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Amin S, Uyeda K, Pagano I, Tabangcura KR, Taketa R, Terawaki Kawamoto C, Pokhrel P. Virtual Assistants' Response to Queries About Nicotine Replacement Therapy: A Mixed-Method Analysis. Eval Health Prof 2024:1632787241235689. [PMID: 38408450 DOI: 10.1177/01632787241235689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
This study focused on investigating the potential of Artificial Intelligent-powered Virtual Assistants (VAs) such as Amazon Alexa, Apple Siri, and Google Assistant as tools to help individuals seeking information about Nicotine Replacement Treatment (NRT) for smoking cessation. The researchers asked 40 NRT-related questions to each of the 3 VAs and evaluated the responses for voice recognition. The study used a cross-sectional mixed-method design with a total sample size of 360 responses. Inter-rater reliability and differences between VAs' responses were examined by SAS software, and qualitative assessments were conducted using NVivo software. Google Assistant achieved 100% voice recognition for NRT-related questions, followed by Apple Siri at 97.5%, and Amazon Alexa at 83.3%. Statistically significant differences were found between the responses of Amazon Alexa relative to both Google Assistant and Apple Siri. Researcher 1's ratings significantly differed from Researcher 2's (p = .001), but not from Researcher 3's (p = .11). Virtual Assistants occasionally struggled to understand the context or nuances of questions, lacked in-depth information in their responses, and provided generic or unrelated responses. Virtual Assistants have the potential to be incorporated into smoking cessation interventions and tobacco control initiatives, contingent upon improving their competencies.
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Affiliation(s)
- Samia Amin
- University of Hawai'i Cancer Center, USA
| | | | - Ian Pagano
- University of Hawai'i Cancer Center, USA
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Nielsen EM, Zhang J, Marsden J, Bays C, Moran WP, Mauldin PD, Lenert LA, Toll BA, Schreiner AD, Heincelman M. Is hospitalization a missed opportunity to intervene on tobacco cessation? Am J Med Sci 2024; 367:89-94. [PMID: 38043793 DOI: 10.1016/j.amjms.2023.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 10/11/2023] [Accepted: 11/21/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Although tobacco use is associated with elevated morbidity and mortality, its use remains widespread among adults within the United States. Nicotine Replacement Therapy (NRT) products are effective aids that improve rates of tobacco cessation. Many smokers interact with the medical system, such as during hospitalization, without their tobacco use addressed. Hospitalization is a teachable moment for patients to make health-related changes, including tobacco cessation. METHODS Retrospective cohort study of adult patients in a university-based patient-centered medical home from 2012 to 2021 evaluating the proportion of adults who smoke who received at least one prescription for NRT. Logistic regression models were used to analyze the association of being hospitalized and receipt of a NRT prescription. RESULTS Of the 4,072 current smokers identified, 1,182 (29%) received at least one prescription for NRT during the study period. Hospitalization was associated with increased odds of receiving a NRT prescription (OR 1.68). Of 1,844 current smokers with a hospitalization during the study period, 1,078 (58%) never received a prescription for NRT at any point. Only 87 (5%) of the smokers received a prescription for NRT during hospitalization or at the time of hospital discharge. CONCLUSIONS Despite hospitalization being associated with NRT prescribing, most patients who use tobacco and are hospitalized are not prescribed NRT. Hospitalization is an underutilized opportunity for both hospitalists and primary care physicians to intervene on smoking cessation through education and prescription of tobacco cessation aids.
