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Harlivasari AD, Susanto AD, Taufik FF, Ginting TT. The Role of Twice-Daily N-acetylcysteine (NAC) 2400 mg in Smoking Cessation: A Randomized, Placebo-Controlled Trial in Indonesia. Cureus 2024; 16:e54322. [PMID: 38500894 PMCID: PMC10944675 DOI: 10.7759/cureus.54322] [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] [Accepted: 02/16/2024] [Indexed: 03/20/2024] Open
Abstract
INTRODUCTION Tobacco smoking remains a health concern, especially in developing countries. Nicotine is significantly linked to many cancers and even second-hand exposure. Hence, smoking can increase the risk of lung and heart disease. This makes quitting smoking important and challenging. Success tends to rise by achieving abstinence with assisted pharmacology. These treatments aim to reduce symptoms of nicotine withdrawal. This is a preclinical trial on glutamate modulator in N-acetylcysteine (NAC) as a new potential treatment for smoking cessation. It is based on the administration of NAC related to elevated levels of dopamine in the central nervous system to accomplish successful smoking cessation. AIM This study evaluated the efficacy and tolerability of NAC for smoking cessation. The primary outcome was abstinence rate and the secondary outcomes of the study were to assess carbon monoxide exhalation value (COexh), the withdrawal symptoms, craving score, safety, and tolerability associated with the administration of NAC. METHODS This is a randomized clinical trial. Eligible smokers were treated with NAC 2400 mg twice daily (BID) or placebo to obtain a potential effective abstinence rate. Subjects recruited from the smoking cessation clinic were screened for eligibility and were randomized to either the NAC or placebo group. The trial consisted of a four-week treatment phase and participants were evaluated each week with a brief counseling. Intention to treat data analysis was performed from 2018 to 2019. Smoking cessation status was verified by measuring the amount of carbon monoxide exhaled and by documenting their smoking habits. Adverse events (AEs) have also been observed on each visit. RESULTS A total of 90 male smokers with a mean (SD) age of 38.7 (11) years were randomized into two groups to receive NAC (n=45) and placebo (n=45). The primary outcome revealed that the abstinence rate was significantly higher for the NAC group than the placebo group (37.7% vs 6.6%; p=0.02). These findings were supported by data comparison between the NAC group and placebo group of COexh (ppm) (9.59 ±7.4 vs 13,4 ±6.1; p=0.04) and cigarette consumption/week (10 vs 46; p <0.001), which were statistically significant. Comparison of withdrawal with the Minnesota Nicotine Withdrawal Score between the NAC group and the placebo group showed lower values (8 (1-31) vs 11 (0-43); p=0.178), respectively, even though not statistically significant. Compared to the placebo group, the craving score (6 (2-29) vs 12 (6-31); p=0.04) in the NAC group was significantly lower. The most common adverse event was mild gastrointestinal effects (28.9%) and arthralgia (2.2%). No serious adverse events were detected. CONCLUSIONS Despite a small sample size, the data demonstrate the potential benefits of NAC that may help elevate abstinence rates and promote successful smoking cessation pharmacotherapy. Comprehensive treatment combining pharmacologic therapy and counseling increases smoking cessation success rates. It is essential to conduct a randomized multicenter study with a large population to support a sustained abstinence rate using NAC.
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Affiliation(s)
- Annisa D Harlivasari
- Pulmonology and Respiratory Medicine, Rumah Sakit Umum Pusat Persahabatan, Jakarta, IDN
| | - Agus D Susanto
- Pulmonology and Respiratory Medicine, Rumah Sakit Umum Pusat Persahabatan, Jakarta, IDN
| | - Feni F Taufik
- Pulmonology and Respiratory Medicine, Rumah Sakit Umum Pusat Persahabatan, Jakarta, IDN
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De-Miguel-Diez J, Llamas-Saez C, Vaquero TS, Jiménez-García R, López-de-Andrés A, Carabantes-Alarcón D, Carricondo F, Romero-Gómez B, Pérez-Farinos N. Association between Asthma and Lower Levels of Physical Activity: Results of a Population-Based Case-Control Study in Spain. J Clin Med 2024; 13:591. [PMID: 38276097 PMCID: PMC10816609 DOI: 10.3390/jcm13020591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/09/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
(1) Background: Our aim was to determine changes in the prevalence of physical activity (PA) in adults with asthma between 2014 and 2020 in Spain, investigate sex differences and the effect of other variables on adherence to PA, and compare the prevalence of PA between individuals with and without asthma. (2) Methods: This study was a cross-sectional, population-based, matched, case-control study using European Health Interview Surveys for Spain (EHISS) for 2014 and 2020. (3) Results: We identified 1262 and 1103 patients with asthma in the 2014 and 2020 EHISS, respectively. The prevalence of PA remained stable (57.2% vs. 55.7%, respectively), while the percentage of persons who reported walking continuously for at least 2 days a week increased from 73.9% to 82.2% (p < 0.001). Male sex, younger age, better self-rated health, and lower body mass index (BMI) were significantly associated with greater PA. From 2014 to 2020, the number of walking days ≥2 increased by 64% (OR1.64 95%CI 1.34-2.00). Asthma was associated with less PA (OR0.87 95%CI 0.47-0.72) and a lower number of walking days ≥2 (OR0.84 95%0.72-0.97). (4) Conclusions: Walking frequency improved over time among people with asthma. Differences in PA were detected by age, sex, self-rated health status, and BMI. Asthma was associated with less LTPA and a lower number of walking days ≥2.
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Affiliation(s)
- Javier De-Miguel-Diez
- Respiratory Care Department, Gregorio Marañón General University Hospital, 28007 Madrid, Spain;
| | - Carlos Llamas-Saez
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (C.L.-S.); (A.L.-d.-A.); (D.C.-A.)
| | | | - Rodrigo Jiménez-García
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (C.L.-S.); (A.L.-d.-A.); (D.C.-A.)
| | - Ana López-de-Andrés
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (C.L.-S.); (A.L.-d.-A.); (D.C.-A.)
| | - David Carabantes-Alarcón
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (C.L.-S.); (A.L.-d.-A.); (D.C.-A.)
| | - Francisco Carricondo
- Department of Immunology, Laboratory of Neurobiology of Hearing (UCM 910915), Ophthalmology and Otorhinolaryngology, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (F.C.); (B.R.-G.)
| | - Barbara Romero-Gómez
- Department of Immunology, Laboratory of Neurobiology of Hearing (UCM 910915), Ophthalmology and Otorhinolaryngology, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (F.C.); (B.R.-G.)
| | - Napoleón Pérez-Farinos
- Epi-PHAAN Research Group, School of Medicine, Universidad de Malaga, 29071 Malaga, Spain;
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Niemiec CP, Ivarsson A, Weman K, Smit E, Williams GC. Self-determination theory and the smoking cessation process: Daily electronic self-reports can identify the initiation of quit attempts. PATIENT EDUCATION AND COUNSELING 2023; 115:107886. [PMID: 37567038 DOI: 10.1016/j.pec.2023.107886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 06/28/2023] [Accepted: 07/06/2023] [Indexed: 08/13/2023]
Abstract
OBJECTIVES To examine the motivational predictors of the smoking cessation process at the between-persons and within-persons levels. METHODS Mediation analyses were conducted on self-report data (N = 236) that were collected using interval contingent sampling over a 39-day study period. RESULTS There was a high rate of attrition, as nearly 50% of participants were lost to follow-up. There were credible indirect effects of autonomous self-regulation on smoking behavior on the next day and seven-day abstinence through perceived competence and medication use. At the between-persons level, these models explained 17% of the variance in smoking behavior on the next day and 31% of the variance in seven-day abstinence; at the within-persons level, these estimates were 39% and 57%, respectively. CONCLUSIONS Day-to-day changes in autonomous self-regulation, perceived competence, and medication use are important initiators of the smoking cessation process. PRACTICE IMPLICATIONS Smokers might be more likely to make a quit attempt if practitioners "tune into" the day-to-day fluctuations of their patients' motivation for stopping smoking, perhaps using an electronic platform to assess and compare smokers' current reports to their previous experiences. Such "motivational attunement" can afford practitioners an opportunity to provide need support when patients are willing and able to initiate a quit attempt.
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Affiliation(s)
| | - Andreas Ivarsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Karin Weman
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Eline Smit
- School of Communication Research, University of Amsterdam, Amsterdam, the Netherlands
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Yang MJ, Brandon KO, Sutton SK, Kleinjan M, Sawyer LE, Brandon TH, Vinci C. Augmented reality as a novel approach for addiction treatment: development of a smoking cessation app. Ann Med 2022; 54:3096-3106. [PMID: 36345961 PMCID: PMC9648377 DOI: 10.1080/07853890.2022.2140451] [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] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE Augmented reality (AR) is a rapidly developing technology that has substantial potential as a novel approach for addiction treatment, including tobacco use. AR can facilitate the delivery of cue exposure therapy (CET) such that individuals can experience the treatment in their natural environments as viewed via a smartphone screen, addressing the limited generalizbility of extinction learning. Previously, our team developed a basic AR app for smoking cessation and demonstrated the necessary mechanisms for CET. Specifically, we showed that the AR smoking cues, compared to neutral cues, elicited substantial cue reactivity (i.e. increased urge) and that repeated exposure to the AR smoking cues reduced urge (i.e. extinction) in a laboratory setting. Here we report the next step in the systematic development of the AR app, in which we assessed the usability and acceptability of the app among daily smokers in their natural environments. METHOD Daily smokers (N = 23, 78.3% female, Mean Age = 43.4, Mean Cigarettes/Day = 14.9), not actively quitting, were instructed to use the AR app in locations and situations where they smoke (e.g. home, bar) at least 5 times per day over one week. The study is registered in clinicaltrials.gov (NCT04101422). RESULTS Results indicated high usability and acceptability. Most of the participants (73.9%) used the AR app on at least 5 days. Participants found the AR cues realistic and well-integrated in their natural environments. The AR app was perceived as easy to use (Mean = 4.1/5) and learn (mean of 2 days to learn). Overall satisfaction with the app was also high. Secondary analyses found that 56.5% reported reduced smoking, with an average 26% reduction in cigarettes per day at follow-up. CONCLUSIONS These findings set the stage for a randomized controlled trial testing the AR app as an adjuvant therapy for treating tobacco dependence, with potential applicability to other substances. KEY MESSAGEThis study found that the augmented reality (AR) smartphone application that utlized cue exposure treatment for smoking cessation was perceived as easy to use and learn in the natural, day-to-day environment of daily smokers. Findings set the stage for a larger clinical trial testing the AR app as an adjuvant therapy for treating tobacco dependence, with potential applicability to other addictive behaviors.
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Affiliation(s)
- Min-Jeong Yang
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Karen O Brandon
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.,Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Steven K Sutton
- Department of Psychology, University of South Florida, Tampa, FL, USA.,Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA.,Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA
| | - Marloes Kleinjan
- Department of Child and Adolescent Health, Trimbos Institute, Utrecht, The Netherlands.,Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
| | - Leslie E Sawyer
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.,Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Thomas H Brandon
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.,Department of Psychology, University of South Florida, Tampa, FL, USA.,Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
| | - Christine Vinci
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.,Department of Psychology, University of South Florida, Tampa, FL, USA.,Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
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Darabseh MZ, Selfe J, Morse CI, Aburub A, Degens H. Does Aerobic Exercise Facilitate Vaping and Smoking Cessation: A Systematic Review of Randomized Controlled Trials with Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14034. [PMID: 36360913 PMCID: PMC9658548 DOI: 10.3390/ijerph192114034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/10/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
Cigarette smokers try to quit using several strategies including electronic cigarette use (vaping). An alternative, easy and cheap method is exercise. However, little is known about the efficacy of aerobic exercise (AE) to augment smoking and vaping cessation. This study aimed to systematically review and discuss the reported effects of AE on long-term vaping and smoking cessation in randomized control trials (RCTs). RCTs were searched on different databases. The outcome measures included long-term vaping or smoking cessation and maximal or peak oxygen uptake (VO2max/peak) after vaping- or smoking cessation. Meta-analysis was conducted to examine the effects of AE on long-term vaping and smoking cessation, and the effects of AE on VO2max/peak. Cochrane Risk of Bias tool 2 was used to assess trials quality. Thirteen trials were included (5 high, 2 moderate and 6 low quality). Although two high quality trials revealed that 3 vigorous supervised AE sessions a week for 12 to 15 weeks increased the number of long-term successful quitters, the meta-analysis including the other trials showed that AE did not significantly increase success rate of long-term quitters. However, VO2max/peak was improved at the end of treatment. There were no trials on AE and vaping cessation. No evidence was found that AE promotes long-term smoking cessation. Nevertheless, AE improved VO2max and/or VO2peak in quitters.
