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Jung B, Lee JA, Kim YJ, Cho HJ. The smoking population is not hardening in South Korea: a study using the Korea Community Health Survey from 2010 to 2018. Tob Control 2024; 33:171-177. [PMID: 35851261 DOI: 10.1136/tc-2022-057332] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 07/08/2022] [Indexed: 11/03/2022]
Abstract
INTRODUCTION The hardening hypothesis proposes that the proportion of hardcore smokers increases when smoking prevalence declines. To evaluate whether such hardening occurs in South Korea, we examined the association between quitting behaviours, the number of cigarettes smoked per day and the proportion of hardcore smokers and smoking prevalence among local districts in South Korea. METHODS This study used the cross-sectional data from the Korea Community Health Survey (2010-2018) to examine local district-level associations between smoking prevalence and quit attempts, quit plans, quit ratios, cigarettes smoked per day and the proportion of hardcore smokers. Panel regression analysis was performed using the indicators of hardcore smoking (quit attempts, quit plans, quit ratios, cigarettes smoked per day and proportion of hardcore smokers) as the outcome variables, and prevalence of smoking, local districts, age and sex as predictor variables. RESULTS When the smoking prevalence of the districts decreased by 1%, quit attempts, quit plans and quit ratios increased by 0.24% (95% CI 0.11 to 0.37), 0.37% (95% CI 0.26 to 0.47) and 1.71% (95% CI 1.65 to 1.76), respectively. Cigarette consumption decreased by 0.17 cigarettes per day (95% 0.15 to 0.19), and the prevalence of hardcore smokers decreased by 0.88% (95% CI 0.78 to 0.98) when smoking prevalence decreased by 1%. CONCLUSION Hardening of smoking did not occur in South Korea when smoking prevalence declined, which suggests tobacco control policies in South Korea have been effective in reducing smoking prevalence without increasing the proportion of hardcore smokers.
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Affiliation(s)
- Boyoung Jung
- Jireh Clinic of Family Medicine, Seoul, The Republic of Korea
| | - Jung Ah Lee
- Workplace Health Institute, Total Health Care Center, Kangbuk Samsung Hospital, Jongno-gu, Seoul, The Republic of Korea
| | - Ye-Jee Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, Songpa-gu, Seoul, The Republic of Korea
| | - Hong-Jun Cho
- Department of Family Medicine, Asan Medical Center. University of Ulsan College of Medicine, Songpa-gu, The Republic of Korea
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Klemperer EM, Streck JM, Lindson N, West JC, Su A, Hughes JR, Carpenter MJ. A systematic review and meta-analysis of interventions to induce attempts to quit tobacco among adults not ready to quit. Exp Clin Psychopharmacol 2023; 31:541-559. [PMID: 35771496 PMCID: PMC10106992 DOI: 10.1037/pha0000583] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The prevalence of past-year smoking cessation remains below 10% in the U.S. Most who smoke are not ready to quit in the near future. Cessation requires both (a) initiating a quit attempt (QA) and (b) maintaining abstinence. Most research has focused on abstinence among people already motivated to quit. We systematically reviewed interventions to promote QAs among people not motivated to quit tobacco. We searched PubMed, CENTRAL, PsycINFO, Embase, and our personal libraries for randomized trials of tobacco interventions that reported QAs as an outcome among adults not ready to quit. We screened studies and extracted data in duplicate. We pooled findings of the 25 included studies using Mantel-Haenszel random effects meta-analyses when ≥ 2 studies tested the same intervention. Most (24) trials addressed cigarettes and one addressed smokeless tobacco. Substantial heterogeneity among trials resulted in a series of small meta-analyses. Findings indicate varenicline may increase QAs more than no varenicline, n = 320; RR = 1.4, 95% CI [1.1, 1.7]; I² = 0%, and nicotine replacement therapy (NRT) may increase QAs more than no NRT, n = 2,568; RR = 1.1, 95% CI [1.02, 1.3]; I² = 0%. Pooled effects for motivational counseling, reduction counseling, and very low nicotine content cigarettes showed no clear evidence of benefit or harm. The evidence was judged to be of medium to very low certainty due to imprecision, inconsistency, and risk of bias, suggesting that further research is likely to change interpretation of our results. Findings demonstrate the need for more high-quality research on interventions to induce QAs among adults not ready to quit tobacco. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Elias M. Klemperer
- Vermont Center on Behavior & Health, Department of Psychiatry, University of Vermont
- Department of Psychological Science, University of Vermont
| | - Joanna M. Streck
- Tobacco Research & Treatment Center, Division of General Internal Medicine and Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School
| | - Nicola Lindson
- Nuffield Department of Primary Care Health Sciences, University of Oxford
| | - Julia C. West
- Vermont Center on Behavior & Health, Department of Psychiatry, University of Vermont
- Department of Psychological Science, University of Vermont
| | - Alan Su
- University of Vermont Medical Center
| | - John R. Hughes
- Vermont Center on Behavior & Health, Department of Psychiatry, University of Vermont
- Department of Psychological Science, University of Vermont
| | - Matthew J. Carpenter
- Department of Psychiatry and Behavioral Sciences & Hollings Cancer Center, Medical University of South Carolina
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Huang LC, Chang YT, Lin CL, Chen RY, Bai CH. Effectiveness of Health Coaching in Smoking Cessation and Promoting the Use of Oral Smoking Cessation Drugs in Patients with Type 2 Diabetes: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4994. [PMID: 36981909 PMCID: PMC10049574 DOI: 10.3390/ijerph20064994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 03/09/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION This study looked into the effectiveness of a 6 month health coaching intervention in smoking cessation and smoking reduction for patients with type 2 diabetes. METHODS The study was carried out via a two-armed, double-blind, randomized-controlled trial with 68 participants at a medical center in Taiwan. The intervention group received health coaching for 6 months, while the control group only received usual smoking cessation services; some patients in both groups participated in a pharmacotherapy plan. The health coaching intervention is a patient-centered approach to disease management which focuses on changing their actual behaviors. By targeting on achieving effective adult learning cycles, health coaching aims to help patients to establish new behavior patterns and habits. RESULTS In this study, the intervention group had significantly more participants who reduced their level of cigarette smoking by at least 50% than the control group (p = 0.030). Moreover, patients participating in the pharmacotherapy plan in the coaching intervention group had a significant effect on smoking cessation (p = 0.011), but it was insignificant in the control group. CONCLUSIONS Health coaching can be an effective approach to assisting patients with type 2 diabetes participating in a pharmacotherapy plan to reduce smoking and may help those who participate in pharmacotherapy plan to quit smoking more effectively. Further studies with higher-quality evidence on the effectiveness of health coaching in smoking cessation and the use of oral smoking cessation drugs in patients with type 2 diabetes are needed.
