Cessation Process Research Articles

Understanding smoking cessation process in Tunisia from 2020 to 2023: description of quit attempts

Abstract Background Many smokers attempt multiple cessation methods before seeking specialist intervention. This study aims to describe these prior cessation attempts and identify relapse factors to enhance support for these individuals. Methods Data from 440 patients consulting the Department of Epidemiology Statistics at Abderrahman Mami Hospital from 2020 to 2023 were analyzed. It included information on previous quit attempts, methods used, longest duration of abstinence, number of attempts, reaction to cessation, and reasons for relapse. Statistical description was conducted using IBM SPSS 25. Results Among participants, More than half of the smokers had previously attempted to quit smoking 63,4%, with an average of 2 attempts ± 1,7 (0-10 attempts) per patient. The majority of patients (86.8%) quit smoking without using substitution methods. Among those who resorted to substitution, nicotine replacement therapy was the most frequently used method (n = 30; 6.8%). The longest duration of abstinence averaged 8 years. The main reaction to smoking cessation among patients was an improvement in their health (9,1%). The most common reasons for relapse were psychosocial problems (5.5%), followed by relapses during social events (4.3%), and withdrawal symptoms (3%). Conclusions This study emphasizes the importance of considering each patient’s journey during their smoking cessation process. Analyzing these factors will enable better management of the cessation program with the patient, as well as a deeper understanding of their feedback regarding our program, ensuring long-term cessation success. Key messages • Failed spontaneous quit attempts prior to NRT initiation are prevalent among smoking patients. • Understanding failed spontaneous cessation attempts can guide the development of more effective strategies.

Exploring the cessation process from adolescence to young adulthood in individuals with lived experience of nonsuicidal self-injury: a qualitative study.

Nonsuicidal self-injury (NSSI) is a common and concerning behavior in adolescents. However, most adolescents cease NSSI as they transition into adulthood. Increased knowledge of the cessation process is needed. This study aimed to qualitatively explore the factors contributing to NSSI cessation in individuals with lived experience of NSSI, providing valuable insights for treatment strategies. Twenty-six individuals assigned female sex at birth, between ages 20-22 years, from Sweden were interviewed between 2021 and 2023 in Linköping, Sweden. Of these, 21 individuals perceived themselves as having ceased NSSI and were included in the analysis. Thematic analysis and Hooley and Franklins' Benefits and Barriers Model of NSSI were used to analyze the transcripts. Three overarching themes were generated: "Something inside me changed", "Something in my close relationships changed", and "Something in my life context changed". The cessation of NSSI was associated with several key factors. Improved well-being and envisioning a different future were pivotal in initiating the cessation process. Additionally, interpersonal relationships and support from others were interpreted as powerful motivators for change. Transitioning to a new social context and leaving behind a destructive environment provided opportunities for personal growth and enhanced well-being, interpreted as initiators in the participants' broader life context. This study underscores the complexity of the NSSI cessation process and highlights the need for a comprehensive understanding of the underlying factors. Access to emotion regulation skills was perceived as a significant barrier to NSSI engagement. Clinical implications and different interventions to support NSSI cessation are discussed.

Feasibility and Engagement of a Mobile App Preparation Program (Kwit) for Smoking Cessation in an Ecological Context: Quantitative Study.

