Perceived addiction to smoking and associations with motivation to stop, quit attempts and quitting success: A prospective study of English smokers

Barriers to seeking tobacco cessation services: a qualitative assessment of university students' needs in Qatar

The prevalence of tobacco use in the Middle East is alarmingly high, especially among university students; most users initiate tobacco use during adolescence and young adulthood. Evidence-based cessation services can be beneficial when quitting tobacco use; however, these services are underutilized. This study aimed to explore the barriers preventing university students in Qatar from seeking tobacco cessation services. Semi-structured interviews were conducted with 20 Qatar University students who are current or former tobacco users (n = 18/2); most current cigarette smokers were also waterpipe users. The interviews were transcribed verbatim, coded, and analyzed using thematic analysis. The major barriers to seeking tobacco cessation services included misconceptions regarding nicotine addiction, negative perceptions of the cessation services' effectiveness, self-efficacy regarding the ability to quit without seeking cessation services, concerns and preferences regarding practitioners' characteristics at clinics, masculine culture that discourages men from seeking cessation help, social stigma around women who use tobacco in Arab culture, and a lack of time to visit cessation clinics. Our findings address gaps in the literature regarding the individual and sociocultural barriers to seeking tobacco cessation among youth in Qatar. A better understanding of these barriers can facilitate successful promotion of tobacco cessation services and enhance cessation-seeking behaviors.

Association between perceived addiction and cessation behaviours among users of smokeless or combustible tobacco in India

INTRODUCTION

Addiction to tobacco is one of the main drivers of continued tobacco use. This study explored whether perceived addiction, type of tobacco and demographic characteristics were associated with past quit attempts (PQA), intention and self-efficacy to quit among combustible tobacco (CT) or smokeless tobacco (SLT) users in India.

METHODS

A cross-sectional survey was conducted among adult tobacco users (N = 607) attending an out-patient department in Mumbai. Logistic regression analysis was used to investigate the association between demographic characteristics, type of tobacco, addiction perceptions and cessation behaviours.

RESULTS

Being 'a little addicted' (adjusted odds ratio, AOR [95% confidence interval, CI] 2.75 [1.83, 4.11], P < 0.0001) or 'quite addicted' (AOR [95% CI] 2.93 [1.53, 5.62], P < 0.0012) was associated with lower odds of making a PQA compared to 'not addicted at all'. Being a SLT user (AOR [95% CI] 0.64 [0.41, 0.99], P = 0.047) and female (AOR [95% CI] 0.46 [0.26, 0.81], P = 0.0068) was associated with lower odds of making a PQA. There was a significant decrease in the odds of intention to quit as age increased by 1 year (AOR [95% CI] 0.98 [0.97, 0.99], P = 0.0018). Being identified as 'a little addicted' (AOR [95% CI] 0.28 [0.14, 0.55], P = 0.0003), 'quite addicted' (AOR [95% CI] 0.16 [0.07, 0.39], P < 0.0001) or 'very addicted' (AOR [95% CI] 0.09 [0.04, 0.19], P < 0.0001) was associated with lower odds of self-efficacy to quit compared to 'not addicted at all'.

DISCUSSION AND CONCLUSION

Lack of awareness about addiction may inhibit cessation, particularly among less educated and female users of SLT and CT products.

Addiction perceptions among users of smokeless or combustible tobacco attending a tertiary care hospital in India

INTRODUCTION

Addiction plays a key role in continued tobacco use. The study assessed association of perceived personal addiction and the perceived addictiveness of different forms of tobacco with type of tobacco product used, demographic characteristics and socio-cultural factors.

METHODS

A cross-sectional survey of 607 adult tobacco users with age 18 years and above attending a general medicine out-patient department was conducted. Participants were asked questions on perceived personal addiction to tobacco use and perception of addiction on tobacco products. Logistic regression was applied to investigate the association between demographic characteristics, type of tobacco, socio-cultural factors and addiction perceptions.

RESULTS

The odds of perceived addiction (PA) were lower among smokeless tobacco (SLT) users [OR (95% CI): 0.57 (0.37, 0.89) P = 0.01]. An increase in the odds of PA was seen as age increased [OR (95% CI):1.02 (1.00, 1.03) P = 0.01] and participants with secondary education and above had higher odds of PA compared to participants with no formal education [OR (95% CI): 1.68 (1.09, 2.58) P = 0.02]. The odds of perceiving SLT products to be addictive was lower among SLT users [OR (95% CI): 0.48 (0.30, 0.75) P = 0.002)] compared to combustible tobacco users. The odds of perceiving SLT products to be addictive was lower [(OR (95% CI): 0.35 (0.18, 0.67) P = 0.002)] among females. Participants with secondary education and above had higher odds of perceiving combustible [OR (95% CI): 1.80 (1.17, 2.77) P = 0.008)] and SLT products [OR (95% CI): 1.98 (1.20, 3.30) P = 0.008)] to be addictive compared to no schooling.

