to inform similar efforts using digital media.
Health professionals’ perceptions of the barriers and facilitators to providing smoking cessation advice to women in pregnancy and during the post-partum period: a systematic review of qualitative research
Full Text Available Abstract Background Reducing smoking in pregnancy is a policy priority in many countries and as a result there has been a rise in the development of services to help pregnant women to quit. A wide range of professionals are involved in providing these services, with midwives playing a particularly pivotal role. Understanding professionals’ experiences of providing smoking cessation support in pregnancy can help to inform the design of interventions as well as to improve routine care. Methods A synthesis of qualitative research of health professionals’ perceptions of the barriers and facilitators to providing smoking cessation advice to women in pregnancy and the post-partum period was conducted using meta-ethnography. Searches were undertaken from 1990 to January 2015 using terms for maternity health professionals and smoking cessation advisors, pregnancy, post-partum, smoking, and qualitative in seven electronic databases. The review was reported in accordance with the ‘Enhancing transparency in reporting the synthesis of qualitative research’ (ENTREQ statement. Results Eight studies reported in nine papers were included, reporting on the views of 190 health professionals/key informants, including 85 midwives and health visitors. The synthesis identified that both the professional role of participants and the organisational context in which they worked could act as either barriers or facilitators to an individual’s ability to provide smoking cessation support to pregnant or post-partum women. Underpinning these factors was an acknowledgment that the association between maternal smoking and social disadvantage was a considerable barrier to addressing and supporting smoking cessation Conclusions The review identifies a role for professional education, both pre-qualification and in continuing professional development that will enable individuals to provide smoking cessation support to pregnant women. Key to the success of this education
Tobacco use including cigarette smoking is an ... Employers thus have an important role to play in instituting workplace ... prohibited use of print and electronic media, including television ..... knowledge about smoking cessation interventions in.
White, A R; Rampes, H; Ernst, E
Acupuncture is promoted as a treatment for smoking cessation, and is believed to reduce withdrawal symptoms. The objective of this review is to determine the effectiveness of acupuncture in smoking cessation in comparison with: a) sham acupuncture b) other interventions c) no intervention. We searched the Cochrane Tobacco Addiction Group trials register, Medline, PsycLit, Dissertation Abstracts, Health Planning and Administration, Social SciSearch, Smoking & Health, Embase, Biological Abstracts and DRUG. Randomised trials comparing a form of acupuncture with either sham acupuncture, another intervention or no intervention for smoking cessation. We extracted data in duplicate on the type of subjects, the nature of the acupuncture and control procedures, the outcome measures, method of randomisation, and completeness of follow-up. We assessed abstinence from smoking at the earliest time-point (before 6 weeks), at six months and at one year follow-up in patients smoking at baseline. We used the most rigorous definition of abstinence for each trial, and biochemically validated rates if available. Those lost to follow-up were counted as continuing to smoke. Where appropriate, we performed meta-analysis using a fixed effects model. We identified 18 publications involving 20 comparisons. Acupuncture was not superior to sham acupuncture in smoking cessation at any time point. The odds ratio (OR) for early outcomes was 1.22 (95% confidence interval 0.99 to 1.49); the OR after 6 months was 1.38 (95% confidence interval 0.90 to 2.11) and after 12 months 1.02 (95% confidence interval 0.72 to 1.43). Similarly, when acupuncture was compared with other anti-smoking interventions, there were no differences in outcome at any time point. Acupuncture appeared to be superior to no intervention in the early results, but this difference was not sustained. The results with different acupuncture techniques do not show any one particular method (i.e. auricular acupuncture or non
Vinci, Christine; Haslam, Aaron; Lam, Cho Y; Kumar, Santosh; Wetter, David W
Ambulatory assessment of smoking behavior has greatly advanced our knowledge of the smoking cessation process. The current article first provides a brief overview of ecological momentary assessment for smoking cessation and highlights some of the primary advantages and scientific advancements made from this data collection method. Next, a discussion of how certain data collection tools (i.e., smoking topography and carbon monoxide detection) that have been traditionally used in lab-based settings are now being used to collect data in the real world. The second half of the paper focuses on the use of wearable wireless sensors to collect data during the smoking cessation process. Details regarding how these sensor-based technologies work, their application to newer tobacco products, and their potential to be used as intervention tools are discussed. Specific focus is placed on the opportunity to utilize novel intervention approaches, such as Just-In-Time Adaptive Interventions, to intervene upon smoking behavior. Finally, a discussion of some of the current challenges and limitations related to using sensor-based tools for smoking cessation are presented, along with suggestions for future research in this area. Copyright © 2018 Elsevier Ltd. All rights reserved.
Burgess, Diana; Fu, Steven S; Joseph, Anne M; Hatsukami, Dorothy K; Solomon, Jody; van Ryn, Michelle
A dearth of information exists about American Indians' views about smoking and cessation. We present results from six focus groups conducted among current and former smokers from American Indian communities in the Minneapolis/St. Paul metropolitan area, as part of a larger qualitative study. Findings indicate that, although smoking is common and acceptable among this population, many would like to quit. The majority of focus group participants attempted cessation without the aid of counseling and pharmacotherapy. Many held negative attitudes toward pharmacotherapy for smoking cessation, including worries about side effects, skepticism about effectiveness, and dislike of medications in general. Negative attitudes were grounded partly in a lack of trust in conventional medicine and, for some, were related to historic and continuing racism. Participants also reported a lack of information about tobacco dependence treatment from health care providers, including information about the functional benefits of such treatment. Nonetheless, participants thought smokers might try pharmacotherapy if it was made more accessible in their community and if community members could offer word-of-mouth testimonials regarding its effectiveness. Results point to the need for community- and peer-based smoking cessation treatment in the American Indian community, including accurate information from trusted sources.
Gallagher, Jennifer E.; Alajbeg, Ivan; Buechler, Silvia; Carrassi, Antonio; Hovius, Marjolijn; Jacobs, Annelies; Jenner, Maryan; Kinnunen, Taru; Ulbricht, Sabina; Zoitopoulos, Liana
The tobacco epidemic presents a major public health challenge, globally, and within Europe. The aim of the Public Health Work Stream at the 2nd European Workshop on Tobacco Use Prevention and Cessation for Oral Health Professionals was to review the public health aspects of tobacco control and make
Jacobs, Megan A; Cobb, Caroline O; Abroms, Lorien; Graham, Amanda L
smoking cessation apps available within Facebook. Among those available, adherence to cessation treatment guidelines was low. Smoking cessation interventions provided via the Facebook platform are a unique and as yet untapped treatment strategy that can harness existing social support and social networks for quitting. Research is needed to examine whether apps that adhere to clinical practice guidelines for tobacco dependence treatment are more effective in promoting cessation than those that do not.
Amemori, Masamitsu; Virtanen, Jorma; Korhonen, Tellervo; Kinnunen, Taru H; Murtomaa, Heikki
Tobacco use adversely affects oral health. Clinical guidelines recommend that oral health professionals promote tobacco abstinence and provide patients who use tobacco with brief tobacco use cessation counselling. Research shows that these guidelines are seldom implemented successfully. This study aimed to evaluate two interventions to enhance tobacco use prevention and cessation (TUPAC) counselling among oral health professionals in Finland. We used a cluster-randomized community trial to test educational and fee-for-service interventions in enhancing TUPAC counselling among a sample of dentists (n=73) and dental hygienists (n=22) in Finland. Educational intervention consisted of 1 day of training, including lectures, interactive sessions, multimedia demonstrations and a role play session with standard patient cases. Fee-for-service intervention consisted of monetary compensation for providing tobacco use prevention or cessation counselling. TUPAC counselling procedures provided were reported and measured using an electronic dental records system. In data analysis, intent-to-treat principles were followed at both individual and cluster levels. Descriptive analysis included chi-square and t-tests. A general linear model for repeated measures was used to compare the outcome measures by intervention group. Of 95 providers, 73 participated (76.8%). In preventive counselling, there was no statistically significant time effect or group-by-time interaction. In cessation counselling, statistically significant group-by-time interaction was found after a 6-month follow-up (F=2.31; P=0.007), indicating that counselling activity increased significantly in intervention groups. On average, dental hygienists showed greater activity in tobacco prevention (F=12.13; P=0.001) and cessation counselling (F=30.19; PTUPAC counselling performance. Other approaches than monetary incentives may be needed to enhance the effectiveness of educational intervention. Further studies with focus
Whitsel, Laurie P; Benowitz, Neal; Bhatnagar, Aruni; Bullen, Chris; Goldstein, Fred; Matthias-Gray, Lena; Grossmeier, Jessica; Harris, John; Isaac, Fikry; Loeppke, Ron; Manley, Marc; Moseley, Karen; Niemiec, Ted; OʼBrien, Vince; Palma-Davis, LaVaughn; Pronk, Nico; Pshock, Jim; Stave, Gregg M; Terry, Paul
In recent years, new products have entered the marketplace that complicate decisions about tobacco control policies and prevention in the workplace. These products, called electronic cigarettes (e-cigarettes) or electronic nicotine delivery systems, most often deliver nicotine as an aerosol for inhalation, without combustion of tobacco. This new mode of nicotine delivery raises several questions about the safety of the product for the user, the effects of secondhand exposure, how the public use of these products should be handled within tobacco-free and smoke-free air policies, and how their use affects tobacco cessation programs, wellness incentives, and other initiatives to prevent and control tobacco use. In this article, we provide a background on e-cigarettes and then outline key policy recommendations for employers on how the use of these new devices should be managed within worksite tobacco prevention programs and control policies.
Full Text Available Despite of the accumulation of scientific evidence confirming the health consequences of smoking and the new paradigm of smoking as a disease where nicotine is the drug that modifies the functional and morphological characteristics of the brain in dependent smokers, tobacco smoking continues as an important public health problem in many Latin American countries. In contrast with big advances in the tobacco control area, as an example the Framework Convention on Tobacco Control signed by 168 countries, the role of health professional in the fight against tobacco is still less than ideal. In many Latin American schools of medicine, deficiencies in medical education has led to insecure physicians when they have to motivate their patients to stop smoking or to prevent young people to begin tobacco consumption. If each general practitioner or specialist during their daily medical assistance could talk to their smoker patients about the big benefits of stop smoking and support them to get free of tobacco, we would be winning a battle against smoking. Also if we could achieve generations of young non smoking doctors, who could be a real example for patients, this could also impact the prevalence of smokers. In this article we analyze the neurobiological bases of nicotine addiction, which we think are missing in the medical curriculum and could help doctors to understand tobacco smoking as a disease rather than a risk factor, and discuss the main reasons supporting an urgent change in the medical approach of tobacco cessation in Latin America as well as the need to actualize the medical curriculum in order to give physicians the skills needed to intervene successfully with their smoker patients and to be themselves non smokers.A pesar de que actualmente contamos con una gran cantidad de evidencias científicas que confirman que el tabaquismo es una enfermedad con graves consecuencias para la salud y que la nicotina es una droga o sustancia psicoactiva
Crankshaw, Erik C.; Beach, Robert H.; Austin, W. David; Altman, David G.; Jones, Alison Snow
Purpose: To examine tobacco farmers' attitudes toward tobacco control, public health, and tobacco manufacturers in order to determine the extent to which rapidly changing economic conditions have influenced North Carolina tobacco farmer attitudes in ways that may provide tobacco control advocates with new opportunities to promote tobacco control…
Emery, Rebecca L; Levine, Michele D; Cheng, Yu; Marcus, Marsha D
Exercise has received attention as a method to prevent or reduce postcessation weight gain. However, little is known about how weight changes following quit attempts contribute to the relationship between exercise and smoking cessation. The present study assessed how exercise relates to cessation and whether initial changes in exercise after quitting smoking promote cessation through attenuated weight gain. Weight-concerned women smokers (N = 342) receiving cessation treatment provided biochemical validation of cessation, reported weekly exercise activities, and were weighed at 1, 3, and 6 months following treatment initiation. Survival analyses were used to determine time to and risk of relapse among women who reported engaging in varied levels of exercise at baseline. A mediation analysis was used to examine whether the effect of initial changes in exercise on longer-term cessation was driven by change in weight. All analyses were adjusted for relevant covariates. Women smokers who reported high levels of exercise at baseline were less likely to relapse and returned to smoking more gradually than did women who reported low levels of exercise. Change in weight did not mediate the relationship between exercise and cessation. Cessation interventions utilizing an exercise component may have to develop exercise regimens of either higher duration or greater intensity to produce beneficial cessation outcomes, particularly when targeting sedentary smokers. Given that change in weight did not mediate the relationship between exercise and cessation, it is likely that other mediational processes are involved. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Full Text Available Background: Two-thirds of treatment-seeking smokers are obese or overweight. Most smokers are concerned about gaining weight after quitting. The average smoker experiences modest post-quit weight gain which discourages many smokers from quitting. Although evidence suggests that combined interventions to help smokers quit smoking and prevent weight gain can be helpful, studies have not been replicated in real world settings. Methods: This paper describes recruitment and participant characteristics of the Best Quit Study, a 3-arm randomized controlled trial testing tobacco cessation treatment alone or combined with simultaneous or sequential weight management. Study participants were recruited via tobacco quitlines from August 5, 2013 to December 15, 2014. Results: Statistical analysis on baseline data was conducted in 2015/2016. Among 5082 potentially eligible callers to a tobacco quitline, 2540 were randomized (50% of eligible. Compared with individuals eligible but not randomized, those randomized were significantly more likely to be female (65.7% vs 54.5%, p < 0.01, overweight or obese (76.3% vs 62.5%, p < 0.01, more confident in quitting (p < 0.01, more addicted (first cigarette within 5 min: 50.0% vs 44.4%, p < 0.01, and have a chronic disease (28.6% vs. 24.4%, p < 0.01. Randomized groups were not statistically significantly different on demographics, tobacco or weight variables. Two-thirds of participants were female and white with a mean age of 43. Conclusions: Adding weight management interventions to tobacco cessation quitlines was feasible and acceptable to smokers. If successful for cessation and weight outcomes, a combined intervention may provide a treatment approach for addressing weight gain with smoking cessation through tobacco quitlines. Trial registration: Clinicaltrials.gov NCT01867983. Keywords: Smoking, Weight gain, Quitlines, Simultaneous, Sequential
Rajani A. Dable
Full Text Available Purpose: The aim of this study was to analyze the smoking prevalence among dental students and to assess the need for promoting tobacco education and intervention by exploring their knowledge about smoking related risk factors. The study also examined the attitudes and practices of the students toward tobacco consumption, and their responsibilities toward the community. Methods: In total, 53 male students participated in the study (21 juniors and 32 seniors. The training program was divided into three modules, and the questionnaire was administered before and after the counseling sessions, which provided the comparative data on the students’ views about smoking cessation. Results: The most commonly practiced mode of tobacco consumption was found to be cigarette smoking (90.6 %, while a few consumed Gutkha (9.4%. All the junior students (100% reported to have been benefitted by the counseling program, while 68.8% of the students from the senior group reported the same. Bivariate statistical analysis was conducted using the Pearson’s chi-square test for testing the difference across the age groups. P-values less than 0.05 were considered statistically significant. Conclusion: Curbing tobacco influence on dental students in their initial days can ensure a smoke-free life for them, as well as prevents them from feeling embarrassed or experiencing a lack of confidence while seeing their patients. Thus, tobacco education and intervention programs can motivate the students and increase their potential to be credible advisors regarding smoking cessation.
Bierer, M F; Rigotti, N A
Public policies concerning tobacco shape the environment of the smoker and nonsmoker alike. These policies use diverse means to achieve the common goal of reducing tobacco use and its attendant health consequences. Educational interventions such as warning labels, school curricula, and public service announcements serve to inform the public about the hazards of tobacco smoke. These are countered by the pervasive marketing of tobacco products by the tobacco industry, despite a ban on tobacco advertising on radio and television. Further restrictions on tobacco advertising and promotion have been proposed and await action. Cigarette excise taxes and smoker-nonsmoker insurance premium differentials discourage smoking by making it more costly to purchase cigarettes. Conversely, health insurance reimbursement for smoking cessation programs could reduce the cost of giving up the habit and might encourage cessation. Restricting or banning smoking in public places and workplaces decreases a smoker's opportunities to smoke, further inhibiting this behavior. Reducing the availability of cigarettes to children and adolescents may help to prevent them from starting to smoke. The environment of the smoker is conditioned by this pastiche of influences. Physicians who become involved in tobacco-control issues have the opportunity to alter the environmental influences on their patients. This is likely to be synergistic with physicians' efforts inside the office to encourage individual smokers to quit. As a first step toward advocacy outside the office, physicians can help to create a smoke-free health-care facility in their own institution. Beyond that, advocacy groups or the voluntary health organizations (e.g., American Lung Association) provide avenues for physicians to take a stand on community issues relevant to tobacco control. Physicians who take these steps to alter the environment of smokers beyond the office are likely to magnify the effect of their work with individual
Harrington Kathleen F
Full Text Available Abstract Background E-health tools are a new mechanism to expand patient care, allowing supplemental resources to usual care, including enhanced patient-provider communication. These applications to smoking cessation have yet to be tested in a hospitalized patient sample. This project aims to evaluate the effectiveness and cost-effectiveness of a tailored web-based and e-message smoking cessation program for current smokers that, upon hospital discharge, transitions the patient to continue a quit attempt when home (Decide2Quit. Design A randomized two-arm follow-up design will test the effectiveness of an evidence- and theoretically-based smoking cessation program designed for post-hospitalization. Methods A total of 1,488 patients aged 19 or older, who smoked cigarettes in the previous 30 days, are being recruited from 27 patient care areas of a large urban university hospital. Study-eligible hospitalized patients receiving usual tobacco cessation usual care are offered study referral. Trained hospital staff assist the 744 patients who are being randomized to the intervention arm with registration and orientation to the intervention website. This e-mail and web-based program offers tailored messages as well as education, self-assessment and planning aids, and social support to promote tobacco use cessation. Condition-blind study staff assess participants for tobacco use history and behaviors, tobacco use cost-related information, co-morbidities and psychosocial factors at 0, 3, 6, and 12 months. The primary outcome is self-reported 30-day tobacco abstinence at 6 months follow-up. Secondary outcomes include 7-day point prevalence quit rates at 3-, 6-, and 12-month follow-up, 30-day point prevalence quit rates at 3 and 12 months, biologically confirmed tobacco abstinence at 6-month follow-up, and multiple point-prevalence quit rates based on self-reported tobacco abstinence rates at each follow-up time period. Healthcare utilization and quality
Pokhrel, Pallav; Herzog, Thaddeus A
Despite the lack of clarity regarding their safety and efficacy as smoking cessation aids, electronic cigarettes (e-cigarettes) are commonly used to quit smoking. Currently, little is understood about why smokers may use e-cigarettes for help with smoking cessation compared with other, proven cessation aids. This study aimed to determine the reasons for wanting to quit cigarettes that are associated with the use of e-cigarettes for cessation help versus the use of conventional nicotine replacement therapy (NRT) products (e.g., gums). Cross-sectional, self-report data were obtained from 1,988 multiethnic current daily smokers (M age = 45.1, SD = 13.0; 51.3% women) who had made an average of 8.5 (SD = 18.7) lifetime quit attempts but were not currently engaged in a cessation attempt. Reasons for wanting to quit smoking were assessed by using the Reasons for Quitting scale. Path analyses suggested that among reasons for quitting cigarettes, "immediate reinforcement"-a measure of wanting to quit cigarettes for extrinsic reasons such as bad smell, costliness and untidiness-was significantly associated with having tried e-cigarettes for cessation help, and "concerns about health" was associated with having tried NRT-only use. E-cigarettes appear to provide an alternative "smoking" experience to individuals who wish to quit cigarette smoking because of the immediate, undesirable consequences of tobacco smoking (e.g., smell, ash, litter) rather than concerns about health. Provided that the safety of e-cigarette use is ensured, e-cigarettes may be effectively used to reduce tobacco exposure among smokers who may not want to quit cigarettes for intrinsic motivation. (c) 2015 APA, all rights reserved).
Garrett, Bridgette E; Dube, Shanta R; Babb, Stephen; McAfee, Tim
Comprehensive tobacco prevention and control efforts that include implementing smoke-free air laws, increasing tobacco prices, conducting hard-hitting mass media campaigns, and making evidence-based cessation treatments available are effective in reducing tobacco use in the general population. However, if these interventions are not implemented in an equitable manner, certain population groups may be left out causing or exacerbating disparities in tobacco use. Disparities in tobacco use have, in part, stemmed from inequities in the way tobacco control policies and programs have been adopted and implemented to reach and impact the most vulnerable segments of the population that have the highest rates of smokings (e.g., those with lower education and incomes). Education and income are the 2 main social determinants of health that negatively impact health. However, there are other social determinants of health that must be considered for tobacco control policies to be effective in reducing tobacco-related disparities. This article will provide an overview of how tobacco control policies and programs can address key social determinants of health in order to achieve equity and eliminate disparities in tobacco prevention and control. Tobacco control policy interventions can be effective in addressing the social determinants of health in tobacco prevention and control to achieve equity and eliminate tobacco-related disparities when they are implemented consistently and equitably across all population groups. Taking a social determinants of health approach in tobacco prevention and control will be necessary to achieve equity and eliminate tobacco-related disparities. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: email@example.com.
Pearson, Jennifer; Xiao, Haijun; Stalgaitis, Carolyn; Vallone, Donna
Objectives. We provided estimates of noncombustible tobacco product (electronic nicotine delivery systems [ENDS]; snus; chewing tobacco, dip, or snuff; and dissolvables) use among current and former smokers and examined harm perceptions of noncombustible tobacco products and reasons for their use. Methods. We assessed awareness of, prevalence of, purchase of, harm perceptions of, and reasons for using noncombustible tobacco products among 1487 current and former smokers from 8 US designated market areas. We used adjusted logistic regression to identify correlates of noncombustible tobacco product use. Results. Of the sample, 96% were aware of at least 1 noncombustible tobacco product, but only 33% had used and 21% had purchased one. Noncombustible tobacco product use was associated with being male, non-Hispanic White, younger, and more nicotine dependent. Respondents used noncombustible tobacco products to cut down or quit cigarettes, but only snus was associated with a higher likelihood of making a quit attempt. Users of noncombustible tobacco products, particularly ENDS, were most likely to endorse the product as less harmful than cigarettes. Conclusions. Smokers may use noncombustible tobacco products to cut down or quit smoking. However, noncombustible tobacco product use was not associated with a reduction in cigarettes per day or cessation. PMID:24922154
Kleinfelder, JoAnn; Price, James H; Dake, Joseph A; Jordan, Timothy R; Price, Joy A
The leading cause of preventable death, in the most vulnerable segments of society, whom social workers often counsel, is cigarette smoking. The purpose of this study was to assess tobacco smoking cessation training in clinical social work programs. A valid 21-item questionnaire was sent to the entire population of 189 clinical graduate social work programs identified by the Council on Social Work Education. A three-wave mailing process was used to maximize the return rate. Directors from 112 clinical social work programs returned completed questionnaires (61 percent). The majority (91 percent) of directors reported having never thought about offering formal smoking cessation training, and only nine of the programs (8 percent) currently provided formal smoking cessation education. The three leading barriers to offering smoking cessation education were as follows: not a priority (60 percent), not enough time (55 percent), and not required by the accrediting body (41 percent). These findings indicate that clinical social work students are not receiving standardized smoking cessation education to assist in improving the well-being of their clients. The national accrediting body for graduate clinical social work programs should consider implementing guidelines for smoking cessation training in the curriculums.
Perriot, J; Underner, M; Peiffer, G; Dautzenberg, B
Smoking is the cause of addictive behavior. Tobacco addiction is a chronic disease that makes difficult to stop smoking and leads to further use. Smoking is a risk factor for COPD, asthma and lung cancer; it may be the cause of severe perioperative complications. This finding justifies that smokers benefit from advice of stopping smoking and smoking cessation assistance. Helping patients to stop smoking increases the chances of quitting, improves the prognosis of tobacco-related diseases, the effectiveness of their treatments and the quality of life of the patients. This article updates the modalities of smoking cessation assistance in smokers with COPD, asthma and lung cancer in operated patients. The goal of the management must be the complete cessation of tobacco smoke intoxication, which alone reduces tobacco mortality. Copyright © 2018 Elsevier Masson SAS. All rights reserved.
