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Orenstein L, Chetrit A, Kalter-Leibovici O. Factors associated with attempting and succeeding in smoking cessation following a National Tobacco Control Plan: Analysis of two nationwide surveys (2010 and 2017). Addict Behav 2024; 149:107912. [PMID: 37979463 DOI: 10.1016/j.addbeh.2023.107912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/09/2023] [Accepted: 11/12/2023] [Indexed: 11/20/2023]
Abstract
INTRODUCTION Lower rates of smoking cessation among disadvantaged groups contribute to widening health-disparities. With this recognition, in 2010 free-of-charge/subsidized smoking cessation services became available to all Israeli residents through the not-for-profit health plans. METHODS Based on two cross-sectional National Social Surveys, data on adult ever-smokers were used (n = 2,998 in 2010 and 2,859 in 2017). The outcome variable comprised three categories: no quit attempt, unsuccessful quit attempt and successful quit attempt. Changes over-time and demographic, socioeconomic, health- and smoking-related factors associated with quitting attempts and success were tested in the pooled sample, using multivariable multinomial logistic regression models. RESULTS The pooled sample of the two surveys included 2,611 participants (44.2%) who were successful quitters, 1,941 (32.7%) who reported an unsuccessful quit attempt, and 1,305 (23.1%) smokers who did not attempt to quit. Compared to 2010, ever-smokers in 2017 were less likely to report an unsuccessful quit attempt (adjusted OR = 0.81, 95%CI: 0.70-0.94). The likelihood of successfully quitting was similar in both surveys. Older age and self-reported health problem were associated with higher likelihood of quitting attempt. Meeting living expenses, being overweight/obese, engaging in physical activity and heavy smoking were associated with higher likelihood of successful smoking cessation; while environmental tobacco exposure was associated with 43% lower likelihood of successful cessation. Finally, there was an interaction between education and ethnicity. Higher education level was associated with a greater likelihood both to attempt to quit smoking and to succeed among Jewish participants, while the opposite phenomenon was observed among Arab smokers. CONCLUSIONS Despite the availability of subsidized smoking cessation services, social disparities in smoking cessation rates persist. Efforts should focus on proactively reaching subpopulations with low cessation rates, using tailored strategies for successful smoking cessation. Promoting smoke free homes and workplaces should be prioritized.
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Affiliation(s)
- Liat Orenstein
- Research Center for Population Health, The Gertner Institute for Epidemiology and Health Policy Research, Chaim Sheba Medical Center, Ramat-Gan 52621, Israel; Epidemiology & Preventive Medicine Department, School of Public Health, Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel.
| | - Angela Chetrit
- Research Center for Population Health, The Gertner Institute for Epidemiology and Health Policy Research, Chaim Sheba Medical Center, Ramat-Gan 52621, Israel; School of Public Health, Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel.
| | - Ofra Kalter-Leibovici
- Research Center for Population Health, The Gertner Institute for Epidemiology and Health Policy Research, Chaim Sheba Medical Center, Ramat-Gan 52621, Israel; Epidemiology & Preventive Medicine Department, School of Public Health, Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel.
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Pichardo CM, Dwyer LA, Ferrer RA, Oh AY. The Association of Context with Reported Self-Efficacy for Cancer-Preventive Behaviors and Perceived Cancer Risk in U.S. Adults from the Midlife in the United States (MIDUS) Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:62. [PMID: 38248527 PMCID: PMC10815586 DOI: 10.3390/ijerph21010062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/20/2023] [Accepted: 12/13/2023] [Indexed: 01/23/2024]
Abstract
Background: Cancer is one of the leading causes of death in the United States. It is critical to understand the associations among multilevel determinants of cancer prevention and control behaviors. This study examined associations of neighborhood factors with perceived risk of cancer and self-efficacy for reducing cancer risk. Methods: Cross-sectional analyses included 2324 U.S. adults from the Midlife in the U.S. Wave 3. Participants completed surveys of neighborhood environment (perceived neighborhood trust and safety, built environment conditions, social integration), perceived cancer risk and cancer prevention efficacy. Multivariate linear regressions examined associations of neighborhood context with risk perceptions and self-efficacy. Results: In the model that adjusted for sociodemographic characteristics, better perceived neighborhood trust and safety were associated with lower perceived cancer risk. In fully adjusted models for sociodemographic characteristics and contextual factors, higher perceptions of neighborhood trust and safety were associated with higher cancer prevention self-efficacy. Perceptions of better built neighborhood conditions and higher social integration were significantly associated with lower perceived cancer risk and higher perceived cancer prevention efficacy. Conclusions: Perceptions of neighborhood context may play a role in shaping psychosocial factors such as perceived cancer risk and self-efficacy, even after controlling for robust predictors of these perceptions.
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Affiliation(s)
- Catherine M. Pichardo
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD 20892, USA;
| | | | - Rebecca A. Ferrer
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD 20892, USA;
| | - April Y. Oh
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD 20892, USA;
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Yang X, Zhang L, Lin H, Lin H, Cao W, Chang C. Psychiatric symptoms and intentions to quit smoking: How regularity and volume of cigarette consumption moderate the relationship. Tob Induc Dis 2023; 21:78. [PMID: 37323507 PMCID: PMC10266331 DOI: 10.18332/tid/163258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 04/10/2023] [Accepted: 04/14/2023] [Indexed: 06/17/2023] Open
Abstract
INTRODUCTION Smoking prevalence is disproportionately higher in those with psychiatric symptoms. Smokers with psychiatric symptoms are less likely to have an intention to quit smoking and attain eventual smoking abstinence. This study presents the relationship between depressive/anxiety symptoms and the intention to quit smoking and related influencing factors. METHODS A cross-sectional study recruited 931 current smoking individuals covering two provinces in China in July 2022. The online survey comprised questions concerning sociodemographic characteristics, smoking conditions and psychiatric symptoms. Chi-squared analyses and moderation analyses were applied. RESULTS The proportion of smokers who had the intention to quit smoking within six months was 46.1%. In comparison with subjects without depressive/anxiety symptoms, individuals who had both psychiatric symptoms were less likely to have the intention to quit smoking (39.3% vs 49.8%, χ2=9.130, p=0.028). As for the moderating model of depression, the interaction term of depressive symptoms and smoking regularly was significant (β=0.554, t=3.260, p=0.001). For those who were occasional smokers, depressive symptoms significantly lowered their quitting intentions. The regularity of smoking similarly moderated the effect of anxiety symptoms on quitting intentions. When the number of cigarettes used weekly served as the moderator, the interaction of this number and depressive symptoms was significant, as well as for anxiety (p<0.001), indicating that the volume of cigarette consumption moderated the relationship between depressive/anxiety symptoms and intention to quit smoking. CONCLUSIONS Psychiatric symptoms were significant factors in reducing the willingness of smokers to quit smoking, and the effects were moderated by smokers' cigarette consumption conditions. Interventions are urged to enhance quitting intentions of these vulnerable smokers.
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Affiliation(s)
- Xiaochen Yang
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Lanchao Zhang
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Hao Lin
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Haoxiang Lin
- Institute for Global Health and Development, Peking University, Beijing, China
| | - Wangnan Cao
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Chun Chang
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
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Naja S, Alchawa M, Adli N, Ahmed WM, Abdu Y, Singh R, Muraikhi HA, Baker WA, Bougmiza I. Telephone versus face-to-face consultation on smoking cessation at primary health care centers in Qatar during COVID-19 pandemic. Prev Med Rep 2023; 33:102174. [PMID: 36937076 PMCID: PMC10007712 DOI: 10.1016/j.pmedr.2023.102174] [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: 10/08/2022] [Revised: 03/05/2023] [Accepted: 03/06/2023] [Indexed: 03/13/2023] Open
Abstract
Smoking cessation leads to a reduction in risks of smoking-related morbidity and mortality. During the coronavirus 2019 (COVID-19) pandemic, smoking cessation services were interrupted. Providing smoking cessation counseling by telephone could be a convenient and safe alternative to traditional face-to-face service. However, the effectiveness of telephone smoking cessation counseling has not yet been thoroughly investigated. This study evaluated telephone smoking cessation counseling compared to face-to-face consultations during the COVID-19 era. In addition, it investigated the association between sociodemographic and health-related factors and cessation rates. A retrospective cohort design was used. Participants were randomly selected from two lists: (1) telephone counseling and (2) face-to-face counseling in smoking cessation clinics in five primary health care centers in Qatar between March 2020 and March 2021. Cessation rates were compared between the two groups at 1, 2, 4, 8, and 12 weeks. A multivariable logistic regression analysis was used to identify the significant associations with smoking cessation. Smokers who underwent telephone consultations had significantly lower quit rates at all follow-ups compared to those who attended face-to-face visits. At the 12-week follow-up, the adjusted odd ratio for quitting through face-to-face consultations was 1.96 (95% CI [1.15-3.35]) times higher than that achieved through telephone consultations. In addition to receiving face-to-face counseling, higher self-efficacy to cease smoking was an independent predictor of successful cessation. Providing smoking cessation counseling by telephone could be a safer but less effective mode of delivery versus traditional face-to-face encounters during the pandemic.
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Affiliation(s)
- Sarah Naja
- Community Medicine Department, Hamad Medical Corporation, Doha, Qatar
- Corresponding author at: Hamad Medical Corporation, Alrayyan Street, Doha P.O.Box: 3050, Qatar.
