Tobacco Smoking Cessation Research Articles

Smoking Cessation Counseling: Practices, Determinants, and Barriers in a Sample of Iranian Primary Care Dentists

Objectives: Despite the successful tobacco smoking cessation counseling (TSCC) efforts of dental professionals, Iranian primary care dentists have not fully utilized their potential for TSCC provision. Thus, this study assessed the TSCC practices and their associations with socio-professional attributes, knowledge, and attitude, and explored the TSCC barriers and their socio-professional determinants in a sample of Iranian primary care dentists. Materials and Methods: This cross-sectional study was conducted at Comprehensive Healthcare Centers (CHCs) in Tehran Province, Iran from March to June 2019. All dentists practicing in these centers (n=190) completed self-administered questionnaires regarding TSCC-related knowledge, attitude, practice, and barriers. Simple and multiple linear regression and multiple logistic regression tests were used for statistical analyses. Results: The respondents (n=180, response rate=93%) were predominantly females (81.6%), recent graduates (69.6%), and non-cigarette smokers (90.2%), with a mean age of 34±9.98 years. Most performed 'Ask' (90.6%) and 'Advise' (69.1%), while a few were engaged in 'Assess' (33.7%) and fewer in 'Assist,' with 21.3% making physician referrals and 31.5% making psychologist referrals. Non-smokers (B=0.80, 95% CI: 0.19 to 1.40; P=0.01), and those with a more positive attitude (B=0.06, 95% CI: 0.04 to 0.08; P< 0.001) were more likely to provide TSCC. The main identified barriers included “absence of educational resources for patients”, “time constraints”, and “lack of patient cooperation. Conclusion: Although the selected sample of Iranian primary care dentists performed “Ask” and “Advise” more frequently than their peers, their TSCC practice required further improvement through simplified guidelines, customized pathways, training, team work, and resource advocacy.

Assessment of Respiratory Health Implications of Vaping: A Systematic Review of Toxicity Mechanisms and Adverse Effects of Electronic Nicotine Delivery Systems.

E-cigarettes are thought to aid in tobacco smoking cessation, but there are concerns about their overall effectiveness and safety for the general population, particularly adults. This review aims to investigate the mechanisms of toxicity and adverse effects of e-cigarettes on the respiratory system, comparing these effects with those of conventional smoking. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches were performed on PubMed, Embase, and the Cochrane Library using keywords, controlled vocabulary, and text words, with the following criteria: studies published in English from 2014 to 2024, open access, peer-reviewed, and full-text availability. Study selection, quality assessment, and data extraction were carried out by two independent reviewers. The Cochrane Risk of Bias 2.0 tool was used to evaluate the risk of bias in included randomized controlled trials, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool was employed to assess the strength of evidence and determine its generalizability. Electronic nicotine delivery systems (ENDS) have diverse mechanisms of toxicity, including inflammation, hypoxia, cardiovascular stress, and metabolic changes. Reported adverse effects include cough, throat irritation, nausea, and hemodynamic changes. However, ENDS are associated with fewer risks compared to conventional cigarette smoking. ENDS users experience fewer respiratory and cardiovascular issues and have lower levels of biomarkers such as NNAL and CO compared to traditional smokers. Additionally, ENDS are more effective than nicotine replacement therapy (nicotine patches) for smoking cessation, particularly in pregnant women. The side effects of ENDS and nicotine-free vaping are similar to those of conventional smoking in pregnant women, with the exception of a lower birth weight among newborns exposed to ENDS (p < 0.05). ENDS present a complex balance of benefits and risks regarding respiratory health. While there are adverse effects, ENDS are considered less detrimental than conventional smoking and a viable option for smoking cessation. Longitudinal studies are needed to evaluate their safety with long-term use (>16 weeks). Policymakers and health practitioners should use these findings to develop balanced public health policies that weigh the benefits of ENDS against potential health risks, enabling informed decision-making for users.

The impact of tobacco tax increases on cost-minimising behaviours and subsequent smoking cessation in Australia: an analysis of the International Tobacco Control Policy Evaluation Project

ObjectiveWe examined the relationship in Australia from 2007 to 2020 between tobacco tax increases and use of cost-minimising behaviours (CMBs) when purchasing tobacco and: (1) tobacco expenditure and (2) smoking...

