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Onigbogi O, Pratt R, Luo X, Everson-Rose SA, Cooney NL, Specker S, Okuyemi K. Association between psychosocial factors and co-morbid cigarette smoking and alcohol use in a population experiencing homelessness. Addict Behav Rep 2024; 19:100523. [PMID: 38155753 PMCID: PMC10753056 DOI: 10.1016/j.abrep.2023.100523] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 12/06/2023] [Accepted: 12/11/2023] [Indexed: 12/30/2023] Open
Abstract
The prevalence of combustible cigarette smoking in populations experiencing homelessness in the United States is five times that of the general population. The psychosocial well-being of persons who smoke and experience homelessness is poorer if such persons also use alcohol heavily. The PTQ2 study was a randomized clinical trial among persons experiencing homelessness who were also current smokers and heavy alcohol consumers. Secondary data analysis of the PTQ2 baseline data was conducted to examine associations among psychosocial variables (anxiety, depression, hopelessness, social network size), heaviness of smoking (cigarettes/day) and alcohol consumption (drinking days/month), and duration and frequency of homelessness. Among the 420 participants, the majority were male (75%), black (70%) and non-Hispanic (94%) with a mean age of 46.6 years (SD = 11.6). Bivariate analyses show that heaviness of smoking was positively correlated with social network size (r = 0.16, p = .001). Heaviness of drinking was positively correlated with the MINI anxiety score (r = 0.13, p = .009) and marijuana use (median total number of drinks in past 30 days among those who used marijuana in past 30 days vs. did not use: 50 vs. 24, p < .0001), and associated with frequency of homelessness (median total number of drinks in past 30 days among those experiencing homelessness once vs. >1 time: 30 vs. 44, p = .022). The findings highlight the psychosocial factors that warrant consideration when addressing heavy smoking and alcohol consumption in persons experiencing homelessness.
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Affiliation(s)
- Olanrewaju Onigbogi
- Department of Family and Preventive Medicine, Spencer Fox Eccles School of Medicine, University of Utah, 375 Chipeta Way, Suite A, Salt Lake City, UT 84108, USA
| | - Rebekah Pratt
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN 55414, USA
| | - Xianghua Luo
- Division of Biostatistics and Health Data Science, School of Public Health and Biostatistics Core, Masonic Cancer Center, University of Minnesota, 2221 University Ave SE, Suite 300, Minneapolis, MN 55414, USA
| | - Susan A. Everson-Rose
- Program in Health Disparities, School of Public Health, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN 55414, USA
- Department of Medicine, University of Minnesota, 420 Delaware St SE, Minneapolis, MN 55455, USA
| | - Ned L. Cooney
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, Suite 901, New Haven, CT 06511, USA
| | - Sheila Specker
- Department of Psychiatry and Behavioral Sciences, F282/2A West, 2450 Riverside Ave, Minneapolis, MN 55454, USA
| | - Kolawole Okuyemi
- Department of Family and Preventive Medicine, Spencer Fox Eccles School of Medicine, University of Utah, 375 Chipeta Way, Suite A, Salt Lake City, UT 84108, USA
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Maselli D. Strategies for tobacco-free survivorship after breast cancer: The possible weaving of preoperative care and public health policies. Public Health Nurs 2024; 41:403-405. [PMID: 38317425 DOI: 10.1111/phn.13293] [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: 09/05/2023] [Revised: 01/12/2024] [Accepted: 01/26/2024] [Indexed: 02/07/2024]
Abstract
Among smoker women with breast cancer quitting smoking has been shown to increase survival and surgical outcomes. Where surgery is indicated, the preoperative seems to be a crucial moment for smoking cessation interventions as it enhances recovery after surgery and motivates prolonged tobacco abstinence. Timing and frequency of preoperative quitting conversations were variables associated with quitting. An early, multidisciplinary, and personalized approach is recommended. A solid integration between primary care services and specialized care is challenging but feasible, implementing prehabilitation pathways that include tobacco treatment routinely as an integral part of breast cancer care. Smoking cessation programs before surgical procedures impact recidivism prevention, survivorship improvement, public health, and cost savings. The contribution of healthcare professionals can make a difference in tobacco control, collaborating with organizations, public health, and nursing research. Integrated solutions in oncological clinical care pathways might help patients build and maintain tobacco abstinence after breast cancer. Future research shall study when patients should abstain from smoking before oncological breast surgery.
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Affiliation(s)
- Deborah Maselli
- International Doctorate School in Clinical and Experimental Medicine, Università degli Studi di Modena e Reggio Emilia, Reggio Emilia, Italy
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Harmatz IM, Alkhatib KY, Leff M, Nolazco JI, Michel KF, Slinger M, McLauchlan N, Cortese BD, Roberson DS, Schurhamer B, Lee DJ, Malkowicz SB, Trinh QD, Bivalacqua TJ, Guzzo TJ, Pierorazio PM. Prostate-Specific Antigen Screening in Smokers: A Comprehensive Analysis Using a National Behavioral Survey. Urol Pract 2024; 11:547-556. [PMID: 38564816 DOI: 10.1097/upj.0000000000000553] [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: 12/06/2023] [Accepted: 02/15/2024] [Indexed: 04/04/2024]
Abstract
INTRODUCTION Cigarette smoking is associated with higher-risk prostate cancer at the time of diagnosis and increased overall and prostate cancer‒specific mortality. Previous studies indicate smokers are less likely to undergo PSA screening. Herein we investigate the association between smoking and PSA screening using a nationally representative US survey. We hypothesize that smokers are less likely to undergo guideline-concordant PSA screening. METHODS We performed a cross-sectional analysis of men aged 55 to 69 who responded to the cigarette smoking and PSA screening questions of the 2018 Behavioral Risk Factor Surveillance System survey. Adjusted prevalence and adjusted risk differences were calculated using complex weighted multivariable Poisson regression modeling. RESULTS We identified 58,996 individuals who qualified for analysis. PSA screening prevalence was 39% (95% CI: 39%-40%) nationally, 42% (95% CI: 41%-44%) for never smokers, 42% (95% CI: 39%-40%) for former smokers, and 27% (95% CI: 25%-29%) for current smokers, including 27% (95% CI: 24%-29%) for daily smokers and 29% (95% CI: 24%-33%) for nondaily smokers. Compared to never smokers, the adjusted relative risk for undergoing PSA screening was 0.81 for current smokers (95% CI: 0.75-0.88, P < .01) and 0.99 for former smokers (95% CI: 0.94-1.03, P = .53). CONCLUSIONS Current smokers are less likely to undergo recommended PSA screening, but former smokers are screened at similar rates as never smokers. As delays in diagnosis may substantially contribute to worse prostate cancer outcomes, targeted interventions to increase screening in this population may yield significant effects.
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Affiliation(s)
- I Mitchell Harmatz
- Division of Urology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Khalid Y Alkhatib
- Division of Urology, University of Pennsylvania, Philadelphia, Pennsylvania
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Morgan Leff
- Division of Urology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - José I Nolazco
- Division of Urological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- Servicio de Urología, Hospital Universitario Austral, Universidad Austral, Pilar, Argentina
| | - Katharine F Michel
- Division of Urology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Michelle Slinger
- Division of Urology, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Brian D Cortese
- Division of Urology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Daniel S Roberson
- Division of Urology, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Daniel J Lee
- Division of Urology, University of Pennsylvania, Philadelphia, Pennsylvania
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - S Bruce Malkowicz
- Division of Urology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Quoc-Dien Trinh
- Division of Urological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Thomas J Guzzo
- Division of Urology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Phillip M Pierorazio
- Division of Urology, University of Pennsylvania, Philadelphia, Pennsylvania
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania
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Schlam TR, Baker TB, Piper ME, Cook JW, Smith SS, Zwaga D, Jorenby DE, Almirall D, Bolt DM, Collins LM, Mermelstein R, Fiore MC. What to do after smoking relapse? A sequential multiple assignment randomized trial of chronic care smoking treatments. Addiction 2024; 119:898-914. [PMID: 38282258 DOI: 10.1111/add.16428] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 11/30/2023] [Indexed: 01/30/2024]
Abstract
AIM To compare effects of three post-relapse interventions on smoking abstinence. DESIGN Sequential three-phase multiple assignment randomized trial (SMART). SETTING Eighteen Wisconsin, USA, primary care clinics. PARTICIPANTS A total of 1154 primary care patients (53.6% women, 81.2% White) interested in quitting smoking enrolled from 2015 to 2019; 582 relapsed and were randomized to relapse recovery treatment. INTERVENTIONS In phase 1, patients received cessation counseling and 8 weeks nicotine patch. Those who relapsed and agreed were randomized to a phase 2 relapse recovery group: (1) reduction counseling + nicotine mini-lozenges + encouragement to quit starting 1 month post-randomization (preparation); (2) repeated encouragement to quit starting immediately post-randomization (recycling); or (3) advice to call the tobacco quitline (control). The first two groups could opt into phase 3 new quit treatment [8 weeks nicotine patch + mini-lozenges plus randomization to two treatment factors (skill training and supportive counseling) in a 2 × 2 design]. Phase 2 and 3 interventions lasted ≤ 15 months. MEASUREMENTS The study was powered to compare each active phase 2 treatment with the control on the primary outcome: biochemically confirmed 7-day point-prevalence abstinence 14 months post initiating phase 2 relapse recovery treatment. Exploratory analyses tested for phase 3 counseling factor effects. FINDINGS Neither skill training nor supportive counseling (each on versus off) increased 14-month abstinence rates; skills on versus off 9.3% (14/151) versus 5.2% (8/153), P = 0.19; support on versus off 6.6% (10/152) versus 7.9% (12/152), P = 0.73. Phase 2 preparation did not produce higher 14-month abstinence rates than quitline referral; 3.6% (8/220) versus 2.1% [3/145; risk difference = 1.5%, 95% confidence interval (CI) = -1.8-5.0%, odds ratio (OR) = 1.8, 95% CI = 0.5-6.9]. Recycling, however, produced higher abstinence rates than quitline referral; 6.9% (15/217) versus 2.1% (three of 145; risk difference, 4.8%, 95% CI = 0.7-8.9%, OR = 3.5, 95% CI = 1.0-12.4). Recycling produced greater entry into new quit treatment than preparation: 83.4% (181/217) versus 55.9% (123/220), P < 0.0001. CONCLUSIONS Among people interested in quitting smoking, immediate encouragement post-relapse to enter a new round of smoking cessation treatment ('recycling') produced higher probability of abstinence than tobacco quitline referral. Recycling produced higher rates of cessation treatment re-engagement than did preparation/cutting down using more intensive counseling and pharmacotherapy.
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Affiliation(s)
- Tanya R Schlam
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
- Department of Kinesiology, School of Education, University of Wisconsin-Madison, Madison, WI, USA
| | - Timothy B Baker
- Center for Tobacco Research and Intervention, Division of General Internal Medicine, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Megan E Piper
- Center for Tobacco Research and Intervention, Division of General Internal Medicine, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Jessica W Cook
- Center for Tobacco Research and Intervention, Division of General Internal Medicine, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Stevens S Smith
- Center for Tobacco Research and Intervention, Division of General Internal Medicine, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Deejay Zwaga
- Center for Tobacco Research and Intervention, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Douglas E Jorenby
- Center for Tobacco Research and Intervention, Division of General Internal Medicine, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Daniel Almirall
- Institute for Social Research and Department of Statistics, University of Michigan, Ann Arbor, MI, USA
| | - Daniel M Bolt
- Department of Educational Psychology, School of Education, University of Wisconsin-Madison, Madison, WI, USA
| | - Linda M Collins
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, USA
| | - Robin Mermelstein
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Michael C Fiore
- Center for Tobacco Research and Intervention, Division of General Internal Medicine, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
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Bush A, Coutts J, Langley R. Vaping in pregnancy: Caution required! Addiction 2024. [PMID: 38637903 DOI: 10.1111/add.16510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 03/28/2024] [Indexed: 04/20/2024]
Affiliation(s)
- Andrew Bush
- Department of Respiratory Medicine, Royal Brompton Hospital, London, UK
| | - Jonathan Coutts
- Neonatal Department, Royal Hospital for Children, Glasgow, UK
| | - Ross Langley
- Department of Paediatric Respiratory and Sleep Medicine, Royal Hospital for Children, Glasgow, UK
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Zhang YY, Su YZ, Tian ZY, Liang SB, Liu YJ, Li YF, Qiao HF, Robinson N, Liu JP. Acupuncture and related acupoint therapies for smoking cessation: An umbrella review and updated meta-analysis. Tob Induc Dis 2024; 22:TID-22-64. [PMID: 38638420 PMCID: PMC11025526 DOI: 10.18332/tid/186147] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/12/2024] [Accepted: 03/15/2024] [Indexed: 04/20/2024] Open
Abstract
INTRODUCTION Acupuncture and related acupoint therapies have been widely used for smoking cessation. Some relevant systematic reviews (SRs) have been published. There is a need to summarize and update the evidence to inform practice and decision-making. METHODS Eight databases were searched from their inception to December 2023. SRs, any randomized controlled trials (RCTs) comparing acupuncture therapies with sham acupuncture, pharmacotherapy, behavioral therapy, or no treatment, were included. The primary outcome was the abstinence rate. AMSTAR-2 was employed to assess the quality of SRs. An updated meta-analysis was conducted based on SRs and RCTs. Data were synthesized using risk ratios (RR) with 95% confidence intervals (CIs). The GRADE approach was employed to assess the certainty of the updated evidence. RESULTS Thirteen SRs and 20 RCTs outside of the SRs were identified. The SRs were of low or very low quality by AMSTAR-2. Sixteen (80%) RCTs were at high risk of performance bias. Eight acupuncture and related acupoint therapies were involved. The short-term (≤6 months) abstinence rate outcome was summarized as follows. Most SRs suggested that filiform needle acupuncture or acupressure had a better effect than sham acupuncture, but the findings were inconsistent. The updated meta-analysis also suggested that filiform needle acupuncture was more effective than sham acupuncture (RR=1.44; 95% CI: 1.02-2.02; I2 = 66%; low certainty; 9 RCTs, n=1358). Filiform needle acupuncture combined with acupressure was comparable to nicotine patches (RR=0.99; 95% CI: 0.74-1.32; low certainty; 6 RCTs, n= 524). Acupressure was superior to counseling (RR=1.46; 95% CI: 1.14-1.87; I2=5%; low certainty; 8 RCTs, n=595). No serious adverse events were reported in these SRs or RCTs. CONCLUSIONS Low certainty evidence suggests that filiform needle acupuncture and auricular acupressure appear to be safe and effective in achieving short-term smoking cessation. However, long-term follow-up data are needed.
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Affiliation(s)
- Ying-Ying Zhang
- College of Acupuncture-Moxibustion and Tuina, Shaanxi University of Chinese Medicine, Xianyang, China
- Key Laboratory of Acupuncture and Medicine in Shaanxi Province, Xianyang, China
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - You-Zhu Su
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Zi-Yu Tian
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Shi-Bing Liang
- Clinical Study Center, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yi-Jie Liu
- College of Acupuncture-Moxibustion and Tuina, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Yu-Fei Li
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Hai-Fa Qiao
- College of Acupuncture-Moxibustion and Tuina, Shaanxi University of Chinese Medicine, Xianyang, China
- Key Laboratory of Acupuncture and Medicine in Shaanxi Province, Xianyang, China
| | - Nicola Robinson
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Institute of Health and Social Care, London South Bank University, London, United Kingdom
| | - Jian-Ping Liu
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
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Gaya PV, Santos JR, Tomaz PRX, Abe TMO, Nassif M, Galas LG, Bellini BB, Moraes IR, Santos PCL, Correa PCRP, Scholz JR. Efficacy of bupropion and varenicline genetic markers in choosing pharmacological treatment for smoking cessation, and implications for combining drugs: A randomized controlled trial - GENTSMOKING. Tob Induc Dis 2024; 22:TID-22-62. [PMID: 38628555 PMCID: PMC11019925 DOI: 10.18332/tid/186072] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 03/09/2024] [Accepted: 03/14/2024] [Indexed: 04/19/2024] Open
Abstract
INTRODUCTION Smoking cessation is the best strategy for reducing tobacco-related morbimortality. The goal of this randomized controlled trial was to test whether using the genetically favorable markers to choose a smoking cessation drug treatment (precision medicine) was superior to using the most effective drug (varenicline) in terms of abstinence rates. Additionally, combination therapy was tested when monotherapy failed. METHODS This partially blind, single-center study randomized (1:1) 361 participants into two major groups. In the genetic group (n=184), CYP2B6 rs2279343 (genotype AA) participants started treatment with bupropion, and CHRNA4 rs1044396 (genotype CT or TT) participants started treatment with varenicline; when genetic favorable to both, participants started treatment with bupropion, and when favorable to neither, on both drugs. In the control group (n=177), participants started treatment with varenicline, regardless of genetic markers. Drug treatment lasted 12 weeks. Efficacy endpoints were abstinence rates at Weeks 4, and Weeks 8-12, biochemically validated by carbon monoxide in exhaled air. Participants who did not achieve complete abstinence at Week 4, regardless of group, were given the choice to receive combination therapy. RESULTS Abstinence rates were 42.9% (95% CI: 36-64) in the control group versus 30.4% (95% CI: 23-37) in the genetic group at Week 4 (p=0.01); and 74% (95% CI: 67-80) versus 52% (95% CI: 49-64) at Week 12 (p<0.001), respectively. The strategy of combining drugs after Week 4 increased abstinence rates in both groups and the significant difference between genetic and control groups was maintained. CONCLUSIONS Results show that using these selected genetic markers was inferior to starting treatment with varenicline (control group), which is currently the most effective smoking cessation drug; moreover, the addition of bupropion in cases of varenicline monotherapy failure improves the efficacy rate until the end of treatment. CLINICAL TRIAL IDENTIFIER NCT03362099.