Mobile health apps can facilitate access to effective treatment and therapeutic information services. However, the real-world effectiveness of mobile apps for smoking cessation and their potential impact in everyday settings remain unclear. In an ecological context, this study aimed to estimate the engagement rate of a mobile app-based smoking cessation preparation program and its potential impact on users' willingness, ability, and readiness to quit smoking. A total of 2331 "organic users" (ie, users who discover and install a mobile app on their own, without any prompts) chose 1 of 2 program versions of the mobile app (Kwit): the basic version or the premium version. Both versions were identical in design, with 4 more evidence-based content items and strategies in the premium version. Outcomes were analyzed based on automated data registered in the app (engagement rate, motivation to quit, motivation type, motivation levels, and satisfaction level). Mann-Whitney and χ2 tests were used to compare the results of both groups. As expected, in the ecological context, a high dropout rate was observed at different moments. A significant difference was observed between the 2 versions (n=2331; χ21=5.4; P=.02), with a proportionally higher engagement rate in the premium version (premium=4.7% vs basic=2%). Likewise, differences were also observed between the 2 groups in terms of reasons to quit (n=2331; χ24=19; P≤.001; V=0.08), motivation type (n=2331; χ27=14.7; P=.04), and motivation level. Users of the app's premium version more frequently reported "well-being" (23.3% vs 17.9%) and "planning a pregnancy" (7.4% vs 4.4%) as their primary reasons for quitting smoking compared to those with the basic version. Moreover, they reported being more likely to be driven in the smoking cessation process by intrinsic motivation (premium=28% vs basic=20.4%), as well as feeling significantly more willing (z score=156,055; P≤.001; Cohen d=0.15), able (z score=172,905; P=.04; Cohen d=0.09), and ready (z score=166,390; P=.005; Cohen d=0.12) to stop smoking than users who had the basic version before completion of the preparation program. Among participants who finished each version of the program (premium: 9/189, 4.8%; basic: 47/2142, 2.19%), significant improvements in motivation levels were observed in both groups, although in different areas for each group (willingness levels for the premium group and ability for the basic group). These results suggest that even in ecological contexts where engagement rates are meager, the Kwit preparation program can address ambivalence by increasing willingness to change, self-confidence, and readiness to quit among its users, especially those who feel less able to do so. Further development and evaluations are needed to better understand determinants for regular mobile health apps.

Preferences of Iranian smokers regarding smart smoking cessation technologies: a parallel convergent mixed methods study

BackgroundConsidering the values and preferences of individuals who attempt to quit smoking is a crucial step in the development of smoking cessation technologies. This study aimed to explore preferences regarding smart smoking cessation technologies.MethodsThis parallel convergent mixed-methods study was conducted in two phases: quantitative and qualitative. In the quantitative phase, a cross-sectional study was conducted with 360 participants selected through stratified random sampling from technology-based smoking cessation clinics in Tabriz, Tehran, and Karaj cities in Iran. Data on demographic characteristics and preferences for smart smoking cessation technologies were collected using questionnaires and analyzed using descriptive statistics. In the qualitative phase, 25 users of these technologies were selected through purposeful and snowball sampling. The data were gathered through in-depth semistructured interviews and analyzed using qualitative content analysis with a conventional approach. Quantitative and qualitative data were integrated using the merging strategy and convergence model.ResultsThe quantitative phase results indicated that the highest preference was related to wearing and using a smartwatch for smoking cessation and using mobile apps. In the qualitative phase, 17 subcategories were extracted and classified into 8 main categories: high effectiveness, better management of the smoking cessation process, personalized technology, safe and uncomplicated technologies, attractiveness and innovative design, scientific basis, mobile applications, and smart monitoring devices.ConclusionBy combining and integrating quantitative and qualitative results, it can be concluded that users are more interested in wearable technologies and interactive mobile applications. The findings of this study can assist smoking cessation technology developers in designing and improving their tools based on user needs and preferences to enhance their effectiveness and acceptability.

The shared educational assessment in the smoking cessation process

In the context of smoking cessation, the shared educational assessment (BEP) enables us to assess the smoker's needs, define specific objectives and set up appropriate educational workshops. This multidisciplinary approach helps smokers to maintain their smoking cessation. The BEP is the first step in the educational process, exploring the various classic dimensions of therapeutic patient education (TPE) and then defining an action plan based on the priorities identified.

