Cessation In Women Research Articles

Skeletal effects of adjuvant zoledronic acid and its cessation in women with early-stage breast cancer.

Skeletal effects of adjuvant zoledronic acid and its cessation in women with early-stage breast cancer.

The effectiveness of a theory -based health education program on waterpipe smoking cessation in Iran: one year follow-up of a quasi-experimental research

BackgroundThe present research aimed to determine the effect of an educational intervention based on the extended theory of planned behavior (ETPB) on waterpipe (WT) smoking cessation in women.MethodsThe present quasi-experimental had a pre-test, post-test design with 3, 6 and 12 months follow-ups was conducted in Bandar Abbas city, south of Iran in December 2021-March 2023. A total of 448 women over the age of 15 (224 in the intervention group (IG), 224 in the control group (CG)), using a two-stage cluster sampling method participated. The educational intervention focused on WT smoking cessation implemented in 14 sessions. The educational methods in the training sessions were lectures, collaborative discussions, Q&As, brainstorming, role plays, and peer education. The main outcome was WT cessation behavior. Repeated measures ANOVA tests and post hoc were run to compare the IG and CG at baseline in terms of demographic variables, t-test and chi square test, and in the four points of time of data collection. The data were analyzed in Stata14. A p-value < 0.05 was considered as statistically significant.ResultsThe mean and standard deviation of WT cessation behavior and all ETPB constructs in the IG was significantly higher than the CG. After the educational intervention, in the IG, the perceived behavioral control, attitude, subjective norm, intention and knowledge increased, and the weekly smoking and WT smoking habit decreased (P < 0.001). The CG did not have any significant change in other variables except for the increased knowledge score. During the 12-month follow-up, the cessation rate was 43.81% (P = 0.645) in the IG and 7.45% in the CG (P = 0.081).ConclusionsThe educational intervention positively affected WT smoking reduction and cessation in women through influencing the ETPB constructs. It is strongly recommended to design theory-based interventions beyond the individual level with an emphasis on interpersonal relationships to facilitate WT cessation as far as possible.

A predictive model of waterpipe smoking cessation among women in southern Iran: application of the theory of planned behavior

BackgroundToday, waterpipe (WT) smoking is a rising issue worldwide, and has taken a significant and growing share of tobacco consumption in the world. Present study aimed to explore the predictors of WT cessation in the light of the theory of planned behavior (TPB).MethodsThis cross-sectional analytical study was conducted in 2021–2022 using a multi-stratified cluster sampling on 1,764 women in Bandar Abbas, southern Iran. Data were collected through a reliable and valid questionnaire. The three-part questionnaire includes demographic information, behavioral information of WT smoking, and the constructs of the TPB along with an additional habit construct. Multivariate logistic regression analysis was run to model the predictor constructs of WT smoking. The data were analyzed statistically in STATA14.2.ResultsWith an increase in one attitude score, the odds of cessation increased by 31% (p < 0.001). Also, with an increase of one score in knowledge, the odds of cessation are increased by 0.05% (0.008). With an increase of one score for intention, the odds of cessation are 26% (0.000). in social norms, the odds of cessation are 0.02% (0.001). With an increase of one score in perceived control, the odds of cessation increased by 16% (0.000) and inhabit score, the odds of cessation decrease by 37% (0.000). In the model where the habit construct was present, the accuracy, sensitivity, and pseudo R2 indices were 95.69%, 77.31%, and 65%, respectively and after removing the habit construct, the so-called indices changed to 90.7%, 50.38% and 0.44%, respectively.ConclusionsThe present research confirmed the effectiveness of the TPB model in predicting waterpipe cessation behavior. The knowledge obtained from this research can help develop a systematic and effective intervention to facilitate waterpipe cessation. Focusing on the habit variable can play a critical role in waterpipe cessation in women.

Outpatient Treatment With Gabapentin in Women With Severe Acute Pain After Cesarean Delivery Is Ineffective: A Randomized, Double-Blind, Placebo-Controlled Trial.