DISCUSSION AND CONCLUSIONS

There is a need to raise awareness in India of the addictiveness of tobacco, particularly for users of SLT, younger people and those with less education.

Exploring the Experiences and Perceptions of Cigar Craving and Addiction among Young Adult Black Cigar Smokers

Black young adults have the highest prevalence of cigar smoking in the U.S. Little is known about how this population perceives addiction to cigar smoking, which may influence long-term smoking and cessation outcomes. This study used semi-structured in-depth interviews to understand cravings, triggers, and perceived addiction from cigar smoking among a purposive sample of Black young adult cigar smokers (N = 40; 21-29 years). An iterative process was used to develop the codebook, and thematic analysis was used to capture findings based on the products predominantly used: cigarillos, large cigars, or blunts. Results suggest that while participants may share similar types of cravings and triggers (e.g., stress) across the use of these products, predominant blunt smokers reported more unique triggers related to relieving physical discomforts. While most participants reported cigars could be addictive to people in general, only a few perceived that they themselves were addicted. Participants who predominantly smoked cigarillos reported high perceived addiction to cigars, while those who predominantly smoked blunts reported low addiction. Education messages are needed to inform young Black adult cigar smokers about the risks and health symptoms of cigar addiction. These efforts may help increase cigar cessation seeking and reduce cigar addiction-related health consequences and disparities among Black populations.

Associations between smoking to relieve stress, motivation to stop and quit attempts across the social spectrum: A population survey in England

Smoking prevalence in several high-income countries is steadily declining but remains persistently high in 'lower' socioeconomic position (SEP) groups, contributing to inequities in morbidity and mortality. Smoking to relieve stress is a commonly endorsed motive for continued smoking; however, it remains unclear whether smoking to relieve stress has a negative impact on motivation to stop and future quit attempts and if so, whether associations are moderated by SEP. This was an observational study with cross-sectional and prospective survey data from the nationally representative Smoking Toolkit Study in England. A total of 1,135 adult smokers were surveyed at baseline, with 153 (13.5%) respondents followed up at 12 months. Respondents provided information on demographic, social and smoking characteristics. A series of multivariable logistic regression analyses was conducted. Bayes Factors (BFs) were calculated to explore non-significant associations. Smoking to relieve stress was commonly endorsed by respondents from both 'lower' (43.2% [95% CI = 39.4%, 47.0%]) and 'higher' (40.5% [95% CI = 35.9%, 45.1%]) SEP groups (p = 0.39). Smoking to relieve stress was associated with high motivation to stop at baseline (ORadj = 1.48, 95% CI = 1.03-2.12, p = 0.035) but not significantly with the odds of making a quit attempt at a 12-month follow-up, although the magnitude and direction of the effect was similar to that observed for high motivation to stop (ORadj = 1.49, 95% CI = 0.69-3.20, p = 0.3). Data were insensitive to detect moderation effects of SEP (BF = 0.90 and BF = 1.65, respectively). Smoking to relieve stress is a commonly endorsed motive and is associated with high motivation to stop but not significantly with the odds of making a quit attempt in the next 12 months, although the magnitude and direction of the effect was similar for both outcomes. There was no clear evidence of moderation by SEP, although data were insensitive to distinguish the alternative from the null hypothesis.

The Effectiveness of Health Education Using Audiovisual on the Santri Smokers' Motivation to Stop Smoking

Background and objective:

Low motivation to quit smoking affects individual smoking behavior. Health education using audiovisual media can increase smokers’ motivation to quit smoking. The objective of this study was to determine the effectiveness of health education using audiovisuals on the Santri smokers’ motivation to stop smoking.

Methods:

This quasi-experimental study was carried out using a pretest-posttest design. The sample in this study included Santri smokers studying at the Traditional Islamic Boarding School in Aceh Besar . This study consisted of 4 groups. Three groups were given intervention (audiovisual health education with different themes) and one group received just health education. Groups were compered in terms of difference in the mean smokers’ motivation to quit smoking. The data analysis was done by running paired t-test and one-way ANOVA.