Deprescribing bisphosphonates in the osteoporosis treatment in older people

The term deprescribing (de-prescribe) means the abolition of appointments. In the modern researches, deprescribing is presented as a planned and controlled process of dose reduction or drug cessation, which can potentially harm the patient and/or does not benefit the patient. The target population for deprescribing is the older people, as old age and limited life expectancy are themselves reasons to try to reduce and optimize the drug load. Frailty syndrome or dementia, decreased kidney function and comorbidity are expected to coexist with polypragmasy and inconsistent appointments of different specialists. In foreign and domestic scientific studies there are manuals and recommendations on deprescribing of various groups of drugs for the elderly and seniors: proton pump inhibitors, sugary drugs, psychotropic drugs and others. However, with regard to osteoporosis drug therapy, the concept of deprescribing is debated rather sparingly, despite the possible serious side effects of osteoporosis treatment in the older age group.The review presents data from small clinical studies and systematic reviews describing deprescribing antiosteoporotic drugs from the bisphosphonate group, the reasons for their withdrawal and its consequences for the elderly and seniors with osteoporosis, as well as the analysis of tools for optimizing pharmacotherapy in elderly and seniors with respect to deprescribing of bisphosphonates.

The Whole Package: A Multi-Component Smoking Cessation Intervention for Adults With Serious Mental Illness: A Qualitative Study.

Introduction: Smoking is one of the most important modifiable risk factors for excess morbidity and mortality in adults with serious mental illness (SMI). Many smokers with SMI are reportedly motivated to quit, however success rates among these smokers remain low and evidence-based treatment targeting this vulnerable group is limited. The purpose of this paper is to report the results of a qualitative inquiry of participants. Methods: We conducted a pilot two-arm randomized controlled trial (RCT) targeting adults with SMI. Our smoking cessation intervention included: (a) group-based physical activity (PA) game intervention (50minutes, 3X/week for 12weeks), (b) pharmacotherapy (bupropion or nicotine replacement therapy), and (c) smoking cessation counseling. Upon completion of the program, participants in the active and control groups completed a qualitative semi-structured interview in order to determine how the program impacted their smoking cessation. Grounded Theory methodology guided our data collection and analysis. Results: Twenty participants completed an interview. Participants described how the "whole package" of the 3 components of the intervention were critical to their smoking cessation process. The group-based program provided the structure, resources, and encouragement needed to start the process of quitting. Conclusion: Adults with SMI need support, resources, and engaging activities as they begin quitting and practice the skills needed to quit.

Unlocking Deprescribing Potential in Nursing Homes: Insights from a Focus Group Study with Healthcare Professionals.

The nursing home population is characterized by multimorbidity and disabilities, which often result in extensive prescription of medication and subsequent polypharmacy. Deprescribing, a planned and supervised process of dose reduction or total cessation of medication, is a solution to combat this. This study aimed to identify barriers and enablers of deprescribing as experienced by nursing home physicians (NHPs) and collaborating pharmacists in the specific nursing home setting. This qualitative study utilized a semi-structured interview format with two focus groups consisting of a mix of NHPs and pharmacists.Directed content analysis was performed based on the Theoretical Domains Framework, a validated framework for understanding determinants of behavior change among health care professionals. Sixteen health care professionals participated in two focus groups, including 13 NHPs and three pharmacists. The participating NHPs and pharmacists believed that deprescribing is a valuable process with enablers, such as multidisciplinary collaboration, good communication with patients and family, and involvement of the nursing staff. NHPs and pharmacists view deprescribing as a core task and feel assured in their ability to carry it out successfully. However, they also noted barriers: deprescribing is time-consuming; communication with residents, their relatives or medical specialists is difficult; and electronic patient systems often do not adequately support it. This study provides insight into the various barriers and enablers faced by NHPs and pharmacists when deprescribing in nursing homes. Specific for this population, deprescribing barriers focus on communication (with residents and their relatives, and also with medical specialists) and resources, while knowledge and expertise are mentioned as enablers.

Tobacco cessation in patients with multiple chronic conditions: nutritional strategies as an additional tool in treatment.