| | - Mohamad Alchawa
- Community Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | - Nada Adli
- Community Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | | | - Yasamin Abdu
- Community Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | - Rajvir Singh
- Cardiology Research Department, Hamad Medical Corporation, Doha, Qatar
| | - Hissa Al Muraikhi
- Wellness Program, Preventive Medicine, Primary Health Care Corporation, Doha, Qatar
| | - Wadha Al Baker
- Wellness Program, Preventive Medicine, Primary Health Care Corporation, Doha, Qatar
| | - Iheb Bougmiza
- Community Medicine Department, Primary Health Care Corporation, Doha, Qatar
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LaRowe LR, Dunsiger SI, Williams DM. Acute exercise-induced changes in motivation and behavioral expectation for quitting smoking as predictors of smoking behavior in women. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2023; 37:475-482. [PMID: 36455006 PMCID: PMC10164050 DOI: 10.1037/adb0000901] [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] [Indexed: 12/03/2022]
Abstract
OBJECTIVE Temporally static self-reports of motivation and behavioral expectation are established predictors of addictive behavior. However, previous research has not tested intervention effects on within-day changes in motivation/behavioral expectation for smoking cessation as mediators of smoking abstinence. The goals of this study were to test whether aerobic exercise exerts acute pre-postexercise effects on motivation and behavioral expectation and to test the main and interactive effects of change in motivation/behavioral expectation for cessation on subsequent smoking abstinence. METHOD We conducted secondary analyses of ecological momentary assessment data collected among N = 105 women who participated in a 12-week randomized controlled trial (RCT) examining thrice weekly aerobic exercise (vs. contact control) as an adjunct to cessation treatment. A multilevel, longitudinal mixed-effects model was used to test all pathways simultaneously. RESULTS Exercise (vs. control) was associated with greater increases in motivation (p = .04), but not behavioral expectation (p > .05), pre-to-postexercise session. Increases in motivation and behavioral expectation were associated with higher odds of abstinence at next session (ps < .05), and for those with larger changes in behavioral expectation, larger changes in motivation were associated with greater odds of abstinence (p = .02). There was also an indirect effect of exercise on abstinence via acute changes in motivation (p < .05). CONCLUSIONS A single bout of exercise can increase motivation for quitting smoking, which may improve quit success. Moreover, increasing behavioral expectation may enhance the effect of increased motivation on cessation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Lisa R LaRowe
- Center for Health Promotion and Health Equity, Department of Behavioral and Social Sciences, Brown University School of Public Health
| | - Shira I Dunsiger
- Center for Health Promotion and Health Equity, Department of Behavioral and Social Sciences, Brown University School of Public Health
| | - David M Williams
- Center for Health Promotion and Health Equity, Department of Behavioral and Social Sciences, Brown University School of Public Health
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Klemperer EM, Streck JM, Lindson N, West JC, Su A, Hughes JR, Carpenter MJ. A systematic review and meta-analysis of interventions to induce attempts to quit tobacco among adults not ready to quit. Exp Clin Psychopharmacol 2023; 31:541-559. [PMID: 35771496 PMCID: PMC10106992 DOI: 10.1037/pha0000583] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The prevalence of past-year smoking cessation remains below 10% in the U.S. Most who smoke are not ready to quit in the near future. Cessation requires both (a) initiating a quit attempt (QA) and (b) maintaining abstinence. Most research has focused on abstinence among people already motivated to quit. We systematically reviewed interventions to promote QAs among people not motivated to quit tobacco. We searched PubMed, CENTRAL, PsycINFO, Embase, and our personal libraries for randomized trials of tobacco interventions that reported QAs as an outcome among adults not ready to quit. We screened studies and extracted data in duplicate. We pooled findings of the 25 included studies using Mantel-Haenszel random effects meta-analyses when ≥ 2 studies tested the same intervention. Most (24) trials addressed cigarettes and one addressed smokeless tobacco. Substantial heterogeneity among trials resulted in a series of small meta-analyses. Findings indicate varenicline may increase QAs more than no varenicline, n = 320; RR = 1.4, 95% CI [1.1, 1.7]; I² = 0%, and nicotine replacement therapy (NRT) may increase QAs more than no NRT, n = 2,568; RR = 1.1, 95% CI [1.02, 1.3]; I² = 0%. Pooled effects for motivational counseling, reduction counseling, and very low nicotine content cigarettes showed no clear evidence of benefit or harm. The evidence was judged to be of medium to very low certainty due to imprecision, inconsistency, and risk of bias, suggesting that further research is likely to change interpretation of our results. Findings demonstrate the need for more high-quality research on interventions to induce QAs among adults not ready to quit tobacco. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Elias M. Klemperer
- Vermont Center on Behavior & Health, Department of Psychiatry, University of Vermont
- Department of Psychological Science, University of Vermont
| | - Joanna M. Streck
- Tobacco Research & Treatment Center, Division of General Internal Medicine and Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School
| | - Nicola Lindson
- Nuffield Department of Primary Care Health Sciences, University of Oxford
| | - Julia C. West
- Vermont Center on Behavior & Health, Department of Psychiatry, University of Vermont
- Department of Psychological Science, University of Vermont
| | - Alan Su
- University of Vermont Medical Center
| | - John R. Hughes
- Vermont Center on Behavior & Health, Department of Psychiatry, University of Vermont
- Department of Psychological Science, University of Vermont
| | - Matthew J. Carpenter
- Department of Psychiatry and Behavioral Sciences & Hollings Cancer Center, Medical University of South Carolina
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Rajalu BM, Jayarajan D, Muliyala KP, Sharma P, Gandhi S, Chand PK. Effectiveness of personalized tobacco cessation intervention package among patients with schizophrenia and related psychotic disorders - A two-group experimental study. Asian J Psychiatr 2023; 81:103447. [PMID: 36652840 DOI: 10.1016/j.ajp.2023.103447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/24/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Persons with schizophrenia and related psychotic disorders (PwS) smoke more, and have twice the rate of mortality, with 10-25 years lower life expectancy than the general population. Evidence-based tobacco cessation interventions would help in quitting. AIM To evaluate the effectiveness of a personalized tobacco cessation intervention package for patients attending the outpatient psychiatry department. METHODS The study adopted a two-group experimental design in PwS, using a simple randomization method. Eligible participants were randomly allocated to either the intervention group (n = 85) receiving the intervention package or the control group (n = 85) receiving brief advice to stop tobacco. The study outcomes were measured at baseline, 1, 3, and 6 months. SPSS 23 was used for data analysis. Intention-to-treat analysis was used to manage missing data. The p-value of < 0.05 is considered statistically significant. RESULTS At 6 months, there was a significant difference (p < 0.001) in 7 days point-prevalence abstinence (28 % vs 10.8 %), reduction of tobacco by at least 50 % (62.4 % vs 40.9 %) with an attrition rate of 15.3 % vs 30.5 % in intervention and control group respectively. Reduction in nicotine dependence and tobacco craving, an increase in motivation level, quit attempts and clinical improvement favored the intervention group. 16.5 % of participants expressed interest in pharmacotherapy for tobacco cessation, 3.5 % were referred to a specialized tobacco cessation center, two control group participants were hospitalized for drug default, and withdrawal symptoms reported were mild. CONCLUSION Implementing a tobacco cessation intervention based on the stage of motivation aids in abstinence and reduction of tobacco use in PwS.
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Affiliation(s)
| | - Deepak Jayarajan
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India.
| | - Krishna Prasad Muliyala
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India.
| | - Priyamvada Sharma
- Centre for Addiction Medicine, Department of Clinical Pharmacology and Neurotoxicology, National Institute of Mental Health and Neurosciences, Bangalore 560029, India.
| | - Sailaxmi Gandhi
- Department of Nursing, National Institute of Mental Health and Neurosciences, Bangalore 560029, India.
| | - Prabhat Kumar Chand
- Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India.
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Krishnan N, Berg CJ, Elmi A, Klemperer EM, Sherman SE, Abroms LC. Predictors of electronic nicotine product quit attempts and cessation: Analysis of waves 3 and 4 of the PATH study. Addict Behav 2022; 134:107419. [PMID: 35810644 DOI: 10.1016/j.addbeh.2022.107419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/17/2022] [Accepted: 06/28/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Identifying theory-based predictors of electronic nicotine product (ENP) quit attempts and cessation can guide the development of effective vaping cessation interventions, which are currently limited. This study examined predictors of ENP quit attempts and cessation among adult ENP users. METHODS Using data from wave 3 (W3; 2015-2016) current established ENP users in the Population Assessment of Tobacco and Health study, we used multivariable logistic regression to identify predictors of (i) wave 4 (W4; 2016-2018) quit attempts (unweighted n = 1,135); and (ii) W4 cessation among those who made a quit attempt (unweighted n = 610). Predictors included Social Cognitive Theory (SCT)-based cognitive (interest in quitting, self-efficacy to quit, outcome expectancies, risk perception), behavioral (smoking status, and use of combustibles, non-combustibles, cannabis, and alcohol), and socio-environmental (perceived disapproval, household rules, exposure to advertising) factors. RESULTS Between W3 and W4, 51.7% of W3 ENP users made a quit attempt. Among those who tried quitting, 68.4% stopped using ENPs. SCT-based predictors of ENP quit attempts included higher interest in quitting ENPs (aOR = 1.18), greater self-efficacy to quit ENPs (aOR = 1.31), and currently using cigarettes (vs non-smoker; aOR = 1.71), non-combustibles (aOR = 2.25), and cannabis (aOR = 1.80). Predictors of ENP cessation included greater self-efficacy to quit ENPs (aOR = 1.33), greater perceived risk of ENPs (aOR = 1.35), and being a current smoker (vs non-smoker; aOR = 3.28). CONCLUSIONS ENP cessation interventions should address cognitive factors, particularly self-efficacy, as it predicted quit attempts and cessation. Cigarette smoking among dual users should be monitored and addressed to ensure that those who quit using ENPs do not maintain cigarette use.
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Affiliation(s)
- Nandita Krishnan
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Angelo Elmi
- Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Elias M Klemperer
- Vermont Center on Behavior & Health, Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Scott E Sherman
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Lorien C Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
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Islam MM. Comparison between Smokers and Smokeless Tobacco Users in Their Past Attempts and Intentions to Quit: Analysis of Two Rounds of a National Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13662. [PMID: 36294241 PMCID: PMC9603089 DOI: 10.3390/ijerph192013662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/20/2022] [Accepted: 10/20/2022] [Indexed: 06/16/2023]
Abstract
This study compares current tobacco smokers and smokeless tobacco (SLT) users in terms of their past quitting attempts and intentions to quit in the future, and identifies approaches used in their recent quitting attempts. Data (n = 14,498) of current tobacco users from two rounds of the Global Adult Tobacco Survey Bangladesh were analysed. Poisson regressions with robust variance were used to examine associations between the study factor and the two outcome variables. About half of smokers and a quarter of SLT users tried to quit during the 12 months before the survey. About two-thirds of smokers and half of SLT users intended to quit in the future. Smokers were more likely (adjusted prevalence ratio (aPR): 1.38, 95%CI: 1.24-1.53) than SLT users to have attempted to quit during the 12 months before the survey and to intend to quit in the future (aPR: 1.09, 95%CI: 1.02-1.16). The corresponding aPRs were even higher for dual users (smoked tobacco and used SLT). Future intention to quit for both smokers (aPR: 1.45, 95%CI: 1.38-1.53) and SLT users (aPR: 1.87, 95%CI: 1.76-1.98) was significantly associated with their past quitting attempts. Most of those who had attempted to quit did not receive any treatment. Proactive and tailored interventions to promote quitting and expansion of tobacco cessation methods are recommended.