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Affiliation(s)
- Ellen M Nielsen
- Department of Medicine, Medical University of South Carolina, Charleston, SC, United States.
| | - Jingwen Zhang
- Department of Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Justin Marsden
- Department of Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Chloe Bays
- Department of Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - William P Moran
- Department of Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Patrick D Mauldin
- Department of Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Leslie A Lenert
- Department of Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Benjamin A Toll
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Andrew D Schreiner
- Department of Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Marc Heincelman
- Department of Medicine, Medical University of South Carolina, Charleston, SC, United States
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Jawed A, Jassal M. Hard to Reach or Just Not Enough? A Narrative Review of Inpatient Tobacco Cessation Programs in Pediatrics. Int J Environ Res Public Health 2021; 18:13423. [PMID: 34949029 DOI: 10.3390/ijerph182413423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/08/2021] [Accepted: 12/14/2021] [Indexed: 11/16/2022]
Abstract
Caregiver smoking is a significant risk factor for children with acute and chronic diseases. Hospitalization presents an opportunity to explore caregiver smoking as a modifiable risk factor during a time of crisis when the motivation to change could be heightened. To date, there has not been a published review on inpatient smoking cessation interventions in pediatrics that focus on supporting caregivers of hospitalized children. The goals of this review were to identify and assess the reach and efficacy of tobacco cessation strategies implemented across inpatient units in pediatrics and mother-baby units. This review also proposes clinical and research implications along with program-building recommendations that can help inform future practice in tobacco cessation. A narrative review of the literature identified 14 peer-reviewed studies that described smoking cessation interventions between 2002 and 2021. There were five randomized controlled trials, seven prospective studies, and one retrospective study. The primary kinds of interventions were counseling to heighten caregiver contemplation to quit (n = 12), provision of Nicotine Replacement Therapy (NRT) medications (n = 7), and follow-up with the local Quitline (n = 12). A diverse range of deliverers implemented interventions across studies. Variation in defining quit attempts along with tobacco reduction and cessation outcomes contributed to mixed findings across studies.
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Abstract
Background Little is known about the safety of nicotine replacement therapy (NRT) in smokers hospitalized with coronary heart disease. Methods and Results We examined the short‐term safety of NRT use among smokers hospitalized for coronary heart disease in a geographically and structurally diverse sample of US hospitals in the year 2014. We compared smokers who started NRT in the first 2 days of hospitalization with smokers without any exposure to NRT and adjusted for baseline differences through propensity score matching. Outcomes included inpatient mortality, hospital length of stay, and 1‐month readmission. From 270 hospitals, we included 27 459 smokers (mean age, 58 years; 69% men; 56.9% in intensive care unit), of whom 4885 (17.8%) received NRT (97.2% used the nicotine patch, at a median dose of 21 mg/d for 3 days). After propensity matching, covariates were well balanced within each patient group. Among patients with myocardial infarction, compared with patients who did not receive NRT, those who received NRT showed no difference in mortality (2.1% versus 2.3%; P=0.98), mean length of stay (4.4±3.5 versus 4.3±3.3 days; P=0.60), or 1‐month readmission (15.8% versus 14.6%; P=0.31). Results were similar for patients undergoing percutaneous coronary intervention or coronary artery bypass surgery. Conclusions Among smokers hospitalized for treatment of coronary heart disease, use of NRT was not associated with any differences in short‐term outcomes. Given the known beneficial effects of NRT in treating nicotine withdrawal, reducing cravings, and promoting smoking cessation after discharge, our findings suggest that NRT is a safe and reasonable treatment option.