Parks, Michael J; Kingsbury, John H; Boyle, Raymond G; Choi, Kelvin
Tobacco use is a leading behavioral risk factor for morbidity and mortality, and the tobacco epidemic disproportionately affects low-socioeconomic status (SES) populations. Taxation is effective for reducing cigarette use, and it is an effective population-based policy for reducing SES-related tobacco disparities. However, progress in implementing cigarette excise taxes has stalled across the United States, and there is a dearth of research on the full spectrum of behavioral shifts that result from taxes, particularly among low-SES populations. This project documents the impact of Minnesota's $1.75 cigarette tax increase implemented in 2013. Data come from the 2014 Minnesota Adult Tobacco Survey. Descriptive analyses and Latent Class Analysis (LCA) were used to provide a typology of the tax impact. From the LCA, six classes were identified, and 42% of respondents were classified as reporting action-oriented behavioral change related to the tax-8% reported sustained smoking abstinence. We found differential behavior change across levels of SES. Low-SES and medium/high-SES individuals were equally likely to report complete tobacco cessation, but the prevalence of daily smokers who reported action-oriented behavior without sustained cessation was nearly double for low-SES individuals. Smokers report a range of behavioral changes in response to cigarette taxes, with differences across SES. The majority of smokers, and particularly low-SES smokers, report behavioral steps toward quitting or achieving sustained tobacco cessation in response to cigarette taxes. Complementary population-based programs geared toward assisting individuals, especially low-SES individuals, to achieve continuous tobacco cessation could increase the reach and effectiveness of cigarette taxes. Copyright © 2017 Elsevier Ltd. All rights reserved.
Full Text Available . Very little, however, is known about the biological significance and origin of cis-isomers. Here we show for the first time the accumulation of cis-5-caffeoylquinic acid in cultured tobacco cells treated with different inducers of plant defence...
Bascombe, Ta Misha S.; Scott, Kimberly N.; Ballard, Denise; Smith, Samantha A.; Thompson, Winifred; Berg, Carla J.
Use prevalence of alternative tobacco products and marijuana has increased dramatically. Unfortunately, clinical guidelines have focused on traditional cigarettes with limited attention regarding these emerging public health issues. Thus, it is critical to understand how healthcare professionals view this issue and are responding to it. This…
Cahill, Kate; Hartmann-Boyce, Jamie; Perera, Rafael
Material or financial incentives are widely used in an attempt to precipitate or reinforce behaviour change, including smoking cessation. They operate in workplaces, in clinics and hospitals, and to a lesser extent within community programmes. In this third update of our review we now include trials conducted in pregnant women, to reflect the increasing activity and resources now targeting this high-risk group of smokers. To determine whether incentives and contingency management programmes lead to higher long-term quit rates. We searched the Cochrane Tobacco Addiction Group Specialised Register, with additional searches of MEDLINE, EMBASE, CINAHL and PsycINFO. The most recent searches were in December 2014, although we also include two trials published in 2015. We considered randomised controlled trials, allocating individuals, workplaces, groups within workplaces, or communities to experimental or control conditions. We also considered controlled studies with baseline and post-intervention measures. We include studies in a mixed-population setting (e.g. community-, work-, institution-based), and also, for this update, trials in pregnant smokers. One author (KC) extracted data and a second (JH-B) checked them. We contacted study authors for additional data where necessary. The main outcome measure in the mixed-population studies was abstinence from smoking at longest follow-up, and at least six months from the start of the intervention. In the trials of pregnant smokers abstinence was measured at the longest follow-up, and at least to the end of the pregnancy. Twenty-one mixed-population studies met our inclusion criteria, covering more than 8400 participants. Ten studies were set in clinics or health centres, one in Thai villages served by community health workers, two in academic institutions, and the rest in worksites. All but six of the trials were run in the USA. The incentives included lottery tickets or prize draws, cash payments, vouchers for goods and
Civljak, Marta; Sheikh, Aziz; Stead, Lindsay F; Car, Josip
The Internet has become a regular part of daily life for the majority of people in many parts of the world. It now offers an additional means of effecting changes to behaviour such as smoking. To determine the effectiveness of Internet-based interventions for smoking cessation. We searched the Cochrane Tobacco Addiction Group Specialized Register, with additional searches of MEDLINE, EMBASE, CINAHL, PsycINFO, and Google Scholar. There were no restrictions placed on language of publication or publication date. The most recent search was in June 2010. We included randomized and quasi-randomized trials. Participants were people who smoked, with no exclusions based on age, gender, ethnicity, language or health status. Any type of Internet-based intervention was eligible. The comparison condition could be a no-intervention control or a different Internet site or programme. Methodological and study quality details were extracted using a standardised form. We selected smoking cessation outcomes at short term (one to three months) and long term (6 months or more) follow up, and reported study effects as a risk ratio with 95% confidence intervals. Only limited meta-analysis was performed, as the heterogeneity of the data for populations, interventions and outcomes allowed for very little pooling. Twenty trials met the inclusion criteria. There were more female than male participants. Some Internet programmes were intensive and included multiple outreach contacts with participants, whilst others relied on participants to initiate and maintain use.Ten trials compared an Internet intervention to a non-Internet based smoking cessation intervention or to a no intervention control. Six of these recruited adults, one recruited young adult university students and three recruited adolescents. Two trials of the same intensive automated intervention in populations of adult who smoked showed significantly increased cessation compared to printed self-help materials at 12 months. In one
Keller, Paula A; Schillo, Barbara A; Kerr, Amy N; Lien, Rebecca K; Saul, Jessie; Dreher, Marietta; Lachter, Randi B
Although state quitlines provide free telephone counseling and often include nicotine replacement therapy (NRT), reach remains limited (1-2% in most states). More needs to be done to engage all smokers in the quitting process. A possible strategy is to offer choices of cessation services through quitlines and to reduce registration barriers. In March 2014, ClearWay Minnesota SM implemented a new model for QUITPLAN® Services, the state's population-wide cessation services. Tobacco users could choose the QUITPLAN® Helpline or one or more Individual QUITPLAN® Services (NRT starter kit, text messaging, email program, or quit guide). The program website was redesigned, online enrollment was added, and a new advertising campaign was created and launched. In 2014-2015, we evaluated whether these changes increased reach. We also assessed quit attempts, quit outcomes, predictors of 30-day abstinence, and average cost per quit via a seven-month follow-up survey. Between March 2014-February 2015, 15,861 unique tobacco users registered, which was a 169% increase over calendar year 2013. The majority of participants made a quit attempt (83.7%). Thirty-day point prevalence abstinence rates (responder rates) were 26.1% for QUITPLAN Services overall, 29.6% for the QUITPLAN Helpline, and 25.5% for Individual QUITPLAN Services. Several variables predicted quit outcomes, including receiving only one call from the Helpline and using both the Helpline and the NRT starter kit. Providing greater choice of cessation services and reducing registration barriers have the potential to engage more tobacco users, foster more quit attempts, and ultimately lead to long-term cessation and reductions in prevalence. Copyright © 2016 Elsevier Inc. All rights reserved.
VanDevanter, Nancy; Zhou, Sherry; Katigbak, Carina; Naegle, Madeline; Sherman, Scott; Weitzman, Michael
The purpose of the study was to assess nursing students' knowledge, beliefs, behaviors, and social norms regarding use of alternative tobacco products (ATPs). This anonymous online survey was conducted with all students enrolled in a college of nursing. The survey utilized measures from several national tobacco studies to assess knowledge and beliefs about ATPs (hookahs, cigars or cigarillos, bidis, kreteks, smokeless tobacco, electronic cigarettes) compared to cigarettes, health effects of ATPs, personal use of ATPs, and social norms. Data were analyzed in SPSS 22.0 (SPSS Inc., Chicago, IL, USA). Descriptive statistics and frequencies were performed for basic sociodemographic data. Paired samples t tests were performed to determine differences for scaled measures. Nursing students demonstrated very low levels of knowledge about ATPs and their health consequences, despite high rates of ATP personal use. About 76% of participants reported use of one or more ATPs once or more in their lifetimes. A greater proportion of students had used hookahs or waterpipes (39.6%) compared to cigarettes (32.7%). Nurses' lack of knowledge about the emerging use and health threats associated with ATPs may undermine their ability to provide appropriate tobacco cessation counseling. Research is needed to identify gaps in nurses' education regarding tobacco cessation counseling and to develop new counseling approaches specific to use of ATPs. Nurses play critical roles in counseling their patients for tobacco cessation. Further research and education about the risks presented by ATPs are critical to reducing excess tobacco-related mortality. © 2016 Sigma Theta Tau International.
Mishra, G A; Majmudar, P V; Gupta, S D; Rane, P S; Hardikar, N M; Shastri, S S
India is known as the Business Process Outsourcing (BPO) capital of the world. Safeguarding health of millions of youngsters employed in this new growing economy is an occupational health challenge. This study was initiated in June 2007 in India with the objectives to assess the prevalence of tobacco use and study the factors responsible for initiating and continuing its use. The main aim, however, was to assess the effect of different tobacco cessation intervention strategies, thus identifying effective methods to assist these employees to quit tobacco. This is a 4-arm cluster randomized trial of 18 months duration among 646 BPO employees, working in 4 different BPO units. The employees were invited to participate in interviews following which tobacco users of each BPO were offered specific tobacco cessation interventions to assist them to quit tobacco use. The prevalence of tobacco dependence is 41%, mainly cigarette smoking. The tobacco quit rate is similar (nearly 20%) in the 3 intervention arms. Significantly higher reduction in tobacco consumption of 45% is seen in Arm 4 with the use of pharmacotherapy. BPO employees change jobs frequently, hence follow-up remains a major challenge. Inaccessibility of pharmacotherapy in the developing countries should not deter tobacco cessation efforts as good tobacco quit rates can be achieved with health education and behavioral therapy. Tobacco cessation should be an integral activity in all BPOs, so that the employees receive this service continuously and millions of our youths are protected from the hazards of tobacco.
Whittaker, Robyn; McRobbie, Hayden; Bullen, Chris; Rodgers, Anthony; Gu, Yulong
interventions were predominantly text messaging-based, although several paired text messaging with in-person visits or initial assessments. Two studies gave pre-paid mobile phones to low-income human immunodeficiency virus (HIV)-positive populations - one solely for phone counselling, the other also included text messaging. One study used text messages to link to video messages. Control programmes varied widely. Studies were pooled according to outcomes - some providing measures of continuous abstinence or repeated measures of point prevalence; others only providing 7-day point prevalence abstinence. All 12 studies pooled using their most rigorous 26-week measures of abstinence provided an RR of 1.67 (95% CI 1.46 to 1.90; I(2) = 59%). Six studies verified quitting biochemically at six months (RR 1.83; 95% CI 1.54 to 2.19). The current evidence supports a beneficial impact of mobile phone-based smoking cessation interventions on six-month cessation outcomes. While all studies were good quality, the fact that those studies with biochemical verification of quitting status demonstrated an even higher chance of quitting further supports the positive findings. However, it should be noted that most included studies were of text message interventions in high-income countries with good tobacco control policies. Therefore, caution should be taken in generalising these results outside of this type of intervention and context.
Murukutla, Nandita; Turk, Tahir; Prasad, C V S; Saradhi, Ranjana; Kaur, Jagdish; Gupta, Shefali; Mullin, Sandra; Ram, Faujdar; Gupta, Prakash C; Wakefield, Melanie
Smokeless tobacco consumption in India is a significant source of morbidity and mortality. In order to educate smokeless tobacco users about the health harms of smokeless tobacco and to denormalise tobacco usage and encourage quitting, a national television and radio mass media campaign targeted at smokeless tobacco users was aired for 6 weeks during November and December 2009. The campaign was evaluated with a nationally representative household survey of smokeless tobacco users (n = 2898). The effect of campaign awareness was assessed with logistic regression analysis. The campaign affected smokeless tobacco users as intended: 63% of smokeless-only users and 72% of dual users (ie, those who consumed both smoking and smokeless forms) recalled the campaign advertisement, primarily through television delivery. The vast majority (over 70%) of those aware of the campaign said that it made them stop and think, was relevant to their lives and provided new information. 75% of smokeless-only users and 77% of dual users said that it made them feel concerned about their habit. Campaign awareness was associated with better knowledge, more negative attitudes towards smokeless tobacco and greater cessation-oriented intentions and behaviours among smokeless tobacco users. Social marketing campaigns that utilise mass media are feasible and efficacious interventions for tobacco control in India. Implications for future mass media tobacco control programming in India are discussed.
Lopez-Trigo, Paula; Khanfar, Nile M; Alameddine, Sarah; Harrington, Catherine
CVS Health has taken a strategic marketing move by banning tobacco sales. They risk losing customers who buy medications and cigarettes at their drugstores. They estimate they will lose 2 billion dollars by banning cigarette sales. CVS Health believes they will benefit from being regarded as health care partner by insurers and banning cigarette sales is an important step in being recognized as such. The Affordable Care Act expanded access to pharmacy-based medical clinics, increased affordability of medications, and expanded the clinical role of pharmacists. CVS Health is positioning itself to take advantage of these changes.
Islami, Farhad; Stoklosa, Michal; Drope, Jeffrey; Jemal, Ahmedin
Tobacco smoking is a major worldwide cause of morbidity and mortality from various diseases, including urologic diseases. We reviewed, at global and regional levels, the prevalence and trends of tobacco smoking and legislative and regulatory efforts around tobacco control. We also provided information about electronic cigarette (e-cigarette) use. We used several sources to present the most up-to-date information from national surveys, including the Global Adult Tobacco Survey, the Global Tobacco Control Report, and the Global Youth Tobacco Survey. Smoking prevalence has been decreasing globally, although trends in smoking vary substantially across countries and by gender. Among men, smoking prevalence in most high-income countries started to decrease in the mid-1990s, followed after a few decades by generally smaller decreases in some low- and middle-income countries (LMICs). However, there has been no change, or there has even been an increase, in smoking prevalence in many other LMICs. Countries with the highest male smoking prevalence are located in East Asia, Southeast Asia, and Eastern Europe. Similar to men, smoking prevalence for women has been decreasing in most high-income countries and some LMICs, although the decrease began later and was slower than that for men. Except in a few countries, smoking is much less common for women than for men. Most countries with the highest smoking prevalence in women are in Europe. Countries that have implemented the best practices for tobacco control, including monitoring, smoke-free policies, cessation programs, health warnings, advertising bans, and taxation, have been able to reduce smoking rates and related harms. E-cigarette use has rapidly increased since its introduction to the market. Health care providers should advise smoking patients about quitting smoking. Countries must improve the implementation and enforcement of tobacco control policies. Particular attention should be paid to preventing an increase in
Kozlowski, Lynn T
This article presents policy perspectives on the marketing of smokeless tobacco products to reduce population harm from tobacco use. Despite consensus that smokeless tobacco products as sold in the United States are less dangerous than cigarettes, there is no consensus on how to proceed. Diverse factions have different policy concerns. While the tobacco industry is exempted from U.S. Food and Drug Administration (FDA) oversight, the pharmaceutical industry whose nicotine replacement therapy (NRT) medicines compete with smokeless tobacco as noncombustible nicotine-delivery systems are regulated by the FDA. Some public health experts support smokeless tobacco use to reduce population harm from tobacco; other public health experts oppose promoting smokeless tobacco for harm reduction. Adult consumers can freely purchase currently-marketed smokeless tobacco products and even more-deadly cigarettes. Concerns with and advantages of smokeless tobacco products are discussed. In that noncombustible medicinal nicotine-delivery systems have been proven to be effective smoking-cessation aids, smokeless tobacco, as another source of psychoactive doses of nicotine, could be used similarly, in a dose-response fashion as a smoking-cessation aid (consistent with FDA principles for evaluating generic versions of drugs). Price measures should be used on tobacco products to make costs to consumers proportional to product health risks (which would make smokeless tobacco much cheaper than cigarettes), and smokeless tobacco should be encouraged as an option for smoking cessation in adult smokers, particularly for those who have failed to stop smoking using NRT or other methods.
van den Brand, F A; Nagelhout, G E; Winkens, B; Evers, S M A A; Kotz, D; Chavannes, N H; van Schayck, C P
Stimulating successful tobacco cessation among employees has multiple benefits. Employees who quit tobacco are healthier, more productive, less absent from work, and longer employable than employees who continue to use tobacco. Despite the evidence for these benefits of tobacco cessation, a successful method to stimulate employees to quit tobacco is lacking. The aim of this study is to evaluate whether adding a financial incentive to behavioral support (compared with no additional incentive) is effective and cost-effective in increasing abstinence rates in tobacco smoking employees participating in a smoking cessation group training. In this cluster-randomized trial employees in the intervention and control group both participate in a smoking cessation group training consisting of seven weekly counseling sessions of ninety minutes each. In addition to the training, employees in the intervention group receive a voucher as an incentive for being abstinent from smoking at the end of the training (€50), after three months (€50), after six months (€50), and after one year (€200). The control group does not receive any incentive. The primary outcome is carbon monoxide validated 12-month continuous abstinence from smoking (Russel's standard). Additionally, an economic evaluation is performed from a societal and an employer perspective. The present paper describes the methods and design of this cluster-randomized trial in detail. We hypothesize that the financial incentive for abstinence in the form of vouchers increases abstinence rates over and above the group training. The results of this study can provide important recommendations for enhancement of employee tobacco cessation. Dutch Trial Register: NTR5657 . First received 27-01-2016.
Allegheny County / City of Pittsburgh / Western PA Regional Data Center — The tobacco vendor information provides the location of all tobacco vendors in Allegheny County in 2015. Data was compiled from administrative records managed by...
Ravi Kumar Bhaskar
School based interventions and tobacco education are necessary to prevent initiation and cessation of tobacco use. Legislations related to tobacco control should be enforced to decrease availability, accessibility and affordability of tobacco products. Social norms of tobacco use among parents and others at home as well as at public place should be modified to curb the tobacco use among school students.
Full Text Available Objectives: To explore the tobacco-dependent subject′s perspectives of what measures are likely to work for tobacco cessation. Materials and Methods: Nicotine-dependent male subjects attending a tertiary level de-addiction center in North India were recruited. Demographic and clinical data was recorded. Open-ended questions were asked to know user′s perspective about the measures by which tobacco use can be effectively stopped in the country. The subjects were allowed as many responses as they desired. Results: A total of 46 subjects were recruited. The median age of the sample was 35 years, with median duration of tobacco use being 12 years. All subjects were males, and most were married, employed, and had urban residence. Supply reducing measures were the most commonly reported to stop tobacco (67.4% of subjects followed by people quitting tobacco use by themselves (19.6% and raising awareness through media (13.1%. Conclusion: This pilot study reflects the perspectives of tobacco users for the measures likely to be effective in tobacco cessation. Evaluating the effect of implementation of individual policies may help focusing towards measures that yield greatest benefits.
Mark W. Vander Weg
Full Text Available Abstract Background Tobacco use remains prevalent among Veterans of military service and those residing in rural areas. Smokers frequently experience tobacco-related issues including risky alcohol use, post-cessation weight gain, and depressive symptoms that may adversely impact their likelihood of quitting and maintaining abstinence. Telephone-based interventions that simultaneously address these issues may help to increase treatment access and improve outcomes. Methods This study was a two-group randomized controlled pilot trial. Participants were randomly assigned to an individually-tailored telephone tobacco intervention combining counseling for tobacco use and related issues including depressive symptoms, risky alcohol use, and weight concerns or to treatment provided through their state tobacco quitline. Selection of pharmacotherapy was based on medical history and a shared decision interview in both groups. Participants included 63 rural Veteran smokers (mean age = 56.8 years; 87 % male; mean number of cigarettes/day = 24.7. The primary outcome was self-reported 7-day point prevalence abstinence at 12 weeks and 6 months. Results Twelve-week quit rates based on an intention-to-treat analysis did not differ significantly by group (Tailored = 39 %; Quitline Referral = 25 %; odds ratio [OR]; 95 % confidence interval [CI] = 1.90; 0.56, 5.57. Six-month quit rates for the Tailored and Quitline Referral conditions were 29 and 28 %, respectively (OR; 95 % CI = 1.05; 0.35, 3.12. Satisfaction with the Tailored tobacco intervention was high. Conclusions Telephone-based treatment that concomitantly addresses other health-related factors that may adversely affect quitting appears to be a promising strategy. Larger studies are needed to determine whether this approach improves cessation outcomes. Trial registration ClinicalTrials.gov identifier number NCT01592695 registered 11 April 2012.
Levy, David T; Jeon, Jihyoun; Clarke, John; Gilkeson, Scott; Hall, Tim; Holford, Theodore R; Meza, Rafael
Introduction Smoking remains the leading cause of preventable death in the USA but can be reduced through policy interventions. Computational models of smoking can provide estimates of the projected impact of tobacco control policies and can be used to inform public health decision making. We outline a protocol for simulating the effects of tobacco policies on population health outcomes. Methods and analysis We extend the Smoking History Generator (SHG), a microsimulation model based on data from the National Health Interview Surveys, to evaluate the effects of tobacco control policies on projections of smoking prevalence and mortality in the USA. The SHG simulates individual life trajectories including smoking initiation, cessation and mortality. We illustrate the application of the SHG policy module for four types of tobacco control policies at the national and state levels: smoke-free air laws, cigarette taxes, increasing tobacco control programme expenditures and raising the minimum age of legal access to tobacco. Smoking initiation and cessation rates are modified by age, birth cohort, gender and years since policy implementation. Initiation and cessation rate modifiers are adjusted for differences across age groups and the level of existing policy coverage. Smoking prevalence, the number of population deaths avoided, and life-years gained are calculated for each policy scenario at the national and state levels. The model only considers direct individual benefits through reduced smoking and does not consider benefits through reduced exposure to secondhand smoke. Ethics and dissemination A web-based interface is being developed to integrate the results of the simulations into a format that allows the user to explore the projected effects of tobacco control policies in the USA. Usability testing is being conducted in which experts provide feedback on the interface. Development of this tool is under way, and a publicly accessible website is available at http
Background. Data on tobacco use have informed the effectiveness of South Africa (SA)'s tobacco control strategies over the past 20 years. Objective. To estimate the prevalence of tobacco use in the adult SA population according to certain demographic variables, and identify the factors influencing cessation attempts ...
Samji, Hasina; Wardman, Dennis
Taxation of tobacco is a widely used strategy that promotes smoking cessation among adults and reduces cigarette consumption among continuing smokers. First Nations (FN) populations' tobacco use is estimated to be 2-3 times that of other Canadians and, in part, a reflection that tobacco products purchased on reserve by FN people are tax exempt.…
Mazurek, Jacek M; Syamlal, Girija; King, Brian A; Castellan, Robert M
Smokeless tobacco causes cancers of the oral cavity, esophagus, and pancreas. CDC analyzed National Health Interview Survey (NHIS) data to estimate the proportion of U.S. working adults who used smokeless tobacco in 2005 and 2010, by industry and occupation. This report describes the results of that analysis, which showed no statistically significant change in the prevalence of smokeless tobacco use among workers from 2005 (2.7%) to 2010 (3.0%). In 2010, smokeless tobacco use was highest among adults aged 25-44 years (3.9%), males (5.6%), non-Hispanic whites (4.0%), those with no more than a high school education (3.9%), and those living in the South (3.9%). By industry, the prevalence of smokeless tobacco use ranged from 1.5% in education services to 18.8% in mining industries, and by occupation from 1.3% in office and administrative support to 10.8% in construction and extraction. These findings highlight opportunities for reducing the health and economic burdens of tobacco use among U.S. workers, especially those in certain industries (e.g., mining) and occupations (e.g., construction and extraction) where use of smokeless tobacco is especially common. CDC recommends best practices for comprehensive tobacco control programs, including effective employer interventions, such as providing employee health insurance coverage for proven cessation treatments, offering easily accessible help for those who want to quit, and establishing and enforcing tobacco-free workplace policies.
Glynn, Deirdre A
As a reflection of an exponential increase in smoking rates throughout the world during the last century, the economic and human burden of mortality and morbidity related to smoking is now clearly defined. Smoking cessation is associated with health benefits for people of all ages. In this paper we provide a comprehensive review of current licensed pharmacological smoking cessation agents including efficacy and safety profiles, with comparisons of individual therapies available. Furthermore, we offer a prospective on the need for further testing of other agents including novel avenues of therapy.
... Exposure is High in Multiunit Housing Smokeless Products Electronic Cigarettes Youth Tobacco Prevention Tobacco Products Tobacco Ingredient ... Tweet Share Compartir Find Fact Sheets on Products (Cigars, Bidis and Betel Quid with Tobacco (Gutka) and ...
Bernat, Jennifer K; Ferrer, Rebecca A; Margolis, Katherine A; Blake, Kelly D
Harm perceptions about tobacco products may influence initiation, continued use, and cessation efforts. We assessed associations between adult traditional tobacco product use and absolute harm perceptions of traditional and alternative tobacco products. We also described the topics individuals looked for during their last search for information, their beliefs about chemicals in cigarettes/cigarette smoke, and how both relate to harm perceptions. We ran multivariable models with jackknife replicate weights to analyze data from the 2015 administration of the National Cancer Institute's Health Information National Trends Survey (N=3376). Compared to never users, individuals reported lower perceived levels of harm for products they use. Among current tobacco users, ethnicity, thinking about chemicals in tobacco, and information-seeking were all factors associated with tobacco product harm perceptions. In the full sample, some respondents reported searching for information about health effects and cessation and held misperceptions about the source of chemicals in tobacco. This study fills a gap in the literature by assessing the absolute harm perceptions of a variety of traditional and alternative tobacco products. Harm perceptions vary among tobacco products, and the relationship among tobacco use, information seeking, thoughts about chemicals in tobacco products, and harm perceptions is complex. Data suggest that some individuals search for information about health effects and cessation and hold misperceptions about chemicals in tobacco products. Future inquiry could seek to understand the mechanisms that contribute to forming harm perceptions and beliefs about chemicals in tobacco products. Published by Elsevier Ltd.
