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Horvath M, Pittman B, O’Malley SS, Grutman A, Khan N, Gueorguieva R, Brewer JA, Garrison KA. Smartband-based smoking detection and real-time brief mindfulness intervention: findings from a feasibility clinical trial. Ann Med 2024; 56:2352803. [PMID: 38823419 PMCID: PMC11146247 DOI: 10.1080/07853890.2024.2352803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 02/29/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND Smartbands can be used to detect cigarette smoking and deliver real time smoking interventions. Brief mindfulness interventions have been found to reduce smoking. OBJECTIVE This single arm feasibility trial used a smartband to detect smoking and deliver brief mindfulness exercises. METHODS Daily smokers who were motivated to reduce their smoking wore a smartband for 60 days. For 21 days, the smartband monitored, detected and notified the user of smoking in real time. After 21 days, a 'mindful smoking' exercise was triggered by detected smoking. After 28 days, a 'RAIN' (recognize, allow, investigate, nonidentify) exercise was delivered to predicted smoking. Participants received mindfulness exercises by text message and online mindfulness training. Feasibility measures included treatment fidelity, adherence and acceptability. RESULTS Participants (N=155) were 54% female, 76% white non-Hispanic, and treatment starters (n=115) were analyzed. Treatment fidelity cutoffs were met, including for detecting smoking and delivering mindfulness exercises. Adherence was mixed, including moderate smartband use and low completion of mindfulness exercises. Acceptability was mixed, including high helpfulness ratings and mixed user experiences data. Retention of treatment starters was high (81.9%). CONCLUSIONS Findings demonstrate the feasibility of using a smartband to track smoking and deliver quit smoking interventions contingent on smoking.
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Affiliation(s)
- Mark Horvath
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Brian Pittman
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | | | - Aurora Grutman
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Nashmia Khan
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Ralitza Gueorguieva
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Judson A. Brewer
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
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Sayed A, Labieb F, Stevens ER, Tamura K, Boakye E, Virani SS, Jiang N, Hu L, Blaha MJ, El-Shahawy O. Association between a diagnosis of diabetes mellitus and smoking abstinence: An analysis of the National Health Interview Survey (2006-2018). Prev Med 2024; 187:108085. [PMID: 39053517 DOI: 10.1016/j.ypmed.2024.108085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 06/28/2024] [Accepted: 07/21/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVE Both diabetes and smoking significantly increase the risk of cardiovascular disease (CVD). Understanding whether a diagnosis of diabetes can be leveraged to promote smoking cessation is a gap in the literature. METHODS We used data from the US National Health Interview Survey, 2006 to 2018, to investigate the relationship between self-report of diagnosis of diabetes and subsequent smoking abstinence among 142,884 respondents who reported regular smoking at baseline. Effect sizes were presented as hazard ratios (HRs) derived from multivariable Cox regression models adjusted for potential confounders using diabetes as a time-dependent covariate. Subgroup-specific estimates were obtained using interaction terms between diabetes and variables of interest. RESULTS A self-reported diagnosis of diabetes was associated with smoking abstinence (HR: 1.21; 95% CI: 1.16 to 1.27). The strength of the association varied based on race (P for interaction: 0.004), where it was strongest in African Americans (HR: 1.44; 95% CI: 1.29 to 1.60); income (P for interaction <0.001), where it was strongest in those with a yearly income less than $35,000 (HR: 1.45; 95% CI: 1.36 to 1.53); and educational attainment (P for interaction <0.001), where it was strongest in those who did not attend college (HR: 1.48; 95% CI: 1.40 to 1.57). CONCLUSION Among adults who smoke, a diagnosis of diabetes is significantly associated with subsequent smoking abstinence. The association is strongest in socially disadvantaged demographics, including African Americans, low-income individuals, and those who did not attend college.
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Affiliation(s)
- Ahmed Sayed
- Ain Shams University, Faculty of Medicine, Cairo, Egypt; Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas, USA
| | - Fatma Labieb
- Beni Suef University, Faculty of Medicine, Beni Suef, Egypt
| | | | - Kosuke Tamura
- Socio-Spatial Determinants of Health (SSDH) Laboratory, Population and Community Health Sciences Branch, Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Ellen Boakye
- Division of Internal Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Salim S Virani
- Department of Medicine, Aga Khan University, Karachi, Pakistan; Baylor College of Medicine and Texas Heart Institute, Houston, TX, USA
| | - Nan Jiang
- New York University Grossman School of Medicine, New York, NY, USA
| | - Lu Hu
- New York University Grossman School of Medicine, New York, NY, USA
| | - Michael J Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Omar El-Shahawy
- Ain Shams University, Faculty of Medicine, Cairo, Egypt; New York University Grossman School of Medicine, New York, NY, USA; New York University School of Global Public Health, New York, NY, USA.
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Lima AVC, de Vargas D, Ramírez ÉGL, Pereira CF. Brief intervention protocol by telephone delivered by nurses to patients with harmful alcohol use in primary health care: A feasibility trial. Arch Psychiatr Nurs 2024; 52:16-23. [PMID: 39260977 DOI: 10.1016/j.apnu.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 03/16/2024] [Accepted: 07/01/2024] [Indexed: 09/13/2024]
Abstract
AIM The aim of this study is to examine the feasibility of a brief intervention protocol by telephone performed by nurses in primary health care facilities. METHODS A nonrandomized single-arm feasibility study was performed. The proposed intervention of this study is the Brief Intervention carried out by the nurse delivered by telephone, synchronously with alcohol users. The brief intervention is a motivational approach based on the FRAMES model, with its components being: Feedback, Responsibility, Advice, Menu of options, Empathy and Self-efficacy. To assess the feasibility of the protocol, we evaluated the procedure for enrolling participants, the acceptability of the protocol to participants, the satisfaction of the participants, convenience and treatment continuity. The quantitative data analysis was carried out in the R software, using descriptive statistics, categorical variables were reported by frequencies and percentages. For continuous variables, medians, means, standard deviations and range values were computed. RESULTS We followed the participants (n = 165) from baseline (T0) until 3 months (T1) and 6 months (T2) after the brief intervention. The partial effect suggests a reduction in alcohol consumption, and statistically significant differences were observed from baseline before the BI, with a decrease of 0.66 points in AUDIT scores at T1. Among the patients who completed the 3-month follow-up, 48 % reported a positive experience of receiving the brief intervention by the nurses, and 44 % reported a decrease in alcohol consumption. CONCLUSIONS Brief intervention delivered by telephone was considered feasible and acceptable by primary health care patients, and they perceived improvement in their alcohol consumption after receiving the BI performed by nurses.
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Affiliation(s)
| | | | - Érika Gisseth León Ramírez
- School of Nursing, University of São Paulo, Brazil; School of Nursing of Federal University of Minas Gerais
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Ma H, Mu X, Jin Y, Luo Y, Wu M, Han Z. Multimorbidity, lifestyle, and cognitive function: A cross-cultural study on the role of diabetes, cardiovascular disease, cancer, and chronic respiratory diseases. J Affect Disord 2024; 362:560-568. [PMID: 39019233 DOI: 10.1016/j.jad.2024.07.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 06/18/2024] [Accepted: 07/12/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND The effect of lifestyle factors on cognitive function related to four major noncommunicable diseases (NCDs) including diabetes, cardiovascular disease, cancer, and chronic respiratory diseases, and the relationship between these NCDs and cognitive function have not been fully studied. We aimed to investigate the longitudinal associations between these NCDs and cognitive function in middle-aged and older people, and the combined effects of lifestyle factors. METHODS By employing the data from three large-scale cohort studies from the U.S. Health and Retirement Study (2010-2019), English Longitudinal Study of Aging (2014-2019), and China Health and Retirement Longitudinal Study (2011-2019), this study carried out a multi-cohort analysis to 77, 210 participants. Fixed-effects regression models were used to examine associations between NCD status and cognitive function. Margin plots were used to illustrate the effect of lifestyle factors. RESULTS Our findings revealed the dose-dependent association between mounting these NCDs and declining cognitive performance, ranging from one NCD (β = -0.05, 95 % CI: -0.08 to -0.02) to four NCDs (β = -0.51, 95 % CI: -0.75 to -0.28). Decline in cognitive function associated with NCDs was exacerbated with physical inactivity, current smoking status, and an increase in unhealthy lifestyle behaviors. LIMITATIONS The observational study design precludes causal interrogation of lifestyles and four NCDs on cognitive function. CONCLUSIONS An increasing number of these NCDs were dose-dependently associated with the decline in cognitive function score. Unhealthy lifestyle factors expedite decline in cognitive function linked to these NCDs.
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Affiliation(s)
- Huifen Ma
- School of Medical Management, Shandong First Medical University, Jinan, China
| | - Xiaomin Mu
- School of Healthcare Security, Shandong First Medical University, Jinan, China
| | - Yinzi Jin
- Department of Global Health, School of Public Health, Peking University, Beijing, China; Institute for Global Health and Development, Peking University, Beijing, China
| | - Yanan Luo
- Department of Global Health, School of Public Health, Peking University, Beijing, China; Institute for Global Health and Development, Peking University, Beijing, China
| | - Min Wu
- School of Healthcare Security, Shandong First Medical University, Jinan, China
| | - Zhiyan Han
- School of Healthcare Security, Shandong First Medical University, Jinan, China.
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Puljević C, Stjepanović D, Meciar I, Kang H, Chan G, Morphett K, Bendotti H, Kunwar G, Gartner C. Systematic review and meta-analyses of cytisine to support tobacco cessation. Addiction 2024; 119:1713-1725. [PMID: 38965792 DOI: 10.1111/add.16592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 05/21/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND AND AIMS Cytisine (also known as cytisinicline) is a low-cost partial agonist of nicotinic acetylcholine receptors used to assist tobacco cessation. We aimed to review the effectiveness of cytisine for tobacco cessation and the effects of dose and co-use of behavioural or other pharmacological interventions on cessation outcomes. METHODS We searched seven databases, Google Scholar, and reference lists of included publications for randomised controlled trials investigating use of cytisine as a tobacco cessation aid. Studies were eligible if participants were ≥15 years old and used tobacco upon study enrolment. We conducted four random effects meta-analyses and sensitivity analyses with fixed effects models. We used the Cochrane risk-of-bias tool for randomised trials version 2 to assess risk of bias in included studies, with adjustments recommended by the Cochrane Tobacco Addiction Group. RESULTS Participants using cytisine were significantly more likely to quit tobacco than participants who received placebo/no intervention/usual care (risk ratio [RR] = 2.65, 95% confidence interval [CI] = 1.50-4.67, 6 trials, 5194 participants) or nicotine replacement therapy (RR = 1.36, 95% CI = 1.06-1.73, p = 0.0152, 2 trials, 1511 participants). The difference in cessation rates among participants receiving cytisine versus varenicline was not statistically significant (RR = 0.96, 95% CI 0.63-1.45, P = 0.8464, 3 trials, 2508 participants). Two trials examined longer versus shorter treatment duration, finding higher abstinence rates with longer treatment (RR = 1.29, 95% CI = 1.02-1.63, 2 trials, 1009 participants). The differences in the number of adverse events reported by participants who received cytisine versus placebo (RR = 1.19, 95% CI = 0.99-1.41, P = 0.0624; 6 trials; 4578 participants) or cytisine versus varenicline (RR = 1.37, 95% CI = 0.57-3.33, P = 0.4835; 2 trials; 1345 participants) were not statistically significant. Most adverse events were mild (e.g. abnormal dreams, nausea, headaches). CONCLUSIONS Cytisine is an effective aid for tobacco cessation and appears to be more effective for tobacco cessation than placebo, no intervention, usual care and nicotine replacement therapy.
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Affiliation(s)
- Cheneal Puljević
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Daniel Stjepanović
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia
| | - Isabel Meciar
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Heewon Kang
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Seoul National University Institute of Health and Environment, Seoul, The Republic of Korea
| | - Gary Chan
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia
| | - Kylie Morphett
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Hollie Bendotti
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Garry Kunwar
- Medical School, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Coral Gartner
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
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Cropsey KL, Wagner WP, Bontemps A, Hawes E, Pridgen B, Lahti AC, Hendricks PS, Azuero A, Carpenter MJ. Effects of in vivo NRT sampling on smoking abstinence and NRT adherence: A randomized clinical trial. Drug Alcohol Depend 2024; 264:112458. [PMID: 39357075 DOI: 10.1016/j.drugalcdep.2024.112458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 09/15/2024] [Accepted: 09/19/2024] [Indexed: 10/04/2024]
Abstract
BACKGROUND Nicotine replacement therapy (NRT) is an effective treatment but is associated with poor adherence during smoking cessation attempts. This study aimed to determine if In Vivo Sampling, an experiential intervention that includes sampling of NRT in-session, increases NRT adherence and smoking abstinence compared to standard smoking cessation behavioral counseling. METHODS Eligible participants were under community corrections supervision and smoked five or more cigarettes per day for the past year. Participants were randomly assigned to receive either In Vivo Sampling or standard smoking cessation behavioral counseling. Both interventions involved four 30-minute sessions and received 12 weeks of combination NRT. Self-reported NRT adherence, quit attempts, and carbon monoxide (CO)-verified smoking cessation were measured at one, three-, and six-months post-intervention. RESULTS From 2017-2022, 515 participants were enrolled and randomized. The In Vivo Sampling group had significantly greater mean adherence to patch and lozenge NRT regimens (71 % vs. 60 %, OR: 1.63, 95 % CI: 1.36-1.96, p<.001). The In Vivo group had a significantly higher likelihood of quit attempts across time (61 % vs. 53 %, OR: 1.4, 95 % CI: 1.05-1.87, p=.021). Groups did not significantly differ on the percent of participants who had quit smoking at 6 months post-intervention (17 % In Vivo Sampling vs. 13 % standard counseling, OR: 1.43, p=.24). CONCLUSION In Vivo Sampling demonstrated better NRT adherence and quit attempts but similar cessation rates to standard behavioral counseling. The In Vivo Sampling intervention represents a novel approach that increased behaviors typically associated with successful cessation over standard behavioral counseling.
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Affiliation(s)
- Karen L Cropsey
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama, Birmingham, USA.
| | - William P Wagner
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama, Birmingham, USA
| | - Andrew Bontemps
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama, Birmingham, USA
| | - Elizabeth Hawes
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama, Birmingham, USA
| | - Bailey Pridgen
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama, Birmingham, USA
| | - Adrienne C Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama, Birmingham, USA
| | - Peter S Hendricks
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama, Birmingham, USA
| | - Andres Azuero
- School of Nursing, University of Alabama, Birmingham, USA
| | - Matthew J Carpenter
- Department of Psychiatry, Hollings Cancer Center, Medical University of South Carolina, USA
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Levchenko M, Parkin M, McEntyre J, Harrison M. Enabling preprint discovery, evaluation, and analysis with Europe PMC. PLoS One 2024; 19:e0303005. [PMID: 39325770 PMCID: PMC11426508 DOI: 10.1371/journal.pone.0303005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 09/09/2024] [Indexed: 09/28/2024] Open
Abstract
Preprints provide an indispensable tool for rapid and open communication of early research findings. Preprints can also be revised and improved based on scientific commentary uncoupled from journal-organised peer review. The uptake of preprints in the life sciences has increased significantly in recent years, especially during the COVID-19 pandemic, when immediate access to research findings became crucial to address the global health emergency. With ongoing expansion of new preprint servers, improving discoverability of preprints is a necessary step to facilitate wider sharing of the science reported in preprints. To address the challenges of preprint visibility and reuse, Europe PMC, an open database of life science literature, began indexing preprint abstracts and metadata from several platforms in July 2018. Since then, Europe PMC has continued to increase coverage through addition of new servers, and expanded its preprint initiative to include the full text of preprints related to COVID-19 in July 2020 and then the full text of preprints supported by the Europe PMC funder consortium in April 2022. The preprint collection can be searched via the website and programmatically, with abstracts and the open access full text of COVID-19 and Europe PMC funder preprint subsets available for bulk download in a standard machine-readable JATS XML format. This enables automated information extraction for large-scale analyses of the preprint corpus, accelerating scientific research of the preprint literature itself. This publication describes steps taken to build trust, improve discoverability, and support reuse of life science preprints in Europe PMC. Here we discuss the benefits of indexing preprints alongside peer-reviewed publications, and challenges associated with this process.
