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Jiang N, Huo LL, Zhang ZZ, Huang YQ, Li YH, Wang R, Guo Y, Qi F, Li SP. Predictors of quitting support from nonsmoking mothers for smoking fathers: a cross-sectional study from Chinese pupils' families. BMC Public Health 2024; 24:709. [PMID: 38443867 PMCID: PMC10916209 DOI: 10.1186/s12889-024-18217-2] [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: 07/20/2023] [Accepted: 02/26/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Quitting support from smokers' partners can predict quit attempts and smoking abstinence but research on factors that predict such support has been limited. To add more evidence for partner support and the improved interventions for smoking cessation, we analyzed some new potential predictors of quitting support from smokers' spouses. METHOD This cross-sectional study was conducted in in 2022 and 2023, selecting the students' families in which fathers smoked and mothers didn't smoke from grade 1-5 of 13 primary schools in Qingdao, China. Parents who met the criteria completed the online questionnaires and 1018 families were included in the analysis. We measured personal information related to smokers and their spouses such as age, education and nicotine dependence, and variables related to family and marital relationship such as family functioning, perceived responsiveness and power in decision-making of quitting smoking. Quitting support from smokers' spouses was measured by Partner Interaction Questionnaire and generalized linear model was used to explore the potential predictors of partner support. RESULTS In this study, the mean age of smokers was 39.97(SD = 5.57) and the mean age of smokers' spouses was 38.24(SD = 4.59). The regression analysis showed that for smokers and their spouses, the older age groups showed the lower ratio of positive/negative support(P < 0.05) and smokers with high education showed the less positive and negative partner support(P < 0.05). Nicotine dependence was positively associated with negative support (β = 0.120, P < 0.01), and perceived responsiveness (β = 0.124, P < 0.05) as well as family functioning (β = 0.059, P < 0.05) was positively associated with positive support. These three factors were associated with ratio of positive/negative support(P < 0.05). In addition, power of smoker's spouse in decision-making of quitting smoking was positively associated with the positive (β = 0.087, P < 0.001) and negative support (β = 0.084, P < 0.001). CONCLUSIONS Nicotine dependence, family functioning, power in decision-making of quitting smoking and perceived responsiveness were found to be the predictors of quitting support from smokers' spouses. By incorporating predictors of partner support and integrating some established theories that can improve family functioning and marital relationships, smoking cessation interventions can be further improved.
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Affiliation(s)
- Nan Jiang
- Department of Epidemiology and Health Statistics, School of Public Health, Qingdao University, Qingdao, Shandong, China
| | - Ling-Ling Huo
- Qingdao West Coast New District Center for Disease Control and Prevention, Qingdao, Shandong, China
| | - Zeng-Zhi Zhang
- Qingdao Shinan District Center for Disease Control and Prevention, Qingdao, Shandong, China
| | - Yi-Qing Huang
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, Shandong, China
| | - Yu-Hua Li
- Qingdao Shibei District Center for Disease Control and Prevention, Qingdao, Shandong, China
| | - Rui Wang
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, Shandong, China
| | - Yi Guo
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
- School of Public Health, Peking University, Beijing, China
| | - Fei Qi
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, Shandong, China.
| | - Shan-Peng Li
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, Shandong, China.
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Yuan P, Westmaas JL, Thrul J, Toussaert S, Hilton JF, White JS. Effectiveness of Peer-Support Interventions for Smoking Cessation: A Systematic Review and Meta-analysis. Nicotine Tob Res 2023; 25:1515-1524. [PMID: 37042206 DOI: 10.1093/ntr/ntad059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 01/23/2023] [Accepted: 04/10/2023] [Indexed: 04/13/2023]
Abstract
INTRODUCTION Peer support has been recommended to promote smoking cessation, but results from prior meta-analyses have not established its efficacy. We conducted a systematic review and meta-analysis to assess current evidence and identify potential modifiers of efficacy. METHODS Randomized controlled trials of peer-support interventions with a smoking cessation outcome were identified in January 2022 from PubMed and references listed in identified studies. The meta-analysis outcome measure was mean risk ratio (RR, 95% confidence interval [CI]) for abstinence at the longest follow-up timepoint between 3 and 9 months from baseline. Potential modifiers tested were peer smoking status (former, current, or unknown), follow-up timepoint, abstinence measure, and cumulative engagement time between peers and smokers ("dose"). Studies were assessed for risk of bias and certainty of evidence. RESULTS We identified 16 trials, which varied in abstinence effect size (RR 0.61-3.07), sample size (23-2121), dose (41-207 minutes), and follow-up timepoint (<1-15 months). Across 15 trials with follow-up between 3 and 9 months (N = 8573 participants; 4565 intervention, 4008 control), the pooled Mantel-Haenszel RR was 1.34 (95% CI: 1.11-1.62). Effect sizes were greatest among interventions with formerly smoking peers (RR 1.43, 95% CI 1.17-1.74; five trials). We found positive effects for follow-up timepoints ≥3 months but no effect of intervention dose. The overall quality of evidence was deemed "very low." CONCLUSIONS Peer-support interventions increased smoking abstinence. There remains a lack of consensus about how to define a peer. Intervention features such as peer smoking status appear to have explanatory power. Additional high-quality and more comparable trials are needed. IMPLICATIONS This study reviewed the latest evidence from randomized controlled trials and found that peer-support interventions enhance smoking cessation. Efficacy varies with key intervention features such as peer smoking status and follow-up timepoint, which may be used to facilitate development of more effective peer-support interventions. Future trials and reviews would benefit from careful consideration and clear reporting of peer smoking status, length of follow-up, abstinence measures, and intervention dose.
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Affiliation(s)
- Patrick Yuan
- Cancer Clinical Trials Office, Stanford University, Palo Alto, CA, USA
| | - J Lee Westmaas
- Population Science, American Cancer Society, Atlanta, Georgia, USA
| | - Johannes Thrul
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | | | - Joan F Hilton
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Justin S White
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA
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Longitudinal analysis of peer social support and quitting Smoking: Moderation by sex and implications for cessation interventions. Prev Med Rep 2022; 30:102059. [DOI: 10.1016/j.pmedr.2022.102059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 11/04/2022] [Accepted: 11/14/2022] [Indexed: 11/16/2022] Open
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Esmaeeli A, Pechmann CC, Prochaska JJ. Buddies as In-Group Influencers in Online Support Groups: A Social Network Analysis of Processes and Outcomes. JOURNAL OF INTERACTIVE MARKETING : A QUARTERLY PUBLICATION FROM THE DIRECT MARKETING EDUCATIONAL FOUNDATION, INC 2022; 57:198-211. [PMID: 35656556 PMCID: PMC9159674 DOI: 10.1177/10949968221076144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Buddies, serving as in-group influencers to aid demographically similar cobuddies, are extensively used in face-to-face support groups to enhance positive social influence. The authors examine the efficacy of buddies in online support groups and investigate underlying mediating processes using social network analysis. They observe what happens when members of support groups for quitting smoking, including members who are relatively active and less active in the group, after a few days are called on to be buddies and assigned to specific cobuddies. The findings indicate that, consistent with normative expectations for buddies, members form especially strong ties with their designated cobuddies. The more active buddies are in the group, the stronger the ties they form with their cobuddies and, in turn, their cobuddies form stronger ties with group members overall, which then relates to cobuddy goal attainment. The findings suggest that interactive marketers should consider using buddies in online support groups but observe activity levels before making buddy assignments, because positive outcomes are contingent on buddies being active in the group. Marketers should also ensure that online support group members post to everyone, not just their buddies, because ties formed among group members as a whole are crucial for goal attainment.
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Cao N, Li X, Chen H, Li X, Li W. Decisional Balance of Smoking and Planning to Quit Smoking: A Moderated Mediation Model among Chinese Male Smokers. J Psychoactive Drugs 2021; 54:158-166. [PMID: 34423746 DOI: 10.1080/02791072.2021.1942339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Decisional balance in quitting smoking involves positive and negative attitudes toward smoking. This study explored the relationship between the decisional balance of smoking and planning to quit smoking, and examined the mediating role of willingness to quit smoking and the moderating role of social support. A questionnaire survey was conducted among 326 daily male smokers from China in 2016, including the decisional balance of smoking, willingness to quit smoking, social support, planning to quit, and nicotine dependence. The results showed: (1) willingness to quit smoking mediated the relationship between the decisional balance of smoking and planning to quit smoking; (2) the relationship between the decisional balance of smoking and planning to quit smoking was moderated by emotional support rather than instrumental support. Smokers with a higher level of emotional support for quitting smoking were more likely to progress to planning to quit smoking, while this relationship was not found among smokers with a lower level of emotional support. These findings suggested that smokers' willingness to quit smoking would be key to promoting their planning to quit. Meanwhile, the dynamic process of planning to quit smoking was moderated by emotional support from others.
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Affiliation(s)
- Ningmeng Cao
- Department of Psychology, College of Education and Human Development, Normal University, Jinhua, Zhejiang, China
| | - Xinwei Li
- Department of Psychology, College of Education and Human Development, Normal University, Jinhua, Zhejiang, China
| | - Haide Chen
- Department of Psychology, College of Education and Human Development, Normal University, Jinhua, Zhejiang, China
| | - Xinyu Li
- Department of Psychology, College of Education and Human Development, Normal University, Jinhua, Zhejiang, China
| | - Weijian Li
- Department of Psychology, College of Education and Human Development, Normal University, Jinhua, Zhejiang, China
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White JS, Lowenstein C, Srivirojana N, Jampaklay A, Dow WH. Incentive programmes for smoking cessation: cluster randomized trial in workplaces in Thailand. BMJ 2020; 371:m3797. [PMID: 33055176 PMCID: PMC7555070 DOI: 10.1136/bmj.m3797] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/02/2020] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To compare several monetary incentive programmes for promoting smoking abstinence among employees who smoke at workplaces in a middle income country. DESIGN Parallel group, open label, assessor blinded, cluster randomized controlled trial. SETTING Large industrial workplaces in metropolitan Bangkok, Thailand. PARTICIPANTS Employees who smoked cigarettes and planned to quit within six months recruited from 101 worksite clusters (84 different companies). INTERVENTIONS Worksites were digitally cluster randomized by an independent investigator to usual care or usual care plus one of eight types of incentive programmes. Usual care consisted of one time group counseling and cessation support through a 28 day text messaging programme. The incentive programmes depended on abstinence at three months and varied on three intervention components: refundable deposits, assignment to a teammate, and bonus size ($20 (£15; €17) or $40). MAIN OUTCOME MEASURES The primary outcome was biochemically verified seven day point prevalence smoking abstinence at 12 months. Secondary outcomes were programme acceptance at enrollment and smoking abstinence at three months (end of intervention) and at six months. All randomized participants who had complete baseline information were included in intention-to-treat analyses; participants with missing outcomes were coded as continuing smokers. RESULTS Between April 2015 and August 2016, the trial enrolled 4190 participants. Eighteen were omitted because of missing baseline covariates and death before the primary endpoint, therefore 4172 participants were included in the intention-to-treat analyses. Programme acceptance was relatively high across all groups: 58.7% (2451/4172) overall and 61.3% (271/442) in the usual care group. Abstinence rates at 12 months did not differ among deposit programmes (336/2253, 14.9%) and non-deposit programmes (280/1919, 14.6%; adjusted difference 0.8 points, 95% confidence interval -2.7 to 4.3, P=0.65), but were somewhat lower for team based programmes (176/1348, 13.1%) than individual based programmes (440/2824, 15.6%; -3.2 points, -6.6 to -0.2, P=0.07), and higher for $40 bonus programmes (322/1954, 16.5%) than programmes with no bonus (148/1198, 12.4%; 5.9 points, 2.1 to 9.7, P=0.002). The $40 individual bonus was the most efficacious randomization group at all endpoints. Intervention components did not strongly interact with each other. CONCLUSIONS Acceptance of monetary incentive programmes for promoting smoking abstinence was high across all groups. The $40 individual bonus programmes increased long term smoking abstinence compared with usual care, although several other incentive designs did not, such as team based programmes and deposit programmes. Incentive design in workplace wellness programmes might influence their effectiveness at reducing smoking rates in low resource settings. TRIAL REGISTRATION ClinicalTrials.gov (NCT02421224).
