1
|
Bhatt G, Goel S, Yadav SK, Patial A, Medhi B, Grover S, Attri S, Kaur R, Singh G, Gill SS. A randomised controlled trial to evaluate the effectiveness of a culture and disease-specific, patient-centric multi-component tobacco cessation intervention package for the patients attending non-communicable disease clinics in Punjab, India. Psychol Health 2024:1-18. [PMID: 38619313 DOI: 10.1080/08870446.2024.2333896] [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: 12/08/2022] [Accepted: 03/15/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Developing an infrastructure to support tobacco cessation through existing systems and resources is crucial for ensuring the greatest possible access to cessation services. The present study aims to evaluate the effectiveness of a newly developed multi-component cessation among tobacco users in Non- Communicable Disease (NCD) clinics, functioning under the National Programme for Prevention & Control of Cancer, Diabetes, Cardiovascular Diseases, & Stroke (NPCDCS) of the Government of India. METHODS The intervention package consisting of culture- and disease-specific four face-to-face counselling sessions, pamphlets, and short text messages (bilingual) with follow-ups at 3rd, 6th, and 9th months with an endline assessment at 12th months was delivered to the intervention arm of the two-arm- parallel group randomised controlled trial at two selected NCD clinics. Self-reported seven-day abstinence, frequency of use, expenditure in seven days at each follow-up, FTND score, stage of change and plasma cotinine values were assessed at baseline, follow-ups, and endline (using Liquid Chromatography -Mass Spectrometry), as applicable. RESULTS The intervention arm reported a significantly more reduction in self-reported frequency of tobacco use at 6 months (mean: 13.6, 95% CI (7.8-19.4)), 9 months (mean: 20.3, 95% CI (12.2-28.4)) and 12 months (mean: 18.7, 95% CI (8.7-28.7)). The plasma cotinine concentration at endline in the intervention arm was statistically significantly lower than the baseline concentration. CONCLUSION Strengthening existing health systems is crucial for offering cessation support in the resource-restraint setting of LMICs to assist in quitting sustainably.
Collapse
Affiliation(s)
- Garima Bhatt
- Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Sonu Goel
- Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
- School of Medicine, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland
- Faculty of Human & Health Sciences, Swansea University, Swansea, United Kingdom
| | - Subodh Kumar Yadav
- Department of Pharmacology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Ajay Patial
- Pediatric Biochemistry, Department of Pediatrics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Bikash Medhi
- Department of Pharmacology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Sandeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Savita Attri
- Pediatric Biochemistry, Department of Pediatrics, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Rajbir Kaur
- Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Gurmandeep Singh
- Department of Health & Family Welfare, Government of Punjab, National Health Mission, Chandigarh, India
| | - Sandeep Singh Gill
- Department of Health & Family Welfare, Government of Punjab, Chandigarh, India
| |
Collapse
|
2
|
Bhatt G, Goel S, Grover S, Medhi B, Singh G, Gill SS, Swasticharan L, Singh RJ. Development of a multi-component tobacco cessation training package utilizing multiple approaches of intervention development for health care providers and patients attending non-communicable disease clinics of Punjab, India. Front Public Health 2022; 10:1053428. [PMID: 36530680 PMCID: PMC9755677 DOI: 10.3389/fpubh.2022.1053428] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 11/08/2022] [Indexed: 12/05/2022] Open
Abstract
Background Providing patients with personalized tobacco cessation counseling that is culturally sensitive, and disease-specific from healthcare providers (HCPs) as part of their routine consultations is an approach that could be incorporated, using existing healthcare systems such as the Non-Communicable Disease (NCD) clinics. This paper describes the development of a multi-component culturally tailored, patient-centric, disease-specific tobacco cessation package utilizing multiple approaches of intervention development for healthcare providers and patients attending these clinics in Punjab, India, along with a proposed framework for implementation. Methods The proposed intervention package was developed in 6 stages. These included a review of literature for identifying successful cessation interventions for ethnic minority groups, co-production of the package with all stakeholders involved via a series of consultative meetings and workshops, understanding contextual factors of the state and 'factor-in' these in the package, pre-test of the package among HCPs and tobacco users using in-depth interviews, micro detailing and expansion of the package by drawing on existing theories of the Cascade Model and Trans-Theoretical Model and developing an evolving analysis plan through real-world implementation at two pilot districts by undertaking a randomized controlled trial, assessing implementer's experiences using a mixed-method with a primary focus on qualitative and economic evaluation of intervention package. Results A multi-component package consisting of a booklet (for HCPs), disease-specific pamphlets and short text messages (for patients; bilingual), and an implementation framework was developed using the 6-step process. A major finding from the in-depth interviews was the need for a specific capacity-building training program on tobacco cessation. Therefore, using this as an opportunity, we trained the in-service human resource and associated program managers at the state and district-level training workshops. Based on the feedback, training objectives were set and supported with copies of intervention package components. In addition, the role and function of each stakeholder were defined in the proposed framework. Conclusion Consideration of tobacco users' socio-cultural and patient-centric approach makes a robust strategy while developing and implementing an intervention providing an enlarged scope to improve care services for diversified socio-cultural communities.
