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Goldgof GM, Mishra S, Bajaj K. Efficacy of the QuitSure App for Smoking Cessation in Adult Smokers: Cross-Sectional Web Survey. JMIR Hum Factors 2024; 11:e49519. [PMID: 38709553 PMCID: PMC11106700 DOI: 10.2196/49519] [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: 05/31/2023] [Revised: 11/28/2023] [Accepted: 02/28/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND Cigarette smoking remains one of the leading causes of preventable death worldwide. A worldwide study by the World Health Organization concluded that more than 8 million people die every year from smoking, tobacco consumption, and secondhand smoke. The most effective tobacco cessation programs require personalized human intervention combined with costly pharmaceutical supplementation, making them unaffordable or inaccessible to most tobacco users. Thus, digital interventions offer a promising alternative to these traditional methods. However, the leading smartphone apps available in the market today have either not been studied in a clinical setting or are unable to match the smoking cessation success rates of their expensive offline counterparts. We would like to understand whether QuitSure, a novel smoking cessation app built by Rapidkart Online Private Limited, is able to bridge this efficacy gap and deliver affordable and effective smoking cessation at scale. OBJECTIVE Our objective was to do an initial exploration into the engagement, efficacy, and safety of QuitSure based on the self-reported experiences of its users. Outcomes measured were program completion, the effect of program completion on smoking behavior, including self-reported cessation outcomes, and negative health events from using the app. METHODS All QuitSure registered users who created their accounts on the QuitSure app between April 1, 2021, and February 28, 2022, were sent an anonymized web-based survey. The survey results were added to their engagement data on the app to evaluate the feasibility and efficacy of the app as a smoking cessation intervention. The data were analyzed using descriptive statistics (frequencies and percentages) and the χ2 test of independence. RESULTS In total, 1299 users who had completed the QuitSure program submitted the survey and satisfied the inclusion criteria of the study. Of these, 1286 participants had completed the program more than 30 days before filling out the survey, and 1040 (80.1%, 95% CI 79.1%-82.6%) of them had maintained prolonged abstinence for at least 30 days after program completion. A majority of participants (770/891, 86.4%) who were still maintaining abstinence at the time of submitting the survey did not experience any severe nicotine withdrawal symptoms, while 41.9% (373/891) experienced no mild withdrawal symptoms either. Smoking quantity prior to completing the program significantly affected quit rates (P<.001), with heavy smokers (>20 cigarettes per day) having a lower 30-day prolonged abstinence rate (relative risk=0.91; 95% CI 90.0%-96.2%) compared to lighter smokers. No additional adverse events outside of known nicotine withdrawal symptoms were reported. CONCLUSIONS The nature of web-based surveys and cohort selection allows for extensive unknown biases. However, the efficacy rates of survey respondents who completed the program were high and provide a case for further investigation in the form of randomized controlled trials on the QuitSure tobacco cessation program.
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Affiliation(s)
- Gregory M Goldgof
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Shweta Mishra
- QuitSure, Rapidkart Online Private Limited, Mumbai, India
| | - Kriti Bajaj
- QuitSure, Rapidkart Online Private Limited, Mumbai, India
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He Y, Fong GT, Cummings KM, Hyland A, Shang C. The association between excise taxes and smoking and vaping transitions-Findings from the 2016-2020 ITC United States surveys. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 126:104372. [PMID: 38422713 DOI: 10.1016/j.drugpo.2024.104372] [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: 09/27/2023] [Revised: 02/19/2024] [Accepted: 02/22/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND While a growing number of studies examined the effect of e-cigarette (EC) excise taxes on tobacco use behaviors using cross-sectional surveys or sales data, there are currently no studies that evaluate the impact of EC taxes on smoking and vaping transitions. METHODS Using data from the US arm of the 2016-2020 International Tobacco Control Four Country Smoking and Vaping Survey (ITC 4CV), we employed a multinomial logit model with two-way fixed effects to simultaneously estimate the impacts of cigarette/EC taxes on the change in smoking and vaping frequencies. RESULTS Our benchmark model suggests that a 10 % increase in cigarette taxes led to an 11 % reduction in smoking frequencies (p < 0.01), while EC taxes did not have a significant effect on smoking frequencies. CONCLUSION Our findings suggest that increasing cigarette taxes may serve as an effective means of encouraging people who smoke to cut back on smoking or quit smoking. The impact of increasing EC taxes on smoking transitions is less certain at this time.
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Affiliation(s)
- Yanyun He
- Center for Tobacco Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada; School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - K Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Andrew Hyland
- Department of Health Behaviors, Division of Cancer Prevention and Population Sciences, Roswell Park Comprehensive Cancer Center, USA
| | - Ce Shang
- Center for Tobacco Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA; Department of Internal Medicine, Medical Oncology Division, The Ohio State University, Columbus, OH, USA
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3
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Farris SG, Smith JE, Steinberg DR, Altman BR, Lambert-Messerlian GM, Dunsiger SI, Williams DM, Saladin ME, Abrantes AM. Methodological approach for an integrated female-specific study of anxiety and smoking comorbidity. Front Psychiatry 2023; 14:1267753. [PMID: 38076702 PMCID: PMC10704195 DOI: 10.3389/fpsyt.2023.1267753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/08/2023] [Indexed: 02/12/2024] Open
Abstract
Two primary ovarian hormones that fluctuate across the female menstrual cycle-estradiol and progesterone-have been independently linked in separate literatures to nicotine reinforcement and anxiety psychopathology. We identify existing methodological limitations in these literatures, describe an example protocol that was developed to address such limitations, highlight case examples, and offer insights on the resulting advantages and challenges. This protocol was an observational, prospective, within-subjects study of female cigarette smokers who were followed over the course of a complete menstrual cycle. Non-treatment seeking, female cigarette smokers (N = 50), between the ages of 18-40 who have a normal menstrual cycle (25-35 days in length) were recruited from the community. Females with anxiety or mood psychopathology represented 38.0% of the sample. Salivary progesterone and estradiol were assessed each morning via at-home saliva collection methods. Self-reported within-day momentary ratings of anxiety and nicotine reinforcement were collected using ecological momentary assessment (EMA) via a mobile app. Protocol compliance was >85%. Within- and between-subjects heterogeneity was observed in the progesterone and estradiol, anxiety, and nicotine craving measures, especially in the context of anxiety psychopathology. We aimed to integrate the anxiety and nicotine dependence literatures and advance the empirical study of the role of ovarian hormones. This protocol reflects an intensive, yet feasible approach to collecting daily-level naturalistic data related to estradiol, progesterone, anxiety, and nicotine reinforcement.
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Affiliation(s)
- Samantha G. Farris
- Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Jacqueline E. Smith
- Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Dana R. Steinberg
- Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Brianna R. Altman
- Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Geralyn M. Lambert-Messerlian
- Pathology and Laboratory Medicine and Obstetrics and Gynecology, Alpert Medical School of Brown University, Providence, RI, United States
| | - Shira I. Dunsiger
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States
| | - David M. Williams
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States
| | - Michael E. Saladin
- Department of Health Science and Research, Medical University of South Carolina, Charleston, SC, United States
| | - Ana M. Abrantes
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
- Behavioral Medicine and Addictions Research Unit, Butler Hospital, Providence, RI, United States
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Bierut LJ, Hendershot TP, Benowitz NL, Cummings KM, Mermelstein RJ, Piper ME, Vrieze SI, Wagener TL, Nelms MD, Ives C, Maiese D, Hamilton CM, Swan GE. Smoking cessation, harm reduction, and biomarkers protocols in the PhenX Toolkit: Tools for standardized data collection. ADDICTION NEUROSCIENCE 2023; 7:100081. [PMID: 38645895 PMCID: PMC11027214 DOI: 10.1016/j.addicn.2023.100081] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
The use of standard protocols in studies supports consistent data collection, improves data quality, and facilitates cross-study analyses. Funded by the National Institutes of Health, the PhenX (consensus measures for Phenotypes and eXposures) Toolkit is a catalog of recommended measurement protocols that address a wide range of research topics and are suitable for inclusion in a variety of study designs. In 2020, a PhenX Working Group of smoking cessation experts followed a well-established consensus process to identify and recommend measurement protocols suitable for inclusion in smoking cessation and smoking harm reduction studies. The broader scientific community was invited to review and provide feedback on the preliminary recommendation of the Working Group. Fourteen selected protocols for measuring smoking cessation, harm reduction, and biomarkers research associated with smoking cessation were released in the PhenX Toolkit ( https://www.phenxtoolkit.org) in February 2021. These protocols complement existing PhenX Toolkit content related to tobacco regulatory research, substance use and addiction research, and other measures of smoking-related health outcomes. Adopting well-established protocols enables consistent data collection and facilitates comparing and combining data across studies, potentially increasing the scientific impact of individual studies.
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Affiliation(s)
- Laura Jean Bierut
- Department of Psychiatry, Washington University School of Medicine of St. Louis, 660 South Euclid, Campus Box 8134, St. Louis, MO 63110, USA
| | - Tabitha P. Hendershot
- RTI International, Center for GenOmics, Bioinformatics and Translational Research, Research Triangle Park, NC, USA
| | - Neal L. Benowitz
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - K. Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | | | - Megan E. Piper
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, Madison, WI, USA
| | - Scott I. Vrieze
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Theodore L. Wagener
- Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Mark D. Nelms
- RTI International, Center for GenOmics, Bioinformatics and Translational Research, Research Triangle Park, NC, USA
| | - Cataia Ives
- RTI International, Center for GenOmics, Bioinformatics and Translational Research, Research Triangle Park, NC, USA
| | - Deborah Maiese
- RTI International, Center for GenOmics, Bioinformatics and Translational Research, Research Triangle Park, NC, USA
| | - Carol M. Hamilton
- RTI International, Center for GenOmics, Bioinformatics and Translational Research, Research Triangle Park, NC, USA
| | - Gary E. Swan
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
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Hajizadeh A, Howes S, Theodoulou A, Klemperer E, Hartmann-Boyce J, Livingstone-Banks J, Lindson N. Antidepressants for smoking cessation. Cochrane Database Syst Rev 2023; 5:CD000031. [PMID: 37230961 PMCID: PMC10207863 DOI: 10.1002/14651858.cd000031.pub6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND The pharmacological profiles and mechanisms of antidepressants are varied. However, there are common reasons why they might help people to stop smoking tobacco: nicotine withdrawal can produce short-term low mood that antidepressants may relieve; and some antidepressants may have a specific effect on neural pathways or receptors that underlie nicotine addiction. OBJECTIVES To assess the evidence for the efficacy, harms, and tolerability of medications with antidepressant properties in assisting long-term tobacco smoking cessation in people who smoke cigarettes. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group Specialised Register, most recently on 29 April 2022. SELECTION CRITERIA We included randomised controlled trials (RCTs) in people who smoked, comparing antidepressant medications with placebo or no pharmacological treatment, an alternative pharmacotherapy, or the same medication used differently. We excluded trials with fewer than six months of follow-up from efficacy analyses. We included trials with any follow-up length for our analyses of harms. DATA COLLECTION AND ANALYSIS We extracted data and assessed risk of bias using standard Cochrane methods. Our primary outcome measure was smoking cessation after at least six months' follow-up. We used the most rigorous definition of abstinence available in each trial, and biochemically validated rates if available. Our secondary outcomes were harms and tolerance outcomes, including adverse events (AEs), serious adverse events (SAEs), psychiatric AEs, seizures, overdoses, suicide attempts, death by suicide, all-cause mortality, and trial dropouts due to treatment. We carried out meta-analyses where appropriate. MAIN RESULTS We included a total of 124 studies (48,832 participants) in this review, with 10 new studies added to this update version. Most studies recruited adults from the community or from smoking cessation clinics; four studies focused on adolescents (with participants between 12 and 21 years old). We judged 34 studies to be at high risk of bias; however, restricting analyses only to studies at low or unclear risk of bias did not change clinical interpretation of the results. There was high-certainty evidence that bupropion increased smoking cessation rates when compared to placebo or no pharmacological treatment (RR 1.60, 95% CI 1.49 to 1.72; I2 = 16%; 50 studies, 18,577 participants). There was moderate-certainty evidence that a combination of bupropion and varenicline may have resulted in superior quit rates to varenicline alone (RR 1.21, 95% CI 0.95 to 1.55; I2 = 15%; 3 studies, 1057 participants). However, there was insufficient evidence to establish whether a combination of bupropion and nicotine replacement therapy (NRT) resulted in superior quit rates to NRT alone (RR 1.17, 95% CI 0.95 to 1.44; I2 = 43%; 15 studies, 4117 participants; low-certainty evidence). There was moderate-certainty evidence that participants taking bupropion were more likely to report SAEs than those taking placebo or no pharmacological treatment. However, results were imprecise and the CI also encompassed no difference (RR 1.16, 95% CI 0.90 to 1.48; I2 = 0%; 23 studies, 10,958 participants). Results were also imprecise when comparing SAEs between people randomised to a combination of bupropion and NRT versus NRT alone (RR 1.52, 95% CI 0.26 to 8.89; I2 = 0%; 4 studies, 657 participants) and randomised to bupropion plus varenicline versus varenicline alone (RR 1.23, 95% CI 0.63 to 2.42; I2 = 0%; 5 studies, 1268 participants). In both cases, we judged evidence to be of low certainty. There was high-certainty evidence that bupropion resulted in more trial dropouts due to AEs than placebo or no pharmacological treatment (RR 1.44, 95% CI 1.27 to 1.65; I2 = 2%; 25 studies, 12,346 participants). However, there was insufficient evidence that bupropion combined with NRT versus NRT alone (RR 1.67, 95% CI 0.95 to 2.92; I2 = 0%; 3 studies, 737 participants) or bupropion combined with varenicline versus varenicline alone (RR 0.80, 95% CI 0.45 to 1.45; I2 = 0%; 4 studies, 1230 participants) had an impact on the number of dropouts due to treatment. In both cases, imprecision was substantial (we judged the evidence to be of low certainty for both comparisons). Bupropion resulted in inferior smoking cessation rates to varenicline (RR 0.73, 95% CI 0.67 to 0.80; I2 = 0%; 9 studies, 7564 participants), and to combination NRT (RR 0.74, 95% CI 0.55 to 0.98; I2 = 0%; 2 studies; 720 participants). However, there was no clear evidence of a difference in efficacy between bupropion and single-form NRT (RR 1.03, 95% CI 0.93 to 1.13; I2 = 0%; 10 studies, 7613 participants). We also found evidence that nortriptyline aided smoking cessation when compared with placebo (RR 2.03, 95% CI 1.48 to 2.78; I2 = 16%; 6 studies, 975 participants), and some evidence that bupropion resulted in superior quit rates to nortriptyline (RR 1.30, 95% CI 0.93 to 1.82; I2 = 0%; 3 studies, 417 participants), although this result was subject to imprecision. Findings were sparse and inconsistent as to whether antidepressants, primarily bupropion and nortriptyline, had a particular benefit for people with current or previous depression. AUTHORS' CONCLUSIONS There is high-certainty evidence that bupropion can aid long-term smoking cessation. However, bupropion may increase SAEs (moderate-certainty evidence when compared to placebo/no pharmacological treatment). There is high-certainty evidence that people taking bupropion are more likely to discontinue treatment compared with people receiving placebo or no pharmacological treatment. Nortriptyline also appears to have a beneficial effect on smoking quit rates relative to placebo, although bupropion may be more effective. Evidence also suggests that bupropion may be as successful as single-form NRT in helping people to quit smoking, but less effective than combination NRT and varenicline. In most cases, a paucity of data made it difficult to draw conclusions regarding harms and tolerability. Further studies investigating the efficacy of bupropion versus placebo are unlikely to change our interpretation of the effect, providing no clear justification for pursuing bupropion for smoking cessation over other licensed smoking cessation treatments; namely, NRT and varenicline. However, it is important that future studies of antidepressants for smoking cessation measure and report on harms and tolerability.