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Affiliation(s)
- Justin S White
- Philip R Lee Institute for Health Policy Studies, University of California, San Francisco, 3333 California Street, Box 0936, San Francisco, CA 94118, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | | | - Nucharee Srivirojana
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand
| | - Aree Jampaklay
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand
| | - William H Dow
- School of Public Health, University of California, Berkeley, CA, USA
- Department of Demography, University of California, Berkeley, CA, USA
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White JS, Toussaert S, Thrul J, Bontemps-Jones J, Abroms L, Westmaas JL. Peer Mentoring and Automated Text Messages for Smoking Cessation: A Randomized Pilot Trial. Nicotine Tob Res 2020; 22:371-380. [PMID: 30892616 DOI: 10.1093/ntr/ntz047] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 03/19/2019] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Text-messaging programs for smoking cessation, while efficacious, have high dropout rates. To address this problem, we developed and tested the feasibility and early efficacy of a peer-mentoring intervention for smoking cessation provided by former smokers. METHODS Adult US smokers were recruited nationally into a randomized pilot trial (N = 200), comparing 6-8 weeks of automated text-messaging support (SmokefreeTXT) and automated text support plus personalized texts from a peer mentor who formerly smoked. The primary outcome was biochemically verified 7-day point-prevalence abstinence at 3 months post-quit date, assessed on an intention-to-treat basis (missing = smoking). Self-reported abstinence, program acceptability, user engagement, and user perceptions were also assessed. RESULTS Biochemically verified abstinence at 3 months was 7.9% (8/101) in the intervention group and 3.0% (3/99) in the control group (adjusted difference 6.5, 95% CI = 0.7% to 12.3%; p = .03). Self-reported abstinence at 3 months was 23.8% (24/101) in the intervention group versus 13.1% (13/99) in the control group (adjusted difference 12.7, 95% CI = 1.2% to 24.1%; p = .03). The intervention had a positive but insignificant effect on overall satisfaction (78.3% vs. 72.9% control group, p = .55). Having a mentor did not significantly alter duration of interaction with the program nor the proportion unsubscribing, although the intervention group reset their quit date with greater frequency (p < .01) and sent more messages (p < .01). CONCLUSIONS Peer mentoring combined with automated text messages was feasible and acceptable and increased smoking abstinence compared with automated messages alone. The results highlight the promise of this intervention approach and the need for a full-scale evaluation. IMPLICATIONS Providing quitting assistance by automated text messaging has been shown to increase smoking abstinence. Yet, dropout rates in text-messaging programs are high. No studies have tested the effectiveness of peer mentors who are former smokers as part of a text-messaging intervention, although they represent a promising way to retain, engage, and support smokers. This randomized pilot trial suggests that peer mentors can complement automated text-messaging programs to promote smoking abstinence.
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Affiliation(s)
- Justin S White
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA.,Department of Epidemiology and Biostatistics, University of California, San Francisco, CA
| | | | - Johannes Thrul
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | | - Lorien Abroms
- Department of Prevention and Community Health, George Washington University, Washington, DC
| | - J Lee Westmaas
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA
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Hasan MZ, Cohen JE, Bishai D, Kennedy CE, Rao KD, Ahuja A, Gupta S. Social capital and peer influence of tobacco consumption: a cross-sectional study among household heads in rural Uttar Pradesh, India. BMJ Open 2020; 10:e037202. [PMID: 32606063 PMCID: PMC7328809 DOI: 10.1136/bmjopen-2020-037202] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE Having the world's second-largest tobacco-consuming population, tobacco control is a priority agenda of the Indian Government. Yet, there is no evidence of how peer influence and nature of social relationships-defined as social capital-affect tobacco use. This study aimed to explore the role of social capital and peer influence on tobacco consumption among household heads in rural Uttar Pradesh (UP), India. DESIGN AND SETTING This study was embedded within the baseline evaluation of Project Samuday. A cross-sectional multistage cluster survey was implemented in six census blocks of Hardoi and Sitapur districts of UP from June to August 2017. Self-reported tobacco consumption status of randomly selected 6218 household heads (≥18 years; men vs women=5312 vs 906) was assessed from 346 rural communities. Peer influence of tobacco use was measured by the non-self cluster proportion of tobacco consumption among respondents. Community engagement, social support, trust and social cohesion were separately measured as unique facets of social capital both at individual and community levels using the Shortened Adapted Social Capital Assessment Tool in India (SASCAT-I). The explanatory power of covariates was assessed using gender-stratified generalised estimating equations (GEE) with robust-variance estimator. RESULT Tobacco consumption patterns were starkly different for men and women (71% vs 14%). The peer influence only affected men (adjusted odds ratio (AOR)=1.10, 95% CI: 1.05 to 1.16, p<0.01), whereas women were more likely to consume tobacco if they were more engaged with community organisations (AOR=1.33, 95% CI=1.07 to 1.66, p<0.01). CONCLUSION Gender alters the way social engagement affects tobacco use in rural India. Countering peer influence on Indian men should be prioritised as a tobacco control strategy. Moreover, as gender mainstreaming is a critical egalitarian agenda in India, further research is needed to understand how social engagement affects tobacco consumption behaviours among women.
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Affiliation(s)
- Md Zabir Hasan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
| | - Joanna E Cohen
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
- Institute for Global Tobacco Control (IGTC), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
| | - David Bishai
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
| | - Caitlin E Kennedy
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
| | - Krishna D Rao
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
| | - Akshay Ahuja
- School of Public Policy, Central European University, Budapest, Hungary
| | - Shivam Gupta
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
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Abstract
Background: Partner Assisted Smoking Cessation Treatment (PACT) was designed to improve smoking abstinence rates by integrating evidence-based relationship education strategies to build effective couple support into standard cognitive behavioral smoking cessation treatment (CBT). Methods: This small randomized clinical trial examined the feasibility, acceptability, and efficacy of PACT versus CBT in improving couple support processes and smoking outcomes, focusing on effect sizes. Thirty-eight smokers and their nonsmoking partners were randomized to and completed either PACT or CBT. Both treatments included 8 weekly group sessions and nicotine replacement therapy. Results: Treatment credibility and satisfaction were high and comparable between conditions, though perceived helpfulness and treatment engagement were higher in PACT (ds = .48-.68). Compared to CBT, PACT showed no difference in effects on perceived partner support, small effects on observed social support behaviors (ds = .23 to .46), a medium effect on dyadic efficacy (d = .63), and a large effect on active listening (d = .85). Biochemically-verified smoking abstinence rates did not differ between conditions at 12-week follow-up (CBT: 27.3%, PACT: 37.5%). Conclusions: PACT may have stronger effects than standard CBT on treatment engagement and some couple support processes, but not abstinence. Program refinement and testing in larger samples are needed.
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Lüscher J, Berli C, Schwaninger P, Scholz U. Smoking cessation with smartphone applications (SWAPP): study protocol for a randomized controlled trial. BMC Public Health 2019; 19:1400. [PMID: 31664959 PMCID: PMC6819348 DOI: 10.1186/s12889-019-7723-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 10/09/2019] [Indexed: 12/27/2022] Open
Abstract
Background Tobacco smoking remains one of the biggest public health threats. Smartphone apps offer new promising opportunities for supporting smoking cessation in real-time. The social context of smokers has, however, been neglected in smartphone apps promoting smoking cessation. This randomized controlled trial investigates the effectiveness of a smartphone app in which smokers quit smoking with the help of a social network member. Methods This protocol describes the design of a single-blind, two-arm, parallel-group, intensive longitudinal randomized controlled trial. Participants of this study are adult smokers who smoke at least one cigarette per day and intend to quit smoking at a self-set quit date. Blocking as means of group-balanced randomization is used to allocate participants to intervention or control conditions. Both intervention and control group use a smartphone-compatible device for measuring their daily smoking behavior objectively via exhaled carbon monoxide. In addition, the intervention group is instructed to use the SmokeFree Buddy app, a multicomponent app that also facilitates smoking-cessation specific social support from a buddy over a smartphone application. All participants fill out a baseline diary for three consecutive days and are invited to the lab for a background assessment. They subsequently participate in an end-of-day diary phase from 7 days before and until 20 days after a self-set quit date. Six months after the self-set quit date a follow-up diary for three consecutive days takes place. The primary outcome measures are daily self-reported and objectively-assessed smoking abstinence and secondary outcome measures are daily self-reported number of cigarettes smoked. Discussion This is the first study examining the effectiveness of a smoking cessation mobile intervention using the SmokeFree Buddy app compared to a control group in a real-life setting around a self-set quit date using a portable objective measure to assess smoking abstinence. Opportunities and challenges with running studies with smoking participants and certain design-related decisions are discussed. Trial registration This trial was prospectively registered on 04/04/2018 at ISRCTNregistry: ISRCTN11154315.
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Affiliation(s)
- Janina Lüscher
- Applied Social and Health Psychology, Department of Psychology, University of Zurich, Binzmuehlestrasse 14 / Box 14, 8050, Zurich, Switzerland.
| | - Corina Berli
- Applied Social and Health Psychology, Department of Psychology, University of Zurich, Binzmuehlestrasse 14 / Box 14, 8050, Zurich, Switzerland
| | - Philipp Schwaninger
- Applied Social and Health Psychology, Department of Psychology, University of Zurich, Binzmuehlestrasse 14 / Box 14, 8050, Zurich, Switzerland
| | - Urte Scholz
- Applied Social and Health Psychology and University Research Priority Program "Dynamics of Healthy Aging", Department of Psychology, University of Zurich, Binzmuehlestrasse 14 / Box 14, 8050, Zurich, Switzerland
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11
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Abstract
BACKGROUND While many cessation programmes are available to assist smokers in quitting, research suggests that support from individual partners, family members, or 'buddies' may encourage abstinence. OBJECTIVES To determine if an intervention to enhance one-to-one partner support for smokers attempting to quit improves smoking cessation outcomes, compared with cessation interventions lacking a partner-support component. SEARCH METHODS We limited the search to the Cochrane Tobacco Addiction Group Specialised Register, which was updated in April 2018. This includes the results of searches of the Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE (via OVID); Embase (via OVID); and PsycINFO (via OVID). The search terms used were smoking (prevention, control, therapy), smoking cessation and support (family, marriage, spouse, partner, sexual partner, buddy, friend, cohabitant and co-worker). We also reviewed the bibliographies of all included articles for additional trials. SELECTION CRITERIA We included randomised controlled trials recruiting people who smoked. Trials were eligible if they had at least one treatment arm that included a smoking cessation intervention with a partner-support component, compared to a control condition providing behavioural support of similar intensity, without a partner-support component. Trials were also required to report smoking cessation at six months follow-up or more. DATA COLLECTION AND ANALYSIS Two review authors independently identified the included studies from the search results, and extracted data using a structured form. A third review author helped resolve discrepancies, in line with standard methodological procedures expected by Cochrane. Smoking abstinence, biochemically verified where possible, was the primary outcome measure and was extracted at two post-treatment intervals where possible: at six to nine months and at 12 months or longer. We used a random-effects model to pool risk ratios from each study and estimate a summary effect. MAIN RESULTS Our update search identified 465 citations, which we assessed for eligibility. Three new studies met the criteria for inclusion, giving a total of 14 included studies (n = 3370). The definition of partner varied among the studies. We compared partner support versus control interventions at six- to nine-month follow-up and at 12 or more months follow-up. We also examined outcomes among three subgroups: interventions targeting relatives, friends or coworkers; interventions targeting spouses or cohabiting partners; and interventions targeting fellow cessation programme participants. All studies gave self-reported smoking cessation rates, with limited biochemical verification of abstinence. The pooled risk ratio (RR) for abstinence was 0.97 (95% confidence interval (CI) 0.83 to 1.14; 12 studies; 2818 participants) at six to nine months, and 1.04 (95% CI 0.88 to 1.22; 7 studies; 2573 participants) at 12 months or more post-treatment. Of the 11 studies that measured partner support at follow-up, only two reported a significant increase in partner support in the intervention groups. One of these studies reported a significant increase in partner support in the intervention group, but smokers' reports of partner support received did not differ significantly. We judged one of the included studies to be at high risk of selection bias, but a sensitivity analysis suggests that this did not have an impact on the results. There were also potential issues with detection bias due to a lack of validation of abstinence in five of the 14 studies; however, this is not apparent in the statistically homogeneous results across studies. Using the GRADE system we rated the overall quality of the evidence for the two primary outcomes as low. We downgraded due to the risk of bias, as we judged studies with a high weighting in analyses to be at a high risk of detection bias. In addition, a study in both analyses was insufficiently randomised. We also downgraded the quality of the evidence for indirectness, as very few studies provided any evidence that the interventions tested actually increased the amount of partner support received by participants in the relevant intervention group. AUTHORS' CONCLUSIONS Interventions that aim to enhance partner support appear to have no impact on increasing long-term abstinence from smoking. However, most interventions that assessed partner support showed no evidence that the interventions actually achieved their aim and increased support from partners for smoking cessation. Future research should therefore focus on developing behavioural interventions that actually increase partner support, and test this in small-scale studies, before large trials assessing the impact on smoking cessation can be justified.