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Affiliation(s)
- M Mofizul Islam
- Department of Public Health, Room 410, Health Sciences Building 2, La Trobe University, Bundoora, VIC 3086, Australia
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Xie J, Zhong R, Zhu L, Chang X, Chen J, Wang W, Zhang L, Chen O, Yu X, Zou Y, Li Y. Smoking cessation rate and factors affecting the success of quitting in a smoking cessation clinic using telephone follow-up. Tob Induc Dis 2021; 19:99. [PMID: 35002594 PMCID: PMC8686120 DOI: 10.18332/tid/143375] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/27/2021] [Accepted: 10/27/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION China has the largest number of smokers in the world. The great majority of China's smokers desire to quit smoking (QS); however, the success rate of self-quitting is low. This study investigated the effects of smoking cessation (SC) clinics in a cancer hospital in Hunan province and determined the influencing factors of successful SC. METHODS Smokers were recruited to QS by healthcare workers in the SC clinic from February 2015 to February 2019. SC counseling was provided and telephone follow-up was conducted at 1 week, and at 1, 3 and 6 months. Patients who continued SC during the follow-up period were considered to have QS. RESULTS Of the 344 patients included in this study, 16.3% QS at one week, 26.5% at one month, 27.6% at three months, and 31.7% at six months. Age ≥60 years, previous SC attempts, immediate quit dates, and telephone follow-up times (3-4 calls) were predictive factors for smokers to SC at six months. CONCLUSIONS Age, previous attempts to QS, immediate quit dates and telephone follow-up times were independent predictors of SC success at six months. SC clinics and frequent telephone follow-up improve the success rate of SC, especially in patients who have previously tried to QS or in those who set immediate quit dates.
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Affiliation(s)
- Jianghua Xie
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha City, China
- School of Nursing, Hunan University of Chinese Medicine, Changsha City, China
| | - Rui Zhong
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha City, China
| | - Lei Zhu
- School of Nursing, Hunan University of Chinese Medicine, Changsha City, China
| | - Xiaochang Chang
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha City, China
| | - Jianhua Chen
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha City, China
| | - Wei Wang
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha City, China
| | - Lemeng Zhang
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha City, China
| | - Ouying Chen
- School of Nursing, Hunan University of Chinese Medicine, Changsha City, China
| | - Xinhua Yu
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha City, China
| | - Yanhui Zou
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha City, China
| | - Yanqun Li
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, Changsha City, China
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11
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de Granda-Orive JI, Pascual-Lledó JF, Asensio-Sánchez S, Solano-Reina S, García-Rueda M, Martínez-Muñiz MÁ, Lázaro-Asegurado L, Buljubasich D, Luhning S, Pendino RL, Cienfuegos-Agustín I, Jiménez-Ruiz CA. Is the motivation to quit smoking a predictor of abstinence maintenance? Tob Prev Cessat 2021; 7:48. [PMID: 34239998 PMCID: PMC8240875 DOI: 10.18332/tpc/136506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 05/07/2021] [Accepted: 05/10/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The aim of this study was to explore the utility of measuring motivation to quit smoking as a predictor of abstinence maintenance among smokers who wanted to quit and who were included in a multicenter study conducted in daily clinical practice. METHODS This observational, longitudinal (prospective cohort), multicenter study was conducted in smoking clinics in Spain and the Argentine Republic in daily clinical practice. Motivation was assessed using three quantitative motivation tests and a Visual Analogue Scale. Statistical analysis included descriptive, association measures and logistic regression models. RESULTS Of a total of 404 subjects, 273 were ultimately included for analysis (147 women; 53.8%), mean age 51±11 years). In one year, 53.5% (36.13% by intention to treat) of subjects (146) were successful in quitting smoking [men: 45.2% (66) and women: 54.8% (80)], with no differences between sexes. None of the scales utilized was associated, in an unquestionable or direct way, with long-term abstinence, although three of them, in a very complex model, with additional variables and added interactions, were associated with the ‘result’ variable, when other variables intervened in certain circumstances. CONCLUSIONS None of the analyzed motivational scales alone demonstrated an association with success or failure in quitting smoking; thus, their use in isolation is of no value. Some of the scales analyzed might be related to the maintenance of abstinence but in complex models where other variables intervene, which makes interpretation considerably difficult. Therefore, the predictive capacity of the tests analyzed, based on the models, was low.
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Affiliation(s)
| | | | | | | | | | | | | | - Daniel Buljubasich
- Respiratory Department, Sanatorio Nuestra Señora del Rosario, IPAM Medical Center, Rosario, Argentine Republic
| | - Susana Luhning
- Pneumonology Department, Humana Private Medical Institute, External Consultation Assistance Center, Córdoba, Argentine Republic
| | - Roge-Lio Pendino
- Respiratory Department, Sanatorio Nuestra Señora del Rosario, IPAM Medical Center, Rosario, Argentine Republic
| | | | - Carlos A Jiménez-Ruiz
- Madrid Community Specialized Smoking Unit, San Carlos Clinical Hospital, Madrid, Spain
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12
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Gold AK, Otto MW, Hoyt DL, Garey L, Smit T, Zvolensky M. Do Pain-Related Anxiety and Difficulties With Emotion Regulation Impact Abstinence Expectancies or Motivation to Quit E-Cigarette Use? J Stud Alcohol Drugs 2021; 82:414-421. [PMID: 34100710 PMCID: PMC8328231 DOI: 10.15288/jsad.2021.82.414] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 09/15/2020] [Indexed: 09/27/2023] Open
Abstract
OBJECTIVE Pain-related anxiety is a psychologically based construct that is associated with tobacco dependence and may have important relevance to e-cigarette use. Difficulties with emotion regulation, a relevant construct in motives for cigarette smoking, may interact with pain-related anxiety to yield worsened clinical outcomes among e-cigarette users. We evaluated whether pain-related anxiety and difficulties with emotion regulation independently and in interaction predict e-cigarette users' expectancies surrounding abstinence and their motivation to stop using e-cigarettes. METHOD Daily e-cigarette users (n = 290, mean age= 35.5, SD = 10.9, 56.6% male) completed an online survey about e-cigarette use. We conducted hierarchical multiple regression analyses to evaluate the main and interactive influence of pain-related anxiety and difficulties with emotion regulation on our outcomes. RESULTS Increased pain-related anxiety independently predicted negative abstinence expectancies and increased motivation to quit e-cigarette use (ps < .001). Increased difficulties with emotion regulation predicted only negative abstinence expectancies (ps < .01) when pain-related anxiety was included in the model. The interaction between pain-related anxiety and difficulties with emotion regulation was not significant. CONCLUSIONS As hypothesized, increased pain-related anxiety was associated with both negative expectancies of abstinence and increased motivation to quit e-cigarette use, but contrary to our hypothesis, difficulties with emotion regulation were not significantly associated with increased motivation to quit e-cigarette use when evaluated with pain-related anxiety in the model. These findings may elucidate processes influencing abstinence expectancies and motivation to quit in a sample of e-cigarette users, although replication in a larger, more diverse sample is warranted.
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Affiliation(s)
- Alexandra K. Gold
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - Michael W. Otto
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - Danielle L. Hoyt
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, Texas
| | - Tanya Smit
- Department of Psychology, University of Houston, Houston, Texas
| | - Michael Zvolensky
- Department of Psychology, University of Houston, Houston, Texas
- University of Texas MD Anderson Cancer Center, Houston, Texas
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13
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Laochai W, Preechawong S. Quit rates and predictors of smoking abstinence in Thai Buddhist monks with noncommunicable diseases. JOURNAL OF HEALTH RESEARCH 2021. [DOI: 10.1108/jhr-08-2020-0336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose
The purpose of this study is to calculate the smoking quit rate and to examine the factors influencing smoking abstinence among Thai Buddhist monks with noncommunicable diseases (NCDs).
Design/methodology/approach
This was a cross-sectional study of 136 Buddhist monks with NCDs purposively sampled from the Priest Hospital. The participants were between 20 and 59 years of age, smoked at least one cigarette a day and received cessation advice from nurses or other health professionals. The dependent variable was self-reported 7-day point-prevalence smoking abstinence assessment at a three-month follow-up. Independent variables were age, schooling level, nicotine dependence, intention to quit, physical activity and perceived self-efficacy in quitting cessation. Logistic regression was performed to evaluate the factors influencing smoking cessation.
Findings
50 of the 136 Thai Buddhist monks (36.8%) reported the 7-day point prevalence abstinence at a three-month follow-up. About two-thirds of the participants indicated health concern as the motivation to quit smoking. Perceived self-efficacy of abstinence (odds ratio 1.04; 95% confidence interval 1.014–1.074) and intention to quit smoking (odds ratio 1.34; 95% confidence interval 1.129–1.599) were significant predictors of abstinence.
Originality/value
This is the first study of its kind to investigate the predictors of smoking cessation in Thai Buddhist monks with NCDs. The findings will be of help to healthcare counselors seeking to motivate monks to quit smoking.
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14
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Carpenter MJ, Hughes JR. If at First You Don't Try …. Nicotine Tob Res 2020; 22:1431-1432. [PMID: 32266393 DOI: 10.1093/ntr/ntaa062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 04/06/2020] [Indexed: 01/31/2023]
Affiliation(s)
- Matthew J Carpenter
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina (MUSC), Charleston, SC.,Department of Public Health Sciences, MUSC, Charleston, SC.,Hollings Cancer Center, MUSC, Charleston, SC
| | - John R Hughes
- Department of Psychiatry, University of Vermont, Burlington, VT
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15
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Parkerson HA, Sareen J, Asmundson GJG. Breaking the cycle of smoking and pain: do pain-related anxiety and pain reduction expectancies sabotage attempts to quit smoking and can smoking cessation improve pain and pain-related disability outcomes? Cogn Behav Ther 2020; 50:154-171. [PMID: 32852241 DOI: 10.1080/16506073.2020.1798498] [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: 10/23/2022]
Abstract
Contemporary models of smoking and pain suggest a reciprocal and self-perpetuating cycle, wherein smoking reduces pain in the short term but indirectly exacerbates pain in the long term. In a sample of participants engaged in an active smoking-cessation attempt, this investigation assessed a) whether specific smoking risk factors (i.e., smoking expectancies for pain reduction, pain-related anxiety) acted as barriers to cessation, and b) whether breaking the smoking-pain cycle through successful smoking abstinence impacted pain and pain-related disability outcomes for participants with pain. Participants comprised 168 smokers (44.4% with pain) who engaged in an online smoking-cessation program. Pain-related anxiety, but not smoking expectancies, accounted for a significant proportion of variance of smoking dependence from pre- to post-intervention. Results suggest that pain-related anxiety is a risk factor for maintained smoking dependence for all smokers regardless of pain status. Participants with pain who successfully quit smoking experienced statistically and clinically meaningful decreases in pain and pain-related disability from pre- to post-intervention. Exploratory post hoc analyses indicated that individuals who signed-up for the smoking cessation program but failed to begin a quit-attempt had significantly higher pain disability, depression, and anxiety scores than participants who commenced a quit-attempt. Theoretical and practical implications are discussed.