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Affiliation(s)
- Patricia V. Gaya
- Programa de Tratamento do Tabagismo do Servico de Prevencao e Reabilitacao, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Juliana R. Santos
- Laboratorio de Genetica e Biologia Molecular, Instituto do Coracao, Hospital da Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Paulo R. X. Tomaz
- Laboratorio de Genetica e Biologia Molecular, Instituto do Coracao, Hospital da Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Tania M. O. Abe
- Programa de Tratamento do Tabagismo do Servico de Prevencao e Reabilitacao, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Miguel Nassif
- Programa de Tratamento do Tabagismo do Servico de Prevencao e Reabilitacao, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Larissa G. Galas
- Programa de Tratamento do Tabagismo do Servico de Prevencao e Reabilitacao, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Bianca B. Bellini
- Programa de Tratamento do Tabagismo do Servico de Prevencao e Reabilitacao, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Iana R. Moraes
- Programa de Tratamento do Tabagismo do Servico de Prevencao e Reabilitacao, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Paulo C. Lima Santos
- Departamento de Farmacologia, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | | | - Jaqueline R. Scholz
- Programa de Tratamento do Tabagismo do Servico de Prevencao e Reabilitacao, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
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Hahn EJ, Bucher A, Rademacher K, Beckett W, Taylor L, Darville A, Ickes MJ. Tobacco use disparities in rural communities. J Rural Health 2024. [PMID: 38602299 DOI: 10.1111/jrh.12838] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 02/26/2024] [Accepted: 03/27/2024] [Indexed: 04/12/2024]
Abstract
PURPOSE This exploratory study described facilitators and barriers to reducing tobacco disparities in 2 small rural communities and identified ways to reduce tobacco use. METHODS This was a descriptive design using qualitative methods. We created a resource database for 2 rural Kentucky counties, using a Culture of Health Framework. We recruited 16 organizational stakeholders serving low-socioeconomic populations and conducted focus groups and key informant interviews. We also completed key informant interviews with 7 tobacco users. Lastly, we tailored Community Action Plans for each county based on the data and then solicited feedback from the key stakeholders. FINDINGS The 2 counties were similar in population size, but County A had fewer resources than County B, and the stakeholders expressed differences toward tobacco use and quitting. County A stakeholders talked most about the protobacco culture and that tobacco users accept the risks of smoking outweighing the benefits of quitting; they also expressed concerns about youth use and the influences of family, society, and industry. County B stakeholders described ambivalence about the health effects of use and quitting. County A's Action Plan identified an opportunity to build Community Health Worker-delivered tobacco treatment into a new school-based health center. County B's Action Plan focused on reaching tobacco users by providing incentives for participation and tailoring messages to different audiences. CONCLUSIONS Tobacco control resources and stakeholder perspectives vary in small rural communities, implying a need for tailored approaches. Tobacco users in rural areas are a critical population to target with cessation resources.
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Affiliation(s)
- Ellen J Hahn
- BREATHE, College of Nursing, University of Kentucky, Lexington, Kentucky, USA
| | - Amanda Bucher
- BREATHE, College of Nursing, University of Kentucky, Lexington, Kentucky, USA
| | - Kathy Rademacher
- BREATHE, College of Nursing, University of Kentucky, Lexington, Kentucky, USA
| | - Whitney Beckett
- BREATHE, College of Nursing, University of Kentucky, Lexington, Kentucky, USA
| | - LeeAnn Taylor
- BREATHE, College of Nursing, University of Kentucky, Lexington, Kentucky, USA
| | - Audrey Darville
- BREATHE, College of Nursing, University of Kentucky, Lexington, Kentucky, USA
| | - Melinda J Ickes
- BREATHE, College of Nursing, University of Kentucky, Lexington, Kentucky, USA
- Department of Kinesiology & Health Promotion, College of Education, University of Kentucky, Lexington, Kentucky, USA
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Borrelli B, Bartlett YK, Fulford D, Frasco G, Armitage CJ, Wearden A. Behavioral Activation Mobile App to Motivate Smokers to Quit: Feasibility and Pilot Randomized Controlled Trial. JMIR Form Res 2024; 8:e54912. [PMID: 38573739 PMCID: PMC11027050 DOI: 10.2196/54912] [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] [Received: 11/28/2023] [Revised: 01/25/2024] [Accepted: 02/21/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Behavioral activation (BA) is an evidence-based treatment for depression that fosters engagement in values-based activities to increase access to positive reinforcement. Depressed mood has been shown to hinder smoking cessation. OBJECTIVE This study determined the feasibility and preliminary efficacy of a mobile app to motivate smokers to quit by using BA and integrating motivational messages to quit smoking. METHODS Adult smokers (N=56; mean age 34.5, SD 9.52 years) who were not ready to quit smoking within 30 days were recruited from advertisements and randomized to either 8 weeks of the BA app (set 2 values-based activities per week+motivational messages+feedback on changes in smoking, mood, and values-based activities) or the control group (no app; received resources for quitting smoking). All participants completed the baseline and end-of-treatment web-based questionnaires. Controls also completed weekly web-based assessments, and BA app participants completed assessments through the app. RESULTS There were no dropouts and only 2 participants in each condition did not complete the end-of-treatment questionnaire. The results demonstrated that it is feasible to recruit smokers who are unmotivated to quit into a smoking cessation induction trial: 86% (57/66) of eligible participants were randomized (BA app: n=27; control: n=29). Participants reported high levels of satisfaction: 80% (20/25) of participants said they would recommend the BA app, there were moderate-to-high scores on the Mobile App Rating Scale, and 88% (22/25) of participants rated the app 3 stars or higher (out of 5). There were high levels of BA app engagement: 96% (26/27) of participants planned activities, and 67% (18/27) of participants planned 7 or more activities. High engagement was found even among those who were at the highest risk for continued smoking (low motivation to quit, low confidence to quit, and high negative affect). The results provided support for the hypothesized relationships between BA constructs: greater pleasant activity completion was associated with greater positive affect (b=0.37, SE 0.21; 95% CI -0.05 to 0.79; P=.08), and greater positive affect tended to predict fewer cigarettes smoked the next day (b=-0.19, SE 0.10; 95% CI -0.39 to 0.01; P=.06). Additionally, a greater number of activities planned was associated with lower negative affect (b=-0.26, SE 0.15; 95% CI -0.55 to 0.04; P=.09). Overall, 16% (4/25) of BA app participants set a quit date versus 4% (1/27) among controls, and there were promising (but not significant) trends for motivation and confidence to quit. CONCLUSIONS The findings suggest that a mobile app intervention can be made appealing to smokers who are unmotivated to quit by focusing on aspects most important to them, such as mood management. This theory-based intervention has shown some initial support for the underlying theoretical constructs, and further efficacy testing is warranted in a fully powered trial.
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Affiliation(s)
- Belinda Borrelli
- Center for Behavioral Science Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA, United States
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Y Kiera Bartlett
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Daniel Fulford
- Department of Psychological & Brain Sciences, Boston University, Boston, MA, United States
- Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, MA, United States
| | - Greg Frasco
- Rafik B. Hariri Institute for Computing and Computational Science & Engineering, Boston University, Boston, MA, United States
| | - Christopher J Armitage
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, United Kingdom
- Greater Manchester Patient Safety Research Collaboration, National Institute for Health and Care Research, Manchester, United Kingdom
| | - Alison Wearden
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, United Kingdom
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10
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De Santi O, Orellana M, Di Niro CA, Greco V. Evaluation of the effectiveness of cytisine for the treatment of smoking cessation: A systematic review and meta-analysis. Addiction 2024; 119:649-663. [PMID: 38161271 DOI: 10.1111/add.16399] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 10/24/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND AND AIMS Smoking is considered the main cause of preventable death world-wide. This study aimed to review the efficacy and safety of cytisine for smoking cessation. METHODS This review included an exhaustive search of databases to identify randomized controlled trials (RCTs) in health centers of any level with smokers of any age or gender investigating the effects of cytisine at standard dosage versus placebo, varenicline or nicotine replacement therapy (NRT). RESULTS We identified 12 RCTs. Eight RCTs compared cytisine with placebo at the standard dose covering 5922 patients, 2996 of whom took cytisine, delivering a risk ratio (RR) of 2.25 [95% confidence interval (CI) = 1.42-3.56; I2 = 88%; moderate-quality evidence]. The greater intensity of behavioral therapy was associated directly with the efficacy findings (moderate-quality evidence). The confirmed efficacy of cytisine was not evidenced in trials conducted in low- and middle-income countries. We estimate a number needed to treat (NNT) of 11. Two trials compared the efficacy of cytisine versus NRT, and the combination of both studies yields modest results in favor of cytisine. Three trials compared cytisine with varenicline, without a clear benefit for cytisine. Meta-analyses of all non-serious adverse events in the cytisine group versus placebo groups yielded a RR of 1.24 (95% CI = 1.11-1.39; participants = 5895; studies = 8; I2 = 0%; high-quality evidence). CONCLUSIONS Cytisine increases the chances of successful smoking cessation by more than twofold compared with placebo and has a benign safety profile, with no evidence of serious safety concerns. Limited evidence suggests that cytisine may be more effective than nicotine replacement therapy, with modest cessation rates.
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Affiliation(s)
- Omar De Santi
- Toxicology, Hospital Nacional Professor Alejandro Posadas, Centro Nacional de Intoxicaciones, (CNI), Buenos Aires, Argentina
| | - Marcelo Orellana
- Toxicology, Hospital Nacional Professor Alejandro Posadas, Centro Nacional de Intoxicaciones, (CNI), Buenos Aires, Argentina
| | | | - Vanina Greco
- Toxicology, Hospital Nacional Professor Alejandro Posadas, Centro Nacional de Intoxicaciones, (CNI), Buenos Aires, Argentina
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11
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Voutilainen T, Keski-Nisula L, Rysä J, Kärkkäinen O. Parental cigarette smoking before and during pregnancy in a cohort of 21 472 pregnancies. Basic Clin Pharmacol Toxicol 2024; 134:543-555. [PMID: 38378277 DOI: 10.1111/bcpt.13987] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/22/2023] [Accepted: 01/30/2024] [Indexed: 02/22/2024]
Abstract
Smoking during pregnancy is one of the leading causes for adverse pregnancy outcomes. We studied parental smoking both before and during pregnancy in a retrospective cohort of 21 472 singleton pregnancies. Although most smoking women (74%) ceased tobacco use, there was possible gestational exposure to maternal cigarette smoking in every fifth pregnancy. Continued smoking throughout pregnancy was more prevalent in the partners (22%) than in the pregnant women (7%). The smoking behaviour of the women, especially the number of cigarettes smoked per day (CPD), before and in early pregnancy predicted the continuation of smoking throughout the pregnancy and could be used in identifying high risk groups. In addition, their partner's smoking habits both before and during pregnancy, were associated with the likelihood that the woman would continue to smoke during her pregnancy (rs ≈ 0.4). Furthermore, continued smoking of both parents were associated with decreased birth weight, head circumference and Apgar score, and increased duration of hospital stay and need for special care after birth. Consequently, addressing the lifestyles of both parents in the health care and maternity clinics could help in reducing maternal cigarette smoking during pregnancy and the adverse pregnancy outcomes associated with smoking.
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Affiliation(s)
- Taija Voutilainen
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Leea Keski-Nisula
- Department of Obstetrics and Gynaecology, Kuopio University Hospital, Finland, Kuopio, Finland
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jaana Rysä
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Olli Kärkkäinen
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
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12
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Leinberger-Jabari A, Golob MM, Lindson N, Hartmann-Boyce J. Effectiveness of culturally tailoring smoking cessation interventions for reducing or quitting combustible tobacco: A systematic review and meta-analyses. Addiction 2024; 119:629-648. [PMID: 38105395 DOI: 10.1111/add.16400] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 10/24/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND AND AIMS Standard approaches to smoking cessation may not be as effective for certain populations, and tailoring on cultural factors could improve their effectiveness. This systematic review measured the effectiveness of culturally tailoring smoking cessation interventions on quitting or reducing smoking combustible tobacco. METHOD We searched MEDLINE, PsychInfo, Embase and Cochrane Central Register from inception to 21 June 2023 for randomized controlled trials (RCTs) of community-based, primary care or web-based interventions for smoking cessation in adults who smoked tobacco, with measurement of smoking abstinence or reduction at least 3 months following baseline. We examined comparisons between either an intensity-matched culturally tailored intervention and a non-tailored intervention or a standard non-tailored intervention and the same intervention plus a culturally tailored adjunct. We sub-grouped studies according to the level of tailoring and performed subgroup analyses where appropriate. We assessed risk of bias and certainty of evidence. RESULTS We identified 43 studies, 33 of which were meta-analyzed (n = 12 346 participants). We found moderate certainty evidence, limited by heterogeneity, that intensity-matched culturally tailored cessation interventions increased quit success when compared with non-tailored interventions at 3-month follow-up or longer (n = 5602, risk ratio [RR] = 1.29 95% confidence interval [CI] 1.10, 1.51, I2 = 47%, 14 studies). We found a positive effect of adding a culturally tailored component to a standard intervention compared with the standard intervention alone (n = 6674, RR = 1.47, 95% CI 1.10, 1.95, I2 = 74%, 18 studies), but our certainty in this effect was low due to imprecision and substantial statistical heterogeneity. CONCLUSION Culturally tailored smoking cessation interventions may help more people to quit smoking than a non-tailored intervention. Adapting or adding cultural components to smoking cessation interventions originally developed for majority populations could improve cessation rates in populations who do not fully identify with majority cultural norms.
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Affiliation(s)
- Andrea Leinberger-Jabari
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
- Department of Continuing Education, University of Oxford, Oxford, United Kingdom
| | - Melanie M Golob
- Department of Continuing Education, University of Oxford, Oxford, United Kingdom
| | - Nicola Lindson
- Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, United Kingdom
| | - Jamie Hartmann-Boyce
- Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, United Kingdom
- Department of Health Policy and Promotion, University of Massachusetts Amherst, Amherst, United States
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13
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Zhu K, Shelton J, Li C, Mendola P, Barnabei VM, Myneni AA, Giovino GA, Stevens R, Taylor RN, Niu Z, Mu L. Association between maternal cigarette smoking cessation and risk of preterm birth in Western New York. Paediatr Perinat Epidemiol 2024. [PMID: 38558461 DOI: 10.1111/ppe.13075] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 02/20/2024] [Accepted: 03/07/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Although many studies suggested the benefit of smoking cessation among pregnant women in reducing the risk of preterm birth (PTB), the timing of the effect of the cessation remains inconclusive. OBJECTIVES To examine the association of trimester-specific smoking cessation behaviours with PTB risk. METHODS We included 199,453 live births in Western New York between 2004 and 2018. Based on self-reported cigarette smoking during preconception and in each trimester, we created six mutually exclusive groups: non-smokers, quitters in each trimester, those who smoked throughout pregnancy, and inconsistent smokers. Risk ratios (RRs) and 95% confidence intervals (CIs) were estimated using Poisson regression to examine the association between smoking cessation and PTB. Effect modification by illegal drug use, maternal age, race and ethnicity and pre-pregnancy body mass index (BMI) was investigated multiplicatively by ratio of relative risk and additively by relative excess risk due to interaction (RERI). RESULTS Overall, 6.7% of women had a PTB; 14.1% smoked throughout pregnancy and 3.4%, 1.8% and 0.8% reported quitting smoking during the first, second and third trimesters, respectively. Compared to non-smokers, third-trimester cessation (RR 1.20, 95% CI 1.01, 1.43) and smoking throughout pregnancy (RR 1.27, 95% CI 1.21, 1.33) were associated with a higher PTB risk, while quitting smoking during the first or second trimester, or inconsistent smoking was not associated with PTB. A positive additive interaction was identified for maternal age and late smoking cessation or smoking throughout pregnancy on PTB risk (RERI 0.17, 95% CI 0.00, 0.36), and a negative interaction was observed for pre-pregnancy BMI ≥30 kg/m2 (ratio of relative risk 0.70, 95% CI 0.63, 0.78; RERI -0.42, 95% CI -0.56, -0.30). CONCLUSION Compared to non-smokers, smoking throughout pregnancy and third-trimester smoking cessation are associated with an increased risk of PTB, while quitting before the third trimester may not increase PTB risk.
