Predictors of past quit attempts and duration of abstinence among cigarette smokers

Correlates of nicotine dependence among patients visiting a tobacco cessation centre in India: A retrospective analysis

Background We did a retrospective secondary analysis of 1-year data of a tobacco cessation clinic (TCC) to assess correlates of nicotine dependence among tobacco users visiting the TCC at a tertiary care dental hospital. Methods Secondary data were obtained from the records of patients who had visited the TCC from January to December 2019. Of the 1436 records, 1144 were found to contain all the information needed for the study. Patient records were obtained from a pre-validated standard TCC patient assessment sheet (PAS), which included various sections: Sociodemo-graphic items, tobacco use profile items, nicotine dependence status, strategy used for cessation and follow-up details. Results Of the 1144 proformas, 97.1% (n=1111) were of men and 2.9% (n=33) were of women. Around 48.5% had medium nicotine dependence followed by high nicotine dependence (29.7%) and low nicotine dependence (21.8%). The mean (SD) age of initiation of tobacco use was 26.1 (9.44) years and a significantly lower age of initiation was observed in patients with high nicotine dependence. Greater number of years of tobacco use was significantly associated with high nicotine dependence. About 47% of patients had attempted to quit tobacco in the past and the quitting attempts were found to be significantly higher in patients with high dependence. Conclusion We explored crucial determinants of nicotine dependence among tobacco users reporting to the TCC. These factors may be incorporated in routine assessment of the tobacco use status and may be used in tailored cessation counselling strategies.

Why Can't I Stop Smoking: Predictors of Tobacco Use and Quit Rates in the Freedom From Tobacco Program

Introduction  As the leading cause of preventable chronic diseases in adults 18 years and older, tobacco usage in the U.S. results in over 20 million premature deaths annually. Current smokers might need extra support on the path to successfully quitting.  Aim To evaluate the influence of predictors of smoking-on-smoking cessation in the Freedom From Tobacco Program (FFT) offered by Southern California Permanente Medical Group (SCPMG). Methods This was a quasi-experimental study to evaluate rates of smoking cessation among participants in the FFT program. There were 471 participants in the study. Factors of the Social Ecological Model (SEM) and demographics were examined to determine if they could predict tobacco cessation. The SEM suggests that an individual's behavior is integrated into a network of intrapersonal characteristics, interpersonal processes, institutional factors, community features, and public policy. In particular, the study mainly addressed the institutional factor. It was promoted within a Health Management Organization and the interpersonal process because it was a group intervention.  Findings  After multiple regression analyses with all predictors from the SEM and demographics, the only significant predictor was the number of previous attempts to quit. Smokers who tried to stop four or more times in the past were 2.6 times (p<0.03) more likely to quit than those who tried fewer times. As we are aware, this was the first time this result was found for programs implemented by Health Management Organizations. The general quit rate at 12 months for the FFT program was 43.1%. Conclusion As the only predictor of quitting in this study was the number of previous attempts to quit smoking, the recommendation is to develop longer-term smoking cessation programs or a longer follow-up to facilitate smokers who relapse to go back and try to quit again. Another recommendation is to identify the main reasons for relapse and try to address these factors in further interventions.

Strict and Comprehensive Tobacco Control Policy is Needed: A Qualitative Study Exploring How People Responding a New Policy of Pictorial Health Warning on Cigarette Package in Indonesia

BACKGROUND: Little is known about the process on how smoker and nonsmoker responses to a Pictorial Health Warning (PHW) which is important for policy improvement. AIM: We aim to explore the nature of the reaction and the extent of impact of the PHW implementation on smoking habit in Indonesia. METHODS: We collected the data among adult aged 18+ years in Sleman District, Yogyakarta, Indonesia, involving 45 informants in in-depth interviews and 22 informants in four Focus Group Discussions, selected using the maximum variation sampling according to smoking status and area of residence. We discussed with respondents about the meaning of the PHWs, how they felt when seeing the PHWs, how those feelings emerged when seeing the PHWs, and the impact of seeing the PHWs. We analyzed the data using the content analysis. RESULTS: PHWs raised the intended negative emotional response, that wearing out over time. However, for smokers, the disease threat in the message was less obvious than to defeat smoking addiction. Smokers tried to manage their risk of illness themselves. Among non-smokers, they were more confident in being non-smokers. Both smokers and non-smokers thought that Government is half-hearted in controlling the smoking problem. Smokers were grateful, but non-smokers were sorry for this. CONCLUSIONS: The application of PHW threatens smokers but does not make them quit smoking because of the fear of defeating cigarette dependence. For non-smokers, they feel more confident to be a smoker-free. Respondents claim the government is not serious about controlling smoking.