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Affiliation(s)
| | - Jitender Sareen
- Department of Psychiatry, University of Manitoba , Winnipeg, Canada
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16
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Haaga DAF, Kaufmann A, Malloy EJ. Looming Vulnerability and Smoking Cessation Attempts. Nicotine Tob Res 2020; 22:1439-1445. [PMID: 32034908 DOI: 10.1093/ntr/ntaa034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 02/05/2020] [Indexed: 12/26/2022]
Abstract
INTRODUCTION The looming vulnerability model holds that people become anxious when they perceive threats as growing larger and accelerating toward them in space and time. Preliminary research suggested that a guided imagery induction designed to activate a sense that health consequences of smoking are a looming threat led more smokers to attempt to quit. This study tested the effect on quit attempts in a larger sample and examined age, sex, and sensation seeking as moderators. AIMS AND METHODS Adult smokers (≥10 cigarettes/day) screened for risk of anxiety or mood disorders (N = 278, 52% male; 77% African American) were randomly assigned to receive (1) looming vulnerability or (2) neutral guided imagery exercises. At a 4-week follow-up, they reported quit attempts, smoking rate, self-efficacy, outcome expectancies, and contemplation status. RESULTS Those in the looming condition (17%) were no more likely than those in the control condition (20%) to make a quit attempt. There were no significant group differences in expectancies, contemplation, or follow-up smoking rate, and no significant moderators. CONCLUSIONS The looming induction was the same one used in earlier work in which it had stronger effects. Those who respond to it with increased urgency about quitting smoking might be offset by others who are more reactant and deny the message. Inconsistencies across studies may reflect differences in inclusion criteria, such that the present sample was on average heavier smokers with longer smoking history and more severe nicotine dependence, yet higher self-efficacy. IMPLICATIONS An induction designed to activate a sense that the health consequences of smoking constitute a looming vulnerability failed to increase quit attempts or reduce smoking rate among adult daily smokers. Inconsistencies across studies might reflect varying sample characteristics resulting from changes in screening criteria.
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Affiliation(s)
- David A F Haaga
- Department of Psychology, American University, Washington, DC
| | - Amanda Kaufmann
- Department of Psychology, American University, Washington, DC
| | - Elizabeth J Malloy
- Department of Mathematics and Statistics, American University, Washington, DC
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17
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Caponnetto P, Polosa R, Robson D, Bauld L. Tobacco smoking, related harm and motivation to quit smoking in people with schizophrenia spectrum disorders. Health Psychol Res 2020; 8:9042. [PMID: 32510003 PMCID: PMC7267811 DOI: 10.4081/hpr.2020.9042] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 05/20/2020] [Indexed: 02/06/2023] Open
Abstract
This narrative review focuses on the topic of tobacco smoking amongst people with schizophrenia spectrum disorders. We searched PubMed, PsycInfo and Scopus databases for schizophrenia spectrum disorders and smoking and included articles about the epidemiology of tobacco smoking in people with schizophrenia spectrum disorders, examining the relationship between smoking and mental health. This narrative review describes that a higher prevalence, frequency and impact of both high nicotine dependence and its harmful effects in patients with schizophrenia spectrum disorders compared with those in the general population. Despite several existent theories, the reasons for high smoking rates, the high dependence on nicotine and severity of nicotine withdrawal symptoms are not fully understood. The main aim of this paper is to inform mental health personnel and particularly clinical and health psychologists about the impact and role of tobacco smoking for smokers with schizophrenia spectrum disorders.
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Affiliation(s)
| | | | | | - Linda Bauld
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
- UK Centre for Tobacco & Alcohol Studies, Nottingham, UK
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18
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Kruse GR, Thawal V, Gupte HA, Chaudhuri L, Pradhan S, Howard S, Rigotti NA. Tobacco Use and Subsequent Cessation Among Hospitalized Patients in Mumbai, India: A Longitudinal Study. Nicotine Tob Res 2020; 22:363-370. [PMID: 30778542 DOI: 10.1093/ntr/ntz026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 02/14/2019] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Hospitalization is an important setting to address tobacco use. Little is known about post-discharge cessation and treatment use in low- and middle-income countries. Our objective was to assess tobacco use after hospital discharge among patients in Mumbai, India. METHODS Longitudinal observational study of inpatients (≥15 years) admitted at one hospital from November 2015 to October 2016. Patients reporting current tobacco use were surveyed by telephone after discharge. RESULTS Of 2894 inpatients approached, 2776 participated and 15.7% (N = 437) reported current tobacco use, including 5.3% (N = 147) smokers, 9.1% (N = 252) smokeless tobacco (SLT) users, and 1.4% (N = 38) dual users. Excluding dual users, SLT users, compared to smokers, were less likely to report a plan to quit after discharge (42.6% vs. 54.2%, p = .04), a past-year quit attempt (38.1% vs. 52.7%, p = .004), to agree that tobacco has harmed them (57.9% vs. 70.3%, p = .02) or caused their hospitalization (43.4% vs. 61.4%, p < .001). After discharge, 77.6% of smokers and 78.6% of SLT users reported trying to quit (p = .81). Six-month continuous abstinence after discharge was reported by 27.2% of smokers and 24.6% of SLT users (p = .56). Nearly all relapses to tobacco use after discharge occurred within 30 days and did not differ by tobacco type (log-rank p = .08). Use of evidence-based cessation treatment was reported by 6.5% (N = 26). CONCLUSIONS Three-quarters of tobacco users in a Mumbai hospital attempted to quit after discharge. One-quarter reported continuous tobacco abstinence for 6 months despite little use of cessation treatment. Increasing post-discharge cessation support could further increase cessation rates and improve patient outcomes. IMPLICATIONS No prior study has measured the patterns of tobacco use and cessation among hospitalized tobacco users in India. Three-quarters of tobacco users admitted to a hospital in Mumbai attempted to quit after discharge, and one-quarter remained tobacco-free for 6 months, indicating that hospitalization may be an opportune time to offer a cessation intervention. Although smokers and SLT users differed in socioeconomic status, perceived risks and interest in quitting, they did not differ in their ability to stay abstinent after hospital discharge.
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Affiliation(s)
- Gina R Kruse
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| | | | | | | | | | - Sydney Howard
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Nancy A Rigotti
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA.,Harvard Medical School, Boston, MA
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19
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Hung CC, Su LW, Yen MY, Chuang P, Yang HJ, Lee TSH. Effectiveness of a brief information, motivation and behavioral skills program on stage transitions and lapse for individuals who use ketamine. Drug Alcohol Depend 2019; 204:107509. [PMID: 31499243 DOI: 10.1016/j.drugalcdep.2019.06.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 05/31/2019] [Accepted: 06/03/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Chronic ketamine use is a significant public health and social problem in East and South East Asia and may lead to impairments in health and cognitive functioning. The study evaluated effects of an information, motivation and behavior skills (IMB) program on changes in motivational stage and ketamine use. METHODS Ketamine using individuals residing in the City of Taipei were recruited (N = 395): 279 selected an IMB program consisting of a 1-day workshop of six 50-minute interactive sessions provided in small groups. The remaining 116 participants selected an education-as-usual (EAU) program consisting of a 1-day workshop of six 50-minute didactic lectures provided in a large group format. Motivational stage of change and ketamine knowledge were assessed before and after the interventions. Participants were followed one year later to assess their ketamine use status. RESULTS No significant difference in knowledge increase between the IMB and EAU groups (p = .59). The proportion of participants who transitioned from the contemplation to preparation motivational stages was greater in the IMB group than in the EAU group (p < .01). A significant difference in the rates of ketamine lapse during a one-year post intervention follow up was observed between the IMB (50%) and EAU (75%) groups (p < .01). CONCLUSIONS Interventions based on IMB principles may be more effective in supporting motivational stage transition and in prevention of lapses to ketamine use as compared to currently offered standard drug education programs. Policy makers should consider including IMB interventions in their rehabilitation programs addressing ketamine use problems.
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Affiliation(s)
- Chia-Chun Hung
- Bali Psychiatric Center, Ministry of Health and Welfare, Taiwan
| | - Lien-Wen Su
- Drug Prevention and Control Center, Taipei City Hospital, Taiwan
| | - Muh-Youg Yen
- Drug Prevention and Control Center, Taipei City Hospital, Taiwan
| | - Peing Chuang
- Drug Prevention and Control Center, Taipei City Hospital, Taiwan
| | - Hao-Jan Yang
- Department of Public Health, Chung Shan Medical University, Taichung, Taiwan
| | - Tony Szu-Hsien Lee
- Department of Health Promotion and Health Education, College of Education, National Taiwan Normal University, Taiwan.
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20
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Caponnetto P, Maglia M, Lombardo D, Demma S, Polosa R. The role of virtual reality intervention on young adult smokers' motivation to quit smoking: a feasibility and pilot study. J Addict Dis 2019; 37:217-226. [PMID: 31613186 DOI: 10.1080/10550887.2019.1664364] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The objective of our research was to compare the initial efficacy and acceptability, in this special population, of different motivational stimuli to improve motivation to quit smoking. We enrolled 40 young adult smokers, between their twenties and their thirties, not motivated to quit. Our study adopted a visual analog scale to assess the motivation to quit at first visit (baseline) and after three different types of stimuli: a packet of cigarettes containing shocking images; a brief film showing pulmonary effects of smoking; a virtual reality period based on the progression of smoking-related illnesses. We compared the motivation to quit smoking between the series of stimuli and between the stimuli and the baseline assessment. Compared with the first assessment, all stimuli were significant in improving the motivation for smoking cessation. There was a statistically significant modification between the packet of cigarettes and the movie. The difference between the packet of cigarettes containing shocking images and the virtual reality was significant. The difference between the film and the virtual reality was also highly significant. The application of virtual reality would appear to greatly increase the motivation to smoking cessation in young adult smokers not motivated to quit.
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Affiliation(s)
- Pasquale Caponnetto
- Centro per la Prevenzione e Cura del Tabagismo (CPCT) and COEHAR "Policlinico-V. Emanuele", Università di Catania, Catania, Italy.,Institute for Social Marketing, University of Stirling, Stirling, UK
| | - Marilena Maglia
- Centro per la Prevenzione e Cura del Tabagismo (CPCT) and COEHAR "Policlinico-V. Emanuele", Università di Catania, Catania, Italy
| | | | - Shirin Demma
- Centro per la Prevenzione e Cura del Tabagismo (CPCT) and COEHAR "Policlinico-V. Emanuele", Università di Catania, Catania, Italy
| | - Riccarco Polosa
- Centro per la Prevenzione e Cura del Tabagismo (CPCT) and COEHAR "Policlinico-V. Emanuele", Università di Catania, Catania, Italy
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21
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A cross-sectional study of the relationship of proximal smoking environments and cessation history, plans, and self-efficacy among low-income smokers. J Smok Cessat 2019; 14:229-238. [PMID: 33777240 DOI: 10.1017/jsc.2019.15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Introduction Proximal environments could facilitate smoking cessation among low-income smokers by making cessation appealing to strive for and tenable. Aims We sought to examine how home smoking rules and proximal environmental factors such as other household members' and peers' smoking behaviors and attitudes related to low-income smokers' past quit attempts, readiness, and self-efficacy to quit. Methods This analysis used data from Offering Proactive Treatment Intervention (OPT-IN) (randomized control trial of proactive tobacco cessation outreach) baseline survey, which was completed by 2,406 participants in 2011/12. We tested the associations between predictors (home smoking rules and proximal environmental factors) and outcomes (past-year quit attempts, readiness to quit, and quitting self-efficacy). Results Smokers who lived in homes with more restrictive household smoking rules, and/or reported having 'important others' who would be supportive of their quitting, were more likely to report having made a quit attempt in the past year, had greater readiness to quit, and greater self-efficacy related to quitting. Conclusions Adjustments to proximal environments, including strengthening household smoking rules, might encourage cessation even if other household members are smokers.
