Effectiveness of smoking cessation interventions for smokers with chronic diseases: A systematic review

Reintroducing face-to-face support alongside remote support to form a hybrid stop smoking service in England: a formative mixed methods evaluation

BACKGROUND

During the COVID-19 pandemic, United Kingdom (UK) stop smoking services had to shift to remote delivery models due to social distancing regulations, later reintroducing face-to-face provision. The "Living Well Smokefree" service in North Yorkshire County Council adopted a hybrid model offering face-to-face, remote, or a mix of both. This evaluation aimed to assess the hybrid approach's strengths and weaknesses and explore potential improvements.

METHODS

Conducted from September 2022 to February 2023, the evaluation consisted of three components. First, qualitative interviews involved 11 staff and 16 service users, analysed thematically. Second, quantitative data from the QuitManager system that monitored the numbers and proportions of individuals selecting and successfully completing a 4-week quit via each service option. Third, face-to-face service expenses data was used to estimate the value for money of additional face-to-face provision. The qualitative findings were used to give context to the quantitative data via an "expansion" approach and complementary analysis.

RESULTS

Overall, a hybrid model was seen to provide convenience and flexible options for support. In the evaluation, 733 individuals accessed the service, with 91.3% selecting remote support, 6.1% face-to-face, and 2.6% mixed provision. Remote support was valued by service users and staff for promoting openness, privacy, and reducing stigma, and was noted as removing access barriers and improving service availability. However, the absence of carbon monoxide monitoring in remote support raised accountability concerns. The trade-off in "quantity vs. quality" of quits was debated, as remote support reached more users but produced fewer carbon monoxide-validated quits. Primarily offering remote support could lead to substantial workloads, as staff often extend their roles to include social/mental health support, which was sometimes emotionally challenging. Offering service users a choice of support options was considered more important than the "cost-per-quit". Improved dissemination of information to support service users in understanding their options for support was suggested.

CONCLUSIONS

The hybrid approach allows smoking cessation services to evaluate which groups benefit from remote, face-to-face, or mixed options and allocate resources accordingly. Providing choice, flexible provision, non-judgmental support, and clear information about available options could improve engagement and match support to individual needs, enhancing outcomes.

Smoking cessation interventions for U.S. adults with disabilities: A systematic review

INTRODUCTION

People with disabilities disproportionately use tobacco products. However, little is known about cessation interventions tailored for people with disabilities. The objective of this study was to conduct a systematic review of smoking cessation interventions for adults with disabilities.

METHODS

Six electronic databases (Cochrane, CINAHL Plus [EBSCOhost], Embase [Ovid], Medline [Ovid], PsycINFO [Ovid], and Web of Science) were searched to identify eligible interventions for people with disabilities (e.g., vision, hearing, mobility, communication, cognition, self-care) through July 2023. Two independent coders evaluated the records and extracted data from studies that met inclusion criteria. Qualitative synthesis was conducted on the included studies in 2023.

RESULTS

One randomized controlled trial and one nonrandomized study met the inclusion criteria. Both studies used mindfulness-based procedures to reduce cigarette use in adults with mild intellectual disability. The outcome was defined as self-reported cigarette use at follow-up, which ranged from 1 year to 3 years. Limited information was provided on how the interventions were tailored to meet the unique needs of people with disabilities in either study.

CONCLUSION

Two interventions conducted in adults with mild intellectual disability showed promising results using mindfulness-based procedures; however, the studies did not address barriers reported by people with disabilities, nor tailor the interventions to meet the needs of the target population. Research is needed to address tobacco use disparities among people with a range of disabilities. Current cessation interventions would be enhanced by integrating disability identifiers alongside other demographic information in future studies and reporting subgroup analyses in adults with disabilities.

Effects of a Smoking Cessation Counseling Education Program on Nursing Students

This is a quasi-experimental study applying a nonequivalent control group pre-test-post-test design with the control of exogenous variables to compare the research variables among experimental groups. Participants totaled 67 and were divided into three groups, each participating in a different training program (lecture, online video, and case-based peer role-play). There were significant increases in attitudes toward smoking cessation interventions in Experiment 2 (online video) (t = -2.48, p = .021) and Experiment 3 (case-based peer role-play) (t = -2.69. p = .013), efficacy of smoking cessation interventions in Experiment 2 (-2.06, p = .052), and intention to deliver smoking cessation intervention in all experimental groups (Exp 1 t = -5.54, p < .001; Exp 2 t = -2.83, p = .010; Exp 3 t = -3.50, p = .002). All three programs of smoking cessation counseling education (lecture, online video, and case-based peer role-play) used in this study showed meaningful results on the study variables. In conclusion, all of the approaches of this study were found to be effective on the intention to deliver smoking cessation intervention, and it is important to creatively apply counseling programs that include essential elements of smoking cessation interventions in nursing education settings.

