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Wang W, Ding X. A pilot randomized trial of self-compassion writing for young adult women engaged in emotional eating in the context of appearance-related cyberbullying. Int J Eat Disord 2023; 56:1520-1533. [PMID: 37080948 DOI: 10.1002/eat.23967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 04/10/2023] [Accepted: 04/10/2023] [Indexed: 04/22/2023]
Abstract
OBJECTIVE To investigate the effectiveness of a 10-min self-compassion writing in alleviating body dissatisfaction, self-objectification, and emotional eating in young adult women engaged in emotional eating in the context of appearance-related cyberbullying. METHOD A total of 175 Chinese young adult women (Mage = 20.90, SD = 1.65) were randomly assigned to one of the three groups: self-compassion, distraction, or control group. At baseline, participants completed assessments of trait and state body dissatisfaction, trait self-objectification, trait self-compassion, emotional eating, and positive and negative affect. Then they needed to recall an appearance-related cyberbullying victimization experience, after which state body dissatisfaction, state self-objectification, and positive and negative affect were measured. After the intervention, participants completed measures of state body dissatisfaction, state self-objectification, positive and negative affect, state self-compassion, and a food-choosing task. At 1-month follow-up, participants completed measures of trait body dissatisfaction, trait self-objectification, trait self-compassion, and emotional eating. RESULTS At post-intervention, state body dissatisfaction and negative affect were significantly lower, and positive affect was significantly higher in both the self-compassion and distraction groups compared to control. State self-objectification was significantly lower in the self-compassion group than in the other two groups. At 1-month follow-up, the self-compassion group showed significantly lower levels of body dissatisfaction than the control group. DISCUSSION The findings provide initial evidence for the potential of self-compassion writing in reducing state self-objectification and state body dissatisfaction in the context of appearance-related cyberbullying. PUBLIC SIGNIFICANCE Appearance-related cyberbullying, a common phenomenon in social networking sites, has been documented to associate with appearance-related concerns and disordered eating in young adult women. However, effective interventions that can reduce these negative associations are scarce. This study preliminarily found that a brief self-compassion writing could be a potential intervention for reducing state self-objectification and state body dissatisfaction in young adult women who had suffered appearance-related cyberbullying.
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Affiliation(s)
- Wenying Wang
- Department of Medical Psychology, School of Medical Humanities, Capital Medical University, Beijing, China
| | - Xinfang Ding
- Department of Medical Psychology, School of Medical Humanities, Capital Medical University, Beijing, China
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2
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Cook JW, Baker TB, Fiore MC, Collins LM, Piper ME, Schlam TR, Bolt DM, Smith SS, Zwaga D, Jorenby DE, Mermelstein R. Evaluating four motivation-phase intervention components for use with primary care patients unwilling to quit smoking: a randomized factorial experiment. Addiction 2021; 116:3167-3179. [PMID: 33908665 PMCID: PMC8492501 DOI: 10.1111/add.15528] [Citation(s) in RCA: 6] [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: 07/27/2020] [Revised: 10/15/2020] [Accepted: 04/14/2021] [Indexed: 11/27/2022]
Abstract
AIMS To assess the effectiveness of intervention components designed to increase quit attempts and promote abstinence in patients initially unwilling to quit smoking. DESIGN A four-factor, randomized factorial experiment. SETTING Sixteen primary care clinics in southern Wisconsin. PARTICIPANTS A total of 577 adults who smoke (60% women, 80% White) recruited during primary care visits who were currently willing to reduce their smoking but unwilling to try to quit. Interventions Four factors contrasted intervention components administered over a 1-year period: (i) nicotine mini-lozenge versus none; (ii) reduction counseling versus none; (iii) behavioral activation (BA) counseling versus none; and (iv) motivational 5Rs counseling versus none. Participants could request cessation treatment at any time. MEASUREMENTS The primary outcome was 7-day point-prevalence abstinence at 52 weeks post enrollment; secondary outcomes were point-prevalence abstinence at 26 weeks and making a quit attempt by weeks 26 and 52. FINDINGS No abstinence main effects were found but a mini-lozenge × reduction counseling × BA interaction was found at 52 weeks; P = 0.03. Unpacking this interaction showed that the mini-lozenge alone produced the highest abstinence rate (16.7%); combining it with reduction counseling produced an especially low abstinence rate (4.1%). Reduction counseling decreased the likelihood of making a quit attempt by 52 weeks relative to no reduction counseling (P = 0.01). CONCLUSIONS Nicotine mini-lozenges may increase smoking abstinence in people initially unwilling to quit smoking, but their effectiveness declines when used with smoking reduction counseling or other behavioral interventions. Reduction counseling decreases the likelihood of making a quit attempt in people initially unwilling to quit smoking.