Results:

The results of statistical tests showed that there was a difference in the mean motivation to quit smoking before and after the intervention in each group (mean ± SD for group 1 to 4 was 11.52 ± 4.76, 15.39 ± 6.06, 22.57 ± 6.23, and 9.84 ± 6.42, respectively). The highest increase in the mean motivation to quit smoking was allocated to group 3 who received audiovisual health education with the theme of risk of developing cancer due to smoking.

Conclusion:

Health education using audiovisuals could increase the motivation of students to quit smoking, especially interventions on the risk of developing cancer due to smoking. Therefore, health workers are suggested to use audiovisuals to implement various intervention in order to change smoking behavior in students.

Is the motivation to quit smoking a predictor of abstinence maintenance?

INTRODUCTION

The aim of this study was to explore the utility of measuring motivation to quit smoking as a predictor of abstinence maintenance among smokers who wanted to quit and who were included in a multicenter study conducted in daily clinical practice.

METHODS

This observational, longitudinal (prospective cohort), multicenter study was conducted in smoking clinics in Spain and the Argentine Republic in daily clinical practice. Motivation was assessed using three quantitative motivation tests and a Visual Analogue Scale. Statistical analysis included descriptive, association measures and logistic regression models.

RESULTS

Of a total of 404 subjects, 273 were ultimately included for analysis (147 women; 53.8%), mean age 51±11 years). In one year, 53.5% (36.13% by intention to treat) of subjects (146) were successful in quitting smoking [men: 45.2% (66) and women: 54.8% (80)], with no differences between sexes. None of the scales utilized was associated, in an unquestionable or direct way, with long-term abstinence, although three of them, in a very complex model, with additional variables and added interactions, were associated with the ‘result’ variable, when other variables intervened in certain circumstances.

CONCLUSIONS

None of the analyzed motivational scales alone demonstrated an association with success or failure in quitting smoking; thus, their use in isolation is of no value. Some of the scales analyzed might be related to the maintenance of abstinence but in complex models where other variables intervene, which makes interpretation considerably difficult. Therefore, the predictive capacity of the tests analyzed, based on the models, was low.

Understanding willingness to access and experiences of NHS Stop Smoking Services: a qualitative systematic review with meta-aggregation synthesis

OBJECTIVES

NHS Stop Smoking Services (NHS-SSS) have been available in the United Kingdom (UK) since 2000. The service has proven to be effective, however uptake remains below aspirations. Understanding people's willingness and reasons for accessing and engaging with NHS-SSS is, therefore, important. The aim of this systematic review is to summarise the findings from qualitative research to understand people's views, perceptions and willingness to access NHS-SSS.

STUDY DESIGN

Qualitative systematic review with meta-aggregation synthesis.

METHODS

Four electronic databases were searched for published qualitative studies, from Jan 2000 to Jan 2020. Following the screening, data extraction and quality assessment, data synthesis was conducted using meta-aggregation based on a patient-centred theoretical framework. We explored five 'demand-side' dimensions of service accessibility: the ability to perceive, seek, reach, pay and engage. Confidence in the synthesised findings relating to dependability and credibility was established using CONQual.

RESULTS

Seventeen studies were included in the review. Twelve categories emerged, contributing to five synthesised statements, all with a CONQual rating of moderate confidence. Access and willingness to use NHS-SSS were found to be related to an individual's readiness to perceive that smoking is a problem for which a solution should be sought, their ability to seek a perceived effective treatment, to conveniently reach NHS-SSS, their perceptions around associated costs and tailoring care to improve engagement with individuals.

CONCLUSIONS

By using a theoretical framework incorporating healthcare access, this study provides policymakers valuable insights into people's willingness to access these services. Willingness to access NHS-SSS is multifaceted, nuanced and complex. Strategies to promote NHS-SSS uptake should include making services more attractive, relevant and responsive to individual perceptions around smoking and health. Given the higher prevalence of smoking in less affluent socioeconomic groups and in some ethnic minority groups, the importance of having a comprehensive and inclusive tobacco control policy, one that is linguistically and culturally sensitive, cannot be overstated.

Network analysis reveals the associations of past quit experiences on current smoking behavior and motivation to quit

INTRODUCTION

Smoking is a leading cause of morbidity and mortality in the United States. While most smokers endorse a desire to quit, achieving abstinence is notoriously difficult. Network analysis is a method for understanding the complex relationships of factors that maintain smoking behavior and impact motivation to quit.