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Affiliation(s)
- Mariia Levchenko
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Wellcome Genome Campus, Hinxton, United Kingdom
| | - Michael Parkin
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Wellcome Genome Campus, Hinxton, United Kingdom
| | - Johanna McEntyre
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Wellcome Genome Campus, Hinxton, United Kingdom
| | - Melissa Harrison
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Wellcome Genome Campus, Hinxton, United Kingdom
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García-Pazo P, Fornés-Vives J, Abad AS. NoFumo+: Mobile Health App to Quit Smoking Using Cognitive-Behavioral Therapy. Nurs Res Pract 2024; 2024:8836672. [PMID: 39364181 PMCID: PMC11449556 DOI: 10.1155/2024/8836672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 07/09/2024] [Accepted: 09/01/2024] [Indexed: 10/05/2024] Open
Abstract
This paper describes the development and test of a smartphone application to quit smoking using cognitive behavioral therapy (CBT). The tool includes recommendations from US Clinical Practice Guidelines (USCPG), drawing on the potential of smartphones and complying with the health App (mHealth) assessment standards. The mHealth created, called NoFumo+, is structured by 4 weeks treatment, implements the USCPG 5A recommendations (ask, advise, assess, assist, and arrange) and incorporates a CBT. It also includes complementary information, monitoring of the smoking behavior, social support for users, proposals for alternative activities to smoking, and innovative gamification to encourage and reward adherence. To technical development, a multidisciplinary team was formed (healthcare, research, and software engineers) that made theoretical decisions on both technical issues and the incorporation of therapeutic techniques. The validation was carried out in two phases; the first in the laboratory by a group of experts in information and communication technologies and CBTs (n = 15) and the second, a field study with smokers (n = 10). The standards for the development of mHealth recommended by the Andalusian Healthcare Quality Agency and the App quality evaluation guidelines of the Catalonian ICT Foundation for Social Health were used as assessment protocols by the experts' panel and the smokers' group, respectively. Experts' assessment results were satisfactory and some improving changes were suggested, such as to add more gamification elements. The group of smokers rated the mHealth as 100% easy to use and effective for quit smoking and understandable by the 83.3%. They also found No Fumo + quite useful to have the information available at all times. The obtained evidence after a complete two-phased validation study, with experts and potential users, shows a mHealth with high quality and easy to use. Finally, investigation project registered in ClinicalTrials.gov with reference to this trial is registered with NCT045402004.
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Affiliation(s)
- Patricia García-Pazo
- Department of Nursing and Physiotherapy University of the Balearic Islands (UBI), Ctra. Valldemossa, km 7.5, Palma E-07122, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, 79, Palma E-07120, Spain
| | - Joana Fornés-Vives
- Department of Nursing and Physiotherapy University of the Balearic Islands (UBI), Ctra. Valldemossa, km 7.5, Palma E-07122, Spain
| | - Albert Sesé Abad
- Health Research Institute of the Balearic Islands (IdISBa), Ctra. Valldemossa, 79, Palma E-07120, Spain
- Department of Psychology University of the Balearic Islands (UBI), Ctra. Valldemossa, km 7.5, Palma E-07122, Spain
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Jackson SE, Cox S, Brown J. Trends in cross-border and illicit tobacco purchases among people who smoke in England, 2019-2022. Tob Control 2024; 33:688-692. [PMID: 37463758 DOI: 10.1136/tc-2023-057991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/15/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVES The last 5 years have seen substantial changes in England's social and economic landscape as a result of Brexit, the COVID-19 pandemic and cost of living crisis. We aimed to examine changes in cross-border and illicit tobacco purchasing over this period. DESIGN Nationally representative monthly cross-sectional survey. SETTING England, 2019-2022. PARTICIPANTS 11 232 adults (≥18 years) who smoked in the past year. MAIN OUTCOME MEASURES We estimated time trends in the proportion reporting purchasing tobacco from (1) cross-border and (2) illicit sources in the past 6 months. RESULTS Between February 2019 and October 2022, there was a non-linear increase in the proportion of participants reporting cross-border tobacco purchases (from 5.2% to 16.1% overall; prevalence ratio (PR)=3.10, 95% CI 2.03-4.73). Prevalence first increased from 5.2% to 15.4% between February 2019 and April 2020, before falling to 7.8% between April 2020 and September 2021 during the COVID-19 pandemic, and then increasing again to 16.1% by the end of the period. Changes in cross-border tobacco purchasing were more pronounced among participants from more advantaged (from 6.6% to 23.3%; PR=3.52, 95% CI 2.05-5.91) compared with less advantaged (4.4% to 11.5%; PR=2.61, 95% CI 1.17-5.20) social grades (pinteraction=0.034). There was no overall change in the proportion reporting illicit tobacco purchases (from 9.2% to 8.5%; PR=0.92, 95% CI 0.70-1.21), nor any significant difference in trends by social grade (pinteraction=0.783). CONCLUSIONS Despite a fall in cross-border tobacco purchasing during the first year of the COVID-19 pandemic among adults in England who smoke, the proportion reporting cross-border tobacco purchases is now three times higher than it was at the start of 2019. The proportion reporting illicit tobacco purchases has not changed substantially.
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Affiliation(s)
| | - Sharon Cox
- Behavioural Science and Health, UCL, London, UK
| | - Jamie Brown
- Behavioural Science and Health, UCL, London, UK
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Duan Z, Berg CJ, Bar-Zeev Y, Abroms LC, Wang Y, Khayat A, Cui Y, LoParco CR, Levine H. Perceptions of Heated Tobacco Products (HTPs) Versus Cigarettes and e-Cigarettes in Relation to Likelihood of Trying HTPs or Suggesting HTPs to Those who Smoke Cigarettes. Nicotine Tob Res 2024; 26:1394-1403. [PMID: 38666732 PMCID: PMC11417126 DOI: 10.1093/ntr/ntae093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 02/12/2024] [Accepted: 04/11/2024] [Indexed: 09/25/2024]
Abstract
INTRODUCTION Heated tobacco products (HTPs), like IQOS, are marketed as innovative, stylish, harm-reduction products distinct from cigarettes and e-cigarettes. Research is needed to better understand how adults who are newly introduced to HTPs perceive them relative to cigarettes and e-cigarettes, and the impact of these perceptions on use outcomes. AIMS AND METHODS We analyzed 2021 cross-sectional survey data from 1914 adults who never used HTPs from the United States and Israel, two countries where IQOS has unique histories and markets. Exploratory factor analysis examined perceptions of HTPs (vs. cigarettes and e-cigarettes) across 12 perception measures (eg, innovative, trendy, harmful, addictive). Multivariable linear regression examined these factors in relation to self-reported likelihood to: (1) "try HTPs in the next year" (1 = not-7 = extremely) and (2) "suggest IQOS to a friend who smokes cigarettes" (1 = not-5 = very), controlling for demographics and past-month cigarette and e-cigarette use (10.1% dual use, 15.4% cigarette-only, 5.7% e-cigarette-only, 68.8% neither). RESULTS Four factors were identified: HTPs' health and utility ("health-utility") and design and appeal ("design-appeal") versus cigarettes and versus e-cigarettes, separately. More favorable perceptions of HTP versus e-cigarette design-appeal (B = 0.30, 95% CI = 0.18, 0.41) were associated with greater likelihood to try HTPs. More favorable perceptions of HTP versus cigarette design-appeal (B = 0.38, 95% CI = 0.26, 0.51) and health-utility (B = 0.25, 95% CI = 0.13, 0.36), and HTP versus e-cigarette design-appeal (B = 0.32, 95% CI = 0.20, 0.45) were associated with greater likelihood to suggest HTPs to smokers. CONCLUSIONS Monitoring perceptions of HTPs versus cigarettes and e-cigarettes is critical given the role of such perceptions in HTP use and their population-level impact. IMPLICATIONS This study examined the relationship of perceptions of HTPs relative to cigarettes and e-cigarettes, with regard to adults' self-reported likelihood to use HTP or to suggest HTPs to those who smoke cigarettes. Favorable perceptions of HTPs' design and appeal versus e-cigarettes correlated with greater likelihood to try HTPs. Favorable perceptions of HTPs' design and appeal, as well as health and utility, versus cigarettes and e-cigarettes correlated with greater likelihood to suggest HTPs to those who smoke. Findings underscore the need for ongoing surveillance of HTP marketing and consumer perceptions to inform regulatory efforts and estimate the population-level impact of HTPs and other tobacco products.
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Affiliation(s)
- Zongshuan Duan
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- George Washington Cancer Center, George Washington University, Washington, DC, USA
| | - Yael Bar-Zeev
- Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah Medical Center, Jerusalem, Israel
| | - Lorien C Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- George Washington Cancer Center, George Washington University, Washington, DC, USA
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- George Washington Cancer Center, George Washington University, Washington, DC, USA
| | - Amal Khayat
- Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah Medical Center, Jerusalem, Israel
| | - Yuxian Cui
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Cassidy R LoParco
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Hagai Levine
- Braun School of Public Health and Community Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and Hadassah Medical Center, Jerusalem, Israel
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Lyzwinski L, Dong M, Wolfinger RD, Filion KB, Eisenberg MJ. e-Cigarettes, Smoking Cessation, and Weight Change: Retrospective Secondary Analysis of the Evaluating the Efficacy of e-Cigarette Use for Smoking Cessation Trial. JMIR Public Health Surveill 2024; 10:e58260. [PMID: 39283667 PMCID: PMC11443201 DOI: 10.2196/58260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 05/09/2024] [Accepted: 07/17/2024] [Indexed: 10/04/2024] Open
Abstract
BACKGROUND While smoking cessation has been linked to substantial weight gain, the potential influence of e-cigarettes on weight changes among individuals who use these devices to quit smoking is not fully understood. OBJECTIVE This study aims to reanalyze data from the Evaluating the Efficacy of e-Cigarette Use for Smoking Cessation (E3) trial to assess the causal effects of e-cigarette use on change in body weight. METHODS This is a secondary analysis of the E3 trial in which participants were randomized into 3 groups: nicotine e-cigarettes plus counseling, nonnicotine e-cigarettes plus counseling, and counseling alone. With adjustment for baseline variables and the follow-up smoking abstinence status, weight changes were compared between the groups from baseline to 12 weeks' follow-up. Intention-to-treat and as-treated analyses were conducted using doubly robust estimation. Further causal analysis used 2 different propensity scoring methods to estimate causal regression curves for 4 smoking-related continuous variables. We evaluated 5 different subsets of data for each method. Selection bias was addressed, and missing data were imputed by the machine learning method extreme gradient boosting (XGBoost). RESULTS A total of 257 individuals with measured weight at week 12 (mean age: 52, SD 12 y; women: n=122, 47.5%) were included. Across the 3 treatment groups, of the 257 participants, 204 (79.4%) who continued to smoke had, on average, largely unchanged weight at 12 weeks, with comparable mean weight gain ranging from -0.24 kg to 0.33 kg, while 53 (20.6%) smoking-abstinent participants gained weight, with a mean weight gain ranging from 2.05 kg to 2.70 kg. After adjustment, our analyses showed that the 2 e-cigarette arms exhibited a mean gain of 0.56 kg versus the counseling alone arm. The causal regression curves analysis also showed no strong evidence supporting a causal relationship between weight gain and the 3 e-cigarette-related variables. e-Cigarettes have small and variable causal effects on weight gain associated with smoking cessation. CONCLUSIONS In the E3 trial, e-cigarettes seemed to have minimal effects on mitigating the weight gain observed in individuals who smoke and subsequently quit at 3 months. However, given the modest sample size and the potential underuse of e-cigarettes among those randomized to the e-cigarette treatment arms, these results need to be replicated in large, adequately powered trials. TRIAL REGISTRATION ClinicalTrials.gov NCT02417467; https://www.clinicaltrials.gov/study/NCT02417467.
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Affiliation(s)
- Lynnette Lyzwinski
- Centre for Clinical Epidemiology, Lady Davis Institute, McGill University, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Meichen Dong
- JMP Statistical Discovery LLC, Cary, NC, United States
| | | | - Kristian B Filion
- Centre for Clinical Epidemiology, Lady Davis Institute, McGill University, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Department of Medicine, McGill University, Montreal, QC, Canada
| | - Mark J Eisenberg
- Centre for Clinical Epidemiology, Lady Davis Institute, McGill University, Montreal, QC, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Department of Medicine, McGill University, Montreal, QC, Canada
- Division of Cardiology, Jewish General Hospital, Montreal, QC, Canada
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12
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Ponnambalam M. The 7 Pillars for Preoperative Optimization and Postoperative Care in Patients Undergoing Minimally Invasive CABG. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2024:15569845241272171. [PMID: 39267407 DOI: 10.1177/15569845241272171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/17/2024]
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13
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He WJA, Wang Q, Chan CHH, Luk TT, Wang MP, Chan SCS, Lam TH, Cheung YTD. Effectiveness of mobile smoking cessation treatment with 1-week nicotine replacement therapy sampling at outdoor smoking hotspots: A cluster randomized controlled trial. Addiction 2024. [PMID: 39256314 DOI: 10.1111/add.16666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 08/07/2024] [Indexed: 09/12/2024]
Abstract
AIMS To evaluate the effectiveness of mobile smoking cessation (SC) treatment with 1-week nicotine replacement therapy (NRT) sampling on recruitment and quitting outcomes. DESIGN Two-arm cluster RCT (1:1 ratio), single-blinded, at 244 recruitment sessions in Hong Kong outdoor smoking hotspots from October 2018-December 2019. SETTING Participant were recruited by ambassadors and treated at the mobile SC truck. PARTICIPANTS 834 adult (≥18 years, male 81.3%) daily smokers, Chinese-speaking, non-NRT users in the past month, consented after nurse-led intervention in mobile SC truck were randomized to the experimental (n = 482 male 79.5%) and the control group (n = 352, male 83.8%). INTERVENTION AND COMPARATOR The experimental group received a 1-week free NRT sample, an NRT instruction card, and mobile SC treatment including onsite nurse-led brief medication advice (about 15 minutes) and referral to SC clinics. The control group received the same mobile SC treatment. MEASUREMENTS Primary outcome was self-reported quit attempts at 1-month follow-up. Secondary outcomes included SC service use at 1 month, and biochemically validated abstinence (exhaled carbon monoxide < 4 ppm; or saliva cotinine < 10 ng/ml) at 6-month follow-up. Additionally, a post-hoc cost analysis was conducted. FINDINGS By intention-to-treat, the two groups showed similar prevalence of quit attempts (44·4% versus 43·5%, risk ratio (RR) = 1·04, 95% confidence interval (CI) = 0·79-1·37, P = 0·79). Compared with the control group, the experimental group showed lower SC service use at clinics (32·4% versus 44·9%, RR = 0·72, 95%CI = 0·57-0·91, P = 0·006), but no significant difference in validated abstinence (4·6% versus 2·8%, RR = 1·64, 95%CI = 0·76-3·50, P = 0·21). The experimental recruitment sessions recruited more smokers for onsite medication advice than the control session (mean 6·7 vs 5·0, adjusted incident rate ratio = 1·30, 95%CI = 1·08-1·56, P = 0·005). CONCLUSIONS Mobile smoking cessation treatment with 1-week nicotine replacement therapy sampling did not increase quit attempts or abstinence outcomes among recruited daily smokers in Hong Kong. The intervention increased smokers' uptake of onsite medication advice but reduced subsequent smoking cessation service use at clinics.
