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Daniel B, Lawrence DE, McKenna BS, Saccone P, McRae T, Evins AE, Anthenelli RM. Do tobacco regulatory and economic factors influence smoking cessation outcomes? A post-hoc analysis of the multinational EAGLES randomised controlled trial. BMJ Open 2024; 14:e079092. [PMID: 39306350 PMCID: PMC11418566 DOI: 10.1136/bmjopen-2023-079092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 08/19/2024] [Indexed: 09/25/2024] Open
Abstract
INTRODUCTION We previously reported global regional differences in smoking cessation outcomes, with smokers of US origin having lower quit rates than smokers from some other countries. This post-hoc analysis examined global regional differences in individual-level and country-level epidemiological, economic and tobacco regulatory factors that may affect cessation outcomes. METHODS EAGLES (Evaluating Adverse Events in a Global Smoking Cessation Study) was a randomised controlled trial that evaluated first-line cessation medications and placebo in 8144 smokers with and without psychiatric disorders from 16 countries across seven regions. Generalised linear and stepwise logistic regression models that considered pharmacotherapy treatment, psychiatric diagnoses, traditional individual-level predictors (eg, demographic and smoking characteristics) and country-specific smoking prevalence rates, gross domestic product (GDP) per capita, relative cigarette cost and WHO-derived MPOWER scores were used to predict 7-day point prevalence abstinence at the end of treatment. RESULTS In addition to several traditional predictors, three of four country-level variables predicted short-term abstinence: GDP (0.54 (95% CI 0.47, 0.63)), cigarette relative income price (0.62 (95% CI 0.53, 0.72)) and MPOWER score (1.03 (95% CI 1.01, 1.06)). Quit rates varied across regions (22.0% in Australasia to 55.9% in Mexico). With northern North America (USA and Canada) as the referent, the likelihood of achieving short-term abstinence was significantly higher in Western Europe (OR 1.4 (95% CI 1.14, 1.61)), but significantly lower in Eastern Europe (0.39 (95% CI 0.22, 0.69)) and South America (0.17 (95% CI 0.08, 0.35)). CONCLUSIONS Increased tobacco regulation was associated with enhanced quitting among participants in the EAGLES trial. Paradoxically, lower GDP, and more affordable cigarette pricing relative to a country's GDP, were also associated with higher odds of quitting. Geographical region was also a significant independent predictor. TRIAL REGISTRATION NUMBER ClinicalTrials.gov, NCT01456936.
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Affiliation(s)
- Belinda Daniel
- Psychiatry, University of California San Diego Health Sciences, La Jolla, California, USA
- Naval Medical Center San Diego, San Diego, California, USA
| | - David E Lawrence
- Global Biometrics and Data Management, Pfizer Inc, New York, New York, USA
| | - Benjamin S McKenna
- Psychiatry, University of California San Diego Health Sciences, La Jolla, California, USA
- Psychiatry, Veterans Affairs San Diego Healthcare System, San Diego, California, USA
| | | | - Thomas McRae
- Global Product Development, Pfizer Inc, New York, New York, USA
| | - A Eden Evins
- Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Robert M Anthenelli
- Psychiatry, University of California San Diego Health Sciences, La Jolla, California, USA
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Qasem NW, Al-Omoush BH, Altbeinat SK, Al-Dlaijem MM, Salahat RI, Okour SA. Smoking cessation rate and predictors of successful quitting in Jordan: A cross-sectional study. Medicine (Baltimore) 2024; 103:e38708. [PMID: 38968519 PMCID: PMC11224826 DOI: 10.1097/md.0000000000038708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 06/06/2024] [Indexed: 07/07/2024] Open
Abstract
Tobacco smoking in Jordan is the highest in the Middle East, with health consequences and economic burdens. Smoking cessation improves health and grows the economy. This study aimed to determine the prevalence of smoking cessation in Jordan and to identify the determinants of effective quitting. This cross-sectional study was conducted using an online survey directed towards the general population of Jordan. The questionnaire was formulated in Arabic and inquired about sociodemographic factors, health status, behaviors, smoking habits, previous quitting attempts, utilization of smoking cessation services, attitudes towards quitting, and barriers to quitting. Data were analyzed using Statistical Package for Social Science version 25. A total of 463 participants were included in this study. Twenty-one percent of them were ex-smokers (n = 97), 86% were male, 63.3% were from the middle governorates, and 29.2% were 24 years old or younger. The rate of sustained quitting for at least 3 months among participants was 13.6%. The factors associated with successful quitting included age > 50 years (P = .001), practicing regular physical activity (P = .003), using more than 1 tobacco product (P = .000), smoking waterpipes or e-cigarettes (P = .000 and .015, respectively), lower levels of nicotine dependence (P = .009), duration of smoking (P = .000), higher number of smoking cessation attempts (P = .000), having 1 or more chronic diseases (P = .049), and having DM (P = .003). More than half of the ex-smokers needed 2 to 5 attempts before successfully quitting smoking. There was a low rate of utilization of smoking cessation services and medications in both groups. On the other hand, there is a high rate of use of other smoking methods, particularly waterpipes and e-cigarettes, as an aid for quitting. Current smokers reported being in a stressful situation as a barrier to quitting significantly more often than did ex-smokers (P = .013). Both groups had moderately positive attitudes toward quitting. Ex-smokers had significantly better attitudes toward their ability to manage stress, weight gain, and increased appetite after quitting (P = .004, .004, and .007, respectively). This study provides valuable insights into the complex dynamics of smoking behavior, cessation attempts, and attitudes. These findings can inform the development of targeted smoking cessation programmes and policies.
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Affiliation(s)
- Nuha W. Qasem
- Internal Medicine and Family Medicine Department, Faculty of Medicine, Hashemite University, Zarqa, Jordan
| | - Batool H. Al-Omoush
- Internal Medicine and Family Medicine Department, Faculty of Medicine, Hashemite University, Zarqa, Jordan
| | - Sami K. Altbeinat
- Internal Medicine and Family Medicine Department, Faculty of Medicine, Hashemite University, Zarqa, Jordan
| | - Moutasem M. Al-Dlaijem
- Internal Medicine and Family Medicine Department, Faculty of Medicine, Hashemite University, Zarqa, Jordan
| | - Reham I. Salahat
- Internal Medicine and Family Medicine Department, Faculty of Medicine, Hashemite University, Zarqa, Jordan
| | - Samer A. Okour
- Internal Medicine and Family Medicine Department, Faculty of Medicine, Hashemite University, Zarqa, Jordan
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Khan AU, Shah A, Majeed MT, Ahmad S. Predictors of quitting smoking behavior: evidence from Pakistan. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024:10.1007/s11356-024-32920-y. [PMID: 38619768 DOI: 10.1007/s11356-024-32920-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 03/11/2024] [Indexed: 04/16/2024]
Abstract
This study attempts to identify factors that significantly encourage the cessation of smoking in the context of Pakistan. The study distributes a modified questionnaire among 421 respondents (current as well as former smokers) in the capital city of Pakistan, Islamabad. The binary regression method was employed to data for analyzing predictors of making quit attempts and successful smoking cessation. The result indicates that respondents having strong intentions to quit, high socioeconomic status, low nicotine dependency, and past quit attempts, and those having no-smoking friends, are more likely to quit cigarette smoking successfully. On the other hand, factors like social pressure to quit smoking, religious information against smoking, intention to quit smoking, and public regulation on smoking are more likely to encourage smokers to make quit attempts. The study calls for community and school-wide smoking cessation campaigns involving officials, peers and parents, religious leaders, and other influential individuals to inform people about the dangers of smoking. In addition, religious leaders should be encouraged to issue rulings against smoking especially during "Friday Prayer." Furthermore, the government should pronounce more strict and comprehensive regulations on smoking by properly monitoring its implementation to encourage cessation of cigarette smoking.
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Affiliation(s)
- Assad Ullah Khan
- School of Economics, Quaid-I-Azam University, Islamabad, Pakistan
| | - Anwar Shah
- School of Economics, Quaid-I-Azam University, Islamabad, Pakistan
| | | | - Sareer Ahmad
- School of Economics, Quaid-I-Azam University, Islamabad, Pakistan.
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Her W, Jung H, Sam Oh Y. Examining Predictors of Nicotine Dependence in Korean Adolescents : Comparing Ever Quitters and Never Quitters. J Psychoactive Drugs 2024; 56:264-271. [PMID: 36967576 DOI: 10.1080/02791072.2023.2184736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 01/30/2023] [Indexed: 03/29/2023]
Abstract
Despite growing research on adolescent smokers, evidence for the differences between the two smoker groups who are ever quitters and never quitters is limited. The study aimed to examine predictors of nicotine dependence (ND) in Korean adolescents by comparing ever quitters and never quitters. Data from 349 adolescents were collected through an online survey. Among respondents, most of them were male, living with families, and were enrolled at schools. Data were analyzed by dividing participants into two groups - ever quitters and never quitters. The study found that adolescents' ND was commonly predicted by smoking peers and anxiety. However, schooling status was significantly associated with ever quitters' ND only. In the total sample, never-quitters were associated with higher ND compared to ever-quitters. This study did not control for differences among ever quitters in terms of the number of attempts to quit smoking and did not significantly control age effects in the sample. Based on study results, we suggest various policy implications. Cessation intervention should be designed keeping in mind the smokers' previous quit attempts and their motivation. It is also recommended that individually tailored smoking cessation programs be used to address the heterogenous nature of the adolescents.
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Affiliation(s)
- Wonbin Her
- Department of Social Welfare, Pukyong National University, Busan, South Korea
| | - Hyejin Jung
- Department of Public Administration, Pusan National University, Busan, South Korea
| | - Young Sam Oh
- Department of Social Welfare, Pukyong National University, Busan, South Korea
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Maspero S, Delle S, Kraus L, Pogarell O, Hoch E, Bachner J, Lochbühler K. Short-term effectiveness of the national German quitline for smoking cessation: results of a randomized controlled trial. BMC Public Health 2024; 24:588. [PMID: 38395782 PMCID: PMC10893695 DOI: 10.1186/s12889-024-18104-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/14/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The objective of the present study was to examine the short-term effectiveness of the national German quitline for smoking cessation. METHODS A parallel-group, two-arm, superiority, randomized controlled trial with data collection at baseline and post-intervention (three months from baseline) was conducted. Individuals were randomized to either the intervention group, receiving up to six telephone counselling calls, or the control group, receiving an active control intervention (self-help brochure). The primary outcome was the seven-day point prevalence abstinence at post-assessment. Secondary outcomes included changes in smoking-related cognitions and coping strategies from pre- to post-assessment, the perceived effectiveness of intervention components, and the satisfaction with the intervention. RESULTS A total of n = 905 adult daily smokers were assigned to either the intervention group (n = 477) or the control group (n = 428). Intention-to-treat analyses demonstrated that individuals allocated to the telephone counselling condition were more likely to achieve seven-day point prevalence abstinence at post-assessment compared to those allocated to the self-help brochure condition (41.1% vs. 23.1%; OR = 2.3, 95% CI [1.7, 3.1]). Participants who received the allocated intervention in both study groups displayed significant improvements in smoking-related cognitions and coping strategies with the intervention group showing greater enhancements than the control group. This pattern was also found regarding the perceived effectiveness of intervention components and the satisfaction with the intervention. CONCLUSION The present study provides first empirical evidence on the short-term effectiveness of the national German quitline for smoking cessation, highlighting its potential as an effective public health intervention to reduce the burden of disease associated with smoking. TRIAL REGISTRATION This study is registered in the German Clinical Trials Register (DRKS00025343). Date of registration: 2021/06/07.
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Affiliation(s)
- Simona Maspero
- IFT Institut für Therapieforschung, Centre for Mental Health and Addiction Research, Munich, Germany
| | - Simone Delle
- IFT Institut für Therapieforschung, Centre for Mental Health and Addiction Research, Munich, Germany
| | - Ludwig Kraus
- Department of Public Health Science, Centre for Social Research On Alcohol and Drugs, Stockholm University, Stockholm, Sweden
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Centre of Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Eva Hoch
- IFT Institut für Therapieforschung, Centre for Mental Health and Addiction Research, Munich, Germany
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Joachim Bachner
- Department Health and Sport Sciences, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Kirsten Lochbühler
- IFT Institut für Therapieforschung, Centre for Mental Health and Addiction Research, Munich, Germany.
- Institute of General Practice and Family Medicine, University Hospital, LMU Munich, Munich, Germany.
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Kim S, Shiffman S, Goldenson NI. Adult smokers' Complete Switching Away from Cigarettes at 6, 9, and 12 Months after Initially Purchasing a JUUL e-Cigarette. Subst Use Misuse 2024; 59:805-815. [PMID: 38238646 DOI: 10.1080/10826084.2024.2303990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
Background: Electronic nicotine delivery systems (ENDS) have the potential to benefit public health if smokers completely switch from cigarettes to ENDS. Methods: A cohort of adult smokers (age ≥ 21) who purchased a JUUL Starter Kit was followed for 12 months after the initial purchase. We defined "switching" as past-30-day abstinence from smoking (even if JUUL use had stopped), and analyzed factors associated with achievement and maintenance of self-reported repeated point-prevalence switching (RPPS) at three follow-ups, i.e., no past-30-day smoking at months 6, 9, and 12. Results: RPPS was reported by 21.6% of the 12,537 evaluable smokers. Smokers with lighter smoking history and lower cigarette dependence at baseline were more likely to report RPPS. RPPS was also associated with daily use of JUUL (Month-3: OR = 2.32, 95% CI = 2.02-2.68; Month-6: OR = 1.73, 95% CI = 1.42-2.10), and with greater subjective reinforcing effects from JUUL use (assessed by the mCEQ, Month-3: OR = 1.46, 95% CI = 1.38-1.56; Month-6: OR = 1.11; 95% CI = 1.02-1.20). Even among smokers who did not meet the criteria of RPPS (i.e., who smoked at least once), 35.5% reported past 30-day point-prevalence switching on at least one follow-up, and their cigarette consumption was substantially reduced compared to baseline. Conclusions: Approximately one-fifth of adult smokers reported 30-day point-prevalence abstinence at 6, 9, and 12 months after purchasing JUUL. Greater use of JUUL and stronger subjective reinforcing effects were associated with nonsmoking, validating the potential for ENDS to substitute for smoking, with potential for positive impacts on individual and population health.