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Affiliation(s)
- Jessica W Cook
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Timothy B Baker
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Michael C Fiore
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Linda M Collins
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, USA
| | - Megan E Piper
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Tanya R Schlam
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Daniel M Bolt
- Department of Educational Psychology, University of Wisconsin, WI, USA
| | - Stevens S Smith
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Deejay Zwaga
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Douglas E Jorenby
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Robin Mermelstein
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
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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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Klemperer EM, Hughes JR, Naud S. Reduction in Cigarettes per Day Prospectively Predicts Making a Quit Attempt: A Fine-Grained Secondary Analysis of a Natural History Study. Nicotine Tob Res 2020; 21:648-654. [PMID: 29579250 DOI: 10.1093/ntr/nty056] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Accepted: 03/21/2018] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Reducing cigarettes per day (CPD) aided by medication increases quit attempts (QA) among smokers not trying to quit. If this is due to reducing CPD per se, then a greater reduction should predict making a QA. AIMS AND METHODS In this secondary analysis, 132 smokers completed nightly calls to report CPD, intention to quit tomorrow, and QAs over 12 weeks. We provided no treatment. We identified episodes of reduction and tested whether (1) percent reduction in CPD, (2) absolute reduction in CPD, (3) duration of reduction, or (4) CPD on the final day predicted a QA immediately after a reduction episode. We tested this separately among reduction episodes that began with and without an intention to quit. RESULTS Among the 1179 episodes that began without intention to quit, all four measures of reduction predicted making a QA. Greater percent reduction, longer duration, and fewer CPD on the final day were retained in a multivariate model (all p < .05). Among the 85 episodes that began with intention to quit, greater percent reduction and greater absolute reduction predicted making a QA. Only mean percent reduction was retained in a multivariate model (p < .001). CONCLUSIONS Our results replicate and extend earlier studies by using fine-grained analyses and examining immediately proximal QAs in a sample of self-quitters. Findings suggest that reducing CPD per se increases the probability of a QA among smokers without intention to quit in a dose-related manner. Whether this is the case among smokers who intend to quit remains unclear. IMPLICATIONS Reducing CPD appears to be an effective strategy to increase the probability of making a QA for the majority of smokers who do not intend to quit in the near future. However, our findings are mixed regarding the effectiveness of reducing among smokers who intend to quit. Clinical interventions and policies that promote reducing CPD are likely to be an effective way to increase QAs. Reduction may be especially helpful for smokers who have not responded to traditional advice to stop abruptly.
