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Dyson J, Skinner J, Crick J, Crooks MG. Designing an intervention to help the quitters quit: A qualitative, intervention co-design study. PEC INNOVATION 2023; 2:100141. [PMID: 37214522 PMCID: PMC10194124 DOI: 10.1016/j.pecinn.2023.100141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 02/17/2023] [Accepted: 02/18/2023] [Indexed: 05/24/2023]
Abstract
Objective E-cigarettes are increasingly being provided by publicly funded stop smoking services. Our objectives were to understand the challenges and establish the means by which services could best support the use and subsequent discontinuation of e-cigarettes for this purpose. Methods Semi-structured interviews and co-design workshops with service users and providers of a stop smoking service. Results Thematic analysis was conducted. Interviews identified: 1. a reluctance to use e-cigarettes for cessation, 2. struggle to quit e-cigarettes (dependency, fear of relapse, compensatory "puffing") and 3. service development needs (consistency of approach). Co-design workshops suggested: 1. facilitation of e-cigarette use through understanding previous failed attempts, 2. offering a longer, two-staged approach to tobacco then e-cigarette cessation, careful timing of behavioural strategies and 3. enhanced communication between providers. Conclusions Our study suggests additional modifications to smoking cessation support measures when e-cigarettes are used for smoking cessation to address the challenges posed by public health guidance: "smokers should switch to vaping and vapers should stop smoking completely". Innovation Our study is the first to consider experiences of service users and providers about the challenges of using e-cigarettes for cessation; our co-design group of providers informed nine strategies needed to support this approach in practice.
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Affiliation(s)
- Judith Dyson
- Faculty of Health, Education and Life Sciences, Birmingham City University, Birmingham, UK
| | - James Skinner
- Faculty of Business, Law and Social Sciences, Birmingham City University, Birmingham, UK
| | - James Crick
- Hull Clinical Commissioning Group/Hull City Council, Hull, UK
| | - Michael G. Crooks
- Respiratory Research Group, Institute for Clinical and Applied Health Research, Hull York Medical School, Hull, UK
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Martinez U, Simmons VN, Brandon KO, Quinn GP, Brandon TH. Examining smoking and vaping behaviors, expectancies, and cessation outcomes between bisexual and heterosexual individuals. Behav Med 2023; 49:392-401. [PMID: 35614523 PMCID: PMC9691792 DOI: 10.1080/08964289.2022.2077295] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 05/05/2022] [Accepted: 05/08/2022] [Indexed: 11/02/2022]
Abstract
Prior research indicates bisexual individuals have higher smoking and vaping rates and heightened vulnerability to negative health outcomes. Thus, we compared adult bisexual (n = 294) and heterosexual (n = 2412) participants enrolled in a smoking cessation trial on baseline smoking and vaping use behaviors, motivations, and expectancies/beliefs as well as follow-up smoking and vaping status. This is a secondary analysis of a large randomized controlled trial testing a smoking cessation intervention for dual users of combustible and electronic cigarettes (e-cigarettes) in the United States. Self-reported 7-day point prevalence smoking and vaping abstinence were collected at 3-, 12-, and 24-month assessments. Bisexual and heterosexual participants did not differ in sociodemographic variables or baseline smoking and vaping history and behavior. We found significant differences among bisexual and heterosexual individuals in smoking and vaping beliefs/expectancies. Specifically, bisexual participants expressed overall greater positive expectancies regarding smoking and vaping, such as smoking and vaping to reduce negative affect and stress. There were no differences in smoking at any follow-up assessment. Only at 3 months were bisexual individuals more likely to be abstinent from vaping and less likely to be dual users than heterosexual individuals. Despite similar smoking and vaping status over time, bisexual individuals reported greater positive expectancies regarding smoking and vaping. Our findings revealed few targets for tailoring cessation interventions to bisexual individuals; thus, it is possible that there may be greater utility in targeting the disparities in prevalence (i.e., via prevention efforts).