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Affiliation(s)
- Wan Jia Aaron He
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Qi Wang
- School of Graduate Studies, Lingnan University, Hong Kong
| | | | - Tzu Tsun Luk
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Man Ping Wang
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Siu Chee Sophia Chan
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Tai Hing Lam
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Yee Tak Derek Cheung
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
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Tillery A, O'Leary R, Aherrera A, Farlee J, Youpee B, Hovhannisyan Romero ES, Cajero M, Duran J, Erdei E, Rule AM. COVID-19 Disease and Chronic Health Outcomes Associated with Nicotine Use in a Great Plains Tribal Community: A Community-Based Study. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02145-3. [PMID: 39256325 DOI: 10.1007/s40615-024-02145-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 08/14/2024] [Accepted: 08/17/2024] [Indexed: 09/12/2024]
Abstract
BACKGROUND The Cheyenne River Sioux Tribe (CRST) is affected by high nicotine use and disease burden. Understanding nicotine exposure is important to recognize what groups may be at higher risk for negative health outcomes, including COVID-19. OBJECTIVE To compare self-reported health outcomes and nicotine use between exclusive electronic cigarette (e-cig) users, users of combustible cigarettes, dual e-cig/cigarette users, and nonusers among adult residents on the CRST. METHODS The CRST "COVID-19 - Wayakta He study" ("Are you on guard against COVID-19?") recruited 562 participants on the reservation who filled out a 97-item survey. Regression models were used to analyze nicotine exposure, demographic characteristics, and health outcomes. RESULTS Prevalence of nicotine use among participants was 53%. Reported median puffs per day was 15 for e-cig, 100 for cigarette, and 20 for dual users (p < 0.001). The odds of having COVID-19 were lower for nicotine users compared to nonusers (p < 0.001). The odds of hypertension (p = 0.04) and high cholesterol (p = 0.03) were lower for nicotine users compared to nonusers. The proportional odds were higher for nicotine users for longer COVID-19 recovery time (p = 0.046) and lower for more severe COVID-19 infection (p = 0.001). SIGNIFICANCE This study provides critical data on self-reported COVID-19, chronic disease outcomes, and exposure to commercial nicotine products. Results from this unique Tribal community-driven study with a large sample size (N = 562 participants from 289 households) will help understand the role that environmental exposures played on increased COVID-19 mortality, help target public health interventions, and inform Tribal public health policies on emergency preparedness and exposure analyses.
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Affiliation(s)
- Anna Tillery
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Rae O'Leary
- Missouri Breaks Industries Research Inc., Eagle Butte, SD, USA
| | - Angela Aherrera
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jaylynn Farlee
- Missouri Breaks Industries Research Inc., Eagle Butte, SD, USA
| | - Brittany Youpee
- Missouri Breaks Industries Research Inc., Eagle Butte, SD, USA
| | | | - Miranda Cajero
- The University of New Mexico Health Sciences Center College of Pharmacy, Albuquerque, NM, USA
| | - Jacob Duran
- The University of New Mexico Health Sciences Center College of Pharmacy, Albuquerque, NM, USA
| | - Esther Erdei
- The University of New Mexico Health Sciences Center College of Pharmacy, Albuquerque, NM, USA
| | - Ana M Rule
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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Zhao B, Chen H, Gao L, Zhang Y, Li X. Social addiction or nicotine addiction? The effect of smoking social motivation on inhibitory control under smoking social cues: Evidence from ERPs. Drug Alcohol Depend 2024; 264:112427. [PMID: 39255741 DOI: 10.1016/j.drugalcdep.2024.112427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 08/18/2024] [Accepted: 08/23/2024] [Indexed: 09/12/2024]
Abstract
INTRODUCTION Previous studies and theoretical models suggest that the decreasing effect of smoking-related cues on inhibitory control in individuals who smoke is one of the underlying mechanisms of smoking behavior. However, many studies have overlooked the effects of other types of smoking-related cues, such as social cues. Moreover, previous studies have lacked investigation into whether this decreasing effect is influenced by internal factors. The present study aims to integrate behavioral and electrophysiological indicators to investigate the effect of smoking social cues on inhibitory control in individuals who smoke, as well as the moderating role of social motivations. METHOD In Experiment 1, a visual Go/NoGo paradigm with four types of backgrounds (neutral, neutral social, smoking object, and smoking social backgrounds) was used to record the error rates and reaction times of 32 participants who smoke. In Experiment 2, the Go/NoGo paradigm with two types of backgrounds (smoking object and smoking social backgrounds) was used to record the error rates, reaction times, and amplitudes of the N2 and P3 event-related potentials among 30 participants who smoke with varying degrees of primed smoking social motivation. RESULTS (1) Individuals who smoke had higher commission error rates and larger P3 amplitude under smoking social background than under smoking object background; (2) individuals who smoke with primed high smoking social motivation, rather than low motivation had higher commission error rates and larger P3 amplitude under smoking social background than under smoking object background. CONCLUSIONS Smoking social cues have a greater capacity to decrease inhibitory control in people who smoke than smoking object cues, and this decreasing effect is bolstered by smoking social motivation.
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Affiliation(s)
- Boqiang Zhao
- School of Psychology, Zhejiang Normal University, Jinhua, China; Intelligent Laboratory of Child and Adolescent Mental Health and Crisis Intervention of Zhejiang Province, Jinhua, China.
| | - Haide Chen
- School of Psychology, Zhejiang Normal University, Jinhua, China; Intelligent Laboratory of Child and Adolescent Mental Health and Crisis Intervention of Zhejiang Province, Jinhua, China.
| | - Lingfeng Gao
- School of Psychology, Zhejiang Normal University, Jinhua, China; Intelligent Laboratory of Child and Adolescent Mental Health and Crisis Intervention of Zhejiang Province, Jinhua, China.
| | - Yuhan Zhang
- School of Psychology, Zhejiang Normal University, Jinhua, China; Intelligent Laboratory of Child and Adolescent Mental Health and Crisis Intervention of Zhejiang Province, Jinhua, China.
| | - XinWei Li
- School of Psychology, Zhejiang Normal University, Jinhua, China; Intelligent Laboratory of Child and Adolescent Mental Health and Crisis Intervention of Zhejiang Province, Jinhua, China.
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Norris E, Prescott A, Noone C, Green JA, Reynolds J, Grant SP, Toomey E. Establishing open science research priorities in health psychology: a research prioritisation Delphi exercise. Psychol Health 2024; 39:1218-1242. [PMID: 36317294 DOI: 10.1080/08870446.2022.2139830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 09/06/2022] [Accepted: 10/19/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Research on Open Science practices in Health Psychology is lacking. This meta-research study aimed to identify research question priorities and obtain consensus on the Top 5 prioritised research questions for Open Science in Health Psychology. METHODS AND MEASURES An international Delphi consensus study was conducted. Twenty-three experts in Open Science and Health Psychology within the European Health Psychology Society (EHPS) suggested research question priorities to create a 'long-list' of items (Phase 1). Forty-three EHPS members rated the importance of these items, ranked their top five and suggested their own additional items (Phase 2). Twenty-four EHPS members received feedback on Phase 2 responses and then re-rated and re-ranked their top five research questions (Phase 3). RESULTS The top five ranked research question priorities were: 1. 'To what extent are Open Science behaviours currently practised in Health Psychology?', 2. 'How can we maximise the usefulness of Open Data and Open Code resources?', 3. 'How can Open Data be increased within Health Psychology?', 4. 'What interventions are effective for increasing the adoption of Open Science in Health Psychology?' and 5. 'How can we increase free Open Access publishing in Health Psychology?'. CONCLUSION Funding and resources should prioritise the research questions identified here.
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Affiliation(s)
- Emma Norris
- Health Behaviour Change Research Group; Department of Health Sciences, Brunel University London, Uxbridge, UK
| | - Amy Prescott
- Department of Life Sciences, Brunel University London, Uxbridge, UK
| | - Chris Noone
- School of Psychology, NUI Galway, Galway, Ireland
| | - James A Green
- Health Research Institute (HRI) and School of Allied Health, University of Limerick, Limerick, Ireland
| | | | - Sean Patrick Grant
- School of Public Health, Indiana and Purdue University Indianapolis, Indianapolis, IN, USA
| | - Elaine Toomey
- Health Research Institute (HRI) and School of Allied Health, University of Limerick, Limerick, Ireland
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Evanoff NG, Dengel DR, Stockelman KA, Fandl H, DeSouza NM, Greiner JJ, Dufresne SR, Kotlyar M, Garcia VP. Circulating extracellular microvesicles associated with electronic cigarette use increase endothelial cell inflammation and reduce nitric oxide production. Exp Physiol 2024; 109:1593-1603. [PMID: 39092897 PMCID: PMC11363099 DOI: 10.1113/ep091715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 07/05/2024] [Indexed: 08/04/2024]
Abstract
The purpose of this study was to determine the effect of circulating microvesicles isolated from chronic electronic (e-)cigarette users on cultured human umbilical vein endothelial cell (HUVEC) expression of nuclear factor-κB (NF-κB), cellular cytokine release, phosphorylation of endothelial nitric oxide synthase (eNOS) and NO production. The HUVECs were treated with microvesicles isolated via flow cytometry from nine non-tobacco users (five male and four female; 22 ± 2 years of age) and 10 e-cigarette users (six male and four female; 22 ± 2 years of age). Microvesicles from e-cigarette users induced significantly greater release of interleukin-6 (183.4 ± 23.6 vs. 150.6 ± 15.4 pg/mL; P = 0.002) and interleukin-8 (160.0 ± 31.6 vs. 129.4 ± 11.2 pg/mL; P = 0.01), in addition to expression of p-NF-κB p65 (Ser536) (18.8 ± 3.4 vs. 15.6 ± 1.5 a.u.; P = 0.02) from HUVECs compared with microvesicles from non-tobacco users. Nuclear factor-κB p65 was not significantly different between microvesicles from the non-tobacco users and from the e-cigarette users (87.6 ± 8.7 vs. 90.4 ± 24.6 a.u.; P = 0.701). Neither total eNOS (71.4 ± 21.8 vs. 80.4 ± 24.5 a.u.; P = 0.413) nor p-eNOS (Thr495) (229.2 ± 26.5 vs. 222.1 ± 22.7 a.u.; P = 0.542) was significantly different between microvesicle-treated HUVECs from non-tobacco users and e-cigarette users. However, p-eNOS (Ser1177) (28.9 ± 6.2 vs. 45.8 ± 9.0 a.u.; P < 0.001) expression was significantly lower from e-cigarette users compared with non-tobacco users. Nitric oxide production was significantly lower (8.2 ± 0.6 vs. 9.7 ± 0.9 μmol/L; P = 0.001) in HUVECs treated with microvesicles from e-cigarette users compared with microvesicles from non-tobacco users. This study demonstrated increased NF-κB activation and inflammatory cytokine production, in addition to diminished eNOS activity and NO production resulting from e-cigarette use. HIGHLIGHTS: What is the central question of this study? Circulating microvesicles contribute to cardiovascular health and disease via their effects on the vascular endothelium. The impact of electronic (e-)cigarette use on circulating microvesicle phenotype is not well understood. What is the main finding and its importance? Circulating microvesicles from e-cigarette users increase endothelial cell inflammation and impair endothelial nitric oxide production. Endothelial inflammation and diminished nitric oxide bioavailability are central factors underlying endothelial dysfunction and, in turn, cardiovascular disease risk. Deleterious changes in the functional phenotype of circulating microvesicles might contribute to the reported adverse effects of e-cigarette use on cardiovascular health.
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Affiliation(s)
- Nicholas G. Evanoff
- School of KinesiologyUniversity of MinnesotaMinneapolisMinnesotaUSA
- Center for Pediatric Obesity MedicineUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA
| | - Donald R. Dengel
- School of KinesiologyUniversity of MinnesotaMinneapolisMinnesotaUSA
- Center for Pediatric Obesity MedicineUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA
| | - Kelly A. Stockelman
- Department of Integrative PhysiologyUniversity of ColoradoBoulderColoradoUSA
| | - Hannah Fandl
- Department of Integrative PhysiologyUniversity of ColoradoBoulderColoradoUSA
| | - Noah M. DeSouza
- Department of Integrative PhysiologyUniversity of ColoradoBoulderColoradoUSA
| | - Jared J. Greiner
- Department of Integrative PhysiologyUniversity of ColoradoBoulderColoradoUSA
| | - Sheena R. Dufresne
- Department of Experimental and Clinical PharmacologyUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Michael Kotlyar
- Department of Experimental and Clinical PharmacologyUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Vinicius P. Garcia
- Department of Integrative PhysiologyUniversity of ColoradoBoulderColoradoUSA
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Surendran A, McSharry J, Meade O, Meredith D, McNamara J, Bligh F, O'Hora D. Barriers and facilitators to adopting safe farm-machine related behaviors: A focus group study exploring older farmers' perspectives. JOURNAL OF SAFETY RESEARCH 2024; 90:19-30. [PMID: 39251277 DOI: 10.1016/j.jsr.2024.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 02/13/2024] [Accepted: 05/16/2024] [Indexed: 09/11/2024]
Abstract
BACKGROUND Tractors and quad bikes pose a significant risk of fatal injuries among farmers, particularly affecting older farmers. This study aimed to explore the barriers and facilitators to the adoption of machine related safety behaviors among older farmers in Irish farm settings. METHOD Four focus groups were conducted via Zoom in February 2021. Nineteen Irish farmers from four farm types participated. The discussions were audio-recorded, transcribed verbatim, and analyzed using an inductive, reflexive thematic analysis approach. The themes identified were then mapped to the COM-B (Capability-Opportunity-Motivation) model, providing a systematic theoretical basis for designing a future intervention to reduce machine-related accidents. RESULTS The analysis identified five inductive themes that encompassed both barriers and facilitators in farm safety practices: (1) Capability to manage competing responsibilities; (2) Characteristics of the farm and its work environment; (3) Availability and affordability of resources; (4) Prevailing sociocultural opportunities; and (5) Perceived likelihood and cost-benefit analysis in safety decision-making. These themes captured the complex interplay of capability, opportunity, and motivation in farmers' decision-making processes. The study also revealed limitations in existing interventions, such as voluntary guidelines and educational methods, in effectively addressing these barriers. CONCLUSIONS Farmers' abilities (capability), prevailing sociocultural factors, resource availability (opportunity), and their perceived consequences and benefits (motivation) affect how safely they work with machines. The study emphasizes the need for comprehensive, theory-driven approaches that consider the interplay of capability, opportunity, and motivational factors that may support or impede machine safety. Understanding the challenges faced by Irish farmers highlights potential strategies for safety intervention, and these strategies should be co-designed with farmers and attentive to the local context. PRACTICAL APPLICATIONS The study provides a template for understanding farmers' perspectives using the COM-B model. The findings can inform the development of theoretically informed intervention strategies based on the Behavior Change Wheel framework.
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Affiliation(s)
- Aswathi Surendran
- School of Psychology, University of Galway, H91 TK33 Galway, Ireland.
| | - Jenny McSharry
- School of Psychology, University of Galway, H91 TK33 Galway, Ireland
| | - Oonagh Meade
- School of Psychology, University of Galway, H91 TK33 Galway, Ireland
| | - David Meredith
- Irish Agriculture and Food Development Authority, R93 XE12 Carlow, Ireland
| | - John McNamara
- Irish Agriculture and Food Development Authority, R93 XE12 Carlow, Ireland
| | - Francis Bligh
- Irish Agriculture and Food Development Authority, R93 XE12 Carlow, Ireland
| | - Denis O'Hora
- School of Psychology, University of Galway, H91 TK33 Galway, Ireland
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Schadegg MJ, Dixon LJ, Lee AA. Emotion Regulation Difficulties and Smoking Behavior among Adults with Chronic Obstructive Pulmonary Diseases. Psychiatr Q 2024; 95:433-445. [PMID: 39008153 PMCID: PMC11420253 DOI: 10.1007/s11126-024-10080-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/07/2024] [Indexed: 07/16/2024]
Abstract
COPD is one of the leading causes of death in the United States and results in increased healthcare costs and disability. Smoking is the main determinant of COPD development and continued use increases mortality as compared to those who have stopped smoking. Research has indicated that cigarette smoking may play a role in attempts to regulate distressing emotional experiences and thus, may be an important transdiagnostic process underlying continued smoking behavior among adults with COPD. The current study investigated the role of ER difficulties in relation to smoking status and cigarettes smoked per day among adults with COPD. This cross-sectional study included a sample was adults with COPD (N = 320). Participants self-reported current smoking status, daily smoking, and the Difficulties in Emotion Regulation Scale. All analyses were adjusted for age, sex, probable depression, probable anxiety, and dyspnea severity. DERS total scores were associated with greater odds of current smoking. With the exception of impulsivity, all other dimensions of emotion regulation were significantly associated with current smoking. Greater difficulties in emotional awareness were associated with greater cigarettes smoked per day. However, neither the DERS total score nor any other dimensions of emotional regulation were significantly associated with cigarettes smoked per day. The present study provides preliminary data linking ER difficulties to smoking behavior among adults with COPD. If corroborated by future research, these findings suggest that ER might be a potential target for smoking cessation programs among adults with COPD.