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Affiliation(s)
- Quinn R Pack
- 1 Division of Cardiovascular Medicine Baystate Medical Center Springfield MA.,2 Department of Internal Medicine Baystate Medical Center Springfield MA.,3 Institute for Healthcare Delivery and Population Science Springfield MA.,4 University of Massachusetts Medical School at Baystate Springfield MA
| | - Aruna Priya
- 3 Institute for Healthcare Delivery and Population Science Springfield MA
| | - Tara C Lagu
- 2 Department of Internal Medicine Baystate Medical Center Springfield MA.,3 Institute for Healthcare Delivery and Population Science Springfield MA.,4 University of Massachusetts Medical School at Baystate Springfield MA.,5 Department of Quantitative Health Science University of Massachusetts Medical School Worcester MA
| | - Penelope S Pekow
- 3 Institute for Healthcare Delivery and Population Science Springfield MA.,6 School of Public Health and Health Sciences University of Massachusetts Amherst MA
| | - Auras Atreya
- 1 Division of Cardiovascular Medicine Baystate Medical Center Springfield MA.,2 Department of Internal Medicine Baystate Medical Center Springfield MA
| | - Nancy A Rigotti
- 7 Department of Medicine Tobacco Research and Treatment Center Massachusetts General Hospital and Harvard Medical School Boston MA
| | - Peter K Lindenauer
- 2 Department of Internal Medicine Baystate Medical Center Springfield MA.,3 Institute for Healthcare Delivery and Population Science Springfield MA.,4 University of Massachusetts Medical School at Baystate Springfield MA.,5 Department of Quantitative Health Science University of Massachusetts Medical School Worcester MA
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Abstract
The emergence of new tobacco heating products and electronic nicotine delivery systems (ENDS) is changing the way humans are exposed to nicotine. The purpose of this narrative review is to provide a broad overview of published scientific literature with respect to the effects of nicotine on three key health-related areas: 1) cardiovascular risk, 2) carcinogenesis and 3) reproductive outcomes. These areas are known to be particularly vulnerable to the effects of cigarette smoke, and in addition, nicotine has been hypothesized to play a role in disease pathogenesis. Acute toxicity will also be discussed. The literature to February 2019 suggests that there is no increased cardiovascular risk of nicotine exposure in consumers who have no underlying cardiovascular pathology. There is scientific consensus that nicotine is not a direct or complete carcinogen, however, it remains to be established whether it plays some role in human cancer propagation and metastasis. These cancer progression pathways have been proposed in models in vitro and in transgenic rodent lines in vivo but have not been demonstrated in cases of human cancer. Further studies are needed to determine whether nicotine is linked to decreased fertility in humans. The results from animal studies indicate that nicotine has the potential to act across many mechanisms during fetal development. More studies are needed to address questions regarding nicotine exposure in humans, and this may lead to additional guidance concerning new ENDS entering the market.
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Affiliation(s)
- Leonie R. Price
- Scientific and Regulatory Affairs, Japan Tobacco International, Genève, Genève, 1202, Switzerland
| | - Javier Martinez
- Scientific and Regulatory Affairs, Japan Tobacco International, Genève, Genève, 1202, Switzerland
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Abstract
The emergence of new tobacco heating products and electronic nicotine delivery systems (ENDS) is changing the way humans are exposed to nicotine. The purpose of this narrative review is to provide a broad overview of published scientific literature with respect to the effects of nicotine on three key health-related areas: 1) cardiovascular risk, 2) carcinogenesis and 3) reproductive outcomes. These areas are known to be particularly vulnerable to the effects of cigarette smoke, and in addition, nicotine has been hypothesized to play a role in disease pathogenesis. Acute toxicity will also be discussed. The literature to February 2019 suggests that there is no increased cardiovascular risk of nicotine exposure in consumers who have no underlying cardiovascular pathology. There is scientific consensus that nicotine is not a direct or complete carcinogen, however, it remains to be established whether it plays some role in human cancer propagation and metastasis. These cancer progression pathways have been proposed in models in vitro and in transgenic rodent lines in vivo but have not been demonstrated in cases of human cancer. Further studies are needed to determine whether nicotine is linked to decreased fertility in humans. The results from animal studies indicate that nicotine has the potential to act across many mechanisms during fetal development. More studies are needed to address questions regarding nicotine exposure in humans, and this may lead to additional guidance concerning new ENDS entering the market.
