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Suh M, Im B, Lee HJ, Kim KS, Sohn M. Smoking cessation strategies for women: An analysis of smoking cessation determinants among Korean female smokers participating in a smoking cessation outreach program. Health Promot Perspect 2023; 13:54-60. [PMID: 37309429 PMCID: PMC10257570 DOI: 10.34172/hpp.2023.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 01/16/2023] [Indexed: 06/14/2023] Open
Abstract
Background: Although there is strong evidence that behavioral counseling improves quit rates, limited data are available on individualized smoking cessation counseling provided to female smokers because they often are hesitant to identify as smokers. This study aimed to elucidate factors related to smoking cessation among Korean women who participated in the smoking cessation outreach program. Methods: This retrospective descriptive study used data retrieved from the Korea Health Promotion Institute. The data included individual participant characteristics, supportive services received, and self-reported smoking cessation outcomes from June 1, 2015, to December 31, 2017. Results: Data from 709 women were analyzed. We found cessation rates of 43.3% (confidence interval [CI]=0.40, 0.47) at four weeks, 28.6% (CI=0.25, 0.32) at 12 weeks, and 21.6% (CI=0.19, 0.25) at six months. Significant determinants of quitting at six months were regular exercise (odds ratio [OR]=3.02; 95% CI=1.28, 3.29; P=0.009) and the number of counseling sessions during the first four weeks of the program (OR=1.26; 95% CI=1.04, 1.82; P=0.041). Conclusion: Providing intensive counseling during initial phase of smoking cessation program and regular exercise would be effective strategies for smoking cessation programs for women smokers to promote their health.
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Affiliation(s)
- Minhee Suh
- Department of Nursing, Inha University, 100 Inharo, Incheon, 22212, South Korea
| | - Boae Im
- Department of Nursing, Inha University, 100 Inharo, Incheon, 22212, South Korea
| | - Hun Jae Lee
- College of Medicine, Inha University, 100 Inharo, Incheon, 22212, South Korea
| | - Kyu-Sung Kim
- College of Medicine, Inha University, 100 Inharo, Incheon, 22212, South Korea
| | - Min Sohn
- Department of Nursing, Inha University, 100 Inharo, Incheon, 22212, South Korea
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2
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Meijer E, Gebhardt WA, van Laar C, Chavannes NH, van den Putte B. Identified or conflicted: a latent class and regression tree analysis explaining how identity constructs cluster within smokers. BMC Psychol 2022; 10:231. [PMID: 36207742 PMCID: PMC9547436 DOI: 10.1186/s40359-022-00937-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 09/22/2022] [Indexed: 11/22/2022] Open
Abstract
Identity, or 'who I am', is important for smoking behaviour. Identity constructs (parts of a person's identity) are typically examined as separate entities, but emerging evidence suggests that the multifaceted nature of identity is relevant in the context of smoking. This cross-sectional study examined how smoking-related self- and group-identity constructs cluster within adult daily smokers (N = 231), whether classes of smokers can be distinguished based on clusters of identity constructs, and which factors explain class membership. Data were collected online in The Netherlands and Belgium, 2017-2018. Latent class and regression tree analyses showed that participants in Class 1 of 'Identified smokers' (estimated population share 54%) reported stronger smoker self- and group-identities, stronger expected identity loss when quitting smoking, and weaker quitter self-identities and non-smoker self- and group-identities (vs. Class 2 of 'Conflicted smokers'). Class membership was explained by the interaction between mental smoking dependence (dominant explanatory variable), consideration of future consequences, age of smoking onset, self-efficacy, and future self thought clarity. Models had good fit. The identity of more dependent smokers is more strongly oriented toward smoking. Smoking is also more strongly embedded in the identity of smokers who started smoking young, are less inclined to think about the future, and have lower self-efficacy.
