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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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Zhu L, Qiu Y, Zhong R, Xie J, Hu Y, Yu X, Chang X, Wang W, Zhang L, Chen O, Cao H, Zhu H, Zou Y. Baseline characteristics and the factors influencing successful smoking cessation: A comparison between a WeChat smoking cessation mini-program and an offline smoking cessation clinic. Tob Induc Dis 2023; 21:154. [PMID: 38026499 PMCID: PMC10664087 DOI: 10.18332/tid/174491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/18/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION Smoking cessation (SC) clinics are a professional SC services in China. However, studies comparing the characteristics and SC rates of smoking populations in SC clinics with those using mobile SC programs are limited. We compared smokers' characteristics, 3-month SC rates, and the factors influencing 3-month SC success, between a large hospital SC clinic and a WeChat SC mini-program. METHODS Between January and November 2021, 384 participants voluntarily enrolled in either the hospital SC clinic (Group A: n=243) or the WeChat SC mini-program (Group B: n=141). Both groups underwent a 3-month SC intervention, and their SC status was monitored at 24 hours, 1 week, 1 month, and 3 months after quitting. SC rate was defined as the self-reported rate of continuous SC. RESULTS The 3-month SC rate was higher in Group A (42.4%) than in Group B (24.8%). Participants with middle school education had a lower likelihood of SC success than those with primary school or lower (p=0.014). Employees in the enterprise/business/services industries were more likely to have SC success than farmers (p=0.013). Participants with SC difficulty scores of 0-60 were more successful than those with scores >60 (p=0.001, p=0.000, respectively). Participants who quit smoking due to their illness, or other reasons, had a higher likelihood of SC success than those who quit due to concerns about their own and their family's health (p=0.006, p=0.098, respectively). While the likelihood of SC success was lower in those who quit because of the influence of their environment than in those who quit due to concerns about their own and their family's health (p=0.057). CONCLUSIONS Both SC clinics and WeChat SC mini-programs achieved satisfactory SC rates. The high accessibility of mobile SC platforms, which save time spent on transportation and medical visits, renders them worth promoting and publicizing as additional SC options for smokers, particularly young smokers.
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Affiliation(s)
- Lei Zhu
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
- School of Nursing, Hunan University of Chinese Medicine, Changsha, China
| | - Yanfang Qiu
- 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
| | - Jianghua Xie
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
- Xiangya Hospital, Central South University, Changsha, China
| | - Yina Hu
- School of Nursing and Health Management, Wuhan Donghu University, Wuhan, China
| | - Xinhua Yu
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Xiaochang Chang
- 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
| | - Ouying Chen
- School of Nursing, Hunan University of Chinese Medicine, Changsha, China
| | - Hui Cao
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Haidong Zhu
- Hunan Yixuan Technology Co., LTD, 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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Bellali T, Karagkounis C, Liamopoulou P, Minasidou E, Manomenidis G. Comparative cross-sectional study of knowledge, attitudes and perceptions among mental health and ward nursing staff towards smoking. Int J Nurs Pract 2023; 29:e13108. [PMID: 36176179 DOI: 10.1111/ijn.13108] [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: 02/02/2022] [Accepted: 09/04/2022] [Indexed: 11/27/2022]
Abstract
AIM The aim of the study was twofold: to estimate smoking prevalence among nurses and to compare their knowledge, perceptions and attitudes towards smoking. BACKGROUND Given the critical role nurses have in the process of patients' smoking cessation both as counsellors and behavioural models, data are needed on their smoking rates and behaviour. DESIGN A cross sectional, comparative study was conducted. METHODS A convenience sample of 847 nurses working in various psychiatric and public hospitals in Northern Greece participated in the study. Data were collected between April and June 2020 using a battery of questionnaires. RESULTS Mental health nurses were less likely to consider quitting smoking within the next 6 months (P < 0.001), despite the fact that they reported higher levels of the importance of stop smoking compared to ward nurses (P < 0.05). However, ward nurses were more likely to quit smoking because of the cost of cigarettes (P = 0.024) and for personal reasons (P = 0.040). CONCLUSION Prevalence of smoking in nurses is high. Training and educational programmes are needed to develop the appropriate culture of health promotion among nurses, thus provide a more active support to patients who smoke.
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Affiliation(s)
- Thalia Bellali
- Department of Nursing, International Hellenic University of Greece, Thermi, Greece
| | | | - Polixeni Liamopoulou
- Department of Nursing, International Hellenic University of Greece, Thermi, Greece
| | - Evgenia Minasidou
- Department of Nursing, International Hellenic University of Greece, Thermi, Greece
| | - Georgios Manomenidis
- Department of Internal Medicine, General Hospital of Ptolemaida, Ptolemaida, Greece
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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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Hempel-Bruder C, Habfast-Robertson I, Durand MA, Berlin I, Marti J, Khazaal Y, Quinto C, Faouzi M, Selby K. Combining default choices and an encounter decision aid to improve tobacco cessation in primary care patients: protocol for a cluster-randomized trial. BMC PRIMARY CARE 2022; 23:246. [PMID: 36151529 PMCID: PMC9508762 DOI: 10.1186/s12875-022-01859-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND While quitting smoking dramatically decreases overall mortality, general practitioners (GPs) are less likely to prescribe medications for smoking cessation than other cardiovascular risk factors. Guidelines recommend providers first assess patients' "readiness" to quit, an "opt-in" strategy, but only a minority of tobacco users are ready to quit on a given day. An "opt-out" strategy offering treatment as the default choice increased quit attempts in hospital and with pregnant women, but has not been tested in primary care. We will assess the efficacy of training GPs to offer treatment as the default choice using an encounter decision aid with current smokers seen in primary care. METHODS This is a pragmatic cluster-randomized controlled superiority trial with block randomization at the GP level in private practice in French-speaking Switzerland. GPs will be blinded to the arm allocation. The intervention is a half-day training course teaching an 'opt-out' approach to smoking cessation using an encounter decision aid (paper or electronic). GPs in the enhanced usual care group receives a brief refresher training about smoking cessation without changing their behaviour. GPs in both arms will recruit 23 patients each prior to routine primary care visits. The primary outcome is the effect of consulting a GP who received the intervention on the 7-day, point prevalence, smoking abstinence 6 months after the baseline appointment. Secondary outcomes include continuous abstinence; number of quit attempts; use of smoking cessation aids; patient-perceived involvement in discussions; and changes in GP behaviour. Patient outcomes will be collected using paper and telephone questionnaires. Assuming 15% drop-out, recruiting 46 GPs with 23 patients each will give us 80% power to detect an increase in smoking cessation from 4% (control) to 10.5% (intervention), with an alpha < 0.05. DISCUSSION GP visits are an opportunity to administer proven smoking cessation treatments. We hypothesize GPs offering smoking cessation treatment as the default choice using an encounter decision aid will increase the number of patients who quit. This study could significantly change our approach to smoking cessation in primary care. Default choices and the electronic decision aid are low-cost, easily diffusible interventions. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04868474, First Posted May 3, 2021, Last Update Posted October 6, 2021.
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Affiliation(s)
- Christina Hempel-Bruder
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Route de Berne 113, 1010, Lausanne, Switzerland
| | - Inès Habfast-Robertson
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Route de Berne 113, 1010, Lausanne, Switzerland
| | - Marie-Anne Durand
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Route de Berne 113, 1010, Lausanne, Switzerland
- UMR 1295, CERPOP, University Toulouse III Paul Sabatier, Toulouse, France
| | | | - Joachim Marti
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Route de Berne 113, 1010, Lausanne, Switzerland
| | - Yasser Khazaal
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Route de Berne 113, 1010, Lausanne, Switzerland
- Department of Addiction Medicine, CHUV, Lausanne, Switzerland
| | | | - Mohamed Faouzi
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Route de Berne 113, 1010, Lausanne, Switzerland
| | - Kevin Selby
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Route de Berne 113, 1010, Lausanne, Switzerland.
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Subramaniyan M, Yee A, Hairi FM, Kaai SC, Nordin ASA, Danaee M, Pravinassh R, Mohamad AS, Kamaludin IS, Hasan SI, Yan M, Quah A, Driezen P, Fong GT. Are smoking restrictions at public venues and psychosocial beliefs associated with intentions to quit smoking among smokers in Malaysia? J Ethn Subst Abuse 2022:1-17. [PMID: 36129734 DOI: 10.1080/15332640.2022.2123421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The Malaysian government reinforced smoking restrictions at public venues to protect nonsmokers from secondhand smoke (SHS) exposure. This study examined whether smokers' reports about smoking restrictions and psychosocial beliefs were associated with quit intentions among Malaysian smokers. Data from 1047 cigarette smokers (103 females and 944 males) aged 18 and older from the 2020 International Tobacco Control (ITC) Malaysia Wave 1 Survey were analyzed with bivariate and multivariable logistic regression models. Most Malaysian smokers (85.2%) reported having quit intentions. Smoking was completely restricted in 34.8% of the nighttime venues, 85.3% of air-conditioned (AC) food and beverage (F&B) venues (restaurants, food courts, coffee shops), 87.3% of non-AC F&B, and 69.4% of indoor workplaces. Smokers who visited nighttime entertainment venues where smoking was fully restricted were less likely to have quit intentions. There was no significant association found with quit intentions for smokers who visited AC and non-AC F&B venues and indoor workplaces where smoking was fully restricted. All five psychosocial beliefs assessed, age, and education were positively associated with quit intentions. Malaysian smokers are interested in quitting and psychosocial beliefs were positively associated with quit intentions. There is a need for the Malaysian government to implement and reinforce comprehensive smoking restrictions in all public venues and indoor workplaces to protect nonsmokers from SHS exposure and to encourage smokers to think about quitting, which may influence their quit intentions.
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Affiliation(s)
| | - Anne Yee
- Universiti Malaya, Kuala Lumpur, Malaysia
| | | | - Susan C Kaai
- University of Waterloo, Waterloo, Ontario, Canada
| | | | | | | | | | | | | | - Mi Yan
- University of Waterloo, Waterloo, Ontario, Canada
| | - Anne Quah
- University of Waterloo, Waterloo, Ontario, Canada
| | - Pete Driezen
- University of Waterloo, Waterloo, Ontario, Canada
| | - Geoffrey T Fong
- University of Waterloo, Waterloo, Ontario, Canada
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
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7
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Vilane ZG, Kodali PB, Thankappan KR. Effect of socioeconomic status on smoking cessation behavior in selected African countries: Secondary analysis of Global Adult Tobacco Survey data (2014–2018). PLoS One 2022; 17:e0274746. [PMID: 36121824 PMCID: PMC9484673 DOI: 10.1371/journal.pone.0274746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 09/04/2022] [Indexed: 12/01/2022] Open
Abstract
Introduction Tobacco use remains a global public health challenge. While studies report that smoking cessation reduces the risk of cancer and other NCDs, evidence is scarce in African region on socio-economic determinants of smoking cessation behavior. This study examined the socio-economic differentials of smoking cessation behavior among smokers in four African countries. Methods The study was conducted through secondary analysis of Global Adult Tobacco Survey (GATS) data from four African countries (Ethiopia, Kenya, Senegal and Tanzania). Smoking cessation behavior was assessed using two variables i) intention to quit smoking in next 12 months and ii) previous quit attempts made within 12 months preceding the survey. The weighted percentages for intention to quit smoking and previous quit attempts were computed. The adjusted odds ratios were computed using multinomial logistic regression to identify the association between socio-economic factors and smoking cessation behavior. Results Across the four countries studied, the previous quit attempts among smokers were in the range of 39.6% to 53.7%. Around 7.6% to 15.8% of the smokers tried to quit with an assistance. In Ethiopia over 76.5% of current smokers reported no intention to quit in next 12 months after survey, whereas the same was 50.4% in Senegal. While country specific differences were observed, females, those belonging to the poorest wealth index, unemployed and those without any formal education reported significantly lower odds of previous quit attempts or having an intention to quit smoking. Conclusion The socio-economic vulnerabilities were found to compromise smoking cessation behavior among the smokers in countries studied. Targeted interventions, adherence to smokefree laws, and provision of cessation support are essential to improve quit rates and mitigate tobacco risks among socio-economically vulnerable population.