METHODS

This study examined self-report prescreen data from treatment-seeking smokers (N = 3913). The number of prior quit attempts and withdrawal symptoms experienced, as well as current smoking behavior and motivation to quit were modeled as interconnected nodes in a network. Two key network metrics were examined: 1) edge weights, which quantify the strength and direction of the associations of interest, and 2) the sum of each node's edge weights, which quantifies the expected influence of a node on the overall network.

RESULTS

The withdrawal symptom of craving, r = 0.10, 95% CI [0.07, 0.13] and digestive problems, r = -0.06, 95% CI [-0.09, -0.03], had the strongest positive and negative association with daily cigarettes, respectively. The number of prior quit attempts, r = 0.17, 95% CI [0.14, 0.20], concentration problems, r = -0.04, 95% CI [-0.027, -0.01], showed the strongest positive and negative associations, respectively, with current motivation to quit. Nodes with significant links to current smoking and motivation to quit were also among the most influential in the overall network.

CONCLUSIONS

Findings suggest prior quit experiences and consequences associated with withdrawal symptoms may differentially relate to maintenance of smoking behavior and motivation to quit in treatment-seeking smokers. Interventions targeting key withdrawal symptoms may enhance motivation to quit.

Predictive Power of Dependence Measures for Quitting Smoking. Findings From the 2016 to 2018 ITC Four Country Smoking and Vaping Surveys

INTRODUCTION

To test whether urges to smoke and perceived addiction to smoking have independent predictive value for quit attempts and short-term quit success over and above the Heaviness of Smoking Index (HSI).

AIMS AND METHODS

Data were from the International Tobacco Control Four Country Smoking and Vaping Wave 1 (2016) and Wave 2 (2018) surveys. About 3661 daily smokers (daily vapers excluded) provided data in both waves. A series of multivariable logistic regression models assessed the association of each dependence measure on odds of making a quit attempt and at least 1-month smoking abstinence.

RESULTS

Of the 3661 participants, 1594 (43.5%) reported a quit attempt. Of those who reported a quit attempt, 546 (34.9%) reported short-term quit success. Fully adjusted models showed that making quit attempts was associated with lower HSI (adjusted odds ratio [aOR] = 0.81, 95% confidence interval [CI] = 0.73 to 0.90, p < .001), stronger urges to smoke (aOR = 1.08, 95% CI = 1.04 to 1.20, p = .002), and higher perceived addiction to smoking (aOR = 0.52, 95% CI = 0.32 to 0.84, p = .008). Lower HSI (aOR = 0.57, 95% CI = 0.40 to 0.87, p < .001), weaker urges to smoke (aOR = 0.85, 95% CI = 0.76 to 0.95, p = .006), and lower perceived addiction to smoking (aOR = 0.55, 95% CI = 0.32 to 0.91, p = .021) were associated with greater odds of short-term quit success. In both cases, overall R2 was around 0.5.

CONCLUSIONS

The two additional dependence measures were complementary to HSI adding explanatory power to smoking cessation models, but variance explained remains small.

IMPLICATIONS

Strength of urges to smoke and perceived addiction to smoking may significantly improve prediction of cessation attempts and short-term quit success over and above routinely assessed demographic variables and the HSI. Stratification of analyses by age group is recommended because the relationship between dependence measures and outcomes differs significantly for younger (aged 18-39) compared to older (aged older than 40) participants. Even with the addition of these extra measures of dependence, the overall variance explained in predicting smoking cessation outcomes remains very low. These measures can only be thought of as assessing some aspects of dependence. Current understanding of the factors that ultimately determine quit success remains limited.

Predictors of Smoking Cessation Attempts and Success Following Motivation-Phase Interventions Among People Initially Unwilling to Quit Smoking

INTRODUCTION

Most people who smoke cigarettes are not willing (ie, not ready) to make a quit attempt (QA) at any given time. Unfortunately, interventions intended to increase QAs and the success of QAs are only modestly effective. Identifying processes leading to QAs and quitting success could guide intervention development.

AIMS AND METHODS

This is a secondary analysis of a randomized factorial trial of 6 weeks of motivation-phase interventions among primary care patients (N = 517) who were initially unwilling to quit but were willing to reduce their smoking. Using logistic regression, we controlled for treatment condition and tested whether baseline or change in smoking-related constructs after 6 weeks of treatment predicted (1) making an at least 24 h QA between weeks 6 and 26 and (2) quitting success at week 26 (7-day point-prevalence abstinence among those who made a QA). Predictors included cigarettes/day, time to first cigarette, motivation to quit, quitting self-efficacy, anticipated urges to smoke if quit, positive affect, negative affect, and time spent around others who smoke.