Implementing a Metabolism-informed approach for smoking cessation in an Alaska Tribal health system: study protocol for a single-arm implementation pilot trial

BackgroundIndividualized treatment for commercial tobacco smoking cessation, such as through the utilization of the nicotine metabolite ratio (NMR), offers potential clinical benefit. NMR is a metabolism-informed biomarker that can be used to guide medication selection. NMR testing is particularly promising for tobacco cessation efforts in populations with high rates of smoking, such as some Alaska Native and American Indian (AN/AI) communities. To date, no prior study has evaluated the implementation of NMR-guided tobacco cessation with AN/AI populations.MethodsThe present “QUIT” protocol is a two-phase study that will occur at Southcentral Foundation (SCF), an Alaska Native-owned health system, serving 70,000 AN/AI people, based in Anchorage, Alaska. In Phase one, qualitative interviews with customer-owners (patients), providers and administrators (n = 36) and a 10-participant beta-test will be used to refine a strategy to implement NMR testing in the health system. Phase two will involve a single-arm pilot trial (n = 50) and qualitative interviews throughout data collection (n = 48) to evaluate the implementation strategy and explore the real-world acceptability and feasibility of NMR testing to guide tobacco cessation with AN/AI populations.DiscussionThis study utilizes a community-based participatory approach to refine and implement a nicotine metabolism-informed smoking cessation program in a Tribal healthcare setting. The process and findings from this study will reflect the importance of customer-owner choice and honor the lived experience involved in quitting commercial tobacco. Pilot study data will inform the effect and sample sizes required for a future pragmatic trial of NMR-guided smoking cessation.Trial registrationThis study will be registered with clinicaltrials.gov after the beta test is complete and the final IRB protocol is approved.

Reduction of head and neck cancer risk following smoking cessation: a systematic review and meta-analysis

ObjectiveHead and neck (HN) cancer comprises the neoplasms originating from the oral cavity, pharynx and larynx. We aimed at reviewing the available literature on the effect of smoking cessation on...

Smoking-attributable Mortality in Korea, 2020: A Meta-analysis of 4 Databases.

Estimating the number of deaths caused by smoking is crucial for developing and evaluating tobacco control and smoking cessation policies. This study aimed to determine smoking-attributable mortality (SAM) in Korea in 2020. Four large-scale cohorts from Korea were analyzed. A Cox proportional-hazards model was used to determine the hazard ratios (HRs) of smoking-related death. By conducting a meta-analysis of these HRs, the pooled HRs of smoking-related death for 41 diseases were estimated. Population-attributable fractions (PAFs) were calculated based on the smoking prevalence for 1995 in conjunction with the pooled HRs. Subsequently, SAM was derived using the PAF and the number of deaths recorded for each disease in 2020. The pooled HR for all-cause mortality attributable to smoking was 1.73 for current men smokers (95% confidence interval [CI], 1.53 to 1.95) and 1.63 for current women smokers (95% CI, 1.37 to 1.94). Smoking accounted for 33.2% of all-cause deaths in men and 4.6% in women. Additionally, it was a factor in 71.8% of men lung cancer deaths and 11.9% of women lung cancer deaths. In 2020, smoking was responsible for 53 930 men deaths and 6283 women deaths, totaling 60 213 deaths. Cigarette smoking was responsible for a significant number of deaths in Korea in 2020. Monitoring the impact and societal burden of smoking is essential for effective tobacco control and harm prevention policies.

Updates on the Natural History and Clinical Characteristics of NSAID-ERD

Nonsteroidal Anti-Inflammatory Drug Exacerbated Respiratory Disease (NSAID-ERD) is a distinct clinical syndrome characterized by NSAID hypersensitivity, asthma, and nasal polyposis. Its diagnosis is challenging due to variable presentations and a lack of simple tests, leading to diagnostic delays. Recent research has revealed its genetic predispositions, environmental triggers, and associations with atopy and second-hand tobacco smoke exposure or smoking cessation. Despite its severity, diagnostic awareness remains low, leading to the delay in effective management. Therapeutically, NSAID-ERD necessitates multidisciplinary approaches, often combining surgical interventions with medical management, including aspirin desensitization and biologic agents. However, predictive biomarkers for treatment response remain elusive. Understanding the underlying mechanisms driving NSAID-ERD pathogenesis and identifying reliable biomarkers are crucial for enhancing diagnostic accuracy and refining targeted therapeutic strategies for this debilitating condition. This review aims to provide a thorough understanding of NSAID-ERD, covering its history, clinical features, epidemiology, diagnosis, systemic and molecular biomarkers, available treatment options, and avenues for future research.