Collapse
Affiliation(s)
- Garima Bhatt
- Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Sonu Goel
- Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India,Public Health Master's Program, School of Medicine and Health Research Institute (HRI), University of Limerick, Limerick, Ireland,Faculty of Human and Health Sciences, Swansea University, Swansea, United Kingdom,*Correspondence: Sonu Goel
| | - Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Bikash Medhi
- Department of Pharmacology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Gurmandeep Singh
- National Health Mission, Department of Health and Family Welfare Government of Punjab, Chandigarh, India
| | - Sandeep Singh Gill
- Department of Health and Family Welfare, Government of Punjab, Chandigarh, India
| | - Leimapokpam Swasticharan
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, New Delhi, India
| | - Rana J. Singh
- Department of Tobacco and NCD Control, International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India
| |
Collapse
|
3
|
Aydin E, Aydin S, Gül M, Yetim M, Demir M, Özkan C, Karakurt M, Burak C, Bayraktar MF, Temizer O, Erbay İ, Muştu M, Karagöz A, Üzoğullari İR, Şen T, Özeke Ö, Topaloğlu S, Aras D, Tanboğa Hİ. Influence of Intermittent Fasting During Ramadan on Circadian Variation of Symptom-Onset and Prehospital Time Delay in Acute ST-Segment Elevation Myocardial Infarction. Angiology 2022; 74:569-578. [PMID: 35975875 DOI: 10.1177/00033197221114087] [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: 11/16/2022]
Abstract
Ramadan interferes with circadian rhythms mainly by disturbing the routine patterns of feeding and smoking. The objective of this study was to investigate the circadian pattern of ST elevation acute myocardial infarction (STEMI) during the month of Ramadan. We studied consecutive STEMI patients 1 month before and after Ramadan (non-Ramadan group-NRG) and during Ramadan (Ramadan group-RG). The RG group was also divided into two groups, based on whether they chose to fast: fasting (FG) and non-fasting group (NFG). The time of STEMI onset was compared. A total of 742 consecutive STEMI patients were classified into 4 groups by 6 h intervals according to time-of-day at symptom onset. No consistent circadian variation in the onset of STEMI was observed both between the RG (P = .938) and NRG (P = .766) or between the FG (P = .232) and NFG (P = .523). When analyzed for subgroups of the study sample, neither smoking nor diabetes showed circadian rhythm. There was a trend towards a delay from symptom onset to hospital presentation, particularly at evening hours in the RG compared with the control group. In conclusion, there was no significant difference in STEMI onset time, but the time from symptom onset to hospital admission was significantly delayed during Ramadan.
