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Trigg J, Rich J, Williams E, Baker A, Bauld L, Borland R, Bullen C, Daglish M, Dunlop A, Gartner C, Jacka D, Lubman D, Manning V, McCrohan R, Segan C, Walker N, Bonevski B. A qualitative study of using nicotine products for smoking cessation after discharge from residential drug and alcohol treatment in Australia. Drug Alcohol Rev 2024; 43:1116-1131. [PMID: 38653554 DOI: 10.1111/dar.13850] [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: 03/06/2023] [Revised: 03/08/2024] [Accepted: 04/03/2024] [Indexed: 04/25/2024]
Abstract
INTRODUCTION Tobacco smoking is highly prevalent among alcohol and other drugs (AOD) service clients and, despite interest in quitting, abstinence is rarely sustained. Nicotine products may assist after discharge from residential treatment services, but little is known about client receptivity to them. This study examined AOD withdrawal service clients' experiences of two types of nicotine products for smoking cessation post-discharge, combination nicotine replacement therapy (cNRT) and nicotine vaping products (NVP). METHODS We held semi-structured telephone interviews with 31 Australian AOD service clients in a clinical trial of a 12-week smoking cessation intervention using Quitline support plus cNRT or NVP delivered post-discharge from a smoke-free residential service. We asked about health and social factors, nicotine cravings, Quitline experience, and barriers and facilitators to cNRT or NVP, then thematically analysed data. RESULTS cNRT and NVP were described by participants as feasible and acceptable for smoking cessation. For most participants, cost limited cNRT access post study, as did difficulty navigating NVP prescription access. Quitline support was valued, but not consistently used, with participants noting low assistance with NVP-facilitated cessation. Participants considered both cessation methods acceptable and socially supported, and sought information on decreasing nicotine use via NVP. DISCUSSION AND CONCLUSIONS AOD service clients highly valued receiving cNRT or NVP with behavioural support for smoking reduction or abstinence. Both interventions were acceptable to service clients. Findings suggest a potential need to examine both whether NVP use should be permitted in this context, and guidance on the individual suitability of cNRT or NVP.
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Affiliation(s)
- Joshua Trigg
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Jane Rich
- School of Medicine and Public Health, College of Medicine, Health and Wellbeing, University of Newcastle, Newcastle, Australia
| | - Edwina Williams
- School of Medicine and Public Health, College of Medicine, Health and Wellbeing, University of Newcastle, Newcastle, Australia
| | - Amanda Baker
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Linda Bauld
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Ron Borland
- School of Psychological Sciences and Honorary Professor, School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Chris Bullen
- The National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Mark Daglish
- Faculty of Medicine, University of Queensland, and Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Adrian Dunlop
- School of Medicine and Public Health, College of Medicine, Health and Wellbeing, University of Newcastle, Newcastle, Australia
- Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, Australia
| | - Coral Gartner
- School of Public Health, University of Queensland, Brisbane, Australia
| | - David Jacka
- Department of Drug and Alcohol Treatment, Monash Health, Melbourne, Australia
| | - Dan Lubman
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
- Turning Point, Eastern Health, Monash University, Melbourne, Australia
| | - Victoria Manning
- Turning Point, Eastern Health, Monash University, Melbourne, Australia
| | | | | | - Natalie Walker
- The National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Billie Bonevski
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, Australia
- School of Medicine and Public Health, College of Medicine, Health and Wellbeing, University of Newcastle, Newcastle, Australia
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LeLaurin JH, Thrasher JF, Strayer SM, Malaty J, Kollath-Cattano C, Williams M, Nguyen OT, Kellner AM, Smith JM, Salloum RG. Feasibility of a primary care patient decision aid for smoking cessation with information about e-cigarettes. Prev Med Rep 2022; 26:101745. [PMID: 35251914 PMCID: PMC8892147 DOI: 10.1016/j.pmedr.2022.101745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/28/2022] [Accepted: 02/26/2022] [Indexed: 11/17/2022] Open
Abstract
Patients had higher confidence and readiness to quit after the decision aids. The decision aid helped prepare patients to make a decision about quitting smoking. Patients expressed satisfaction with the decision aid and clinician consultation. Smoking cessation decision aids are acceptable and may promote behavior change.