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Affiliation(s)
- Elias M Klemperer
- Department of Psychiatry, Vermont Center on Behavior and Health, University of Vermont, Burlington, VT.,Department of Psychological Science, University of Vermont, Burlington, VT
| | - John R Hughes
- Department of Psychiatry, Vermont Center on Behavior and Health, University of Vermont, Burlington, VT.,Department of Psychological Science, University of Vermont, Burlington, VT
| | - Shelly Naud
- Department of Biostatistics, University of Vermont, Burlington, VT
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Livingstone‐Banks J, Ordóñez‐Mena JM, Hartmann‐Boyce J. Print-based self-help interventions for smoking cessation. Cochrane Database Syst Rev 2019; 1:CD001118. [PMID: 30623970 PMCID: PMC7112723 DOI: 10.1002/14651858.cd001118.pub4] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Many smokers give up smoking on their own, but materials that provide a structured programme for smokers to follow may increase the number who quit successfully. OBJECTIVES The aims of this review were to determine the effectiveness of different forms of print-based self-help materials that provide a structured programme for smokers to follow, compared with no treatment and with other minimal contact strategies, and to determine the comparative effectiveness of different components and characteristics of print-based self-help, such as computer-generated feedback, additional materials, tailoring of materials to individuals, and targeting of materials at specific groups. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group Trials Register, ClinicalTrials.gov, and the International Clinical Trials Registry Platform (ICTRP). The date of the most recent search was March 2018. SELECTION CRITERIA We included randomised trials of smoking cessation with follow-up of at least six months, where at least one arm tested print-based materials providing self-help compared with minimal print-based self-help (such as a short leaflet) or a lower-intensity control. We defined 'self-help' as structured programming for smokers trying to quit without intensive contact with a therapist. DATA COLLECTION AND ANALYSIS We extracted data in accordance with standard methodological procedures set out by Cochrane. The main outcome measure was abstinence from smoking after at least six months' follow-up in people smoking at baseline. We used the most rigorous definition of abstinence in each study and biochemically validated rates when available. Where appropriate, we performed meta-analysis using a random-effects model. MAIN RESULTS We identified 75 studies that met our inclusion criteria. Many study reports did not include sufficient detail to allow judgement of risk of bias for some domains. We judged 30 studies (40%) to be at high risk of bias for one or more domains.Thirty-five studies evaluated the effects of standard, non-tailored self-help materials. Eleven studies compared self-help materials alone with no intervention and found a small effect in favour of the intervention (n = 13,241; risk ratio (RR) 1.19, 95% confidence interval (CI) 1.03 to 1.37; I² = 0%). We judged the evidence to be of moderate certainty in accordance with GRADE, downgraded for indirect relevance to populations in low- and middle-income countries because evidence for this comparison came from studies conducted solely in high-income countries and there is reason to believe the intervention might work differently in low- and middle-income countries. This analysis excluded two studies by the same author team with strongly positive outcomes that were clear outliers and introduced significant heterogeneity. Six further studies of structured self-help compared with brief leaflets did not show evidence of an effect of self-help materials on smoking cessation (n = 7023; RR 0.87, 95% CI 0.71 to 1.07; I² = 21%). We found evidence of benefit from standard self-help materials when there was brief contact that did not include smoking cessation advice (4 studies; n = 2822; RR 1.39, 95% CI 1.03 to 1.88; I² = 0%), but not when self-help was provided as an adjunct to face-to-face smoking cessation advice for all participants (11 studies; n = 5365; RR 0.99, 95% CI 0.76 to 1.28; I² = 32%).Thirty-two studies tested materials tailored for the characteristics of individual smokers, with controls receiving no materials, or stage-matched or non-tailored materials. Most of these studies used more than one mailing. Pooling studies that compared tailored self-help with no self-help, either on its own or compared with advice, or as an adjunct to advice, showed a benefit of providing tailored self-help interventions (12 studies; n = 19,190; RR 1.34, 95% CI 1.20 to 1.49; I² = 0%) with little evidence of difference between subgroups (10 studies compared tailored with no materials, n = 14,359; RR 1.34, 95% CI 1.19 to 1.51; I² = 0%; two studies compared tailored materials with brief advice, n = 2992; RR 1.13, 95% CI 0.86 to 1.49; I² = 0%; and two studies evaluated tailored materials as an adjunct to brief advice, n = 1839; RR 1.72, 95% CI 1.17 to 2.53; I² = 10%). When studies compared tailored self-help with non-tailored self-help, results favoured tailored interventions when the tailored interventions involved more mailings than the non-tailored interventions (9 studies; n = 14,166; RR 1.42, 95% CI 1.20 to 1.68; I² = 0%), but not when the two conditions were contact-matched (10 studies; n = 11,024; RR 1.07, 95% CI 0.89 to 1.30; I² = 50%). We judged the evidence to be of moderate certainty in accordance with GRADE, downgraded for risk of bias.Five studies evaluated self-help materials as an adjunct to nicotine replacement therapy; pooling three of these provided no evidence of additional benefit (n = 1769; RR 1.05, 95% CI 0.86 to 1.30; I² = 0%). Four studies evaluating additional written materials favoured the intervention, but the lower confidence interval crossed the line of no effect (RR 1.20, 95% CI 0.91 to 1.58; I² = 73%). A small number of other studies did not detect benefit from using targeted materials, or find differences between different self-help programmes. AUTHORS' CONCLUSIONS Moderate-certainty evidence shows that when no other support is available, written self-help materials help more people to stop smoking than no intervention. When people receive advice from a health professional or are using nicotine replacement therapy, there is no evidence that self-help materials add to their effect. However, small benefits cannot be excluded. Moderate-certainty evidence shows that self-help materials that use data from participants to tailor the nature of the advice or support given are more effective than no intervention. However, when tailored self-help materials, which typically involve repeated assessment and mailing, were compared with untailored materials delivered similarly, there was no evidence of benefit.Available evidence tested self-help interventions in high-income countries, where more intensive support is often available. Further research is needed to investigate effects of these interventions in low- and middle-income countries, where more intensive support may not be available.