Collapse
Affiliation(s)
- Ertan Aydin
- Cardiology, Prof. Dr A. İlhan Özdemir Training and Research Hospital, Giresun University, Giresun, Turkey
| | | | - Murat Gül
- Cardiology, Faculty of Medicine, Aksaray University, Aksaray, Turkey
| | - Mucahit Yetim
- Cardiology, Erol Olçok Training and Research Hospital, Hitit University, Çorum, Turkey
| | - Mevlüt Demir
- Cardiology, Evliya Celebi Training and Research Hospital, Kütahya Health Sciences University, Kutahya, Turkey
| | - Can Özkan
- Cardiology, Muş State Hospital, Muş, Turkey
| | - Mustafa Karakurt
- Cardiology, Kırıkkale Yuksek Ihtisas Hospital, Kırıkkale, Turkey
| | - Cengiz Burak
- Cardiology, Faculty of Medicine, 485644Kafkas University, Kars, Turkey
| | | | | | - İlke Erbay
- Cardiology, Muş State Hospital, Muş, Turkey
| | - Mehmet Muştu
- Cardiology, Faculty of Medicine, Karamanoğlu Mehmetbey University, Karaman, Turkey
| | - Ahmet Karagöz
- Cardiology, Prof. Dr A. İlhan Özdemir Training and Research Hospital, Giresun University, Giresun, Turkey
| | | | - Taner Şen
- Cardiology, Evliya Celebi Training and Research Hospital, Kütahya Health Sciences University, Kutahya, Turkey
| | - Özcan Özeke
- Cardiology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Serkan Topaloğlu
- Cardiology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Dursun Aras
- Cardiology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | | |
Collapse
|
4
|
Youn JH, Shin S. The experience of continued smoking after stroke in Korean males: A qualitative study. Nurs Open 2021; 8:2750-2759. [PMID: 33704928 PMCID: PMC8363419 DOI: 10.1002/nop2.851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 01/26/2021] [Accepted: 02/17/2021] [Indexed: 01/25/2023] Open
Abstract
AIM This study aimed to identify the nature and meaning of continued smoking in male stroke patients based on a deep understanding of their lived experiences. DESIGN Phenomenological qualitative methodology. METHODS In total, 10 male stroke patients participated in this study. We used purposive sampling for recruitment. Data collection was performed through in-depth interviews and analysis through van Manen's methodology. RESULTS Five essential themes were derived from the analyses and described participants' experiences with continued smoking, as follows: "Natural relapse into smoking," "Behaving like a healthy person," "Believing that smoking will not be a problem," "Finding consolation in smoking behaviour," and "Consoling oneself by the rationalization of smoking behaviour." CONCLUSION The results showcased the need for the development of a smoking cessation educational programme tailored for male stroke patients who have perceptions towards being "like healthy people" after early recovery and who think that smoking is not a problematic behaviour. Participants' reports underpinned the necessity for these programmes to have contents focused on the transformation of patients' awareness toward their own health status.
Collapse
Affiliation(s)
- Jung Hee Youn
- Division of Nursing, Ewha Seoul Hospital, Seoul, Republic of Korea
| | - Sujin Shin
- College of Nursing, Ewha Womans University, Seoul, Republic of Korea
| |
Collapse
|
5
|
Mentrup S, Harris E, Gomersall T, Köpke S, Astin F. Patients' Experiences of Cardiovascular Health Education and Risk Communication: A Qualitative Synthesis. QUALITATIVE HEALTH RESEARCH 2020; 30:88-104. [PMID: 31729937 DOI: 10.1177/1049732319887949] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Coronary heart disease (CHD) has no cure, and patients with myocardial infarction are at high risk for further cardiac events. Health education is a key driver for patients' understanding and motivation for lifestyle change, but little is known about patients' experience of such education. In this review, we aimed to explore how patients with CHD experience health education and in particular risk communication. A total of 2,221 articles were identified through a systematic search in five databases. 40 articles were included and synthesized using thematic analysis. Findings show that both "what" was communicated, and "the way" it was communicated, had the potential to influence patients' engagement with lifestyle changes. Communication about the potential of lifestyle change to reduce future risk was largely missing causing uncertainty, anxiety, and, for some, disengagement with lifestyle change. Recommendations for ways to improve health education and risk communication are discussed to inform international practice.
Collapse
Affiliation(s)
| | - Emma Harris
- University of Huddersfield, Huddersfield, United Kingdom
| | - Tim Gomersall
- University of Huddersfield, Huddersfield, United Kingdom
| | | | - Felicity Astin
- University of Huddersfield, Huddersfield, United Kingdom
- Huddersfield Royal Infirmary, Huddersfield, United Kingdom
| |
Collapse
|
6
|
Deveci B, Ozeke O, Gul M, Acar B, Hande Ozcan Cetin E, Burak C, Cay S, Topaloglu S, Aras D, Ilkay E. Impact of the radial versus femoral access for primary percutaneous intervention on smoking cessation rates: A paradoxus between the health related quality of life and smoking quitting? COR ET VASA 2018. [DOI: 10.1016/j.crvasa.2018.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
|
7
|
Bhagwat MM, Woods JA, Dronavalli M, Hamilton SJ, Thompson SC. Evidence-based interventions in primary care following acute coronary syndrome in Australia and New Zealand: a systematic scoping review. BMC Cardiovasc Disord 2016; 16:214. [PMID: 27829379 PMCID: PMC5103388 DOI: 10.1186/s12872-016-0388-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 10/29/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Coronary artery disease has a significant disease burden, but there are many known barriers to management of acute coronary syndrome (ACS). General practitioners (GPs) bear considerable responsibility for post-discharge management of ACS in Australia and New Zealand (NZ), but knowledge about the extent and efficacy of such management is limited. This systematic review summarises published evidence from Australia and New Zealand regarding management in primary care after discharge following ACS. METHODS A search of PubMed, Scopus, CINAHL-Plus and PSYCINFO databases in August 2015 was supplemented by citation screening and hand-searching. Literature was selected based on specified criteria, and assessed for quality using the Mixed Methods Appraisal Tool (MMAT). Extracted data was related to evidence-based interventions specified by published guidelines. RESULTS The search yielded 19 publications, most of which reported on quantitative and observational studies from Australia. The majority of studies scored at least 75 % on the MMAT. Diverse aspects of management by GPs are presented according to categories of evidence-based guidelines. Data suggests that GPs are more likely to prescribe ACS medications than to assist in lifestyle or psychological management. GP referral to cardiac rehabilitation varied, and one study showed an improvement in the number of ACS patients with documented ACS management plans. Few studies described successful interventions to improve GP management, though some quality improvement efforts through education and integration of care with hospitals were beneficial. Limited data was published about interventions effective in rural, minority, and Indigenous populations. CONCLUSIONS Research reflects room for improvement in GP post-discharge ACS management, but little is known about effective methods for improvement. Additional research, both observational and interventional, would assist GPs in improving the quality of post-discharge ACS care.