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Affiliation(s)
- Zinto Gabsile Vilane
- Department of Public Health and Community Medicine, Central University of Kerala, Kasaragod, Kerala, India
- * E-mail:
| | - Prakash Babu Kodali
- Department of Public Health and Community Medicine, Central University of Kerala, Kasaragod, Kerala, India
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Demissie HS, Smith T, de Quevedo IG, Kress AC, Twentyman E. Factors associated with quit attempt and successful quitting among adults who smoke tobacco in Ethiopia: Global Adult Tobacco Survey (GATS) 2016. Tob Prev Cessat 2022; 8:12. [PMID: 35350770 PMCID: PMC8915294 DOI: 10.18332/tpc/146170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/26/2022] [Accepted: 02/02/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION METHODS RESULTS CONCLUSIONS
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Affiliation(s)
| | - Tenecia Smith
- Global Tobacco Control Branch, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, United States
| | - Isabel G. de Quevedo
- Global Tobacco Control Branch, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, United States
- CDC Foundation, Atlanta, United States
| | - Alissa C. Kress
- Global Tobacco Control Branch, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, United States
| | - Evelyn Twentyman
- Global Tobacco Control Branch, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, United States
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El-Osta A, Hennessey C, Pilot C, Aumran Tahir M, Bagkeris E, Akram M, Alboksmaty A, Barbanti E, Bakhet M, Vos V, Banarsee R, Majeed A. A digital solution to streamline access to smoking cessation interventions in England; findings from a primary care pilot (STOPNOW study). PUBLIC HEALTH IN PRACTICE 2021; 2:100176. [PMID: 36101579 PMCID: PMC9461505 DOI: 10.1016/j.puhip.2021.100176] [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: 03/21/2021] [Revised: 07/26/2021] [Accepted: 07/30/2021] [Indexed: 11/26/2022] Open
Abstract
Objectives Despite the proven efficacy of several smoking cessation medications that have been shown to improve long-term abstinence rates, approximately two-thirds of smokers report not having used medication in their most recent quit attempt. A main barrier could be delayed access to pharmacological interventions. This study investigated the utility of a primary care linked online portal to streamline timely access to pharmacological support to patients who want to quit smoking by making an asynchronous request for treatment to their general practitioner. Study design Prospective cohort study. Methods An online portal with added functionality was developed, which allowed patients with a unique link to make an asynchronous request for treatment. Two GP practices identified a total of 4337 eligible patients who received an SMS or email invite to engage with an online portal including an electronic survey to capture information about smoking behaviours and to request treatment. Portal informatics and patient level data were analysed to measure the efficacy of the online system in reducing the time between making a formal request to treatment and access to pharmacological support. The primary outcome measure was the time between making a formal request for treatment and access to pharmacological support from a designated community pharmacy. Results 323 patients (7.4%) initiated the survey, but only 56 patients completed the survey and made a formal request for treatment. 94% of participants did not return to use the portal to make a second or follow-up request for treatment. Only 3 participants completed the 12-week pathway. A total of 75 medication items were prescribed and collected by 56 patients. The time difference between the formal request to treatment and GP review ranged between 20 h and 1 week. The time difference between approval of prescription by the GP and access to medication was 5 days ± 2.1 days (range = 1.9–7.0 days). Conclusion The widespread adoption and diffusion of an IT enabled and asynchronous primary care led remote consultation pathway can streamline timely access to smoking cessation support without the need for the patient to see a GP or an independent prescriber in the first instance. Traditional face-to-face smoking cessation interventions may result in significant delays between the patient's decision to quit and access to effective pharmacological support or behavioural therapies. This was the first attempt in the UK where a GP-led online portal with added functionality was used to streamline timely access to pharmacotherapy for smoking cessation using an asynchronous formal request for treatment. We evaluated the findings of a primary care pilot from two general practices in West London where 4337 patients who are registered as smokers were contacted with unique link to access the portal. The pervasive use of a primary care-led online portal could enablie patients to make an asynchronous request for treatment without the need to visit the general practice.
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Müller T, Shevchenko Y, Gerhardt S, Kiefer F, Vollstädt-Klein S. The influence of perceived stress and self-control on efficacy of repeated transcranial direct current stimulation in non-treatment-seeking smokers. Drug Alcohol Depend 2021; 226:108861. [PMID: 34198135 DOI: 10.1016/j.drugalcdep.2021.108861] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 05/15/2021] [Accepted: 05/20/2021] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Transcranial direct current stimulation (tDCS) has recently been raising interest in its therapeutic impact on tobacco use disorder. This study investigates the effects of repeated frontal tDCS (anode: F3, cathode: F4) on cigarette consumption, craving and executive functions. MATERIAL AND METHODS In a randomized sham-controlled trial, 24 individuals received active (2.0 mA) and 20 individuals received sham stimulation (0.3 mA) for 20 min on five consecutive days. The participants indicated their tobacco cravings, answered questionnaires and completed neuropsychological tasks at various time points throughout the study. Carbon monoxide (CO) levels and the daily numbers of consumed cigarettes were recorded. RESULTS Both intervention groups experienced a significant decrease in the daily number of smoked cigarettes, CO levels, and craving after the stimulation, however, there were no improvements in executive functions. These results did not differ significantly between both intervention groups. Additionally, in the active group, a higher level of perceived stress and a lower level of self-control were linked to a lower cigarette consumption, respectively a higher reduction of the level of CO. CONCLUSION This study does not support the hypotheses that tDCS reduces cigarette consumption, attenuates substance craving, or improves executive functions beyond the placebo effect. Our subgroup analysis suggests that high levels of perceived stress and low self-control may be predictors for a successful reduction in cigarette consumption. Furthermore, the placebo effect might be rather high for light smokers, whereas heavy smokers seem to benefit more from the specific effects of tDCS. CLINICAL TRIAL REGISTRATION NUMBER NCT03691805.
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Affiliation(s)
- Tobias Müller
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
| | - Yury Shevchenko
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany; Research Methods, Assessment, and iScience, University of Konstanz, Universitätsstraße 10, D-78464, Konstanz, Germany
| | - Sarah Gerhardt
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
| | - Falk Kiefer
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany; Mannheim Center for Translational Neurosciences (MCTN), Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany; Feuerlein Center on Translational Addiction Medicine, University of Heidelberg, Heidelberg, Germany
| | - Sabine Vollstädt-Klein
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany; Mannheim Center for Translational Neurosciences (MCTN), Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany.
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11
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Grolleau E, Fonteille V, Lebourgeois C, Darrason M, Michel P, Ragonnet D, Freyer G, Deculty A, Gippet C, Leclercq C, Neugnot C, Malek R, Perdriolat O, Rigaud M, Torrecillas S, Barral MC, Souquet PJ, Fassier JB, Tanguy L, Rolland B, Couraud S. Tobacco use and related behaviors among staff and students in a university hospital: A large cross-sectional survey. Tob Prev Cessat 2021; 7:49. [PMID: 34268457 PMCID: PMC8265395 DOI: 10.18332/tpc/137670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/14/2021] [Accepted: 05/18/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Smoking prevalence in the overall population in France was 27% in 2017. There are few data about smoking prevalence in hospital workers. The aim of this study was to assess prevalence of current smoking in student and staff populations at Lyon University Hospital. Secondary objectives were to identify main variables associated with current smoking and willingness to quit. METHODS We designed a single center, cross-sectional survey, using printed questionnaires. During one day, all registered staff and students were surveyed. We used optical reading to extract information from questionnaires. We performed univariate and multivariate analysis adjusted on most relevant factors. RESULTS We analyzed 9712 questionnaires. The participating rates were high: 40.6% in the student cohort and 51.5% in the staff cohort. The proportion of current cigarette users was 26% in students and 25% in staff. In multivariate analysis, current smoking was significantly associated with: younger age, male sex, occupation type (e.g. logistical staff, and paramedical students), overnight work, and e-cigarette use. Among smokers, 53% reported a willingness to quit. In multivariate analysis, number of quit attempts, and feeling symptoms from tobacco were associated with willingness to quit. CONCLUSIONS Current smoking is less frequent in our cohorts of hospital staff and students than in the general French population. However, there are deep disparities in current smoking prevalence underlining a heterogeneous population. Among smokers, the majority reported a willingness to quit and some predictive factors may help to target this audience.
