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Domić A, Pilipović-Broćeta N, Grabež M, Divac N, Igić R, Škrbić R. Intensive Intervention on Smoking Cessation in Patients Undergoing Elective Surgery: The Role of Family Physicians. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:965. [PMID: 38929582 PMCID: PMC11205568 DOI: 10.3390/medicina60060965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 05/29/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024]
Abstract
Background and Objectives: The aim of this study was to determine the role of physicians in the intensive intervention and education regarding the smoking cessation of patients undergoing elective surgery under general anaesthesia. Materials and Methods: A randomised prospective study was conducted in family physicians' clinics in which smokers of both sexes, aged 21-65 years, without cognitive impairments, and who were not addicted to psychoactive substances voluntarily participated. Four weeks preoperatively, 120 smokers were randomised into two equal groups; the intervention group (IG) underwent an intervention for the purpose of smoking cessation and the control group (CG) underwent no intervention. Biochemical tests were performed in order to determine the smoking status of the participants in the phase of randomisation, one week preoperatively, as well as 40, 120, and 180 days and 12 months postoperatively. The examinees of the IG talked to the physician five times and received 140 telephone messages, leaflets, and motivational letters along with the pharmacotherapy, while the participants in the CG received little or no advice on smoking cessation. Results: The results of this study confirmed a significant influence of the intervention and education on the smoking abstinence in the IG compared to the CG (p < 0.001). The smokers in the IG had 7.31 (95% CI: 2.32-23.04) times greater odds of abstinence upon the 12-month follow-up than the smokers in the CG. The smokers in the IG who did not stop smoking had a lower degree of dependence and smoked fewer cigarettes (p < 0.0001) compared to those in the CG, as well as a multiple times higher prevalence of short- and long-term abstinence. Conclusions: It can be concluded that the intensive intervention and education can motivate patients preparing for elective surgery to stop smoking in the short- and long term.
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Affiliation(s)
- Anto Domić
- Primary Health Care Centre, 76100 Brčko, Bosnia and Herzegovina;
| | - Nataša Pilipović-Broćeta
- Department of Family Medicine, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, The Republic of Srpska, Bosnia and Herzegovina;
| | - Milkica Grabež
- Department of Hygiene, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, The Republic of Srpska, Bosnia and Herzegovina;
| | - Nevena Divac
- Department of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Rajko Igić
- The Academy of Sciences and Arts of The Republic of Srpska, 78000 Banja Luka, Bosnia and Herzegovina;
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
| | - Ranko Škrbić
- The Academy of Sciences and Arts of The Republic of Srpska, 78000 Banja Luka, Bosnia and Herzegovina;
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
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Minué-Lorenzo C, Olano-Espinosa E, Minué-Estirado M, Vizcaíno-Sánchez JM, Camarelles-Guillem F, Granados-Garrido JA, Ruiz-Pacheco M, Gámez-Cabero MI, Martínez-Suberviola FJ, Serrano-Serrano E, Cura-González ID. Gender, smoking, and tobacco cessation with pharmacological treatment in a cluster randomized clinical trial. Tob Induc Dis 2024; 22:TID-22-38. [PMID: 38362269 PMCID: PMC10867739 DOI: 10.18332/tid/177260] [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: 08/09/2023] [Revised: 12/03/2023] [Accepted: 12/18/2023] [Indexed: 02/17/2024] Open
Abstract
INTRODUCTION Whether men find it easier to quit smoking than women is still controversial. Different studies have reported that the efficacy of pharmacological treatments could be different between men and women. This study conducted a secondary analysis of 'Subsidized pharmacological treatment for smoking cessation by the Spanish public health system' (FTFT-AP study) to evaluate the effectiveness of a drug-funded intervention for smoking cessation by gender. METHODS A pragmatic randomized clinical trial by clusters was used. The population included smokers aged ≥18 years, smoking >10 cigarettes per day, randomly assigned to an intervention group receiving regular practice and financed pharmacological treatment, or to a control group receiving only regular practice. The main outcome was continued abstinence at 12 months, self-reported and validated with CO-oximetry. The percentage, with 95% confidence intervals, of continued abstinence was compared between both groups at 12 months post-intervention, by gender and the pharmacological treatment used. Multilevel logistic regression analysis was performed. RESULTS A total of 1154 patients from 29 healthcare centers were included. The average age was 46 years (SD=11.78) and 51.7% were men. Overall, the self-reported abstinence at 12 months was 11.1% (62) in women and 15.7% (93) in men (AOR=1.4; 95% CI: 1.0-2.0), and abstinence validated by CO-oximetry was 4.6% (26) and 5.9% (35) in women and men, respectively (OR=1.3; 95% CI: 0.7-2.2). In the group of smokers receiving nicotine replacement treatment, self-reported abstinence was higher in men compared to women (29.5% vs 13.5%, OR=2.7; 95% CI: 1.3-5.8). CONCLUSIONS The effectiveness of a drug-financed intervention for smoking cessation was greater in men, who also showed better results in self-reported abstinence with nicotine replacement treatment.