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Affiliation(s)
- Leonie R. Price
- Scientific and Regulatory Affairs, Japan Tobacco International, Genève, Genève, 1202, Switzerland
| | - Javier Martinez
- Scientific and Regulatory Affairs, Japan Tobacco International, Genève, Genève, 1202, Switzerland
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Abstract
Objective The urge to smoke is a predictor of smoking relapse. Little research has focused on the impact of acute urges during treatment among African Americans. This study examined the relationship between smoking urges and long-term abstinence among treatment seekers. Design Longitudinal prospective investigation. Urges to smoke were assessed at the initial (session 1) and final (session 8) sessions among adult smokers (N=308) enrolled in a 4-week group intervention trial. Nicotine patch use was assessed over 30 days. Main Outcome Measures Biochemically verified 7-day point prevalence abstinence (7-day ppa) was assessed immediately post-intervention, and at 3-, 6-, and 12-month follow-ups. Hierarchical logistic regressions tested associations between session 1 and session 8 urges and 7-day ppa at each smoking status assessment. Results There was a significant overall decrease in smoking urges (M=29, SD=15 at session 1; M=17, SD=11 at session 8). After controlling for covariates, urges to smoke at session 1 were unrelated to 7-day ppa at any of the assessment points. However, session 8 urges were inversely associated with 7-day ppa post-intervention (AOR=.94, CI:.92-.97), at 3-months (AOR=.93, CI: .89-.97), 6-months (AOR=.93, CI: .90-.97), and 12-months (AOR=.96, CI: .96-.99). Nicotine patch use was positively associated with 7-day ppa at each assessment. Conclusions The most robust predictors of abstinence through 12-months post-intervention were decreased urges over the 4-week, 8-session group intervention and the frequency of nicotine patch use. Interventions aimed at addressing the needs of African American smokers should address urges and encourage nicotine replacement adherence to increase abstinence rates.
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Affiliation(s)
- Monica Webb Hooper
- Case Western Reserve University School of Medicine, Case Comprehensive Cancer Center, Cleveland, Ohio.,Department of Psychology, University of Miami, Coral Gables, Florida
| | - Noella A Dietz
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Joseph C Wilson
- Psychology Department, Binghamton University State University of New York, Binghamton, New York
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Chehab OM, Dakik HA. Interventions for smoking cessation in patients admitted with Acute Coronary Syndrome: a review. Postgrad Med J 2017; 94:116-120. [PMID: 28942430 DOI: 10.1136/postgradmedj-2017-135040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 08/20/2017] [Accepted: 09/09/2017] [Indexed: 11/03/2022]
Abstract
Tobacco smoking contributes to about six million deaths per year and is predicted to increase in the future. Several pharmacological interventions are used for smoking cessation. Trials using nicotine replacement therapy (NRT) in acute coronary syndrome (ACS) showed inconclusive results. Furthermore, three trials using bupropion in patients admitted with ACS failed to show improvement in smoking cessation compared with placebo. Interestingly, only one trial using varenicline was successful in achieving smoking abstinence in the acute setting. With regard to behavioural interventions, a meta-analysis found that telephone counselling was successful in both the acute and stable settings, with greater effect in the acute setting. The best results for smoking cessation were found in trials that used a combination of pharmacological and behavioural interventions. The objective of this report is to review the results of studies on interventions used for smoking cessation after an ACS.