Effectiveness of smoking cessation interventions for smokers with Crohn's disease: a systematic review

Aims

Smoking cessation (SC) in Crohn's disease (CD) is widely accepted to be the most important modifiable factor to improve outcomes in these patients. We aimed in this review to provide a summary of the evidence base regarding the effectiveness of SC interventions in patients with CD.

Materials & methods

The following databases were systematically searched from inception to February 2022: PubMed, Google Scholar and Cochrane Library.

Results

Overall, five articles met the research criteria. Studies sample size ranged from 17 to 474 patients. At the outcome level, the abstinence rates ranged from 14.8 to 42% and was ≤25% in four studies. The three studies with control groups did not report statistically higher SC rates in the intervention groups. No predictors of interventions success were identified in this review.

Conclusion

Implementation and evaluation of tailored SC interventions for CD patients must be promptly addressed in further studies.

Smoking cessation interventions for US adults with disabilities: protocol for a systematic review

INTRODUCTION

People with disabilities have a higher prevalence of cigarette smoking than people without disabilities. However, little information exists on smoking cessation interventions tailored to address the unique needs of people with disabilities. This paper describes a systematic review protocol to identify and evaluate tobacco smoking cessation interventions designed to improve outcomes for people with disabilities.

METHODS AND ANALYSIS

We will conduct a systematic review of the literature using the procedures outlined by Cochrane. We will search four electronic databases (CINAHL Plus (EBSCO), Embase (Ovid), Medline (Ovid) and PsycINFO (Ovid)) with no date restriction to identify tobacco cessation interventions tailored to meet the needs of people with disabilities. We will extract data and assess risk of bias using the RoB2 and ROBINS-I for included studies using Covidence systematic review software. Quantitative and qualitative syntheses will summarise key study characteristics and outcomes with text, tables and forest plots; a meta-analysis will be conducted, if appropriate.

ETHICS AND DISSEMINATION

Ethical approval is not required as there are no primary data associated with the study. Data will be disseminated through a peer-reviewed articles and conference presentations.

PROSPERO REGISTRATION NUMBER

CRD42022337434.

A general health promotion approach to helping smokers with non-communicable diseases quit smoking: A pilot randomized controlled trial

Background

Despite evidence showing that continued smoking in patients with non-communicable diseases can reduce treatment efficacy and increase the risk of disease progression and multimorbidity, many smoker patients either have no intention to quit or have had failed attempts at quitting.

Objective

To examine the feasibility of a general health promotion approach that uses instant messaging to deliver brief motivational interviewing to help smokers with non-communicable diseases quit smoking.

Methods

In total, 60 participants who had medical follow-up in a special out-patient clinic were randomized into two groups, 30 in the intervention group received brief motivational interviewing to assist them with their chosen behavioral changes, and 30 in the control group received only a smoking cessation booklet. The outcome measures included self-reported 7-day point prevalence of smoking abstinence and any behavioral change reported by the participants at 6 and 12 months. Biochemical validation was performed for those who verbally reported a 7-day point prevalence of smoking abstinence at 12 months.

Results

The majority (95%) of smokers who attended the out-patient clinic owned a smartphone. The response rate was 73.2%. Retention rates at 6-month and 12-month follow-up were 83.3 and 71.7%, respectively. The process evaluation indicated that participants were satisfied with the content of the brief MI messages and appreciated the use of instant messaging as a way to provide them with professional advice and support for managing their health-related lifestyles. The intervention group had a higher biochemically validated abstinence rate than the control group at 12 months (16.7 vs. 6.7 P = 0.23) although the difference was not statistically significant (Adjusted odd ratio 2.4, 95% confidence interval, 0.43-13.75; P = 0.32.), In addition, the proportion of participants reporting a behavioral change was higher in the intervention group at 6 and 12 months.

Conclusion

This study suggested the potential efficacy and feasibility of a general health promotion approach that uses instant messaging to deliver brief motivational interviewing to help smokers with non-communicable diseases quit smoking. The findings can be used to create a new smoking cessation service model that implements a flexible, proactive and personalized approach to help smokers quit smoking.

Clinical trial registration

ClinicalTrials.gov, identifier: NCT03983330.