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Affiliation(s)
- César Minué-Lorenzo
- Centro de Salud Perales del Río, Dirección Asistencial Centro, Servicio Madrileño de Salud, Madrid, España
- Red de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud, Madrid, España
- Instituto de Investigación Sanitaria Hospital Doce de Octubre (i+12), Madrid, España
- Research Network on Preventive Activities and Health Promotion, Madrid, Spain
| | - Eduardo Olano-Espinosa
- Red de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud, Madrid, España
- Instituto de Investigación Sanitaria Hospital Doce de Octubre (i+12), Madrid, España
- Research Network on Preventive Activities and Health Promotion, Madrid, Spain
- Centro de Salud Los Castillos, Dirección Asistencial Oeste, Servicio Madrileño de Salud, Madrid, España
| | - María Minué-Estirado
- Centro de Salud José María Llanos, Dirección Asistencial Este, Servicio Madrileño de Salud, Madrid, España
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España
| | - Jose-María Vizcaíno-Sánchez
- Instituto de Investigación Sanitaria Hospital Doce de Octubre (i+12), Madrid, España
- Centro de Salud Fuentelarreina, Dirección Asistencial Norte, Servicio Madrileño de Salud, Madrid, España
| | - Francisco Camarelles-Guillem
- Red de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud, Madrid, España
- Instituto de Investigación Sanitaria Hospital Doce de Octubre (i+12), Madrid, España
- Research Network on Preventive Activities and Health Promotion, Madrid, Spain
- Centro de Salud Infanta Mercedes, Dirección Asistencial Norte, Servicio Madrileño de Salud, Madrid, España
| | - José-Antonio Granados-Garrido
- Instituto de Investigación Sanitaria Hospital Doce de Octubre (i+12), Madrid, España
- Research Network on Preventive Activities and Health Promotion, Madrid, Spain
- Centro de Salud Guayaba, Dirección Asistencial Centro, Servicio Madrileño de Salud, Madrid, España
| | - Margarita Ruiz-Pacheco
- Centro de Salud Algete, Dirección Asistencial Norte, Servicio Madrileño de Salud, Madrid, España
| | - María Isabel Gámez-Cabero
- Instituto de Investigación Sanitaria Hospital Doce de Octubre (i+12), Madrid, España
- Centro de Salud Majadahonda Valle de la Oliva, Dirección Asistencial Noroeste, Servicio Madrileño de Salud, Madrid, España
| | - Francisco Javier Martínez-Suberviola
- Red de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud, Madrid, España
- Instituto de Investigación Sanitaria Hospital Doce de Octubre (i+12), Madrid, España
- Centro de Salud Guayaba, Dirección Asistencial Centro, Servicio Madrileño de Salud, Madrid, España
| | - Encarnación Serrano-Serrano
- Red de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud, Madrid, España
- Instituto de Investigación Sanitaria Hospital Doce de Octubre (i+12), Madrid, España
- Research Network on Preventive Activities and Health Promotion, Madrid, Spain
- Centro de Salud Los Fresnos, Dirección Asistencial Este, Servicio Madrileño de Salud, Madrid, España
| | - Isabel Del Cura-González
- Red de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud, Madrid, España
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España
- Unidad de Investigación, Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Madrid, España
- Red de Investigación Servicios de Salud en enfermedades crónicas, REDISSEC, Madrid, España
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Messer S, Siegel A, Bertin L, Erblich J. Sex differences in affect-triggered lapses during smoking cessation: A daily diary study. Addict Behav 2018; 87:82-85. [PMID: 29966963 DOI: 10.1016/j.addbeh.2018.06.