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22
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Combining Education With Auricular Acupressure to Facilitate Smoking Cessation in Young Adults. Holist Nurs Pract 2019; 33:230-236. [PMID: 31192835 DOI: 10.1097/hnp.0000000000000335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Young adults rarely use pharmacotherapy to cease smoking. This prospective experimental study was performed using a nonpharmacotherapy design. Smoking cessation education combined with auricular acupressure may be more attractive. The key factor for superior smoking cessation was the decrease of nicotine dependence in the early stage of smoking cessation.
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Engle JL, Mermelstein R, Baker TB, Smith SS, Schlam TR, Piper ME, Jorenby DE, Collins LM, Cook JW. Effects of motivation phase intervention components on quit attempts in smokers unwilling to quit: A factorial experiment. Drug Alcohol Depend 2019; 197:149-157. [PMID: 30825795 PMCID: PMC6573018 DOI: 10.1016/j.drugalcdep.2019.01.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 01/12/2019] [Accepted: 01/14/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND Smoking reduction treatment is a promising approach to increase abstinence amongst smokers initially unwilling to quit. However, little is known about which reduction treatment elements increase quit attempts and the uptake of cessation treatment amongst such smokers. METHODS This study is a secondary analysis of a 4-factor randomized factorial experiment conducted amongst primary care patients (N = 517) presenting for regular healthcare visits in Southern Wisconsin who were unwilling to quit smoking but willing to cut down. We evaluated the main and interactive effects of Motivation-phase intervention components on whether participants: 1) made a quit attempt (intentional abstinence ≥24 h) by 6- and 26-weeks post-study enrollment and, 2) used cessation treatment. We also evaluated the relations of quit attempts with abstinence. The four intervention components evaluated were: 1) Nicotine Patch vs. None; 2) Nicotine Gum vs. None; 3) Motivational Interviewing (MI) vs. None; and 4) Behavioral Reduction Counseling (BR) vs. None. Intervention components were administered over 6 weeks, with an option to repeat treatment; participants could request cessation treatment at any point. RESULTS Nicotine gum significantly increased the likelihood of making a quit attempt by 6 weeks (23% vs. 15% without gum; p < .05). Conversely, nicotine patch reduced quit attempts when used with BR. Patch also discouraged use of cessation treatment (15.8% vs. 23% without patch; p < .05). Aided vs. unaided quit attempts produced abstinence in 42% vs. 10% of participants, respectively. CONCLUSION Nicotine gum is a promising Motivation-phase intervention that may spur quit attempts amongst smokers initially unwilling to quit.
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Affiliation(s)
- Jessica L. Engle
- William S. Middleton Memorial Veterans Hospital, Addictive Disorders Treatment Program, 2500 Overlook Terrace, Madison, WI, 53705, USA
| | - Robin Mermelstein
- Institute for Health Research and Policy, University of Illinois at Chicago (MC 275), 544 Westside Research Office Bldg., 1747 West Roosevelt Road, Chicago, IL, 60608, USA
| | - Timothy B. Baker
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, 1930 Monroe St. Suite 200, Madison, WI, 53711, USA
| | - Stevens S. Smith
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, 1930 Monroe St. Suite 200, Madison, WI, 53711, USA
| | - Tanya R. Schlam
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, 1930 Monroe St. Suite 200, Madison, WI, 53711, USA
| | - Megan E. Piper
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, 1930 Monroe St. Suite 200, Madison, WI, 53711, USA
| | - Douglas E. Jorenby
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, 1930 Monroe St. Suite 200, Madison, WI, 53711, USA
| | - Linda M. Collins
- The Pennsylvania State University, The Methodology Center and Department of Human Development & Family Studies, 404 Health and Human Development Building, University Park, PA 16802
| | - Jessica W. Cook
- William S. Middleton Memorial Veterans Hospital, Addictive Disorders Treatment Program, 2500 Overlook Terrace, Madison, WI, 53705, USA.,Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, 1930 Monroe St. Suite 200, Madison, WI, 53711, USA
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24
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Kruse G, Park ER, Shahid NN, Abroms L, Haberer JE, Rigotti NA. Combining Real-Time Ratings With Qualitative Interviews to Develop a Smoking Cessation Text Messaging Program for Primary Care Patients. JMIR Mhealth Uhealth 2019; 7:e11498. [PMID: 30912755 PMCID: PMC6454345 DOI: 10.2196/11498] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 11/15/2018] [Accepted: 11/22/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Text messaging (short message service, SMS) interventions show promise as a way to help cigarette smokers quit. Few studies have examined the effectiveness of text messaging (SMS) programs targeting smokers associated with primary care or hospital settings. OBJECTIVE This study aimed to develop a text messaging (SMS) program targeting primary care smokers. METHODS Adult smokers in primary care were recruited from February 2017 to April 2017. We sent patients 10 to 11 draft text messages (SMS) over 2 days and asked them to rate each message in real time. Patients were interviewed daily by telephone to discuss ratings, message preferences, and previous experiences with nicotine replacement therapy (NRT). Content analysis of interviews was directed by a step-wise text messaging (SMS) intervention development process and the Information-Motivation-Behavioral Skills model of medication adherence. RESULTS We sent 149 text messages (SMS) to 15 patients. They replied with ratings for 93% (139/149) of the messages: 134 (96%, 134/139) were rated as clear or useful and 5 (4%, 5/139) as unclear or not useful. Patients' preferences included the addition of graphics, electronic cigarette (e-cigarette) content, and use of first names. Regarding NRT, patients identified informational gaps around safety and effectiveness, preferred positively framed motivational messages, and needed behavioral skills to dose and dispose of NRT. CONCLUSIONS Patients recommended text message (SMS) personalization, inclusion of e-cigarette information and graphics, and identified barriers to NRT use. Combining real-time ratings with telephone interviews is a feasible method for incorporating primary care patients' preferences into a behavioral text messaging (SMS) program.
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Affiliation(s)
- Gina Kruse
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, United States
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Elyse R Park
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - Naysha N Shahid
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Lorien Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Jessica E Haberer
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
- Center for Global Health, Massachusetts General Hospital, Boston, MA, United States
| | - Nancy A Rigotti
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, United States
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
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Meshefedjian GA. The smoking spectrum: review of the existing evidence and future directions. J Public Health (Oxf) 2019. [DOI: 10.1007/s10389-018-01009-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Ngo CQ, Chiu RG, Chu HT, Vu GV, Nguyen QN, Nguyen LH, Tran TT, Nguyen CT, Tran BX, Latkin CA, Ho CSH, Ho RCM. Correlated Factors with Quitting Attempts Among Male Smokers in Vietnam: A QUITLINE-Based Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 16:ijerph16010084. [PMID: 30598002 PMCID: PMC6339115 DOI: 10.3390/ijerph16010084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 12/18/2018] [Accepted: 12/18/2018] [Indexed: 12/11/2022]
Abstract
Despite its decreasing prevalence, cigarette smoking remains the second leading cause of preventable death worldwide. In Vietnam, despite recent smoking cessation efforts, the prevalence of tobacco consumption remains high, particularly among males. In this study, we aim to evaluate the self-efficacy in quitting smoking (i.e., quitting confidence), intention to quit, and identifying associated factors among both rural and urban Vietnamese male populations. A cross-sectional study was conducted on 321 patients (52.7% urban and 47.4% rural inhabitants) who utilized QUITLINE services of Bach Mai Hospital (Hanoi, Vietnam). Socio-economic status, smoking history, cigarette usage data, and intent to quit were assessed. Baseline data were correlated with quitting confidence, to identify significant associated factors. The majority (75.9%) of participants were in the planning phase of cessation, yet 90.8% lacked complete confidence in their quitting ability. Older age, fewer cigarettes per day and previous quitting attempts were associated with quitting confidence (p < 0.05) and plans to quit (p < 0.05). Older smokers and previous quitters were more confident in their ability to quit in the near future and more likely to have made plans to quit. Future smoking cessation efforts should focus on improving self-efficacy, particularly among younger and newer smokers.
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Affiliation(s)
- Chau Quy Ngo
- Department of Internal Medicine, Hanoi Medical University, Hanoi 100000, Vietnam.
| | - Ryan G Chiu
- College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA.
- Center of Excellence in Health Service and System Research, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam.
| | - Hanh Thi Chu
- Department of Internal Medicine, Hanoi Medical University, Hanoi 100000, Vietnam.
| | - Giap Van Vu
- Department of Internal Medicine, Hanoi Medical University, Hanoi 100000, Vietnam.
| | - Quang Nhat Nguyen
- Université Claude Bernard Lyon 1, 69100 Villeurbanne, France.
- Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam.
| | - Long Hoang Nguyen
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam.
| | - Tung Thanh Tran
- Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam.
| | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam.
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam.
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
| | - Carl A Latkin
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
| | - Cyrus S H Ho
- Department of Psychological Medicine, National University Hospital, Singapore 119074, Singapore.
| | - Roger C M Ho
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam.
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore.
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Coppo A, Baldissera S, Migliardi A, Minardi V, Quarchioni E, Ferrante G, Dal Molin A, Faggiano F. Quit attempts and smoking cessation in Italian adults (25-64 years): factors associated with attempts and successes. Eur J Public Health 2018; 27:717-722. [PMID: 28108591 DOI: 10.1093/eurpub/ckw262] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Over the past 50 years there was a substantial decrease in the prevalence of smoking in Italy. The objective of this work is to describe attempts to quit and cessation success in Italian smokers. Methods A surveillance on health-related behaviors (PASSI) was conducted in 2007-13 on a sample of 203 610 Italian adults 25-64 years of age. An analysis of smokers' characteristics and behaviors was performed, focusing on attempts to quit and quit success. Data from national surveys (ISTAT) from 1983 to 2013 (Italian adults, 25-64 years of age, 1983: 46 634; 1987: 40 915; 1990: 36 622; 2000: 77 531; 2005: 71 032; 2013: 64 205) were used to explore if a cessation trend in Italy exists. Results Smokers who quit in the previous year and were still abstinent when interviewed increased from 1990 to 2013. In the years 2011-13, 38% of people who had smoked in the last 12 months reported at least a quit attempt during the same period and 7% were still abstinent when interviewed. An association of successful recent quit attempts with higher educational level, absence of economic difficulties and younger age was found. In the years 2007-13, the great majority tried to stop unaided. Having received assistance from a cessation program did not increase the probability of enduring abstinence. Conclusions In Italy interventions to drive more smokers to quit should be focused in particular on disadvantaged groups. Initiatives have to be studied not only to incentive more smokers to try to quit, but also to maintain abstinence over time.