Tobacco smoking, smoking cessation and life expectancy among people with HIV on antiretroviral therapy in South Africa: a simulation modelling study.

As access to effective antiretroviral therapy (ART) has improved globally, tobacco-related illnesses, including cardiovascular disease, cancer and chronic respiratory conditions, account for a growing proportion of deaths among people with HIV (PWH). We estimated the impact of tobacco smoking and smoking cessation on life expectancy among PWH in South Africa. In a microsimulation model, we simulated 18 cohorts of PWH with virologic suppression, each homogenous by sex, initial age (35y/45y/55y) and smoking status (current/former/never). Input parameters were from data sources published between 2008 and 2022. We used South African data to estimate age-stratified mortality hazard ratios: 1.2-2.3 (females)/1.1-1.9 (males) for people with current versus never smoking status; and 1.0-1.3 (females)/1.0-1.5 (males) for people with former versus never smoking status, depending on age at cessation. We assumed smoking status remains unchanged during the simulation; people who formerly smoked quit at model start. Simulated PWH face a monthly probability of disengagement from care and virologic non-suppression. In sensitivity analysis, we varied smoking-associated and HIV-associated mortality risks. Additionally, we estimated the total life-years gained if a proportion of all virologically suppressed PWH stopped smoking. Forty-five-year-old females/males with HIV with virologic suppression who smoke lose 5.3/3.7 life-years compared to PWH who never smoke. Smoking cessation at age 45y adds 3.4/2.4 life-years. Simulated PWH who continue smoking lose more life-years from smoking than from HIV (females, 5.3 vs. 3.0 life-years; males, 3.7 vs. 2.6 life-years). The impact of smoking and smoking cessation increase as smoking-associated mortality risks increase and HIV-associated mortality risks, including disengagement from care, decrease. Model results are most sensitive to the smoking-associated mortality hazard ratio; varying this parameter results in 1.0-5.1 life-years gained from cessation at age 45y. If 10-25% of virologically suppressed PWH aged 30-59y in South Africa stopped smoking now, 190,000-460,000 life-years would be gained. Among virologically suppressed PWH in South Africa, tobacco smoking decreases life expectancy more than HIV. Integrating tobacco cessation interventions into HIV care, as endorsed by the World Health Organization, could substantially improve life expectancy.

Opportunistic smoking cessation interventions for people accessing financial support settings: A scoping review.

The aim of this work was to systematically scope the evidence on opportunistic tobacco smoking cessation interventions for people accessing financial support settings. We searched MEDLINE, Embase, PsycINFO and the Cochrane Tobacco Addiction Group specialized register to 21 March 2023. We duplicate screened 20% of titles/abstracts and all full texts. We included primary studies investigating smoking cessation interventions delivered opportunistically to people who smoked tobacco, within settings offering support for problems caused by financial hardship, for example homeless support services, social housingand food banks. Data were charted by one reviewer, checked by anotherand narratively synthesized. We included 25 studies conducted in a range of financial support settings using qualitative (e.g. interviews and focus groups) and quantitative (e.g. randomized controlled trials, surveys and single arm intervention studies) methodologies. Evidence on the acceptability and feasibility of opportunistic smoking cessation advice was investigated among both clients and providers. Approximately 90% of service providers supported such interventions; however, lack of resources, staff training and a belief that tobacco smoking reduced illicit substance use were perceived barriers. Clients welcomed being asked about smoking and offered assistance to quit and expressed interest in interventions including the provision of nicotine replacement therapy, e-cigarettes and incentives to quit smoking. Six studies investigated the comparative effectiveness of opportunistic smoking cessation interventions on quitting success, with five comparing more to less intensive interventions, with mixed results. Most studies investigating opportunistic smoking cessation interventions in financial support settings have not measured their effectiveness. Where they have,settings, populations, interventions and findings have varied. There is more evidence investigating acceptability, with promising results.

Protocol for the 'Supporting Young Cancer Survivors who Smoke' study (PRISM): Informing the development of a smoking cessation intervention for childhood, adolescent and young adult cancer survivors in England.