RESULTS

In multivariable models that included all smoking-related constructs, changes in the following variables predicted initiating a QA above and beyond other variables: greater baseline time to first cigarette (odds ratio [OR] = 1.60), increases in time to first cigarette (OR = 1.27), and increases in quitting self-efficacy (OR = 1.14). Increased motivation to quit predicted conversion of a QA into quitting success at 26 weeks (OR = 1.36).

CONCLUSION

Predictors of making a QA differed from predictors of quitting success. Predictors of QAs and success could each serve as important treatment targets of motivation-phase interventions.

IMPLICATIONS

Motivation-phase interventions for people initially unwilling to quit smoking cigarettes may be improved by striving to increase their (1) time to first cigarette and quitting self-efficacy to promote QAs and (2) motivation to quit to promote quit success. Future experimental tests of such interventions are needed to identify causal determinants of QAs and quitting success.

Preferences for Tobacco Cessation Information and Support During Covid-19

OBJECTIVE

To identify how best to provide smoking cessation advice and support during the Covid-19 pandemic. Preferences were assessed in relation to: (i) specific forms of tobacco cessation support (eg, nicotine replacement therapy (NRT) and various counseling formats); (ii) information sources (eg, government officials, doctors); and (iii) channels via which to receive relevant information (eg, television, social media).

METHODS

An online survey was administered to adults who smoke tobacco in Australia (n = 604) and the UK (n = 600). Descriptive analyses were conducted to identify levels of interest in cessation support and information provision. Differences in responses according to demographic characteristics and smoking history were assessed.

RESULTS

Around half of the respondents were interested in receiving personal counseling and/or participating in a text support program over the next month. By far the most popular delivery mechanism for personal counseling was email. Three-quarters of the sample expressed an interest in receiving free, home-delivered NRT. The most popular information sources nominated by respondents seeking more information about smokers' Covid-related risks were government departments and their doctor/general practitioner. Television and online news sources were the most preferred information dissemination channels.

CONCLUSIONS

The substantial levels of interest expressed in accessing various forms of cessation assistance within the next month suggest that Covid-19 may be increasing receptiveness to quitting. The strong interest in free, home-delivered NRT indicates that this may be a useful mechanism for facilitating quit attempts during the pandemic.

Perceptions, Predictors of and Motivation for Quitting among Smokers from Six European Countries from 2016 to 2018: Findings from EUREST-PLUS ITC Europe Surveys

The European Tobacco Products Directive (TPD) was introduced in 2016 in an effort to decrease prevalence of smoking and increase cessation in the European Union (EU). This study aimed to explore quitting behaviours, motivation, reasons and perceptions about quitting, as well as predictors (reported before the TPD implementation) associated with post-TPD quit status. A cohort study was conducted involving adult smokers from six EU countries (n = 3195). Data collection occurred pre-(Wave 1; 2016) and post-(Wave 2; 2018) TPD implementation. Bivariate and logistic regression analyses of weighted data were conducted. Within this cohort sample, 415 (13.0%) respondents reported quitting at Wave 2. Predictors of quitting were moderate or high education, fewer cigarettes smoked per day at baseline, a past quit attempt, lower level of perceived addiction, plans for quitting and the presence of a smoking-related comorbidity. Health concerns, price of cigarettes and being a good example for children were among the most important reasons that predicted being a quitter at Wave 2. Our findings show that the factors influencing decisions about quitting may be shared among European countries. European policy and the revised version of TPD could emphasise these factors through health warnings and/or campaigns and other policies.

Patients' User Experience of a Blended Face-to-Face and Web-Based Smoking Cessation Treatment: Qualitative Study

Background

Blended web-based and face-to-face (F2F) treatment is a promising electronic health service because the strengths of one mode of delivery should compensate for the weaknesses of the other.

Objective

The aim of this study was to explore this compensation by examining patients’ user experience (UX) in a blended smoking cessation treatment (BSCT) in routine care.

Methods

Data on patients’ UX were collected through in-depth interviews (n=10) at an outpatient smoking cessation clinic in the Netherlands. A content analysis of the semantic domains was used to analyze patients’ UX. To describe the UX, the Hassenzahl UX model was applied, examining 4 of the 5 key elements of UX from a user’s perspective: (1) patients’ standards and expectations, (2) apparent character (pragmatic and hedonic attributes), (3) usage situation, and (4) consequences (appeal, emotions, and behavior).