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Affiliation(s)
- Mohammad Z. Darabseh
- Al-Ahliyya Amman University, Department of Physiotherapy, Faculty of Allied Medical Sciences, Amman 19328, Jordan
- Manchester Metropolitan University, Department of Life Sciences, Research Centre of Musculoskeletal Sciences and Sport Medicine, Manchester M15 6BH, UK
| | - James Selfe
- Manchester Metropolitan University, Department of Health Professions, Faculty of Health, Psychology and Social Care, Manchester M15 6BH, UK
| | - Christopher I. Morse
- Manchester Metropolitan University, Department of Sport and Exercise Sciences, Research Centre of Musculoskeletal Sciences and Sport Medicine, Manchester M15 6BH, UK
| | - Aseel Aburub
- Keele University, School of Allied Health Professions, Keele ST5 5BG, UK
| | - Hans Degens
- Manchester Metropolitan University, Department of Life Sciences, Research Centre of Musculoskeletal Sciences and Sport Medicine, Manchester M15 6BH, UK
- Lithuanian Sports University, Institute of Sport Science and Innovations, 44221 Kaunas, Lithuania
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6
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Gakkhar A, Mehendale A, Mehendale S. Tobacco Cessation Intervention for Young People. Cureus 2022; 14:e30308. [PMID: 36407239 PMCID: PMC9659423 DOI: 10.7759/cureus.30308] [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: 09/10/2022] [Accepted: 10/14/2022] [Indexed: 06/16/2023] Open
Abstract
Most adolescent tobacco control programs focus on preventing consumption, but teen smoking persists. It is uncertain whether adult-specific therapies can assist adolescents in quitting smoking. The rising incidence of smoking in low and middle-socioeconomic countries and the challenges of conducting tobacco cessation programs in these settings (due to increasing population, poor lifestyle, lack of awareness and education, professional stress, and non-compliance) need an emphasis on the scope of trials to conduct tobacco cessation in these settings. In the 11th Five Year Plan, the Indian government introduced a new National Tobacco Control Program, which currently spans 108 districts in 31 states across the country. The objective is to review the randomized control trials of selected individuals held in India and assess and evaluate the effectiveness of the steps taken by the government to help people quit tobacco consumption. These programs are important because of the hazards and impact they have on the public health indices of the nation. The government has taken steps like prohibiting smoking in public areas and banning sources. Several programs, particularly those that employed group counselling, included a range of approaches that proved beneficial in helping young people quit smoking. The RCTs mentioned are psychosocially followed by behavioral and pharmacological therapies. The challenges faced are not having participatory health care, motivating tobacco users to quit even in the short-term, adequate coverage; barriers at a different level of implementation (at a regional, state, or national level); and interference by the tobacco industry should be eliminated. The currently functioning programs in India are the National Tobacco Control Program, the National and three Regional Quitlines and mCessation.
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Affiliation(s)
- Avni Gakkhar
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Ashok Mehendale
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Shivansh Mehendale
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Insititute of Medical Sciences, Wardha, IND
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Iqbal S, Barolia R, Petrucka P, Ladak L, Rehmani R, Kabir A. Smoking cessation interventions in South Asian Region: a systematic scoping review. BMC Public Health 2022; 22:1096. [PMID: 35650606 PMCID: PMC9158221 DOI: 10.1186/s12889-022-13443-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 04/27/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Cigarette smoking is one of the most preventable causes of morbidities and mortalities. Since 2005, the World Health Organization Framework Convention for Tobacco Control (WHO-FCTC) provides an efficient strategic plan for tobacco control across the world. Many countries in the world have successfully reduced the prevalence of cigarette smoking. However, in developing countries, the prevalence of cigarette smoking is mounting which signifies a need of prompt attention. This scoping review aims to explore the extent and nature of Smoking Cessation (SmC) interventions and associated factors in South Asian Region (SAR) by systematically reviewing available recently published and unpublished literature.
Methods
The Joanna Briggs Institute (JBI) framework frames the conduct of this scoping review.
PubMed, EBSCO CINAHL Complete, Cochrane Library, ProQuest Dissertation and Theses, and local websites as well as other sources of grey literature were searched for relevant literature. In total, 573 literature sources were screened. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram, finally, 48 data sources were included for data extraction and analysis.
We analyzed the extracted SmC interventions through the FCTC. Factors that affect smoking cessation interventions will be extracted through manual content analysis.
Results
Regarding FCTC recommended smoking cessation strategies (articles), most of the articles were either neglected or addressed in a discordant way by various anti-smoking groups in SAR. Key barriers that hamper the effectiveness of smoking cessation interventions included lack of awareness, poor implementation of anti-smoking laws, and socio-cultural acceptance of tobacco use. Conversely, increased levels of awareness, through different mediums, related to smoking harms and benefits of quitting, effective implementation of anti-smoking laws, smoking cessation trained healthcare professionals, support systems, and reluctance in the community to cigarette smoking were identified as facilitators to smoking cessation interventions.
Conclusion
The ignored or uncoordinated FCTC’s directions on smoking cessation strategies have resulted in continued increasing prevalence of cigarette smoking in developing countries, especially SAR. The findings of this review highlight the need for refocusing the smoking cessation strategies in SAR.
Strengths
The review was conducted by a team of expert comprising information specialists, and senior professors bringing rich experience in systematic and scoping reviews. Every effort was made to include all available literature sources addressing cigarette SmC and associated factors in SAR. The review findings signal the need and direction for more SmC efforts in SAR which may contribute to development of effective policies and guidelines for the control of smoking prevalence.
Limitations
Despite efforts, potentially relevant records may have been missed due to unpublished or inaccessible articles, unintended selection bias, or those published in local languages, etc. Moreover, the exclusion of literature on under 18 participants and mentally ill smokers may limit the generalizability of findings.
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Shepherd LM, Schmidtke KA, Hazlehurst JM, Melson E, Dretzke J, Hawks N, Arlt W, Tahrani AA, Swift A, Carrick-Sen DM. Interventions for the prevention of adrenal crisis in adults with primary adrenal insufficiency: a systematic review. Eur J Endocrinol 2022; 187:S1-S20. [PMID: 35536876 PMCID: PMC9175553 DOI: 10.1530/eje-21-1248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 05/10/2022] [Indexed: 11/08/2022]
Abstract
Objective The incidence of adrenal crisis (AC) remains high, particularly for people with primary adrenal insufficiency, despite the introduction of behavioural interventions. The present study aimed to identify and evaluate available evidence of interventions aiming to prevent AC in primary adrenal insufficiency. Design This study is a systematic review of the literature and theoretical mapping. Methods MEDLINE, MEDLINE in Process, EMBASE, ERIC, Cochrane CENTRAL, CINAHL, PsycINFO, the Health Management Information Consortium and trial registries were searched from inception to November 2021. Three reviewers independently selected studies and extracted data. Two reviewers appraised the studies for the risk of bias. Results Seven observational or mixed methods studies were identified where interventions were designed to prevent AC in adrenal insufficiency. Patient education was the focus of all interventions and utilised the same two behaviour change techniques, 'instruction on how to perform a behaviour' and 'pharmacological support'. Barrier and facilitator themes aiding or hindering the intervention included knowledge, behaviour, emotions, skills, social influences and environmental context and resources. Most studies did not measure effectiveness, and assessment of knowledge varied across studies. The study quality was moderate. Conclusion This is an emerging field with limited studies available. Further research is required in relation to the development and assessment of different behaviour change interventions to prevent AC.
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Affiliation(s)
- Lisa M Shepherd
- Diabetes & Endocrine Centre, Birmingham Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- School of Nursing, Institute of Clinical Sciences
- Institute of Metabolism and Systems Research (IMSR), University of Birmingham, Birmingham, UK
- Centre for Endocrinology, Diabetes and Metabolism (CEDAM), Birmingham Health Partners, Birmingham, UK
| | | | - Jonathan M Hazlehurst
- Diabetes & Endocrine Centre, Birmingham Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Centre for Endocrinology, Diabetes and Metabolism (CEDAM), Birmingham Health Partners, Birmingham, UK
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Eka Melson
- Institute of Metabolism and Systems Research (IMSR), University of Birmingham, Birmingham, UK
- Centre for Endocrinology, Diabetes and Metabolism (CEDAM), Birmingham Health Partners, Birmingham, UK
- Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Janine Dretzke
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Noel Hawks
- Addison Disease Self-Help Group, Starling House, Bristol, UK
| | - Wiebeke Arlt
- Institute of Metabolism and Systems Research (IMSR), University of Birmingham, Birmingham, UK
- Centre for Endocrinology, Diabetes and Metabolism (CEDAM), Birmingham Health Partners, Birmingham, UK
- Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Abd A Tahrani
- Diabetes & Endocrine Centre, Birmingham Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Institute of Metabolism and Systems Research (IMSR), University of Birmingham, Birmingham, UK
- Centre for Endocrinology, Diabetes and Metabolism (CEDAM), Birmingham Health Partners, Birmingham, UK
- Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Amelia Swift
- School of Nursing, Institute of Clinical Sciences
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Fox C, Pace W, Brandt E, Carter V, Chang KL, Edwards C, Evans A, Gaona G, Han MK, Kaplan A, Kent R, Kocks JWH, Kruszyk M, Chantal LL, LiVoti T, Mahle C, Make B, Ratigan A, Shaikh A, Skolnik N, Stanley B, Yawn BP, Price DB. Variation in Demographic and Clinical Characteristics of Patients with COPD Receiving Care in US Primary Care: Data from the Advancing the Patient EXperience (APEX) in COPD Registry. Pragmat Obs Res 2022; 13:17-31. [PMID: 35516162 PMCID: PMC9064065 DOI: 10.2147/por.s342736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 04/15/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Little is known about the variability in chronic obstructive pulmonary disease (COPD) management and how it may be affected by patient characteristics across different healthcare systems in the US. This study aims to describe demographic and clinical characteristics of people with COPD and compare management across five primary care medical groups in the US. Methods This is a retrospective observational registry study utilizing electronic health records stored in the Advancing the Patient Experience (APEX) COPD registry. The APEX registry contains data from five US healthcare organizations located in Texas, Ohio, Colorado, New York, and North Carolina. Data on demographic and clinical characteristics of primary care patients with COPD between December 2019 and January 2020 were extracted and compared. Results A total of 17,192 patients with COPD were included in analysis: Texas (n = 811), Ohio (n = 8722), Colorado (n = 472), New York (n = 1149) and North Carolina (n = 6038). The majority of patients at each location were female (>54%) and overweight/obese (>60%). Inter-location variabilities were noted in terms of age, race/ethnicity, exacerbation frequency, treatment pattern, and prevalence of comorbid conditions. Patients from the Colorado site experienced the lowest number of exacerbations per year while those from the New York site reported the highest number. Hypertension was the most common co-morbidity at 4 of 5 sites with the highest prevalence in New York. Depression was the most common co-morbidity in Ohio. Treatment patterns also varied by site; Colorado had the highest proportion of patients not on any treatment. ICS/LABA was the most commonly prescribed treatment except in Ohio, where ICS/LABA/LAMA was most common. Conclusions and Relevance Our data show heterogeneity in demographic, clinical, and treatment characteristics of patients diagnosed with COPD who are managed in primary care across different healthcare organizations in the US.
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Affiliation(s)
- Chester Fox
- DARTNet Institute, Aurora, CO, USA
- University at Buffalo, Buffalo, NY, USA
| | - Wilson Pace
- DARTNet Institute, Aurora, CO, USA
- University of Colorado, Denver, CO, USA
| | | | - Victoria Carter
- Optimum Patient Care, Cambridge, UK
- Observational and Pragmatic Research Institute, Singapore
| | - Ku-Lang Chang
- University of Florida College of Medicine, Gainesville, FL, USA
| | | | | | | | | | - Alan Kaplan
- Observational and Pragmatic Research Institute, Singapore
- Family Physician Airways Group of Canada, Stouffville, Ontario, Canada
- University of Toronto, Toronto, Canada
| | | | - Janwillem W H Kocks
- Observational and Pragmatic Research Institute, Singapore
- General Practitioners Research Institute, Groningen, the Netherlands
- Groningen Research Institute Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Department of Pulmonology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Maja Kruszyk
- Observational and Pragmatic Research Institute, Singapore
- Optimum Patient Care, Brisbane, Queensland, Australia
| | - Le Lievre Chantal
- Observational and Pragmatic Research Institute, Singapore
- Optimum Patient Care, Brisbane, Queensland, Australia
| | - Tessa LiVoti
- Optimum Patient Care, Cambridge, UK
- Observational and Pragmatic Research Institute, Singapore
| | | | - Barry Make
- Department of Medicine, NJH, Denver, CO, USA
| | | | | | - Neil Skolnik
- Abington Jefferson Health, Jenkintown, PA, USA
- University of Minnesota, Minneapolis, MN, USA
| | | | | | - David B Price
- Optimum Patient Care, Cambridge, UK
- Observational and Pragmatic Research Institute, Singapore
- Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
- Correspondence: David B Price, Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, UK, Tel +65 3105 1489, Email
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10
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Telatar TG, Karadoğan D, Baykal MH, Yurtsever BA. Role of tobacco exposure in the course of COVID-19 disease and the impact of the disease on smoking behavior. THE CLINICAL RESPIRATORY JOURNAL 2022; 16:57-62. [PMID: 34652066 PMCID: PMC8652890 DOI: 10.1111/crj.13452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 09/29/2021] [Accepted: 10/08/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The effect of COVID-19 on smoking behavior is not fully known. Studies evaluating the link between smoking and COVID-19 have controversial results. This study aims to evaluate patients' smoking status with COVID-19 and the effect of COVID-19 on smoking behavior. METHODS Data were collected from 150 COVID-19 patients with a positive polymerase chain reaction test for SARS-CoV-2 between 11 March 2020 and 15 May 2020 in Rize, Turkey. Patients were interviewed by phone calls 2 months after their recovery. After 9 months, a follow-up was performed for those who quit smoking. RESULTS Of the participants, 19 (12.7%) were current smokers before the COVID-19 diagnosis, and 15 (78.9%) of them stated that they quit smoking after their diagnosis. After nine months of follow-up, 11 of those 15 participants (57.8%) sustained abstinence. CONCLUSION Smoking cessation rates are high in people with COVID-19. Besides, the frequency of sustaining abstinence in the long term was also high in these individuals. The COVID-19 pandemic should be viewed as an open opportunity to strengthen and prioritize smoking cessation activities.