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Do HP, Tran BX, Le Pham Q, Nguyen LH, Tran TT, Latkin CA, Dunne MP, Baker PR. Which eHealth interventions are most effective for smoking cessation? A systematic review. Patient Prefer Adherence 2018; 12:2065-2084. [PMID: 30349201 PMCID: PMC6188156 DOI: 10.2147/ppa.s169397] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
PURPOSE To synthesize evidence of the effects and potential effect modifiers of different electronic health (eHealth) interventions to help people quit smoking. METHODS Four databases (MEDLINE, PsycINFO, Embase, and The Cochrane Library) were searched in March 2017 using terms that included "smoking cessation", "eHealth/mHealth" and "electronic technology" to find relevant studies. Meta-analysis and meta-regression analyses were performed using Mantel-Haenszel test for fixed-effect risk ratio (RR) and restricted maximum-likelihood technique, respectively. Protocol Registration Number: CRD42017072560. RESULTS The review included 108 studies and 110,372 participants. Compared to nonactive control groups (eg, usual care), smoking cessation interventions using web-based and mobile health (mHealth) platform resulted in significantly greater smoking abstinence, RR 2.03 (95% CI 1.7-2.03), and RR 1.71 (95% CI 1.35-2.16), respectively. Similarly, smoking cessation trials using tailored text messages (RR 1.80, 95% CI 1.54-2.10) and web-based information and conjunctive nicotine replacement therapy (RR 1.29, 95% CI 1.17-1.43) may also increase cessation. In contrast, little or no benefit for smoking abstinence was found for computer-assisted interventions (RR 1.31, 95% CI 1.11-1.53). The magnitude of effect sizes from mHealth smoking cessation interventions was likely to be greater if the trial was conducted in the USA or Europe and when the intervention included individually tailored text messages. In contrast, high frequency of texts (daily) was less effective than weekly texts. CONCLUSIONS There was consistent evidence that web-based and mHealth smoking cessation interventions may increase abstinence moderately. Methodologic quality of trials and the intervention characteristics (tailored vs untailored) are critical effect modifiers among eHealth smoking cessation interventions, especially for web-based and text messaging trials. Future smoking cessation intervention should take advantages of web-based and mHealth engagement to improve prolonged abstinence.