To evaluate the impacts of a nutritional education intervention for patients with multiple chronic conditions during smoking cessation. The non-probabilistic sample comprised 18 adults and seniors of both sexes recruited from a smoking cessation treatment group. At the beginning of treatment, smoking history, degree of dependence, and stage of motivation were assessed. Degree of craving was evaluated weekly for the 1st month. Anthropometric and biochemical assessments were conducted at baseline, at 1 month, and at 3 months. Dietary intake was assessed with the "How is your diet?" questionnaire. The nutritional intervention was delivered in three sessions. The themes covered were energy balance and physical activity, healthy eating, and the importance of fruit and vegetables in the diet. Statistical analysis was conducted with the Shapiro Wilk test of normality, the paired t test, and the Wilcoxon or Mann-Whitney U tests (significance ≤ 0.05). Most people (55.6%) in the intervention group had a high degree of smoking dependence, while the frequency in the control group was 22.2%. Degree of craving decreased significantly after 1 month of treatment (p = 0.017). After 3 months, both groups had a positive variation in mean body weight, although below 3%. In both groups, the average percentage of weight gain was less than 3%, suggesting that delivery of the nutritional education sessions and the nutritionist's use of the protocol proposed by the Instituto Nacional de Câncer (INCA) helped to control weight gain. Blood glucose and homeostasis model assessment-insulin resistance (HOMA-IR) both increased significantly in the intervention group (p = 0.15 and p = 0.50, respectively). Greater proximity and more frequent intervention by a nutritionist assists and encourages healthy eating practices during the smoking cessation process, which can benefit individuals' control of chronic diseases over the long term.

The Experiences of Smokers Admitted to a Smoking Cessation Center in Samsun Regarding their Addiction: A Qualitative Study

Abstract: Background: Primary care physicians have a vital opportunity to help their patients quit smoking. They need to provide an individualized approach to them while in the cessation process in order to help them understand. Objective: The aim of this study is to investigate the individualized interacting factors and principles of starting, maintaining, quitting, and relapse of tobacco addiction among smokers. Materials and Methods: This qualitative research performed between March and December 2015 involved 331 smokers who had applied to the Ondokuz Mayis University, Medical Faculty Family Medicine Cessation Clinic, Türkiye. In the first meeting, a workshop (lasting approximately 1 hour) was held for all the participants (31) and recorded. In this workshop the participants discussed how they started smoking and why they wanted to quit. They reported examples of successful quitting with which they were familiar, together with any precautions they took in order to protect themselves and the people around them. Every workshop was decoded and analyzed by the researchers. Result: One hundred nineteen (35.7%) of the participants were women, and the mean age of the study group was 37.75 ± 12.41 years. Most of the participants (n=280, 85%) began smoking under the age of 18, with a close friend providing the cigarettes in the majority of cases (n=212, 64%). The main motivation differed between younger and older participants. In order to protect themselves, participants used external tar filters, smoked ‘light’ cigarettes, and refrained from smoking after eating or before sleeping. They also tended to smoke in the kitchen or on the balcony to protect other household members from their smoke. In addition, the participants increased their physical activity levels, requested more laboratory or screening tests from their physicians, and consumed healthier diets (honey, vitamin pills, and water). Conclusion: The addiction dynamics of cigarette addicts differ very widely.

An implementation evaluation of the Driving and Dementia Roadmap (DDR) in Alzheimer Society organizations

AbstractBackgroundIn response to the immense challenges that people with dementia (PWD) and family/friend carers (FCs) face in the driving cessation process, we developed the Driving and Dementia Roadmap (DDR). The DDR is a web‐based resource comprised of information and tools to support PWD, FCs and healthcare providers in the decision‐making and transition to non‐driving. To understand the factors (i.e., barriers and facilitators) that influenced the DDR’s implementation in Alzheimer Society (AS) settings, we conducted an implementation evaluation.MethodThe DDR was implemented by AS staff in six organizations in four Canadian provinces. Nineteen AS staff were interviewed after a three to six month period of delivering the DDR to their clients. Participants also recorded details about each interaction involving the DDR (e.g., setting, mode and rationale). Data were examined using a thematic analysis approach guided by the Consolidated Framework for Implementation Research (CFIR), which is a meta‐theoretical framework comprised of constructs organized into five domains (e.g., user characteristics, intervention characteristics and process).ResultThe DDR was implemented mainly via individual consultations by telephone/email to FCs who expressed concern about driving issues. Main factors that facilitated the DDR’s implementation were related to the characteristics of the DDR, such as its perceived evidence strength (e.g., research‐based) and quality (e.g., variety of tools, association with reputable organizations), superiority to other resources (e.g., more in‐depth, comprehensive and user friendly) and its ease of delivery (e.g., via telephone/email with minimal instruction required by clients). AS staff characteristics’ that facilitated implementation included their enthusiastic and favorable views about the DRR’s potential to be an empowering resource that could facilitate conversations and early planning for driving cessation. Barriers to implementation included clients’ lack of computer skills as well as competing priorities for AS staff such as other projects and tasks, and attending to issues related to the COVID‐19 pandemic (e.g., isolation, caregiver burnout, staying safe).ConclusionThis study highlights how the perceived strengths of the DDR resource itself and AS staff’s favourable beliefs about the DDR facilitated its successful implementation in AS settings. Strategies to address implementation barriers include offering a print‐based version of the DDR.