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Affiliation(s)
- Omar M Chehab
- Division of Cardiology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.,National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK
| | - Habib A Dakik
- Division of Cardiology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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Klonizakis M, Crank H, Gumber A, Brose LS. Smokers making a quit attempt using e-cigarettes with or without nicotine or prescription nicotine replacement therapy: Impact on cardiovascular function (ISME-NRT) - a study protocol. BMC Public Health 2017; 17:293. [PMID: 28376818 PMCID: PMC5379660 DOI: 10.1186/s12889-017-4206-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 03/29/2017] [Indexed: 11/29/2022] Open
Abstract
Background The estimated number of cigarette smokers in the world is 1.3 billion, expected to rise to 1.7 billion by 2025, with 10 million smokers living in the U.K. Smoking is the leading, preventable death-cause worldwide, being responsible for almost 650,000 deaths in the E.U. annually. A combination of pharmacological interventions, including nicotine replacement therapy, bupropion and varenicline, and behavioural support is the most effective approach to smoking cessation. However, even the best methods have high relapse rates of approximately 75% within 6 months. Electronic (or “e-“) cigarettes use battery power to disperse a solution that usually contains propylene glycol or glycerine, water, flavouring and nicotine. E-cigarettes have become the most popular smoking cessation aid in England, however, information on their effects on cardiovascular function is limited and contradictory. As e-cigarettes are not solely nicotine-based products, existing research exploring the effects of nicotine on the cardio-vasculature provides only limited information, while their extensive uptake urges the need of evidence to inform the general public, smokers and policy-makers. Methods This is a pragmatic, 3-group, randomised, assessor-blinded, single-centre trial exploring the cardiovascular physiological effects of the use of e-cigarettes (nicotine-free and nicotine-inclusive, assessed separately) combined with behavioural support as a smoking cessation method in comparison to the combination of NRT and behavioural support. The primary outcome will be macro-vascular function, determined by a Flow Mediated Dilatation ultrasound assessment, 6 months following participants’ “quit date”. Discussion Participants will be assessed at baseline, 3 days following their self-determined “quit date”, at intervention end (3 months) and 6 months following their “quite date”. Findings are expected to give an indication of the cardiovascular effects of e-cigarettes both in the short- and in the medium-term period, informing the general public, policy holders and researchers, helping to define the future role of e-cigarettes as a smoking cessation aid. Trial registration Clinicaltrials.gov NCT03061253. Registered 17th February 2017.
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Affiliation(s)
- Markos Klonizakis
- Centre for Sport and Exercise Science, Collegiate Hall, Collegiate Crescent, Sheffield Hallam University, Sheffield, S10 2BP, UK.
| | - Helen Crank
- Centre for Sport and Exercise Science, Collegiate Hall, Collegiate Crescent, Sheffield Hallam University, Sheffield, S10 2BP, UK
| | - Anil Gumber
- Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK
| | - Leonie S Brose
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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López Zubizarreta M, Hernández Mezquita MÁ, Miralles García JM, Barrueco Ferrero M. Tobacco and diabetes: clinical relevance and approach to smoking cessation in diabetic smokers. ACTA ACUST UNITED AC 2017; 64:221-231. [PMID: 28417877 DOI: 10.1016/j.endinu.2017.02.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 02/15/2017] [Accepted: 02/18/2017] [Indexed: 01/19/2023]
Abstract
Smoking is, together with diabetes mellitus, one of the main risk factors for cardiovascular disease. Diabetic patients have unique features and characteristics, some of which are not well known, that cause smoking to aggravate the effects of diabetes and impose difficulties in the smoking cessation process, for which a specificand more intensive approach with stricter controls is required. This review details all aspects with a known influence on the interaction between smoking and diabetes, both as regards the increased risk of macrovascular and microvascular complications of diabetes and the factors with an impact on the results of smoking cessation programs. The treatment guidelines for these smokers, including the algorithms and drug treatment patterns which have proved most useful based on scientific evidence, are also discussed.