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 05/24/2018] [Accepted: 06/15/2018] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Smoking lapses during a cessation attempt are common and are thought to be a key predictor of full relapse. Positive and negative affective states have been hypothesized as important precipitants of lapses during quit attempts, although findings have been mixed. Accumulating evidence suggests that women may smoke more when experiencing negative affective states, while men may smoke more when experiencing positive affective states. The possibility that these sex differences may play a role in predicting lapses during a smoking cessation attempt, however, has not been well-investigated. In this study, we hypothesized that, during a quit attempt, negative affect would be more strongly associated with lapses among women, and positive affect would be more strongly associated with lapses among men. METHOD We conducted a prospective study in which male and female nicotine-dependent smokers (n = 60) made an unaided, 'cold-turkey' quit attempt. For fourteen days following the initiation of the quit attempt, participants completed daily diaries in which they recorded the degree to which states of 'good mood' and 'bad mood' preceded smoking lapses. RESULTS Consistent with the study hypothesis, findings indicated that men reported higher good-mood-induced smoking lapses than women across the 14-day study interval. Conversely, while levels of bad-mood-induced smoking subsided over the 14-day interval among men, levels persisted among women. DISCUSSION Results further underscore the need to address sex-specific affective triggers when developing smoking cessation strategies.
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Abstract
BACKGROUND Healthcare professionals, including nurses, frequently advise people to improve their health by stopping smoking. Such advice may be brief, or part of more intensive interventions. OBJECTIVES To determine the effectiveness of nursing-delivered smoking cessation interventions in adults. To establish whether nursing-delivered smoking cessation interventions are more effective than no intervention; are more effective if the intervention is more intensive; differ in effectiveness with health state and setting of the participants; are more effective if they include follow-ups; are more effective if they include aids that demonstrate the pathophysiological effect of smoking. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group Specialized Register and CINAHL in January 2017. SELECTION CRITERIA Randomized trials of smoking cessation interventions delivered by nurses or health visitors with follow-up of at least six months. DATA COLLECTION AND ANALYSIS Two review authors extracted data independently. The main outcome measure was abstinence from smoking after at least six months of follow-up. We used the most rigorous definition of abstinence for each trial, and biochemically-validated rates if available. Where statistically and clinically appropriate, we pooled studies using a Mantel-Haenszel fixed-effect model and reported the outcome as a risk ratio (RR) with a 95% confidence interval (CI). MAIN RESULTS Fifty-eight studies met the inclusion criteria, nine of which are new for this update. Pooling 44 studies (over 20,000 participants) comparing a nursing intervention to a control or to usual care, we found the intervention increased the likelihood of quitting (RR 1.29, 95% CI 1.21 to 1.38); however, statistical heterogeneity was moderate (I2 = 50%) and not explained by subgroup analysis. Because of this, we judged the quality of evidence to be moderate. Despite most studies being at unclear risk of bias in at least one domain, we did not downgrade the quality of evidence further, as restricting the main analysis to only those studies at low risk of bias did not significantly alter the effect estimate. Subgroup analyses found no evidence that high-intensity interventions, interventions with additional follow-up or interventions including aids that demonstrate the pathophysiological effect of smoking are more effective than lower intensity interventions, or interventions without additional follow-up or aids. There was no evidence that the effect of support differed by patient group or across healthcare settings. AUTHORS' CONCLUSIONS There is moderate quality evidence that behavioural support to motivate and sustain smoking cessation delivered by nurses can lead to a modest increase in the number of people who achieve prolonged abstinence. There is insufficient evidence to assess whether more intensive interventions, those incorporating additional follow-up, or those incorporating pathophysiological feedback are more effective than one-off support. There was no evidence that the effect of support differed by patient group or across healthcare settings.