FC17: Effects of the CarFreeMe driving cessation intervention to identify and improve transport and lifestyle issues for people with dementia: Participant feedback and satisfaction after program completion

Objective:Without intensive practical and emotional support to plan for, and eventually, cease driving, people with dementia are at high risk for depression, anxiety, grief, social isolation, unsafe and unlicensed driving and injury. This study focused on evaluation of a 7-module intensive support program targeted at people living with dementia and their care partners to manage driving cessation (“CarFreeMe”).Methods:Our intervention was person-centered according to geographic location and needs of participants. Participants were encouraged to consider future transport arrangements, plan for lifestyle changes, form realistic expectations of life changes after driving cessation, practice using alternative transport, and supported in their emotional adjustment to the role loss. We collected program evaluation from PWD and care partners via survey, including open and closed questions. Participants reported their satisfaction with content and delivery on a scale of 1-10 (where 1 = not satisfied at all, 10 = extremely satisfied).Results:We describe our program and report the results of evaluation from 41 participants (PWD = 54%) who completed the survey after program conclusion. There was overall satisfaction with the program, program Content was rated on average 8.6/10, program Presentation and Delivery was rated average 9.1/10. Content analysis identified ‘personalized support’, ‘finding and trying out alternative transports’, ‘psychoeducation’ and ‘a safe space to discuss grief and loss’ as most relevant and helpful to participants.Conclusion:Findings indicated that PWD and care partners valued the individualized support for the cessation process, and highly valued the psychoeducation components and strategies to address the practical and emotional challenges. Additionally, feedback indicated that for PWD who had involuntarily retired from driving, more focused attention to coping with grief and loss was needed before moving on, accepting support, and finding alternative ways to get out and about.

The Role of Pain Avoidance in the Relation between Pain Intensity and Smoking Cessation Processes

Scientific evidence suggests that smokers who experience varying levels of pain are more likely to maintain their addiction to tobacco. The relationship between pain intensity and cognitive-based smoking processes within a mechanistic framework has received relatively little attention. Pain avoidance may influence the association between pain intensity and smoking, as it is a construct that is related to adverse pain and smoking processes. Thus, the current cross-sectional study examined the indirect effect of pain intensity on three clinically significant smoking processes (i.e., prior quit problems, perceived barriers for cessation, and negative affect reduction smoking expectancies) through pain avoidance among 95 treatment-seeking adult smokers. Regression analyses were conducted using bootstrapping techniques through PROCESS, a conditional modeling program that utilizes an ordinary least squares-based path analytical framework to test for both direct and indirect associations. Results indicated that pain intensity had a statistically significant indirect association with quit problems and perceived barriers for cessation, through pain avoidance. Pain intensity did not have a statistically significant indirect association with the negative affect reduction of smoking expectancies through pain avoidance. The current findings provide evidence for the role of pain avoidance as a potential transdiagnostic mechanism that contributes to maladaptive smoking outcomes within the larger context of the reciprocal model of pain and substance use.