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Affiliation(s)
- Huyen Phuc Do
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia,
- Institute for Global Health Innovations, Duy Tan University, Danang, Vietnam,
| | - Bach Xuan Tran
- Department of Health, Behaviours and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Quyen Le Pham
- Department of Internal Medicine, Hanoi Medical University, Hanoi, Vietnam
| | - Long Hoang Nguyen
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Tung Thanh Tran
- Institute for Global Health Innovations, Duy Tan University, Danang, Vietnam,
| | - Carl A Latkin
- Department of Health, Behaviours and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Michael P Dunne
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia,
- Institute for Community Health Research, Hue University, Hue, Vietnam
| | - Philip Ra Baker
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia,
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Smoking Cessation for Smokers Not Ready to Quit: Meta-analysis and Cost-effectiveness Analysis. Am J Prev Med 2018; 55:253-262. [PMID: 29903568 PMCID: PMC6055474 DOI: 10.1016/j.amepre.2018.04.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 03/20/2018] [Accepted: 04/10/2018] [Indexed: 11/23/2022]
Abstract
CONTEXT To provide a systematic review and cost-effectiveness analysis on smoking interventions targeting smokers not ready to quit, a population that makes up approximately 32% of current smokers. EVIDENCE ACQUISITION Twenty-two studies on pharmacological, behavioral, and combination smoking-cessation interventions targeting smokers not ready to quit (defined as those who reported they were not ready to quit at the time of the study) published between 2000 and 2017 were analyzed. The effectiveness (measured by the number needed to treat) and cost effectiveness (measured by costs per quit) of interventions were calculated. All data collection and analyses were performed in 2017. EVIDENCE SYNTHESIS Smoking interventions targeting smokers not ready to quit can be as effective as similar interventions for smokers ready to quit; however, costs of intervening on this group may be higher for some intervention types. The most cost-effective interventions identified for this group were those using varenicline and those using behavioral interventions. CONCLUSIONS Updating clinical recommendations to provide cessation interventions for this group is recommended. Further research on development of cost-effective treatments and effective strategies for recruitment and outreach for this group are needed. Additional studies may allow for more nuanced comparisons of treatment types among this group.
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Wang MP, Li WH, Cheung YT, Lam OB, Wu Y, Kwong AC, Lai VW, Chan SS, Lam TH. Brief Advice on Smoking Reduction Versus Abrupt Quitting for Smoking Cessation in Chinese Smokers: A Cluster Randomized Controlled Trial. Nicotine Tob Res 2018; 20:67-72. [PMID: 28182243 DOI: 10.1093/ntr/ntx026] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 01/23/2017] [Indexed: 11/13/2022]
Abstract
Aims To compare the efficacy of brief advice about cut-down-to-quit (CDTQ) with that of brief advice about quit immediately (QI), as delivered by trained volunteers, without the use of pharmacological therapy, to outreach-recruited Chinese smokers in Hong Kong who intend to quit smoking. Methods Smokers (N = 1077) who enrolled in the Quit and Win Contest 2014 and intended to quit or reduce smoking were randomized in participation sessions to CDTQ (n = 559) and QI (n = 518) groups. Subjects in the CDTQ group received brief advice and a card about smoking reduction. Subjects in the QI group received brief advice and a leaflet about quitting smoking. All received a smoking cessation booklet and corresponding CDTQ or QI brief telephone advice at intervals of 1 week, 1 month, or 2 months. The primary outcomes were self-reported 7-day point prevalence abstinence (PPA) at the 3-month and 6-month follow-ups. The secondary outcomes included abstinence rate as validated by biochemical tests, smoking reduction (≥50% reduction from baseline), and quit attempt (QA). The outcome assessors were blinded as to group assignment. Results By intention to treat, the QI and CDTQ groups showed similar results as regards (i) self-reported PPA (10.6% [95% CI 8.1%-13.6%] vs. 9.1% [95% CI 6.9%-11.8%]), (ii) validated abstinence rate (5.6% [3.8%-7.9%] vs. 5.4% [3.6%-7.6%]), and (iii) QA rate (59.2% [53.5%-64.8%] vs. 54.1% [48.7%-59.3%]) at 6-month. However, the CDTQ group showed a significantly higher reduction rate than the QI group (20.9% [CI 17.6%-24.5%] vs. 14.5% [11.6%-17.8%]). The overall intervention adherence was suboptimal (45.4%), particularly in the CDTQ group (42.3%). Self-efficacy as regards quitting of smoking was similar between the groups at 6 months. Conclusions Brief advice on CDTQ and QI had similar short-term PPAs. Longer-term follow-up is needed to understand the latent effect of smoking reduction on abstinence. Implications This is the first randomized controlled trial in ethnic Chinese smokers to evaluate the relative efficacy of brief advice on (a) CDTQ and (b) QI as regards quitting. The two interventions showed similar effects as regards PPA. The findings suggested that brief advice on CDTQ may be as effective as brief advice on QI in smokers recruited in community settings.