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Affiliation(s)
- Ursula Martinez
- Department of Health Outcomes and Behavior, H. Lee Moffitt
Cancer Center, Tampa, FL, USA
- Department of Oncologic Sciences, University of South
Florida, Tampa, FL, USA
| | - Vani N. Simmons
- Department of Health Outcomes and Behavior, H. Lee Moffitt
Cancer Center, Tampa, FL, USA
- Department of Oncologic Sciences, University of South
Florida, Tampa, FL, USA
- Department of Psychology, University of South Florida,
Tampa, FL, USA
| | - Karen O. Brandon
- Department of Health Outcomes and Behavior, H. Lee Moffitt
Cancer Center, Tampa, FL, USA
| | - Gwendolyn P. Quinn
- Deparment of Obstetrics and Gynecology, New York University
Grossman School of Medicine, New York, NY, USA
| | - Thomas H. Brandon
- Department of Health Outcomes and Behavior, H. Lee Moffitt
Cancer Center, Tampa, FL, USA
- Department of Oncologic Sciences, University of South
Florida, Tampa, FL, USA
- Department of Psychology, University of South Florida,
Tampa, FL, USA
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Ashour AM. Use of Vaping as a Smoking Cessation Aid: A Review of Clinical Trials. J Multidiscip Healthc 2023; 16:2137-2144. [PMID: 37529148 PMCID: PMC10389080 DOI: 10.2147/jmdh.s419945] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/21/2023] [Indexed: 08/03/2023] Open
Abstract
Purpose Smoking is a global public health concern, with a significant negative impact on human health and healthcare spending. Vaping, or the use of electronic cigarettes (e-cigarettes), has emerged as a popular alternative to traditional nicotine replacement therapies (NRTs) for smoking cessation. While considered less harmful than combustible cigarettes, the long-term health effects of e-cigarettes (vaping) are unknown. Therefore, this study aimed to identify and provide a comprehensive overview of the performance of vaping in clinical trials. Patients and Methods A search was conducted in the ClinicalTrials.gov database on April 14th, 2023, using the search term "smoking cessation, e-cigarettes, NRTs, and vaping". Inclusion and exclusion criteria were defined to identify relevant clinical trials. Randomized controlled trials (RCTs) and non-randomized clinical trials that evaluated vaping as a therapeutic approach to smoking cessation were included. Results A total of 87 clinical trials were identified, of which only seven were related to smoking cessation through vaping as a form of treatment. The primary endpoint was the effect of vaping as smoking cessation, and the secondary endpoints were patients' abstinence rate, withdrawal symptoms, and adverse events of e-cigarettes. Most of the trials used e-cigarettes as an intervention, with some trials including a combination of e-cigarettes and other NRTs. The trials lasted from 4 weeks to 12 months. The overall results of the trials indicated that vaping was effective in helping smokers to quit. It was also associated with a lower risk of adverse events than combustible cigarettes. Conclusion Vaping appears to be an effective method for smoking cessation, and it is associated with a lower risk of adverse events than combustible cigarettes.
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Affiliation(s)
- Ahmed M Ashour
- Pharmacology and Toxicology Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
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Coleman SRM, Piper ME, Byron MJ, Bold KW. Dual Use of Combustible Cigarettes and E-cigarettes: a Narrative Review of Current Evidence. CURRENT ADDICTION REPORTS 2022; 9:353-362. [PMID: 36467719 PMCID: PMC9718538 DOI: 10.1007/s40429-022-00448-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2022] [Indexed: 11/28/2022]
Abstract
Purpose of Review E-cigarette use (vaping) among adults has increased, and various patterns of concurrent smoking and vaping (i.e., "dual use") have emerged. Understanding dual use is important for mitigating tobacco-related harm. This narrative review summarizes recent research on dual use, including prevalence and types of dual use, sociodemographic and psychiatric characteristics, nicotine dependence, reasons for dual use, harm perceptions, toxicant exposure, trajectories of dual use, and emerging treatments for dual use. Recent Findings Nearly half of e-cigarette users concurrently use cigarettes, and many smoke more frequently than they use e-cigarettes. This is concerning because dual users are exposed to both cigarette and potential e-cigarette toxicants and the data are mixed regarding the ability of e-cigarettes to promote smoking cessation. Summary Further work is needed to identify ways to increase complete smoking abstinence and optimize harm reduction among dual users, including strategies to encourage e-cigarette cessation after stopping smoking.
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Affiliation(s)
- Sulamunn R. M. Coleman
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, 1 South Prospect Street, Burlington, VT 05401-1419, USA
| | - Megan E. Piper
- Center for Tobacco Research and Intervention, Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - M. Justin Byron
- Department of Family Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Krysten W. Bold
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
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Dyson J, Bhatnagar M, Skinner J, Crooks M. Helping the quitters quit: A systematic review and narrative synthesis of the barriers and facilitators to e-cigarette cessation and the support that is needed. PATIENT EDUCATION AND COUNSELING 2022; 105:1402-1410. [PMID: 34579994 DOI: 10.1016/j.pec.2021.09.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 09/10/2021] [Accepted: 09/13/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To investigate the barriers and facilitators to and support needed for e-cigarette cessation. METHODS We systematically searched the subject-specific databases MEDLINE, CINAHL complete and psycINFO and the Cochrane database using synonyms relating to the terms e-cigarettes and cessation including English language, empirical, peer reviewed research papers, published from 2010 to 2021. We included papers that addressed the research question in its broadest sense, including papers reporting reasons for and interventions to support e-cigarette cessation. Data extraction was completed two authors independently using a bespoke spreadsheet. We conducted a narrative synthesis of all data and we were able to extract and combine descriptive quantitative data from included survey papers. RESULTS After reviewing 2593 titles 10 papers fit our criteria. Barriers to e-cigarette cessation were: a fear of returning to tobacco, dependency and stress reduction. Barriers or facilitators were: health and hazard beliefs, degree of enjoyment, social influences and environmental factors. A number of e-cigarette smoking support measures were suggested by participants. PRACTICE IMPLICATIONS E-cigarette cessation poses similar and additional challenges to that of tobacco cessation. E-cigarettes are not the final step on a journey to smoking cessation. Addressing barriers specific to e-cigarettes need to be considered in intervention design.