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Affiliation(s)
- Anisa Hajizadeh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Seth Howes
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Annika Theodoulou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Elias Klemperer
- Departments of Psychological Sciences & Psychiatry, University of Vermont, Burlington, VT, USA
| | - Jamie Hartmann-Boyce
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Nicola Lindson
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Khowaja S, Hashmi S, Zaheer S, Shafique K. Patterns of smoked and smokeless tobacco use among multimorbid and non-multimorbid middle-aged and older-aged adults in Karachi, Pakistan: a cross-sectional survey. BMJ Open 2022; 12:e060090. [PMID: 36600352 PMCID: PMC9730344 DOI: 10.1136/bmjopen-2021-060090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES The objective of this study was to compare the patterns of smoked and smokeless tobacco use among multimorbid and non-multimorbid middle-aged and older-aged individuals in Karachi, Pakistan. STUDY DESIGN This was an observational cross-sectional study conducted during 2015-2016. STUDY SETTING AND PARTICIPANTS A total of 3250 participants aged 30 years and above, residing in the Gulshan-e-Iqbal town, Karachi, Pakistan were enrolled in the study through systematic random sampling. The selected area of residence represents diverse socioeconomic and ethnic groups of the city. People who could speak and write English or Urdu, and those who provided written informed consent were included in the study. OUTCOME MEASURES The primary outcome measure of the study was to determine the differences in patterns of tobacco consumption among multimorbid and non-multimorbid adult individuals. RESULTS We found no difference in patterns of smoked (adjusted OR (aOR) 1.15, 95% CI 0.88 to 1.50, p=0.289) or smokeless tobacco (aOR 1.13, 95% CI 0.86 to 1.48, p= 0.379) use among multimorbid and non-multimorbid individuals. Individuals who perceived tobacco as a risk were less likely to consume smokeless tobacco products. CONCLUSION There was no difference in tobacco consumption among individuals with and without multimorbidity. Evidenced-based guidelines are required to implement mental and behavioural interventions in patients with multiple chronic diseases to help them modify their behaviours.
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Affiliation(s)
- Salima Khowaja
- School of Public Health, Dow University of Health Sciences, Karachi, Pakistan
| | - Shahkamal Hashmi
- School of Public Health, Dow University of Health Sciences, Karachi, Pakistan
| | - Sidra Zaheer
- School of Public Health, Dow University of Health Sciences, Karachi, Pakistan
| | - Kashif Shafique
- School of Public Health, Dow University of Health Sciences, Karachi, Pakistan
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Caggiano M, Gasparro R, D’Ambrosio F, Pisano M, Di Palo MP, Contaldo M. Smoking Cessation on Periodontal and Peri-Implant Health Status: A Systematic Review. Dent J (Basel) 2022; 10:162. [PMID: 36135157 PMCID: PMC9497918 DOI: 10.3390/dj10090162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 08/16/2022] [Accepted: 08/27/2022] [Indexed: 12/22/2022] Open
Abstract
Since smoking is considered among the main risk factors for the onset and progression of periodontitis and peri-implantitis, the present systematic review aimed to evaluate the effect of smoking cessation on clinical, radiographic, and gingival crevicular periodontal parameters around natural teeth and dental implants in ex-smokers compared to current and non-smokers. The study protocol was developed based on the PRISMA guidelines, the research question was formulated according to the PICO model, and the literature search was conducted through PubMed/MEDLINE, Cochrane library, and BioMed Central databases. From the 916 title/abstracts initially identified, seven articles were included in the present systematic review and assessed for quality through the ROBINS-I tool. Reported findings on clinical and crevicular periodontal parameters around natural teeth were contrasting when comparing ex-smokers to current and non-smokers; thus, individualized recommendations for previous smoker periodontal patients are currently lacking. No data on radiographic parameters were retrieved. Similarly, data on periodontal parameters around dental implants were not available, highlighting the need for focused investigations assessing the role of both smoking habit and cessation on peri-implant health status and responsiveness to treatment.
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Affiliation(s)
- Mario Caggiano
- Department of Medicine, Surgery and Dentistry “Schola Medica Salernitana”, University of Salerno, Via S. Allende, 84081 Baronissi, Italy
| | - Roberta Gasparro
- Department of Neuroscience, Reproductive Science and Dentistry, University of Naples Federico II, 80131 Naples, Italy
| | - Francesco D’Ambrosio
- Department of Medicine, Surgery and Dentistry “Schola Medica Salernitana”, University of Salerno, Via S. Allende, 84081 Baronissi, Italy
| | - Massimo Pisano
- Department of Medicine, Surgery and Dentistry “Schola Medica Salernitana”, University of Salerno, Via S. Allende, 84081 Baronissi, Italy
| | - Maria Pia Di Palo
- Department of Medicine, Surgery and Dentistry “Schola Medica Salernitana”, University of Salerno, Via S. Allende, 84081 Baronissi, Italy
| | - Maria Contaldo
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialities, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
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8
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Green R, Lin J, Montoya AK, Bello MS, Grodin EN, Ryu H, Ho D, Leventhal AM, Ray LA. Characteristics associated with treatment seeking for smoking cessation among heavy-drinking research participants. Front Psychiatry 2022; 13:951364. [PMID: 36245856 PMCID: PMC9554538 DOI: 10.3389/fpsyt.2022.951364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/25/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Treatment seeking for smoking cessation has tremendous clinical implications with the potential to reduce tobacco-related morbidity and mortality. The present study seeks to elucidate clinical variables that distinguish treatment seeking versus non-treatment seeking status for smoking cessation in a large sample of heavy drinking smokers using data-driven methods. MATERIALS AND METHODS This secondary data analysis examines n = 911 (n = 267 female) individuals who were daily smokers and heavy drinkers (≥ 7 drinks per week for women, ≥ 14 for men) that were enrolled in either a treatment-seeking study (N = 450) or a non-treatment seeking study (N = 461) using identical pharmacotherapies. Participants completed measures of demographics, alcohol and cigarette use, alcohol craving, the Barratt Impulsiveness Scale (BIS-11), and the Wisconsin Inventory of Smoking Dependence Motives (WISDM-68). These measures were used in a random forest model to identify predictors of treatment seeking status. RESULTS The top variables of importance in identifying treatment seeking status were: age, drinks per drinking day, cigarettes per smoking day, BIS-11 cognitive impulsivity, WISDM social environmental goads, WISDM loss of control, WISDM craving, and WISDM tolerance. Age and drinks per drinking day were two of the most robust predictors, followed by measures of nicotine craving and tolerance. CONCLUSION Individuals who are daily smokers and consume more drinks per drinking day are less likely to belong to the smoking cessationtreatment-seeking group. Targeting heavy drinking smokers, particularly younger individuals, may be necessary to engage this group in smoking cessation efforts and to reduce the burden of disease of nicotine dependence earlier in the lifespan.
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Affiliation(s)
- ReJoyce Green
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Johnny Lin
- Institute for Digital Research and Education, University of California, Los Angeles, Los Angeles, CA, United States
| | - Amanda K Montoya
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Mariel S Bello
- Institute for Addiction Science, University of Southern California, Los Angeles, CA, United States
| | - Erica N Grodin
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Howon Ryu
- Institute for Digital Research and Education, University of California, Los Angeles, Los Angeles, CA, United States
| | - Diana Ho
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Adam M Leventhal
- Institute for Addiction Science, University of Southern California, Los Angeles, CA, United States.,Department of Preventive Medicine, University of Southern California, Los Angeles, CA, United States
| | - Lara A Ray
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
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9
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Ocak M, Unal M, Ozturk O, Vural A, Ayraler A, Oruc MA, Yasin Selcuk M, Ozturk G, Fidanci I, Goktepe ME. Attitudes and Behaviors Regarding Smoking in Friends and Relatives of Patients in Emergency Room: A New Frontier in the Fight against Tobacco. ADDICTION & HEALTH 2022; 14:15-25. [PMID: 35573762 PMCID: PMC9057646 DOI: 10.22122/ahj.v14i1.1226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/30/2021] [Indexed: 12/02/2022]
Abstract
BACKGROUND Emergency rooms (ERs) are usually crowded with friends and relatives (F&Rs) of the patients. This experience may result in changes in smoking behaviors and create opportunities for smoking cessation interventions. The study aims to investigate these changes and offers a new frontier in the fight against smoking. METHODS This cross-sectional study was conducted in the ERs of two universities in different cities. A questionnaire consisting of 18 questions was applied to F&Rs of the emergency patients. Statistical analysis was performed using Jamovi program. FINDINGS A total of 603 respondents were included in the study. Of them, 71.3% were first-degree relatives, 51.7% waited 5 or more times in ER before, and 68.6% spent 0-2 hours in a day around the ER. Upon witnessing patients in the ERs, 53.4% of the F&Rs had the idea of quitting smoking and 42.9% wanted to have smoking cessation therapy during their wait in the hospital. While 76.1% of the participants were not using different brands of cigarettes when offered in normal life, this rate was lower around the ERs (64.6%) (P < 0.001). Participants smoked 0.82 ± 0.34 cigarette per hour in normal life excluding sleeping time; this number raised almost 6 folds during the wait (4.85 ± 2.11) (P < 0.001). CONCLUSION F&Rs smoked more during waiting around ERs. However, they also expressed desire to quit smoking and receive smoking cessation intervention during the wait. Providing smoking cessation counseling to F&Rs in the ER may be a valuable intervention.
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Affiliation(s)
- Metin Ocak
- Department of Emergency Medicine, Gazi State Hospital, Samsun, Turkey
| | - Mustafa Unal
- Department of Family Medicine, School of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Onur Ozturk
- Department of Family Medicine, Samsun Education and Research Hospital, Samsun, Turkey
| | - Abdussamed Vural
- Department of Emergency Medicine, Giresun University Prof. Dr. A. Ilhan Ozdemir Education and Research Hospital, Giresun, Turkey
| | - Arzu Ayraler
- Department of Family Medicine, Giresun University Prof. Dr. A. Ilhan Ozdemir Education and Research Hospital, Giresun, Turkey
| | - Muhammed Ali Oruc
- Department of Family Medicine, School of Medicine, Ahi Evran University, Kirsehir, Turkey
| | - Mustafa Yasin Selcuk
- Department of Family Medicine, School of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Gulsah Ozturk
- Gokberk Family Healthcare Center, Samsun Provincial Health Directorate, Samsun, Turkey
| | - Izzet Fidanci
- Department of Family Medicine, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Muhammed Emin Goktepe
- Department of Family Medicine, Samsun Education and Research Hospital, Samsun, Turkey,Correspondence to: Muhammed Emin Goktepe; Department of Family Medicine, Samsun Education and Research Hospital, Samsun,
Turkey;
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10
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Pericot-Valverde I, Heo M, Litwin AH, Niu J, Gaalema DE. Modeling the effect of stress on vaping behavior among young adults: A randomized cross-over pilot study. Drug Alcohol Depend 2021; 225:108798. [PMID: 34091155 PMCID: PMC8504555 DOI: 10.1016/j.drugalcdep.2021.108798] [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: 10/28/2020] [Revised: 02/24/2021] [Accepted: 04/04/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Laboratory models have been useful in identifying the motivational processes underlying tobacco use. This pilot study aimed at (1)validating a human laboratory model initially developed for smokers to e-cigarette users; (2)applying this model to examine the effects of stress on the reinforcing value of nicotine among young adults. METHODS Using a randomized cross-over design, young e-cigarette users (n = 30) who were nicotine deprived were exposed to a stress or a non-stress task, and then engaged in a laboratory task assessing vaping's reward value on two separate days. During the first part of the task, participants had the option of initiating an e-cigarette self-administration session or delaying initiation for up to 50 min in exchange for money. During the second part of the task, participants chose between vaping or receiving money. The length of the delay and the number of e-cigarette uses consumed were the primary outcomes. Craving and puff topography were secondary outcomes. RESULTS There was no difference in the length of time that participants were able to refrain from vaping in the stress and control task (p = .90). Participants purchased and consumed more puffs after being exposed to the stress task compared to the control task (p<.001), puff topography and craving were unaffected. CONCLUSIONS Exposure to a stressor did not undermine the ability to resist vaping among deprived e-cigarette users (first part), but it influenced the number of uses purchased once users decided to vape (second part). This study evidences that these two parts of the task for assessing reward value are differentially sensitive to the stress manipulation.
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Affiliation(s)
- Irene Pericot-Valverde
- School of Health Research, Clemson University, Greenville, SC, USA; Prisma Health, Department of Medicine, Greenville, SC, USA; Department of Public Health Science, Clemson University, Clemson, SC, USA.
| | - Moonseong Heo
- Department of Public Health Science, Clemson University, Clemson, SC, USA.
| | - Alain H Litwin
- School of Health Research, Clemson University, Greenville, SC, USA; Prisma Health, Department of Medicine, Greenville, SC, USA; Department of Medicine, University of South Carolina School of Medicine, Greenville, SC, USA.
| | - Jiajing Niu
- School of Mathematical and Statistical Sciences, Clemson University, Clemson, SC, USA.
| | - Diann E Gaalema
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Departments of Psychology and Psychiatry, University of Vermont, Burlington, VT, USA.
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11
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Causes of smoking relapse in the 12 months after smoking cessation treatment: Affective and cigarette dependence-related factors. Addict Behav 2021; 119:106903. [PMID: 33773201 DOI: 10.1016/j.addbeh.2021.106903] [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: 09/01/2020] [Revised: 01/15/2021] [Accepted: 03/02/2021] [Indexed: 11/22/2022]
Abstract
Despite advances in smoking cessation treatments, smoking relapse remains common. Experiencing positive or negative affect and cigarette dependence are the most common causes of relapse; however, little is known about the characteristics that increase the risk of relapse from these causes among current treatment-seeking smokers. Thus, this study aimed to identify the most frequent causes of relapse and the individual characteristics that increase the risk of relapse from these causes during a 12-month period after smoking cessation. Participants included 121 treatment-seeking smokers who quit smoking at the end of treatment and relapsed during a 12-month follow-up period (60.3% female;Mage = 42.57, SD = 11.07). Results indicated that the most frequent smoking relapse situations occurred when smokers experienced positive (e.g., being relaxed; 43.0%) or negative (e.g., being angry; 37.2%) affect or cigarette dependence-related situations (e.g., craving; 19.8%). At an individual level, males with a higher level of education and without a psychopharmaceutical prescription had a higher risk of relapsing in positive-affect situations. Smoking the first cigarette at an older age increased the risk of relapse in negative-affect situations. Finally, being younger and less motivated to quit at pretreatment increased the likelihood of relapse in cigarette dependence-related situations. These findings provide detailed information about smoking relapse situations and identify a set of characteristics that might help to improve current relapse-prevention interventions.