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Affiliation(s)
- Kexin Zhu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - James Shelton
- Department of Obstetrics and Gynecology, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Chan Li
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - Pauline Mendola
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - Vanessa M Barnabei
- Department of Obstetrics and Gynecology, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Ajay A Myneni
- Department of Surgery, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Gary A Giovino
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - Rebeccah Stevens
- Department of Obstetrics and Gynecology, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Robert N Taylor
- Department of Obstetrics and Gynecology, Jacobs School of Medicine & Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Zhongzheng Niu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - Lina Mu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
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14
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Bricker JB, Santiago-Torres M, Mull KE, Sullivan BM, David SP, Schmitz J, Stotts A, Rigotti NA. Do medications increase the efficacy of digital interventions for smoking cessation? Secondary results from the iCanQuit randomized trial. Addiction 2024; 119:664-676. [PMID: 38009551 DOI: 10.1111/add.16396] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 10/20/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND AND AIMS iCanQuit is a smartphone application (app) proven efficacious for smoking cessation in a Phase III randomized controlled trial (RCT). This study aimed to measure whether medications approved by the US Food and Drug Administration (FDA) for smoking cessation would further enhance the efficacy of iCanQuit, relative to its parent trial comparator-the National Cancer Institute's (NCI's) QuitGuide app. DESIGN Secondary analysis of the entire parent trial sample of a two-group (iCanQuit and QuitGuide), stratified, doubled-blind RCT. SETTING United States. PARTICIPANTS Participants who reported using an FDA-approved cessation medication on their own (n = 619) and those who reported no use of cessation medications (n = 1469). INTERVENTIONS Participants were randomized to receive iCanQuit app or NCI's QuitGuide app. MEASUREMENTS Use of FDA-approved medications was measured at 3 months post-randomization. Smoking cessation outcomes were measured at 3, 6 and 12 months. The primary outcome was 12-month self-reported 30-day point prevalence abstinence (PPA). FINDINGS The data retention rate at the 12-month follow-up was 94.0%. Participants were aged 38.5 years, 71.0% female, 36.6% minority race/ethnicity, 40.6% high school or less education, residing in all 50 US States and smoking 19.2 cigarettes/day. The 29.6% of all participants who used medications were more likely to choose nicotine replacement therapy (NRT; 78.8%) than other cessation medications (i.e. varenicline or bupropion; 18.3 and 10.5%, respectively) and use did not differ by app treatment assignment (all P > 0.05). There was a significant (P = 0.049) interaction between medication use and app treatment assignment on PPA. Specifically, 12-month quit rates were 34% for iCanQuit versus 20% for QuitGuide [odds ratio (OR) = 2.36, 95% confidence interval (CI) = 1.59, 3.49] among participants reporting any medication use, whereas among participants reporting no medication use, quit rates were 28% for iCanQuit versus 22% for QuitGuide (OR = 1.41, 95% CI = 1.09, 1.82). Results were stronger for those using only NRT: 40% quit rates for iCanQuit versus 18% quit rates for QuitGuide (OR = 3.57, 95% CI = 2.20, 5.79). CONCLUSIONS The iCanQuit smartphone app for smoking cessation was more efficacious than the QuitGuide smartphone app, regardless of whether participants used medications to aid cessation. Smoking cessation medications, especially nicotine replacement therapy, might enhance the efficacy of the iCanQuit app.
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Affiliation(s)
- Jonathan B Bricker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Psychology, University of Washington, Seattle, WA, USA
| | | | - Kristin E Mull
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Brianna M Sullivan
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Sean P David
- University of Chicago Pritzker School of Medicine, NorthShore University Health System, Chicago, IL, USA
| | - Joy Schmitz
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Angela Stotts
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
- Department of Family and Community Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Nancy A Rigotti
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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15
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Pozzi P, Boffi R, Veronese C, Trussardo S, Valsecchi C, Sabia F, Pastorino U, Apolone G, Cardani E, Tarantini F, Munarini E. Cytisine as a smoking cessation aid: Preliminary observations with a modified therapeutic scheme in real life. Tumori 2024; 110:124-131. [PMID: 38149659 PMCID: PMC11005299 DOI: 10.1177/03008916231216906] [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: 08/18/2023] [Revised: 11/06/2023] [Accepted: 11/09/2023] [Indexed: 12/28/2023]
Abstract
INTRODUCTION Cigarette smoke accounts for over 90,000 deaths each year in Italy. Tobacco dependence treatment guidelines suggest adopting an integrated pharmacological-behavioral model of intervention. Cytisine is a partial agonist of nicotinic receptors. Trials conducted to date have demonstrated its good efficacy in promoting smoking cessation. The cytisine scheme of treatment consists of 25 days of treatment. A 40-day regimen, with an escalating dose and an extended duration of the treatment, has been in use in many anti-smoking centers in Italy for several years, but to date there are no reports on the use of cytisine with this scheme. METHODS A retrospective, real-life, observational study was conducted between January 2016 and September 2022. The 300 patients who had received at least one dose of study medication were selected. Continuous variables were compared by the Wilcoxon-Mann-Whitney test. Univariate and multivariate logistic regression models were implemented for self-reported seven-day point prevalence for abstinence at three, six and 12 months. RESULTS The median age of the patients was 59 years, 57% were women. The median smoking exposure was 33.8 pack-years. Self-reported smoking abstinence at three, six and 12 months was 68.7%, 56.3% and 47.3% respectively. 84% completed the cytisine treatment, 31.3% reported adverse events and in 8.3% these led to dropping out of the treatment. CONCLUSION Cytisine, administered with a novel therapeutic scheme in the real-life setting of a specialized anti-smoking center, significantly promotes smoking abstinence. However, more studies are needed to assess the tolerability and efficacy of this new regimen.
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Affiliation(s)
- Paolo Pozzi
- Pulmonology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Roberto Boffi
- Pulmonology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Chiara Veronese
- Pulmonology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Sara Trussardo
- Department of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Camilla Valsecchi
- Department of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Federica Sabia
- Department of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Ugo Pastorino
- Department of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Giovanni Apolone
- Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Elisa Cardani
- Pulmonology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Francesco Tarantini
- Pulmonology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Elena Munarini
- Pulmonology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
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Addendum: Bupropion safety in pregnancy. Med Lett Drugs Ther 2024; 66:56. [PMID: 38576145 DOI: 10.58347/tml.2024.1699c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
Our December 11, 2023 article on Drugs for Depression1 included a single sentence on the safety of bupropion use during pregnancy: "The safety of bupropion during pregnancy has not been established; data from a bupropion pregnancy registry suggested a possible increase in cardiac malformations." A reader asked us to provide more information.
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La Rosa GRM, Qureshi MA, Frittitta L, Anastasi E, Polosa R. Effects of Electronic Nicotine Delivery Systems Substitution on Body Weight Status: Protocol for a Systematic Review and Meta-Analysis. JMIR Res Protoc 2024; 13:e56324. [PMID: 38530329 PMCID: PMC11005425 DOI: 10.2196/56324] [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] [Received: 01/12/2024] [Revised: 01/31/2024] [Accepted: 02/01/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Weight gain following smoking cessation is a well-documented concern, often attributed to the absence of nicotine's metabolic influence. The adoption of Electronic Nicotine Delivery Systems (ENDS) has been used to achieve smoking cessation, with claims of aiding weight control. However, existing reviews present conflicting conclusions on ENDS' impact on weight status, necessitating a rigorous evaluation. OBJECTIVE We aim to conduct a systematic review with meta-analysis to assess the actual impact of ENDS on weight status in individuals who have ceased or reduced conventional smoking. The primary goal is to provide clinicians with evidence-based insights into the potential effects of ENDS use as a smoking substitute on weight control. METHODS Adhering to PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols) guidelines, our systematic review will analyze randomized and nonrandomized controlled trials, clinical trials (quasi-experimental), and prospective or retrospective cohort studies on the weight status effects of ENDS among individuals who have either quit or reduced smoking. Searches will include PubMed, Scopus, and Cochrane Library, covering the period from 2010 to January 2024. A gray literature search and supplementary searches will be performed. Data will be extracted independently by 2 reviewers and quality assessments will be conducted concurrently. Quality assessments will use Joanna Briggs Institute tools, 2020 version, along with bias assessments for internal validity and reporting bias based on the Catalogue of Bias. The included studies will be examined for any internal data reporting discrepancies by using Puljak's checklist. Meta-analysis and subgroup analyses (ie, general ENDS usage, ENDS use coupled with a reduction in smoking exceeding 50%, and exclusive ENDS use for achieving smoking cessation) are planned. Certainty of evidence will be evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. RESULTS The protocol has been registered in PROSPERO (CRD42023494974) and the entire systematic review is expected to be completed by April 2024. The main goal of this review is to retrieve all current human research studies investigating the influence of ENDS on weight management among individuals who have quit or reduced smoking. Furthermore, the review will assess the quality of these studies and examine potential biases to identify the most dependable evidence available. Dissemination strategies will include traditional journal publications, social media announcements, and a white paper. The latter, available for download and distributed at conferences, aims to reach a broad audience, including clinicians and ENDS users. CONCLUSIONS The review will address the importance of informing health care professionals and patients about the current and robust evidence regarding the effects of transitioning to ENDS for smoking cessation on weight status. TRIAL REGISTRATION PROSPERO CRD42023494974; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=494974. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/56324.
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Affiliation(s)
- Giusy Rita Maria La Rosa
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Centre of Excellence for the Acceleration of Harm Reduction, University of Catania, Catania, Italy
| | - Maria Ahmed Qureshi
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Centre of Excellence for the Acceleration of Harm Reduction, University of Catania, Catania, Italy
| | - Lucia Frittitta
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Centre of Excellence for the Acceleration of Harm Reduction, University of Catania, Catania, Italy
- Diabetes and Obesity Center, Garibaldi Hospital, Catania, Italy
| | - Erika Anastasi
- ECLAT Srl, Spin-off of the University of Catania, Catania, Italy
| | - Riccardo Polosa
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Centre of Excellence for the Acceleration of Harm Reduction, University of Catania, Catania, Italy
- Centre for the Prevention and Treatment of Tobacco Addiction, University Hospital, University of Catania, Catania, Italy
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Chaisai C, Patikorn C, Thavorn K, Lee SWH, Chaiyakunapruk N, Veettil SK. Incremental net monetary benefit of using varenicline for smoking cessation: A systematic review and meta-analysis of economic evaluation studies. Addiction 2024. [PMID: 38520121 DOI: 10.1111/add.16464] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 01/25/2024] [Indexed: 03/25/2024]
Abstract
AIMS To conduct a systematic review and meta-analysis and pool the incremental net benefits (INBs) of varenicline compared with behaviour support with bupropion or nicotine replacement therapy (NRT), behaviour support alone and unaided cessation in adult smokers making a first-time attempt to quit. METHODS A search for economic evaluation studies was conducted from inception to 30 September 2022, on PubMed, Embase, Cost-Effectiveness Analysis (CEA) Registry by Tufts Medical Centre, EconLit and the NHS Economic Evaluation Database (NHS EED). Eligible studies were included if they were (1) conducted among adults ages 18 years old and older who were smokers attempting to quit for the first time; (2) compared varenicline to behaviour support with bupropion or NRT, behaviour support alone and unaided cessation; and (3) performed a CEA or cost-utility analysis. The INBs were calculated and pooled across studies stratified by country income level and study perspective using the random-effects model. Statistical heterogeneity between studies was assessed using the I2 statistic and Cochrane Q statistic. RESULTS Of the 1433 identified studies, 18 studies were included in our review. Our findings from healthcare system/payer perspective suggested that the use of varenicline is statistically significantly cost-effective compared with bupropion (pooled INB, $830.75 [95% confidence interval, $208.23, $1453.28]), NRTs ($636.16 [$192.48, $1079.84]) and unaided cessation ($4212.35 [$1755.79, $6668.92]) in high-income countries. Similarly, varenicline is also found to be cost-effective compared to bupropion ($2706.27 [$1284.44, $4128.11]), NRTs ($3310.01 [$1781.53, $4838.50]) and behavioural support alone ($5438.22 [$4105.99, $6770.46]) in low- and middle-income countries. CONCLUSION Varenicline is cost-effective as a smoking cessation aid when compared with behavioural support with bupropion or nicotine replacement therapies and behavioural support alone in both high-income countries and low- and middle-income countries, from the healthcare system/payer perspective in adult smokers who attempt to quit for the first time.
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Affiliation(s)
- Chayutthaphong Chaisai
- School of Pharmacy, Monash University Malaysia, Selangor, Malaysia
- Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand
| | - Chanthawat Patikorn
- Department of Pharmacotherapy, University of Utah, Salt Lake City, Utah, USA
- Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Kednapa Thavorn
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University Malaysia, Selangor, Malaysia
- School of Medicine, Taylor's University, Selangor, Malaysia
| | - Nathorn Chaiyakunapruk
- School of Pharmacy, Monash University Malaysia, Selangor, Malaysia
- Department of Pharmacotherapy, University of Utah, Salt Lake City, Utah, USA
- IDEAS Centre, Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, Utah, USA
| | - Sajesh K Veettil
- Department of Pharmacotherapy, University of Utah, Salt Lake City, Utah, USA
- School of Medicine, Taylor's University, Selangor, Malaysia
- School of Pharmacy, Department of Pharmacy Practice, International Medical University, Kuala Lumpur, Malaysia
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High J, Grant K, Hope A, Shepstone L, West C, Colles A, Naughton F. Effects of an increased financial incentive on follow-up in an online, automated smoking cessation trial: A randomised controlled Study Within a Trial (SWAT). Nicotine Tob Res 2024:ntae068. [PMID: 38513087 DOI: 10.1093/ntr/ntae068] [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] [Received: 10/31/2023] [Indexed: 03/23/2024]
Abstract
INTRODUCTION Poor retention in clinical trials can impact on statistical power, reliability, validity and generalisability of findings and is a particular challenge in smoking cessation studies. In online trials with automated follow up mechanisms, poor response also increases resource-need for manual follow up. This study compared two financial incentives on response rates at 6 months follow up, in an online, automated smoking cessation feasibility trial of a cessation smartphone app (Quit Sense). METHODS A study within a trial (SWAT), embedded within a host randomised controlled trial. Host trial participants were randomised 1:1 to receive either a £10 or £20 voucher incentive, for completing the 6-month questionnaire. Stratification for randomisation to the SWAT was by minimisation to ensure an even split of host trial arm participants, and by 6-week response rate. Outcome measures were: questionnaire completion rate, time to completion, number of completers requiring manual follow up and completeness of responses. RESULTS 204 participants were randomised to the SWAT. The £20 and £10 incentives did not differ in completion rate at 6 months (79% versus 74%; p=0.362) but did reduce the proportion of participants requiring manual follow up (46% versus 62%; p=0.018) and the median completion time (7 days versus 15 days; p=0.008). Measure response completeness rates were higher among £20 incentive participants, though differences were small for the host trial's primary smoking outcome. CONCLUSIONS Benefits to using relatively modest increases in incentive for online smoking cessation trials include more rapid completion of follow up questionnaires and reduced manual follow up. IMPLICATIONS A modest increase in incentive (from £10 to £20) to promote the completion of follow up questionnaires in online smoking cessation trials may not increase overall response rates but could lead to more rapid data collection, a reduced need for manual follow-up and reduced missing data among those who initiate completing a questionnaire. Such an improvement may help to reduce bias, increase validity and generalisability, and improve statistical power in smoking cessation trials.