Relationships among Self-Efficacy, Quality of Life, Perceived Vulnerability, and Readiness to Quit Smoking in People Living with HIV

Smoking-related diseases (e.g., lung cancer) are the leading cause of mortality in HIV-infected patients. While many PLWH who smoke report a desire to quit, a majority of them have low readiness to quit. This study used logistic and linear regression to examine the relations among two (continuous vs. binary) measures of readiness to quit, smoking cessation self-efficacy (SE), quality of life (QoL), and perceived vulnerability (PV) using baseline data from 100 PLWH who smoke who participated in a clinical trial. Results showed no significant main effects (SE, QoL, and PV) or interaction effects (SE × QoL and SE × PV) on a continuous measure of readiness to quit. However, a follow-up analysis revealed that SE had a curvilinear effect on readiness to quit such that self-efficacy was positively associated with readiness to quit except at the highest levels of self-efficacy where readiness to quit declined. Greater SE significantly increased the likelihood of reporting readiness to quit (yes/no) among those with low QoL or high PV. For PLWH who smoke, improving self-efficacy may increase readiness to quit especially among those with lower quality of life. Psychoeducation tailored to PLWH designed to reduce unrealistic invulnerability to smoking-related diseases along with interventions that target self-efficacy may improve readiness to quit.

Smoking Cessation Intention and Its Association with Advice to Quit from Significant Others and Medical Professionals

Few studies have simultaneously considered the effects of significant others and medical professionals’ advice to quit smoking on smoking cessation intention. The present study involved 3841 current adult Korean smokers, divided into four groups with an intention to quit within 1 month, within 6 months, someday, and without intention to quit. Multinomial multiple logistic regression analysis was conducted according to smoking cessation intention level, adjusted for potential confounders, including past smoking cessation attempts. Smokers who had been advised to quit smoking by both significant others and medical professionals, significant others only, and medical professionals only were 2.63 (95% confidence interval (CI): 1.62–4.29), 1.84 (95% CI: 1.17–2.89), and 1.44 (95% CI: 0.70–2.94) times more likely to intend to quit within 1 month, respectively, than those who were not advised to quit. The odds ratios of an intention to quit within 6 months were 2.91 (95% CI: 1.87–4.54), 2.49 (95% CI: 1.69–3.68), and 0.94 (95% CI: 0.44–2.05), respectively. To promote smokers’ intention to quit, the role of significant others should be considered. Medical professionals’ advice to quit smoking remains important, increasing the effects of significant others’ advice.

Prevalence and Factors Associated With Attempts to Quit and Smoking Cessation in Malaysia

Smoking cessation significantly reduces risk of smoking-related diseases and mortality. This study aims to determine the prevalence and factors associated with attempts to quit and smoking cessation among adult current smokers in Malaysia. Data from the National E-Cigarette Survey 2016 were analyzed. Forty nine percent of current smokers had attempted to quit at least once in the past 12 months and 31.4% of the respondents were former smokers. Multivariable analysis revealed that current smokers with low nicotine addiction and aged below 45 years were more likely to attempt to quit smoking. Being married, older age group, and having tertiary education were significantly associated with smoking cessation. Only half of the current smokers ever attempted to quit smoking and only a third of smokers quit. Stronger tobacco control policies are needed in Malaysia to encourage more smokers to quit smoking. Improved access to cessation support for underprivileged smokers is also needed.

Is There an Association Between the Degree of Nicotine Dependence and the Motivation to Stop Smoking?

OBJECTIVE

To evaluate the association between degrees of nicotine dependence measured by the Fagerström test (FTCD) and different tests of motivation to stop smoking.

MATERIAL AND METHODS

Observational study, multicenter conducted in smoking clinics in daily clinical practice. Demographics, smoking status, FTCD scores, and motivation test results were collected: Richmond test (TR), Henri Mondor Paris motivation test (HMP), Khimji-Watts test (KW), and the visual analog scale of motivation to stop smoking. The statistical analysis was descriptive, and correlation and analysis tests and regression models were used.

RESULTS

A total of 314 subjects were included [162 women (51.59%)]. Males smoked an average of 3.3 cigarettes/day more than women (95% CI: 0.9-5.6 cigarettes/day, p=0.006) and their cumulative consumption was 7.8 pack-years higher than in women (95% CI: 2.1 to 13.5 pack-years). We found no association between FTCD and the motivation tests to stop smoking used in this study.

CONCLUSIONS

We found no association between the degree of dependence and the motivation to quit smoking measured by the aforementioned instruments.

Factors associated with smoking cessation success in Lebanon

Objective:

The objective is to assess factors associated with the success rate of smoking cessation among Lebanese smokers in a smoking cessation center.

Methods:

A cross-sectional data study, conducted between March 2014 and March 2016 in an outpatient smoking cessation center with 156 enrolled patients. The patient’s nicotine dependence and motivation to quit smoking were evaluated according to the Fagerstrom Test for Nicotine Dependence and Richmond tests respectively.

Results:

The number of packs smoked per year decreased the odds of smoking cessation success (p=0.004, ORa=0.982, CI 0.97-0.994), while the compliance with the offered treatment increased the odds of success by 7.68 times (p<0.001, ORa=7.68, CI 3.438-17.187). Highly dependent and highly motivated smokers had more success in the quitting process compared to those with a lower dependence and motivation respectively.

Conclusion:

Our findings showed that many factors can influence smoking cessation, an experience described as difficult, most significantly the number of packs per year and compliance with the smoking cessation treatment. Moreover, although these outcomes are not representative of the entire Lebanese population, we believe that health authorities could utilize these results when implementing upcoming smoking cessations programs. All attempts at cessation should have a goal of reducing the number of packs smoked per year to improve the chances of ceasing into the future.