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Affiliation(s)
- Virginia Hill Rice
- Wayne State UniversityCollege of Nursing5557 Cass AvenueDetroitMichiganUSA48202
| | - Laura Heath
- University of OxfordNuffield Department of Primary Care Health SciencesRadcliffe Observatory QuarterWoodstock RoadOxfordUKOX2 6GG
| | - Jonathan Livingstone‐Banks
- University of OxfordNuffield Department of Primary Care Health SciencesRadcliffe Observatory QuarterWoodstock RoadOxfordUKOX2 6GG
| | - Jamie Hartmann‐Boyce
- University of OxfordNuffield Department of Primary Care Health SciencesRadcliffe Observatory QuarterWoodstock RoadOxfordUKOX2 6GG
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Rasmussen M, Fernández E, Tønnesen H. Effectiveness of the Gold Standard Programme compared with other smoking cessation interventions in Denmark: a cohort study. BMJ Open 2017; 7:e013553. [PMID: 28242770 PMCID: PMC5337720 DOI: 10.1136/bmjopen-2016-013553] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES We compared the effectiveness of the Gold Standard Programme (a comprehensive smoking cessation intervention commonly used in Denmark) with other face-to-face smoking cessation programmes in Denmark after implementation in real life, and we identified factors associated with successful quitting. DESIGN Prospective cohort study. SETTING A total of 423 smoking cessation clinics from different settings reported data from 2001 to 2013. PARTICIPANTS In total, 82 515 patients were registered. Smokers ≥15 years old and attending a programme with planned follow-up were included. Smokers who did not want further contact, who intentionally were not followed up or who lacked information about the intervention they received were excluded. A total of 46 287 smokers were included. INTERVENTIONS Various real-life smoking cessation interventions were identified and compared: The Gold Standard Programme, Come & Quit, crash courses, health promotion counselling (brief intervention) and other interventions. MAIN OUTCOME Self-reported continuous abstinence for 6 months. RESULTS Overall, 33% (11 184) were continuously abstinent after 6 months; this value was 24% when non-respondents were considered smokers. The follow-up rate was 74%. Women were less likely to remain abstinent, OR 0.83 (CI 0.79 to 0.87). Short interventions were more effective among men. After adjusting for confounders, the Gold Standard Programme was the only intervention with significant results across sex, increasing the odds of abstinence by 69% for men and 31% for women. In particular, compliance, and to a lesser degree, mild smoking, older age and not being disadvantaged were associated with positive outcomes for both sexes. Compliance increased the odds of abstinence more than 3.5-fold. CONCLUSIONS Over time, Danish smoking cessation interventions have been effective in real life. Compliance is the main predictor of successful quitting. Interestingly, short programmes seem to have relatively strong effects among men, but the absolute numbers are very small. Only the comprehensive Gold Standard Programme works across sexes.