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Affiliation(s)
- Mary J Schadegg
- Department of Psychiatry, NYU Grossman School of Medicine, One Park Ave, New York, NY, 10016, USA
| | - Laura J Dixon
- Department of Psychology, University of Mississippi, P.O. Box 1848, University, MS, 38677, USA
| | - Aaron A Lee
- Department of Psychology, University of Mississippi, P.O. Box 1848, University, MS, 38677, USA.
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Sreeramareddy CT, Kuan LP. Smoking Cessation and Utilization of Cessation Assistance in 13 low- and middle-income countries - changes between Two Survey Rounds of Global Adult Tobacco Surveys, 2009-2021. J Epidemiol Glob Health 2024; 14:1257-1267. [PMID: 39133364 PMCID: PMC11442961 DOI: 10.1007/s44197-024-00283-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Accepted: 07/30/2024] [Indexed: 08/13/2024] Open
Abstract
INTRODUCTION Monitoring changes in cessation behaviors and cessation assistance is critical for policymaking. METHODS We analyzed two rounds (2009-2014 and 2015-2021) of Global Adult Tobacco Surveys in 13 countries. We estimated the quit ratio, quit attempt, and utilization of cessation assistance. The availability of cessation services was obtained from World Health Organization reports. We calculated absolute and relative changes in quit ratio, quit attempt, and cessation assistance. We assessed socio-economic determinants of cessation behaviors by binary logistic regression analyses on pooled data. RESULTS In all countries during both rounds smoking prevalence was 7.6-33.8%, the quit ratio was 0.15-0.54%, and the quit attempt was 17.7-52.8%. Quit ratio improved in Indonesia by 100% but declined in Turkey by 56%. Quit attempts increased in Indonesia (31.9%), Mexico (16.9%) and China (15.9%) but decreased in Turkey (140.4%), Vietnam (43.1%), and Romania (62.4%). In both rounds, using at least one method was 12.5-99.8% while the WHO-recommended method was 4.1-88.4%. In both rounds "try to quit without any assistance" and "other methods" were the most frequently reported cessation assistance. Nicotine replacement therapy (0.2-25.3%) was frequently used as recommended cessation assistance. Nicotine replacement therapy was available in most countries but not quitline and support services. CONCLUSION Limited progress was made in smoking cessation behaviors and cessation assistance in most countries. Health education to improve demand for smoking cessation and availability of evidence-based, low-cost smoking cessation assistance including quit-smoking may improve quit ratios in the population.
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Affiliation(s)
- Chandrashekhar T Sreeramareddy
- Division of Community Medicine and Public Health, International Medical University, Kuala Lumpur, Malaysia.
- Centre for Translational Research Institute for Research Development and Innovation, International Medical University, Kuala Lumpur, Malaysia.
| | - Lai Pei Kuan
- Centre for Translational Research Institute for Research Development and Innovation, International Medical University, Kuala Lumpur, Malaysia
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Rahman T, Bennett J, Kennedy M, Baker AL, Gould GS. "It's a big conversation": Views of service personnel on systemic barriers to preventing smoking relapse among pregnant and postpartum Aboriginal and Torres Strait Islander women - A qualitative study. Midwifery 2024; 139:104163. [PMID: 39243596 DOI: 10.1016/j.midw.2024.104163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 08/05/2024] [Accepted: 08/26/2024] [Indexed: 09/09/2024]
Abstract
BACKGROUND Providing smoking cessation care has not successfully prevented women who quit smoking during pregnancy from relapsing due to multi-level barriers. AIM This paper explores systemic barriers to providing smoking cessation care, focusing on relapse prevention among pregnant and postpartum Aboriginal and Torres Strait Islander women (hereafter Aboriginal). METHODS Twenty-six interviews were conducted between October 2020 and July 2021 with health professionals, health promotion workers and managers working in Aboriginal smoking cessation across six Australian states and territories. Data were thematically analysed. FINDINGS Themes emerging from the data included: (a) limited time, competing priorities and shortage of health professionals; (b) a need for more knowledge and skills for health professionals; (c) influences of funding allocations and models of smoking cessation care; (d) lack of relevance of anti-tobacco messages to pregnancy and postpartum relapse; and (e) ways forward. Several barriers emerged from policies influencing access to resources and approaches to smoking cessation care for Aboriginal women. Individual-level maternal smoking cessation care provision was often under-resourced and time-constrained to adequately meet Aboriginal women's needs. Identified needs for health professionals included more time, knowledge and skills, better cultural awareness for non-Indigenous health professionals, and salient anti-tobacco messages for pregnant women related to long-term cessation. CONCLUSION To drive smoking cessation in pregnant and postpartum Aboriginal women, we recommend adequately reimbursing midwives and Aboriginal Health Workers/Professionals to allow them to provide intensive support, build confidence in Quitline, continue health professionals' capacity-building and allocate consistent funding to initiatives that have been efficacious with Aboriginal women.
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Affiliation(s)
- Tabassum Rahman
- Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria, Australia.
| | - Jessica Bennett
- School of Medicine and Public Health, The University of Newcastle, New South Wales, Australia; Hunter Medical Research Institute, New South Wales, Australia
| | - Michelle Kennedy
- School of Medicine and Public Health, The University of Newcastle, New South Wales, Australia; Hunter Medical Research Institute, New South Wales, Australia; Lowitja Institute, Victoria, Australia
| | - Amanda L Baker
- National Drug and Alcohol Research Centre, The University of New South Wales, New South Wales, Australia
| | - Gillian S Gould
- Faculty of Health, Southern Cross University, New South Wales, Australia
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22
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Cosson E, Tatulashvili S, Vicaut E, Carbillon L, Bihan H, Rezgani I, Pinto S, Sal M, Zerguine M, Fermaut M, Portal JJ, Puder JJ, Benbara A. Hyperglycaemia in Pregnancy Is Less Frequent in Smokers: A French Observational Study of 15,801 Women. J Clin Med 2024; 13:5149. [PMID: 39274361 PMCID: PMC11396654 DOI: 10.3390/jcm13175149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Revised: 08/22/2024] [Accepted: 08/27/2024] [Indexed: 09/16/2024] Open
Abstract
Background: We aimed to explore the still-debated association between smoking and hyperglycaemia in pregnancy (HIP). Methods: A multiethnic prospective study of 15,801 women who delivered at Jean Verdier University Hospital between 2012 and 2018. Of these, 13,943 (88.2%) were non-smokers, 624 (4.5%) former smokers, and 1234 (7.8%) current smokers. Universal HIP screening was proposed to the entire sample (IADPSG/WHO criteria). Results: A total of 13,958 women were screened for HIP. Uptake differed between non-smokers, former smokers, and current smokers (89.5%, 88.3%, and 75.7%, respectively, p < 0.0001). HIP prevalence in these groups was 19.9%, 15.4%, and 12.3%, respectively (p < 0.0001). After adjusting for age, body mass index, family history of diabetes, history of HIP, history of macrosomic baby, and ethnicity, current (odds ratio 0.790 [95% confidence interval 0.636-0.981], p < 0.05) but not former (1.017 [0.792-1.306]) smokers were less likely to have HIP than non-smokers. Furthermore, 1 h and 2 h oral plasma glucose test values were lower in current smokers than in non-smokers (p < 0.01). To exclude potential selection bias, we compared risk factors for HIP and HIP-related adverse pregnancy outcomes in current smokers according to HIP screening status. Compared with screened current smokers (n = 934), their unscreened counterparts (n = 300) were younger, less frequently employed, and more likely to be of non-European origin. Moreover, infant birthweight was lower in this group, and preterm deliveries and perinatal deaths were more likely (all p < 0.01). Conclusions: Smoking during pregnancy was independently associated with lower HIP prevalence. The low HIP screening rate in current smokers did not explain this finding.
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Affiliation(s)
- Emmanuel Cosson
- AP-HP, Avicenne Hospital, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, 93000 Bobigny, France
- INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord and Université Paris Cité, 93017 Bobigny, France
| | - Sopio Tatulashvili
- AP-HP, Avicenne Hospital, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, 93000 Bobigny, France
- INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord and Université Paris Cité, 93017 Bobigny, France
| | - Eric Vicaut
- AP-HP, Unité de Recherche Clinique St-Louis-Lariboisière, Université Denis Diderot, 75010 Paris, France
| | - Lionel Carbillon
- AP-HP, Jean Verdier Hospital, Sorbonne Paris Cité, Department of Obstetrics and Gynecology, Paris 13 University, 93140 Bondy, France
| | - Hélène Bihan
- AP-HP, Avicenne Hospital, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, 93000 Bobigny, France
| | - Imen Rezgani
- AP-HP, Avicenne Hospital, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, 93000 Bobigny, France
| | - Sara Pinto
- AP-HP, Avicenne Hospital, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, 93000 Bobigny, France
| | - Meriem Sal
- AP-HP, Avicenne Hospital, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, 93000 Bobigny, France
| | - Mohamed Zerguine
- AP-HP, Avicenne Hospital, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Paris 13 University, 93000 Bobigny, France
| | - Marion Fermaut
- AP-HP, Jean Verdier Hospital, Sorbonne Paris Cité, Department of Obstetrics and Gynecology, Paris 13 University, 93140 Bondy, France
| | - Jean-Jacques Portal
- AP-HP, Unité de Recherche Clinique St-Louis-Lariboisière, Université Denis Diderot, 75010 Paris, France
| | - Jardena J Puder
- Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, 1000 Lausanne, Switzerland
| | - Amélie Benbara
- AP-HP, Jean Verdier Hospital, Sorbonne Paris Cité, Department of Obstetrics and Gynecology, Paris 13 University, 93140 Bondy, France
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Shangase PZ, Shandu NM. Perspectives of Hospital Staff on Barriers to Smoking Cessation Interventions among Drug-Resistant Tuberculosis Patients in a South African Management Hospital. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1137. [PMID: 39338021 PMCID: PMC11431632 DOI: 10.3390/ijerph21091137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Revised: 08/22/2024] [Accepted: 08/24/2024] [Indexed: 09/30/2024]
Abstract
Drug-resistant tuberculosis (DR-TB) remains a major cause of illness and death, with personal and non-addiction-related barriers. This study aimed to explore the perspectives of hospital staff on barriers to smoking cessation interventions (SCIs) for in-patients at a DR-TB management hospital in Durban, KwaZulu-Natal, South Africa. In-depth interviews were conducted with a purposive sample of eighteen hospital staff (HS), and the data were analyzed using NVivo 10. Three core themes were identified: patients' barriers (addiction to tobacco, relapse after improvement in health, and non-disclosure of smoking status to HS), staff personal barriers (poor knowledge of smoking's effect on treatment outcomes and smoking cessation aids), and institutional barriers (staff shortage, time constraints, lack of pharmacological smoking cessation aids, access to cigarettes around hospital premises, and SCIs not prioritized and not assigned to a specific category of HS). Training on SCIs for HS, assigning SCIs to specific HS, integrating SCIs within existing services, and banning access to cigarettes within the hospital premises are assumed to assist DR-TB patients in smoking cessation, improving their response to TB treatment and overall health outcomes.
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Affiliation(s)
- Phindile Zifikile Shangase
- Division of Public Health, Faculty of Health Sciences, University of Free State, Bloemfontein 9300, South Africa;
| | - Nduduzo Msizi Shandu
- Department of Human Movement Science, Faculty of Science and Agriculture, University of Zululand, KwaDlangezwa 3886, South Africa
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24
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Fang P, Adkins-Hempel M, Lischka T, Basile S, Rindal DB, Carpenter MJ, Kopycka-Kedzierawski DT, Dahne J, Helseth SA, Levy DE, Truong A, Leo MC, Funkhouser K, Louis DR, Japuntich SJ. A National Dental Practice-Based Research Network phase II, cluster-randomized clinical trial assessing nicotine replacement therapy sampling in dental settings: study protocol for the Free Samples for Health (FreSH) study. BMC Oral Health 2024; 24:1007. [PMID: 39198824 PMCID: PMC11360338 DOI: 10.1186/s12903-024-04758-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Accepted: 08/15/2024] [Indexed: 09/01/2024] Open
Abstract
BACKGROUND Cigarette smoking has major detrimental effects on oral health. Tobacco interventions in dental settings are effective, but rarely delivered. The American Dental Hygienists Association recommends that oral health providers: Ask patients about tobacco use, Advise quitting tobacco use, and Refer to state quitlines (Ask-Advise-Refer; AAR). While AAR connects patients to counseling, it does not directly connect patients to medication. Nicotine replacement therapy sampling (NRTS) is an empirically supported intervention to provide starter packs of nicotine replacement therapy (NRT) to people who smoke. NRTS combined with AAR could be an effective tobacco treatment intervention for dental settings. METHODS This manuscript describes the study protocol for the Free Samples for Health (FreSH) study, a group randomized clinical trial testing the effectiveness of NRTS + AAR vs. AAR alone on long-term smoking abstinence. Fifty dental practices in the Midwest and Northeast nodes of the National Dental Practice-Based Research Network are randomly assigned to provide AAR and either a 2-week supply of 14-mg nicotine patches and 4-mg nicotine lozenges (NRTS condition) or an electric toothbrush (ET condition). Approximately 1,200 patients who currently smoke-regardless of interest in quitting- are recruited during dental visits. Participants complete a baseline survey in-person, then after visit, 1-, 3-, and 6-month follow-up surveys remotely. The primary outcome is carbon monoxide-confirmed 7-day point prevalence abstinence from combustible tobacco measured at 6 months post-enrollment. Secondary outcomes include: 24-h intentional quit attempts, change in cigarettes smoked per day, NRT utilization, attitudes toward NRT, intention to use NRT, and intention to quit smoking. A key informant process evaluation and cost effectiveness analysis will provide information for future implementation of NRTS. DISCUSSION This is the first clinical trial to assess the effectiveness of NRTS on promoting smoking cessation in dental settings. If effective, this treatment could be implemented to increase the provision of smoking cessation interventions in dental settings to provide an additional treatment access point for people who smoke. TRIAL REGISTRATION Registered at ClincalTrials.gov (NCT05627596) on 11/25/2022.
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Affiliation(s)
- Pearl Fang
- Behavioral Health Equity Research Group, Hennepin Healthcare Research Institute, 701 Park Ave. S9.104, Minneapolis, MN, 55415, USA
| | - Melissa Adkins-Hempel
- Behavioral Health Equity Research Group, Hennepin Healthcare Research Institute, 701 Park Ave. S9.104, Minneapolis, MN, 55415, USA
| | - Tamara Lischka
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave, Portland, OR, 97227, USA
| | - Sarah Basile
- HealthPartners Institute, 8170 33rd , Ave. S MS 21112R, Minneapolis, MN, 55440, USA
| | - D Brad Rindal
- HealthPartners Institute, 8170 33rd , Ave. S MS 21112R, Minneapolis, MN, 55440, USA
| | - Matthew J Carpenter
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Dorota T Kopycka-Kedzierawski
- Department of Dentistry, Eastman Institute for Oral Health, University of Rochester Medical Center, 625 Elmwood Ave., Box 683, Rochester, NY, 14620, USA
| | - Jennifer Dahne
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Sarah A Helseth
- Department of Psychiatry and Behavioral Health, Center for Dissemination and Implementation Science, Northwestern University Feinberg School of Medicine, 633 N. St. Clair St., Suite 2000, Chicago, IL, 60611, USA
| | - Douglas E Levy
- Mongan Institute Health Policy Research Center and Tobacco Research and Treatment Center, Massachusetts General Hospital, 100 Cambridge St, Boston, MA, 02114, USA
- Harvard Medical School, Boston, MA, 02115, USA
| | - Arthur Truong
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave, Portland, OR, 97227, USA
| | - Michael C Leo
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave, Portland, OR, 97227, USA
| | - Kimberly Funkhouser
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave, Portland, OR, 97227, USA
| | - David R Louis
- Health Partners Dental Group, 8455 Flying Cloud Dr., Eden Prairie, MN, 55344, USA
| | - Sandra J Japuntich
- Behavioral Health Equity Research Group, Hennepin Healthcare Research Institute, 701 Park Ave. S9.104, Minneapolis, MN, 55415, USA.