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Affiliation(s)
- Emmanuel Grolleau
- Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Centre hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France.,Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, Lyon, France
| | - Véronique Fonteille
- Equipe de Liaison en Addictologie, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
| | - Caroline Lebourgeois
- Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, Lyon, France.,Direction de la Performance et du Contrôle de Gestion, Hospices Civils de Lyon, Lyon, France
| | - Marie Darrason
- Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Centre hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Philippe Michel
- Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, Lyon, France.,Direction de l'Organisation, de la Qualité des Soins et des Relations avec les Usagers Hospices Civils de Lyon, Lyon, France
| | - Delphine Ragonnet
- Service d'Addictologie, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Gilles Freyer
- Institut de Cancérologie des Hospices Civils de Lyon, Hospices Civils de Lyon, Lyon, France
| | - Amélie Deculty
- Centre de Coordination en Cancérologie, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Carine Gippet
- Centre de Coordination en Cancérologie, Hospices Civils de Lyon, Lyon, France
| | - Céline Leclercq
- Centre de Coordination en Cancérologie, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France
| | - Carole Neugnot
- Centre de Coordination en Cancérologie, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
| | - Radoudja Malek
- Centre de Coordination en Cancérologie, Groupement Hospitalier Centre, Hospices Civils de Lyon, Lyon, France
| | - Odile Perdriolat
- Unité de Tabacologie, Service de Maternité, Hôpital Femme-Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - Michele Rigaud
- Centre de Coordination en Cancérologie, Groupement Hospitalier Centre, Hospices Civils de Lyon, Lyon, France
| | - Séverine Torrecillas
- Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Centre hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France.,Centre de Coordination en Cancérologie, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Maud-Catherine Barral
- Unité de Tabacologie, Service de Maternité, Hôpital Femme-Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - Pierre-Jean Souquet
- Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Centre hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Jean-Baptiste Fassier
- Service de Médecine et Santé au Travail, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - Lénaïck Tanguy
- Institut de Cancérologie des Hospices Civils de Lyon, Hospices Civils de Lyon, Lyon, France.,Direction de la Coopération et des Stratégies, Hospices Civils de Lyon, Lyon, France
| | - Benjamin Rolland
- Equipe de Liaison en Addictologie, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France.,Service d'Addictologie, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.,Service Universitaire d'Addictologie de Lyon, Centre Hospitalier du Vinatier, Bron, France
| | - Sébastien Couraud
- Service de Pneumologie Aigue Spécialisée et Cancérologie Thoracique, Centre hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France.,Equipe IBISCUS, Centre d'Innovation en Cancérologie de Lyon (CICLY), Faculté de Médecine Lyon Sud, Oullins, France
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12
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Koyama S, Tabuchi T, Okawa S, Kadobayashi T, Shirai H, Nakatani T, Miyashiro I. Changes in Smoking Behavior Since the Declaration of the COVID-19 State of Emergency in Japan: A Cross-sectional Study From the Osaka Health App. J Epidemiol 2021; 31:378-386. [PMID: 33746148 PMCID: PMC8126679 DOI: 10.2188/jea.je20200533] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 03/07/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND In April 2020, the Japanese government declared a state of emergency due to the COVID-19 pandemic, and infection control measures, including requests to work from home and stay-at-home restrictions, were introduced. This study examined changes in smoking behavior during the COVID-19 state of emergency. METHODS An online cross-sectional survey was conducted in Osaka, Japan. To assess differences in smoking behavior among 5,120 current smokers before and after the declaration of a state of emergency, prevalence ratios (PRs) for two outcomes, increased smoking and quitting smoking, were calculated using multivariable Poisson regression, adjusting for potential covariates. RESULTS We found 32.1% increased the number of cigarettes smoked and 11.9% quit smoking. After adjustment for all variables, we found risk factors for COVID-19 (men and older age group) had both significantly higher PR for quitting smoking (men: PR 1.38; 95% confidence interval [CI], 1.17-1.62) and participants aged ≥65 years: PR 2.45; 95% CI, 1.92-3.12) and significantly lower PR of increased smoking (men: PR 0.85; 95% CI, 0.78-0.93 and participants ≥65 years: PR 0.38; 95% CI, 0.29-0.49). Additionally, respondents working from home or living alone had significantly higher PR for increased smoking (working from home: PR 1.29; 95% CI, 1.17-1.41 and living alone: PR 1.23; 95% CI, 1.10-1.38) and respondents who changed from cigarettes to heated tobacco products (HTPs) had significantly lower PR for quitting smoking (PR 0.150; 95% CI, 0.039-0.582). CONCLUSIONS We suggest people who have high-risk factors for COVID-19 might change their smoking behavior for the better, while people who work from home or live alone might change their smoking behavior for the worse, during the COVID-19 state of emergency. Additionally, changing from smoking cigarettes to using HTPs makes smokers less likely to quit.
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Affiliation(s)
- Shihoko Koyama
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Sumiyo Okawa
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Takayoshi Kadobayashi
- Health Promotion Division, Department of Public Health and Medical Affairs, Osaka Prefectural Government, Osaka, Japan
| | - Hisaya Shirai
- Health Promotion Division, Department of Public Health and Medical Affairs, Osaka Prefectural Government, Osaka, Japan
| | - Takeshi Nakatani
- Health Promotion Division, Department of Public Health and Medical Affairs, Osaka Prefectural Government, Osaka, Japan
| | - Isao Miyashiro
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
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Truong MK, Berger M, Haba-Rubio J, Siclari F, Marques-Vidal P, Heinzer R. Impact of smoking on sleep macro- and microstructure. Sleep Med 2021; 84:86-92. [PMID: 34126401 DOI: 10.1016/j.sleep.2021.05.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 05/14/2021] [Accepted: 05/20/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Existing data suggest that smoking may be associated with sleep disturbances. This study aimed to determine the association between smoking and both subjective and objective sleep quality. METHODS Cross-sectional analysis of sleep characteristics in 3233 participants from the population-based CoLaus-HypnoLaus cohort (52.2% women, mean age 56.6 ± 10.2 years) who completed questionnaires on sleep quality, of whom 1489 (46%) had a full polysomnography. Smoking data were self-reported; participants were classified by smoking status as current, former or never smokers. Primary outcomes were subjective sleep quality assessed by sleep questionnaires, and objective sleep quality based on polysomnography (sleep macrostructure), including power spectral analysis of the electroencephalogram on C4 electrode (sleep microstructure), quantifying the relative amount of delta power (1-4 Hz), a marker of sleep depth, and arousal-associated alpha power (8-12 Hz). RESULTS Current smokers had a shift toward faster sleep electroencephalogram activity with lower delta power in non-REM sleep compared with former and never smokers (-2.8 ± 0.4% and -2.4 ± 0.4%, respectively; both p < 0.001) and higher alpha power (+0.8 ± 0.2%; p < 0.001) compared with never smokers. There was a dose-dependent negative association between electroencephalogram delta power and smoking intensity (r2 = -1.2 [-1.9, -0.5]; p = 0.001). Additionally, mean nocturnal oxygen saturation was lower in current smokers. CONCLUSIONS Current smokers had decreased objective sleep quality, with a dose-dependent association between smoking intensity and decrease in electroencephalogram delta power during non-REM sleep, in addition to an increase in alpha power. Considering the importance of sleep quality for wellbeing and health, these results provide further data to support smoking cessation.
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Affiliation(s)
- Minh Khoa Truong
- Department of Medicine, Service of Pulmonary Medicine, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland.
| | - Mathieu Berger
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland
| | - José Haba-Rubio
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland
| | - Francesca Siclari
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland; Department of Clinical Neurosciences, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland
| | - Pedro Marques-Vidal
- Department of Medicine, Service of Internal Medicine, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland
| | - Raphaël Heinzer
- Department of Medicine, Service of Pulmonary Medicine, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland; Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland
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14
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Chen H, Zhao B, Li X, Xie R, Li W. Nicotine Dependence, Perceived Behavioral Control, Descriptive Quitting Norms, and Intentions to Quit Smoking among Chinese Male Regular Smokers. Subst Use Misuse 2021; 56:145-152. [PMID: 33280473 DOI: 10.1080/10826084.2020.1846195] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The association between nicotine dependence and intentions to quit smoking is well established. However, the underlying mechanisms and psychosocial factors that moderate this relationship have not been adequately delineated. Reinforcement theory, social learning theory, the theory of planned behavior, and the focus theory of normative conduct suggest that perceived behavioral control (PBC) over smoking cessation is a central mechanism that underlies the relationship between nicotine dependence and quitting intentions. Purpose/Objectives: The present study tested a moderated mediation model to examine the roles of PBC over smoking cessation and social norms, in the relationship between nicotine dependence and quit intentions among male regular smokers. Methods: Self-report measures of nicotine dependence, PBC over smoking cessation, descriptive and injunctive quitting norms, and intentions to quit smoking were administered to 204 Chinese male regular smokers. Results: Nicotine dependence was negatively related to quit intentions, and this relationship was mediated by PBC over smoking cessation. Further, the relationship between nicotine dependence and PBC was moderated by descriptive rather than injunctive quitting norms. The negative effects of nicotine dependence on PBC over smoking cessation were not significant among male regular smokers who reported strong descriptive quitting norms. Conclusions/Importance: Poor PBC over smoking cessation underlies the negative effects of nicotine dependence, and descriptive quitting norms act as a buffer against the adverse effects of nicotine dependence on PBC over smoking cessation. These findings have implications for smoking cessation interventions for male regular smokers.
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Affiliation(s)
- Haide Chen
- Institute of Psychological and Brain Sciences, Zhejiang Normal University, Jinhua, Zhejiang, China
| | - Boqiang Zhao
- Institute of Psychological and Brain Sciences, Zhejiang Normal University, Jinhua, Zhejiang, China
| | - Xinwei Li
- Institute of Psychological and Brain Sciences, Zhejiang Normal University, Jinhua, Zhejiang, China
| | - Ruibo Xie
- Institute of Psychological and Brain Sciences, Zhejiang Normal University, Jinhua, Zhejiang, China
| | - Weijian Li
- Institute of Psychological and Brain Sciences, Zhejiang Normal University, Jinhua, Zhejiang, China
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15
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Influence of Dental Pain and Tooth Sensitivity on the Intention to Quit Smoking among Schoolchildren. Int J Dent 2020; 2020:8823146. [PMID: 32695169 PMCID: PMC7368192 DOI: 10.1155/2020/8823146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/03/2020] [Accepted: 06/17/2020] [Indexed: 11/20/2022] Open
Abstract
Objective To evaluate the association between oral health problems and sociodemographic factors with the intention to quit smoking and join the tobacco cessation program among schoolchildren. Materials and Methods This cross-sectional study included a sample of 10–12 grade male students from public high schools in different cities of the Eastern province of Saudi Arabia. Schoolchildren responded to a pilot-tested questionnaire about self-reported oral health problems and the intention to quit smoking. Bivariate and multivariate logistic regression analyses were performed. Results Out of 587 schoolchildren, 199 were smokers with a smoking prevalence of 33.9%. Significantly higher proportions of smokers than nonsmokers had tooth sensitivity (P = 0.029) and dryness of the mouth (P = 0.001). Most smokers (75.9%) had a family history of smoking, and 51.8% started smoking within the last two years. Tooth sensitivity (56.3%), dental cavities (52.8%), and dental pain (44.7%) were highly prevalent among smokers. About one-third of smokers expressed their intention to quit smoking (38.2%) and join a smoking cessation program (33.7%). Tooth sensitivity (OR = 3.7, P = 0.004) and dental pain (OR = 2.84, P = 0.014) were significantly associated with quitting smoking. In addition, smokers with tooth sensitivity (OR = 3.22, P = 0.007) had higher odds of joining a smoking cessation program than those without tooth sensitivity. The smokers who started smoking within the last two years (OR = 3.97, P = 0.002) were more likely to quit smoking than those who initiated smoking for more than two years. Conclusion Oral health problems were highly prevalent among smokers. Tooth sensitivity was significantly associated with quitting smoking and joining a cessation program in children. The awareness about the adverse effects of smoking on oral health should be part of regional, national, and global tobacco prevention policies and programs.