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Affiliation(s)
- Sooyong Kim
- PinneyAssociates, Inc., Pittsburgh, Pennsylvania, USA
| | - Saul Shiffman
- PinneyAssociates, Inc., Pittsburgh, Pennsylvania, USA
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Farran D, Abla R, Nakkash R, Abu Rmeileh N, Jawad M, Khader Y, Mostafa A, Salloum RG, Chalak A. Factors associated with intentions to quit tobacco use in Lebanon: A cross-sectional survey. Prev Med Rep 2024; 37:102572. [PMID: 38186664 PMCID: PMC10767259 DOI: 10.1016/j.pmedr.2023.102572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/16/2023] [Accepted: 12/19/2023] [Indexed: 01/09/2024] Open
Abstract
Introduction The prevalence of tobacco smoking in Lebanon is among the highest globally. This study aims to determine past attempts to quit smoking among adults and identify factors associated with intentions to quit. Methods A nationally representative telephone survey was conducted between June and August 2022. Eligibility criteria included people aged >=18 years residing in Lebanon. The questionnaire was divided into three components: socio-demographic characteristics, cigarette and waterpipe tobacco use behaviours. Binary logistic regression was used to examine factors associated with intention to quit cigarette and waterpipe tobacco use. Results A total of 2003 respondents were included in the study. The prevalence of any tobacco product use was 41%, the prevalence of current cigarette smoking was 41% and the prevalence of current waterpipe tobacco use was 20%. Approximately 24% of adults who smoke cigarettes and 26% of those who use waterpipe tobacco had previous quit attempts mainly due to health concerns. Intentions to quit smoking within the next 6 months were reported among 12% of survey respondents. Among adults who smoke, past quit attempts increased the likelihood of intentions to quit cigarette smoking by 5-fold (OR: 5.11; 95% CI: 1.80-14.47, p = 0.002) and waterpipe tobacco use by 7-fold (OR: 6.98, 95% CI: 2.63-18.51, p = <0.001). Age and income were associated with intentions to quit cigarette but not waterpipe tobacco use. Conclusion Intention to quit smoking was strongly associated with past quitting attempts. Understanding factors associated with intentions to quit can help inform the development of context specific smoking cessation interventions.
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Affiliation(s)
- Dina Farran
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Ruba Abla
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Lebanon
| | - Rima Nakkash
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Lebanon
- Global and Community Health Department, George Mason University, VA, USA
| | - Niveen Abu Rmeileh
- Institute of Community and Public Health, Birzeit University, Birzeit, Palestine
| | - Mohammed Jawad
- Public Health Policy Evaluation Unit, Imperial College London School of Public Health, London, UK
| | - Yousef Khader
- Department of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Aya Mostafa
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ramzi G. Salloum
- Department of Health Outcomes & Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL, USA
| | - Ali Chalak
- Department of Agriculture, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
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Kale D, Tattan-Birch H, Brown J, Cox S, Dawkins L, Goniewicz ML, Morris K, Shahab L. Examining acute psychopharmacological effects of nicotine vaping versus heated tobacco products in a randomised crossover study of product naïve adult smokers. Sci Rep 2023; 13:22676. [PMID: 38114686 PMCID: PMC10730620 DOI: 10.1038/s41598-023-49602-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 12/10/2023] [Indexed: 12/21/2023] Open
Abstract
Nicotine vaping products (NVPs) and heated tobacco products (HTPs) are designed to replicate the sensory and behavioural aspects of smoking cigarettes while avoiding combustion. The success of these products as harm reduction tools will partially depend on their ability to satisfy smokers and alleviate nicotine-related withdrawal symptoms. This study aims to compare short-term effects of NVPs (Juul and Aspire PockeX) versus HTPs (IQOS) on smoking-related withdrawal relief, product satisfaction, intention to switch to NVP/HTP, perceptions and attitudes in UK adult cigarette smokers naïve to these products. In a randomized cross-over study, 45 participants visited the lab twice, at each visit trying one of the two products (NVP/HTP) and completing a questionnaire. Responses were normalized on a 0-100% scale and mean differences (MD) between NVP and HTP scores computed, with positive and negative MD values indicating greater endorsement for NVP and HTP, respectively. Cigarette cravings were reduced similarly (~ 20.0%) by both products (MD = 4.5%, 95%Confidence Interval (CI) - 4.8, 13.8). Direct positive effects (MD = - 3.5%, 95%CI - 7.2, 0.2) and adverse side effects (MD = 1.8%, 95%CI - 0.3, 3.8) were comparable after each product use, though marginally favouring HTPs. HTPs were perceived as more satisfying overall (MD = - 13.2%, 95%CI - 20.3 - 6.1) than NVPs but both were perceived as similarly addictive (MD = 3.6%, 95%CI - 4.6, 11.8), relative to cigarettes. Intention to switch to either product was comparable (MD = 4.0%, 95%CI - 5.7, 13.8). Comparison of acute use of NVP versus HTP in a sample of UK smokers naïve to these products suggests that HTPs are perceived as more satisfying than NVPs, though still less satisfying than cigarettes.Registration: The analysis plan was pre-registered, and it is available at https://osf.io/6ymdu.
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Affiliation(s)
- Dimitra Kale
- Department of Behavioural Science and Health, University College London, London, UK.
- SPECTRUM Consortium, London, UK.
| | - Harry Tattan-Birch
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, London, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, London, UK
| | - Sharon Cox
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, London, UK
| | - Lynne Dawkins
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, London, UK
| | - Maciej L Goniewicz
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Kierra Morris
- Department of Behavioural Science and Health, University College London, London, UK
| | - Lion Shahab
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, London, UK
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Kang W. Age and mental health moderate the association between environmental concern (EC) and smoking frequency: smoking as a polluting behavior. Front Public Health 2023; 11:1089148. [PMID: 37860793 PMCID: PMC10582950 DOI: 10.3389/fpubh.2023.1089148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 08/31/2023] [Indexed: 10/21/2023] Open
Abstract
It is well-recognized that smoking is detrimental to the environment. However, much less is understood about smoking behavior from an environmental perspective with a focus on environmental concern (EC). This study aims to establish the association between EC and smoking frequency in smokers and test whether age and mental health moderate such an association. Obtained by analyzing data using regressions on smokers (N = 3,599) from Understanding Society: the UK Household Longitudinal Study (UKHLS), which is a representative sample in the UK, the results revealed that age and mental health moderate the association between EC and smoking frequency. This association is important to understand because smoking pollutes the environment, and very few studies have looked at smoking behavior from an environmental perspective.
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Affiliation(s)
- Weixi Kang
- Department of Brain Sciences, Imperial College London, London, United Kingdom
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Nguyen TNP, Love J, Hunsberger M, Tran TPT, Nguyen TL, Phan TH, Luong NK, Hoang VM, Ng N. Individual-, social- and policy- factors associated with smoking cessation among adult male cigarette smokers in Hanoi, Vietnam: a longitudinal study. BMC Public Health 2023; 23:1883. [PMID: 37770890 PMCID: PMC10540420 DOI: 10.1186/s12889-023-16781-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 09/18/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Nearly one-in-two Vietnamese men smoke cigarettes placing them among the highest tobacco consumers in the world. Despite the need for smoking cessation to curb the burden of tobacco-related diseases in Vietnam, this rate remains at less than 30%. Therefore, this study examines individual-, social- and policy factors associated with smoking cessation among adult male smokers in Vietnam. METHODS We established a longitudinal International Tobacco Control study of male smokers in Hanoi, Vietnam, in September 2018. This paper analyses 1525 men who participated in baseline and one-year follow-up. We applied a weighted multivariable logistic regression to examine the association between smoking cessation and individual-, social- and policy predictors. RESULTS At follow-up, 14.8% of participants had quit smoking for at least 30 consecutive days during the last year. Among the persistent smokers, 56.6% expressed intention to quit smoking. Factors associated with smoking cessation included a lower number of cigarettes smoked per day (aOR = 0.96, 95% CI: 0.94, 0.99) and having several attempts to quit smoking (aOR = 2.16, 95% CI 1.13, 4.12). Intention to quit smoking was associated with multiple quit attempts, a chronic condition diagnosis, more tobacco-related knowledge, greater self-efficacy, and more worries about their future health. The perceived impact of smoke-free policy and health warning labels were positively associated with intention to quit at any stage. CONCLUSIONS Interventions aimed at increasing smoking cessation should focus on all aspects of individual, social, and policy factors. Persistent smokers are more motivated to quit if they have made multiple quit attempts, more self-efficacy of quitting and worried about their future health, indicating that increasing smokers' beliefs and knowledge may be important for behavioural change. Health warning labels and tobacco taxation policies should be maintained and promoted as they are perceived to be particularly useful for persistent smokers' intention to quit.
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Affiliation(s)
- Thi Ngoc Phuong Nguyen
- School of Public Health & Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 41390, Gothenburg, Sweden.
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam.
| | - Jesper Love
- School of Public Health & Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 41390, Gothenburg, Sweden
| | - Monica Hunsberger
- School of Public Health & Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 41390, Gothenburg, Sweden
| | - Thi Phuong Thao Tran
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | | | | | | | - Van Minh Hoang
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Nawi Ng
- School of Public Health & Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 41390, Gothenburg, Sweden
- Department of Epidemiology and Global Health, Faculty of Medicine, Umea University, Umea, Sweden
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Alalwan MA, Keller-Hamilton B, Long L, Lipkus I, Wagener TL, Mays D. Correlates of motivation to quit waterpipe tobacco smoking among US young adults: implications for cessation interventions. HEALTH EDUCATION RESEARCH 2023; 38:338-349. [PMID: 36880171 PMCID: PMC10558042 DOI: 10.1093/her/cyad010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 02/06/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
Waterpipe tobacco smoking is a public health concern that poses many of the same health risks as cigarette smoking, especially among young adults-a subpopulation characterized by the highest prevalence of waterpipe tobacco smoking. Nevertheless, it remains understudied relative to other forms of tobacco use. We examined sociodemographic, behavioral and cognitive factors associated with young adults' motivation to quit waterpipe smoking using a theory-informed approach. We completed a secondary analysis of baseline data on waterpipe tobacco smoking beliefs and behavior collected from 349 US young adults aged 18-30 years. We analyzed sociodemographics, tobacco use and cessation behaviors and perceptions, and theory-related constructs associated with motivation to quit waterpipe tobacco smoking using linear regression. Overall, participants reported low motivation (mean = 2.68, SD = 1.56, scale range 1-7) and high self-efficacy (mean = 5.12, SD = 1.79) to quit waterpipe tobacco smoking. In multivariable analysis, prior quit attempts (β = 1.10, P < 0.01), greater perceived risks of waterpipe tobacco smoking (β = 0.42, P < 0.01) and increasingly negative attitudes toward waterpipe tobacco smoking (β = 0.29, P < 0.01) were associated with higher motivation to quit. These findings highlight the importance of those factors as potential cessation determinants. These findings can help guide the development and refinement of interventions targeting young adult waterpipe tobacco smoking.
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Affiliation(s)
- Mahmood A Alalwan
- Division of Epidemiology, College of Public Health, The Ohio State University, 1841 Neil Ave., Columbus, OH 43210, USA
| | - Brittney Keller-Hamilton
- Department of Internal Medicine, Wexner Medical Center, Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, 3650 Olentangy River Road, Suite 410/420, Columbus, OH 43214, USA
| | - Lauren Long
- Department of Internal Medicine, Wexner Medical Center, Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, 3650 Olentangy River Road, Suite 410/420, Columbus, OH 43214, USA
| | - Isaac Lipkus
- Duke University School of Nursing, 307 Trent Dr., Durham, NC 27710, USA
| | - Theodore L Wagener
- Department of Internal Medicine, Wexner Medical Center, Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, 3650 Olentangy River Road, Suite 410/420, Columbus, OH 43214, USA
| | - Darren Mays
- Department of Internal Medicine, Wexner Medical Center, Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, 3650 Olentangy River Road, Suite 410/420, Columbus, OH 43214, USA
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12
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Goyal M, Khokhar A, Lukhmana S, Debnath A, Srivastava N. Willingness to Quit and Associated Factors Among Tobacco Users Attending Outpatient Departments of a Tertiary Care Hospital in Delhi, India. ADDICTION & HEALTH 2023; 15:192-201. [PMID: 38026724 PMCID: PMC10658099 DOI: 10.34172/ahj.2023.1444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/15/2023] [Indexed: 12/01/2023]
Abstract
Background Tobacco use has become a modern-day epidemic which significantly impacts health, socioeconomic status, and environmental sustainability. The readiness to quit or stop using tobacco is a crucial first step in changing one's behavior. Hence, the current study sought to assess the prevalence of willingness to quit and associated factors among tobacco users. Methods This study was conducted on 425 tobacco users selected using multi-stage random sampling from the outpatient departments (OPDs) of a tertiary care hospital in Delhi, India. A pre-designed, interviewer-administered questionnaire was used to elicit information. Logistic regression was performed to assess the effect of independent factors on the willingness to quit. Findings The mean age of the study participants was 39.37 years (S.D.=±12.99). The majority of the participants were male (400, 94.1%), and 25 (6.9%) were female. Overall, the prevalence of willingness to quit in the current study was 70% among the study participants. The results of the multivariable analysis showed that those belonging to urban areas, tobacco users with a duration of≤10 years, and those who received advice from a doctor to quit had a significantly higher willingness to quit than their counterparts. However, age, gender, marital status, education, religion, age of initiation of tobacco use, and nicotine dependence were not found to have a statistically significant relationship with the willingness to quit tobacco products. Conclusion Willingness to quit was high among the study participants. The data in this study suggested that belonging to urban areas, duration of tobacco use, and doctor's advice to quit are important factors which need to be considered when framing future tobacco cessation programs.
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Affiliation(s)
- Mohit Goyal
- Department of Community Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, Delhi-110029, India
| | - Anita Khokhar
- Department of Community Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, Delhi-110029, India
| | - Shveta Lukhmana
- Department of Community Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, Delhi-110029, India
| | - Aninda Debnath
- Department of Community Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, Delhi-110029, India
| | - Namita Srivastava
- Department of Community Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, Delhi-110029, India
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Bold K, O’Malley S, Krishnan-Sarin S, Morean M. E-cigarette Use Patterns, Flavors, and Device Characteristics Associated With Quitting Smoking Among a U.S. sample of Adults Using E-cigarettes in a Smoking Cessation Attempt. Nicotine Tob Res 2023; 25:954-961. [PMID: 36462196 PMCID: PMC10077943 DOI: 10.1093/ntr/ntac276] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 11/03/2022] [Accepted: 11/30/2022] [Indexed: 12/05/2022]
Abstract
INTRODUCTION Many adults who smoke cigarettes use e-cigarettes to try to quit smoking; however, some are not successful. Identifying factors that are associated with successfully quitting smoking using e-cigarettes is important for maximizing cigarette cessation. AIMS AND METHODS Online survey data were collected in 2021 from 857 adults in the United States who reported using e-cigarettes in a recent attempt to quit smoking. Survey items assessed patterns of e-cigarette use and device characteristics (flavors, device, and nicotine) used when trying to quit smoking. Multivariable linear regression models examined characteristics associated with the longest duration of smoking abstinence when using e-cigarettes to try to quit. RESULTS The average duration of smoking abstinence when using e-cigarettes during a quit attempt was 65 days (SD = 104). In the multivariable model, greater frequency of e-cigarette use when quitting and abruptly switching to e-cigarettes from cigarettes (vs. gradually reducing) were significantly associated with longer durations of abstinence (p < .001). Preference for non-tobacco (relative to tobacco) flavors and nicotine concentration were not associated with duration of abstinence, although preference for rechargeable pod and mod device types (vs. cig-a-likes) was associated with longer durations of abstinence. CONCLUSIONS Patterns of e-cigarette use were related to abstinence duration, which may provide guidance for adults who are using e-cigarettes to quit smoking to encourage complete substitution and maximize smoking cessation. Findings indicate that non-tobacco e-cigarette flavors and nicotine strength are not related to longer durations of cessation success for adults, which may inform tobacco regulatory policies limiting these constituents to protect public health. IMPLICATIONS This study provides important new information about the characteristics of e-cigarettes used during an attempt to quit smoking among adults across the United States and identifies factors associated with quitting success. Patterns of e-cigarette use were associated with longer durations of abstinence. In contrast, few e-cigarette characteristics were associated with abstinence. Although preference for some pod and mod device types was associated with longer abstinence duration compared to earlier cig-a-like devices, preference for non-tobacco (vs. tobacco) flavor and nicotine concentration were not associated with abstinence. Findings may help inform guidance for adults using e-cigarettes to quit smoking and support tobacco regulatory policies.