- Division of Clinical Pharmacology, Department of Medicine, & Department of Psychiatry, Hennepin Healthcare, 900 S. 8th St., G5, Minneapolis, MN, 55415, USA.
- Division of General Internal Medicine, Department of Medicine, University of Minnesota, 401 East River Parkway, Suite 131, Minneapolis, MN, 55455, USA.
- Department of Medicine, University of Minnesota Medical School, Minneapolis, USA.
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25
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Aguiar A, Abreu M, Duarte R. Healthcare professionals perspectives on tuberculosis barriers in Portuguese prisons-a qualitative study. J Public Health (Oxf) 2024; 46:e389-e399. [PMID: 38710659 DOI: 10.1093/pubmed/fdae065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/15/2024] [Accepted: 04/18/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Tuberculosis (TB) remains a significant public health concern, particularly within prison settings, where the confluence of adverse health factors and high-risk behaviors contribute to a heightened risk of transmission. This study delves into the perspectives of medical doctors, regarding the implementation of the 2014 TB protocol in Portugal. METHODS The study has a qualitative, descriptive design. Individual semi-structured interviews with medical doctors from TB outpatient centers in Porto and Lisbon were used for data collection. For the analysis thematic analysis method was used. RESULTS The study population comprised 21 medical doctors with the majority being female (61.9%) and 57.1% specializing in pulmonology. The results indicate varied perceptions of the protocol's usefulness, with positive impacts on coordination reported by some participants. Improved communication and evolving collaboration between TB outpatient centers and prisons were highlighted, although challenges in contact tracing and resource constraints were acknowledged. The study also sheds light on the role of nurses in patient education. CONCLUSION Despite overall positive perceptions, challenges such as sustaining therapy post-symptomatic improvement and delays in diagnostic methods were identified. The findings underscore the importance of continuous collaboration between prisons and TB control programs to address challenges, improve disease control and prevent TB transmission.
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Affiliation(s)
- Ana Aguiar
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
- Estudo das Populações, ICBAS-Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, 4050-313 Porto, Portugal
| | - Mariana Abreu
- Unidade de Saúde Pública de Gaia, Agrupamento de Centros de Saúde do Grande Porto VII-Gaia, Vila Nova de Gaia, Portugal
| | - Raquel Duarte
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
- Estudo das Populações, ICBAS-Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, 4050-313 Porto, Portugal
- INSA-Instituto de Saúde Pública Doutor Ricardo Jorge-INSA Porto, 4000-053 Porto, Portugal
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Gomes MN, Reid JL, Rynard VL, East KA, Goniewicz ML, Piper ME, Hammond D. Comparison of Indicators of Dependence for Vaping and Smoking: Trends Between 2017 and 2022 Among Youth in Canada, England, and the United States. Nicotine Tob Res 2024; 26:1192-1200. [PMID: 38531767 PMCID: PMC11339172 DOI: 10.1093/ntr/ntae060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 03/13/2024] [Accepted: 03/17/2024] [Indexed: 03/28/2024]
Abstract
INTRODUCTION The current study sought to examine trends in indicators of dependence for youth vaping and smoking during a period of rapid evolution in the e-cigarette market. AIMS AND METHODS Data are from repeat cross-sectional online surveys conducted between 2017 and 2022 among youth aged 16-19 in Canada, England, and the United States (US). Participants were 23 145 respondents who vaped and/or smoked in the past 30 days. Four dependence indicators were assessed for smoking and vaping (perceived addiction, frequent strong urges, time to first use after waking, days used in past month) and two for vaping only (use events per day, e-cigarette dependence scale). Regression models examined differences by survey wave and country, adjusting for sex, age, race, and exclusive/dual use. RESULTS All six indicators of dependence increased between 2017 and 2022 among youth who vaped in the past 30 days (p < .001 for all). For example, more youth reported strong urges to vape at least most days in 2022 than in 2017 (Canada: 26.5% to 53.4%; England: 25.5% to 45.4%; US: 31.6% to 50.3%). In 2017, indicators of vaping dependence were substantially lower than for smoking; however, by 2022, youth vaping was associated with a greater number of days used in the past month (Canada, US), shorter time to first use (all countries), and a higher likelihood of frequent strong urges (Canada, US) compared to youth smoking. CONCLUSIONS From 2017 to 2022, indicators of vaping dependence increased substantially. By 2022, vaping dependence indices were comparable to those of smoking. IMPLICATIONS Indicators of vaping dependence among youth have increased substantially since 2017 to levels that are comparable to cigarette dependence among youth who smoke. Future research should examine factors underlying the increase in dependence among youth who vape, including changes to the nicotine profile and design of e-cigarette products.
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Affiliation(s)
- Makenna N Gomes
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Jessica L Reid
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Vicki L Rynard
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Katherine A East
- Department of Addictions, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
| | - Maciej L Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Megan E Piper
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin Madison, Madison, WI, USA
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
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Baughman DJ, Rauhut M, Anselm E. A Lost Opportunity in Tobacco Cessation Care: Impact of Underbilling in a Large Health System. Am J Prev Med 2024:S0749-3797(24)00276-9. [PMID: 39179184 DOI: 10.1016/j.amepre.2024.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 08/13/2024] [Accepted: 08/13/2024] [Indexed: 08/26/2024]
Abstract
INTRODUCTION Tobacco cessation remains a critical challenge in healthcare, with evidence-based interventions often underutilized due to misaligned economic incentives and inadequate training. This study aims to quantify the economic impact of missed billing opportunities for tobacco cessation in a healthcare system, thereby assessing potential revenue loss and evaluating the effectiveness of systems-based approaches to enhancing tobacco cessation efforts. METHODS A retrospective cohort study utilized aggregated deidentified patient health data from an 8-hospital regional health system across Pennsylvania and Maryland, from 1/1/21 to 12/31/23. The analysis focused on primary care encounters eligible for tobacco cessation counseling (CPT codes 99406 or 99407), with potential revenue calculated based on the Medicare reimbursement rate. RESULTS Over 3 years, and 507,656 office visits, only 1,557 (0.3%) of encounters with persons using tobacco were billed for cessation services. The estimated total potential revenue gained if each person who was identified as using tobacco was billed consistently for tobacco cessation counseling was $5,947,018.13, and $1,982,339.38 annually. CONCLUSIONS The study reveals a significant gap between the potential and actual billing for tobacco cessation services, highlighting not only the financial implications of missed opportunities but also a validation of a health system's public health impact. Underbilling contributes to considerable annual revenue loss and undermines primary prevention efforts against tobacco-related diseases. The findings illuminate the need for enhanced billing practices and systemic changes, including policy improvements that influence proper billing to promote public health benefits through improved tobacco cessation interventions.
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Affiliation(s)
- Derek J Baughman
- Departmet of Family Medicine, WellSpan Health, York, Pennsylvania; Departmet of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, Tennessee.
| | - Marcus Rauhut
- Research & Development, WellSpan Health, York, Pennsylvania
| | - Edward Anselm
- Icahn School of Medicine at Mount Sinai, New York, New York
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28
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Sharma P, Nelson RJ. Disrupted Circadian Rhythms and Substance Use Disorders: A Narrative Review. Clocks Sleep 2024; 6:446-467. [PMID: 39189197 PMCID: PMC11348162 DOI: 10.3390/clockssleep6030030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 08/12/2024] [Accepted: 08/15/2024] [Indexed: 08/28/2024] Open
Abstract
Substance use disorder is a major global health concern, with a high prevalence among adolescents and young adults. The most common substances of abuse include alcohol, marijuana, cocaine, nicotine, and opiates. Evidence suggests that a mismatch between contemporary lifestyle and environmental demands leads to disrupted circadian rhythms that impair optimal physiological and behavioral function, which can increase the vulnerability to develop substance use disorder and related problems. The circadian system plays an important role in regulating the sleep-wake cycle and reward processing, both of which directly affect substance abuse. Distorted substance use can have a reciprocal effect on the circadian system by influencing circadian clock gene expression. Considering the detrimental health consequences and profound societal impact of substance use disorder, it is crucial to comprehend its complex association with circadian rhythms, which can pave the way for the generation of novel chronotherapeutic treatment approaches. In this narrative review, we have explored the potential contributions of disrupted circadian rhythms and sleep on use and relapse of different substances of abuse. The involvement of circadian clock genes with drug reward pathways is discussed, along with the potential research areas that can be explored to minimize disordered substance use by improving circadian hygiene.
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Affiliation(s)
- Pallavi Sharma
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV 26506, USA;
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29
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Tota M, Jonderko L, Witek J, Novickij V, Kulbacka J. Cellular and Molecular Effects of Magnetic Fields. Int J Mol Sci 2024; 25:8973. [PMID: 39201657 PMCID: PMC11354277 DOI: 10.3390/ijms25168973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Revised: 08/09/2024] [Accepted: 08/14/2024] [Indexed: 09/02/2024] Open
Abstract
Recently, magnetic fields (MFs) have received major attention due to their potential therapeutic applications and biological effects. This review provides a comprehensive analysis of the cellular and molecular impacts of MFs, with a focus on both in vitro and in vivo studies. We investigate the mechanisms by which MFs influence cell behavior, including modifications in gene expression, protein synthesis, and cellular signaling pathways. The interaction of MFs with cellular components such as ion channels, membranes, and the cytoskeleton is analyzed, along with their effects on cellular processes like proliferation, differentiation, and apoptosis. Molecular insights are offered into how MFs modulate oxidative stress and inflammatory responses, which are pivotal in various pathological conditions. Furthermore, we explore the therapeutic potential of MFs in regenerative medicine, cancer treatment, and neurodegenerative diseases. By synthesizing current findings, this article aims to elucidate the complex bioeffects of MFs, thereby facilitating their optimized application in medical and biotechnological fields.
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Affiliation(s)
- Maciej Tota
- Student Research Group № K148, Faculty of Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland;
| | - Laura Jonderko
- Student Research Group № K148, Faculty of Pharmacy, Wroclaw Medical University, 50-367 Wroclaw, Poland; (L.J.); (J.W.)
| | - Julia Witek
- Student Research Group № K148, Faculty of Pharmacy, Wroclaw Medical University, 50-367 Wroclaw, Poland; (L.J.); (J.W.)
| | - Vitalij Novickij
- Institute of High Magnetic Fields, Vilnius Gediminas Technical University, LT-03227 Vilnius, Lithuania;
- Department of Immunology, State Research Institute Centre for Innovative Medicine, Santariškių 5, LT-08410 Vilnius, Lithuania
| | - Julita Kulbacka
- Department of Immunology, State Research Institute Centre for Innovative Medicine, Santariškių 5, LT-08410 Vilnius, Lithuania
- Department of Molecular and Cellular Biology, Faculty of Pharmacy, Wroclaw Medical University, 50-367 Wrocław, Poland
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30
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Parra A, Morales V, Lebron CN, Potter J, Pan Y, Santos HP. Adverse Birth Outcomes and Maternal Morbidity Among Afro-Latinas and Their Infants: A Systematic Literature Review. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02107-9. [PMID: 39141245 DOI: 10.1007/s40615-024-02107-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 07/19/2024] [Accepted: 07/22/2024] [Indexed: 08/15/2024]
Abstract
OBJECTIVES To evaluate and synthesize research findings on adverse birth outcomes and maternal morbidity among Afro-Latinas and their infants. METHODS A systematic review was conducted within PubMed, Web of Science, and SCOPUS databases. Four thousand five hundred twenty-six published peer-reviewed articles from 1970 to 2023 that reported outcomes related to maternal morbidity and/or birth outcomes were screened. After screening, we assessed 22 for eligibility, and ultimately, seven studies were included for data extraction and analysis. RESULTS Although limited, the existing studies revealed disparities in abnormal birth weight (LBW & SGA) and higher preterm birth prevalence among Afro-Latinas compared to other racial and ethnic peers. These disparities are also prevalent among U.S.-born Afro-Latinas compared to foreign-born Afro-Latinas. CONCLUSIONS By critically examining the current empirical evidence, we can gain a deeper understanding of how intersectionality impacts perinatal health outcomes among Afro-Latinas. Understanding the root causes of these outcomes through increased research is critical to preventing and reducing poor maternal and child health among Afro-Latinas, particularly those who are U.S.-born.
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Affiliation(s)
- Alexa Parra
- School of Nursing and Health Studies, University of Miami, 5030 Brunson Dr, Coral Gables, FL, 33146, USA.
| | - Vanessa Morales
- Miller School of Medicine, Department of Public Health, University of Miami, 1120 NW 14Th St, Miami, FL, 33136, USA
| | - Cynthia N Lebron
- School of Nursing and Health Studies, University of Miami, 5030 Brunson Dr, Coral Gables, FL, 33146, USA
| | - JoNell Potter
- Miller School of Medicine, Department of Public Health, University of Miami, 1120 NW 14Th St, Miami, FL, 33136, USA
| | - Yue Pan
- Miller School of Medicine, Department of Public Health, University of Miami, 1120 NW 14Th St, Miami, FL, 33136, USA
| | - Hudson P Santos
- School of Nursing and Health Studies, University of Miami, 5030 Brunson Dr, Coral Gables, FL, 33146, USA
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Cartujano-Barrera F, Cox LS, Catley D, Cai X, Diaz FJ, Arana-Chicas E, Chávez-Iñiguez A, Ogedegbe C, Graves KD, Rivera MP, Ponce A, Ellerbeck EF, Cupertino AP. Decídetexto: Mobile Cessation Support for Latino Adults Who Smoke: A Randomized Clinical Trial. Chest 2024:S0012-3692(24)04904-3. [PMID: 39134144 DOI: 10.1016/j.chest.2024.07.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 07/01/2024] [Accepted: 07/25/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Latino adults experience multiple barriers to health care access and treatment that result in tobacco-related disparities. Mobile interventions have the potential to deliver smoking cessation treatment among Latino adults, the highest users of mobile technologies. RESEARCH QUESTION Is Decídetexto, a culturally accommodated mobile health intervention, more effective for smoking cessation compared with standard care among Latinx adults who smoke? STUDY DESIGN AND METHODS A two-arm parallel group randomized clinical trial (RCT) was conducted in Kansas, New Jersey, and New York between October 2018 and September 2021. Eligible Latino adults who smoke (n = 457) were randomly assigned to Decídetexto or a standard care group. The primary outcome was biochemically verified 7-day smoking abstinence at week 24. Secondary outcomes included self-reported 7-day smoking abstinence at weeks 12 and 24 and uptake and adherence of nicotine replacement therapy (NRT). RESULTS Participants' mean age was 48.7 (SD, 11.1) years, 45.2% were female, and 50.3% smoked ≥10 cigarettes per day. Two hundred twenty-nine participants were assigned to Decídetexto and 228 to standard care. Treating those lost to follow-up as participants who continued smoking, 14.4% of participants in the Decídetexto group were biochemically verified abstinent at week 24 compared with 9.2% in the standard care group (OR, 1.66; 95% CI, 0.93-2.97; P = .09). Treating those lost to follow-up as participants who continued smoking, 34.1% of the participants in the Decídetexto group self-reported smoking abstinence at week 24 compared with 20.6% of participants in the standard care group (OR, 1.99; 95% CI, 1.31-3.03; P < .001). Analyzing only participants who completed the assessment at week 24, 90.6% (174/192) of participants in the Decídetexto group self-reported using NRT for at least 1 day compared with 70.2% (139/198) of participants in standard care (OR, 4.10; 95% CI, 2.31-7.28; P < .01). INTERPRETATION Among Latino adults who smoke, the Decídetexto intervention was not associated with a statistically significant increase in biochemically verified abstinence at week 24. However, the Decídetexto intervention was associated with a statistically significant increase in self-reported 7-day smoking abstinence at weeks 12 and 24 and uptake of NRT. This RCT provides encouragement for the use of Decídetexto for smoking cessation among Latino adults. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03586596.