Rass, Olga; Pacek, Lauren R; Johnson, Patrick S; Johnson, Matthew W
Awareness and use of electronic cigarettes (e-cigarettes) is increasing. Questions regarding positive (e.g., smoking reduction/cessation) and negative (e.g., delay of cessation) potential public health consequences of e-cigarettes may be informed by studying dual users of e-cigarettes and tobacco cigarettes. A cross-sectional online survey assessed demographics, product use patterns, and beliefs about relative product benefits and harms among dual users (n = 350) in the United States using the website Amazon Mechanical Turk. Compared to tobacco cigarettes, e-cigarettes were used less often and were associated with lower dependence. Participants reported a 30% reduction in self-reported tobacco cigarette smoking since beginning to use e-cigarettes. Reported primary reasons for e-cigarette use were harm reduction and smoking cessation. E-cigarette use was reported as more likely in settings with smoking restrictions and when others' health could be adversely affected. Conversely, participants reported having used tobacco cigarettes more often than e-cigarettes in hedonic situations (e.g., after eating, drinking coffee or alcohol, or having sex), outdoors, or when stressed. Participants were twice as likely to report wanting to quit tobacco cigarettes compared to e-cigarettes in the next year and intended to quit tobacco cigarettes sooner. Tobacco cigarettes were described as more harmful and addictive, but also as more enjoyable than e-cigarettes. Participants provided evidence consistent with both positive and negative public health consequences of e-cigarettes, highlighting the need for experimental research, including laboratory studies and clinical trials. Policies should consider potential public health benefits of e-cigarettes, in addition to potential harms. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
Rass, Olga; Pacek, Lauren R.; Johnson, Patrick S.; Johnson, Matthew W.
Awareness and use of electronic cigarettes (e-cigarettes) is increasing. Questions regarding positive (e.g., smoking reduction/cessation) and negative (e.g., delay of cessation) potential public health consequences of e-cigarettes may be informed by studying dual users of e-cigarettes and tobacco cigarettes. A cross-sectional online survey assessed demographics, product use patterns, and beliefs about relative product benefits and harms among dual users (n = 350) in the United States using the website Amazon Mechanical Turk (MTurk). Compared to tobacco cigarettes, e-cigarettes were used less often and were associated with lower dependence. Participants reported a 30% reduction in self-reported tobacco cigarette smoking since beginning to use e-cigarettes. Reported primary reasons for e-cigarette use were harm reduction and smoking cessation. E-cigarette use was reported as more likely in settings with smoking restrictions and when others’ health could be adversely affected. Conversely, participants reported having used tobacco cigarettes more often than e-cigarettes in hedonic situations (e.g., after eating, drinking coffee or alcohol, or having sex), outdoors, or when stressed. Participants were twice as likely to report wanting to quit tobacco cigarettes compared to e-cigarettes in the next year and intended to quit tobacco cigarettes sooner. Tobacco cigarettes were described as more harmful and addictive, but also more enjoyable than e-cigarettes. Participants provided evidence consistent with both positive and negative public health consequences of e-cigarettes, highlighting the need for experimental research, including laboratory studies and clinical trials. Policies should consider potential public health benefits of e-cigarettes, in addition to potential harms. PMID:26389638
Hall, Amanda K; Mercado, Rebeccah; Anderson-Lewis, Charkarra; Darville, Gabrielle; Bernhardt, Jay M
Games for health, including digital videogames and gaming-based approaches, are increasingly being used in health promotion research and practice. Recently published research has shown that videogames have significant potential to promote healthy behaviors among youth and adolescents. Yet, there is a lack of available evidence-based resources to guide practitioners on the integration of games into tobacco prevention and smoking cessation interventions. To address this gap, expert researchers and game developers were interviewed to further define games for health, explore the current research, and provide recommendations for developing, evaluating, and promoting effective anti-tobacco games. Nationally recognized experts on game development, games for health, tobacco, and health behavior were asked to participate. A qualitative analysis of 25 in-depth individual interviews using a constant comparative approach for emerging themes was conducted. Main themes that emerged from the data analysis included the following: (1) the current state of games for health research to facilitate health behavior change, (2) strategies for how to develop and evaluate games for quality and impact, and (3) recommendations for how to effectively design tobacco prevention and smoking cessation educational videogames that engage youth and adolescents. The synthesized findings identified through these expert interviews offer stakeholders strategies for how to incorporate games for health within their current and future work. Specific recommendations are presented for developers and researchers to consider when developing and evaluating videogames for tobacco prevention and smoking cessation targeted at youth and adolescents.
Godtfredsen, Nina; Prescott, E.; Osler, Merete
daily tobacco consumption of 10 g or more. Using multivariate logistic regression, subjects who reported reduced smoking or who reported smoking cessation were compared with subjects who continued the habit unchanged. RESULTS: After 5 years 13% of the men and 9% of the women had reduced their tobacco...... function and a tobacco consumption of 15-24 g/day. Additional determinants of smoking reduction and cessation such as inhalation habits and sociodemographic variables differed by gender. CONCLUSIONS: Several predictors of smoking reduction and cessation were identified, indicating that these subgroups......BACKGROUND: The aim of this study was to examine the extent and gender distribution of unassisted tobacco reduction and cessation in a cohort of moderate and heavy smokers and to identify possible predictor variables associated with these changes in smoking behavior. METHODS: This was a prospective...
Sobell, Mark B; Peterson, Alan; Sobell, Linda C; Hunter, Christopher; Hunter, Christine
.... Participants are randomly assigned to BCAP or to a Self-Guided Program (SGP) where they receive NRT and a pamphlet discussing change strategies for tobacco cessation, minimizing weight gain, and how to plan for and deal with possible relapses...
Pizzo, Giuseppe; Davis, Joan M; Licata, Maria E; Giuliana, Giovanna
The aim of this study was to assess the level of tobacco dependence education offered by Italian dental hygiene programs. A fifty-question survey was mailed to the thirty-one active public and private dental hygiene programs in Italy during the 2008-09 academic year. The survey assessed faculty confidence in teaching tobacco treatment, which courses contained tobacco dependence content, the number of minutes spent on specific content areas, and the level of clinical competence that dental hygiene graduates should be able to demonstrate. Surveys were returned by sixteen programs for a response rate of 52 percent. Respondents indicated tobacco dependence education was included in clinic or clinic seminar (56 percent), periodontics (44 percent), oral pathology (31 percent), and prevention (19 percent). All programs reported including the effects of tobacco on general and oral diseases in courses. However, more in-depth topics received less curriculum time; these included tobacco treatment strategies (63 percent) and discussion of cessation medications (31 percent). Interestingly, 62 percent of the respondents indicated they expected dental hygiene graduates to demonstrate a tobacco treatment competency level of a moderate intervention or higher (counseling, discussion of medications, follow-up) rather than a brief intervention in which patients are advised to quit then referred to a quitline. The results of this study indicated that Italian dental hygiene students are not currently receiving adequate instruction in tobacco treatment techniques nor are they being adequately assessed. This unique overview of Italian dental hygiene tobacco dependence education provides a basis for further discussion towards a national competency-based curriculum.
The most direct and effective method for reducing tobacco consumption is to increase the price of tobacco products through legislating higher taxes. Raising tobacco prices promotes cessation, stops potential users from starting, and reduces tobacco usage among those who continue to consume it. The World Health ...
Trinh, Kien; Andrews, Laurie; Krause, James; Hanak, Tyler; Lee, Daewoo; Gelb, Michael; Pallanck, Leo
Epidemiological studies have revealed a significantly reduced risk of Parkinson's disease (PD) among coffee and tobacco users, although it is unclear whether these correlations reflect neuroprotective/symptomatic effects of these agents or preexisting differences in the brains of tobacco and coffee users. Here, we report that coffee and tobacco, but not caffeine or nicotine, are neuroprotective in fly PD models. We further report that decaffeinated coffee and nicotine-free tobacco are as neur...
Cockburn, Nicole; Gartner, Coral; Ford, Pauline J
Reducing smoking prevalence among Indigenous Australians is a vital part of closing the health gap between Indigenous and non-Indigenous Australians. Community-controlled health clinics are an important setting for delivering smoking cessation advice and assistance. This study measured tobacco and e-cigarette use, knowledge of smoking-related health effects, motivations to quit and interest in cessation aids. Clients of Aboriginal & Torres Strait Islander Community Health Service dental clinics in Southeast Queensland (n = 421) completed a brief written questionnaire while in the waiting room. Nearly half (n = 184, 47%) of the participants currently smoked daily, of which 9% (n = 7) currently used e-cigarettes. Few smokers (8%, n = 13) had no intention to quit smoking. For current smokers, previously used quit methods were abrupt cessation (42%, n = 78), nicotine replacement therapies (NRT; 25%, n = 45), prescription medications (23%, n = 43), e-cigarettes (9%, n = 17) and other methods (3%, n = 6). Current smokers were most interested in cutting down (85%, n = 110), abrupt cessation (75%, n = 98) and free NRT (72%, n = 101). Fewer (34%, n = 36) were interested in purchasing NRT for smoking cessation. Our study found there was interest in accessing smoking cessation aids among the clients of this community-controlled health clinic, particularly if provided free of charge. Embedding smoking cessation advice and assistance into a range of community-controlled health clinics could provide opportunities for addressing the high smoking prevalence among Indigenous Australians. © 2018 Australasian Professional Society on Alcohol and other Drugs.
Furber, Susan; Jackson, Janet; Johnson, Keryn; Sukara, Radmila; Franco, Lisa
Anecdotal evidence suggests that there are high rates of smoking among Burmese men in Wollongong, Australia. A qualitative study was undertaken to explore the beliefs and experiences of Burmese refugees in Wollongong on smoking to guide the development of smoking cessation interventions. Three focus groups were conducted with Burmese refugees. Ten semi-structured interviews were conducted with service providers involved with Burmese refugees. Qualitative content analysis was used to categorise responses to the questions. Participants were aware of the health effects of tobacco smoking but had little knowledge of support for quitting. Many participants chewed betel quid and were unaware of the health consequences. Service providers noted the lack of resources on smoking and betel quid use for Burmese people. Smoking cessation interventions for Burmese people should consider the co-related use of betel quid due to the possibility of inadvertently encouraging use of betel nut as an alternative to tobacco.
de Almeida, Liz Maria; Cavalcante, Tânia Maria; Casado, Letícia; Fernandes, Elaine Masson; Warren, Charles Wick; Peruga, Armando; Jones, Nathan R; Curi Hallal, Ana Luiza; Asma, Samira; Lee, Juliette
The Global Youth Tobacco Survey (GYTS) in Brazil was developed to provide data on youth tobacco use to the National Tobacco Control Program. The GYTS uses a standardized methodology for constructing sampling frames, selecting schools and classes, preparing questionnaires, carrying out field procedures, and processing data. The GYTS questionnaire is self-administered and includes questions about: initiation; prevalence; susceptibility; knowledge and attitudes; environmental tobacco smoke; cessation; media and advertising. SUDDAN and Epi-Info Software were used for analysis. Weighted analysis was used in order to obtain percentages and 95% confidence intervals. Twenty-three studies were carried out between 2002 and 2005 in Brazilian capitals: 2002 (9); 2003 (4); 2004 (2) and 2005 (9). The total number of students was 22832. The prevalence rate among the cities varied from 6.2% (João Pessoa, 2002) to 17.7% (Porto Alegre, 2002). The tobacco use prevalence rates in 18 Brazilian cities show significant heterogeneity among the macro regions. Data in this report can be used to evaluate the efforts already done and also as baseline for evaluation of new steps for tobacco control in Brazil regarding the goals of the WHO FCTC.
Olsen, G W; Lacy, S E; Sprafka, J M; Arceneaux, T G; Potts, T A; Kravat, B A; Gondek, M R; Bond, G G
This 5-year study of the Dow Chemical Texas Operations 1984-1985 Smoking Cessation Incentive Program (SCIP) evaluated the smoking habits of 1,097 participants and 1,174 nonparticipants. We observed, via questionnaire and saliva cotinine data, that participants were 2.3 times more likely to be long-term (greater than or equal to 5 years) nonusers of tobacco than nonparticipants (10.2% vs 4.4%, P less than or equal to 0.01). However, smoking cessation rates for 3-4 years, 1-2 years, and less than 1 year were similar for participants who remained smokers at the conclusion of SCIP and nonparticipants. Age and the interaction between the management job category and having quit smoking for at least 30 days sometime prior to the worksite program were important predictors of smoking cessation among participants. Thirty-six percent of the participants who were considered exsmokers of 6 months duration at the conclusion of the program in 1985 remained long-term quitters 5 years later. Stress and enjoyment of smoking were the two most important reasons provided by participants for recidivism. The results of this 5-year evaluation demonstrate the heterogeneity of employee participation and success with a worksite smoking cessation program.
Adams, Alex J; Hudmon, Karen Suchanek
To characterize the status of state laws regarding the expansion of pharmacists' prescriptive authority for smoking cessation medications and to summarize frequently asked questions and answers that arose during the associated legislative debates. Legislative language was reviewed and summarized for all states with expanded authority, and literature supporting the pharmacist's capacity for an expanded role in smoking cessation is described. The core elements of autonomous tobacco cessation prescribing models for pharmacists vary across states. Of 7 states that currently have fully or partially delineated protocols, 4 states (Colorado, Idaho, Indiana, New Mexico) include all medications approved by the U.S. Food and Drug Administration for smoking cessation, and 3 (Arizona, California, Maine) include nicotine replacement therapy products only. The state protocol in Oregon is under development. Most states specify minimum cessation education requirements and define specific elements (e.g., patient screening, cessation intervention components, and documentation requirements) for the autonomous prescribing models. Through expanded authority and national efforts to advance the tobacco cessation knowledge and skills of pharmacy students and licensed pharmacists, the profession's role in tobacco cessation has evolved substantially in recent years. Eight states have created, or are in the process of creating, pathways for autonomous pharmacist prescriptive authority. States aiming to advance tobacco control strategies to help patients quit smoking might consider approaches like those undertaken in 8 states. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.
The proposed optimum locations for establishing smoking cessation services are expected to contribute to the enhancement of cancer control in Crete. Furthermore, this study will guide a smoking cessation program in the region of Crete aiming to minimize the burden of tobacco-induced cancers.
Ramsay, Jim; Hoffmann, Anne
The prevalence of college students' tobacco use is widely recognized, but successful cessation and relapse-prevention programs for these smokers have drawn little attention. The authors, who explored the feasibility of training peers to lead cessation and relapse-prevention programs for undergraduates, found a quit rate of 88.2%, suggesting that…
Schoonheim-Klein, M.; Gresnigt, C.; van der Velden, U.
Aim To test whether education of dental students in motivational interviewing (MI) for smoking cessation counselling will increase the number of patients and students who quit smoking and will improve knowledge and attitudes of dental students towards tobacco cessation counselling. Methods Over 2
Villanti, Andrea C.; Cullen, Jennifer; Vallone, Donna M.; Stuart, Elizabeth A.
Sustained mass media campaigns have been recommended to stem the tobacco epidemic in the United States. Propensity score matching (PSM) was used to estimate the effect of awareness of a national smoking cessation media campaign (EX[R]) on quit attempts and cessation-related cognition. Participants were 4,067 smokers and recent quitters aged 18-49…
El Hajj, Dana G; Cook, Paul F; Magilvy, Kathy; Galbraith, Michael E; Gilbert, Lynn; Corwin, Marla
The authors determined the prevalence of smoking among Arab immigrants living in Colorado. The authors also evaluated the relationship between acculturation and tobacco use, including both cigarettes and hookah among Arab immigrants. A cross-sectional survey of 100 adult Arab immigrants living in Colorado was carried out. The results revealed that 19% of the study participants were current cigarette smokers and 21% were current hookah smokers. Participants who were more integrated into Arab culture were more likely to use tobacco products ( p = .03) and to have family members ( p = .02) and friends who use tobacco products ( p = .007). Acculturation plays a major role in affecting the health habits of Arab immigrants living in Colorado, especially in the area of hookah smoking. Understanding some culturally relevant predictors of tobacco use might assist health care providers in designing successful smoking cessation programs.
Full Text Available Introduction: India is the second largest consumer of tobacco in the world, and varieties of both smoked and smokeless tobacco products are widely available. The national program for tobacco control is run like a vertical stand-alone program. There is a lack of understanding of existing opportunities and barriers within the health programs that influence the integration of tobacco control messages into them. The present formative research identifies such opportunities and barriers. Methods: We conducted a multi-step, mixed methodological study of primary care personnel and policy-makers in two Indian states of Andhra Pradesh and Gujarat. The primary purpose of our study was to investigate health worker and policy-maker perceptions on the integration of tobacco control intervention. We systematically collected data in three steps: In Step I, we conducted in-depth interviews (IDIs and focus group discussions with primary care health personnel, Step II consists of a quantitative survey among health care providers (n = 1457 to test knowledge, attitudes and practices in tobacco control and Step III we conducted 75 IDIs with program heads and policy-makers to evaluate the relative congruence of their views on integration of the tobacco control program. Results: Majority of the health care providers recognized tobacco use as a major health problem. There was a general consensus for the need of training for effective dissemination of information from health care providers to patients. Almost 92% of the respondents opined that integration of tobacco control with other health programs will be highly effective to downscale the tobacco epidemic. Conclusions: Our findings suggest the need for integration of tobacco control program into existing health programs. Integration of tobacco control strategies into the health care system within primary and secondary care will be more effective and counseling for tobacco cessation should be available for population
Keyser-Marcus, Lori; Vassileva, Jasmin; Stewart, Karen; Johns, Sade
Smoking remains one of the most preventable causes of morbidity and mortality in the United States (1). A number of factors contribute to the initiation and maintenance of smoking behavior, including psychosocial influences (2,3), neurobehavioral traits (4), and genetic susceptibility (5-7). Prevalence rates of tobacco dependence among individuals with mental health issues are strikingly high when compared to the general population, particularly among individuals with depression and anxiety disorders (8). There are well-established relationships between impulsivity, cue reactivity, and tobacco use in the literature (9). However, the interaction between these relationships remains unclear. The primary goal of this paper is to provide an overview of the existing literature across these domains and explore their interrelationship and subsequent impact on smoking initiation and tobacco dependence. Further, the clinical implications regarding the development of potential targeted smoking cessation strategies for this population are presented.
Donaldson, S I; Dent, C W; Sussman, S; Stoddard, J L; Severson, H H
Although much is known about the characteristics of employees who smoke cigarettes, very little is known about workers who use smokeless tobacco. The current study was designed to understand the characteristics of smokeless tobacco users in relation to their performance at work and compare them with smokers and former tobacco users. Data were collected via interviews and questionnaires from a random sample of employees working at Pacific Lumber Company (N = 146), the largest single-site lumber mill in California. A total of 63 smokeless tobacco users (21 of whom also smoked cigarettes), 43 cigarette smokers, and 40 employees who had successfully quit using tobacco (34 of whom previously used cigarettes only) provided information about their health behavior, quality of work life, and performance at work. Analyses revealed that smokeless tobacco users reported less healthful sleep patterns, drank alcohol more often, were intoxicated more often, reported less job satisfaction and organizational commitment, and reported that both chewers and smokers do not work as hard and take more breaks than do tobacco-free employees (quitters). Specific differences among chewers-only, smokers-only, smokers-and-chewers, and quitters are presented. Results suggest the organizational value of developing worksite cessation programs for smokeless tobacco users.
Balbach, Edith D; Smith, Elizabeth A; Malone, Ruth E
To analyse trial and deposition testimony of tobacco industry executives to determine how they use the concepts of "information" and "choice" and consider how these concepts are related to theoretical models of health behaviour change. We coded and analysed transcripts of trial and deposition testimony of 14 high-level executives representing six companies plus the Tobacco Institute. We conducted an interpretive analysis of industry executives' characterisation of the industry's role as information provider and the agency of tobacco consumers in making "choices". Tobacco industry executives deployed the concept of "information" as a mechanism that shifted to consumers full moral responsibility for the harms caused by tobacco products. The industry's role was characterised as that of impartial supplier of value-free "information", without regard to its quality, accuracy and truthfulness. Tobacco industry legal defences rely on assumptions congruent with and supported by individual rational choice theories, particularly those that emphasise individual, autonomous decision-makers. Tobacco control advocates and health educators must challenge the industry's preferred framing, pointing out that "information" is not value-free. Multi-level, multi-sectoral interventions are critical to tobacco use prevention. Over-reliance on individual and interpersonal rational choice models may have the effect of validating the industry's model of smoking and cessation behaviour, absolving it of responsibility and rendering invisible the "choices" the industry has made and continues to make in promoting the most deadly consumer product ever made.
Ioannidis, John P. A.; Henriksen, Lisa; Prochaska, Judith J.
A billion deaths from tobacco are expected by 2100. Many policy interventions such as increased taxation, restrictions on advertisement, smoking bans, as well as behavioral interventions, such as pharmacological and psychological treatments for smoking cessation, decrease tobacco use, but they reach their limits. Endgame scenarios focusing on tobacco supply rather than demand are increasingly discussed, but meet with resistance by the industry and even by many tobacco control experts. A main ...
Lando, Harry A
This is a personal retrospective in which I describe my career as a smoking cessation researcher and place cessation into an overall perspective of tobacco reduction. I spent approximately the first 15 years focusing primarily upon small group approaches to cessation emphasising relatively intensive behavioural interventions. It became apparent, however, that these types of approaches in isolation, even if broadly disseminated, would have relatively minimal impact on overall tobacco use. In part because I became discouraged with the potential of group programmes to reduce overall smoking prevalence, I began to focus more on population-based studies, especially in the context of 'teachable moments' including pregnancy, hospitalisation, forced abstinence in the military and existing smoking-related disease. I became concerned especially with the fact that there has been relatively little work with hard-core medically compromised smokers. It also became apparent that promoting cessation would be most likely to be effective with a comprehensive evidence-based tobacco reduction strategy including school and community-based prevention programmes, enforcement of ordinances restricting minors' access to tobacco, restrictions on tobacco advertising and promotion, counter advertising and strong smoke-free policies. In recent years I have become very concerned about the overall global tobacco epidemic and the projections of dramatically increasing tobacco morbidity and mortality in developing countries. I am now devoting my primary career emphasis to global tobacco reduction initiatives, including cessation research in India and Indonesia, cessation as part of broader tobacco reduction strategies and networking to increase resources and emphasis devoted to global tobacco reduction.
Hartmann-Boyce, Jamie; Stead, Lindsay F; Cahill, Kate; Lancaster, Tim
The Cochrane Collaboration is an international not-for-profit organization which produces and disseminates systematic reviews of health-care interventions. This paper is the first in a series of annual updates of Cochrane reviews on tobacco addiction interventions. It also provides an up-to-date overview of review findings in this area to date and summary statistics for cessation reviews in which meta-analyses were conducted. In 2012, the Group published seven new reviews and updated 13 others. This update summarizes and comments on these reviews. It also summarizes key findings from all the other reviews in this area. New reviews in 2012 found that in smokers using pharmacotherapy, behavioural support improves success rates [risk ratio (RR) 1.16, 95% confidence interval (CI) = 1.09-1.24], and that combining behavioural support and pharmacotherapy aids cessation (RR 1.82, 95% CI = 1.66-2.00). Updated reviews established mobile phones as potentially helpful in aiding cessation (RR 1.71, 95% CI = 1.47-1.99), found that cytisine (RR 3.98, 95% CI = 2.01-7.87) and low-dose varenicline (RR 2.09, 95% CI = 1.56-2.78) aid smoking cessation, and found that training health professionals in smoking cessation improves patient cessation rates (RR 1.60, 95% CI = 1.26-2.03). The updated reviews confirmed the benefits of nicotine replacement therapy, standard dose varenicline and providing cessation treatment free of charge. Lack of demonstrated efficacy remained for partner support, expired-air carbon monoxide feedback and lung function feedback. Cochrane systematic review evidence for the first time establishes the efficacy of behavioural support over and above pharmacotherapy, as well as the efficacy of cytisine, mobile phone technology, low-dose varenicline and health professional training in promoting smoking cessation. © 2013 Society for the Study of Addiction.