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Affiliation(s)
- Tahsin Gökhan Telatar
- Department of Public Health, Faculty of MedicineRecep Tayyip Erdoğan UniversityRizeTurkey
| | - Dilek Karadoğan
- Department of Chest Diseases, Faculty of MedicineRecep Tayyip Erdoğan UniversityRizeTurkey
| | - Mehmet Halit Baykal
- Department of Public Health ServicesProvincial Directorate of HealthRizeTurkey
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11
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Social Norms Change and Tobacco Use: A Protocol for a Systematic Review and Meta-Analysis of Interventions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212186. [PMID: 34831942 PMCID: PMC8618876 DOI: 10.3390/ijerph182212186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/05/2021] [Accepted: 11/15/2021] [Indexed: 11/16/2022]
Abstract
Tobacco use kills more than eight million individuals each year, and results in substantial economic and human capital loss across nations. While effective supply-side solutions to tobacco control exist, these approaches are less effective at promoting cessation among heavy smokers, and less feasible to implement in countries with weaker tobacco control policy environments. Thus, effective demand-side solutions are needed. Shifting social norms around tobacco use is one such promising approach. To this end, a systematic review and meta-analysis of social norms intervention studies to influence tobacco use will be conducted following PRISMA 2020 guidance. Tobacco intervention studies with at least two time points that explicitly mention social norms or social influence as part of an intervention or set of measured variables will be included. Literature sources will comprise PubMed, Scopus, PsycInfo, and the Cochrane Trial Registry, as well as several grey literature sources. Two reviewers will independently screen studies, and risk of bias will be assessed using the Cochrane Risk of Bias 2 and ROBINS-I tools. The primary outcomes will be change in tobacco use and change in social norms. A random-effects meta-analysis will be conducted for both outcomes. Sources of heterogeneity will be explored using meta-regression with key covariates. Non-reporting biases will be explored using funnel plots. PROSPERO: CRD42021251535.
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12
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Singh T, Olivares S, Cohen T, Cobb N, Wang J, Franklin A, Myneni S. Pragmatics to Reveal Intent in Social Media Peer Interactions: Mixed Methods Study. J Med Internet Res 2021; 23:e32167. [PMID: 34787578 PMCID: PMC8663565 DOI: 10.2196/32167] [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: 07/16/2021] [Revised: 10/04/2021] [Accepted: 10/07/2021] [Indexed: 11/13/2022] Open
Abstract
Background Online health communities (OHCs) have emerged as the leading venues for behavior change and health-related information seeking. The soul and success of these digital platforms lie in their ability to foster social togetherness and a sense of community by providing personalized support. However, we have a minimal understanding of how conversational posts in these settings lead to collaborative societies and ultimately result in positive health changes through social influence. Objective Our objective is to develop a content-specific and intent-sensitive methodological framework for analyzing peer interactions in OHCs. Methods We developed and applied a mixed-methods approach to understand the manifestation of expressions in peer interactions in OHCs. We applied our approach to describe online social dialogue in the context of two online communities, QuitNet (QN) and the American Diabetes Association (ADA) support community. A total of 3011 randomly selected peer interactions (n=2005 from QN, n=1006 from ADA) were analyzed. Specifically, we conducted thematic analysis to characterize communication content and linguistic expressions (speech acts) embedded within the two data sets. We also developed an empirical user persona based on their engagement levels and behavior profiles. Further, we examined the association between speech acts and communication themes across observed tiers of user engagement and self-reported behavior profiles using the chi-square test or the Fisher test. Results Although social support, the most prevalent communication theme in both communities, was expressed in several subtle manners, the prevalence of emotions was higher in the tobacco cessation community and assertions were higher in the diabetes self-management (DSM) community. Specific communication theme-speech act relationships were revealed, such as the social support theme was significantly associated (P<.05) with 9 speech acts from a total of 10 speech acts (ie, assertion, commissive, declarative, desire, directive, expressive, question, stance, and statement) within the QN community. Only four speech acts (ie, commissive, emotion, expressive, and stance) were significantly associated (P<.05) with the social support theme in the ADA community. The speech acts were also significantly associated with the users’ abstinence status within the QN community and with the users’ lifestyle status within the ADA community (P<.05). Conclusions Such an overlay of communication intent implicit in online peer interactions alongside content-specific theory-linked characterizations of social media discourse can inform the development of effective digital health technologies in the field of health promotion and behavior change. Our analysis revealed a rich gradient of expressions across a standardized thematic vocabulary, with a distinct variation in emotional and informational needs, depending on the behavioral and disease management profiles within and across the communities. This signifies the need and opportunities for coupling pragmatic messaging in digital therapeutics and care management pathways for personalized support.
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Affiliation(s)
- Tavleen Singh
- School of Biomedical Informatics, University of Texas Health Science Center, Houston, TX, United States
| | - Sofia Olivares
- School of Biomedical Informatics, University of Texas Health Science Center, Houston, TX, United States
| | - Trevor Cohen
- Biomedical Informatics and Medical Education, University of Washington, Seattle, WA, United States
| | - Nathan Cobb
- Georgetown University Medical Center, Washington, DC, United States
| | - Jing Wang
- Florida State University College of Nursing, Tallahassee, FL, United States
| | - Amy Franklin
- School of Biomedical Informatics, University of Texas Health Science Center, Houston, TX, United States
| | - Sahiti Myneni
- School of Biomedical Informatics, University of Texas Health Science Center, Houston, TX, United States
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Kim D, Chen C, Tysinger B, Park S, Chong MZ, Wang L, Zhao M, Yuan J, Koh W, Yoong J, Bhattacharya J, Eggleston K. Smoking, life expectancy, and chronic disease in South Korea, Singapore, and the United States: A microsimulation model. HEALTH ECONOMICS 2021; 30 Suppl 1:92-104. [PMID: 31802569 PMCID: PMC7269831 DOI: 10.1002/hec.3978] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 10/17/2019] [Accepted: 11/03/2019] [Indexed: 06/10/2023]
Abstract
The substantial social and economic burden attributable to smoking is well-known, with heavy smokers at higher risk of chronic disease and premature mortality than light smokers and nonsmokers. In aging societies with high rates of male smoking such as in East Asia, smoking is a leading preventable risk factor for extending lives (including work-lives) and healthy aging. However, little is known about whether smoking interventions targeted at heavy smokers relative to light smokers lead to disproportionately larger improvements in life expectancy and prevalence of chronic diseases and how the effects vary across populations. Using a microsimulation model, we examined the health effects of smoking reduction by simulating an elimination of smoking among subgroups of smokers in South Korea, Singapore, and the United States. We found that life expectancy would increase by 0.2 to 1.5 years among light smokers and 2.5 to 3.7 years among heavy smokers. Whereas both interventions led to an increased life expectancy and decreased the prevalence of chronic diseases in all three countries, the life-extension benefits were greatest for those who would otherwise have been heavy smokers. Our findings illustrate how smoking interventions may have significant economic and social benefits, especially for life extension, that vary across countries.
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Affiliation(s)
- Daejung Kim
- Department of Health Care Policy ResearchKorea Institute for Health and Social AffairsSejongSouth Korea
| | - Cynthia Chen
- Saw Swee Hock School of Public HealthNational University of Singapore and National University Health SystemSingapore
- Schaeffer Center for Health Policy and EconomicsUniversity of Southern CaliforniaLos AngelesCalifornia
| | - Bryan Tysinger
- Schaeffer Center for Health Policy and EconomicsUniversity of Southern CaliforniaLos AngelesCalifornia
| | - Sungchul Park
- Department of Health Management and Policy, Dornsife School of Public HealthDrexel UniversityPhiladelphiaPennsylvania
| | - Ming Zhe Chong
- Saw Swee Hock School of Public HealthNational University of Singapore and National University Health SystemSingapore
| | - Lijia Wang
- Saw Swee Hock School of Public HealthNational University of Singapore and National University Health SystemSingapore
| | - Michelle Zhao
- Health Systems and Behavioural Sciences DomainStanford UniversityStanfordCalifornia
| | - Jian‐Min Yuan
- Department of Epidemiology, Graduate School of Public HealthUniversity of PittsburghPittsburghPennsylvania
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer CenterUniversity of PittsburghPittsburghPennsylvania
| | - Woon‐Puay Koh
- Saw Swee Hock School of Public HealthNational University of Singapore and National University Health SystemSingapore
- Health Services and Systems ResearchDuke‐NUS Medical SchoolSingapore
| | - Joanne Yoong
- Center for Economic and Social ResearchUniversity of Southern CaliforniaLos AngelesCalifornia
| | | | - Karen Eggleston
- Shorenstein Asia Pacific Research CenterStanford UniversityStanfordCalifornia
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14
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Martínez C, Castellano Y, Laroussy K, Fu M, Baena A, Margalef M, Feliu A, Aldazabal J, Tigova O, Galimany J, Puig-Llobet M, Moreno C, Bueno A, López A, Guydish J, Fernández E. Knowledge, Attitudes, and Training in Tobacco Dependence and Cessation Treatment Among Nursing Students in Catalonia (ECTEC Study): Cross-Sectional Study. Int J Ment Health Addict 2021. [PMID: 37261115 PMCID: PMC10229109 DOI: 10.1007/s11469-021-00640-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Nursing students are part of the future health labor force; thus, knowing their knowledge and participation in tobacco control is of importance. Multicentre cross-sectional study conducted to assess nursing students' knowledge, attitudes, and training in tobacco dependence and treatment at 15 nursing schools in Catalonia. We employed a self-administered questionnaire. 4,381 students participated. Few respondents (21.1%) knew how to assess smokers' nicotine dependence, and less than half (41.4%) knew about the smoking cessation therapies. Most (80%) had been educated on the health risks of smoking, 50% about the reasons why people smoke and, one third on how to provide cessation aid. Students in the last years of training were more likely to have received these two contents. Nursing students lack sufficient knowledge to assess and treat tobacco dependence and are rarely trained in such subjects. Nursing curricula in tobacco dependence and treatment should be strengthened to tackle the first preventable cause of disease worldwide.
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15
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Miliani A, Cherid H, Rachedi M. Modèles alternatifs dans la pratique de la rééducation à l’ère de la pandémie de Covid-19. KINÉSITHÉRAPIE, LA REVUE 2021. [PMCID: PMC7862881 DOI: 10.1016/j.kine.2021.01.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
La pandémie de Covid-19 a imposé un changement soudain et forcé dans le spectre des soins de santé qui s’est produit avec une rapidité sans précédent. La nécessité d’accommoder le changement à une grande échelle a exigé de l’ingéniosité et une réflexion décisive. Ces changements affectent les acteurs du domaine de la médecine physique et de la réadaptation (MPR) personnellement et professionnellement. Les experts réfléchissent maintenant à la manière d’améliorer la pratique médicale en utilisant de nouvelles approches en réadaptation. Les modèles et les expériences rapportés dans la littérature, tels que la téléréadaptation, la préadaptation et l’activité physique adaptée sont basés sur la stratégie de l’auto-rééducation collaborative qui est proposée comme un élément-clé de ces voies alternatives. Ces approches innovantes aideront à restructurer les processus d’exercice de la réadaptation, non seulement dans ces moments inhabituels, mais aussi dans l’avenir de la MPR. Niveau de preuve NA.
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16
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Hagerman CJ, Hoffman RK, Vaylay S, Dodge T. Implementation Intentions to Reduce Smoking: A Systematic Review of the Literature. Nicotine Tob Res 2021; 23:1085-1093. [PMID: 33220048 DOI: 10.1093/ntr/ntaa235] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 11/17/2020] [Indexed: 11/14/2022]
Abstract
Implementation intentions are a goal-setting technique in which an individual commits to perform a particular behavior when a specific context arises. Recently, researchers have begun studying how implementation intention (II) interventions can facilitate antismoking efforts. The current systematic review synthesized results of experimental studies that tested the effect of an II intervention on smoking cognitions and behavior. Of 29 reviewed articles, 11 studies met inclusion criteria. Nine studies (81.8%) tested an II intervention as a cessation tool for current smokers, whereas two tested II interventions as a tool to prevent smoking among predominantly nonsmoking adolescents. A majority of the studies (66.7%) testing II interventions as a cessation tool reported a positive effect on cessation at long-term follow-up. Of the two studies testing II interventions as a tool for prevention, one study found a positive effect on long-term follow-up. Methodology varied between the studies, highlighting the discrepancies between what researchers consider "implementation intentions" to be. II interventions are a promising tool for antismoking efforts, but more research is necessary to determine the best methodology and the populations for whom this intervention will be most effective. IMPLICATIONS Brief, free, and easily scalable, II interventions to prevent smoking are highly attractive for antismoking efforts. This review outlines the circumstances under which II interventions have demonstrated effectiveness in helping people resist smoking cigarettes. We illuminate gaps in the existing literature, limitations, methodological discrepancies between studies, and areas for future study.
