Tobacco craving and withdrawal symptoms in psychiatric patients during a motivational enhancement intervention based on a 26-hour smoking abstinence period

Nurses’ Perspectives on Smoking Policies, Safety and Cessation Support in Psychiatric Wards: A Cross-Sectional Survey

A high prevalence of smoking and low rates of smoking cessation interventions can be observed in psychiatric wards. A questionnaire-based, cross-sectional study was performed in five hospitals among 107 psychiatric ward nurses. The aim was to investigate nurses’ views on patients’ smoking practices and their influence on the safety of both the patients and medical personnel. In addition, we asked about the availability of smoking cessation support. Most of the respondents noticed the negative impacts of smoking on patients and medical personnel. Nearly a third of our respondents (29.0%) recalled smoking-related accidents in their facilities. In 45.2% of these accidents, a patient set someone else on fire. Around one fifth of nurses had rather permissive attitudes towards tobacco use in hospital wards. Significant associations were identified between respondents’ smoking status and their opinions on amending smoking policies and on unsupervised smoking. Regarding professional help available to smoking patients, 88.8% of participants reported that interventions to address smoking were available in their wards. Psychiatric hospitalisation can be an opportunity to offer tobacco treatment to patients with mental health conditions. To make use of this opportunity, smoke-free policies need to be put in place and hospital personnel, particularly nurses, should be trained and equipped with the knowledge and skills needed to assist in the smoking care of psychiatric ward patients.

Practice Quit Attempts: Scoping Review of a Novel Intervention Strategy

OBJECTIVE

Fostering practice quit attempts (PQAs)--that is, attempts to not smoke for a few hours or days, without pressure to permanently quit--represents a potential means to engage more individuals who smoke in efforts to change their smoking. However, little is known about interventions designed to foster PQAs. We aimed to identify the available evidence on PQA-focused intervention strategies and their impact on quit attempt and cessation outcomes.

METHOD

We conducted a scoping review of behavioral and pharmacological treatment studies targeting PQAs among adult cigarette smokers.

RESULTS

The systematic literature search yielded 3,879 articles, and the full-text review was narrowed to 86. Twenty-three studies were deemed relevant, and 5 were added through other sources, yielding 28 studies total. Fifteen studies included behavioral intervention techniques focused on the development and rehearsal of individualized coping skills, whereas eight studies provided brief advice/instruction. More than half of the PQA-focused interventions incorporated sampling of nicotine replacement products, through either guided or ad lib use. Five studies reported on PQA-focused digital health interventions that prompted brief abstinence challenges. Of eight large-scale controlled trials, six demonstrated an increase in quit attempt and cessation outcomes among the PQA-focused intervention group.

CONCLUSIONS

Fostering PQAs through behavioral and pharmacological interventions offers a promising technique for cessation induction that warrants future research.

The Role of Anxiety in Smoking Onset, Severity, and Cessation-Related Outcomes: a Review of Recent Literature

PURPOSE OF REVIEW

Anxiety is one of the most common mental health conditions globally and co-occurs with smoking at a markedly high rate. The present review offers a narrative overview of the most recent research on the role of anxiety in smoking onset, maintenance, and cessation-related outcomes. Additionally, given the rise in electronic cigarette use, we review the emerging literature on the influence of anxiety on e-cigarette use.

RECENT FINDINGS

Evidence across studies varied as to the role of anxiety or anxiety symptoms in smoking behavior. The most consistent findings suggested that those with anxiety are more likely to be a smoker, supporting a high rate of co-occurrence across these conditions. Less consistent evidence was observed for the association between anxiety and onset, indicators of severity, and cessation outcomes. Although there is robust evidence for an association between smoking and anxiety, there were considerable discrepancies for the precise role of anxiety in smoking onset, severity, and cessation outcomes. Future work utilizing more sophisticated methodologies is needed to identify causal relations as well as putative moderators and mediators of the anxiety-smoking relation.

Clinical, sociodemographic and tobacco-use factors associated with smoking cessation rates at three years follow-up, Ankara, Turkey

INTRODUCTION

Smoking is a well-known major cause of early preventable mortality and morbidity. Maintenance of smoke-free status is important after a smoking cessation attempt. The present study aims to compare the sociodemographic and clinical characteristics of subjects participating in a smoking-cessation program, according to the duration of smoking cessation.

METHODS

A study was conducted in 261 smokers who had attended a smoking cessation clinic in a tertiary hospital, in Ankara, Turkey. The smoking status of the subjects at three years follow-up after participating in the smoking-cessation program was assessed. Sociodemographic, employment, environmental, smoking-related, health and clinical characteristics of subjects were compared according to the smoking cessation duration.

RESULTS

Marital status, having a child, absence of household smoking and lower levels of nicotine dependence were significantly higher in quitters, and anxiety was lower. Parameters that significantly differed between subjects that were and were not abstinent for >36 months were marital status (p<0.001), childbearing status (p=0.007), household smoking (p<0.001), age of smoking initiation (p=0.02), psychiatric illness history (p=0.01), and number of follow-up visits (p<0.001). The number of follow-up visits at the smoking cessation clinic was an important factor of quitting and maintenance of quit status.

CONCLUSIONS

Family and home environment as well as smoking-related and mental health characteristics influenced maintenance of long-term smoking cessation. Characteristics such as sociodemographic, clinical and smoking-related conditions should be considered in smoking cessation interventions. Personalized treatment strategies and follow-up visits at the smoking cessation clinic should be planned for maintenance of smoking cessation.