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Affiliation(s)
- Krysten Bold
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Yale Cancer Center, New Haven, CT, USA
| | | | | | - Meghan Morean
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
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14
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Guo Y, Liu DY, Wang YJ, Huang MJ, Jiang N, Hou Q, Feng B, Wu WY, Wu YB, Qi F, Sun XY. Family functioning and nicotine dependence among smoking fathers: a cross-sectional study. BMC Public Health 2023; 23:658. [PMID: 37024859 PMCID: PMC10080741 DOI: 10.1186/s12889-023-15475-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 03/20/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND Nicotine dependence is a significant public health issue, and understanding the factors associated with nicotine dependence in this population is crucial for developing effective interventions. This study examined the association between family functioning and nicotine dependence levels of smoking fathers based on the McMaster model of family functioning (MMFF), providing evidence for future interventions. METHODS In this study, we selected fathers of first- to fifth-grade students from 10 pilot elementary schools in Qingdao whose families smoked. We used the Fagerstrom test to assess nicotine dependence and the Family Assessment Device to evaluate family functioning. We performed univariate analysis to compare differences among those with different levels of nicotine dependence, and we used an ordinal logistic regression analysis to investigate the influences related to nicotine dependence. RESULTS This study included 874 smokers, with 78.5% having mild nicotine dependence, 11.7% having moderate dependence, and 9.84% having severe dependence. Univariate analysis showed that smokers with severe dependence had lower education levels, higher prevalence of chronic diseases, more frequent alcohol consumption, and poorer family functioning compared to those with mild to moderate dependence. Ordinal logistic regression analysis showed that poorer general functioning scores (OR = 1.087, 95% CI: 1.008-1.173, P = 0.030), poorer behavioral control (OR = 1.124, 95% CI: 1.026-1.232, P = 0.012), more quit attempts, frequent alcohol consumption, and longer smoking duration may be associated with a higher likelihood of developing severe nicotine dependence. The older age of starting smoking and higher education level may be associated with a lower likelihood of developing severe nicotine dependence. However, it is important to note that the cross-sectional nature of this study precludes the determination of causal relationships. CONCLUSIONS This study finds that heavy nicotine dependence in smoking fathers is associated with risky behaviors and demographics such as longer smoking duration and frequent alcohol consumption. Targeted smoking cessation interventions are crucial for this group, taking these specific factors into consideration. Family functioning, particularly general functioning and behavioral control, may also be linked to nicotine dependence, indicating the need for further research in this area.
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Affiliation(s)
- Yi Guo
- School of Public Health, Peking University, Beijing, China
| | - Di-Yue Liu
- International School of Public Health and One Health, Hainan Medical University, Haikou, China
| | - Yu-Jia Wang
- College of Humanities and Social Sciences, Harbin Medical University, Heilongjiang, China
| | - Meng-Jie Huang
- School of Public Health, Shandong University, Jinan, China
| | - Nan Jiang
- School of Public Health, Qingdao University, Qingdao, China
| | - Qiang Hou
- College of Medical Sciences, Shanxi Medical University, Shanxi, China
| | - Bojunhao Feng
- School of Medicine, Macau University of Science and Technology, Macao, China
| | - Wen-Yu Wu
- School of Health Management, Harbin Medical University, Heilongjiang, China
| | - Yi-Bo Wu
- School of Public Health, Peking University, Beijing, China
| | - Fei Qi
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
| | - Xin-Ying Sun
- School of Public Health, Peking University, Beijing, China.
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Abstract
PURPOSE OF REVIEW Tobacco use is associated with significant health consequences especially for people with medical conditions. Although lifestyle strategies (e.g., sleep, diet) are commonly recommended as part of migraine treatment, tobacco-related strategies (e.g., smoking cessation) are rarely included. This review is aimed at elucidating what is known about tobacco use and migraine and at identifying gaps in the research. RECENT FINDINGS The prevalence of smoking is higher among people with migraine, and people with migraine believe that smoking makes migraine attacks worse. There is also evidence that smoking may exacerbate migraine-related consequences (e.g., stroke). Very few studies have examined other aspects of smoking and migraine or tobacco products other than cigarettes. There are significant gaps in our knowledge of smoking and migraine. More research is needed to understand the relationship of tobacco use to migraine and potential benefits of adding smoking cessation efforts into migraine care.
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16
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Sæbø G, Lund KE. Indexing Quit-Smoking Interest among Norwegian Smokers 2019-2021. J Smok Cessat 2023; 2023:9536270. [PMID: 36814442 PMCID: PMC9940954 DOI: 10.1155/2023/9536270] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 12/20/2022] [Accepted: 01/12/2023] [Indexed: 02/16/2023] Open
Abstract
Even if smoking prevalence is declining in several western countries, continued smoking cessation is required to reduce tobacco-related harms and to achieve future goals of smoke-free societies or the tobacco endgame. But how many of the current smokers want to quit? Estimates vary and depend on the type of question asked. We investigate how a pooled sample of Norwegian smokers (N = 1321) is distributed over four indicators of interest in quitting: (i) degree of desire to quit, (ii) prediction of future smoking status, (iii) reported plan for quitting smoking, and (iv) statements on previous attempts to quit. Based on these variables, we constructed an index. One-third of the smokers (32.6%) was categorized as having a high or very high interest in quitting. However, nearly half of the smokers (47.8%) had low or very low interest in quitting. Like several other countries, Norway has legislated a vision of a smoke-free society and, under the government's plans; this goal will be achieved by intensified use of structural measures such as tax hikes, tighter restrictions on outdoor smoking, and reduced availability of cigarettes. For the third who want to quit smoking, such constraints on their behaviour may help them to pursue their desire to quit. However, for the half who want to continue smoking, these measures may not be helpful but instead be experienced as a loss of welfare, less freedom to act, and increased social disqualification.
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Affiliation(s)
- Gunnar Sæbø
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, PO Box 222, 0213 Skøyen, Oslo, Norway
| | - Karl Erik Lund
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, PO Box 222, 0213 Skøyen, Oslo, Norway
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17
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Lee SH, Han DH, Seo DC. Toward a better understanding of adult dual use of cigarettes and e-cigarettes based on use intensity and reasons for dual use. Addict Behav 2023; 137:107517. [PMID: 36228363 DOI: 10.1016/j.addbeh.2022.107517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/30/2022] [Accepted: 10/02/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Dual use of combustible cigarettes and e-cigarettes is an emerging phenomenon among U.S. adults. Literature suggests two primary reasons for this emerging use (i.e., to help quit smoking and to stealth vape). This study investigated user profiles based on use intensity and the reasons for dual use. METHODS A total of 1,151 U.S. adult dual users were drawn from the 2018-2019 Tobacco Use Supplement to the Current Population Survey. We divided them into four groups: daily dual users (n = 189), predominant smokers (n = 608), predominant vapers (n = 143), and non-daily dual users (n = 211). We performed weighted multivariable logistic regressions to identify factors associated with the two primary reasons for dual use. RESULTS 3 in 10 of U.S. adult dual users used e-cigarettes to help quit smoking while 2 in 10 of U.S. adult dual users used e-cigarettes to stealth vape. Compared to daily dual users, predominant smokers [adjusted odds ratio (AOR) = 0.61, 95% CI = 0.23, 0.62] were less likely to use e-cigarettes to help quit smoking whereas predominant vapers (AOR = 1.80, 95% CI = 1.04, 3.13) were more likely to use e-cigarettes to help quit smoking and less likely to use e-cigarettes to stealth vape (AOR = 0.30, 95% CI = 0.10, 0.89). CONCLUSIONS There was notable heterogeneity among the four groups of dual users. As the landscape of tobacco use is rapidly changing with an increasing popularity of e-cigarettes, reasons as well as behaviors of dual users need to be regularly monitored for effective tobacco control.
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Affiliation(s)
- Shin Hyung Lee
- Department of Applied Health Science, Indiana University School of Public Health, Bloomington, IN, USA
| | - Dae-Hee Han
- University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Dong-Chul Seo
- Department of Applied Health Science, Indiana University School of Public Health, Bloomington, IN, USA.
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18
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Gautam P, Kalan ME, Li W, Taleb ZB, Vargas-Rivera M, Jebai R, Osibogun O, Maziak W. The Effects of Pictorial Health Warning Label on Waterpipe (Low- and High-Frequency) Smokers' Experiences, Toxicant Exposures, and Puffing Behavior. Int J Behav Med 2023; 30:146-153. [PMID: 35260948 PMCID: PMC10127153 DOI: 10.1007/s12529-022-10074-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Pictorial health warning label (PHWL) is an effective risk communication measure among cigarette smokers. However, there is a lack of knowledge regarding the effect of PHWL on low- and high-frequency waterpipe (WP) smokers. This study examined the effects of PHWL on puffing behavior, subjective experiences, and toxicant exposures among low- and high-frequency WP smokers in the United States (US). METHODS Sixty current (past-month) WP smokers (low-frequency; n = 30 and high-frequency; n = 30) completed two 45-min ad libitum WP smoking sessions in a cross-over design study (WP with no-PHWL vs. WP with PHWL). We compared the mean differences of puff topography, expired carbon monoxide (eCO), plasma nicotine concentration, and subjective experiences between the two smoking groups. RESULTS Mean age of low-frequency smokers was 21.5 years and high-frequency smokers was 21.3 years. Compared to high-frequency, low-frequency smokers had significant reduction in average total smoking time [mean difference (SD) = -7.6 (10.2) min vs. -2.6 (6.7) min, p = 0.03] and number of puffs [mean difference (SD) = -33.37 (70.7) vs. -0.70 (29.2), p = 0.02] following exposure to PHWL compared to no-PHWL condition. Post-session subjective experiences were lower among high-frequency smokers compared to low-frequency smokers following smoking WP with PHWL compared to the no-PHWL session (puff liking -1.2 vs. -0.5; puff satisfaction -1.0 vs. -0.3; craving reduction -0.5 vs. 1.2) (p < 0.05 for all). CONCLUSION Our findings indicate that placing PHWL on the WP device may be a promising strategy with differential effectiveness among WP smokers: low-frequency (reduce puffing behaviors) and high-frequency (reduce smoking experience).
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Affiliation(s)
- Prem Gautam
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, 1240 S.W. 108 AVE, Path, University Park, Miami, FL, 33174, USA
| | - Mohammad Ebrahimi Kalan
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Wei Li
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, 1240 S.W. 108 AVE, Path, University Park, Miami, FL, 33174, USA
| | - Ziyad Ben Taleb
- Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, USA
| | - Mayra Vargas-Rivera
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, 1240 S.W. 108 AVE, Path, University Park, Miami, FL, 33174, USA
| | - Rime Jebai
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, 1240 S.W. 108 AVE, Path, University Park, Miami, FL, 33174, USA
| | - Olatokunbo Osibogun
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, 1240 S.W. 108 AVE, Path, University Park, Miami, FL, 33174, USA
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, 1240 S.W. 108 AVE, Path, University Park, Miami, FL, 33174, USA. .,Syrian Center for Tobacco Studies, Tishreen Street, P.O.Box: 16542, Sheehan, Aleppo, Syria.
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Albasheer O, Alhazmi AH, Alharbi A, Makeen AM, Alqassim AY, Al-Musawa HI, Alabah AE, Alhazmi AK, Khormi NA, Hamzi YA, Sharhah EYA, Salami RM, Alshareef M, Suwaydi H, Elkhobby A. Effectiveness and determinants of smoking cessation in the Saudi Arabian Region of Jazan: A cross-sectional study. Tob Induc Dis 2023; 21:06. [PMID: 36721860 PMCID: PMC9865635 DOI: 10.18332/tid/156842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 10/27/2022] [Accepted: 11/23/2022] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Smoking cessation has significant health benefits. The purpose of this study is to assess the efficacy and related factors of smoking cessation therapies in the Jazan Region of Saudi Arabia. METHODS This is a cross-sectional study that took place at smoking cessation clinics in primary healthcare centers between January 2019 and January 2020. RESULTS This study enrolled a total of 103 people. The success rate for quitting smoking was 36% at three months, with a 13% relapse rate at six months. Age (p=0.017), occupation (p=0.046), daily cigarette intake (p=0.015), and number of visits (p=0.001) were all found to be significant determinants of smoking cessation. In the multivariate analysis, only the number of visits increased the likelihood to quit smoking (AOR=0.31; 95% CI: 0.15-0.63). Self-efficacy was cited as the primary reason for quitting smoking by 71% of the participants, whereas family support, smoking cessation therapies, and friends' support were cited as predictive variables by 18%, 10%, and 1% of the participants, respectively. CONCLUSIONS Smokers who received the smoking cessation intervention package were three times more likely to succeed in giving up smoking when compared to those who received the routine service. Regular follow-up during smoking cessation interventions significantly enhanced the quit rate. It is recommended that pharmacotherapy strategies and intense therapy performed face-to-face with a cessation counselor be combined to improve the quit rate.