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Affiliation(s)
- Babalola Faseru
- University of Kansas Medical CenterDepartment of Preventive Medicine and Public Health3901 Rainbow BoulevardKansas CityKSUSA66160
| | - Kimber P Richter
- University of Kansas Medical CenterDepartment of Preventive Medicine and Public Health3901 Rainbow BoulevardKansas CityKSUSA66160
| | - Taneisha S Scheuermann
- University of Kansas Medical CenterDepartment of Preventive Medicine and Public Health3901 Rainbow BoulevardKansas CityKSUSA66160
| | - Eal Whan Park
- Medical College of Dankook UniversityDepartment of Family Medicine16‐5 Anseo‐DongCheonanChungnamKorea, South330‐715
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Ollier W, Muir KR, Lophatananon A, Verma A, Yuille M. Risk biomarkers enable precision in public health. Per Med 2018; 15:329-342. [PMID: 29957132 DOI: 10.2217/pme-2017-0068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Precision medicine uses biomarkers to diagnose disease. However, they can also be used to measure risk of disease. Thus, biomarkers herald a new addition to public health - Precision Public Health. We examine the implications. Risk biomarkers are identified by analyzing population cohorts. They constitute risk factors in mathematical 'Disease Risk Models'. The risk may be fixed as in a genetic biomarker or variable as in some protein biomarkers. They help monitor current risk of disease in an individual, thereby aiding efforts to reduce risk. In the UK, the NHS Health Check system is a universal system for assessing risk and for risk reduction. The system can now make use of modern biomarkers once appropriate infrastructure and governance are in place.
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Affiliation(s)
- William Ollier
- Center for Epidemiology, Division of Population Health, Faculty of Biology, Medicine & Health, The University of Manchester, Stopford Building, 99 Oxford Rd, Manchester, M13 9PG, UK
| | - Kenneth R Muir
- Center for Epidemiology, Division of Population Health, Faculty of Biology, Medicine & Health, The University of Manchester, Stopford Building, 99 Oxford Rd, Manchester, M13 9PG, UK
| | - Artitaya Lophatananon
- Center for Epidemiology, Division of Population Health, Faculty of Biology, Medicine & Health, The University of Manchester, Stopford Building, 99 Oxford Rd, Manchester, M13 9PG, UK
| | - Arpana Verma
- Center for Epidemiology, Division of Population Health, Faculty of Biology, Medicine & Health, The University of Manchester, Stopford Building, 99 Oxford Rd, Manchester, M13 9PG, UK
| | - Martin Yuille
- Center for Epidemiology, Division of Population Health, Faculty of Biology, Medicine & Health, The University of Manchester, Stopford Building, 99 Oxford Rd, Manchester, M13 9PG, UK
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McRobbie H, Hajek P, Peerbux S, Kahan BC, Eldridge S, Trépel D, Parrott S, Griffiths C, Snuggs S, Myers Smith K. Tackling obesity in areas of high social deprivation: clinical effectiveness and cost-effectiveness of a task-based weight management group programme - a randomised controlled trial and economic evaluation. Health Technol Assess 2018; 20:1-150. [PMID: 27802843 DOI: 10.3310/hta20790] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND An increasing number of people require help to manage their weight. The NHS recommends weight loss advice by general practitioners and/or a referral to a practice nurse. Although this is helpful for some, more effective approaches that can be disseminated economically on a large scale are needed. OBJECTIVE To assess whether or not a task-based weight management programme [Weight Action Programme (WAP)] has better long-term effects than a 'best practice' intervention provided in primary care by practice nurses. DESIGN Randomised controlled trial with cost-effectiveness analysis. SETTING General practices in east London, UK. PARTICIPANTS Three hundred and thirty adults with a body mass index (BMI) of ≥ 30 kg/m2 or a BMI of ≥ 28 kg/m2 plus comorbidities were recruited from local general practices and via media publicity. Those who had a BMI of > 45 kg/m2, had lost > 5% of their body weight in the previous 6 months, were currently pregnant or taking psychiatric medications were excluded. Participants were randomised (2 : 1) to the WAP or nurse arms. INTERVENTIONS The WAP intervention was delivered in eight weekly group sessions that combined dietary and physical activity, advice and self-monitoring in a group-oriented intervention. The initial course was followed by 10 monthly group maintenance sessions open to all participants in this study arm. The practice nurse intervention (best usual care) consisted of four one-to-one sessions delivered over 8 weeks, and included standard advice on diet and physical activity based on NHS 'Change4Life' materials and motivational support. MAIN OUTCOME MEASURES The primary outcome measure was weight change at 12 months. Secondary outcome measures included change in BMI, waist circumference and blood pressure, and proportion of participants losing at least 5% and 10% of baseline body weight. Staff collecting measurements at the 6- and 12-month follow-ups were blinded to treatment allocation. The primary outcome measure was analysed according to the intention-to-treat principle, and included all participants with at least one recorded outcome at either 1, 2, 6 or 12 months. The analysis employed a mixed-effects linear regression model, adjusted for baseline weight, age, sex, ethnicity, smoking status and general practice. The European Quality of Life-5 Dimensions-5 Levels questionnaire was completed and used to estimate quality-adjusted life-years (QALYs) within the cost-effectiveness analysis. RESULTS There were 330 participants (WAP arm, n = 221; nurse arm, n = 109; 72% women). A total of 291 (88%) participants (WAP arm, n = 194; nurse arm, n = 97) were included in the main analysis for the primary outcome. Weight loss at 12 months was greater in the WAP arm than in the nurse intervention arm [-4.2 kg vs. -2.3 kg; difference -1.9 kg, 95% confidence interval (CI) -3.7 to -0.1 kg; p = 0.04]. Participants in the WAP arm were more likely than participants in the nurse arm to have lost at least 5% of their baseline body weight at 12 months (41% vs. 27%; odds ratio 14.61, 95% CI 2.32 to 91.96; p = 0.004). The incremental cost-effectiveness ratio for WAP over and above the nurse arm is £7742 per QALY. CONCLUSIONS A WAP delivered in general practice better promotes weight loss over 12 months than a best usual practice nurse-led weight loss programme. LIMITATIONS The trial recruited mostly women. Research is needed into factors that would make weight loss programmes more attractive to men. TRIAL REGISTRATION Current Controlled Trials ISRCTN45820471. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 20, No. 79. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Hayden McRobbie
- Health and Lifestyle Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Peter Hajek
- Health and Lifestyle Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Sarrah Peerbux
- Health and Lifestyle Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Brennan C Kahan
- Pragmatic Clinical Trials Unit, Queen Mary University of London, London, UK
| | - Sandra Eldridge
- Pragmatic Clinical Trials Unit, Queen Mary University of London, London, UK
| | - Dominic Trépel
- Department of Health Sciences, University of York, York, UK
| | - Steve Parrott
- Department of Health Sciences, University of York, York, UK
| | - Chris Griffiths
- Centre for Primary Care and Public Health, Blizard Institute, Queen Mary University of London, London, UK
| | - Sarah Snuggs
- Health and Lifestyle Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Katie Myers Smith
- Health and Lifestyle Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
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Ronchi F, Lewis L, Hauck YL, Doherty DA. Exploring young pregnant smokers' experiences with a self-nominated non-smoking buddy. Midwifery 2018; 59:68-73. [PMID: 29396382 DOI: 10.1016/j.midw.2018.01.002] [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] [Received: 06/30/2017] [Revised: 12/08/2017] [Accepted: 01/03/2018] [Indexed: 11/30/2022]
Abstract
INTRODUCTION psychosocial interventions can increase the proportion of women who stop smoking in pregnancy. There is limited research exploring self-nominated, non-smoking buddy support, to assist young pregnant smokers to quit. METHODS this qualitative descriptive study was embedded within a randomised controlled study assisting young (16 to 24 years) pregnant smokers to quit. Women were recruited from two public maternity hospitals in Western Australia. Interviews were performed every two weeks from recruitment to six weeks post birth. The study aim was to explore women's experiences with a self-nominated non-smoking buddy. Thematic analysis was utilised to identify common themes. FINDINGS a total of 204 interviews were performed with 36 women, who had a mean of six interviews, with four conducted in pregnancy and two post birth. Two themes were revealed. The first 'Challenges of finding the right buddy' reflected the experiences women had in finding a non-smoking buddy to provide support and encompassed three sub themes; 'The only non-smoker I know', 'Reluctance to alter the existing relationship' and 'Limited discussion around expectations of buddy support'. The second theme 'Sustaining the buddy relationship' centred on the continuing relationship the woman had with her buddy and encompassed three sub themes; 'Consistent relationship', 'Changeable buddies' and 'Unofficial buddies'. CONCLUSION our findings reveal the complexity of incorporating non-smoking buddy support into smoking cessation programs for young pregnant smokers. The characteristics and social environment of individual women may have the capacity to influence their ability to engage and sustain a relationship with a non-smoking buddy.
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Affiliation(s)
- Fiona Ronchi
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Western Australia 6008, Australia.
| | - Lucy Lewis
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Western Australia 6008, Australia; School of Nursing, Midwifery and Paramedicine, Curtin University, Bentley, Perth, Western Australia 6102, Australia.
| | - Yvonne L Hauck
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Western Australia 6008, Australia; School of Nursing, Midwifery and Paramedicine, Curtin University, Bentley, Perth, Western Australia 6102, Australia.
| | - Dorota A Doherty
- Division of Obstetrics and Gynaecology, The University of Western Australia, Nedlands, Perth, Western Australia 6009, Australia; Women and Infants Research Foundation, Subiaco, King Edward Memorial Hospital, Western Australia 6008, Australia.
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Sadasivam RS, Cutrona SL, Luger TM, Volz E, Kinney R, Rao SR, Allison JJ, Houston TK. Share2Quit: Online Social Network Peer Marketing of Tobacco Cessation Systems. Nicotine Tob Res 2017; 19:314-323. [PMID: 27613918 DOI: 10.1093/ntr/ntw187] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 07/18/2016] [Indexed: 11/13/2022]
Abstract
Introduction Although technology-assisted tobacco interventions (TATIs) are effective, they are underused due to recruitment challenges. We tested whether we could successfully recruit smokers to a TATI using peer marketing through a social network (Facebook). Methods We recruited smokers on Facebook using online advertisements. These recruited smokers (seeds) and subsequent waves of smokers (peer recruits) were provided the Share2Quit peer recruitment Facebook app and other tools. Smokers were incentivized for up to seven successful peer recruitments and had 30 days to recruit from date of registration. Successful peer recruitment was defined as a peer recruited smoker completing the registration on the TATI following a referral. Our primary questions were (1) whether smokers would recruit other smokers and (2) whether peer recruitment would extend the reach of the intervention to harder-to-reach groups, including those not ready to quit and minority smokers. Results Overall, 759 smokers were recruited (seeds: 190; peer recruits: 569). Fifteen percent (n = 117) of smokers successfully recruited their peers (seeds: 24.7%; peer recruits: 7.7%) leading to four recruitment waves. Compared to seeds, peer recruits were less likely to be ready to quit (peer recruits 74.2% vs. seeds 95.1%), more likely to be male (67.1% vs. 32.9%), and more likely to be African American (23.8% vs. 10.8%) (p < .01 for all comparisons). Conclusions Peer marketing quadrupled our engaged smokers and enriched the sample with not-ready-to-quit and African American smokers. Peer recruitment is promising, and our study uncovered several important challenges for future research. Implications This study demonstrates the successful recruitment of smokers to a TATI using a Facebook-based peer marketing strategy. Smokers on Facebook were willing and able to recruit other smokers to a TATI, yielding a large and diverse population of smokers.