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Affiliation(s)
| | - Lisa Sanderson Cox
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS
| | - Delwyn Catley
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City, Kansas City, MO
| | - Xueya Cai
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY
| | - Francisco J Diaz
- Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, MO
| | - Evelyn Arana-Chicas
- Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, NJ
| | - Arlette Chávez-Iñiguez
- Emergency and Trauma Center, Hackensack University Medical Center (C. O.), Hackensack, NJ
| | - Chinwe Ogedegbe
- Department of Oncology, Georgetown University, Washington, DC
| | - Kristi D Graves
- Department of Oncology, Georgetown University, Washington, DC
| | - M Patricia Rivera
- Department of Medicine, University of Rochester Medical Center, Rochester, NY
| | | | - Edward F Ellerbeck
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS
| | - Ana Paula Cupertino
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY; Department of Surgery, University of Rochester Medical Center, Rochester, NY
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Onda M, Horiguchi M, Domichi M, Sakane N. Effect of a Smoking Cessation Education Program on the Knowledge, Attitude, and Self-Efficacy of Community Pharmacists in Japan: A Quasi-Experimental Study. Tob Use Insights 2024; 17:1179173X241272362. [PMID: 39131666 PMCID: PMC11311180 DOI: 10.1177/1179173x241272362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 07/12/2024] [Indexed: 08/13/2024] Open
Abstract
Background Supporting smoking cessation at pharmacies can be challenging owing to difficulties in recruiting smokers to participate in cessation programs, insufficient communication skills among pharmacists, and lack of knowledge and self-efficacy in successfully quitting smoking in Japan. Objective This study evaluates the effectiveness of a smoking cessation training program on community pharmacists' knowledge, attitude, and self-efficacy in supporting smoking cessation. Methods The study, conducted in Japanese pharmacies with 100 community pharmacists, employed a quasi-experimental design. Two online training programs were implemented. Participants completed a web-based survey assessing their knowledge, attitude, and self-efficacy in supporting smoking cessation before, immediately after, and 1 year after the training program. A two-way analysis of variance with a mixed model was used to examine score changes at each time point. Results Total knowledge scores significantly increased between baseline and immediately after training and baseline and 1 year after training. The total attitude scores between baseline and immediately after training differed significantly. However, no differences were noted between baseline and 1 year after training. Total self-efficacy scores significantly increased at baseline, immediately after training, and between baseline and 1 year after training. Despite no significant interactions between the programs, there was a partial interaction effect on knowledge, with only the customized program having items whose knowledge levels improved after 1 year. Conclusion and Relevance The training program improved community pharmacists' knowledge, attitude, and self-efficacy regarding smoking cessation support. The customized program must be reinforced to improve support performance and maintain attitude.
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Affiliation(s)
- Mitsuko Onda
- Department of Social and Administrative Pharmacy, Faculty of Pharmacy, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Michiko Horiguchi
- Department of Dispensing Management Section, MCC Management Co., Osaka, Japan
| | - Masayuki Domichi
- Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Naoki Sakane
- Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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Sahebihagh MH, Hosseinzadeh M, Mirghafourvand M, Sarbakhsh P, Nemati H. Preferences of Iranian smokers regarding smart smoking cessation technologies: a parallel convergent mixed methods study. BMC Public Health 2024; 24:2163. [PMID: 39123187 PMCID: PMC11316382 DOI: 10.1186/s12889-024-19708-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Accepted: 08/07/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Considering the values and preferences of individuals who attempt to quit smoking is a crucial step in the development of smoking cessation technologies. This study aimed to explore preferences regarding smart smoking cessation technologies. METHODS This parallel convergent mixed-methods study was conducted in two phases: quantitative and qualitative. In the quantitative phase, a cross-sectional study was conducted with 360 participants selected through stratified random sampling from technology-based smoking cessation clinics in Tabriz, Tehran, and Karaj cities in Iran. Data on demographic characteristics and preferences for smart smoking cessation technologies were collected using questionnaires and analyzed using descriptive statistics. In the qualitative phase, 25 users of these technologies were selected through purposeful and snowball sampling. The data were gathered through in-depth semistructured interviews and analyzed using qualitative content analysis with a conventional approach. Quantitative and qualitative data were integrated using the merging strategy and convergence model. RESULTS The quantitative phase results indicated that the highest preference was related to wearing and using a smartwatch for smoking cessation and using mobile apps. In the qualitative phase, 17 subcategories were extracted and classified into 8 main categories: high effectiveness, better management of the smoking cessation process, personalized technology, safe and uncomplicated technologies, attractiveness and innovative design, scientific basis, mobile applications, and smart monitoring devices. CONCLUSION By combining and integrating quantitative and qualitative results, it can be concluded that users are more interested in wearable technologies and interactive mobile applications. The findings of this study can assist smoking cessation technology developers in designing and improving their tools based on user needs and preferences to enhance their effectiveness and acceptability.
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Affiliation(s)
- Mohammad Hasan Sahebihagh
- Professor of Nursing Education, Tabriz Health Services Management Research Center, Department of Community Health Nursing, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mina Hosseinzadeh
- Department of Community Health Nursing, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Professor of Reproductive Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parvin Sarbakhsh
- Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Nemati
- Department of Community Health Nursing, Member of Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
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Grigoriou I, Kotoulas SC, Porpodis K, Spyratos D, Papagiouvanni I, Tsantos A, Michailidou A, Mourelatos C, Mouratidou C, Alevroudis I, Marneri A, Pataka A. The Interactions between Smoking and Sleep. Biomedicines 2024; 12:1765. [PMID: 39200229 PMCID: PMC11351415 DOI: 10.3390/biomedicines12081765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 07/31/2024] [Accepted: 08/01/2024] [Indexed: 09/02/2024] Open
Abstract
Smoking a cigarette before bed or first thing in the morning is a common habit. In this review, the relationship between smoking and sleep is investigated based on the existing literature. Out of 6504 unique items that were identified via a PubMed search related to smoking and sleep, 151 were included in this review. Tobacco smoking disrupts sleep architecture by reducing slow wave and rapid eye movement (REM) sleep and undermining sleep quality. Furthermore, smoking affects sleep-related co-morbidities, such as obstructive sleep apnea-hypopnea syndrome (OSAHS), insomnia, parasomnias, arousals, bruxism, and restless legs, as well as non-sleep-related conditions such as cardiovascular, metabolic, respiratory, neurologic, psychiatric, inflammatory, gynecologic and pediatric issues, while poor sleep quality also seems to worsen the chances of successful smoking cessation. In conclusion, the existing literature suggests that there is a wicked relation between smoking and sleep.
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Affiliation(s)
- Ioanna Grigoriou
- Respiratory Failure Clinic and Sleep Laboratory, General Hospital of Thessaloniki “G. Papanikolaou”, Aristotle’s University of Thessaloniki, 54642 Thessaloniki, Greece; (I.G.); (A.P.)
| | | | - Konstantinos Porpodis
- Pulmonary Department, General Hospital of Thessaloniki “G. Papanikolaou”, Aristotle’s University of Thessaloniki, 54642 Thessaloniki, Greece; (K.P.); (D.S.)
| | - Dionysios Spyratos
- Pulmonary Department, General Hospital of Thessaloniki “G. Papanikolaou”, Aristotle’s University of Thessaloniki, 54642 Thessaloniki, Greece; (K.P.); (D.S.)
| | - Ioanna Papagiouvanni
- 4th Internal Medicine Department, General Hospital of Thessaloniki “Ippokrateio”, Aristotle’s University of Thessaloniki, 54642 Thessaloniki, Greece;
| | - Alexandros Tsantos
- Pulmonary Department, General Hospital of Thessaloniki “Ippokrateio”, 54642 Thessaloniki, Greece;
| | - Anastasia Michailidou
- 2nd Propaedeutic Internal Medicine Department, General Hospital of Thessaloniki “Ippokrateio”, Aristotle’s University of Thessaloniki, 54642 Thessaloniki, Greece;
| | | | - Christina Mouratidou
- Adult ICU, General Hospital of Thessaloniki “Ippokrateio”, 54642 Thessaloniki, Greece; (C.M.); (I.A.); (A.M.)
| | - Ioannis Alevroudis
- Adult ICU, General Hospital of Thessaloniki “Ippokrateio”, 54642 Thessaloniki, Greece; (C.M.); (I.A.); (A.M.)
| | - Alexandra Marneri
- Adult ICU, General Hospital of Thessaloniki “Ippokrateio”, 54642 Thessaloniki, Greece; (C.M.); (I.A.); (A.M.)
| | - Athanasia Pataka
- Respiratory Failure Clinic and Sleep Laboratory, General Hospital of Thessaloniki “G. Papanikolaou”, Aristotle’s University of Thessaloniki, 54642 Thessaloniki, Greece; (I.G.); (A.P.)
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Garey L, Thai JM, Zvolensky MJ, Smits JAJ. Exercise and Smoking Cessation. Curr Top Behav Neurosci 2024. [PMID: 39090290 DOI: 10.1007/7854_2024_497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
Smoking is a public health crisis, leading to a multitude of health complications. Exercise is associated with numerous health benefits and is accepted by health professionals and smokers as a potentially effective smoking cessation aid. This chapter discusses the extant literature on the relation between exercise and smoking, including cross-sectional studies, experiments, and randomized clinical trials. There is robust evidence for exercise's efficacy in reducing cigarette craving, tobacco withdrawal symptoms, and negative affect. Further, exercise-based interventions appear to boost short-term abstinence yet may fall short of facilitating long-term abstinence. Methodological limitations of extant work are reviewed. We conclude with a discussion of the next steps in this line of work to fine-tune exercise interventions and their application for smoking cessation.
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Affiliation(s)
- Lorra Garey
- Department of Psychology, University of Houston, Houston, TX, USA.
- HEALTH Institute, University of Houston, Houston, TX, USA.
| | - Jessica M Thai
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA
- HEALTH Institute, University of Houston, Houston, TX, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jasper A J Smits
- Department of Psychology, The University of Texas at Austin, Austin, TX, USA
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Anuntaseree W, Kongkanin U, Ruangnapa K, Saelim K, Prasertsan P. Effectiveness of a Telephone Counseling Intervention in Reducing Passive Smoking Among Children. HEALTH EDUCATION & BEHAVIOR 2024; 51:583-591. [PMID: 38606976 DOI: 10.1177/10901981241242798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Legislative smoking bans that prohibit smoking in public places have successfully reduced passive smoking in public areas. However, smokers only partially adhere to smoking restrictions in their homes. Young children are particularly vulnerable to exposure to tobacco smoke because they spend more time at home. In this study, we designed an intervention program based on an empowerment theory to reduce passive smoking among children. The priority participants were nonsmoking mothers living with smokers who smoke in the presence of children. The aim of this randomized control trial study was to examine the effectiveness of this intervention in reducing children's exposure to tobacco smoke at home. The intervention group received tailored educational brochures and two follow-up counseling telephone calls at 2 and 8 weeks, which provided resources to support the mothers to increase their knowledge, skill, and self-confidence in promoting behavior shaping of smokers. The control group received only tailored educational brochures. We found the intervention group demonstrated a higher rate of maternal actions to reduce their children's exposure to smoke and a higher rate than the control group of attempts to avoid smoking in the presence of children at the 16-week follow-up. These results suggest that the intervention helped reduce passive smoking among children. These findings highlight the need to empower and train mothers to help them develop rules for smoking at home. These interventions could be applied in the home of children who live with smokers who are unable or unwilling to quit smoking.
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Rose JE, Behm FM, Cohen G, Willette PN, Botts TL, Botts DR. Smoking reduction using an electronic nicotine delivery system (ENDS) with nicotine delivery similar to combustible cigarettes. Harm Reduct J 2024; 21:142. [PMID: 39075535 PMCID: PMC11285397 DOI: 10.1186/s12954-024-01064-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 07/20/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND Electronic nicotine delivery systems (ENDS) offer a promising approach to tobacco harm reduction, but many people use both ENDS and combustible cigarettes ("dual use"), which undermines potential risk reduction. To explore the role of ENDS nicotine delivery in promoting switching to ENDS, we conducted a study in which people who smoked cigarettes were offered an ENDS that had previously been shown to replicate the rapid nicotine pharmacokinetics of combustible cigarettes (BIDI® Stick). METHODS Twenty-five cigarette smoking adults, not seeking smoking cessation treatment, but open to using ENDS as a cigarette substitute, were provided with a 12-week supply of BIDI® Stick in tobacco or menthol flavors, during a study that included seven biweekly sessions and a 6-month follow-up. Daily diaries assessed ENDS and cigarette use, and exhaled carbon monoxide (eCO) served as an objective marker of smoke intake. Subjective ratings were collected to assess the rewarding properties of ENDS and combustible cigarettes, and indices of nicotine dependence. RESULTS Over 12 weeks, ENDS use increased to an average of 15.8 occasions per day (SD = 20.2) and self-reported cigarette consumption decreased by 82% from 16.7 cigarettes/day (SD = 6.0) at baseline to 3.0 cigarettes/day (SD = 4.1) at week 12. The eCO level decreased by 27% from an average of 20.0 ppm (SD = 9.8) at baseline to 14.5 ppm (SD = 9.9) at week 12. Four of 25 participants completely switched to ENDS and were smoking abstinent during weeks 9-12. At 6 months one participant was confirmed to be abstinent. Ratings of subjective reward for the ENDS were very similar to those of participants' usual brands of cigarettes. Dependence level was lower for the ENDS than for combustible cigarettes. CONCLUSIONS In this study, the ENDS effectively replicated the subjective rewarding effects of participants' usual brands of cigarettes and led to a substantial reduction in reported cigarettes/day. Exhaled CO showed less of a decrease, possibly due to compensatory smoking behavior and/or the timing of eCO measurements that might not have reflected smoke intake throughout the day. The relatively low rate of sustained smoking abstinence at 6 months suggests that additional approaches continue to be needed for achieving higher rates of complete switching. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT05855343.
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Affiliation(s)
- Jed E Rose
- Rose Research Center, LLC, 7240 ACC Blvd, Raleigh, NC, 27617, USA.
| | | | - Gal Cohen
- Rose Research Center, LLC, 7240 ACC Blvd, Raleigh, NC, 27617, USA
| | - Perry N Willette
- Rose Research Center, LLC, 7240 ACC Blvd, Raleigh, NC, 27617, USA
| | - Tanaia L Botts
- Rose Research Center, LLC, 7240 ACC Blvd, Raleigh, NC, 27617, USA
| | - David R Botts
- Rose Research Center, LLC, 7240 ACC Blvd, Raleigh, NC, 27617, USA
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Bontemps AP, Piper ME, Cropsey KL. Psychometric Properties of the FTCD and Brief WISDM: Support for Validity in a Legal-System-Involved Sample. Nicotine Tob Res 2024; 26:976-983. [PMID: 38267236 PMCID: PMC11260893 DOI: 10.1093/ntr/ntae013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 01/16/2024] [Accepted: 01/19/2024] [Indexed: 01/26/2024]
Abstract
INTRODUCTION The Fagerström test for cigarette dependence (FTCD) and Brief Wisconsin index of smoking dependence motives (WISDM) are widely used measures of smoking dependence. The FTCD was previously found to have 1-factor and 2-factor structures and Brief WISDM has been found to have an 11-factor and 11-factor hierarchical structure. As such, the current study sought to further investigate the psychometric properties of the FTCD and Brief WISDM with a novel criminal-legal system-involved sample using both a factor-analytic and an item response theory (IRT) approach. AIMS AND METHODS Data from 517 criminal-legal system-involved adults (ie, 18 years of age or older) who smoke from Alabama, USA were analyzed. Confirmatory factor analyses (CFA) were conducted on 1-factor and 2-factor structures of the FTCD and 1-factor, 11-factor, and 11-factor hierarchical structures of the Brief WISDM. IRT analyses investigating item discrimination and threshold parameters were also conducted on the brief WISDM. RESULTS The CFA showed poor fit for a single-factor structure and mixed results for two 2-factor results for the FTCD. CFA also showed poor fit for a single-factor and mixed results for the 11-factor model. Initial IRT investigations using the 11-factor model showed strong item discrimination, but non-ordered threshold parameters. CONCLUSIONS Two-factor structures for the FTCD and the 11-factor model for the Brief WISDM were partially supported in a criminal-legal population, suggesting continued support for the multidimensional structure of the measures. Additionally, exploratory IRT analyses suggested good discrimination across the use spectrum for the Brief WISDM. IMPLICATIONS The Fagerström Test of Cigarette Dependence (FTCD) and Brief Wisconsin index of smoking dependence motives (WISDM) are two widely used measures of nicotine dependence, though previous research has shown mixed results for their internal consistency and factor structure. The current study used a unique sample of criminal-legal-involved participants who generally have moderate to high levels of nicotine dependence. The current study found that the FTCD displayed poor internal consistency, a poor fit for a single-factor model, but mixed support for two two-factor models. The Brief-WISDM was found to have strong internal consistency, a poor fit for a single-factor model, but mixed fit for an 11-factor model and good item discrimination.