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Affiliation(s)
- Osama Albasheer
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan City, Saudi Arabia
| | - Abdulaziz H. Alhazmi
- Emerging and Epidemic Infectious Diseases Research Unit, Medical Research Center, Jazan University, Jazan City, Saudi Arabia,Microbiology and Parasitology Department, College of Medicine, Jazan University, Jazan City, Saudi Arabia
| | - Abdullah Alharbi
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan City, Saudi Arabia
| | - Anwar M. Makeen
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan City, Saudi Arabia
| | - Ahmad Y. Alqassim
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan City, Saudi Arabia
| | | | - Amjad E. Alabah
- Faculty of Medicine, Jazan University, Jazan City, Saudi Arabia
| | | | - Nawaf A. Khormi
- Faculty of Medicine, Jazan University, Jazan City, Saudi Arabia
| | - Yazeed A. Hamzi
- Faculty of Medicine, Jazan University, Jazan City, Saudi Arabia
| | | | | | - Mohammed Alshareef
- Family Medicine and Primary Health Care, Ministry of Health, Jazan City, Saudi Arabia
| | - Hassan Suwaydi
- Family Medicine and Primary Health Care, Ministry of Health, Jazan City, Saudi Arabia
| | - Ahmed Elkhobby
- Family Medicine and Primary Health Care, Ministry of Health, Jazan City, Saudi Arabia
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20
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Krishnan N, Berg CJ, Elmi A, Klemperer EM, Sherman SE, Abroms LC. Predictors of electronic nicotine product quit attempts and cessation: Analysis of waves 3 and 4 of the PATH study. Addict Behav 2022; 134:107419. [PMID: 35810644 DOI: 10.1016/j.addbeh.2022.107419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/17/2022] [Accepted: 06/28/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Identifying theory-based predictors of electronic nicotine product (ENP) quit attempts and cessation can guide the development of effective vaping cessation interventions, which are currently limited. This study examined predictors of ENP quit attempts and cessation among adult ENP users. METHODS Using data from wave 3 (W3; 2015-2016) current established ENP users in the Population Assessment of Tobacco and Health study, we used multivariable logistic regression to identify predictors of (i) wave 4 (W4; 2016-2018) quit attempts (unweighted n = 1,135); and (ii) W4 cessation among those who made a quit attempt (unweighted n = 610). Predictors included Social Cognitive Theory (SCT)-based cognitive (interest in quitting, self-efficacy to quit, outcome expectancies, risk perception), behavioral (smoking status, and use of combustibles, non-combustibles, cannabis, and alcohol), and socio-environmental (perceived disapproval, household rules, exposure to advertising) factors. RESULTS Between W3 and W4, 51.7% of W3 ENP users made a quit attempt. Among those who tried quitting, 68.4% stopped using ENPs. SCT-based predictors of ENP quit attempts included higher interest in quitting ENPs (aOR = 1.18), greater self-efficacy to quit ENPs (aOR = 1.31), and currently using cigarettes (vs non-smoker; aOR = 1.71), non-combustibles (aOR = 2.25), and cannabis (aOR = 1.80). Predictors of ENP cessation included greater self-efficacy to quit ENPs (aOR = 1.33), greater perceived risk of ENPs (aOR = 1.35), and being a current smoker (vs non-smoker; aOR = 3.28). CONCLUSIONS ENP cessation interventions should address cognitive factors, particularly self-efficacy, as it predicted quit attempts and cessation. Cigarette smoking among dual users should be monitored and addressed to ensure that those who quit using ENPs do not maintain cigarette use.
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Affiliation(s)
- Nandita Krishnan
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Angelo Elmi
- Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Elias M Klemperer
- Vermont Center on Behavior & Health, Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Scott E Sherman
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Lorien C Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
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21
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Avila JC, Berg CJ, Robinson JD, Ahluwalia JS. Short- and Long-Term Cigarette and Tobacco Abstinence Among Daily and Nondaily Older Smokers. Nicotine Tob Res 2022; 24:1773-1780. [PMID: 35511741 PMCID: PMC9597074 DOI: 10.1093/ntr/ntac116] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 04/05/2022] [Accepted: 04/27/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION There is mixed evidence regarding whether older (vs. younger) smokers are more or less likely to quit smoking. We examined how age is associated with cigarette and all tobacco product abstinence and the potential moderating effects of smoking frequency. AIMS AND METHODS Data from a 4-year cohort of the Population Assessment of Tobacco and Health (PATH) study were used, including 7512 smokers at Wave 1 who had smoking status data at Wave 4. Logistic regression models were used to examine the effects of age (18-24, 25-34, 35-44, 45-54, and ≥55 years) on Wave 4, 30-day and 12-month cigarette and all tobacco product abstinence, adjusting for covariates and the interaction between age and cigarette use frequency (nondaily, light daily, and heavy daily). RESULTS Older smokers (≥55 years) were more likely to be heavy daily smokers than younger smokers 18-24 and 25-34 years, but were less likely to have a past-year cigarette quit attempt. Younger smokers 45-54 years were less likely to report 12-month cigarette abstinence than older smokers (odds ratio = 0.72 [0.54-0.95]). Younger smokers 18-24 and 45-54 years were less likely to report 12-month tobacco product abstinence than older smokers (odds ratio = 0.65 [0.45-0.93]; odds ratio = 0.73 [0.55-0.96], respectively). Thirty-day cigarette abstinence significantly decreased as age increased for nondaily smokers, significantly increased for heavier daily smokers, but remained similar across age for light daily smokers. CONCLUSIONS Older smokers were more likely to report 12-month cigarette and tobacco abstinence than younger smokers 45-54 years old, and the effect of age on abstinence differed by smoking frequency/intensity. Smoking cessation interventions need to be age specific and consider smoking frequency. IMPLICATIONS This study shows that although older smokers are more likely to be heavy smokers and less likely to have a quit attempt at baseline, they are more likely to have 12-month cigarette and tobacco abstinence than younger smokers. Furthermore, 30-day cigarette abstinence significantly decreases as age increases for nondaily smokers and significantly increases for heavy daily smokers, suggesting that the effect of cigarette smoking frequency and intensity changes with age. Smoking cessation interventions need to be age specific as well as consider the smoking frequency/intensity of each age group. Younger smokers may need more targeted cessation interventions to successfully quit.
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Affiliation(s)
- Jaqueline C Avila
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Jason D Robinson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jasjit S Ahluwalia
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
- Department of Medicine, Brown University Alpert Medical School, Providence, RI, USA
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22
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Jackson MA, Buykx P, Brown AL, Baker AL, Dunlop AJ, Gould GS. Using mixed methods to establish tobacco treatment acceptability from the perspective of clients and clinicians of antenatal substance use services. Addict Sci Clin Pract 2022; 17:56. [PMID: 36195932 PMCID: PMC9531520 DOI: 10.1186/s13722-022-00337-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 09/12/2022] [Indexed: 11/29/2022] Open
Abstract
Background Up to 95% of pregnant women with alcohol and other drug (AOD) problems also smoke tobacco. Challenging psychosocial circumstances and a lack of targeted tobacco interventions contribute to low rates of prenatal abstinence and more effective treatment strategies are required. This study explores smoking in pregnant clients of AOD treatment services from a consumer and healthcare provider perspective to examine characteristics of behaviour change and the acceptability of evidence-based tobacco treatment strategies. Outcomes will support the design and implementation of a comprehensive tobacco intervention. Methods A mixed methods triangulated design was used. Thirteen women who smoked and attended antenatal AOD services in New South Wales, Australia, were interviewed and 28 clinicians from the same services were surveyed. Domains including experiences of tobacco smoking in pregnancy, motivators and barriers to cessation and evidence-based strategies to assist cessation during pregnancy were explored. Interviews were analysed using Iterative Categorization, with interpretation guided by Qualitative Description. Online surveys were analysed descriptively. A convergent-parallel mixed methods analysis was performed. Results Women and clinicians agreed that improving baby’s health outcomes was the primary motivation to stop smoking. Negative experiences with nicotine replacement therapy (NRT), financial constraints and maternal contraindications restricted its uptake and effectiveness during pregnancy. Both groups agreed that other AOD use, stopping multiple substances concurrently, difficulty coping with stress and the influence of partners who smoke had the biggest impacts on cessation efforts. Clinicians favoured harm-reduction rather than abstinence-based tobacco interventions and women appeared satisfied with reduction efforts. Both views may influence the attainment of prenatal abstinence-based goals. Although previous evidence suggested the contrary, clinicians were willing to encourage simultaneous cessation of tobacco and other substances. Non-judgmental treatment approaches that provide extra support, education and motivation were important for women. Women and clinicians supported use of NRT despite concerns. Financial incentives, counselling, partner support and offering tobacco treatment with antenatal AOD care were considered acceptable treatment options. Conclusions NRT, incentives, counselling and partner support could be utilized in a tobacco intervention for pregnant women with substance use concerns. Non-judgmental education, motivation, and provision of NRT including instruction for correct use are important considerations. Supplementary Information The online version contains supplementary material available at 10.1186/s13722-022-00337-y.
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Affiliation(s)
- Melissa A Jackson
- Hunter New England Local Health District Drug and Alcohol Clinical Services, Level 3, 670 Hunter Street, Newcastle, NSW, 2290, Australia.
| | - Penny Buykx
- School of Humanities, Creative Industries and Social Sciences, University of Newcastle, Callaghan, NSW, Australia
| | - Amanda L Brown
- Hunter New England Local Health District Drug and Alcohol Clinical Services, Level 3, 670 Hunter Street, Newcastle, NSW, 2290, Australia
| | - Amanda L Baker
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Adrian J Dunlop
- Hunter New England Local Health District Drug and Alcohol Clinical Services, Level 3, 670 Hunter Street, Newcastle, NSW, 2290, Australia
| | - Gillian S Gould
- Faculty of Health, Southern Cross University, Lismore, NSW, Australia
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Gallegos-Carrillo K, Barrientos-Gutiérrez I, Arillo-Santillán E, Rodríguez-Bolaños R, Cruz-Jiménez L, Desirée VP, Cho YJ, Thrasher JF. Transitions between tobacco products: Correlates of changes in cigarette smoking and e-cigarette use among exclusive adult smokers and dual users in Mexico. Prev Med Rep 2022; 29:101869. [PMID: 35911576 PMCID: PMC9326312 DOI: 10.1016/j.pmedr.2022.101869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 06/24/2022] [Indexed: 11/05/2022] Open
Abstract
This study examined transitions in tobacco products use among Mexican smokers and dual users. Data were analyzed from exclusive smokers (n = 2,946) and dual users (n = 1,643) recruited from an online consumer research panel and surveyed every-four months from November 2018 to April 2021. For exclusive smokers, estimated transitions were (time "t + 1" four months after prior survey): a) remain as exclusive smokers; b) dual use; c) exclusive e-cigarette use or quit both products. Among dual users, transitions analyzed were: a) remain as dual user; b) exclusive smoker; c) exclusive e-cigarette user or quit both products. Multinomial models regressed transitions at "t + 1" on time "t" for control variables. Most exclusive smokers (81%) remained as such, 12.6% transitioned to dual use, 2.3% to exclusive e-cigarette use, and 4% quitted both products. Exclusive smokers were more likely to transition to dual use if they recently attempted to quit (AOR = 1.45) or had partners/family or friends who used e-cigarettes (AOR = 2.47 & 2.56 respectively). Most dual users (74.8%) remained as dual users, 20.4% transitioned to exclusive smoking, 1.6% transitioned to exclusive e-cigarette use, and 3.2% quitted both products. Dual users were more likely to transition to exclusive smoking if they had lower educational attainment, recently attempted to quit e-cigarettes (AOR = 1.70). Having friends who use e-cigarettes (AOR = 0.29) and higher smoking dependence (AOR = 0.55) were associated with a lower likelihood of quitting. Recent quit attempts and e-cigarette use among close social network members may explain the short-term transitions, though longer follow-up is needed to assess sustained smoking cessation.
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Affiliation(s)
- Katia Gallegos-Carrillo
- Epidemiology and Health Services Research Unit, Morelos, Mexican Institute of Social Security, Mexico
- Evaluation and Surveys Research Center, National Institute of Public Health, Cuernavaca, Mexico
| | | | - Edna Arillo-Santillán
- Tobacco Research Department, National Institute of Public Health, Cuernavaca, Mexico
| | | | - Lizeth Cruz-Jiménez
- Evaluation and Surveys Research Center, National Institute of Public Health, Cuernavaca, Mexico
| | - Vidaña-Pérez Desirée
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - Yoo Jin Cho
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - James F. Thrasher
- Tobacco Research Department, National Institute of Public Health, Cuernavaca, Mexico
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA
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24
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Han M, Seo D, Kim Y, Seo HG, Cho SI, Lee S, Lim S, Kaai SC, Quah ACK, Yan M, Xu SS, Fong GT. Factors Associated with Quit Intentions among Adult Smokers in South Korea: Findings from the 2020 ITC Korea Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10839. [PMID: 36078553 PMCID: PMC9518068 DOI: 10.3390/ijerph191710839] [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: 07/22/2022] [Revised: 08/24/2022] [Accepted: 08/24/2022] [Indexed: 06/15/2023]
Abstract
Background: South Korea has made substantial progress on tobacco control, but cigarette smoking prevalence is still high. Previous studies were conducted before the use of nicotine vaping products (NVPs) or heated tobacco products (HTPs) became popular. Thus, whether the concurrent use of NVPs or HTPs affects quit intentions among Korean smokers remains a question that needs to be explored. This study aims to identify predictors of quit intentions among cigarette-only smokers and concurrent users of cigarettes and NVPs or HTPs. Methods: Data were from the 2020 International Tobacco Control Korea Survey. Included in the analysis were 3778 adult cigarette smokers: 1900 at-least-weekly exclusive smokers and 1878 at-least-weekly concurrent smokers and HTP or NVP users. Bivariate and multivariable logistic regression analyses were conducted. Results: Quit intentions were reported by 66.4% of respondents. Factors significantly associated with quit intentions included younger age, having a spouse/partner, lower nicotine dependence, reporting a past quit attempt, regretting starting smoking, believing that smoking had damaged health, worrying that smoking will damage future health, and perceiving health benefits of quitting. Current use of NVPs or HTPs was not significantly associated with quit intentions. Conclusions: This study contributes the following to current literature: intrinsic health-related beliefs were more important than societal norms in shaping quit intentions. These findings should be considered in shaping future smoking cessation policies, such as reinforcing education programs that emphasize the benefits of quitting for personal health reasons, lowering nicotine dependence, and encouraging multiple quit attempts and successful quitting.
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Affiliation(s)
- Minjung Han
- Department of Family Medicine, Myongji Hospital, Goyang 10475, Korea
| | - Donghee Seo
- Department of Family Medicine, National Cancer Center, Goyang 10408, Korea
| | - Yeol Kim
- Department of Family Medicine, National Cancer Center, Goyang 10408, Korea
- Department of Cancer Control, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea
| | - Hong Gwan Seo
- Department of Family Medicine, National Cancer Center, Goyang 10408, Korea
- Department of Cancer Control, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea
| | - Sung-il Cho
- Graduate School of Public Health, Seoul National University, Seoul 08826, Korea
| | - Sungkyu Lee
- Korea Center for Tobacco Control Research and Education, Seoul 04554, Korea
| | - Sujin Lim
- National Tobacco Control Center, Korean Health Promotion Institute, Seoul 04933, Korea
| | - Susan C. Kaai
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Anne C. K. Quah
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Mi Yan
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Steve S. Xu
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
- Ontario Institute for Cancer Research, Toronto, ON M5G 0A3, Canada
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25
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Quadri MFA, John T, Kaur D, Nayeem M, Ahmed MK, Kamel AM, Tadakamadla SK, Caponio VCA, Muzio LL. Poor implementation of tobacco control measures and lack of education influences the intention to quit tobacco: a structural equation modelling approach. BMC Public Health 2022; 22:1199. [PMID: 35705940 PMCID: PMC9202196 DOI: 10.1186/s12889-022-13565-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 06/01/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Tobacco consumption remains a public health issue and is one of the major causes of death in India. This study presents a validated conceptual model to assess the interaction between education, perceived application of tobacco control measures, type of tobacco and their effects on the intention to quit tobacco. Additionally, the direct and mediating roles of tobacco use -frequency, -duration, and -dependency on the intention to quit is also investigated. METHODS An analytical cross-sectional study was carried out, and data from tobacco users of six randomly selected states in India was collected via face-to-face interviews. Structural equation modeling (SEM) was performed using R v 3.6.3 to test the model fit and to explore the association between tobacco control measures and the intention to quit tobacco. RESULTS From 1962 tobacco users, 43.7% wanted to quit tobacco immediately. Tambakoo (57.7%) was the most common type of tobacco used and 68.9% said that minors could buy tobacco. Findings from SEM showed that that one standard deviation (SD) increase in the perceived application of tobacco control measures is directly associated with a 0.181 SD increase in the intention to quit tobacco (B = 0.181, P < 0.001), and this effect was partially mediated by frequency of tobacco consumption (B = 0.06, P < 0.05). Also, a better education level was associated with a higher intention to quit tobacco (B = 0.14, P < 0.001). CONCLUSIONS To conclude, the application of tobacco control measures and a better education level may positively affect the intention to quit tobacco. The frequency of tobacco use and the number of influencers play an essential role in deciding to quit. In future, longitudinal studies are recommended to further substantiate the evidence.
