Development and preliminary evaluation of a structured and personalized self-help smoking cessation program: A prospective observational study

Participants and nonparticipants of a mass media self-help smoking cessation program

Predicting smoking cessation with self-reported measures of nicotine dependence: FTQ, FTND, and HSI

Everyday discrimination indirectly influences smoking cessation through post-quit self-efficacy

The purpose of this article is to present a review of the literature on employee self-help smoking cessation programs. Included in this discussion are: (1) a rationale for self-help smoking cessation interventions; (2) a synopsis of their applicability to occupational settings; (3) a rational and description of the self-help smoking cessation interventions selected for a large group of employees; and (4) several methodological issues faced in conducting evaluations of smoking cessation programs.

Many Australian hospitals have recently introduced smoke-free policies. The aim of this study was to determine the smoking habits of hospital inpatients and to investigate the scope for an inpatient smoking cessation programme. A cross-sectional survey of adult inpatients of a tertiary-referral hospital who were smoking just before admission. The questionnaire contained items on general demographics, views on quitting, past quit attempts and validated scales - Fagerström test of nicotine dependence, Biener's contemplation ladder and Velicer's smoking decisional balance. Participants' (n= 125) median age was 53 years and had smoked for 35.0 ± 17.2 years. The majority were male (n= 84; 67.2%) and 45 (36.3%) lived with someone who smoked. Participants self-reported 4.5 ± 7.3 past attempts to quit. Only 61 (49.6%) said that their health professionals ever discussed options to assist quitting. Forty-nine (39.2%) reported accessing smoking areas during their hospital stay. Participants scored 4.5 ± 2.5 on the Fagerström test. Forty-two (33.8%) ranked themselves very high (9 or 10) on the contemplation ladder. The mean difference between the Velicer's subscales -'cons' (α= 0.81) and 'pros' (α= 0.80) was 3.2 ± 10.6 in favour of quitting. Fifty-four (43.9%) participants were interested in starting smoking cessation therapy during their hospital stay. Nicotine patches (31; 25.4%) were the preferred dosage forms to assist quitting followed by oral tablets (23; 18.9%) and chewing gum (20; 16.4%). Our findings could guide the design of inpatient smoking cessation interventions. Greater efforts from health professionals are essential for informing people about smoking cessation options, promoting their uptake, potentially resulting in higher quit rates.

Objective: Between September 2002 and February 2003, the authors assessed the effectiveness of a new, agetailored, self-help smoking-cessation program for college students. Participants: College student smokers (N = 216) from 6 Ontario universities participated. Methods: The researchers used a randomized controlled trial with a 3-month telephone follow-up. Interventions included a new program (Smoke|Quit), the Canadian Cancer Society's self-help program, and a usual care quit kit. Results: Intention-to-treat analysis of 7-day point prevalence cessation revealed quit rates of 11.4% for Smoke|Quit, 2.9% for the Cancer Society's program, and 5.6% for the usual care intervention (p < .05). Among nonquitters, 46.5% had made a quit attempt, and weekly consumption decreased from 54.01 to 42.08 cigarettes (p < .001) with no differences across interventions. Conclusions: Making tailored, self-help programs widely available on campus may be an effective way to provide smoking-cessation support to a large segment of the young adult population.

In order to replicate the rewarding effects of smoking, nicotine replacement therapies must deliver nicotine via the pulmonary route. We aimed to measure the efficacy of a simple pressurized metered dose inhaler containing nicotine combined with a nicotine patch for smoking cessation. Double-blind randomized placebo-controlled, parallel group trial conducted at the University of Otago, Wellington, New Zealand. Five-hundred two adults (≥18 years) who smoked at least nine cigarettes per day, with a Fagerström Test for Nicotine Dependence ≥3 who wanted to quit, were randomized (1:1). active nicotine pressurized metered dose inhaler (pMDI) plus active nicotine patch, versus placebo pMDI plus active nicotine patch. Subjects were instructed to use the aerosols for 6 months when they felt an urge to smoke and the patches daily for 5 months, reduce their smoking and quit by the end of the fourth week. Subjects were followed for 7 months. The primary outcome was prolonged 6 month not smoked on 7 consecutive days, analyzed by intention-to-treat. For the primary outcome, 78/246 (31.71%) in the active group versus 46/256 (17.97%) in the control group were abstinent (odds ratio 2.12, 95% confidence interval 1.40 to 3.23). Adverse events were reported by 245/246 (99.6%) and 247/256 (96.5%) subjects in the active and control groups, respectively. Mild coughing which decreased with regular use was common with the nicotine aerosols. Inhaled nicotine from a metered dose inhaler combined with a nicotine patch substantially improves abstinence for 6 months amongst adult nicotine dependant smokers wanting to quit. In 2012, we published a systematic review of the use nicotine by inhalation in this journal. At that time we were unable to find any studies that had measured the effects of nicotine delivery by pMDI on smoking cessation, and we are not aware of any since 2012. Our study is the first to look at nicotine by pMDI in smoking cessation. The present trial demonstrates that a simple nonproprietary nicotine inhaler, using relatively inexpensive standard technology, increases smoking cessation rates over and above nicotine patch therapy, and could usefully enhance nicotine replacement in smoking cessation treatment.