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Affiliation(s)
- Mette Rasmussen
- WHO-CC Clinical Health Promotion Centre, Bispebjerg and Frederiksberg Hospital, Part of Copenhagen University Hospital, Frederiksberg, Denmark
| | - Esteve Fernández
- Tobacco Control Unit, Institut Català d'Oncologia (ICO-IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Hanne Tønnesen
- Health Science, University of Southern Denmark, Odense, Denmark
- WHO-CC Clinical Health Promotion Centre, Department of Health Sciences, Lund University, Skåne University Hospital, Malmö, Sweden
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Walker NJ, van Woerden HC, Kiparoglou V, Yang Y, Robinson H, Croghan E. Gender difference and effect of pharmacotherapy: findings from a smoking cessation service. BMC Public Health 2016; 16:1038. [PMID: 27716223 PMCID: PMC5048401 DOI: 10.1186/s12889-016-3672-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 09/16/2016] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Smoking cessation services are available in England to provide assistance to those wishing to quit smoking. Data from one such service were analysed in order to investigate differences in quit rate between males and females prescribed with different treatments. METHODS A logistic regression model was fitted to the data using the binary response of self-reported quit (failed attempt = 0, successful attempt = 1), validated by Carbon Monoxide (CO) monitoring, 4 weeks after commencing programme. Main effects fitted were: client gender; age; region; the type of advisory sessions; and pharmacotherapy, Nicotine Replacement Therapy (NRT) or Varenicline. A second model was fitted including all main effects plus two-way interactions except region. These models were repeated using 12-week self-reported quit as the outcome. RESULTS At 4 weeks, all main effects were statistically significant, with males more likely (odds ratio and 95 % CI, females v males = 0.88 [0.79-0.97]), older smokers more likely (adjusted odds ratios [OR] and 95 % confidence interval [CI] respectively for groups 20-29, 30-49, 50-69 and 70+ vs 12-19 age group: 1.79 [1.39-2.31], 2.12 [1.68-2.68], 2.30 [1.80-2.92] and 2.47 [1.81-3.37] and for overall difference between groups, χ2(4) = 53.5, p < 0.001) and clients being treated with Varenicline more likely to have successfully quit than those on NRT (adjusted OR and 95 % CI for Varenicline vs NRT = 1.41 [1.21-1.64]). Statistically significant interactions were observed between (i) gender and type of counselling, and (ii) age and type of counselling. Similar results were seen in relation to main effects at 12 weeks except that type of counselling was non-significant. The only significant interaction at this stage was between gender and pharmacotherapy (adjusted OR and 95 % CI for females using Varenicline versus all other groups = 1.43 [1.06-1.94]). CONCLUSION Gender and treatment options were identified as predictors of abstinence at both 4 and 12 weeks after quitting smoking. Furthermore, interactions were observed between gender and (i) type of counselling received (ii) pharmacotherapy. In particular, the quit rate in women at 12 weeks was significantly improved in conjunction with Varenicline use. These findings have implications for service delivery.
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Affiliation(s)
- N. J. Walker
- Oxford Biomedical Research Centre, Churchill Hospital, Oxford, England
| | - H. C. van Woerden
- Institute of Primary Care & Public Health, Cardiff University, Cardiff, Wales
- Centre for Health Sciences, University of the Highlands and Islands, Inverness, Scotland
| | - V. Kiparoglou
- Oxford Biomedical Research Centre, Churchill Hospital, Oxford, England
| | - Y. Yang
- Nuffield Department of Primary Care Health Science, University of Oxford, Oxford, England
| | - H. Robinson
- Quit 51 Stop Smoking Service, Burton-on-Trent, England
| | - E. Croghan
- Quit 51 Stop Smoking Service, Burton-on-Trent, England
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Martín Cantera C, Puigdomènech E, Ballvé JL, Arias OL, Clemente L, Casas R, Roig L, Pérez-Tortosa S, Díaz-Gete L, Granollers S. Effectiveness of multicomponent interventions in primary healthcare settings to promote continuous smoking cessation in adults: a systematic review. BMJ Open 2015; 5:e008807. [PMID: 26428333 PMCID: PMC4606220 DOI: 10.1136/bmjopen-2015-008807] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE The objective of the present review is to evaluate multicomponent/complex primary care (PC) interventions for their effectiveness in continuous smoking abstinence by adult smokers. DESIGN A systematic review of randomised and non-randomised controlled trials was undertaken. ELIGIBILITY CRITERIA FOR INCLUDED STUDIES Selected studies met the following criteria: evaluated effects of a multicomponent/complex intervention (with 2 or more intervention components) in achieving at least 6-month abstinence in adult smokers who