Most of the 1.1 million women who deliver by cesarean in the United States each year have an uncomplicated recovery. However, severe pain resistant to standard multimodal therapy within the first days after surgery is associated with an increased risk for prolonged pain and opioid use. The best outpatient management for parturients with severe resistant early onset pain is not known. We performed a prospective, double-blind, placebo-controlled, randomized trial of up to 12 weeks of outpatient treatment with gabapentin to evaluate its effectiveness to facilitate opioid cessation in women with at least 2 reports of severe pain during the immediate postpartum period resistant to standard multimodal pain management. Time to opioid cessation was the primary outcome. Time to pain resolution; time to discontinuation of gabapentin, acetaminophen, and ibuprofen; time to self-reported recovery; and National Institute of Health Patient-Reported Outcomes System (PROMIS) surveys for anxiety, depression, fatigue, and physical function were assessed as secondary outcomes. There was no difference in time to opioid cessation between patients who were randomly assigned to be treated with gabapentin (Kaplan-Meier estimated median of 2 [25th-75th percentiles of 1-3] weeks, n = 35) versus those who were treated with placebo (2 [1-3] weeks, n = 35). The hazard ratio was 1.1 (95% confidence interval [CI], 0.67-1.8), P = .65. There were no differences in any secondary end points between the study groups. Outpatient supplementation with gabapentin did not reduce time to opioid cessation, pain, anxiety, depression, fatigue, or improve physical function in women with severe pain after cesarean delivery. Gabapentin should not be routinely added to the standard outpatient multimodal regimen of ibuprofen, acetaminophen, and opioids.

Smoking in women.

Smoking has numerous increased health risks for women, including the risks for cancer, cardiovascular disease, chronic obstructive pulmonary disease, gastric and duodenal ulcers, reduced fertility, ovulatory dysfunction, ectopic pregnancy, spontaneous abortion, sudden infant death, and earlier menopause. Such health risks, smoking cessation therapy, and unique obstacles to smoking cessation in women are the focus of this article.

"Appagalo" a Customized Mobile Health Intervention (mHealth) for Smoking Cessation in Women: A Randomized Controlled Trial.

Almost 30% of Chilean women report cigarette smoking with important repercussions on their health. Design and test a mobile phone intervention for smoking cessation in young women. A mobile application (app) was created using the best available evidence and consumer input. Its effectiveness was assessed through a randomized clinical trial. Women 18 to 44years old from middle-class neighborhoods in Santiago, Chile. Inclusion criteria were intention to quit cigarette smoking in the following month and having a smartphone cell phone. Women with positive screening for risky alcohol consumption were excluded. App with content to support cigarette smoking cessation over 6 months. The control arm included an app that delivered general messages to promote permanence in the study. Telephone follow-up was performed at 6 weeks, and at 3 and 6 months after randomization. No smoking in the past 7days at 6weeks from enrolment. Intention-to-treat analysis was carried out using SPSS 17.0 with a significance level set at .05. 309 women entered the study. Mean number of cigarettes smoked in a day was 8.8. 58.6% of the participants (n = 181) completed the follow-up for the primary outcome. With intention-to-treat analysis, 9.7% of participants in the intervention group reported not having smoked any cigarettes in the last 7days vs 3.2% in the control group (RR 2.98 CI 95% 1.11-8.0, P = .022). Additionally, 12.3% vs 1.9% of the participants in the intervention group and control group reported continuous abstinence at 6weeks, respectively (RR 6.29 95% CI 1.9-20.8, P < .001). Continuous abstinence was also significant at 6 months (P-value of .036). The "Appagalo" app is an effective tool to support smoking cessation in young women. It is a simple mHealth alternative for smoking cessation that can contribute to improving women's health in the Americas and worldwide.

Potential uses of cytisine for smoking cessation in menopausal women - literature summary.

Menopause is a vital stage in which the risk of the appearance of metabolic syndrome and cardiovascular diseases is increased. Cardiovascular risk in menopausal women must be monitored because it is one of the most common causes of mortality in these women. Smoking is an important risk factor for the development of many diseases, including cardiovascular diseases, so promoting smoking cessation in these women is important for the maintenance of cardiovascular health. Current smoking cessation programs mainly include nicotine and varenicline as therapeutic agents, due to their history of success, safety, and efficacy in aiding in cessation, but they do not include "new" agents such as cytisine as coadjuvant in the elimination of the habit of smoking. Cytisine is a therapeutic agent traditionally used in Eastern Europe, which has demonstrated efficacy and safety in smoking cessation, also showing other new pharmacological actions. It has been widely used since World War II as a nicotine substitute. These pharmacological actions, together with their efficacy in smoking cessation, should be explored to evaluate the convenience of the use of cytisine in premenopausal and postmenopausal women, so that cytisine can be identified as a useful therapeutic tool in smoking cessation programs and in particular in menopausal women.