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Affiliation(s)
- Li-Chi Huang
- Endocrinology & Metabolism, Cathay General Hospital, Taipei 106438, Taiwan
- School of Public Health, Taipei Medical University, Taipei 110301, Taiwan
| | - Yao-Tsung Chang
- School of Public Health, Taipei Medical University, Taipei 110301, Taiwan
| | - Ching-Ling Lin
- Endocrinology & Metabolism, Cathay General Hospital, Taipei 106438, Taiwan
- School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
- School of Medicine, National Tsing Hua University, Hsinchu 300044, Taiwan
| | - Ruey-Yu Chen
- School of Public Health, Taipei Medical University, Taipei 110301, Taiwan
| | - Chyi-Huey Bai
- School of Public Health, Taipei Medical University, Taipei 110301, Taiwan
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Islam MM. Hardcore use of smoked and smokeless tobacco products among men and women in Bangladesh: data from two rounds of the global adult tobacco survey. J Ethn Subst Abuse 2022:1-13. [PMID: 36409782 DOI: 10.1080/15332640.2022.2148150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study examines the prevalence of and factors associated with "hardcore" use of smoked and smokeless tobacco (SLT) products in Bangladesh and the variation in the ages people started using them daily. Data from the 2009 and 2017 rounds of the Global Adult Tobacco Survey for Bangladesh were analyzed using multilevel logistic regression. The prevalence of "hardcore" use of smoked tobacco among current smokers decreased from 15.5% in 2009 to 13.1% in 2017. Almost all hardcore smokers were male in both rounds. Among the current users of SLT, 7.0% were "hardcore" users in 2009, with a higher proportion of females (8.9%) than males (4.8%) and these percentages remained similar in 2017. The current smokers in the age-group 25-64 and the current SLT users in the age-group 45-65+ were more likely than their counterparts to be "hardcore" users. The earlier the participants started using daily, the more likely they were to become "hardcore" users. There was regional variation in the prevalence of "hardcore" use. Coordinated preventive interventions and comprehensive treatment programmes and their equitable geographical distribution are needed.
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Affiliation(s)
- M Mofizul Islam
- Department of Public Health, La Trobe University, Melbourne, Australia
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Li WHC, Ho LLK, Cheung AT, Wong MP, Cheung DYT, Xia W, Lam TH. A general health promotion approach to helping smokers with non-communicable diseases quit smoking: A pilot randomized controlled trial. Front Public Health 2022; 10:957547. [PMID: 36330106 PMCID: PMC9623171 DOI: 10.3389/fpubh.2022.957547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 10/03/2022] [Indexed: 01/24/2023] Open
Abstract
Background Despite evidence showing that continued smoking in patients with non-communicable diseases can reduce treatment efficacy and increase the risk of disease progression and multimorbidity, many smoker patients either have no intention to quit or have had failed attempts at quitting. Objective To examine the feasibility of a general health promotion approach that uses instant messaging to deliver brief motivational interviewing to help smokers with non-communicable diseases quit smoking. Methods In total, 60 participants who had medical follow-up in a special out-patient clinic were randomized into two groups, 30 in the intervention group received brief motivational interviewing to assist them with their chosen behavioral changes, and 30 in the control group received only a smoking cessation booklet. The outcome measures included self-reported 7-day point prevalence of smoking abstinence and any behavioral change reported by the participants at 6 and 12 months. Biochemical validation was performed for those who verbally reported a 7-day point prevalence of smoking abstinence at 12 months. Results The majority (95%) of smokers who attended the out-patient clinic owned a smartphone. The response rate was 73.2%. Retention rates at 6-month and 12-month follow-up were 83.3 and 71.7%, respectively. The process evaluation indicated that participants were satisfied with the content of the brief MI messages and appreciated the use of instant messaging as a way to provide them with professional advice and support for managing their health-related lifestyles. The intervention group had a higher biochemically validated abstinence rate than the control group at 12 months (16.7 vs. 6.7 P = 0.23) although the difference was not statistically significant (Adjusted odd ratio 2.4, 95% confidence interval, 0.43-13.75; P = 0.32.), In addition, the proportion of participants reporting a behavioral change was higher in the intervention group at 6 and 12 months. Conclusion This study suggested the potential efficacy and feasibility of a general health promotion approach that uses instant messaging to deliver brief motivational interviewing to help smokers with non-communicable diseases quit smoking. The findings can be used to create a new smoking cessation service model that implements a flexible, proactive and personalized approach to help smokers quit smoking. Clinical trial registration ClinicalTrials.gov, identifier: NCT03983330.