visited a PC, biochemical confirmation of abstinence, intention-to-treat analysis and results published in English/Spanish. METHODS We followed PRISMA statement to report the review. We searched the following data sources: MEDLINE, Web of Science, Scopus (from inception to February 2014), 3 key journals and a tobacco research bulletin. The Scottish Intercollegiate Guidelines Network checklists were used to evaluate methodological quality. Data selection, evaluation and extraction were done independently, using a paired review approach. Owing to the heterogeneity of interventions in the studies included, a meta-analysis was not conducted. RESULTS Of 1147 references identified, 9 studies were selected (10,204 participants, up to 48 months of follow-up, acceptable methodological quality). Methodologies used were mainly individual or group sessions, telephone conversations, brochures or quit-smoking kits, medications and economic incentives for doctors and no-cost medications for smokers. Complex interventions achieved long-term continuous abstinence ranging from 7% to 40%. Behavioural interventions were effective and had a dose-response effect. Both nicotine replacement and bupropion therapy were safe and effective, with no observed differences. CONCLUSIONS Multicomponent/complex interventions in PC are effective and safe, appearing to achieve greater long-term continuous smoking cessation than usual care and counselling alone. Selected studies were heterogeneous and some had significant losses to follow-up. Our results show that smoking interventions should include more than one component and a strong follow-up of the patient to maximise results.
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Affiliation(s)
- Carlos Martín Cantera
- Unitat de Suport a la Recerca Barcelona, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
- Centre d'Atenció Primària (CAP) Passeig de Sant Joan, Institut Català de la Salut (ICS), Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elisa Puigdomènech
- Unitat de Suport a la Recerca Barcelona, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
| | - Jose Luis Ballvé
- Centre d'Atenció Primària (CAP) Florida Nord, Institut Català de la Salut (ICS), Hospitalet de Llobregat, Barcelona, Spain
| | - Olga Lucía Arias
- Centre d'Atenció Primària (CAP) Florida Nord, Institut Català de la Salut (ICS), Hospitalet de Llobregat, Barcelona, Spain
| | | | - Ramon Casas
- Centre d'Atenció Primària (CAP) Sant Antoni, Institut Català de la Salut (ICS), Barcelona, Spain
| | - Lydia Roig
- Centre d'Atenció Primària (CAP) La Garriga, Institut Català de la Salut (ICS), La Garriga, Barcelona, Spain
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Sabadell, Spain
| | - Santiago Pérez-Tortosa
- Centre d'Atenció Primària (CAP) La Llagosta, Institut Català de la Salut (ICS), La Llagosta, Spain
| | - Laura Díaz-Gete
- Centre d'Atenció Primària (CAP) la Sagrera, Institut Català de la Salut (ICS), Barcelona, Spain
| | - Sílvia Granollers
- Centre d'Atenció Primària (CAP) Esplugues de Llobregat, Institut Català de la Salut (ICS), Esplugues de Llobregat, Spain
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Higashibata T, Nakagawa H, Okada R, Wakai K, Hamajima N. Trends in smoking rates among urban civil servants in Japan according to occupational categories. NAGOYA JOURNAL OF MEDICAL SCIENCE 2015; 77:417-23. [PMID: 26412888 PMCID: PMC4574329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 07/06/2015] [Indexed: 10/24/2022]
Abstract
Occupation could affect the distribution of smoking status of workers, and the success of smoking cessation among workers depends partly on worksite conditions. Blue collar workers have been identified as a high-risk group for smoking. The aim of the present study was to examine trends in smoking rates among urban civil servants in Japan according to occupational categories. Subjects were urban civil servants aged 30-59 years. They annually reported smoking status in a questionnaire in a worksite health check-up each year from 2004 to 2011. Urban civil servants reported substantially lower current smoking rates than national smoking rates in Japan (20.2%, 23.8%, and 27.0% for males in their 30s, 40s, and 50s and 2.4%, 6.3%, and 9.5% for females, respectively, in 2011). In analysis by occupational categories, current smoking rates declined among all groups except female white collar workers in their 50s. The current and persistent smoking rates (number of current smokers/[number of ex-smokers and current smokers]) among blue collar workers were higher than those among white collar workers at almost all time points in all age and gender groups. This study found relatively lower current smoking rates among urban civil servants than the national average and higher current and persistent smoking rates in blue collar workers than in white collar workers among them. These results would help to make suitable worksite smoking cessation policies for each occupational category.