CRUISE TOURISM: TENDENCIES OF THE INDUSTRY DEVELOPMENT IN THE PERIOD OF UNCERTAINTY

The modern cruise industry is a dynamic industry globally integrated into the world economy that is continuously developing. Cruise tours become more and more popular among tourists. Before the beginning of the COVID-19 pandemic, cruise tourism was highly developed and was one of the most rapidly growing industries of the global tourism. The full-scale russian invasion of Ukraine has affected the cruise industry, especially in the Black Sea region. Tourism operators have started changing routes, there has been a fall in the demand for such recreation, economic restrictions and safety have become key factors which should be considered in this period. The study examines advantages of cruise tourism in comparison with other types of recreation. It analyzes the impact of tourism industry on the economies of the countries where it is developing. The research indicates negative processes of recession and cessation of the development of sea tourism in Ukraine caused by the full-scale attack of russia. The study makes a conclusion that the Black Sea region can definitely become an independent cruise direction in a mid-term perspective, the home port for liners, independent routes will be available and motor ships of different classes will sail in it.

Impacts of the Covid-19 pandemic on smoking cessation success.

Current COVID-19 outbreak has led to many behavioural changes, including smoking behaviours. We aimed to investigate the success of quitting smoking of smoking cessation outpatients. Patients who applied to the smoking cessation outpatient clinic of a state hospital during the pandemic were retrospectively analysed. Smoking cessation success, personal views and experiences about COVID-19 were questioned. Hospital Anxiety and Depression (HAD) Scale was applied. The smoking cessation rate in the study population was 14.7%. The reasons for not being able to quit smoking were; stress (51.9%), drug discontinuation (28.4%) and reasons related to COVID-19 (12.3%). According to HADS scores; 35.8% of the participants were at risk for anxiety and 72.6% for depression. Those with pulmonary symptoms at the time of application (p=0.001), those who continued smoking cessation treatment (p=0.016), and those without depressive symptoms (p=0.040) were significantly more successful in quitting smoking. The rate of continuing smoking was significantly higher in patients with a history of COVID-19 <18.9% of participants>(p=0.013). Intense stress and depressive symptoms, discontinuation of smoking cessation treatment and being infected with Coronavirus negatively affect the smoking cessation process in pandemic. These parameters should be considered during smoking cessation interviews and behavioural support should be obtained if necessary.

Smoking in French prisons: Factors associated with consumption and cessation

For the past twenty years, researchers have emphasized the importance of producing data on tobacco use among incarcerated people. With a prevalence rate that can reach 97% in some countries, smoking is much more frequent in that population compared to the general population and this constitutes one of the main causes of chronic pathologies and mortality in prisons. In France, more than 80% of inmates use tobacco while the prevalence of smoking is 31.9% in the general population in 2021. In a global context of decreasing smoking rates, tobacco use in prison contributes to the persistence of social inequalities in health. This article presents the results of a sociological study which was part of the diagnostic phase of an interventional study whose overreaching goal was to construct, implement and evaluate an intervention aiming to reduce tobacco use in prisons. The objective of this paper is to identify the factors associated with tobacco use among inmates as well as the factors that hinder or facilitate the cessation process. Qualitative interviews with 21 inmates and 30 professionals were conducted and analysed thematically, using an inductive approach and Nvivo software. In light of our findings, we discuss the importance of behavioral awareness and the community-based approach that are essential to the construction and implementation of a relevant and acceptable public health program.

Adverse physiological effects of smoking cessation on the gastrointestinal tract: A review.

Smoking cessation is known to have numerous health benefits, but it can also induce adverse physiological effects, including those affecting the gastrointestinal tract (GIT). Understanding the adverse physiological effects of smoking cessation on the GIT is critical for healthcare professionals and smokers attempting to quit, as it enables them to anticipate and manage potential challenges during the smoking cessation process. Although the detrimental effects of smoking on the GIT have been well established, there is a gap in the literature regarding the specific physiological reactions that may occur upon smoking cessation. This mini-review summarizes the current literature on the predisposing factors, pathophysiology, clinical presentation, and treatment options for adverse physiological effects of smoking cessation on the GIT. We aimed to raise awareness among busy clinical professionals about these adverse effects, empowering them to effectively support individuals striving to quit smoking and maintain their cessation. By consolidating the existing knowledge in this field, this review offers practical implications for smokers, healthcare providers, and policymakers to optimize smoking cessation interventions and support strategies to improve health outcomes.