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Affiliation(s)
- William Ho Cheung Li
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Laurie Long Kwan Ho
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Ankie Tan Cheung
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Man Ping Wong
- Li Ka Shing Faculty of Medicine, School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Derek Yee Tak Cheung
- Li Ka Shing Faculty of Medicine, School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Wei Xia
- School of Nursing, The Sun Yat-sen University of Medical Sciences, Guangzhou, China
| | - Tai Hing Lam
- Li Ka Shing Faculty of Medicine, School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Harris M, Martin M, Yazidjoglou A, Ford L, Lucas RM, Newman E, Banks E. Smokers increasingly motivated and able to quit as smoking prevalence falls: umbrella and systematic review of evidence relevant to the 'hardening hypothesis', considering transcendence of manufactured doubt. Nicotine Tob Res 2022; 24:1321-1328. [PMID: 35239960 PMCID: PMC9278822 DOI: 10.1093/ntr/ntac055] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 02/15/2022] [Accepted: 03/01/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION The "hardening hypothesis" proposes that as the prevalence of smoking in a population declines, there will be a "hardening" of the remaining smoker population. This review examines the evidence regarding smokers' motivation, dependence and quitting behaviour as smoking prevalence declines, to assess whether population "hardening" (decreasing propensity to quit) or "softening" (the converse) is occurring. METHODS MEDLINE, PsychINFO, Scopus, Web of Science and Cochrane Library were searched to July 2019, using terms related to smoking and hardening, for reviews and large, population-based repeat cross-sectional studies. There were additional searches of reference lists and citations of key research articles. Two reviewers screened half the titles and abstracts each, and two reviewers screened full texts independently using tested criteria. Four reviewers independently and systematically extracted data from eligible publications, with one reviewer per study, checked by another reviewer. RESULTS Of 265 titles identified, three reviews and ten repeat cross-sectional studies were included. Reviews concluded that hardening has not occurred among the general smoking population over time. Among repeated cross-sectional studies, five examined motivation, nine examined dependence, five examined hardcore smoking, and two examined quit outcomes. All but one study found a lack of hardening. Most found softening within the smoking population, consistent across hardening indicators, definitions, countries (and tobacco control environments) and time periods examined. CONCLUSIONS Tobacco control reduces smoking prevalence and fosters a smoking population more amenable to evidence-based interventions. Based on the weight of the available evidence, the "hardening hypothesis" should be rejected and the reality of softening accepted. IMPLICATIONS This umbrella review and systematic review provides a critical consideration of evidence from psychology and other fields regarding the "hardening hypothesis" - a persistent myth undermining tobacco control. It reaches the conclusion that the sum-total of the world-wide evidence indicates either "softening" of the smoking population, or a lack of hardening. Hence, tobacco control reduces smoking prevalence and fosters a smoking population more amenable to evidence-based interventions. The review indicates that the time has come to take active steps to combat the myth of hardening and to replace it with the reality of "softening".
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Affiliation(s)
- Miranda Harris
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory, 2601, Australia
| | - Melonie Martin
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory, 2601, Australia
| | - Amelia Yazidjoglou
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory, 2601, Australia
| | - Laura Ford
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory, 2601, Australia
| | - Robyn M Lucas
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory, 2601, Australia
| | - Eryn Newman
- Research School of Psychology, College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, 2601, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory, 2601, Australia
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Lee SY, Lee J, Kwon M. Impacts of heavy smoking and alcohol consumption on workplace presenteeism: A cross-sectional study. Medicine (Baltimore) 2021; 100:e27751. [PMID: 34964731 PMCID: PMC8615302 DOI: 10.1097/md.0000000000027751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 10/27/2021] [Indexed: 01/05/2023] Open
Abstract
Presenteeism refers to the practice of going to work despite poor health, resulting in subpar performance. This study aimed to explore the impacts of smoking and alcohol consumption on workplace presenteeism based on demographic, health-related, and employment variables.The study adopted a cross sectional design with 60,051 wage workers from the database of the second and third Korean Working Conditions Surveys in 2010 and 2011, respectively. A total of 41,404 workers aged 19 years and older, who had worked for at least 1 hour in the previous week, answered the survey questions. Chi-square test as well as univariate and multiple logistic regression analyses were conducted using SPSS, version 18.0, to determine the impacts of smoking and alcohol consumption on workplace presenteeism.Of the 41,404 Korean workers, 8512 (20.6%) had experienced presenteeism in the past 12 months. There were significant differences among gender, age, educational status, income, health problems, absenteeism, shift work, night shift, weekly working hours, exposure to secondhand smoke at work, and satisfaction with the workplace environment. Based on the results of multiple regression analysis, heavy smoking (adjusted odds ratio = 1.38, 95% confidence intervals [1.11, 1.72]) and high-risk drinking (adjusted odds ratio = 1.19, 95% confidence intervals [1.08, 1.31]) were significantly related to presenteeism among workers.The results of our study confirmed that smoking and alcohol drinking were related to presenteeism even after controlling other variables (demographic, health-related, and employment variables) that affect presenteeism. Smoking and alcohol drinking are associated with and potentially influence presenteeism; in particular, heavy smoking and high-risk drinking contributed to presenteeism. Companies that encourage employees to receive treatments for reduction of smoking or alcohol consumption may benefit from greater productivity. Hence, we should consider the impact of smoking and alcohol consumption in the workplace and build appropriate strategies and programs to help reduce these behaviors.