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Logo DD, Kyei-Faried S, Oppong FB, Ae-Ngibise KA, Ansong J, Amenyaglo S, Ankrah ST, Singh A, Owusu-Dabo E. Waterpipe use among the youth in Ghana: Lessons from the Global Youth Tobacco Survey (GYTS) 2017. Tob Induc Dis 2020; 18:47. [PMID: 32547350 PMCID: PMC7291957 DOI: 10.18332/tid/120937] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 04/14/2020] [Accepted: 04/21/2020] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION The Global Youth Tobacco Survey’s findings have been used to support Ghana’s tobacco control legislation, monitor tobacco use among the youth and also used in meeting various Articles of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC). These Articles include: Article 8 (Protection for exposure to tobacco smoke); Article 12 (Education, communication, training and public awareness); Article 13 (Tobacco advertising, promotion, and sponsorship); Article 14 (Demand reduction measures concerning tobacco dependence and cessation); and Article 16 (Sales to and by minors). Among the four waves of GYTS in Ghana, the 2017 GYTS was the first to assess waterpipe smoking, through optional questions included in the GYTS questionnaire. We assessed sex, age and regional differentials in waterpipe smoking among the youth in Ghana, and also explored the association between the use of other tobacco products and waterpipe use. METHODS The GYTS employs a standardized methodology with self-administered questionnaires, consisting of core, optional, and country specific questions. Fourteen questions, out of the seventy-four (74) questions administered for the entire GYTS, assessed waterpipe tobacco smoking (WTS). Chi-squared test was used to assess sex, age, grade/form and regional differentials in waterpipe use. Furthermore, the association between smoking cigarettes, smokeless tobacco, electronic cigarettes and waterpipe smoking, was explored by employing a chi-squared test with a 5% significance level. RESULTS Of a total of 5664 students who participated in the study, 90.9% were aged 13–15 years. The respondents were almost equally distributed among males and females. Overall, 3.1% of the respondents had ever smoked waterpipe. The overall prevalence of current waterpipe use was 1.7%; with 2.1% in girls (95% CI: 0.9–4.7%) and 0.9% in boys (95% CI: 0.5–1.6%), p=0.033. Additionally, more than half (55.0%) of the current waterpipe users smoked three or more sessions per day. Surprisingly, close to half (46.9%) of the current waterpipe users smoked at home. CONCLUSIONS Waterpipe use, particularly among the female student population, represents an emerging tobacco epidemic and hence deserves immediate attention from authorities. This study revealed that waterpipe is being used among Junior High students in Ghana. Education on the health implications of waterpipe use should be intensified among the youth, to help minimize its use and to prevent its associated health harms.
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Affiliation(s)
- Divine D Logo
- Research and Development Division, Ghana Health Service, Accra, Ghana.,Department of Global and International Health, School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Felix B Oppong
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana
| | - Kenneth A Ae-Ngibise
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana.,School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
| | - Joana Ansong
- World Health Organization Ghana Country Office, Accra, Ghana
| | - Seidu Amenyaglo
- Department of Global and International Health, School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Sampson T Ankrah
- Department of Global and International Health, School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Arti Singh
- Department of Global and International Health, School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ellis Owusu-Dabo
- Department of Global and International Health, School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Kwon J, Kim H, Kim H, Yoo S, Park SG. Effect of Increasing Tobacco Prices on Stages of Smoking Cessation: A Korean Nationwide Data Analysis. Korean J Fam Med 2020; 42:17-23. [PMID: 32423180 PMCID: PMC7884892 DOI: 10.4082/kjfm.19.0135] [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: 10/19/2019] [Accepted: 02/14/2020] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND In 2015, tobacco prices significantly increased in Korea as part of the government's smoking cessation policy. This study examined the changes in the stages of smoking cessation among Korean male smokers before and after the implementation of the tobacco price policy, and identified the predictors of such changes. METHODS The study population comprised 3,533 male current smokers (age ≥19 years) who participated in the Korea National Health and Nutrition Survey in 2012, 2013, 2015, and 2016. Current smokers were defined as persons who had smoked ≥100 cigarettes during their lifetime and are continuing to smoke. In accordance with the transtheoretical model, smokers were classified into the precontemplation stage (no plan to quit), contemplation stage, and preparation stage (planning to quit within 6 months). We examined the changes in the smoking cessation stages before and after the implementation of the policy. Multivariate logistic regression analysis was conducted to identify factors related to the likelihood of continuing smoking, after adjustments for potential confounders. RESULTS Immediately after the policy implementation, the percentage of smokers in the precontemplation stage decreased from 65.6% to 60.8% (P=0.014). However, this effect was temporary. Significant risk factors for remaining in the precontemplation stage were older age (odds ratio [OR], 1.010; 95% confidence interval [CI], 1.002-1.018; P=0.004), being in the lowest income quartile (OR, 1.226; 95% CI, 1.001-1.502; P=0.049), and manual worker or unemployed status (OR, 1.256; 95% CI, 1.036-1523; P=0.020). CONCLUSION Increasing tobacco prices only temporarily change the stage of smoking cessation among Korean male smokers.
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Affiliation(s)
- Jihye Kwon
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Hyunji Kim
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Hyoeun Kim
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Sunmi Yoo
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Seung Guk Park
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
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18
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Kumar N, Ainooson J, Billings A, Chen G, Cueto L, Janmohamed K, Jiang J, Niaura R, Zhang A. The scope of tobacco cessation randomized controlled trials in low- to middle-income countries: protocol for a scoping review. Syst Rev 2020; 9:86. [PMID: 32317003 PMCID: PMC7171801 DOI: 10.1186/s13643-020-01361-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 04/14/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Tobacco consumption is the leading cause of preventable death globally. The global mortality burden of tobacco use lies predominantly in low- to middle-income countries (LMICs). There is much evidence on the effectiveness of tobacco cessation RCTs in high-income nations. However, the evidence base in LMICs is far more limited. To effectively design randomized controlled trials (RCTs) that mitigate tobacco-related harms in LMICs, further understanding of RCTs in this environment will be helpful. We will provide quality evidence regarding the scope of tobacco cessation RCTs in LMICs. METHODS A scoping review of tobacco cessation RCTs will be conducted. MEDLINE, Embase, PsycINFO, Global Health, Web of Science and Sociological Abstracts will be searched to capture current literature. We will review RCTs that have already been done on tobacco cessation in the LMICs. The key outcome will be tobacco cessation in adults. Examples of the key outcome include smoking abstinence and reduction of tobacco use. Study selection will conform to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines and study quality assessed with a modified version of the Cochrane Collaboration's instrument. DISCUSSION As researchers attempt to minimize the harms from tobacco in LMICs, they need to be aware of scientific evidence to develop RCTs to achieve their aim. The review will complement the evidence base on tobacco cessation in LMICs.
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Affiliation(s)
- Navin Kumar
- Human Nature Lab, Department of Sociology, Yale University, New Haven, CT, USA.
| | - Jessica Ainooson
- Human Nature Lab, Department of Sociology, Yale University, New Haven, CT, USA
| | - Ameera Billings
- Human Nature Lab, Department of Sociology, Yale University, New Haven, CT, USA
| | - Grace Chen
- Human Nature Lab, Department of Sociology, Yale University, New Haven, CT, USA
| | - Lauren Cueto
- Human Nature Lab, Department of Sociology, Yale University, New Haven, CT, USA
| | - Kamila Janmohamed
- Human Nature Lab, Department of Sociology, Yale University, New Haven, CT, USA
| | - Jeannette Jiang
- Human Nature Lab, Department of Sociology, Yale University, New Haven, CT, USA
| | - Raymond Niaura
- Department of Social and Behavioral Sciences, College of Global Public Health, New York University, 715 Broadway, New York, NY, USA.,Department of Epidemiology, College of Global Public Health, New York University, 715 Broadway, New York, NY, USA
| | - Amy Zhang
- Human Nature Lab, Department of Sociology, Yale University, New Haven, CT, USA
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19
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Park MB, Kang CK, Choi JK. Smoking cessation is related to change in metabolic syndrome onset: A rural cohort study. Tob Induc Dis 2020; 18:14. [PMID: 32180691 PMCID: PMC7067233 DOI: 10.18332/tid/118232] [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: 12/10/2019] [Revised: 01/20/2020] [Accepted: 02/17/2020] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Relatively few, mainly cross-sectional, studies have examined the relationship between smoking cessation and metabolic syndrome (MetS). In particular, information on smoking cessation after MetS is limited. This study aimed to investigate the probability of smoking cessation after the onset of MetS. METHODS In this study we used cohort data from a rural area of Korea and extracted the data of 1054 smokers who were identifiable at baseline and were followed up. Of these, 1041 individuals were selected. Descriptive statistical analyses were performed to identify the basic characteristics of smokers. Multiple logistic regression was performed to determine the association between changes in MetS and smoking cessation. RESULTS The probability of smoking cessation was 1.84 times higher in the newly developed MetS cohort than in the reference group (without MetS at any time point), and it was 1.61 times higher in the persistent MetS cohort than in the reference group, with both probabilities being significant. CONCLUSIONS We found that patients with MetS were more likely to quit smoking than those without MetS. However, intervention is still needed, as numerous patients with MetS continued to smoke. Interventions that actively involve medical institutions or organizations are among the most effective approaches to promote smoking cessation in patients with MetS. In particular, women, farmers and current drinkers should be prioritized.
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Affiliation(s)
- Myung-Bae Park
- Department of Gerontology Health and Welfare, Pai Chai University, Daejeon, Republic of Korea
| | - Cheon-Kook Kang
- Department of Health Administration, Baekseok Culture University, Cheonan, Republic of Korea
| | - Jung-Kyu Choi
- Institute of Health Insurance and Clinical Research, National Health Insurance Corporation Ilsan Hospital, Goyang, Republic of Korea
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Herbeć A, Zatoński M, Zatoński WA, Janik-Koncewicz K, Mons U, Fong GT, Quah ACK, Driezen P, Demjén T, Tountas Y, Trofor AC, Fernández E, McNeill A, Willemsen M, Vardavas CI, Przewoźniak K. Dependence, plans to quit, quitting self-efficacy and past cessation behaviours among menthol and other flavoured cigarette users in Europe: The EUREST-PLUS ITC Europe Surveys. Tob Induc Dis 2019; 16:A19. [PMID: 34671234 PMCID: PMC8525627 DOI: 10.18332/tid/111356] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 07/24/2019] [Accepted: 07/26/2019] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION This study characterises smoking and cessation-related behaviours among menthol and other flavoured cigarette users in Europe prior to the implementation of the European Tobacco Products Directive (TPD) ban on the sale of flavoured cigarettes. METHODS An analysis of cross-sectional data from the 2016 EUREST-PLUS ITC Europe Surveys was conducted among a sample of 10760 adult smokers from eight European Union Member States. Respondents were classified as menthol, other flavoured, unflavoured, or no usual flavour cigarette users and compared on smoking and cessation behaviours and characteristics. Data were analysed in SPSS Complex Samples Package using bivariate and multivariate regression analyses adjusted for sociodemographic characteristics, dependence, and country. RESULTS In bivariate analyses, cigarette flavour was significantly associated with all outcomes (p<0.001). After adjusting for sociodemographic characteristics, these associations attenuated but remained significant and in the same direction for dependence, self-efficacy, plans to quit, past quit attempts, and ever e-cigarette use. In fully adjusted models, compared to smokers of non-flavoured cigarettes, menthol smokers were less likely to smoke daily (AOR=0.47, 95% CI: 0.32-0.71), smoke within 30 min of waking (0.52,0.43-0.64), consider themselves addicted (0.74,0.59-0.94), and more likely to have ever used e-cigarettes (1.26,1.00-1.57); other flavoured cigarette smokers were less likely to smoke daily (0.33,0.15-0.77), and have higher self-efficacy (1.82,1.20-2.77); no usual flavour smokers were less likely to smoke daily (0.34,0.22-0.51), smoke within 30 min of waking (0.66,0.55-0.80), consider themselves addicted (0.65,0.52-0.78), have ever made a quit attempt (0.69,0.58-0.84), have ever used e-cigarettes (0.66,0.54-0.82), and had higher self-efficacy (1.46,1.19-1.80). CONCLUSIONS Smokers of different cigarette flavours in Europe differ on smoking and cessation characteristics. The lower dependence of menthol cigarette smokers could lead to greater success rates if quit attempts are made, however cross-country differences in smoking behaviours and quitting intentions could lead to the TPD ban on cigarette flavours having differential impact if not accompanied by additional measures, such as smoking cessation support.