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Affiliation(s)
- Rajani S Sadasivam
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
| | - Sarah L Cutrona
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA.,Meyers Primary Care Institute, Worcester, MA
| | - Tana M Luger
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA.,Center for Healthcare Organization and Implementation Research, Department of Veterans Affairs, Bedford, MA
| | | | - Rebecca Kinney
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
| | - Sowmya R Rao
- Department of Surgery, Boston University, Boston, MA
| | - Jeroan J Allison
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
| | - Thomas K Houston
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA.,Center for Healthcare Organization and Implementation Research, Department of Veterans Affairs, Bedford, MA
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A prospective examination of online social network dynamics and smoking cessation. PLoS One 2017; 12:e0183655. [PMID: 28832621 PMCID: PMC5568327 DOI: 10.1371/journal.pone.0183655] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 06/29/2017] [Indexed: 11/24/2022] Open
Abstract
Introduction Use of online social networks for smoking cessation has been associated with abstinence. Little is known about the mechanisms through which the formation of social ties in an online network may influence smoking behavior. Using dynamic social network analysis, we investigated how temporal changes of an individual’s number of social network ties are prospectively related to abstinence in an online social network for cessation. In a network where quitting is normative and is the focus of communications among members, we predicted that an increasing number of ties would be positively associated with abstinence. Method Participants were N = 2,657 adult smokers recruited to a randomized cessation treatment trial following enrollment on BecomeAnEX.org, a longstanding Internet cessation program with a large and mature online social network. At 3-months post-randomization, 30-day point prevalence abstinence was assessed and website engagement metrics were extracted. The social network was constructed with clickstream data to capture the flow of information among members. Two network centrality metrics were calculated at weekly intervals over 3 months: 1) in-degree, defined as the number of members whose posts a participant read; and 2) out-degree-aware, defined as the number of members who read a participant’s post and commented, which was subsequently viewed by the participant. Three groups of users were identified based on social network engagement patterns: non-users (N = 1,362), passive users (N = 812), and active users (N = 483). Logistic regression modeled 3-month abstinence by group as a function of baseline variables, website utilization, and network centrality metrics. Results Abstinence rates varied by group (non-users = 7.7%, passive users = 10.7%, active users = 20.7%). Significant baseline predictors of abstinence were age, nicotine dependence, confidence to quit, and smoking temptations in social situations among passive users (ps < .05); age and confidence to quit among active users. Among centrality metrics, positive associations with abstinence were observed for in-degree increases from Week 2 to Week 12 among passive and active users, and for out-degree-aware increases from Week 2 to Week 12 among active users (ps < .05). Conclusions This study is the first to demonstrate that increased tie formation among members of an online social network for smoking cessation is prospectively associated with abstinence. It also highlights the value of using individuals’ activities in online social networks to predict their offline health behaviors.
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Green JP, Lynn SJ. A Multifaceted Hypnosis Smoking-Cessation Program: Enhancing Motivation and Goal Attainment. Int J Clin Exp Hypn 2017; 65:308-335. [PMID: 28506140 DOI: 10.1080/00207144.2017.1314740] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Smoking cessation remains a major health priority. Despite public campaigns against smoking and widespread availability of smoking-cessation treatments, many people continue to smoke. The authors argue that the "problem of motivation," that is, suboptimal or fluctuating motivation to resist smoking urges and to comply with the demands of treatment, commonly undermines treatment seeking and adherence, appreciably reducing the success rates of smoking-cessation programs. The authors describe the history of the Winning Edge smoking-cessation program and discuss ways to enhance motivation before, during, and after formal treatment. They illustrate how hypnotic suggestions, administered in the context of their program, can promote cognitive, behavioral, and emotional commitment to treatment and enhance motivation to live a smoke-free life.
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Fisher EB, Boothroyd RI, Elstad EA, Hays L, Henes A, Maslow GR, Velicer C. Peer support of complex health behaviors in prevention and disease management with special reference to diabetes: systematic reviews. Clin Diabetes Endocrinol 2017; 3:4. [PMID: 28702258 PMCID: PMC5471959 DOI: 10.1186/s40842-017-0042-3] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Accepted: 05/09/2017] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Examine Peer Support (PS) for complex, sustained health behaviors in prevention or disease management with emphasis on diabetes prevention and management. DATA SOURCES AND ELIGIBILITY PS was defined as emotional, motivational and practical assistance provided by nonprofessionals for complex health behaviors. Initial review examined 65 studies drawn from 1442 abstracts identified through PubMed, published 1/1/2000-7/15/2011. From this search, 24 reviews were also identified. Extension of the search in diabetes identified 30 studies published 1/1/2000-12/31/2015. RESULTS In initial review, 54 of all 65 studies (83.1%) reported significant impacts of PS, 40 (61.5%) reporting between-group differences and another 14 (21.5%) reporting significant within-group changes. Across 19 of 24 reviews providing quantifiable findings, a median of 64.5% of studies reviewed reported significant effects of PS. In extended review of diabetes, 26 of all 30 studies (86.7%) reported significant impacts of PS, 17 (56.7%) reporting between-group differences and another nine (30.0%) reporting significant within-group changes. Among 19 of these 30 reporting HbA1c data, average reduction was 0.76 points. Studies that did not find effects of PS included other sources of support, implementation or methodological problems, lack of acceptance of interventions, poor fit to recipient needs, and possible harm of unmoderated PS. CONCLUSIONS Across diverse settings, including under-resourced countries and health care systems, PS is effective in improving complex health behaviors in disease prevention and management including in diabetes.
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Affiliation(s)
- Edwin B. Fisher
- Peers for Progress, Gillings School of Global Public Health, University of North Carolina, Box 7440, Chapel Hill, NC 27599-7440 USA
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Box 7440, Chapel Hill, NC 27599-7440 USA
| | - Renée I. Boothroyd
- Frank Porter Graham Child Development Institute, University of North Carolina, Chapel Hill, NC USA
| | | | - Laura Hays
- Indiana University School of Nursing, Indianapolis, IN USA
| | - Amy Henes
- RTI International, Research Triangle Park, NC USA
| | - Gary R. Maslow
- Department of Pediatrics, Duke University, Durham, NC USA
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC USA
| | - Clayton Velicer
- National Public Relations and Communications, Kaiser Permanente, Oakland, CA USA
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Pechmann C, Delucchi K, Lakon CM, Prochaska JJ. Randomised controlled trial evaluation of Tweet2Quit: a social network quit-smoking intervention. Tob Control 2017; 26:188-194. [PMID: 26928205 PMCID: PMC5112138 DOI: 10.1136/tobaccocontrol-2015-052768] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 02/10/2016] [Indexed: 01/07/2023]
Abstract
BACKGROUND We evaluated a novel Twitter-delivered intervention for smoking cessation, Tweet2Quit, which sends daily, automated communications to small, private, self-help groups to encourage high-quality, online, peer-to-peer discussions. DESIGN A 2-group randomised controlled trial assessed the net benefit of adding a Tweet2Quit support group to a usual care control condition of nicotine patches and a cessation website. PARTICIPANTS Participants were 160 smokers (4 cohorts of 40/cohort), aged 18-59 years, who intended to quit smoking, used Facebook daily, texted weekly, and had mobile phones with unlimited texting. INTERVENTION All participants received 56 days of nicotine patches, emails with links to the smokefree.gov cessation website, and instructions to set a quit date within 7 days. Additionally, Tweet2Quit participants were enrolled in 20-person, 100-day Twitter groups, and received daily discussion topics via Twitter, and daily engagement feedback via text. MEASURES The primary outcome was sustained abstinence at 7, 30 and 60 days post-quit date. RESULTS Participants (mean age 35.7 years, 26.3% male, 31.2% college degree, 88.7% Caucasian) averaged 18.0 (SD=8.2) cigarettes per day and 16.8 (SD=9.8) years of smoking. Participants randomised to Tweet2Quit averaged 58.8 tweets/participant and the average tweeting duration was 47.4 days/participant. Tweet2Quit doubled sustained abstinence out to 60 days follow-up (40.0%, 26/65) versus control (20.0%, 14/70), OR=2.67, CI 1.19 to 5.99, p=0.017. Tweeting via phone predicted tweet volume, and tweet volume predicted sustained abstinence (p<0.001). The daily autocommunications caused tweeting spikes accounting for 24.0% of tweets. CONCLUSIONS Tweet2Quit was engaging and doubled sustained abstinence. Its low cost and scalability makes it viable as a global cessation treatment. TRIAL REGISTRATION NUMBER NCT01602536.
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Affiliation(s)
- Cornelia Pechmann
- The Paul Merage School of Business, University of California Irvine, Irvine, California, USA
| | - Kevin Delucchi
- Department of Psychiatry, University of California San Francisco, San Francisco, California, USA
| | - Cynthia M Lakon
- Program in Public Health, University of California Irvine, Irvine, California, USA
| | - Judith J Prochaska
- Department of Medicine, Stanford Prevention Research Center, Stanford University, Stanford, California, USA
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Abstract
The tobacco addiction treatment field is progressing through innovations in medication development, a focus on precision medicine, and application of new technologies for delivering support in real time and over time. This article reviews the evidence for combined and extended cessation pharmacotherapy and behavioral strategies including provider advice, individual counseling, group programs, the national quitline, websites and social media, and incentives. Healthcare policies are changing to offer cessation treatment to the broad population of smokers. With knowledge of the past and present, this review anticipates what is likely on the horizon in the clinical and public health effort to address tobacco addiction.
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Affiliation(s)
- Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, California 94305;
| | - Neal L Benowitz
- Departments of Medicine and Bioengineering & Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics, University of California, San Francisco, California 94143;
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R u a smkn m0m?: Aspects of a Text Messaging Smoking Cessation/Reduction Intervention for Younger Mothers. J Smok Cessat 2015. [DOI: 10.1017/jsc.2013.34] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Introduction: Women who are younger in age are more likely to smoke during pregnancy and postpartum and tend to have less success with cessation/reduction. There is an unmet need for interventions targeted to pregnant and postpartum young women that provide them with support to quit/reduce long-term into the postpartum period and beyond.Aims: Our study aimed to gain an in-depth understanding of the perspectives of young pregnant and postpartum women of text messaging (TM) as a conduit for smoking cessation/reduction, and to determine the appropriate content, frequency, duration and unique features needed for an effective cessation/reduction TM programme.Methods: Six focus groups and six telephone interviews were convened with 36 pregnant and postpartum women 16–30 years of age.Results: Three main themes were identified: 1) topic areas that women would like TM to focus on; 2) the need for messages to be tailored; and 3) the importance for the programme to take a woman-centered approach.Conclusions: Respondents supported the idea of a TM cessation/reduction intervention and had clear programme recommendations. A personalised, woman-centered TM programme that meets a young woman's unique needs and addresses her concerns through her participation and direction is likely to empower and support her to quit/reduce.
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Burns RJ, Rothman AJ, Fu SS, Lindgren B, Joseph AM. The relation between social support and smoking cessation: revisiting an established measure to improve prediction. Ann Behav Med 2015; 47:369-75. [PMID: 24222508 DOI: 10.1007/s12160-013-9558-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Although social support is an integral element in smoking cessation, the literature presents mixed findings regarding the type(s) of social support that are most helpful. The Partner Interaction Questionnaire (PIQ) is commonly used to measure social support in this context. PURPOSE We explored the possibility that more nuanced distinctions between items on the PIQ than what is customarily used could improve the prediction of cessation. METHODS Baseline PIQ responses of smokers enrolled in a cessation program was submitted to an exploratory factor analysis. Emergent factors were used to predict cessation at several time points. RESULTS Four factors emerged, which differed from the two subscales that are typically used. The four-factor version predicted cessation; the two-factor version did not. CONCLUSIONS Identifying the types of social support that predict smoking cessation depend on our ability to measure social support. More nuanced measures will likely clarify the role of social support in cessation.