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12
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Dunbar MS, Nicosia N, Kilmer B. Exposure to new smoking environments and individual-level cigarette smoking behavior: Insights from exogenous assignment of military personnel. Soc Sci Med 2021; 280:113983. [PMID: 34020313 PMCID: PMC8223508 DOI: 10.1016/j.socscimed.2021.113983] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/09/2021] [Accepted: 04/29/2021] [Indexed: 10/21/2022]
Abstract
Despite overall declines in cigarette smoking prevalence in the United States (U.S.) in the past several decades, smoking rates remain highly variable across geographic areas. Past work suggests that smoking norms and exposure to other smokers in one's social environment may correlate with smoking risk and cessation, but little is known about how exposure to other smokers in one's community is causally linked to smoking behavior - in part due to endogeneity and inability to randomly assign individuals to different 'smoking environments.' The goal of this study was to evaluate how exposure to localities with high population-level smoking prevalence affects individual-level cigarette smoking behaviors, including quitting. The study addresses key limitations in the literature by leveraging a unique natural experiment: the plausibly exogenous compulsory assignment of military personnel to installations. Logistic and multivariate regressions estimated cross-sectional associations between smoking/quitting behaviors and our proxy for social environments for smoking, county-level smoking prevalence (CSP). Across 563 U.S. counties, CSP ranged from 3.8 to 37.9%. Among the full sample, a 10 percentage point increase in CSP was associated with an 11% greater likelihood of smoking. In subgroup analyses, young adults, women, those without children in the household, and risk/sensation-seekers were more likely to smoke and less likely to quit when exposed to counties with higher CSP. Relocation to areas with high population-level smoking prevalence may increase likelihood of smoking and impede quitting, and may disparately affect some population subgroups. Findings provide novel evidence that community smoking environments affect adult smoking risk and underscore a need for sustained, targeted efforts to reduce smoking in areas where prevalence remains high.
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Affiliation(s)
- Michael S Dunbar
- RAND Corporation, 4750 Fifth Avenue, Suite 600, Pittsburgh, PA, 15213, USA.
| | - Nancy Nicosia
- RAND Corporation, 20 Park Plaza, Suite 920, Boston, MA, 02116, USA
| | - Beau Kilmer
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA
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13
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Hu Y, Zhao Z, Ehrich M, Zhang C. Formulation of Nanovaccines toward an Extended Immunity against Nicotine. ACS APPLIED MATERIALS & INTERFACES 2021; 13:27972-27982. [PMID: 34105952 PMCID: PMC9201939 DOI: 10.1021/acsami.1c07049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Nicotine vaccines have been investigated to assist with smoking cessation. Because smoking cessation is a long process, past nicotine vaccines required multiple injections to achieve long-term efficacy. It would be of great significance if extended efficacy can be achieved with fewer injections. Here, we report the assembly of lipid-polylactic acid (PLA) and lipid-poly(lactic-co-glycolic acid) (PLGA) hybrid nanoparticle (NP) based nicotine vaccines. Mice immunized with the lipid-PLGA vaccine produced higher titers of nicotine-specific antibodies than the lipid-PLA vaccine in short-term. However, the lipid-PLA vaccine was found to induce long-lasting antibodies. Three months after the immunization, only mice that received first two injections of the lipid-PLGA vaccine and a third injection of the lipid-PLA vaccine achieved a significantly lower brain nicotine concentration of 65.13 ± 20.59 ng/mg than 115.88 ± 37.62 ng/mg from the negative controls. The results indicate that not only the stability of the vaccines but also the combination of the vaccines impacted the long-term efficacy of the immunization. Lastly, both the body weight and the histopathology study suggest that the vaccines were safe to mice. These findings suggest that long-term immunity against nicotine can be realized by a rational administration of nanovaccines of different levels of stability.
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Affiliation(s)
- Yun Hu
- Department of Biological Systems Engineering, Virginia Tech, Blacksburg, Virginia 24061, United States
| | - Zongmin Zhao
- Department of Biological Systems Engineering, Virginia Tech, Blacksburg, Virginia 24061, United States
| | - Marion Ehrich
- Department of Biomedical Sciences and Pathobiology, Virginia Tech, Blacksburg, Virginia 24061, United States
| | - Chenming Zhang
- Department of Biological Systems Engineering, Virginia Tech, Blacksburg, Virginia 24061, United States
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14
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Hsueh KC, Tang PL, McRobbie H. Effectiveness of Varenicline Versus Combination Nicotine Replacement Therapy for Smoking Cessation: One-Year Outcomes in a Smoking Cessation Clinic in Taiwan. Nicotine Tob Res 2021; 23:1094-1102. [PMID: 33538831 DOI: 10.1093/ntr/ntab018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 01/26/2021] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Varenicline and combination nicotine replacement treatment (cNRT) have been recommended as the most effective pharmacotherapies, with equal abstinence rate for smoking cessation in a network meta-analysis of randomized trials, but data from real-world long-term follow-up studies are rare. This study aimed to compare the 12-month sustained abstinence rates of smokers using varenicline versus cNRT in their quit attempt. METHODS A total of 3569 smokers were recruited via the Department of Family Medicine outpatient department at Kaohsiung Veteran General Hospital between June 2013 and March 2019. Participants received counseling from a physician and chose either varenicline (N = 2870) or cNRT (N = 699) for smoking cessation. Both varenicline and cNRT users could receive a free 8-week supply and eight clinic visits over 90 days. Participants were followed-up by telephone at 12, 24, and 52 weeks from first visit. The primary outcome measure of the study was self-reported sustained abstinence up to 52 weeks. RESULTS Varenicline users had a significantly higher sustained abstinence rate at weeks 12-52, adjusted for baseline variables (15.2% vs 10.3%, p = .001; adjusted odds ratio = 1.47, 95% confidence interval: 1.05-2.05). Other significant predictors of 52 weeks sustained abstinence were being male, having a higher income, attending more clinical visits, and have lower nicotine dependence. CONCLUSION Varenicline appears to have higher sustained abstinence rates to 52 weeks compared with cNRT, in a smoking cessation clinic where smokers can choose their medication option. IMPLICATIONS Network meta-analysis of randomized trials suggests that varenicline and cNRT are similarly effective for smoking cessation. This study shows that 1-year sustained abstinence rates were significantly higher among smokers using varenicline, compared with smokers using cNRT, when used as part of a structured smoking cessation program. These findings are highly relevant to policy makers and service providers to help determine provision of smoking cessation treatment.
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Affiliation(s)
- Kuang-Chieh Hsueh
- Department of Family Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Smoking Cessation Treatment and Management Center of Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Shu-Zen College of Medicine and Management, Kaohsiung, Taiwan
| | - Pei-Ling Tang
- Research Center of Medical Informatics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Department of Health-Business Administration, Fooyin University, Kaohsiung, Taiwan
| | - Hayden McRobbie
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, NSW, Australia.,Lakes District Health Board, Rotorua, New Zealand
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15
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Martínez-Vispo C, López-Durán A, Rodríguez-Cano R, Senra C, Becoña E. Treatment completion and anxiety sensitivity effects on smoking cessation outcomes. Addict Behav 2021; 117:106856. [PMID: 33609810 DOI: 10.1016/j.addbeh.2021.106856] [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: 07/12/2020] [Revised: 01/12/2021] [Accepted: 01/31/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Treatment completion is associated with abstinence outcomes in smoking cessation interventions. Previous research has stated that anxiety sensitivity (AS) is associated with smoking-related variables and smoking-cessation outcomes. To date, research has not examined the interaction between AS and treatment completion on smoking-cessation outcomes over time. This study aims to examine the main and the interactive effects of treatment completion and AS (total score and specific dimensions) on smoking-cessation outcomes at 3-, 6-, and 12-month follow-ups. METHOD The sample consisted of 210 smokers enrolled in an eight-session smoking-cessation cognitive-behavioral treatment (62.1% women; Mage = 45.2, SD = 11.0). Participants were classified as completers (attended the eight treatment sessions) and non-completers (attended ≤ 7 sessions). Abstinence was biochemically confirmed. RESULTS Main effects indicated that completers had a higher likelihood of being abstinent over time when compared to non-completers. Regarding AS, those with greater AS-Physical Concerns had lower abstinence rates. Besides, a significant interaction between treatment completion, time and AS-Physical Concerns was found. Particularly, completers with greater AS-Physical Concerns had a higher likelihood of being abstainers than non-completers over time, while no significant differences were found for those with lower AS-Physical Concerns. CONCLUSION These data highlight the relevance of AS-Physical levels and smoking-cessation treatment completion on abstinence outcomes over time among treatment-seeking smokers.
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Affiliation(s)
- Carmela Martínez-Vispo
- Smoking Cessation and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Spain.
| | - Ana López-Durán
- Smoking Cessation and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Spain; Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Spain
| | - Rubén Rodríguez-Cano
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, USA
| | - Carmen Senra
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Spain
| | - Elisardo Becoña
- Smoking Cessation and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Spain; Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Spain
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16
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Vitzthum K, Drazetic A, Markstein A, Rohde M, Pankow W, Mache S. Evaluation of long-term quitters: who stays smoke free forever? Wien Med Wochenschr 2021; 171:330-334. [PMID: 33822284 DOI: 10.1007/s10354-020-00797-4] [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: 07/06/2020] [Accepted: 11/29/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Smoking cessation is one of the most powerful health promotion tools in the Western world. Behavioral group therapies are regarded as very promising interventions in this field. Quitting rates are usually evaluated after 6-12 months and lie between 30 and 45%. So far, there are no scientific data on potential protective indicators to remain successfully smoke free after this period. Therefore, the aim of this study was to detect the current smoking status of former participants of a cessation service in an urban German surrounding. We investigated reasons for relapses, quitting strategies, and psychosocial parameters. METHODS In 2019, 130 former patients (2011-2017; mean age 54 years; 37 pack/years; Fagerstroem = 5.75; 58.5% male, 41.5% female; 66% physical comorbidities; 35% psychiatric diagnoses) were invited to participate in a mailed survey (including WHO 5, SF 12, self-efficacy scale) and were asked about their current smoking status, personal history of smoking, and individual experiences with stopping after the 1‑year abstinence date. RESULTS A total of 53 persons replied (RR 41%), 29 (54%) of whom are currently smoke free; 24 relapsed intermittently or permanently, 9 experimented with e‑cigarettes, and 2 became dual users. Daily hassles as well as physical and mental challenges were the main reasons for relapsing. CONCLUSION Due to the low response rate, conclusions are limited; however, the 1‑year abstinence rate might not be as reliable as thought so far; long-term "sober" nicotine addicts remain at risk of relapse.
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Affiliation(s)
- Karin Vitzthum
- Vivantes Netzwerk für Gesundheit GmbH, Rudower Straße 48, 12351, Berlin, Germany.
| | - Alicia Drazetic
- Humboldt Universität Berlin, Unter den Linden 6, 10099, Berlin, Germany
| | - Anne Markstein
- Technische Universität Chemnitz, Wilhelm-Raabe-Straße 43, 09120, Chemnitz, Germany
| | - Maggie Rohde
- Humboldt Universität Berlin, Unter den Linden 6, 10099, Berlin, Germany
| | - Wulf Pankow
- Vivantes Netzwerk für Gesundheit GmbH, Rudower Straße 48, 12351, Berlin, Germany
| | - Stefanie Mache
- Zentralinstitut für Arbeitsmedizin und Maritime Medizin (ZfAM), Universitätsklinikum Hamburg-Eppendorf (UKE), Seewartenstraße 10, 20459, Hamburg, Germany
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17
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Duarte PM, Nogueira CFP, Silva SM, Pannuti CM, Schey KC, Miranda TS. Impact of Smoking Cessation on Periodontal Tissues. Int Dent J 2021; 72:31-36. [PMID: 33653595 PMCID: PMC9275328 DOI: 10.1016/j.identj.2021.01.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 01/28/2021] [Indexed: 11/26/2022] Open
Abstract
There is cumulative evidence supporting the negative effects of smoking on periodontal tissues. Smoking cessation can be successfully accomplished through specific programs, including behaviour modification and medications, and has been suggested as a suitable way to reduce the risk of several diseases, including periodontitis. The aim of this review is to provide a concise overview of the current knowledge about the impact of smoking cessation on periodontal tissues and therapy, with data from studies published in the last 15 years. Literature was searched using Medline database from 2005 up to and including September 2020 using medical subject heading (MeSH) terms and other search terms, restricted to the English language. Studies were evaluated and summarised in a narrative review format. Results demonstrated that there is convincing evidence to support the benefits of tobacco cessation in reducing the risk of periodontitis and tooth loss. In addition, the harmful effects of smoking on periodontal tissues seem to be assuaged as the number of years since quitting increases. The existing current evidence, even limited, also shows that smoking cessation may result in additional benefits to the outcome of nonsurgical periodontal treatment. Periodontal care providers should not only check their patient's smoking habit for estimating risk of disease progression and predictability of periodontal therapy, but they should also help smokers improve their oral and systemic health by providing efficient and personalised tobacco‐cessation counselling and treatment.
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Affiliation(s)
- Poliana Mendes Duarte
- Department of Periodontology, Dental Research Division, Guarulhos University, São Paulo, Brazil; Department of Periodontology, College of Dentistry, University of Florida, Gainesville, USA.
| | | | - Sarah Monique Silva
- Department of Periodontology, Dental Research Division, Guarulhos University, São Paulo, Brazil
| | - Cláudio Mendes Pannuti
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Karin C Schey
- Department of Periodontology, College of Dentistry, University of Florida, Gainesville, USA
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18
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Kim Y, Lee JS, Cho WK. Factors Associated with Successful Smoking Cessation According to Age Group: Findings of an 11-Year Korea National Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041576. [PMID: 33562345 PMCID: PMC7915736 DOI: 10.3390/ijerph18041576] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/16/2021] [Accepted: 02/04/2021] [Indexed: 12/23/2022]
Abstract
Previous studies suggest that factors related to smoking cessation may vary with age. This study examined the factors affecting smoking cessation by age among Korean adult male smokers using data from the Korea National Health and Nutrition Examination Survey from 2007 to 2018 (excluding 2013). Logistic regression analyses were used to investigate various factors associated with smoking cessation in three different age groups. Out of a total of 15,492 individuals, 31.5% of the 3523 individuals aged 19–39 years (young adult), 54.7% of the 7390 individuals aged 40–64 years (middle-aged), and 78.6% of the 4589 individuals aged ≥65 years (older adults) succeeded in quitting. In the young adult and middle-aged groups, being married was associated with successful quitting, and lifetime smoking was associated with unsuccessful quitting. Willpower and several comorbidities were related to successful cessation in the middle-aged and older adult groups. Skipping any meal, which suggests unhealthy behavior, was negatively related to quitting in the young adult group. We observed that factors associated with smoking cessation success or failure differed by age, which should be considered when developing smoking cessation policies and programs.