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Affiliation(s)
- Aleksandra Herbeć
- Health Promotion Foundation (HPF), Warsaw, Poland.,Department of Behavioural Science and Health, University College London, London, United Kingdom.,Centre for Behaviour Change, Clinical, Educational and Health Psychology, University College London, United Kingdom
| | - Mateusz Zatoński
- Health Promotion Foundation (HPF), Warsaw, Poland.,European Observatory of Health Inequalities, President Stanisław Wojciechowski State University of Applied Sciences, Kalisz, Poland.,Tobacco Control Research Group, Department for Health, University of Bath, Bath, United Kingdom
| | - Witold A Zatoński
- European Observatory of Health Inequalities, President Stanisław Wojciechowski State University of Applied Sciences, Kalisz, Poland.,Health Promotion Foundation (HPF), Warsaw, Poland
| | | | - Ute Mons
- Cancer Prevention Unit and WHO Collaborating Centre for Tobacco Control, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo (UW), Waterloo, Canada.,School of Public Health and Health Systems, University of Waterloo (UW), Waterloo, Canada.,Ontario Institute for Cancer Research, Toronto, Canada
| | - Anne C K Quah
- Department of Psychology, University of Waterloo (UW), Waterloo, Canada
| | - Pete Driezen
- Department of Psychology, University of Waterloo (UW), Waterloo, Canada
| | - Tibor Demjén
- Smoking or Health Hungarian Foundation (SHHF), Budapest, Hungary
| | - Yannis Tountas
- National and Kapodistrian University of Athens (UoA), Athens, Greece
| | - Antigona C Trofor
- University of Medicine and Pharmacy 'Grigore T. Popa' Iasi, Iasi, Romania.,Aer Pur Romania, Bucharest, Romania
| | - Esteve Fernández
- Tobacco Control Unit, Catalan Institute of Oncology (ICO), and Tobacco Control Research Group, Bellvitge Biomedical Research Institute (IDIBELL), Catalonia, Spain.,School of Medicine and Health Sciences, University of Barcelona, Catalonia, Spain
| | - Ann McNeill
- UK Centre for Tobacco and Alcohol Studies, London, United Kingdom.,National Addiction Centre, King's College London, London, United Kingdom
| | - Marc Willemsen
- Department of Health Promotion, Maastricht University, Maastricht, the Netherlands
| | - Constantine I Vardavas
- European Network for Smoking and Tobacco Prevention (ENSP), Brussels, Belgium.,University of Crete (UoC), Heraklion, Greece
| | - Krzysztof Przewoźniak
- Maria Skłodowska-Curie Institute - Oncology Center, Warsaw, Poland.,Health Promotion Foundation (HPF), Warsaw, Poland
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Ngan TT, Do VV, Huang J, Redmon PB, Minh HV. Willingness to use and pay for smoking cessation service via text-messaging among Vietnamese adult smokers, 2017. J Subst Abuse Treat 2019; 104:1-6. [PMID: 31370973 DOI: 10.1016/j.jsat.2019.05.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 05/21/2019] [Accepted: 05/23/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To examine willingness to use (WTU) and willingness to pay (WTP) for smoking cessation service via text-messaging among adult smokers in Vietnam in 2017; and to identify demographic and socioeconomic factors associated with the WTU and WTP. METHODS A cross-sectional study of 602 adult smokers who had intention to quit in the next 12 months was conducted in Vietnam in 2017. Participants were provided with the information about a mobile health (mHealth) smoking cessation service via text-messaging and asked about their willingness to use and pay for it. The contigent valuation method was used to estimate the WTP for the service, using single bound question format. Discrete choice model was applied to estimate the average WTP and its associated factors. RESULTS Seventy-two percent of smokers expressed willingness to use smoking cessation service via text-messaging if it were available. The average willingness to pay among those interested in using the mHealth cessation service was 82,000 VND (US$3.5). Smoking status and quit attempts in the last twelve months were associated with WTU, whereas age of the smokers and monthly income were significant predictors of WTP. CONCLUSION A high proportion of Vietnamese smokers with intention to quit were interested in using smoking cessation services via text-messaging. The high level of smokers' willingness to use and pay for the text messaging cessation program indicates the mHealth methods could be a potential option for developing and delivering smoking cessation services in Vietnam.
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Affiliation(s)
- Tran Thu Ngan
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Viet Nam.
| | - Vuong Van Do
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Viet Nam.
| | - Jidong Huang
- School of Public Health, Georgia State University, Atlanta, GA, USA.
| | | | - Hoang Van Minh
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Viet Nam.
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Han JW, Lee H. The Longitudinal Relationships between Depression and Smoking in Hardcore Smokers Using Autoregressive Cross-Lagged Modeling. J Korean Acad Nurs 2019; 49:69-79. [PMID: 30837444 DOI: 10.4040/jkan.2019.49.1.69] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 01/07/2019] [Accepted: 01/08/2019] [Indexed: 11/09/2022]
Abstract
PURPOSE This study aimed to identify the directionality of the causal relationship and interaction between depression and amount of smoking over time in hardcore smokers using longitudinal descriptive analysis. METHODS Secondary data from the Korean Welfare Panel Study were analyzed using autoregressive cross-lagged modeling. Participants included 342 hardcore smokers who participated in the 8th to 11th waves of the panel study. RESULTS Analyses revealed that change(s) in depression levels according to time had a significant positive relationship with the total amount of smoking per day (β=.29, β=.19, β=.17, p<.001), while change(s) in total amount of smoking per day according to time had a significant positive relationship with depression (β=.43, β=.50, β=.38, p<.001). Analysis of the cross-lagged effect between depression and total amount of smoking per day showed that depression at one time point had a significantly positive relationship with the total amount of smoking per day at the next time point (β=.14, β=.13, β=.13, p=.021), and that the total amount of smoking per day at one time point had a significant positive relationship with depression at the next time point (β=.04, β=.04, β=.03, p=.044). CONCLUSION The findings in the present study confirmed a cross-interaction between depression and total amount of smoking per day in hardcore smokers. The present findings could be used to develop appropriate smoking-related interventions.
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Affiliation(s)
- Jeong Won Han
- College of Nursing Science, Kyung Hee University, Seoul, Korea
| | - Hanna Lee
- Department of Nursing, Changwon National University, Changwon, Korea.
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Wang Q, Mati K. Intention to Quit among Smokers in Kazakhstan: Data from 2014 Global Adult Tobacco Survey. J Epidemiol Glob Health 2019; 9:23-28. [PMID: 30932386 PMCID: PMC7310764 DOI: 10.2991/jegh.k.190212.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 01/16/2019] [Indexed: 12/14/2022] Open
Abstract
Kazakhstan is one of the countries with higher-than-average smoking prevalence and tobacco-related mortality. Intention to quit is a key step toward smoking cessation, yet has not been studied in Kazakhstan. This study explored prevalence and correlates of intention to quit among smokers in Kazakhstan. We drew data from the nationally representative survey, the Global Adult Tobacco Survey (GATS), conducted during 2014 in Kazakhstan. Our sample consisted of 649 smokers aged ≥15 years. We examined prevalence of intention to quit by demographics, knowledge of tobacco-related diseases, nicotine dependence, attempt to quit in the past 12 months, household smoking restrictions, and awareness of antismoking messages. Univariate and multivariate logistic regressions were used to test the significance of these correlates. Prevalence of intention to quit was around 75.9% among smokers. Older age (p < 0.001), knowledge of tobacco-related diseases (p < 0.01), moderate nicotine dependence (p < 0.001), attempt to quit within the past 12 months (p < 0.001), and having household smoking restrictions (p < 0.001) were all significant correlates. We suggest investing in efforts to promote cessation activities for smokers of all ages, to disseminate comprehensive information on tobacco-related diseases, and to uphold and strengthen policies on smoking bans.
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Affiliation(s)
- Qian Wang
- Department of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Komi Mati
- Dobson DaVanzo & Associates, Vienna, VA 22180, USA
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Põld M, Pärna K. Factors associated with desire to quit smoking among Estonian physicians: Cross-sectional data of 2002 and 2014. Tob Prev Cessat 2018; 4:29. [PMID: 32411855 PMCID: PMC7205111 DOI: 10.18332/tpc/93009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 06/29/2018] [Accepted: 07/04/2018] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Smoking is a major health threat and quitting smoking would be a notable benefit. The aim of the present study was to explore factors associated with desire to quit smoking among Estonian physicians in 2002 and 2014. METHODS Self-reported data of current smokers were drawn from Estonian physicians' cross-sectional postal surveys in 2002 (n=322) and 2014 (n=189). A logistic regression model was used to analyse the association between desire to quit smoking and factors related to smoking behaviour among 'current smokers'. RESULTS The prevalence of desire to quit smoking among physicians was 55.3% in 2002 and 52.9% in 2014. Physicians who were concerned about harms of smoking, had higher odds for desire to quit compared with those who were not concerned (OR=9.06; 95% CI: 4.15-19.74). Compared to physicians with no quit attempts, odds for desire to give up smoking were significantly higher among physicians with quit attempts. Wish to set a good example was significantly associated with desire to quit (OR=2.38; 95% CI: 1.12-5.09). Compared to specialist doctors, dentists had higher odds for desire to quit smoking (OR=2.42; 95% CI: 1.25-4.69). CONCLUSIONS More than half of Estonian smoking physicians expressed the desire to quit. Desire to quit was associated with concern about harms of smoking, number of previous quit attempts, setting a good example, and medical specialty. The findings suggest that there is a need for smoking cessation counselling services that are addressed, especially for physicians in Estonia.
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A 10-year observational study on the trends and determinants of smoking status. PLoS One 2018; 13:e0200010. [PMID: 29979744 PMCID: PMC6034816 DOI: 10.1371/journal.pone.0200010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 06/18/2018] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Most studies on motivation and intention to quit smoking have been conducted among adolescents and young adults but little is known regarding middle-aged subjects. We aimed to assess the trends and determinants of smoking status in a population-based cohort. METHOD Observational, prospective study with a first mean follow-up at 5.6 years and a second at 10.9 years. Data from 3999 participants (49.2% women, aged 35-75 years) living in Lausanne (Switzerland). RESULTS Baseline prevalence of never, former and current smokers was 41.3, 34.3 and 24.3%, respectively. During the study period, more than 90% of never and former and almost 60% of current smokers at baseline retained their status after 10.9 years. Among 973 current smokers, 216 (22.2%) had quit for at least 5 years. Multivariable analysis showed increasing age to be positively associated with quitting (p-value for trend <0.001). Among 1373 former smokers, 149 (10.9%) had relapsed; increasing age (p-value for trend <0.001) was negatively associated and family history of lung disease was positively associated with relapse [OR and 95% CI: 1.53 (1.06-2.21)]. Among 1653 never smokers, 128 (7.7%) initiated smoking; Male gender [1.46 (1.01-2.12)] and living in coupled relationship [0.66 (0.45-0.97)] were associated with smoking initiation. CONCLUSION Most middle-aged never and former smokers did not change their status with time, while 22.2% of current smokers sustained quitting. This is encouraging and could be improved with adequate supportive methods. In comparison to available data, this study confirms the difficult task of identifying subjects at risk of a negative behavioral change.