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Affiliation(s)
- E. Meijer
- Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- National eHealth Living Lab, Leiden University Medical Center, Leiden, The Netherlands
| | - W. A. Gebhardt
- Health, Medical and Neuropsychology, Leiden University, Leiden, The Netherlands
| | - C. van Laar
- Social and Cultural Psychology, University of Leuven, Leuven, Belgium
| | - N. H. Chavannes
- Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- National eHealth Living Lab, Leiden University Medical Center, Leiden, The Netherlands
| | - B. van den Putte
- Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, The Netherlands
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Sorgen LJ, Ferrer RA, Klein WMP, Kaufman AR. Smoking self-concept moderates the effects of self-affirmation on smoking-related beliefs and behavioral intentions. Psychol Health 2021; 37:964-984. [PMID: 33870815 DOI: 10.1080/08870446.2021.1912346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Smoking stigmatization has been shown to hinder cigarette smoking cessation, especially among individuals with a strong smoker identity. Self-affirmation, a psychological threat-management coping strategy, can promote smoking cessation, and may mitigate the adverse consequences of stigmatization. DESIGN Data from an online sample of 1,020 U.S. adult smokers were analyzed using multiple linear regression. MAIN OUTCOME MEASURES Participants completed a self-affirmation (or no-affirmation control) writing task before viewing a smoking stigma (or non-stigma control) anti-smoking public service announcement video. Participants then reported smoking-related cognitions and behavioral intentions. RESULTS Among participants with strong-but not weak-ties to a smoker identity (smoking self-concept), self-affirming led to higher quit intentions compared to the control condition. Among participants with weak-but not strong-smoking self-concepts, those who self-affirmed had lower intentions to switch completely to e-cigarettes relative to the control condition. Exposure to stigmatization reduced intentions to seek cessation counseling, particularly among those with weak smoking self-concepts. CONCLUSION Findings demonstrate the critical role that smoking identity centrality plays in moderating reactions to both affirming and stigmatizing stimuli. Additional research is needed to better understand how self-affirmation and stigma-reduction interventions can be tailored and implemented in natural contexts.
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Affiliation(s)
- Lia J Sorgen
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Rebecca A Ferrer
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - William M P Klein
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Annette R Kaufman
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
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Hasan SI, Mohd Hairi F, Amer Nordin AS, Danaee M. Development and Validation of an Evaluation Tool to Measure the Effectiveness of a Smoking Cessation Training among Healthcare Providers in Malaysia: The Providers' Smoking Cessation Training Evaluation (ProSCiTE). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4297. [PMID: 31694286 PMCID: PMC6862003 DOI: 10.3390/ijerph16214297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 10/22/2019] [Accepted: 10/31/2019] [Indexed: 11/17/2022]
Abstract
Background: In line with Article 14 of the Framework Convention for Tobacco Control, we have witnessed vast developments in smoking cessation training for healthcare providers, offering help for smokers. However, there is no specific evaluation tool to monitor and evaluate the effectiveness of these programs for future enhancement and sustainability. Objective: To develop and validate a new tool for evaluating smoking cessation training programs for healthcare providers called the Providers' Smoking Cessation Training Evaluation (ProSCiTE). Methods: The 74-item ProSCiTE tool was developed based on a review of the literature and an expert panel review. The tool was validated in a sample of 403 healthcare providers using a cross-sectional study design from July to December 2016. Content validity was assessed by the Scale-Content Validity Index (S-CVI). The construct validity of the ProSCiTE was analyzed using exploratory factor analysis (EFA) to confirm psychometric properties. Internal consistency reliability was determined using Cronbach's alpha. Results: The content validity showed that the S-CVI ranged from 0.82 to 1.00 for consistency, representativeness, relevancy, and the clarity of each construct, resulting in 67 items for the questionnaire. The construct validity of the ProSCiTE (based on eigenvalues and factor loadings to confirm the four-factor structure (attitude, self-efficacy, behavior, and barriers) with 54.74% total variance) was acceptable (Kaiser-Mayer-Olkin = 0.923; Bartlett's test of sphericity was significant, p < 0.001). The internal consistency reliability of the four-factor structure was very good, with Cronbach's alpha values at 0.89, 0.94, 0.95, and 0.90, respectively. Conclusions: This study showed that 67 items of the ProSCiTE demonstrated good content and construct validity, as well as a high internal consistency reliability for the measurement of knowledge, attitudes, self-efficacy, behavior, and barriers to smoking cessation interventions among healthcare providers. Therefore, the ProSCiTE is a valid and reliable research tool with which to evaluate the effectiveness of smoking cessation training programs.