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Affiliation(s)
- Rachel J Burns
- Department of Psychology, University of Minnesota, 75 East River Road, Minneapolis, MN, 55455, USA,
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Naidoo SS, Gathiram P, Schlebusch L. Effectiveness of a Buddy intervention support programme for suicidal behaviour in a primary care setting. S Afr Fam Pract (2004) 2015. [DOI: 10.1080/20786190.2014.980159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Challenges for Smoking Cessation Intervention as Part of Primary Health Care Services in Developing Countries. J Smok Cessat 2014. [DOI: 10.1017/jsc.2014.28] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Background:Smoking cessation is most needed but, least accessible public health intervention in developing countries. Practicality of smoking cessation interventions determines their feasibility to implement in resource-limited setting.Objectives:This review aimed at identifying strategic mechanisms to launch accessible smoking cessation services within primary health care settings of developing countries.Methods:The efficacy of smoking cessation methods were reviewed in Cochrane reviews and clinical trials. Relevant research with an outcome of smoking cessation for six months and articles published after 2000 indexed in the PubMed database were reviewed. The practicality of each intervention was narratively appraised with further reviewing relevant effectiveness trials and observational studies.Finding and discussion:Contemporary evidence favours multi-components smoking cessation strategy combining more than one efficacy-proven methods such as brief advice, nicotine replacement therapy (NRT) and nursing intervention. Future trials to evaluate social and family influences on smoking behaviour in combination with above interventions are necessary. Moreover, training health care professionals in primary health care to implement smoking cessation intervention may overcome human resource insufficiency and ensure smokers’ access to cessation service within the community setting.
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Lau-Barraco C, Linden AN. Drinking Buddies: Who Are They and When Do They Matter? ADDICTION RESEARCH & THEORY 2014; 22:57-67. [PMID: 25429255 PMCID: PMC4241859 DOI: 10.3109/16066359.2013.772585] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The present study sought to further examine the role of peers on alcohol use and problems among young adults. In particular, we focused on a specific subset of peers in one's social network mostly for activities related to alcohol use called "drinking buddies." The presence of drinking buddies in one's social network has been shown to predict heavy drinking uniquely over but few studies have focused on potential factors moderating the relationship. Consequently, an aim of present study was to examine the influence of drinking buddies on alcohol outcomes and the extent to which the relationship may be dependent on one's normative perceptions. Another aim was to provide a descriptive examination of drinking buddies. Participants were college students (N = 250; 72.8% women) who completed self-report measures of alcohol use and problems, injunctive norms, descriptive norms, and social network characteristics. Results showed that descriptive norms moderated the relationship between drinking buddies and all alcohol outcomes assessed. Specifically, the influence of drinking buddies was stronger for those who perceived a lower prevalence of peer drinking. Examination of drinking buddies characteristics revealed that these peers tended to be young adults who were moderate social drinkers with whom they felt close and perceived to be available for concrete and emotional support. Several differences emerged between the drinking buddies of heavy versus non-heavy drinkers. The present study contributed to the larger body of work on peer influence and alcohol use by examining a specific subgroup of peers that may promote risky drinking.
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Pennington M, Visram S, Donaldson C, White M, Lhussier M, Deane K, Forster N, Carr SM. Cost-effectiveness of health-related lifestyle advice delivered by peer or lay advisors: synthesis of evidence from a systematic review. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2013; 11:30. [PMID: 24304826 PMCID: PMC4175508 DOI: 10.1186/1478-7547-11-30] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Accepted: 09/28/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Development of new peer or lay health-related lifestyle advisor (HRLA) roles is one response to the need to enhance public engagement in, and improve cost-effectiveness of, health improvement interventions. This article synthesises evidence on the cost-effectiveness of HRLA interventions aimed at adults in developed countries, derived from the first systematic review of the effectiveness, cost-effectiveness, equity and acceptability of different types of HRLA role. METHODS The best available evidence on the cost-effectiveness of HRLA interventions was obtained using systematic searches of 20 electronic databases and key journals, as well as searches of the grey literature and the internet. Interventions were classified according to the primary health behaviour targeted and intervention costs were estimated where necessary. Lifetime health gains were estimated (in quality-adjusted life years, where possible), based on evidence of effectiveness of HRLAs in combination with published estimates of the lifetime health gains resulting from lifestyle changes, and assumptions over relapse. Incremental cost-effectiveness ratios are reported. RESULTS Evidence of the cost-effectiveness of HRLAs was identified from 24 trials included in the systematic review. The interventions were grouped into eight areas. We found little evidence of effectiveness of HRLAs for promotion of exercise/improved diets. Where HRLAs were effective cost-effectiveness varied considerably: Incremental Cost effectiveness Ratios were estimated at £6,000 for smoking cessation; £14,000 for a telephone based type 2 diabetes management; and £250,000 or greater for promotion of mammography attendance and for HIV prevention amongst drug users. We lacked sufficient evidence to estimate ICERs for breastfeeding promotion and mental health promotion, or to assess the impact of HRLAs on health inequalities. CONCLUSIONS Overall, there is limited evidence suggesting that HRLAs are cost-effective in terms of changing health-related knowledge, behaviours or health outcomes. The evidence that does exist indicates that HRLAs are only cost-effective when they target behaviours likely to have a large impact on overall health-related quality of life. Further development of HRLA interventions needs to target specific population health needs where potential exists for significant improvement, and include rigorous evaluation to ensure that HRLAs provide sufficient value for money.
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Affiliation(s)
- Mark Pennington
- Health Economics, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
| | - Shelina Visram
- Centre for Public Policy and Health (CPPH), School of Medicine, Pharmacy and Health, Wolfson Research Institute for Health and Wellbeing, Durham University Queen’s Campus, Stockton-on-Tees TS17 6BH, UK
| | - Cam Donaldson
- Yunus Centre for Social Business & Health, Glasgow Caledonian University, Level 3 - Buchanan House, 58 Port Dundas Road, Glasgow G4 0BA, UK
| | - Martin White
- Institute of Health & Society/Fuse UKCRC Centre for Translational Research in Public Health, Newcastle University, Baddiley-Clark Building, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
| | - Monique Lhussier
- Faculty of Health & Life Sciences/Fuse UKCRC Centre for Translational Research in Public Health, Room H012, Coach Lane Campus East, Northumbria University, Newcastle-upon-Tyne NE7 7XA, UK
| | - Katherine Deane
- School of Nursing Sciences, Faculty of Medicine and Health Sciences, Edith Cavell Building, University of East Anglia, Norwich NR4 7TJ, UK
| | - Natalie Forster
- Faculty of Health & Life Sciences/Fuse UKCRC Centre for Translational Research in Public Health, Room H012, Coach Lane Campus East, Northumbria University, Newcastle-upon-Tyne NE7 7XA, UK
| | - Susan M Carr
- Faculty of Health & Life Sciences/Fuse UKCRC Centre for Translational Research in Public Health, Room H012, Coach Lane Campus East, Northumbria University, Newcastle-upon-Tyne NE7 7XA, UK
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White JS, Dow WH, Rungruanghiranya S. Commitment contracts and team incentives: a randomized controlled trial for smoking cessation in Thailand. Am J Prev Med 2013; 45:533-42. [PMID: 24139765 PMCID: PMC3806235 DOI: 10.1016/j.amepre.2013.06.020] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 05/01/2013] [Accepted: 06/25/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Treatment for tobacco dependence is not available in many low-resource settings, especially in developing countries. PURPOSE To test the impact of a novel mix of monetary and social incentives on smoking abstinence in rural communities of Thailand. DESIGN An RCT of commitment contracts and team incentives for rural smokers to quit smoking. Smokers were not blinded to treatment status, although the assessor of the biochemical urine test was. SETTING/PARTICIPANTS All adult smokers living in the study area were eligible to participate; 215 adult smokers from 42 villages in Nakhon Nayok province, Thailand, participated. Fourteen smokers who lacked teammates were dropped. INTERVENTION A total of 201 smokers were assigned to a two-person team, and then randomly assigned by team (in a 2:1 ratio) with computer-generated random numbers to receive smoking-cessation counseling (control group) or counseling plus offer of a commitment contract, team incentives, and text message reminders for smoking cessation at 3 months (intervention group). MAIN OUTCOME MEASURES The primary outcome was biochemically verified 7-day abstinence at 6 months, assessed on an intention-to-treat basis. Secondary outcomes include study participation, biochemically verified abstinence at 3 months, self-reported abstinence at 14 months, and the incremental cost per quitter of the intervention, nicotine gum, and varenicline in Thailand. Data were collected in 2010-2011 and analyzed in 2012. RESULTS The trial enrolled 215 (10.5%) of 2055 smokers. The abstinence rate was 46.2% (61/132) in the intervention group and 14.5% (10/69) in the control group (adjusted OR 7.5 [3.0-18.6]) at 3 months; 44.3% (58/131) and 18.8% (13/69) at the primary end point of 6 months (adjusted OR 4.2 [1.8-9.7]); and 42.0% (55/131) and 24.6% (17/69) at 14 months (adjusted OR 2.2 [1.0-4.8]). The purchasing power parity-adjusted incremental cost per quitter from the intervention is $281 (95% CI=$187, $562), less than for nicotine gum ($1780, 95% CI=$1414, $2401) or varenicline ($2073, 95% CI=$1357, $4388) in Thailand. CONCLUSIONS The intervention enhanced abstinence by 91%-136% at 6 months, relative to the control group, although self-reports at 14 months suggest tapering of the treatment effect. The intervention may offer a viable, cost-effective alternative to current smoking-cessation approaches in low-resource settings. TRIAL REGISTRATION This study is registered at ClinicalTrials.gov NCT01311115.
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Affiliation(s)
- Justin S White
- Stanford University (White), Stanford Prevention Research Center, Stanford, the University of California, Berkeley (Dow), School of Public Health, Berkeley, California.
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Becker J, Hungerbuehler I, Berg O, Szamrovicz M, Haubensack A, Kormann A, Schaub MP. Development of an integrative cessation program for co-smokers of cigarettes and cannabis: demand analysis, program description, and acceptability. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2013; 8:33. [PMID: 24025478 PMCID: PMC3848026 DOI: 10.1186/1747-597x-8-33] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 09/03/2013] [Indexed: 11/18/2022]
Abstract
Background Tobacco and cannabis use are strongly interrelated, but current national and international cessation programs typically focus on one substance, and address the other substance either only marginally or not at all. This study aimed to identify the demand for, and describe the development and content of, the first integrative group cessation program for co-smokers of cigarettes and cannabis. Methods First, a preliminary study using expert interviews, user focus groups with (ex-)smokers, and an online survey was conducted to investigate the demand for, and potential content of, an integrative smoking cessation program (ISCP) for tobacco and cannabis co-smokers. This study revealed that both experts and co-smokers considered an ISCP to be useful but expected only modest levels of readiness for participation. Based on the findings of the preliminary study, an interdisciplinary expert team developed a course concept and a recruitment strategy. The developed group cessation program is based on current treatment techniques (such as motivational interviewing, cognitive behavioural therapy, and self-control training) and structured into six course sessions. The program was evaluated regarding its acceptability among participants and course instructors. Results Both the participants and course instructors evaluated the course positively. Participants and instructors especially appreciated the group discussions and the modules that were aimed at developing personal strategies that could be applied during simultaneous cessation of tobacco and cannabis, such as dealing with craving, withdrawal, and high-risk situations. Conclusions There is a clear demand for a double cessation program for co-users of cigarettes and cannabis, and the first group cessation program tailored for these users has been developed and evaluated for acceptability. In the near future, the feasibility of the program will be evaluated. Trial registration Current Controlled Trials ISRCTN15248397
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Affiliation(s)
- Julia Becker
- Swiss Research Institute for Public Health and Addiction ISGF, University of Zurich, Konradstrasse 32, P, O, Box, 8031, Zurich, Switzerland.