El Hajj, Maguy Saffouh; Kheir, Nadir; Al Mulla, Ahmad Mohd; Al-Badriyeh, Daoud; Al Kaddour, Ahmad; Mahfoud, Ziyad R; Salehi, Mohammad; Fanous, Nadia
It had been reported that up to 37% of the adult male population smokes cigarettes in Qatar. The Global Youth Tobacco Survey also stated that 13.4% of male school students aged 13 to 15 years in Qatar smoke cigarettes. Smoking cessation is key to reducing smoking-related diseases and deaths. Healthcare providers are in an ideal position to encourage smoking cessation. Pharmacists are the most accessible healthcare providers and are uniquely situated to initiate behavior change among patients. Many studies have shown that pharmacists can be successful in helping patients quit smoking. Studies demonstrating the effectiveness of pharmacist-delivered smoking cessation programs are lacking in Qatar. This proposal aims to test the effect of a structured smoking cessation program delivered by trained ambulatory pharmacists in Qatar. A prospective, randomized, controlled trial is conducted at eight ambulatory pharmacies in Qatar. Participants are randomly assigned to receive an at least four-session face-to-face structured patient-specific smoking cessation program conducted by the pharmacist or 5 to 10 min of unstructured brief smoking cessation advice (emulating current practice) given by the pharmacist. Both groups are offered nicotine replacement therapy if feasible. The primary outcome of smoking cessation will be confirmed by an exhaled carbon monoxide test at 12 months. Secondary outcomes constitute quality-of-life adjustment as well as cost analysis of program resources consumed, including per case and patient outcome. If proven to be effective, this smoking cessation program will be considered as a model that Qatar and the region can apply to decrease the smoking burden. Clinical Trials NCT02123329 .
Kelly L Kandra
Full Text Available Electronic cigarettes (e-cigarettes are not currently approved or recommended by the Food and Drug Administration (FDA or various medical organizations; yet, they appear to play a substantial role in tobacco users' cessation attempts. This study reports on a physician survey that measured beliefs, attitudes, and behavior related to e-cigarettes and smoking cessation. To our knowledge this is the first study to measure attitudes toward e-cigarettes among physicians treating adult smokers.Using a direct marketing company, a random sample of 787 North Carolina physicians were contacted in 2013 through email, with 413 opening the email and 128 responding (response rate = 31%. Physicians' attitudes towards e-cigarettes were measured through a series of close-ended questions. Recommending e-cigarettes to patients served as the outcome variable for a logistic regression analysis.Two thirds (67% of the surveyed physicians indicated e-cigarettes are a helpful aid for smoking cessation, and 35% recommended them to their patients. Physicians were more likely to recommend e-cigarettes when their patients asked about them or when the physician believed e-cigarettes were safer than smoking standard cigarettes.Many North Carolina physicians are having conversations about e-cigarettes with their patients, and some are recommending them. Future FDA regulation of e-cigarettes may help provide evidence-based guidance to physicians about e-cigarettes and will help ensure that patients receive evidence-based recommendations about the safety and efficacy of e-cigarettes in tobacco cessation.
Teo, Eng Wah; Lee, Yuin Yi; Khoo, Selina; Morris, Tony
Background Smoking tobacco is a major concern in Malaysia, with 23.1% of Malaysian adults smoking tobacco in 2012. Withdrawal symptoms and self-efficacy to quit smoking have been shown to have significant effects on the outcomes of smoking cessation. The Shiffman-Jarvik Withdrawal Scale (Psychopharmacology, 50: 35-39, 1976) and the Cessation Self-Efficacy Questionnaire (Cognitive Ther Res 5: 175-187, 1981) are two questionnaires that have been widely used in various smoking cessation research...
Krishnan, Nandita; Gittelsohn, Joel; Ross, Alexandra; Elf, Jessica; Chon, Sandy; Niaura, Raymond; Martinson, Neil; Golub, Jonathan E
barriers to smoking cessation that people with HIV face will lead to the development of contextually appropriate interventions. This study also provides feedback on interventions from a recently concluded smoking cessation randomized trial and will help guide the design of future smoking cessation trials. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Yahya, Nurul Asyikin; Saub, Roslan; Nor, Mariani Md; Yusoff, Noriah
Dentists can offer their patients who smoke tobacco assistance with smoking cessation. We conducted this study to assess dental patient knowledge about the effects of smoking and perceptions and attitudes regarding the role of dentists in smoking cessation counselling. We conducted this study to inform tobacco cessation programs that could potentially include dentists. We conducted a cross-sectional study using a self-administered questionnaire among 375 patients. The mean age of subjects was 33.4 years; females comprised 51.5%. Participants were divided into 3 groups: those who never smoked (n = 263, 70.7%), smokers (n = 92, 24.7%), and ex-smokers (n = 17, 4.5%). Significantly more participants (p = 0.046) who never smoked (92.9%) knew smoking can cause bad breath than smokers (86.9%). Significantly more participants (p = 0.002) who never smoked (74.8%) knew smoking can cause periodontal disease than smokers (57.6%). Significantly more participants (p smoked (84.5%) knew smoking can cause oral cancer than smokers (66.7%). Significantly more participants (p smoked (86.7%) knew smoking can cause lung cancer than smokers (69.7%). Significantly more participants who never smoked (85.5%) felt dentists should be interested in the smoking status of their patients (p = 0.004) than smokers (72.6%). Significantly more participants (p = 0.08) who never smoked (69.6%) stated dentists should give smoking cessation advice than smokers/ex-smokers (59.0%). Smoker/ ex-smokers had less knowledge about the effects of smoking on oral and general health than non-smokers. Both smokers/ex-smokers and non-smokers felt dentists should provide smoking cessation advice.
Borderud, Sarah P.; Li, Yuelin; Burkhalter, Jack; Sheffer, Christine E.; Ostroff, Jamie S.
Background Given that continued smoking after a cancer diagnosis increases the risk for adverse health outcomes, cancer patients are strongly advised to quit. Despite a current lack of evidence regarding their safety and effectiveness as a cessation tool, electronic cigarettes (e-cigarettes) are becoming increasingly popular. In order to guide oncologists’ communication with their patients about e-cigarette use, this paper provides the first published clinical data about e-cigarette use and cessation outcomes among cancer patients. Methods Participants (n=1074) included smokers (cancer patients) who recently enrolled in a tobacco treatment program at a comprehensive cancer center. Standard demographic, tobacco use history and follow-up cessation outcomes were assessed. Results A threefold increase in e-cigarette use was observed from 2012 to 2013 (10.6% vs. 38.5%). E-cigarette users were more nicotine dependent than non-users, had more prior quit attempts, and were more likely to be diagnosed with thoracic and head or neck cancers. Using a complete case analysis, e-cigarette users were as likely to be smoking at follow-up as non-users, (OR: 1.0; 95%CI 0.5–1.7). Using an intention to treat analysis, e-cigarette users were twice as likely to be smoking at follow-up as non-users, (OR: 2.0; 95%CI 1.2–3.3). Conclusions The high rate of e-cigarette use observed is consistent with recent papers highlighting increased e-cigarette use in the general population. Our longitudinal findings raise doubt about the utility of e-cigarettes for facilitating smoking cessation among cancer patients. Further research is needed to evaluate the safety and efficacy of e-cigarettes as a cessation treatment for cancer patients. PMID:25252116
Borderud, Sarah P; Li, Yuelin; Burkhalter, Jack E; Sheffer, Christine E; Ostroff, Jamie S
Given that continued smoking after a cancer diagnosis increases the risk of adverse health outcomes, patients with cancer are strongly advised to quit. Despite a current lack of evidence regarding their safety and effectiveness as a cessation tool, electronic cigarettes (E-cigarettes) are becoming increasingly popular. To guide oncologists' communication with their patients about E-cigarette use, this article provides what to the authors' knowledge is the first published clinical data regarding E-cigarette use and cessation outcomes among patients with cancer. A total of 1074 participants included smokers (patients with cancer) who recently enrolled in a tobacco treatment program at a comprehensive cancer center. Standard demographic, tobacco use history, and follow-up cessation outcomes were assessed. A 3-fold increase in E-cigarette use was observed from 2012 to 2013 (10.6% vs 38.5%). E-cigarette users were more nicotine dependent than nonusers, had more prior quit attempts, and were more likely to be diagnosed with thoracic and head or neck cancers. Using a complete case analysis, E-cigarette users were as likely to be smoking at the time of follow-up as nonusers (odds ratio, 1.0; 95% confidence interval, 0.5-1.7). Using an intention-to-treat analysis, E-cigarette users were twice as likely to be smoking at the time of follow-up as nonusers (odds ratio, 2.0; 95% confidence interval, 1.2-3.3). The high rate of E-cigarette use observed is consistent with recent articles highlighting increased E-cigarette use in the general population. The current longitudinal findings raise doubts concerning the usefulness of E-cigarettes for facilitating smoking cessation among patients with cancer. Further research is needed to evaluate the safety and efficacy of E-cigarettes as a cessation treatment for patients with cancer. © 2014 American Cancer Society.
Williams, Geoffrey C; Patrick, Heather; Niemiec, Christopher P; Ryan, Richard M; Deci, Edward L; Lavigne, Holly McGregor
A previous randomized clinical trial based on self-determination theory (SDT) and consistent with the Public Health Service (PHS) Guideline for Treating Tobacco Use and Dependence demonstrated that an intensive intervention could change autonomous self-regulation and perceived competence, which in part facilitated long-term tobacco abstinence. The current article describes a pragmatic comparative effectiveness trial of three SDT-based intensive tobacco-dependence interventions. Eligible participants are randomized to one of the three treatment conditions designed to facilitate long-term maintenance of tobacco abstinence, namely, Community Care (CC), which includes the 6 month SDT-based intervention previously shown to promote autonomous self-regulation, perceived competence, medication use, and tobacco abstinence; Extended Need Support (ENS), which extends the 6 month SDT-based intervention to 12 months and trains an important other to provide support for smokers' basic psychological needs; and Harm Reduction (HR), which provides extended need support and recommends medication use for participants who do not want to stop smoking completely within 30 days but who are willing to reduce their cigarette use by half. The primary outcome is 12 month prolonged abstinence from tobacco, which is assessed one year following termination of treatment (two years post-randomization). Secondary outcomes include 7- and 30 day point prevalence tobacco abstinence, number of days using smoking-cessation medication, change in autonomous self-regulation and perceived competence, and perceived need support from important others. Copyright © 2011 Elsevier Inc. All rights reserved.
Turan, Onur; Turan, Pakize Ayse
Smoking is a serious problem in prisons. This work aimed to assess smoking-related behaviors and the effectiveness of tobacco cessation therapy in prison. This study includes four visits to a prison in Bolvadin-Afyon, Turkey. Pharmacologic options for tobacco cessation were offered to the participants who wanted to quit smoking. One hundred seventy-nine subjects (109 prisoners and 70 prison staff) with 68.7% current smokers were included. There was an increase of cigarette smoking in 41.8% (the most common reason was stress) and decrease in 18.7% (the most common reason was health problems) of the participants after incarceration. Fifty-nine participants accepted the offered tobacco cessation treatment. Only 2 participants started their planned medications, but they could not quit smoking. The most common reason for failed attempts to quit was the high prices of cessation therapies. Factors like stress and being in prison may provoke smoking. A smoking ban does not seem to be a total solution for preventing tobacco use in prisons. Tobacco cessation programs may be a better option. Cost-free cessation medications may increase quitting rates among prisoners and prison staff. Copyright © 2016 by Daedalus Enterprises.
Lepage, Mario; Dumas, Louise; Saint-Pierre, Chantal
Smoking cessation strategies are barely discussed in nursing education programs, even though initial education shapes how future professionals practice their profession. The aim of this research is to describe the practices, attitudes, and beliefs of nursing educators of Quebec with regard to smoking cessation strategies in initial nursing education. A descriptive design was chosen along with an online questionnaire. A total of 278 educators (20.8%) participated in the survey. Although educators recognize the importance of incorporating smoking cessation strategies into their teaching practice, they allocate an average of only one hour per year to the topic. Tobacco use is addressed mostly in terms of risk factors, with little focus on how to help patients quit. The perceived obstacles are related to false beliefs and a lack of knowledge. The results of this study demonstrate the need to raise educators' awareness of the importance of incorporating smoking cessation strategies into classroom teaching. © The Author(s) 2013.
Pazarli Bostan, Pınar; Elbek, Osman; Kilinç, Oğuz; Akçay, Müşerref Şule; Kiran, Sibel
Although helping patients to stop smoking is a good clinical practice that has to be carried out by physicians everywhere and in every area, it is known that carrying out this help systematically in accordance to a programme in smoking cessation outpatient clinics significantly improves the chance of success. The study is a cross-sectional survey performed among chest disease specialists who are members of Turkish Thoracic Society (TTS), between June 2010 and February 2011. As independent variables relevant to status of performing/not performing Smoking Cessation Outpatient Clinic (SCOC); sex, age (younger or older than 40), being graduated before or after 1996, being or not being in a consultant position, work place (Hospital of Ministry of Health/private hospital/university hospital), having or not having an education for smoking cessation help and being or not being member of a City Tobacco Control Committee (CTCC) were investigated. Data was collected via a web-questionnaire prepared by using WHO Global Health Professionals Questionnaire which was sent to members through TTS secreteriat. 41% (699/1701) of members of TTS responded. 39.5% of responders reported that they perform SCOC. When the factors possibly affecting the performance of SCOC are evaluated with logistic regression analysis; being graduated after 1996, having an education for smoking cessation help, being a member of CTCC and not being an active smoker are found to improve this performance. Our study showed that having an education for smoking cessation help (and tobacco control) makes chest disease specialists get more responsibility on this topic. Accordingly, continuous efforts for improving awareness of personal and social responsibilities of all physicians, especially chest disease specialists, have to be made to provide their taking active roles in tobacco control.
Cesar Augusto Oviedo Tejada
Full Text Available Tobacco has been identified as the drug with the highest addiction rate and the leading cause of avoidable deaths. The current study thus aimed to identify the determinants of smoking cessation in a Brazilian population sample based on data from the National Household Sample Survey for 2008. The study analyzed socioeconomic, residential, and health-related data as well as individual habits. Data analysis used Poisson regression. The following factors were associated with smoking cessation: age 45 years or older, higher income, medical consultation in the previous 12 months, private health plan, physical exercise, believing that smoking is bad for one's health and that cigarette smoke is harmful to passive smokers, and Internet access in the household. Subjects with heart conditions, diabetes, and cancer were also more prone to quit smoking.
Tejada, Cesar Augusto Oviedo; Ewerling, Fernanda; Santos, Anderson Moreira Aristides dos; Bertoldi, Andréa Dâmaso; Menezes, Ana Maria
Tobacco has been identified as the drug with the highest addiction rate and the leading cause of avoidable deaths. The current study thus aimed to identify the determinants of smoking cessation in a Brazilian population sample based on data from the National Household Sample Survey for 2008. The study analyzed socioeconomic, residential, and health-related data as well as individual habits. Data analysis used Poisson regression. The following factors were associated with smoking cessation: age 45 years or older, higher income, medical consultation in the previous 12 months, private health plan, physical exercise, believing that smoking is bad for one's health and that cigarette smoke is harmful to passive smokers, and Internet access in the household. Subjects with heart conditions, diabetes, and cancer were also more prone to quit smoking.
Schoj, Veronica; Mejia, Raul; Alderete, Mariela; Kaplan, Celia P.; Peña, Lorena; Gregorich, Steven E.; Alderete, Ethel; Pérez-Stable, Eliseo J.
Background Physician-implemented interventions for smoking cessation are effective but infrequently used. We evaluated smoking cessation practices among physicians in Argentina. Methods A self-administered survey of physicians from six clinical systems asked about smoking cessation counselling practices, barriers to tobacco use counselling and perceived quality of training received in smoking cessation practices. Results Of 254 physicians, 52.3% were women, 11.8% were current smokers and 52% never smoked. Perceived quality of training in tobacco cessation counselling was rated as very good or good by 41.8% and as poor/very poor by 58.2%. Most physicians (90%) reported asking and recording smoking status, 89% advised patients to quit smoking but only 37% asked them to set a quit date and 44% prescribed medications. Multivariate analyses showed that Physicians’ perceived quality of their training in smoking cessation methods was associated with greater use of evidence-based cessation interventions. (OR = 6.5; 95% CI = 2.2–19.1); motivating patients to quit (OR: 7.9 CI 3.44–18.5), assisting patients to quit (OR = 9.9; 95% CI = 4.0–24.2) prescribing medications (OR = 9.6; 95% CI = 3.5–26.7), and setting up follow-up (OR = 13.0; 95% CI = 4.4–38.5). Conclusions Perceived quality of training in smoking cessation was associated with using evidence-based interventions and among physicians from Argentina. Medical training programs should enhance the quality of this curriculum. PMID:27594922
Bekiroglu, Korkut; Russell, Michael A; Lagoa, Constantino M; Lanza, Stephanie T; Piper, Megan E
To understand the dynamic relations among tobacco withdrawal symptoms to inform the development of effective smoking cessation treatments. Dynamical system models from control engineering are introduced and utilized to evaluate complex treatment effects. We demonstrate how dynamical models can be used to examine how distinct withdrawal-related processes are related over time and how treatment influences these relations. Intensive longitudinal data from a randomized placebo-controlled smoking cessation trial (N=1504) are used to estimate a dynamical model of withdrawal-related processes including momentary craving, negative affect, quitting self-efficacy, and cessation fatigue for each of six treatment conditions (nicotine patch, nicotine lozenge, bupropion, patch + lozenge, bupropion + lozenge, and placebo). Estimation and simulation results show that (1) withdrawal measurements are interrelated over time, (2) nicotine patch + nicotine lozenge showed reduced cessation fatigue and enhanced self-efficacy in the long-term while bupropion + nicotine lozenge was more effective at reducing negative affect and craving, and (3) although nicotine patch + nicotine lozenge had a better initial effect on cessation fatigue and self-efficacy, nicotine lozenge had a stronger effect on negative affect and nicotine patch had a stronger impact on craving. This approach can be used to provide new evidence illustrating (a) the total impact of treatment conditions (via steady state values) and (b) the total initial impact (via rate of initial change values) on smoking-related outcomes for separate treatment conditions, noting that the conditions that produce the largest change may be different than the conditions that produce the fastest change. Copyright © 2017 Elsevier B.V. All rights reserved.
Trinh, Kien; Andrews, Laurie; Krause, James; Hanak, Tyler; Lee, Daewoo; Gelb, Michael; Pallanck, Leo
Epidemiological studies have revealed a significantly reduced risk of Parkinson's disease (PD) among coffee and tobacco users, although it is unclear whether these correlations reflect neuroprotective/symptomatic effects of these agents or preexisting differences in the brains of tobacco and coffee users. Here, we report that coffee and tobacco, but not caffeine or nicotine, are neuroprotective in fly PD models. We further report that decaffeinated coffee and nicotine-free tobacco are as neuroprotective as their caffeine and nicotine-containing counterparts and that the neuroprotective effects of decaffeinated coffee and nicotine-free tobacco are also evident in Drosophila models of Alzheimer's disease and polyglutamine disease. Finally, we report that the neuroprotective effects of decaffeinated coffee and nicotine-free tobacco require the cytoprotective transcription factor Nrf2 and that a known Nrf2 activator in coffee, cafestol, is also able to confer neuroprotection in our fly models of PD. Our findings indicate that coffee and tobacco contain Nrf2-activating compounds that may account for the reduced risk of PD among coffee and tobacco users. These compounds represent attractive candidates for therapeutic intervention in PD and perhaps other neurodegenerative diseases.
Tuteja, Narendra; Banu, Mst Sufara Akhter; Huda, Kazi Md Kamrul; Gill, Sarvajeet Singh; Jain, Parul; Pham, Xuan Hoi; Tuteja, Renu
The DEAD-box helicases are required mostly in all aspects of RNA and DNA metabolism and they play a significant role in various abiotic stresses, including salinity. The p68 is an important member of the DEAD-box proteins family and, in animal system, it is involved in RNA metabolism including pre-RNA processing and splicing. In plant system, it has not been well characterized. Here we report the cloning and characterization of p68 from pea (Pisum sativum) and its novel function in salinity stress tolerance in plant. The pea p68 protein self-interacts and is localized in the cytosol as well as the surrounding of cell nucleus. The transcript of pea p68 is upregulated in response to high salinity stress in pea. Overexpression of p68 driven by constitutive cauliflower mosaic virus-35S promoter in tobacco transgenic plants confers enhanced tolerances to salinity stress by improving the growth, photosynthesis and antioxidant machinery. Under stress treatment, pea p68 overexpressing tobacco accumulated higher K+ and lower Na+ level than the wild-type plants. Reactive oxygen species (ROS) accumulation was remarkably regulated by the overexpression of pea p68 under salinity stress conditions, as shown from TBARS content, electrolyte leakage, hydrogen peroxide accumulation and 8-OHdG content and antioxidant enzyme activities. To the best of our knowledge this is the first direct report, which provides the novel function of pea p68 helicase in salinity stress tolerance. The results suggest that p68 can also be exploited for engineering abiotic stress tolerance in crop plants of economic importance.
Full Text Available The DEAD-box helicases are required mostly in all aspects of RNA and DNA metabolism and they play a significant role in various abiotic stresses, including salinity. The p68 is an important member of the DEAD-box proteins family and, in animal system, it is involved in RNA metabolism including pre-RNA processing and splicing. In plant system, it has not been well characterized. Here we report the cloning and characterization of p68 from pea (Pisum sativum and its novel function in salinity stress tolerance in plant.The pea p68 protein self-interacts and is localized in the cytosol as well as the surrounding of cell nucleus. The transcript of pea p68 is upregulated in response to high salinity stress in pea. Overexpression of p68 driven by constitutive cauliflower mosaic virus-35S promoter in tobacco transgenic plants confers enhanced tolerances to salinity stress by improving the growth, photosynthesis and antioxidant machinery. Under stress treatment, pea p68 overexpressing tobacco accumulated higher K+ and lower Na+ level than the wild-type plants. Reactive oxygen species (ROS accumulation was remarkably regulated by the overexpression of pea p68 under salinity stress conditions, as shown from TBARS content, electrolyte leakage, hydrogen peroxide accumulation and 8-OHdG content and antioxidant enzyme activities.To the best of our knowledge this is the first direct report, which provides the novel function of pea p68 helicase in salinity stress tolerance. The results suggest that p68 can also be exploited for engineering abiotic stress tolerance in crop plants of economic importance.
Dozier, A M; Ossip-Klein, D J; Diaz, S; Chin, N P; Sierra, E; Quiñones, Z; Dye, T D; McIntosh, S; Armstrong, L
To conduct formative research on the landscape of tobacco use to guide survey and subsequent intervention development in the Dominican Republic (DR). Rapid Assessment Procedures, systematic qualitative methods (participant-observations, in-depth interviewing, focus groups) using bilingual mixed age and gendered teams from the United States and DR. Over 160 adults (men and women), ages 18 to 90 years, current, former and never smokers, community members and leaders from six underserved, economically disadvantaged DR communities. Key domains: tobacco use patterns and attitudes; factors affecting smoking initiation, continuation, quitting; perceived risks/benefits/effects of smoking; and awareness/effects of advertising/regulations. Perceptions of prevalence varied widely. While "everybody" smokes, smokers or ex-smokers were sometimes difficult to find. Knowledge of health risks was limited to the newly mandated statement "Fumar es prejudicial para la salud" [Smoking is harmful to your health]. Smokers started due to parents, peers, learned lifestyle, fashion or as something to do. Smoking served as an escape, relaxation or diversion. Quit attempts relied on personal will, primarily for religious or medical reasons. Social smoking (custom or habit) (lifestyle choice rather than a vice or addiction. Out of respect, smokers selected where they smoked and around whom. Health care providers typically were reactive relative to tobacco cessation, focusing on individuals with smoking related conditions. Tobacco advertising was virtually ubiquitous. Anti-tobacco messages were effectively absent. Cultures of smoking and not smoking coexisted absent a culture of quitting. Systematic qualitative methods provided pertinent information about tobacco attitudes and use to guide subsequent project steps. Integrating qualitative then quantitative research can be replicated in similar countries that lack empirical data on the cultural dimensions of tobacco use.
Lam, Sum; Patel, Priti N
Tobacco smoking remains a significant health problem in the United States. It has been associated with staggering morbidity and mortality, specifically due to malignancies and cardiovascular disease. Smoking cessation can be difficult and frequently requires pharmacologic interventions in addition to nonpharmacologic measures. Previously available agents are nicotine replacement products and bupropion, which increased quit rates by about 2-fold compared with placebo. Varenicline is the first drug in a new class known as the selective alpha4beta2 nicotinic receptor partial agonists. In several randomized, double-blind, 52-week clinical trials involving healthy chronic smokers, varenicline demonstrated superiority to placebo and bupropion in terms of efficacy measures. Additionally, it improved tobacco withdrawal symptoms and reinforcing effects of smoking in relapsed patients. Patients should start therapy in combination with tobacco cessation counseling 1 week before quit date and continue the regimen for 12 weeks. The dose of varenicline should be titrated to minimize nausea. The recommended dosage is 0.5 mg once daily (QD) on days 1-3; titrate to 0.5 mg twice daily (BID) on days 4-7; and 1 mg BID starting on day 8. An additional 12-week maintenance therapy may be considered for those who achieve abstinence. The most common side effects are nausea (30%), insomnia (18%), headache (15%), abnormal dreams (13%), constipation (8%), and abdominal pain (7%). Overall, varenicline is a breakthrough in the management of tobacco addiction and has demonstrated good efficacy in motivated quitters. It also provides an option for smokers who cannot tolerate other pharmacologic interventions.