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Affiliation(s)
- Youngmee Kim
- Red Cross College of Nursing, Chung-Ang University, Seoul 06974, Korea; or
| | - Ji Sung Lee
- College of Medicine, University of Ulsan, Seoul 05505, Korea;
- Asan Institute for Life Sciences, Clinical Research Center, Asan Medical Center, Seoul 05505, Korea
| | - Won-Kyung Cho
- College of Medicine, University of Ulsan, Seoul 05505, Korea;
- Department of Pulmonary and Critical Care Medicine, International Healthcare Center, Asan Medical Center, Seoul 05505, Korea
- Correspondence: or ; Tel.: +82-2-3010-5001
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Ashe ML, Wilson SJ. Very Light Daily Smoking in Young Adults: Relationships Between Nicotine Dependence and Lapse. Nicotine Tob Res 2021; 23:327-333. [PMID: 32877533 DOI: 10.1093/ntr/ntaa169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 08/28/2020] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Very light daily smoking is increasingly common among young adults. Evidence suggests that levels of nicotine dependence vary significantly among young adults who engage in very light daily smoking. However, the links between dependence and clinically relevant outcomes (eg, lapse) in this population remain unclear. The goal of this study was to address this gap by evaluating how well different nicotine dependence scales predict lapse behavior among very light daily smoking young adults. AIMS AND METHODS Very light daily smokers (1-5 cigarettes/day) aged 18-25 participated in an initial laboratory session, during which nicotine dependence was assessed using four commonly used measures: the Fagerstrӧm Test for Cigarette Dependence (FTCD), the Hooked On Nicotine Checklist (HONC), the Transdisciplinary Tobacco Use Research Centers (TTURC) Nicotine Dependence Inventory, and the Wisconsin Inventory of Smoking Dependence Motives (WISDM). After a baseline period, eligible participants (n = 40) completed a 10-day abstinence incentive period in which they attempted to refrain from smoking to earn monetary rewards. Cox proportional hazards models were used to test whether dependence predicted days to first lapse. RESULTS FTCD scores significantly predicted days to lapse, as did scores on the FTCD item assessing time to first cigarette of the day (TTFC). No other dependence measures predicted time to lapse. Both the FTCD and TTFC continued to independently predict time to lapse after controlling for smoking frequency and duration. CONCLUSIONS The FTCD may be a particularly useful tool for capturing clinically meaningful variability in nicotine dependence among young adults who engage in very light daily smoking. IMPLICATIONS This is the first study to directly link self-reported nicotine dependence with the ability to achieve and maintain abstinence among very light daily smoking young adults. The results may aid clinicians in selecting among variable measures of nicotine dependence when assessing and treating this population.
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Affiliation(s)
- Melinda L Ashe
- The Pennsylvania State University, Department of Psychology, University Park, PA
| | - Stephen J Wilson
- The Pennsylvania State University, Department of Psychology, University Park, PA
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20
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Reciprocal influences of tobacco use on illicit opioid and alcohol use during the first six-months of specialist addiction treatment. Drug Alcohol Depend 2021; 218:108418. [PMID: 33262003 DOI: 10.1016/j.drugalcdep.2020.108418] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/23/2020] [Accepted: 11/12/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND This is the first national study of lagged reciprocal associations between tobacco smoking frequency and change in illicit opioid or alcohol use frequency within six-months of treatment. METHODS All adults admitted to publicly-funded specialist addiction treatment in England in 2018/19 and enrolled for at least six months for either opioid use disorder (OUD; n = 22,046; 82.4 % of those eligible) or alcohol use disorder (AUD; n = 15,251; 78.8 % of those eligible). Two cross-lagged panel models estimated, separately for OUD and AUD patients, the relationships between smoking at admission and change in main drug over six months, and between main drug use at admission and change in smoking over six months. RESULTS Within the OUD cohort, illicit opioid use frequency reduced from 17.7 days to 8.0 days and smoking tobacco remained at 18.8 days. After controlling for available covariates, higher smoking frequency at admission was associated with a relative increase in illicit opioid use at six-months (0.02 days [95 % CI 0.00-0.03]). Within the AUD cohort, alcohol use frequency reduced from 21.2 days to 14.4 days while smoking tobacco reduced from 12.6 days to 11.5 days. Higher smoking frequency at admission was associated with a relative increase in alcohol use at six-months (0.03 days [95 % CI 0.02-0.04]) and higher alcohol use frequency at admission was associated with a relative increase in smoking at six-months (0.04 [95 % CI 0.02-0.06]), controlling for available covariates. CONCLUSIONS Higher smoking frequency at admission is associated with higher illicit opioid and alcohol use frequency after six-months of specialist addiction treatment.
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Piper ME, Bullen C, Krishnan-Sarin S, Rigotti NA, Steinberg ML, Streck JM, Joseph AM. Defining and Measuring Abstinence in Clinical Trials of Smoking Cessation Interventions: An Updated Review. Nicotine Tob Res 2020; 22:1098-1106. [PMID: 31271211 DOI: 10.1093/ntr/ntz110] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 07/02/2019] [Indexed: 11/12/2022]
Abstract
BACKGROUND Changes in tobacco products, use patterns, and assessment technology in the last 15 years led the Society for Research on Nicotine and Tobacco (SRNT) Treatment Research Network to call for an update to the 2003 SRNT recommendations for assessing abstinence in clinical trials of smoking cessation interventions. METHODS The SRNT Treatment Research Network convened a group of investigators with decades of experience in conducting tobacco treatment clinical trials. To arrive at the updated recommendations, the authors reviewed the recommendations of the prior SRNT Workgroup as well as current literature. Ten additional experts in the field provided feedback on this paper and these recommendations. RESULTS With respect to defining abstinence, the authors recommend: (1) continuing to use the definition of no use of combustible tobacco products (regardless of use of noncombustible tobacco products [e.g., snus] and alternative products [e.g., e-cigarettes]) and collecting additional data to permit alternate abstinence definitions; (2) no use of combustible or smokeless tobacco products; and (3) no use of combustible or smokeless tobacco products or alternative products, as appropriate for the research question being addressed. The authors also recommend reporting point prevalence and prolonged abstinence at multiple timepoints (end of treatment, ≥3 months after the end of treatment, and ≥6 months postquit or posttreatment initiation). CONCLUSIONS Defining abstinence requires specification of which products a user must abstain from using, the type of abstinence (i.e., point prevalence or continuous), and the duration of abstinence. These recommendations are intended to serve as guidelines for investigators as they collect the necessary data to accurately describe participants' abstinence during smoking cessation clinical trials. IMPLICATIONS This paper provides updated recommendations for defining abstinence in the context of smoking cessation treatment clinical trials.
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Affiliation(s)
- Megan E Piper
- Center for Tobacco Research and Intervention of Wisconsin, Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, WI
| | - Christopher Bullen
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | | | - Nancy A Rigotti
- Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Marc L Steinberg
- Division of Addiction Psychiatry, Rutgers University, New Brunswick, NJ
| | - Joanna M Streck
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Anne M Joseph
- Department of Medicine, University of Minnesota, Minneapolis, MN
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Hashimoto R, Tomioka H, Wada T, Yoshizumi Y. Outcomes and predictive factors for successful smoking cessation therapy in COPD patients with nicotine dependence. Respir Investig 2020; 58:387-394. [PMID: 32381453 DOI: 10.1016/j.resinv.2020.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 03/05/2020] [Accepted: 03/27/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The data on smoking cessation treatment outcomes for smokers with chronic obstructive pulmonary disease (COPD) are limited. The present study assessed the effectiveness of smoking cessation interventions at our clinic. METHODS Data from a prospective registry of a 3-month smoking cessation program were evaluated. The primary outcome, smoking cessation, was defined as the complete abstinence from smoking between the 8-week and 12-week clinic visits. Pulmonary function and health-related quality of life using St. George's Respiratory Questionnaire (SGRQ) were assessed at baseline and at the end of the program. RESULTS Out of the 155 COPD patients with nicotine dependence (female/male = 39/116; mean age, 67.2 ± 9.8 years; mean forced expiratory volume in 1 s (FEV1), 59.7 ± 21.1% predicted), 107 participants completed the program. Among the completers, 74 achieved smoking cessation. In the multivariate analysis, mental disorders (odds ratio [OR] 3.678, 95% confidence interval [CI]: 1.182, 11.445), higher exhaled carbon monoxide (CO) level (OR 1.080, 95% CI: 1.013, 1.151) and lower FEV1/forced vital capacity (FVC) (OR 0.958, 95% CI: 0.923, 0.995) were negatively associated with successful smoking termination. Significant changes in pulmonary function were found in quitters but not in continuous smokers (increases in FEV1 by 0.09 L/s [95% CI: 0.03, 0.15] and peak expiratory flow by 0.23 L/s [95% CI: 0.01, 0.44]). SGRQ total scores improved significantly in both quitters (-5.4 [95% CI: -8.4, -2.5]) and continuous smokers (-7.0 [95% CI: -11.6, -2.5]). CONCLUSION In the program completers, the exhaled CO levels, FEV1/FVC ratio, and presence of mental disorders were significantly associated with program success or failure in COPD patients with nicotine dependence.
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Affiliation(s)
- Rika Hashimoto
- Department of Respiratory Medicine, Kobe City Medical Center West Hospital, 4, 2-chome, Ichibancho, Nagata-ku, Kobe, 653-0013, Japan.
| | - Hiromi Tomioka
- Department of Respiratory Medicine, Kobe City Medical Center West Hospital, 4, 2-chome, Ichibancho, Nagata-ku, Kobe, 653-0013, Japan.
| | - Takamasa Wada
- Department of Respiratory Medicine, Kobe City Medical Center West Hospital, 4, 2-chome, Ichibancho, Nagata-ku, Kobe, 653-0013, Japan.
| | - Yuko Yoshizumi
- Department of Respiratory Medicine, Kobe City Medical Center West Hospital, 4, 2-chome, Ichibancho, Nagata-ku, Kobe, 653-0013, Japan.
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Abstract
BACKGROUND Whilst the pharmacological profiles and mechanisms of antidepressants are varied, there are common reasons why they might help people to stop smoking tobacco. Firstly, nicotine withdrawal may produce depressive symptoms and antidepressants may relieve these. Additionally, some antidepressants may have a specific effect on neural pathways or receptors that underlie nicotine addiction. OBJECTIVES To assess the evidence for the efficacy, safety and tolerability of medications with antidepressant properties in assisting long-term tobacco smoking cessation in people who smoke cigarettes. SEARCH METHODS We searched the Cochrane Tobacco Addiction Specialized Register, which includes reports of trials indexed in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and PsycINFO, clinicaltrials.gov, the ICTRP, and other reviews and meeting abstracts, in May 2019. SELECTION CRITERIA We included randomized controlled trials (RCTs) that recruited smokers, and compared antidepressant medications with placebo or no treatment, an alternative pharmacotherapy, or the same medication used in a different way. We excluded trials with less than six months follow-up from efficacy analyses. We included trials with any follow-up length in safety analyses. DATA COLLECTION AND ANALYSIS We extracted data and assessed risk of bias using standard Cochrane methods. We also used GRADE to assess the certainty of the evidence. The primary outcome measure was smoking cessation after at least six months follow-up, expressed as a risk ratio (RR) and 95% confidence intervals (CIs). We used the most rigorous definition of abstinence available in each trial, and biochemically validated rates if available. Where appropriate, we performed meta-analysis using a fixed-effect model. Similarly, we presented incidence of safety and tolerance outcomes, including adverse events (AEs), serious adverse events (SAEs), psychiatric AEs, seizures, overdoses, suicide attempts, death by suicide, all-cause mortality, and trial dropout due to drug, as RRs (95% CIs). MAIN RESULTS We included 115 studies (33 new to this update) in this review; most recruited adult participants from the community or from smoking cessation clinics. We judged 28 of the studies to be at high risk of bias; however, restricting analyses only to studies at low or unclear risk did not change clinical interpretation of the results. There was high-certainty evidence that bupropion increased long-term smoking cessation rates (RR 1.64, 95% CI 1.52 to 1.77; I2 = 15%; 45 studies, 17,866 participants). There was insufficient evidence to establish whether participants taking bupropion were more likely to report SAEs compared to those taking placebo. Results were imprecise and CIs encompassed no difference (RR 1.16, 95% CI 0.90 to 1.48; I2 = 0%; 21 studies, 10,625 participants; moderate-certainty evidence, downgraded one level due to imprecision). We found high-certainty evidence that use of bupropion resulted in more trial dropouts due to adverse events of the drug than placebo (RR 1.37, 95% CI 1.21 to 1.56; I2 = 19%; 25 studies, 12,340 participants). Participants randomized to bupropion were also more likely to report psychiatric AEs compared with those randomized to placebo (RR 1.25, 95% CI 1.15 to 1.37; I2 = 15%; 6 studies, 4439 participants). We also looked at the safety and efficacy of bupropion when combined with other non-antidepressant smoking cessation therapies. There was insufficient evidence to establish whether combination bupropion and nicotine replacement therapy (NRT) resulted in superior quit rates to NRT alone (RR 1.19, 95% CI 0.94 to 1.51; I2 = 52%; 12 studies, 3487 participants), or whether combination bupropion and varenicline resulted in superior quit rates to varenicline alone (RR 1.21, 95% CI 0.95 to 1.55; I2 = 15%; 3 studies, 1057 participants). We judged the certainty of evidence to be low and moderate, respectively; in both cases due to imprecision, and also due to inconsistency in the former. Safety data were sparse for these comparisons, making it difficult to draw clear conclusions. A meta-analysis of six studies provided evidence that bupropion resulted in inferior smoking cessation rates to varenicline (RR 0.71, 95% CI 0.64 to 0.79; I2 = 0%; 6 studies, 6286 participants), whilst there was no evidence of a difference in efficacy between bupropion and NRT (RR 0.99, 95% CI 0.91 to 1.09; I2 = 18%; 10 studies, 8230 participants). We also found some evidence that nortriptyline aided smoking cessation when compared with placebo (RR 2.03, 95% CI 1.48 to 2.78; I2 = 16%; 6 studies, 975 participants), whilst there was insufficient evidence to determine whether bupropion or nortriptyline were more effective when compared with one another (RR 1.30 (favouring bupropion), 95% CI 0.93 to 1.82; I2 = 0%; 3 studies, 417 participants). There was no evidence that any of the other antidepressants tested (including St John's Wort, selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs)) had a beneficial effect on smoking cessation. Findings were sparse and inconsistent as to whether antidepressants, primarily bupropion and nortriptyline, had a particular benefit for people with current or previous depression. AUTHORS' CONCLUSIONS There is high-certainty evidence that bupropion can aid long-term smoking cessation. However, bupropion also increases the number of adverse events, including psychiatric AEs, and there is high-certainty evidence that people taking bupropion are more likely to discontinue treatment compared with placebo. However, there is no clear evidence to suggest whether people taking bupropion experience more or fewer SAEs than those taking placebo (moderate certainty). Nortriptyline also appears to have a beneficial effect on smoking quit rates relative to placebo. Evidence suggests that bupropion may be as successful as NRT and nortriptyline in helping people to quit smoking, but that it is less effective than varenicline. There is insufficient evidence to determine whether the other antidepressants tested, such as SSRIs, aid smoking cessation, and when looking at safety and tolerance outcomes, in most cases, paucity of data made it difficult to draw conclusions. Due to the high-certainty evidence, further studies investigating the efficacy of bupropion versus placebo are unlikely to change our interpretation of the effect, providing no clear justification for pursuing bupropion for smoking cessation over front-line smoking cessation aids already available. However, it is important that where studies of antidepressants for smoking cessation are carried out they measure and report safety and tolerability clearly.