Relationship of constipation, body mass index increase and cigarette craving with nutrition in the smoking cessation process: A cross-sectional study from Turkey

This cross-sectional study was conducted to determine the complaints of constipation, increase in body mass index (BMI) and cigarette craving levels and their relationship with nutrition at the end of the 1st month following quit smoking. Individuals who applied to a Smoking Cessation Clinic in Izmir, Turkey were included in the study (N = 87, mean age 44.13 ± 12.67 years). Frequent constipation in daily life and greater than 30 g fat consumption increased constipation complaints, whereas increasing the number of cigarettes smoked before quitting decreased constipation complaints. BMI increase was higher in those who experienced severe constipation after quitting smoking. Cigarette cravings increased as the educational level of the participants increased. Individuals who were obese before quitting had lower levels of cigarette craving. During the smoking cessation process, it will be useful to question the situation of constipation in daily life. Studies examining types of fat and fatty acids should be planned.

Integrated approach to pharmacotherapy in smoking cessation: the role of varenicline, bupropion, cytisine, and nicotine replacement therapy

Introduction: Smoking tobacco is a significant global health issue, contributing to various diseases, including heart disease, cancer, and respiratory disorders. Quitting smoking is not only a beneficial decision for an individual's health but also for society as a whole. Pharmacological therapy plays a crucial role in the smoking cessation process by supporting and increasing the chances of success. Aim: To compare four medications used in smoking cessation: varenicline, bupropion, cytisine, and nicotine replacement therapy, in terms of their characteristics, mechanism of action, efficacy, and adverse effects. Materials and Methods: A review of available data in the PubMed database regarding medications registered in Poland for the treatment of nicotine addiction. Key Results: The efficacy of all four medications in smoking cessation was demonstrated. Individuals using varenicline, bupropion, cytisine, or nicotine replacement therapy had higher chances of quitting smoking compared to placebo groups. Specifically, varenicline showed the highest efficacy among all the medications studied. Despite a high level of safety profile, each therapy can cause various adverse effects, with the most serious being the risk of seizures associated with bupropion. Conclusions: Varenicline, bupropion, cytisine, and nicotine replacement therapy are valuable tools in the process of smoking cessation and increase the chances of successfully quitting the addiction. The choice of a specific medication may depend on individual patient preferences and clinical factors. These findings should be taken into consideration when making therapeutic decisions in the field of smoking cessation.

Interactive effects of financial strain and distress tolerance on prequit tobacco withdrawal symptoms in smokers preparing to initiate a quit attempt.

Smokers experiencing greater financial strain are less likely to successfully quit smoking, possibly due to greater severity of tobacco withdrawal. However, limited research has explored whether individual-level psychological factors (i.e., distress tolerance) may buffer the deleterious effects of financial strain on withdrawal. This study examined the main and interactive effects of financial strain and distress tolerance on tobacco withdrawal experienced prior to quitting smoking among smokers preparing to initiate a quit attempt. Fifty-nine adult smokers completed a baseline session including a financial strain measure and subjective and behavioral assessments of distress tolerance. Participants were then instructed to initiate a quit attempt, without any behavioral or pharmacological assistance, 14 days following baseline. Prequit tobacco withdrawal symptoms were assessed once per day for 3 days prior to quit date. Linear regression models tested main and interactive effects between financial strain and distress tolerance on experiences and perceptions of prequit withdrawal. Findings demonstrated significant interactions between financial strain, distress tolerance, and perceptions of tolerating withdrawal. Negative associations found between higher distress tolerance and lower perceptions of tobacco withdrawal and negative mood as being "intolerable" prior to quitting were stronger for those experiencing greater levels of financial strain. Financial strain may negatively impact one's perceived ability to tolerate mood- and tobacco-related withdrawal prior to quitting. Yet, higher distress tolerance may buffer the effects of financial strain on smoking cessation processes. Psychosocial interventions designed to promote tolerance of distress from both internal and external stressors may benefit cessation efforts among smokers experiencing high financial strain. (PsycInfo Database Record (c) 2023 APA, all rights reserved).