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Alanazi AM, Monshi SS, Alfahadi NA, Alsayari SS, Alkhonain FS, Alsulami NM, Alotaibi TF, Algarni SS, Abunurah HY, Al-Zalabani AH, Ismaeil TT. The associations between the credibility of the tobacco control regulatory body and smoking behavior change among Saudi smokers. Tob Induc Dis 2022; 20:107. [PMID: 36514796 PMCID: PMC9717579 DOI: 10.18332/tid/155814] [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: 03/15/2022] [Revised: 06/21/2022] [Accepted: 10/17/2022] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Recently, Saudi Arabia has extensively reformed its tobacco control policies and extended its smoking cessation services. A public outrage on social media among smokers was witnessed, especially after the implementation of plain cigarette packaging, which might have discredited the significant efforts of tobacco treatment services and tobacco control policies. However, it is not known how the credibility of the tobacco control regulatory body among Saudi smokers might affect their smoking behavior. METHODS Saudi tobacco smokers (n=511) were recruited using a convenience sampling technique. A cross-sectional survey was conducted comprising questions related to the credibility of the tobacco control regulatory body (modified Food and Drug Administration Tobacco Credibility Scale), quit attempts, use of nicotine replacement therapy (NRT), and motivation to change smoking behavior in the future. Logistic and linear regression models were used for the analysis. RESULTS The public interest subscale of the credibility of the tobacco control regulatory body, was positively associated with confidence in changing smoking behavior (β=0.204; 95% CI: 0.078-0.713; t=2.449, p=0.015) and readiness to change smoking behavior (β=0.237; 95% CI: 0.127-0.727; t=2.802, p=0.005). Moreover, the subscale of expertise was positively associated with confidence in changing smoking behavior (β=0.190; 95% CI: 0.006-0.697; t=1.999, p=0.046) and readiness to change smoking behavior (β=0.225; 95% CI: 0.063-0.710; t=2.352, p=0.019). However, public interest in the credibility of the tobacco control regulatory body was negatively associated with NRT use among smokers who tried to quit (adjusted odds ratio, AOR=0.691; 95% CI: 0.526-0.909). The credibility of the tobacco control regulatory body, however, was not associated with the last month's or ever quit attempts. CONCLUSIONS The credibility of the tobacco control regulatory body was positively associated with motivation to change smoking behavior but negatively associated with NRT use. Optimizing communication tools with the public is a potential avenue for improving smoking treatment and prevention in Saudi Arabia.
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Affiliation(s)
- Abdullah M. Alanazi
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Sarah S. Monshi
- Department of Health Services Management, College of Public Health and Health Informatics, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Nada A. Alfahadi
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Sadeem S. Alsayari
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Foton S. Alkhonain
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Norah M. Alsulami
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Tareq F. Alotaibi
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Saleh S. Algarni
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Hassan Y. Abunurah
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Abdulmohsen H. Al-Zalabani
- Department of Family and Community Medicine, College of Medicine, Taibah University, Medina, Saudi Arabia
| | - Taha T. Ismaeil
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
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Osborne B, Larance B, Ivers R, Deane FP, Robinson LD, Kelly PJ. Systematic review of guidelines for managing physical health during treatment for substance use disorders: Implications for the alcohol and other drug workforce. Drug Alcohol Rev 2022; 41:1367-1390. [PMID: 35765725 PMCID: PMC9539873 DOI: 10.1111/dar.13504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 05/29/2022] [Accepted: 06/01/2022] [Indexed: 11/28/2022]
Abstract
ISSUES Substance use disorders are associated with significant physical health comorbidities, necessitating an integrated treatment response. However, service fragmentation can preclude the management of physical health problems during addiction treatment. The aim of this systematic review was to synthesise the recommendations made by clinical practice guidelines for addressing the physical health of people attending alcohol and other drug (AOD) treatment. APPROACH An iterative search strategy of grey literature sources was conducted from September 2020 to February 2021 to identify clinical practice guidelines. Content pertaining to physical health care during AOD treatment was extracted. Quality of guidelines were appraised using the Appraisal of Guidelines Research and Evaluation II (AGREE-II) tool. FINDINGS Thirty-three guidelines were included for review. Fourteen guidelines were considered high quality based on AGREE-II scores. Neurological conditions (90.9%) and hepatitis (81.8%) were the most frequent health problems addressed. Most guidelines recommended establishing referral pathways to address physical health comorbidities (90.9%). Guidance on facilitating these referral pathways was less common (42.4%). Guidelines were inconsistent in their recommendations related to oral health, tobacco use, physical activity, nutrition and the use of standardised assessment tools. IMPLICATIONS AND CONCLUSIONS Greater consistency and specificity in the recommendations made for integrating physical health care within addiction treatment is needed. Ensuring that recommendations are applicable to the AOD workforce and to treatment services limited by funding and resource constraints should enhance implementation. Future guideline development groups should consider increased consultation with the AOD workforce and inclusion of clinical tools and decision aids to facilitate referral pathways.