BackgroundSocioeconomic disadvantage is associated with a reduced likelihood of smoking cessation. Smartphone ownership is increasing rapidly, including among low-income adults, and smartphone interventions for smoking cessation may increase access to smoking cessation treatment among socioeconomically disadvantaged adults.ObjectiveThis study aimed to evaluate the feasibility of an automated smartphone-based approach to delivering financial incentives for smoking cessation.MethodsSocioeconomically disadvantaged adults initiating tobacco cessation treatment were followed from 1 week before a scheduled quit attempt through 26 weeks after the quit date. Participants received telephone counseling and nicotine replacement therapy. Smoking cessation was verified 5 times per week via smartphone prompts to self-report smoking status and submit a breath sample via a portable carbon monoxide (CO) monitor that was connected with participants’ smartphones. Identity was verified during smoking status assessments using smartphone-based facial recognition software. When smoking abstinence and identity were verified, an automated credit card payment was triggered. Participants were incentivized for abstinence on the quit date and up to five days per week during the first 4 weeks after the scheduled quit date, with additional incentives offered during postquit weeks 8 and 12. In total, participants had the opportunity to earn up to US $250 in abstinence-contingent incentives over the first 12 weeks of the quit attempt.ResultsParticipants (N=16) were predominantly female (12/16, 75%) and non-Hispanic white (11/16, 69%), black (4/16, 25%), or Hispanic of any race (1/16, 6%). Most participants (9/16, 56%) reported an annual household income of <US $11,000. During the first 4 weeks after the scheduled quit date, participants completed a median of 16 (out of 21; range 1-21) mobile smoking status assessments, and they earned a median of US $28 in abstinence-contingent incentives (out of a possible US $150; range US $0-US $135). Median earnings did not change during the 8- and 12-week incentivized follow-up periods (total median earnings over 12 weeks=US $28; range US $0-US $167). During the first 4 weeks after the scheduled quit date, participants abstained from smoking on a median of 5 (out of 21) assessment days (range 0-20). At the in-person follow-up visits, the expired CO-confirmed 7-day point prevalence abstinence rates were 19% (3/16) and 13% (2/16) at 12 and 26 weeks postquit, respectively. Overall, most participants reported that the system was easy to use and that they would recommend this treatment to their friends and family.ConclusionsPreliminary data suggest that this smartphone-based approach to verifying identity and smoking status and automating the delivery of abstinence-contingent incentives to a credit card is feasible for use among socioeconomically disadvantaged adults. However, continued refinement is warranted.

Financial strain indirectly influences smoking cessation through withdrawal symptom severity

BackgroundSmoking cessation reduces lung cancer mortality. However, little is known about whether diagnosis of lung cancer impacts changes in smoking behaviors. Furthermore, the effects of smoking cessation on the risk of second primary lung cancer (SPLC) have not been established yet. This study aims to examine smoking behavior changes after initial primary lung cancer (IPLC) diagnosis and estimate the effect of smoking cessation on SPLC risk following IPLC diagnosis.MethodsThe study cohort consisted of 986 participants in the Multiethnic Cohort Study who were free of lung cancer and active smokers at baseline (1993-1996), provided 10-year follow-up smoking data (2003-2008), and were diagnosed with IPLC in 1993-2017. The primary outcome was a change in smoking status from “current” at baseline to “former” at 10-year follow-up (ie, smoking cessation), analyzed using logistic regression. The second outcome was SPLC incidence after smoking cessation, estimated using cause-specific Cox regression. All statistical tests were 2-sided.ResultsAmong 986 current smokers at baseline, 51.1% reported smoking cessation at 10-year follow-up. The smoking cessation rate was statistically significantly higher (80.6%) for those diagnosed with IPLC between baseline and 10-year follow-up vs those without IPLC diagnosis (45.4%) during the 10-year period (adjusted odds ratio = 5.12, 95% confidence interval [CI] = 3.38 to 7.98; P < .001). Incidence of SPLC was statistically significantly lower among the 504 participants who reported smoking cessation at follow-up compared with those without smoking cessation (adjusted hazard ratio = 0.31, 95% CI = 0.14 to 0.67; P = .003).ConclusionLung cancer diagnosis has a statistically significant impact on smoking cessation. Quitting smoking after IPLC diagnosis may reduce the risk of developing a subsequent malignancy in the lungs.

Smoking cessation for people with severe mental illness (SCIMITAR+): a pragmatic randomised controlled trial

Effects of smoking intensity and cessation on inflammatory markers in a large cohort of active smokers

Predictors of Smoking Reduction and Cessation in a Cohort of Danish Moderate and Heavy Smokers

Reaching nonvolunteer female smokers with effective smoking cessation programs is a critical public health challenge. Smokers (N = 2,786) among 15,004 female members of a health maintenance organization who completed a routine needs assessment were invited into the "UCLA Preventive Health Behavior Study," consisting of five telephone interviews over 2 years assessing health practices. Participants (N = 1,396) were randomized into experimental or control conditions of an unsolicited, mailed, self-help smoking cessation program. Subjects were not alerted to the link between the program and the health study. Smoking status was assessed at 1, 6, 12, and 18 months. Across all subjects, point prevalence at 18 months was 18.62, and continuous abstinence was 2.71%. No difference was found between treatment and control groups regarding smoking status or readiness to stop smoking--raising questions about the value of mailing cessation materials to nonvolunteers. Quit rates increased over the 18-month follow-up; those still smoking at 18 months reported increased readiness to quit. Predictors at each follow-up point were examined multivariately.

INTEGRATING TOBACCO HEALTH INTO MAINSTREAM PULMONARY CLINIC: A NOVEL APPROACH