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Affiliation(s)
- Takahiro Higashibata
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroko Nakagawa
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Rieko Okada
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Garcia-Portilla MP, Garcia-Alvarez L, Saiz PA, Diaz-Mesa E, Galvan G, Sarramea F, Garcia-Blanco J, Elizagarate E, Bobes J. Effectiveness of a multi-component Smoking Cessation Support Programme (McSCSP) for patients with severe mental disorders: study design. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 11:373-89. [PMID: 24368428 PMCID: PMC3924449 DOI: 10.3390/ijerph110100373] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 12/13/2013] [Accepted: 12/14/2013] [Indexed: 11/24/2022]
Abstract
Only a few studies have examined the efficacy and safety of smoking cessation programmes in patients with mental disorders. The aim of this paper is to describe in detail the methodology used in the study as well as the Multi-component Smoking Cessation Support Programme in terms of pharmacological treatments and psychological interventions. An open-label 9-month follow-up study was conducted in Spain. A total of 82 clinically stable outpatients with schizophrenia, schizoaffective or bipolar disorder were enrolled. Treatment consisted of a programme specifically developed by the research team for individuals with severe mental disorders. The programme consisted of two phases: (1) weekly individual motivational therapy for 4–12 weeks, and (2) a 12-week active treatment phase. During this phase, at each study visit patients received a one- or two-week supply of medication (transdermal nicotine patches, varenicline or bupropion) with instructions on how to take it, in addition to group psychotherapy for smoking cessation. Evaluations were performed: (1) at the time of enrolment in the study, (2) during the 12-week active treatment phase of the study (weekly for the first 4 weeks and then biweekly), and (3) after the end of this phase (two follow-up assessments at weeks 12 and 24). Evaluations included: (1) smoking history, (2) substance use, (3) psychopathology, (4) adverse events, and (5) laboratory tests. The importance of this study lies in addressing a topical issue often ignored by psychiatrists: the unacceptably high rates of tobacco use in patients with severe mental disorders.
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Affiliation(s)
- Maria Paz Garcia-Portilla
- Departmento de Psiquiatría, Universidad de Oviedo, 33006 Oviedo, Spain; E-Mails: (M.P.G.-P.); (J.B.)
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Universidad de Oviedo, 33006 Oviedo, Spain; E-Mails: (L.G.-A.); (E.D.-M.)
| | - Leticia Garcia-Alvarez
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Universidad de Oviedo, 33006 Oviedo, Spain; E-Mails: (L.G.-A.); (E.D.-M.)
| | - Pilar Alejandra Saiz
- Departmento de Psiquiatría, Universidad de Oviedo, 33006 Oviedo, Spain; E-Mails: (M.P.G.-P.); (J.B.)
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Universidad de Oviedo, 33006 Oviedo, Spain; E-Mails: (L.G.-A.); (E.D.-M.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +34-985-103-552; Fax: +34-985-103-553
| | - Eva Diaz-Mesa
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Universidad de Oviedo, 33006 Oviedo, Spain; E-Mails: (L.G.-A.); (E.D.-M.)
| | - Gonzalo Galvan
- Universidad Nacional de la Patagonia Austral, Puerto San Julián, 9310 Santa Cruz, Argentina; E-Mail:
- Instituto Interuniversitario de Postgrado en Salud, Santa Rosa, 6300 La Pampa, Argentina
| | - Fernando Sarramea
- Complejo Hospitalario de Jaén, Equipo de Salud Mental de Andújar, 23740 Jaén, Spain; E-Mails: (F.S.); (J.G.-B.)