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Affiliation(s)
- Siti Idayu Hasan
- Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Lembah Pantai, 50603 Kuala Lumpur, Malaysia; (S.I.H.); (M.D.)
- Nicotine Addiction Research Group UMCAS, Wisma R & D University of Malaya, Jalan Pantai Baharu, 59200 Kuala Lumpur, Malaysia;
| | - Farizah Mohd Hairi
- Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Lembah Pantai, 50603 Kuala Lumpur, Malaysia; (S.I.H.); (M.D.)
- Nicotine Addiction Research Group UMCAS, Wisma R & D University of Malaya, Jalan Pantai Baharu, 59200 Kuala Lumpur, Malaysia;
| | - Amer Siddiq Amer Nordin
- Nicotine Addiction Research Group UMCAS, Wisma R & D University of Malaya, Jalan Pantai Baharu, 59200 Kuala Lumpur, Malaysia;
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Lembah Pantai, 50603 Kuala Lumpur, Malaysia
| | - Mahmoud Danaee
- Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Lembah Pantai, 50603 Kuala Lumpur, Malaysia; (S.I.H.); (M.D.)
- Nicotine Addiction Research Group UMCAS, Wisma R & D University of Malaya, Jalan Pantai Baharu, 59200 Kuala Lumpur, Malaysia;
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Facilitating smoking cessation in patients who smoke: a large-scale cross-sectional comparison of fourteen groups of healthcare providers. BMC Health Serv Res 2019; 19:750. [PMID: 31653215 PMCID: PMC6815021 DOI: 10.1186/s12913-019-4527-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 09/11/2019] [Indexed: 01/10/2023] Open
Abstract
Background Although healthcare providers are well placed to help smokers quit, implementation of smoking cessation care is still suboptimal. The Ask-Advise-Refer tasks are important aspects of smoking cessation care. We examined to which extent a large and diverse sample of healthcare providers expressed the intention to implement smoking cessation care and which barriers they encountered. We moreover examined to which extent the Ask-Advise-Refer tasks were implemented as intended, and which determinants (in interaction) influenced intentions and the implementation of Ask-Advise-Refer. Methods Cross-sectional survey among addiction specialists, anaesthesiologists, cardiologists, general practitioners, internists, neurologists, paediatricians, pulmonologists, ophthalmologists, surgeons, youth specialists, dental hygienists, dentists, and midwives (N = 883). Data were analysed using multivariate linear and logistic regression analyses and regression tree analyses. Results The Ask-Advice-Refer tasks were best implemented among general practitioners, pulmonologists, midwives, and addiction specialists. Overall we found a large discrepancy between asking patients about smoking status and advising smokers to quit. Participants mentioned lack of time, lack of training, lack of motivation to quit in patients, and smoking being a sensitive subject as barriers to smoking cessation care. Regression analyses showed that the most important determinants of intentions and implementation of Ask-Advise-Refer were profession, role identity, skills, guideline familiarity and collaboration agreements for smoking cessation care with primary care. Determinants interacted in explaining outcomes. Conclusions There is much to be gained in smoking cessation care, given that implementation of Ask-Advise-Refer is still relatively low. In order to improve smoking cessation care, changes are needed at the level of the healthcare provider (i.e., facilitate role identity and skills) and the organization (i.e., facilitate collaboration agreements and guideline familiarity). Change efforts should be directed towards the specific barriers encountered by healthcare providers, the contexts that they work in, and the patients that they work with.