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Affiliation(s)
- Andrew P Bontemps
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Megan E Piper
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin––Madison, Madison, WI, USA
| | - Karen L Cropsey
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
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Jiang N, Zhao A, Rogers ES, Cupertino AP, Zhao X, Cartujano-Barrera F, Siu K, Sherman SE. Feasibility and Preliminary Effects of a Social Media-Based Peer-Group Mobile Messaging Smoking Cessation Intervention Among Chinese Immigrants who Smoke: Pilot Randomized Controlled Trial. JMIR Mhealth Uhealth 2024; 12:e59496. [PMID: 39037756 PMCID: PMC11318363 DOI: 10.2196/59496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Revised: 05/31/2024] [Accepted: 06/05/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND Chinese immigrants experience significant disparities in tobacco use. Culturally adapted tobacco treatments targeting this population are sparse and the use is low. The low use of these treatment programs is attributed to their exclusive focus on individuals who are ready to quit and the wide range of barriers that Chinese immigrants face to access these programs. To support Chinese immigrant smokers at all levels of readiness to quit and address their access barriers, we developed the WeChat Quit Coach, a culturally and linguistically appropriate WeChat (Tencent Holdings Limited)-based peer group mobile messaging smoking cessation intervention. OBJECTIVE This study aims to assess the feasibility, acceptability, and preliminary effects of WeChat Quit Coach. METHODS We enrolled a total of 60 Chinese immigrant smokers in 2022 in New York City for a pilot randomized controlled trial (RCT) and a single-arm pilot test. The first 40 participants were randomized to either the intervention arm (WeChat Quit Coach) or the control arm (self-help print material) using 1:1 block randomization stratified by sex. WeChat Quit Coach lasted 6 weeks, featuring small peer groups moderated by a coach, daily text messages with text questions, and chat-based instant messaging support from the coach in response to peer questions. The next 20 participants were enrolled in the single-arm pilot test to further assess intervention feasibility and acceptability. All 60 participants were offered a 4-week supply of complimentary nicotine replacement therapy. Surveys were administered at baseline and 6 weeks, with participants in the pilot RCT completing an additional survey at 6 months and biochemical verification of abstinence at both follow-ups. RESULTS Of 74 individuals screened, 68 (92%) were eligible and 60 (88%) were enrolled. The majority of participants, with a mean age of 42.5 (SD 13.8) years, were male (49/60, 82%) and not ready to quit, with 70% (42/60) in the precontemplation or contemplation stage at the time of enrollment. The pilot RCT had follow-up rates of 98% (39/40) at 6 weeks and 93% (37/40) at 6 months, while the single-arm test achieved 100% follow-up at 6 weeks. On average, participants responded to daily text questions for 25.1 days over the 42-day intervention period and 23% (9/40) used the chat-based instant messaging support. Most participants were satisfied with WeChat Quit Coach (36/39, 92%) and would recommend it to others (32/39, 82%). At 6 months, self-reported 7-day point prevalence abstinence rates were 25% (5/20) in the intervention arm and 15% (3/20) in the control arm, with biochemically verified abstinence rates of 25% (5/20) and 5% (1/20), respectively. CONCLUSIONS WeChat Quit Coach was feasible and well-received by Chinese immigrants who smoke and produced promising effects on abstinence. Large trials are warranted to assess its efficacy in promoting abstinence in this underserved population. TRIAL REGISTRATION ClinicalTrials.gov NCT05130788; https://clinicaltrials.gov/study/NCT05130788.
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Affiliation(s)
- Nan Jiang
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
| | - Ariel Zhao
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
| | - Erin S Rogers
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
| | - Ana Paula Cupertino
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States
| | - Xiaoquan Zhao
- Department of Communication, College of Humanities and Social Sciences, George Mason University, Fairfax, VA, United States
| | | | - Katherine Siu
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
| | - Scott E Sherman
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
- Department of Medicine, VA New York Harbor Healthcare System, New York, NY, United States
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Flores A, Wiener RS, Hon S, Wakeman C, Howard J, Virani N, Mattus B, Foreman AG, Singh J, Rosen L, Bulekova K, Kathuria H. Sustainability of an Opt-Out Electronic-Health Record-Based Tobacco Treatment Consult Service at a Large Safety-Net Hospital: A 6-Year Analysis. Nicotine Tob Res 2024; 26:1081-1088. [PMID: 38320328 DOI: 10.1093/ntr/ntae023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/30/2023] [Accepted: 01/31/2024] [Indexed: 02/08/2024]
Abstract
INTRODUCTION Our safety-net hospital implemented a hospital-based tobacco treatment intervention in 2016. We previously showed the intervention, an "opt-out" Electronic Health Record (EHR)-based Best Practice Alert (BPA)+ order-set that triggers consultation to an inpatient Tobacco Treatment Consult (TTC) service for all patients who smoke, improves smoking abstinence. We now report on sustainability, 6 years after inception. AIMS AND METHODS We analyzed data collected between July 2016-June 2022 of patients documented as "currently smoking" in the EHR. Across the 6 years, we used Pearson's correlation analysis to compare Adoption (clinician acceptance of the BPA+ order-set, thus generating consultation to the TTC service); Reach (number of consultations completed by the TTC service); and Effectiveness (receipt of pharmacotherapy orders between patients receiving and not receiving consultations). RESULTS Among 39 558 adult admissions (July 2016-June 2022) with "currently smoking" status in the EHR for whom the BPA triggered, clinicians accepted the TTC order set on 50.4% (19 932/39 558), though acceptance varied across services (eg, Cardiology [71%] and Obstetrics-Gynecology 12%]). The TTC service consulted on 17% (6779/39 558) of patients due to staffing constraints. Consultations ordered (r = -0.28, p = .59) and completed (r = 0.45, p = .37) remained stable over 6-years. Compared to patients not receiving consultations, patients receiving consultations were more likely to receive pharmacotherapy orders overall (inpatient: 50.8% vs. 35.1%, p < .0001; at discharge: 27.1% vs. 10%, p < .0001) and in each year. CONCLUSIONS The "opt-out" EHR-based TTC service is sustainable, though many did not receive consultations due to resource constraints. Health care systems should elevate the priority of hospital-based tobacco treatment programs to increase reach to underserved populations. IMPLICATIONS Our study shows that opt-out approaches that utilize the EHR are a sustainable approach to providing evidence-based tobacco treatment to all hospitalized individuals who smoke, regardless of readiness to stop smoking and clinical condition.
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Affiliation(s)
- Adriana Flores
- Division of General Internal Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Renda Soylemez Wiener
- Center for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, MA, USA
- Pulmonary Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Stephanie Hon
- Division of Pulmonary, Critical Care, and Sleep Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Cornelia Wakeman
- Center for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, MA, USA
| | - Jinesa Howard
- Pulmonary Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Nikita Virani
- Pulmonary Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Bruce Mattus
- Pulmonary Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Alexis Gallardo Foreman
- Pulmonary Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Johar Singh
- Research Computing Services (RCS) Group, Information Services & Technology, Boston University, Boston, MA, USA
| | - Linda Rosen
- Clinical Data Warehouse, Boston Medical Center, Boston, MA, USA
| | - Katia Bulekova
- Research Computing Services (RCS) Group, Information Services & Technology, Boston University, Boston, MA, USA
| | - Hasmeena Kathuria
- Pulmonary Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
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Cummings KM, Toll BA, Talbot V, Roberson A, Wilson D, Dunlap M, Ware EC, Palmer AM, Bliss AA, Anokye VS, Warren G. Implementation, enrollment, and engagement in an opt-out telehealth pharmacist-assisted tobacco treatment program for patients seen in oncology outpatient clinics. Cancer 2024; 130:2482-2492. [PMID: 38546445 PMCID: PMC11214603 DOI: 10.1002/cncr.35291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 02/07/2024] [Accepted: 02/29/2024] [Indexed: 06/30/2024]
Abstract
OBJECTIVE To describe the workflow, reach, cost, and self-reported quit rates for an opt-out tobacco treatment program (TTP) for patients seen in 43 oncology outpatient clinics. METHODS Between May 25, 2021, and December 31, 2022, adult patients (≥18 years) visiting clinics affiliated with the Medical University of South Carolina Hollings Cancer Center were screened for smoking status. Those currently smoking were referred to a telehealth pharmacy-assisted TTP. An attempt was made to contact referred patients by phone. Patients reached were offered free smoking cessation counseling and a 2-week starter kit of nicotine replacement medication. A random sample of 420 patients enrolled in the TTP were selected to participate in a telephone survey to assess smoking status 4 to 12 months after enrollment. RESULTS During the reference period 35,756 patients were screened and 9.3% were identified as currently smoking. Among the 3319 patients referred to the TTP at least once, 2393 (72.1%) were reached by phone, of whom 426 (12.8%) were ineligible for treatment, 458 (13.8%) opted out of treatment, and 1509 (45.5%) received treatment. More than 90% of TTP enrollees smoked daily, with an average of 13.1 cigarettes per day. Follow-up surveys were completed on 167 of 420 patients, of whom 23.4% to 33.5% reported not smoking; if all nonresponders to the survey are counted as smoking, the range of quit rates is 9.3% to 13.3%. CONCLUSION The findings demonstrate the feasibility of reaching and delivering smoking cessation treatments to patients from a diverse set of geographically dispersed oncology clinics.
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Affiliation(s)
- K. Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Benjamin A. Toll
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | | | - Avery Roberson
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Dianne Wilson
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Martha Dunlap
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Emily C. Ware
- Pharmacy Services, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Amanda M. Palmer
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Asia A. Bliss
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Vincent S. Anokye
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Graham Warren
- Department of Radiation Oncology, Medical University of South Carolina, Charleston, South Carolina, USA
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Rungruanghiranya S, Tulatamakit S, Chittawatanarat K, Preedapornpakorn K, Wongphan T, Sutanthavibul N, Preechawong S, Petborom P. Efficacy and safety of cytisine versus nortriptyline for smoking cessation: A multicentre, randomized, double-blinded and placebo-controlled trial. Respirology 2024. [PMID: 39004954 DOI: 10.1111/resp.14787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 06/16/2024] [Indexed: 07/16/2024]
Abstract
BACKGROUND AND OBJECTIVE Cytisine serves as an affordable smoking cessation aid with acceptable safety profile. However, data comparing its efficacy and safety to standard therapies are limited. We aimed to examine efficacy and safety of cytisine compared to nortriptyline, which is the only approved smoking-cessation medication in Thailand. METHODS A 12-month, multicentre, randomized, double-blinded, placebo-controlled trial was conducted. Participants aged ≥20 years who smoked ≥10 cigarettes/day were randomly assigned to receive a 25-day cytisine or a 12-week nortriptyline treatment course. Brief interventions (BI) for smoking cessation were provided to all participants. The primary outcome was biochemically verified continuous abstinence rate (CAR) at 12 months. Additionally, self-reported abstinence, verified by exhaled carbon monoxide (CO) ≤ 10 ppm, was collected at 2 weeks, 1, 3, 6 and 12 months to assess both CAR and 7-day point prevalence abstinence rate (PAR). RESULTS A total of 1086 participants were recruited and randomized into cytisine (n = 540) and nortriptyline (n = 546) groups. The 12-month CAR was 12.22% for cytisine and 9.52% for nortriptyline. The relative difference was 0.03 (95% confidence interval [CI]; -0.01 to 0.06) and the relative risk was 1.28 (95% CI; 0.91-1.81). No differences were observed in secondary outcomes between both groups. The incidence of adverse effects from cytisine appeared to be lower than that of nortriptyline. CONCLUSION At 12 months, cytisine plus BI was as effective as nortriptyline plus BI for smoking cessation. The adverse events for both cytisine and nortriptyline were minimal and well-tolerated.
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Affiliation(s)
- Suthat Rungruanghiranya
- Department of Medicine, Faculty of Medicine, Srinakharinwirot University, NakhonNayok, Thailand
| | - Sirapat Tulatamakit
- Department of Medicine, Faculty of Medicine, Srinakharinwirot University, NakhonNayok, Thailand
| | | | - Kanokwan Preedapornpakorn
- HRH Mahachakri Sirindhorn Medical Center, Faculty of Medicine, Srinakharinwirot University, NakhonNayok, Thailand
| | | | - Narueporn Sutanthavibul
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | | | - Pichaya Petborom
- Department of Medicine, Faculty of Medicine, Srinakharinwirot University, NakhonNayok, Thailand
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Jareebi MA. The Association Between Smoking Behavior and the Risk of Hypertension: Review of the Observational and Genetic Evidence. J Multidiscip Healthc 2024; 17:3265-3281. [PMID: 39006872 PMCID: PMC11246652 DOI: 10.2147/jmdh.s470589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Accepted: 07/04/2024] [Indexed: 07/16/2024] Open
Abstract
Background Cigarette smoking is one of the world's largest avoidable risk factors for morbidity and mortality. Numerous studies have investigated the association between smoking and hypertension (HTN). Although observational data and cross-sectional research often exhibit a link between smoking and HTN, establishing causation remains challenging owing to potential confounding variables. Mendelian randomization (MR), a genetic epidemiological technique that employs genetic variants as instrumental variables, offers a more robust approach for evaluating causal links. This review aimed to explore both the observational and causal relationships between smoking and the risk of HTN. Methodology A comprehensive literature search across major electronic databases was conducted to identify relevant observational and Mendelian randomization (MR) studies on smoking and HTN risk. Various characteristics were included during study selection, such as study design, exposure assessment, and age range. Standardized processes were used for data retrieval and quality evaluation. Results Analysis of observational data revealed a paradoxical association between smoking and the risk of HTN, where a lower risk was observed among current smokers when compared to non-smokers. However, observational analysis also presented a dose-response effect with greater smoking intensity showed a modest linear increase in HTN risk, and older smoking initiation was associated with a slight increase in HTN risk (compared with younger). In contrast, MR-based causal estimates provide inconsistent evidence regarding the causal relationship between smoking behavior and HTN. Some MR analyses indicated a potential causal link between smoking and HTN; but this was not consistent. Conclusion Observational studies suggest a paradoxical association between smoking and HTN. However, MR studies do not provide sufficient evidence to establish a causal relationship. Regardless, lifestyle variables remain crucial for overall health. Healthcare professionals should regularly assess smoking status and provide counseling for quitting. Further research is needed to clarify the underlying processes, identify mediators, and evaluate the interventions.