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Affiliation(s)
- Seth Howes
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | - Jamie Hartmann-Boyce
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | | | - Bosun Hong
- Birmingham Dental Hospital, Oral Surgery Department, 5 Mill Pool Way, Birmingham, UK, B5 7EG
| | - Nicola Lindson
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Oxford, UK
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McClure EA, Baker NL, Gray KM, Hood CO, Tomko RL, Carpenter MJ, Ramakrishnan VR, Buchanan CJ, Saladin ME. The influence of gender and oxytocin on stress reactivity, cigarette craving, and smoking in a randomized, placebo-controlled laboratory relapse paradigm. Psychopharmacology (Berl) 2020; 237:543-555. [PMID: 31792646 PMCID: PMC7024045 DOI: 10.1007/s00213-019-05392-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 11/04/2019] [Indexed: 12/11/2022]
Abstract
RATIONALE Female cigarette smokers tend to show greater cessation failure compared with males. Variables that contribute to the maintenance of smoking, including stress and craving, may differentially impact male and female smokers. Novel pharmacotherapies, such as oxytocin, may attenuate stress reactivity and craving in smokers, but work in this area is limited. OBJECTIVES This study assessed the influence of gender and oxytocin on stress reactivity, craving, and smoking in a randomized, placebo-controlled laboratory relapse paradigm. METHODS Male and female adult cigarette smokers (ages 18-45) were enrolled (women oversampled 2:1) and completed a laboratory session, in which intranasal oxytocin or placebo was administered followed by a laboratory social stress task. The role of gender and oxytocin were assessed on measures of stress reactivity, cigarette craving, latency to smoke in a resistance task, subjective responses to smoking, and ad-libitum smoking. RESULTS Participants (N = 144) had a mean age of 31 were 63% female and 56% White. Following stress induction, female smokers evidenced greater subjective stress than males, though males demonstrated greater neuroendocrine reactivity and smoking intensity than females. No gender differences were demonstrated for craving. Oxytocin did not attenuate any aspect of stress reactivity, craving, smoking, or subjective responses to smoking compared with placebo. CONCLUSIONS Gender differences in stress reactivity were shown in the hypothesized direction, but oxytocin appeared to exert little impact on subjective or behavioral metrics. Results highlight the complex relationship between gender, stress, and smoking, as well as the implications for oxytocin as a potential pharmacotherapy for smoking cessation.
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Affiliation(s)
- Erin A McClure
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | - Nathaniel L Baker
- Department of Public Health Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Kevin M Gray
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Caitlyn O Hood
- Department of Psychology, College of Arts & Sciences, University of Kentucky, Lexington, KY, USA
| | - Rachel L Tomko
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Matthew J Carpenter
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Viswanathan R Ramakrishnan
- Department of Public Health Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Cole J Buchanan
- College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Michael E Saladin
- Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA
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John WS, Grover K, Greenblatt LH, Schwartz RP, Wu LT. E-Cigarette Use Among Adult Primary Care Patients: Results from a Multisite Study. J Gen Intern Med 2020; 35:268-275. [PMID: 31705467 PMCID: PMC6957581 DOI: 10.1007/s11606-019-05488-4] [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: 03/01/2019] [Revised: 09/05/2019] [Accepted: 09/25/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Primary care settings provide opportunities to identify electronic-cigarette (e-cigarette) use and to implement strategies for changing tobacco use behavior. However, a better understanding of the extent and associated characteristics of e-cigarette use among primary care patients are needed to inform such efforts. OBJECTIVE To describe patient demographic and substance use characteristics by e-cigarette use status among a large sample of primary care patients. To examine the prevalence and correlates of e-cigarette use among tobacco users in the sample. DESIGN Cross-sectional analysis from a multisite validation study of a substance use screening instrument. PARTICIPANTS Adult primary care patients aged 18 and older (n = 2000) recruited across 5 primary care clinics in the Eastern USA from 2014 to 2015. MAIN MEASURES Patients reported past 3-month e-cigarette use, sociodemographics, tobacco use, and other substance use. Current nicotine dependence and DSM-5 criteria for past-year substance use disorders were also assessed. KEY RESULTS Among the total sample, 7.7% (n = 154) adults reported past 3-month e-cigarette use. Adults who reported e-cigarette use (vs. no use) were more likely to be younger, white, or have frequent tobacco use, nicotine dependence, or past-year illicit drug use/disorders. Among past 3-month tobacco users, 16.3% reported e-cigarette use. Adjusted logistic regression indicated that odds of e-cigarette use were greater among tobacco users who had some college education or more (vs. < high school) or were daily/almost daily tobacco users (vs. not); odds were lower among Blacks/African-Americans (vs. whites). E-cigarette use among tobacco users was associated with increased odds of current nicotine dependence or tobacco use disorder as well as more severe dependence/disorder. CONCLUSIONS Enhanced surveillance of e-cigarette use among adult tobacco users in primary care, particularly among those who use tobacco frequently, may have implications for helping patients with tobacco cessation using established approaches including behavioral support, pharmacotherapy, or referral to specialized care.
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Affiliation(s)
- William S John
- Department of Psychiatry and Behavioral Sciences, Division of Social and Community Psychiatry , Duke University Medical Center, Durham, NC, USA.
| | - Kiran Grover
- Department of Psychiatry and Behavioral Sciences, Division of Social and Community Psychiatry , Duke University Medical Center, Durham, NC, USA
| | - Lawrence H Greenblatt
- Department of Medicine, Division of General Internal Medicine, Duke University Medical Center, Durham, NC, USA
| | | | - Li-Tzy Wu
- Department of Psychiatry and Behavioral Sciences, Division of Social and Community Psychiatry , Duke University Medical Center, Durham, NC, USA
- Department of Medicine, Division of General Internal Medicine, Duke University Medical Center, Durham, NC, USA
- Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA
- Center for Child and Family Policy, Sanford School of Public Policy, Duke University, Durham, NC, USA
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26
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Chronic Obstructive Pulmonary Disease Risk and Smoking Cessation Changes Induced by CHRNA5-A3 and CHRNB3-A6 Variation in a Chinese Male Population. Balkan J Med Genet 2019; 22:51-58. [PMID: 31942417 PMCID: PMC6956637 DOI: 10.2478/bjmg-2019-0018] [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] [Indexed: 11/20/2022] Open
Abstract
Most studies in the field of CHRNA5-A3 and CHRNB3-A6 have only focused on lung cancer risk; however, the associations with chronic obstructive pulmonary disease (COPD) risk and smoking cessation is less understood, particularly in the Chinese male population. In this study, samples from 823 male patients with COPD (non smokers: 416; still smoking: 407) and 435 smoking male healthy control subjects were performed with DNA extraction and single nucleotide polymorphism (SNP) genotyping. We studied three SNPS in two genes, namely rs667282 and rs3743073 in CHRNA5-A3 and rs4950 in CHRNB3-A6, and their distributions in the three groups are not statistically different (p >0.05). We grouped COPD patients according to whether they had successfully quit smoking, the CT genotype of rs667282 demonstrated association with an increased rate of successful smoking cessation compared with the TT genotype [adjusted odds ratio (OR) = 0.54, 95% confidence interval (95% CI) = 0.37-0.7, p <0.001); rs4950 AG genotypes were distinctly associated with increased rates of successful smoking cessation (adjusted OR = 0.55, 95% CI = 0.40-0.76, p <0.001). The effect is significant under the assumption of an over dominant mode of inheritance (adjusted OR = 0.58, 95% CI = 0.43 to 0.79, p <0.001). No significant difference in rs3743073 was found (p >0.05). Our findings confirmed the hypothesis that CHRNA5-A3 and CHRNB3-A6 variation are not associated with the risk of COPD. We found CHRNA5-A3 and CHRNB3-A6 were significantly associated with successful smoking cessation in smoking COPD patients.
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Powell GL, Cabrera-Brown G, Namba MD, Neisewander JL, Marusich JA, Beckmann JS, Gipson CD. Economic demand analysis of within-session dose-reduction during nicotine self-administration. Drug Alcohol Depend 2019; 201:188-196. [PMID: 31238241 PMCID: PMC6639047 DOI: 10.1016/j.drugalcdep.2019.03.033] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 03/28/2019] [Accepted: 03/28/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND This study determined if a within-session dose-reduction design sufficiently captures elasticity of demand for nicotine in male and female rats using environmental enrichment to manipulate demand elasticity. METHODS Male and female Sprague-Dawley rats were trained to self-administer nicotine (60 μg/kg/infusion). In Experiment 1, rats began daily dose-reduction for nine sessions following acquisition. Rats then underwent a minimum of five within-session dose-reduction sessions where each dose was available for 10 min. In Experiment 2, rats were reared in isolated, social, or enriched housing followed by acquisition of nicotine self-administration. Rats then underwent within-session dose-reduction. Housing environments were then switched, followed by additional testing sessions. Consumption was calculated for each dose and exponential demand curves were fit. RESULTS No sex differences in acquisition of nicotine self-administration were detected for either experiment. In experiment 1, demand intensity (Q0; estimated intake if nicotine were freely available), was higher with between- compared to within-session dose-reduction, although elasticity of demand (α; rate of decline in nicotine intake as a function of increasing unit price), was lower. In Experiment 2, animals reared in enrichment had fewer infusions during acquisition compared to animals in isolation. Enriched males had reduced demand intensity compared to both isolated and social males, whereas isolated females had reduced intensity compared to enriched females. CONCLUSIONS The within-session dose-reduction procedure for nicotine self-administration replicated effects of environmental enrichment on consumption behaviors. Additionally, this procedure captured differences in nicotine demand due to sex, laying important groundwork for future translational research on mechanisms of nicotine dependence.
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Affiliation(s)
- Gregory L Powell
- Department of Psychology, Arizona State University, 950 McAllister Ave., Psychology Room 203, Tempe, AZ, 85287 USA; School of Life Sciences, Arizona State University, TEMPE Campus, Mailcode 4701, Tempe, AZ, 85281 USA
| | - Gabriella Cabrera-Brown
- Department of Psychology, Arizona State University, 950 McAllister Ave., Psychology Room 203, Tempe, AZ, 85287 USA
| | - Mark D Namba
- Department of Psychology, Arizona State University, 950 McAllister Ave., Psychology Room 203, Tempe, AZ, 85287 USA
| | - Janet L Neisewander
- School of Life Sciences, Arizona State University, TEMPE Campus, Mailcode 4701, Tempe, AZ, 85281 USA
| | - Julie A Marusich
- Center for Drug Discovery, RTI International, 3040 Cornwallis Rd, Research Triangle Park, NC, 27709 USA.
| | - Joshua S Beckmann
- Department of Psychology, University of Kentucky, 741 S. Limestone, B453 BBSRB, Lexington, KY, 40536 USA.
| | - Cassandra D Gipson
- Department of Psychology, Arizona State University, 950 McAllister Ave., Psychology Room 203, Tempe, AZ, 85287 USA.
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A cross-sectional study of the relationship of proximal smoking environments and cessation history, plans, and self-efficacy among low-income smokers. J Smok Cessat 2019; 14:229-238. [PMID: 33777240 DOI: 10.1017/jsc.2019.15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Introduction Proximal environments could facilitate smoking cessation among low-income smokers by making cessation appealing to strive for and tenable. Aims We sought to examine how home smoking rules and proximal environmental factors such as other household members' and peers' smoking behaviors and attitudes related to low-income smokers' past quit attempts, readiness, and self-efficacy to quit. Methods This analysis used data from Offering Proactive Treatment Intervention (OPT-IN) (randomized control trial of proactive tobacco cessation outreach) baseline survey, which was completed by 2,406 participants in 2011/12. We tested the associations between predictors (home smoking rules and proximal environmental factors) and outcomes (past-year quit attempts, readiness to quit, and quitting self-efficacy). Results Smokers who lived in homes with more restrictive household smoking rules, and/or reported having 'important others' who would be supportive of their quitting, were more likely to report having made a quit attempt in the past year, had greater readiness to quit, and greater self-efficacy related to quitting. Conclusions Adjustments to proximal environments, including strengthening household smoking rules, might encourage cessation even if other household members are smokers.
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Ten-year experience of smoking cessation in a single center in Japan. Respir Investig 2019; 57:380-387. [PMID: 30795920 DOI: 10.1016/j.resinv.2019.01.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 01/16/2019] [Accepted: 01/29/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND Long-term, real-world data, as opposed to academic or research data, on outcomes of smoking cessation clinics are scarce. We assessed patient outcomes over a 10-year period at a smoking cessation clinic in a community teaching hospital in Japan and explored predictors of successful smoking cessation. METHODS We used data from a prospective registry of cigarette smokers who participated in a 3-month smoking cessation program comprising combined pharmacological treatment and cognitive behavioral therapy and explored factors associated with program execution and successful smoking cessation. The primary outcome was smoking cessation, defined by quitting completely between the 8-week and 12-week sessions, with verification according to exhaled carbon monoxide (CO) level of ≤10 ppm. RESULTS Between August 2007 and December 2017, 813 patients with nicotine dependence participated in the program. The number of participants decreased after Japan׳s 2010 tobacco tax increase. Among participants, 433 (53.3%) completed the program. In multivariate analysis, the number of cigarettes smoked daily (odds ratio [OR] 0.98, 95% confidence interval [CI] 0.96, 0.99), cardiovascular disease (OR 1.75, 95% CI 1.16, 2.68), chronic obstructive pulmonary disease (OR 1.74, 95% CI 1.10, 2.78), and gastric/duodenal ulcer (OR 1.77, 95% CI 1.04, 3.08) were significantly associated with program completion. Among program completers, 288 (66.5%) achieved smoking cessation. Exhaled CO level (OR 0.94, 95% CI 0.93, 0.97) and mental disorders (OR 0.53, 95% CI 0.33, 0.85) were negatively associated with successful smoking cessation. CONCLUSIONS Baseline exhaled CO level and mental disorders were significantly associated with either success or failure of smoking cessation.