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Affiliation(s)
| | | | | | - Miguel Barrueco Ferrero
- Servicio de Neumología, Complejo Asistencial Universitario de Salamanca, Salamanca, España; Departamento de Medicina USAL, IBSAL, Salamanca, España
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Walker NJ, van Woerden HC, Kiparoglou V, Yang Y, Robinson H, Croghan E. Gender difference and effect of pharmacotherapy: findings from a smoking cessation service. BMC Public Health 2016; 16:1038. [PMID: 27716223 DOI: 10.1186/s12889-016-3672-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 09/16/2016] [Indexed: 01/22/2023] Open
Abstract
Background Smoking cessation services are available in England to provide assistance to those wishing to quit smoking. Data from one such service were analysed in order to investigate differences in quit rate between males and females prescribed with different treatments. Methods A logistic regression model was fitted to the data using the binary response of self-reported quit (failed attempt = 0, successful attempt = 1), validated by Carbon Monoxide (CO) monitoring, 4 weeks after commencing programme. Main effects fitted were: client gender; age; region; the type of advisory sessions; and pharmacotherapy, Nicotine Replacement Therapy (NRT) or Varenicline. A second model was fitted including all main effects plus two-way interactions except region. These models were repeated using 12-week self-reported quit as the outcome. Results At 4 weeks, all main effects were statistically significant, with males more likely (odds ratio and 95 % CI, females v males = 0.88 [0.79–0.97]), older smokers more likely (adjusted odds ratios [OR] and 95 % confidence interval [CI] respectively for groups 20–29, 30–49, 50–69 and 70+ vs 12–19 age group: 1.79 [1.39–2.31], 2.12 [1.68–2.68], 2.30 [1.80–2.92] and 2.47 [1.81–3.37] and for overall difference between groups, χ2(4) = 53.5, p < 0.001) and clients being treated with Varenicline more likely to have successfully quit than those on NRT (adjusted OR and 95 % CI for Varenicline vs NRT = 1.41 [1.21–1.64]). Statistically significant interactions were observed between (i) gender and type of counselling, and (ii) age and type of counselling. Similar results were seen in relation to main effects at 12 weeks except that type of counselling was non-significant. The only significant interaction at this stage was between gender and pharmacotherapy (adjusted OR and 95 % CI for females using Varenicline versus all other groups = 1.43 [1.06–1.94]). Conclusion Gender and treatment options were identified as predictors of abstinence at both 4 and 12 weeks after quitting smoking. Furthermore, interactions were observed between gender and (i) type of counselling received (ii) pharmacotherapy. In particular, the quit rate in women at 12 weeks was significantly improved in conjunction with Varenicline use. These findings have implications for service delivery.
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Pakhale S, Kaur T, Florence K, Rose T, Boyd R, Haddad J, Pettey D, Muckle W, Tyndall M. The Ottawa Citizen Engagement and Action Model (OCEAM): A Citizen engagement Strategy Operationalized Through The Participatory Research in Ottawa, Management and Point-of-care of Tobacco (PROMPT) Study: A Community Based Participatory Action Research Project in Inner City Ottawa. Res Involv Engagem 2016; 2:20. [PMID: 29507759 PMCID: PMC5831885 DOI: 10.1186/s40900-016-0034-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 05/11/2016] [Indexed: 06/01/2023]
Abstract
PLAIN LANGUAGE SUMMARY The PROMPT study is a community-based research project designed to understand the factors which affect smoking as well as ways to manage, reduce and quit smoking among people who use drugs in Ottawa. There is strong medical evidence that smoking tobacco is related to more than two dozen diseases and conditions. Smoking tobacco remains the leading cause of preventable death and has negative health impacts on people of all ages. Although Ottawa has one of the lowest smoking rates in Ontario (12 %), major differences exist, with approximately a 96 % smoking rate among those who use drugs in the city of Ottawa. To address this inequity, we recruited and trained four community research peers who were representative of the study target population (ex- or currently homeless, insecurely housed or multi-drug users). We designed the ten-step Ottawa Citizen Engagement and Action Model (OCEAM) for the PROMPT study. In this paper we have described this process in a step-by-step fashion, as used in the PROMPT study. The eighty PROMPT participants are being followed for six months and are being provided with free and off-label Nicotine Replacement Therapy (NRT). ABSTRACT Objectives The PROMPT study, Participatory Research in Ottawa, Management and Point-of-care of Tobacco, is a prospective cohort study which utilizes community-based participation and social network-based approaches to address tobacco dependence in inner city Ottawa. The project was designed to: facilitate retention of participants; to understand the barriers and facilitators of smoking; optimize ways to manage, reduce, and quit tobacco use among people who use drugs