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Affiliation(s)
- Man Ping Wang
- School of Nursing, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - William H Li
- School of Nursing, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Yee Tak Cheung
- School of Nursing, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.,School of Public Health, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Oi Bun Lam
- School of Nursing, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Yongda Wu
- School of Nursing, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Antonio C Kwong
- Hong Kong Council on Smoking and Health, Hong Kong Special Administrative Region, People's Republic of China
| | - Vienna W Lai
- Hong Kong Council on Smoking and Health, Hong Kong Special Administrative Region, People's Republic of China
| | - Sophia S Chan
- School of Nursing, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Tai Hing Lam
- School of Public Health, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
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9
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Klemperer EM, Hughes JR. Commentary on Wu et al. (2017): Do very brief reduction interventions increase quitting among smokers not ready to quit? Addiction 2017; 112:2041-2042. [PMID: 28990300 DOI: 10.1111/add.13970] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 07/20/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Elias M Klemperer
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA.,Department of Psychiatry, University of Vermont, Burlington, VT, USA.,Department of Psychological Sciences, University of Vermont, Burlington, VT, USA
| | - John R Hughes
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA.,Department of Psychiatry, University of Vermont, Burlington, VT, USA.,Department of Psychological Sciences, University of Vermont, Burlington, VT, USA
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10
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Wu L, He Y, Jiang B, Zhang D, Tian H, Zuo F, Lam TH. Very brief physician advice and supplemental proactive telephone calls to promote smoking reduction and cessation in Chinese male smokers with no intention to quit: a randomized trial. Addiction 2017. [PMID: 28623848 DOI: 10.1111/add.13908] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND AIMS There is inconsistent evidence that behavioural support to promote smoking reduction is effective at increasing smoking cessation. We examined the effectiveness of brief physician advice together with four very brief telephone calls in promoting smoking cessation among Chinese men via reduction compared with equivalent advice on diet and exercise. DESIGN A two-group pragmatic randomized controlled trial. PARTICIPANTS AND SETTING Male patients attending the Endocrinology and Acupuncture out-patient clinics of a general hospital in Beijing, China. INTERVENTION AND COMPARATORS Physicians advised participants allocated to the smoking-reduction intervention (SRI, n = 181) group to reduce smoking to at least half of their current consumption within 1 month at baseline. At follow-up, a telephone counsellor repeated this advice if the participant had not reduced their cigarette consumption. Participants who had reduced consumption were encouraged to quit smoking. Physicians gave participants in the exercise and diet advice (EDA, n = 188) control group brief advice about physical activity and healthy diet at baseline, and a telephone counsellor reinforced this at each follow-up interview. Both groups had one face-to-face interview at baseline plus five telephone interviews and interventions (approximately 1 minute each) at 1 week and 1-, 3-, 6- and 12-month follow-up. MEASUREMENTS The primary outcome was self-reported 6-month prolonged abstinence rate at 12-month follow-up interview. FINDINGS By intention-to-treat, the self-reported 6-month prolonged abstinence rate at 12-month follow-up in the SRI groups (19 quitters, 15.7%) was higher, but not significantly, than the EDA control group (10 quitters, 7.8%), and the adjusted odds ratio (OR) and 95% confidence interval (CI) was 2.26 (0.97-5.26), P = 0.062. The self-reported 7-day point prevalence quit rate (secondary outcome) in the SRI group was significantly higher than the control group at each follow-up interview (at 12-month follow-up: 13.3 versus 6.9%, OR (95% CI) = 2.09 (1.01, 4.34), P = 0.049). CONCLUSIONS A very brief, proactive and low-cost smoking-reduction intervention without medications for Chinese male smokers with no intention to quit appears to increase smoking abstinence.