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Palmer J, Lloyd A, Steele L, Fotheringham J, Teare D, Iqbal J, Grech ED. Differential Risk of ST-Segment Elevation Myocardial Infarction in Male and Female Smokers. J Am Coll Cardiol 2019; 73:3259-3266. [DOI: 10.1016/j.jacc.2019.03.525] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 03/26/2019] [Indexed: 12/15/2022]
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Meijer E, van der Kleij R, Segaar D, Chavannes N. Determinants of providing smoking cessation care in five groups of healthcare professionals: A cross-sectional comparison. PATIENT EDUCATION AND COUNSELING 2019; 102:1140-1149. [PMID: 30718091 DOI: 10.1016/j.pec.2019.01.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 01/16/2019] [Accepted: 01/18/2019] [Indexed: 06/09/2023]
Abstract
Objective To investigate implementation of a tobacco dependence treatment guideline among five groups of healthcare professionals. Methods Data collected in The Netherlands (2016-2017) were compared among gynaecologists (N = 49), midwives (N = 68), respiratory nurses (N = 72), practice nurses (N = 84) and paediatricians (N = 38). Intentions to use the guideline, satisfaction with own implementation, and dosage delivered of quit-advice and assisting in quitting were predicted using linear regression analyses and regression tree analyses. Results Implementation of smoking cessation care (SCC) and barriers differed between the groups, with nurses reporting better implementation and fewer barriers. Main barriers were lacking training (gynecologists, pediatricians) and time (midwives). Regression tree analyses showed that self-efficacy and training interacted; participants with weaker self-efficacy provided more quit advice if they had participated in SCC training. Training was positively related to intentions to use the guideline, satisfaction, providing quit-advice, and assisting smokers in quitting. Conclusion Implementation of SCC is suboptimal, such that patients who smoke do not receive the highest quality of care. Profession and training in SCC are important determinants of implementation of SCC. Practice implications Efforts to improve implementation should be targeted at profession. Training is indicated, and may focus on skills for nurses, and knowledge for gynecologists, midwives and pediatricians.
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Affiliation(s)
- Eline Meijer
- Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands.
| | - Rianne van der Kleij
- Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
| | - Dewi Segaar
- Dutch Alliance for a Smokefree Society, Utrecht, the Netherlands
| | - Niels Chavannes
- Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
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Meijer E, Chavannes N, Segaar D, Parlevliet J, Van Der Kleij R. Optimizing smoking cessation guideline implementation using text-messages and summary-sheets: A mixed-method evaluation. CLINICAL EHEALTH 2019. [DOI: 10.1016/j.ceh.2019.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Meijer E, Kampman M, Geisler MS, Chavannes NH. "It's on everyone's plate": a qualitative study into physicians' perceptions of responsibility for smoking cessation. Subst Abuse Treat Prev Policy 2018; 13:48. [PMID: 30541580 PMCID: PMC6290505 DOI: 10.1186/s13011-018-0186-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 11/30/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Little research has investigated in-depth how physicians perceive their role in smoking cessation care. This qualitative study sought to understand physicians' perceptions of responsibility for smoking cessation. METHODS Data were collected through individual semi-structured interviews and focus group interviews between June and November 2017 in The Netherlands. We interviewed 5 addiction specialists, 5 anesthesiologist, 4 cardiologists, 8 GPs, 5 internists, 5 neurologists, 2 pediatricians, 6 pulmonologists, 7 surgeons, and 8 youth healthcare physicians (N = 55). Data analysis followed the framework approach. RESULTS The analysis showed that three actors were perceived as responsible for smoking cessation: physicians, patients, and the government. Participants perceived physicians as responsible for facilitating smoking cessation -albeit to different extents-, patients as carrying the ultimate responsibility for quitting smoking, and the government as responsible for creating a society in which smoking uptake is more difficult and quitting smoking easier. Perceptions of smoking itself were found to be important for how participants viewed responsibility for smoking cessation. It remained unclear for many participants which healthcare provider is responsible for smoking cessation care. CONCLUSIONS The organization of smoking cessation care within health systems should be a focus of intervention, to better define physician roles and perceptions of responsibility. In addition, it seems important to target perceptions of smoking itself on the level of physicians and -as suggested by comments by several participants- the government.
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Affiliation(s)
- E. Meijer
- Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - M. Kampman
- Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - M. S. Geisler
- Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - N. H. Chavannes
- Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, PO Box 9600, 2300 RC Leiden, The Netherlands
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