Decision aids can promote shared decision making and behavior change and may be effective in helping patients quit smoking. Patients are increasingly using e-cigarettes for smoking cessation; however, little is known about the impact of including e-cigarette information in smoking cessation decision aids. Our objective was to assess the feasibility and acceptability of a smoking cessation decision aid including e-cigarette information. This study was conducted at one family medicine clinic in the United States. We used a pre-post design. In Phase I, the decision aid presented information about approved cessation methods. In Phase II, current e-cigarette users and patients with no intention of quitting received additional information on switching to e-cigarettes. We assessed the impact of the decision aids on quit attempts and abstinence, confidence and readiness to quit, confidence and readiness to switch to e-cigarettes, and patient satisfaction. We enrolled 60 patients in each phase (N = 120). Patients reported higher confidence and readiness to quit after viewing the decision aids and consulting with their physician (p < 0.01). Patients reported the decision aid helped prepare them to make a decision about quitting smoking and expressed satisfaction with the decision aid and clinician consultation. We did not observe an impact of including e-cigarette information. Smoking cessation decision aids are acceptable to patients and may promote behavior change. Future studies should explore the impact of providing patients e-cigarette information using larger sample sizes and rigorous designs. Further research is needed to identify strategies to promote shared decision-making regarding e-cigarettes.
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Affiliation(s)
- Jennifer H. LeLaurin
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - James F. Thrasher
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Scott M. Strayer
- Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - John Malaty
- Department of Community Health and Family Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | | | - Maribeth Williams
- Department of Community Health and Family Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Oliver T. Nguyen
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Allie M. Kellner
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - James M. Smith
- Division of General Internal Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Ramzi G. Salloum
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA
- Corresponding author at: Department of Health Outcomes and Biomedical Informatics, P.O. Box 100177, Gainesville, FL 32610-0177, USA.
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Morphett K, Gartner C. Informed choice in the context of tobacco use disorder. Nicotine Tob Res 2021; 24:1-2. [PMID: 34648625 DOI: 10.1093/ntr/ntab215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 10/13/2021] [Indexed: 11/14/2022]
Affiliation(s)
- Kylie Morphett
- The NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Australia
| | - Coral Gartner
- The NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Australia
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Hollanda De Sa Neto H, Habfast-Robertson I, Hempel-Bruder C, Durand MA, Jacot-Sadowski I, Khazaal Y, Berlin I, Selby K. Formative provider testing of a New Encounter Decision Aid for Smoking Cessation (Preprint). JMIR Form Res 2021; 6:e32960. [PMID: 35442200 PMCID: PMC9069282 DOI: 10.2196/32960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/22/2021] [Accepted: 02/19/2022] [Indexed: 11/13/2022] Open
Abstract
Background Smoking cessation is an essential part of preventing and reducing the risk of smoking-associated morbidity and mortality. However, there is often little time to discuss smoking cessation in primary care. Decision aids (DAs) designed for clinic visits (encounter DAs) need to be clear, short, and concise to optimize therapeutic education, increase interaction, and improve the therapeutic alliance. Such a DA for smoking cessation could potentially improve counseling and increase the use of pharmacological treatments. Objective We aimed to collect feedback on an electronic encounter DA that facilitates physician-patient interaction and shared decision-making for smoking cessation in primary care. Methods We developed an electronic, encounter DA (howtoquit.ch) from a paper version created by our team in 2017 following user-centered design principles. The DA is a 1-page interactive website presenting and comparing medications for tobacco cessation and electronic cigarettes. Each smoking cessation medication has a drop down menu that presents additional information, a video demonstration, and prescribing information for physicians. To test the DA, we submitted a questionnaire to approximately 20 general practitioner residents of an academic general medicine department, 5 general practitioners, and 6 experts in the field of smoking cessation. The questionnaire consisted of 4 multiple-choice and 2 free-text questions assessing the usability or acceptability of the DA, the acquisition of new knowledge for practitioners, the perceived utility in supporting shared decision-making, perceived strengths and weaknesses, and whether the participants would recommend the tool to other clinicians. Results In all, 6 residents, 3 general practitioners in private practice, and 2 tobacco cessation experts completed the questionnaire (N=11), with 4 additional experts providing open-text feedback. On the 11 questionnaires, the DA was rated as practical and intuitive (mean 4.6/5), and providers felt it supported shared decision-making (mean 4.4/5), as comparisons were readily possible. Inclusion of explanatory videos was seen as a bonus. Several changes were suggested, like grouping together similar medications and adding a landing page to briefly explain the site. Changes were implemented according to end-user comments. Conclusions The overall assessment of the encounter DA by a group of physicians and experts was positive. The ultimate objective is to have the tool deployed and easily accessible for all to use.
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Affiliation(s)
| | | | | | - Marie-Anne Durand
- Lausanne University Hospital, Lausanne, Switzerland
- Centre d'Epidémiologie et de Recherche en Santé des Populations, University of Toulouse, Institut National de la Santé et de la Recherche Médicale, Toulouse, France
- Dartmouth Institute for Health Policy and Clinical Practice, University of Dartmouth, Lebanon, NH, United States
| | | | - Yasser Khazaal
- Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Ivan Berlin
- Hôpital Pitié-Salpêtrière, Sorbonne University, Paris, France
| | - Kevin Selby
- Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
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