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Affiliation(s)
- So Young Lee
- College of Nursing, Kyungbok University, Gyeonggi-do, South Korea
| | - Jinhwa Lee
- Department of Nursing, University of Ulsan, Ulsan, South Korea
| | - Min Kwon
- Department of Nursing, the University of Suwon, Gyeonggi-do, South Korea
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Huang HW, Yang YH, Li WW, Huang CL. Factors Associated with Attempt for Smoking Cessation among Hardcore Smokers in Taiwan. Asian Pac Isl Nurs J 2021; 5:251-258. [PMID: 33791414 PMCID: PMC7993883 DOI: 10.31372/20200504.1117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: Tobacco control activities have mostly influenced those smokers who found it easier to quit and, thus, remaining smokers are those who are less likely to stop smoking. This phenomenon is called “hardening hypothesis,” which individuals unwilling or unable to quit smoking and likely to remain so. The aim of this study was to identify the factors correlated with smoking cessation among hardcore smokers. Methods: A cross-sectional descriptive correlational research design was employed. Hardcore smokers from communities in Taiwan were recruited to participate in the study (N = 187). Self-report questionnaires were used to collect demographic data as well as data on nicotine dependence, quitting self-efficacy, social smoking motives, attitudes towards the Tobacco Hazards Prevention Act (THPA), and smoking cessation. Logistic regression analysis was used to examine the factors that were related to quit smoking. Results: About 30.3% (n = 54) reported having experienced quitting smoking over 7 days in the past year. Logistic regression analysis indicated that attitudes towards the THPA was identified as a particularly important factor contributing to the increase in smoking cessation among hardcore smokers. Conclusions: Nurses should cooperate with smoking cessation coaches to facilitate the improvement of attitudes towards the THPA as a key means through which to increase the smoking cessation rate among hardcore smokers.
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Affiliation(s)
- Hui-Wen Huang
- ESH Integration Department, Innolux Corporation, Tainan City, Taiwan
| | - Ya-Hui Yang
- Department of Nursing, Jianan Psychiatric Center, Ministry of Health and Welfare, Taiwan
| | - Wen-Wen Li
- School of Nursing, San Francisco State University, California, United States
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Huang HW, Hsueh KC, Li WW, Huang CL. Characteristics of Hardcore Male Smokers in Taiwan: A Qualitative Study. Asian Pac Isl Nurs J 2020; 5:55-62. [PMID: 33043134 PMCID: PMC7544014 DOI: 10.31372/20200502.1085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objectives: The purpose of this study was to explore the characteristics of hardcore smokers who were previously hospitalized. Study design: A descriptive qualitative design was used to investigate a sample of 29 male Taiwanese smokers. Methods: Male hardcore smokers were recruited at a hospital in southern Taiwan and their smoking behaviors and attitudes were explored in semistructured interviews. Inclusion criteria were: (1) smoking at least weekly or daily during the past year, (2) 100 cigarettes during the lifetime, (3) persistent smoking, or (4) at least one hospitalization. Audio-recorded interview data were analyzed using content categorization of the responses. Results: Four main themes emerged to describe characteristics of Taiwanese hardcore smokers: (1) physiological and psychological dependence, (2) no motivation to quit despite knowledge of negative health consequences, (3) social interaction and cultural norms, and (4) negative attitudes toward, but compliance with, smoking-free policies. Conclusions: The results can inform public health nurses of characteristics of Taiwanese hardcore smokers, which in turn may develop effective smoking cessation program to increase smoking cessation rate among Taiwanese hardcore smokers.
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Affiliation(s)
- Hui-Wen Huang
- Department of Nursing, Chung Hwa University of Medical Technology, Taiwan
| | - Kuang-Chieh Hsueh
- b Department of Family Medicine, Kaohsiung Veterans General Hospital, Taiwan
| | - Wen-Wen Li
- c School of Nursing, San Francisco State University, United States
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Lindson N, Klemperer E, Hong B, Ordóñez‐Mena JM, Aveyard P. Smoking reduction interventions for smoking cessation. Cochrane Database Syst Rev 2019; 9:CD013183. [PMID: 31565800 PMCID: PMC6953262 DOI: 10.1002/14651858.cd013183.pub2] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND The standard way most people are advised to stop smoking is by quitting abruptly on a designated quit day. However, many people who smoke have tried to quit many times and may like to try an alternative method. Reducing smoking behaviour before quitting could be an alternative approach to cessation. However, before this method can be recommended it is important to ensure that abrupt quitting is not more effective than reducing to quit, and to determine whether there are ways to optimise reduction methods to increase the chances of cessation. OBJECTIVES To assess the effect of reduction-to-quit interventions on long-term smoking cessation. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group Specialised Register, MEDLINE, Embase and PsycINFO for studies, using the terms: cold turkey, schedul*, cut* down, cut-down, gradual*, abrupt*, fading, reduc*, taper*, controlled smoking and smoking reduction. We also searched trial registries to identify unpublished studies. Date of the most recent search: 29 October 2018. SELECTION CRITERIA Randomised controlled trials in which people who smoked were advised to reduce their smoking consumption before quitting smoking altogether in at least one trial arm. This advice could be delivered using self-help materials or behavioural support, and provided alongside smoking cessation pharmacotherapies or not. We excluded trials that did not assess cessation as an outcome, with follow-up of less than six months, where participants spontaneously reduced without being advised to do so, where the goal of reduction was not to quit altogether, or where participants were advised to switch to cigarettes with lower nicotine levels without reducing the amount of cigarettes smoked or the length of time spent smoking. We also excluded trials carried out in pregnant women. DATA COLLECTION AND ANALYSIS We followed standard Cochrane methods. Smoking cessation was measured after at least six months, using the most rigorous definition available, on an intention-to-treat basis. We calculated risk ratios (RRs) and 95% confidence intervals (CIs) for smoking cessation for each study, where possible. We grouped eligible studies according to the type of comparison (no smoking cessation treatment, abrupt quitting interventions, and other reduction-to-quit interventions) and carried out meta-analyses where appropriate, using a Mantel-Haenszel random-effects model. We also extracted data on quit attempts, pre-quit smoking reduction, adverse events (AEs), serious adverse events (SAEs) and nicotine withdrawal symptoms, and meta-analysed these where sufficient data were available. MAIN RESULTS We identified 51 trials with 22,509 participants. Most recruited adults from the community using media or local advertising. People enrolled in the studies typically smoked an average of 23 cigarettes a day. We judged 18 of the studies to be at high risk of bias, but restricting the analysis only to the five studies at low or to the 28 studies at unclear risk of bias did not significantly alter results.We identified very low-certainty evidence, limited by risk of bias, inconsistency and imprecision, comparing the effect of reduction-to-quit interventions with no treatment on cessation rates (RR 1.74, 95% CI 0.90 to 3.38; I2 = 45%; 6 studies, 1599 participants). However, when comparing reduction-to-quit interventions with abrupt quitting (standard care) we found evidence that neither approach resulted in superior quit rates (RR 1. 