| | - Josefa Garcia-Blanco
- Complejo Hospitalario de Jaén, Equipo de Salud Mental de Andújar, 23740 Jaén, Spain; E-Mails: (F.S.); (J.G.-B.)
| | - Edorta Elizagarate
- Unidad de Psicosis Refractarias, Hospital Psiquiátrico de Álava, 01006 Vitoria, Spain; E-Mail:
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Universidad del País Vasco, 48940 Leioa-Bizkaia, Spain
| | - Julio Bobes
- Departmento de Psiquiatría, Universidad de Oviedo, 33006 Oviedo, Spain; E-Mails: (M.P.G.-P.); (J.B.)
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Universidad de Oviedo, 33006 Oviedo, Spain; E-Mails: (L.G.-A.); (E.D.-M.)
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Abstract
BACKGROUND Healthcare professionals, including nurses, frequently advise people to improve their health by stopping smoking. Such advice may be brief, or part of more intensive interventions. OBJECTIVES To determine the effectiveness of nursing-delivered smoking cessation interventions. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group specialized Register and CINAHL in June 2013. SELECTION CRITERIA Randomized trials of smoking cessation interventions delivered by nurses or health visitors with follow-up of at least six months. DATA COLLECTION AND ANALYSIS Two authors extracted data independently. The main outcome measure was abstinence from smoking after at least six months of follow-up. We used the most rigorous definition of abstinence for each trial, and biochemically validated rates if available. Where statistically and clinically appropriate, we pooled studies using a Mantel-Haenszel fixed-effect model and reported the outcome as a risk ratio (RR) with a 95% confidence interval (CI). MAIN RESULTS Forty-nine studies met the inclusion criteria. Pooling 35 studies (over 17,000 participants) comparing a nursing intervention to a control or to usual care, we found the intervention to increase the likelihood of quitting (RR 1.29; 95% CI 1.20 to 1.39). In a subgroup analysis the estimated effect size was similar for the group of seven studies using a particularly low intensity intervention but the confidence interval was wider. There was limited indirect evidence that interventions were more effective for hospital inpatients with cardiovascular disease than for inpatients with other conditions. Interventions in non-hospitalized adults also showed evidence of benefit. Eleven studies comparing different nurse-delivered interventions failed to detect significant benefit from using additional components. Six studies of nurse counselling on smoking cessation during a screening health check or as part of multifactorial secondary prevention in general practice (not included in the main meta-analysis) found nursing intervention to have less effect under these conditions. AUTHORS' CONCLUSIONS The results indicate the potential benefits of smoking cessation advice and/or counselling given by nurses, with reasonable evidence that intervention is effective. The evidence for an effect is weaker when interventions are brief and are provided by nurses whose main role is not health promotion or smoking cessation. The challenge will be to incorporate smoking behaviour monitoring and smoking cessation interventions as part of standard practice so that all patients are given an opportunity to be asked about their tobacco use and to be given advice and/or counselling to quit along with reinforcement and follow-up.
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Affiliation(s)
- Virginia Hill Rice
- College of Nursing, Wayne State University, 5557 Cass Avenue, Detroit, Michigan, USA, 48202
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Abstract
Cigarette smokers experience greater rates of morbidity and mortality. Despite the known health risks, use of tobacco products remains high throughout the United States (approximately 19.3% of adults). Tobacco use is associated with higher rates of cardiovascular illness, cardiovascular risk factors (ie, hypertension and atherosclerosis), chronic obstructive pulmonary disease, emphysema, and various types of cancer. Pharmacologic smoking cessation therapies have been used to facilitate abstinence from smoking. This article provides clinicians with instructions for the use of pharmacologic agents for smoking cessation, including considerations for special populations.
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Affiliation(s)
- Abby M Bailey
- UK HealthCare, Department of Pharmacy Services, University of Kentucky, Lexington, Kentucky 40536-0293, USA
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