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Affiliation(s)
- Juliet High
- Norwich Clinical Trials Unit, University of East Anglia, UK
| | - Kelly Grant
- Norwich Clinical Trials Unit, University of East Anglia, UK
| | - Aimie Hope
- Behavioural and Implementation Science Group, School of Health Sciences, University of East Anglia
- Addiction Research Group, Norwich Medical School, University of East Anglia, UK
| | - Lee Shepstone
- Norwich Clinical Trials Unit, University of East Anglia, UK
| | - Claire West
- Norwich Clinical Trials Unit, University of East Anglia, UK
| | - Antony Colles
- Norwich Clinical Trials Unit, University of East Anglia, UK
| | - Felix Naughton
- Behavioural and Implementation Science Group, School of Health Sciences, University of East Anglia
- Addiction Research Group, Norwich Medical School, University of East Anglia, UK
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20
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Chen S, Tang J, Wu C, Zhang G, Zhang J, Liao Y. Preliminary Efficacy of a Cognitive Behavioral Therapy-Based Smartphone App for Smoking Cessation in China: Randomized Controlled Pilot Trial. JMIR Form Res 2024; 8:e48050. [PMID: 38498030 PMCID: PMC10985609 DOI: 10.2196/48050] [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] [Received: 04/10/2023] [Revised: 08/27/2023] [Accepted: 09/28/2023] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND The overall prevalence of cigarette smokers in China is very high, and China's total cigarette consumption makes up more than 40% of the world's consumption. In view of the lack of smoking cessation services and social support in China and the effectiveness of mobile phone apps for quitting smoking in other countries, we carried out a smartphone app-based smoking cessation trial in China. OBJECTIVE This study aimed to evaluate the efficacy of a cognitive behavioral therapy (CBT)-based smoking cessation smartphone app among smokers seeking treatment in China. METHODS We conducted a randomized controlled, web-based pilot clinical trial in China between February 23 and June 27, 2021. Eligible participants were randomly assigned to the smoking cessation app intervention group or the control group in a ratio of 1:1. The intervention group received the CBT smoking cessation intervention using a smartphone app, and the control group received a "thank you" message. The intervention was 4 weeks long, and the patients were followed up for 4 weeks. The primary outcome was self-reported continuous smoking abstinence at week 4 after the quit date. The secondary outcomes included self-reported 7-day point prevalence of smoking abstinence; reduction of the number of cigarettes smoked per day at weeks 1, 2, 3, and 4; and program acceptability. RESULTS A total of 973 people were recruited to quit smoking, of whom 262 completed basic information, 56 were excluded, and 206 were randomized and included in the final analysis. There were 189 (91.7%) men and 17 (8.3%) women, with an average age of 34.46 (SD 7.53) years and an average daily smoking rate of 15.93 (SD 7.10) cigarettes/day. We found 30 (29.7%) of the 101 participants in the intervention group and 7 (6.7%) of the 105 participants in the control group reported continuous smoking cessation after the quit date at week 4 (odds ratio 5.92, 95% CI 3.78-9.26; P<.001). The 7-day point prevalence abstinence rate of the intervention group varied from 42.6% (43/101) to 46.5% (47/101) after 1, 2, 3, and 4 weeks, while the control group varied from 18.1% (19/105) to 26.7% (28/105). Compared to the control group, continued smokers consumed 1.5-3.0 fewer cigarettes per day in the intervention group. The overall program got positive user feedback with a high satisfaction rate (66/87, 76%) and an average Mobile Application Rating Scale user version score of 3.46. CONCLUSIONS Our pilot study provided preliminary evidence that the CBT-based smoking cessation smartphone app led to improved smoking quit rates versus control in Chinese smokers. The study demonstrated the CBT-based smartphone app may be an effective and feasible digital treatment model to help smokers quit, which may improve smoking cessation service quality and accessibility in China. TRIAL REGISTRATION ClinicalTrials.gov NCT04421170; https://clinicaltrials.gov/study/NCT04421170. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1136/bmjopen-2020-041985.
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Affiliation(s)
- Shanshan Chen
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jinsong Tang
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Congyang Wu
- Johnson & Johnson Pharmaceutical Company, Shanghai, China
| | - Ge Zhang
- Johnson & Johnson Pharmaceutical Company, Shanghai, China
| | - Jing Zhang
- Johnson & Johnson Pharmaceutical Company, Shanghai, China
| | - Yanhui Liao
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
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21
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Qin R, Liu Z, Cheng AQ, Zhou XM, Su Z, Cui ZY, Li JX, Wei XW, Zhao L, Chung KF, Xiao D, Wang C. Efficacy of varenicline or bupropion and its association with nicotine metabolite ratio among smokers with COPD. Respirology 2024. [PMID: 38494828 DOI: 10.1111/resp.14702] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/14/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND AND OBJECTIVE Nicotine metabolic ratio (NMR) has been associated with nicotine metabolism and smoking characteristics. However, there are few studies on the potential association between NMR and smoking cessation efficacy in smokers with chronic obstructive pulmonary disease (COPD) in China or elsewhere. METHODS This study was a stratified block randomized controlled trial for smoking cessation in Chinese smokers with COPD. NMR was used as a stratification factor; slow metabolizers were defined as those with NMR <0.31, and normal metabolizers as those with NMR ≥0.31. Participants were randomly assigned to the varenicline or bupropion group. Follow-up visits were conducted at 1, 2, 4, 6, 9, 12 and 24 weeks. RESULTS Two hundred twenty-four participants were recruited and analysed from February 2019 to June 2022. In normal metabolizers, the 9-12 weeks continuous abstinence rate of varenicline (43.1%) was higher than in bupropion (23.5%) (OR = 2.47, 95% CI 1.05-5.78, p = 0.038). There was no significant difference in abstinence rates between treatment groups in slow metabolizers (54.1% vs. 45.9%, OR = 1.39, 95% CI 0.68-2.83, p = 0.366). For slow metabolizers, the total score of side effects in the varenicline group was significantly higher than the bupropion group (p = 0.048), while there was no significant difference in side effects between groups for normal metabolizers (p = 0.360). CONCLUSION Varenicline showed better efficacy than bupropion in normal metabolizers, and bupropion showed equivalent efficacy in slow metabolizers with less side effects. According to our study, NMR provides a better justification for both scientific research and tailoring optimal pharmacotherapy for smoking cessation among smokers in COPD.
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Affiliation(s)
- Rui Qin
- China-Japan Friendship Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Department of Tobacco Control and Prevention of Respiratory Disease, China-Japan Friendship Hospital, Beijing, China
- WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
| | - Zhao Liu
- Department of Tobacco Control and Prevention of Respiratory Disease, China-Japan Friendship Hospital, Beijing, China
- WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
| | - An-Qi Cheng
- Department of Tobacco Control and Prevention of Respiratory Disease, China-Japan Friendship Hospital, Beijing, China
- WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
| | - Xin-Mei Zhou
- Department of Tobacco Control and Prevention of Respiratory Disease, China-Japan Friendship Hospital, Beijing, China
- WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
| | - Zheng Su
- Department of Tobacco Control and Prevention of Respiratory Disease, China-Japan Friendship Hospital, Beijing, China
- WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
| | - Zi-Yang Cui
- Department of Geriatric Medicine, Beijing Shijitan Hospital, Beijing, China
| | - Jin-Xuan Li
- Department of Tobacco Control and Prevention of Respiratory Disease, China-Japan Friendship Hospital, Beijing, China
- WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
- Capital Medical University, Beijing, China
| | - Xiao-Wen Wei
- Department of Tobacco Control and Prevention of Respiratory Disease, China-Japan Friendship Hospital, Beijing, China
- WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
- Capital Medical University, Beijing, China
| | - Liang Zhao
- Department of Tobacco Control and Prevention of Respiratory Disease, China-Japan Friendship Hospital, Beijing, China
- WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
| | - Kian Fan Chung
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Dan Xiao
- China-Japan Friendship Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Department of Tobacco Control and Prevention of Respiratory Disease, China-Japan Friendship Hospital, Beijing, China
- WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
| | - Chen Wang
- China-Japan Friendship Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
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22
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Baek SU, Kim MS, Lim MH, Kim T, Yoon JH, Lee YM, Won JU. Association between temporary employment and current smoking and change in smoking behaviors: A prospective cohort study from South Korea (2009-2018). J Epidemiol 2024:JE20230223. [PMID: 38462531 DOI: 10.2188/jea.je20230223] [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: 03/12/2024] Open
Abstract
Background Previous studies have suggested that employment insecurity is associated with adverse health outcomes. We explored the association between temporary employment and smoking behaviors.Methods We analyzed 11,795 workers (51,867 observations) from the Korea Health Panel Study (2009-2018). Employment types were categorized as regular, fixed-term, or daily, based on the duration of labor contract. The outcomes were current smoking status and changes in smoking behavior (initiation or cessation) in the following year. Generalized estimating equations were used to estimate odds ratio (OR) and 95% confidence interval (CI).Results The proportions of fixed-term and daily workers were 41.2% and 16.4% for women and 23.6% and 12.4% for men, respectively. Temporary employment was associated with increased odds of current smoking, while also demonstrating prospective associations with changes in smoking behaviors. For instance, in prospective analyses, male workers with fixed-term and daily employments were associated with a decreased likelihood of smoking cessation (OR:0.77; 95% CI:0.65-0.91 for fixed-term employment and OR:0.66; 95% CI:0.52-0.83 for daily employment) in the following year compared to those with regular employment. Moreover, those experiencing consecutive temporary employment was most inversely associated with smoking cessation in both men (OR:0.56; 95% CI:0.44-0.71) and women (OR:0.37; 95% CI:0.16-0.85) compared to those experiencing consecutive regular employment. However, no clear association between temporary employment and smoking initiation was observed in both men and women.Conclusions Temporary employment is directly associated with current smoking and inversely associated with smoking cessation. Policies are needed to improve job insecurity among temporary employees.
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Affiliation(s)
- Seong-Uk Baek
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine
- The Institute for Occupational Health, Yonsei University College of Medicine
- Graduate School, Yonsei University College of Medicine
| | - Min-Seok Kim
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine
- The Institute for Occupational Health, Yonsei University College of Medicine
- Department of Public Health, Graduate School of Yonsei University
| | - Myeong-Hun Lim
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine
- The Institute for Occupational Health, Yonsei University College of Medicine
- Department of Public Health, Graduate School of Yonsei University
| | - Taeyeon Kim
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine
- The Institute for Occupational Health, Yonsei University College of Medicine
- Department of Public Health, Graduate School of Yonsei University
| | - Jin-Ha Yoon
- The Institute for Occupational Health, Yonsei University College of Medicine
- Department of Preventive Medicine, Yonsei University College of Medicine
| | - Yu-Min Lee
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine
- The Institute for Occupational Health, Yonsei University College of Medicine
| | - Jong-Uk Won
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine
- The Institute for Occupational Health, Yonsei University College of Medicine
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23
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Mahabee-Gittens EM, Southworth H, Kranich C, Lorenz A, Arnold MW, Gittelman MA. Assessment of the Smoke Free Families Tobacco Screening, Counseling, and Referral Program in Pediatric Primary Care Practices. Acad Pediatr 2024; 24:277-283. [PMID: 37245665 PMCID: PMC10676440 DOI: 10.1016/j.acap.2023.05.009] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/10/2023] [Accepted: 05/22/2023] [Indexed: 05/30/2023]
Abstract
OBJECTIVE The Smoke Free Families (SFF) program trained pediatric providers to use an SFF tool during well-child visits (WCVs) of infants ≤12 months to "Ask" caregivers about tobacco use, "Advise" smokers to quit, and "Refer" smokers to cessation services (AAR). The primary objectives were to assess the prevalence and changes in caregiver tobacco use after being screened and counseled by providers using the SFF tool. A secondary objective was to examine providers' AAR behavior facilitated by using the SFF tool. METHODS Pediatric practices participated in 1 of 3 6-9-month SFF program waves. Over the 3 waves, all initial SFF tools completed on caregivers during their infant's WCV were evaluated for the caregiver and household tobacco use and providers' AAR rates. An infant's first and next WCV was matched to determine changes in caregiver tobacco product use. RESULTS In total, the SFF tool was completed at 19,976 WCVs; 2081 (18.8%) infants were exposed to tobacco smoke. A total of 834 (74.1%) caregivers who smoked received counseling: 786 (69.9%) were advised to quit, 700 (62.2%) were given cessation resources, and 198 (17.6%) were referred to the Quitline. In total, 230 (27.6%) of caregivers who smoked had a second visit; 58 (25.2%) self-reported that they quit using tobacco. Among cigarette users (n = 183), 89 (48.6%) reported that they used fewer cigarettes or quit at their infants' second WCV. CONCLUSIONS Systematic use of the SFF AAR tool during infants' WCVs could improve the health of caregivers and children, resulting in decreases in tobacco-related morbidity.
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Affiliation(s)
- E Melinda Mahabee-Gittens
- Division of Emergency Medicine (EM Mahabee-Gittens and MA Gittelman), Cincinnati Children's Hospital Medical Center, Ohio; University of Cincinnati (EM Mahabee-Gittens and MA Gittelman), College of Medicine, Ohio.
| | - Hayley Southworth
- Ohio Chapter (H Southworth, MW Arnold, and MA Gittelman), American Academy of Pediatrics, Columbus
| | - Christiana Kranich
- Ohio Colleges of Medicine (C Kranich and A Lorenz), Government Resource Center, Columbus
| | - Allison Lorenz
- Ohio Colleges of Medicine (C Kranich and A Lorenz), Government Resource Center, Columbus
| | - Melissa Wervey Arnold
- Ohio Chapter (H Southworth, MW Arnold, and MA Gittelman), American Academy of Pediatrics, Columbus
| | - Michael A Gittelman
- Division of Emergency Medicine (EM Mahabee-Gittens and MA Gittelman), Cincinnati Children's Hospital Medical Center, Ohio; University of Cincinnati (EM Mahabee-Gittens and MA Gittelman), College of Medicine, Ohio; Ohio Chapter (H Southworth, MW Arnold, and MA Gittelman), American Academy of Pediatrics, Columbus
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24
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Baker AL, McCarter K, Turner A, Segan C, Castle D, Brophy L, Borland R, Kelly PJ, Bonevski B, Baird D, Filia S, Attia J, Szwec S, Palazzi K, White SL, Williams JM, Wrobel AL, Ireland A, Saxby K, Ghijben P, Petrie D, Sweeney R. 'Quitlink': Outcomes of a randomised controlled trial of peer researcher facilitated referral to a tailored quitline tobacco treatment for people receiving mental health services. Aust N Z J Psychiatry 2024; 58:260-276. [PMID: 37353970 PMCID: PMC10903138 DOI: 10.1177/00048674231181039] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/25/2023]
Abstract
OBJECTIVE The aim of this study was to test the effectiveness of a tailored quitline tobacco treatment ('Quitlink') among people receiving support for mental health conditions. METHODS We employed a prospective, cluster-randomised, open, blinded endpoint design to compare a control condition to our 'Quitlink' intervention. Both conditions received a brief intervention delivered by a peer researcher. Control participants received no further intervention. Quitlink participants were referred to a tailored 8-week quitline intervention delivered by dedicated Quitline counsellors plus combination nicotine replacement therapy. The primary outcome was self-reported 6 months continuous abstinence from end of treatment (8 months from baseline). Secondary outcomes included additional smoking outcomes, mental health symptoms, substance use and quality of life. A within-trial economic evaluation was conducted. RESULTS In total, 110 participants were recruited over 26 months and 91 had confirmed outcomes at 8 months post baseline. There was a difference in self-reported prolonged abstinence at 8-month follow-up between Quitlink (16%, n = 6) and control (2%, n = 1) conditions, which was not statistically significant (OR = 8.33 [0.52, 132.09] p = 0.131 available case). There was a significant difference in favour of the Quitlink condition on 7-day point prevalence at 2 months (OR = 8.06 [1.27, 51.00] p = 0.027 available case). Quitlink costs AU$9231 per additional quit achieved. CONCLUSION The Quitlink intervention did not result in significantly higher rates of prolonged abstinence at 8 months post baseline. However, engagement rates and satisfaction with the 'Quitlink' intervention were high. While underpowered, the Quitlink intervention shows promise. A powered trial to determine its effectiveness for improving long-term cessation is warranted.