01, 95% CI 0.87 to 1.17; I2 = 29%; 22 studies, 9219 participants). We judged this estimate to be of moderate certainty, due to imprecision. Subgroup analysis provided some evidence (P = 0.01, I2 = 77%) that reduction-to-quit interventions may result in more favourable quit rates than abrupt quitting if varenicline is used as a reduction aid. Our analysis comparing reduction using pharmacotherapy with reduction alone found low-certainty evidence, limited by inconsistency and imprecision, that reduction aided by pharmacotherapy resulted in higher quit rates (RR 1. 68, 95% CI 1.09 to 2.58; I2 = 78%; 11 studies, 8636 participants). However, a significant subgroup analysis (P < 0.001, I2 = 80% for subgroup differences) suggests that this may only be true when fast-acting NRT or varenicline are used (both moderate-certainty evidence) and not when nicotine patch, combination NRT or bupropion are used as an aid (all low- or very low-quality evidence). More evidence is likely to change the interpretation of the latter effects.Although there was some evidence from within-study comparisons that behavioural support for reduction to quit resulted in higher quit rates than self-help resources alone, the relative efficacy of various other characteristics of reduction-to-quit interventions investigated through within- and between-study comparisons did not provide any evidence that they enhanced the success of reduction-to-quit interventions. Pre-quit AEs, SAEs and nicotine withdrawal symptoms were measured variably and infrequently across studies. There was some evidence that AEs occurred more frequently in studies that compared reduction using pharmacotherapy versus no pharmacotherapy; however, the AEs reported were mild and usual symptoms associated with NRT use. There was no clear evidence that the number of people reporting SAEs, or changes in withdrawal symptoms, differed between trial arms. AUTHORS' CONCLUSIONS There is moderate-certainty evidence that neither reduction-to-quit nor abrupt quitting interventions result in superior long-term quit rates when compared with one another. Evidence comparing the efficacy of reduction-to-quit interventions with no treatment was inconclusive and of low certainty. There is also low-certainty evidence to suggest that reduction-to-quit interventions may be more effective when pharmacotherapy is used as an aid, particularly fast-acting NRT or varenicline (moderate-certainty evidence). Evidence for any adverse effects of reduction-to-quit interventions was sparse, but available data suggested no excess of pre-quit SAEs or withdrawal symptoms. We downgraded the evidence across comparisons due to risk of bias, inconsistency and imprecision. Future research should aim to match any additional components of multicomponent reduction-to-quit interventions across study arms, so that the effect of reduction can be isolated. In particular, well-conducted, adequately-powered studies should focus on investigating the most effective features of reduction-to-quit interventions to maximise cessation rates.
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Affiliation(s)
- Nicola Lindson
- University of OxfordNuffield Department of Primary Care Health SciencesRadcliffe Observatory QuarterWoodstock RoadOxfordOxfordshireUKOX2 6GG
| | - Elias Klemperer
- University of VermontDepartments of Psychological Sciences & Psychiatry1 S Prospect Street, Mail Stop 482, OH4BurlingtonVTUSA05405
| | - Bosun Hong
- Birmingham Dental HospitalOral Surgery Department5 Mill Pool WayBirminghamUKB5 7EG
| | - José M Ordóñez‐Mena
- University of OxfordNuffield Department of Primary Care Health SciencesRadcliffe Observatory QuarterWoodstock RoadOxfordOxfordshireUKOX2 6GG
| | - Paul Aveyard
- University of OxfordNuffield Department of Primary Care Health SciencesRadcliffe Observatory QuarterWoodstock RoadOxfordOxfordshireUKOX2 6GG
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Ho KY, Li WHC, Lam KKW, Wang MP, Xia W, Ho LY, Tan KCB, Sin HKM, Cheung E, Mok MPH, Lam TH. Smoking behaviours of Hong Kong Chinese hospitalised patients and predictors of smoking abstinence after discharge: a cross-sectional study. BMJ Open 2018; 8:e023965. [PMID: 30573486 PMCID: PMC6303614 DOI: 10.1136/bmjopen-2018-023965] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES Patients admitted to hospitals represent an excellent teachable moment for smoking cessation, as they are required to abstain from tobacco use during hospitalisation. Nevertheless, smoking behaviours of hospitalised patients, and factors that lead to smoking abstinence thereafter, remain relatively underexplored, particularly in a Hong Kong Chinese context. This study aimed to examine the smoking behaviours of hospitalised patients and explore factors leading to their abstaining from cigarette use after being hospitalised. DESIGN A cross-sectional design was employed. SETTING This study was conducted in three outpatient clinics in different regions in Hong Kong. PARTICIPANTS A total of 382 recruited Chinese patients. PRIMARY AND SECONDARY OUTCOME MEASURES The patients were asked to complete a structured questionnaire that assessed their smoking behaviours before, during and after hospitalisation. RESULTS The results indicated 23.6% of smokers smoked secretly during their hospital stay, and about 76.1% of smokers resumed smoking after discharge. Multivariate logistic regression analysis found that number of days of hospitalisation admission in the preceding year (OR 1.02; 95% CI 1.01 to 1.27; p=0.036), patients' perceived correlation between smoking and their illness (OR 1.08; 95% CI 1.01 to 1.17; p=0.032), withdrawal symptoms experienced during hospitalisation (OR 0.75; 95% CI 0.58 to 0.97; p=0.027) and smoking cessation support from healthcare professionals (OR 1.18; 95% CI 1.07 to 1.36; p=0.014) were significant predictors of smoking abstinence after discharge. CONCLUSIONS The results of this study will aid development of appropriate and innovative smoking cessation interventions that can help patients achieve more successful smoking abstinence and less relapse. TRIAL REGISTRATION NUMBER NCT02866760.