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Johansen AB, Brendryen H, Darnell FJ, Wennesland DK. Practical support aids addiction recovery: the positive identity model of change. BMC Psychiatry 2013; 13:201. [PMID: 23898827 PMCID: PMC3751355 DOI: 10.1186/1471-244x-13-201] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 07/22/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a need for studies that can highlight principles of addiction recovery. Because social relationships are involved in all change processes, understanding how social motivations affect the recovery process is vital to guide support programs. METHODS The objective was to develop a model of recovery by examining addicted individuals' social motivations through longitudinal assessment of non-professional support dyads. A qualitative, longitudinal study design was used, combining focus groups and in-depth interviews with addicted individuals and their sponsors. Data were analyzed using the principles of grounded theory: open coding and memos for conceptual labelling, axial coding for category building, and selective coding for theory building. The setting was an addiction recovery social support program in Oslo, Norway. The informants included nine adults affected by addiction, six sponsors, and the program coordinator. The participants were addicted to either alcohol (2), benzodiazepines (1), pain killers (1) or polydrug-use (5). The sponsors were unpaid, and had no history of addiction problems. RESULTS Support perceived to be ineffective emerged in dyads with no operationalized goal, and high emotional availability with low degree of practical support. Support perceived to be effective was signified by the sponsor attending to power imbalance and the addict coming into position to help others and feel useful. CONCLUSIONS The findings appear best understood as a positive identity-model of recovery, indicated by the pursuit of skill building relevant to a non-drug using identity, and enabled by the on-going availability of instrumental support. This produced situations where role reversals were made possible, leading to increased self-esteem. Social support programs should be based on a positive identity-model of recovery that enable the building of a life-sustainable identity.
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Affiliation(s)
- Ayna B Johansen
- Norwegian Centre for addiction Research, Ullevål University Hospital, Postboks 1039, Blindern, 0315 Oslo, Norway
- Centre for the Study of Mind in Nature, University of Oslo, PO box 1020 Blindern, N-0316 Oslo, Norway
| | - Håvar Brendryen
- Norwegian Centre for addiction Research, Ullevål University Hospital, Postboks 1039, Blindern, 0315 Oslo, Norway
| | - Farnad J Darnell
- Norwegian Centre for addiction Research, Ullevål University Hospital, Postboks 1039, Blindern, 0315 Oslo, Norway
| | - Dag K Wennesland
- Norwegian Centre for addiction Research, Ullevål University Hospital, Postboks 1039, Blindern, 0315 Oslo, Norway
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Duke JC, Nonnemaker JM, Davis KC, Watson KA, Farrelly MC. The impact of cessation media messages on cessation-related outcomes: results from a national experiment of smokers. Am J Health Promot 2013; 28:242-50. [PMID: 23875987 DOI: 10.4278/ajhp.120920-quan-452] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Examine effects of exposure to two types of cessation advertisements on changes in cessation-related outcomes. DESIGN Experimental data from a nationally representative, longitudinal sample of smokers, collected in three waves over 4 weeks. SETTING National. Subjects. Three thousand and two adult U.S. smokers aged 18+ completed baseline and follow-up interviews at 2 and 4 weeks, from December 2010 to February 2011. INTERVENTION Six randomly assigned conditions consisting of repeated exposure to cessation advertisements: why-to-quit advertisements featuring emotional, personal testimonies (1: WTQ-T) or graphic images (2: WTQ-G); how-to-quit advertisements (3: HTQ), a combination of both (4: WTQ-T + HTQ; 5: WTQ-G + HTQ), and no-ad condition (6: control). MEASURES Cessation-related beliefs, attitudes, intentions, and quitting behavior. ANALYSIS Multivariable ordinary least squares and logistic regressions testing whether exposure to antitobacco television advertisements were associated with changes in tobacco-related outcomes. RESULTS Exposure to WTQ-T or WTQ-G advertisements, both alone and combined with HTQ advertisements, elicited positive change in beliefs, attitudes, and intentions as compared to controls. Smokers in three of four WTQ conditions were substantially more likely to have quit smoking at 4 weeks than controls (odds ratios range from 5.9 to 10.1, p < .05 or better). No effects were found for the HTQ-only condition. CONCLUSION Exposure to WTQ advertisements markedly increases the odds that a smoker will quit in the study period, suggesting positive movement toward successful, long-term cessation. HTQ advertisements did not enhance advertising effectiveness and may not be suitable as a primary message strategy.
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Prestwich A, Conner MT, Lawton RJ, Ward JK, Ayres K, McEachan RRC. Partner- and planning-based interventions to reduce fat consumption: randomized controlled trial. Br J Health Psychol 2013; 19:132-48. [PMID: 23659492 DOI: 10.1111/bjhp.12047] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2012] [Revised: 03/28/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The research tested the efficacy of partner- and planning-based interventions to reduce dietary fat intake over a 6-month period. DESIGN Randomized controlled, blinded, parallel trial. METHODS A computer randomization feature was used to allocate council employees (N = 427, of which 393 completed baseline measures) to one of four conditions (partner + implementation intentions, partner-only, implementation intentions, and control group) before they completed measures at baseline and follow-ups at 1, 3, and 6 months post-baseline. Outcome measures were comprised of validated self-report measures of dietary fat intake (saturated fat intake, fat intake, ratio of 'good' fats to 'bad' fats); psychosocial mediators (enjoyment, intention, self-efficacy, social influence, partner support); weight and waist size (baseline and 6 months only). RESULTS Data from 393 participants were analysed in accordance with intention-to-treat analyses. All intervention groups reported greater reductions in fat intake than the control group at 3 months. The partner-based groups increased the ratio of 'good' fats to 'bad' fats at 3 and 6 months and lost more inches on their waist, versus the non-partner groups. The impacts of the partner-based manipulations on outcomes were partially mediated by greater perceived social influences, partner support, and enjoyment of avoiding high-fat foods. The partner-based interventions also increased intention and self-efficacy. However, the effects in this study were typically small and generally marginally significant. CONCLUSIONS Partner-based interventions had some positive benefits on dietary-related outcomes at 3 and 6 months. Support for implementation intentions was more limited.
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Sattler AC, Cade NV. Prevalência da abstinência ao tabaco de pacientes tratados em unidades de saúde e fatores relacionados. CIENCIA & SAUDE COLETIVA 2013; 18:253-64. [DOI: 10.1590/s1413-81232013000100026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Accepted: 02/13/2012] [Indexed: 11/22/2022] Open
Abstract
O objetivo é conhecer a prevalência e identificar as variáveis relacionadas com a abstinência do tabaco em pacientes tratados nos Grupos de Apoio Terapêutico ao Tabagista (GATT) em unidades de saúde do município de Vitória (ES), no ano de 2009. Estudo transversal com 160 participantes do GATT que participaram de 75% das sessões. Realizada entrevista por telefone, 9 a 20 meses após o tratamento, e usado dados secundários do roteiro de entrevista inicial. Na análise estatística, foram utilizados os testes qui-quadrado e Fisher. A significância estatística foi 5%. Eram abstinentes 28,7%, recaíram 51,9% e 19,4% não pararam de fumar. Houve diferença estatística entre os grupos nas variáveis estado civil (0,039), tentativas anteriores para parar de fumar (0,029), quantidade de cigarros fumados por dia (0,019), uso de fármacos (0,001) e transtorno do humor referidos (0,040). O grupo de abstinente teve mais casados, tentou mais vezes parar de fumar, fumou menos cigarro/dia, apresentou menos ansiedade/alteração do humor. A abstinência foi semelhante a outros estudos e o maior percentual de sujeitos recaiu.
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Tay L, Tan K, Diener E, Gonzalez E. Social Relations, Health Behaviors, and Health Outcomes: A Survey and Synthesis. Appl Psychol Health Well Being 2012; 5:28-78. [PMID: 23281315 DOI: 10.1111/aphw.12000] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Louis Tay
- Singapore Management University; Singapore
| | | | - Ed Diener
- University of Illinois and the Gallup Organization; USA
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Abstract
BACKGROUND While many cessation programmes are available to assist smokers in quitting, research suggests that partner involvement may encourage long-term abstinence. OBJECTIVES The purpose of this review was to determine if an intervention to enhance partner support helps smoking cessation when added as an adjunct to a smoking cessation programme, and to estimate the size of any effect. SEARCH METHODS For the most recent update, the search was limited to the Cochrane Tobacco Addiction Group Specialized Register. This was searched in December 2011. The Specialized Register includes reports of controlled trials of smoking cessation identified from electronic searches of the Cochrane Central Register of Controlled Trials (CENTRAL) to Issue 4, 2011, MEDLINE to update 20110826, EMBASE to 2011 week 33, PsycINFO to 20110822 and Web of Science. The search terms used were smoking (prevention, control, therapy), smoking cessation, and support (family, marriage, spouse, partner, sexual partner, buddy, friend, co-habitees and co-worker). SELECTION CRITERIA Randomized controlled trials of smoking cessation interventions that compared an intervention that included a partner support component with an otherwise identical intervention and reported follow-up of six months or longer. DATA COLLECTION AND ANALYSIS Two authors independently identified the included studies and extracted data using a structured form. A third author was consulted to aid in the resolution of discrepancies. Abstinence, biochemically validated if possible, was the primary outcome measure and was extracted at two post-treatment intervals: six to nine months and 12 months or greater. Partner Interaction Questionnaire and Support Provided Measure scores were also analysed to assess partner support. A fixed-effect model was used to pool relative risks from each study and estimate a summary effect. MAIN RESULTS A total of 57 articles were identified for this review. Twelve articles (13 studies, > 2000 participants) met the inclusion criteria. The definition of partner varied between studies. All studies gave self-reported smoking cessation rates, but there was limited biochemical validation of abstinence. The pooled risk ratio for self-reported abstinence was 0.99 (95% confidence interval (CI) 0.84 to 1.15) at six to nine months and 1.04 (95% CI 0.87 to 1.24) at 12 months or more post-treatment. Of the eight studies that measured partner support at follow-up, only two studies reported a significant increase in partner support in the intervention groups. One study reported a significant increase in partner support in the intervention group, but smokers' reports of partner support received did not differ significantly in this study. AUTHORS' CONCLUSIONS In this review of randomized controlled trials of interventions designed to enhance partner support for smokers in cessation programmes, we failed to detect an increase in quit rates. Limited data from several of the trials suggest that these interventions also did not increase partner support. No conclusions can be made about the impact of partner support on smoking cessation. Additional studies with larger samples are needed to adequately explore the effects of partner support interventions for smoking cessation.
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Affiliation(s)
- Eal Whan Park
- Department of FamilyMedicine,Medical College of Dankook University, Cheonan, Korea, South.
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Mantler T, Irwin JD, Morrow D. Motivational interviewing and smoking behaviors: a critical appraisal and literature review of selected cessation initiatives. Psychol Rep 2012; 110:445-60. [PMID: 22662398 DOI: 10.2466/02.06.13.18.pr0.110.2.445-460] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The present paper systematically reviewed and critically appraised three different dimensions of motivational interviewing currently utilized in smoking cessation initiatives: social support, motivation, and tailored interventions. A review of four databases generated 57 primary articles, 17 of which met the inclusion criteria of an intervention study utilizing at least one dimension of motivational interviewing, adults between 18 and 64 years, no comorbidities, and a follow-up period of at least 6 weeks. More than 11,600 participants are represented in this review. The implementation of social support, motivation, and tailored interventions yielded mixed results. Furthermore, threats to validity emerged, including self-report, follow-up period, sample sizes, a priori differences in groups, and web-based and text-based interventions. Further research must ascertain the efficacy of the three dimensions of motivational interviewing indicated by the mixed results reported in terms of statistical significance of cessation rates. More empirically rigorous designs with evaluations based on stringent replicable criteria are needed.
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Lau-Barraco C, Braitman AL, Leonard KE, Padilla M. Drinking buddies and their prospective influence on alcohol outcomes: alcohol expectancies as a mediator. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2012; 26:747-58. [PMID: 22732054 DOI: 10.1037/a0028909] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The process by which peers or the social network influence individual alcohol use, particularly among adults, remains a necessary area of research. The purpose of the present study was to examine the longitudinal influence of "drinking buddies" on alcohol outcomes (i.e., alcohol use, heavy drinking, and alcohol-related problems) as mediated by alcohol expectancies of social facilitation. Participants were 1347 (men = 660, women = 687) newly married individuals recruited from the community. They were assessed at the time of marriage and through the fourth wedding anniversary. Longitudinal mediation across time was evaluated using latent growth modeling. Overall, the prospective association between the number of drinking buddies in the social network and all three alcohol outcomes was mediated by alcohol expectancies. In testing group invariance across gender, findings suggest that social-facilitation expectancies may be more relevant to men than women in predicting typical alcohol use and alcohol-related problems. Given that the social network may impact alcohol use at least in part through social expectancies, tailoring alcohol interventions to modify these specific beliefs may be particularly beneficial. In addition, strategies that target drinkers' social networks or their drinking buddies specifically may be useful.