in Ottawa, Canada. The purpose of this paper is to describe the processes utilized in citizen or patient engagement in academic research, through our tobacco dependence management project in the inner city population in Ottawa, Canada.Background Tobacco smoking is inequitably distributed in Canada with rates at 12 % in Ottawa, as compared to 18 % in rest of Canada. However, the PROUD Study (Participatory Research in Ottawa: Understanding Drugs) demonstrated that 96 % of the inner city population, of Ottawa currently smoke tobacco. This distinct inequity in tobacco use translates into inequitable distribution of health outcomes, such morbidity and mortality in this population. Consequently, a community-based participatory, peer-led research project was conducted in the inner city population of Ottawa.Methods We recruited and trained four community research peers who were representative of the study target population. We conceived, designed and operationalized the ten-step Ottawa Citizen Engagement and Action Model (OCEAM) for the PROMPT study. The peers have co-led all aspects of the project from conceptualizing the study question to participating in knowledge translation. Each step of the project had defined objectives and outcome measures.Discussion The involvement of peers in recruitment ensured representation of tobacco and drug users-individuals truly representative of the intended target population. Peer, participant engagement and trust was established from the conception of the project. For historical and self-evident reasons, trust and engagement is rarely found in this population. Peers successfully participated in all ten steps of the Citizen Engagement and Action model. The PROMPT study utilized the CBPR (Community Based Participatory research) approach to encourage engagement and build trust in a difficult to reach and hard to treat, inner city population. The ten-step OCEAM model was conceived, designed and operationalized and the PROMPT study will continue to follow the eighty PROMPT participants for six months to understand the optimal ways to manage, reduce, and quit smoking within an inner city population.
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Affiliation(s)
- Smita Pakhale
- The Ottawa Hospital, University of Ottawa, Ottawa, Canada
- The Ottawa Hospital Research Institute (OHRI), University of Ottawa, Ottawa, Canada
- University of Ottawa, Ottawa, Canada
| | - Tina Kaur
- The Ottawa Hospital Research Institute (OHRI), University of Ottawa, Ottawa, Canada
| | - Kelly Florence
- The Ottawa Hospital Research Institute (OHRI), University of Ottawa, Ottawa, Canada
- Community research peers, Oasis, Sandy Hill Community Health Centre, Ottawa, Canada
| | - Tiffany Rose
- The Ottawa Hospital Research Institute (OHRI), University of Ottawa, Ottawa, Canada
- Community research peers, Oasis, Sandy Hill Community Health Centre, Ottawa, Canada
| | - Robert Boyd
- Oasis, Sandy Hill Community Health Centre, Ottawa, Canada
| | - Joanne Haddad
- Canadian Mental Health Association, Ottawa Branch, Ottawa, Canada
| | - Donna Pettey
- Canadian Mental Health Association, Ottawa Branch, Ottawa, Canada
| | | | - Mark Tyndall
- British Columbia CDC, University of British Columbia, Vancouver, BC Canada
- University of British Columbia, Vancouver, BC Canada
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Chandrashekar M, Sattar FA, Bondade S, Kumar KK. A comparative study of different modalities of treatment in nicotine dependence syndrome. Asian J Psychiatr 2015; 17:29-35. [PMID: 26293443 DOI: 10.1016/j.ajp.2015.07.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 06/28/2015] [Accepted: 07/11/2015] [Indexed: 11/30/2022]
Abstract
UNLABELLED There are different modalities for management of Nicotine dependence, but it is still inconclusive which is the best modality for the treatment of Nicotine dependence syndrome (NDS). In this background the present study was carried out to assess the efficacy and to compare different modalities for the treatment of NDS. METHODS Patients diagnosed as NDS as per ICD-10 were taken up for study. These patients were administered proforma to elicit sociodemographic details, Fagerstrom test for Nicotine Dependence, Questionnaire of Smoking Urges-Brief and breath analysis was done using carbon monoxide meter. Assessment was done at base line and at weekly follow-ups for 12 weeks. Patients were divided into six groups randomly. Group A received BUP at a dose of 150mg/day for 3 days; subsequently increased to 300mg/day, Group B: for initial 6 weeks Nicotine gum of 4mg every 1-2 hourly was used and next 6 weeks every 2-4 hourly was used, Group C: BI, Group D: BI+BUP, Group E: BI+NRT, Group F received BUP+NRT+BI. RESULTS The quit rates at end of the study were BUP-30%, NRT-26.66%, BI-23.33%, BI+BUP-43.33%, BI+NRT-33.33%, and BI+BUP+NRT-50%. BI+BUP+NRT had 2-3 times more quit rates than the individual modality treatment group. CONCLUSION There was no statistically significant difference between the study groups, but there was clinical difference in quit rates. Among the groups BI+BUP+NRT had higher quit rates compared to other groups. Combination modalities yield better quit rates than individual modalities.