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Affiliation(s)
- Ka Yan Ho
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | | | | | - Man Ping Wang
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Wei Xia
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Lok Yin Ho
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | | | - Hubert Kit Man Sin
- Department of Medicine and Geriatrics, Tuen Mun Hospital, Hong Kong, China
| | - Elaine Cheung
- Department of Medicine and Geriatrics, United Christian Hospital, Hong Kong, China
| | - Maisy Pik Hung Mok
- Department of Medicine and Geriatrics, United Christian Hospital, Hong Kong, China
| | - Tai Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong, China
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12
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Wang MP, Li WH, Cheung YT, Lam OB, Wu Y, Kwong AC, Lai VW, Chan SS, Lam TH. Brief Advice on Smoking Reduction Versus Abrupt Quitting for Smoking Cessation in Chinese Smokers: A Cluster Randomized Controlled Trial. Nicotine Tob Res 2018; 20:67-72. [PMID: 28182243 DOI: 10.1093/ntr/ntx026] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 01/23/2017] [Indexed: 11/13/2022]
Abstract
Aims To compare the efficacy of brief advice about cut-down-to-quit (CDTQ) with that of brief advice about quit immediately (QI), as delivered by trained volunteers, without the use of pharmacological therapy, to outreach-recruited Chinese smokers in Hong Kong who intend to quit smoking. Methods Smokers (N = 1077) who enrolled in the Quit and Win Contest 2014 and intended to quit or reduce smoking were randomized in participation sessions to CDTQ (n = 559) and QI (n = 518) groups. Subjects in the CDTQ group received brief advice and a card about smoking reduction. Subjects in the QI group received brief advice and a leaflet about quitting smoking. All received a smoking cessation booklet and corresponding CDTQ or QI brief telephone advice at intervals of 1 week, 1 month, or 2 months. The primary outcomes were self-reported 7-day point prevalence abstinence (PPA) at the 3-month and 6-month follow-ups. The secondary outcomes included abstinence rate as validated by biochemical tests, smoking reduction (≥50% reduction from baseline), and quit attempt (QA). The outcome assessors were blinded as to group assignment. Results By intention to treat, the QI and CDTQ groups showed similar results as regards (i) self-reported PPA (10.6% [95% CI 8.1%-13.6%] vs. 9.1% [95% CI 6.9%-11.8%]), (ii) validated abstinence rate (5.6% [3.8%-7.9%] vs. 5.4% [3.6%-7.6%]), and (iii) QA rate (59.2% [53.5%-64.8%] vs. 54.1% [48.7%-59.3%]) at 6-month. However, the CDTQ group showed a significantly higher reduction rate than the QI group (20.9% [CI 17.6%-24.5%] vs. 14.5% [11.6%-17.8%]). The overall intervention adherence was suboptimal (45.4%), particularly in the CDTQ group (42.3%). Self-efficacy as regards quitting of smoking was similar between the groups at 6 months. Conclusions Brief advice on CDTQ and QI had similar short-term PPAs. Longer-term follow-up is needed to understand the latent effect of smoking reduction on abstinence. Implications This is the first randomized controlled trial in ethnic Chinese smokers to evaluate the relative efficacy of brief advice on (a) CDTQ and (b) QI as regards quitting. The two interventions showed similar effects as regards PPA. The findings suggested that brief advice on CDTQ may be as effective as brief advice on QI in smokers recruited in community settings.
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Affiliation(s)
- Man Ping Wang
- School of Nursing, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - William H Li
- School of Nursing, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Yee Tak Cheung
- School of Nursing, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.,School of Public Health, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Oi Bun Lam
- School of Nursing, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Yongda Wu
- School of Nursing, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Antonio C Kwong
- Hong Kong Council on Smoking and Health, Hong Kong Special Administrative Region, People's Republic of China
| | - Vienna W Lai
- Hong Kong Council on Smoking and Health, Hong Kong Special Administrative Region, People's Republic of China
| | - Sophia S Chan
- School of Nursing, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
| | - Tai Hing Lam
- School of Public Health, University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China
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Wang MP, Suen YN, Li WHC, Lau OS, Lam TH, Chan SSC. Proactive outreach smoking cessation program for Chinese employees in China. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2018; 73:67-78. [PMID: 28350250 DOI: 10.1080/19338244.2017.1308309] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 03/14/2017] [Indexed: 06/06/2023]
Abstract
We evaluated the first workplace intervention to help smokers quit in Hong Kong. Smoking employees (N = 642) received a 26-page self-help booklet and 15 fix SMS within 3 months and chose to receive cognitive behavioral workshop (N = 76), or face-to-face counseling (N = 11), or group health talk (N = 516), or telephone counseling (N = 39). Twenty participants were interviewed individually for their opinions about the interventions. By intention-to-treat, the overall self-reported past 7-day point prevalence quit rate was 31.0% and 32.9%, and reduction rate was 15.0% and 13.2% at 6 and 12-months, respectively. More than 20% of the unmotivated smokers at baseline (N = 399) quit in this program. Proactive outreach workplace smoking cessation programs with diverse intensity but without medications, chosen by smokers and supported by employers without further incentives, were feasible in busy working environment in Hong Kong.