Ben Taleb, Ziyad; Ward, Kenneth D; Asfar, Taghrid; Bahelah, Raed; Maziak, Wasim
The development of evidence-based smoking cessation programs is in its infancy in developing countries, which continue to bear the main brunt of the tobacco epidemic. Adherence to treatment recommendations is an important determinant of the success of smoking cessation programs, but little is known about factors influencing adherence to either pharmacological or behavioral treatment in developing countries settings. Our study represents the first attempt to examine the predictors of adherence to cessation treatment in a low-income developing country. Predictors of adherence to pharmacological and behavioral treatment were identified by analyzing data from a multi-site, two-group, parallel-arm, double-blind, randomized, placebo-controlled smoking cessation trial in primary care clinics in Aleppo, Syria. Participants received 3 in-person behavioral counseling sessions plus 5 brief follow-up phone counseling sessions, and were randomized to either 6 weeks of nicotine or placebo patch. Of the 269 participants, 68% adhered to pharmacological treatment, while 70% adhered to behavioral counseling. In logistic regression modeling, lower adherence to pharmacological and behavioral treatment was associated with higher daily smoking at baseline, greater withdrawal symptoms, and perception of receiving placebo instead of active nicotine patch. Women showed lower adherence than men to behavioral treatment, while being assigned to placebo condition and baseline waterpipe use were associated with lower adherence to pharmacological treatment. Adherence to cessation treatment for cigarette smokers in low-income countries such as Syria may benefit from integrated cessation components that provide intensive treatment for subjects with higher nicotine dependence, and address concurrent waterpipe use at all stages. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Amer Siddiq AN
Full Text Available Dentist has long been recognized as a formal health profession. Health professionals have an important role to play in the fight against tobacco. Smoking tobacco is dangerous because it related disease and also due to it being labeled as a gateway to illicit drug abuse. As individuals, the dentist can help educate the population, as community members they can support anti-smoking policies and at a societal level, they can influence national and global tobacco control efforts. The associations between tobacco use and diseases affecting the oral cavity, such as periodontal disease and cancer, are now well recognized. This has lead to proposals from some members of the profession that members of the dental team should provide smoking cessation services. Before exploring effective ways to help smokers quit, it is important to understand the nature of the addictive process and how it affects both nicotine use and cessation attempts. The potential influence of dentists as agents of change is clear from even a brief consideration of the nature and conditions of the dentist-patient relationship. The dental practice setting provides a unique opportunity to assist tobacco users in achieving tobacco abstinence. The role of psychiatrists to support the effort, therefore, becomes all the more important.
Prochaska, Judith J.; Fromont, Sebastien C.; Leek, Desiree; Hudmon, Karen Suchanek; Louie, Alan K.; Jacobs, Marc H.; Hall, Sharon M.
Objective Smokers with mental illness and addictive disorders account for nearly one in two cigarettes sold in the United States and are at high risk for smoking-related deaths and disability. Psychiatry residency programs provide a unique arena for disseminating tobacco treatment guidelines, influencing professional norms, and increasing access to tobacco cessation services among smokers with mental illness. The current study evaluated the Rx for Change in Psychiatry curriculum, developed for psychiatry residency programs and focused on identifying and treating tobacco dependence among individuals with mental illness. Methods The 4-hour curriculum emphasized evidence-based, patient-oriented cessation treatments relevant for all tobacco users, including those not yet ready to quit. The curriculum was informed by comprehensive literature review, consultation with an expert advisory group, faculty interviews, and a focus group with psychiatry residents. This study reports on evaluation of the curriculum in 2005–2006, using a quasi-experimental design, with 55 residents in three psychiatry residency training programs in Northern California. Results The curriculum was associated with improvements in psychiatry residents’ knowledge, attitudes, confidence, and counseling behaviors for treating tobacco use among their patients, with initial changes from pre- to posttraining sustained at 3-months’ follow-up. Residents’ self-reported changes in treating patients’ tobacco use were substantiated through systematic chart review. Conclusion The evidence-based Rx for Change in Psychiatry curriculum is offered as a model tobacco treatment curriculum that can be implemented in psychiatry residency training programs and disseminated widely, thereby effectively reaching a vulnerable and costly population of smokers. PMID:19190293
Zillich, Alan J.; Corelli, Robin L.; Zbikowski, Susan M.; Magnusson, L. Brooke; Fenlon, Christine M.; Prokhorov, Alexander V.; de Moor, Carl; Hudmon, Karen S.
Background Historically, community pharmacies have not integrated tobacco cessation activities into routine practice, instead unbundling them as unique services. This approach might have limited success and viability. Objective The objective of this report is to describe the methods and baseline findings for a two-state, randomized trial evaluating two intervention approaches for increasing pharmacy-based referrals to their state’s tobacco quitline. Methods Participating community pharmacies in Connecticut (n=32) and Washington (n=32) were randomized to receive either (a) on-site education with an academic detailer, describing methods for implementing brief interventions with patients and providing referrals to the tobacco quitline, or (b) quitline materials delivered by mail. Both interventions advocated for pharmacy personnel to ask about tobacco use, advise patients who smoke to quit, and refer patients to the tobacco quitline for additional assistance with quitting. Study outcome measures include the number of quitline registrants who are referred by pharmacies (before and during the intervention period), the number of quitline materials distributed to patients, and self-reported behavior of cessation counseling and quitline referrals, assessed using written surveys completed by pharmacy personnel (pharmacists, technicians). Results Pharmacists (n=124) and pharmacy technicians (n=127), representing 64 participating pharmacies with equal numbers of retail chain and independently-owned pharmacies, participated in the study. Most pharmacists (67%) and half of pharmacy technicians (50%) indicated that they were “not at all” familiar with the tobacco quitline. During the baseline (pre-intervention) monitoring period, the quitline registered 120 patients (18 in CT and 102 in WA) who reported that they heard about the quitline from a pharmacy. Conclusion Novel tobacco intervention approaches are needed to capitalize on the community pharmacy’s frequent
Poulsen, Peter Bo; Dollerup, Jens; Møller, Ann Merete
Tobacco smoke is the leading preventable cause of death in the world. A total of 50% of all smokers will die from a smoking-related disease with a major impact upon quality of life and health-care costs. Tobacco-controlling policies, including smoking cessation, have increasingly been implemented...... across European countries. Reported effectiveness data on smoking cessation interventions are important for decision making....
Cadier, Benjamin; Durand-Zaleski, Isabelle; Thomas, Daniel; Chevreul, Karine
In France more than 70,000 deaths from diseases related to smoking are recorded each year, and since 2005 prevalence of tobacco has increased. Providing free access to smoking cessation treatment would reduce this burden. The aim of our study was to estimate the incremental cost-effectiveness ratios (ICER) of providing free access to cessation treatment taking into account the cost offsets associated with the reduction of the three main diseases related to smoking: lung cancer, chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD). To measure the financial impact of such a measure we also conducted a probabilistic budget impact analysis. We performed a cost-effectiveness analysis using a Markov state-transition model that compared free access to cessation treatment to the existing coverage of €50 provided by the French statutory health insurance, taking into account the cost offsets among current French smokers aged 15-75 years. Our results were expressed by the incremental cost-effectiveness ratio in 2009 Euros per life year gained (LYG) at the lifetime horizon. We estimated a base case scenario and carried out a Monte Carlo sensitivity analysis to account for uncertainty. Assuming a participation rate of 7.3%, the ICER value for free access to cessation treatment was €3,868 per LYG in the base case. The variation of parameters provided a range of ICER values from -€736 to €15,715 per LYG. In 99% of cases, the ICER for full coverage was lower than €11,187 per LYG. The probabilistic budget impact analysis showed that the potential cost saving for lung cancer, COPD and CVD ranges from €15 million to €215 million at the five-year horizon for an initial cessation treatment cost of €125 million to €421 million. The results suggest that providing medical support to smokers in their attempts to quit is very cost-effective and may even result in cost savings.
Graham, Amanda L; Burke, Michael V; Jacobs, Megan A; Cha, Sarah; Croghan, Ivana T; Schroeder, Darrell R; Moriarty, James P; Borah, Bijan J; Rasmussen, Donna F; Brookover, M Jody; Suesse, Dale B; Midthun, David E; Hays, J Taylor
Delivering effective tobacco dependence treatment that is feasible within lung cancer screening (LCS) programs is crucial for realizing the health benefits and cost savings of screening. Large-scale trials and systematic reviews have demonstrated that digital cessation interventions (i.e. web-based and text message) are effective, sustainable over the long-term, scalable, and cost-efficient. Use of digital technologies is commonplace among older adults, making this a feasible approach within LCS programs. Use of cessation treatment has been improved with models that proactively connect smokers to treatment rather than passive referrals. Proactive referral to cessation treatment has been advanced through healthcare systems changes such as modifying the electronic health record to automatically link smokers to treatment. This study evaluates the impact of a proactive enrollment strategy that links LCS-eligible smokers with an evidence-based intervention comprised of a web-based (WEB) program and integrated text messaging (TXT) in a three-arm randomized trial with repeated measures at one, three, six, and 12 months post randomization. The primary outcome is biochemically confirmed abstinence at 12 months post randomization. We will randomize 1650 smokers who present for a clinical LCS to: (1) a usual care control condition (UC) which consists of Ask-Advise-Refer; (2) a digital (WEB + TXT) cessation intervention; or (3) a digital cessation intervention combined with tobacco treatment specialist (TTS) counseling (WEB + TXT + TTS). The scalability and sustainability of a digital intervention may represent the most cost-effective and feasible approach for LCS programs to proactively engage large numbers of smokers in effective cessation treatment. We will also evaluate the impact and cost-effectiveness of adding proven clinical intervention provided by a TTS. We expect that a combined digital/clinical intervention will yield higher quit rates than digital
Orleans, C T
Nicotine addiction is the most common serious medical problem in the country. Tobacco use is responsible for 30% of cancer deaths in the United States and 90% of all lung cancer deaths. The physical addiction to nicotine explains why over 30% of Americans continue to smoke or use tobacco despite their desires and efforts to quit. The testimony summarized in this paper recommends four broad strategies for preventing tobacco-caused cancers in the United States: a) mandating and reimbursing effective treatments for nicotine addiction; b) increasing Federal and state tobacco excise taxes and earmarking a fraction of tax revenues for tobacco prevention and cessation; c) enacting other policy changes to prevent tobacco use and addiction among children, including expanded clean indoor air legislation, comprehensive youth tobacco access legislation, and the regulation of tobacco products and their advertising and promotion; and d) expanding tobacco control research and critical Federal research support. Specific recommendations are given for each broad strategy.
Our findings suggest missed opportunities for youth tobacco use prevention and cessation efforts in the clinical setting. Further research is needed to better facilitate an open dialogue on tobacco use between physicians and their adolescent patients.
Krittanawong, Chayakrit; Wang, Zhen
Smoking cessation is challenging and lack of positive support is a known major barrier to quitting cigarettes. Previous studies have suggested that social influences might increase smokers’ awareness of social norms for appropriate behavior, which might lead to smoking cessation. Although social media use is increasing among young adults in the United States, research on the relationship between social media use and smoking cessation is lacking. Twitter has provided a rich source of informati...
Arora, Monika; Mathur, Manu Raj; Singh, Neha
The objective of this paper is to provide a comprehensive evidence based model aimed at addressing multi-level risk factors influencing tobacco use among children and adolescents with multi-level policy and programmatic approaches in India. Evidences around effectiveness of policy and program interventions from developed and developing countries were reviewed using Pubmed, Scopus, Google Scholar and Ovid databases. This evidence was then categorized under three broad approaches: Policy level approaches (increased taxation on tobacco products, smoke-free laws in public places and work places, effective health warnings, prohibiting tobacco advertising, promotions and sponsorships, and restricting access to minors); Community level approaches (school health programs, mass media campaigns, community based interventions, promoting tobacco free norms) and Individual level approaches (promoting cessation in various settings). This review of literature around determinants and interventions was organized into developing the IMPACT framework. The paper further presents a comparative analysis of tobacco control interventions in India vis a vis the proposed approaches. Mixed results were found for prevention and control efforts targeting youth. However, this article suggests a number of intervention strategies that have shown to be effective. Implementing these interventions in a coordinated way will provide potential synergies across interventions. Pediatricians have prominent role in advocating and implementing the IMPACT framework in countries aiming to prevent and control tobacco use among adolescents and children.
Carter, Stacy M; Chapman, Simon
Community members are occasionally polled about tobacco control policies, but are rarely given opportunities to elaborate on their views. We examined laypeople's conversations to understand how 11 regulatory options were supported or opposed in interactions. Qualitative design; purposive quota sampling; data collection via focus groups. Three locations in Sydney, Australia. 63 smokers and 75 non-smokers, men and women, from three age groups (18-24, 35-44, 55-64 years), recruited primarily via telephone. Semi-structured question route; data managed in NVivo; responses compared between groups. Laypeople rejected some regulatory proposals and certain arguments about taxation and the cost of cessation treatments. Protecting children and hypothecating tobacco excise for health education and care were highly acceptable. Plain packaging, banning retail displays and youth smoking prevention received qualified support. Bans on political donations from tobacco corporations were popular in principle but considered logistically fraught. Smokers asked for better cessation assistance and were curious about cigarette ingredients. Justice was an important evaluative principle. Support was often conditional and unresolved arguments frequent. We present both sides of these conflicts and the ways in which policies were legitimised or de-legitimised in conversation. Simple measures of agreement used in polls may obscure the complexity of community responses to tobacco policy. Support was frequently present but contested; some arguments that seem self-evident to advocates were not so to participants. The detailed understanding of laypeople's responses provided through qualitative methods may help frame proposals and arguments to meet concerns about justice, effectiveness and feasibility.
Turk, Tahir; Chaturvedi, Pankaj; Murukutla, Nandita; Mallik, Vaishakhi; Sinha, Praveen; Mullin, Sandra
The evidence on the efficacy of tobacco control messages in low and middle-income country (LMIC) settings is limited but growing. Low message salience and disengagement, in the face of tobacco control messages, are possible barriers to self-efficacy and cessation-related behaviours of tobacco users. Although adaptations of existing pretested graphic and emotional appeals have been found to impact on behaviours, more personalised, culturally relevant and compelling appeals may more fully engage message receivers to elicit optimal behavioural responses. The objective of these case studies is to use lessons learnt from high-income country tobacco control communication programmes, and adapt practical approaches to provide cost-effective, culturally nuanced, graphic and personalised messages from tobacco victims to achieve the optimal behavioural impact for population-level communication campaigns in the resource-constrained settings of LMICs. The 'raw and real' messaging approach, which emanated from message pretesting in India, outlines creative and production processes for the production of tobacco victim testimonials, given the need to source patients, facing life-threatening conditions. This cost-efficient approach uses real tobacco victims, doctors and family members in a cinéma vérité style approach to achieve more personalised and culturally resonant messages. The methodological approach, used for the development of a number of patient testimonial messages initially in India, and later adapted for tobacco cessation, smoke-free and graphic health warning communication campaigns in other countries, is outlined. Findings from campaigns evaluated to date are encouraging as a result of the simple fact that true stories of local people's suffering are simply too difficult to ignore. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Occhialini, Alessandro; Lin, Myat T; Andralojc, P John; Hanson, Maureen R; Parry, Martin A J
Introducing a carbon-concentrating mechanism and a faster Rubisco enzyme from cyanobacteria into higher plant chloroplasts may improve photosynthetic performance by increasing the rate of CO2 fixation while decreasing losses caused by photorespiration. We previously demonstrated that tobacco plants grow photoautotrophically using Rubisco from Synechococcus elongatus, although the plants exhibited considerably slower growth than wild-type and required supplementary CO2 . Because of concerns that vascular plant assembly factors may not be adequate for assembly of a cyanobacterial Rubisco, prior transgenic plants included the cyanobacterial chaperone RbcX or the carboxysomal protein CcmM35. Here we show that neither RbcX nor CcmM35 is needed for assembly of active cyanobacterial Rubisco. Furthermore, by altering the gene regulatory sequences on the Rubisco transgenes, cyanobacterial Rubisco expression was enhanced and the transgenic plants grew at near wild-type growth rates, although still requiring elevated CO2 . We performed detailed kinetic characterization of the enzymes produced with and without the RbcX and CcmM35 cyanobacterial proteins. These transgenic plants exhibit photosynthetic characteristics that confirm the predicted benefits of introduction of non-native forms of Rubisco with higher carboxylation rate constants in vascular plants and the potential nitrogen-use efficiency that may be achieved provided that adequate CO2 is available near the enzyme. © 2015 The Authors The Plant Journal © 2015 John Wiley & Sons Ltd.
Gamarel, Kristi E; Mereish, Ethan H; Manning, David; Iwamoto, Mariko; Operario, Don; Nemoto, Tooru
Research has demonstrated associations between reports of minority stressors and smoking behaviors among lesbian, gay, and bisexual populations; however, little is known about how minority stressors are related to smoking behaviors and cessation attempts among transgender women. The purpose of this study was twofold: (1) to examine the associations between transgender-based discrimination and smoking patterns among a sample of transgender women; and (2) to identify barriers to smoking cessation in a sample of transgender women with a history of smoking. A community sample of 241 transgender women completed a one-time survey. Binary and multinomial logistic regression models examined associations between minority stressors and (1) smoking behaviors and (2) cessation attempts. Both models adjusted for income, education, race/ethnicity, recent sex work, HIV status, depression, alcohol use, and current hormone use. Overall, 83% of participants indicated that they had smoked a cigarette in the last month. Of these women, 62.3% reported daily smoking and 51.7% reported an unsuccessful quit attempt. Discrimination was positively associated with currently smoking (adjusted odds ratio [AOR] = 1.04, 95% confidence interval [CI]: 1.01, 1.08). Discrimination was positively associated with unsuccessful cessation (AOR = 1.03, 95% CI: 1.01, 1.18) and never attempting (AOR = 1.04, 95% CI: 1.01, 1.11) compared to successful cessation. Discrimination was also positively associated with never attempting compared to unsuccessful cessation (AOR = 1.01, 95% CI: 1.00, 1.03). Smoking cessation may be driven by unique transgender-related minority stressors, such as discrimination. Future research is warranted to address unique stigmatizing contexts when understanding and providing tailored intervention addressing smoking among transgender women. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco 2015. This work is written by (a) US Government
Full Text Available With growing recognition of stagnant rates of attempted cigarette smoking cessation, the current study examined demographic and psychometric characteristics associated with successful and attempted smoking cessation in a nationally representative sample. This additional understanding may help target tobacco cessation treatments toward sub-groups of smokers in order to increase attempts to quit smoking.Data were used from the 2011 U.S. National Health and Wellness Survey (n = 50,000.Current smoking status and demographics, health characteristics, comorbidities, and health behaviors.In 2011, 18%, 29%, and 52% of U.S. adults were current, former, or never smokers, respectively. Over one quarter (27% of current smokers were attempting to quit. Current smokers (vs. others were significantly more likely to be poorer, non-Hispanic White, less educated, ages 45-64, and uninsured, and they had fewer health-conscious behaviors (e.g., influenza vaccination, exercise. Attempting quitters vs. current smokers were significantly less likely to be non-Hispanic White and more likely to be younger, educated, insured, non-obese, with family history of chronic obstructive pulmonary disease, and they had more health-conscious behaviors.Smokers, attempting quitters, and successful quitters differ on characteristics that may be useful for targeting and personalizing interventions aiming to increase cessation attempts, likelihood, and sustainability.
Krittanawong, Chayakrit; Wang, Zhen
Smoking cessation is challenging and lack of positive support is a known major barrier to quitting cigarettes. Previous studies have suggested that social influences might increase smokers' awareness of social norms for appropriate behavior, which might lead to smoking cessation. Although social media use is increasing among young adults in the United States, research on the relationship between social media use and smoking cessation is lacking. Twitter has provided a rich source of information for researchers, but no overview exists as to how the field uses Twitter in smoking cessation research. To the best of our knowledge, this study conducted a data mining analysis of Twitter to assess barriers to smoking cessation. In conclusion, Twitter is a cost-effective tool with the potential to disseminate information on the benefits of smoking cessation and updated research to the Twitter community on a global scale.
Ailsa J McKay
Full Text Available Tobacco control needs in India are large and complex. Evaluation of outcomes to date has been limited.To review the extent of tobacco control measures, and the outcomes of associated trialled interventions, in India.Information was identified via database searches, journal hand-searches, reference and citation searching, and contact with experts. Studies of any population resident in India were included. Studies where outcomes were not yet available, not directly related to tobacco use, or not specific to India, were excluded. Pre-tested proformas were used for data extraction and quality assessment. Studies with reliability concerns were excluded from some aspects of analysis. The Framework Convention on Tobacco Control (FCTC was use as a framework for synthesis. Heterogeneity limited meta-analysis options. Synthesis was therefore predominantly narrative.Additional to the Global Tobacco Surveillance System data, 80 studies were identified, 45 without reliability concerns. Most related to education (FCTC Article 12 and tobacco-use cessation (Article 14. They indicated widespread understanding of tobacco-related harm, but less knowledge about specific consequences of use. Healthcare professionals reported low confidence in cessation assistance, in keeping with low levels of training. Training for schoolteachers also appeared suboptimal. Educational and cessation assistance interventions demonstrated positive impact on tobacco use. Studies relating to smoke-free policies (Article 8, tobacco advertisements and availability (Articles 13 and 16 indicated increasingly widespread smoke-free policies, but persistence of high levels of SHS exposure, tobacco promotions and availability-including to minors. Data relating to taxation/pricing and packaging (Articles 6 and 11 were limited. We did not identify any studies of product regulation, alternative employment strategies, or illicit trade (Articles 9, 10, 15 and 17.Tobacco-use outcomes could be improved
Schoenberg, Nancy E; Bundy, Henry E; Baeker Bispo, Jordan A; Studts, Christina R; Shelton, Brent J; Fields, Nell
Although health promotion programming in faith institutions is promising, most faith-based or placed health projects focus on diet, exercise, or cancer screening and many have been located in urban environments. This article addresses the notable absence of faith programming for smoking cessation among underserved rural US residents who experience tobacco-related health inequities. In this article, we describe our faith-oriented smoking cessation program in rural Appalachia, involving 590 smokers in 26 rural churches randomized to early and delayed intervention groups. We present three main themes that account for participants' positive evaluation of the program; the program's ability to leverage social connections; the program's convenience orientation; and the program's financial support for smoking cessation. We also present themes on the roles of faith and church in smoking cessation programming, including some mixed perceptions on smoking stigma and comfort in church settings; challenges in faith-placed smoking cessation recruitment; and the positive perception of such programming by church leaders. We conclude that faith-placed smoking cessation programs offer great potential, although they must be administered with great sensitivity to individual and community norms.
Williams, Geoffrey C.; Patrick, Heather; Niemiec, Christopher P.; Ryan, Richard M.; Deci, Edward L.; Lavigne, Holly McGregor
A previous randomized clinical trial based on self-determination theory (SDT) and consistent with the Public Health Service (PHS) Guideline for Treating Tobacco Use and Dependence demonstrated that an intensive intervention could change autonomous self-regulation and perceived competence which in part facilitated long-term tobacco abstinence. The current article describes a pragmatic comparative effectiveness trial of three SDT-based intensive tobacco-dependence interventions. Eligible participants are randomized to one of three treatment conditions designed to facilitate long-term maintenance of tobacco abstinence, namely, Community Care (CC), which includes the 6-month SDT-based intervention previously shown to promote autonomous self-regulation, perceived competence, medication use, and tobacco abstinence; Extended Need Support (ENS), which extends the 6-month SDT-based intervention to 12 months and trains an important other to provide support for smokers’ basic psychological needs; and Harm Reduction (HR), which provides extended need support and recommends medication use for participants who do not want to stop smoking completely within 30 days but who are willing to reduce their cigarette use by half. The primary outcome is 12-month prolonged abstinence from tobacco, which is assessed one year following termination of treatment (two years post-randomization). Secondary outcomes include 7- and 30-day point prevalence tobacco abstinence, number of days using smoking-cessation medication, change in autonomous self-regulation and perceived competence, and perceived need support from important others. PMID:21382516
This is a review of tobacco& its products, their health consequences, diseases caused, anaesthetic consider-ations& their role in helping these patients quit smoking Preventing nicotine addiction and improving smoking cessa-tion strategies should be the priority and despite these being only partially successful, strong measures at all levels should he continued& enforced.
Labib, N.A.; Radwan, G.N.; Salma, R.A.A.; Horeesh, N.A.