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Meshefedjian GA. The smoking spectrum: review of the existing evidence and future directions. J Public Health (Oxf) 2019. [DOI: 10.1007/s10389-018-01009-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Notley C, Ward E, Dawkins L, Holland R, Jakes S. Vaping as an alternative to smoking relapse following brief lapse. Drug Alcohol Rev 2019; 38:68-75. [PMID: 30488650 PMCID: PMC6587865 DOI: 10.1111/dar.12876] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 10/14/2018] [Accepted: 10/16/2018] [Indexed: 12/05/2022]
Abstract
BACKGROUND AND AIMS E-cigarettes are the most popular aid to quitting smoking in the UK. Although many smokers quit, relapse is common. Historically, the literature has reported strong associations between tobacco smoking lapse and relapse following a quit attempt. This article aims to explore how smoking lapse is experienced by those who vape to quit smoking. DESIGN AND METHODS A purposive sample of 40 UK vapers were matched to a sampling frame from a representative sample of UK quitters. Semi-structured qualitative interviews were conducted. Data were thematically analysed iteratively situating reported experiences of smoking lapse within narrative descriptions of vaping. Iterative categorization was used as a technique to further explore a subset of data specifically focused on smoking lapse. RESULTS Analysis revealed that smoking lapse is perceived qualitatively differently when using e-cigarettes as compared to past quit attempts. Having the pleasurable alternative of vaping meant that full relapse to smoking was not inevitable. Instead, lapses were perceived as 'permissive' or 'purposive', intentional and contextualised, or for some as unintentional, with the resulting emotional response negatively reinforcing ongoing tobacco smoking abstinence. DISCUSSION AND CONCLUSIONS Our novel findings suggest that the role of tobacco smoking lapse in relation to relapse status may be theoretically redefined, drawing on data from vapers. These findings question the utility of previous theories of the role of smoking lapse in the relapse process. For ex-smokers, vaping offers a pleasurable, viable pharmacological, but also social and psychological, substitution option for smoking and potentially powerfully alters the experience and threat of any lapse.
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Affiliation(s)
- Caitlin Notley
- Norwich Medical SchoolUniversity of East AngliaNorwichUK
| | - Emma Ward
- Norwich Medical SchoolUniversity of East AngliaNorwichUK
| | - Lynne Dawkins
- Centre for Addictive Behaviours Research, School of Applied SciencesLondon South Bank UniversityLondonUK
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Brown RA, Palm Reed KM, Bloom EL, Minami H, Strong DR, Lejuez CW, Zvolensky MJ, Hayes SC. A randomized controlled trial of distress tolerance treatment for smoking cessation. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2018; 32:389-400. [PMID: 29927279 DOI: 10.1037/adb0000372] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
We previously developed a distress tolerance (DT)-based treatment that showed promising results for smokers with a history of early lapse. In the current study, we conducted a randomized controlled trial of this DT treatment for a general population of smokers not limited to those with a history of early lapse. We randomized 116 participants (41% female) to DT or standard treatment (ST). Both treatments included 1 individual session during Week 1 followed by 7 group sessions during Weeks 2-9 (quit date at Session 4), two 20-min phone sessions, and 8 weeks of transdermal nicotine patch. Results indicated no significant differences between conditions in the primary outcome of biochemically verified 7-day point prevalence smoking abstinence or in time to 1st lapse. Verified abstinence rates in DT were 38.7%, 38.7%, 46.77%, 40.32%, 20.9%, and 17.7% versus 40.7%, 37.0%, 53.7%, 44.4%, 33.3%, and 22.2% in ST at 1, 2, 4, 8, 13, and 26 weeks postquit, respectively. Additionally, we found no significant moderators of treatment efficacy and few differences in treatment process variables. These findings stand somewhat in contrast to those in our previous study and other recent studies of similar acceptance-based treatments. However, differences in methodology, inclusion of nicotine replacement therapy in both treatment conditions, and strict inclusion-exclusion criteria that excluded many smokers with affective vulnerabilities may underlie this discrepancy. Future research should evaluate the utility of DT and other acceptance-based treatments in populations with affective vulnerabilities who might specifically benefit from a DT-based approach. (PsycINFO Database Record
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Affiliation(s)
| | | | | | | | - David R Strong
- Department of Family Medicine, University of California, San Diego
| | - Carl W Lejuez
- College of Liberal Arts and Sciences, University of Kansas
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van Agteren JEM, Lawn S, Bonevski B, Smith BJ. Kick.it: The development of an evidence-based smoking cessation smartphone app. Transl Behav Med 2018; 8:243-267. [PMID: 29447386 DOI: 10.1093/tbm/ibx031] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Currently, the evidence for mobile health (mHealth) smoking cessation interventions is limited and heterogeneous, warranting the need for innovative rigorously developed solutions. The aim of this study was to describe the development of a smoking cessation smartphone application (app) developed using evidence-based principles. The app (Kick.it) was designed using the Intervention Mapping framework, incorporating an extensive literature review and qualitative study, in combination with the Behavioural Change Taxonomy v1, the Theoretical Domains Framework, and the Persuasive System Design framework. Kick.it provides quit smoking education, skills training, motivational content and self-regulation functionality for smokers, as well as their social support network. By logging cravings and cigarettes smoked, users will create their own smoking profile, which will be used to provide tailored interventions. It hosts a social network to allow 24/7 social support and provides in-app tools to help with urges to smoke. The app aims to motivate smokers to retry if they slip-up or relapse, allowing them to learn from previous smoking cessation attempts. Rather than basing the app on a singular behavioral change approach, Kick.it will use elements stemming from a variety of behavioral approaches by combining methods of multiple psychological theories. The use of best-practice intervention development frameworks in conjunction with evidence-based behavioral change techniques is expected to result in a smartphone app that has an optimal chance of helping people to quit smoking.
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Affiliation(s)
| | | | | | - Brian J Smith
- Department of Respiratory Medicine, The Queen Elizabeth Hospital, Adelaide, Australia
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Gu F, He Y, Mao Y, Lu S, Zhao C, Li X, Zhou C, Hirsch FR. Risk factors for nicotine dependence in Chinese patients with lung cancer. J Int Med Res 2018; 47:391-397. [PMID: 30304970 PMCID: PMC6384457 DOI: 10.1177/0300060518802738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objective Smoking is a poor prognostic factor for lung cancer. Nicotine dependence remains the major cause of failure of smoking cessation. We investigated the risk factors for nicotine dependence in patients with lung cancer. Methods Eligible patients were identified from November 2014 to February 2015. Age, marital status, educational level, annual household income, occupation, histology of lung cancer, tumor stage, smoking status, neuron-specific enolase (NSE) level, drive gene mutations, sleep quality, and patient personality were assessed. Physical nicotine dependence was assessed by the Fagerstrom Test for Nicotine Dependence (FTND). Results In total, 202 smokers were included in this study. Univariate analysis showed that marital status and pain were significantly correlated with nicotine dependence. Pearson’s correlation analysis showed that age at the initiation of smoking, attempts to quit, NSE level, and sleep quality were significantly correlated with FTND scores. Conclusions Pain, more attempts to quit, and poorer sleep quality were significantly associated with nicotine dependence. These risk factors could help to prevent smoking in Chinese patients with lung cancer.
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Affiliation(s)
- Fen Gu
- 1 Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute, Tongji University School of Medicine, No. 507 Zhengmin Road, Shanghai, People's Republic of China
| | - Yayi He
- 1 Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute, Tongji University School of Medicine, No. 507 Zhengmin Road, Shanghai, People's Republic of China
| | - Yanjun Mao
- 1 Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute, Tongji University School of Medicine, No. 507 Zhengmin Road, Shanghai, People's Republic of China
| | - Shiwen Lu
- 1 Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute, Tongji University School of Medicine, No. 507 Zhengmin Road, Shanghai, People's Republic of China
| | - Chao Zhao
- 2 Department of Lung Cancer and Immunology, Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute, Tongji University School of Medicine, No. 507 Zhengmin Road, Shanghai, People's Republic of China
| | - Xuefei Li
- 2 Department of Lung Cancer and Immunology, Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute, Tongji University School of Medicine, No. 507 Zhengmin Road, Shanghai, People's Republic of China
| | - Caicun Zhou
- 1 Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute, Tongji University School of Medicine, No. 507 Zhengmin Road, Shanghai, People's Republic of China
| | - Fred R Hirsch
- 3 Division of Medical Oncology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Farris SG, Abrantes AM, Zvolensky MJ. Emotional distress and tobacco demand during the menstrual cycle in female smokers. Cogn Behav Ther 2018; 48:177-183. [PMID: 30064348 DOI: 10.1080/16506073.2018.1494208] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Fluctuations in ovarian hormones over the menstrual cycle contribute to cigarette reward, however less is known about menstrual cycle influences on emotional distress in female smokers. We examined between-group differences in emotional distress (negative affectivity, emotion dysregulation, distress intolerance) and hypothetical cigarette purchasing (i.e. tobacco demand) among female smokers at three different menstrual stages. Women (n = 32) were non-treatment seeking daily smokers not on hormonal contraceptive, and were currently in their follicular (estradiol-dominant; n = 10), early-mid luteal (progesterone-dominant; n = 15), and late-luteal phase (decreasing progesterone/estradiol; n = 7). Effect sizes are reported given the small sample. Women in the late-luteal phase, relative to the follicular and early-mid luteal phases, reported higher levels of negative affectivity (d = 0.69), emotion dysregulation (d = 1.03), and distress intolerance (d = -0.86). Compared to the early-mid luteal and late-luteal phases, women in the follicular phase reported the highest hypothetical cigarette consumption when cigarettes were free (d = 0.71) and made the largest maximum expenditures on cigarettes (d = 0.74). Findings offer preliminary evidence that the late-luteal phase is characterized by emotional distress, and the follicular phase is associated with elevated tobacco demand, which if replicated could implicate ovarian hormones in emotion-focused smoking.
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Affiliation(s)
- Samantha G Farris
- a Department of Psychiatry and Human Behavior Alpert Medical School of Brown University , Providence , RI , USA.,b Centers for Behavioral and Preventative Medicine, The Miriam Hospital , Providence , RI , USA.,c Department of Psychology , Rutgers, the State University of New Jersey , Piscataway , NJ , USA
| | - Ana M Abrantes
- a Department of Psychiatry and Human Behavior Alpert Medical School of Brown University , Providence , RI , USA.,d Behavioral Medicine and Addictions Research Group , Butler Hospital , Providence , RI , USA
| | - Michael J Zvolensky
- e Department of Psychology , University of Houston , Houston , TX , USA.,f Department of Behavioral Science , The University of Texas MD Anderson Cancer Center , Houston , TX , USA
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Bailey SR, Heintzman J, Jacob RL, Puro J, Marino M. Disparities in Smoking Cessation Assistance in US Primary Care Clinics. Am J Public Health 2018; 108:1082-1090. [PMID: 29927641 DOI: 10.2105/ajph.2018.304492] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To examine associations between patient factors and smoking cessation assistance in US safety-net clinics. METHODS Using electronic health record data from the OCHIN network, we identified adults with at least 1 primary care visit to a study clinic (n = 143 clinics in 12 states) with at least 1 documented "current smoker" status during 2014 to 2016 (n = 136 314; 29.8%). We estimated odds ratios (ORs) of smoking cessation assistance receipt (none [reference], counseling, medication, or both) by patient covariates. RESULTS For all cessation assistance categories, odds of assistance were higher among women, those with more visits, those assessed and ready to quit, and patients with asthma or chronic obstructive pulmonary disease and hyperlipidemia. Odds of receiving both counseling and medication were lower among uninsured patients (OR = 0.56; 95% confidence interval [CI] = 0.48, 0.64), those of a race/ethnicity other than non-Hispanic White (OR range = 0.65-0.82), and those with diabetes (OR = 0.85; 95% CI = 0.79, 0.92), and higher among older patients and those with a comorbidity, with few exceptions. CONCLUSIONS Disparities in smoking cessation assistance receipt exist in safety-net settings, in particular by health insurance coverage and across race/ethnicity, even after control for other socioeconomic and demographic factors.
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Affiliation(s)
- Steffani R Bailey
- Steffani R. Bailey, John Heintzman, and Miguel Marino are with the Department of Family Medicine, Oregon Health & Science University, Portland, OR. John Heintzman, R. Lorie Jacob, and Jon Puro are with OCHIN Inc, Portland. Miguel Marino is also with Oregon Health & Science University-Portland State University School of Public Health, Division of Biostatistics, Portland
| | - John Heintzman
- Steffani R. Bailey, John Heintzman, and Miguel Marino are with the Department of Family Medicine, Oregon Health & Science University, Portland, OR. John Heintzman, R. Lorie Jacob, and Jon Puro are with OCHIN Inc, Portland. Miguel Marino is also with Oregon Health & Science University-Portland State University School of Public Health, Division of Biostatistics, Portland
| | - R Lorie Jacob
- Steffani R. Bailey, John Heintzman, and Miguel Marino are with the Department of Family Medicine, Oregon Health & Science University, Portland, OR. John Heintzman, R. Lorie Jacob, and Jon Puro are with OCHIN Inc, Portland. Miguel Marino is also with Oregon Health & Science University-Portland State University School of Public Health, Division of Biostatistics, Portland
| | - Jon Puro
- Steffani R. Bailey, John Heintzman, and Miguel Marino are with the Department of Family Medicine, Oregon Health & Science University, Portland, OR. John Heintzman, R. Lorie Jacob, and Jon Puro are with OCHIN Inc, Portland. Miguel Marino is also with Oregon Health & Science University-Portland State University School of Public Health, Division of Biostatistics, Portland
| | - Miguel Marino
- Steffani R. Bailey, John Heintzman, and Miguel Marino are with the Department of Family Medicine, Oregon Health & Science University, Portland, OR. John Heintzman, R. Lorie Jacob, and Jon Puro are with OCHIN Inc, Portland. Miguel Marino is also with Oregon Health & Science University-Portland State University School of Public Health, Division of Biostatistics, Portland
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Notley C, Ward E, Dawkins L, Holland R. The unique contribution of e-cigarettes for tobacco harm reduction in supporting smoking relapse prevention. Harm Reduct J 2018; 15:31. [PMID: 29921278 PMCID: PMC6011187 DOI: 10.1186/s12954-018-0237-7] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 05/22/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We have little understanding of how vapers use e-cigarettes beyond cessation. E-cigarettes may have a role to play in reducing the health-related harms of tobacco smoking, through not only assisting smoking cessation attempts but also supporting long-term abstinence from smoking. However, there are fears that vaping may lead to the 'renormalisation' of smoking type behaviours. This study aimed to explore patterns of use and reported experiences of vapers quitting smoking using an e-cigarette in relation to long-term smoking status (abstinence or relapse). METHODS A purposive sample of 40 UK vapers was matched to a sampling frame of demographic characteristics from a representative sample of UK quitters. Following full informed consent, semi-structured qualitative interviews were conducted. Data were thematically analysed by two members of the research team. Final thematic analysis was verified and agreed by consensus. RESULTS The sample self-reported long histories of tobacco use and multiple previous quit attempts which had eventually resulted in relapse back to smoking, although a small but important group had never before attempted to quit. Initiating e-cigarette use was experienced as a revelation for some, who were quickly able to fully switch to using e-cigarettes as an alternative to tobacco smoking. For others, periods of dual use or smoking relapse combined with attempts at vaping that were not initially satisfactory. Many of these chose a cheaper 'cig-a-like' device which they found to be inadequate. Experimentation with different devices and different setups, over time, resulted in some 'sliding' rather than switching to vaping. This involved periods of 'dual use'. Some settled on patterns of vaping as a direct substitute of previous tobacco smoking, whereas others reported 'grazing' patterns of vaping throughout the day that were perceived to support tobacco smoking abstinence. CONCLUSIONS Our data demonstrates that e-cigarettes may be a unique harm reduction innovation for smoking relapse prevention. E-cigarettes meet the needs of some ex-smokers by substituting physical, psychological, social, cultural and identity-related aspects of tobacco addiction. Some vapers reported that they found vaping pleasurable and enjoyable-being more than a substitute but actually preferred, over time, to tobacco smoking. This clearly suggests that vaping is a viable long-term substitute for smoking, with substantial implications for tobacco harm reduction.