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Affiliation(s)
- Man Ping Wang
- a School of Nursing , the University of Hong Kong , Hong Kong SAR , China
| | - Yi Nam Suen
- a School of Nursing , the University of Hong Kong , Hong Kong SAR , China
| | | | - Oi Sze Lau
- b The Lok Sin Tong Benevolent Society Kowloon , Hong Kong SAR , China
| | - Tai Hing Lam
- c School of Public Health , the University of Hong Kong , Hong Kong SAR , China
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Lu CC, Hsiao YC, Huang HW, Lin JY, Huang CL. Effects of a Nurse-Led, Stage-Matched, Tailored Program for Smoking Cessation in Health Education Centers: A Prospective, Randomized, Controlled Trial. Clin Nurs Res 2018; 28:812-829. [PMID: 29363339 DOI: 10.1177/1054773817754276] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to examine the effectiveness of a stage-matched intervention performed at outpatient clinics. Participants were randomly assigned to an intervention group (IG) or usual care group (UCG). The trial was targeted on smoking patients with coronary heart disease or diabetes. After completing the 3-month intervention, both groups received a telephone follow-up at 6 months. This analysis showed that the outcomes of the IG for the 7-day point prevalence (PP) of abstinence (odds ratio [OR] = 2.00; p = .001) and 30-day PP (OR = 2.27; p = .004) at 6 months were significantly better than the UCG. Stage of change (OR = 4.06; p < .001) and decreased daily cigarette consumption by 50% at 6 months (OR = 2.26; p = .019) outcomes also improved significantly. The preliminary results showed that a nurse-led cessation intervention in clinics may be an effective approach to help outpatients quit smoking.
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Affiliation(s)
- Chia-Chen Lu
- 1 Changhua Christian Hospital Erlin Branch, Taiwan
| | - Yu-Chuan Hsiao
- 2 Min-Hwei College of Health Care Management, Tainan, Taiwan
| | - Hui-Wen Huang
- 3 Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Jhen-Yi Lin
- 1 Changhua Christian Hospital Erlin Branch, Taiwan
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Wu L, He Y, Jiang B, Zhang D, Tian H, Zuo F, Lam TH. Very brief physician advice and supplemental proactive telephone calls to promote smoking reduction and cessation in Chinese male smokers with no intention to quit: a randomized trial. Addiction 2017. [PMID: 28623848 DOI: 10.1111/add.13908] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND AIMS There is inconsistent evidence that behavioural support to promote smoking reduction is effective at increasing smoking cessation. We examined the effectiveness of brief physician advice together with four very brief telephone calls in promoting smoking cessation among Chinese men via reduction compared with equivalent advice on diet and exercise. DESIGN A two-group pragmatic randomized controlled trial. PARTICIPANTS AND SETTING Male patients attending the Endocrinology and Acupuncture out-patient clinics of a general hospital in Beijing, China. INTERVENTION AND COMPARATORS Physicians advised participants allocated to the smoking-reduction intervention (SRI, n = 181) group to reduce smoking to at least half of their current consumption within 1 month at baseline. At follow-up, a telephone counsellor repeated this advice if the participant had not reduced their cigarette consumption. Participants who had reduced consumption were encouraged to quit smoking. Physicians gave participants in the exercise and diet advice (EDA, n = 188) control group brief advice about physical activity and healthy diet at baseline, and a telephone counsellor reinforced this at each follow-up interview. Both groups had one face-to-face interview at baseline plus five telephone interviews and interventions (approximately 1 minute each) at 1 week and 1-, 3-, 6- and 12-month follow-up. MEASUREMENTS The primary outcome was self-reported 6-month prolonged abstinence rate at 12-month follow-up interview. FINDINGS By intention-to-treat, the self-reported 6-month prolonged abstinence rate at 12-month follow-up in the SRI groups (19 quitters, 15.7%) was higher, but not significantly, than the EDA control group (10 quitters, 7.8%), and the adjusted odds ratio (OR) and 95% confidence interval (CI) was 2.26 (0.97-5.26), P = 0.062. The self-reported 7-day point prevalence quit rate (secondary outcome) in the SRI group was significantly higher than the control group at each follow-up interview (at 12-month follow-up: 13.3 versus 6.9%, OR (95% CI) = 2.09 (1.01, 4.34), P = 0.049). CONCLUSIONS A very brief, proactive and low-cost smoking-reduction intervention without medications for Chinese male smokers with no intention to quit appears to increase smoking abstinence.
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Affiliation(s)
- Lei Wu
- Institute of Geriatrics, Chinese People's Liberation Army of China General Hospital, Beijing, China.,Beijing Key Laboratory of Aging and Geriatrics, Chinese People's Liberation Army of China General Hospital, Beijing, China
| | - Yao He
- Institute of Geriatrics, Chinese People's Liberation Army of China General Hospital, Beijing, China.,Beijing Key Laboratory of Aging and Geriatrics, Chinese People's Liberation Army of China General Hospital, Beijing, China.,State Key Laboratory of Kidney Disease, Chinese People's Liberation Army of China General Hospital, Beijing, China
| | - Bin Jiang
- Nanlou Department of Acupuncture, Chinese People's Liberation Army of China General Hospital, Beijing, China
| | - Di Zhang
- Institute of Geriatrics, Chinese People's Liberation Army of China General Hospital, Beijing, China.,Beijing Key Laboratory of Aging and Geriatrics, Chinese People's Liberation Army of China General Hospital, Beijing, China
| | - Hui Tian
- Nanlou Department of Endocrinology, Chinese People's Liberation Army of China General Hospital, Beijing, China
| | - Fang Zuo
- Nanlou Department of Acupuncture, Chinese People's Liberation Army of China General Hospital, Beijing, China
| | - Tai Hing Lam
- Institute of Geriatrics, Chinese People's Liberation Army of China General Hospital, Beijing, China.,School of Public Health, The University of Hong Kong, Hong Kong
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Joly B, Perriot J, d’Athis P, Chazard E, Brousse G, Quantin C. Success rates in smoking cessation: Psychological preparation plays a critical role and interacts with other factors such as psychoactive substances. PLoS One 2017; 12:e0184800. [PMID: 29020085 PMCID: PMC5636087 DOI: 10.1371/journal.pone.0184800] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 08/31/2017] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION The aim of this study was to identify factors associated with the results of smoking cessation attempts. METHODS Data were collected in Clermont-Ferrand from a smoking cessation clinic between 1999 and 2009 (1,361 patients). Smoking cessation was considered a success when patients were abstinent 6 months after the beginning of cessation. Multivariate logistic regression was used to investigate the association between abstinence and different factors. RESULTS The significant factors were a history of depression (ORadjusted = 0.57, p = 0.003), state of depression at the initial consultation (ORa = 0.64, p = 0.005), other psychoactive substances (ORa = 0.52, p<0.0001), heart, lung and Ear-Nose-Throat diseases (ORa = 0.65, p = 0.005), age (ORa = 1.04, p<0.0001), the Richmond test (p<0.0001; when the patient's motivation went from insufficient to moderate, the frequency of abstinence was twice as high) and the Prochaska algorithm (p<0.0001; when the patient went from the 'pre-contemplation' to the 'contemplation' level, the frequency of success was four times higher). A high score in the Richmond test had a greater impact on success with increasing age (significant interaction: p = 0.01). In exclusive smokers, the contemplation level in the Prochaska algorithm was enough to obtain a satisfactory abstinence rate (65.5%) whereas among consumers of other psychoactive substances, it was necessary to reach the preparation level in the Prochaska algorithm to achieve a success rate greater than 50% (significant interaction: p = 0.02). CONCLUSION The psychological preparation of the smoker plays a critical role. The management of smoking cessation must be personalized, especially for consumers of other psychoactive substances and/or smokers with a history of depression.