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Affiliation(s)
- Cathy Lau-Barraco
- Department of Psychology, Old Dominion University, Norfolk, VA 23529-0267, USA.
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Abstract
AIMS To examine the (i) prevalence, (ii) predictors and (iii) cessation outcomes of smokers who engage in undisclosed quit attempts. DESIGN Online survey (n = 524), with balanced recruitment of current smokers (55%) and past-year quitters (45%). Participants were daily smokers (current or previous) who had at least one quit attempt in the past year. MEASUREMENTS Respondents were grouped on whether they did versus did not make advanced disclosure to others of their most recent quit attempt. FINDINGS Almost half (n = 234; 45%) reported that their most recent quit attempt was undisclosed to anyone in advance. Those who planned their quit attempt in advance [odds ratio (OR) = 0.10; 95% confidence interval (CI): 0.05-0.23] and those who used behavioral treatment (OR = 0.14; 95% CI: 0.05-0.43) were less likely to make 'closet quit attempts', while those who rated their attempt as being serious (OR = 2.52; 95% CI: 1.16-5.46) and those who deemed social support to be unhelpful (OR = 1.91; 95% CI: 1.24-2.95) were more likely to make such attempts. Closet quit attempters were more likely to achieve 30 days of abstinence than were those who made advanced disclosure (67% versus 58%; adjusted OR 1.8; 95% CI: 1.1-2.8), but there were no differences for achieving 6 months of abstinence (52% versus 49%; adjusted OR 1.2; 95% CI: 0.7-2.0). CONCLUSIONS Attempting to quit smoking without telling anyone in advance is common, and does not appear to impede success. These findings do not support blanket advice to smokers to tell others about pending quit attempts.
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Affiliation(s)
- Matthew J Carpenter
- Department of Psychiatry and Behavioral Sciences, Hollings Cancer Center, Medical University of SouthCarolina, 86 Jonathan Lucas Street, Charleston, SC 29425, USA.
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Graham AL, Papandonatos GD, Kang H, Moreno JL, Abrams DB. Development and validation of the online social support for smokers scale. J Med Internet Res 2011; 13:e69. [PMID: 21955465 PMCID: PMC3222172 DOI: 10.2196/jmir.1801] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Revised: 05/10/2011] [Accepted: 05/11/2011] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Social networks play an important role in smoking. Provision of social support during cessation is a cornerstone of treatment. Online social networks for cessation are ubiquitous and represent a promising modality for smokers to receive and provide the support necessary for cessation. There are no existing measures specific to online social support for smoking cessation. OBJECTIVE The objective was to develop a measure of social support to be used in online smoking cessation treatment research. METHODS Initial items for the Online Social Support for Smokers Scale (OS4) were based on existing theory and scales delineated in various taxonomies. Preliminary field analysis (N = 73) was conducted on 23 initial items to optimize the scale. Further development was conducted on a refined 15-item scale in the context of a large randomized trial of Internet and telephone cessation treatment with follow-ups at 3, 6, 12, and 18 months. In all, 1326 participants were randomized to an enhanced Internet arm that included a large online social network; psychometric analyses employed 3-month follow-up data from those reporting use of the enhanced Internet intervention at least once (n = 873). Items were subjected to a factor analysis, and the internal consistency reliability of the scale was examined along with construct and criterion validity. Other measures used in the study included demographics, nicotine dependence, partner support for cessation, general social support, social integration, stress, depression, health status, online community use, Internet use behaviors, intervention satisfaction, and 30-day point prevalence abstinence. RESULTS The final 12-item OS4 scale demonstrated high internal consistency reliability (Cronbach alphas .86-.89) across demographic and smoking strata of interest. The OS4 also demonstrated good construct and criterion validity, with the directionality of the observed associations providing support for most a priori hypotheses. Significant Pearson correlations were observed between the OS4 and the Partner Interaction Questionnaire (PIQ) Positive subscale (ρ = .24, P < .001). As hypothesized, participants with the highest OS4 scores were more likely to have actively participated in the enhanced Internet community and to have high levels of satisfaction with the enhanced Internet intervention. In logistic regression analyses, the OS4 was highly predictive of 30-day point-prevalence abstinence at 6, 12, and 18 months (all P values <.001). The odds of abstinence at 6 months rose by 48% for each standard unit increase in online social support (95% confidence interval [CI] 1.17-1.71), dropping only slightly to 37% at 12 and 18 months (95% CI 1.17-1.59). CONCLUSIONS The OS4 is a brief, reliable, and valid instrument for measuring online social support for smoking cessation. Results should be replicated and extended, but this study suggests the OS4 can be used to advance theory, understand mechanisms, and potentially help to improve the tailoring of Internet-based smoking cessation treatments. It can also inspire development of similar measures for other online health-related intervention research. TRIAL REGISTRATION Clinicaltrials.gov #NCT00282009; http://clinicaltrials.gov/ct2/show/NCT00282009 (Archived by WebCite at http://www.webcitation.org/60XNj3xM6).
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Affiliation(s)
- Amanda L Graham
- Schroeder Institute for Tobacco Research and Policy Studies, American Legacy Foundation, Washington, DC, USA.
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Begh RA, Aveyard P, Upton P, Bhopal RS, White M, Amos A, Prescott RJ, Bedi R, Barton P, Fletcher M, Gill P, Zaidi Q, Sheikh A. Promoting smoking cessation in Pakistani and Bangladeshi men in the UK: pilot cluster randomised controlled trial of trained community outreach workers. Trials 2011; 12:197. [PMID: 21854596 PMCID: PMC3177779 DOI: 10.1186/1745-6215-12-197] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Accepted: 08/19/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Smoking prevalence is high among Pakistani and Bangladeshi men in the UK, but there are few tailored smoking cessation programmes for Pakistani and Bangladeshi communities. The aim of this study was to pilot a cluster randomised controlled trial comparing the effectiveness of Pakistani and Bangladeshi smoking cessation outreach workers with standard care to improve access to and the success of English smoking cessation services. METHODS A pilot cluster randomised controlled trial was conducted in Birmingham, UK. Geographical lower layer super output areas were used to identify natural communities where more than 10% of the population were of Pakistani and Bangladeshi origin. 16 agglomerations of super output areas were randomised to normal care controls vs. outreach intervention. The number of people setting quit dates using NHS services, validated abstinence from smoking at four weeks, and stated abstinence at three and six months were assessed. The impact of the intervention on choice and adherence to treatments, attendance at clinic appointments and patient satisfaction were also assessed. RESULTS We were able to randomise geographical areas and deliver the outreach worker-based services. More Pakistani and Bangladeshi men made quit attempts with NHS services in intervention areas compared with control areas, rate ratio (RR) 1.32 (95%CI: 1.03-1.69). There was a small increase in the number of 4-week abstinent smokers in intervention areas (RR 1.30, 95%CI: 0.82-2.06). The proportion of service users attending weekly appointments was lower in intervention areas than control areas. No difference was found between intervention and control areas in choice and adherence to treatments or patient satisfaction with the service. The total cost of the intervention was £124,000; an estimated cost per quality-adjusted life year (QALY) gained of £8,500. CONCLUSIONS The intervention proved feasible and acceptable. Outreach workers expanded reach of smoking cessation services in diverse locations of relevance to Pakistani and Bangladeshi communities. The outreach worker model has the potential to increase community cessation rates and could prove cost-effective, but needs evaluating definitively in a larger, appropriately powered, randomised controlled trial. These future trials of outreach interventions need to be of sufficient duration to allow embedding of new models of service delivery. TRIAL REGISTRATION Current Controlled Trials ISRCTN82127540.
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Affiliation(s)
- Rachna A Begh
- UK Centre for Tobacco Control Studies, Primary Care Clinical Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Paul Aveyard
- UK Centre for Tobacco Control Studies, Primary Care Clinical Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Penney Upton
- Psychological Sciences, Institute of Health and Society, University of Worcester, Worcester, WR2 6AJ, UK
| | - Raj S Bhopal
- Ethnicity and Health Research Group, Centre for Population Health Sciences, University of Edinburgh, Edinburgh, EH8 9AG, UK
| | - Martin White
- Fuse, UKCRC Centre for Translational Research in Public Health, Institute of Health & Society, Newcastle University, NE2 4HH, UK
| | - Amanda Amos
- UK Centre for Tobacco Control Studies, Centre for Population Health Sciences, University of Edinburgh, Edinburgh, EH8 9AG, UK
| | - Robin J Prescott
- Ethnicity and Health Research Group, Centre for Population Health Sciences, University of Edinburgh, Edinburgh, EH8 9AG, UK
| | - Raman Bedi
- International Centre for Child Oral Health, King's College London, London, WC2B 5RL, UK
| | - Pelham Barton
- Health Economics, University of Birmingham, Birmingham, B15 2TT, UK
| | | | - Paramjit Gill
- UK Centre for Tobacco Control Studies, Primary Care Clinical Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Qaim Zaidi
- British Heart Foundation, London, W1H 6DH, UK
| | - Aziz Sheikh
- Allergy & Respiratory Research Group, Centre for Population Health Sciences, University of Edinburgh, Edinburgh, EH8 9AG, UK
- CAPHRI, University of Maastricht, The Netherlands
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Abstract
Managing smoking cessation during pregnancy is vital to the wellbeing of the fetus and the mother. Women who continue to smoke during pregnancy expose the fetus to thousands of chemicals which have been shown to cause deleterious short- and long-term effects. Although a large majority of women cease smoking early in the pregnancy, many of them relapse following delivery. Following a review of current research, an overview of the safety and efficacy of smoking cessation treatments for pregnant women will be considered. Limited research has been performed in this field; however, it can be concluded that low-dose intermittent nicotine replacement therapy is a safe treatment modality for women who smoke during pregnancy. At present there has been no research on other current smoking cessation treatments; however, we will suggest techniques to improve cessation rates and strategies to reduce relapse.
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Affiliation(s)
- Renee Bittoun
- Brain and Mind Research Institute, Smoking Cessation Clinics, University of Sydney, Sydney, New South Wales, Australia
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Buyze J, Van Rompaye B, Goetghebeur E. Designing a sequentially randomized study with adherence enhancing interventions for diabetes patients. Stat Med 2010; 29:1114-26. [PMID: 20101597 DOI: 10.1002/sim.3856] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Adaptive treatment strategies can change treatment prescription over time in response to intermediate outcomes. They are the natural choice for treating chronic diseases or for prevention, since the condition of subjects tends to change over the long term. Similarly, flexible intervention strategies are vital for generating or sustaining better adherence in long term treatment settings. When a cost-efficient first-line treatment is available, for instance, good adherence is expected to help delay or avoid second-line treatment.Sequentially randomized trials enable unbiased evaluation of how to best adapt adherence supporting interventions to a history of outcomes and adherence with the goal to optimize future treatment response. In this paper we propose and study different sequential designs targeting cost-efficient control of type II diabetes under first-line treatment through two different classes of adherence support: by (bio)technical and by behavioural means. We study their respective and joint impact first through double factorial adaptive designs, where interventions are triggered by an elevated risk of current treatment failure predicted by poor surrogate response.We develop the double factorial design and several derived designs that are more cost-efficient in the context of managed care of diabetes patients. We evaluate the marginal responses over time to different adaptive treatment strategies by means of doubly robust estimators. We consider sample sizes needed to thus detect realistic and worthwhile effects and discuss the relative practical and theoretical merits of the separate designs.
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Affiliation(s)
- Jozefien Buyze
- Department of Applied Mathematics and Computer Science, Ghent University, Ghent, Belgium.