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Affiliation(s)
- Alessandro Coppo
- Department of Translational Medicine, Avogadro University, Novara, Italy
| | - Sandro Baldissera
- Surveillance and Health Promotion, National Centre of Epidemiology, Rome, Italy
| | | | - Valentina Minardi
- Surveillance and Health Promotion, National Centre of Epidemiology, Rome, Italy
| | - Elisa Quarchioni
- Surveillance and Health Promotion, National Centre of Epidemiology, Rome, Italy
| | - Gianluigi Ferrante
- Surveillance and Health Promotion, National Centre of Epidemiology, Rome, Italy
| | - Alberto Dal Molin
- Department of Translational Medicine, Avogadro University, Novara, Italy
| | - Fabrizio Faggiano
- Department of Translational Medicine, Avogadro University, Novara, Italy
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Shanahan WR, Rose JE, Glicklich A, Stubbe S, Sanchez-Kam M. Lorcaserin for Smoking Cessation and Associated Weight Gain: A Randomized 12-Week Clinical Trial. Nicotine Tob Res 2018; 19:944-951. [PMID: 27815511 DOI: 10.1093/ntr/ntw301] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 11/01/2016] [Indexed: 11/13/2022]
Abstract
Introduction Lorcaserin is a selective serotonin 2C receptor agonist approved by the Food and Drug Administration for chronic weight management. Preclinical data suggest that it may also be effective in smoking cessation through modulation of the dopaminergic reward system. Methods This was a 12-week, randomized, double-blind, placebo-controlled trial conducted in 30 centers in the United States. Six hundred three adult smokers with a Body Mass Index of 18.5-35 kg/m2, averaging at least 10 cigarettes/day with no period of abstinence >3 months for the past year were randomized to lorcaserin 10 mg once daily (QD), 10 mg twice daily (BID) or placebo; all received standardized smoking cessation counseling weekly. The target quit date was day 15. The primary endpoint was the exhaled carbon monoxide confirmed Continuous Abstinence Rate for weeks 9-12 (month 3). Results Continuous Abstinence Rates for month 3 were 5.6%, 8.7%, and 15.3% for the placebo, QD and BID groups, respectively (BID vs. placebo odds ratio 3.02, 95% confidence interval 1.47, 6.22, p = .0027. Change in weight at week 12 (randomized population) was -0.01, -0.35 and -0.98 kg, respectively (p = .0004, BID vs. placebo), and +0.73, +0.76, and -0.41 kg in participants achieving month 3 continuous abstinence. The most frequent adverse events were headache, nausea, constipation, and fatigue. Conclusions Lorcaserin with counseling was associated with dose-related increases in smoking cessation and prevention of associated weight gain over a 3-month period. Further investigation of lorcaserin in smoking cessation is warranted. Trial Registration: ClinicalTrials.gov. Identifier: NCT02044874. Implications This randomized, controlled trial demonstrated that lorcaserin used in conjunction with standard cessation counseling was associated with dose-related increases in smoking cessation and prevention of associated weight gain. To our knowledge, this is the first demonstration in humans of a potential role of 5-HT2C agonism in the modulation of central neurological circuits involved with reward.
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Affiliation(s)
- William R Shanahan
- Department of Drug Development, Arena Pharmaceuticals, Inc., San Diego, CA.,Department of Clinical Development, Anthera Pharmaceuticals Inc, Hayward, CA
| | - Jed E Rose
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | - Alan Glicklich
- Department of Drug Development, Arena Pharmaceuticals, Inc., San Diego, CA.,Department of Clilnical Development, Bird Rock Bio Inc., La Jolla, CA
| | - Scott Stubbe
- Department of Drug Development, Arena Pharmaceuticals, Inc., San Diego, CA
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Kruse GR, Kelley JHK, Chase K, Rigotti NA. Feasibility of a proactive text messaging intervention for smokers in community health centers. JMIR Form Res 2017; 2:v2i1e11. [PMID: 30506038 PMCID: PMC6261471 DOI: 10.2196/formative.9608] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Few smokers receive evidence-based cessation services during primary care visits. Objective We aimed to assess the feasibility of a proactive text messaging program for primary care patients who smoke. Methods We used electronic health records to identify smokers who had a mobile phone number listed from two community health centers in Massachusetts. Between March 2014 and June 2015, patients were screened by their primary care physician and then sent a proactive text message inviting them to enroll by texting back. Patients who opted in were asked about their readiness to quit. The text message program included messages from the QuitNowTXT library and novel content for smokers who were not ready to quit. Results Among 949 eligible smokers, 88 (9.3%) enrolled after receiving a single proactive text message. Compared with those who did not enroll, enrollees were more often female (54/88, 61% vs 413/861, 48.0%, P=.02), but otherwise did not differ in age, race, insurance status, or comorbidities. In all, 28% (19/67) of enrollees reported they were not ready to quit in the next 30 days, 61% (41/67) were ready to quit, and 11% (7/67) already quit. The median time in the program was 9 days (interquartile range 2-32 days). Of current smokers, 25% (15/60) sent one or more keyword requests to the server. These did not differ by readiness to quit. Conclusions A proactively delivered text messaging program targeting primary care patients who smoke was feasible and engaged both smokers ready to quit and those not ready to quit. This method shows promise as part of a population health model for addressing tobacco use outside of the primary care office.
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Affiliation(s)
- Gina R Kruse
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital.,Tobacco Research and Treatment Center, Massachusetts General Hospital.,Harvard Medical School.,Partners Center for Connected Health, Massachusetts General Hospital
| | - Jennifer H K Kelley
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital.,Tobacco Research and Treatment Center, Massachusetts General Hospital.,Harvard Medical School.,Partners Center for Connected Health, Massachusetts General Hospital
| | - Karen Chase
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital.,Tobacco Research and Treatment Center, Massachusetts General Hospital.,Harvard Medical School.,Partners Center for Connected Health, Massachusetts General Hospital
| | - Nancy A Rigotti
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital.,Tobacco Research and Treatment Center, Massachusetts General Hospital.,Harvard Medical School.,Partners Center for Connected Health, Massachusetts General Hospital
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Piñeiro B, López-Durán A, del Río EF, Martínez Ú, Brandon TH, Becoña E. Motivation to quit as a predictor of smoking cessation and abstinence maintenance among treated Spanish smokers. Addict Behav 2016; 53:40-5. [PMID: 26441045 DOI: 10.1016/j.addbeh.2015.09.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 09/12/2015] [Accepted: 09/28/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Although quitting motivation predicts smoking cessation, there have been inconsistent findings regarding motivation predicting long-term maintenance of abstinence. Moreover, most such research has been conducted in North America and the United Kingdom. The aim of this study was to examine motivation to quit as a predictor of smoking cessation and of abstinence maintenance in a Spanish sample. METHOD The sample comprised 286 Spanish smokers undergoing psychological treatment for smoking cessation. Motivation to quit was assessed pre-treatment and post-treatment with the Readiness to Quit Ladder. Abstinence post-treatment and at 6month follow-up was biochemically verified. RESULTS Participants with higher levels of pre-treatment and post-treatment motivation were more likely to be abstinent at the end of the treatment (OR=1.36) and at 6month follow-up (OR=4.88). Among abstainers at the end of the treatment (61.9%), higher levels of motivation to quit post-treatment predicted maintaining abstinence at 6months (OR=2.83). Furthermore, participants who failed to quit smoking reported higher levels of motivation to quit post-treatment than they had pretreatment (p<.001). CONCLUSIONS Motivation to quit smoking predicted short and long-term cessation, and also predicted long-term maintenance of abstinence. These results have implications for understanding motivational processes of smoking cessation in general, while extending research to Spanish smokers. They may also help in the design of cessation and relapse-prevention interventions. Specifically, the results suggest that motivational enhancement is important throughout the cessation and maintenance periods.
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Abstract
For the past 30 years, research examining predictors of successful smoking cessation treatment response has focused primarily on clinical variables, such as levels of tobacco dependence, craving, and self-efficacy. However, recent research has begun to determine biomarkers (such as genotype, nicotine and metabolite levels, and brain imaging findings) that may have utility in predicting smoking cessation. For genotype, genes associated with nicotinic acetylcholine receptors (nAChRs) and related proteins have been found to predict response to first-line medications (e.g. nicotine replacement therapy [NRT], bupropion, or varenicline) or quitting over time without a controlled treatment trial. For nicotine and metabolite levels, function of the cytochrome P450 2A6 liver enzyme, which can be assessed with the nicotine metabolite ratio or via genotype, has been found to predict response, with slow nicotine metabolizers having less severe nicotine dependence and a greater likelihood of quitting with NRT than normal metabolizers. For brain imaging, decreased activation of brain regions associated with emotion regulation and increased connectivity in emotion regulation networks, increased responsiveness to pleasant cues, and altered activation with the Stroop effect have been found in smokers who quit with the first-line medications listed above or counseling. In addition, our group recently demonstrated that lower pre-treatment brain nAChR density is associated with a greater chance of quitting smoking with NRT or placebo. Several of these studies found that specific biomarkers may provide additional information for predicting response beyond subjective symptom or rating scale measures, thereby giving an initial indication that biomarkers may, in the future, be useful for guiding smoking cessation treatment intensity, duration, and type.
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Lam TH, Cheung YTD, Leung DYP, Abdullah ASM, Chan SSC. Effectiveness of smoking reduction intervention for hardcore smokers. Tob Induc Dis 2015; 13:9. [PMID: 25859176 PMCID: PMC4391680 DOI: 10.1186/s12971-015-0034-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 03/20/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The prevalence and correlates of hardcore smokers, who have high daily cigarette consumption, no quitting history and no intention to quit, have been studied in several western developed countries, but no previous trials of smoking cessation have tested intervention effectiveness for these smokers. The current study examined if hardcore smokers can benefit from smoking reduction intervention to achieve cessation, and explored the underlying reasons. METHODS A posteriori analysis was conducted on data from a randomized controlled trial of smoking reduction intervention on 1,154 smokers who did not want to quit. Odds ratios of 7-day point prevalence of abstinence, smoking reduction by at least 50% and quit attempt at the 6-month follow-up comparing subgroups of smokers were analyzed. RESULTS In hardcore smokers, the odds ratio comparing the quit rate between the intervention and control group was 4.18 (95% CI: 0.51-34.65), which was greater than non-hardcore smokers (OR = 1.58, 95% CI: 0.98-2.54). The number needed to treat for hardcore and non-hardcore smokers was 8.33 (95% CI: 5.56-16.67) and 16.67 (95% CI: 8.33-233.64), respectively. In smokers who did not have quit attempt experience and those who smoked more than 15 cigarettes daily, the odds ratio comparing intervention and control group was 3.29 (95% CI: 0.72-14.98) and 1.36 (95% CI: 0.78-2.36), respectively. CONCLUSIONS The a posteriori analysis provided pilot results that smoking reduction intervention may be effective to help hardcore smokers to quit and reduce smoking. Having no previous quit attempt was identified as more important than having large cigarette consumption in explaining the greater effectiveness of the intervention.