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Affiliation(s)
- Caitlin Notley
- Norwich Medical School, Norwich Research Park, University of East Anglia, Norwich, NR4 7TJ, UK.
| | - Emma Ward
- Norwich Medical School, Norwich Research Park, University of East Anglia, Norwich, NR4 7TJ, UK
| | - Lynne Dawkins
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, 103 Borough Road, London, SE1 0AA, UK
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Bailey SR, Stevens VJ, Fortmann SP, Kurtz SE, McBurnie MA, Priest E, Puro J, Solberg LI, Schweitzer R, Masica AL, Hazlehurst B. Long-Term Outcomes From Repeated Smoking Cessation Assistance in Routine Primary Care. Am J Health Promot 2018. [PMID: 29534598 DOI: 10.1177/0890117118761886] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE To test the association between repeated clinical smoking cessation support and long-term cessation. DESIGN Retrospective, observational cohort study using structured and free-text data from electronic health records. SETTING Six diverse health systems in the United States. PARTICIPANTS Patients aged ≥18 years who were smokers in 2007 and had ≥1 primary care visit in each of the following 4 years (N = 33 691). MEASURES Primary exposure was a composite categorical variable (comprised of documentation of smoking cessation medication, counseling, or referral) classifying the proportions of visits for which patients received any cessation assistance (<25% (reference), 25%-49%, 50%-74%, and ≥75% of visits). The dependent variable was long-term quit (LTQ; yes/no), defined as no indication of being a current smoker for ≥365 days following a visit where nonsmoker or former smoker was indicated. ANALYSIS Mixed effects logistic regression analysis adjusted for age, sex, race, and comorbidities, with robust standard error estimation to account for within site correlation. RESULTS Overall, 20% of the cohort achieved LTQ status. Patients with ≥75% of visits with any assistance had almost 3 times the odds of achieving LTQ status compared to those with <25% visits with assistance (odds ratio = 2.84; 95% confidence interval: 1.50-5.37). Results were similar for specific assistance types. CONCLUSIONS These findings provide support for the importance of repeated assistance at primary care visits to increase long-term smoking cessation.
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Affiliation(s)
- Steffani R Bailey
- 1 Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Victor J Stevens
- 2 Kaiser Permanente Center for Health Research, Portland, OR, USA
| | | | - Stephen E Kurtz
- 2 Kaiser Permanente Center for Health Research, Portland, OR, USA
| | | | | | | | | | - Rebecca Schweitzer
- 6 Department is Office of Public Health Studies, University of Hawai'i at Manoa, Honolulu, HI, USA
| | | | - Brian Hazlehurst
- 2 Kaiser Permanente Center for Health Research, Portland, OR, USA
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Ovarian Hormones and Transdermal Nicotine Administration Independently and Synergistically Suppress Tobacco Withdrawal Symptoms and Smoking Reinstatement in the Human Laboratory. Neuropsychopharmacology 2018; 43:828-837. [PMID: 28905874 PMCID: PMC5809791 DOI: 10.1038/npp.2017.216] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 09/08/2017] [Accepted: 09/10/2017] [Indexed: 12/19/2022]
Abstract
Modeling intra-individual fluctuations in estradiol and progesterone may provide unique insight into the effects of ovarian hormones on the etiology and treatment of nicotine dependence. This randomized placebo-controlled laboratory study tested the independent and interactive effects of intra-individual ovarian hormone variation and nicotine on suppression of tobacco withdrawal symptoms and smoking behavior. Female smokers randomized to 21 mg nicotine (TNP; n=37) or placebo (PBO; n=43) transdermal patch following overnight abstinence completed three sessions occurring during hormonally distinct menstrual cycle phases. At each session, participants provided saliva for hormone assays and completed repeated self-report measures (ie, tobacco withdrawal symptoms, smoking urge, and negative affect (NA)) followed by an analog smoking reinstatement task for which participants could earn money to delay smoking and subsequently purchase cigarettes to smoke. Higher (vs lower) progesterone levels were associated with greater reductions in NA. Higher (vs lower) progesterone levels and progesterone to estradiol ratios were associated with reducing smoking urges over time to a greater extent with TNP compared to PBO. There was an interaction between Patch and estradiol on NA. With TNP, higher-than-usual estradiol was associated with greater decreases in NA. However with PBO, lower-than-usual estradiol was associated with greater decreases in NA. These results suggest that the effects of TNP on mood- and smoking-related outcomes may vary depending on the ovarian hormone levels.
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Outcomes for a Public Hospital Tobacco Cessation Program: The Cook County Health and Hospitals System Experience. J Community Health 2018; 41:1130-1139. [PMID: 27393143 DOI: 10.1007/s10900-016-0215-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The objective of this study is to determine the rate and predictors of sustained smoking cessation for a cohort of smokers exposed to a guideline-based health education program delivered during routine clinical care at an urban public hospital. This is a retrospective analysis of 755 public hospital system patients who had at least two health educator contacts embedded in routine clinical care, with the latter contact 12-18 months after the baseline. The education occurred during visits to primary care, specialty clinics, urgent/episodic care, or during hospitalization. The assessment of smoking status is determined by the health educators as part of their routine assessment and recorded in the program's database. The primary outcomes are self-reported 12-month sustained smoking cessation at the 12-18 month contact and predictors of cessation. The cohort is predominantly minority smokers (African American 69 % and Latino 15 %) and uninsured (70 %) or on Medicaid (13 %). The sustained cessation rate was 9.3 %. Latino ethnicity, smoking 1-9 cigarettes/day at baseline, reporting smoke-free home, and additional educator contact in the year after the baseline were independent predictors of sustained cessation in the multivariate analysis. Smokers with multiple risks for poor cessation outcomes exposed to a guideline-based program of health education during routine healthcare encounters had sustained smoking cessation rates that compare favorably with published National Health Interview Study population cessation rates. An additional educator contact after the baseline was a predictor of cessation. The findings support development of cessation programs in which health educators are integrated into clinical care settings.
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Piñeiro B, López-Durán A, Martínez-Vispo C, Fernández Del Río E, Martínez Ú, Rodríguez-Cano R, Míguez MC, Becoña E. Smoking relapse situations among a community-recruited sample of Spanish daily smokers. Addict Behav 2017; 75:152-158. [PMID: 28735149 DOI: 10.1016/j.addbeh.2017.07.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 07/10/2017] [Accepted: 07/13/2017] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Relapse is a common factor within the behavior change process. However, there is scarce and limited knowledge of smoking relapse situations in population-based samples. The aim of this study was to identify smoking relapse situations among a sample of Spanish relapsers from the general population. METHODS A sample of 775 relapsers was recruited among the general population using a snowball method. Participants completed a survey including sociodemographic, smoking-related and psychopathology variables. Smoking relapse situations were identified through specific questions assessing different aspects related to the last relapse episode. RESULTS The majority of smoking relapse situations were attributed to positive affect (36.6%) and negative affect (34.3%), followed by lack of control (10.1%), smoking habit (6.7%), craving or nicotine withdrawal (6.3%), and social pressure (5.9%). Being unemployed and having a mental disorder in the past increased the likelihood of relapse in situations of negative affect. Being single and having quit smoking to save money were associated with an increased likelihood of relapse in situations of positive affect. CONCLUSIONS Affect plays a significant role in smoking relapse among a community sample of unassisted Spanish smokers. Relapse may be much more of an affective and situational process than a habit, physiological or social pressure. Findings from this study may help develop tailored community smoking relapse prevention strategies or programs.
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Affiliation(s)
- Bárbara Piñeiro
- Smoking Cessation and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universidade de Santiago de Compostela, Galicia, Spain.
| | - Ana López-Durán
- Smoking Cessation and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universidade de Santiago de Compostela, Galicia, Spain
| | - Carmela Martínez-Vispo
- Smoking Cessation and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universidade de Santiago de Compostela, Galicia, Spain
| | | | - Úrsula Martínez
- Smoking Cessation and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universidade de Santiago de Compostela, Galicia, Spain
| | - Rubén Rodríguez-Cano
- Smoking Cessation and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universidade de Santiago de Compostela, Galicia, Spain
| | - M Carmen Míguez
- Smoking Cessation and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universidade de Santiago de Compostela, Galicia, Spain
| | - Elisardo Becoña
- Smoking Cessation and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, Universidade de Santiago de Compostela, Galicia, Spain
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Bailey SR, Heintzman JD, Marino M, Jacob RL, Puro JE, DeVoe JE, Burdick TE, Hazlehurst BL, Cohen DJ, Fortmann SP. Smoking-Cessation Assistance: Before and After Stage 1 Meaningful Use Implementation. Am J Prev Med 2017; 53:192-200. [PMID: 28365090 PMCID: PMC5522621 DOI: 10.1016/j.amepre.2017.02.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 01/10/2017] [Accepted: 02/02/2017] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Brief smoking-cessation interventions in primary care settings are effective, but delivery of these services remains low. The Centers for Medicare and Medicaid Services' Meaningful Use (MU) of Electronic Health Record (EHR) Incentive Program could increase rates of smoking assessment and cessation assistance among vulnerable populations. This study examined whether smoking status assessment, cessation assistance, and odds of being a current smoker changed after Stage 1 MU implementation. METHODS EHR data were extracted from 26 community health centers with an EHR in place by June 15, 2009. AORs were computed for each binary outcome (smoking status assessment, counseling given, smoking-cessation medications ordered/discussed, current smoking status), comparing 2010 (pre-MU), 2012 (MU preparation), and 2014 (MU fully implemented) for pregnant and non-pregnant patients. RESULTS Non-pregnant patients had decreased odds of current smoking over time; odds for all other outcomes increased except for medication orders from 2010 to 2012. Among pregnant patients, odds of assessment and counseling increased across all years. Odds of discussing or ordering of cessation medications increased from 2010 compared with the other 2 study years; however, medication orders alone did not change over time, and current smoking only decreased from 2010 to 2012. Compared with non-pregnant patients, a lower percentage of pregnant patients were provided counseling. CONCLUSIONS Findings suggest that incentives for MU of EHRs increase the odds of smoking assessment and cessation assistance, which could lead to decreased smoking rates among vulnerable populations. Continued efforts for provision of cessation assistance among pregnant patients is warranted.
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Affiliation(s)
- Steffani R Bailey
- Department of Family Medicine, Oregon Health & Science University, Portland, Oregon.
| | - John D Heintzman
- Department of Family Medicine, Oregon Health & Science University, Portland, Oregon
| | - Miguel Marino
- Department of Family Medicine, Oregon Health & Science University, Portland, Oregon
| | | | | | - Jennifer E DeVoe
- Department of Family Medicine, Oregon Health & Science University, Portland, Oregon
| | - Tim E Burdick
- Department of Community and Family Medicine, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
| | | | - Deborah J Cohen
- Department of Family Medicine, Oregon Health & Science University, Portland, Oregon
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Berndt N, Lechner L, Mudde A, De Vries H, Bolman C. Feasibility and acceptability of a telephone- and face-to-face-delivered counseling intervention for smoking cessation in Dutch patients with coronary heart disease. Res Nurs Health 2017; 40:444-458. [PMID: 28715122 DOI: 10.1002/nur.21810] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 06/09/2017] [Indexed: 11/10/2022]
Abstract
Intensive behavioral counseling interventions combined with nicotine replacement therapy have increased smoking abstinence rates in cardiac patients, but little is known about their feasibility when initiated upon hospital admission and continued post-discharge. The current study was an evaluation of the use, appreciation, and fidelity of two post-discharge counseling interventions designed for cardiac patients to quit smoking that differed in their delivery mode. In a controlled trial with cross-over randomization at the cardiac unit level, hospitalized smokers in eight cardiac units of eight Dutch hospitals were assigned either telephone counseling (n = 223) or nurse-administered face-to-face counseling (n = 157) using the Ask-Advise-Refer strategy. Eligible patients also received nicotine replacement therapy. Data based on counselors' registration forms and patients' telephone surveys at 6-month follow-up were analyzed. Most patients (>90%) participated in at least one counseling session, and the majority participated in at least five out of a maximum of seven sessions. Higher levels of adherence to either the telephone or face-to-face counseling sessions were associated with higher smoking abstinence rates at the 6-month follow-up, whereas higher nicotine patch use was not associated with abstinence. Patients positively evaluated the content, duration, and number of sessions, and rated the face-to-face counseling significantly better than the telephone counseling for quitting smoking. The counselors largely complied with the intervention protocols. The current intervention offers evidence of feasibility and may improve outpatient continuity of smoking care. Monitoring the use and delivery of such complex interventions is recommended to promote effective dissemination in cardiac practice.
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Affiliation(s)
- Nadine Berndt
- Department of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands.,Cellule d'Expertise Médicale, Inspection Générale de la Sécurité Sociale, Ministère de la Sécurité Sociale, Luxembourg
| | - Lilian Lechner
- Department of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
| | - Aart Mudde
- Department of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
| | - Hein De Vries
- Department of Health Promotion, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Catherine Bolman
- Department of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
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Rodríguez-Cano R, Paulus DJ, López-Durán A, Martínez-Vispo C, Fernández del Río E, Becoña E, Zvolensky MJ. The interplay of history of depression and craving in terms of smoking relapse among treatment seeking smokers. J Addict Dis 2017; 36:175-182. [DOI: 10.1080/10550887.2017.1314696] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Rubén Rodríguez-Cano
- Smoking and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Daniel J. Paulus
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Ana López-Durán
- Smoking and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Carmela Martínez-Vispo
- Smoking and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Elena Fernández del Río
- Smoking and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
- Department of Psychology and Sociology, Faculty of Social Sciences and Work, University of Zaragoza, Zaragoza, Spain
| | - Elisardo Becoña
- Smoking and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, Texas, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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45
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Zhou S, Xiao D, Peng P, Wang SK, Liu Z, Qin HY, Li SS, Wang C. Effect of smoking on resting-state functional connectivity in smokers: An fMRI study. Respirology 2017; 22:1118-1124. [PMID: 28374936 DOI: 10.1111/resp.13048] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Revised: 12/22/2016] [Accepted: 01/01/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVE Smoking is a leading cause of death in the world. Aberrant brain function has been repeatedly linked to tobacco smoking. However, little is known about insula-based resting-state functional connectivity (rsFC) in non-deprived tobacco-dependent smokers. This study characterized the correlation between insula-based rsFC and tobacco dependence severity in non-deprived smokers. METHODS A total of 37 male smokers and 37 age-matched male non-smokers completed resting-state functional MRI (fMRI) scans. The insula-based rsFC differences between smokers and controls were investigated and the correlation between insula-based rsFC and FTND (Fagerström Test for Nicotine Dependence) scores were then assessed. RESULTS Compared with controls, smokers showed significantly lower rsFC between orbitofrontal cortex, superior frontal gyrus, temporal lobe and insula. The rsFC between orbitofrontal cortex, temporal lobe, inferior parietal cortex, occipital lobe and insula was positively correlated with FTND. However, the rsFC between anterior cingulate cortex and insula was negatively correlated with FTND. CONCLUSION Our findings suggest differences in brain functional connectivity between smokers and non-smokers. This study sheds new insights into the neural mechanisms of tobacco dependence.