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Cobb NK, Graham AL, Abrams DB. Social network structure of a large online community for smoking cessation. Am J Public Health 2010; 100:1282-9. [PMID: 20466971 PMCID: PMC2882421 DOI: 10.2105/ajph.2009.165449] [Citation(s) in RCA: 161] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We evaluated the social network structure of QuitNet, one of the largest online communities for behavior change, and compared its characteristics to other known social networks. METHODS Using modern network analysis methods, we identified QuitNet members who were active during a 60-day period, along with their ties. We then derived multiple subgroups, such as key players and integrators, from connections and communication patterns. RESULTS Among 7569 participants, we identified 103,592 connections to other members. Metrics of social network integration were associated with increased likelihood of being female, being older, having been in the system longer, and not smoking. CONCLUSIONS The QuitNet community is a large-scale social network with the characteristics required for sustainability of social support and social influence to promote smoking cessation and abstinence. These characteristics include persistence of members over time, heterogeneity of smoking status, and evidence of rich, bidirectional communications. Some of the influential subgroups we identified may provide targets for future network-level interventions.
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Affiliation(s)
- Nathan K Cobb
- Schroeder Institute for Tobacco Research and Policy Studies, Washington, DC 20036, USA.
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43
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Westmaas JL, Bontemps-Jones J, Bauer JE. Social support in smoking cessation: Reconciling theory and evidence. Nicotine Tob Res 2010; 12:695-707. [PMID: 20513695 DOI: 10.1093/ntr/ntq077] [Citation(s) in RCA: 135] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- J Lee Westmaas
- Behavioral Research Center, American Cancer Society, 250 Williams Street, NW, Suite 6D.432, Atlanta, GA 30303, USA.
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44
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Thomas JL, Patten CA, Mahnken JD, Offord KP, Hou Q, Lynam IM, Wirt BA, Croghan IT. Validation of the support provided measure among spouses of smokers receiving a clinical smoking cessation intervention. PSYCHOL HEALTH MED 2010; 14:443-53. [PMID: 19697254 DOI: 10.1080/13548500903016559] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Studies indicate a positive association between social support and smoking cessation. However, clinic-based interventions designed to increase social support have had limited success. Most studies have relied on only the smoker's perceptions of support received while few have assessed the support provider's report of support delivered. Understanding supportive interactions between support providers and recipients may assist in developing effective support interventions for cessation. The current investigation examined the perceptions of smoking-specific support provided by the spouse of a partner who smokes and was seen for a nicotine dependence consultation. Specifically, we examined spouse reported willingness to help their spouse quit, interest in learning ways to help their spouse quit, and characteristics associated with the provision of smoking-specific supportive behaviors (as assessed via the Support Provided Measure, SPM), in the 2-weeks prior to the consultation. The current investigation also examined the concurrent validity of the SPM with a validated measure of support provided to a smoker, the Partner Interaction Questionnaire (PIQ), accounting for social desirability bias and smoker readiness to change. The sample comprised 84 adult cigarette smokers seen for a clinical smoking cessation intervention and their spouses (N = 84). Results indicate that a high percentage of spouses are willing to help their partner who smokes and interested in learning way to help. As expected, spouses who were females and had never smoked had higher scores on the SPM than males or current smokers. The SPM was significantly correlated with the PIQ positive (r = 0.50, p < 0.01) and negative (r = 0.44, p <0.01) item scales overall and for spouses whose partners reported higher levels of readiness to quit smoking (r = 0.54, p < 0.01; r = 0.50, p < 0.01, respectively). Suggestions for future research are offered.
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Affiliation(s)
- Janet L Thomas
- Nicotine Dependence Center, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
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Bauld L, Bell K, McCullough L, Richardson L, Greaves L. The effectiveness of NHS smoking cessation services: a systematic review. J Public Health (Oxf) 2009; 32:71-82. [PMID: 19638397 DOI: 10.1093/pubmed/fdp074] [Citation(s) in RCA: 119] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To analyse evidence on the effectiveness of intensive NHS treatments for smoking cessation in helping smokers to quit. METHODS A systematic review of studies published between 1990 and 2007. Electronic databases were searched for published studies. Unpublished reports were identified from the national research register and experts. RESULTS Twenty studies were included. They suggest that intensive NHS treatments for smoking cessation are effective in helping smokers to quit. The national evaluation found 4-week carbon monoxide monitoring validated quit rates of 53%, falling to 15% at 1 year. There is some evidence that group treatment may be more effective than one-to-one treatment, and the impact of 'buddy support' varies based on treatment type. Evidence on the effectiveness of in-patient interventions is currently very limited. Younger smokers, females, pregnant smokers and more deprived smokers appear to have lower short-term quit rates than other groups. CONCLUSION Further research is needed to determine the most effective models of NHS treatment for smoking cessation and the efficacy of those models with subgroups. Factors such as gender, age, socio-economic status and ethnicity appear to influence outcomes, but a current lack of diversity-specific analysis of results makes it impossible to ascertain the differential impact of intervention types on particular subpopulations.
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Affiliation(s)
- Linda Bauld
- Department of Social and Policy Sciences and UK Centre for Tobacco Control Studies, University of Bath, Bath, UK.
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Díaz-Maroto Muñoz J, Jiménez Ruiz C, Alonso Fernández M, Alonso Moreno J, Iglesias Dorado P, Bassa Massanas À. Recomendaciones de buena práctica clínica en tabaquismo. Semergen 2009. [DOI: 10.1016/s1138-3593(09)70179-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Väänänen A, Kouvonen A, Kivimäki M, Pentti J, Vahtera J. Social support, network heterogeneity, and smoking behavior in women: the 10-town study. Am J Health Promot 2008; 22:246-55. [PMID: 18421889 DOI: 10.4278/0701094r1.1] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Examine the associations among social support, network heterogeneity, and smoking behavior in a large sample of Finnish female municipal employees. DESIGN Cross-sectional observational study. SETTING Workplaces in 10 towns in Finland. MEASURES Smoking behavior and social support from one's partner, relatives, friends, supervisor, and coworkers was assessed by a questionnaire survey in 2000 to 2001. ANALYSIS Logistic regression analysis. SUBJECTS Total of 23,069 female employees (mean age = 45 years). Separate models for heavy smoking (> or = 20 cigarettes per day) were calculated for 4119 current smokers. The association between social support and ex-smoking was examined in 7352 ever-smokers. RESULTS After adjustment for various confounders, women who reported low heterogeneity of their support network or no support from their partners or relatives were approximately 1.2 times more likely to be smokers compared with their counterparts with high heterogeneity or high support. Low network heterogeneity was also significantly associated with an elevated prevalence of heavy smoking in current smokers (odds ratio [OR] = 1.52; 95% confidence intervals [CI] = 1.06, 2.19) and a lower likelihood of ex-smoking in ever-smokers (OR = 0.74; 95% CI = 0.63, 0.87). The associations were more pronounced among nonmanual vs. manual employees. CONCLUSION Our findings suggest an association among network heterogeneity, sources of social support, and smoking in female employees. The preventive impact of these social resources on smoking behavior is stronger among nonmanual female employees.
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Affiliation(s)
- Ari Väänänen
- Centre of Expertise for Work Organisations, Finnish Institute of Occupational Health, Topeliuksenkatu, Helsinki, Finland.
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Aveyard P, Brown K, Saunders C, Alexander A, Johnstone E, Munafò MR, Murphy M. Weekly versus basic smoking cessation support in primary care: a randomised controlled trial. Thorax 2007; 62:898-903. [PMID: 17483139 PMCID: PMC2094265 DOI: 10.1136/thx.2006.071837] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2006] [Revised: 03/31/2007] [Indexed: 11/04/2022]
Abstract
BACKGROUND There is insufficient and conflicting evidence about whether more intensive behavioural support is more effective than basic behavioural support for smoking cessation and whether primary care nurses can deliver effective behavioural support. METHODS A randomised controlled trial was performed in 26 UK general practices. 925 smokers of >or=10 cigarettes per day were randomly allocated to basic or weekly support. All participants were seen before quitting, telephoned around quit day, and seen 1 and 4 weeks after the initial appointment (basic support). Participants receiving weekly support had an additional telephone call at 10 days and 3 weeks after the initial appointment and an additional visit at 2 weeks to motivate adherence to nicotine replacement and renew quit attempts. 15 mg/16 h nicotine patches were given to all participants. The outcome was assessed by intention to treat analyses of the percentage confirmed sustained abstinence at 4, 12, 26 and 52 weeks after quit day. RESULTS Of the 469 and 456 participants in the basic and weekly arms, the numbers (%) who quit and the percentage difference were 105 (22.4%) vs 102 (22.4%), 0.1% (95% CI -5.3% to 5.5%) at 4 weeks, 66 (14.1%) vs 52 (11.4%), -2.6% (95% CI -6.9% to 1.7%) at 12 weeks, 50 (10.7%) vs 40 (8.8%), -1.9% (95% CI -5.7% to 2.0%) at 26 weeks and 36 (7.7%) vs 30 (6.6%), -1.1% (95% CI -4.4% to 2.3%) at 52 weeks. CONCLUSIONS The absolute quit rates achieved are those expected from nicotine replacement alone, implying that neither basic nor weekly support were effective. Primary care smoking cessation treatment should provide pharmacotherapy with sufficient support only to ensure it is used appropriately, and those in need of support should be referred to specialists.
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Affiliation(s)
- Paul Aveyard
- Cancer Research UK General Practice Research Group, Department of Clinical Pharmacology, University of Oxford, Oxford, UK.
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Park EW, Schultz JK, Tudiver F, Campbell T, Becker L. Enhancing partner support to improve smoking cessation. Cochrane Database Syst Rev 2004:CD002928. [PMID: 15266469 DOI: 10.1002/14651858.cd002928.pub2] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND While many cessation programs are available to assist smokers in quitting, research suggests that partner involvement may encourage long-term abstinence. OBJECTIVES The purpose of this review was to determine if an intervention to enhance partner support helps smoking cessation when added as an adjunct to a smoking cessation program. SEARCH STRATEGY The search was performed in: Cochrane Tobacco Addiction Group specialized register (Apr 2004), Cochrane controlled trials register (Apr 2004), CDC and Prevention-Tobacco Information and Prevention Database (Jul 2000), MEDLINE (1966-Apr 2004), Cancer Lit (1966-Apr 2004), EMBASE (1974-Apr 2004), CINAHL (1966-Jul 2000), PsycInfo (1861-Apr 2004), ERIC, PsycLit, & Dissertation Abstracts (1861-Dec 1999), SSCI (1972-Apr 2004) and HealthStar (1975-Jul 2000). The search terms used were smoking (prevention, control, therapy), smoking cessation, and support (family, marriage, spouse, partner, sexual partner, buddy, friend, co-habitees, and co-worker). The search was also limited to English language. SELECTION CRITERIA Randomized controlled trials of smoking cessation interventions that compared an intervention that included a partner support component with an otherwise identical intervention and reported follow-up of 6 months or greater. DATA COLLECTION AND ANALYSIS Two reviewers independently identified the included studies and extracted data using a structured form. A third reviewer was consulted to aid in the resolution of discrepancies. Abstinence and biochemical assessment were the primary outcome measures and were analyzed at two post-treatment intervals: 6-9 months and >12 months. The scores of PIQ (partner interaction questionnaire) were also analyzed to assess partner support. A fixed-effects model was used to assess the summary effect of the studies. MAIN RESULTS A total of 40 articles were identified for this review. Only eight articles (nine studies) met the inclusion criteria. The definition of partner varied among the studies. All studies included data on self reported smoking cessation rates, but there was limited biochemical validation of abstinence rates. The odds ratio for self-reported abstinence at 6-9 months was 1.08 (CI 95%, 0.81 -1.44); and at 12 months post-treatment was 1.0 (CI 95%, 0.75 - 1.34). Of the six studies that measured partner support at follow-up, only two studies reported significant increase in partner support in the intervention groups. REVIEWERS' CONCLUSIONS In this review of the randomized controlled trials of interventions designed to enhance partner support for smokers in cessation programs, we failed to detect an increase in quit rates. Limited data from several of the trials suggest that these interventions did not increase partner support either. No conclusions can be made about the impact of partner support on smoking cessation. More systematic intervention to affect partnership significantly should be delivered if partner support were part of an existing cessation program.
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Affiliation(s)
- E-W Park
- Department of Family Medicine, Medical College of Dankook University, 16-5 Anseo-Dong, Cheonan, Chungnam, South Korea, 330-715
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