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Affiliation(s)
- Bertrand Joly
- Biostatistics and Bioinformatics (DIM), University Hospital, Dijon, France; Bourgogne Franche-Comté University, Dijon, France
| | - Jean Perriot
- Dispensaire Emile Roux, Centre d'Aide à I'Arrêt du Tabagisme (IRAAT), Centre de Lutte Anti-Tuberculeuse (CLAT), Clermont-Ferrand, France
| | - Philippe d’Athis
- Biostatistics and Bioinformatics (DIM), University Hospital, Dijon, France; Bourgogne Franche-Comté University, Dijon, France
| | - Emmanuel Chazard
- Univ. Lille, CHU Lille, Department of Public Health, Lille, France
| | - Georges Brousse
- Psychiatry B-Department of Addictology, Université Clermont 1, UFR Médecine, Clermont-Ferrand, and CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Catherine Quantin
- Biostatistics and Bioinformatics (DIM), University Hospital, Dijon, France; Bourgogne Franche-Comté University, Dijon, France
- INSERM, CIC 1432, Dijon, France; Dijon UniversityHospital, Clinical Investigation Center, Clinicalepidemiology/ Clinical trials unit, Dijon, France
- Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), INSERM, UVSQ, Institut Pasteur, Université Paris-Saclay, Paris, France
- * E-mail:
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17
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Joly B, D'Athis P, Gerbaud L, Hazart J, Perriot J, Quantin C. Smoking cessation attempts: is it useful to treat hard core smokers? Tob Induc Dis 2016; 14:34. [PMID: 27822177 PMCID: PMC5093930 DOI: 10.1186/s12971-016-0100-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 10/21/2016] [Indexed: 02/08/2023] Open
Abstract
Background Hard core smokers have been studied in many countries but only a few trials have compared the effectiveness of smoking cessation with other smokers. The objective of this study was to compare the frequencies of success in smoking cessation between hard-core smokers and other smokers. Methods Data were collected in Clermont-Ferrand from the Emile Roux dispensary ‘Pneumology and Tobaccology Centre’ between 1999 and 2009. Assistance with smoking cessation was proposed to 1367 patients but only 1296 patients were included: 219 HCS and 1077 other smokers. Smoking cessation was considered a success when patients were abstinent 6 months after the beginning of cessation. The profiles of the two types of smokers were compared using Chi square test and Student’s t test. Multivariate logistic regression was used to investigate the association between the smoking cessation result and the type of smokers. Results HCS more frequently consumed other psychoactive substances (41.1 % vs 25.7 % for other smokers; p < 0.001). Current depression was more frequent in HCS (46.6 % vs 34.8 % for other smokers; p = 0.001). Smoking cessation was less frequent in HCS (45.2 % vs 56.5 % for other smokers ; p = 0.002). In multivariate analysis, after controlling for other factors, the frequency of smoking cessation was not significantly associated with the type of smokers (p = 0.47). After limiting to initial factors (present before the beginning of smoking cessation), the frequency of smoking cessation was still not significantly associated with the type of smokers (p = 0.78). Conclusion Smoking cessation is possible for hard core smokers, who should be treated as other types of smokers taking into account other factors:the problem is how to encourage them to try to stop smoking.
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Affiliation(s)
- B Joly
- Service de Biostatistique et d'Informatique Médicale (DIM), CHRU Dijon, Dijon, F-21000 France
| | - P D'Athis
- Service de Biostatistique et d'Informatique Médicale (DIM), CHRU Dijon, Dijon, F-21000 France
| | - L Gerbaud
- Service de santé Publique, CHU Clermont-Ferrand, EA PEPRADE4681 Université d'Auvergne, Clermont-Ferrand, France
| | - J Hazart
- Service de santé Publique, CHU Clermont-Ferrand, EA PEPRADE4681 Université d'Auvergne, Clermont-Ferrand, France
| | - J Perriot
- Dispensaire Emile Roux, Centre d'Aide à I'Arrêt du Tabagisme (IRAAT), Centre de Lutte Anti-Tuberculeuse (CLAT), 63100 Clermont-Ferrand, France
| | - C Quantin
- Service de Biostatistique et d'Informatique Médicale (DIM), CHRU Dijon, Dijon, F-21000 France ; INSERM, CIC 1432, Dijon, France; Dijon University Hospital, Clinical Investigation Center, Clinical epidemiology/clinical trials unit, Dijon, France ; Inserm UMR 1181 « Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases » (B2PHI), Univ. Bourgogne Franche-Comté, F-21000 Dijon, France
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