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Affiliation(s)
- Charlotte J Hagerman
- Department of Psychological and Brain Sciences, George Washington University, Washington, DC
| | - Rebecca K Hoffman
- Department of Psychological and Brain Sciences, George Washington University, Washington, DC
| | - Sruthi Vaylay
- Department of Psychological and Brain Sciences, George Washington University, Washington, DC
| | - Tonya Dodge
- Department of Psychological and Brain Sciences, George Washington University, Washington, DC
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Hunger T, Wanka-Pail E, Brix G, Griebel J. Lung Cancer Screening with Low-Dose CT in Smokers: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2021; 11:diagnostics11061040. [PMID: 34198856 PMCID: PMC8228723 DOI: 10.3390/diagnostics11061040] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/21/2021] [Accepted: 06/01/2021] [Indexed: 02/06/2023] Open
Abstract
Lung cancer continues to be one of the main causes of cancer death in Europe. Low-dose computed tomography (LDCT) has shown high potential for screening of lung cancer in smokers, most recently in two European trials. The aim of this review was to assess lung cancer screening of smokers by LDCT with respect to clinical effectiveness, radiological procedures, quality of life, and changes in smoking behavior. We searched electronic databases in April 2020 for publications of randomized controlled trials (RCT) reporting on lung cancer and overall mortality, lung cancer morbidity, and harms of LDCT screening. A meta-analysis was performed to estimate effects on mortality. Forty-three publications on 10 RCTs were included. The meta-analysis of eight studies showed a statistically significant relative reduction of lung cancer mortality of 12% in the screening group (risk ratio = 0.88; 95% CI: 0.79-0.97). Between 4% and 24% of screening-LDCT scans were classified as positive, and 84-96% of them turned out to be false positive. The risk of overdiagnosis was estimated between 19% and 69% of diagnosed lung cancers. Lung cancer screening can reduce disease-specific mortality in (former) smokers when stringent requirements and quality standards for performance are met.
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18
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Ronchetti J, Terriau A. Help me quit smoking but don't make me sick! The controversial effects of electronic cigarettes on tobacco smokers. Soc Sci Med 2021; 274:113770. [PMID: 33667743 DOI: 10.1016/j.socscimed.2021.113770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/06/2021] [Accepted: 02/08/2021] [Indexed: 10/22/2022]
Abstract
Despite its increasing use, little is known about the effect of electronic cigarette. This study estimates the impact of the use of electronic cigarettes on tobacco smoking and health among tobacco smokers, using French panel data derived from the Health, Health Care, and Insurance Survey for 2010-2014. We use a difference-in-differences propensity score matching approach to identify the effect of electronic cigarette use on a sample of 982 smokers. We show that the use of electronic cigarettes increases the probability of quitting smoking and reduces the number of regular cigarettes smoked per day. However, we also find evidence that electronic cigarette users have a higher probability of reporting poor health status and suffering from a chronic disease compared with those who only smoke regular cigarettes. Overall, our results do not support the use of electronic cigarettes for tobacco smokers.
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Affiliation(s)
- Jérôme Ronchetti
- Magellan, Université Lyon 3, Iaelyon School of Management, 1C Avenue des Frères Lumière, 69372, Lyon, France; Paris University, 45, rue des Saints Pères, 75006, Paris, France.
| | - Anthony Terriau
- Le Mans University, Avenue Olivier Messiaen, 72000, Le Mans, France.
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19
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Picot-Ngo C, Kivits J, Chevreul K. Réduire le tabagisme dans les prisons : éléments théoriques et méthodologiques nécessaires à la co-construction d’une intervention en contexte pénitentiaire. Glob Health Promot 2021. [DOI: 10.1177/1757975921993434] [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]
Abstract
Révélateur des inégalités sociales de santé, le tabagisme en établissement pénitentiaire exige des interventions visant sa réduction d’être adaptées aux spécificités du milieu carcéral. Dans le cadre de la recherche interventionnelle TABAPRI, nous avons mobilisé une première étude sociologique afin d’apporter des connaissances sur cette problématique. Une enquête a été réalisée au sein de trois établissements pénitentiaires, précédant les phases de construction, d’implémentation et d’évaluation de l’intervention. Cet article décrit d’une part la démarche méthodologique et d’autre part, la contribution de la sociologie, tant dans ses apports conceptuels que méthodologiques, à la construction d’une intervention. Notre travail a notamment souligné l’importance d’aménager des espaces d’échange permettant aux professionnels et aux personnes détenues de construire ensemble les modalités d'intervention qui participent à la réduction du tabagisme en détention.
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Affiliation(s)
- Clément Picot-Ngo
- UMR 1123 Eceve, Institut national de la santé et de la recherche médicale (Inserm), Université de Paris, Paris, France
- Observatoire français des drogues et des toxicomanies (OFDT), Paris, France
| | - Joëlle Kivits
- Université de Lorraine, Unité « Adaptation, mesure et évaluation en santé. Approches interdisciplinaires » (APEMAC), Nancy, France
| | - Karine Chevreul
- UMR 1123 Eceve, Institut national de la santé et de la recherche médicale (Inserm), Université de Paris, Paris, France
- URC Eco Île-de-France (AP-HP, Hôtel Dieu), Paris, France
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20
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Ishimo MC, Sampasa-Kanyinga H, Olibris B, Chawla M, Berfeld N, Prince SA, Kaplan MS, Orpana H, Lang JJ. Universal interventions for suicide prevention in high-income Organisation for Economic Co-operation and Development (OECD) member countries: a systematic review. Inj Prev 2021; 27:184-193. [PMID: 33483327 PMCID: PMC8005806 DOI: 10.1136/injuryprev-2020-043975] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 02/05/2023]
Abstract
INTRODUCTION To examine the effectiveness of universal suicide prevention interventions on reducing suicide mortality in high-income Organisation for Economic Co-operation and Development (OECD) member countries. METHODS We implemented a comprehensive search strategy across three electronic databases: MEDLINE (Ovid), PsycINFO (Ovid) and Embase (Ovid). All studies using time-series, retrospective, prospective, pre-post or cross-sectional study designs were included. Studies were required to examine suicide mortality as the outcome of interest. To help organise the results, studies were grouped into six broad categories of universal interventions consistent with the World Health Organization (WHO) Comprehensive Mental Health Action Plan. A narrative synthesis of results was used to describe the findings. RESULTS Of the 15 641 studies identified through the search strategy, 100 studies were eligible in the following categories: law and regulation reforms (n=66), physical barriers (n=13), community-based interventions (n=9), communication strategies (n=4), mental health policies and strategies (n=7), and access to healthcare (n=1). Overall, 100% (13/13) of the included physical barrier interventions resulted in a significant reduction in suicide mortality. Although only 70% (46/66) of the law and regulation reform interventions had a significant impact on reducing suicide, they hold promise due to their extended reach. Universal suicide prevention interventions seem to be more effective at reducing suicide among males than females, identifying a need to stratify results by sex in future studies. CONCLUSIONS These findings suggest that universal suicide prevention interventions hold promise in effectively reducing suicide mortality in high-income OECD countries.
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Affiliation(s)
- Marie-Claire Ishimo
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Hugues Sampasa-Kanyinga
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Brieanne Olibris
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada.,Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Mitulika Chawla
- Centre for Health Promotion, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Noami Berfeld
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | - Stephanie A Prince
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | - Mark S Kaplan
- Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, California, USA
| | - Heather Orpana
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | - Justin J Lang
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada .,School of Mathematics and Statistics, Carleton University, Ottawa, Ontario, Canada
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21
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Smartphone health apps for tobacco Cessation: A systematic review. Addict Behav 2021; 112:106616. [PMID: 32932102 DOI: 10.1016/j.addbeh.2020.106616] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 08/06/2020] [Accepted: 08/15/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Given the low retention and lack of persistent support by traditional tobacco cessation programs, evidence-based smartphone app-supported interventions can be an important tobacco control component. The objective of this systematic review was to identify and evaluate the types of studies that use smartphone apps for interventions in tobacco cessation. METHODS We conducted a systematic review of PubMed (1946-2019), EMBASE (1974-2019), and PsycINFO (1806-2019) databases with keywords related to smartphone-supported tobacco cessation. Included articles were required to meet 3 baseline screening criteria: 1) be written in English, 2) include an abstract, and 3) be a full, peer-reviewed manuscript. The criteria for the second level of review were: 1) primary outcome of tobacco cessation, 2) intervention study, and 3) smartphone app as primary focus of study. RESULTS Of 1973 eligible manuscripts, 18 met inclusion criteria. Most studies (n = 17) recruited adult participants (18 + years); one included teens (16 + years). Tobacco cessation was usually self-reported (n = 11), compared to biochemical verification (n = 3) or both (n = 4). There were 11 randomized controlled trials, 4 of which reported statistically significant results, and 7 single-arm trials that reported a mean abstinence rate of 33.9%. DISCUSSION The majority of studies that use tobacco cessation apps as an intervention delivery modality are mostly at the pilot/feasibility stage. The growing field has resulted in studies that varied in methodologies, study design, and inclusion criteria. More consistency in intervention components and larger randomized controlled trials are needed for tobacco cessation smartphone apps.
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22
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Are Loneliness and Social Isolation Associated with Quality of Life in Older Adults? Insights from Northern and Southern Europe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228637. [PMID: 33233793 PMCID: PMC7699832 DOI: 10.3390/ijerph17228637] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/12/2020] [Accepted: 11/18/2020] [Indexed: 12/18/2022]
Abstract
Purpose: Loneliness and social isolation have detrimental effects on health in old age; however, the prospective associations with quality of life (QoL) remain unclear. Furthermore, despite the existence of a European north-south gradient in the distribution of loneliness and social isolation, little is known whether the associations are context-specific. We investigated the relationships between loneliness, social isolation and QoL of older adults residing in the North (Sweden) and South (Spain) of Europe. Methods: Study sample consisted of 2995 Swedish and 4154 Spanish older adults who participated in waves six and seven of the Study on Health, Aging and Retirement in Europe (SHARE). Loneliness and social isolation were measured at the baseline, and QoL was measured at the baseline and follow-up using CASP-12. Prospective associations were assessed via multivariate linear regression. Results: In Sweden, subjects with higher vs. lower loneliness had 1.01 (95% CI: −1.55, −0.40) units lower QoL, while every standard deviation increase in social isolation was associated with a 0.27 (95% CI: −0.42, −0.09)-unit decrease in QoL. In Spain, every standard deviation increase in social isolation was associated with a 0.66 (95% CI: −1.11, −0.22)-unit decrease in QoL. The association was stronger in subjects aged ≤65 years old and those with no chronic diseases. The association with loneliness was not statistically significant in Spain. Conclusion: Loneliness and social isolation are prospectively associated with decreased QoL among older adults, yet the associations are contextually bound. Future interventions should target both exposures, among others, in order to increase QoL in this group.
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Abstract
Lung cancer is the leading cause of US cancer-related deaths. Lung cancer screening with a low radiation dose chest computed tomography scan is now standard of care for a high-risk eligible population. It is imperative for clinicians and surgeons to evaluate the trade-offs of benefits and harms, including the identification of many benign lung nodules, overdiagnosis, and complications. Integration of smoking cessation interventions augments the clinical benefits of screening. Screening programs must develop strategies to manage screening-detected findings to minimize potential harms. Further research should focus on how to improve patient selection, minimize harms, and facilitate access to screening.
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Affiliation(s)
- Humberto K Choi
- Respiratory Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
| | - Peter J Mazzone
- Respiratory Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
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Li J, Chung S, Martinez MC, Luft HS. Smoking-Cessation Interventions After Lung Cancer Screening Guideline Change. Am J Prev Med 2020; 59:88-97. [PMID: 32417022 DOI: 10.1016/j.amepre.2020.01.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 01/07/2020] [Accepted: 01/08/2020] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Recent guideline changes for lung cancer screening with low-dose computed tomography recommend smoking-cessation interventions be done in parallel with screening. The purpose of this study is to determine the post-guideline rates of smoking-cessation interventions among patients eligible and ineligible for lung cancer screening. METHODS Using electronic health records collected from a large ambulatory care system in northern California between 2010 and 2017, authors identified new patients who were current smokers aged 55-80 years visiting a primary care provider, and grouped patients into lung cancer screening-eligible heavy smokers, screening-ineligible moderate smokers, and screening-ineligible light smokers. Screening-eligible smokers versus screening-ineligible smokers were compared in receipt of smoking-cessation interventions before (2010-2013) and after (2014-2017) the guideline change, overall and by intervention type (formal counseling, informal counseling, pharmacotherapy) using hierarchical generalized linear models. Analyses were conducted in 2018-2019. RESULTS After the guideline change, the likelihood of receiving any smoking-cessation intervention (OR=1.44, 95% CI=1.28, 1.61, p<0.05), informal counseling (OR=1.29, 95% CI=1.15, 1.46, p<0.05), and pharmacotherapy (OR=1.24, 95% CI=1.02, 1.50, p<0.05) during a new patient visit significantly increased, with the increase not varying by level of smoking. For formal counseling, the post-guideline increase was greater for screening-eligible heavy smokers (OR=3.15, 95% CI=1.18, 8.36, p<0.05) and moderate smokers (OR=3.58, 95% CI=1.29, 9.95, p<0.05) relative to light smokers. CONCLUSIONS Smoking-cessation interventions increased after new lung cancer screening guidelines. Given the sizable adverse impacts of smoking on morbidity and mortality, small increases in the implementation of smoking-cessation interventions could have substantial public health benefits.