Childhood, adolescent and young adult (CAYA) cancer survivors are vulnerable to adverse late-effects. For CAYA cancer survivors, tobacco smoking is the most important preventable cause of ill-health and early death. Yet, effective strategies to support smoking cessation in this group are lacking. The PRISM study aims to undertake multi-method formative research to explore the need for, and if appropriate, inform the future development of an evidence-based and theory-informed tobacco smoking cessation intervention for CAYA cancer survivors. PRISM involves three phases of: 1) an environmental scan using multiple strategies to identify and examine a) smoking cessation interventions for CAYA cancer survivors that are published in the international literature and b) current smoking cessation services in England that may be available to, or tailorable to, CAYA cancer survivors; 2) a qualitative study involving semi-structured interviews with CAYA cancer survivors (aged 16-29 years and who are current or recent ex-smokers and/or current vapers) to explore their views and experiences of smoking, smoking cessation and vaping; and 3) stakeholder workshops with survivors, healthcare professionals and other stakeholders to consider the potential for a smoking cessation intervention for CAYA cancer survivors and what such an intervention would need to target and change. Findings will be disseminated to patient groups, healthcare professionals and researchers, through conference presentations, journal papers, plain English summaries and social media. PRISM will explore current delivery of, perceived need for, and barriers and facilitators to, smoking cessation advice and support to CAYA cancer survivors from the perspective of both survivors and healthcare professionals. A key strength of PRISM is the user involvement throughout the study and the additional exploration of survivors' views on vaping, a behaviour which often co-occurs with smoking. PRISM is the first step in the development of a person-centred, evidence- and theory-based smoking cessation intervention for CAYA cancer survivors who smoke, which if effective, will reduce morbidity and mortality in the CAYA cancer survivor population.

Social networks of people with serious mental illness who smoke: potential role in a smoking cessation intervention.

Smoking is a major contributor to morbidity and mortality among individuals with serious mental illness (SMI) and social networks may play an important role in smoking behaviors. Our objectives were to (1) describe the network characteristics of adults with SMI who smoke tobacco (2) explore whether network attributes were associated with nicotine dependence. We performed a secondary analysis of baseline data from a tobacco smoking cessation intervention trial among 192 participants with SMI. A subgroup (n = 75) completed questions on the characteristics of their social network members. The network characteristics included network composition (e.g. proportion who smoke) and network structure (e.g. density of connections between members). We used multilevel models to examine associations with nicotine dependence. Participant characteristics included: a mean age 50 years, 49% women, 48% Black, and 41% primary diagnosis of schizophrenia/schizoaffective disorder. The median personal network proportion of active smokers was 22%, active quitters 0%, and non-smokers 53%. The density of ties between actively smoking network members was greater than between non-smoking members (55% vs 43%, p = .02). Proportion of network smokers was not associated with nicotine dependence. We identified potential social network challenges and assets to smoking cessation and implications for network interventions among individuals with SMI.

Electronic nicotine delivery system: a narrative review on growing threat to tobacco control and health of the young Indian population.

The electronic cigarette (EC) was developed as an alternative to cigarette smoking. In less than a decade, theprevalence of past-month EC usage increased from 1.5to27.5 % among US high-school students. In the coming years, Asia-Pacific countries will have the highest sales ofelectronic nicotine/non-nicotine delivery systems (ENDS/ENNDS) after Western Europe. Based on the World Health Organization and Indian Council of Medical Research recommendations, India approved a complete ban on EC in2019. Even though it has been three years since the ban, ECis still being sold in India's grey markets, where marketing is not regulated. In this narrative review, we discuss that vaping is not just a harm reduction strategy for tobacco smoking cessation but poses a serious threat toIndia's existing tobacco control efforts as well as the health of the country's young people.

Determining the Short-term Effects of Smoking Cessation Using Nicotine Gum on Oral Health-Related Quality of Life: A Pilot Study.

Nowadays, the adverse effects of smoking on general, oral, and dental health are reported time and again worldwide. However, evidence to quantify the effects of tobacco smoking and smoking cessation on health-related quality of life (HRQoL) and oral health-related quality of life (OHQoL) is inadequate. Accordingly, this study aimed to assess the effects of nicotine gum on HRQoL and OHQoL of cigarette smokers. This pilot study was conducted on 40 smokers, half of whom received nicotine gum. HRQoL and OHQoL were measured twice at the beginning of the study and after three months using standard versions of Short Form Health Survey (SF-12) and Oral Health Impact Profile (OHIP-5) questionnaires. T-test, Fischer's exact test, and Pearson's correlation coefficient were used to compare the participants' scores on the questionnaires. The mean age of the participants was 43.39±12.32 years. Using nicotine gum significantly increased the scores of general health (P=0.046) and physical functioning (P=0.021) domains of HRQoL in comparison with the cigarette smoking group. Moreover, using nicotine gum significantly increased the scores of the two questions about the reduced sense of taste (P<0.001) and difficulty doing usual jobs (P=0.071). Using nicotine gum was associated with the improvement of HRQoL and OHQoL to some extent. To better understand the relationship between smoking cessation and improved OHQoL, it is necessary to conduct further studies in this field.

