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Smiley SL, Shin H. Motivation to Quit Smoking Among Black Adults Residing in Los Angeles County Communities With Menthol Cigarette Sales Restrictions. Subst Use Misuse 2024; 59:727-731. [PMID: 38226661 DOI: 10.1080/10826084.2023.2294984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
Background: Research is needed to identify the determinants of motivation to quit smoking among non-Hispanic Black (NHB) adults who smoke menthol cigarettes and reside in communities covered by menthol cigarette bans. Objectives: This study examined the associations between motivation to quit smoking and a range of individual-level predictors, including measures of demographics, harm/risk perception of menthol cigarettes, and awareness of a ban on menthol cigarettes in Los Angeles County unincorporated communities. Self-identified NHB adults who currently smoke menthol cigarettes (N=50; M=47.2 years; SD=13.7; 46% female) were recruited in Los Angeles County unincorporated communities. Participants completed an interviewer-administered cross-sectional survey between January to September 2021. Results: Participants (74%) reported an annual household income of less than $25,000. Participants' mean age at cigarette initiation was 15.7 years old (SD=5.68). Most (88%) were aware of the ordinance banning menthol cigarette sales. Employing multivariable linear regression analysis, harm/risk perception of menthol cigarettes (B=14.69, p<0.01) and awareness of the local menthol ban (B=26.18, p<0.05) were found to be independently associated with motivation to quit smoking. Conclusions: Findings from this community-based sample suggest that among NHB adults who smoke menthol cigarettes, motivation to quit smoking is influenced by their perception of menthol cigarettes as harmful and awareness of local policy banning the sale of menthol cigarettes. Findings underscore the need for community-centered and culturally grounded interventions to facilitate quitting among NHB adults who smoke in order for communities covered by menthol bans to achieve health equity in reducing preventable racial inequities due to menthol cigarettes.
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Affiliation(s)
- Sabrina L Smiley
- Division of Health Promotion and Behavioral Science, School of Public Health, College of Health and Human Services, San Diego State University, San Diego, California, USA
| | - Heesung Shin
- Division of Health Promotion and Behavioral Science, School of Public Health, College of Health and Human Services, San Diego State University, San Diego, California, USA
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Kumari L, Sood M, Gupta S. Effect of age of tobacco initiation and number of failed quit attempts on maintenance of tobacco abstinence. J Cancer Res Ther 2024; 20:333-339. [PMID: 38554343 DOI: 10.4103/jcrt.jcrt_1780_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 10/09/2022] [Indexed: 04/01/2024]
Abstract
BACKGROUND The decision to make a quit attempt is the first step toward the tobacco cessation process. It is well established in the literature that if someone does not take tobacco till the age of 21 years then his chances of remaining tobacco-free for life are higher than his counterparts who start tobacco at early developmental ages. METHODOLOGY AND TOOLS The present study was conducted among 400 university undergraduate students. A cross-sectional survey design was used, multi-stage sampling was done, and four colleges were selected via random sampling. The motivation to quit tobacco, tobacco craving, and maintenance of tobacco abstinence was assessed via contemplation ladder, tobacco craving questionnaire Short Form, and smoking abstinence questionnaire. To validate subjective data, a urine cotinine test was performed. RESULTS The age of tobacco initiation significantly impacts intentions to quit tobacco and tobacco craving levels. The number of unsuccessful quit attempts was also significantly associated with the maintenance of tobacco abstinence. The failed quit attempts play a vital role in altering tobacco cravings and make the withdrawals more complicated to handle for recent tobacco quitters.
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Affiliation(s)
- Laxmi Kumari
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Meenakshi Sood
- Chitkara School of Health Sciences, Chitkara University, Punjab, India
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Rajan S, Mitchell A, Zavala GA, Podmore D, Khali H, Chowdhury AH, Muliyala KP, Appuhamy KK, Aslam F, Nizami AT, Huque R, Shiers D, Murthy P, Siddiqi N, Siddiqi K. Tobacco use in people with severe mental illness: Findings from a multi-country survey of mental health institutions in South Asia. Tob Induc Dis 2023; 21:166. [PMID: 38098747 PMCID: PMC10720264 DOI: 10.18332/tid/174361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 12/17/2023] Open
Abstract
INTRODUCTION People with severe mental illness (SMI) tend to die early due to cardiovascular and respiratory diseases, which may be linked to tobacco use. There is limited information on tobacco use in people with SMI in low- and middle-income countries where most tobacco users reside. We present novel data on tobacco use in people with SMI and their access to tobacco cessation advice in South Asia. METHODS We conducted a multi-country survey of adults with SMI attending mental health facilities in Bangladesh, India, and Pakistan. Using data collected with a standardized WHO STEPS survey tool, we estimated the prevalence and distribution of tobacco use and assessed receipt of tobacco cessation advice. RESULTS We recruited 3874 participants with SMI; 46.8% and 15.0% of men and women consumed tobacco, respectively. Smoking prevalence in men varied by country (Bangladesh 42.8%, India 20.1% and Pakistan 31.7%); <4% of women reported smoking in each country. Smokeless tobacco use in men also varied by country (Bangladesh 16.2%, India 18.2% and Pakistan 40.8%); for women, it was higher in Bangladesh (19.1%), but similar in India (9.9%) and Pakistan (9.1%). Just over a third of tobacco users (38.4%) had received advice to quit tobacco. Among smokers, 29.1% (n=244) made at least one quit attempt in the past year. There was strong evidence for the association between tobacco use and the severity of depression (OR=1.29; 95% CI: 1.12-1.48) and anxiety (OR=1.29; 95% CI: 1.12-1.49). CONCLUSIONS As observed in high-income countries, we found higher tobacco use in people with SMI, particularly in men compared with rates reported for the general population in South Asia. Tobacco cessation support within mental health services offers an opportunity to close the gap in life expectancy between SMI and the general population. STUDY REGISTRATION ISRCTN88485933; https://doi.org/10.1186/ISRCTN88485933 39.