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Affiliation(s)
- Jiang Li
- Center for Health Systems Research, Sutter Health, Palo Alto Medical Foundation Research Institute, Palo Alto, California.
| | - Sukyung Chung
- Center for Health Systems Research, Sutter Health, Palo Alto Medical Foundation Research Institute, Palo Alto, California
| | - Meghan C Martinez
- Center for Health Systems Research, Sutter Health, Palo Alto Medical Foundation Research Institute, Palo Alto, California
| | - Harold S Luft
- Center for Health Systems Research, Sutter Health, Palo Alto Medical Foundation Research Institute, Palo Alto, California
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Abstract
The current COVID-19 pandemic will place enormous pressure on healthcare systems around the world. Large numbers of people are predicted to become critically ill with acute respiratory distress syndrome and will require management in intensive care units. High levels of physical, cognitive, and psychosocial impairments can be anticipated. Rehabilitation providers will serve as an important link in the continuum of care, helping move patients on from acute sites to eventual discharge to the community. Likely impairment patterns, considerations for healthcare practitioner resilience, and organization of services to meet demand are discussed. Innovative approaches to care, such as virtual rehabilitation, are likely to become common in this environment.
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Affiliation(s)
- Robert Simpson
- From the University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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Kuriakose L, Kuczynska P, Timpel P, Yakub F, Bayley A, Papachristou Nadal I. Effectiveness of behaviour change techniques on lifestyle interventions of patients with a high risk of developing cardiovascular disease. Using a qualitative approach. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:998-1009. [PMID: 31965675 DOI: 10.1111/hsc.12933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 10/29/2019] [Accepted: 12/06/2019] [Indexed: 06/10/2023]
Abstract
This study aimed to identify key active ingredients on the maintenance of behaviour change for lifestyle interventions of patients with a high risk of developing cardiovascular disease (CVD) who participated in a MOtiVational intErviewing InTervention (MOVE IT) randomised control trial (RCT). A process evaluation was carried out using focus groups. Twenty-six participants of the MOVE IT RCT were purposively recruited and split into six focus groups. Four groups had attended six or more sessions of the intensive phase (completers) and two groups had withdrawn before the end of the intensive phase or had not attended any sessions (non-completers). Focus groups were audio recorded, transcribed verbatim and analysed inductively using thematic analysis. Three overall themes were generated from the six focus groups: (a) long-term benefits from diet and physical activity education, (b) group versus individual structure and adherence and (c) impact on health beliefs and risk of CVD. A fourth theme was generated from the two groups of non-completers only: (d) need for professional rapport building and feedback. We found that the key active ingredients for effective behavioural change in lifestyle interventions are having well-developed rapport between facilitators and patients; and providing alternative forms of feedback to encourage maintenance of behaviour change. Furthermore, such programmes also need to have established and strong relationships with associated health professionals (i.e. the General Practitioner) to increase participation and maintenance of engagement.
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Affiliation(s)
- Lisa Kuriakose
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Paulina Kuczynska
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Division of Health Services and Management, School of Health Sciences, University of London, London, UK
| | - Patrick Timpel
- Department for Prevention and Care of Diabetes, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Farah Yakub
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Adam Bayley
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Iliatha Papachristou Nadal
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
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27
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Otavova M, Van Oyen H, Yokota RTC, Charafeddine R, Joossens L, Molenberghs G, Nusselder WJ, Boshuizen HC, Devleesschauwer B. Potential impact of reduced tobacco use on life and health expectancies in Belgium. Int J Public Health 2019; 65:129-138. [PMID: 31781804 PMCID: PMC7049546 DOI: 10.1007/s00038-019-01315-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 10/30/2019] [Accepted: 11/19/2019] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES We investigated the potential impact of reduced tobacco use scenarios on total life expectancy and health expectancies, i.e., healthy life years and unhealthy life years. METHODS Data from the Belgian Health Interview Survey 2013 were used to estimate smoking and disability prevalence. Disability was based on the Global Activity Limitation Indicator. We used DYNAMO-HIA to quantify the impacts of risk factor changes and to compare the "business-as-usual" with alternative scenarios. RESULTS The "business-as-usual" scenario estimated that in 2028 the 15-year-old men/women would live additional 50/52 years without disability and 14/17 years with disability. The "smoking-free population" scenario added 3.4/2.8 healthy life years and reduced unhealthy life years by 0.79/1.9. Scenarios combining the prevention of smoking initiation with smoking cessation programs are the most effective, yielding the largest increase in healthy life years (1.9/1.7) and the largest decrease in unhealthy life years (- 0.80/- 1.47). CONCLUSIONS Health impact assessment tools provide different scenarios for evidence-informed public health actions. New anti-smoking strategies or stricter enforcement of existing policies potentially gain more healthy life years and reduce unhealthy life years in Belgium.
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Affiliation(s)
- Martina Otavova
- Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, 5000, Odense, Denmark.,Interdisciplinary Center on Population Dynamics, Department of Public Health, University of Southern Denmark, 5000, Odense, Denmark
| | - Herman Van Oyen
- Department of Epidemiology and public health, Sciensano, Rue J Wytsman 14, 1050, Brussels, Belgium.,Department of Public Health and Primary Care, Faculty of Medicine, Ghent University, Ghent, Belgium
| | - Renata T C Yokota
- Department of Epidemiology and public health, Sciensano, Rue J Wytsman 14, 1050, Brussels, Belgium
| | - Rana Charafeddine
- Department of Epidemiology and public health, Sciensano, Rue J Wytsman 14, 1050, Brussels, Belgium
| | - Luk Joossens
- Association of European Cancer Leagues, Brussels, Belgium
| | | | - Wilma J Nusselder
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Hendriek C Boshuizen
- Department of Statistics, Informatics and Mathematical Modeling, Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Brecht Devleesschauwer
- Department of Epidemiology and public health, Sciensano, Rue J Wytsman 14, 1050, Brussels, Belgium. .,Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
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Utap MS, Tan C, Su AT. Effectiveness of a brief intervention for smoking cessation using the 5A model with self-help materials and using self-help materials alone: A randomised controlled trial. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2019; 14:2-9. [PMID: 31827729 PMCID: PMC6818691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION The '5A' model for smoking cessation was introduced in 2000 by the US Department of Health and Services. This brief intervention was recommended worldwide for smoking cessation. However, little is known about its effectiveness for smoking cessation in a primary care setting in Malaysia. OBJECTIVE To determine the effectiveness of a brief intervention for smoking cessation using the '5A' model with self-help materials compared to using self-help materials alone. METHODS This randomised controlled trial was conducted at the Primary Care Clinic at the University Malaya Medical Centre (UMMC) between June and October 2009. Subjects were all current smokers aged 18 years and above. A total of 208 subjects were recruited and randomised into two groups. Subjects in the intervention group were given a brief intervention based on the '5A' model with selfhelp materials, while the control group received self-help materials alone. Subjects were later followed up at one and four months via telephone calls. The outcome measure was a self-reported attempt to quit smoking. RESULTS At one-month follow-up, 15/77 (19.5%) of the participants in the intervention group had attempted to quit smoking compared to 8/80 (10.0%) in the control group. There was no significant difference between the two groups (p=0.09). At the four-month follow-up, 13/58 (22.4%) participants in the intervention group had attempted to quit smoking compared to 9/57 (15.8%) in the control group. Once more, there was no significant difference between the two groups (p=0.37). CONCLUSION This study showed that there was no significant difference between a brief intervention using the '5A' model with self-help materials and using self-help materials alone for smoking cessation in a Malaysian primary care setting. However, these results do need to be treated with caution when taking into consideration the high dropout rate and bias in the study design.
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Affiliation(s)
- M S Utap
- MBBS (UM), Master in Family Medicine (UM), Tudan Health Clinic, Miri Divisional, Health Office, 98100 Miri, Sarawak, Malaysia.
| | - Cpl Tan
- PhD, MPhil (HealthScEd), FRCGP, MRCGP, MBBS, Department of Primary Care, Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| | - A T Su
- MBBS, MPH, MPH (Occupational Health), MFOM (Ireland), Community Medicine and Public, Health Department, University, Malaysia Sarawak, 94300 Kota, Samarahan, Sarawak, Malaysia.
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29
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Sociodemographic differences in awareness of e-cigarette in Malaysia. JOURNAL OF ONCOLOGICAL SCIENCES 2019. [DOI: 10.1016/j.jons.2019.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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30
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Soyster PD, Fisher AJ. Involving stakeholders in the design of ecological momentary assessment research: An example from smoking cessation. PLoS One 2019; 14:e0217150. [PMID: 31116777 PMCID: PMC6530840 DOI: 10.1371/journal.pone.0217150] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 05/06/2019] [Indexed: 02/07/2023] Open
Abstract
Ecological momentary assessment (EMA) is a data collection method that involves repeated sampling of participants’ real-time experience and behavior as they unfold in context. A primary challenge in EMA research is to design surveys that adequately assess constructs of interest while minimizing participant burden. To achieve this balance, researchers must make decisions regarding which constructs should be included and how those constructs should be assessed. To date, a dearth of direction exists for how to best design and carry out EMA studies. The lack of guidelines renders it difficult to systematically compare findings across EMA studies. Study design decisions may be improved by including input from potential research participants (stakeholders). The goal of the present paper is to introduce a general approach for including stakeholders in the development of EMA research design. Rather than suggesting rigid prescriptive guidelines (e.g., the correct number of survey items), we present a systematic and reproducible process through which extant research and stakeholder experience can be leveraged to make design decisions. To that end, we report methods and results for a series of focus group discussions with current tobacco users that were conducted to inform the design of an EMA study aimed at identifying person-specific mechanisms driving tobacco use. We conclude by providing recommendations for item-selection procedures in EMA studies.
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Affiliation(s)
- Peter D. Soyster
- Department of Psychology, University of California, Berkeley, Berkeley, California, United States of America
- * E-mail:
| | - Aaron J. Fisher
- Department of Psychology, University of California, Berkeley, Berkeley, California, United States of America
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Rojas-Rueda D, Vrijheid M, Robinson O, Gunn Marit A, Gražulevičienė R, Slama R, Nieuwenhuijsen M. Environmental Burden of Childhood Disease in Europe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1084. [PMID: 30917598 PMCID: PMC6466397 DOI: 10.3390/ijerph16061084] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 03/22/2019] [Accepted: 03/24/2019] [Indexed: 12/17/2022]
Abstract
Background: Environmental factors determine children's health. Quantifying the health impacts related to environmental hazards for children is essential to prioritize interventions to improve health in Europe. Objective: This study aimed to assess the burden of childhood disease due to environmental risks across the European Union. Methods: We conducted an environmental burden of childhood disease assessment in the 28 countries of the EU (EU28) for seven environmental risk factors (particulate matter less than 10 micrometer of diameter (PM10) and less than 2.5 micrometer of diameter (PM2.5), ozone, secondhand smoke, dampness, lead, and formaldehyde). The primary outcome was disability-adjusted life years (DALYs), assessed from exposure data provided by the World Health Organization, Global Burden of Disease project, scientific literature, and epidemiological risk estimates. Results: The seven studied environmental risk factors for children in the EU28 were responsible for around 211,000 DALYs annually. Particulate matter (PM10 and PM2.5) was the main environmental risk factor, producing 59% of total DALYs (125,000 DALYs), followed by secondhand smoke with 20% of all DALYs (42,500 DALYs), ozone 11% (24,000 DALYs), dampness 6% (13,000 DALYs), lead 3% (6200 DALYs), and formaldehyde 0.2% (423 DALYs). Conclusions: Environmental exposures included in this study were estimated to produce 211,000 DALYs each year in children in the EU28, representing 2.6% of all DALYs in children. Among the included environmental risk factors, air pollution (particulate matter and ozone) was estimated to produce the highest burden of disease in children in Europe, half of which was due to the effects of PM10 on infant mortality. Effective policies to reduce environmental pollutants across Europe are needed.
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Affiliation(s)
- David Rojas-Rueda
- Barcelona Institute of Global Health (ISGlobal), 08003 Barcelona, Spain.
- Municipal Institute of Medical Research (IMIM-Hospital del Mar), 08003 Barcelona, Spain.
- Universitat Pompeu Fabra (UPF), Departament de Ciències Experimentals i de la Salut, 08003 Barcelona, Spain.
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain.
- Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523, USA.
| | - Martine Vrijheid
- Barcelona Institute of Global Health (ISGlobal), 08003 Barcelona, Spain.
- Municipal Institute of Medical Research (IMIM-Hospital del Mar), 08003 Barcelona, Spain.
- Universitat Pompeu Fabra (UPF), Departament de Ciències Experimentals i de la Salut, 08003 Barcelona, Spain.
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain.
| | - Oliver Robinson
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London SW7 2AZ, UK.
| | - Aasvang Gunn Marit
- Department of Air Pollution and Noise, Division for Infection Control and Environmental Health, Norwegian Institute of Public Health, N-0213 Oslo, Norway.
| | - Regina Gražulevičienė
- Department of Environmental Sciences, Faculty of Natural Sciences, Vytauto Didžiojo Universitetas, 44248 Kaunas, Lithuania.
| | - Remy Slama
- Department of Prevention and Therapy of Chronic Diseases, Institute of Advanced Biosciences (IAB), Inserm-CNRS-University Grenoble-Alpes, 38700 Grenoble, France.
| | - Mark Nieuwenhuijsen
- Barcelona Institute of Global Health (ISGlobal), 08003 Barcelona, Spain.