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Affiliation(s)
- Briony Osborne
- School of Psychology, University of Wollongong, Wollongong, Australia.,Centre for Health Psychology Practice and Research, Wollongong, Australia
| | - Briony Larance
- School of Psychology, University of Wollongong, Wollongong, Australia.,Centre for Health Psychology Practice and Research, Wollongong, Australia
| | - Rowena Ivers
- Graduate School of Medicine, University of Wollongong, Wollongong, Australia
| | - Frank P Deane
- School of Psychology, University of Wollongong, Wollongong, Australia.,Centre for Health Psychology Practice and Research, Wollongong, Australia
| | - Laura D Robinson
- School of Psychology, University of Wollongong, Wollongong, Australia.,Centre for Health Psychology Practice and Research, Wollongong, Australia
| | - Peter J Kelly
- School of Psychology, University of Wollongong, Wollongong, Australia.,Centre for Health Psychology Practice and Research, Wollongong, Australia
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Lum A, Skelton E, Robinson M, Guillaumier A, Wynne O, Gartner C, Borland R, Baker A, Dunlop A, Wilkinson RB, Bonevski B. Barriers and facilitators to using vaporised nicotine products as smoking cessation aids among people receiving treatment for substance use disorder. Addict Behav 2022; 124:107097. [PMID: 34536632 DOI: 10.1016/j.addbeh.2021.107097] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 08/20/2021] [Accepted: 08/21/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Vaporised nicotine products (VNPs) may be useful smoking cessation aids for people in alcohol and other drug (AOD) treatment, a population with high tobacco-related morbidity and mortality rates. This qualitative study aimed to examine the barriers and facilitators of using VNPs as part of a clinical trial to reduce or quit smoking among people in AOD treatment. METHODS Thirteen people in AOD treatment who were participating in a trial of VNPs for smoking cessation (QuitENDs) completed a brief semi-structured interview examining experiences of using VNPs to reduce or quit smoking. Transcribed data was analysed using the iterative categorisation framework. RESULTS Many participants expressed the benefit of having a smoking cessation aid that addressed nicotine cravings and the behavioural hand-to-mouth action to help them reduce or quit smoking. Although many participants reported that VNPs were easy to use, some found maintaining the device to be challenging. Some participants described Australian regulations limiting use of VNPs as reducing their desire to use the device as a cessation aid. Many participants attempting to reduce or quit tobacco and cannabis simultaneously stated that VNPs alone were insufficient to help them reduce or quit tobacco. CONCLUSIONS VNPs hold significant promise as smoking cessation aids among people in AOD treatment because of their unique ability to satisfy both nicotine cravings and behavioural habits. However, multiple barriers, such as accessibility, maintenance, and the challenges of reducing other substance use simultaneously also need to be addressed for optimal engagement in clinical trials with VNPs to quit smoking.
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Affiliation(s)
- Alistair Lum
- The University of Newcastle, Faculty of Health and Medicine, School of Medicine and Public Health, 1 University Drive, Callaghan, NSW 2308, Australia.