Collapse
Affiliation(s)
- Manavi M. Bhagwat
- Western Australian Centre for Rural Health, The University of Western Australia (M706), 35 Stirling Highway, Crawley, Western Australia 6009 Australia
- Georgetown University, Washington, DC USA
| | - John A. Woods
- Western Australian Centre for Rural Health, The University of Western Australia (M706), 35 Stirling Highway, Crawley, Western Australia 6009 Australia
| | - Mithilesh Dronavalli
- Western Australian Centre for Rural Health, The University of Western Australia (M706), 35 Stirling Highway, Crawley, Western Australia 6009 Australia
| | - Sandra J. Hamilton
- Western Australian Centre for Rural Health, The University of Western Australia (M706), 35 Stirling Highway, Crawley, Western Australia 6009 Australia
| | - Sandra C. Thompson
- Western Australian Centre for Rural Health, The University of Western Australia (M706), 35 Stirling Highway, Crawley, Western Australia 6009 Australia
| |
Collapse
|
8
|
Hansen EC, Nelson MR. Staying a smoker or becoming an ex-smoker after hospitalisation for unstable angina or myocardial infarction. Health (London) 2016; 21:461-477. [DOI: 10.1177/1363459316644493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of our study was to better understand processes of ongoing smoking or smoking cessation (quitting) following hospitalisation for myocardial infarction or unstable angina (acute cardiac syndromes). In-depth interviews were used to elicit participants’ stories about ongoing smoking and quitting. In total, 18 interviews with smokers and 14 interviews with ex-smokers were analysed. Our findings illustrate the complex social nature of smoking practices including cessation. We found that smoking cessation following hospitalisation for acute cardiac syndromes is to some extent a performative act linked to ‘doing health’ and claiming a new identity, that of a virtuous ex-smoker in the hope that this will prevent further illness. For some ex-smokers hospitalisation had facilitated this shift, acting as a rite of passage and disrupting un-contemplated habits. Those participants who continued to smoke had often considered quitting or had even stopped smoking for a short period of time after hospitalisation; however, they did not undergo the identity shift described by ex-smokers and smoking remained firmly entrenched in their sense of self and the pattern of their daily lives. The ongoing smokers described feeling ashamed and stigmatised because of their smoking and felt that quitting was impossible for them. Our study provides an entry point into the smokers’ world at a time when their smoking has become problematised and highly visible due to their illness and when smoking cessation or continuance carries much higher stakes and more immediate consequences than might ordinarily be the case.