One of the major barriers to smoking cessation practice is that many health professionals do not have the knowledge and skills on how to intervene. Objectives: To assess the effect of a training program on physicians' knowledge about tobacco dependence and cessation interventions. Subjects and Methods: A comprehensive training program was given to internal medicine residents in Cairo University Hospitals, Egypt during 2008-2009. An anonymous, 11- item questionnaire was administered before and after the training program. The training process was evaluated by participants' satisfaction using a 13- item checklist. The objective of the study was adequately explained to participants and their consensus was obtained with assured confidentiality. Results: A total of 163 internists entered the training program. Improvement in overall knowledge was evidenced by higher mean score in the post-test than pre-test (6.2 vs. 4.7; p<0.001). Significant improvement were seen in the participants' knowledge related to assessment of tobacco dependence (61% vs. 27%;p<0.001), interventions for smokers willing to quit (51.6 vs. 28.2%; p<0.001), interventions for smokers unwilling to quit (40.8 vs. 19.6%; p<0.001) and coping skills to handle withdrawal symptoms (52.9 vs. 30.7;p<0.001). Almost all participants reported that the training was very useful (96%) and applicable (85.6%) in their medical practices. Conclusions: Targeted training of health professionals has a potential to translate into improved smoking cessation counseling and to increase their inclination to intervene. Policy message: Continued medical education and regular/targeted training of health providers should be done. (author)
... and lighters—anything that you connect with your smoking habit. Get rid of all old chewing tobacco containers ... nicotine addiction and more to do with the habit of smoking or using chewing tobacco. Some people gain weight ...
David, A M; Mercado, S P; Klein, J D; Kaundan, M s/o K; Koong, H N; Garcia, E
Non-communicable diseases (NCDs) are generally considered diseases of adulthood, but NCD risk factors like tobacco use often are taken up during childhood and adolescence, and second-hand smoke exposure affects child survival and development. At a regional meeting of the Asia Pacific Child and Family Health Alliance for Tobacco Control, members reviewed existing good practices of child-focused tobacco control approaches using health promotion strategies. These interventions were implemented nationally in Malaysia, the Philippines and Singapore. Three good practice national examples were identified that focused on creating supportive tobacco-free environments and upgrading cessation skills among paediatricians. These country examples highlight strategic areas to protect children and families from the harms of tobacco, as part of NCD prevention and control. Training paediatricians in brief cessation advice has enabled them to address tobacco-using parents. Fully enforcing smoke-free public areas has led to an increase in smoke-free homes. The Tobacco Free Generation is a tobacco control 'endgame' strategy that taps into a social movement to deglamorize tobacco use and empower youth born in and after year 2000 to reject tobacco and nicotine addiction. Tobacco control is pivotal in the fight against NCDs; health promotion strategies to protect children and youth from tobacco have a critical role to play in NCD prevention and control. Frontline health workers, including primary care paediatricians, need to step up and actively advocate for full implementation of the WHO Framework Convention on Tobacco Control, including tobacco tax increases and smoke-free areas, while monitoring patients and their parents for tobacco use and second-hand smoke exposure, preventing adolescent smoking uptake, and offering cessation support. A life-course approach incorporating child-focused efforts to prevent initiation of smoking and second-hand smoke exposure with measures promoting
Bello, Mariel S; Pang, Raina D; Cropsey, Karen L; Zvolensky, Michael J; Reitzel, Lorraine R; Huh, Jimi; Leventhal, Adam M
Persistent tobacco use among racial and ethnic minority populations in the United States is a critical public health concern. Yet, potential sources of racial/ethnic disparities in tobacco use remain unclear. The present study examined racial/ethnic differences in tobacco withdrawal-a clinically-relevant underpinning of tobacco use that has received sparse attention in the disparities literature-utilizing a controlled laboratory design. Daily smokers (non-Hispanic African American [n = 178], non-Hispanic white [n = 118], and Hispanic [n = 28]) attended two counterbalanced sessions (non-abstinent vs. 16-hour abstinent). At both sessions, self-report measures of urge, nicotine withdrawal, and affect were administered and performance on an objective behavioral task that assessed motivation to reinstate smoking was recorded. Abstinence-induced changes (abstinent scores vs. non-abstinent scores) were analyzed as a function of race/ethnicity. Non-Hispanic African American smokers reported greater abstinence-induced declines in several positive affect states in comparison to other racial/ethnic groups. Relative to Hispanic smokers, non-Hispanic African American and non-Hispanic white smokers displayed larger abstinence-provoked increases in urges to smoke. No racial/ethnic differences were detected for a composite measure of nicotine withdrawal symptomatology, negative affect states, and motivation to reinstate smoking behavior. These results suggest qualitative differences in the expression of some components of tobacco withdrawal across three racial/ethnic groups. This research helps shed light on bio-behavioral sources of tobacco-related health disparities, informs the application of smoking cessation interventions across racial/ethnic groups, and may ultimately aid the overall effort towards reducing the public health burden of tobacco addiction in minority populations. The current study provides some initial evidence that there may be qualitative differences in the
Ginexi, Elizabeth M; Vollinger, Robert E
The National Cancer Institute (NCI) has been at the vanguard of funding tobacco control research for decades with major efforts such as the Community Intervention Trial for Smoking Cessation (COMMIT) in 1988 and the American Stop Smoking Intervention Study (ASSIST) in 1991, followed by the Tobacco Research Initiative for State and Community Interventions in 1999. Most recently, in 2011, the NCI launched the State and Community Tobacco Control (SCTC) Research Initiative to address gaps in secondhand smoke policies, tax and pricing policies, mass media countermeasures, community and social norms and tobacco marketing. The initiative supported large scale research projects and time-sensitive ancillary pilot studies in response to expressed needs of state and community partners. This special issue of Tobacco Control showcases exciting findings from the SCTC. In this introductory article, we provide a brief account of NCI's historical commitment to promoting research to inform tobacco control policy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Richter Kimber P
Full Text Available Abstract Most persons in drug treatment smoke cigarettes. Until drug treatment facilities systematically treat their patients' tobacco use, millions will flow through the drug treatment system, overcome their primary drug of abuse, but die prematurely from tobacco-related illnesses. This paper reviews the literature on the health benefits of quitting smoking for drug treatment patients, whether smoking causes relapse to other drug or alcohol abuse, the treatment of tobacco dependence, and good and bad times for quitting smoking among drug treatment patients. It also presents a conceptual model and recommendations for treating tobacco in substance abuse treatment, and provides references to internet and paper-copy tools and information for treating tobacco dependence. At present, research on tobacco treatment in drug treatment is in its infancy. Although few drug treatment programs currently offer formal services, many more will likely begin to treat nicotine dependence as external forces and patient demand for these services increases. In the absence of clear guidelines and attention to quality of care, drug treatment programs may adopt smoking cessation services based on cost, convenience, or selection criteria other than efficacy. Because research in this field is relatively new, substance abuse treatment professionals should adhere to the standards of care for the general population, but be prepared to update their practices with emerging interventions that have proven to be effective for patients in drug treatment.
Barik, Anamitra; Rai, Rajesh Kumar; Chowdhury, Abhijit
Aim To measure the prevalence of self-reported morbidity and its associated factors among adults (aged ⩾15 years) in a select rural Indian population. Self-reporting of smoking has been validated as population-based surveys using self-reported data provide reasonably consistent estimates of smoking prevalence, and are generally considered to be sufficiently accurate for tracking the general pattern of morbidity associated with tobacco use in populations. However, to gauge the true disease burden using self-reported morbidity data requires cautious interpretation. During 2010-2011, a cross-sectional survey was conducted under the banner of the Health and Demographic Surveillance System, Birbhum, an initiative of the Department of Health and Family Welfare, Government of West Bengal, India. With over 93.6% response rate from the population living in 12 300 households, this study uses the responses from 16 354 individuals: 8012 smokers, and 8333 smokeless tobacco users. Smokers and smokeless tobacco users were asked whether they have developed any morbidity symptoms due to smoking, or smokeless tobacco use. Bivariate, as well as multivariate logistic regression analyses were deployed to attain the study objective. Findings Over 20% of smokers and over 9% of smokeless tobacco users reported any morbidity. Odds ratio (OR) with 95% confidence interval (CI) estimated using logistic regression shows that women are less likely to report any morbidity attributable to smoking (OR: 0.69; CI: 0.54-0.87), and more likely to report any morbidity due to smokeless tobacco use (OR: 1.68; CI: 1.36-2.09). Non-Hindus have higher odds, whereas the wealthiest respondents have lower odds of reporting any morbidity. With a culturally appropriate intervention to change behaviour, youth (both men and women) could be targeted with comprehensive tobacco cessation assistance programmes. A focussed intervention could be designed for unprocessed tobacco users to curb hazardous effects of
Knudsen, Hannah K; Studts, Jamie L; Boyd, Sara; Roman, Paul M
Few studies have examined associations between the availability of smoking cessation services in addiction treatment organizations and specific cultural, staffing, and resource barriers. Telephone interviews were conducted with administrators of 897 addiction treatment organizations in the United States. These data revealed that few programs had adopted the full bundle of five recommended tobacco-related intake procedures, and that less than half of programs offered any smoking cessation services. Barriers to adoption of the intake bundle and availability of services included organizational culture and low levels of staff skills. Adoption of cessation services was associated with center type, location in a hospital setting, levels of care, and organizational size. Although a substantial proportion of organizations offer smoking cessation services, expansion of these services and greater adoption of tobacco-related intake procedures are needed to address the needs of nicotine-dependent individuals in addiction treatment.
Orr, Katherine Kelly; Asal, Nicole J
To review data demonstrating effective smoking cessation with electronic cigarettes (e-cigarettes). A literature search of MEDLINE/PubMed (1946-March 2014) was performed using the search terms e-cigarettes, electronic cigarettes, and smoking cessation. Additional references were identified from a review of literature citations. All English-language clinical studies assessing efficacy of e-cigarettes compared with baseline, placebo, or other pharmacological methods to aid in withdrawal symptoms, smoking reduction, or cessation were evaluated. A total of 6 clinical studies were included in the review. In small studies, e-cigarettes significantly decreased desire to smoke, number of cigarettes smoked per day, and exhaled carbon monoxide levels. Symptoms of nicotine withdrawal and adverse effects were variable. The most common adverse effects were nausea, headache, cough, and mouth/throat irritation. Compared with nicotine patches, e-cigarettes were associated with fewer adverse effects and higher adherence. Most studies showed a significant decrease in cigarette use acutely; however, long-term cessation was not sustained at 6 months. There is limited evidence for the effectiveness of e-cigarettes in smoking cessation; however, there may be a place in therapy to help modify smoking habits or reduce the number of cigarettes smoked. Studies available provided different administration patterns such as use while smoking, instead of smoking, or as needed. Short-term studies reviewed were small and did not necessarily evaluate cessation with a focus on parameters associated with cessation withdrawal symptoms. Though long-term safety is unknown, concerns regarding increased poisoning exposures among adults in comparison with cigarettes are alarming. © The Author(s) 2014.
Regmi, Kabindra; Kaphle, Dinesh; Timilsina, Sabina; Tuha, Nik Annie Afiqah
Economic evidence relating to tobacco control is generally derived from the cost effectiveness of smoking-cessation programs or the economic impact of tobacco-induced disease, based on revealed-preference data. However, empirical estimates from stated-preference data on tobacco users' preferences, smoking behaviour and smoking cessation aids using analytical techniques such as discrete-choice experiments (DCEs) could be important for policy decision making in tobacco control. Our objective was to review the practice and utility of DCE methodology across nicotine- and tobacco-related issues, particularly smoking and smoking-cessation behaviour, anti-smoking policies and preferences for smoking-cessation aids. We searched the PubMed, MEDLINE and ECONLIT databases for full-text original research articles on tobacco-related issues published between January 2000 and April 2016 that used a DCE method. We summarised the evidence and methodological characteristics of DCEs according to Lancsar and Louviere, 2008. Our review of the 12 eligible studies showed that DCE methodology was used to elicit smoker preferences and to evaluate tobacco-control policies. The majority of the studies were published in the last 5 years. The areas of application were smoking cessation, smoking behaviour, electronic cigarette use, water-pipe smoking and tobacco packaging. Monetary attributes were the most influential attributes in all studies. The design of the DCEs varied. DCE studies of tobacco-related issues were methodologically consistent with guidelines proposed for conducting health-related DCEs.
Shah, J.; Sohail, N.
Tobacco is an important cash crop in Pakistan. It is a sensitive plant, prone to bacterial, fungal and viral diseases. Therefore, high levels of pesticides are used to grow tobacco. Many of these pesticides are highly toxic and have profound impacts not only on the smokers but also on the lives of tobacco farmers, their families and the environment. The environmental impacts of tobacco crop start right from its seedlings stage till throwing away of cigarette filters. These impacts are divided into three stages: (a) Environmental impacts at the tobacco growing stage, (b) Environmental impacts at tobacco manufacturing/processing stage, and (c) Environmental impacts of the tobacco use. This paper provides information of environmental impacts of tobacco crop at all the above-mentioned three stages and recommends measures for mitigation. (author)
Carim-Todd, Laura; Mitchell, Suzanne H; Oken, Barry S
Tobacco chippers are light smokers with stable patterns of smoking that exhibit lower nicotine dependence severity than heavy smokers. Chippers may provide valuable information about the factors influencing drug dependence. Impulsivity and stress are two factors known to influence smoking. By comparing nondependent smokers (tobacco chippers, n = 25) to dependent smokers (heavy smokers, n = 23) and nonsmokers (n = 25), this study examines the relationship between nicotine dependence, impulsivity, chronic stress, and stress reactivity. A total of 73 adult participants completed a study visit that included questionnaires to measure nicotine dependence, chronic stress, personality, affect, withdrawal, and craving. Impulsivity was measured with the delay discounting task and the flanker task. Stress reactivity was assessed by monitoring respiration, heart rate, and salivary cortisol during performance of a titrated Stroop task. Effects of acute stress on affect and craving were examined. Tobacco chippers were as impulsive as heavy smokers on the delay discounting task but no different from nonsmokers on the flanker task. Heavy smokers reported higher perceived stress than chippers and nonsmokers. Perceived stress was a significant predictor of discounting only in heavy smokers. Acute stress induced changes in respiration, heart rate, and heart rate variability. Craving and negative affect increased after stress in both smoking groups, but craving was associated with affect only in chippers. Tobacco chippers do not differ from heavy smokers in impulsivity, but do differ in perceived stress. One's perception and experience of stress might be associated to nicotine dependence resistance and could inform smoking cessation treatments. By examining impulsivity, chronic stress, and stress reactivity in nondependent smokers (tobacco chippers) compared to dependent smokers and nonsmokers, this study contributes to the understanding of nicotine addiction and informs smoking
Schuurmans, Macé M
Electronic cigarettes (e-cigarettes) are vaporisers of liquids often containing nicotine. In the inhaled aerosol carcinogens, ultrafine and metal particles are detected usually in concentrations below those measured in tobacco smoke. Therefore, these products are expected to be less harmful. This has not yet been proven. The long-term safety of e-cigarettes is unknown. Short duration use leads to airway irritation and increased diastolic blood pressure. So far only two randomised controlled trials have investigated efficacy and safety of e-cigarettes for smoking cessation: No clear advantage was shown in comparison to smoking cessation medication. Due to insufficient evidence, e-cigarettes cannot be recommended for smoking cessation. Problematic are the lack of regulation and standardisation of e-cigarette products, which makes general conclusions impossible.
Merson, Frédéric; Perriot, Jean
Smoking addiction and tobacco dependence are related to social deprivation and time perspective. The objective of this study was to understand how these factors influenced the results of smoking cessation in order to optimize the care of this population. We included 200 patients from our outpatient clinic from March 1, 2009 to June 30, 2010. This study focused on the impact of social disadvantages and time perspective on smoking cessation. Time perspective was measured with the short version of the Zimbardo Time Perspective Inventory, social disadvantages with Epices scale. Information on each individual's characteristics, smoking addiction, and smoking cessation was collected. One hundred and ninety-two patients (of whom 45% were socially disadvantaged) participated. Socially disadvantaged people tend to lean towards dimensions "Past Negative" (Pdisadvantages and time perspective in helping these addicted patients to stop smoking. Copyright © 2011. Published by Elsevier Masson SAS.
Poulsen, Peter Bo; Dollerup, Jens; Møller, Ann Merete
Tobacco smoke is the leading preventable cause of death in the world. A total of 50% of all smokers will die from a smoking-related disease with a major impact upon quality of life and health-care costs. Tobacco-controlling policies, including smoking cessation, have increasingly been implemented...
Full Text Available During the first summit of world tobacco control leaders in Central and Eastern Europe, held in 1990 in Kazimierz in Poland, the inadequate engagement of medical professionals in helping people to quit smoking was identified as one of the main problems of the region. The Health Promotion Foundation was established in 1992 to co-ordinate the anti-tobacco movement in Poland and to implement the resolutions of Kazimierz. The Foundation initiated actions to introduce anti-tobacco legislation in Poland passed by the Polish Parliament in 1995. It was one of the first legislative acts in the world to recommend tobacco dependence treatment. The Foundation also took active part in the preparation of the Framework Convention on Tobacco Control, and was one of the contributing authors of Article 14. The Foundation has also engaged in competence building among healthcare providers. It has trained thousands of Polish doctors and nurses using a core, nation-wide tool: the Consensus on Diagnosis and Treatment of Tobacco Dependence. Finally, the Foundation engaged in activities to increase cessation drug availability, e.g. by conducting research, disseminating knowledge on, and promoting cytisine. Since the 1990s millions of Poles quit smoking, also thanks to the Foundation’s comprehensive activities. Further work is now focused on developing effective ways to engage greater numbers of medical doctors in the treatment of tobacco dependence and building innovative technologies supporting them and people who want to quit smoking.
Garrison, Kathleen A; Pal, Prasanta; Rojiani, Rahil; Dallery, Jesse; O'Malley, Stephanie S; Brewer, Judson A
Tobacco use is responsible for the death of about 1 in 10 individuals worldwide. Mindfulness training has shown preliminary efficacy as a behavioral treatment for smoking cessation. Recent advances in mobile health suggest advantages to smartphone-based smoking cessation treatment including smartphone-based mindfulness training. This study evaluates the efficacy of a smartphone app-based mindfulness training program for improving smoking cessation rates at 6-months follow-up. A two-group parallel-randomized clinical trial with allocation concealment will be conducted. Group assignment will be concealed from study researchers through to follow-up. The study will be conducted by smartphone and online. Daily smokers who are interested in quitting smoking and own a smartphone (n = 140) will be recruited through study advertisements posted online. After completion of a baseline survey, participants will be allocated randomly to the control or intervention group. Participants in both groups will receive a 22-day smartphone-based treatment program for smoking. Participants in the intervention group will receive mobile mindfulness training plus experience sampling. Participants in the control group will receive experience sampling-only. The primary outcome measure will be one-week point prevalence abstinence from smoking (at 6-months follow-up) assessed using carbon monoxide breath monitoring, which will be validated through smartphone-based video chat. This is the first intervention study to evaluate smartphone-based delivery of mindfulness training for smoking cessation. Such an intervention may provide treatment in-hand, in real-world contexts, to help individuals quit smoking. Clinicaltrials.gov NCT02134509 . Registered 7 May 2014.
Graham, Amanda L; Fang, Ye; Moreno, Jose L; Streiff, Shawn L; Villegas, Jorge; Muñoz, Ricardo F; Tercyak, Kenneth P; Mandelblatt, Jeanne S; Vallone, Donna M
Background Tobacco cessation among Latinos is a public health priority in the United States, particularly given the relatively high growth of this population segment. Although a substantial percentage of American Latinos use the Internet, they have not engaged in Web-based cessation programs as readily as other racial/ethnic subgroups. A lack of culturally specific advertising efforts may partly explain this disparity. Objective Phase I of this study focused on the development of four Spanish...
Connolly, Mark P; Baker, Christine L; Kotsopoulos, Nikolaos
Smoking gives rise to many cross-sectorial public costs and benefits for government. Costs arise from increased healthcare spending and work-related social benefits, while smoking itself provides significant revenue for government from tobacco taxes. To better understand the public economic impact of smoking and smoking cessation therapies, this study developed a government perspective framework for assessing smoking-attributable morbidity and mortality and associated public costs. This framework includes changes in lifetime tax revenue and health costs, as well as changes in tobacco tax revenue, from fewer smokers. A modified generational accounting framework was developed to assess relationships between smoking-attributable morbidity and mortality and public economic consequences of smoking, including lifetime tax revenue gains/losses, government social transfers, and health spending. Based on the current prevalence of smoking in South Korean males, a cohort model was developed for smokers, former-smokers, and never-smokers. The model simulated the lifetime discounted fiscal transfers for different age cohorts in 5 year age bands, and the return on investment (ROI) from smoking cessation therapy. Former smokers are estimated to generate higher lifetime earnings and direct tax revenues and lower lifetime healthcare costs due to the reduction of smoking-attributable mortality and morbidity compared to smokers, even after accounting for reduced tobacco taxes paid. Based on the costs of public investments in varenicline, this study estimated a ROI from 1.4-1.7, depending on treatment age, with higher ROI in younger cohorts, with an average ROI of 1.6 for those aged less than 65. This analysis suggests that reductions in smoking can generate positive public economic benefits for government, even after accounting for lost tobacco tax revenues. The results described here are likely applicable to countries having similar underlying smoking prevalence, comparable taxation
El Hajj, Maguy Saffouh; Al Nakeeb, Reem Raad; Al-Qudah, Raja'a Ali
Smoking is a major public health problem in Qatar. The potential for community pharmacists to offer smoking cessation counseling in this country can be high. To determine the current smoking cessation practices of community pharmacists in Qatar, to examine their attitudes about tobacco use and smoking cessation, to evaluate their perceptions about performing professional roles with respect to smoking cessation and to assess their perceived barriers for smoking cessation counseling in the pharmacy setting in Qatar. Community pharmacies in Qatar. The objectives were addressed in a cross sectional survey of community pharmacists in Qatar from June 2010 to October 2010. A phone call was made to all community pharmacists in Qatar (318 pharmacists) inviting them to participate. Consenting pharmacists anonymously completed the survey either online or as paper using fax. Data was analyzed using Statistical Package of Social Sciences (SPSS®) Version 18. Qatar community pharmacists' smoking cessation practices, their attitudes toward tobacco use, smoking cessation and smoking cessation counseling and their perceived barriers for smoking cessation counseling. Over 5 months, we collected 127 surveys (40 % response rate). Only 21 % of respondents reported that they always or most of the time asked their patients if they smoke. When the patients' smoking status was identified, advising quitting and assessing readiness to quit were always or most of the time performed by 66 and 52 % of respondents respectively. Only 15 % always or most of the time arranged follow-up with smokers and 22 % always or most of the time made smoking cessation referrals. Most respondents (>80 %) agreed that smoking could cause adverse health effects and that smoking cessation could decrease the risk of these effects. In addition, the majority (>80 %) believed that smoking cessation counseling was an important activity and was an efficient use of their time. The top two perceived barriers for smoking
Westmaas, J Lee; McDonald, Bennett R; Portier, Kenneth M
smoking or quitting is discussed. Results indicated that smoking and quitting discussions were relatively rare, but nevertheless provide insight into barriers that may need to be addressed in cessation interventions for survivors. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: email@example.com.
Kahnert, S; Nair, U; Mons, U; Pötschke-Langer, M
Menthol is the most widely used and the most prominent tobacco additive in tobacco products advertised and marketed by the tobacco industry. Besides its characteristic flavor, it possesses a variety of pharmacological properties facilitating tobacco smoke inhalation and potentiating dependence. These properties of menthol not only favor tobacco initiation and consumption but can also prevent smoking cessation. This article summarizes the effect of menthol as an additive in tobacco products and its effect on tobacco consumption that causes a number of chronic diseases and premature death and, therefore, counteracts tobacco control measures. Currently, there is no legislative regulation in Germany that considers the health hazard, addiction-enhancing and attractiveness-increasing properties of additives permitted in tobacco products. Effective regulation or even a ban could contribute to a reduction of tobacco consumption and, hence, save many people from a long-lasting tobacco dependence.
U.S. Department of Health & Human Services — 1999-2016. National Association of Attorneys General (NAAG). PolicyâTobacco Settlement Payments. The National Association of Attorneys General (NAAG) provides...
U.S. Department of Health & Human Services — 1999-2017. National Association of Attorneys General (NAAG). Policy—Tobacco Settlement Payments. The National Association of Attorneys General (NAAG) provides...