- Municipal Institute of Medical Research (IMIM-Hospital del Mar), 08003 Barcelona, Spain.
- Universitat Pompeu Fabra (UPF), Departament de Ciències Experimentals i de la Salut, 08003 Barcelona, Spain.
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain.
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32
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Mannocci A, Backhaus I, D'Egidio V, Federici A, Villari P, La Torre G. What public health strategies work to reduce the tobacco demand among young people? An umbrella review of systematic reviews and meta-analyses. Health Policy 2019; 123:480-491. [PMID: 30922630 DOI: 10.1016/j.healthpol.2019.02.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 02/11/2019] [Accepted: 02/19/2019] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To perform an umbrella review of systematic reviews and meta-analyses of health policy and health promotion strategies to reduce the tobacco demand in adolescents, youth and young adults. METHODS Reviewers independently performed an electronic database search, reviewed titles and abstracts, assessed articles' eligibility for inclusion and quality, and extracted relevant data. Only systematic reviews and meta-analyses reporting data on tobacco policies and interventions focusing on individuals aged <25 years were included. The Framework Convention on Tobacco Control was used to guide data synthesis. RESULTS 13 articles were included. Studies were of mixed quality with five studies ranked as critically low and seven as high quality. Overall, mixed results were found on the effectiveness for tobacco policies and interventions. Strategies such as increasing taxes on tobacco products were most promising. CONCLUSION Though data on a variety of measures to reduce smoking is available, conclusions concerning the effectiveness are inconclusive. Tobacco policies and interventions have the potential to reduce smoking, but conclusions are hampered due to both lack of high-quality trials and numerous biases in primary studies. Further high-quality research is required to examine the effectiveness of interventions and policies to reduce the tobacco demand in adolescents, youth and young adults.
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Affiliation(s)
- Alice Mannocci
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Insa Backhaus
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy.
| | - Valeria D'Egidio
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | | | - Paolo Villari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Giuseppe La Torre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
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Troelstra SA, Harting J, Kunst AE. Effectiveness of a Large, Nation-Wide Smoking Abstinence Campaign in the Netherlands: A Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030378. [PMID: 30699988 PMCID: PMC6388192 DOI: 10.3390/ijerph16030378] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 01/21/2019] [Accepted: 01/23/2019] [Indexed: 11/21/2022]
Abstract
From 2014, the 28-day smoking abstinence campaign ‘Stoptober’ is held in the Netherlands. Each year, more than 50,000 people participate in what has become a nation-wide collective cessation attempt. This study aims to determine the short-term effects of ‘Stoptober’ on participants’ smoking behavior and behavioral determinants. Stoptober participants completed online surveys before the start of the campaign (n = 6856) and three months later (n = 1127). Descriptive statistics and t-tests were performed to determine changes in smoking and behavioral determinants. Logistic regression analyses were used to identify differences between subgroups. After three months, 71.8% of respondents had quit smoking and consumption was reduced among sustained smokers. Cessation rates were similar for subgroups by age, sex and educational level. Cessation was positively associated with confidence and self-efficacy at baseline and negatively associated with past year quit attempts and addiction level at baseline. For quitters, we found favorable changes in attitude towards cessation related stress, social norms, social pressure to smoke, self-efficacy to quit, smoking habit strength and smoker identity. For sustained smokers, we found favorable changes in attitude towards cessation related stress, self-efficacy and smoking habit strength. These results suggest that an abstinence campaign with a wide reach in a national population may be effective in decreasing smoking prevalence and cigarette consumption among a broad range of participants.
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Affiliation(s)
- Sigrid A Troelstra
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | - Janneke Harting
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
| | - Anton E Kunst
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
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Jung S, Lee J, Biocca F, Kim JW. Augmented Reality in the Health Domain: Projecting Spatial Augmented Reality Visualizations on a Perceiver's Body for Health Communication Effects. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2019; 22:142-150. [PMID: 30668138 DOI: 10.1089/cyber.2018.0028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
An experiment is reported that studied the effects of spatial embodiment in augmented reality on medical attitudes about the self. College students (N = 90) viewed public service announcements (PSAs) with overlaid virtual fetuses and X-rayed images of lungs on various interfaces representing embodiment-a two-dimensional screen, a three-dimensional (3D) mannequin, and the participants' bodies (3D). Results indicated that PSA messages with richer embodied interfaces increase the sense of "being there," also known as spatial presence (SP), in sequential order; this leads to increased negative emotion regarding smoking cigarettes and an increased willingness to engage with a cigarette cessation campaign. When the SP mediates the dual model process, only affective attitudes increase the behavioral intention to engage with the campaign.
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Affiliation(s)
- Soyoung Jung
- 1 S.I. School of Newhouse Public Communications, Syracuse University, Syracuse, New York.,2 M.I.N.D. Lab, Digital Design, School of Art & Design College of Architecture & Design, New Jersey Institute of Technology. Newark, New Jersey
| | - Jiyoung Lee
- 1 S.I. School of Newhouse Public Communications, Syracuse University, Syracuse, New York
| | - Frank Biocca
- 3 Department of Informatics, Ying Wu College of Computing, New Jersey Institute of Technology, Newark, New Jersey
| | - Ji Won Kim
- 1 S.I. School of Newhouse Public Communications, Syracuse University, Syracuse, New York
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35
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Jeong BY, Lim MK, Yun EH, Oh JK. User characteristics of national smoking cessation services in Korea: who chooses each type of tobacco cessation program? BMC Health Serv Res 2019; 19:14. [PMID: 30621771 PMCID: PMC6323760 DOI: 10.1186/s12913-018-3817-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 12/13/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Relatively little is known about which characteristics of smokers are related to choosing a specific type of smoking cessation service. The user characteristics of different smoking cessation services were compared to determine the service preferred by user characteristics. METHODS The characteristics of adult smokers from Korea National Health and Nutrition Examination Survey (3762) and registered users of national smoking cessation services operated through the web (14,762), at Public Health Center-based Smoking Cessation Clinics (PHC-based SCCs) (335,532), and by telephone (Quitline) (2983) were compared. RESULTS Females and younger aged were more in web and telephone-based cessation service users, while aged 50 years or older were more in PHC-based SCCs users. Although manufacturing and production workers were the most prevalent among smokers in the general population, office workers and others including housewives and unemployed were most prevalent among the users of Quitline and PHC-based SCCs, respectively. The number of cigarettes smoked per day was twice as high among cessation service users as in general population. Smokers with greater nicotine dependency were most prevalent in the web-based service. Overseas users were in the web-based cessation service. CONCLUSION Identifying user-specific characteristics by the type of cessation services looks necessary to develop and offer appropriate cessation services.
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Affiliation(s)
- Bo Yoon Jeong
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Min Kyung Lim
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
| | - E. Hwa Yun
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
| | - Jin-Kyoung Oh
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
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36
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Bull ER, McCleary N, Li X, Dombrowski SU, Dusseldorp E, Johnston M. Interventions to Promote Healthy Eating, Physical Activity and Smoking in Low-Income Groups: a Systematic Review with Meta-Analysis of Behavior Change Techniques and Delivery/Context. Int J Behav Med 2018; 25:605-616. [PMID: 30003476 PMCID: PMC6244564 DOI: 10.1007/s12529-018-9734-z] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE Healthy eating, physical activity and smoking interventions for low-income groups may have small, positive effects. Identifying effective intervention components could guide intervention development. This study investigated which content and delivery components of interventions were associated with increased healthy behavior in randomised controlled trials (RCTs) for low-income adults. METHOD Data from a review showing intervention effects in 35 RCTs containing 45 interventions with 17,000 participants were analysed to assess associations with behavior change techniques (BCTs) and delivery/context components from the template for intervention description and replication (TIDieR) checklist. The associations of 46 BCTs and 14 delivery/context components with behavior change (measures of healthy eating, physical activity and smoking cessation) were examined using random effects subgroup meta-analyses. Synergistic effects of components were examined using classification and regression trees (meta-CART) analyses based on both fixed and random effects assumptions. RESULTS For healthy eating, self-monitoring, delivery through personal contact, and targeting multiple behaviors were associated with increased effectiveness. Providing feedback, information about emotional consequences, or using prompts and cues were associated with reduced effectiveness. In synergistic analyses, interventions were most effective without feedback, or with self-monitoring excluding feedback. More effective physical activity interventions included behavioral practice/rehearsal or instruction, focussed solely on physical activity or took place in home/community settings. Information about antecedents was associated with reduced effectiveness. In synergistic analyses, interventions were most effective in home/community settings with instruction. No associations were identified for smoking. CONCLUSION This study identified BCTs and delivery/context components, individually and synergistically, linked to increased and reduced effectiveness of healthy eating and physical activity interventions. The identified components should be subject to further experimental study to help inform the development effective behavior change interventions for low-income groups to reduce health inequalities.
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Affiliation(s)
- Eleanor R Bull
- Manchester Metropolitan University, Manchester, UK.
- University of Manchester, Manchester, UK.
| | | | - Xinru Li
- Mathematical Institute, Leiden University, Leiden, the Netherlands
| | | | - Elise Dusseldorp
- Institute of Psychology, Leiden University, Leiden, the Netherlands
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Gu A, Yue Y, Kim J, Argulian E. The Burden of Modifiable Risk Factors in Newly Defined Categories of Blood Pressure. Am J Med 2018; 131:1349-1358.e5. [PMID: 30056103 DOI: 10.1016/j.amjmed.2018.06.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 06/26/2018] [Accepted: 06/26/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND The 2017 American College of Cardiology/American Heart Association Guideline introduced new categories of high blood pressure. The vast majority of individuals in these newly defined categories are recommended for nonpharmacological intervention rather than antihypertensive therapy. This study sought to determine the burden of potentially modifiable risk factors of hypertension among untreated adults in the newly defined categories of blood pressure. METHODS We analyzed data from the 1999-2014 National Health and Nutrition Examination Survey (N = 37,448). Potentially modifiable risk factors included abdominal obesity, high non-high-density lipoprotein (HDL) cholesterol, secondhand smoking, binge drinking, suboptimal physical activity, and low-fiber diet. RESULTS Although the prevalence of certain modifiable risk factors decreased during the study period, the prevalence of low fiber intake, suboptimal physical activity, abdominal obesity, and binge drinking remained high during the last combined survey cycle (2011-2014). Modifiable risk factors generally demonstrated dose-response relationships with high blood pressure categories. The most common type of risk factor clustering included low fiber intake, suboptimal physical activity, high non-HDL cholesterol, and abdominal obesity, with its prevalence increasing gradually from 9.5% (95% confidence interval, 8.8%-10.3%) in the normal blood pressure group to 16.5% (95% confidence interval, 14.8%-18.3%) in the stage 2 hypertension group (Ptrend < .001). The prevalence of 4 or more modifiable risk factors per participant increased stepwise, ranging from 28.5% in the normal blood pressure group to 48.0% in the stage 2 hypertension group (Ptrend < .001). CONCLUSIONS The burden of potentially modifiable risk factors for hypertension shows progressive increase along the blood pressure categories and represents an important target for nonpharmacologic intervention.
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Affiliation(s)
- Anna Gu
- St. John's University, Queens, NY.
| | - Yu Yue
- CUNY Baruch College, New York, NY
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Smith KE, Mason TB, Johnson JS, Lavender JM, Wonderlich SA. A systematic review of reviews of neurocognitive functioning in eating disorders: The state-of-the-literature and future directions. Int J Eat Disord 2018; 51:798-821. [PMID: 30102781 PMCID: PMC6594106 DOI: 10.1002/eat.22929] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 06/11/2018] [Accepted: 06/13/2018] [Indexed: 01/01/2023]
Abstract
OBJECTIVE In recent years there has been increasing clinical and empirical interest in neurocognitive functioning in eating disorders (EDs), which has resulted in numerous quantitative and qualitative reviews. However, there has yet to be a comprehensive synthesis or critical review of this literature to identify future directions to advance the field in this area. Therefore the aim of this systematic review of systematic reviews was to (a) characterize the existing literature on neurocognitive functioning in EDs based on recent reviews (i.e., published since 2010), (b) describe related limitations, and (c) suggest avenues for future research to address gaps in the current literature. METHOD Electronic databases were queried for reviews of neurocognitive domains (i.e., inhibitory control, decision-making, central coherence, set-shifting, working memory, and attention bias) in EDs, which identified 28 systematic and meta-analytic reviews. RESULTS Broadly, the literature indicates deficits across these neurocognitive domains in EDs, though heterogeneity was noted in the magnitude of these effects, which varied to some extent across ED subtypes, sample characteristics, and methodological approaches. DISCUSSION While these reviews have generally suggested varying patterns of neurocognitive deficits across EDs, there remain critical limitations regarding the methodological quality of these studies (e.g., the lack of prospective designs, consideration of confounding influences, or examination of interrelationships between neurocognitive domains and relationships between neurocognition and other relevant behavioral constructs). Specifically, we outline 10 key areas that are imperative to address in future research in this area in order to move our field forward.