How place matters for smoking cessation: Barriers to smoking cessation among low-income Black women.

African Americans start smoking later in life, yet they are less likely to quit smoking than other racial/ethnic groups. Drawing upon 40 in-depth interviews with former and current Black women smokers in the South Side of Chicago, this study examines external barriers to successful smoking cessation among socioeconomically disadvantaged Black women smokers. Beyond individual factors (e.g., stressors), this study finds interpersonal and structural factors that influence Black women's cessation efforts, including the high prevalence and normality of smoking and access to cheaper, loose cigarettes in their communities. Findings highlight the importance of considering local contexts for future tobacco research and policies.

Atypical working hours are associated with tobacco, cannabis and alcohol use: longitudinal analyses from the CONSTANCES cohort

BackgroundThis study examined prospective associations between atypical working hours with subsequent tobacco, cannabis and alcohol use as well as sugar and fat consumption.MethodsIn the French population-based CONSTANCES cohort, 47,288 men and 53,324 women currently employed included between 2012 and 2017 were annually followed for tobacco and cannabis use. Among them, 35,647 men and 39,767 women included between 2012 and 2016 were also followed for alcohol and sugar and fat consumption. Three indicators of atypical working hours were self-reported at baseline: working at night, weekend work and non-fixed working hours. Generalized linear models computed odds of substance use and sugar and fat consumption at follow-up according to atypical working hours at baseline while adjusting for sociodemographic factors, depression and baseline substance use when appropriate.ResultsWorking at night was associated with decreased smoking cessation and increased relapse in women [odds ratios (ORs) of 0.81 and 1.25], increased cannabis use in men [ORs from 1.46 to 1.54] and increased alcohol use [ORs from 1.12 to 1.14] in both men and women. Weekend work was associated with decreased smoking cessation in women [ORs from 0.89 to 0.90] and increased alcohol use in both men and women [ORs from 1.09 to 1.14]. Non-fixed hours were associated with decreased smoking cessation in women and increased relapse in men [ORs of 0.89 and 1.13] and increased alcohol use in both men and women [ORs from 1.12 to 1.19]. Overall, atypical working hours were associated with decreased sugar and fat consumption.ConclusionsThe potential role of atypical working hours on substance use should be considered by public health policy makers and clinicians in information and prevention strategies.

Smoking and Smoking Cessation in Women

Smoking and Smoking Cessation in Women

Hypofractionated radiation leads to more rapid bleeding cessation in women with vaginal bleeding secondary to gynecologic malignancy

BackgroundVaginal bleeding (VB) is common in women with gynecologic (GYN) malignancies. Radiation therapy (RT) is used for the definitive treatment of GYN cancers and palliation of bleeding. The historical dogma is that high dose-per-fraction radiation leads to more rapid bleeding cessation, yet there is scant data supporting this claim. We sought to examine the effect of RT fraction size on VB via retrospective analysis of patients receiving hypofractionated radiation (HFRT) compared to conventionally fractionated radiation (CFRT) for control of bleeding secondary to GYN malignancies.MethodsWe identified patients receiving external beam RT for continuous VB from GYN malignancy treated in our department from 2012 to 2020. RT was classified as HFRT (> 2.0 Gy/fx) or CFRT (1.8–2.0 Gy/fx). Demographic information, disease characteristics, and treatment details were collected. The primary endpoint was days from RT initiation until bleeding resolution. Characteristics between groups were compared via Fisher’s exact test. Time to bleeding cessation was assessed via Kaplan–Meier and log-rank test. Univariable and multivariable Cox-proportional hazards were used to identify factors associated with bleeding cessation.ResultsWe identified 43 patients meeting inclusion criteria with 26 and 17 patients receiving CFRT and HFRT, respectively. Comparison of baseline characteristics revealed patients receiving HFRT were older (p = 0.001), more likely to be post-menopausal (p = 0.002), and less likely to receive concurrent chemotherapy (p = 0.004). Time to bleeding cessation was significantly shorter for patients receiving HFRT (log-rank p < 0.001) with median time to bleeding cessation of 5 days (HFRT) versus 16 days (CFRT). Stratification by dose-per-fraction revealed a dose–response effect with more rapid bleeding cessation with increased dose-per-fraction. While HFRT, age, recurrent disease, prior pelvic RT, and prior systemic therapy were associated with time to bleeding cessation on univariable analysis, HFRT was the only factor significantly associated with time to bleeding cessation in the final multivariable model (HR 3.26, p = 0.008).ConclusionsPatients with continuous VB from GYN tumors receiving HFRT experienced more rapid bleeding cessation than those receiving CFRT. For patients with severe VB, initiation of HFRT to control malignancy related bleeding quickly may be warranted.

