Do predictors of abstinence change in the medium- and long-term follow-up of smokers who have quit smoking? A prospective cohort study

Smoking cessation is difficult to obtain, even among pregnant women who should be highly motivated to quit. Identification of predictors of unsuccessful smoking cessation may be of help in identifying pregnant smokers who need special attention in order to reduce or eliminate the intrauterine tobacco smoke exposure. The study was done in two consecutive samples of pregnant women in Odense and Aalborg, Denmark. Altogether 13,815 pregnant women participated in the study by reporting detailed information on their lifestyle during pregnancy and before pregnancy. Recruitment of pregnant women started in 1984 and ended in 1987. The study is based upon self-administered questionnaires filled out in the 36th week of gestation. Only those who were smokers prior to the pregnancy are included in the study (5,724). The study showed that the strongest predictors of unsuccessful smoking cessation were: the level of smoking prior to pregnancy, coffee consumption, and the partners smoking habits. Parity, school education, and social status also played a role but were less strongly associated with continuous smoking in pregnancy.

The aim of this paper is to assess the extent to which the smoking status of a pregnant woman's partner is a predictor or correlate of smoking cessation or relapse. A systematic review of the literature (including surveys with and without follow-ups, trials and evaluations) identified 62 papers on smoking and pregnancy, which included 25 studies, in which the smoking status of the' woman's partner (or 'other in household') was reported. Fifteen considered the relationship between partner's smoking status and Cessation or relapse. Despite methodological limitations, including the infrequency with which some important variables feature in the study designs, there is evidence that women whose partners smoke are: less likely to quit spontaneously; less likely to quit after taking part in a smoking cessation intervention; and more likely to relapse to smoking after the birth. The possibility that interventions in pregnancy may be more effective if offered to pregnant women and their partners should be explored.

276 Background: Abiraterone acetate + prednisone (AA) and cabazitaxel (CB) have shown an improvement in overall survival after Docetaxel (DOC) in (mCRPC)1,2. There is little evidence about the optimal sequencing treatment in prospective trials. In this final analysis we now compare the efficacy of AA and CB as second line (2L) treatment in mCRPC patients (pts) in routine clinical practice (RCP) in Spain. Methods: The CAPRO study is a prospective multicenter national observational descriptive study. The primary endpoint was to describe the management in 2L mCRPC pts after DOC in RCP. bPFS (biochemical progression free survival) and PFS (clinical or radiological progression free survival) were assessed by the Kaplan-Meier method. Results: 150 patients were recruited (Jul 2013-Jan 2015). At median follow-up of 7.8 mo (IQR 4.2-12.8) 67% (n = 100) of the pts received AA, 29% (n = 44) CB, and 4% (n = 6) other treatments as 2L. PSA response > 50% was 47.3% and 32.3% for AA group and CB group respectively (p = 0.146). Median bPFS was similar between the AA and the CB group (9.19 mo [95% CI 6.84-11.55] vs 9.92 mo [95% CI 6.08-13.76]; hazard ratio 0.779 [95% CI 0·49–1.24]; p = 0·29), whereas median PFS was significantly longer in the AA group than in the CB group (8.74 mo [95% CI 6.54-10.94] vs 6.41 mo [95% CI 4.99-7.82]; hazard ratio 0·56 [95% CI 0·38–0·85]; p = 0·005). A difference was observed in bPFS and PFS depending on the time of progression to first line (during treatment, < 3 or more than 3 mo) for both AA and CB. The most common toxicities of special interest (all grades/grade 3–4 as % of pts) were fatigue (31/1% in the AA group vs 54/4% in the CB group), oedema (15/0% AA group vs 13/4% CB group), hypertension 7/1% AA group, diarrhea (8/0% AA group vs 31/4% CB group), vomits (9/2% AA group vs 11/0 CB group) and neutropenia 7/4% CB group. Conclusions: In this final analysis AA was the 2L treatment of choice in routine clinical practice in Spain during the period of time in which the study was conducted. PSA response and bPFS were similar between AA and CB, whereas PFS was significantly longer in the AA group. There were no new safety signals observed.