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Bartlem K, Bailey J, Metse A, Asara A, Wye P, Clancy R, Wiggers J, Bowman J. Do mental health consumers want to improve their long-term disease risk behaviours? A survey of over 2000 psychiatric inpatients. Int J Ment Health Nurs 2018; 27:1032-1043. [PMID: 29197143 PMCID: PMC6446942 DOI: 10.1111/inm.12411] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/03/2017] [Indexed: 12/13/2022]
Abstract
Policies and clinical guidelines acknowledge the role mental health services have in addressing the physical health of individuals with a mental illness; however, little research has explored interest in reducing health risk behaviours or the acceptability of receiving support to reduce such risks among psychiatric inpatients. This study estimated the prevalence of four long-term disease risk behaviours (tobacco smoking, hazardous alcohol consumption, inadequate fruit and/or vegetable consumption, and inadequate physical activity); patient interest in reducing these risks; and acceptability of being provided care to do so during a psychiatric inpatient stay. A cross-sectional survey was undertaken with 2075 inpatients from four inpatient psychiatric facilities in one health district in Australia (October 2012-April 2014). Prevalence of risk behaviours ranged from 50.2% (inadequate physical activity) to 94.8% (inadequate fruit and/or vegetable consumption). The majority of respondents (88.4%) had more than one risk behaviour, and most were seriously considering improving their risk behaviours (47.6% to 65.3%). The majority (80.4%) agreed that it would be acceptable to be provided support and advice to change such behaviours during their psychiatric inpatient stay. Some diagnoses were associated with smoking and hazardous alcohol consumption, interest in reducing alcohol consumption and increasing fruit and/or vegetable consumption, and acceptability of receiving advice and support. The findings reinforce the need and opportunity for psychiatric inpatient facilities to address the long-term disease risk behaviours of their patients.
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Affiliation(s)
- Kate Bartlem
- School of PsychologyFaculty of Science and Information TechnologyUniversity of NewcastleCallaghanNew South WalesAustralia
- Clinical Research CentreHunter Medical Research InstituteNewcastleNew South WalesAustralia
- Population Health, Hunter New England Local Health DistrictWallsend Health ServicesNewcastleNew South WalesAustralia
| | - Jacqueline Bailey
- School of PsychologyFaculty of Science and Information TechnologyUniversity of NewcastleCallaghanNew South WalesAustralia
- Clinical Research CentreHunter Medical Research InstituteNewcastleNew South WalesAustralia
| | - Alexandra Metse
- School of PsychologyFaculty of Science and Information TechnologyUniversity of NewcastleCallaghanNew South WalesAustralia
- Clinical Research CentreHunter Medical Research InstituteNewcastleNew South WalesAustralia
| | - Ashley Asara
- School of PsychologyFaculty of Science and Information TechnologyUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Paula Wye
- School of PsychologyFaculty of Science and Information TechnologyUniversity of NewcastleCallaghanNew South WalesAustralia
- Clinical Research CentreHunter Medical Research InstituteNewcastleNew South WalesAustralia
- Population Health, Hunter New England Local Health DistrictWallsend Health ServicesNewcastleNew South WalesAustralia
| | - Richard Clancy
- Clinical Research CentreHunter Medical Research InstituteNewcastleNew South WalesAustralia
- School of Nursing and MidwiferyFaculty of Health and MedicineUniversity of NewcastleCallaghanNew South WalesAustralia
- Centre for Translational Neuroscience and Mental HealthHunter New England Mental HealthMater HospitalNewcastleNew South WalesAustralia
| | - John Wiggers
- Clinical Research CentreHunter Medical Research InstituteNewcastleNew South WalesAustralia
- Population Health, Hunter New England Local Health DistrictWallsend Health ServicesNewcastleNew South WalesAustralia
- School of Medicine and Public HealthFaculty of Health and MedicineUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Jenny Bowman
- School of PsychologyFaculty of Science and Information TechnologyUniversity of NewcastleCallaghanNew South WalesAustralia
- Clinical Research CentreHunter Medical Research InstituteNewcastleNew South WalesAustralia
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Manis M, Tamm M, Stolz D. Unaided Smoking Cessation in Healthy Employees. Respiration 2017; 95:80-86. [PMID: 29131057 DOI: 10.1159/000481826] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 09/26/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND According to guidelines, behavioral and pharmacological assistance should be offered to all smokers willing to quit. However, a large proportion of ex-cigarette smokers are self-quitters. OBJECTIVES To identify characteristics of long-term, unaided self-quitters, as compared to recurrent smokers among health care employees. METHODS University hospital employees (n = 5,218) were addressed through a 17-question questionnaire inquiring about past and current smoking behavior. Questions included daily cigarette consumption, pack-years, previous quit attempts, smoking-free period, and utilization of pharmacological therapies and counseling. RESULTS 2,574 (49.3%) questionnaires were returned. 791 subjects declared to have successfully quit smoking. A complete data set was available for 763 cases. Patients remained smoking free for a mean period of 11.8 ± 9.7 years. The most common smoking cessation method in these subjects was unaided (77.2%), followed by alternative approaches (15.4%), nicotine replacement therapy (4.5%), counseling (1.7%), and bupropion (1.2%). Smoking cessation was achieved with 1 attempt in 53% of the cases, 2 in 19%, 3 in 13%, and more than 3 attempts in 15%, respectively. On average, 2.4 ± 3.02 attempts led to successful smoking cessation. After 2 or more unsuccessful attempts, the odds ratio for a further unsuccessful smoking cessation was 2.58 (95% CI 1.94-3.45). CONCLUSION The majority of the ex-smokers quitted smoking without any behavioral or pharmacological support. The chance to successfully quit smoking without any help in a first or second attempt is considerably high. The risk for smoking recurrence after 2 ineffective quit attempts is markedly increased (OR 2.58).
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Sebo P, Maisonneuve H, Cerutti B, Fournier JP, Senn N, Rat C, Haller DM. Overview of preventive practices provided by primary care physicians: A cross-sectional study in Switzerland and France. PLoS One 2017; 12:e0184032. [PMID: 28873433 PMCID: PMC5584957 DOI: 10.1371/journal.pone.0184032] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Accepted: 08/16/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND A range of preventive practices are recommended to reduce the burden of chronic diseases. The aim of our study was to describe the preventive practices of French-speaking primary care physicians. METHODS A cross-sectional survey was conducted in 2015 in a randomly selected sample of 1100 primary care physicians (700 in Switzerland, 400 in France). The physicians were asked how often they performed the following recommended preventive practices: blood pressure, weight and height measurements, screening for dyslipidemia, screening for alcohol use and brief intervention, screening for smoking (and brief advice for smokers), colon and prostate cancer screening, and influenza immunization. Response options on the five points Likert scale were never, rarely, sometimes, often, always. The physicians were considered to be performing the preventive practice regularly if they declared performing it often or always. RESULTS 518 participants (47%) returned the questionnaire. The most commonly reported preventive practices were: blood pressure measurement (99%), screening for smoking (95%) and brief advice for smokers (95%). The least frequently reported practices were annual influenza immunization for at-risk patients <65 years (37%), height measurement (53%), screening for excessive alcohol use (60%) and brief advice for at-risk drinkers (67%). All other practices were reported by 70 to 90% of participants. CONCLUSION Whereas some preventive practices now appear to be part of primary care routine, others were not applied by a large proportion of primary care physicians in our study. Further studies should explore whether these findings are related to miss-knowledge of common guidelines, or other implementation barriers in this primary care context.
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Affiliation(s)
- Paul Sebo
- Primary Care Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- * E-mail:
| | - Hubert Maisonneuve
- Primary Care Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Bernard Cerutti
- Unit of Research and Development in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Jean-Pascal Fournier
- Department of General Practice, Faculty of Medicine, University of Nantes, Nantes, France
| | - Nicolas Senn
- Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland
| | - Cédric Rat
- Department of General Practice, Faculty of Medicine, University of Nantes, Nantes, France
- French National Institute of Health and Medical Research, Unit 1232-team 2, Nantes, France
| | - Dagmar M. Haller
- Primary Care Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Community, Primary Care and Emergency Medicine & Department of Paediatrics, Geneva University Hospitals, Geneva, Switzerland
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Driezen P, Abdullah AS, Quah ACK, Nargis N, Fong GT. Determinants of intentions to quit smoking among adult smokers in Bangladesh: findings from the International Tobacco Control (ITC) Bangladesh wave 2 survey. Glob Health Res Policy 2016; 1:11. [PMID: 29202060 PMCID: PMC5693557 DOI: 10.1186/s41256-016-0012-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 08/09/2016] [Indexed: 11/10/2022] Open
Abstract
Background With about 22 million adult smokers, Bangladesh needs strong measures that would promote smoking cessation. Using data from Wave 2 of the International Tobacco Control (ITC) Survey, this study examined the factors associated with intention to quit smoking among Bangladeshi smokers. Methods Data from Wave 2 of the International Tobacco Control (ITC) Survey in Bangladesh, a face to face survey of adult smokers, were analysed. In the ITC survey, households were sampled using a stratified multistage design and interviewed using a structured questionnaire. Results Of the respondents (N = 2982), most were male (96 %), married (80 %), and Muslim (83 %); 33 % were illiterate and 54 % were aged below 40. Almost two-thirds were from areas outside Dhaka, 78 % smoked cigarettes exclusively; and 36 % had an intention to quit smoking in the future. This study identified several predictors, comparable to other international studies, of intention to quit smoking: area of residence, number of cigarettes smoked daily, previous quit attempt, visiting a doctor in the past, having child aged 5 or below at home, perceived benefit from quitting, being worried about own health, knowledge of SHS, not enjoying smoking and workplace smoking policy. Conclusions These findings suggest that the prevalence of intention to quit smoking is lower among Bangladeshi smokers than those among smokers in developed countries. However, the factors relating to quit intentions among Bangladeshi smokers are comparable to those found in Western countries. Population based tobacco control programs and policies should consider these predictors in the design of interventions to increase quitting among smokers in Bangladesh.
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Affiliation(s)
- Pete Driezen
- Department of Psychology, University of Waterloo, Waterloo, ON Canada
| | - Abu S Abdullah
- Global Health Program, Duke Kunshan University, Kunshan, Jiangsu Province 215347 China.,Duke Global Health Institute, Duke University, Durham, NC 27710 USA.,Department of General Internal Medicine, Boston University School of Medicine, Boston Medical Center, 801 Massachusetts Avenue, Crosstown Center (2nd Floor), Boston, MA 02118 USA
| | - Anne C K Quah
- Department of Psychology, University of Waterloo, Waterloo, ON Canada
| | - Nigar Nargis
- Department of Economics, University of Dhaka, Dhaka, Bangladesh.,American Cancer Society, Washington DC, USA
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, ON Canada.,Ontario Institute for Cancer Research, Toronto, ON Canada
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Wong LP, Alias H, Aghamohammadi N, Aghazadeh S, Hoe VCW. Shisha Smoking Practices, Use Reasons, Attitudes, Health Effects and Intentions to Quit among Shisha Smokers in Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E726. [PMID: 27447655 PMCID: PMC4962267 DOI: 10.3390/ijerph13070726] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 05/20/2016] [Accepted: 05/24/2016] [Indexed: 12/01/2022]
Abstract
Despite its popularity, shisha smoking practices, reasons for its use, attitudes, detrimental health effects and intention to quit among shisha users in Malaysia have never been investigated. A total of 503 shisha users responded to a cross-sectional study conducted between July 2015 and March 2016. The majority of users were young people aged 21-30; a small minority were underage. The reasons for shisha use were its growing popularity as a favourite pastime activity and the perception of shisha use as cool and trendy. Just over half (57.3%) agree that shisha use exposes the smoker to large amounts of smoke and the majority were unsure about the health risks of shisha smoking compared to tobacco smoking. The three most common detrimental health effects reported by the study respondents were dry throat, headache and nausea. Regular shisha users have significantly higher detrimental health effects compared to no-regular shisha users. Shisha users with a duration of smoking of 6-12 months (odds ratio (OR) 3.212; 95% confidence interval (CI) 1.651-6.248) and 6 months and below (OR 2.601; 95% CI 1.475-4.584) were significantly more likely to have a higher proportion who intend quitting smoking than shisha users of more than 12 months duration.