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Affiliation(s)
- Kathryn E Smith
- Center for Bio-Behavioral Research, Sanford Research, South Fargo, ND
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, North Dakota
| | - Tyler B Mason
- Department of Preventive Medicine, University of Southern California, Los Angeles, California
| | - Jeffrey S Johnson
- Center for Bio-Behavioral Research, Sanford Research, South Fargo, ND
- Department of Psychology, North Dakota State University, North Dakota
| | - Jason M Lavender
- Department of Psychiatry, University of California, San Diego, California
| | - Stephen A Wonderlich
- Center for Bio-Behavioral Research, Sanford Research, South Fargo, ND
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, North Dakota
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Németh B, Józwiak‐Hagymásy J, Kovács G, Kovács A, Demjén T, Huber MB, Cheung K, Coyle K, Lester‐George A, Pokhrel S, Vokó Z. Cost-effectiveness of possible future smoking cessation strategies in Hungary: results from the EQUIPTMOD. Addiction 2018; 113 Suppl 1:76-86. [PMID: 29368363 PMCID: PMC6032939 DOI: 10.1111/add.14089] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 08/07/2017] [Accepted: 11/02/2017] [Indexed: 12/02/2022]
Abstract
AIMS To evaluate potential health and economic returns from implementing smoking cessation interventions in Hungary. METHODS The EQUIPTMOD, a Markov-based economic model, was used to assess the cost-effectiveness of three implementation scenarios: (a) introducing a social marketing campaign; (b) doubling the reach of existing group-based behavioural support therapies and proactive telephone support; and (c) a combination of the two scenarios. All three scenarios were compared with current practice. The scenarios were chosen as feasible options available for Hungary based on the outcome of interviews with local stakeholders. Life-time costs and quality-adjusted life years (QALYs) were calculated from a health-care perspective. The analyses used various return on investment (ROI) estimates, including incremental cost-effectiveness ratios (ICERs), to compare the scenarios. Probabilistic sensitivity analyses assessed the extent to which the estimated mean ICERs were sensitive to the model input values. RESULTS Introducing a social marketing campaign resulted in an increase of 0.3014 additional quitters per 1 000 smokers, translating to health-care cost-savings of €0.6495 per smoker compared with current practice. When the value of QALY gains was considered, cost-savings increased to €14.1598 per smoker. Doubling the reach of existing group-based behavioural support therapies and proactive telephone support resulted in health-care savings of €0.2539 per smoker (€3.9620 with the value of QALY gains), compared with current practice. The respective figures for the combined scenario were €0.8960 and €18.0062. Results were sensitive to model input values. CONCLUSIONS According to the EQUIPTMOD modelling tool, it would be cost-effective for the Hungarian authorities introduce a social marketing campaign and double the reach of existing group-based behavioural support therapies and proactive telephone support. Such policies would more than pay for themselves in the long term.
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Affiliation(s)
| | | | - Gábor Kovács
- Korányi National Institute of Tuberculosis and PulmonologyBudapestHungary
- Smoking Cessation Support CenterBudapestHungary
| | - Attila Kovács
- National Public Health and Medical Officer ServiceBudapestHungary
| | - Tibor Demjén
- National Institute for Health Development—Focal Point for Tobacco ControlBudapestHungary
| | - Manuel B. Huber
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München (GmbH) ‐ German Research Center for Environmental Health, Comprehensive Pneumology Center Munich (CPC‐M), Member of the German Center for Lung Research (DZL)NeuherbergGermany
| | - Kei‐Long Cheung
- CAPHRI School of Public Health and Primary Care, Health Services ResearchMaastricht UniversityMaastrichtthe Netherlands
| | - Kathryn Coyle
- Health Economics Research GroupInstitute of Environment, Health and Societies, Brunel University LondonLondonUK
| | | | - Subhash Pokhrel
- Health Economics Research GroupInstitute of Environment, Health and Societies, Brunel University LondonLondonUK
| | - Zoltán Vokó
- Syreon Research InstituteBudapestHungary
- Department of Health Policy and Health EconomicsEötvös Loránd UniversityBudapestHungary
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Holt-Lunstad J, Robles TF, Sbarra DA. Advancing social connection as a public health priority in the United States. ACTA ACUST UNITED AC 2018; 72:517-530. [PMID: 28880099 DOI: 10.1037/amp0000103] [Citation(s) in RCA: 412] [Impact Index Per Article: 68.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
A robust body of scientific evidence has indicated that being embedded in high-quality close relationships and feeling socially connected to the people in one's life is associated with decreased risk for all-cause mortality as well as a range of disease morbidities. Despite mounting evidence that the magnitude of these associations is comparable to that of many leading health determinants (that receive significant public health resources), government agencies, health care providers and associations, and public or private health care funders have been slow to recognize human social relationships as either a health determinant or health risk marker in a manner that is comparable to that of other public health priorities. This article evaluates current evidence (on social relationships and health) according to criteria commonly used in determining public health priorities. The article discusses challenges for reducing risk in this area and outlines an agenda for integrating social relationships into current public health priorities. (PsycINFO Database Record
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41
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Systematic review of self-reported cognitive function in cancer patients following chemotherapy treatment. J Cancer Surviv 2018; 12:537-559. [DOI: 10.1007/s11764-018-0692-x] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 04/19/2018] [Indexed: 12/21/2022]
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Sipos V, Pálinkás A, Kovács N, Csenteri KO, Vincze F, Szőllősi JG, Jenei T, Papp M, Ádány R, Sándor J. Smoking cessation support for regular smokers in Hungarian primary care: a nationwide representative cross-sectional study. BMJ Open 2018; 8:e018932. [PMID: 29431134 PMCID: PMC5829607 DOI: 10.1136/bmjopen-2017-018932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Our study aimed to evaluate the effectiveness of general practitioners' (GPs') smoking cessation support (SCS). STUDY DESIGN We carried out a cross-sectional study between February and April 2016. SETTING AND PARTICIPANT A sample of 2904 regular smokers aged 18 years or older was selected randomly from 18 general medical practices involved in a national representative, general medical practice-based morbidity monitoring system. The GPs surveyed the selected adults and identified 708 regular smokers. MAIN OUTCOME MEASURES Multivariate logistic regression models have been applied to evaluate the determinants (age, gender, education, smoking-related comorbidity, smoking intensity, intention to quit smoking and nicotine dependence) of provision of GP-mediated SCS such as brief intervention, pharmacological and non-pharmacological programmatic support. RESULTS According to the survey, 24.4% of the adults were regular smokers, 30% of them showed high nicotine dependence and 38.2% willing to quit smoking. Most of the smokers were not participated in SCS by GPs: brief intervention, programmatic non-pharmacological support and pharmacotherapy were provided for 25%, 7% and 2% of smokers, respectively. Low-nicotine-dependence individuals were less (OR 0.30, 95% CI 0.12 to 0.75), patients with intention to quit were more (OR 1.49, 95% CI 1.00 to 2.22) likely to receive a brief intervention. Vocational (OR 1.71, 95% CI 1.13 to 2.59) and high school education (OR 2.08, 95% CI 1.31 to 3.31), chronic obstructive pulmonary disease and cardiovascular diseases (OR 3.34, 95% CI 1.04 to 10.68; OR 3.91, 95% CI 2.33 to 6.54) increased the probability to receive support by GP. CONCLUSIONS Although there are differences among smokers' subgroups, the SCS in Hungarian primary care is generally insufficient, compared with guidelines. Practically, the pharmacological support is not included in Hungarian GPs' practice. GPs should increase substantially the working time devoted to SCS, and the organisation of primary healthcare should support GPs in improving SCS services.
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Affiliation(s)
- Valéria Sipos
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Anita Pálinkás
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Nóra Kovács
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Karola Orsolya Csenteri
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Ferenc Vincze
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - József Gergő Szőllősi
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Tibor Jenei
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Magor Papp
- National Institute for Health Development, Budapest, Hungary
| | - Róza Ádány
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
- MTA-DE-Public Health Research Group, University of Debrecen, Debrecen, Hungary
- Department of Preventive Medicine, Faculty of Public Health, WHO Collaborating Centre on Vulnerability and Health, University of Debrecen, Debrecen, Hungary
| | - János Sándor
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
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Bishop FM. Self-guided Change: The most common form of long-term, maintained health behavior change. Health Psychol Open 2018; 5:2055102917751576. [PMID: 29375888 PMCID: PMC5777567 DOI: 10.1177/2055102917751576] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Millions of people change risky, health-related behaviors and maintain those changes. However, they often take years to change, and their unhealthy behaviors may harm themselves and others and constitute a significant cost to society. A review-similar in nature to a scoping review-was done of the literature related to long-term health behavior change in six areas: alcohol, cocaine and heroin misuse, gambling, smoking, and overeating. Based on the limited research available, reasons for change and strategies for changing and for maintaining change were also reviewed. Fifty years of research clearly indicate that as people age, in the case of alcohol, heroin and cocaine misuse, smoking, and gambling, 80-90 percent moderate or stop their unhealthy behaviors. The one exception is overeating; only 20 percent maintain their weight loss. Most of these changes, when they occur, appear to be the result of self-guided change. More ways to accelerate self-guided, health-related behavior change need to be developed and disseminated.
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van der Aalst CM, Ten Haaf K, de Koning HJ. Lung cancer screening: latest developments and unanswered questions. THE LANCET RESPIRATORY MEDICINE 2017; 4:749-761. [PMID: 27599248 DOI: 10.1016/s2213-2600(16)30200-4] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 06/29/2016] [Accepted: 07/04/2016] [Indexed: 12/13/2022]
Abstract
The US National Lung Screening Trial showed that individuals randomly assigned to screening with low-dose CT scans had 20% lower lung cancer mortality than did those screened with conventional chest radiography. On the basis of a review of the literature and a modelling study, the US Preventive Services Task Force recommends annual screening for lung cancer for individuals aged 55-80 years who have a 30 pack-year smoking history and either currently smoke or quit smoking within the past 15 years. However, the balance between benefits and harms of lung cancer screening is still greatly debated. The large number of false-positive results and the potential for overdiagnosis are causes for concern. Some investigators suggest the ratio between benefits and harms could be improved through various means. Nevertheless, many questions remain with regard to the implementation of lung cancer screening. This paper highlights the latest developments in CT lung cancer screening and provides an overview of the main unanswered questions.
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Affiliation(s)
- Carlijn M van der Aalst
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands.
| | - Kevin Ten Haaf
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Harry J de Koning
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands
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Cheung KL, de Ruijter D, Hiligsmann M, Elfeddali I, Hoving C, Evers SMAA, de Vries H. Exploring consensus on how to measure smoking cessation. A Delphi study. BMC Public Health 2017; 17:890. [PMID: 29162043 PMCID: PMC5696733 DOI: 10.1186/s12889-017-4902-7] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 11/12/2017] [Indexed: 01/25/2023] Open
Abstract
Background Different criteria regarding outcome measures in smoking research are used, which can lead to confusion about study results. Consensus in outcome criteria may enhance the comparability of future studies. This study aims (1) to provide an overview of tobacco researchers’ considered preferences regarding outcome criteria in randomized controlled smoking cessation trials, and (2) to identify the extent to which researchers can reach consensus on the importance of these outcome criteria. Methods A three-round online Delphi study was conducted among smoking cessation experts. In the first round, the most important smoking cessation outcome measures were collected by means of open-ended questions, which were categorized around self-reported and biochemical validation measures. Experts (n = 17) were asked to name the outcome measures (as well as their assessment method and ideal follow-up period) that they thought were important when assessing smoking-related outcomes. In the second (n = 48) and third rounds (n = 37), a list of outcome measures—identified in the first round—was presented to experts. Asking them to rate the importance of each measure on a seven-point scale. Results Experts reached consensus on several items. For self-reports, experts agreed that prolonged abstinence (6 or/and 12 months), point prevalence abstinence (7 days), continuous abstinence (6 months), and the number of cigarettes smoked (7 days) are important outcome measures. Experts reached consensus that biochemical validation methods should not always be used. The preferred biochemical validation methods were carbon monoxide (expired air) and cotinine (saliva). Preferred follow-ups included 6 and/or 12 months, with or without intermediate measurements. Conclusions Findings suggest only partial compliance with the Russell standard and that more outcome measures may be important (including seven-day point-prevalence abstinence, number of cigarettes smoked, and cotinine when using biochemical validation). This study showed where there is and is not consensus, reflecting the need to develop a more comprehensive standard. For these purposes we provided suggestions for the Russell 2.0 standard.
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Affiliation(s)
- Kei Long Cheung
- Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, Maastricht, the Netherlands. .,Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht, the Netherlands.
| | - Dennis de Ruijter
- Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht, the Netherlands
| | - Mickaël Hiligsmann
- Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, Maastricht, the Netherlands
| | - Iman Elfeddali
- GGzBreburg, Tilburg, the Netherlands.,Tranzo Department, Tilburg University, Tilburg, the Netherlands
| | - Ciska Hoving
- Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht, the Netherlands
| | - Silvia M A A Evers
- Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, Maastricht, the Netherlands.,Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Hein de Vries
- Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht, the Netherlands
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Sanchez-Aguadero N, Mora-Simon S, Recio-Rodriguez JI, Alonso-Dominguez R, Gonzalez-Sanchez J, Martin-Martin C, Gomez-Marcos MA, Rodriguez-Sanchez E, Garcia-Ortiz L. Effectiveness of an intensive intervention to improve lifestyles in people with intermediate cardiovascular risk (DATE study): Study protocol for a randomized controlled trial. J Adv Nurs 2017; 74:957-967. [PMID: 29148088 DOI: 10.1111/jan.13503] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 10/24/2017] [Indexed: 11/26/2022]
Abstract
AIM The aim of this study was to evaluate the effectiveness of an intensive intervention led by primary care nurses for lifestyle modification among people with intermediate cardiovascular risk. BACKGROUND Cardiovascular diseases may be prevented by adopting healthy lifestyles. Interventions focused on populations at risk are more efficient than those aimed at the general population. More than 50 per cent of cardiovascular events occur in people with intermediate cardiovascular risk, but only a few studies have targeted this population. DESIGN A randomized controlled trial approved in January 2017. METHODS We will recruit 208 participants aged 35-74 years who have intermediate cardiovascular risk. They will be selected by consecutive sampling and will be randomized into a control group or intervention group. Individual standardized brief counselling on healthy lifestyles will be provided to both groups. Additionally, individuals from the intervention group will receive four weekly group sessions focusing on cardiovascular risk, healthy diet, moderation in alcohol consumption, daily physical activity, stress management and smoking cessation and two motivational follow-up calls. The primary outcome will be the lifestyle modification measured by total steps recorded by a pedometer, total score on the Mediterranean Diet Adherence Screener and percentage of current smokers. DISCUSSION This study will allow us to investigate whether an intensive intervention based on a multifactorial group approach is more effective in lifestyle modification than individual standardized brief counseling among adults with intermediate cardiovascular risk. Our results could lead to the establishment of new strategies for cardiovascular risk management.