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Affiliation(s)
- Sukanya Rajan
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Alex Mitchell
- Department of Health Sciences, University of York, York, United Kingdom
| | - Gerardo A. Zavala
- Department of Health Sciences, University of York, York, United Kingdom
| | - Danielle Podmore
- Department of Health Sciences, University of York, York, United Kingdom
| | | | | | | | | | - Faiza Aslam
- Institute of Psychiatry, Rawalpindi, Pakistan
| | | | | | - David Shiers
- Psychosis Research Unit, Greater Manchester Mental Health National Health Service Foundation Trust, Manchester City, United Kingdom
- Division of Psychology and Mental Health, The University of Manchester, Manchester City, United Kingdom
- School of Medicine, Keele University, Keele, United Kingdom
| | - Pratima Murthy
- National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Najma Siddiqi
- Department of Health Sciences, University of York, York, United Kingdom
- Bradford District Care National Health Service Foundation Trust, Bradford, United Kingdom
- Hull York Medical School, Hull, United Kingdom
- Hull York Medical School, York, United Kingdom
| | - Kamran Siddiqi
- Department of Health Sciences, University of York, York, United Kingdom
- Hull York Medical School, Hull, United Kingdom
- Hull York Medical School, York, United Kingdom
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Sinha I, Goel R, Bitzer ZT, Trushin N, Liao J, Sinha R. Evaluating electronic cigarette cytotoxicity and inflammatory
responses in vitro. Tob Induc Dis 2022; 20:45. [PMID: 35611070 PMCID: PMC9081552 DOI: 10.18332/tid/147200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 02/15/2022] [Accepted: 03/07/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Indu Sinha
- Department of Biochemistry and Molecular Biology, Penn State College of Medicine, United States
| | - Reema Goel
- Department of Public Health Sciences, Penn State College of Medicine, United States
| | - Zachary T. Bitzer
- Department of Public Health Sciences, Penn State College of Medicine, United States
| | - Neil Trushin
- Department of Public Health Sciences, Penn State College of Medicine, United States
| | - Jason Liao
- Department of Public Health Sciences, Penn State College of Medicine, United States
| | - Raghu Sinha
- Department of Biochemistry and Molecular Biology, Penn State College of Medicine, United States
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Neumann M, Murphy N, Seetharamu N. Impact of Family and Social Network on Tobacco Cessation Amongst Cancer Patients. Cancer Control 2021; 28:10732748211056691. [PMID: 34798778 PMCID: PMC8606921 DOI: 10.1177/10732748211056691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Continued smoking after a cancer diagnosis adversely affects outcomes, including recurrence of the primary cancer and/or the development of second primary cancers. Despite this, prevalence of smoking is high in cancer survivors and higher in survivors of tobacco-related cancers. The diagnosis of cancer provides a teachable moment, and social networks, such as family, friends, and social groups, seem to play a significant role in smoking habits of cancer patients. Interventions that involve members of patients’ social network, especially those who also smoke, might improve tobacco cessation rates. Very few studies have been conducted to evaluate and target patients’ social networks. Yet, many studies have demonstrated that cancer survivors who received higher levels of social support were less likely to be current smokers. Clinicians should be doing as much as they can to encourage smoking cessation in both patients and relevant family members. Research aimed at influencing smoking behavioral change in the entire family is needed to increase cessation intervention success rate, which can ultimately improve the health and longevity of patients as well as their family members.
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Affiliation(s)
- Melissa Neumann
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
| | - Neal Murphy
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 5799Northwell Health Cancer Institute, Lake Success, NY, USA
| | - Nagashree Seetharamu
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 5799Northwell Health Cancer Institute, Lake Success, NY, USA
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Nollen NL, Ahluwalia JS, Sanderson Cox L, Okuyemi K, Lawrence D, Samuels L, Benowitz NL. Assessment of Racial Differences in Pharmacotherapy Efficacy for Smoking Cessation: Secondary Analysis of the EAGLES Randomized Clinical Trial. JAMA Netw Open 2021; 4:e2032053. [PMID: 33464316 PMCID: PMC7816102 DOI: 10.1001/jamanetworkopen.2020.32053] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
IMPORTANCE Understanding Black vs White differences in pharmacotherapy efficacy and the underlying reasons is critically important to reducing tobacco-related health disparities. OBJECTIVE To compare pharmacotherapy efficacy and examine variables to explain Black vs White differences in smoking abstinence. DESIGN, SETTING, AND PARTICIPANTS This study is a secondary analysis of the Evaluating Adverse Events in a Global Smoking Cessation Study (EAGLES) double-blind, placebo-controlled, randomized clinical trial, which took place at clinical trial centers, academic centers, and outpatient clinics in 29 states in the US. US Black and White smokers who smoked 10 or more cigarettes per day with and without psychiatric comorbidity were enrolled between November 2011 and January 2015. Data analysis was performed from July 2019 to January 2020. INTERVENTIONS Participants were randomized (1:1:1:1) in a double-blind, triple-dummy, placebo- and active-controlled (nicotine patch) trial of varenicline and bupropion for 12 weeks with follow-up through week 24. MAIN OUTCOMES AND MEASURES Biochemically verified continuous cigarette abstinence rate (CAR) from weeks 9 to 24. Baseline, postbaseline treatment, and safety characteristics were examined as variables to explain race differences in abstinence. RESULTS Of the 1065 Black smokers enrolled, 255 were randomized to receive varenicline, 259 received bupropion, 286 received nicotine replacement therapy (NRT [ie, nicotine patch]), and 265 received placebo. Among the 3044 White smokers enrolled, 778 were randomized to receive varenicline, 769 received bupropion, 738 received NRT, and 759 received placebo. Participants were predominantly female (614 Black [57.7%] and 1786 White [58.7%] women) and heavy smokers (mean [SD] cigarettes per day, 18.2 [7.9] for Black and 20.0 [7.5] for White smokers), with a mean (SD) age of 47.2 (11.2) years for Black and 46.5 (12.7) years for White participants. Treatment and race were associated with CAR for weeks 9 to 24. The CAR was 4.9% lower for Black vs White participants (odds ratio [OR], 0.53; 95% CI, 0.41-0.69; P < .001); differences were found across all treatments. Pooling psychiatric and nonpsychiatric cohorts, varenicline (OR, 2.63; 95% CI, 1.90-3.63; P < .001), bupropion (OR, 1.75; 95% CI, 1.25-2.46; P = .001), and NRT (OR, 1.52; 95% CI, 1.07-2.16; P = .02) had greater efficacy than placebo for White participants. Only varenicline (OR, 2.63; 95% CI, 1.26-5.48; P = .01) had greater efficacy than placebo for Black participants. Baseline, postbaseline, and safety characteristics differed by race, but these variables did not eliminate the association of race with CAR. Black participants had 49% reduced odds of CAR for weeks 9 to 24 compared with White participants in the adjusted model (OR, 0.51; 95% CI, 0.39-0.66; P < .001). CONCLUSIONS AND RELEVANCE Black and White smokers achieved the highest rate of abstinence while taking varenicline, suggesting that it is the best first-line therapy for these groups. However, Black smokers were less responsive to all therapies, including placebo. Understanding variables (eg, socioeconomic or biological) beyond those may lead to improved treatment outcomes for Black smokers. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01456936.