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Affiliation(s)
- Lei Wu
- Institute of Geriatrics, Chinese People's Liberation Army of China General Hospital, Beijing, China.,Beijing Key Laboratory of Aging and Geriatrics, Chinese People's Liberation Army of China General Hospital, Beijing, China
| | - Yao He
- Institute of Geriatrics, Chinese People's Liberation Army of China General Hospital, Beijing, China.,Beijing Key Laboratory of Aging and Geriatrics, Chinese People's Liberation Army of China General Hospital, Beijing, China.,State Key Laboratory of Kidney Disease, Chinese People's Liberation Army of China General Hospital, Beijing, China
| | - Bin Jiang
- Nanlou Department of Acupuncture, Chinese People's Liberation Army of China General Hospital, Beijing, China
| | - Di Zhang
- Institute of Geriatrics, Chinese People's Liberation Army of China General Hospital, Beijing, China.,Beijing Key Laboratory of Aging and Geriatrics, Chinese People's Liberation Army of China General Hospital, Beijing, China
| | - Hui Tian
- Nanlou Department of Endocrinology, Chinese People's Liberation Army of China General Hospital, Beijing, China
| | - Fang Zuo
- Nanlou Department of Acupuncture, Chinese People's Liberation Army of China General Hospital, Beijing, China
| | - Tai Hing Lam
- Institute of Geriatrics, Chinese People's Liberation Army of China General Hospital, Beijing, China.,School of Public Health, The University of Hong Kong, Hong Kong
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Loreto AR, Carvalho CFC, Frallonardo FP, Ismael F, Andrade AGD, Castaldelli-Maia JM. Smoking Cessation Treatment for Patients With Mental Disorders Using CBT and Combined Pharmacotherapy. J Dual Diagn 2017; 13:238-246. [PMID: 28489501 DOI: 10.1080/15504263.2017.1328149] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVES The aim of this study was to investigate smoking treatment effectiveness and retention in a population with and without mental disorders (MD). Participants received cognitive behavioral therapy (CBT) plus nicotine patch alone or in combination with other medications (i.e., gum, bupropion, or nortriptyline) for smoking cessation treatment in a Brazilian Psychosocial Care Center unit (CAPS), taking into account sociodemographics and smoking profile covariates. METHODS The study involved comparison of treatment success (seven-day point prevalence abstinence at the end of the treatment) and retention (presence of the individual in all of the four medical consultations and six group sessions) in two subsamples of patients with MD (n = 267) and without MD (n = 397) who were included in a six-week treatment provided by a CAPS from 2007 to 2013. The treatment protocol comprised group CBT and pharmacotherapy (nicotine patches, nicotine gums, and bupropion and nortriptyline available, prescribed by psychiatrists). RESULTS Within patients with MD, CBT plus nicotine patch plus bupropion (aOR = 2.00, 95% CI [1.14, 3.50], p = .015) and CBT plus nicotine patch plus gum (aOR = 2.10, 95% CI [1.04, 4.23], p = .036) were associated with treatment success. Within patients without MD, female gender (aOR = 0.60, 95% CI [0.37, 0.95], p = .031) and lower Heaviness of Smoking Index score (aOR = 0.80, 95% CI [0.65, 0.99], p = .048) were associated with treatment success. No variable was associated with dropout or retention within patients with or without MD. CONCLUSION Our findings support the use of CBT plus nicotine patch plus bupropion as well as CBT plus nicotine patch plus gum in samples with high rates of medical, psychiatric, and addiction disorders. These findings support those of previous studies in the general population. Pharmacological treatment associated with group CBT based on cognitive-behavioral concepts and combined with ongoing MD treatment seems to be the best option for smoking cessation treatment among patients with MD. Units that deal with patients with MD, such as CAPS in Brazil, should be encouraged to treat smoking addiction in this population. Future studies should investigate retention rates in other samples of patients with MD.