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Affiliation(s)
- Natalia Sanchez-Aguadero
- Primary Care Research Unit, The Alamedilla Health Centre, Castilla and León Health Service (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | - Sara Mora-Simon
- Primary Care Research Unit, The Alamedilla Health Centre, Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain.,Department of Basic Psychology, Psychobiology and Behavioral Sciences Methodology, University of Salamanca, Salamanca, Spain
| | - Jose I Recio-Rodriguez
- Primary Care Research Unit, The Alamedilla Health Centre, Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain.,Department of Nursing and Physiotherapy, University of Salamanca, Salamanca, Spain
| | - Rosario Alonso-Dominguez
- Primary Care Research Unit, The Alamedilla Health Centre, Castilla and León Health Service (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | - Jesus Gonzalez-Sanchez
- Primary Care Research Unit, The Alamedilla Health Centre, Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain.,Department of nursing, University of Extremadura, Plasencia, Cáceres, Spain
| | - Cristina Martin-Martin
- Primary Care Research Unit, The Alamedilla Health Centre, Castilla and León Health Service (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
| | - Manuel A Gomez-Marcos
- Primary Care Research Unit, The Alamedilla Health Centre, Castilla and León Health Service (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain.,Department of medicine, University of Salamanca, Salamanca, Spain
| | - Emiliano Rodriguez-Sanchez
- Primary Care Research Unit, The Alamedilla Health Centre, Castilla and León Health Service (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain.,Department of medicine, University of Salamanca, Salamanca, Spain
| | - Luis Garcia-Ortiz
- Primary Care Research Unit, The Alamedilla Health Centre, Castilla and León Health Service (SACYL), Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain.,Department of Biomedical and Diagnostic sciences, University of Salamanca, Salamanca, Spain
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Alagiyawanna AMAAP, Rajapaksa-Hewageegana N, Gunawardena N. The impact of multiple interventions to reduce household exposure to second-hand tobacco smoke among women: a cluster randomized controlled trial in Kalutara district, Sri Lanka. BMC Public Health 2017; 17:810. [PMID: 29037230 PMCID: PMC5644088 DOI: 10.1186/s12889-017-4820-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 10/04/2017] [Indexed: 11/29/2022] Open
Abstract
Background Second-hand smoke (SHS) in households remains a serious public health problem in Sri Lanka, partly due to a lack of voluntary prohibitions of tobacco smoking inside houses. Women are especially at risk of being exposed. Effective community based interventions to reduce the SHS in households targeting women is scarce. The objective of this study was to examine the impact of a multi-component intervention on household SHS exposure among Sri Lankan women. Methods Thirty clusters of 25 women (aged 18–65) from 750 households were randomized into the intervention and control groups. Women in the intervention group were exposed to activities which focused on improving knowledge on the health effects of SHS, attitudes towards SHS exposure, right to a smoke-free living and women empowerment against smoking. The duration of the intervention was six months. The comparison group received no intervention. The primary outcome of interest was self-reported SHS exposure in the household within 7 days prior to data collection. The secondary outcomes were exposure in the past 30 days, knowledge of the health risks of exposure, attitudes towards exposure, right to smoke-free living, women empowerment against smoking, and smoking inside the homes. Results Final assessment was in 329 (89.6%) in the intervention group and 309 (85.8%) in the comparison group. Following the intervention, significantly lower proportion of women in the intervention group as compared to the control group reported SHS exposure in their households within 7-days (9.2% vs. 15.3%, p = 0.02) and 30-days (13.6% vs. 21.6%, p = 0.008) prior to the post survey. As compared to the control group, significantly higher median scores were observed in the intervention group on the knowledge of the health risks of exposure to SHS (p < 0.001), attitudes on exposure to SHS (p = 0.004), right to smoke free living (p = 0.001) and women empowerment (p < 0.001). Conclusion Multi-component intervention activities were effective in reducing household exposure to SHS among women. Trial registration Sri Lanka Clinical Trials Registry SLCTR/2014/033. Electronic supplementary material The online version of this article (10.1186/s12889-017-4820-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- A M A A P Alagiyawanna
- Ministry of Healthcare and Indigenous Medicine, Health Promotion Bureau, No 02, Kynsey Road, Colombo, 08, Sri Lanka.
| | - N Rajapaksa-Hewageegana
- Ministry of Healthcare and Indigenous Medicine, Health Promotion Bureau, No 02, Kynsey Road, Colombo, 08, Sri Lanka
| | - N Gunawardena
- Department of Community Medicine, University of Colombo, No.25, PO Box, 271 Kynsey Road, Colombo-08, Colombo, Western Province, Sri Lanka
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Abstract
PURPOSE OF REVIEW This review aimed to examine the latest evidence linking cigarette smoking and cessation to risk of incident diabetes and its complications. RECENT FINDINGS Abundant evidence has demonstrated that smoking is associated with increased risk of type 2 diabetes and cardiovascular disease among diabetic patients, while its relationship with microvascular complications is more limited to diabetic nephropathy and neuropathy in type 1 diabetes. In addition, diabetes risk remains high in the short term after smoking cessation, while it reduces gradually in the long term. Risk of cardiovascular complications also substantially decreases after quitting smoking, but results for microvascular complications are not consistent. Smoking is associated with increased risks of incident diabetes in the general population and cardiovascular complications among diabetic patients. Although the short-term post-cessation diabetes risk needs to be acknowledged, this review calls for urgent action to implement population-wide policies and individual pharmaceutical and lifestyle interventions (if evidence accumulated in future) to aid smoking cessation and prevent diabetes and its complications.
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Affiliation(s)
- Ping Zhu
- Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Xiong-Fei Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, China
| | - Liting Sheng
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, China
| | - Henggui Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, China
| | - An Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, China.
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Schick RS, Kelsey TW, Marston J, Samson K, Humphris GW. MapMySmoke: feasibility of a new quit cigarette smoking mobile phone application using integrated geo-positioning technology, and motivational messaging within a primary care setting. Pilot Feasibility Stud 2017; 4:19. [PMID: 28725452 PMCID: PMC5513177 DOI: 10.1186/s40814-017-0165-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 06/25/2017] [Indexed: 11/20/2022] Open
Abstract
Background Approximately 11,000 people die in Scotland each year as a result of smoking-related causes. Quitting smoking is relatively easy; maintaining a quit attempt is a very difficult task with success rates for unaided quit attempts stubbornly remaining in the single digits. Pharmaceutical treatment can improve these rates by lowering the overall reward factor of nicotine. However, these and related nicotine replacement therapies do not operate on, or address, the spatial and contextual aspects of smoking behaviour. With the ubiquity of smartphones that can log spatial, quantitative and qualitative data related to smoking behaviour, there exists a person-centred clinical opportunity to support smokers attempting to quit by first understanding their smoking behaviour and subsequently sending them dynamic messages to encourage health behaviour change within a situational context. Methods We have built a smartphone app—MapMySmoke—that works on Android and iOS platforms. The deployment of this app within a clinical National Health Service (NHS) setting has two distinct phases: (1) a 2-week logging phase where pre-quit patients log all of their smoking and craving events; and (2) a post-quit phase where users receive dynamic support messages and can continue to log craving events, and should they occur, relapse events. Following the initial logging phase, patients consult with their general practitioner (GP) or healthcare provider to review their smoking patterns and to outline a precise, individualised quit attempt plan. Our feasibility study consists of assessment of an initial app version during and after use by eight patients recruited from an NHS Fife GP practice. In addition to evaluation of the app as a potential smoking cessation aid, we have assessed the user experience, technological requirements and security of the data flow. Results In an initial feasibility study, we have deployed the app for a small number of patients within one GP practice in NHS Fife. We recruited eight patients within one surgery, four of whom actively logged information about their smoking behaviour. Initial feedback was very positive, and users indicated a willingness to log their craving and smoking events. In addition, two out of three patients who completed follow-up interviews noted that the app helped them reduce the number of cigarettes they smoked per day, while the third indicated that it had helped them quit. The study highlighted the use of pushed notifications as a potential technology for maintaining quit attempts, and the security of collection of data was audited. These initial results influenced the design of a planned second larger study, comprised of 100 patients, the primary objectives of which are to use statistical modelling to identify times and places of probable switches into smoking states, and to target these times with dynamic health behaviour messaging. Conclusions While the health benefits of quitting smoking are unequivocal, such behaviour change is very difficult to achieve. Many factors are likely to contribute to maintaining smoking behaviour, yet the precise role of cues derived from the spatial environment remains unclear. The rise of smartphones, therefore, allows clinicians the opportunity to better understand the spatial aspects of smoking behaviour and affords them the opportunity to push targeted individualised health support messages at vulnerable times and places. Trial registration ClinicalTrial.gov, NCT02932917.
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Affiliation(s)
- Robert S Schick
- School of Mathematics and Statistics, The Observatory, University of St Andrews, Buchanan Gardens, St Andrews, KY16 9LZ UK.,Marine Geospatial Ecology Lab, Nicholas School of the Environment, Duke University, Durham, NC 27708 USA
| | - Thomas W Kelsey
- School of Computer Science, University of St Andrews, North Haugh, St Andrews, KY16 9SX UK
| | - John Marston
- Dr Kyle and Partners Surgery, 2 Routine Row, Pittenweem, Anstruther KY10 2LG UK
| | - Kay Samson
- NHS Fife Smoking Cessation Services, Cameron Hospital, Leven, KY8 5RR UK
| | - Gerald W Humphris
- School of Medicine, Medical and Biological Sciences, University of St Andrews, North Haugh, St Andrews, KY16 9TF UK
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50
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Bommelé J, Schoenmakers TM, Kleinjan M, Peters GJY, Dijkstra A, van de Mheen D. Targeting hardcore smokers: The effects of an online tailored intervention, based on motivational interviewing techniques. Br J Health Psychol 2017; 22:644-660. [PMID: 28703470 DOI: 10.1111/bjhp.12256] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 05/16/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Hardcore smokers have smoked for many years and do not intend to quit. They also seem unreceptive to information about smoking cessation. We developed a 30-min, tailored web-based intervention that includes motivational interviewing principles. It aims to increase hardcore smokers' intention to quit and their receptivity to information about smoking cessation. DESIGN In a two-arm experiment, we compared outcome scores of the experimental intervention (n = 346) with those of a control intervention (n = 411). METHODS Our main outcomes were receptivity to information about quitting, intention to quit, quitting self-efficacy, and interest in a subsequent online intervention. Our secondary outcomes were cigarettes smoked per day and quit attempts. All outcomes were measured directly post-experiment (t1 ), after 2 weeks (t2 ), and after 2 months (t3 ). RESULTS At t1 , hardcore smokers in the intervention condition were more receptive to information about quitting than controls. At both t2 and t3 , those in the experimental group had reduced the number of cigarettes more than those in the control group. At t2 , but not t3 , more participants in the experimental group had reduced their cigarette consumption by at least 50% than among controls. We found no significant differences in intention to quit, quitting self-efficacy, interest in a subsequent online quitting intervention, and number of quit attempts. CONCLUSIONS The intervention increased hardcore smokers' receptivity to information about smoking cessation and decreased their cigarette consumption by about 1 cigarette per day. Although the results are positive, the clinical relevance may be limited. We recommend further developing this intervention for practical use in health care settings. Statement of contribution What is already known on this subject? Hardcore smokers have smoked for many years and do not intend to quit. There are currently no online interventions for hardcore smokers. What does this study add? This study tested an online intervention for hardcore smokers. The intervention increased hardcore smokers' receptivity to information about quitting. It also helped to reduce the number of cigarettes per day.
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Affiliation(s)
- Jeroen Bommelé
- IVO Addiction Research Institute, Rotterdam, the Netherlands.,Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Tim M Schoenmakers
- IVO Addiction Research Institute, Rotterdam, the Netherlands.,Erasmus Medical Centre, Rotterdam, the Netherlands.,NIVEL, Netherlands Institute for Health Sciences Research, Utrecht, the Netherlands
| | | | | | - Arie Dijkstra
- Faculty of Behavioural and Social Sciences, University of Groningen, the Netherlands
| | - Dike van de Mheen
- IVO Addiction Research Institute, Rotterdam, the Netherlands.,Erasmus Medical Centre, Rotterdam, the Netherlands.,Tranzo, School of Social and Behavioral Sciences, Tilburg University, the Netherlands
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