| | - Eliza Skelton
- The University of Newcastle, Faculty of Health and Medicine, School of Medicine and Public Health, 1 University Drive, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Maryanne Robinson
- Drug & Alcohol Clinical Services, Hunter New England Local Health District, Newcastle Community Health Centre, 670 Hunter Street, Newcastle West, NSW 2302, Australia
| | - Ashleigh Guillaumier
- The University of Newcastle, Faculty of Health and Medicine, School of Medicine and Public Health, 1 University Drive, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Olivia Wynne
- Drug & Alcohol Clinical Research & Improvement Network, St Leonards, NSW 2065, Australia
| | - Coral Gartner
- University of Queensland, Faculty of Medicine, School of Public Health, St Lucia, QLD 4072, Australia
| | - Ron Borland
- University of Melbourne, Faculty of Medicine, Dentistry and Health Sciences, School of Psychological Sciences, Melbourne, VIC 3010, Australia
| | - Amanda Baker
- The University of Newcastle, Faculty of Health and Medicine, School of Medicine and Public Health, 1 University Drive, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Adrian Dunlop
- The University of Newcastle, Faculty of Health and Medicine, School of Medicine and Public Health, 1 University Drive, Callaghan, NSW 2308, Australia; Drug & Alcohol Clinical Services, Hunter New England Local Health District, Newcastle Community Health Centre, 670 Hunter Street, Newcastle West, NSW 2302, Australia; Drug & Alcohol Clinical Research & Improvement Network, St Leonards, NSW 2065, Australia
| | - Ross B Wilkinson
- Clinical Research Design & Statistics, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Billie Bonevski
- The University of Newcastle, Faculty of Health and Medicine, School of Medicine and Public Health, 1 University Drive, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; Flinders University, College of Medicine & Public Health, Level 5 Flinders Medical Centre, Bedford Park, SA 5042, Australia
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Obieche O, Lee M, Salehi N. Exploring attitudes towards smoking behaviour and cessation among hospitalised smokers via a socio-ecological framework: A scoping review. Addict Behav 2021; 122:107040. [PMID: 34246988 DOI: 10.1016/j.addbeh.2021.107040] [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: 01/12/2021] [Revised: 06/10/2021] [Accepted: 06/30/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Cigarette smoking is a leading cause of preventable mortality and disability. Smoke-free policies in healthcare settings have been implemented as a public health measure. This scoping review aims to explore attitudes on smokers' cessation in smoke-free healthcare settings using a socio-ecological framework. METHODS Four databases were searched for terms: smoking cessation, patient attitudes, and smoke-free policy. Of 420 studies, 17 met full inclusion criteria. RESULTS The review identified four socio-ecological aspects of smoking cessation in smoke-free healthcare settings: Intrapersonal factors (health literacy, health conditions, and self-efficacy), interpersonal factors (social support, peer pressure, and social responsibility), healthcare factors (perceived mixed messages, healthcare setting, clinical, psychosocial and health promotion supports), and societal factors (restrictions on smoking in a public place and social acceptability of smoking). Smoke-free policies effectively encouraged cessation in some patients but were ineffective in those that felt a loss of autonomy. Provision of smoke breaks within smoke-free policies was considered a mixed message. CONCLUSIONS Holistic strategies are required to interconnect the four socio-ecological dimensions for successful smoking cessation.
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Healthy recovery: A stepped wedge cluster randomised controlled trial of a healthy lifestyle intervention for people attending residential alcohol and other drug treatment. Drug Alcohol Depend 2021; 221:108557. [PMID: 33714901 DOI: 10.1016/j.drugalcdep.2021.108557] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 12/18/2020] [Accepted: 12/28/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Unhealthy lifestyle behaviours contribute to the poor health of people attending alcohol and other drug (AOD) treatment. Healthy Recovery is an 8-session group-based intervention that targets smoking, diet and physical inactivity as part of an integrated healthy lifestyle approach. The current study aimed to examine the effectiveness of Healthy Recovery when delivered within residential AOD treatment settings. METHODS The study design was a stepped-wedge cluster randomised trial. Participants were 151 current smokers attending residential AOD programs provided by the Australian Salvation Army (n = 71, Control condition; n = 80, Intervention condition). The primary outcome was number of cigarettes smoked per day. Secondary outcomes examined other smoking behaviours (7-day point prevalence, use of nicotine replacement therapy [NRT]), diet (servings and variety of fruit and vegetables), and physical activity. RESULTS The mean number of cigarettes smoked per day was significantly lower in the Intervention condition at 2-, 5-, and 8-month follow-up. There were also significant differences in favour of the Intervention condition for number of quit attempts, use of NRT and variety of fruit. There were no other significant differences for other dietary or physical activity variables. CONCLUSIONS Healthy Recovery had a positive impact on smoking behaviours. Future research should consider strategies to further promote smoking cessation (e.g. promoting longer-term use of NRT), as well as addressing physical activity and dietary behaviours. The introduction of broader organisational approaches (e.g. smoke free policies, organised group exercise and cooking activities) might help to enhance healthy lifestyle approaches within AOD treatment settings.
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