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Wang Y, Guadalupe-Fernández V, Salamanca LF, Saiz PG, Saiz JG, Sánchez CS. Characteristics of patients seeking outpatient smoking cessation treatment before and after the implementation of a smoke-free law in Valencia (Spain): a cross-sectional study. BMJ Open 2020; 10:e035319. [PMID: 32414826 PMCID: PMC7232619 DOI: 10.1136/bmjopen-2019-035319] [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] [Received: 10/28/2019] [Revised: 03/06/2020] [Accepted: 04/15/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Explore potential changes in the characteristics of patients requesting smoking cessation treatment at an outpatient setting in Spain before and after Law 42/2010 was enacted. DESIGN This is a cross-sectional study with convenience sampling. The information was obtained from the medical records of patients receiving smoking cessation treatment from January 2008 to December 2014. SETTING Hospital Clinico Universitario de Valencia. PARTICIPANTS 423 patients who sought smoking cessation treatment 36 months before or 48 months after the enactment of the law. RESULTS After the enactment of a comprehensive smoke-free law in Spain, the patients seeking smoking cessation treatment were older (p=0.003), had lower values of exhaled CO (p<0.0001), lower number of previous attempts to quit (p=0.027) and more history of medical problems related to smoking (p=0.002). CONCLUSION Our findings support the idea that society-nation level interventions could have an impact at the individual level, reflected by the change of patients' characteristics. It seems that the Law 42/2010 mobilised certain group of patients to seek treatment.
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Affiliation(s)
- Yang Wang
- Editorial department, Chinese General Practice Press, Beijing, China
| | - Víctor Guadalupe-Fernández
- Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Legal Medicine, University of Valencia, Valencia, Spain
| | - Ludwing Florez Salamanca
- Department of Psychiatry, Columbia University, New York, New York, USA
- Department of Psychiatry, New York State Psychiatric Institute, New York, New York, USA
| | - Patricia Guillem Saiz
- Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Legal Medicine, University of Valencia, Valencia, Spain
| | - Javier Guillem Saiz
- Department of Psychology, University International of Valencia, Valencia, Spain
| | - Carmen Saiz Sánchez
- Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Legal Medicine, University of Valencia, Valencia, Spain
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Ponciano-Rodríguez G, Reynales-Shigematsu LM, Rodríguez-Bolaños R, Pruñonosa-Santana J, Cartujano-Barrera F, Cupertino AP. Enhancing smoking cessation in Mexico using an e-Health tool in primary healthcare. SALUD PUBLICA DE MEXICO 2019; 60:549-558. [PMID: 30550116 DOI: 10.21149/9348] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 06/22/2018] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE To evaluate an e-Health tool designed to enhance smoking cessation in Mexico in primary healthcare. MATERIALS AND METHODS Smokers 18 years of age and older were recruited in the waiting room of two primary healthcare clinics in Mexico City. Participants used an eHealth smoking cessation tool that included smoking-related assessments, education on pharmacotherapy, and motivational videos. A follow-up assessment was conducted at 12 weeks week on smoking status. Logistic regression models were performed to identify factors associated with smoking cessation or consumption reduction. RESULTS A total of 132 smokers were enrolled in the study. At follow-up, 23.5% of participants self-reported smoking cessation. Among those who did not quit smoking, 65.0% decreased the number of cigarettes. Factors associated significantly with smoking cessation were: being a non-daily smoker, being interested in quitting smoking, having low level of physical dependence, and participating in cessation treatment. CONCLUSIONS The e-Health tool produced a high rate of smoking cessation. Better outcomes are obtained when this tool is used with conventional cessation programs.