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Affiliation(s)
- Amanda L Baker
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, NSW, Australia
| | - Kristen McCarter
- School of Psychological Sciences, College of Engineering, Science and Environment, University of Newcastle, Callaghan, NSW, Australia
| | - Alyna Turner
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, NSW, Australia
- IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Catherine Segan
- Cancer Council Victoria, Melbourne, VIC, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - David Castle
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, ON, Canada
| | - Lisa Brophy
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Social Work and Social Policy, School of Allied Health, Human Services and Sport, La Trobe University Melbourne, VIC, Australia
| | - Ron Borland
- Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Peter J Kelly
- Illawarra Health and Medical Research Institute and the School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Billie Bonevski
- Flinders Health and Medical Research Institute (FHMRI), College of Medicine & Public Health, Flinders University, Bedford Park, SA, Australia
| | - Donita Baird
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, NSW, Australia
| | - Sacha Filia
- Cancer Council Victoria, Melbourne, VIC, Australia
| | - John Attia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, NSW, Australia
| | - Stuart Szwec
- Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Kerrin Palazzi
- Hunter Medical Research Institute, Newcastle, NSW, Australia
| | | | - Jill M Williams
- Division of Addiction Psychiatry, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Anna L Wrobel
- IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Andrew Ireland
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC, Australia
| | - Karinna Saxby
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC, Australia
| | - Peter Ghijben
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC, Australia
| | - Dennis Petrie
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC, Australia
| | - Rohan Sweeney
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC, Australia
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Yon B, Williams R, Wedin J, Underhill L, Kurti A. Incentivizing Pregnant Women to Quit Smoking in the Real World-A Community-Based Pilot Intervention. Health Promot Pract 2024; 25:164-166. [PMID: 36444556 DOI: 10.1177/15248399221139299] [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] [Indexed: 02/17/2024]
Abstract
Smoking during pregnancy is a leading preventable cause of poor pregnancy outcomes. Financial incentives interventions yield quit rates of approximately 30% during pregnancy, versus approximately 4% in traditional smoking cessation programs. This pilot study assessed the feasibility of translating an efficacious University of Vermont research-based intervention into a rural community setting delivered by the Vermont Department of Health. Pregnant women using tobacco products were recruited from the Women, Infants and Children program and Rutland Women's Healthcare. Women were provided in-person tobacco cessation counseling during regularly scheduled meetings and received gift cards throughout pregnancy and 3 months postpartum contingent upon biochemically verified smoking abstinence. Cessation counseling and abstinence monitoring began with high frequency (three visits per week), tapering through postpartum to biweekly visits. Gift card values began at $15, increasing by $5 for consecutive negative samples, to $40 maximum. Participants completed three surveys (enrollment, 4-6 weeks postpartum, 6-12 months postpartum) assessing smoking habits, and barriers and facilitators of treatment engagement and success. From 2018 to 2020, we enrolled 20 pregnant women, of whom six self-reported quitting tobacco at some point during the intervention. At study completion, three reported sustained abstinence. Results suggest that it is feasible to translate a research-based smoking cessation program into a community setting. This article discusses the challenges faced and the lessons learned when implementing research in a rural community setting, recruiting and retaining participants, and adapting protocols during the Covid-19 pandemic.
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Affiliation(s)
- Bethany Yon
- Vermont Department of Health, Burlington, VT, USA
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Golden T, Courtney-Long E, VanFrank B. Healthcare Providers' Knowledge of Evidence-Based Treatment for Tobacco Dependence, DocStyles 2020. Am J Health Promot 2024; 38:316-324. [PMID: 37731286 DOI: 10.1177/08901171231202626] [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] [Indexed: 09/22/2023]
Abstract
PURPOSE Although smoking cessation reduces the risk of all-cause mortality, evidence-based cessation treatments are underused. This study examined healthcare provider knowledge of evidence-based cessation treatments and associations between knowledge and clinical practice characteristics. DESIGN Cross-sectional survey. SETTING 2020 DocStyles. SUBJECTS 1480 U.S. healthcare providers. MEASURES Provider knowledge of availability of tobacco use disorder diagnostic criteria, clinical practice guideline availability, treatment efficacy, evidence-based counseling modalities, and medications approved by the U.S. Food and Drug Administration (FDA). ANALYSIS Adjusted odds ratios (aORs), adjusted for personal and clinical practice characteristics. RESULTS Less than half of respondents demonstrated high knowledge of availability of diagnostic criteria (36.8%), cessation treatment efficacy (33.2%), evidence-based counseling modalities (5.6%), and FDA-approved medications (40.1%). Significant differences were found between specialties: compared to internists, family physicians were less likely to have low knowledge of medications (aOR = .69, 95% CI = .53, .90) and obstetricians/gynecologists were more likely to have low knowledge of medications (aOR = 2.62, 95% CI = 1.82, 3.76). Overall, few associations between knowledge and clinical practice characteristics were identified. CONCLUSION Most providers had low knowledge of the topics of interest, with little variation across clinical practice characteristics, indicating room for improvement. Efforts to improve provider knowledge of evidence-based treatments are an important component of a comprehensive approach to improving delivery and use of cessation interventions and increasing tobacco cessation.
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Affiliation(s)
- Thomas Golden
- Epidemic Intelligence Service, Office of Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Elizabeth Courtney-Long
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Brenna VanFrank
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Moreira RDC, Rodrigues A, Leonardo BM, Arabe D, Santos R, Cardoso SW, Grinsztejn B, Veloso V, Pacheco AG. Smoking Cessation Is Associated With Short-Term Improvement of Vascular Health in a Cohort of People Living With HIV in Rio de Janeiro, Brazil. Am J Cardiol 2024; 214:157-166. [PMID: 38160920 DOI: 10.1016/j.amjcard.2023.12.034] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/24/2023] [Accepted: 12/17/2023] [Indexed: 01/03/2024]
Abstract
Smoking is highly prevalent in people living with HIV/AIDS (PLHA), leading to detrimental effects in different tissues. We examined the effects of nicotine replacement therapy (NRT) on smoking cessation and vascular health. From December 2019 to October 2021, we prospectively enrolled PLHA who were actively smoking. The primary outcome was endothelial function measured by brachial artery flow-mediated dilatation (FMD). We evaluated the percent change in FMD compared to the baseline measure (Δ%FMD) to detect improvements among participants who quit smoking. To confirm the results, we used linear regression models to account for classical cardiovascular (CV) confounders. We included 117 participants with median age of 45.5 years (IQR= 36.4-54.8); 22 (20.4%) had hypertension, 9 (8.3%) had diabetes, almost half were smoking 20+ cigarettes/day (41.7%). After 12 weeks 30.76% participants quit smoking. Comparison of Δ%FMD change from baseline to week 12 showed that among participants adherent to therapy, there has been an increase in Δ%FMD when compared to those who relapsed (1.17% [0.29-2.98] vs -0.19% [-1.95-0.91], p<0.001). After adjustment for CV factors, multiple linear regression showed that Δ%FMD in participants who quit smoking presented a 2.54 mean increase in comparison to those who continued smoking (p=0.007). In conclusion, this study provides evidence that a strategy of NRT and counseling is modestly effective for smoking cessation in PLHA and improves vascular health in a short period of time. This reinforces the importance of the widespread anti-tobacco programs in HIV clinics and the expected impact lowering the incidence of future cardiovascular events.
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Affiliation(s)
| | | | | | - Daniel Arabe
- Evandro Chagas National Institute of Infectology, Rio de Janeiro, Brazil
| | - Renata Santos
- Evandro Chagas National Institute of Infectology, Rio de Janeiro, Brazil
| | | | - Beatriz Grinsztejn
- Evandro Chagas National Institute of Infectology, Rio de Janeiro, Brazil
| | - Valdilea Veloso
- Evandro Chagas National Institute of Infectology, Rio de Janeiro, Brazil
| | - Antonio G Pacheco
- Scientific Computing Program of Oswaldo Cruz Fundation (PROCC), Rio de Janeiro, Brazil
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Bourne DE, Williams R, Osbahr L, Roemhildt M, Villanti AC. Implementation of Quitline Financial Incentives to Increase Counseling Sessions Among Adults Who Use Menthol Tobacco Products. Health Promot Pract 2024; 25:167-169. [PMID: 37118924 PMCID: PMC10611895 DOI: 10.1177/15248399231171143] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Since 2017, the Vermont Tobacco Control Program (VTCP) has worked to reduce the impact of flavored tobacco products on Vermonters. With the proposed U.S. Food and Drug Administration (FDA) rules banning menthol cigarettes and flavored cigars and proposed legislation banning sales of all menthol and flavored tobacco products in Vermont, VTCP prioritized resources to support cessation among Vermonters who use menthol tobacco products. In March 2021, VTCP began offering a tailored quitline protocol for adults who use menthol tobacco, including financial incentives, for completed coaching sessions. From March 2021 to May 2022, 66 quitline callers enrolled in the menthol incentive protocol, representing 8% of all quitline callers and 25% of participants in the state's quitline incentive programs. A greater proportion of callers in the menthol incentive program completed three or more quitline calls (58% vs. 38%) and enrolled in phone and text support (61% vs. 32%). Quitline callers enrolled in any incentive protocols (menthol, Medicaid/uninsured, or pregnant) were more likely to request one or two forms of nicotine replacement therapy (NRT). Quitlines remain an effective, evidence-based method of tobacco cessation, especially in reaching vulnerable populations. Given the targeted marketing of menthol brands to Black and African American populations, LGBTQ+ populations, youth, and neighborhoods with lower incomes, addressing menthol cigarette use is key to improving health equity and health of Vermonters. Early data indicates that the use of financial incentives can increase engagement with a state quitline among menthol tobacco users through greater completion of cessation coaching calls, enrollment in text message support, and NRT usage.
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Affiliation(s)
| | | | - Lisa Osbahr
- Vermont Department of Health, Burlington, VT, USA
| | | | - Andrea C. Villanti
- Rutgers Center for Tobacco Studies, New Brunswick, NJ, USA
- Rutgers School of Public Health, Piscataway, NJ, USA
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Li Y, Gao L, Chao Y, Wang J, Qin T, Zhou X, Chen X, Hou L, Lu L. Effects of interventions on smoking cessation: A systematic review and network meta-analysis. Addict Biol 2024; 29:e13376. [PMID: 38488699 DOI: 10.1111/adb.13376] [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: 07/17/2023] [Revised: 12/17/2023] [Accepted: 01/16/2024] [Indexed: 03/19/2024]
Abstract
A network meta-analysis (NMA) including randomized controlled trials (RCTs) was conducted to evaluate the effects of different interventions on smoking cessation. Studies were collected from online databases including PubMed, EMBASE, Cochrane Library, and Web of Science based on inclusion and exclusion criteria. Eligible studies were further examined in the NMA to compare the effect of 14 interventions on smoking cessation. Thirty-four studies were examined in the NMA, including a total of 14 interventions and 28 733 participants. The results showed that health education (HE; odds ratio ([OR] = 200.29, 95% CI [1.62, 24 794.61])), other interventions (OI; OR = 29.79, 95% CI [1.07, 882.17]) and multimodal interventions (MUIs; OR = 100.16, 95% CI [2.06, 4867.24]) were better than self-help material (SHM). HE (OR = 243.31, 95% CI [1.39, 42531.33]), MUI (OR = 121.67, 95% CI [1.64, 9004.86]) and financial incentive (FI; OR = 14.09, 95% CI [1.21, 164.31]) had positive effects on smoking cessation rate than smoking cessation or quitting APP (QA). Ranking results showed that HE (83.6%) and motivation interviewing (MI; 69.6%) had better short-term effects on smoking cessation. HE and MUI provided more smoking cessation benefits than SHM and QA. FI was more effective at quitting smoking than QA. Also, HE and MI were more likely to be optimal smoking cessation interventions.
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Affiliation(s)
- Ying Li
- College of Sports Science, Jishou University, Jishou, China
| | - Lei Gao
- School of Nursing, Dalian University, Dalian, China
| | - Yaqing Chao
- Ophthalmology Department, Xuzhou First People's Hospital, Xuzhou, China
| | - Jianhua Wang
- College of Nursing, Weifang University of Science and Technology, Weifang, China
| | - Tianci Qin
- College of Sports Science, Jishou University, Jishou, China
| | - Xiaohua Zhou
- School of Nursing, Dalian University, Dalian, China
| | - Xiaoan Chen
- College of Sports Science, Jishou University, Jishou, China
| | - Lingyu Hou
- Nursing Department, Peking University Shenzhen Hospital, Shenzhen, China
| | - Linlin Lu
- Nursing Department, Peking University Shenzhen Hospital, Shenzhen, China
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Mundt MP, McCarthy DE, Baker TB, Zehner ME, Zwaga D, Fiore MC. Cost-Effectiveness of a Comprehensive Primary Care Smoking Treatment Program. Am J Prev Med 2024; 66:435-443. [PMID: 37844710 PMCID: PMC10922402 DOI: 10.1016/j.amepre.2023.10.011] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 10/18/2023]
Abstract
INTRODUCTION Smoking is the leading preventable cause of death and disease in the U.S. This study evaluates the cost-effectiveness from a healthcare system perspective of a comprehensive primary care intervention to reduce smoking rates. METHODS This pragmatic trial implemented electronic health record prompts during primary care visits and employed certified tobacco cessation specialists to offer proactive outreach and smoking cessation treatment to patients who smoke. The data, analyzed in 2022, included 10,683 patients in the smoking registry from 2017 to 2020. Pre-post analyses compared intervention costs to treatment engagement, successful self-reported smoking cessation, and acute health care utilization (urgent care, emergency department visits, and inpatient hospitalization). Cost per quality-adjusted life year was determined by applying conversion factors obtained from the tobacco research literature to the cost per patient who quit smoking. RESULTS Tobacco cessation outreach, medication, and counseling costs increased from $2.64 to $6.44 per patient per month, for a total post-implementation intervention cost of $500,216. Smoking cessation rates increased from 1.3% pre-implementation to 8.7% post-implementation, for an incremental effectiveness of 7.4%. The incremental cost-effectiveness ratio was $628 (95% CI: $568, $695) per person who quit smoking, and $905 (95% CI: $822, $1,001) per quality-adjusted life year gained. Acute health care costs decreased by an average of $42 (95% CI: -$59, $145) per patient per month for patients in the smoking registry. CONCLUSIONS Implementation of a comprehensive and proactive smoking cessation outreach and treatment program for adult primary care patients who smoke meets typical cost-effectiveness thresholds for healthcare.
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Affiliation(s)
- Marlon P Mundt
- Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin.
| | - Danielle E McCarthy
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin; Department of Medicine, Division of General Internal Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Timothy B Baker
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin; Department of Medicine, Division of General Internal Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Mark E Zehner
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Deejay Zwaga
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Michael C Fiore
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin; Department of Medicine, Division of General Internal Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
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Mornsaeng I, Sripichyakan K, Sansiriphun N, Chaloumsuk N. Prenatal passive smoking at home: The experiences of women in Thailand. Belitung Nurs J 2024; 10:48-55. [PMID: 38425690 PMCID: PMC10900058 DOI: 10.33546/bnj.3014] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/07/2023] [Accepted: 12/15/2023] [Indexed: 03/02/2024] Open
Abstract
Background Passive smoking poses a threat to the well-being of an unborn baby; however, women's understanding and practice in this regard remain unclear. Objective This study aimed to describe prenatal passive smoking at home based on the experiences of women in Thailand. Methods A qualitative descriptive approach was employed. Data were collected between September 2020 and April 2022 through semi-structured in-depth interviews with 16 postpartum women purposively selected from five hospitals. Thematic analysis was used for data analysis. Results Three themes emerged. The first theme, 'safeguard for an unborn baby,' was performed through smoking reduction, far distance, abstinence from smoke/odor inhalation, and residual elimination since harm was highly aware. However, justifying safety from the absence of smoke and foul odor was misperceived. The second theme, 'intervention for smoking cessation,' was attempted through various methods, including acquired empathy, persuasion, compromise, and supportiveness. They also needed family/friend assistance in warning and professional care in terms of advice, health education, learning materials, cessation therapy, care continuation, and dealing with complex situations. The last theme, 'maternal perseverance,' was acquired by the motives of safety goals, rights/responsibilities, changeable norms, and a golden period. Conclusion Pregnant women persistently aimed to prevent their husbands from smoking and safeguard their unborn babies from passive smoking. However, misunderstandings and improper practices were observed. Healthcare and nursing services need comprehensive approaches to enhance understanding, perseverance, and tailored practices catering to women's needs.