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Affiliation(s)
- Judith Dyson
- Social Care, Health and Related Research (C-SCHaRR) Birmingham City University, Westbourne Road, Edgbaston, Birmingham B15 3TN, United Kingdom.
| | | | - James Skinner
- School of Sociology, Politics and International Studies (SPAIS), University of Bristol, Bristol, United Kingdom
| | - Michael Crooks
- Respiratory Research Group, Institute for Clinical and Applied Health Research, Hull York Medical school, Hull HU16 5JQ, United Kingdom
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Piper ME, Baker TB, Zwaga D, Bolt DM, Kobinsky K, Jorenby DE. Understanding contexts of smoking and vaping among dual users: analysis of ecological momentary assessment data. Addiction 2022; 117:1416-1426. [PMID: 34791744 PMCID: PMC9940410 DOI: 10.1111/add.15747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 10/29/2021] [Indexed: 11/29/2022]
Abstract
AIMS To understand dual users' cigarette and e-cigarette use patterns, including the contexts in which they vape versus smoke and to understand how environmental and internal contexts and smoking patterns differ between dual users and exclusive smokers. DESIGN Longitudinal observational trial. SETTING Research center in Wisconsin, USA. PARTICIPANTS Adult dual users (n = 162) and adults who exclusively smoked (n = 143), with no plans to quit smoking or vaping in the next 30 days. MEASUREMENTS Participants carried smartphones for 2 weeks at baseline to record each use event for the two products and report on the context of their product use. The percentage of mornings where participants vaped first versus smoked were used to compute e-cigarette dependence. FINDINGS Hierarchical linear regression models with random slopes and intercepts examined the within- and between-subject effects of context on the likelihood of vaping (versus smoking); significant fixed effects were tested for moderation by e-cigarette dependence. Dual users reported significantly more puffs/cigarette [mean = 13.1, standard deviation (SD) = 10.2] than puffs/vape event (mean = 11.7, SD = 11.5; P = 0.01). E-cigarette dependence moderated the influence of social cues (t-ratio = 2.4, P = 0.02) and smoking restrictions (t-ratio = 3.1, P = 0.003) on the likelihood of vaping versus smoking [odds ratio (OR) = 2.30, P = 0.02]. Context was more related to which product was used in those of low versus higher e-cigarette dependence. Reports of strong cravings to smoke and positive expectancies for cigarettes were associated with a reduced likelihood of vaping, whereas strong cravings to vape and positive vaping expectancies were related to increased likelihood of vaping. CONCLUSIONS Among dual users of cigarettes and e-cigarettes with no motivation to quit, vaping appears to be related to internal cues and more highly linked with social contexts and smoking restrictions (i.e. under stronger external stimulus control) among those with low to moderate e-cigarette dependence compared with high e-cigarette dependence. These findings illustrate the importance of contextual factors in tobacco product use among dual users with the influence of context being reduced at high levels of e-cigarette dependence.
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Affiliation(s)
- Megan E. Piper
- University of Wisconsin, School of Medicine and Public Health, Center for Tobacco Research and Intervention, University of Wisconsin-Madison, Madison, WI,Correspondence concerning this article should be addressed to Megan E. Piper, Ph.D., Center for Tobacco Research and Intervention, University of Wisconsin, Madison, WI, 53711; Tel: 608-265-5472; Fax: 608-265-3102;
| | - Timothy B. Baker
- University of Wisconsin, School of Medicine and Public Health, Center for Tobacco Research and Intervention, University of Wisconsin-Madison, Madison, WI
| | - Deejay Zwaga
- University of Wisconsin, School of Medicine and Public Health, Center for Tobacco Research and Intervention, University of Wisconsin-Madison, Madison, WI
| | - Daniel M. Bolt
- Department of Educational Psychology, University of Wisconsin-Madison, Madison, WI
| | - Kate Kobinsky
- University of Wisconsin, School of Medicine and Public Health, Center for Tobacco Research and Intervention, University of Wisconsin-Madison, Madison, WI
| | - Douglas E. Jorenby
- University of Wisconsin, School of Medicine and Public Health, Center for Tobacco Research and Intervention, University of Wisconsin-Madison, Madison, WI
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