Liautaud, Madalyn M; Leventhal, Adam M; Pang, Raina D
African-American (AA) smokers are at disproportionate risk of tobacco dependence, utilizing smoking to regulate stress, and poor cessation outcomes. Positive emotional traits may function as coping factors that buffer the extent to which dependence increases vulnerability to adverse responses to acute tobacco abstinence (i.e., tobacco withdrawal). This laboratory study examined subjective happiness (SH; dispositional orientation towards frequent and intense positive affect [PA] and life satisfaction) as a moderator of the relation between tobacco dependence and subjective and behavioral abstinence effects among AA smokers. AA smokers (N=420, 39.0% female) completed self-report measures of tobacco dependence and SH followed by two counterbalanced experimental sessions (non-abstinent vs. 16-hr abstinent) involving self-report measures of composite withdrawal, urge to smoke, and mood, and a behavioral smoking task in which participants could: (a) earn money to delay smoking reinstatement, and (b) subsequently purchase cigarettes to smoke. Tobacco dependence was positively associated with increased abstinence effects in composite withdrawal, urge to smoke, PA, and latency to smoking reinstatement (pssmokers. The current study contributes to a growing body of literature examining the potentially advantageous role of positive emotional traits to smokers. We do so by identifying a relatively understudied psychological construct within tobacco research-subjective happiness-that may suppress the extent to which more severe tobacco dependence increases risk for subjective withdrawal-related distress during acute smoking abstinence in African American smokers. In doing so, the study provides a primer for future targeting of subjective happiness and other positive emotional traits as means to understand and treat acute tobacco abstinence effects among dependent African American smokers. © The Author 2017. Published by Oxford University Press on behalf of the Society for
Riley William T
Full Text Available Abstract Background The Consortium of Hospitals Advancing Research on Tobacco (CHART is a network of six projects and a research coordinating unit funded by the National Heart, Lung, and Blood Institute, the National Cancer Institute, the National Institute on Drug Abuse, and the National Institutes of Health (NIH Office of Behavioral and Social Science Research. The CHART projects will assess the effectiveness and cost-effectiveness of smoking cessation interventions initiated during hospitalization and continued post-discharge. Methods/design Along with a seventh project funded previously under the NIH Challenge grants, the CHART projects will assess smoking cessation strategies delivered to approximately 10,000 hospitalized smokers across a geographically diverse group of nearly 20 private, public, academic, and community hospitals. The CHART research coordinating unit at Kaiser Permanente Center for Health Research provides organizational and data coordination support, facilitating the development of common measures for combining data from multiple CHART projects. Discussion The targeted enrollment in CHART, if achieved, will represent the largest, most diverse pooled dataset of hospitalized smokers receiving smoking cessation assistance, and is designed to contribute to the dissemination and implementation of smoking cessation interventions provided by hospital systems.
OBJECTIVES: To provide a short review of the evidence base supporting smoking cessation interventions, including behavioral therapy and pharmacological treatment options. METHODS: Published meta-analysis was mainly used supplemented with a limited literature search. RESULTS: Effective smoking ces...... in smoking cessation. On-going research is examining the potential effects of nicotine vaccination as relapse prevention.......OBJECTIVES: To provide a short review of the evidence base supporting smoking cessation interventions, including behavioral therapy and pharmacological treatment options. METHODS: Published meta-analysis was mainly used supplemented with a limited literature search. RESULTS: Effective smoking...... cessation consists of pharmacotherapy and behavioral support. Counseling increases abstinence rates parallel to the intensity of support. First-line pharmacological drugs for smoking cessation are nicotine replacement products (patch, gum, inhaler, nasal spray, lozenge/tablets), varenicline and bupropion SR...
Hamann, Stephen L; Mock, Jeremiah; Hense, Sibasis; Charoenca, Naowarut; Kungskulniti, Nipapun
In low- and middle-income countries (LMICs) over the past two decades locally relevant tobacco control research has been scant. Experience shows that tobacco control measures should be based on sound research findings to ensure that measures are appropriate for local conditions and that they are likely to have an impact. Research should also be integrated within tobacco control measures to ensure ongoing learning and the production of knowledge. Thailand, a middle-income country, has a public health community with a record of successful tobacco control and a longstanding commitment to research. Thailand's comprehensive approach includes taxation; bans on tobacco advertising, sponsorship and promotion; smoke-free areas; graphic cigarette pack warnings; social marketing campaigns; cessation counseling; and an established tobacco control research program. The purpose of this study was to document and analyze the development of tobacco control research capacity in Thailand and the impact of research on Thai tobacco control measures. We used mixed methods including review of historical documentation and policy reports, qualitative interviews with key members of Thailand's tobacco control community, and an analysis of research productivity. In Thailand, tobacco control research has evolved through three phases: (1) discovery of the value of research in the policymaking arena, (2) development of a structure to support research capacity building through international collaborations supported by foreign funding agencies, and (3) delivery of locally relevant research made possible largely through substantial stable funding from a domestic health promotion foundation. Over two decades, Thai tobacco control advocates have constructed five steppingstones to success: (1) adapting foreign research to inform policymaking and lobbying for more support for domestic research; (2) attracting foreign funding agencies to support small-scale research and capacity building; (3
Hamann Stephen L
Full Text Available Abstract Introduction In low- and middle-income countries (LMICs over the past two decades locally relevant tobacco control research has been scant. Experience shows that tobacco control measures should be based on sound research findings to ensure that measures are appropriate for local conditions and that they are likely to have an impact. Research should also be integrated within tobacco control measures to ensure ongoing learning and the production of knowledge. Thailand, a middle-income country, has a public health community with a record of successful tobacco control and a longstanding commitment to research. Thailand's comprehensive approach includes taxation; bans on tobacco advertising, sponsorship and promotion; smoke-free areas; graphic cigarette pack warnings; social marketing campaigns; cessation counseling; and an established tobacco control research program. The purpose of this study was to document and analyze the development of tobacco control research capacity in Thailand and the impact of research on Thai tobacco control measures. Method We used mixed methods including review of historical documentation and policy reports, qualitative interviews with key members of Thailand's tobacco control community, and an analysis of research productivity. Findings In Thailand, tobacco control research has evolved through three phases: (1 discovery of the value of research in the policymaking arena, (2 development of a structure to support research capacity building through international collaborations supported by foreign funding agencies, and (3 delivery of locally relevant research made possible largely through substantial stable funding from a domestic health promotion foundation. Over two decades, Thai tobacco control advocates have constructed five steppingstones to success: (1 adapting foreign research to inform policymaking and lobbying for more support for domestic research; (2 attracting foreign funding agencies to support small
U.S. Department of Health & Human Services — 2005-2011. The World Health Organization, CDC, and the Canadian Public Health Association, developed the GHPSS to collect data on tobacco use and cessation...
Tzelepis, Flora; Daly, Justine; Dowe, Sarah; Bourke, Alex; Gillham, Karen; Freund, Megan
Tobacco use during pregnancy is substantially higher among Aboriginal women compared to non-Aboriginal women in Australia. However, no studies have investigated the amount or type of smoking cessation care that staff from Aboriginal antenatal and postnatal services provide to clients who smoke or staff confidence to do so. This study examined Aboriginal antenatal and postnatal staff confidence, perceived role and delivery of smoking cessation care to Aboriginal women and characteristics associated with provision of such care. Staff from 11 Aboriginal Maternal and Infant Health Services and eight Aboriginal Child and Family Health services in the Hunter New England Local Health District in Australia completed a cross-sectional self-reported survey (n = 67, response rate = 97.1%). Most staff reported they assessed clients' smoking status most or all of the time (92.2%). However, only a minority reported they offered a quitline referral (42.2%), provided follow-up support (28.6%) or provided nicotine replacement therapy (4.7%) to most or all clients who smoked. Few staff felt confident in motivating clients to quit smoking (19.7%) and advising clients about using nicotine replacement therapy (15.6%). Staff confident with talking to clients about how smoking affected their health had significantly higher odds of offering a quitline referral [OR = 4.9 (1.7-14.5)] and quitting assistance [OR = 3.9 (1.3-11.6)] to clients who smoke. Antenatal and postnatal staff delivery of smoking cessation care to pregnant Aboriginal women or mothers with young Aboriginal children could be improved. Programs that support Aboriginal antenatal and postnatal providers to deliver smoking cessation care to clients are needed. Aboriginal antenatal and postnatal service staff have multiple opportunities to assist Aboriginal women to quit smoking during pregnancy and postpartum. However, staff confidence and practices of offering various forms of smoking cessation support to pregnant Aboriginal
Nordin, Amer Siddiq Amer; Kadir, Rahimah Abdul; Yahya, Nurul Asyikin; Zakaria, Hazli; Rashid, Rusdi Abdul; Habil, Mohamed Hussain
As a signatory to the World Health Organisation 2003 Framework Convention on Tobacco Control, Malaysia has policies in place and funded 300 public Quit clinics. Unfortunately, government dentists are not included to run tobacco dependence treatment. A cross-sectional exploratory survey was carried out to seek Malaysian dentists' opinion on their knowledge, perception and willingness to conduct tobacco dependence treatment. Participation was voluntary from those who attended a specially designed one-day, four-module workshop on tobacco cessation intervention. Data were collected using the Audience-Response-System equipment which tracked immediate responses covering four domains namely: smoking as a public health problem, smoking as an addiction, the role of dentists in the programme and confidence in conducting smoking cessation in the clinic. Sample comprised more female dentists (73.5%), mean age 33.6 (SD 8.99) years and with more than 3 years working experience. Findings indicated that the majority agreed Malaysia has a rising problem in the prevalence of smoking (71.6%) and predicted that it will affect mostly the young (81.9%). Only half of the dentists surveyed (58.9%) routinely recorded their patients' smoking habits. The majority (71.6%) believed that dentists are effective in helping their patient to stop smoking and 76.3% agreed that dentists should discuss the smoking habit with their patients; however, 60% agreed that doing so is too time consuming. In addition, only 24.7% knew of more ways to treat a smoking habit. The majority felt comfortable giving advice to patients about changing their habits (76.5%) or discussing treatment options (60.5%): 75% would opt for a combined programme of counselling and use of medication if they have to do, 15% would choose to go on counselling only, while 8% did not want to treat. In conclusion, the findings suggest that dentists have a strong potential to contribute significantly to providing smoking cessation
Farris, Samantha G; Aston, Elizabeth R; Zvolensky, Michael J; Abrantes, Ana M; Metrik, Jane
Behavioral economic measurement of the relative value of tobacco (Cigarette Purchase Task; CPT) is used to examine individual differences in motivation for tobacco under certain contexts. Smokers with psychopathology, relative to those without, may demonstrate stronger demand for tobacco following a period of smoking deprivation, which could account for disparate rates of smoking and cessation among this subgroup. Participants (n=111) were community-recruited adult daily smokers who completed the CPT after a deprivation period of approximately 60min. Presence of psychopathology was assessed via clinical interview; 40.5% (n=45) of the sample met criteria for past-year psychological diagnosis. Specifically, 31.5% (n=35) had an emotional disorder (anxiety/depressive disorder), 17.1% (n=19) had a substance use disorder, and 19.1% of the sample had more than one disorder. Smokers with any psychopathology showed significantly higher intensity (demand at unrestricted cost; $0) and O max (peak expenditure for a drug) relative to smokers with no psychopathology. Intensity was significantly higher among smokers with an emotional disorder compared to those without. Smokers with a substance use disorder showed significantly higher intensity and O max , and lower elasticity, reflecting greater insensitivity to price increases. Having≥2 disorders was associated with higher intensity relative to having 1 or no disorders. Findings suggest that presence of psychopathology may be associated with greater and more persistent motivation to smoke. Future work is needed to explore the mechanism linking psychopathology to tobacco demand. Copyright © 2017 Elsevier B.V. All rights reserved.
Heredia-Pi, Ileana B; Servan-Mori, Edson; Reynales-Shigematsu, Luz Myriam; Bautista-Arredondo, Sergio
To estimate the maximum willingness to pay (WTP) for an effective smoking cessation treatment among smokers in Mexico and to identify the environmental, demographic, and socioeconomic factors associated with the WTP. A cross-sectional study was conducted. The sample contained 777 smokers (willingness to quit using a WTP of >0) who had responded to the 2009 Global Adult Tobacco Survey conducted in Mexico. Statistical associations and descriptive analyses were conducted to describe smokers and their WTP by using tobacco-related environmental, socioeconomic, and demographic variables. Overall, 74.4% of the smokers were men and 51.4% were daily smokers. On average, the smokers had been consuming tobacco for more than 15 years, 58.6% had made cessation attempts in the past, and around 10.0% knew about the existence of centers to aid in smoking cessation. The average WTP for an effective cessation method was US $191. Among men, the WTP was US $152 lower than among women. In all the estimated models, the higher an individual's education and socioeconomic level, the higher his or her WTP. This study suggests that Mexican smokers interested in quitting smoking attribute a high monetary value to an effective cessation method. Male smokers demonstrated less altruistic behavior than did female smokers. Mexico requires the implementation of more policies designed to support smoking cessation and to limit tobacco addiction. Expanding the availability of cessation programs and access to pharmacological treatments may contribute to reaching universal coverage by integrating new pharmacological alternatives into the health sector's medicine formulary. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
Lorencatto, Fabiana; Harper, Alice M; Francis, Jill J; Lawrenson, John G
Smoking is a risk factor for a number of eye conditions, including age-related macular degeneration, cataracts and thyroid eye disease. Smoking cessation interventions have been shown to be highly cost-effective when delivered by a range of healthcare professionals. Optometrists are well placed to deliver smoking cessation advice to a wide population of otherwise healthy smokers. Yet optometrists remain a relatively neglected healthcare professional group in smoking cessation research and policy. Surveys of UK medical/nursing schools and of optometrists' training internationally demonstrate significant deficits in current curricular coverage regarding smoking cessation. This study aimed to identify the extent of smoking cessation training in UK optometry trainees' undergraduate and pre-registration training. All undergraduate optometry schools in the UK (n = 9) were invited to participate in a web-based survey of their curricular coverage and assessment related to smoking cessation, and of perceived barriers to delivering smoking cessation training. A content analysis of the College of Optometrists Scheme for Registration Trainee Handbook 2014 was conducted to identify competence indicators related to smoking cessation. Nine undergraduate optometry schools (100%) responded to the survey. The majority reported dedicating limited hours (0-3) to teaching smoking cessation, and predominantly focused on teaching the harmful effects of smoking (89%). Only one school provides practical skills training for delivering evidence-based smoking cessation interventions, including very brief advice. The majority of schools (78%) reported that they did not formally examine students on their knowledge or skills for supporting smoking cessation, and rated confidence in their graduates' abilities to deliver smoking cessation interventions as 'poor' (78%). Lack of knowledge amongst staff was identified as the key barrier to teaching about smoking cessation support. The pre
Tan, Crystal E.; Kyriss, Thomas; Glantz, Stanton A.
Background Spurred by the creation of potential modified risk tobacco products, the US Food and Drug Administration (FDA) commissioned the Institute of Medicine (IOM) to assess the science base for tobacco “harm reduction,” leading to the 2001 IOM report Clearing the Smoke. The objective of this study was to determine how the tobacco industry organized to try to influence the IOM committee that prepared the report. Methods and Findings We analyzed previously secret tobacco industry documents in the University of California, San Francisco Legacy Tobacco Documents Library, and IOM public access files. (A limitation of this method includes the fact that the tobacco companies have withheld some possibly relevant documents.) Tobacco companies considered the IOM report to have high-stakes regulatory implications. They developed and implemented strategies with consulting and legal firms to access the IOM proceedings. When the IOM study staff invited the companies to provide information on exposure and disease markers, clinical trial design for safety and efficacy, and implications for initiation and cessation, tobacco company lawyers, consultants, and in-house regulatory staff shaped presentations from company scientists. Although the available evidence does not permit drawing cause-and-effect conclusions, and the IOM may have come to the same conclusions without the influence of the tobacco industry, the companies were pleased with the final report, particularly the recommendations for a tiered claims system (with separate tiers for exposure and risk, which they believed would ease the process of qualifying for a claim) and license to sell products comparable to existing conventional cigarettes (“substantial equivalence”) without prior regulatory approval. Some principles from the IOM report, including elements of the substantial equivalence recommendation, appear in the 2009 Family Smoking Prevention and Tobacco Control Act. Conclusions Tobacco companies
Taylor, Kathryn L; Hagerman, Charlotte J; Luta, George; Bellini, Paula G; Stanton, Cassandra; Abrams, David B; Kramer, Jenna A; Anderson, Eric; Regis, Shawn; McKee, Andrea; McKee, Brady; Niaura, Ray; Harper, Harry; Ramsaier, Michael
Incorporating effective smoking cessation interventions into lung cancer screening (LCS) programs will be essential to realizing the full benefit of screening. We conducted a pilot randomized trial to determine the feasibility and efficacy of a telephone-counseling (TC) smoking cessation intervention vs. usual care (UC) in the LCS setting. In collaboration with 3 geographically diverse LCS programs, we enrolled current smokers (61.5% participation rate) who were: registered to undergo LCS, 50-77 years old, and had a 20+ pack-year smoking history. Eligibility was not based on readiness to quit. Participants completed pre-LCS (T0) and post-LCS (T1) telephone assessments, were randomized to TC (N=46) vs. UC (N=46), and completed a final 3-month telephone assessment (T2). Both study arms received a list of evidence-based cessation resources. TC participants also received up to 6 brief counseling calls with a trained cessation counselor. Counseling calls incorporated motivational interviewing and utilized the screening result as a motivator for quitting. The outcome was biochemically verified 7-day point prevalence cessation at 3-months post-randomization. Participants (56.5% female) were 60.2 (SD=5.4) years old and reported 47.1 (SD=22.2) pack years; 30% were ready to stop smoking in the next 30 days. TC participants completed an average of 4.4 (SD=2.3) sessions. Using intent-to-treat analyses, biochemically verified quit rates were 17.4% (TC) vs. 4.3% (UC), p<.05. This study provides preliminary evidence that telephone-based cessation counseling is feasible and efficacious in the LCS setting. As millions of current smokers are now eligible for lung cancer screening, this setting represents an important opportunity to exert a large public health impact on cessation among smokers who are at very high risk for multiple tobacco-related diseases. If this evidence-based, brief, and scalable intervention is replicated, TC could help to improve the overall cost
Calo, William A; Krasny, Sarah E
Tobacco control strategies have contributed to substantial declines in smoking in the United States. However, smoking still remains the single largest preventable cause of disease and premature deaths in the country. Despite the continuing challenges of implementing tobacco control strategies and the pervasive influence of the tobacco industry to undermine such strategies, there are now unprecedented opportunities to prevent smoking initiation, facilitate cessation, and protect nonsmokers from secondhand smoke. In this paper, we briefly review the most recent literature discussing key strategies that have proven effective in tobacco control including regulations on sales and marketing of tobacco products, taxation, and smoke-free legislation. We focused on these three tobacco control strategies because of their potential to positively influence the environment of both minors and adults regardless of their smoking status. Although research has identified significant individual and social predictors of tobacco use, environmental influences are also important risk factors for tobacco use.
Asfar, Taghrid; Al-Ali, Radwan; Ward, Kenneth D; Vander Weg, Mark W; Maziak, Wasim
To document primary health care (PHC) providers' tobacco use, and how this influences their smoking cessation practices and attitudes towards tobacco-control policies. Anonymous questionnaires were distributed to PHC providers in 7 randomly selected PHC centers in Aleppo, Syria. All PHC providers completed the questionnaires (100% response rate). A quarter of these providers smoke cigarettes and more than 10% smoke waterpipes. Physicians who smoke were less likely to advise patients to quit (OR=0.29; 95% CI, 0.09-0.95), assess their motivation to quit (OR=0.13, 95% CI=0.02-0.72), or assist them in quitting (OR=0.24, 95% CI=0.06-0.99). PHC providers who smoke were less likely to support a ban on smoking in PHC settings (68.2% vs. 89.1%) and in enclosed public places (68.2% vs. 86.1%) or increases in the price of tobacco products (43.2% vs. 77.4%) (PSyria and will negatively influence implementation of anti-smoking program in PHC settings. Smoking awareness and cessation interventions targeted to PHC providers, and training programs to build providers' competency in addressing their patients' smoking is crucial in Syria. Published by Elsevier Ireland Ltd.
... past 30 days. † Any tobacco product includes cigarettes, cigars, smokeless tobacco (including chewing tobacco, snuff, dip, snus, and dissolvable tobacco), tobacco pipes, bidis, hookah, and electronic cigarettes. § Where percentages are missing, sample sizes were ...
Full Text Available Abstract Background Dentists are in a unique position to advise smokers to quit by providing effective counseling on the various aspects of tobacco-induced diseases. The present study assessed the feasibility and acceptability of integrating dentists in a medical smoking cessation intervention. Methods Smokers willing to quit underwent an 8-week smoking cessation intervention combining individual-based counseling and nicotine replacement therapy and/or bupropion, provided by a general internist. In addition, a dentist performed a dental exam, followed by an oral hygiene treatment and gave information about chronic effects of smoking on oral health. Outcomes were acceptability, global satisfaction of the dentist's intervention, and smoking abstinence at 6-month. Results 39 adult smokers were included, and 27 (69% completed the study. Global acceptability of the dental intervention was very high (94% yes, 6% mostly yes. Annoyances at the dental exam were described as acceptable by participants (61% yes, 23% mostly yes, 6%, mostly no, 10% no. Participants provided very positive qualitative comments about the dentist counseling, the oral exam, and the resulting motivational effect, emphasizing the feeling of oral cleanliness and health that encouraged smoking abstinence. At the end of the intervention (week 8, 17 (44% participants reported smoking abstinence. After 6 months, 6 (15%, 95% CI 3.5 to 27.2 reported a confirmed continuous smoking abstinence. Discussion We explored a new multi-disciplinary approach to smoking cessation, which included medical and dental interventions. Despite the small sample size and non-controlled study design, the observed rate was similar to that found in standard medical care. In terms of acceptability and feasibility, our results support further investigations in this field. Trial Registration number ISRCTN67470159
Full Text Available BACKGROUND: Xylanases deserve particular attention due to their potential application in the feed, pulp bleaching and paper industries. We have developed here an efficient system for the production of an active xylanase in tobacco plants fused to a proline-rich domain (Zera of the maize storage protein γ-zein. Zera is a self-assembling domain able to form protein aggregates in vivo packed in newly formed endoplasmic reticulum-derived organelles known as protein bodies (PBs. METHODOLOGY/PRINCIPAL FINDINGS: Tobacco leaves were transiently transformed with a binary vector containing the Zera-xylanase coding region, which was optimized for plant expression, under the control of the 35S CaMV promoter. The fusion protein was efficiently expressed and stored in dense PBs, resulting in yields of up to 9% of total protein. Zera-xylanase was post-translationally modified with high-mannose-type glycans. Xylanase fused to Zera was biologically active not only when solubilized from PBs but also in its insoluble form. The resistance of insoluble Zera-xylanase to trypsin digestion demonstrated that the correct folding of xylanase in PBs was not impaired by Zera oligomerization. The activity of insoluble Zera-xylanase was enhanced when substrate accessibility was facilitated by physical treatments such as ultrasound. Moreover, we found that the thermostability of the enzyme was improved when Zera was fused to the C-terminus of xylanase. CONCLUSION/SIGNIFICANCE: In the present work we have successfully produced an active insoluble aggregate of xylanase fused to Zera in plants. Zera-xylanase chimeric protein accumulates within ER-derived protein bodies as active aggregates that can easily be recovered by a simple density-based downstream process. The production of insoluble active Zera-xylanase protein in tobacco outlines the potential of Zera as a fusion partner for producing enzymes of biotechnological relevance. Zera-PBs could thus become efficient and low
Coady, Micaela H; Chan, Christina A; Auer, Kari; Farley, Shannon M; Kilgore, Elizabeth A; Kansagra, Susan M
To increase knowledge of smoking-related health risks and provide smoking cessation information at the point of sale, in 2009, New York City required the posting of graphic point-of-sale tobacco health warnings in tobacco retailers. This study is the first to evaluate the impact of such a policy in the USA. Cross-sectional street-intercept surveys conducted among adult current smokers and recent quitters before and after signage implementation assessed the awareness and impact of the signs. Approximately 10 street-intercept surveys were conducted at each of 50 tobacco retailers in New York City before and after policy implementation. A total of 1007 adults who were either current smokers or recent quitters were surveyed about the awareness and impact of tobacco health warning signs. Multivariate risk ratios (RR) were calculated to estimate awareness and impact of the signs. Most participants (86%) were current smokers, and the sample was 28% African-American, 32% Hispanic/Latino and 27% non-Hispanic white. Awareness of tobacco health warning signs more than doubled after the policy implementation (adjusted RR =2.01, 95% CI 1.74 to 2.33). Signage posting was associated with an 11% increase in the extent to which signs made respondents think about quitting smoking (adjusted RR =1.11, 95% CI 1.01 to 1.22). A policy requiring tobacco retailers to display graphic health warning signs increased awareness of health risks of smoking and stimulated thoughts about quitting smoking. Additional research aimed at evaluating the effect of tobacco control measures in the retail environment is necessary to provide further rationale for implementing these changes.