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Affiliation(s)
- Aline Rodrigues Loreto
- a Department of Neuroscience , Medical School, Fundação ABC , Santo André , São Paulo , Brazil
| | | | - Fernanda Piotto Frallonardo
- a Department of Neuroscience , Medical School, Fundação ABC , Santo André , São Paulo , Brazil.,c ABC Center for Mental Health Studies , Santo André , São Paulo , Brazil
| | - Flavia Ismael
- a Department of Neuroscience , Medical School, Fundação ABC , Santo André , São Paulo , Brazil.,c ABC Center for Mental Health Studies , Santo André , São Paulo , Brazil
| | - Arthur Guerra de Andrade
- a Department of Neuroscience , Medical School, Fundação ABC , Santo André , São Paulo , Brazil.,c ABC Center for Mental Health Studies , Santo André , São Paulo , Brazil.,d Department of Psychiatry , Medical School, University of São Paulo , São Paulo , São Paulo , Brazil
| | - João Maurício Castaldelli-Maia
- a Department of Neuroscience , Medical School, Fundação ABC , Santo André , São Paulo , Brazil.,b Clima Clinic , São Paulo , SP , Brazil.,c ABC Center for Mental Health Studies , Santo André , São Paulo , Brazil.,d Department of Psychiatry , Medical School, University of São Paulo , São Paulo , São Paulo , Brazil
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Klemperer EM, Hughes JR, Solomon LJ, Callas PW, Fingar JR. Motivational, reduction and usual care interventions for smokers who are not ready to quit: a randomized controlled trial. Addiction 2017; 112:146-155. [PMID: 27566993 PMCID: PMC5152625 DOI: 10.1111/add.13594] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Revised: 06/20/2016] [Accepted: 08/25/2016] [Indexed: 11/29/2022]
Abstract
AIMS To test whether, in comparison to usual care, brief motivational or reduction interventions increase quit attempts (QA) or abstinence among smokers who are not ready to quit. DESIGN A parallel-group randomized controlled trial of brief motivational (n = 185), reduction (n = 186) or usual care (n = 189) telephone interventions delivered over the course of 4 weeks. Outcomes were assessed at 6- and 12-month follow-ups. No medication was provided. SETTING United States. PARTICIPANTS A total of 560 adult smokers of ≥ 10 cigarettes per day who were not ready to quit in the next 30 days. MEASUREMENTS The primary outcomes were whether participants made a QA that lasted ≥ 24 hours and whether they made a QA of any length between baseline and 6 months. Secondary outcomes included 7-day point-prevalence abstinence at 6 and 12 months. The 12-month follow-up was added after the study began. FINDINGS A priori-defined comparisons were between motivational versus usual care and reduction versus usual care conditions. The probability of making a QA that lasted ≥ 24 hours was not significantly different between the motivational (38%) or the reduction (31%) conditions and the usual care (34%) condition [motivational versus usual care odds ratio (OR) = 1.19, 95% confidence interval (CI) = 0.78-1.82; reduction versus usual care OR = 0.89, 95% CI = 0.57-1.36]. Bayes factors ranged from 0.13 to 0.18. Findings regarding a QA of any length were similar. At 6 months, the motivational condition had marginally more abstinence than usual care (11 versus 5%, OR = 2.17, 95% CI = 0.99-4.77), but the reduction condition was not significantly different from usual care (8 versus 5%, OR = 1.57, 95% CI = 0.69-3.59). At 12 months, the motivational condition had significantly more abstinence than usual care (10 versus 4%, OR = 2.80, 95% CI = 1.14-6.88) and the reduction condition had marginally more abstinence than usual care (9 versus 4%, OR = 2.45, 95% CI = 0.98-6.09). CONCLUSIONS Among adult smokers who are not ready to quit, both logistic regression and Bayesian analysis indicate that neither motivational nor reduction-based telephone interventions increased the odds of making a quit attempt in comparison to usual care at 6 months. The motivational intervention appeared to increase abstinence at 6 months and did increase abstinence at 12 months. The reduction intervention did not increase abstinence at 6 months but appeared to increase abstinence at 12 months.
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Affiliation(s)
- Elias M. Klemperer
- Vermont Center on Behavior & Health, University of Vermont
- Departments of Psychiatry, University of Vermont
- Psychological Science, University of Vermont
| | - John R. Hughes
- Vermont Center on Behavior & Health, University of Vermont
- Departments of Psychiatry, University of Vermont
- Psychological Science, University of Vermont
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