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Affiliation(s)
- Tai Hing Lam
- />School of Public Health, The University of Hong Kong, Hong Kong, China
| | | | - Doris Yin Ping Leung
- />The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Abu Saleh M Abdullah
- />Global Health Program, Duke Kunshan University, Kunshan, China
- />Duke Global Health Institute, Duke University, Durham, NC USA
- />Department of Medicine, Boston University Medical Center, Boston, USA
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Predictors of tobacco smoking abstinence among tuberculosis patients in South Africa. J Behav Med 2015; 38:472-82. [PMID: 25655663 DOI: 10.1007/s10865-015-9620-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 01/22/2015] [Indexed: 10/24/2022]
Abstract
This study examines predictors of smoking cessation in tuberculosis patients with high HIV co-infection rates in a South African primary care setting. Current smokers were randomly allocated to brief motivational interviewing (n = 205) or receipt of a brief message (n = 204). Multi-level logistic regression was performed to identify predictors of sustained 3- and 6-month abstinence and 7-day point prevalence abstinence (PPA) at 1 month, with the facility as a random effect. The intervention was ineffective among smokers with high nicotine-dependence at 1 month, but was effective for all smokers over longer periods. Higher baseline self-efficacy predicted the 1-month 7-day PPA, but not sustained abstinence. HIV-positive participants' odds of sustained abstinence were about three times higher than those of their HIV-negative counterparts. Results support a more intensive motivational intervention and/or coping skills' training to increase self-efficacy and abstinence rates. Tobacco cessation services can be introduced in tuberculosis services where high HIV co-infection rates occur.
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KIM Y, CHO WK. Factors Associated with Successful Smoking Cessation in Korean Adult Males: Findings from a National Survey. IRANIAN JOURNAL OF PUBLIC HEALTH 2014; 43:1486-96. [PMID: 26060715 PMCID: PMC4449497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2014] [Accepted: 10/05/2014] [Indexed: 11/05/2022]
Abstract
BACKGROUND Smoking cessation rates have remained stagnant globally. This study was conducted to explore the factors associated with successful smoking cessation among South Korean adult males using nationally representative data from the Korea National Health and Nutrition Examination Survey (KNHANES) from 2007 to 2012. A comparison was made between successful quitters and those who failed to quit after attempts to stop smoking. METHODS A total of 7,839 males, aged 19-65 years, were included in this cross-sectional study. The outcome measures were the success and failure rates in smoking cessation, sociodemographic and clinical characteristics, health behaviors, perceived health status, quality of life, and mental health. Multiple logistic regression analyses were used to examine the various factors associated with smoking cessation success. RESULTS The cessation success and failure rates were 45.5% and 54.5%, respectively. Smoking cessation was related to older age, marriage, higher income, smoking larger amounts of cigarettes, use of willpower, alcohol abstinence, cancer history, better mental health, and higher levels of quality of life, after controlling for multiple variables. Second-hand smoke exposure at home and using nicotine replacement therapy were associated with a lower likelihood of smoking cessation. CONCLUSION A smoke-free environment, use of willpower, alcohol abstinence, and better stress management are important for smoking cessation. Unlike previous studies, not using nicotine replacement therapy and higher levels of daily cigarette consumption were associated with successful smoking cessation, suggesting that motivation appears to be important to smoking cessation in Korean adult male population.
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Affiliation(s)
- Youngmee KIM
- 1. Red Cross College of Nursing, Chung-Ang University, Seoul, Korea
| | - Won-Kyung CHO
- 2. Section of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA,* Corresponding Author:
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Jardin BF, Cropsey KL, Wahlquist AE, Gray KM, Silvestri GA, Cummings KM, Carpenter MJ. Evaluating the effect of access to free medication to quit smoking: a clinical trial testing the role of motivation. Nicotine Tob Res 2014; 16:992-9. [PMID: 24610399 PMCID: PMC4133568 DOI: 10.1093/ntr/ntu025] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 02/01/2014] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Although the majority of smokers are ambivalent about quitting, few treatments specifically target smokers lacking motivation to quit in the near future. Most existing interventions are instead predicated on the belief that active treatments should only be distributed to smokers interested in quitting, a largely untested assumption. METHODS In the current clinical trial (N = 157), motivated smokers wanting to quit in the next 30 days were given a 2-week nicotine replacement therapy (NRT) sample and a referral to a quitline (Group MNQ), while unmotivated smokers were randomized to receive the same treatment (Group UNQ) or a quitline referral only (Group UQ). Participants were tracked via telephone for 3 months to assess quitting behaviors and smoking reduction. RESULTS Groups significantly differed across all comparisons with regard to incidence of any quit attempt (MNQ: 77%, UNQ: 40%, UQ: 18%, p < .05) and any 24-hr quit attempts (62%, 32%, 16%, p < .05). Clinically meaningful differences emerged in the rates of floating (19%, 17%, 6%) and point prevalence abstinence (17%, 15%, 5%). Compared to participants in Group UQ (11%), a greater proportion of participants in Group MNQ (48%, p = .01) and Group UNQ (31%, p = .01) reduced their daily cigarette consumption by at least half. Proxy measures of cessation readiness (e.g., motivation) favored participants receiving active forms of treatment. CONCLUSIONS Providing NRT samples engaged both motivated and unmotivated smokers into the quitting process and produced positive changes in smoking outcomes. This suggests that motivation should not be considered a necessary precondition to receiving treatment.
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Affiliation(s)
- Bianca F Jardin
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Karen L Cropsey
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL
| | - Amy E Wahlquist
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC; Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC
| | - Kevin M Gray
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Gerard A Silvestri
- Department of Medicine, Division of Pulmonary/Critical Care Medicine, Medical University of South Carolina, Charleston, SC
| | - K Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC; Hollings Cancer Center, Medical University of South Carolina, Charleston, SC
| | - Matthew J Carpenter
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC; Hollings Cancer Center, Medical University of South Carolina, Charleston, SC;
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Brook JS, Zhang C, Balka EB, Seltzer N, Brook DW. Personality characteristics in the mid-forties predict women's smoking cessation in their mid-sixties. Psychol Rep 2014; 113:921-9. [PMID: 24693821 DOI: 10.2466/09.10.13.pr0.113x26z9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study examined whether personality characteristics measured when a woman is in her mid-40s can predict success in sustained smoking cessation 22 years later, when the woman is in her mid-60s. Multivariate logistic regression analyses were conducted on data from a sample of 195 women (M ages 43 and 65, respectively), who were regular smokers and participated in a longitudinal study from 1983 to 2009. The results suggest that women who exhibited low self-control, high resistance to rules, impulsivity, and sensation seeking in their mid-40s were significantly less likely to succeed in quitting smoking for a period of 5 years or more by the time they reached their mid-60s. Addressing some personal characteristics in smoking cessation programs might enhance their effectiveness and success.
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Sharma A, Szatkowski L. Characteristics of smokers who have never tried to quit: evidence from the British Opinions and Lifestyle Survey. BMC Public Health 2014; 14:346. [PMID: 24721488 PMCID: PMC4008410 DOI: 10.1186/1471-2458-14-346] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 04/07/2014] [Indexed: 11/17/2022] Open
Abstract
Background An understanding of the characteristics of smokers who have never tried to quit may be useful to help identify and target these individuals and encourage them to attempt to give up smoking. Using national survey data we investigated variables associated with smokers reporting never having tried to quit. Methods Using data from the 2007 and 2009 UK Office for National Statistics Opinions and Lifestyle Survey we identified all self-reported current smokers aged 16+. The primary outcome was response to the question ‘have you ever tried to quit smoking?’ Univariable and multivariable logistic regression quantified the association between this outcome and several potential explanatory variables, including age, sex, socioeconomic status, health status, smoking behaviour, and knowledge of the dangers of smoking. Results Desire to quit was the most significant independent predictor of whether a smoker reported never having tried to quit. Smokers who reported that their health was good or very good were more likely to report never having tried to quit than those whose health was fair, bad or very bad (OR 1.59, 95% CI 1.05-2.41). Smokers who reported that no family members, friends or colleagues had been trying to get them to quit smoking in the last year were more likely to report never having tried to quit than those who reported that someone was trying to persuade them (OR 1.57, 95% CI 1.09-2.28). Smokers who hadn’t received any cessation advice from a health professional in the last five years which they considered to be helpful were also more likely to report never having tried to quit. Conclusions Smokers who do not want to quit, who are in good health, whose friends and family are not trying to get them to quit, and who do not report receiving helpful advice to quit from a health professional, are more likely to report never having tried to quit.
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Affiliation(s)
| | - Lisa Szatkowski
- Division of Epidemiology and Public Health, UK Centre for Tobacco and Alcohol Studies, University of Nottingham, Clinical Sciences Building, Nottingham City Hospital, NG5 1 PB Nottingham, UK.
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Goren A, Annunziata K, Schnoll RA, Suaya JA. Smoking cessation and attempted cessation among adults in the United States. PLoS One 2014; 9:e93014. [PMID: 24676348 PMCID: PMC3968049 DOI: 10.1371/journal.pone.0093014] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Accepted: 02/28/2014] [Indexed: 11/18/2022] Open
Abstract
AIMS With growing recognition of stagnant rates of attempted cigarette smoking cessation, the current study examined demographic and psychometric characteristics associated with successful and attempted smoking cessation in a nationally representative sample. This additional understanding may help target tobacco cessation treatments toward sub-groups of smokers in order to increase attempts to quit smoking. DESIGN, SETTING, AND PARTICIPANTS Data were used from the 2011 U.S. National Health and Wellness Survey (n = 50,000). MEASUREMENTS Current smoking status and demographics, health characteristics, comorbidities, and health behaviors. FINDINGS In 2011, 18%, 29%, and 52% of U.S. adults were current, former, or never smokers, respectively. Over one quarter (27%) of current smokers were attempting to quit. Current smokers (vs. others) were significantly more likely to be poorer, non-Hispanic White, less educated, ages 45-64, and uninsured, and they had fewer health-conscious behaviors (e.g., influenza vaccination, exercise). Attempting quitters vs. current smokers were significantly less likely to be non-Hispanic White and more likely to be younger, educated, insured, non-obese, with family history of chronic obstructive pulmonary disease, and they had more health-conscious behaviors. CONCLUSIONS Smokers, attempting quitters, and successful quitters differ on characteristics that may be useful for targeting and personalizing interventions aiming to increase cessation attempts, likelihood, and sustainability.