MMPI data collected from a sample of college men and women during 1964-1967 were used to predict smoking initiation and cessation over a 20-year follow-up period. People who subsequently began smoking were more rebellious, impulsive, sensation seeking, and hostile; were less likely to present a positive self-image; and were socially extraverted while in college. People who continued to smoke 20 years later were more hostile and sensation seeking. The personality variables that predicted smoking initiation and cessation were the same for men and women. Discussion centers on the potential role of hostility as a predictor of smoking cessation.

Consensus statement on the use of alemtuzumab in daily clinical practice in Spain

Sex differences in predictors of smoking cessation were investigated among 337 male and 490 female participants in the RAND adolescent panel study. Participants reported smoking at least 11-20 times during the past year at Grade 10, with cessation defined as not smoking during the past year at Grade 12. Controlling for demographics, sex-specific analyses indicated that girls who quit smoking within 2 years had friends who smoked less frequently, perceived less parental approval of their smoking, had weaker intentions to continue smoking, used marijuana less frequently, attended fewer different schools, were more likely to have an intact nuclear family, experienced greater peer support, and rated themselves as healthier. Similar analyses for boys yielded results that were generally weaker and nonsignificant, with smoking quantity accounting for several associations in the sex-specific models. Despite these differences, interaction tests revealed significant sex differences for only three predictors. Implications of these results for understanding adolescent smoking cessation are discussed.

Introduction and Objective: Smoking is a key cardiovascular risk factor. The potential contributory effect of smoking cessation to survival and quality of life of cardiovascular patients in daily clinical practice in Spain is not known. The objective of the study is to assess the Cardiovascular risk for a smoker who attends to a Spanish primary care setting based on the Score model and loss in life expectancy attributable to tobacco smoking. Methods: Non-interventional study performed in a Spanish primary care setting at a national level. Patients: 2124 patients, aged 35 to 80 years, 1597 smokers and 527 non-smokers, were included in 52 Spanish primary units. Patients were asked about their smoking habits, comorbidities, Cardiovascular risk factors and medications. Results: Mean age was 53.1 years; Body Mass Index27.2 and 60.6% were men. The mean number of cigarettes/day was 20.3 and the average smoking duration was 28.6 years. All smokers had a high nicotine dependence and 77.1% lived in an urban environment. Comparing smokers with non-smokers all comorbidities and risk factors were significantly more prevalent in smokersThe prevalence of previous myocardial infarction or peripheral vascular disease was 3.13 times higher and 1.51 times higher respectively in smokers patients than in non-smokers. Conclusion: Cigarette smoking is a major cardiovascular risk factor and is associated with a negative lipid profile, higher blood pressure and worse glucose metabolism. Smoking cessation is beneficial at any stage as it improves prognosis and quality of life, even after disease onset.

Rivaroxaban versus standard of care in venous thromboembolism prevention following hip or knee arthroplasty in daily clinical practice (Spanish data from the international study XAMOS)

Smoking cessation has been known to be associated with drinking behaviors, which are influenced by polymorphisms in genes encoding alcohol metabolizing enzymes. The aim was to evaluate the impact of aldehyde dehydrogenase 2 (ALDH2, rs671) and alcohol dehydrogenase 1B (ADH1B, rs1229984) polymorphisms together with drinking behaviors on smoking cessation. We conducted a cross-sectional study with 1137 former smokers and 1775 current smokers without any cancer at Aichi Cancer Center Hospital between 2001 and 2005. Unconditional logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) for successful smoking cessation by comparing former smokers (quitters) with current smokers (non-quitters). Older age, lower amount of cumulative smoking exposure, lower number of cigarettes per day, younger age of smoking initiation, shorter smoking duration, longer time to first cigarette in the morning, and lower amount of drinking among ever drinkers were predictors of smoking cessation. After careful adjustment for age, sex, smoking patterns, and drinking status, the ORs for smoking cessation among subjects with ALDH2 Glu/Lys and Lys/Lys were 1.02 (95% CI 0.84-1.23) and 1.78 (95% CI 1.23-2.58) compared with those with ALDH2 Glu/Glu, respectively Mediation analyses confirmed that the effect of ALDH2 Lys/Lys on smoking cessation was independent by dinking behaviors. No statistically significant association between ADH1B polymorphism and smoking cessation was observed. In our Japanese population, ALDH2 polymorphism predicts smoking cessation, independent by drinking behaviors. Interventions for promoting smoking cessation by ALDH2 polymorphism may be useful in Asian populations. We newly show that subjects with ALDH2 Lys/Lys genotype in a functional polymorphism, rs671, are more likely to quit smoking than those with ALDH2 Glu allele in a Japanese population. Our finding suggests that ALDH2 polymorphism may be useful for promoting smoking cessation in those specific populations as East Asian ones with frequent ALDH2 Lys allele carriers.