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Affiliation(s)
- Li Ping Wong
- Julius Centre University of Malaya (JCUM), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| | - Haridah Alias
- Julius Centre University of Malaya (JCUM), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| | - Nasrin Aghamohammadi
- Centre for Occupational and Environmental Health, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| | - Sima Aghazadeh
- Innovative International College, Petaling Jaya, 46000 Selangor, Malaysia.
| | - Victor Chee Wai Hoe
- Julius Centre University of Malaya (JCUM), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
- Centre for Occupational and Environmental Health, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
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Intention to Quit Smoking and Associated Factors in Smokers Newly Diagnosed with Pulmonary Tuberculosis. TANAFFOS 2016; 15:17-24. [PMID: 27403174 PMCID: PMC4937757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Several studies have shown that smoking, as a modifiable risk factor, can affect tuberculosis (TB) in different aspects such as enhancing development of TB infection, activation of latent TB and its related mortality. Since willingness to quit smoking is a critical stage, which may lead to quit attempts, being aware of smokers' intention to quit and the related predictors can provide considerable advantages. MATERIALS AND METHODS In this cross-sectional study, subjects were recruited via a multi-stage cluster sampling method. Sampling was performed during 2012-2014 among pulmonary TB (PTB) patients referred to health centers in Tehran implementing the directly observed treatment short course (DOTS) strategy and a TB referral center. Data analysis was conducted using SPSS version 22 and the factors influencing quit intention were assessed using bivariate regression and multiple logistic regression models. RESULTS In this study 1,127 newly diagnosed PTB patients were studied; from which 284 patients (22%) were current smokers. When diagnosed with TB, 59 (23.8%) smokers quit smoking. Among the remaining 189 (76.2%) patients who continued smoking, 52.4% had intention to quit. In the final multiple logistic regression model, living in urban areas (OR=8.81, P=0.003), having an office job (OR= 7.34, P=0.001), being single (OR=4.89, P=0.016) and a one unit increase in the motivation degree (OR=2.60, P<0.001) were found to increase the intention to quit smoking. CONCLUSION The study found that PTB patients who continued smoking had remarkable intention to quit. Thus, it is recommended that smoking cessation interventions should be started at the time of TB diagnosis. Understanding the associated factors can guide the consultants to predict patients' intention to quit and select the most proper management to facilitate smoking cessation for each patient.
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Selby P, Hussain S, Voci S, Zawertailo L. Empowering smokers with a web-assisted tobacco intervention to use prescription smoking cessation medications: a feasibility trial. Implement Sci 2015; 10:139. [PMID: 26429100 PMCID: PMC4590254 DOI: 10.1186/s13012-015-0329-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 09/21/2015] [Indexed: 11/10/2022] Open
Abstract
Background Varenicline and bupropion, efficacious smoking cessation medications, have had suboptimal impact due to barriers at the patient, practitioner and system level. This study explored the feasibility of a web-assisted tobacco intervention offering free prescription smoking cessation medication by mail if the smoker visited a physician for authorization. Methods Adult Ontarians, smoking at least 10 cigarettes daily, intending to quit within 30 days, with no contraindications to bupropion or varenicline were eligible. After an online assessment, eligible participants received an electronic personalized printable prescription form for a 12-week course of varenicline or bupropion to bring to a physician within 3 weeks for authorization, if appropriate. The physician’s office faxed prescriptions to an online pharmacy that couriered medication to the patient following medication counselling by telephone. Weekly motivational emails were sent during treatment. Participants were asked to complete follow-up questionnaires online at 7, 11, 15 and 41 weeks after enrollment. Results In total, 1214 individuals submitted an online assessment from April to September 2010 and 73.6 % (95 % confidence interval (CI) = 71.1–76.1 %; n = 893) were eligible. At least 65.8 % (95 % CI = 62.7–68.9 %; n = 588) of eligible participants subsequently visited a physician and 58.7 % (95 % CI = 55.5–61.9 %; n = 524) received medication (50.6 % varenicline [n = 265] and 49.4 % bupropion [n = 259]). Reasons for not filling a prescription were failure to visit a physician (80.1 %; 95 % CI = 73.8–86.5 %; n = 121), physician not prescribing the medication (15.9 %; 95 % CI = 10.1–21.7 %; n = 24) or other reasons (4.0 %; 95 % CI = 0.9–7.1 %; n = 6). Follow-up response rate was 66.7 % (95 % CI = 63.7–69.8 %; n = 596). Minimal issues were encountered with printing the prescription or medication delivery. Conclusions This study establishes the feasibility of using the Internet and free medication to enable smokers to engage physicians to treat this addiction. Implementation of this intervention can be scaled up by leveraging existing healthcare systems to treat smokers on a population level. Further evaluation in a randomized controlled trial is necessary. Trial registration ClinicalTrials.gov Identifier NCT01023659 Electronic supplementary material The online version of this article (doi:10.1186/s13012-015-0329-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Peter Selby
- Addictions Program, Centre for Addiction and Mental Health, 100 Stokes St., Toronto, ON, M6J 1H4, Canada. .,Department of Family and Community Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada. .,Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON, M5T 1R8, Canada. .,Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada. .,Ontario Tobacco Research Unit, 155 College Street, Toronto, ON, M5T 3M7, Canada.
| | - Sarwar Hussain
- Addictions Program, Centre for Addiction and Mental Health, 100 Stokes St., Toronto, ON, M6J 1H4, Canada.
| | - Sabrina Voci
- Addictions Program, Centre for Addiction and Mental Health, 100 Stokes St., Toronto, ON, M6J 1H4, Canada.
| | - Laurie Zawertailo
- Addictions Program, Centre for Addiction and Mental Health, 100 Stokes St., Toronto, ON, M6J 1H4, Canada. .,Department of Pharmacology and Toxicology, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.
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Zhang B, Cohen JE, Bondy SJ, Selby P. Duration of nicotine replacement therapy use and smoking cessation: a population-based longitudinal study. Am J Epidemiol 2015; 181:513-20. [PMID: 25740789 PMCID: PMC4371764 DOI: 10.1093/aje/kwu292] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In the present study, we examined the association between duration of nicotine replacement therapy (NRT) use and smoking cessation using data from the Ontario Tobacco Survey longitudinal study (3 waves of data collected between July 2005 and December 2009). We used logistic regression with generalized estimating equations to examine the association between NRT use (any use and <4 weeks, 4.0–7.9 weeks, 8.0–11.9 weeks, and ≥12 weeks of use compared with nonuse) and quitting smoking (≥1 month). Using NRT was not associated with quitting when use duration was not taken into account (adjusted odds ratio (OR) = 1.08, 95% confidence interval (CI): 0.86, 1.35). Compared with abstaining from NRT when attempting to quit smoking, using NRT for less than 4 weeks was associated with a lower likelihood of quitting (adjusted OR = 0.51, 95% CI: 0.38, 0.67); however, using NRT for 4 weeks or longer was associated with a higher likelihood of cessation (for 4.0–7.9 weeks of NRT use, adjusted OR = 2.26, 95% CI: 1.58, 3.22; for 8.0–11.9 weeks of NRT use, adjusted OR = 3.84, 95% CI: 2.24, 6.58; and for ≥12 weeks of NRT use, adjusted OR = 2.80, 95% CI: 1.70, 4.61). Thus, use of NRT for less than 4 weeks was associated with reduced likelihood of cessation, whereas NRT use for longer periods of time was associated with a higher likelihood of cessation.
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Affiliation(s)
- Bo Zhang
- Correspondence to Dr. Bo Zhang, Room: T521, Ontario Tobacco Research Unit (OTRU), 33 Russell Street, Toronto, Ontario, Canada M5S 2S1 (e-mail: )
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Kaleta D, Usidame B, Dziankowska-Zaborszczyk E, Makowiec-Dąbrowska T. Correlates of cessation success among Romanian adults. BIOMED RESEARCH INTERNATIONAL 2014; 2014:675496. [PMID: 24995319 PMCID: PMC4065768 DOI: 10.1155/2014/675496] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 04/23/2014] [Accepted: 05/18/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND Tobacco smoking and its consequences are a serious public health problem in Romania. Evidence-based data on factors associated with successful smoking cessation are crucial to optimize tobacco control. The aim of the study was to determine the sociodemographic and other factors associated with smoking cessation success among adults. MATERIALS AND METHODS Data was from a sample of 4,517 individuals derived from the Global Adult Tobacco Survey (GATS). GATS is a cross-sectional, nationally representative household survey implemented in Romania in 2011. Data was analyzed with logistic regression. RESULTS Among females, the quit rate was 26.3% compared with 33.1% in males (P < 0.02). We found disparities in cessation success among the analyzed groups of respondents. Being economically active, being aged 40 and above, and having an awareness of smoking health consequences were associated with long-term quitting smoking among men, while initiating smoking at a later age increased the odds of quitting smoking among women. However, cohabitation with nonsmokers was the strongest predictor of successful cessation among both genders. CONCLUSION Programs increasing quit rates and encourage cessation among groups less likely to quit, adopting voluntary smoke-free homes, and increasing the awareness of smoking and tobacco pollution risks are needed.
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Affiliation(s)
- Dorota Kaleta
- Department of Preventive Medicine, Medical University of Łódź, 90 752 Łódź, Poland
| | - Bukola Usidame
- Department of Public Policy, University of Massachusetts, Boston, MA 02125, USA
| | | | - Teresa Makowiec-Dąbrowska
- Department of Work Physiology and Ergonomics, Nofer Institute of Occupational Medicine, 91 348 Łódź, Poland
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Lim KH, Ibrahim N, Ghazali SM, Kee CC, Lim KK, Chan YY, Teh CH, Tee EO, Lai WY, Nik Mohamad MH, Sidek SM. Stages of smoking cessation among Malaysian adults--findings from national health morbidity survey 2006. Asian Pac J Cancer Prev 2013; 14:805-10. [PMID: 23621242 DOI: 10.7314/apjcp.2013.14.2.805] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Increasing the rate of smoking cessation will reduce the burden of diseases related to smoking, including cancer. Understanding the process of smoking cessation is a pre-requisite to planning and developing effective programs to enhance the rate of smoking cessation.The aims of the study were to determine the demographic distribution of smokers across the initial stages of smoking cessation (the pre-contemplation and contemplation stages) and to identify the predictors of smoking cessation among Malaysian adult smokers. Data were extracted from a population-based, cross-sectional survey carried out from April 2006 to July 2006. The distribution of 2,716,743 current smokers across the pre-contemplation stage (no intention to quit smoking in the next six months) or contemplation stage (intended to quit smoking in the next six months) was described. Multivariable logistic regression analysis was used to examine the relationship between socio-demographic variables and the stages of smoking cessation. Of the 2,716,743 current smokers, approximately 30% and 70% were in the pre-contemplative and contemplative stages of smoking cessation respectively. Multivariable analysis showed that male gender, low education level, older age group, married and those from higher income group and number of cigarettes smoked were associated with higher likelihood of pre-contemplation to cease smoking in the next six months. The majority of current smokers in Malaysia were in the contemplative stage of smoking cessation. Specific interventions should be implemented to ensure the pre-contemplative smokers proceed to the contemplative stage and eventually to the preparation stage.