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Affiliation(s)
- Amir Goren
- Health Outcomes Practice, Kantar Health, New York, New York, United States of America
| | - Kathy Annunziata
- Health Outcomes Practice, Kantar Health, Princeton, New Jersey, United States of America
| | - Robert A. Schnoll
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Jose A. Suaya
- GlaxoSmithKline Vaccines, Philadelphia, Pennsylvania, United States of America
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Sanders-Jackson A. Rated measures of narrative structure for written smoking-cessation texts. HEALTH COMMUNICATION 2014; 29:1009-19. [PMID: 24447036 PMCID: PMC4103165 DOI: 10.1080/10410236.2013.830205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
This article describes the effect of a series of rated measures of narrative structure on recognition memory, agreement on story-relevant beliefs, and intention to engage in a health-related behavior-in this case smoking cessation. Using short smoking-cessation stories as stimuli, data were collected in a nationally representative sample of adult smokers (n = 1,312). Results suggested that messages rated as more sequential improved encoding and messages rated as containing more context decreased encoding. Messages rated high in transportation were associated with increased recognition, agreement with story-relevant beliefs, and intention to quit. Both positive and negative emotion were positively associated with intention to quit, but were negatively associated with recognition memory.
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Jena PK, Kishore J, Pati S, Sarkar BK, Das S. Tobacco use and quit behaviour assessment in the Global Adult Tobacco Survey (GATS): invalid responses and implications. Asian Pac J Cancer Prev 2014; 14:6563-8. [PMID: 24377568 DOI: 10.7314/apjcp.2013.14.11.6563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tobacco use and quit attempts are two key indicators of the Global Adult Tobacco Survey (GATS) that assess quit attempts among current as well as former tobacco users. The relevant data have inherent policy implications for tobacco cessation programme evaluation. This study aimed to review the concepts of quit attempt assessment and quantifying invalid responses considering GATS-India data. MATERIALS AND METHODS GATS assessment of tobacco use and quit attempts were examined in the current literature. Two categories of invalid responses were identified by stratified analysis of the duration of last quit attempt among current users and duration of abstinence among former users. Category A included absolute invalid responses when time- frame of assessment of current tobacco use and less than former tobacco use were violated. Category B included responses that violated the unit of measurement of time. RESULTS Current daily use, current less than daily use and former use in GATS were imprecisely defined with overlapping of time-frame of assessment. Overall responses of 3,102 current smokers, 4,036 current smokeless users, 1,904 former smokers and 1,343 former smokeless users were analyzed to quantify invalid responses. Analysis indicated overall 21.2% (category A: 7.32%; category B: 17.7%) and 22.7% (category A: 8.05%; category B: 18.1%) invalid responses among current smokers and smokeless users respectively regarding their duration of last quit attempt. Similarly overall 6.62% (category A: 4.7%; category B: 2.3%) and 10.6% (category A: 8.6%; category B: 3.5%) invalid responses were identified among former smokers and smokeless users respectively regarding their duration of abstinence. CONCLUSIONS High invalid responses for a single assessment are due to the imprecise definition of current use, former use and quit attempt; and failure to utilize opportunity of direct data entry interface use during the survey to validate responses instantly. Redefining tobacco use and quit attempts considering an appropriate timeframe would reduce invalid responses.
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Affiliation(s)
- Pratap Kumar Jena
- Project STEPS, Public Health Foundation of India, New Delhi, and Heath Systems Research India Initiative, Bangalore, India E-mail :
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McClure EA, Saladin ME, Baker NL, Carpenter MJ, Gray KM. Smoking topography and abstinence in adult female smokers. Addict Behav 2013; 38:2833-6. [PMID: 24018226 DOI: 10.1016/j.addbeh.2013.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 07/08/2013] [Accepted: 08/06/2013] [Indexed: 11/28/2022]
Abstract
Preliminary evidence, within both adults and adolescents, suggests that the intensity with which cigarettes are smoked (i.e., smoking topography) is predictive of success during a cessation attempt. These reports have also shown topography to be superior compared to other variables, such as cigarettes per day, in the prediction of abstinence. The possibility that gender may influence this predictive relationship has not been evaluated but may be clinically useful in tailoring gender-specific interventions. Within the context of a clinical trial for smoking cessation among women, adult daily smokers completed a laboratory session that included a 1-hour ad libitum smoking period in which measures of topography were collected (N=135). Participants were then randomized to active medication (nicotine patch vs. varenicline) and abstinence was monitored for 4weeks. Among all smoking topography measures and all abstinence outcomes, a moderate association was found between longer puff duration and greater puff volume and continued smoking during the active 4-week treatment phase, but only within the nicotine patch group. Based on the weak topography-abstinence relationship among female smokers found in the current study, future studies should focus on explicit gender comparisons to examine if these associations are specific to or more robust in male smokers.
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Affiliation(s)
- Erin A McClure
- Medical University of South Carolina, Charleston, SC, USA.
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Burris JL, Carpenter MJ, Wahlquist AE, Cummings KM, Gray KM. Brief, instructional smokeless tobacco use among cigarette smokers who do not intend to quit: a pilot randomized clinical trial. Nicotine Tob Res 2013; 16:397-405. [PMID: 24130144 DOI: 10.1093/ntr/ntt161] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Low-nitrosamine smokeless tobacco (SLT) may have efficacy for smoking reduction and cessation, but its public health impact depends on how smokers use it. METHODS This pilot study explored brief, instructional low-nitrosamine SLT use among smokers unmotivated to quit. Participants (N = 57) were randomized to either a free 2-week supply of Camel Snus group or a no-supply group. Of those randomized to use Camel Snus, half were told to use it to cope with smoking restrictions (Snus to Cope), and the remaining half were advised to use it to reduce smoking (Snus to Reduce). Participants were assessed before, during, and immediately after the intervention. RESULTS Many Snus to Cope and Snus to Reduce participants reported daily use of Camel Snus, although the amount of use was low. Snus to Cope (18.4%) and Snus to Reduce (37.6%) participants reported a decline in number of cigarettes used per day, which was not reported by the control participants (p < .001). Intention to quit smoking and intention to quit all tobacco use (ps < .001) increased to a greater extent among Snus to Cope and Snus to Reduce participants than among control participants. CONCLUSIONS This study replicates previous work that shows that low-nitrosamine SLT use can lead to reduced smoking and increased intention to quit, and it adds direct evidence to suggest that the function of low-nitrosamine SLT use-either to cope with smoking restrictions or to reduce smoking-can have a differential impact on smoking behavior. Overall, the results highlight the importance of messaging and, more specifically, marketing of low-nitrosamine SLT to smokers.
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Affiliation(s)
- Jessica L Burris
- Department of Psychiatry and Behavioral Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC
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Kashigar A, Habbous S, Eng L, Irish B, Bissada E, Irish J, Brown D, Gilbert R, Gullane P, Xu W, Huang SH, Witterick I, Freeman J, O'Sullivan B, Waldron J, Liu G, Goldstein D. Social environment, secondary smoking exposure, and smoking cessation among head and neck cancer patients. Cancer 2013; 119:2701-9. [DOI: 10.1002/cncr.28088] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 02/24/2013] [Accepted: 02/25/2013] [Indexed: 11/11/2022]
Affiliation(s)
- Aidin Kashigar
- Otolaryngology-Head & Neck Surgery; University of Toronto; Toronto Ontario Canada
| | - Steven Habbous
- Ontario Cancer Institute; Princess Margaret Cancer Centre; Toronto Ontario Canada
- Biostatistics; Ontario Cancer Institute; Toronto Ontario Canada
| | - Lawson Eng
- Ontario Cancer Institute; Princess Margaret Cancer Centre; Toronto Ontario Canada
| | - Brendan Irish
- Ontario Cancer Institute; Princess Margaret Cancer Centre; Toronto Ontario Canada
| | - Eric Bissada
- Otolaryngology-Head & Neck Surgery; University of Toronto; Toronto Ontario Canada
- Ontario Cancer Institute; Princess Margaret Cancer Centre; Toronto Ontario Canada
| | - Jonathan Irish
- Otolaryngology-Head & Neck Surgery; University of Toronto; Toronto Ontario Canada
- Ontario Cancer Institute; Princess Margaret Cancer Centre; Toronto Ontario Canada
| | - Dale Brown
- Otolaryngology-Head & Neck Surgery; University of Toronto; Toronto Ontario Canada
- Ontario Cancer Institute; Princess Margaret Cancer Centre; Toronto Ontario Canada
| | - Ralph Gilbert
- Otolaryngology-Head & Neck Surgery; University of Toronto; Toronto Ontario Canada
- Ontario Cancer Institute; Princess Margaret Cancer Centre; Toronto Ontario Canada
| | - Patrick Gullane
- Otolaryngology-Head & Neck Surgery; University of Toronto; Toronto Ontario Canada
- Ontario Cancer Institute; Princess Margaret Cancer Centre; Toronto Ontario Canada
| | - Wei Xu
- Biostatistics; Ontario Cancer Institute; Toronto Ontario Canada
| | - Shao-Hui Huang
- Ontario Cancer Institute; Princess Margaret Cancer Centre; Toronto Ontario Canada
- Radiation Oncology; University of Toronto; Toronto Ontario Canada
| | - Ian Witterick
- Otolaryngology-Head & Neck Surgery; University of Toronto; Toronto Ontario Canada
- Ontario Cancer Institute; Mt. Sinai Hospital, University Health Network; Toronto Ontario Canada
| | - Jeremy Freeman
- Otolaryngology-Head & Neck Surgery; University of Toronto; Toronto Ontario Canada
- Ontario Cancer Institute; Mt. Sinai Hospital, University Health Network; Toronto Ontario Canada
| | - Brian O'Sullivan
- Ontario Cancer Institute; Princess Margaret Cancer Centre; Toronto Ontario Canada
- Radiation Oncology; University of Toronto; Toronto Ontario Canada
| | - John Waldron
- Ontario Cancer Institute; Princess Margaret Cancer Centre; Toronto Ontario Canada
- Radiation Oncology; University of Toronto; Toronto Ontario Canada
| | - Geoffrey Liu
- Ontario Cancer Institute; Princess Margaret Cancer Centre; Toronto Ontario Canada
- Medicine and Epidemiology; Dalla Lana School of Public Health, University of Toronto; Toronto Ontario Canada
| | - David Goldstein
- Otolaryngology-Head & Neck Surgery; University of Toronto; Toronto Ontario Canada
- Ontario Cancer Institute; Princess Margaret Cancer Centre; Toronto Ontario Canada
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