Collapse
|
9
|
Smith AL, Carter SM, Chapman S, Dunlop SM, Freeman B. Why do smokers try to quit without medication or counselling? A qualitative study with ex-smokers. BMJ Open 2015; 5:e007301. [PMID: 25933811 PMCID: PMC4420973 DOI: 10.1136/bmjopen-2014-007301] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE When tobacco smokers quit, between half and two-thirds quit unassisted: that is, they do not consult their general practitioner (GP), use pharmacotherapy (nicotine-replacement therapy, bupropion or varenicline), or phone a quitline. We sought to understand why smokers quit unassisted. DESIGN Qualitative grounded theory study (in-depth interviews, theoretical sampling, concurrent data collection and data analysis). PARTICIPANTS 21 Australian adult ex-smokers (aged 28-68 years; 9 males and 12 females) who quit unassisted within the past 6 months to 2 years. 12 participants had previous experience of using assistance to quit; 9 had never previously used assistance. SETTING Community, Australia. RESULTS Along with previously identified barriers to use of cessation assistance (cost, access, lack of awareness or knowledge of assistance, including misperceptions about effectiveness or safety), our study produced new explanations of why smokers quit unassisted: (1) they prioritise lay knowledge gained directly from personal experiences and indirectly from others over professional or theoretical knowledge; (2) their evaluation of the costs and benefits of quitting unassisted versus those of using assistance favours quitting unassisted; (3) they believe quitting is their personal responsibility; and (4) they perceive quitting unassisted to be the 'right' or 'better' choice in terms of how this relates to their own self-identity or self-image. Deep-rooted personal and societal values such as independence, strength, autonomy and self-control appear to be influencing smokers' beliefs and decisions about quitting. CONCLUSIONS The reasons for smokers' rejection of the conventional medical model for smoking cessation are complex and go beyond modifiable or correctable problems relating to misperceptions or treatment barriers. These findings suggest that GPs could recognise and respect smokers' reasons for rejecting assistance, validate and approve their choices, and modify brief interventions to support their preference for quitting unassisted, where preferred. Further research and translation may assist in developing such strategies for use in practice.
Collapse
Affiliation(s)
- Andrea L Smith
- Centre for Values, Ethics and the Law in Medicine, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Stacy M Carter
- Centre for Values, Ethics and the Law in Medicine, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Simon Chapman
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Sally M Dunlop
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
- Cancer Screening and Prevention, Cancer Institute NSW, Eveleigh, New South Wales, Australia
| | - Becky Freeman
- Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
10
|
Smoking Cessation in Long-Term Conditions: Is There “An Opportunity in Every Difficulty”? ACTA ACUST UNITED AC 2013. [DOI: 10.1155/2013/251048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
11
|
Smith AL, Chapman S, Dunlop SM. What do we know about unassisted smoking cessation in Australia? A systematic review, 2005-2012. Tob Control 2013; 24:18-27. [PMID: 24026163 DOI: 10.1136/tobaccocontrol-2013-051019] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
CONTEXT A significant proportion of smokers who quit do so on their own without formal help (ie, without professionally or pharmacologically mediated assistance), yet research into how smokers quit focuses primarily on assisted methods of cessation. OBJECTIVE The aim of the present work was to systematically review recent smoking cessation research in Australia, a nation advanced in tobacco control, to determine what is known about smokers who quit unassisted in order to (1) inform a research agenda to develop greater understanding of the many smokers who quit unassisted and (2) elucidate possible lessons for policy and mass communication about cessation. METHODS In January 2013, four e-databases and the grey literature were searched for articles published between 2005 and 2012 on smoking cessation in Australia. Articles focusing solely on interventions designed to stimulate cessation were excluded, as were articles focusing solely on assisted cessation, leaving articles reporting on smokers who quit unassisted. Data from articles reporting on unassisted cessation were extracted and grouped into related categories. RESULTS A total of 248 articles reported on smoking cessation, of which 63 focused solely on interventions designed to stimulate cessation, leaving 185 reporting on the method of cessation ('how' a smoker quits). Of these, 166 focused solely on assisted cessation, leaving 19 reporting, either directly or indirectly, on smokers who quit unassisted. Data from these studies indicated 54% to 69% of ex-smokers quit unassisted and 41% to 58% of current smokers had attempted to quit unassisted. CONCLUSIONS The majority of Australian smokers quit or attempt to quit unassisted, yet little research has been dedicated to understanding this process. Almost all research that reported unassisted cessation referenced it as a comparator to the focal point of assisted cessation. Public health may benefit from insights gained from greater research into the cessation method used by most smokers. Suggestions and a rationale for such research are provided.
Collapse
Affiliation(s)
- Andrea L Smith
- Sydney School of Public Health, The University of Sydney, New South Wales, Australia
| | - Simon Chapman
- Sydney School of Public Health, The University of Sydney, New South Wales, Australia
| | - Sally M Dunlop
- Sydney School of Public Health, The University of Sydney, New South Wales, Australia Cancer Prevention Division, Cancer Institute NSW, Eveleigh, New South Wales, Australia
| |
Collapse
|
12
|
Davies L, Bell E. Plain cigarette packaging: A policy analysis of Australia’s integrated “whole-of-system” model for smoking cessation. Health (London) 2012. [DOI: 10.4236/health.2012.412187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|