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Batra A, Eck S, Riegel B, Friedrich S, Fuhr K, Torchalla I, Tönnies S. Hypnotherapy compared to cognitive-behavioral therapy for smoking cessation in a randomized controlled trial. Front Psychol 2024; 15:1330362. [PMID: 38476396 PMCID: PMC10929270 DOI: 10.3389/fpsyg.2024.1330362] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 02/15/2024] [Indexed: 03/14/2024] Open
Abstract
Worldwide, more than eight million people die each year as a result of tobacco use. A large proportion of smokers who want to quit are interested in alternative smoking cessation methods, of which hypnotherapy is the most popular. However, the efficacy of hypnotherapy as a tobacco cessation intervention cannot be considered sufficiently proven due to significant methodological limitations in the studies available to date. The aim of the present study was to compare the efficacy of a hypnotherapeutic group program for smoking cessation with that of an established cognitive-behavioral group program in a randomized controlled trial. A total of 360 smokers who were willing to quit were randomly assigned to either hypnotherapy (HT) or cognitive-behavioral therapy (CBT) at two study sites, without regard to treatment preference. They each underwent a 6 weeks smoking cessation course (one 90 min group session per week) and were followed up at regular intervals over a 12 months period. The primary outcome variable was defined as continuous abstinence from smoking according to the Russell standard, verified by a carbon monoxide measurement at three measurement time points. Secondary outcome variables were 7 days point prevalence abstinence during the 12 months follow up and the number of cigarettes the non-quitters smoked per smoking day (smoking intensity). Generalized estimating equations were used to test treatment condition, hypnotic suggestibility, and treatment expectancy as predictors of abstinence. The two interventions did not differ significantly in the proportion of participants who remained continuously abstinent throughout the follow-up period (CBT: 15.6%, HT: 15.0%) and also regarding the 7 days abstinence rates during the 12 months follow-up (CBT: 21.2%, HT: 16.7%). However, when controlling for hypnotic suggestibility, CBT showed significantly higher 7 days abstinence rates. In terms of the continuous abstinence rates, it can be concluded that the efficacy of hypnotherapeutic methods for smoking cessation seem to be comparable to established programs such as CBT. Clinical trial registration ClinicalTrials.gov, identifier NCT01129999.
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Affiliation(s)
- Anil Batra
- Department for Psychiatry and Psychotherapy, Section for Addiction Research and Medicine, University Hospital Tuebingen, Tuebingen, Germany
| | - Sandra Eck
- Department for Psychiatry and Psychotherapy, Section for Addiction Research and Medicine, University Hospital Tuebingen, Tuebingen, Germany
| | | | | | - Kristina Fuhr
- Department for Psychiatry and Psychotherapy, Section for Addiction Research and Medicine, University Hospital Tuebingen, Tuebingen, Germany
| | | | - Sven Tönnies
- Department of Clinical Psychology and Psychotherapy, University Hamburg, Hamburg, Germany
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Eser P, Klaus C, Vetsch T, Ernst R, Engel D. Qualitative assessment of expectations on the content, form and way of delivery of a prehabilitation programme in patients with lung resection surgery - A Swiss tertiary centre experience. SAGE Open Med 2024; 12:20503121241233427. [PMID: 38414831 PMCID: PMC10898307 DOI: 10.1177/20503121241233427] [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] [Received: 08/29/2023] [Accepted: 01/25/2024] [Indexed: 02/29/2024] Open
Abstract
Objective To assess the interest in a prehabilitation programme of patients awaiting lung resection and to identify expectations from such a programme. Introduction At present, in Switzerland, there are no multimodal clinical prehabilitation programmes for lung resection patients awaiting surgery. Methods Semi-structured face-to-face interviews were conducted with patients who have had or were awaiting lung resection at a Swiss tertiary centre. Thematic analysis was performed to identify common prespecified themes. Results Twenty-two patients (45.5% female, age 70.6 ± 16.6 years) were interviewed. Seventy-seven percent were interested in a prehabilitation programme. Sixty-two percent, 67% and 90% were interested in endurance, strength and respiratory training, respectively. Six patients (27%) were active smokers, of whom two (one-third) were interested in a smoking cessation programme. Seventy-six percent were interested in nutrition counselling and 90% in receiving education on risk factor management. Forty percent preferred centre-based training/counselling sessions, 20% preferred home-based training/counselling and 30% found both forms acceptable. Patients were willing to perform prehabilitation activities on 2.6 days/week for a total of 162 min/week. Participating in peer groups was desired by only 25%. Conclusions Patients with lung resection were highly interested in participating in prehabilitation, albeit only for a mean time cost of 2.7 h per week. Offering a prehabilitation programme with a combination of in-hospital group sessions and home-based training seems feasible.
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Affiliation(s)
- Prisca Eser
- Rehabilitation & Sports Medicine, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Colette Klaus
- Rehabilitation & Sports Medicine, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Thomas Vetsch
- Department of Anaesthesiology and Pain Medicine, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Raphaela Ernst
- Rehabilitation & Sports Medicine, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Dominique Engel
- Department of Anaesthesiology and Pain Medicine, Inselspital, University Hospital Bern, Bern, Switzerland
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Siemer L, Pieterse ME, Ben Allouch S, Postel MG, Brusse-Keizer MGJ. Comparing the Effectiveness of the Blended Delivery Mode With the Face-to-Face Delivery Mode of Smoking Cessation Treatment: Noninferiority Randomized Controlled Trial. J Med Internet Res 2024; 26:e47040. [PMID: 38376901 PMCID: PMC10915740 DOI: 10.2196/47040] [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: 03/06/2023] [Revised: 11/04/2023] [Accepted: 12/29/2023] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Tobacco consumption is a leading cause of death and disease, killing >8 million people each year. Smoking cessation significantly reduces the risk of developing smoking-related diseases. Although combined treatment for addiction is promising, evidence of its effectiveness is still emerging. Currently, there is no published research comparing the effectiveness of blended smoking cessation treatments (BSCTs) with face-to-face (F2F) treatments, where web-based components replace 50% of the F2F components in blended treatment. OBJECTIVE The primary objective of this 2-arm noninferiority randomized controlled trial was to determine whether a BSCT is noninferior to an F2F treatment with identical ingredients in achieving abstinence rates. METHODS This study included 344 individuals who smoke (at least 1 cigarette per day) attending an outpatient smoking cessation clinic in the Netherlands. The participants received either a blended 50% F2F and 50% web-based BSCT or only F2F treatment with similar content and intensity. The primary outcome measure was cotinine-validated abstinence rates from all smoking products at 3 and 15 months after treatment initiation. Additional measures included carbon monoxide-validated point prevalence abstinence; self-reported point prevalence abstinence; and self-reported continuous abstinence rates at 3, 6, 9, and 15 months after treatment initiation. RESULTS None of the 13 outcomes showed statistically confirmed noninferiority of the BSCT, whereas 4 outcomes showed significantly (P<.001) inferior abstinence rates of the BSCT: cotinine-validated point prevalence abstinence rate at 3 months (difference 12.7, 95% CI 6.2-19.4), self-reported point prevalence abstinence rate at 6 months (difference 19.3, 95% CI 11.5-27.0) and at 15 months (difference 11.7, 95% CI 5.8-17.9), and self-reported continuous abstinence rate at 6 months (difference 13.8, 95% CI 6.8-20.8). The remaining 9 outcomes, including the cotinine-validated point prevalence abstinence rate at 15 months, were inconclusive. CONCLUSIONS In this high-intensity outpatient smoking cessation trial, the blended mode was predominantly less effective than the traditional F2F mode. The results contradict the widely assumed potential benefits of blended treatment and suggest that further research is needed to identify the critical factors in the design of blended interventions. TRIAL REGISTRATION Netherlands Trial Register 27150; https://onderzoekmetmensen.nl/nl/trial/27150. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-doi.org/10.1186/s12889-016-3851-x.
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Affiliation(s)
- Lutz Siemer
- School of Social Work, Saxion University of Applied Sciences, Enschede, Netherlands
- Department of Psychology, Health and Technology, Centre for eHealth & Well-being Research - Behavioural, Management and Social Sciences, University of Twente, Enschede, Netherlands
- Research Group Technology, Health & Care, Saxion University of Applied Sciences, Enschede, Netherlands
| | - Marcel E Pieterse
- Department of Psychology, Health and Technology, Centre for eHealth & Well-being Research - Behavioural, Management and Social Sciences, University of Twente, Enschede, Netherlands
| | - Somaya Ben Allouch
- Digital Life Research Group, Amsterdam University of Applied Science, Amsterdam, Netherlands
- Digital Interactions Lab (DIL), Informatics Institute, University of Amsterdam, Amsterdam, Netherlands
| | - Marloes G Postel
- Research Group Technology, Health & Care, Saxion University of Applied Sciences, Enschede, Netherlands
| | - Marjolein G J Brusse-Keizer
- Medical School Twente, Medisch Spectrum Twente, Enschede, Netherlands
- Health Technology & Services Research, Technical Medical (TechMed) Centre, University of Twente, Enschede, Netherlands
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Batı BÇ, Buduneli N, Meriç P. Examining awareness of tobacco's oral health effects: Dentists' role in smoking cessation among dental patients. Tob Induc Dis 2024; 22:TID-22-41. [PMID: 38370493 PMCID: PMC10870343 DOI: 10.18332/tid/176227] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 11/26/2023] [Accepted: 12/01/2023] [Indexed: 02/20/2024] Open
Abstract
INTRODUCTION Tobacco products are well-known as a major risk factor for systemic and oral diseases. Dentists may play an important role in the prevention and progression of oral problems related to smoking. The aim of this study was to evaluate the level of awareness about the poor oral health effects of tobacco products and the role of dentists in smoking cessation among dental patients. METHODS A survey containing 40 questions was prepared, and patients seeking dental treatment between June and October 2019 at the School of Dentistry, Ege University, were asked to participate. The survey included demographic variables in the first part, habits of using tobacco products in the second part, relations between smoking and oral health, and the possible role of dentists in smoking cessation in the last part. Data were tested statistically by Mann Whitney U and chi-squared tests. RESULTS A total of 501 patients participated in the survey; more than half of the participants were non-smokers (63.7%). Cigarettes (95.06%), hookah (7.69%), e-cigarettes (2.75%), and cigars (1.65%) were the most frequently consumed tobacco products. The biggest obstacle to quitting smoking was 'having smoker friends'. The rate of non-smokers (41.4%) agreeing that smoking is related to periodontal diseases was more than that of smokers (32.4%) (p<0.05). The most known side effect of tobacco products was halitosis (81.6%). Half of the respondents (46.7%) did not know about dentists' role in helping them quit smoking. The rate of participants previously recommended by a dentist to quit smoking was only 36%. CONCLUSIONS The aesthetic and social consequences of using tobacco products are well known, but smokers are substantially less aware than non-smokers of the relationship between tobacco products and oral diseases. The present findings suggest that dentists should inform their patients about the detrimental effects of tobacco products and play an active role in advising them to quit.
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Affiliation(s)
- Betül Çalışkan Batı
- Department of Periodontology, Faculty of Dentistry, Ege University, İzmir, Türkiye
| | - Nurcan Buduneli
- Department of Periodontology, Faculty of Dentistry, Ege University, İzmir, Türkiye
| | - Pınar Meriç
- Department of Periodontology, Faculty of Dentistry, Ege University, İzmir, Türkiye
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Williams PJ, Philip KEJ, Buttery SC, Perkins A, Chan L, Bartlett EC, Devaraj A, Kemp SV, Addis J, Derbyshire J, Chen M, Polkey MI, Laverty AA, Hopkinson NS. Immediate smoking cessation support during lung cancer screening: long-term outcomes from two randomised controlled trials. Thorax 2024; 79:269-273. [PMID: 37875371 DOI: 10.1136/thorax-2023-220367] [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: 04/11/2023] [Accepted: 09/24/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND Immediate smoking cessation interventions delivered alongside targeted lung health checks (TLHCs) to screen for lung cancer increase self-reported abstinence at 3 months. The impact on longer term, objectively confirmed quit rates remains to be established. METHODS We followed up participants from two clinical trials in people aged 55-75 years who smoked and took part in a TLHC. These randomised participants in the TLHC by day of attendance to either usual care (UC) (signposting to smoking cessation services) or an offer of immediate smoking cessation support including pharmacotherapy. In the QuLIT1 trial, this was delivered face to face and in QuLIT2, it was delivered remotely. Follow-up was conducted 12 months after the TLHC by telephone interview with subsequent biochemical verification of smoking cessation using exhaled CO. RESULTS 430 people were enrolled initially (115 in QuLIT1 and 315 in QuLIT2), with 4 deaths before 12 months leaving 426 (62.1±5.27 years old and 48% women) participants for analysis. At 12 months, those randomised to attend on smoking cessation support intervention days had higher quit rates compared with UC adjusted for age, gender, deprivation, and which trial they had been in; self-reported 7-day point prevalence (20.0% vs 12.8%; adjusted OR (AOR)=1.78; 95% CI 1.04 to 2.89) and CO-verified quits (12.1% vs 4.7%; AOR=2.97; 95% CI 1.38 to 6.90). Those in the intervention arm were also more likely to report having made a quit attempt (30.2% vs UC 18.5%; AOR 1.90; 95% CI 1.15 to 3.15). CONCLUSION Providing immediate smoking cessation support alongside TLHC increases long term, biochemically confirmed smoking abstinence. TRIAL REGISTRATION NUMBER ISRCTN12455871.
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Affiliation(s)
- Parris J Williams
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
- NIHR Respiratory BRU, Royal Brompton Hospital and National Heart and Lung Institute, London, UK
| | - Keir E J Philip
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Sara C Buttery
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
- NIHR Respiratory BRU, Royal Brompton Hospital and National Heart and Lung Institute, London, UK
| | - Alexis Perkins
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
- NIHR Respiratory BRU, Royal Brompton Hospital and National Heart and Lung Institute, London, UK
| | - Ley Chan
- National Heart and Lung Institute, Imperial College London, London, UK
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - Emily C Bartlett
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
- Radiology, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Anand Devaraj
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
- Radiology, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Samuel V Kemp
- Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, UK
| | - James Addis
- Radiology, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Jane Derbyshire
- West London Cancer Alliance, Royal Marsden Partners, London, UK
| | - Michelle Chen
- West London Cancer Alliance, Royal Marsden Partners, London, UK
| | - Michael I Polkey
- NIHR Respiratory BRU, Royal Brompton Hospital and National Heart and Lung Institute, London, UK
| | - Anthony A Laverty
- Department of Primary Care and Public Health, Imperial College London School of Public Health, London, UK
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Minué-Lorenzo C, Olano-Espinosa E, Minué-Estirado M, Vizcaíno-Sánchez JM, Camarelles-Guillem F, Granados-Garrido JA, Ruiz-Pacheco M, Gámez-Cabero MI, Martínez-Suberviola FJ, Serrano-Serrano E, Cura-González ID. Gender, smoking, and tobacco cessation with pharmacological treatment in a cluster randomized clinical trial. Tob Induc Dis 2024; 22:TID-22-38. [PMID: 38362269 PMCID: PMC10867739 DOI: 10.18332/tid/177260] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/03/2023] [Accepted: 12/18/2023] [Indexed: 02/17/2024] Open
Abstract
INTRODUCTION Whether men find it easier to quit smoking than women is still controversial. Different studies have reported that the efficacy of pharmacological treatments could be different between men and women. This study conducted a secondary analysis of 'Subsidized pharmacological treatment for smoking cessation by the Spanish public health system' (FTFT-AP study) to evaluate the effectiveness of a drug-funded intervention for smoking cessation by gender. METHODS A pragmatic randomized clinical trial by clusters was used. The population included smokers aged ≥18 years, smoking >10 cigarettes per day, randomly assigned to an intervention group receiving regular practice and financed pharmacological treatment, or to a control group receiving only regular practice. The main outcome was continued abstinence at 12 months, self-reported and validated with CO-oximetry. The percentage, with 95% confidence intervals, of continued abstinence was compared between both groups at 12 months post-intervention, by gender and the pharmacological treatment used. Multilevel logistic regression analysis was performed. RESULTS A total of 1154 patients from 29 healthcare centers were included. The average age was 46 years (SD=11.78) and 51.7% were men. Overall, the self-reported abstinence at 12 months was 11.1% (62) in women and 15.7% (93) in men (AOR=1.4; 95% CI: 1.0-2.0), and abstinence validated by CO-oximetry was 4.6% (26) and 5.9% (35) in women and men, respectively (OR=1.3; 95% CI: 0.7-2.2). In the group of smokers receiving nicotine replacement treatment, self-reported abstinence was higher in men compared to women (29.5% vs 13.5%, OR=2.7; 95% CI: 1.3-5.8). CONCLUSIONS The effectiveness of a drug-financed intervention for smoking cessation was greater in men, who also showed better results in self-reported abstinence with nicotine replacement treatment.