BackgroundSmoking is a major risk factor for chronic obstructive pulmonary disease (COPD), and smoking cessation is the only intervention that slows disease progression. It is important to know whether current factors related to smoking and smoking cessation are different among subjects with and without COPD in order to support smoking cessation. The aim of this study was to evaluate factors related to smoking cessation and to compare characteristics and nicotine dependence among smokers with and without COPD.MethodsIn 2005, 1614 subjects in a population-based longitudinal study of subjects with COPD and controls were examined. The Fagerström Test for Nicotine Dependence (FTND) and motivation for smoking cessation were assessed for current smokers (n = 299 total, 194 with COPD). Data on smoking cessation were collected in a follow-up in 2008 (n = 240).ResultsSmokers with COPD had more pack-years and respiratory symptoms than smokers without COPD, whereas higher FTND scores were associated with anxiety/depression and respiratory symptoms in both groups. Nineteen percent of the smokers had quit smoking by the follow-up 3 years later, and they had significantly lower FTND scores (2.54 vs. 3.75, p < 0.001) and higher self-efficacy scores (10.0 vs. 6.0, p = 0.020) at baseline than the sustained smokers. Smoking cessation was related to low FTND scores and high self-efficacy independent of the presence of COPD, respiratory symptoms, anxiety/depression, and heart disease.ConclusionsThe FTND score and a simple visual analog scale for assessing self-efficacy seem to be valuable instruments for predicting smoking cessation over several years, independent of COPD, respiratory symptoms, presence of anxiety/depression, and heart disease.

Predictors of smoking cessation: A longitudinal study in a large cohort of smokers.

To examine whether mood, personality and coping predict smoking cessation and whether the associations of personality and coping are mediated through depressed mood. Multicenter (n = 8) smoking cessation trial. A total of 600 smokers (> or = 15 cigarettes/day) without current depression who participated in a smoking cessation study. The outcome was continuous abstinence during the last 4 weeks of the 3-month trial: depressed mood was measured by the Beck Depression Inventory (BDI), personality by the Revised NEO Personality Inventory (NEO-PI-R) and coping by the Revised Ways of Coping Checklist (RWCC). A total of 14.7% (88/600) were abstainers. Controlling for potential confounders, baseline BDI independently predicted smoking cessation. Smokers with BDI > or = 10 were less likely to quit than those with BDI < 10 (odds ratio: 6.39, 95% CI: 1.44-28.3, P = 0.01). Compared to BDI < 10 smokers, BDI > or = 10 smokers had significantly higher scores for neuroticism and lower scores for extraversion and conscientiousness (NEO-PI-R). On the RWCC, BDI > or = 10 smokers scored higher for blame self, wishful thinking and problem avoidance and they scored lower on problem focus than smokers with BDI < 10. A mediational analysis showed that neither personality traits nor coping skills predicted directly smoking cessation. However, low level of problem focusing and social support seeking predicted a negative outcome via depressed mood. A BDI score > or = 10, even in smokers who do not meet a current diagnosis of major depression, directly predicts inability to quit. This suggests the utility of assessing depression symptoms in routine smoking cessation care.

Commentary on Vangeli <i>et al</i>. (2011): Towards an improved understanding of smoking relapse predictors – recipe for success?

Daily Clinical Practice in the Management of Chronic Urticaria in Spain: Results of the UCREX Study

Rivaroxaban frente al tratamiento estándar en la prevención del tromboembolismo venoso tras artroplastia de cadera o rodilla en la práctica clínica diaria (datos de España del estudio internacional XAMOS)