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Affiliation(s)
- Guadalupe Ponciano-Rodríguez
- Departamento de Farmacología, Universidad Nacional Autónoma de México. Mexico City, Mexico.,Departamento de Salud Pública, Universidad Nacional Autónoma de México. Mexico City, Mexico
| | | | - Rosibel Rodríguez-Bolaños
- Departamento de Prevención y Control de Tabaquismo, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, Mexico
| | - Javier Pruñonosa-Santana
- Departamento de Prevención y Control de Tabaquismo, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, Mexico
| | | | - Ana Paula Cupertino
- Department of Biomedical Research, Medical Center, Hackensack University. Hackensack, NJ, US
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Effects of Delay Discounting and Other Predictors on Smoking Relapse. SPANISH JOURNAL OF PSYCHOLOGY 2019; 22:E9. [DOI: 10.1017/sjp.2019.11] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractDespite the substantial decrease in the prevalence of tobacco smoking and the availability of effective smoking cessation treatments, smoking relapse after formal treatments remains extremely high. Evidence regarding clinical predictors of relapse after quitting is essential to promote long-term abstinence among those who successfully quit. This study aimed to explore whether baseline delay discounting (DD) rates and other sociodemographic, psychological, and smoking-related variables predicted relapse to smoking at six-month follow-up. Participants were 188 adult smokers (mean age = 42.9, SD = 12.9; 64.4% females) who received one of three treatment conditions: 6-weeks of cognitive–behavioral treatment (CBT) alone; or combined with contingency management (CBT + CM); or combined with cue exposure treatment (CBT+CET). Smoking status was biochemically verified. Logistic regression was conducted to examine prospective predictors of smoking relapse at six months after an initial period of abstinence. Greater DD rates (OR: 0.18; 95% CI [0.03, 0.93]), being younger (OR: 0.96; 95% CI [0.94, 0.99]), high nicotine dependence (OR: 1.34; 95% CI [1.13, 1.60]), and a higher number of previous quit attempts (OR: 4.47; 95% CI [1.14, 17.44]) increased the likelihood of smoking relapse at six-month follow-up. Besides sociodemographic and smoking-related characteristics, greater DD predisposes successful quitters to relapse back to smoking. These results stress the relevance of incorporating specific treatment components for reducing impulsivity.
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Cobos-Campos R, Apiñaniz Fernández de Larrinoa A, Sáez de Lafuente Moriñigo A, Parraza Diez N, Aizpuru Barandiaran F. Effectiveness of Text Messaging as an Adjuvant to Health Advice in Smoking Cessation Programs in Primary Care. A Randomized Clinical Trial. Nicotine Tob Res 2018; 19:901-907. [PMID: 27838659 DOI: 10.1093/ntr/ntw300] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 11/10/2016] [Indexed: 12/22/2022]
Abstract
Introduction Smoking remains a major risk factor for chronic diseases. Health advice is considered one of the most cost-effective interventions; however, changes produced by counseling tend not to persist over time, it is necessary to implement enforcement mechanisms. Methods Randomized clinical trial to evaluate the effectiveness of a combined program that includes health advice and text messaging to mobile phone (SMSalud®). Patients were randomized to one of two interventions: health advice (control group) or health advice and text messaging (intervention group). We included 320 smoker patients who met the inclusion criteria: being motivated, aged over 18 years, having a mobile phone, being able to read and send messages. Patients were excluded if they had a history of mental or behavioral disorders, or depression. The primary endpoint was the percentage of patients who had stopped smoking by 6 months and confirmed by CO breath test. Results By 6 months after the start of the program, 24.4% (39/160) of patients in the intervention group and 11.9% (19/160) of controls had stopped smoking (OR: 2.3; 95% CI: 1.3-4.3, p = .007). Patients with no dependence or mild dependence were more likely to stop (28.3%, 36/127 vs. 11.4%, 22/193; OR: 3.0, 95% CI: 1.7-5.5, p < .001). The rate of continuous abstinence at 12 months was 16.3% (26/160) in intervention group patients and 5.6% (9/160) in controls (OR: 3.2; 95% CI: 1.3-5.9).]. Conclusions The combined program is effective for smoking cessation. Patients with less tobacco dependence have a higher probability of success. Implications Health advice is effective for promoting changes in lifestyle but these changes do not persist over time, so we have to use strengthening mechanisms, as e-health, and specifically, mobile phone based interventions. SMSalud® is an innovate program that includes text messaging and health advice, and it's effective for smoking cessation. The only feature that seems to affect the probability of smoking cessation is the degree of tobacco dependence.