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Affiliation(s)
- Mir Faeq Ali Quadri
- Department of Preventive Dental Sciences, Dental Public Health, Jazan University, PO Box: 114, 45142 Jazan, Saudi Arabia
| | - Tenny John
- Department of Maxillofacial Surgery and Diagnostic Sciences, Jazan University, 45142 Jazan, Saudi Arabia
| | - Damanpreet Kaur
- Department Oral Medicine and Radiology, BJS Dental College and Hospital, Ludhiana, India
| | - Maryam Nayeem
- Department of Pharmacology, Jazan University, 45142 Jazan, Saudi Arabia
| | | | - Ahmed M. Kamel
- Clinical Pharmacy and Pharmacy Practice Department, Cairo University, Cairo, Egypt
| | - Santosh Kumar Tadakamadla
- School of Medicine and Dentistry & Menzies Health Institute Queensland, Griffith University, QLD Gold Coast, Australia
| | | | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
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26
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Akinola LS, Rahman Y, Ondo O, Gonzales J, Bagdas D, Jackson A, Davidson-Wert N, Damaj MI. Genotypic Differences in the Effects of Menthol on Nicotine Intake and Preference in Mice. Front Neurosci 2022; 16:905330. [PMID: 35769694 PMCID: PMC9234577 DOI: 10.3389/fnins.2022.905330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 05/17/2022] [Indexed: 11/13/2022] Open
Abstract
Menthol has been shown to exacerbate elements of nicotine addiction in humans and rodents; however, the mechanisms mediating its effects are not fully understood. This study examined the impact of genetic factors in menthol’s effects on oral nicotine consumption by comparing two inbred mouse strains with differing sensitivities to nicotine. C57BL/6J (B6J) mice are nicotine-preferring, while DBA/2J (D2J) mice are not. While the effects of menthol on oral nicotine consumption have been highlighted in B6J mice, it is unknown if they extend to the D2J strain as well. Consequently, adolescent (PND 21) and adult (PND 63), male and female D2J mice were subjected to the nicotine two-bottle choice (2BC) paradigm with orally and systemically administered menthol. Then, we evaluated its impact on nicotine pharmacological responses in conditioned reward and nociception after systemic administration and, lastly, investigated the potential involvement of the TAAR1 gene and α7 nAChRs in menthol’s effects. Menthol failed to enhance oral nicotine consumption in adult and adolescent female and male D2J mice. Moreover, this lack in effect was not due to nicotine concentration, oral aversion to menthol, or basal preference for nicotine. Menthol also failed to augment nicotine reward or enhance nicotine-induced antinociception in D2J mice, demonstrating that genetic background plays a significant role in sensitivity to menthol’s effects on nicotine. Furthermore, TAAR1 or α7 nAChRs did not seem to mediate menthol’s differential effects in D2J mice. These findings support the existence of genotype-specific mechanisms that may contribute to the variable effects of menthol in different populations.
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Affiliation(s)
- Lois S. Akinola
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA, United States
- *Correspondence: Lois S. Akinola,
| | - Yumna Rahman
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA, United States
| | - Olivia Ondo
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA, United States
| | - Jada Gonzales
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA, United States
| | - Deniz Bagdas
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, United States
- Yale Tobacco Center of Regulatory Science, Yale School of Medicine, New Haven, CT, United States
| | - Asti Jackson
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, United States
- Yale Tobacco Center of Regulatory Science, Yale School of Medicine, New Haven, CT, United States
| | - Nicole Davidson-Wert
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA, United States
| | - M. Imad Damaj
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA, United States
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27
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Tran TPT, Park J, Nguyen TNP, Hoang VM, Lim MK. Association between perceived harm of tobacco and intention to quit: a cross-sectional analysis of the Vietnam Global Adult Tobacco Survey. BMC Public Health 2022; 22:909. [PMID: 35524326 PMCID: PMC9077992 DOI: 10.1186/s12889-022-13348-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 04/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Perception of harm plays an important role in predicting intention to quit-an integral part of the cessation process. Perception on harm from bamboo waterpipe tobacco was unknown, even the predominant of this type of tobacco use. This study investigated the effects of perceived harm from cigarette and bamboo waterpipe tobacco on intention to quit among adult male Vietnamese tobacco users. METHODS From the nationally-representative 2015 Global Adult Tobacco Survey, we included 1,351 adult males (≥ 18 years old) who used cigarettes, bamboo waterpipes, or both. Demographic characteristics, tobacco use behaviors, perceived harm from tobacco use, and regulation/policy exposure were measured. Effects of perceived harm from cigarette and bamboo waterpipe tobacco on intention to quit were assessed by logistic regression. RESULTS Intention to quit prevalence was 59.0%, 55.0%, and 58.4% for cigarette, waterpipe, and dual users, respectively. Tobacco users who perceived that "using cigarettes and/or waterpipe could cause severe illness" and "waterpipe use is less harmful than cigarette smoking", had tobacco use bans at home, or were exposed to anti-smoking campaigns or encouragement to quit information were more likely to intend to quit. When analyzed by tobacco users, intention to quit was more likely for those users who perceived their tobacco product as more harmful than the other product type, although statistical significance was only observed for cigarette users. CONCLUSIONS Misperceptions regarding harm from tobacco use could negatively affect intention to quit. Dissemination of accurate information on the risks from all forms of tobacco use and enforcement of tobacco control policies are important for encouraging intention to quit.
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Affiliation(s)
- Thi Phuong Thao Tran
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, 323 Ilsan-ro Ilsandong-gu, Goyang-si, Gyeounggi-do, 410-769, Republic of Korea
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Jinju Park
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, 323 Ilsan-ro Ilsandong-gu, Goyang-si, Gyeounggi-do, 410-769, Republic of Korea
| | - Thi Ngoc Phuong Nguyen
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Van Minh Hoang
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Min Kyung Lim
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, 323 Ilsan-ro Ilsandong-gu, Goyang-si, Gyeounggi-do, 410-769, Republic of Korea.
- College of Medicine, Inha University, 100 Inha-ro, Michuhol-gu, Incheon, 22212, Republic of Korea.
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28
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Hoang LT, Tuyet Hanh TT, Khue LN, Hai PT, Can PV, Long KQ, Linh NT, Anh DT, Van Minh H. Intention to Quit and Predictive Factors Among Current Smokers in Vietnam: Findings From Adult Tobacco Survey 2020. Tob Use Insights 2022; 15:1179173X221098460. [PMID: 35510034 PMCID: PMC9058567 DOI: 10.1177/1179173x221098460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/16/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Smoking leads to many smoking-attributable diseases. The promotion of quitting tobacco smoking is urgent as it has significant and immediate health benefits and improves the impacts of other tobacco control strategies. Intention to quit smoking is considered the first step before quitting smoking. METHODOLOGY This paper used data from Vietnam provincial GATS 2020 on 80,166 participants who were 15-year-old or older. Data were collected from 34 provinces and cities throughout Vietnam and managed using REDCap. RESULTS Among those who were current smokers, 50.3% (95% CI: 49.1%–51.4%) had the intention to quit smoking. Some predictive factors found to be positively associated with the intention to quit smoking were age (from 45-64), education level, received information about harmful effects or encouragement to quit smoking from media channels (from 6 channels), hearing about the Tobacco Control Law and noticing health warnings on the cigarette package. There was no significant difference in intention to quit smoking between current smokers from urban and rural areas or among different age groups to start smoking. CONCLUSIONS Interventions or health promotion programs on smoking cessation should be focused on current smokers who have low education levels as they have a higher smoking rate and are less motivated to stop smoking. Received information about harmful effects or encouragement to quit smoking from media channels is also associated with stopping smoking in the future. The importance of health warning pictures on tobacco packages should be maintained and promoted as it has a specific effect on one’s intention to stop smoking.
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Affiliation(s)
- Le T Hoang
- Hanoi University of Public Health, North Tu Liem, Hanoi, Vietnam
| | | | - Luong N Khue
- Department of Medical Service Administration, Ministry of Health, Hanoi, Vietnam
| | - Phan T Hai
- Department of Medical Service Administration, Ministry of Health, Hanoi, Vietnam
| | - Phan V Can
- Hanoi University of Public Health, North Tu Liem, Hanoi, Vietnam
| | - Khuong Q Long
- Hanoi University of Public Health, North Tu Liem, Hanoi, Vietnam
| | - Nguyen T Linh
- Department of Medical Service Administration, Ministry of Health, Hanoi, Vietnam
| | - Duong T Anh
- Department of Medical Service Administration, Ministry of Health, Hanoi, Vietnam
| | - Hoang Van Minh
- Hanoi University of Public Health, North Tu Liem, Hanoi, Vietnam
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He L, Basar E, Wiers RW, Antheunis ML, Krahmer E. Can chatbots help to motivate smoking cessation? A study on the effectiveness of motivational interviewing on engagement and therapeutic alliance. BMC Public Health 2022; 22:726. [PMID: 35413887 PMCID: PMC9003955 DOI: 10.1186/s12889-022-13115-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 03/25/2022] [Indexed: 12/30/2022] Open
Abstract
Background Cigarette smoking poses a major threat to public health. While cessation support provided by healthcare professionals is effective, its use remains low. Chatbots have the potential to serve as a useful addition. The objective of this study is to explore the possibility of using a motivational interviewing style chatbot to enhance engagement, therapeutic alliance, and perceived empathy in the context of smoking cessation. Methods A preregistered web-based experiment was conducted in which smokers (n = 153) were randomly assigned to either the motivational interviewing (MI)-style chatbot condition (n = 78) or the neutral chatbot condition (n = 75) and interacted with the chatbot in two sessions. In the assessment session, typical intake questions in smoking cessation interventions were administered by the chatbot, such as smoking history, nicotine dependence level, and intention to quit. In the feedback session, the chatbot provided personalized normative feedback and discussed with participants potential reasons to quit. Engagement with the chatbot, therapeutic alliance, and perceived empathy were the primary outcomes and were assessed after both sessions. Secondary outcomes were motivation to quit and perceived communication competence and were assessed after the two sessions. Results No significant effects of the experimental manipulation (MI-style or neutral chatbot) were found on engagement, therapeutic alliance, or perceived empathy. A significant increase in therapeutic alliance over two sessions emerged in both conditions, with participants reporting significantly increased motivation to quit. The chatbot was perceived as highly competent, and communication competence was positively associated with engagement, therapeutic alliance, and perceived empathy. Conclusion The results of this preregistered study suggest that talking with a chatbot about smoking cessation can help to motivate smokers to quit and that the effect of conversation has the potential to build up over time. We did not find support for an extra motivating effect of the MI-style chatbot, for which we discuss possible reasons. These findings highlight the promise of using chatbots to motivate smoking cessation. Implications for future research are discussed.
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Affiliation(s)
- Linwei He
- Department of Communication and Cognition, Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, the Netherlands.
| | - Erkan Basar
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, the Netherlands
| | - Reinout W Wiers
- Addiction Development and Psychopathology (ADAPT)-Lab, Department of Psychology, and Centre for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands
| | - Marjolijn L Antheunis
- Department of Communication and Cognition, Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, the Netherlands
| | - Emiel Krahmer
- Department of Communication and Cognition, Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, the Netherlands
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Feldman K, Amaral LMD, Ronzani TM, Richter KP, Machado NM. Vaping, perceptions of vaping, and plans to quit among e-cigarette users in the United States and the United Kingdom. Nicotine Tob Res 2022; 24:1504-1508. [PMID: 35380698 DOI: 10.1093/ntr/ntac092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 02/24/2022] [Accepted: 03/31/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Government and health organizations in the US and the UK have taken different stances on e-cigarettes policy. To explore the potential effects of these policies we describe e-cigarette user characteristics, intentions to quit, and perceived attitudes toward vaping. METHODS We used the online crowdsourcing platform Prolific to conduct a cross-sectional survey of current vapers in both countries. Measures were drawn from international surveys. RESULTS The sample included 1044 vapers (524 UK; 520 US) with a mean age of 34. Samples differed by gender (US: 57% male versus 45% in UK), race (US: 79% White versus 90% in UK) and employment (US: 73% employed versus 79% in UK). UK respondents were more likely than US respondents to be ever smokers (89% vs 71%, p<.0001); be daily vapers (69% vs 53%, p<.0001) and to use e-cigarettes to quit smoking (75% vs 65%, p=.0007). Most vapers in the UK and the US want to stop vaping (62% vs 61%; p=.9493), but US respondents plan to quit significantly sooner (OR 0.47, p=.0004). Attitudes differed as well. Over half (56%) of UK respondents reported their government approved e-cigarette use, and 24% felt health care providers had positive views on e-cigarettes versus 29% and 13% from the US, respectively (p=.0004 for both). CONCLUSIONS Plans for quitting and perceptions regarding e-cigarettes differ markedly between demographically similar groups of vapers in the two countries. Future research should determine whether e-cigarette cessation for adults should be a public health goal, and if so, identify effective ways to stop. IMPLICATIONS The contribution of this study is that it describes differences in behaviors and attitudes of vapers recruited through the same research platform and adjusted to account for minor demographic differences across country samples. For clinicians, these findings suggest that most vapers would welcome assistance in quitting. For researchers and policymakers, findings suggest that government policy regarding nicotine devices might influence behaviors and attitudes related to use, and also that future research is needed to determine effective ways to quit.