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Affiliation(s)
- Shuang Zhou
- Medical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Dan Xiao
- National Clinical Research Center for Respiratory Diseases, Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China.,Tobacco Medicine and Tobacco Cessation Center, China-Japan Friendship Hospital, Beijing, China.,WHO Collaborating Centre for Tobacco Cessation and Respiratory Diseases Prevention, China-Japan Friendship Hospital, Beijing, China
| | - Peng Peng
- Department of Radiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Shuang-Kun Wang
- Department of Radiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Zhao Liu
- National Clinical Research Center for Respiratory Diseases, Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China.,Tobacco Medicine and Tobacco Cessation Center, China-Japan Friendship Hospital, Beijing, China.,WHO Collaborating Centre for Tobacco Cessation and Respiratory Diseases Prevention, China-Japan Friendship Hospital, Beijing, China
| | - Hai-Yan Qin
- Department of Respiration, Affiliated Hospital of Wei-Fang Medical University, Weifang, China
| | - Sheng-Shu Li
- Department of Respiration, Hainan Branch of the General Hospital of People's Liberation Army, Sanya, China
| | - Chen Wang
- National Clinical Research Center for Respiratory Diseases, Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China.,WHO Collaborating Centre for Tobacco Cessation and Respiratory Diseases Prevention, China-Japan Friendship Hospital, Beijing, China.,Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China.,Department of Respiratory Medicine, Capital Medical University, Beijing, China.,Capital Medical University, Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing, China
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46
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Rodríguez-Cano R, López-Durán A, Martínez-Vispo C, Martínez Ú, Fernández Del Río E, Becoña E. Hazardous Alcohol Drinking as Predictor of Smoking Relapse (3-, 6-, and 12-Months Follow-Up) by Gender. J Subst Abuse Treat 2016; 71:79-84. [PMID: 27776682 DOI: 10.1016/j.jsat.2016.09.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 08/26/2016] [Accepted: 09/14/2016] [Indexed: 11/19/2022]
Abstract
Diverse studies have found a relation between alcohol consumption and smoking relapse. Few studies have analyzed the relation of smoking relapse with pretreatment alcohol consumption and gender differences. The main purpose of this study is to analyze the influence of alcohol consumption in smoking relapse over 12 months (3-, 6-, and 12-months follow-up) and to determine possible gender differences. The sample included 374 smokers who quit smoking by participating in a psychological smoking cessation treatment. We assessed hazardous pretreatment alcohol drinking (AUDIT), cigarette consumption (FTND; number of cigarettes) and sociodemographic variables. Higher scores on hazardous pretreatment alcohol drinking predict smoking relapse at 3-, 6-, and 12-months after smoking cessation. In males, higher scores on hazardous pretreatment alcohol drinking predict relapse at 6 and at 12 months. In females, higher scores on hazardous pretreatment alcohol drinking predict tobacco relapse at 3 months. Hazardous pretreatment alcohol drinking predicts relapse at all intervals after smoking cessation (3-, 6-, and 12-months follow-up). However, the influence of hazardous pretreatment alcohol drinking on smoking relapse differs as a function of gender, as it is a short-term predictor in women (3 months) and a long-term predictor in men (6 and 12 months).
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Affiliation(s)
- Rubén Rodríguez-Cano
- Smoking and Addictive Disorders Unit, Faculty of Psychology, Department of Clinical Psychology and Psychobiology, Department of Clinical Psychology and Psychobiology, Santiago de Compostela, Spain.
| | - Ana López-Durán
- Smoking and Addictive Disorders Unit, Faculty of Psychology, Department of Clinical Psychology and Psychobiology, Department of Clinical Psychology and Psychobiology, Santiago de Compostela, Spain.
| | - Carmela Martínez-Vispo
- Smoking and Addictive Disorders Unit, Faculty of Psychology, Department of Clinical Psychology and Psychobiology, Department of Clinical Psychology and Psychobiology, Santiago de Compostela, Spain.
| | - Úrsula Martínez
- Smoking and Addictive Disorders Unit, Faculty of Psychology, Department of Clinical Psychology and Psychobiology, Department of Clinical Psychology and Psychobiology, Santiago de Compostela, Spain.
| | - Elena Fernández Del Río
- Smoking and Addictive Disorders Unit, Faculty of Psychology, Department of Clinical Psychology and Psychobiology, Department of Clinical Psychology and Psychobiology, Santiago de Compostela, Spain; Department of Psychology and Sociology, Faculty of Social Sciences and Work, University of Zaragoza, 50009, Zaragoza, Spain.
| | - Elisardo Becoña
- Smoking and Addictive Disorders Unit, Faculty of Psychology, Department of Clinical Psychology and Psychobiology, Department of Clinical Psychology and Psychobiology, Santiago de Compostela, Spain.
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47
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Patten CA, Bronars CA, Vickers Douglas KS, Ussher MH, Levine JA, Tye SJ, Hughes CA, Brockman TA, Decker PA, DeJesus RS, Williams MD, Olson TP, Clark MM, Dieterich AM. Supervised, Vigorous Intensity Exercise Intervention for Depressed Female Smokers: A Pilot Study. Nicotine Tob Res 2016; 19:77-86. [PMID: 27613946 DOI: 10.1093/ntr/ntw208] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 08/06/2016] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Few studies have evaluated exercise interventions for smokers with depression or other psychiatric comorbidities. This pilot study evaluated the potential role of supervised vigorous exercise as a smoking cessation intervention for depressed females. METHODS Thirty adult women with moderate-severe depressive symptoms were enrolled and randomly assigned to 12 weeks of thrice weekly, in person sessions of vigorous intensity supervised exercise at a YMCA setting (EX; n = 15) or health education (HE; n = 15). All participants received behavioral smoking cessation counseling and nicotine patch therapy. Assessments were done in person at baseline, at the end of 12 weeks of treatment, and at 6 months post-target quit date. Primary end points were exercise adherence (proportion of 36 sessions attended) and biochemically confirmed 7-day point prevalence abstinence at Week 12. Biomarkers of inflammation were explored for differences between treatment groups and between women who smoked and those abstinent at Week 12. RESULTS Treatment adherence was high for both groups (72% for EX and 66% for HE; p = .55). The Week 12 smoking abstinence rate was higher for EX than HE (11/15 [73%] vs. 5/15 [33%]; p = .028), but no significant differences emerged at 6-month follow-up. Interleukin-6 levels increased more for those smoking than women abstinent at Week 12 (p = .040). CONCLUSIONS Vigorous intensity supervised exercise is feasible and enhances short-term smoking cessation among depressed female smokers. Innovative and cost-effective strategies to bolster long-term exercise adherence and smoking cessation need evaluation in this population. Inflammatory biomarkers could be examined in future research as mediators of treatment efficacy. IMPLICATIONS This preliminary study found that vigorous intensity supervised exercise is feasible and enhances short-term smoking cessation among depressed female smokers. This research addressed an important gap in the field. Despite decades of research examining exercise interventions for smoking cessation, few studies were done among depressed smokers or those with comorbid psychiatric disorders. A novel finding was increases in levels of a pro-inflammatory biomarker observed among women who smoked at the end of the intervention compared to those who did not.
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Affiliation(s)
- Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN;
| | - Carrie A Bronars
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | | | - Michael H Ussher
- Population Health Research Institute, St. George's University of London, London, UK
| | | | | | | | | | - Paul A Decker
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Ramona S DeJesus
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Mark D Williams
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Thomas P Olson
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
| | - Matthew M Clark
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
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Riaz M, Lewis S, Coleman T, Aveyard P, West R, Naughton F, Ussher M. Which measures of cigarette dependence are predictors of smoking cessation during pregnancy? Analysis of data from a randomized controlled trial. Addiction 2016; 111:1656-65. [PMID: 26997495 PMCID: PMC5084769 DOI: 10.1111/add.13395] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 11/26/2015] [Accepted: 03/14/2016] [Indexed: 11/27/2022]
Abstract
AIMS To examine the ability of different common measures of cigarette dependence to predict smoking cessation during pregnancy. DESIGN Secondary analysis of data from a parallel-group randomized controlled trial of physical activity for smoking cessation. The outcomes were biochemically validated smoking abstinence at 4 weeks post-quit and end-of-pregnancy. SETTING Women identified as smokers in antenatal clinics in 13 hospital trusts predominantly in southern England, who were recruited to a smoking cessation trial. PARTICIPANTS Of 789 pregnant smokers recruited, 784 were included in the analysis. MEASUREMENTS Using random-effect logistic regression models, we analysed the effects of baseline measures of cigarette dependence, including numbers of cigarettes smoked daily, Fagerström Test of Cigarette Dependence (FTCD) score, the two FTCD subscales of Heaviness of Smoking Index (HSI) and non-Heaviness of Smoking Index (non-HSI), expired carbon monoxide (CO) level and urges to smoke (strength and frequency) on smoking cessation. Associations were adjusted for significant socio-demographic/health behaviour predictors and trial variables, and area under the receiver operating characteristic (ROC) curve was used to determine the predictive ability of the model for each measure of dependence. FINDINGS All the dependence variables predicted abstinence at 4 weeks and end-of-pregnancy. At 4 weeks, the adjusted odds ratio (OR) (95% confidence interval) for a unit standard deviation increase in FTCD was 0.59 (0.47-0.74), expired CO = 0.54 (0.41-0.71), number of cigarettes smoked per day 0.65 (0.51-0.84) and frequency of urges to smoke 0.79 (0.63-0.98); at end-of-pregnancy they were: 0.60 (0.45-0.81), 0.55 (0.37-0.80), 0.70 (0.49-0.98) and 0.69 (0.51-0.94), respectively. HSI and non-HSI exhibited similar results to the full FTCD. CONCLUSIONS Four common measures of dependence, including number of cigarettes smoked per day, scores for Fagerström Test of Cigarette Dependence and frequency of urges and level of expired CO, all predicted smoking abstinence in the short term during pregnancy and at end-of-pregnancy with very similar predictive validity.
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Affiliation(s)
- Muhammad Riaz
- Population Health Research Institute, St George's University of LondonLondonUK
| | - Sarah Lewis
- Division of Epidemiology and Public Health and UK Centre for Tobacco and Alcohol StudiesUniversity of NottinghamNottinghamUK
| | - Tim Coleman
- Division of Primary Care and UK Centre for Tobacco and Alcohol StudiesUniversity of NottinghamNottinghamUK
| | - Paul Aveyard
- Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK
| | - Robert West
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, UCLLondonUK
| | - Felix Naughton
- Behavioural Science Group, Institute of Public HealthUniversity of CambridgeCambridgeUK
| | - Michael Ussher
- Population Health Research Institute, St George's University of LondonLondonUK
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49
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Bray BC, Smith RA, Piper ME, Roberts LJ, Baker TB. Transitions in Smokers' Social Networks After Quit Attempts: A Latent Transition Analysis. Nicotine Tob Res 2016; 18:2243-2251. [PMID: 27613925 DOI: 10.1093/ntr/ntw173] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 06/30/2016] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Smokers' social networks vary in size, composition, and amount of exposure to smoking. The extent to which smokers' social networks change after a quit attempt is unknown, as is the relation between quitting success and later network changes. METHODS Unique types of social networks for 691 smokers enrolled in a smoking-cessation trial were identified based on network size, new network members, members' smoking habits, within network smoking, smoking buddies, and romantic partners' smoking. Latent transition analysis was used to identify the network classes and to predict transitions in class membership across 3 years from biochemically assessed smoking abstinence. RESULTS Five network classes were identified: Immersed (large network, extensive smoking exposure including smoking buddies), Low Smoking Exposure (large network, minimal smoking exposure), Smoking Partner (small network, smoking exposure primarily from partner), Isolated (small network, minimal smoking exposure), and Distant Smoking Exposure (small network, considerable nonpartner smoking exposure). Abstinence at years 1 and 2 was associated with shifts in participants' social networks to less contact with smokers and larger networks in years 2 and 3. CONCLUSIONS In the years following a smoking-cessation attempt, smokers' social networks changed, and abstinence status predicted these changes. Networks defined by high levels of exposure to smokers were especially associated with continued smoking. Abstinence, however, predicted transitions to larger social networks comprising less smoking exposure. These results support treatments that aim to reduce exposure to smoking cues and smokers, including partners who smoke. IMPLICATIONS Prior research has shown that social network features predict the likelihood of subsequent smoking cessation. The current research illustrates how successful quitting predicts social network change over 3 years following a quit attempt. Specifically, abstinence predicts transitions to networks that are larger and afford less exposure to smokers. This suggests that quitting smoking may expand a person's social milieu rather than narrow it. This effect, plus reduced exposure to smokers, may help sustain abstinence.
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Affiliation(s)
- Bethany C Bray
- The Methodology Center, The Pennsylvania State University, University Park, PA;
| | - Rachel A Smith
- Communication Arts and Sciences, The Pennsylvania State University, University Park, PA
| | - Megan E Piper
- Center for Tobacco Research and Intervention, University of Wisconsin-Madison, Madison, WI
| | - Linda J Roberts
- School of Human Ecology, University of Wisconsin-Madison, Madison, WI
| | - Timothy B Baker
- Center for Tobacco Research and Intervention, University of Wisconsin-Madison, Madison, WI
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50
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Withdrawal exposure with withdrawal regulation training for smoking cessation: a randomized controlled pilot trial. Drug Alcohol Depend 2016; 164:28-37. [PMID: 27179823 DOI: 10.1016/j.drugalcdep.2016.04.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 03/30/2016] [Accepted: 04/10/2016] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Although withdrawal processes form a key motivational basis for cigarette use, smoking cessation treatments appear to exert only modest effects on withdrawal. One treatment option for further reducing withdrawal severity would be to provide smokers with withdrawal regulation training. The objective of this study was to pilot a smoking cessation intervention comprising withdrawal exposure with withdrawal regulation training. METHODS Adult smokers (N=80) were randomized to one of two conditions: 1) Withdrawal Exposure with Withdrawal Regulation Training (WT), which included the development and application of individualized withdrawal regulation strategies over four separate sessions that spanned the first four hours of abstinence; 2) or Relaxation Control (RC) training, which controlled for the therapeutic contact of WT. All sessions occurred before the quit date, after which differential treatment was discontinued and all participants received brief counseling, nicotine replacement therapy, and self-help literature. Biochemically-confirmed (CO≤3) seven-day point-prevalence abstinence was assessed at Months 2 and 3 after end-of-treatment. RESULTS Treatment completion and ratings of credibility and efficacy were high and equivalent across conditions. 22.2% of participants in the WT condition were abstinent at both time points, whereas 0% and 4.2% of participants in the RC condition were abstinent at Months 2 and 3 (Month 3 OR=6.5 [0.73, 59.19]). In-session withdrawal ratings suggested WT improved regulation of withdrawal symptoms, which were in turn associated with abstinence. CONCLUSIONS This small pilot study suggests that WT promotes abstinence by enhancing withdrawal regulation. Results warrant further investigation of this innovative treatment approach.
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