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Affiliation(s)
- Raquel Cobos-Campos
- BIOARABA, Health Research Institute, Integrated Health Organization Araba (university hospital),Álava, Spain
| | | | | | - Naiara Parraza Diez
- BIOARABA, Health Research Institute, Integrated Health Organization Araba (university hospital),Álava, Spain
| | - Felipe Aizpuru Barandiaran
- BIOARABA, Health Research Institute, Integrated Health Organization Araba (university hospital), Álava, Spain.,Health Services Research on Chronic Patients Network (REDISSEC), Spain.,University of the Basque Country, Álava, Spain
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Walker NJ, van Woerden HC, Kiparoglou V, Yang Y, Robinson H, Croghan E. Gender difference and effect of pharmacotherapy: findings from a smoking cessation service. BMC Public Health 2016; 16:1038. [PMID: 27716223 PMCID: PMC5048401 DOI: 10.1186/s12889-016-3672-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 09/16/2016] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Smoking cessation services are available in England to provide assistance to those wishing to quit smoking. Data from one such service were analysed in order to investigate differences in quit rate between males and females prescribed with different treatments. METHODS A logistic regression model was fitted to the data using the binary response of self-reported quit (failed attempt = 0, successful attempt = 1), validated by Carbon Monoxide (CO) monitoring, 4 weeks after commencing programme. Main effects fitted were: client gender; age; region; the type of advisory sessions; and pharmacotherapy, Nicotine Replacement Therapy (NRT) or Varenicline. A second model was fitted including all main effects plus two-way interactions except region. These models were repeated using 12-week self-reported quit as the outcome. RESULTS At 4 weeks, all main effects were statistically significant, with males more likely (odds ratio and 95 % CI, females v males = 0.88 [0.79-0.97]), older smokers more likely (adjusted odds ratios [OR] and 95 % confidence interval [CI] respectively for groups 20-29, 30-49, 50-69 and 70+ vs 12-19 age group: 1.79 [1.39-2.31], 2.12 [1.68-2.68], 2.30 [1.80-2.92] and 2.47 [1.81-3.37] and for overall difference between groups, χ2(4) = 53.5, p < 0.001) and clients being treated with Varenicline more likely to have successfully quit than those on NRT (adjusted OR and 95 % CI for Varenicline vs NRT = 1.41 [1.21-1.64]). Statistically significant interactions were observed between (i) gender and type of counselling, and (ii) age and type of counselling. Similar results were seen in relation to main effects at 12 weeks except that type of counselling was non-significant. The only significant interaction at this stage was between gender and pharmacotherapy (adjusted OR and 95 % CI for females using Varenicline versus all other groups = 1.43 [1.06-1.94]). CONCLUSION Gender and treatment options were identified as predictors of abstinence at both 4 and 12 weeks after quitting smoking. Furthermore, interactions were observed between gender and (i) type of counselling received (ii) pharmacotherapy. In particular, the quit rate in women at 12 weeks was significantly improved in conjunction with Varenicline use. These findings have implications for service delivery.