Feasibility and acceptability of testing a menstrual-cycle timed smoking cessation intervention for women of reproductive age (Project Phase): Results of a pilot randomized control trial

IntroductionMenstrual phase influences cigarette smoking-related outcomes. Telephone-based cessation programs (e.g., quitlines) may incorporate the role of the menstrual cycle in an effort to tailor interventions for women. Purpose: The goal of this preliminary randomized clinical trial was to examine the feasibility and acceptability of timing quit date to menstrual phase in women in a quitline setting. MethodsWe recruited treatment-seeking women with regular menstrual cycles between the ages of 18–40 years. Participants were randomized to the follicular phase (FP; quit date set 6–8 days post onset of menses) or standard of care (SC; no menstrual timing of quit date). All participants received four weeks of nicotine replacement therapy transdermal patch concurrent with six weeks of telephone-based counseling. We explored self-reported and biochemically-verified seven-day point prevalence abstinence at end-of-treatment and three-month follow-up. ResultsParticipants (n = 119; FP: n = 58, SC: n = 61) were, on average, 33.4 years old and smoked 13.6 cigarettes/day. The median number of counseling sessions completed was 6 out of 6 available, and 66% of participants completed the intervention. Over 90% of participants reported they would recommend this study to friends/family. Cessation rates did not significantly vary by randomization. ConclusionsResults of this preliminary trial indicate that timing quit date to FP is an acceptable and feasible approach to address smoking cessation in women of reproductive age. While we observed similar smoking cessation rates between groups, this preliminary study was not fully powered to determine efficacy. Therefore, the feasibility and acceptability results indicate that a fully-powered efficacy trial is warranted.

Sigara İçme Davranışında Cinsiyet Farklılıkları: Türkiye’de 2008-2014 Dönemi Değişimlerinin Analizi

The motivations and reasons for smoking initiation, continuation, and cessation for women are different from men. This paper investigates the differences in smoking rate and intensity by gender in Turkey from 2008 to 2014. The results indicate significant differences in the decision to smoke and how much to smoke by gender. Results further indicate that the positive effects of the anti-smoking policies are fading away over time. Especially for women, the smoking and consumption levels are higher in 2014 than in 2008. This study argues that policies designed to combat the initialization and the intensity of smoking should account for the behavioural differences observed across genders.

Gender differences within the barriers to smoking cessation and the preferences for interventions in primary care a qualitative study using focus groups in The Hague, The Netherlands

ObjectivesThis research aimed to provide a deeper insight into the gender-specific barriers to smoking cessation and gender-specific preferences for interventions in primary care, in order to contribute to better aligned...

O efeito do polimorfismo TaqIA (rs1800497) no comportamento do tabagismo em um grupo populacional Brasileiro

Objetivo: Investigar a associação entre um polimorfismo relacionado aos receptores de dopamina, conhecido como TaqIA, e o comportamento tabágico em uma amostra da população Brasileira. Métodos: Trata-se de um estudo transversal, com 449 indivíduos de ambos os sexos, maiores de 18 anos. O histórico do comportamento tabágico foi obtido por meio de um questionário. Amostras de sangue foram genotipadas para TaqIA (rs1800497) por Reação em Cadeia da Polimerase em tempo real. Análises de Regressão logística e linear foram usadas para verificar o efeito dos genótipos no comportamento tabágico. Resultados: 66,4% dos participantes eram Nunca fumantes, 12,2% Fumantes atuais e 21,4% Ex-fumantes. O alelo variante T de TaqIA foi associado ao início do tabagismo mais tardio em comparação a CC (16,97 vs. 15,09; IC 95%: 15,75-18,19; p= 0,02). O alelo T também conferiu maior probabilidade de cessação em mulheres (OR= 3,17; 95% IC: 1,06-9,45; p=0,04). Nos homens não foi encontrada diferença significativa. Não foi observada associação entre o polimorfismo e o risco para se tornar fumante, CPD, e FTND. Conclusão: TaqIA rs1800497 foi associado com um efeito protetor para idade de iniciação do tabagismo e maior probabilidade de cessação em mulheres, em uma amostra da população Brasileira.