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Affiliation(s)
- M Chandrashekar
- Department of Psychiatry, V.I.M.S&R.C, EPIP Area, Whitefield, Bangalore 560066, Karnataka, India.
| | - F A Sattar
- Department of Psychiatry, V.I.M.S&R.C, EPIP Area, Whitefield, Bangalore 560066, Karnataka, India.
| | - S Bondade
- Department of Psychiatry, V.I.M.S&R.C, EPIP Area, Whitefield, Bangalore 560066, Karnataka, India.
| | - K Kiran Kumar
- Department of Psychiatry, V.I.M.S&R.C, EPIP Area, Whitefield, Bangalore 560066, Karnataka, India.
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Hiscock R, Murray S, Brose LS, McEwen A, Bee JL, Dobbie F, Bauld L. Behavioural therapy for smoking cessation: the effectiveness of different intervention types for disadvantaged and affluent smokers. Addict Behav 2013; 38:2787-96. [PMID: 23954946 PMCID: PMC3776925 DOI: 10.1016/j.addbeh.2013.07.010] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Revised: 07/04/2013] [Accepted: 07/10/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Disadvantaged smokers are less likely to be successful when trying to stop smoking than more affluent smokers. In the UK, NHS Stop Smoking Services (SSS) provide a range of pharmacotherapy and behavioural support, delivered by advisors with a range of backgrounds. Whether the types of support provided and who provides it influence differences in quit rates amongst low SES smokers compared with high SES smokers has not previously been examined. METHODS 202,084 records of smokers in England who attended a NHS Stop Smoking Service between July 2010 and June 2011 were acquired. Smokers were followed-up by services at four weeks post quit date. Multilevel logistic regression models of CO validated quits were employed. Disadvantage was explored through the National Statistics Socio-Economic Classification (NS-SEC) and by eligibility for free prescriptions, an indicator of low income amongst adults aged between 19 and 59 in England. RESULTS Affluent smokers were more likely to quit than disadvantaged smokers (OR 1.38 (1.35 to 1.42) for clients who paid for prescriptions compared to those eligible for free prescriptions). 80% of service clients received one-to-one counselling but open group forms of behavioural therapy were more successful (main effect OR 1.26 (1.12 to 1.41)) except amongst some of the most disadvantaged clients (long-term unemployed and prisoners). Closed groups were little deployed and they were not significantly more successful than one-to-one behavioural therapy after controls. Who delivered treatment did make a difference for some clients, with all but the most affluent less likely to be successful if they had been treated by a nurse compared with other types of advisers, including smoking cessation specialists (main effect OR 0.73 (0.65 to 0.83)). CONCLUSION This study provides further evidence that disadvantaged smokers find quitting more difficult even when they have attended a smoking cessation programme. The findings suggest that open groups should be promoted, although they may not be as effective as other forms of behavioural therapy for the long-term unemployed or prisoners. Further research is required to explore why most groups of smokers who attended services staffed by nurses were less likely to quit than those who received treatment from other types of advisors.
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