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Affiliation(s)
- César Minué-Lorenzo
- Centro de Salud Perales del Río, Dirección Asistencial Centro, Servicio Madrileño de Salud, Madrid, España
- Red de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud, Madrid, España
- Instituto de Investigación Sanitaria Hospital Doce de Octubre (i+12), Madrid, España
- Research Network on Preventive Activities and Health Promotion, Madrid, Spain
| | - Eduardo Olano-Espinosa
- Red de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud, Madrid, España
- Instituto de Investigación Sanitaria Hospital Doce de Octubre (i+12), Madrid, España
- Research Network on Preventive Activities and Health Promotion, Madrid, Spain
- Centro de Salud Los Castillos, Dirección Asistencial Oeste, Servicio Madrileño de Salud, Madrid, España
| | - María Minué-Estirado
- Centro de Salud José María Llanos, Dirección Asistencial Este, Servicio Madrileño de Salud, Madrid, España
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España
| | - Jose-María Vizcaíno-Sánchez
- Instituto de Investigación Sanitaria Hospital Doce de Octubre (i+12), Madrid, España
- Centro de Salud Fuentelarreina, Dirección Asistencial Norte, Servicio Madrileño de Salud, Madrid, España
| | - Francisco Camarelles-Guillem
- Red de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud, Madrid, España
- Instituto de Investigación Sanitaria Hospital Doce de Octubre (i+12), Madrid, España
- Research Network on Preventive Activities and Health Promotion, Madrid, Spain
- Centro de Salud Infanta Mercedes, Dirección Asistencial Norte, Servicio Madrileño de Salud, Madrid, España
| | - José-Antonio Granados-Garrido
- Instituto de Investigación Sanitaria Hospital Doce de Octubre (i+12), Madrid, España
- Research Network on Preventive Activities and Health Promotion, Madrid, Spain
- Centro de Salud Guayaba, Dirección Asistencial Centro, Servicio Madrileño de Salud, Madrid, España
| | - Margarita Ruiz-Pacheco
- Centro de Salud Algete, Dirección Asistencial Norte, Servicio Madrileño de Salud, Madrid, España
| | - María Isabel Gámez-Cabero
- Instituto de Investigación Sanitaria Hospital Doce de Octubre (i+12), Madrid, España
- Centro de Salud Majadahonda Valle de la Oliva, Dirección Asistencial Noroeste, Servicio Madrileño de Salud, Madrid, España
| | - Francisco Javier Martínez-Suberviola
- Red de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud, Madrid, España
- Instituto de Investigación Sanitaria Hospital Doce de Octubre (i+12), Madrid, España
- Centro de Salud Guayaba, Dirección Asistencial Centro, Servicio Madrileño de Salud, Madrid, España
| | - Encarnación Serrano-Serrano
- Red de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud, Madrid, España
- Instituto de Investigación Sanitaria Hospital Doce de Octubre (i+12), Madrid, España
- Research Network on Preventive Activities and Health Promotion, Madrid, Spain
- Centro de Salud Los Fresnos, Dirección Asistencial Este, Servicio Madrileño de Salud, Madrid, España
| | - Isabel Del Cura-González
- Red de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud, Madrid, España
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España
- Unidad de Investigación, Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Madrid, España
- Red de Investigación Servicios de Salud en enfermedades crónicas, REDISSEC, Madrid, España
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Toyon A, Bursac Z, Werner N, Krukowski RA. Impact of Weight Concern on Post-Cessation Weight Management, Smoking Cessation, and Program Engagement. Am J Health Promot 2024:8901171241234136. [PMID: 38356272 DOI: 10.1177/08901171241234136] [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: 02/16/2024]
Abstract
PURPOSE Weight concern is a barrier to smoking cessation. We examined the impact of weight concern on post-cessation weight gain, abstinence and program engagement. DESIGN Randomized-controlled trial. SETTING Telephone-based and group-based intervention sessions. SUBJECTS 305 participants were randomized and analyzed. INTERVENTION Participants were randomized to receive a self-guided intervention, a weight loss intervention, or a weight stability intervention prior to all receiving the same smoking cessation intervention. MEASURES Level of weight concern on three measures, point-prevalence abstinence, weight change, and session attendance at 12 months. ANALYSIS Continuous and discrete outcomes were compared between weight-concerned and non-weight-concerned participants using two-sample t-tests and chi-square tests respectively. RESULTS There were no significant differences in weight change (range: +1.77, -1.91 kg) when comparing weight-concerned and non-weight-concerned participants. Point-prevalence abstinence ranged from 36% to 64%, with no differences by condition based on level of weight concern. There were no significant differences in session attendance by weight concern (Weight sessions: 50-70%, Smoking cessation sessions: 41-56%, Booster sessions: 28-45%). Weight concern, on all measures, significantly decreased between screening and 2 months (after the weight management intervention), for most of the comparisons made overall and by condition. CONCLUSION It may not be necessary to screen for weight concerns in smoking cessation and/or post-cessation weight management programs, as the trial interventions were beneficial regardless of weight concern.
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Affiliation(s)
- Anjola Toyon
- School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Zoran Bursac
- Department of Biostatistics, Florida International University, Miami, FL, USA
| | - Nicole Werner
- Department of Health & Wellness Design, Indiana University, Bloomington, IN, USA
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De Santi O, Orellana M, Di Niro CA, Greco V. Response to Siddiqi et al. Addiction 2024. [PMID: 38351609 DOI: 10.1111/add.16451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 01/22/2024] [Indexed: 03/06/2024]
Affiliation(s)
- Omar De Santi
- Toxicology, Hospital Nacional Prof. Alejandro Posadas, Centro Nacional de Intoxicaciones (CNI), Buenos Aires, Argentina
| | - Marcelo Orellana
- Toxicology, Hospital Nacional Prof. Alejandro Posadas, Centro Nacional de Intoxicaciones (CNI), Buenos Aires, Argentina
| | - Cecilia Andrea Di Niro
- Cardiology, Hospital Municipal Central de San Isidro, Dr Melchor Posse, Buenos Aires, Argentina
| | - Vanina Greco
- Toxicology, Hospital Nacional Prof. Alejandro Posadas, Centro Nacional de Intoxicaciones (CNI), Buenos Aires, Argentina
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Watts C, Burton S, Lizama N, Chapman L, Garlin F, Daley M, Egger S. Tobacco sales through vending machines: Insights from owners and managers of Australian alcohol-licenced premises with different licencing schemes. Aust N Z J Public Health 2024:100126. [PMID: 38453540 DOI: 10.1016/j.anzjph.2024.100126] [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] [Received: 09/21/2023] [Revised: 12/18/2023] [Accepted: 12/22/2023] [Indexed: 03/09/2024] Open
Abstract
OBJECTIVE Tobacco sales in alcohol-licenced premises present a very problematic trigger for tobacco sales-a trigger that is particularly problematic for attempting quitters and people who smoke occasionally. This study reports on the attitudes, beliefs, and experiences of owners or managers of alcohol-licenced venues that sell tobacco exclusively through vending machines. METHODS The study involved a telephone survey of alcohol-licenced venue owners or managers in New South Wales, Queensland, and Western Australia. Associations between outlet characteristics and current selling of tobacco exclusively via vending machines were examined, and responses to the open-ended question asking why the venue was likely or unlikely to stop selling cigarettes were manually coded. RESULTS For most alcohol-licenced venues that sold tobacco exclusively through a vending machine, the profit from these sales was not considered important for the business. However, only a small minority (4%) of these venues reported that they were likely to stop selling tobacco. The most commonly cited concerns about stopping were customer dissatisfaction and potential loss of customers. CONCLUSION The study provides the first evidence on the attitudes of owners/managers to the importance of tobacco sales, revealing that the vast majority of those owners/managers do not believe that tobacco sales are important for their venue. IMPLICATIONS FOR PUBLIC HEALTH The presence of tobacco vending machines implicitly promotes tobacco products and therefore contravenes Australia's obligations under the World Health Organization Framework Convention on Tobacco Control. The results provide powerful evidence that restrictions on tobacco sales can be implemented without major financial damage to those vendors.
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Affiliation(s)
- Christina Watts
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Woolloomooloo, NSW Australia.
| | - Suzan Burton
- School of Business, Western Sydney University, Parramatta, NSW Australia
| | | | | | - Francine Garlin
- School of Business, Western Sydney University, Parramatta, NSW Australia
| | | | - Sam Egger
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Woolloomooloo, NSW Australia
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Park J, Lim MK, Kim Y, Paek YJ, Cho SI. National Smoking Cessation Services (NSCS) enrollment and their effect on long-term tobacco cessation in Korea: Results from a 1-year prospective follow-up of NSCS participants. Tob Induc Dis 2024; 22:TID-22-33. [PMID: 38333885 PMCID: PMC10851190 DOI: 10.18332/tid/178499] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 01/08/2024] [Accepted: 01/11/2024] [Indexed: 02/10/2024] Open
Abstract
INTRODUCTION The study aimed to identify predictors associated with long-term tobacco cessation at 12-month follow-up among users of the National Smoking Cessation Services (NSCS) in Korea. METHODS To measure the long-term effect of NSCS delivery, the target sample size of 5167 adult smokers registered in the NSCS in 2018 was enrolled with proportional random sampling. A multiple logistic regression analysis (crude, adjusted) was performed to identify the changes in smoking status at the 12-month follow-up after the last NSCS enrollment and the potential factors associated with changes in smoking status. RESULTS The response rate to reach the number of subjects targeted was 22.4%. A total of 41.2% of the tobacco users enrolled had successfully quit at baseline, and the 7-day point prevalence of tobacco cessation at the follow-up at 12 months, via a telephone survey, was 34.4%. Factors positively associated with cessation at the 12-month follow-up were longer experience with tobacco abstinence and additional quitting attempts with or without NSCS enrollment, although every additional quit attempt with NSCS use had a better outcome. In addition, having a successful quit outcome with NSCS use at the baseline and having more satisfaction with the service of professional counseling or incentives than others provided by NSCS, increased cessation at follow-up after adjustment of other factors considered. CONCLUSIONS In addition to multiple quitting attempts, longer experience with tobacco abstinence, and additional enrollment in NSCS, the service experience, and satisfaction with the content that NSCS offered, might improve the lasting success of abstinence. These results might be considered to improve the contents and protocols of the NSCS for better outcomes.
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Affiliation(s)
- Jinju Park
- Central Division of Cardio-cerebrovascular Disease Management, Seoul National University Hospital, Seoul, Republic of Korea
| | - Min Kyung Lim
- Department of Social and Preventive Medicine, Inha University College of Medicine, Incheon, Republic of Korea
| | - Yunhee Kim
- Department of Nursing, Pukyong National University, Busan, Republic of Korea
| | - Yu-Jin Paek
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Sung-il Cho
- Department of Public Health Sciences, Seoul National University Graduate School of Public Health, Seoul, Republic of Korea
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Gu D, Rafferty H, Vijayaraghavan M. Factors Associated with Smoking Cessation and the Receipt of Cessation Services in a Public, Safety-Net Primary Care System. J Gen Intern Med 2024:10.1007/s11606-024-08664-3. [PMID: 38332442 DOI: 10.1007/s11606-024-08664-3] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/25/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Prevalence of smoking is high among patients receiving care in safety-net settings, and there is a need to better understand patient factors associated with smoking cessation and receipt of cessation services. OBJECTIVE To identify patient factors associated with smoking cessation attempts and receipt of cessation counseling and pharmacotherapy in a large safety-net health system. DESIGN We conducted a retrospective cohort analysis using EHR data in a safety-net system in San Francisco, CA. PARTICIPANTS We included 7384 adult current smokers who had at least three unique primary care encounters with documented smoking status between August 2019 and April 2022. MAIN MEASURES We assessed four outcomes using multivariate generalized estimating equation models: (1) any cessation attempt, indicating a transition in smoking status from "current smoker" to "former smoker"; (2) sustained cessation, defined as transition in smoking status from current smoker to former smokers for two or more consecutive visits; (3) receipt of smoking cessation counseling from healthcare providers; and (4) receipt of pharmacotherapy. KEY RESULTS Of 7384 current adult smokers, 17.6% had made any cessation attempt, and of those 66.5% had sustained cessation. Most patients (81.1%) received counseling and 41.8% received pharmacotherapy. Factors associated with lower odds of any cessation attempt included being aged 45-64, non-Hispanic black, and experiencing homelessness. The factor associated with lower odds of sustained cessation was being male. Factors associated with lower odds of receiving counseling were being insured by Medicaid or being uninsured. Factors associated with lower odds of receiving pharmacotherapy included speaking languages other than English, being male, and identifying as racial and ethnic minorities. CONCLUSIONS Health system interventions could close the gap in access to smoking cessation services for unhoused and racial/ethnic minority patients in safety-net settings, thereby increasing cessation among these populations.
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Affiliation(s)
- Dian Gu
- Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA, USA.
- Division of General Internal Medicine, San Francisco General Hospital, University of California, San Francisco, San Francisco, CA, USA.
| | - Henry Rafferty
- San Francisco Department of Public Health, San Francisco, CA, USA
| | - Maya Vijayaraghavan
- Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA, USA
- San Francisco Department of Public Health, San Francisco, CA, USA
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Cruvinel E, Mussulman L, Scheuermann T, Shergina E, He J, Sherman S, Harrington K, Rigotti NA, Tindle H, Zhu SH, Richter K. Hospital-Initiated Smoking Cessation Among Patients Admitted with Behavioral Health Conditions. J Gen Intern Med 2024:10.1007/s11606-024-08646-5. [PMID: 38326585 DOI: 10.1007/s11606-024-08646-5] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 01/22/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND Smoking rates among people living with behavioral health conditions (BHC) range from 30 to 65% and are 2-4 times higher than rates found in the general population. Starting tobacco treatment during a hospital stay is effective for smoking cessation, but little is known regarding treatment response among inpatients with BHC. OBJECTIVE This study pooled data across multiple clinical trials to determine the relative success in quitting among participants with BHC compared to other study participants. PARTICIPANTS Adults who smoke (≥ 18 years old) from five hospital-based smoking cessation randomized clinical trials. DESIGN A retrospective analysis using data from the electronic health record to identify participants with primary diagnoses related to BHC. Recruitment and data analysis were conducted from 2011 to 2016. We used propensity score matching to pair patients with BHC to those with similar characteristics and logistic regression to determine differences between groups. MEASURES The main outcome was self-reported 30-day abstinence 6 months post-discharge. RESULTS Of 6612 participants, 798 patients had a BHC-related primary diagnosis. The matched sample included 642 pairs. Nearly 1 in 3 reported using tobacco medications after hospitalization, with no significant difference between patients with and without BHC (29.3% vs. 31.5%; OR (95% CI) = 0.90 (0.71, 1.14), p = 0.40). Nearly 1 in 5 patients with BHC reported abstinence at 6 months; however, their odds of abstinence were 30% lower than among people without BHC (OR (95% CI) = 0.70 (0.53,0.92), p = 0.01). CONCLUSION When offered tobacco treatment, hospitalized patients with BHC were as likely as people without BHC to accept and engage in treatment. However, patients with BHC were less likely to report abstinence compared to those without BHC. Hospitals are a feasible and promising venue for tobacco treatment among inpatients with BHC. More studies are needed to identify treatment approaches that help people with BHC achieve long-term abstinence.
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Affiliation(s)
- Erica Cruvinel
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Laura Mussulman
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - Taneisha Scheuermann
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - Elena Shergina
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS, USA
| | - Jianghua He
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS, USA
| | - Scott Sherman
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Kathleen Harrington
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nancy A Rigotti
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Hilary Tindle
- Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Shu-Hong Zhu
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
| | - Kimber Richter
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA
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Siddiqi K, Dogar O, Gabe R, Sheikh A. The systematic review and meta-analysis of cytisine. Addiction 2024. [PMID: 38321591 DOI: 10.1111/add.16441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 02/08/2024]
Affiliation(s)
- Kamran Siddiqi
- Department of Health Sciences, University of York, York, UK
| | - Omara Dogar
- Department of Health Sciences, University of York, York, UK
| | - Rhian Gabe
- Wolfson Institute of Population Health, Queen Mary University London, London, UK
| | - Aziz Sheikh
- Usher Institute, The University of Edinburgh, Old Medical School, Edinburgh, UK
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Costantino C, Bonaccorso N, Minutolo G, Sciortino M, Ripoli G, Berardi M, Gallo M, Nastasi S, Serra S, Trapani E, Busalacchi E, Ficano P, Siciliano S, Immordino P, Mazzucco W, Restivo V, Vitale F, Casuccio A. Prevalence of smoking habits, attitudes and knowledge on counteractive strategies among a sample of healthcare employees: results of the smoking-free health environments project in the province of Palermo, Italy. Front Public Health 2024; 12:1335937. [PMID: 38375336 PMCID: PMC10875051 DOI: 10.3389/fpubh.2024.1335937] [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: 11/09/2023] [Accepted: 01/17/2024] [Indexed: 02/21/2024] Open
Abstract
Introduction Tobacco use is responsible for over 7 million deaths annually, making smoking the leading cause of preventable mortality globally. Over the last two decades in Italy, the prevalence of smoking among physicians has consistently decreased, while it remains higher and is gradually decreasing among non-physician healthcare workers. The aim of this study was to investigate the Prevalence of smoking habits, attitudes, and knowledge on counteractive strategies among employees in the Primary Healthcare Facilities in the Province of Palermo, Italy. Methods A cross-sectional survey was conducted between June 2020 and December 2020 through a previously validated anonymous questionnaire structured in four sections including 34 items. Data were analyzed using Stata/MP 12.1 statistical software. Results Overall, 2,645 participants answered the questionnaire. The prevalence of either current or former smokers was 18.6%. Based on the multivariable analysis conducted, a significantly higher frequency of current smokers was observed among male participants (AdjOR: 1.29; CI95%: 1.02-1.64) and those belonging to the Surgical Unit (AdjOR: 1.92; CI95%: 1.27-2.90). Conversely, the prevalence of current smokers was significantly lower among those with at least one child (AdjOR: 0.67; CI95%: 0.49-0.91), with an educational qualification equal to or greater than a graduation degree (AdjOR: 0.56; CI95%: 0.43-0.73), those who considered second-hand smoke harmful (AdjOR: 0.06; CI95%: 0.008-0.60), those who had observed smoking or detected the smell of smoke in their workplace (AdjOR: 0.64; CI95%: 0.45-0.91). Furthermore, the prevalence of current smokers was significantly lower among participants who believed that healthcare professionals could play a crucial role in influencing their patients' lifestyles (AdjOR: 0.67; CI95%: 0.50-0.90) and among those who recommend their patients to quit smoking (AdjOR: 0.35; CI95%: 0.24-0.51). Discussion The results of the current research demonstrate that, despite the decline in smoking prevalence among physicians, the rate of smokers among healthcare facility employees remains unacceptably high. This underscores the need to re-evaluate current anti-tobacco strategies in the workplace.