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Affiliation(s)
- Kuang Hock Lim
- Institute for Public Health, Jalan Pahang, Kuala Lumpur, Malaysia.
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Kotz D, Brown J, West R. Predictive validity of the Motivation To Stop Scale (MTSS): a single-item measure of motivation to stop smoking. Drug Alcohol Depend 2013; 128:15-9. [PMID: 22943961 DOI: 10.1016/j.drugalcdep.2012.07.012] [Citation(s) in RCA: 181] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Revised: 07/18/2012] [Accepted: 07/25/2012] [Indexed: 11/17/2022]
Abstract
BACKGROUND Many different measures of motivation to stop smoking exist but it would be desirable to have a brief version that is standard for use in population surveys and for evaluations of interventions to promote cessation. The aim of this study was to assess the predictive validity and accuracy of the single-item Motivation To Stop Scale (MTSS). METHODS This study is part of the "Smoking Toolkit Study;" a monthly survey of representative samples of the English population. We used data from 2483 respondents to the surveys from November 2008 to January 2011, who were smokers, used the MTSS, and were followed up 6 months later to provide information on quit attempts since baseline. The MTSS consists of one item with seven response categories ranging from 1 (lowest) to level 7 (highest level of motivation to stop smoking). RESULTS A total of 692 smokers (27.9% (95% CI=26.1-29.6)) made an attempt to quit smoking between baseline and 6-month follow-up. The odds of quit attempts increased linearly with increasing level of motivation at baseline (p<0.001) and were 6.8 (95% CI=4.7-9.9) times higher for the highest level of motivation compared with the lowest. The accuracy of the MTSS for discriminating between smokers who did and did not attempt to quit was ROC(AUC)=0.67 (95% CI=0.65-0.70). CONCLUSIONS The MTSS provides strong and accurate prediction of quit attempts and is a candidate for a standard single-item measure of motivation to stop smoking. Further research should assess the external validity of this measure in different smoking populations.
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Affiliation(s)
- D Kotz
- Department of General Practice, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, The Netherlands.
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Kaleta D, Korytkowski P, Makowiec-Dąbrowska T, Usidame B, Bąk-Romaniszyn L, Fronczak A. Predictors of long-term smoking cessation: results from the global adult tobacco survey in Poland (2009-2010). BMC Public Health 2012; 12:1020. [PMID: 23173904 PMCID: PMC3563479 DOI: 10.1186/1471-2458-12-1020] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2012] [Accepted: 11/17/2012] [Indexed: 11/18/2022] Open
Abstract
Background Expanding the information on determinants of smoking cessation is crucial for developing and implementing more effective tobacco control measures at the national as well as European levels. Data on smoking cessation and its social correlates among adults from middle-income countries of Central and Eastern Europe are still poorly reported in the literature. The aim of the study was to analyze the association of socio-demographic indicators with long term tobacco smoking cessation (quit smoking for at least one year prior to interview) among adults. Moreover, we evaluated motives for giving up smoking from former smokers. Methods Data on former as well as current smokers’ socio-demographic and smoking-related characteristics were derived from the Global Adult Tobacco Survey (GATS). GATS is a cross-sectional, nationally representative household survey implemented in Poland between 2009 and 2010. GATS collected data on a representative sample of 7,840 individuals including 1,206 individuals who met the criteria of long-term smoking cessation and 2,233 current smokers. Smoking cessation rate was calculated as the number of former smokers divided by the number of ever smokers. Logistic regression analyses were used to obtain odds ratios (ORs) and 95% confidence interval (CI) of the broad number of variables on successful cessation of smoking. Results Among females the quit rate was 30.4% compared to 37.9% in males (p < 0.01). Former smokers declared concerns about the health hazard of smoking (60.8%) and the high price of cigarettes (11.6%) as primary reasons for smoking cessation. Older age, high education attainment, awareness of smoking health consequences was associated with long-term quitting among both genders. Also employed males had over twice the probability of giving up smoking compared with unemployed, and being religious did not contribute to successful smoking cessation. Conclusion Results indicated that smoking cessation policies focused on younger age groups are vital for curbing tobacco epidemic in Poland and should become a public health main concern. There is also the need for interventions to raise awareness on smoking health risks and quitting benefits are crucial to increase cessation potential among adult smokers. Nevertheless further effort needs to be done to prevent smoking uptake.
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Affiliation(s)
- Dorota Kaleta
- Department of Preventive Medicine, Medical University of Łódź, Łódź, Poland.
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Barry SA, Tammemagi MC, Penek S, Kassan EC, Dorfman CS, Riley TL, Commin J, Taylor KL. Predictors of adverse smoking outcomes in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. J Natl Cancer Inst 2012; 104:1647-59. [PMID: 23104210 DOI: 10.1093/jnci/djs398] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The impact of lung cancer screening on smoking behavior is unclear. The aims of this ancillary study of the Prostate Lung Colorectal and Ovarian Cancer Screening Trial were to produce risk prediction models to identify individuals at risk of relapse or continued smoking and to evaluate whether cancer-screening variables affect long-term smoking outcomes. METHODS Participants completed a baseline questionnaire at trial enrollment and a supplemental questionnaire 4-14 years after enrollment, which assessed several cancer-related variables, including family history of cancer, comorbidities, and tobacco use. Multivariable logistic regression models were used to predict smoking status at completion of the supplemental questionnaire. The models' predictive performances were evaluated by assessing discrimination via the receiver operator characteristic area under the curve (ROC AUC) and calibration. Models were internally validated using bootstrap methods. RESULTS Of the 31 694 former smokers on the baseline questionnaire, 1042 (3.3%) had relapsed (ie, reported being a current smoker on the supplemental questionnaire). Of the 6807 current smokers on the baseline questionnaire, 4439 (65.2%) reported continued smoking on the supplemental questionnaire. Relapse was associated with multiple demographic, medical, and tobacco-related characteristics. This model had a bootstrap median ROC AUC of 0.862 (95% confidence interval [CI] = 0.858 to 0.866) and a calibration slope of 1.004 (95% CI = 0.978 to 1.029), indicating excellent discrimination and calibration. Predictors of continued smoking also included multiple demographic, medical, and tobacco-related characteristics. This model had an ROC AUC of 0.611 (95% CI = 0.605 to 0.614) and a slope of 1.006 (95% CI = 0.962 to 1.041), indicating modest discrimination. Neither the trial arm nor the lung-screening result was statistically significantly associated with smoking outcomes. CONCLUSION These models, if validated externally, may have public health utility in identifying individuals at risk for adverse smoking outcomes, who may benefit from relapse prevention and smoking cessation interventions.
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Stockings E, Bowman J, McElwaine K, Baker A, Terry M, Clancy R, Bartlem K, Wye P, Bridge P, Knight J, Wiggers J. Readiness to quit smoking and quit attempts among Australian mental health inpatients. Nicotine Tob Res 2012; 15:942-9. [PMID: 23089486 PMCID: PMC3621580 DOI: 10.1093/ntr/nts206] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Mental health inpatients smoke at higher rates than general population smokers. However, provision of nicotine-dependence treatment in inpatient settings is low, with barriers to the provision of such care including staff views that patients do not want to quit. This paper reports the findings of a survey of mental health inpatients at a psychiatric hospital in New South Wales, Australia, assessing smoking and quitting motivations and behaviors. METHODS Smokers (n = 97) were surveyed within the inpatient setting using a structured survey tool, incorporating the Fagerström Test for Nicotine Dependence, Reasons for Quitting Scale, Readiness and Motivation to Quit Smoking Questionnaire, and other measures of smoking and quitting behavior. RESULTS Approximately 47% of smokers reported having made at least one quit attempt within the past 12 months, despite nearly three quarters (71.2%) being classified as in a "precontemplative" stage of change. Multinomial logistic regressions revealed that self-reporting "not enjoying being a smoker" and having made a quit attempt in the last 12 months predicted having advanced beyond a precontemplative stage of change. A high self-reported desire to quit predicted a quit attempt having been made in the last 12 months. CONCLUSIONS The majority of smokers had made several quit attempts, with a large percentage occurring recently, suggesting that the actual quitting behavior should be considered as an important indication of the "desire to quit." This paper provides further data supporting the assertion that multimodal smoking cessation interventions combining psychosocial and pharmacological support should be provided to psychiatric inpatients who smoke.
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D'Souza G, Rekha DP, Sreedaran P, Srinivasan K, Mony PK. Clinico-epidemiological profile of tobacco users attending a tobacco cessation clinic in a teaching hospital in Bangalore city. Lung India 2012; 29:137-42. [PMID: 22628928 PMCID: PMC3354487 DOI: 10.4103/0970-2113.95314] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Tobacco-attributable mortality in India is estimated to be at least 10%. Tobacco cessation is more likely to avert millions of deaths before 2050 than prevention of tobacco use initiation. Objective: To describe the clinico-epidemiological profile of attendees of a tobacco cessation clinic in a teaching hospital in Bangalore city. Materials and Methods: A descriptive study of 189 attendees seen over 2 years in the Tobacco Cessation Clinic of a tertiary-care teaching hospital in Bangalore, with information on socio demographic characteristics, tobacco-use details, nicotine dependence, family/medical history, past quit attempts, baseline stage-of-change, and treatment initiated. Results: Only 5% were ‘walk-in’ patients; 98% of attendees were smokers; 97% were males. The mean (±SD) age of attendees was 48.0 (±14.0) years. Most participants were married (88%), and predominantly urban (69%). About 62% had completed at least 8 years of schooling. Two-thirds of smokers reported high levels of nicotine dependence (Fagerström score >5/10). About 43% of patients had attempted quitting earlier. Four-fifths (79%) of tobacco-users reported a family member using tobacco. Commonly documented comorbidities included: Chronic respiratory disease (44%), hypertension (23%), diabetes (12%), tuberculosis (9%), myocardial infarction (2%), stroke (1%), sexual dysfunction (1%) and cancer (0.5%). About 52% reported concomitant alcohol use. At baseline, patients’ motivational stage was: Precontemplation (14%), contemplation (48%), preparation/action (37%) and maintenance (1%). Treatment modalities started were: Counseling alone (41%), nicotine replacement therapy alone (NRT) (34%), medication alone (13%), and NRT+medication (12%). Conclusions: This is the first study of the baseline profile of patients attending a tobacco cessation clinic located within a chest medicine department in India. Important determinants of outcome have been captured for follow-up and prospective documentation of outcomes.
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Affiliation(s)
- George D'Souza
- Tobacco Cessation Clinic, St John's Medical College Hospital, Koramangala, Bangalore, India
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