Association of urinary cotinine-verified smoking status with hyperuricemia: Analysis of population-based nationally representative data

INTRODUCTIONSmoking status based solely on self-reporting is unreliable and might be inaccurate, particularly among women. This study investigated the association between urinary cotinine-verified smoking status and hyperuricemia in a nationwide Korean population.METHODSThis study included 5329 participants aged ≥19 years with information on smoking status, urine cotinine levels and serum uric acid. We determined smoking status according to self-reports and urinary cotinine levels. Multivariate linear regression analysis was used to measure the association between smoking exposure and serum uric acid levels. The effects of smoking on hyperuricemia were evaluated by multivariate logistic regression analysis.RESULTSBiochemically verified active and passive smokers comprised 22% (38.7% of men and 8.8% of women) and 12.3% (11.9% of men and 12.6% of women) of the study population, respectively. While reclassification rate of active smokers was 1.4% in men, 31.8% of cotinine-verified female active smokers were self-reported never smokers. Higher uric acid levels were observed with increased tobacco exposure among women (p-trend=0.007) but not among men. After adjusting for confounders, the risk of hyperuricemia increased with tobacco exposure only in women (p-trend=0.016).CONCLUSIONSCotinine-verified smoking status was associated with increased serum uric acid and hyperuricemia in a dose-response manner only in women. This study might provide evidence to support the importance of smoking cessation in women with gout and further studies are necessary to elucidate the underlying mechanism of the observed association.

Pilot Randomized Controlled Trial of a Digital Storytelling Intervention for Smoking Cessation in Women Living With HIV.

People living with HIV in the USA smoke at a rate nearly three times that of the general population, and Black women are disproportionately affected by HIV infection. This study was conducted to test the preliminary efficacy of a digital storytelling intervention for smoking cessation in U.S. women living with HIV. Participants in the treatment arm viewed a film in which women living with HIV talk about quitting smoking, and those in the control arm viewed an attention-control film in which women talk about living with HIV infection. Participants in both arms received eight weekly video-call counseling sessions focused on smoking cessation and nicotine patches or gum during the same period. Participants were followed on a monthly basis from quit day for 3 months. Of the 53 participants randomized, four withdrew before receiving any intervention, one dropped out during the intervention, and 48 (90.6%) completed the study. No difference was found in the baseline characteristics between the two arms with the exception that the treatment arm had higher nicotine dependence scores [t(1.51) = 2.30, p = .03] than the control arm. Seven day point-prevalence abstinence rates at 3 month follow-up were not found to differ between the two arms. However, the odds of achieving 3 month prolonged abstinence were four times greater (odds ratio = 4.23, 95% confidence interval = 1.10, 16.23) in the treatment arm than the control arm when the analysis was performed with those (n = 49, 92.5%) who received any part of the allotted intervention. A digital storytelling intervention seems to be a valuable strategy to enhance the effect of conventional tobacco dependence treatment for women living with HIV. However, the underlying mechanism of the effect of digital storytelling necessitates further investigations in a large RCT.Clinical Trials Registration No. NCT03289676.

Subjective response to intranasal nicotine administration in oral contraceptive users and naturally-cycling women

IntroductionApproximately half of premenopausal women who smoke cigarettes also use hormonal contraceptives, with most using oral contraceptives (OCs). While research on the effects of endogenous hormones on smoking-related outcomes continues to expand, little is known about the influence of OCs on similar outcomes. We sought to explore differences in the subjective response to nicotine by OC use after stratifying by testing condition (e.g., smoking status). MethodsParticipants were regular (≥5 cigarettes/day) smokers, classified into OC and naturally cycling (NC) groups. All participants completed four total lab sessions by smoking status (ad libitum smoking, acute smoking abstinence) and anticipated progesterone level (low progesterone week (LPW), high progesterone week (HPW)). Each lab session included self-administration of intranasal nicotine (Time 0 min), assessment of subjective response via the Subjective State Scale (−30 and + 5 min). ResultsCompared to the NC group (n = 28), the OC group (n = 14) was younger (26.2 ± 1.1 versus 24.2 ± 1.1; p < 0.001) and had a lower Fagerström Test for Nicotine Dependence score (3.4 ± 0.5 versus 2.6 ± 0.5; p = 0.011). Progesterone-to-estradiol ratios varied significantly by group at three of the four time points (p < 0.05). During ad libitum smoking, the OC group had significantly lower craving after nicotine administration than the NC group (1.93 ± 0.33 versus 2.89 ± 0.23; p = 0.024). No other significant differences in subjective response were identified. ConclusionsDespite significantly different hormone levels, group differences in subjective response to nicotine were relatively few. Additional research is needed to elucidate the mechanisms involved in these observations, as well as explore how they may influence cessation in women.