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Affiliation(s)
- Keith Feldman
- Department of Pediatrics, Children's Mercy Kansas City, MO, USA
| | - Ligia Menezes do Amaral
- Medical Clinic Department, Universidade Federal de Juiz de Fora, Campus Universitário, Rua Jose Lourenco Kelmer, s/n - São Pedro, Juiz de Fora, MG, Brazil
| | - Telmo Mota Ronzani
- Department of Psychology, Universidade Federal de Juiz de Fora, Campus Universitário, Rua Jose Lourenco Kelmer, s/n - São Pedro, Juiz de Fora, MG, Brazil
| | - Kimber P Richter
- Department of Population Health, University of Kansas Medical Center, USA
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“Quit Cold Turkey”: Effects of a Quit-and-Win Smoking Cessation Challenge Offered at Christmas on Abstinence, Daily Cigarette Intake, and Cravings. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00780-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Hasan SI, Kaai SC, Amer Nordin AS, Mohd Hairi F, Danaee M, Yee A, Ahmad Tajuddin NA, Kamaludin IS, Grey M, Yan M, Driezen P, Thompson ME, Quah ACK, Fong GT. Who Are More Likely to Have Quit Intentions among Malaysian Adult Smokers? Findings from the 2020 ITC Malaysia Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3035. [PMID: 35270727 PMCID: PMC8910535 DOI: 10.3390/ijerph19053035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/16/2022] [Accepted: 02/23/2022] [Indexed: 11/17/2022]
Abstract
Increasing quitting among smokers is essential to reduce the population burden of smoking-related diseases. Smokers' intentions to quit smoking are among the strongest predictors of future quit attempts. It is therefore important to understand factors associated with intentions to quit, and this is particularly important in low- and middle-income countries, where there have been few studies on quit intentions. The present study was conducted to identify factors associated with quit intentions among smokers in Malaysia. Data came from the 2020 International Tobacco Control (ITC) Malaysia Survey, a self-administered online survey of 1047 adult (18+) Malaysian smokers. Smokers who reported that they planned to quit smoking in the next month, within the next six months, or sometime beyond six months were classified as having intentions to quit smoking. Factors associated with quit intentions were examined by using multivariable logistic regression. Most smokers (85.2%) intended to quit smoking. Smokers were more likely to have quit intentions if they were of Malay ethnicity vs. other ethnicities (adjusted odds ratio (AOR) = 1.82, 95% confidence interval (CI) = 1.03-3.20), of moderate (AOR = 2.11, 95% CI = 1.12-3.99) or high level of education vs. low level of education (AOR = 1.97, 95% CI = 1.04-3.75), if they had ever tried to quit smoking vs. no quit attempt (AOR = 8.81, 95% CI = 5.09-15.27), if they received advice to quit from a healthcare provider vs. not receiving any quit advice (AOR = 3.78, 95% CI = 1.62-8.83), and if they reported worrying about future health because of smoking (AOR = 3.11, 95% CI = 1.35-7.15 (a little worried/moderately worried vs. not worried); AOR = 7.35, 95% CI = 2.47-21.83 (very worried vs. not worried)). The factors associated with intentions to quit smoking among Malaysian smokers were consistent with those identified in other countries. A better understanding of the factors influencing intentions to quit can strengthen existing cessation programs and guide the development of more effective smoking-cessation programs in Malaysia.
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Affiliation(s)
- Siti Idayu Hasan
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur 50603, Malaysia; (S.I.H.); (F.M.H.); (M.D.); (A.Y.); (N.A.A.T.); (I.S.K.)
| | - Susan C. Kaai
- Department of Psychology, University of Waterloo, 200 University Ave. W., Waterloo, ON N2L 3G1, Canada; (S.C.K.); (M.G.); (M.Y.); (P.D.); (A.C.K.Q.); (G.T.F.)
- School of Public Health Sciences, University of Waterloo, 200 University Ave. W., Waterloo, ON N2L 3G1, Canada
| | - Amer Siddiq Amer Nordin
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur 50603, Malaysia; (S.I.H.); (F.M.H.); (M.D.); (A.Y.); (N.A.A.T.); (I.S.K.)
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Farizah Mohd Hairi
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur 50603, Malaysia; (S.I.H.); (F.M.H.); (M.D.); (A.Y.); (N.A.A.T.); (I.S.K.)
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Mahmoud Danaee
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur 50603, Malaysia; (S.I.H.); (F.M.H.); (M.D.); (A.Y.); (N.A.A.T.); (I.S.K.)
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Anne Yee
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur 50603, Malaysia; (S.I.H.); (F.M.H.); (M.D.); (A.Y.); (N.A.A.T.); (I.S.K.)
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Nur Amani Ahmad Tajuddin
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur 50603, Malaysia; (S.I.H.); (F.M.H.); (M.D.); (A.Y.); (N.A.A.T.); (I.S.K.)
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Ina Sharyn Kamaludin
- Nicotine Addiction Research Group, University of Malaya Centre of Addiction Sciences, University of Malaya, Kuala Lumpur 50603, Malaysia; (S.I.H.); (F.M.H.); (M.D.); (A.Y.); (N.A.A.T.); (I.S.K.)
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Matt Grey
- Department of Psychology, University of Waterloo, 200 University Ave. W., Waterloo, ON N2L 3G1, Canada; (S.C.K.); (M.G.); (M.Y.); (P.D.); (A.C.K.Q.); (G.T.F.)
| | - Mi Yan
- Department of Psychology, University of Waterloo, 200 University Ave. W., Waterloo, ON N2L 3G1, Canada; (S.C.K.); (M.G.); (M.Y.); (P.D.); (A.C.K.Q.); (G.T.F.)
| | - Pete Driezen
- Department of Psychology, University of Waterloo, 200 University Ave. W., Waterloo, ON N2L 3G1, Canada; (S.C.K.); (M.G.); (M.Y.); (P.D.); (A.C.K.Q.); (G.T.F.)
- School of Public Health Sciences, University of Waterloo, 200 University Ave. W., Waterloo, ON N2L 3G1, Canada
| | - Mary E. Thompson
- Department of Statistics and Actuarial Sciences, University of Waterloo, 200 University Ave. W., Waterloo, ON N2L 3G1, Canada;
| | - Anne C. K. Quah
- Department of Psychology, University of Waterloo, 200 University Ave. W., Waterloo, ON N2L 3G1, Canada; (S.C.K.); (M.G.); (M.Y.); (P.D.); (A.C.K.Q.); (G.T.F.)
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, 200 University Ave. W., Waterloo, ON N2L 3G1, Canada; (S.C.K.); (M.G.); (M.Y.); (P.D.); (A.C.K.Q.); (G.T.F.)
- School of Public Health Sciences, University of Waterloo, 200 University Ave. W., Waterloo, ON N2L 3G1, Canada
- Ontario Institute for Cancer Research, 661 University Ave., Suite 510, Toronto, ON M5G 0A3, Canada
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Alalwan MA, Singer JM, Roberts ME. Factors Associated with Quit Interest and Quit Attempts among Young Adult JUUL Users. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031403. [PMID: 35162426 PMCID: PMC8835240 DOI: 10.3390/ijerph19031403] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 01/24/2022] [Indexed: 02/01/2023]
Abstract
Despite reports suggesting young people are interested in quitting e-cigarettes, little work has examined predictors of quit outcomes. This study aimed to identify factors associated with quit outcomes among JUUL e-cigarette users in a longitudinal sample of young adults. We assessed undergraduate past-30-day JUUL users during autumn 2018 (N = 225); Our outcomes included short-term quit attempts and interest (spring 2019), and long-term quit attempts (spring 2020). We used logistic regression to examine the associations between our outcomes and JUUL use characteristics, other tobacco use, and sociodemographic factors. Findings indicated 76% of users were interested in quitting JUUL, and more than 40% reported a quit attempt. Quit outcomes were not related to sociodemographics. Short-term quit outcomes were more likely among freshmen and less likely among recent cigarillo users. Heavy JUUL users were more likely to report short- and long-term quit attempts, but JUUL device owners were less likely to report short- and long-term quit attempts. Higher nicotine dependence reduced the likelihood of a long-term quit attempt. There is a need for policy level actions that address tobacco control among this population. Findings suggest a range of unique factors that can inform such policies and programs to curb young adult e-cigarette use.
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Affiliation(s)
- Mahmood A. Alalwan
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH 43210, USA
- Correspondence:
| | - Jill M. Singer
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH 43210, USA; (J.M.S.); (M.E.R.)
| | - Megan E. Roberts
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH 43210, USA; (J.M.S.); (M.E.R.)
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The relationship between working hours and the intention to quit smoking in male office workers: data from the 7th Korean National Health and Nutrition Examination Survey (2016-2017). Ann Occup Environ Med 2021; 33:e13. [PMID: 34754474 PMCID: PMC8203838 DOI: 10.35371/aoem.2021.33.e13] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 04/21/2021] [Indexed: 12/28/2022] Open
Abstract
Background The intention to quit smoking is one of the most important factors in smoking cessation. Long working hours is also a constant issue, and many studies have shown an association between the working hours and diseases, including cardiovascular and gastrointestinal diseases. This study evaluated the relationship between working hours and the intention to quit smoking among Korean male office workers, and blue collar workers for comparison. Methods This study was based on the Seventh Korea National Health and Nutrition Examination Survey (2016–2017). A total of 1,389 male workers were smokers, and then office workers and blue collar workers were selected. Logistic regression was used to calculate the odds ratio (OR) for the intention to quit smoking according to smoking-related characteristics and working hours after adjusting for age group, body mass index (kg/m2), marital status, household income (quartile), educational level, drinking, exercise, smoking-related characteristics (smoking initiation age, smoking amount, and attempt to quit smoking more than 1day in the past year) and working hours. Results The percentage of workers who had the intention to quit smoking in 6 months was higher in office workers (38.9% for office workers and 29.4% for blue collars, p = 0.017). Blue collar workers had higher percentages of workers who worked more than 52 hours per week (19.8% for office workers and 38.9% for blue collar workers, p < 0.001). Logistic regression analysis showed that working > 52 hours per week was significantly associated with a lower intention to quit smoking within 6 months among male office workers (OR = 0.30, 95% confidence interval = 0.14–0.66). Conclusions Working more than 52 hours per week was positively related with a lower intention to quit smoking among currently smoking male office workers. Further studies are needed considering more work-related variables such as job stress and physical load.
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Lin H, Chen M, Yun Q, Zhang L, Chang C. Tobacco dependence affects determinants related to quitting intention and behaviour. Sci Rep 2021; 11:20202. [PMID: 34642382 PMCID: PMC8511040 DOI: 10.1038/s41598-021-99766-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 09/23/2021] [Indexed: 11/09/2022] Open
Abstract
This study uses protection motivation theory (PMT) to examine the quitting intentions and behaviours of smokers who have varying levels of nicotine dependence. Our goals are to identify the psychological factors that influence smoking cessation and to provide valuable evidence to promote theory-guided interventions. This is a cross-sectional study that was conducted from July to August 2020. Participants were randomly selected on the streets of 26 provinces on mainland China. Data were collected via face-to-face interviews. Our analysis was conducted in three steps. First, we employed descriptive statistics to present the overall characteristics of our sample. Second, we analysed the association between PMT constructs and quitting intentions stratified by nicotine dependence. Third, we tested how quitting intentions were associated with quitting behaviours in each subgroup using logistic regression models. For intention, almost all the PMT constructs were significantly associated with quitting intention in the low-dependence group. For the moderate- and high-dependence groups, only perceived vulnerability (coefficient = 0.35, P = 0.04) was positively associated with quitting intention. For behaviour, we found a stronger association between quitting intention and behaviour in the low-dependence group (Coef. = 1.67, P = 0.00) than for the other groups. We found a significant association between e-cigarette use and quitting behaviour only in the low-dependence group (Coef. = 1.34, P = 0.00). Coefficients for the moderate- and high-dependence groups were not statistically significant. Smokers at various levels of nicotine dependence have different psychological factors that influence their intentions to stop smoking. Quitting intention was more significantly associated with quitting behaviour for the low nicotine-dependence group than for the other groups. More convincing research is necessary to determine how e-cigarette use affects quitting behaviour in the long term.
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Affiliation(s)
- Haoxiang Lin
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, 38 Xueyuan Rd, Haidian District, Beijing, China
| | - Meijun Chen
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, 38 Xueyuan Rd, Haidian District, Beijing, China
| | - Qingping Yun
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, 38 Xueyuan Rd, Haidian District, Beijing, China
| | - Lanchao Zhang
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, 38 Xueyuan Rd, Haidian District, Beijing, China
| | - Chun Chang
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, 38 Xueyuan Rd, Haidian District, Beijing, China.
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Mak YW, Loke AY, Leung DYP. Acceptance and Commitment Therapy versus Social Support for Smoking Cessation for People with Schizophrenia: A Randomised Controlled Trial. J Clin Med 2021; 10:4304. [PMID: 34640321 PMCID: PMC8509331 DOI: 10.3390/jcm10194304] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/25/2021] [Accepted: 09/14/2021] [Indexed: 11/16/2022] Open
Abstract
Smoking is prevalent among people with schizophrenia. It has been found that Acceptance and commitment therapy (ACT) is effective for treating psychotic symptoms and addictive behaviours, but the therapy has not been modified to help individuals with schizophrenia to quit smoking. A randomised controlled trial was conducted with the objective of comparing a 10-week, individual, face-to-face ACT programme (n = 65) to a social support programme on smoking cessation, experiential avoidance, and emotion-regulation strategies among people with schizophrenia who smoke (n = 65). The primary outcome was self-reported smoking abstinence for 7 days at 6 months after the start of the intervention. Secondary outcomes were self-reported and biochemically validated quit rates post-intervention. The Avoidance and Inflexibility Scale (AIS), Acceptance and Action Questionnaire II (AAQII), and Emotion Regulation Questionnaire (ERQ) were employed. The self-reported quit rates in the ACT group were higher than in the social support group, although no significant differences were found (6 months: 12.3% vs. 7.7%, p = 0.56, 12 months: 10.8% vs. 7.7%, p = 0.76). We found significantly greater improvements in smoking-specific and ACT-specific experiential avoidance and less reliance on emotion regulation strategies in the ACT group at some time points. Overall, ACT is better than social support at enhancing experiential avoidance and reducing reliance on emotion regulation strategies in adults with schizophrenia who smoke. However, ACT did not produce a much better result than social support in helping them to completely quit smoking.
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Affiliation(s)
- Yim-Wah Mak
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China; (A.-Y.L.); (D.Y.P.L.)
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Arancini L, Borland R, Le Grande M, Mohebbi M, Dodd S, Dean OM, Berk M, McNeill A, Fong GT, Cummings KM. Age as a predictor of quit attempts and quit success in smoking cessation: findings from the International Tobacco Control Four-Country survey (2002-14). Addiction 2021; 116:2509-2520. [PMID: 33651412 PMCID: PMC8328881 DOI: 10.1111/add.15454] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 09/28/2020] [Accepted: 02/10/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS Past research has found that young smokers are more likely to make quit attempts; however, there are conflicting findings regarding age and quit success. This study examined the degree to which smoker age is related to making quit attempts and quit success. DESIGN Ten waves of the International Tobacco Control Policy Cohort survey (ITC-4C) collected between 2002 and 2014, with nine wave-to-wave transitions with predictors at the first wave predicting quit attempts and success by the next wave. SETTING Canada, the United States, the United Kingdom and Australia. PARTICIPANTS Data from 15 874 smokers categorized into four age groups at baseline (18-24, 25-39, 40-54 and 55+ years). MEASUREMENTS Age, quit attempts and success (defined as ≥ 30 days abstinence confirmed, if possible, on a third wave for recent attempts). FINDINGS Older smokers were more likely to smoke daily (χ2 = 1557.86, r = 0.136, P < 0.001) than younger smokers. Daily smokers were less likely to report quit attempts (38.1 versus 58.2%) and to achieve 30 days of abstinence (22.9 versus 34.3%) than non-daily smokers. Older daily smokers were less likely to make quit attempts [0.61, confidence interval (CI) = 0.54-0.70, P < 0.001], even after controlling for indicators of nicotine dependence, country, sex, education, income, relationship status and household composition, than younger smokers. Younger smokers (< 25) were more likely to succeed for at least 30 days of abstinence, but only when compared with those aged 40-54 (OR = 0.83, 95% CI = 0.68-0.99). However, when controlling for heaviness of smoking the age effect disappeared. Significant interactions with age were found between age and intention when predicting quit attempts, and age and heaviness of smoking when predicting quit success. CONCLUSIONS An international cohort study indicates that young smokers are more likely to attempt to quit and appear to have similar levels of success in abstaining from smoking compared with older smokers when controlling for dependence. Quit success in all ages is most predicted by lower levels of nicotine dependence.