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Affiliation(s)
- Nicole L. Nollen
- Department of Population Health, University of Kansas School of Medicine, Kansas City
| | - Jasjit S. Ahluwalia
- Alpert Medical School, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island
- Alpert Medical School, Department of Medicine, Brown University School of Public Health, Providence, Rhode Island
| | - Lisa Sanderson Cox
- Department of Population Health, University of Kansas School of Medicine, Kansas City
| | - Kolawole Okuyemi
- Department of Family and Preventive Medicine, The University of Utah School of Medicine, Salt Lake City
| | | | | | - Neal L. Benowitz
- Department of Medicine, Bioengineering, and Therapeutic Sciences, University of California, San Francisco
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Stanel SC, Rivera-Ortega P. Smoking cessation: strategies and effects in primary and secondary cardiovascular prevention. Panminerva Med 2020; 63:110-121. [PMID: 33325671 DOI: 10.23736/s0031-0808.20.04241-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although smoking is seen as a major health problem by most clinicians, few are able to provide evidence based smoking cessation interventions to their patients. Most individuals who smoke actually want to quit. Unfortunately, smoking is still seen as a vice or lifestyle choice, when it is actually a chronic disease which often starts in adolescence. Nicotine dependence is complex and must be quantified and treated differently for each patient in order to achieve high quit rates. Smoking has a significant impact on the development and progression of cardiovascular disease. Smoking cessation is a cost effective and often overlooked prevention tool which improves both short- and long-term outcomes. There are both pharmacological and non-pharmacological strategies for smoking cessation that can be applied in clinical practice. Brief advice, specialized counseling including therapeutic education and behavioral support, and first- and second-line pharmacological interventions have been proven to be effective to help smokers quit. Although classically tobacco dependence was seen in relation to smoking, since the early 2000s, new nicotine delivery systems have appeared on the market, which despite being marketed as "healthy" alternatives, can often complicate smoking cessation efforts and act as gateway devices for new generations of smokers. In this article we review the results of several large systematic reviews and meta-analyses, which have shown that many cessation strategies are effective. We also offer practical tips on providing brief cessation advice and how pharmacotherapy can be prescribed and incorporated into clinical practice in both primary and secondary cardiovascular prevention.
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Affiliation(s)
- Stefan C Stanel
- Department of Respiratory Medicine, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Wythenshawe, UK
| | - Pilar Rivera-Ortega
- Department of Respiratory Medicine, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Wythenshawe, UK -
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Attarabeen O, Alkhateeb F, Sambamoorthi U, Larkin K, Newton M, Kelly K. Impact of Cognitive and Social Factors on Smoking Cessation Attempts among US Adult Muslim Smokers. Innov Pharm 2020; 11. [PMID: 34007626 PMCID: PMC8075139 DOI: 10.24926/iip.v11i3.3382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Muslims in the United States (US) exhibit high rates of cigarette smoking. Guided by the Social Cognitive Theory, the study aimed to investigate the associations between the number of serious cigarette smoking cessation attempts and cognitive as well as environmental factors in adult US Muslim smokers. Methods This cross-sectional study was based on a convenience sample of adult (≥ 18 years) US Muslim smokers. After receiving IRB approval, data were collected using an on-line survey. Unadjusted Poisson regression followed by adjusted multivariable Poisson regression analyses were conducted to answer the research question. Results One hundred thirty-two smokers completed the questionnaire. Smokers reported more serious cigarette smoking cessation attempts if they 1) had more knowledge about the consequences of cigarette smoking cessation, 2) had more positive attitudes regarding quitting, and 3) reported greater religiosity. Additionally, smokers reported fewer serious cigarette smoking cessation attempts if they 1) were employed, 2) affiliated with Sunnah sect, 3) reported better self-assessed health, 4) reported higher perceived value for quitting, and 5) indicated that using tobacco was not allowed inside the home. Only three smokers reported using both prescription medications and counseling to aid with smoking cessation attempts. Conclusions Inadequate utilization of pharmaceutical smoking cessation products and provider professional assistance may exacerbate the problems associated with elevated rates of smoking among US Muslim smokers. Knowledge of the consequences, more positive attitudes, and greater religiosity can be influential constructs in future interventions aimed at encouraging smoking cessation attempts in this population.
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Affiliation(s)
- Omar Attarabeen
- Department of Pharmacy Practice, Research, & Administration, School of Pharmacy, Marshall University
| | - Fadi Alkhateeb
- Department of Pharmacy Practice, South College School of Pharmacy, Knoxville, TN
| | - Usha Sambamoorthi
- Robert C. Byrd Health Sciences Center (North), Department of Pharmaceutical Systems & Policy, West Virginia University
| | - Kevin Larkin
- Department of Psychology, Eberly College of Arts & Sciences, Life Sciences Building, West Virginia University
| | - Michael Newton
- Robert C. Byrd Health Sciences Center (North), Department of Clinical Pharmacy, West Virginia University
| | - Kimberly Kelly
- Robert C. Byrd Health Sciences Center (North), Department of Pharmaceutical Systems & Policy, West Virginia University
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9
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Nollen NL, Mayo MS, Sanderson Cox L, Benowitz NL, Tyndale RF, Ellerbeck EF, Scheuermann TS, Ahluwalia JS. Factors That Explain Differences in Abstinence Between Black and White Smokers: A Prospective Intervention Study. J Natl Cancer Inst 2020; 111:1078-1087. [PMID: 30657926 DOI: 10.1093/jnci/djz001] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 10/03/2018] [Accepted: 01/02/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Black-white differences in smoking abstinence are not well understood. This trial sought to confirm previously reported differences in quitting between blacks and whites and to identify factors underlying this difference. METHODS During enrollment, 224 black and 225 white low-income smokers were stratified on race and within race on age and sex to ensure balance on these factors known to impact abstinence. The intervention included varenicline for 12 weeks and six guideline-based smoking cessation counseling sessions. The primary endpoint was cotinine-verified 7-day point prevalence smoking abstinence at week 26. A priori socioeconomic, smoking, treatment process (eg, treatment utilization, side effects, withdrawal relief), psychosocial, and biological factors were assessed to investigate race differences in abstinence. Unadjusted odds ratios (OR) were used to compare abstinence between blacks and whites. Adjusted odds ratios from logistic regression models were used to examine predictors of abstinence. All statistical tests were two-sided. RESULTS Blacks were less likely to achieve abstinence at week 26 (14.3% vs 24.4%, OR = 0.51, 95% confidence interval [CI] = 0.32 to 0.83, P = .007). Utilizing best subsets logistic regression, five factors associated with race jointly predicted abstinence: home ownership (yes/no, OR = 3.03, 95% CI = 1.72 to 5.35, P < .001), study visits completed (range = 0-6, OR = 2.81, 95% CI = 1.88 to 4.20, P < .001), income (household member/$1000, OR = 1.03, 95% CI = 1.01 to 1.06, P = .02), plasma cotinine (per 1 ng/mL, OR = 0.997, 95% CI = 0.994 to 0.999, P = .002), and neighborhood problems (range = 10-30, OR = 0.88, 95% CI = 0.81 to 0.96, P = .003). CONCLUSIONS The race difference in abstinence was fully explained by lack of home ownership, lower income, greater neighborhood problems, higher baseline cotinine, and higher visit completion, which were disproportionately represented among blacks. Findings illuminate factors that make it harder for blacks in the United States to quit smoking relative to whites and provide important areas for future studies to reduce tobacco-related health disparities.