Struik, Laura Louise; Baskerville, Neill Bruce
Social networking sites, particularly Facebook, are increasingly included in contemporary smoking cessation interventions directed toward young adults. Little is known about the role of Facebook in smoking cessation interventions directed toward this age demographic. The aim of this study was to characterize the content of posts on the Facebook page of Crush the Crave, an evidence-informed smoking cessation intervention directed toward young adults aged 19 to 29 years. Crush the Crave Facebook posts between October 10, 2012 and June 12, 2013 were collected for analysis, representing page activity during the pilot phase of Crush the Crave. Of the 399 posts included for analysis, 121 were original posts, whereas the remaining 278 were reply posts. Posts were coded according to themes using framework analysis. We found that the original Crush the Crave Facebook posts served two main purposes: to support smoking cessation and to market Crush the Crave. Most of the original posts (86/121, 71.1%) conveyed support of smoking cessation through the following 7 subthemes: encouraging cessation, group stimulation, management of cravings, promoting social support, denormalizing smoking, providing health information, and exposing tobacco industry tactics. The remaining original posts (35/121, 28.9%) aimed to market Crush the Crave through 2 subthemes: Crush the Crave promotion and iPhone 5 contest promotion. Most of the reply posts (214/278, 77.0%) were in response to the supporting smoking cessation posts and the remaining 64 (23.0%) were in response to the marketing Crush the Crave posts. The most common response to both the supporting smoking cessation and marketing Crush the Crave posts was user engagement with the images associated with each post at 40.2% (86/214) and 45% (29/64), respectively. The second most common response consisted of users sharing their smoking-related experiences. More users shared their smoking-related experiences in response to the supporting
Braun, Raffael; Huwiler, Bernhard
Side Effects of Smoking Cessation Abstract. We present the case of a clozapine intoxication associated with aspiration pneumonia due to smoking cessation. Clozapine is mainly metabolized by CYP1A2. CYP1A2 is induced by cigarette smoking, which may change the plasma level of clozapine, especially if consuming habits change.
Panaitescu, Catalina; Moffat, Mandy A.; Williams, Sian; Pinnock, Hilary; Boros, Melinda; Oana, Cristian Sever; Alexiu, Sandra; Tsiligianni, Ioanna
BACKGROUND: Smoking cessation is the most effective intervention to prevent and slow down the progression of several respiratory and other diseases and improve patient outcomes. Romania has legislation and a national tobacco control programme in line with the World Health Organization Framework for
Nåsell, Hans; Adami, Johanna; Samnegård, Eva
Tobacco smoking is a major health and economic concern and is also known to have a significant negative effect on surgical outcomes. The benefits of a smoking cessation intervention prior to elective orthopaedic surgery have been evaluated previously. Our aim was to assess whether a smoking...
Rodriguez-Artalej..., F; Lafuente, U; Guallar-Castillon, P; Garteizaurrekoa, D.; Sainz, M; Diez, A; Foj, A; Banegas, J
Aims: To assess the effectiveness of a smoking cessation intervention at the workplace. The intervention was adapted to smokers‘ tobacco dependence, and included minimal structured counselling at the first visit (5–8 minutes), nicotine patches for three months, and three sessions of counselling for reinforcement of abstinence (2–3 minutes) over a three month period.
Heikkinen, Anna Maria; Broms, Ulla; Pitkaniemi, Janne; Koskenvuo, Markku; Meurman, Jukka
The authors aimed to investigate factors associated with smoking cessation among adolescents after tobacco intervention. They examined smokers (n = 127) from one birth cohort (n = 545) in the city of Kotka in Finland. These smokers were randomized in 3 intervention groups the dentist (n = 44) and the school nurse (n = 42 groups), and a control…
Ylioja, Thomas; Reddy, Vivek; Ambrosino, Richard; Davis, Esa M; Douaihy, Antoine; Slovenkay, Kristin; Kogut, Valerie; Frenak, Beth; Palombo, Kathy; Schulze, Anna; Cochran, Gerald; Tindle, Hilary A
Hospitals face increasing regulations to provide and document inpatient tobacco treatment, yet few blueprint data exist to implement a tobacco treatment service (TTS). A hospitalwide, opt-out TTS with three full-time certified counselors was developed in a large tertiary care hospital to proactively treat smokers according to Chronic Care Model principles and national treatment guidelines. A bioinformatics platform facilitated integration into the electronic health record to meet evolving Centers for Medicare & Medicaid Services meaningful use and Joint Commission standards. TTS counselors visited smokers at the bedside and offered counseling, recommended smoking cessation medication to be ordered by the primary clinical service, and arranged for postdischarge resources. During a 3.5-year span, 21,229 smokers (31,778 admissions) were identified; TTS specialists reached 37.4% (7,943), and 33.3% (5,888) of daily smokers received a smoking cessation medication order. Adjusted odds ratios (AORs) of receiving a chart order for smoking cessation medication during the hospital stay and at discharge were higher among patients the TTS counseled > 3 minutes and recommended medication: inpatient AOR = 7.15 (95% confidence interval [CI] = 6.59-7.75); discharge AOR = 5.3 (95% CI = 4.71-5.97). As implementation progressed, TTS counseling reach and medication orders increased. To assess smoking status ≤ 1 month postdischarge, three methods were piloted, all of which were limited by low follow-up rates (4.5%-28.6%). The TTS counseled approximately 3,000 patients annually, with increases over time for reach and implementation. Remaining challenges include the development of strategies to engage inpatient care teams to follow TTS recommendations, and patients postdischarge in order to optimize postdischarge smoking cessation. Copyright © 2017. Published by Elsevier Inc.
Haskins, Brianna L; Lesperance, Donna; Gibbons, Patric; Boudreaux, Edwin D
Tobacco use is the leading cause of preventable disease and death in the USA. However, limited data exists regarding smoking cessation mobile app quality and intervention effectiveness. Innovative and scalable interventions are needed to further alleviate the public health implications of tobacco addiction. The proliferation of the smartphone and the advent of mobile phone health interventions have made treatment more accessible than ever. The purpose of this review was to examine the relation between published scientific literature and available commercial smartphone health apps for smoking cessation to identify the percentage of scientifically supported apps that were commercially available to consumers and to determine how many of the top commercially available apps for smoking cessation were supported by the published scientific literature. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, apps were reviewed in four phases: (1) identified apps from the scientific literature, (2) searched app stores for apps identified in the literature, (3) identified top apps available in leading app stores, and (4) determined which top apps available in stores had scientific support. Seven articles identified six apps with some level of scientific support, three (50%) were available in at least one app store. Conversely, among the top 50 apps suggested by each of the leading app stores, only two (4%) had any scientific support. While half of the scientifically vetted apps remain available to consumers, they are difficult to find among the many apps that are identified through app store searches.
Full Text Available Asthma is a common disease causing cough, wheezing and shortness of breath. It has been shown that the lung microbiota in asthma patients is different from the lung microbiota in healthy controls suggesting that a connection between asthma and the lung microbiome exists. Individuals with asthma who are also tobacco smokers experience more severe asthma symptoms and smoking cessation is associated with improved asthma control. In the present study we investigated if smoking cessation in asthma patients is associated with a change in the bacterial community in the lungs, examined using induced sputum. We found that while tobacco smokers with asthma have a greater bacterial diversity in the induced sputum compared to non-smoking healthy controls, smoking cessation does not lead to a change in the microbial diversity.
The Framework Convention on Tobacco Control (FCTC) contains no provisions covering tobacco industry investments. This creates the potential for tobacco companies to benefit from investment liberalisation by using foreign investments to avoid tobacco tariffs, increase tobacco consumption and otherwise impair the implementation of FCTC-style measures. Reducing and ultimately eliminating foreign investment activities by tobacco companies can be justified on health grounds, even though it runs counter to current investment liberalisation trends. Through the FCTC process, non-binding guidelines can be elaborated to assist parties in recognising and responding to foreign investment strategies of tobacco companies, to support efforts to exclude the tobacco sector from investment liberalisation and otherwise would improve all countries' awareness of the threat from foreign investment strategies of tobacco companies and provide them with approaches to handle the problems.
McNeill, Ann; Hammond, David; Gartner, Coral
Despite decades of industry innovation and regulatory efforts, the harmfulness of conventional cigarettes has not changed. There are several pitfalls in this area, including the long time lag before health impacts of product regulatory changes become apparent, the danger of consumers deriving false reassurance of lesser harm in the interim period, the lack of relevant expertise and the lack of an internationally agreed and evidence-based strategic approach. Articles 9 and 10 of the Framework Convention on Tobacco Control provide the potential for such a global strategy, and knowledge and research has increased significantly over recent years. However, there are huge opportunity costs in implementing product disclosure and regulatory strategies: most national regulators have very limited human and financial resources, which should be focused on other evidence-based tobacco control interventions. We believe therefore that it is now time to abandon the notion of safe or safer cigarettes while moving consumers towards cleaner nicotine products as soon as possible. In parallel to this, we recommend a number of other strategies be implemented including: reducing the appeal of all tobacco products, forbidding new tobacco products or brand variants being marketed without evidence of reduced harm, appeal or addictiveness, and developing a tobacco industry resourced, but industry independent, Framework Convention on Tobacco Control global repository to assist national regulators in understanding and regulating the products on their markets.
Dunlop, Sally; Lyons, Claudine; Dessaix, Anita; Currow, David
To explore how and why tobacco smokers and recent quitters in NSW use e-cigarettes, as well as common places of purchase. The Cancer Institute Tobacco Tracking Survey is a serial cross-sectional telephone survey, with 40 interviews in NSW each week. 2966 tobacco smokers and recent quitters (in the past 12 months) interviewed January 2014 - June 2015. Current e-cigarette use; reasons for using; places of purchase. 9% of the sample reported currently using e-cigarettes; the rate was highest among 18-29-year-old people (16%). Infrequent use (less than weekly; 57%) was more common than frequent use (at least weekly; 43%). Frequent use was more likely among older adults (55 years and older v 18-29 years: adjusted odds ratio [aOR], 4.43; P = 0.002) and less likely among current tobacco smokers (v recent quitters: aOR, 0.38, P = 0.020). The most common reasons for using e-cigarettes by those over 30 years of age was "to help me quit" (42%) and to "cut down" smoking (35%); for younger adults it was "because they are not as bad for your health as cigarettes" (25%). Common places of purchase were the internet (29%) and tobacconists (27%). Although use of e-cigarettes by tobacco smokers in NSW remains low, some are using e-cigarettes in attempts to reduce tobacco-related harm. Physicians and public health campaigners should inform smokers about the risks associated with dual e-cigarette and tobacco use, advise interested quitters that e-cigarettes are currently unregulated as cessation aids, and continue to provide evidence-based recommendations and cessation services to smokers wanting to quit.
Thomson, George; Wilson, Nick; Blakely, Tony; Edwards, Richard
We discuss some of the practical and ethical questions that may arise for a jurisdiction where a sinking lid endgame strategy for tobacco supply is implemented. Such a strategy would involve regular required reductions in the amount of tobacco released to the market for sale, sufficient to achieve the desired level of commercial sales by a target date. Tobacco manufacturers would periodically bid to the government for a residual quota. Prices would increase as supply reduced. The price level would be influenced by demand, which in turn would reflect the impact of other interventions to reduce demand and the changing normality of smoking. Higher priced tobacco could result in increased smuggling, theft, illegal sales and short-to-medium-term aggravation of some social inequalities. We suggest that the strategy be introduced in conjunction with a range of complementary interventions that would help reduce demand, and thus help ensure that the possible adverse effects are minimised. These complementary interventions include: providing comprehensive best practice smoking cessation support, better information to smokers and the public, strengthened regulation of tobacco retailing and supply, further controlling the pack and product design, measures to restrict supplies that bypass the increases in product price, strengthened enforcement and combating industry attacks. General prerequisites for a sinking lid strategy include public support for the goal of a tobacco-free society, and strong political leadership. The likely context for initial success in jurisdictions includes geographical isolation and/or strong border controls, absence of significant tobacco production and/or manufacturing and low government corruption.
Prem K Mony
Full Text Available Background: Tobacco use is a major cause of avoidable mortality. Postgraduate doctors in training are an important group of physicians likely to influence patients′ tobacco use/cessation. Objective: To assess preparedness for tobacco control among clinical postgraduate residents of a medical college in southern India. Materials and Methods: A cross-sectional study was undertaken among all clinical postgraduate residents enrolled in St. John′s Medical College, Bangalore, to assess knowledge, attitude, and practice regarding tobacco cessation in their patients. A self-administered, anonymous questionnaire was used. Simple descriptive analysis was undertaken. Results: The overall response rate was 66% (76/116. Mean (S.D. knowledge score on tobacco use prevalence and disease burden was 6.2 (2.0 out of 10. About 25% of them were not aware of nicotine replacement therapy as a treatment option for tobacco cessation. Nearly two thirds of them expected their patients to ask for assistance with quitting and nearly half were sceptical about patients′ ability to quit. While 80% of them enquired routinely about tobacco use in their patients, only 50% offered advice on quitting and less than a third assessed readiness to quit or offered assistance with quitting in their patients. Conclusion: Our study revealed suboptimal levels of knowledge and tobacco cessation practice among postgraduate residents. Attitudes toward tobacco cessation by their patients was however generally positive and there was substantial interest in further training in tobacco control. Reorienting postgraduate medical education to include tobacco control interventions would enable future physicians to be better equipped to deal with nicotine addiction.
Opportunities for best practice strategies for tobacco control were identified for community colleges, and would require little additional infrastructure. Policy adherence and enforcement could be improved with awareness raising with students, faculty and staff. Cessation tools for students must be convenient, understandable, and accessible from multiple locations. Feasible approaches for future initiatives could include testing low cost technology such as quitlines, Web Assisted Tobacco Interventions (WATI and outside partnerships with community organizations and health agencies.
Lemieux, Andrine; Nakajima, Motohiro; Hatsukami, Dorothy K; Allen, Sharon; al'Absi, Mustafa
Leptin has been linked to tobacco craving and withdrawal-related symptoms. Very few studies have examined leptin prospectively in both male and female nonsmokers and smokers. We examine leptin concentrations prospectively in both male and female nonsmokers and smokers to assess the associations of leptin with psychological symptoms and smoking relapse during ad libitum smoking, the first 48 h post quit, and 4 weeks post-cessation. Self-report psychological, anthropomorphic, and biological measures (cotinine, carbon monoxide, and plasma leptin) were collected before and after 48 h of smoking abstinence. Smokers were stratified at 28 days post quit as abstinent or relapsed if they had smoked daily for seven consecutive days at any point in the 28 days. Leptin concentration (square root transformed ng/ml) increased over the 48-h abstinence, but only in female abstainers. In contrast, leptin was very stable across time for nonsmokers, relapsers, and males. Cox regression supported that increased leptin was associated with decreased risk of relapse. Leptin was correlated negatively with withdrawal symptoms for abstainers only. Females produce more leptin than males and this level increases from ad libitum smoking to 48-h post quit. The current analysis indicates that a leptin increase early in cessation predicts abstinence. The increase in women, but not men, in response to abstinence provides further evidence of important gender differences. The negative correlation between leptin and withdrawal symptoms indicates a possible protective effect of leptin. Further research is ongoing to elucidate the psychological and biological determinants of this effect.
Full Text Available The goal of the present work is to determine if menthol and non-menthol cigarette smokers differ with respect to time to first cigarette (TTFC and successful smoking cessation via a meta-analysis of published results. For 13 independent estimates, menthol smokers were slightly but statistically significantly more likely to exhibit TTFC ≤ 5 min (random-effects odds ratio (OR = 1.12; 95% confidence interval (CI, 1.04–1.21, while 17 independent estimates provided a non-significant difference for TTFC ≤ 30 min (random-effects OR = 1.06; 95% CI, 0.96–1.16. For cessation studies, meta-analysis of 30 published estimates indicated a decreased likelihood for menthol cigarette smokers to quit (random-effects OR = 0.87; 95% CI, 0.80–0.96. There was no difference between cessation rates for Caucasian menthol and non-menthol cigarette smokers, but the results support that African American menthol cigarette smokers find it more difficult to quit. Adjustment of cessation for socioeconomic status eliminated any statistically significant advantage for smoking cessation in non-menthol smokers. In conclusion, these results suggest that the observed differences in cessation rates between menthol and non-menthol cigarette smokers are likely explained by differences in socioeconomic status and also suggest that TTFC may not be a robust predictor of successful smoking cessation.
Mathew, Amanda R; Heckman, Bryan W; Meier, Ellen; Carpenter, Matthew J
Smoking cessation fatigue, or tiredness of attempting to quit smoking, has been posited as a latent construct encompassing loss of motivation, loss of hope in cessation success, decreased self-efficacy, and exhaustion of self-control resources. Despite the potential clinical impact of characterizing cessation fatigue, there is currently no validated measure to assess it. Using a rational scale development approach, we developed a cessation fatigue measure and examined its reliability and construct validity in relation to a) smokers' experience of a recently failed quit attempt (QA) and b) readiness to engage in a subsequent QA. Data were drawn from an online cross-sectional survey of 484 smokers who relapsed from a QA within the past 30days. Exploratory factor analysis identified three factors within the 17-item Cessation Fatigue Scale (CFS), which we labeled: emotional exhaustion, pessimism, and devaluation. High internal consistency was observed for each factor and across the full scale. As expected, CFS overall was positively associated with withdrawal severity and difficulty quitting. CFS was negatively associated with previously validated measures of intention to quit, self-efficacy, and abstinence-related motivational engagement, even after adjusting for nicotine dependence. Findings provide initial validation for a new tool to assess cessation fatigue and contribute needed information on a theory-driven component of cessation-related motivation and relapse risk. Copyright © 2017. Published by Elsevier B.V.
Cho, Youn-Mo; Myong, Jun-Pyo; Kim, Hyoung-Ryoul; Lee, HyeEun; Koo, Jung-Wan
The aim of the present study was to evaluate the association between failed smoking cessation and occupation by age stratification among Korean males and provide quantitative evidence of factors associated with failed smoking cessation. The study comprised 3,127 male workers who had attempted smoking cessation during their life time. Data were obtained from the Korea National Health and Nutrition Examination Survey from 2010 to 2012. Participants were stratified by age into two subgroups comprising a younger group (19-40 yr) and an older group (41-60 yr). Multiple logistic regression analyses were used to estimate odds ratios (ORs) for failed smoking cessation. In the younger group, failed smoking cessation was related to the occupational fields "service and sales" and "manual work" compared to "office work" (OR: 2.10, 95% confidence interval (CI): 1.34-3.29; and OR: 1.47, 95% CI: 1.02-2.12, respectively). In the older group, the ORs of failed smoking cessation occupational categories "service and sales" and "manual work" [ref: office workers] were 0.58 (0.40-0.85) and 0.90 (0.66-1.24), respectively. Failed smoking cessation is associated with occupational categories and age stratification. Policy makers need to create tailored anti-smoking policy considering the occupation and the age of the subjects.
Rinfel, József; Oberling, János; Tóth, Ildikó; Prugberger, László; Nagy, Lajos
Medical years are very important in shaping the attitudes of future doctors. It is proven that doctors who smoke do not advise their patient to stop smoking. We have to know the students' smoking habits and attitudes about smoking cessation to make them interested in the fight against tobacco. To investigate medical students' smoking habits and attitudes about cessation. We applied the Hungarian translation of the Global Health Professionals Student Survey. Medical students from the first and fifth year filled in the survey anonymously during the seminars. Statistical analysis was performed with SPSS. In both years 245 students filled in the questionnaire. In the first year 30.8%, in the fifth year 38.9% of the students were defined as smokers. During the academic study the number of daily smokers and the number of smoked cigarettes increases. Students require training about smoking cessation, however they would entrust it to a specialist. Based on our data we need a teaching block in the curricula about smoking and smoking cessation.
Chatdokmaiprai, Kannikar; Kalampakorn, Surintorn; McCullagh, Marjorie; Lagampan, Sunee; Keeratiwiriyaporn, Sansanee
The purpose of this study was to identify factors predicting occupational health nurses' provision of smoking cessation services. Data were collected via a self-administered questionnaire distributed to 254 occupational health nurses in Thailand. Analysis by structural equation modeling revealed that self-efficacy directly and positively influenced smoking cessation services, and mediated the relationship between workplace factors, nurse factors, and smoking cessation services. The final model had good fit to the data, accounting for 20.4% and 38.0% of the variance in self-efficacy and smoking cessation services, respectively. The findings show that self-efficacy is a mediator that influences provision of smoking cessation services by occupational health nurses. Interventions to enhance nurses' self-efficacy in providing smoking cessation services are expected to promote provision of smoking cessation services to workers.
Full Text Available We conducted a systematic literature review and meta-analysis (ID: CRD42016051017 of smoking cessation interventions for patients with current depression. We examined the effectiveness of smoking cessation treatments in improving abstinence rates and depressive symptoms. The following electronic databases were used for potentially eligible studies: PUBMED, PSYCINFO, DIALNET and WEB OF KNOWLEDGE. The search terms used were: smoking cessation, depressive disorder, depression, mood, depressive, depressed, smoking, smokers, nicotine, nicotine dependence, and tobacco cigarette smoking. The methodological quality of included studies was assessed using the Effective Public Health Practice Project Quality assessment tool (EPHPP. Of the 6,584 studies identified, 20 were eligible and included in the review. Trial designs of studies were 16 randomized controlled trials and 4 secondary studies. Studies included three types of intervention: psychological (6/30%, pharmacological (6/30% or combined (8/40%. Four trials comprised special populations of smokers. Four studies received a strong methodological quality, 7 were scored as moderate and 9 studies received a weak methodological rating. Analyses of effectiveness showed that smoking cessation interventions appear to increase short-term and long-term smoking abstinence in individuals with current depression. Subgroup analyses revealed stronger effects among studies that provided pharmacological treatments than in studies using psychological treatments. However, the evidence is weak due to the small number of studies. Smoking abstinence appears to be associated with an improvement in depressive symptoms. Heterogeneity in protocols in similar types of treatment also prevent firm conclusions being drawn on the effectiveness of any particular treatment model to optimally manage abstinence among depressed smokers. Further research is required to strengthen the evidence base.
Naik, Sachin; Khanagar, Sanjeev; Kumar, Amit; Ramachandra, Sujith; Vadavadagi, Sunil V; Dhananjaya, Kiran Murthy
Tobacco smoking is an integral part of prison life and an established part of the culture. Little attention has been paid to prevention of smoking in prison. Approximately 70-80% of prisoners have been identified as current smokers. To assess the effectiveness of smoking cessation intervention among male prisoners at Central Jail, Bangalore city. To assess the effectiveness of smoking cessation intervention among male prisoners at Central Jail, Bangalore city. A randomized controlled trial was planned among male prisoners in Central Jail, Bangalore city. There were 1600 convicted prisoners. A self-administered questionnaire was given to the prisoners to assess their smoking behavior by which prevalence of tobacco smoking was found. Exactly 1352 tobacco users were studied. Among them, there were 1252 smokers. Based on inclusion criteria and informed consent given by the prisoners, a sample of 600 was chosen for the study by systematic random sampling. Among the 600 prisoners, 300 were randomly selected for the study group and 300 for the control group. Prevalence of tobacco smoking among the prisoners was 92.60%. In the present study, after smoking cessation intervention, 17% showed no change in smoking, 21.66% reduced smoking, 16% stopped smoking, and 45.33% relapsed (P prison even if the living conditions are not favorable. Relatively high rate of relapse in our study indicates that some policies should be adopted to improve smokers' information on consequences of tobacco on health and motivational intervention should be added to prisoners.
D'Souza, Manoranjan S
Morbidity and mortality associated with tobacco smoking constitutes a significant burden on healthcare budgets all over the world. Therefore, promoting smoking cessation is an important goal of health professionals and policy makers throughout the world. Nicotine is a major psychoactive component in tobacco that is largely responsible for the widespread addiction to tobacco. A majority of the currently available FDA-approved smoking cessation medications act via neuronal nicotinic receptors. These medications are effective in approximately half of all the smokers, who want to quit and relapse among abstinent smokers continues to be high. In addition to relapse among abstinent smokers, unpleasant effects associated with nicotine withdrawal are a major motivational factor in continued tobacco smoking. Over the last two decades, animal studies have helped in identifying several neural substrates that are involved in nicotine-dependent behaviors including those associated with nicotine withdrawal and relapse to tobacco smoking. In this review, first the role of specific brain regions/circuits that are involved in nicotine dependence will be discussed. Next, the review will describe the role of specific nicotinic receptor subunits in nicotine dependence. Finally, the review will discuss the role of classical neurotransmitters (dopamine, serotonin, noradrenaline, glutamate, and γ-aminobutyric acid) as well as endogenous opioid and endocannabinoid signaling in nicotine dependence. The nicotinic and nonnicotinic neural substrates involved in nicotine-dependent behaviors can serve as possible targets for future smoking cessation medications. © 2016 Elsevier B.V. All rights reserved.
Maxwell, Annette E; Garcia, Gabriel M; Berman, Barbara A
Although lung cancer is the top cancer killer among Filipino American men, data on tobacco-related knowledge and attitudes, cessation efforts, and preferences for smoking cessation programs among this population are lacking. We interviewed a community sample of 318 Filipino American me