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Affiliation(s)
- Lauren Arancini
- IMPACT Strategic Research Centre, Deakin University, Geelong, VIC, Australia
| | - Ron Borland
- Centre for Behaviour Change, The University of Melbourne, School of Psychological Sciences, Parkville, VIC, Australia
| | - Michael Le Grande
- Centre for Behaviour Change, The University of Melbourne, School of Psychological Sciences, Parkville, VIC, Australia
| | - Mohammadreza Mohebbi
- Biostatistics Unit, Faculty of Health, Deakin University, Burwood, VIC, Australia
| | - Seetal Dodd
- IMPACT Strategic Research Centre, Deakin University, Geelong, VIC, Australia
- University Hospital Geelong, Barwon Health, Geelong, VIC, Australia
- Department of Psychiatry, the University of Melbourne, Parkville, VIC, Australia
- Orygen, the National Centre for Excellence in Youth Mental Health, Parkville, VIC, Australia
| | - Olivia M Dean
- IMPACT Strategic Research Centre, Deakin University, Geelong, VIC, Australia
- University Hospital Geelong, Barwon Health, Geelong, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
| | - Michael Berk
- IMPACT Strategic Research Centre, Deakin University, Geelong, VIC, Australia
- University Hospital Geelong, Barwon Health, Geelong, VIC, Australia
- Department of Psychiatry, the University of Melbourne, Parkville, VIC, Australia
- Orygen, the National Centre for Excellence in Youth Mental Health, Parkville, VIC, Australia
- Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
| | - Ann McNeill
- King's College London, London, England, UK
- UK Centre for Tobacco and Alcohol Studies, UK
| | - Geoffrey T Fong
- University of Waterloo, Waterloo, Ontario, Canada
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
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Panda R, Persai D, Mahapatra S, Mohanty I. Does behavioral intervention affect intention to quit? : A quasi-experimental study from primary healthcare settings in India. Tob Prev Cessat 2021; 7:56. [PMID: 34395953 PMCID: PMC8330841 DOI: 10.18332/tpc/138951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 05/30/2021] [Accepted: 06/14/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Tobacco is the leading cause of death and disease in India. This study examines the effect of training intervention in behavioral counseling on intention to quit tobacco in primary healthcare settings in India. The intervention included training to improve behavioral counseling practices of primary care physicians (PCPs) based on the 5As approach to increase patients' motivation to quit tobacco. METHODS A quasi-experimental design was used for the study. The intervention consists of training of primary care physicians in the behavioral intervention in tobacco cessation. The intervention was conducted in twelve districts of two states in India (Rajasthan and Odisha) in 2016-2017. Four districts were randomly sampled for the study. A total of 1314 participants (intervention and control) were recruited for the study in the baseline and end-line surveys, respectively. Intention to quit in 30 days was the primary outcome measure. Difference-in-difference (DiD) logistic regression models were used separately for smokers and smokeless tobacco users to estimate the odds of intention to quit. Analysis was done in STATA Version 14. RESULTS The intervention and time variable had a significantly positive influence on the intention to quit tobacco among smokers. Smokers in the intervention districts had higher odds of intention to quit (OR=9.82; 95% CI: 1.67-57.72) compared to smokers in the control districts. Smokeless tobacco (SLT) users had higher odds of intention to quit (OR=3.06; 95% CI: 1.35-6.98) in the end-line survey compared to baseline survey. CONCLUSIONS Our findings indicate that building capacity in behavioral intervention in primary care settings can help increase the intention to quit among smokers. The observed difference in intention to quit between smokers and SLT users suggests the need of tailored counseling interventions for SLT users. There is a need for further research to design and evaluate training and behavioral interventions for SLT and dual (smoking and SLT) users in primary care settings in low- and middle-income countries.
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Affiliation(s)
| | - Divya Persai
- Public Health Foundation of India, Gurugram, India
| | | | - Itismita Mohanty
- Health Research Institute, University of Canberra, Canberra, Australia
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Chen C, Zhang KZ, Gong X, Lee MK, Wang YY. Preventing relapse to information technology addiction through weakening reinforcement: A self-regulation perspective. INFORMATION & MANAGEMENT 2021. [DOI: 10.1016/j.im.2021.103485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Scheffers-van Schayck T, Wetter DW, Otten R, Engels RCME, Kleinjan M. Program uptake of a parent-tailored telephone smoking cessation counselling: An examination of recruitment approaches. Tob Prev Cessat 2021; 7:30. [PMID: 33907722 PMCID: PMC8066574 DOI: 10.18332/tpc/133019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/22/2021] [Accepted: 02/02/2021] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Recently, a Dutch proactive parent-tailored telephone smoking cessation counselling program, Smoke-free Parents (SFP), was demonstrated to be effective in helping parents to quit smoking. This study aimed to examine the program’s uptake and the costs of two recruitment approaches (i.e. healthcare vs mass media) for SFP. In addition, parent’s barriers to participating in SFP and the characteristics of participating parents were assessed. METHODS As part of an effectiveness-implementation hybrid trial, 402 smoking parents were recruited via healthcare settings and mass media for an informal, proactive, and free phone call with a smoking cessation counsellor about SFP (the Netherlands, September 2016 – September 2018). Parents were asked whether they wanted to participate in SFP. If parents refused, reasons for decline and additional information (e.g. educational level) were collected. RESULTS Results revealed that 26.4% of the recruited parents participated in SFP. Although the program uptake of parents recruited via mass media was slightly, but not significantly, higher than via healthcare (27.3% vs 26.8%, p=0.92), the healthcare approach resulted in lower costs per participant (€99.62 vs €205.72). Smoking cessation counsellors were unable to reach almost one-third (32.7%) of the parents after they had agreed to be called about SFP. CONCLUSIONS The present study showed that more than a quarter of all recruited parents participated in SFP and that the mass media approach and healthcare approach can be used to recruit parents for SFP. To increase the number of parents participating in SFP, it is important to overcome the identified barriers that prevent parents from participating.
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Affiliation(s)
- Tessa Scheffers-van Schayck
- Epidemiology and Research Support, Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands.,Department of Interdisciplinary Social Sciences, Utrecht University, Utrecht, the Netherlands
| | - David W Wetter
- Center for Health Outcomes and Population Equity, Huntsman Cancer Institute, the University of Utah, Salt Lake City, United States
| | - Roy Otten
- Research and Development, Pluryn, Nijmegen, the Netherlands.,Department of Psychology, ASU REACH Institute, Arizona State University, Tempe, United States.,Developmental Psychopathology, Radboud University, Nijmegen, the Netherlands
| | | | - Marloes Kleinjan
- Department of Interdisciplinary Social Sciences, Utrecht University, Utrecht, the Netherlands.,Youth, Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
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Psychosocial Factors, Smoke-Free Restrictions, and Media Exposure in Relation to Smoking-Related Attitudes and Behaviors among Adults in Armenia and Georgia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084013. [PMID: 33920451 PMCID: PMC8068968 DOI: 10.3390/ijerph18084013] [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: 02/19/2021] [Revised: 04/02/2021] [Accepted: 04/07/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Perceived harm, social influences, smoke-free policies, and media exposure have been understudied in relation to tobacco-related attitudes/behaviors in aggregate or in low and middle-income countries; thus, this study examined these factors collectively in relation to smoking-related outcomes among Armenian and Georgian adults. METHODS Using 2018 cross-sectional survey data (n = 1456), multivariable regression analyses examined these factors in relation to smoking status, perceived harm among nonsmokers, and readiness to quit and past-year quit attempts among smokers. RESULTS Significant predictors (p < 0.05) of current smoking (27.3%) included lower perceived harm, more smoking friends, and fewer home and vehicle restrictions. Among nonsmokers, more home and restaurant/bar restrictions, fewer vehicle restrictions, greater anti-tobacco media exposure, and less pro-tobacco media exposure predicted greater perceived harm. Among smokers, greater perceived social acceptability of smoking, less anti-tobacco media exposure, and greater pro-tobacco media exposure predicted readiness to quit (12.7% of smokers). More smoking friends, more home restrictions, less anti-tobacco media exposure, and greater pro-tobacco media exposure predicted past-year quit attempts (19.2%). CONCLUSIONS Findings support the importance of smoke-free policies but were counterintuitive regarding the roles of social and media influences, underscoring the need to better understand how to address these influences, particularly in countries with high smoking rates.
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Hu Y, Xie J, Chang X, Chen J, Wang W, Zhang L, Zhong R, Chen O, Yu X, Zou Y. Characteristics and Predictors of Abstinence Among Smokers of a Smoking Cessation Clinic in Hunan China. Front Public Health 2021; 9:615817. [PMID: 33816416 PMCID: PMC8017299 DOI: 10.3389/fpubh.2021.615817] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 02/23/2021] [Indexed: 11/25/2022] Open
Abstract
Background: More than 300 million smokers make China the largest cigarette consumer globally, which is a huge economic burden. Smoking cessation (SC) clinics can offer counseling and follow-up services. The operational experience of SC clinics in China needs to be summarized and improved based on research evidence. Purpose: The objectives of this study were to describe quit rates among attendees of SC clinics in Hunan and assess predictors of successful SC. Methods: The participants in this study were smokers who visited the SC clinic of Hunan Cancer Hospital from February 1, 2015 to September 30, 2018. Individuals who received individual counseling and assessment from the SC clinic staff and were willing to quit smoking were eligible for inclusion. Those with critical illness or cancer were excluded. Application of smoking cessation clinic registration form (unified by Chinese Center for Disease Control and Prevention) was used to assess participants at the consultation. Follow-ups and counseling were performed over telephone at 1 week, 1 month, and 3 months after the initial cessation consultation or in times of need. Successful SC was checked for at 3 months after the start of SC. Results: A total of 328 smokers (mean age 45.67 ± 12.38 years) had participated. The abstinence rate at 3 months was 28.4%. Binary regression analysis revealed significant independent predictors to be the total numbers of SC follow up sessions, previous SC attempts, and participants' decision on when to quit smoking (The relative to quit immediately group, quit within 30 days, quit after 30 days, and undecided quit were less likely to succeed in quitting. while quit within seven days had no statistical significance. Conclusion: SC clinics can achieve a desirably high quit rate. Participant's previous attempts at quitting, three or more follow-ups, and the decision to quit immediately or within seven days were factors helpful in predicting the success of SC.
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Affiliation(s)
- Yina Hu
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Jianghua Xie
- Hunan University of Chinese Medicine, Changsha, China
| | - Xiaochang Chang
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Jianhua Chen
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Wei Wang
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Lemeng Zhang
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Rui Zhong
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Ouying Chen
- Hunan University of Chinese Medicine, Changsha, China
| | - Xinhua Yu
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Yanhui Zou
- Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
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Kim Y, Lee JS, Cho WK. Factors Associated with Successful Smoking Cessation According to Age Group: Findings of an 11-Year Korea National Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1576. [PMID: 33562345 PMCID: PMC7915736 DOI: 10.3390/ijerph18041576] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/16/2021] [Accepted: 02/04/2021] [Indexed: 12/23/2022]
Abstract
Previous studies suggest that factors related to smoking cessation may vary with age. This study examined the factors affecting smoking cessation by age among Korean adult male smokers using data from the Korea National Health and Nutrition Examination Survey from 2007 to 2018 (excluding 2013). Logistic regression analyses were used to investigate various factors associated with smoking cessation in three different age groups. Out of a total of 15,492 individuals, 31.5% of the 3523 individuals aged 19-39 years (young adult), 54.7% of the 7390 individuals aged 40-64 years (middle-aged), and 78.6% of the 4589 individuals aged ≥65 years (older adults) succeeded in quitting. In the young adult and middle-aged groups, being married was associated with successful quitting, and lifetime smoking was associated with unsuccessful quitting. Willpower and several comorbidities were related to successful cessation in the middle-aged and older adult groups. Skipping any meal, which suggests unhealthy behavior, was negatively related to quitting in the young adult group. We observed that factors associated with smoking cessation success or failure differed by age, which should be considered when developing smoking cessation policies and programs.
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Affiliation(s)
- Youngmee Kim
- Red Cross College of Nursing, Chung-Ang University, Seoul 06974, Korea; or
| | - Ji Sung Lee
- College of Medicine, University of Ulsan, Seoul 05505, Korea;
- Asan Institute for Life Sciences, Clinical Research Center, Asan Medical Center, Seoul 05505, Korea
| | - Won-Kyung Cho
- College of Medicine, University of Ulsan, Seoul 05505, Korea;
- Department of Pulmonary and Critical Care Medicine, International Healthcare Center, Asan Medical Center, Seoul 05505, Korea
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Le Grande M, Borland R, Yong HH, Cummings KM, McNeill A, Thompson ME, Fong GT. Predictive Power of Dependence Measures for Quitting Smoking. Findings From the 2016 to 2018 ITC Four Country Smoking and Vaping Surveys. Nicotine Tob Res 2021; 23:276-285. [PMID: 32556210 PMCID: PMC7822098 DOI: 10.1093/ntr/ntaa108] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 06/12/2020] [Indexed: 12/27/2022]
Abstract
INTRODUCTION To test whether urges to smoke and perceived addiction to smoking have independent predictive value for quit attempts and short-term quit success over and above the Heaviness of Smoking Index (HSI). AIMS AND METHODS Data were from the International Tobacco Control Four Country Smoking and Vaping Wave 1 (2016) and Wave 2 (2018) surveys. About 3661 daily smokers (daily vapers excluded) provided data in both waves. A series of multivariable logistic regression models assessed the association of each dependence measure on odds of making a quit attempt and at least 1-month smoking abstinence. RESULTS Of the 3661 participants, 1594 (43.5%) reported a quit attempt. Of those who reported a quit attempt, 546 (34.9%) reported short-term quit success. Fully adjusted models showed that making quit attempts was associated with lower HSI (adjusted odds ratio [aOR] = 0.81, 95% confidence interval [CI] = 0.73 to 0.90, p < .001), stronger urges to smoke (aOR = 1.08, 95% CI = 1.04 to 1.20, p = .002), and higher perceived addiction to smoking (aOR = 0.52, 95% CI = 0.32 to 0.84, p = .008). Lower HSI (aOR = 0.57, 95% CI = 0.40 to 0.87, p < .001), weaker urges to smoke (aOR = 0.85, 95% CI = 0.76 to 0.95, p = .006), and lower perceived addiction to smoking (aOR = 0.55, 95% CI = 0.32 to 0.91, p = .021) were associated with greater odds of short-term quit success. In both cases, overall R2 was around 0.5. CONCLUSIONS The two additional dependence measures were complementary to HSI adding explanatory power to smoking cessation models, but variance explained remains small. IMPLICATIONS Strength of urges to smoke and perceived addiction to smoking may significantly improve prediction of cessation attempts and short-term quit success over and above routinely assessed demographic variables and the HSI. Stratification of analyses by age group is recommended because the relationship between dependence measures and outcomes differs significantly for younger (aged 18-39) compared to older (aged older than 40) participants. Even with the addition of these extra measures of dependence, the overall variance explained in predicting smoking cessation outcomes remains very low. These measures can only be thought of as assessing some aspects of dependence. Current understanding of the factors that ultimately determine quit success remains limited.