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Affiliation(s)
- Mohammad A Jareebi
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
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Mursa R, Patterson C, McErlean G, Halcomb E. Understanding health literacy in men: a cross-sectional survey. BMC Public Health 2024; 24:1804. [PMID: 38971741 PMCID: PMC11227143 DOI: 10.1186/s12889-024-19223-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 06/21/2024] [Indexed: 07/08/2024] Open
Abstract
BACKGROUND Males have a shorter life expectancy than females. Men are less likely to seek the advice of a health professional or utilise preventive health services and programs. This study seeks to explore health literacy and the characteristics affecting this among Australian men. METHODS Four hundred and thirty-one adult males engaged with the New South Wales Rural Fire Service, completed an online cross-sectional survey, undertaken from September - November 2022. The survey tool captured demographic data, health status and lifestyle risk characteristics. Health literacy was measured using the 44-item Health Literacy Questionnaire (HLQ). Descriptive statistics, frequencies, percentages, means and standard deviations, were used to describe the sample. Interferential statistics, including the Mann-Whitney U Test and the Kruskal-Wallis Test, were used to explore differences between demographics and HLQ scales. RESULTS For the first 5 scales (4-point Likert scale), the lowest score was seen for 'Appraisal of health information' (Mean 2.81; SD 0.52) and the highest score was seen for 'Feeling understood and supported by healthcare providers ' (Mean 3.08; SD 0.64). For the other 4 scales (5-point Likert scale), the lowest score was seen for 'Navigating the healthcare system' (Mean 3.74; SD 0.69). The highest score was seen for 'Understand health information well enough to know what to do' (Mean 4.10; SD 0.53). Age, income level and living in an urban/rural location were significantly related to health literacy scales. CONCLUSIONS This study provides new insight into men's health literacy and the factors impacting it. This knowledge can inform future strategies to promote men's engagement with health services and preventive care.
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Affiliation(s)
- Ruth Mursa
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Northfields Ave, Wollongong, NSW, 2522, Australia.
- Health Innovations Research Centre, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Northfields Ave, NSW, 2522, Australia.
| | - Christopher Patterson
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Northfields Ave, Wollongong, NSW, 2522, Australia
- Health Innovations Research Centre, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Northfields Ave, NSW, 2522, Australia
| | - Gemma McErlean
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Northfields Ave, Wollongong, NSW, 2522, Australia
- Health Innovations Research Centre, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Northfields Ave, NSW, 2522, Australia
- Center for Research in Nursing and Health, St George Hospital, Kogarah, NSW, 2217, Australia
| | - Elizabeth Halcomb
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Northfields Ave, Wollongong, NSW, 2522, Australia
- Health Innovations Research Centre, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Northfields Ave, NSW, 2522, Australia
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Qasem NW, Al-Omoush BH, Altbeinat SK, Al-Dlaijem MM, Salahat RI, Okour SA. Smoking cessation rate and predictors of successful quitting in Jordan: A cross-sectional study. Medicine (Baltimore) 2024; 103:e38708. [PMID: 38968519 PMCID: PMC11224826 DOI: 10.1097/md.0000000000038708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 06/06/2024] [Indexed: 07/07/2024] Open
Abstract
Tobacco smoking in Jordan is the highest in the Middle East, with health consequences and economic burdens. Smoking cessation improves health and grows the economy. This study aimed to determine the prevalence of smoking cessation in Jordan and to identify the determinants of effective quitting. This cross-sectional study was conducted using an online survey directed towards the general population of Jordan. The questionnaire was formulated in Arabic and inquired about sociodemographic factors, health status, behaviors, smoking habits, previous quitting attempts, utilization of smoking cessation services, attitudes towards quitting, and barriers to quitting. Data were analyzed using Statistical Package for Social Science version 25. A total of 463 participants were included in this study. Twenty-one percent of them were ex-smokers (n = 97), 86% were male, 63.3% were from the middle governorates, and 29.2% were 24 years old or younger. The rate of sustained quitting for at least 3 months among participants was 13.6%. The factors associated with successful quitting included age > 50 years (P = .001), practicing regular physical activity (P = .003), using more than 1 tobacco product (P = .000), smoking waterpipes or e-cigarettes (P = .000 and .015, respectively), lower levels of nicotine dependence (P = .009), duration of smoking (P = .000), higher number of smoking cessation attempts (P = .000), having 1 or more chronic diseases (P = .049), and having DM (P = .003). More than half of the ex-smokers needed 2 to 5 attempts before successfully quitting smoking. There was a low rate of utilization of smoking cessation services and medications in both groups. On the other hand, there is a high rate of use of other smoking methods, particularly waterpipes and e-cigarettes, as an aid for quitting. Current smokers reported being in a stressful situation as a barrier to quitting significantly more often than did ex-smokers (P = .013). Both groups had moderately positive attitudes toward quitting. Ex-smokers had significantly better attitudes toward their ability to manage stress, weight gain, and increased appetite after quitting (P = .004, .004, and .007, respectively). This study provides valuable insights into the complex dynamics of smoking behavior, cessation attempts, and attitudes. These findings can inform the development of targeted smoking cessation programmes and policies.
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Affiliation(s)
- Nuha W. Qasem
- Internal Medicine and Family Medicine Department, Faculty of Medicine, Hashemite University, Zarqa, Jordan
| | - Batool H. Al-Omoush
- Internal Medicine and Family Medicine Department, Faculty of Medicine, Hashemite University, Zarqa, Jordan
| | - Sami K. Altbeinat
- Internal Medicine and Family Medicine Department, Faculty of Medicine, Hashemite University, Zarqa, Jordan
| | - Moutasem M. Al-Dlaijem
- Internal Medicine and Family Medicine Department, Faculty of Medicine, Hashemite University, Zarqa, Jordan
| | - Reham I. Salahat
- Internal Medicine and Family Medicine Department, Faculty of Medicine, Hashemite University, Zarqa, Jordan
| | - Samer A. Okour
- Internal Medicine and Family Medicine Department, Faculty of Medicine, Hashemite University, Zarqa, Jordan
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Gruda D, McCleskey JA. Hit me with your best puff: Personality predicts preference for cigar vs. cigarette smoking. PLoS One 2024; 19:e0305634. [PMID: 38959187 PMCID: PMC11221740 DOI: 10.1371/journal.pone.0305634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 06/02/2024] [Indexed: 07/05/2024] Open
Abstract
In this study, we examine the association between Big Five personality traits and cigar or cigarette smoking in a sample of 9,918 older adults across 11 European countries derived from the Survey of Health, Ageing and Retirement in Europe (SHARE) dataset. We find significant associations between several traits and smoking groups. Smoking was associated with lower scores on Conscientiousness and Agreeableness and higher Extraversion scores. In addition, cigar smokers exhibit lower Neuroticism and higher Openness compared to both cigarette smokers and non-smokers. These findings suggest that both personality traits are antecedents of smoking behavior, offering implications for targeted public health interventions and social policies aimed at combating the global tobacco epidemic.
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Affiliation(s)
- Dritjon Gruda
- Catolica Porto Business School, Research Centre in Economics and Management, Universidade Catolica Portuguesa, Lisboa, Portugal
- School of Business, Maynooth University, Maynooth, Ireland
| | - Jim A. McCleskey
- Western Governors University, Millcreek, Utah, United States of America
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Liu Y, Che CC, Hamdan M, Chong MC. Measuring empowerment in pregnant women: A scoping review of progress in instruments. Midwifery 2024; 134:104002. [PMID: 38669756 DOI: 10.1016/j.midw.2024.104002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 02/25/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND The empowerment of pregnant women is a meaningful strategy that profoundly impacts the health of women and their children. Despite a significant increase in the empowerment of pregnant women and its measurement, little attention was given to a consensus on the selection and application of assessment instruments used for pregnant women. OBJECTIVE To identify the available assessment instruments for measuring the empowerment of pregnant women and to describe the appraisal content and their psychometric properties. METHODS We searched nine bibliographic databases for original studies that focus on the measurement of empowerment in pregnant women. Arksey and O'Malley's methodology and PRISMA-ScR were selected to guide the implementation of this scoping review. The COSMIN criteria was employed to assess the methodological quality and the quality of psychometric properties. RESULTS A total of 23 studies were included and 13 instruments were extracted. Given comprehensive considerations, Kameda's prenatal empowerment scale may be deemed suitable. The included instruments comprehensively measured the attributes of empowerment, with a particular focus on facilitating women's choice and decision-making. Except for the four most recent self-designed questionnaires, the remaining instruments had been tested for reliability and/or validity. CONCLUSION There were heterogeneous results regarding the included instruments' appraisal content and psychometric properties. Future studies focusing on the development or validation of measurement instruments should be guided by influential and identical standards.
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Affiliation(s)
- Yanjia Liu
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Malaysia
| | - Chong Chin Che
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Malaysia
| | - Mukhri Hamdan
- Department of Obstetric and Gynaecology, Faculty of Medicine, Universiti Malaya, Malaysia
| | - Mei Chan Chong
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Malaysia.
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Medina-Martínez J, Aliño M, Vázquez-Martínez A, Villanueva-Blasco VJ, Cano-López I. Risk and Protective Factors Associated with Drug Use in Healthcare Professionals: A Systematic Review. J Psychoactive Drugs 2024; 56:397-411. [PMID: 37341709 DOI: 10.1080/02791072.2023.2227173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 06/01/2023] [Indexed: 06/22/2023]
Abstract
Healthcare professionals are exposed to stressful situations that may favor substance use vulnerability. This systematic review aims to synthesize the risk and protective factors associated with use, abuse, and dependence of alcohol, tobacco, psychoactive drugs, and cannabis in healthcare professionals. Following PRISMA recommendations, a systematic search was performed in PsycINFO, Web of Science, PubMed/MEDLINE, Embase, Scopus, and Cochrane Library. The search yielded 1523 studies, of which 19 were selected. The identified risk factors were demographic factors (i.e. male gender, and single/divorced marital status), psychopathological factors, social factors, positive attitudes toward drugs, unhealthy lifestyle habits, the COVID-19 pandemic, and the coexistence of the use of several substances. The protective factors were demographic factors (i.e. ethnicity and having dependent children), healthy lifestyle habits, and workplace anti-drug policies (i.e. restriction of tobacco use). These findings highlight the need for preventive actions against drug use in healthcare professionals to improve their health and reduce the possible negative impact on their healthcare practice. Knowledge of modifiable risk and protective factors allows their incorporation as components in preventive actions, and non-modifiable factors (e.g. demographic variables) may contribute to the detection of groups of greater vulnerability to propose selective prevention actions in this population.
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Affiliation(s)
| | - Marta Aliño
- Faculty of Health Sciences, Valencian International University, Valencia, Spain
- Research Group in Psychology and Quality of Life (PsiCal)/VIU-NED Chair of Global Neuroscience and Social Change, Valencian International University, Valencia, Spain
| | - Andrea Vázquez-Martínez
- Faculty of Health Sciences, Valencian International University, Valencia, Spain
- Research Group in Health and Psycho-Social Adjustment (GI-SAPS), Valencian International University, Valencia, Spain
| | - Víctor José Villanueva-Blasco
- Faculty of Health Sciences, Valencian International University, Valencia, Spain
- Research Group in Health and Psycho-Social Adjustment (GI-SAPS), Valencian International University, Valencia, Spain
| | - Irene Cano-López
- Faculty of Health Sciences, Valencian International University, Valencia, Spain
- Research Group in Psychology and Quality of Life (PsiCal)/VIU-NED Chair of Global Neuroscience and Social Change, Valencian International University, Valencia, Spain
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Brust M, Gebhardt WA, Ter Hoeve N, Numans ME, Kiefte-de Jong JC. Exploring timing and delivery of lifestyle advice following an acute cardiac event hospitalization: The cardiac patient's perspective. PATIENT EDUCATION AND COUNSELING 2024; 124:108279. [PMID: 38565073 DOI: 10.1016/j.pec.2024.108279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 03/19/2024] [Accepted: 03/25/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE To explore the perspective of cardiac patients regarding the timing and manner of delivering lifestyle advice following an acute cardiac event hospitalization. METHODS Dutch cardiac patients who experienced a cardiac event hospitalization participated in a semi-structured interview (n = 14) or a cross-sectional survey study (n = 119). RESULTS Our findings indicate that cardiac patients are receptive to lifestyle advice throughout the care trajectory. Advice delivered by a cardiologist had the highest self-reported impact. Furthermore, receiving advice at multiple phases during the care trajectory was associated with a greater intention to change lifestyle (B = 0.37, CI = 0.17 - 0.57). Patients favored clear-cut, feasible, and friendly but confronting advice. Moreover, they stressed the importance of advice being aligned with their identity and beliefs about the causes of their disease. CONCLUSION The period following an acute cardiac event provides a unique opportunity to offer tailored and patient-centered lifestyle advice. This "teachable window" for lifestyle change, when used wisely, may improve health outcomes for cardiac patients. PRACTICE IMPLICATIONS Healthcare professionals should initiate lifestyle advice already during hospitalization and continue during follow-up appointments and cardiac rehabilitation. Advice should be feasible and empathy-based, as well as tailored to the patient's needs, values, and perceptions of the causes of their cardiovascular disease.
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Affiliation(s)
- Michelle Brust
- Department of Public Health and Primary Care/ Health Campus The Hague, Leiden University Medical Center, The Hague, the Netherlands.
| | - Winifred A Gebhardt
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, the Netherlands.
| | - Nienke Ter Hoeve
- Capri Cardiac Rehabilitation, Rotterdam, the Netherlands; Erasmus University Medical Centre, Department of Rehabilitation Medicine, Rotterdam, the Netherlands.
| | - Mattijs E Numans
- Department of Public Health and Primary Care/ Health Campus The Hague, Leiden University Medical Center, The Hague, the Netherlands.
| | - Jessica C Kiefte-de Jong
- Department of Public Health and Primary Care/ Health Campus The Hague, Leiden University Medical Center, The Hague, the Netherlands.
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Businelle MS, Benson L, Hébert ET, Neil J, Kendzor DE, Frank-Pearce S, Kezbers KM, Vidrine D, Gaur A. Project phoenix: Pilot randomized controlled trial of a smartphone-delivered intervention for people who are not ready to quit smoking. Drug Alcohol Depend 2024; 260:111351. [PMID: 38838477 PMCID: PMC11179962 DOI: 10.1016/j.drugalcdep.2024.111351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 05/23/2024] [Accepted: 05/24/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Most people who smoke cigarettes report they want to quit in the future, but only 20 % are ready to quit within the next 30 days. This 3-arm pilot randomized controlled trial examined the feasibility and initial efficacy of a novel smartphone-based intervention that aimed to induce smoking cessation attempts among adults not initially ready to quit. METHODS Participants randomized into the two intervention groups (Group 1: Phoenix App Only; Group 2: Phoenix App + Nicotine Replacement Therapy) received daily smoking cessation messages via smartphone application that were tailored to their current readiness to quit, while the attention control group (i.e., Factoid) received messages not related to smoking cessation. All participants completed a weekly survey for 26 weeks and used the app to set quit dates when/if desired. RESULTS Participants (N=152) were female (67.8 %), White (75.7 %), 50.0 years old (SD=12.5), and smoked 20.4 cigarettes per day (SD=10.5). Results indicated that the Phoenix interventions were feasible (e.g., participants viewed ~185 messages over 26 weeks; 74.8 % of weekly surveys were completed; 85.5 % completed the 26-week follow-up assessment). Phoenix participants set more quit dates, set quit dates sooner, were abstinent for more days, and used smoking cessation medications on more days than those assigned to the Factoid group. CONCLUSIONS This low-burden, smartphone-based smoking cessation induction intervention may increase smoking cessation attempts, and may reduce barriers that are encountered with traditional in-person or call-based interventions. TRIAL REGISTRATION Clinicaltrials.gov number: NCT03405129; https://clinicaltrials.gov/ct2/show/NCT03405129.
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Affiliation(s)
- Michael S Businelle
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, USA; Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
| | - Lizbeth Benson
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, USA
| | - Emily T Hébert
- Department of Health Promotion and Behavioral Sciences, UT Health School of Public Health, Austin, TX, USA
| | - Jordan Neil
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, USA; Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Darla E Kendzor
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, USA; Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Summer Frank-Pearce
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, USA; College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Krista M Kezbers
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, USA
| | - Damon Vidrine
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Akshay Gaur
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, USA
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