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Jones MR, Joshu CE, Navas-Acien A, Platz EA. Racial/Ethnic Differences in Duration of Smoking Among Former Smokers in the National Health and Nutrition Examination Surveys. Nicotine Tob Res 2019; 20:303-311. [PMID: 28003510 DOI: 10.1093/ntr/ntw326] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 12/10/2016] [Indexed: 01/22/2023]
Abstract
Introduction The burden of tobacco-related disease is not uniformly distributed across racial/ethnic groups. Differences in smoking duration by race/ethnicity may contribute to this disparity. Previous studies have examined racial/ethnic differences in smoking duration among ever smokers (former and current smokers combined). It is unknown if racial/ethnic differences in smoking duration are evident among quitters. This study examined racial/ethnic differences in duration of smoking among former smokers in the United States. Methods We studied 6030 white, black, and Mexican-American former smokers (3647 men and 2383 women) aged 20-79 years who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999 through 2012. Mean differences in smoking duration by race/ethnicity were estimated using linear regression models. Results After adjustment for demographics, age at smoking initiation and smoking intensity, compared to white men, black men smoked for 2.3 (95% confidence interval [CI]: 1.3, 3.3) years longer before quitting and Mexican-American men for 0.2 (95% CI: -1.6, 1.2) years less before quitting. Compared to white women, black women smoked for 1.9 (95% CI: 0.7, 3.0) years longer before quitting and Mexican-American women for 0.9 (95% CI: -2.4, 0.5) years less before quitting. Conclusions In a representative sample of US adults, black former smokers continued smoking for longer periods before quitting compared to white former smokers. These findings support the need for smoking cessation efforts that address racial/ethnic differences in smoking behaviors. The longer time to quit among black former smokers should be investigated as an explanation for racial/ethnic disparities in smoking-associated diseases. Implications In a representative sample of US adults that successfully quit smoking, the timing of smoking cessation differed by race/ethnicity with blacks smoking for longer periods before quitting compared to whites. Racial/ethnic differences in duration of smoking among former smokers differed by participant age and age at smoking initiation. These findings support the need for smoking cessation efforts that address racial/ethnic differences in smoking behaviors.
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Affiliation(s)
- Miranda R Jones
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Corinne E Joshu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
| | - Ana Navas-Acien
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Department of Environmental Health Sciences, Columbia University, Mailman School of Public Health, New York, NY
| | - Elizabeth A Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD.,Department of Urology and the James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD
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11
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Meshefedjian GA. The smoking spectrum: review of the existing evidence and future directions. J Public Health (Oxf) 2019. [DOI: 10.1007/s10389-018-01009-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Carroll AJ, Labarthe DR, Huffman MD, Hitsman B. Global tobacco prevention and control in relation to a cardiovascular health promotion and disease prevention framework: A narrative review. Prev Med 2016; 93:189-197. [PMID: 27717667 PMCID: PMC5125629 DOI: 10.1016/j.ypmed.2016.10.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 08/18/2016] [Accepted: 10/03/2016] [Indexed: 11/21/2022]
Abstract
The purpose of this review is to emphasize the role of tobacco prevention and control in cardiovascular health (CVH) promotion and cardiovascular disease (CVD) prevention, including the importance of these endpoints for measuring the full impact of tobacco-related policies, programs, and practices. In this review, we describe an overview of tobacco control interventions that have led to substantial declines in tobacco use and the relationship between these declines with CVH and CVD. We review interventions that have had success in high-income countries (HICs) as well as those that are gaining traction in low- and middle-income countries (LMICs). We emphasize the challenges to comprehensive tobacco prevention and control strategies faced by LMICs, and highlight the special role of cardiovascular health professionals in achieving CVH promotion and CVD prevention endpoints through tobacco control. Tobacco prevention and control strategies have a strong scientific basis, yet a distinct gap remains between this evidence and implementation of tobacco control policies, particularly in LMICs. Health professionals can contribute to tobacco control efforts, especially through patient-level clinical interventions, when supported by a health care system and government that recognize and support tobacco control as a critical strategy for CVH promotion and CVD prevention. Understanding, supporting, and applying current and evolving policies, programs, and practices in tobacco prevention and control is the province of all health professionals, especially those concerned with CVH promotion and CVD prevention. A new tobacco control roadmap from the World Heart Federation provides a strong impetus to the needed interdisciplinary collaboration.
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Affiliation(s)
- Allison J Carroll
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, United States
| | - Darwin R Labarthe
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, United States
| | - Mark D Huffman
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, United States
| | - Brian Hitsman
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, United States.
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Kulak JA, Cornelius ME, Fong GT, Giovino GA. Differences in Quit Attempts and Cigarette Smoking Abstinence Between Whites and African Americans in the United States: Literature Review and Results From the International Tobacco Control US Survey. Nicotine Tob Res 2016; 18 Suppl 1:S79-87. [PMID: 26980868 PMCID: PMC5009448 DOI: 10.1093/ntr/ntv228] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 09/30/2015] [Indexed: 12/12/2022]
Abstract
INTRODUCTION While cigarette smoking prevalence is declining among US adults, quit rates may differ between white and African American smokers. Here, we summarize the literature on smoking cessation behaviors in whites and African Americans across four study designs and report the findings of new analyses of International Tobacco Control (ITC) US Survey cohort data. METHODS We reviewed 32 publications containing 39 relevant analyses that compared quit attempts and abstinence between US whites and African Americans. Two additional longitudinal analyses were conducted on 821 white and 76 African American cigarette smokers from Waves 7 and 8 of the ITC US Survey (mean follow-up = 19 months). RESULTS Of 17 total analyses of quit attempts, nine (including the ITC US Survey) observed that African American smokers were more likely than whites to attempt to quit during a given year; seven found no differences. Whites were more likely than African Americans to be abstinent in five of six retrospective cohort analyses and in two of five considered community- and population-based cohort studies. Four of these 11 analyses, including one from the ITC US Survey, found no differences. CONCLUSIONS Of 11 population- or community-based analyses, all seven that found significant differences indicated that whites were more likely to quit than African Americans. These findings, combined with the similar results from population-based birth cohort analyses, support the conclusion that white smokers are more likely to quit than African American smokers. Efforts to encourage and support quitting among all tobacco users remain a priority. IMPLICATIONS This article provides a review of the literature on smoking cessation among African American and white smokers, and adds new analyses that compare quit attempts and abstinence between US African Americans and whites. Results demonstrate a clear distinction between the findings of cross-sectional and retrospective cohort studies with those of cohort studies. Reasons for these differences merit further study.