Results

BSCT appeared to be a mostly positively experienced service. Patients had a positive-pragmatic standard and neutral-open expectation toward BSCT at the treatment start. The pragmatic attributes of the F2F sessions were mostly perceived as positive, whereas the pragmatic attributes of the web sessions were perceived as both positive and negative. For the hedonic attributes, there seemed to be a difference between the F2F and web sessions. Specifically, the hedonic attributes of the web sessions were experienced as mostly negative, whereas those of the F2F sessions were experienced as mostly positive. For the usage situation, the physical and social contexts were experienced positively, whereas the task and technical contexts were experienced negatively. Nevertheless, the consequential appeal of BSCT was positive. However, the consequential emotions and behavior varied, ultimately resulting in diverse combinations of consequential appeal, emotions, and behavior (positive, negative, and mixed).

Conclusions

This study provided insights into the UX of a blended treatment, and the results support the expectation that in a blended treatment, the strengths of one mode of delivery may compensate for the weaknesses of the other. However, in this certain setting, this is mainly achieved in only one way: F2F sessions compensated for the weaknesses of the web sessions. As a practical conclusion, this may mean that the web sessions, supported by the strengths of the F2F sessions, offer an interesting approach for further improving the blended treatment. Our theoretical findings reflect the relevance of the aspects of hedonism, such as fun, joy, or happiness in the UX, which were not mentioned in relation to the web sessions and were only scarcely mentioned in relation to the F2F sessions. Future research should further investigate the role of hedonistic aspects in a blended treatment and whether increased enjoyment of a blended treatment could increase treatment adherence and, ultimately, effectiveness.

Tobacco dependence and smoking cessation: The mediating role of smoker and ex-smoker self-concepts

Tobacco dependence is a complex phenomenon in which physical and psychological components go hand in hand, and it is often considered as one of the major barriers to quit smoking. However, we still need to increase our understanding of the processes through which tobacco dependence relates to smoking cessation. This research aimed to investigating whether changes in smoker versus ex-smoker (abstainer) self-concept account for the association between tobacco dependence and successful smoking cessation. We used longitudinal data drawn from the evaluation of a smoking cessation intervention. A sample of smokers enrolled in the program filled in a questionnaire at the beginning of the intervention (baseline: N = 779), 6 months later (i.e., at the end of the intervention: T1, N = 532), and 9 months later (T2; N = 387). We assessed tobacco dependence (baseline), smoker versus ex-smoker self-concept (baseline, T1, and T2) and smoking status (baseline, T1 and T2). Tobacco dependence was negatively associated with smoking cessation maintenance, and this effect was mediated by changes in self-concept: The greater tobacco dependence, the lower the likelihood that former smokers develop an ex-smoker self-concept during the program, which results in relapse at T1 or T2. Successful smoking cessation interventions should provide strategies preventing the negative effects of tobacco dependence on identity transition.

Factors associated with tobacco cessation attempts among inpatients in a psychiatric hospital

Introduction

Several effective evidence-based tobacco treatment approaches can optimize cessation attempts; however, little is known about the utilization of such strategies by people with mental illnesses (MI) during their cessation attempts.

Aims

To examine methods used during and factors associated with tobacco cessation attempts among people with MI.

Methods

Self-administered cross-sectional survey data were obtained from 132 tobacco using inpatients from a psychiatric facility in Kentucky, USA.

Results

Our study found ‘cold turkey’ as the most reported method by inpatient tobacco users with MI in their prior cessation attempts regardless of the psychiatric diagnosis category. Multivariate logistic regression found ethnicity (OR 26.1; 95% CI 2.9–237.1), age at 1st smoke (OR 1.1; 95% CI 1.0–1.1), importance to quit (OR 1.2; 95% CI 1.0–1.4), and receipt of brief tobacco treatment interventions (OR 1.1; 95% CI 1.0–1.3) significantly associated with quit attempt in the past year.

Conclusion

Despite the existence of various evidence-based approaches to enhance tobacco cessation among people with MI, ‘cold-turkey’ was the most preferred method in this sample. In addition, this study highlighted ethnicity, importance to quit, age at 1st smoke, and receipt of brief interventions as important factors to consider when tailoring tobacco cessation in this population. Though ethnicity is a non-modifiable factor, an informed provider may intervene skillfully by addressing socio-cultural barriers specific to an ethnic group. Lower ratings on the motivation ruler and early age of smoking initiation could also inform providers when using motivational interviewing and other evidence-based tobacco-cessation approaches.