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Affiliation(s)
- Claudio Costantino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Palermo, Italy
- Palermo Local Health Authority, Palermo, Italy
- Dedalus Unit - Palermo Local Health Authority, Palermo, Italy
- University Hospital - UH - “P. Giaccone” of Palermo, Palermo, Italy
| | - Nicole Bonaccorso
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Palermo, Italy
| | - Giuseppa Minutolo
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Palermo, Italy
| | - Martina Sciortino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Palermo, Italy
| | | | | | | | | | | | | | | | | | | | - Palmira Immordino
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Palermo, Italy
| | - Walter Mazzucco
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Palermo, Italy
- Palermo Local Health Authority, Palermo, Italy
- Dedalus Unit - Palermo Local Health Authority, Palermo, Italy
- University Hospital - UH - “P. Giaccone” of Palermo, Palermo, Italy
| | | | - Francesco Vitale
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Palermo, Italy
- Palermo Local Health Authority, Palermo, Italy
- Dedalus Unit - Palermo Local Health Authority, Palermo, Italy
- University Hospital - UH - “P. Giaccone” of Palermo, Palermo, Italy
| | - Alessandra Casuccio
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University of Palermo, Palermo, Italy
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Santiago-Torres M, Mull KE, Sullivan BM, Matthews AK, Skinta MD, Thrul J, Vogel EA, Bricker JB. Do Smartphone Apps Impact Long-Term Smoking Cessation for Sexual and Gender Minority Adults? Exploratory Results from a 2-Arm Randomized Trial Comparing Acceptance and Commitment Therapy with Standard US Clinical Practice Guidelines. J Homosex 2024:1-22. [PMID: 38305816 DOI: 10.1080/00918369.2024.2309491] [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] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Sexual and gender minority (SGM) adults face unique challenges in accessing smoking cessation care due to stigma tied to their identities and smoking. While cessation apps show promise in the general population, their efficacy for SGM adults is unclear. This study utilized data from a randomized trial to compare two cessation apps, iCanQuit (Acceptance and Commitment Therapy-based) and QuitGuide (US Clinical Practice Guidelines-based) among 403 SGM adults. The primary outcome was self-reported complete-case 30-day abstinence from cigarette smoking at 12 months. Mediation analyses explored whether interventions operated through acceptance of cues to smoke and app engagement. At 12 months, quit rates did not differ between arms (26% iCanQuit vs. 22% QuitGuide, OR = 1.22; 95% CI: 0.74 to 2.00, p = .43). iCanQuit positively impacted cessation via acceptance of cues to smoke (indirect effect = 0.23; 95% CI: 0.06 to 0.50, p < .001) and demonstrated higher engagement (no. logins, 28.4 vs. 12.1; p < .001) and satisfaction (91% vs. 75%, OR = 4.18; 95% CI: 2.12 to 8.25, p < .001) than QuitGuide. Although quit rates did not differ between arms, acceptance of cues to smoke seemed to play a crucial role in helping SGM adults quit smoking. Future interventions should consider promoting acceptance of cues to smoke in this population.
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Affiliation(s)
| | - Kristin E Mull
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Brianna M Sullivan
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Alicia K Matthews
- Department of Population Health Nursing, College of Nursing, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Matthew D Skinta
- Department of Psychology, Roosevelt University, Chicago, Illinois, USA
| | - Johannes Thrul
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins, Baltimore, Maryland, USA
- Department of Mental Health, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore, Maryland, USA
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Erin A Vogel
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Jonathan B Bricker
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Department of Psychology, University of Washington, Seattle, Washington, USA
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Harlivasari AD, Susanto AD, Taufik FF, Ginting TT. The Role of Twice-Daily N-acetylcysteine (NAC) 2400 mg in Smoking Cessation: A Randomized, Placebo-Controlled Trial in Indonesia. Cureus 2024; 16:e54322. [PMID: 38500894 PMCID: PMC10944675 DOI: 10.7759/cureus.54322] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2024] [Indexed: 03/20/2024] Open
Abstract
INTRODUCTION Tobacco smoking remains a health concern, especially in developing countries. Nicotine is significantly linked to many cancers and even second-hand exposure. Hence, smoking can increase the risk of lung and heart disease. This makes quitting smoking important and challenging. Success tends to rise by achieving abstinence with assisted pharmacology. These treatments aim to reduce symptoms of nicotine withdrawal. This is a preclinical trial on glutamate modulator in N-acetylcysteine (NAC) as a new potential treatment for smoking cessation. It is based on the administration of NAC related to elevated levels of dopamine in the central nervous system to accomplish successful smoking cessation. AIM This study evaluated the efficacy and tolerability of NAC for smoking cessation. The primary outcome was abstinence rate and the secondary outcomes of the study were to assess carbon monoxide exhalation value (COexh), the withdrawal symptoms, craving score, safety, and tolerability associated with the administration of NAC. METHODS This is a randomized clinical trial. Eligible smokers were treated with NAC 2400 mg twice daily (BID) or placebo to obtain a potential effective abstinence rate. Subjects recruited from the smoking cessation clinic were screened for eligibility and were randomized to either the NAC or placebo group. The trial consisted of a four-week treatment phase and participants were evaluated each week with a brief counseling. Intention to treat data analysis was performed from 2018 to 2019. Smoking cessation status was verified by measuring the amount of carbon monoxide exhaled and by documenting their smoking habits. Adverse events (AEs) have also been observed on each visit. RESULTS A total of 90 male smokers with a mean (SD) age of 38.7 (11) years were randomized into two groups to receive NAC (n=45) and placebo (n=45). The primary outcome revealed that the abstinence rate was significantly higher for the NAC group than the placebo group (37.7% vs 6.6%; p=0.02). These findings were supported by data comparison between the NAC group and placebo group of COexh (ppm) (9.59 ±7.4 vs 13,4 ±6.1; p=0.04) and cigarette consumption/week (10 vs 46; p <0.001), which were statistically significant. Comparison of withdrawal with the Minnesota Nicotine Withdrawal Score between the NAC group and the placebo group showed lower values (8 (1-31) vs 11 (0-43); p=0.178), respectively, even though not statistically significant. Compared to the placebo group, the craving score (6 (2-29) vs 12 (6-31); p=0.04) in the NAC group was significantly lower. The most common adverse event was mild gastrointestinal effects (28.9%) and arthralgia (2.2%). No serious adverse events were detected. CONCLUSIONS Despite a small sample size, the data demonstrate the potential benefits of NAC that may help elevate abstinence rates and promote successful smoking cessation pharmacotherapy. Comprehensive treatment combining pharmacologic therapy and counseling increases smoking cessation success rates. It is essential to conduct a randomized multicenter study with a large population to support a sustained abstinence rate using NAC.
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Affiliation(s)
- Annisa D Harlivasari
- Pulmonology and Respiratory Medicine, Rumah Sakit Umum Pusat Persahabatan, Jakarta, IDN
| | - Agus D Susanto
- Pulmonology and Respiratory Medicine, Rumah Sakit Umum Pusat Persahabatan, Jakarta, IDN
| | - Feni F Taufik
- Pulmonology and Respiratory Medicine, Rumah Sakit Umum Pusat Persahabatan, Jakarta, IDN
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Hooper MW, Lee DJ, Simmons VN, Brandon KO, Antoni MH, Asfar T, Koru-Sengul T, Brandon TH. Cognitive behavioral therapy versus general health education for smoking cessation: A randomized controlled trial among diverse treatment seekers. Psychol Addict Behav 2024; 38:124-133. [PMID: 37141036 PMCID: PMC10624643 DOI: 10.1037/adb0000928] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVE Racial and ethnic disparities in smoking cessation persist. This randomized controlled trial compared the efficacy of group cognitive behavioral therapy (CBT) for cessation among African American/Black, Latino/Hispanic, and White adults. METHOD African American/Black (39%), Latino/Hispanic (29%), and White (32%) adults (N = 347) were randomly assigned to eight group sessions of CBT or general health education (GHE), both including nicotine patch therapy. Biochemically confirmed 7-day point prevalence abstinence (7-day ppa) was measured at the end-of-therapy, and at 3-, 6-, and 12-month follow-ups. Generalized linear mixed models and logistic regressions tested abstinence rates by condition, stratified by race and ethnicity, and interaction effects. RESULTS CBT led to greater abstinence than GHE across 12-months of follow-up (AOR = 1.84, 95% CI [1.59, 2.13]) overall [12-month follow-up: CBT = 54% vs. GHE = 38%] and within racial and ethnic groups [12-months: African American/Black (CBT = 52%, GHE = 29%), Latino/Hispanic (CBT = 57%, GHE = 47%), and White (CBT = 54%, GHE = 41%)]. African American participants were less likely than White participants to quit irrespective of condition, as were persons with lower education and income. Socioeconomic status indicators positively predicted abstinence among racial and ethnic minority participants, but not White participants. CONCLUSIONS Group CBT was efficacious compared with GHE. However, cessation patterns suggested that intensive group interventions were less beneficial over the longer term among lower socioeconomic African American and Latino individuals, compared with White participants. Tobacco interventions should target racial and ethnic and socioeconomic differences, via culturally specific approaches and other means. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Monica Webb Hooper
- Case Western Reserve University School of Medicine, Case Comprehensive Cancer Center, 11000 Euclid Ave, 44106, Cleveland, OH, United States
| | - David J. Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St., Miami, FL 33136
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1475 NW 12th Ave., Miami, FL 33136
| | | | | | - Michael H. Antoni
- Department of Psychology, University of Miami College of Arts and Sciences, PO Box 248185, Coral Gables, FL 33124
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1475 NW 12th Ave., Miami, FL 33136
| | - Taghrid Asfar
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St., Miami, FL 33136
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1475 NW 12th Ave., Miami, FL 33136
| | - Tulay Koru-Sengul
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St., Miami, FL 33136
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1475 NW 12th Ave., Miami, FL 33136
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Bendotti H, Lawler S, Gartner C, Ireland D, Marshall HM. Smoking Cessation Counseling in Practice: A Qualitative Analysis of Quitline Conversations in Queensland, Australia. Health Educ Behav 2024; 51:43-53. [PMID: 37846946 PMCID: PMC10785561 DOI: 10.1177/10901981231206068] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
Telephone-based services are a practical and effective behavioral support for smoking cessation, yet no in-depth analyses of this counseling have been conducted. Understanding the general content of Quitline conversations can help to improve current practices and may inform future interventions. Therefore, we aimed to independently explore conversation themes, topics, and client questions during Quitline counseling sessions with Quitline clients in Queensland, Australia. A purposive sample of 30 recorded counseling sessions, completed between January and March 2019, were de-identified, transcribed, and thematically analyzed. Seven themes, encompassing 35 topics, were derived from 26 initial calls and four follow-up calls: (1) Client details and building rapport; (2) Client history and motivation to quit; (3) Pharmacotherapy; (4) Behavioral aspects of quitting and relationship with smoking; (5) Understanding nicotine dependence and other important considerations; (6) Additional support and smoking cessation resources; and (7) Planning, goal setting and follow-up. Three themes emerged from 18 client questions including (1) Pharmacotherapy safety and contraindications; (2) Pharmacotherapy instructions and mechanism of action; and (3) Physiology of nicotine dependence. This is the first qualitative analysis of the content of Quitline counseling sessions in Australia. Counselors collect and deliver a breadth of information to provide tailored, evidence-based health care, while building rapport and trust. Findings may be translatable into personalized self-help interventions that are more accessible or appealing to people reluctant to contact Quitline. Harnessing educational opportunities regarding pharmacotherapy adherence and misconceptions can improve client confidence in the product and smoking cessation outcomes. Further research will map conversations to motivational interviewing and behavior change techniques.
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Affiliation(s)
- Hollie Bendotti
- Thoracic Research Centre, Faculty of Medicine, The University of Queensland, Chermside, Australia
- The Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Herston, Queensland, Australia
| | - Sheleigh Lawler
- School of Public Health, The University of Queensland, Herston, Australia
| | - Coral Gartner
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Australia
| | - David Ireland
- The Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Herston, Queensland, Australia
| | - Henry M. Marshall
- Thoracic Research Centre, Faculty of Medicine, The University of Queensland, Chermside, Australia
- The Prince Charles Hospital, Metro North Hospital and Health Service, Chermside, Queensland, Australia
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Palmer AM, Carpenter MJ, Baker NL, Froeliger B, Foster MG, Garland EL, Saladin ME, Toll BA. Development of two novel treatments to promote smoking cessation: Savor and retrieval-extinction training pilot clinical trial findings. Exp Clin Psychopharmacol 2024; 32:16-26. [PMID: 36913266 PMCID: PMC10497721 DOI: 10.1037/pha0000644] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
Despite decades of progress, cigarette smoking remains a significant contributor to disease burden. This effect is especially pronounced for specific priority populations, such as individuals who live in rural communities, in that the burden of tobacco smoking is greater among these groups than in urban areas and the general population. The present study aims to evaluate the feasibility and acceptability of two novel tobacco treatment interventions delivered through remote telehealth procedures to individuals who smoke in the state of South Carolina. Results also include exploratory analyses of smoking cessation outcomes. Study I evaluated savoring, a strategy based on mindfulness practices, alongside nicotine replacement therapy (NRT). Study II evaluated retrieval-extinction training (RET), a memory-modification paradigm alongside NRT. In Study I (savoring), recruitment and retention data showed high interest and engagement in the intervention components, and participants who received this intervention decreased cigarette smoking throughout the course of the treatment (ps < .05). In Study II (RET), results showed high interest and moderate engagement in treatment, although exploratory outcome analyses did not demonstrate significant treatment effects on smoking behaviors. Overall, both studies showed promise in generating interest among individuals who smoke in participating in remotely delivered, telehealth smoking cessation interventions with novel therapeutic targets. A brief savoring intervention appeared to have effects on cigarette smoking throughout treatment, whereas RET did not. Gaining insight from the present pilot study, future studies may improve the efficacy of these procedures and incorporate the treatment components into more robust available treatments. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Amanda M. Palmer
- Department of Public Health Sciences, Medical University of South Carolina
| | - Matthew J. Carpenter
- Department of Public Health Sciences, Medical University of South Carolina
- Department of Psychiatry, Medical University of South Carolina
- Cancer Control and Prevention, Hollings Cancer Center, Medical University of South Carolina
| | - Nathaniel L. Baker
- Department of Public Health Sciences, Medical University of South Carolina
| | - Brett Froeliger
- Department of Psychiatry, University of Missouri School of Medicine
- Department of Psychological Sciences, University of Missouri School of Medicine
| | - Madeline G. Foster
- Cancer Control and Prevention, Hollings Cancer Center, Medical University of South Carolina
| | - Eric L. Garland
- Center on Mindfulness and Integrative Health Intervention Development, College of Social Work, University of Utah
- Supportive Oncology and Survivorship, Huntsman Cancer Institute, University of Utah Health
| | - Michael E. Saladin
- Department of Psychiatry, Medical University of South Carolina
- Department of Health Sciences and Research, Medical University of South Carolina
| | - Benjamin A. Toll
- Department of Public Health Sciences, Medical University of South Carolina
- Department of Psychiatry, Medical University of South Carolina
- Cancer Control and Prevention, Hollings Cancer Center, Medical University of South Carolina
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