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Affiliation(s)
- Jessica A Kulak
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY;
| | - Monica E Cornelius
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Geoffrey T Fong
- Department of Psychology and School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Gary A Giovino
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY
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Filippidis FT, Gerovasili V, Vardavas CI, Agaku IT, Tountas Y. Determinants of use of smoking cessation aids in 27 European countries. Prev Med 2014; 65:99-102. [PMID: 24832820 DOI: 10.1016/j.ypmed.2014.05.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Revised: 04/06/2014] [Accepted: 05/05/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To identify determinants of use of smoking cessation aids among current and former smokers in the European Union (EU). METHODS Data from n=9921 current and ex-smokers from 27 European countries (Eurobarometer 77.1, February-March 2012) were analysed. Multivariate binary logistic regression was used to assess for correlates of use of any recommended aid with proven efficacy, defined as use of pharmacotherapy or psychosocial counselling (p<0.05). The regression analyses assessed for socio-demographic characteristics, EU region, as well as scope of national smoking cessation policies. RESULTS Among current smokers who had made a quit attempt and ex-smokers, 19.9% had used any recommended aid with proven efficacy. Respondents from Northern (adjusted odds ratio [aOR]=1.90), Western (aOR=3.21) and Eastern Europe (aOR=1.69) were more likely to have used an efficacious smoking cessation aid compared to respondents from Southern Europe (all p<0.05). Respondents in countries with comprehensive tobacco cessation programmes that offered cost-covered national quit lines, medication, and other cessation services had increased likelihood of using efficacious cessation aids (OR=1.29; 95% Confidence Interval: 1.07-1.55). CONCLUSIONS These findings underscore the need for enhanced and sustained efforts to ensure increased access to cessation services and aids as part of a comprehensive tobacco control programme.
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Affiliation(s)
- Filippos T Filippidis
- School of Public Health, Imperial College London, The Reynolds Building, St. Dunstan's Road, London W6 8RP, UK; Center for Health Services Research, University of Athens, Alexandroupoleos 25, 11527, Athens, Greece.
| | - Vasiliki Gerovasili
- 1st Critical Care Medicine Department, Cardiopulmonary Exercise Testing and Rehabilitation Laboratory, "Evgenidio" Hospital, NKUA, Papadiamantopoulou 20, 15128, Athens, Greece.
| | - Constantine I Vardavas
- Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard School of Public Health, 401 Park Drive, 4th West, Boston, MA, 02215 USA.
| | - Israel T Agaku
- Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard School of Public Health, 401 Park Drive, 4th West, Boston, MA, 02215 USA.
| | - Yannis Tountas
- Center for Health Services Research, University of Athens, Alexandroupoleos 25, 11527, Athens, Greece.
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Mowls DS, Cheruvu VK, Zullo MD. Clinical and individual factors associated with smoking quit attempts among adults with COPD: do factors vary with regard to race? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:3717-27. [PMID: 24705359 PMCID: PMC4025017 DOI: 10.3390/ijerph110403717] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 03/24/2014] [Accepted: 03/25/2014] [Indexed: 11/16/2022]
Abstract
Only half of adults with chronic obstructive pulmonary disease (COPD) report a smoking quit attempt in the past year. Adults with COPD have frequent encounters with the healthcare system that are opportunities for health behavior interventions that support quit attempts. The purpose of this research was to examine individual- and clinical-level factors associated with smoking quit attempts in adults with COPD. Cross-sectional data were from the 2011 Behavioral Risk Factor Surveillance System. Race-stratified, weighted logistic regression examined factors associated with quit attempt among current smokers with COPD. Overall, quit attempt was reported by 65% (95% confidence interval (CI): 61.9, 67.5) of adults and was more likely among blacks than whites (p < 0.0001). Among whites with COPD quit attempt was associated with: Female gender (adjusted odds ratio (AOR) = 1.3; CI: 1.0, 1.7), exercise (AOR = 2.0; CI: 1.5, 2.5), and medications for COPD (AOR = 1.6; CI: 1.3, 2.2). Among black adults with COPD quit attempt was associated with: Having a partner (AOR = 4.5; CI: 1.3, 15.0), exercise (AOR = 3.7; CI: 1.6, 8.7), spirometry (AOR = 9.5; CI: 3.2, 28.7), and having a personal doctor (AOR = 6.4; CI: 1.8, 22.5). Individual and clinical-factors associated with quit attempt varied by race. These findings suggest an impact of the healthcare system that supports quit attempts in blacks but not whites with COPD.
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Affiliation(s)
- Dana S Mowls
- Department of Epidemiology and Biostatistics, College of Public Health, Kent State University, Kent, OH 44242, USA.
| | - Vinay K Cheruvu
- Department of Epidemiology and Biostatistics, College of Public Health, Kent State University, Kent, OH 44242, USA.
| | - Melissa D Zullo
- Department of Epidemiology and Biostatistics, College of Public Health, Kent State University, Kent, OH 44242, USA.
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Goren A, Annunziata K, Schnoll RA, Suaya JA. Smoking cessation and attempted cessation among adults in the United States. PLoS One 2014; 9:e93014. [PMID: 24676348 PMCID: PMC3968049 DOI: 10.1371/journal.pone.0093014] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Accepted: 02/28/2014] [Indexed: 11/18/2022] Open
Abstract
AIMS With growing recognition of stagnant rates of attempted cigarette smoking cessation, the current study examined demographic and psychometric characteristics associated with successful and attempted smoking cessation in a nationally representative sample. This additional understanding may help target tobacco cessation treatments toward sub-groups of smokers in order to increase attempts to quit smoking. DESIGN, SETTING, AND PARTICIPANTS Data were used from the 2011 U.S. National Health and Wellness Survey (n = 50,000). MEASUREMENTS Current smoking status and demographics, health characteristics, comorbidities, and health behaviors. FINDINGS In 2011, 18%, 29%, and 52% of U.S. adults were current, former, or never smokers, respectively. Over one quarter (27%) of current smokers were attempting to quit. Current smokers (vs. others) were significantly more likely to be poorer, non-Hispanic White, less educated, ages 45-64, and uninsured, and they had fewer health-conscious behaviors (e.g., influenza vaccination, exercise). Attempting quitters vs. current smokers were significantly less likely to be non-Hispanic White and more likely to be younger, educated, insured, non-obese, with family history of chronic obstructive pulmonary disease, and they had more health-conscious behaviors. CONCLUSIONS Smokers, attempting quitters, and successful quitters differ on characteristics that may be useful for targeting and personalizing interventions aiming to increase cessation attempts, likelihood, and sustainability.