Tobacco or marijuana use and infertility: a committee opinion

In the United States, approximately 21% of adults report some form of tobacco use, although 18% report marijuana use. Although the negative impact of tobacco use in pregnancy is well documented, the impact of tobacco and marijuana on fertility and reproduction is less clear. This committee opinion reviews the potential deleterious effects of tobacco, nicotine, and marijuana use on conception, ovarian follicular dynamics, sperm parameters, gamete mutations, early pregnancy, and assisted reproductive technology outcomes. It also reviews the current status of tobacco smoking cessation strategies. This document replaces the 2018 American Society for Reproductive Medicine Practice Committee document entitled Smoking and Infertility: a committee opinion (Fertil Steril 2018).

Healthcare providers' knowledge, attitudes and practices on smoking cessation intervention in the Northern Cape.

Clinicians are crucial in encouraging smokers to quit through behavioural or pharmacological smoking cessation interventions. Smokers quit better with professional help. The level of healthcare providers' (HCPs) knowledge, attitudes and counselling skills related to effective smoking cessation support in the study area remains uncertain. The study aimed to determine HCPs' knowledge, attitudes and practices (KAP) on smoking cessation intervention strategies in the Sol Plaatje district, Northern Cape. Sol Plaatje's 13 district municipality clinics, Kimberley, Northern Cape. A descriptive, cross-sectional analytical study involving healthcare workers in the above setting. A total of 165 HCPs, including medical officers, professional nurses, enrolled nurses and assistant-enrolled nurses working in primary healthcare clinics, were invited to participate in the study, with 156 completing the questionnaires. About 53.9% had no knowledge of South African tobacco smoking cessation guidelines, while 87.2% knew the importance of counselling patients about smoking and its impact on quitting. The majority of them did not know the medicines recommended for tobacco treatment in South Africa. About 89.7% expressed that smoking cessation counselling is an important part of their jobs. However, less than half indicated that they make follow-up arrangements for those attempting to quit. The study revealed gaps in KAP regarding smoking cessation among the respondents, necessitating the need for continuing education on the existing smoking cessation guidelines among these HCPs. The results of this study will help to improve smoking cessation intervention knowledge among health providers.

Electronic cigarette use in relation to changes in smoking status and respiratory symptoms.

How e-cigarette use relates to changes in smoking status and respiratory symptoms in the population remains controversial. The aim was to study the association between e-cigarette use and, changes in smoking status and changes in respiratory symptoms. A prospective, population-based study of random samples of the population (age 16-69 years) was performed within The Obstructive Lung Disease in Northern Sweden (OLIN) study and West Sweden Asthma Study (WSAS). A validated postal questionnaire containing identical questions was used in OLIN and WSAS at baseline in 2006-2008 and at follow-up in 2016. In total, 17325 participated on both occasions. Questions about respiratory symptoms and tobacco smoking were included in both surveys, while e-cigarette use was added in 2016. In 2016, 1.6% used e-cigarettes, and it was significantly more common in persistent tobacco smokers (10.6%), than in those who quit smoking (2.1%), started smoking (7.8%), or had relapsed into tobacco smoking at follow-up (6.4%) (p<0.001). Among current smokers at baseline, tobacco smoking cessation was less common in e-cigarette users than e-cigarette non-users (14.2% vs 47.6%, p<0.001) and there was no association with a reduction in the number of tobacco cigarettes smoked per day. Those who were persistent smokers reported increasing respiratory symptoms. In contrast, the symptoms decreased among those who quit tobacco smoking, but there was no significant difference in respiratory symptoms between quitters with and without e-cigarette use. E-cigarette use was associated with persistent tobacco smoking and reporting respiratory symptoms. We found no association between e-cigarette use and tobacco smoking cessation, reduction of number of tobacco cigarettes smoked per day or reduction of respiratory symptoms.