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Affiliation(s)
- N. J. Walker
- Oxford Biomedical Research Centre, Churchill Hospital, Oxford, England
| | - H. C. van Woerden
- Institute of Primary Care & Public Health, Cardiff University, Cardiff, Wales
- Centre for Health Sciences, University of the Highlands and Islands, Inverness, Scotland
| | - V. Kiparoglou
- Oxford Biomedical Research Centre, Churchill Hospital, Oxford, England
| | - Y. Yang
- Nuffield Department of Primary Care Health Science, University of Oxford, Oxford, England
| | - H. Robinson
- Quit 51 Stop Smoking Service, Burton-on-Trent, England
| | - E. Croghan
- Quit 51 Stop Smoking Service, Burton-on-Trent, England
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Martínez-Vispo C, Becoña E. La sensibilidad a la ansiedad y el consumo de tabaco: una revisión. ANSIEDAD Y ESTRES-ANXIETY AND STRESS 2016. [DOI: 10.1016/j.anyes.2016.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Nerin I. Género y salud: Estudiar las diferencias para mejorar los resultados. Rev Clin Esp 2015; 215:391-2. [DOI: 10.1016/j.rce.2015.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 04/15/2015] [Indexed: 12/29/2022]
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Jiménez-Ruiz CA, Pascual Lledó JF, Cicero Guerrero A, Mayayo Ulibarri M, Cristóbal Fernández M, Perera López L. Searching for phenotypes in smoking cessation treatment. Int J Clin Pract 2014; 68:1530-9. [PMID: 25234284 DOI: 10.1111/ijcp.12490] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND It is important to define smoking phenotypes according to different variables, such as age, sex and degree of dependence, for which available treatments could have different efficacies. OBJECTIVE The main objective of our study was aimed at defining different combinations of these variables to allow the best possible treatment to be chosen in routine clinical practice. METHODS We reviewed the clinical records of smokers who had been treated in our Smoking Cessation Service. In all cases, the treatment programme consisted of a combination of behavioural therapy and optional drug treatment. RESULTS The group consisted of 3622 subjects, specifically 1757 men (48.5%). The mean age of the participants in the group was 48.11 ± 11.19 years. The mean score of the FTCD-questionnaire was 6.66 ± 2.38. In addition, 78% of the subjects smoked their first cigarette within 30 min after waking. For the total sample, continuous abstinence rate from 9 to 24 weeks was 57.7%. A multivariate analysis using the logistic regression model was implemented, and it showed that: (i) Nicotine Replacement Therapy was less effective in patients with high tobacco dependence, (ii) young subjects can be highly resistant to all treatments and (iii) subjects with low tobacco dependence can be treated with any treatment, but bupropion and varenicline provided the best results. CONCLUSION It was possible to identify several smoking phenotypes in which different treatments have different efficacies.
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Kim SE, Shim JH, Noh H, Hwang HS, Park HK. The Relationship between Smoking Status and Suicidal Behavior in Korean Adults: The 4th Korea National Health and Nutrition Examination Survey (2007-2009). Korean J Fam Med 2013; 34:178-89. [PMID: 23730485 PMCID: PMC3667225 DOI: 10.4082/kjfm.2013.34.3.178] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Accepted: 03/05/2013] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND This study was performed to evaluate the relationship between smoking status and suicidal ideations or suicide attempts in Korean adults. METHODS The study used data from the 4th Korea National Health and Nutrition Examination Survey, and involved 17,065 participants. We used multiple logistic regression analysis to evaluate the relationship between smoking status and suicidal behavior. The results were adjusted for covariates including depression and physical disease. RESULTS After adjusting for covariates, current smokers (odds ratio [OR], 1.66; 95% confidence interval [CI], 1.34 to 2.05) and former smokers (OR, 1.39; 95% CI, 1.13 to 1.72) proved more likely to have suicidal ideations than non-smokers. Among women, current smokers (OR, 2.00; 95% CI, 1.47 to 2.72) and former smokers (OR, 1.48; 95% CI, 1.11 to 1.99) were more likely to have suicidal ideations than non-smokers. However, among the men there was no significant relationship between smoking status and suicidal ideations. Among all the participants who had had suicidal ideations, there was a significant relationship between current smoking and suicide attempts (OR, 1.80; 95% CI, 1.05 to 3.07). There was also a relationship between current smoking and suicide attempts among women (OR, 2.40; 95% CI, 1.31 to 4.37), but no significant relationship among men. CONCLUSION There is a relationship between smoking status and suicidal ideations and suicide attempts in the general population of Korea. This relationship is particularly clear in women, and is independent of comorbid chronic disease and depression. Current smokers and former smokers are more likely to have suicidal ideations than non-smokers; current smokers are also more likely to have attempted suicide.
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Affiliation(s)
- So-Eun Kim
- Department of Family Medicine, Hanyang University College of Medicine, Seoul, Korea
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