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Affiliation(s)
- Amir Goren
- Health Outcomes Practice, Kantar Health, New York, New York, United States of America
| | - Kathy Annunziata
- Health Outcomes Practice, Kantar Health, Princeton, New Jersey, United States of America
| | - Robert A. Schnoll
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Jose A. Suaya
- GlaxoSmithKline Vaccines, Philadelphia, Pennsylvania, United States of America
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Harrington KF, Haven KM, Nuño VL, Magruder T, Bailey WC, Gerald LB. Parent report and electronic medical record agreement on asthma education provided and children's tobacco smoke exposure. J Asthma 2013; 50:968-74. [PMID: 23883356 DOI: 10.3109/02770903.2013.828303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To examine the concordance between parent report and electronic medical record documentation of asthma health education provided during a single clinic visit and second-hand tobacco smoke exposure among children with asthma. METHODS Parents of children with asthma were recruited from two types of clinics using different electronic medical record systems: asthma-specialty or general pediatric health department clinics. After their child's outpatient visit, parents were interviewed by trained study staff. Interview data were compared to electronic medical records for agreement in five categories of asthma health education and for the child's environmental tobacco smoke exposure. Kappa statistics were used to identify strength of agreement. Chi square and t-tests were used to examine differences between clinic types. RESULTS Of 255 parents participating in the study 90.6% were African American and 96.1% were female. Agreement was poor across all clinics but was higher within the asthma specialty clinics than the health department clinics for smoke exposure (κ = 0.410 versus 0.205), asthma diagnosis/disease process (κ = 0.213 versus -0.016) and devices reviewed (κ = 0.253 versus -0.089) with parents generally reporting more education provided. For the 203 children with complete medical records, 40.5% did not have any documentation regarding smoking exposure in the home and 85.2% did not have any documentation regarding exposure elsewhere. CONCLUSIONS We found low concordance between the parent's report and the electronic medical record for smoke exposure and asthma education provided. Un- or under-documented smoke exposure and health education have the potential to affect continuity of care for pediatric patients with asthma.
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Affiliation(s)
- Kathleen F Harrington
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, School of Medicine, University of Alabama , Birmingham, AL , USA
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Rafful C, García-Rodríguez O, Wang S, Secades-Villa R, Martínez-Ortega JM, Blanco C. Predictors of quit attempts and successful quit attempts in a nationally representative sample of smokers. Addict Behav 2013; 38:1920-3. [PMID: 23380497 DOI: 10.1016/j.addbeh.2012.12.019] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Revised: 11/13/2012] [Accepted: 12/27/2012] [Indexed: 10/27/2022]
Abstract
Although most current smokers report that they would like to quit, most quit attempts fail suggesting that predictors of quitting attempts may differ from those of successful attempts. We examined sociodemographic and clinical predictors of quit attempts and successful quit attempts in a nationally representative sample of US adults. Data was collected in 2001-2002 (Wave 1) and 2004-2005 (Wave 2). Almost 40% of individuals who had not previously attempted to quit, tried to quit over the next three years; only 4.6% of those who tried had succeeded at the time of the evaluation. Hispanics, Asians, individuals with high income, and those with college education were less likely to attempt to quit, whereas those with daily nicotine use, younger age at first use and most symptoms of dependence were more likely to do so. Having an educational level below high school and older age at first nicotine use were predictors of successful quitting. Despite relatively high rates of quit attempts, rates of success are extremely low, indicating a gap between the public health need of decreasing tobacco use, and existing means to achieve it. Although there is a need to encourage people to quit tobacco, there may be an equally large need to develop more effective interventions that increase the rate of successful quit attempts.
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Rindal DB, Rush WA, Schleyer TKL, Kirshner M, Boyle RG, Thoele MJ, Asche SE, Thyvalikakath T, Spallek H, Durand ECU, Enstad CJ, Huntley CL. Computer-assisted guidance for dental office tobacco-cessation counseling: a randomized controlled trial. Am J Prev Med 2013; 44:260-4. [PMID: 23415123 PMCID: PMC3579569 DOI: 10.1016/j.amepre.2012.10.023] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Revised: 08/27/2012] [Accepted: 10/22/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND Decreases in smoking prevalence from recent decades have slowed, and national goals to reduce tobacco use remain unmet. Healthcare providers, including those in physician and dental teams, have access to evidence-based guidelines to help patients quit smoking. Translation of those guidelines into practice, however, remains low. Approaches that involve screening for drug use, brief intervention, and referral to treatment (SBIRT) are a promising, practical solution. PURPOSE This study examined whether dentists and dental hygienists would assess interest in quitting, deliver a brief tobacco intervention, and refer to a tobacco quitline more frequently as reported by patients if given computer-assisted guidance in an electronic patient record versus a control group providing usual care. DESIGN A blocked, group-randomized trial was conducted from November 2010 to April 2011. Randomization was conducted at the clinic level. Patients nested within clinics represented the lowest-level unit of observation. SETTING/PARTICIPANTS Participants were patients in HealthPartners dental clinics. INTERVENTION Intervention clinics were given a computer-assisted tool that suggested scripts for patient discussions. Usual care clinics provided care without the tool. MAIN OUTCOME MEASURES Primary outcomes were post-appointment patient reports of the provider assessing interest in quitting, delivering a brief intervention, and referring them to a quitline. RESULTS Patient telephone surveys (72% response rate) indicated that providers assessed interest in quitting (control 70% vs intervention 87%, p=0.0006); discussed specific strategies for quitting (control 26% vs intervention 47%, p=0.003); and referred the patient to a tobacco quitline (control 17% vs intervention 37%, p=0.007) more frequently with the support of a computer-assisted tool integrated into the electronic health record. CONCLUSIONS Clinical decision support embedded in electronic health records can effectively help providers deliver tobacco interventions. These results build on evidence in medical settings supporting this approach to improve provider-delivered tobacco cessation. TRIAL REGISTRATION This study is registered at ClinicalTrials.govNCT01584882.