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Affiliation(s)
- Michael Le Grande
- Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Ron Borland
- Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Hua-Hie Yong
- School of Psychology, Deakin University, Geelong, Australia
| | - K Michael Cummings
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Ann McNeill
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Mary E Thompson
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, ON
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON
- Ontario Institute for Cancer Research, Toronto, ON
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Lubitz SF, Flitter A, Wileyto EP, Ziedonis D, Stevens N, Leone F, Mandell D, Kimberly J, Beidas R, Schnoll RA. History and Correlates of Smoking Cessation Behaviors Among Smokers With Serious Mental Illness. Nicotine Tob Res 2021; 22:1492-1499. [PMID: 31816049 DOI: 10.1093/ntr/ntz229] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 12/06/2019] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Individuals with serious mental illness (SMI) smoke at rates two to three times greater than the general population but are less likely to receive treatment. Increasing our understanding of correlates of smoking cessation behaviors in this group can guide intervention development. AIMS AND METHODS Baseline data from an ongoing trial involving smokers with SMI (N = 482) were used to describe smoking cessation behaviors (ie, quit attempts, quit motivation, and smoking cessation treatment) and correlates of these behaviors (ie, demographics, attitudinal and systems-related variables). RESULTS Forty-three percent of the sample did not report making a quit attempt in the last year, but 44% reported making one to six quit attempts; 43% and 20%, respectively, reported wanting to quit within the next 6 months or the next 30 days. Sixty-one percent used a smoking cessation medication during their quit attempt, while 13% utilized counseling. More quit attempts were associated with lower nicotine dependence and carbon monoxide and greater beliefs about the harms of smoking. Greater quit motivation was associated with lower carbon monoxide, minority race, benefits of cessation counseling, and importance of counseling within the clinic. A greater likelihood of using smoking cessation medications was associated with being female, smoking more cigarettes, and receiving smoking cessation advice. A greater likelihood of using smoking cessation counseling was associated with being male, greater academic achievement, and receiving smoking cessation advice. CONCLUSIONS Many smokers with SMI are engaged in efforts to quit smoking. Measures of smoking cessation behavior are associated with tobacco use indicators, beliefs about smoking, race and gender, and receiving cessation advice. IMPLICATIONS Consideration of factors related to cessation behaviors among smokers with SMI continues to be warranted, due to their high smoking rates compared to the general population. Increasing our understanding of these predictive characteristics can help promote higher engagement in evidence-based smoking cessation treatments among this subpopulation.
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Affiliation(s)
- Su Fen Lubitz
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Alex Flitter
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - E Paul Wileyto
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA
| | - Douglas Ziedonis
- Department of Psychiatry, University of California, San Diego, CA
| | - Nathaniel Stevens
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Frank Leone
- Department of Medicine, Pulmonary, Allergy, & Critical Care Division, University of Pennsylvania, Philadelphia, PA
| | - David Mandell
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - John Kimberly
- Department of Management, The Wharton School of Business, University of Pennsylvania, Philadelphia, PA
| | - Rinad Beidas
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania, Philadelphia, PA
| | - Robert A Schnoll
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Bolívar HA, Elliott RJ, Middleton W, Yoon JH, Okoli CTC, Haliwa I, Miller CC, Ades PA, Gaalema DE. Social Smoking Environment and Associations With Cardiac Rehabilitation Attendance. J Cardiopulm Rehabil Prev 2021; 41:46-51. [PMID: 32925296 PMCID: PMC7755730 DOI: 10.1097/hcr.0000000000000518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE Continued cigarette smoking after a major cardiac event predicts worse health outcomes and leads to reduced participation in cardiac rehabilitation (CR). Understanding which characteristics of current smokers are associated with CR attendance and smoking cessation will help improve care for these high-risk patients. We examined whether smoking among social connections was associated with CR participation and continued smoking in cardiac patients. METHODS Participants included 149 patients hospitalized with an acute cardiac event who self-reported smoking prior to the hospitalization and were eligible for outpatient CR. Participants completed a survey on their smoking habits prior to hospitalization and 3 mo later. Participants were dichotomized into two groups by the proportion of friends or family currently smoking ("None-Few" vs "Some-Most"). Sociodemographic, health, secondhand smoke exposure, and smoking measures were compared using t tests and χ2 tests (P < .05). ORs were calculated to compare self-reported rates of CR attendance and smoking cessation at 3-mo follow-up. RESULTS Compared with the "None-Few" group, participants in the "Some-Most" group experienced more secondhand smoke exposure (P < .01) and were less likely to attend CR at follow-up (OR = 0.40; 95% CI, 0.17-0.93). Participants in the "Some-Most" group tended to be less likely to quit smoking, but this difference was not statistically significant. CONCLUSION Social environments with more smokers predicted worse outpatient CR attendance. Clinicians should consider smoking within the social network of the patient as an important potential barrier to pro-health behavior change.
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Affiliation(s)
- Hypatia A Bolívar
- Vermont Center on Behavior and Health (Drs Bolívar, Ades, and Gaalema, Ms Elliott, and Mr Middleton) and Departments of Psychiatry (Drs Bolívar and Gaalema and Ms Elliott) and Psychology (Mr Middleton and Dr Gaalema), University of Vermont, Burlington; Departments of Psychiatry and Behavioural Sciences (Dr Yoon and Ms Haliwa) and Cardiothoracic and Vascular Surgery (Dr Miller), University of Texas Health Science at Houston; College of Nursing, University of Kentucky, Lexington (Dr Okoli); and Division of Cardiology, University of Vermont College of Medicine, Burlington (Dr Ades)
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Kastaun S, Brown J, Kotz D. Association between income and education with quit attempts, use of cessation aids, and short-term success in tobacco smokers: A social gradient analysis from a population-based cross-sectional household survey in Germany (DEBRA study). Addict Behav 2020; 111:106553. [PMID: 32717499 DOI: 10.1016/j.addbeh.2020.106553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 07/10/2020] [Accepted: 07/11/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Smoking is more prevalent in smokers from lower compared with higher socioeconomic (SES) groups, but studies are inconsistent regarding underlying mechanisms. We aimed to assess associations between SES indicators and three distinct aspects of the smoking cessation process: attempting to quit; use of evidence-based cessation treatments; and success. METHODS We analysed data of 12,161 last-year smokers (i.e., current smokers and recent ex-smokers who quit ≤ 12 months) from 20 waves (June/July 2016 to August/September 2019) of the German Study on Tobacco Use (DEBRA) - a representative household survey. Associations between indicators of SES (income and education) and (1) last-year quit attempts; (2) use of evidence-based cessation treatment or electronic cigarettes during the last attempt; and (3) short-term self-reported abstinence were analysed using multivariable logistic regression, adjusted for potential confounders. RESULTS Of all last-years smokers, 18.6% had attempted to quit, of whom 15.2% had successfully stopped. Higher income (OR 0.82, 95%CI = 0.77-0.88 per 1000€) but low vs. high education (OR 0.83, 95%CI = 0.73-0.95) were associated with lower odds of quit attempts. In smokers with quit attempts, higher income but not education was associated with higher odds of using cessation medication (OR 1.31, 95%CI = 1.08-1.59 per 1000 €). Neither income nor education were associated with using behavioural support or success. CONCLUSIONS In the German healthcare system without free access to evidence-based cessation therapy, low-income smokers are more likely to make a quit attempt but less likely to use cessation medication than high-income smokers. Equitable access to such medication is crucial to reduce SES-related health disparities.
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Affiliation(s)
- Sabrina Kastaun
- Institute of General Practice, Addiction Research and Clinical Epidemiology Unit, Medical Faculty of the Heinrich-Heine-University, Düsseldorf, Germany.
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK.
| | - Daniel Kotz
- Institute of General Practice, Addiction Research and Clinical Epidemiology Unit, Medical Faculty of the Heinrich-Heine-University, Düsseldorf, Germany; Department of Behavioural Science and Health, University College London, London, UK.
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Kar SS, Sivanantham P, Rehman T, Chinnakali P, Thiagarajan S. Willingness to quit tobacco and its correlates among Indian tobacco users-Findings from the Global Adult Tobacco Survey India, 2016-17. J Postgrad Med 2020; 66:141-148. [PMID: 32675450 PMCID: PMC7542056 DOI: 10.4103/jpgm.jpgm_408_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Willingness to quit in a tobacco user forms the basis for future quit attempts and quitting successfully. Objective To determine the prevalence and correlates of willingness to quit among tobacco users in India using the Global Adult Tobacco Survey (GATS), India, 2016-2017. Methods GATS, 2016-17 was a multistage geographically clustered sample survey done among 74,037 individuals aged 15 years and above across all the states and two of the Union Territories of India. Data of all those reported using any form of tobacco were studied for past attempts to quit tobacco, advised to quit by a health care provider, and exposure to anti-tobacco messages delivered through various media and the correlation of these with the willingness to quit using multivariate analysis. Results Of the 21,085 current tobacco users in the survey, 11,679 (52.2%), were willing to quit all forms of tobacco. Multivariate analysis showed that those in younger age groups (OR: 1.39 [1.23-1.56]), higher education levels (OR 1.15 [1.05-1.18]), time of first tobacco use in the day being more than 60 min after waking up in the morning (OR 1.11 [1.03-1.2]), history of attempts to quit in the past 12 months (OR 1.78 [1.69-1.87]), those advised to quit by health care provider in the past 12 months (OR 1.11 [1.06-1.17]), those using single form of tobacco (OR 1.1 [1.05-1.17]), those exposed to anti-tobacco messages in newspapers/magazines (OR 1.1 [1.05-1.17]), and cinemas (1.14 [1.08-1.20]) were more willing to quit compared to their counterparts. Conclusion Enhanced publicizing of anti-tobacco messages through the currently employed media, and ensuring that doctors give a brief advice to quit during any contact with a tobacco user could improve the willingness to quit and the consequent quit rate, especially among those tobacco users who are in younger age groups and who have attempted to quit earlier.
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Affiliation(s)
- S S Kar
- Department of PSM, JIPMER, Puducherry, India
| | | | - T Rehman
- Department of PSM, JIPMER, Puducherry, India
| | | | - S Thiagarajan
- Independent Consultant, Former Professor and Dean, TISS, Mumbai, Maharashtra, India
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Zhu N, Lin S, Cao C, Xu N, Yu X, Chen X. Nomogram to predict successful smoking cessation in a Chinese outpatient population. Tob Induc Dis 2020; 18:86. [PMID: 33117113 PMCID: PMC7586925 DOI: 10.18332/tid/127736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 08/08/2020] [Accepted: 09/22/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The study aimed to establish and internally validate a nomogram to predict successful smoking cessation in a Chinese outpatient population. METHODS A total of 278 participants were included, and data were collected from March 2016 to December 2018. Predictors for successful smoking cessation were evaluated by 3-month sustained abstinence rates. Least absolute shrinkage and selection operator (LASSO) regression was used to select variables for the model to predict successful smoking cessation, and multivariable logistic regression analysis was performed to establish a novel predictive model. The discriminatory ability, calibration, and clinical usefulness of the nomogram were determined by the concordance index (C-index), calibration plot, and decision curve analysis, respectively. Internal validation with bootstrapping was performed. RESULTS The nomogram included living with a smoker or experiencing workplace smoking, number of outpatient department visits, reason for quitting tobacco, and varenicline use. The nomogram demonstrated valuable predictive performance, with a C-index of 0.816 and good calibration. A high C-index of 0.804 was reached with interval validation. Decision curve analysis revealed that the nomogram for predicting successful smoking cessation was clinically significant when intervention was conducted at a successful cessation of smoking possibility threshold of 19%. CONCLUSIONS This novel nomogram for successful smoking cessation can be conveniently used to predict successful cessation of smoking in outpatients.
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Affiliation(s)
- Ning Zhu
- Department of Respiratory and Critical Care Medicine, Ningbo First Hospital, Ningbo, China
| | - Shanhong Lin
- Department of Ultrasound, Ningbo First Hospital, Ningbo, China
| | - Chao Cao
- Department of Respiratory and Critical Care Medicine, Ningbo First Hospital, Ningbo, China
| | - Ning Xu
- Department of Respiratory and Critical Care Medicine, Ningbo First Hospital, Ningbo, China
| | - Xiaopin Yu
- Department of Prevention and Health Care, Ningbo First Hospital, Ningbo, China
| | - Xueqin Chen
- Department of Traditional Medicine, Ningbo First Hospital, Ningbo, China
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Becerra N, García-Padilla P, Gil F, Vergara A. Características biopsicosociales relacionadas con el consumo de cigarrillo y la intención de cesación en fumadores en un entorno universitario. REVISTA DE LA FACULTAD DE MEDICINA 2020. [DOI: 10.15446/revfacmed.v68n4.77666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción. El tratamiento de la dependencia tabáquica requiere la comprensión de múltiples factores que determinan los patrones de consumo y la posibilidad de lograr un cambio conductual. Objetivo. Establecer las características biopsicosociales asociadas con el consumo de cigarrillo y la intención de cesación de los usuarios de un programa interdisciplinario para dejar de fumar en un entorno universitario.Materiales y métodos. Estudio descriptivo transversal. Se revisaron las historias clínicas de 134 usuarios del programa que completaron la fase de evaluación.Resultados. 56.7% de los participantes presentó un grado leve de tabaquismo; además, 67.2% tuvo una baja dependencia a la nicotina. Se encontró una tamización positiva para ansiedad y depresión en el 62.7% y 34.3% de la muestra, respectivamente. La mayoría de sujetos tenía por lo menos un amigo fumador (91%) (n=122) y había realizado al menos un intento previo de cesación (85.1%) (n=114); los individuos con riesgo de desarrollar ansiedad presentaron un mayor consumo diario de cigarrillos (Kruskal-Wallis p=0.041) que aquellos que no estaban en riesgo.Conclusiones. Diferentes aspectos personales, familiares y contextuales determinan la posibilidad de iniciar, continuar y/o recaer en el consumo de cigarrillos, por lo que la implementación de intervenciones efectivas exige la comprensión integral de los factores implicados en su consumo y en la intención de cesación.
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