Knowledge, perception, and willingness of emerging Public Health Advocates to effectively communicate about smoking cessation and Tobacco Harm Reduction in Africa

BackgroundMedia campaigns targeting young people are a valuable tool for promoting awareness about tobacco harm reduction (THR). Advocacy and communication efforts that inform about the risks of tobacco use, THR strategies, and smoking cessation methods can enhance policy compliance, minimize tobacco-related damages, and motivate individuals to quit smoking. This study investigates the understanding, perceptions, and capabilities of burgeoning public health advocates in effectively communicating smoking cessation and THR strategies in Africa.MethodsThis research adopts a concurrent explanatory sequential design. The target demographic population consists of public health enthusiasts, healthcare students, health communicators, and budding journalists aged 18–30 in Nigeria. The questionnaire, validated through an extensive literature review, was distributed via Google Forms. From 450 individuals expressing interest in the THRjourno project, 415 agreed to participate, responding to open-ended questions on smoking cessation and THR among young people. Data were analysed with Microsoft Excel and IBM SPSS for quantitative aspects, while Atlas.ti was used for the qualitative interpretation of open-ended responses.ResultsOf the 415 participants, 73.7% lacked prior knowledge or proper understanding of THR. Most respondents (60.0%) regarded Nicotine Replacement Therapy (NRT) as the most effective THR strategy, with 26.7% favoring e-cigarettes. A majority (73.3%) perceived NRT to be safer than smoking, while 48.3% believed e-cigarettes were safer. Approximately 70.8% agreed that THR products aid in smoking cessation. However, 38.3% were uncertain if these products are addictive. Participants referenced strategies/activities for creating awareness for THR, which include, “More advocacy and sensitization programs should be organized”, and “These programs should engage people who smoke tobacco and nicotine products themselves as champions.”Ambassadorial roles in public Universities should be granted to students as a medium to proliferate the central message of the THR.ConclusionIdentified barriers to effective THR communication included misinformation propagated by health professionals and the media, religious and cultural constraints, and challenges in reaching remote areas. Strategies to enhance THR communication encompass increased advocacy and communication, government engagement and policy development, simplification of THR messages, and capacity building and engagement of advocates and stakeholders.

Forecasting tobacco smoking recurrence in lung TB patients

Aim of study: Identify tobacco smoking (TS) recurrence predictors in lung TB patients. Маterials and Methods: In all, the results of over the phone consulting on to-bacco smoking cessation with 335 smoking TB pa-tients (age from 18 to 70). Inclusion criteria: tobacco smoking in the course of 3 years and longer. Exclusion criteria: psychic diseases and disorders, аlcohol or narcotic drugs’ addiction. Number of cigarettes per day, duration of TS, nicotine dependence (ND) degree based on Fagerstrom test, motivation for smoking cessation, and anxiety and depression markers by HADS score were defined in all the patients. The smoking patients were offered over the phone consulting throughout the first month of smoking cessation in case they cease (time for consulting sessions coordinated with patients). Effectiveness of cessation was evaluated after 6 months. The patients were aggregated into the following groups: those who successfully ceased smoking and have not smoked for 6 months and longer (Group 1), and those who resumed TS after treatment (Group 2). Data was statistically processed with the help of SPSS programme

Tobacco control in Qatar from 2002 to 2022: 20 years of progress and challenges.

Tobacco use and exposure has been known as one of the leading causes of premature mortality worldwide. Tobacco control measures have been considered one of the strategies for reducing the burden of NCDs, improving public health, and strengthening the health system's response to threats and pandemics. The State of Qatar has put tobacco control a national public health priority as it has adopted various tobacco control measures that the WHO classified as high-impact measures. This has resulted in achieving tobacco control milestones which led to constant monitoring of tobacco use and the provision of smoking cessation services at all healthcare levels. However, there is still much work to be done to fill the gaps and respond to the emergence of novel tobacco products and market strategies in an effective way. This review highlights the status of tobacco use and exposure in the State of Qatar, and focus on the progress, and challenges in the implementation of tobacco control policies and smoking cessation services between 2002 and 2022.

Approaches to Tobacco Use and Smoking Cessation in Primary Care: 5A and 5R Strategies

Approaches to Tobacco Use and Smoking Cessation in Primary Care: 5A and 5R Strategies