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Affiliation(s)
- D Brad Rindal
- HealthPartners Institute for Education and Research, Minneapolis, MN 55425, USA.
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Abstract
Around 19% of US adults smoke cigarettes, and smoking remains the leading avoidable cause of death in this country. Without treatment only ~5% of smokers who try to quit achieve long-term abstinence, but evidence-based cessation treatment increases this figure to 10% to 30%. The process of smoking cessation comprises different pragmatically defined phases, and these can help guide smoking treatment development and evaluation. This review evaluates the effectiveness of smoking interventions for smokers who are unwilling to make a quit attempt (motivation phase), who are willing to make a quit attempt (cessation phase), who have recently quit (maintenance phase), and who have recently relapsed (relapse recovery phase). Multiple effective treatments exist for some phases (cessation), but not others (relapse recovery). A chronic care approach to treating smoking requires effective interventions for every phase, especially interventions that exert complementary effects both within and across phases and that can be disseminated broadly and cost-effectively.
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Affiliation(s)
- Tanya R Schlam
- Center for Tobacco Research and Intervention, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53711, USA.
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Eklund BM, Nilsson S, Hedman L, Lindberg I. Why do smokers diagnosed with COPD not quit smoking? - a qualitative study. Tob Induc Dis 2012; 10:17. [PMID: 23088811 PMCID: PMC3488476 DOI: 10.1186/1617-9625-10-17] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Accepted: 10/15/2012] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Chronic Obstructive Pulmonary Disease (COPD) is currently one of the most widespread chronic lung diseases and a growing cause of suffering and mortality worldwide. It is predicted to become the third leading cause of death in the near future. Smoking is the most important risk factor, and about 50% of smokers develop COPD. Smoking cessation is the most important way to improve prognosis. The aim of the study was to describe difficulties of smoking cessation experienced by individuals with COPD who are unable to stop smoking. METHODS Ten smokers (five women) with COPD, GOLD stage II, participated in semi-structured interviews in 2010. The data were analyzed using qualitative content analysis. The participants were recruited from the Obstructive Lung Disease in Northern Sweden (OLIN) studies. RESULTS The participants lives were governed by a lifelong smoking habit that was difficult to break although they had knowledge about the harmful effects and the consequences of COPD. The participants described incidents in their lives as reasons for never finding the time to quit smoking. Demands to quit smoking from other people could lead to continued smoking or get them started again after cessation as they did not want to be patronized. They wanted to receive support from relatives and care providers but they wanted to make the decision to quit on their own. CONCLUSION For successful smoking cessation, it is important to understand the difficulties smokers are experiencing that influence their efforts to quit smoking. To achieve a successful lasting smoking cessation it might be more effective to first ensure that the smoker has the right internal motivation to make the decision to quit, then assist with smoking cessation.
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Affiliation(s)
- Britt-Marie Eklund
- The OLIN-studies, Norrbotten County Council, Luleå, Sweden
- Department of Health Science, Luleå University of Technology, Luleå, Sweden
| | - Siv Nilsson
- Department of Health Science, Luleå University of Technology, Luleå, Sweden
| | - Linnea Hedman
- The OLIN-studies, Norrbotten County Council, Luleå, Sweden
| | - Inger Lindberg
- Department of Health Science, Luleå University of Technology, Luleå, Sweden
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Kruger TM, Howell BM, Haney A, Davis RE, Fields N, Schoenberg NE. Perceptions of smoking cessation programs in rural Appalachia. Am J Health Behav 2012; 36:373-84. [PMID: 22370438 DOI: 10.5993/ajhb.36.3.8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To identify perspectives on smoking cessation programs in Appalachian Kentucky, a region with particularly high smoking rates and poor health outcomes. METHODS Insufficient existing research led us to conduct 12 focus groups (smokers and nonsmokers) and 23 key informant interviews. RESULTS Several findings previously not described in this high-risk population include (1) transition from pro-tobacco culture toward advocacy for tobacco cessation approaches, (2) region-specific challenges to program access, and (3) strong and diverse social influences on cessation. CONCLUSIONS To capitalize on changes from resistance to support for smoking cessation, leaders should incorporate culturally appropriate programs and characteristics identified here.
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Affiliation(s)
- Tina M Kruger
- Department of Applied Health Sciences, Indiana State University, Terre Haute, IN, USA.
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Kahende JW, Malarcher AM, Teplinskaya A, Asman KJ. Quit attempt correlates among smokers by race/ethnicity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2011; 8:3871-88. [PMID: 22073018 PMCID: PMC3210587 DOI: 10.3390/ijerph8103871] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Accepted: 09/23/2011] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Cigarette smoking is the leading preventable cause of premature deaths in the U.S., accounting for approximately 443,000 deaths annually. Although smoking prevalence in recent decades has declined substantially among all racial/ethnic groups, disparities in smoking-related behaviors among racial/ethnic groups continue to exist. Two of the goals of Healthy People 2020 are to reduce smoking prevalence among adults to 12% or less and to increase smoking cessation attempts by adult smokers from 41% to 80%. Our study assesses whether correlates of quit attempts vary by race/ethnicity among adult (≥ 18 years) smokers in the U.S. Understanding racial/ethnic differences in how both internal and external factors affect quit attempts is important for targeting smoking-cessation interventions to decrease tobacco-use disparities. METHODS We used 2003 Tobacco Use Supplement to the Current Population Survey (CPS) data from 16,213 adults to examine whether the relationship between demographic characteristics, smoking behaviors, smoking policies and having made a quit attempt in the past year varied by race/ethnicity. RESULTS Hispanics and persons of multiple races were more likely to have made a quit attempt than whites. Overall, younger individuals and those with >high school education, who smoked fewer cigarettes per day and had smoked for fewer years were more likely to have made a quit attempt. Having a smoke-free home, receiving a doctor's advice to quit, smoking menthol cigarettes and having a greater time to when you smoked your first cigarette of the day were also associated with having made a quit attempt. The relationship between these four variables and quit attempts varied by race/ethnicity; most notably receiving a doctor's advice was not related to quit attempts among Asian American/Pacific Islanders and menthol use among whites was associated with a lower prevalence of quit attempts while black menthol users were more likely to have made a quit attempt than white non-menthol users. CONCLUSIONS Most correlates of quit attempts were similar across all racial/ethnic groups. Therefore population-based comprehensive tobacco control programs that increase quit attempts and successful cessation among all racial/ethnic groups should be continued and expanded. Additional strategies may be needed to encourage quit attempts among less educated, older, and more addicted smokers.