Exogenous progesterone for smoking cessation in men and women: a pilot double-blind, placebo-controlled randomized clinical trial.

In some clinical studies men and women have been found to differ in their ability to quit smoking, perhaps as a result of progesterone. The primary aim of this study was to provide a preliminary test of whether progesterone (PRO), compared with placebo (PBO), was more effective for smoking cessation in men and women. Pilot double-blind, placebo-controlled randomized clinical trial. Minneapolis/St Paul metro area, Minnesota, USA. A total of 216 participants were randomized, including 113 men (18-60years; PRO=56, PBO=57) and 103 women (18-50years, pre-menopausal with self-reported regular menstrual cycles; PRO=51, PBO=52). Participants were randomized (1:1 within sex group) to either PRO (200mg twice daily) or PBO. Participants were assigned a quit date approximately 7days after starting medication (luteal phase for women) and were followed for 12weeks to assess relapse. The primary outcome was self-reported 7-day point prevalence abstinence (PPA) at week 4. Secondary outcomes included 7-day PPA at weeks 8 and 12, prolonged abstinence, continuous abstinence, urine cotinine <50ng/ml, expired carbon monoxide ≤5parts per million (p.p.m.) and days to relapse. There was a significant difference in 7-day PPA at week 4 among women [PRO: 18 (35.3%) versus PBO: 9 (17.3%), odds ratio (OR)=2.61, 95% confidence interval (CI)=1.04, 6.54, P=0.041], but not among men [PRO: 13 (23.2%) versus PBO: 12 (21.1%), 1.13 (0.47, 2.76), P=0.782]. There was some evidence that PRO delayed relapse in women (days to relapse; PRO: 20.5±29.6 versus PBO: 14.3±26.8, P=0.03) but not in men (PRO: 13.4±25.9 versus PBO: 13.3±23.8, P=0.69). Oral micronized progesterone may aid smoking cessation in women.

Abstract WP377: A Stroke and Cardiovascular Disease Risk Alert in the Electronic Health Record Increased Prescriptions for Smoking Cessation in Women

Introduction: The purpose of the study was to determine if incorporating a risk stratification alert in the electronic health record (EHR) improved screening of women for stroke and cardiovascular disease (CVD) risk and the treatment of modifiable conditions in primary care clinics. Methods: Primary care faculty physicians were by cluster randomization divided into an intervention group who received a stroke and CVD risk alert in the EHR for their patients and a control group who used the EHR in the usual manner. Validated risk scores for stroke, treatment of cholesterol, atrial fibrillation, and bleeding risk were calculated from data extracted from the EHR and automatically displayed in the alert for intervention group physicians, who were also provided evidence-based order sets. Baseline data for study physician patients were evaluated. Electronic prescriptions by study physicians were compared by group and patient gender for 1) statin, 2) antihypertensive, 3) anticoagulant, 4) aspirin/statin in patients with diabetes mellitus, 5) anticoagulant/warfarin/aspirin and 6) smoking cessation. Results: There were 7190 consecutive study physician patient encounters, of whom 19% were 40-50 years, 32% 51-60 years, 27% 61-70 years, and 22% 71 years or older. Patients included 65% women, 35% men, 63% African Americans, 33% white and 5% other ethnicity. Of these patients, 41% had hypertension, 37% diabetes mellitus, 27% cardiovascular disease, 5% congestive heart failure, 4% atrial fibrillation, 1% prior stroke, TIA, or thromboembolism, and 33% were cigarette smokers. For 860 patients with cholesterol data, 42% had abnormal cholesterol. Physicians in the intervention group generated smoking cessation prescriptions for women at a rate more than double that of control group physicians (OR 2.38, 95% CI 1.20-4.74, aOR 2.37, 95% CI 1.23-4.57); men showed no significant difference. No significant differences were found for the other five prescription categories. Conclusion: In conclusion, primary care physicians in this study provided with a pre-calculated stroke and CVD risk alert in the EHR for their patients were significantly more likely to provide smoking cessation prescriptions for women compared to primary care physicians who were not provided the alert.