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Affiliation(s)
- Jennifer W. Kahende
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 4770 Buford Highway, Atlanta, GA 30341, USA; E-Mails: (A.M.M.); (A.T.)
| | - Ann M. Malarcher
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 4770 Buford Highway, Atlanta, GA 30341, USA; E-Mails: (A.M.M.); (A.T.)
| | - Anna Teplinskaya
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 4770 Buford Highway, Atlanta, GA 30341, USA; E-Mails: (A.M.M.); (A.T.)
| | - Kat J. Asman
- Research Triangle International, Statistics and Epidemiology Division, 4770 Buford Highway, Atlanta, GA 30341, USA; E-Mail:
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Li L, Feng G, Jiang Y, Yong HH, Borland R, Fong GT. Prospective predictors of quitting behaviours among adult smokers in six cities in China: findings from the International Tobacco Control (ITC) China Survey. Addiction 2011; 106:1335-45. [PMID: 21438942 PMCID: PMC3107915 DOI: 10.1111/j.1360-0443.2011.03444.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIMS To examine predictors of quitting behaviours among adult smokers in China, in light of existing knowledge from previous research in four western countries and two southeast Asian countries. DESIGN Face-to-face interviews were carried out with smokers in 2006 using the International Tobacco Control (ITC) China Survey, with follow-up about 16 months later. A stratified multi-stage cluster sampling design was employed. SETTING Beijing and five other cities in China. PARTICIPANTS A total of 4732 smokers were first surveyed in 2006. Of these, 3863 were re-contacted in 2007, with a retention rate of 81.6%. MEASUREMENTS Baseline measures of socio-demographics, dependence and interest in quitting were used prospectively to predict both making quit attempts and staying quit among those who attempted. FINDINGS Overall, 25.3% Chinese smokers reported having made at least one quit attempt between waves 1 and 2; of these, 21.7% were still stopped at wave 2. Independent predictors of making quit attempts included having higher quitting self-efficacy, previous quit attempts, more immediate intentions to quit, longer time to first cigarette upon waking, negative opinion of smoking and having smoking restrictions at home. Independent predictors of staying quit were being older, having longer previous abstinence from smoking and having more immediate quitting intentions. CONCLUSIONS Predictors of Chinese smokers' quitting behaviours are somewhat different to those found in previous research from other countries. Nicotine dependence and self-efficacy seem to be more important for attempts than for staying quit in China, and quitting intentions are related to both attempts and staying quit.
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Affiliation(s)
- Lin Li
- VicHealth Centre for Tobacco Control, Cancer Council Victoria, Melbourne, Australia.
| | - Guoze Feng
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yuan Jiang
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hua-Hie Yong
- VicHealth Centre for Tobacco Control, Cancer Council Victoria, Melbourne, Australia
| | - Ron Borland
- VicHealth Centre for Tobacco Control, Cancer Council Victoria, Melbourne, Australia
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Waterloo, Canada
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Caban-Martinez AJ, Davila EP, Zhao W, Arheart K, Hooper MW, Byrne M, Messiah A, Dietz N, Huang Y, Fleming LE, Lee DJ. Disparities in hypertension control advice according to smoking status. Prev Med 2010; 51:302-6. [PMID: 20600258 PMCID: PMC2939289 DOI: 10.1016/j.ypmed.2010.06.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2010] [Revised: 05/25/2010] [Accepted: 06/11/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Hypertension is the most common modifiable cardiovascular risk factor. Blood pressure (BP) reduction, particularly among smokers, is highly effective at preventing cardiovascular diseases. We examined the association between patient smoking status and hypertension management advice. METHODS Adults who participated in the 2007 Behavioral Risk Factor Surveillance System with self-reported hypertension were examined (n=51,063). Multivariable logistic regression analysis controlling for age, gender, race/ethnicity, education, marital status, insurance status, body mass index, alcohol use, self-reported general health and survey design were conducted to examine the association between smoking status (never, former, or current) and receipt of hypertension control advice. RESULTS After controlling for potential confounders, being a current smoker was significantly associated with lower odds of receiving advice to lower salt intake (Adjusted Odds Ratio, AOR, 0.91 [95% confidence interval=0.84-0.99]), exercise (AOR 0.89 [0.80-0.98]), and to take hypertensive medication (AOR 0.80 [0.66-0.98]) compared to never smokers. However, hypertensive smokers had greater odds of receiving advice to reduce alcohol consumption (AOR 1.23 [1.10-1.45]). CONCLUSIONS Although healthcare providers are in an optimal position to provide patient education to improve BP control, hypertensive smokers may be less likely to receive important BP control lifestyle modification messages from their healthcare provider than non-smokers.
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Affiliation(s)
- Alberto J Caban-Martinez
- Department of Epidemiology and Public Health, University of Miami, Miller School of Medicine, Miami, Florida 33136, USA.
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Lima e Costa MFFD, Peixoto SV, César CC, Malta DC, Moura ECD. Health behaviors among older adults with hypertension, Brazil, 2006. Rev Saude Publica 2010; 43 Suppl 2:18-26. [PMID: 19936495 DOI: 10.1590/s0034-89102009000900004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2008] [Accepted: 08/19/2009] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of unhealthy behaviors and other cardiovascular risk factors among older adults with self-reported arterial hypertension, and to compare these prevalences with those of non-hypertensives. METHODS Data used was obtained from the system Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (VIGITEL--Telephone-based Surveillance of Risk and Protective Factors for Chronic Diseases) referring to the 9,038 older adults living in households with at least one fixed telephone line in the 26 Brazilian state capitals and Federal District in 2006. RESULTS Prevalence of self-reported hypertension was 55% (95% CI: 53;57). The majority of hypertensives showed three or more concomitant risk factors (69%; 95% CI: 67;71). It was found a high prevalence of insufficient physical activity during leisure (88%; 95% CI: 86;89) and of fruit and vegetable intake below five daily portions (90%; 95% CI: 88;90) among hypertensive subjects, followed by adding salt to meals (60%; 95% CI: 57;63), regular intake of fatty meats (23%; 95% CI: 21;25), smoking (9%; 95% CI: 7;10), and binge drinking (3%; 95% CI: 2;4). With the exception of smoking, these prevalences were similar to those reported by non-hypertensive subjects (p >0.05). Prevalence of smoking was lower among hypertensives (adjusted prevalence ratio [APR] = 0.75; 95% CI: 0.64;0.89), whereas prevalence of overweight (APR = 1.37; 95% CI: 1.25;1.49), dyslipidemia (APR = 1.36; 95% CI: 1.26;1.36), and diabetes (APR = 1.37; 95% CI: 1.27;1.37) was higher. CONCLUSIONS Results suggest that, with the exception of smoking, unhealthy behaviors persist among older adults after hypertension is diagnosed.
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