Difference In Smoking Cessation Rates Research Articles

Preoperative intervention for smoking cessation: A systematic review

BackgroundSmoking is associated with increased postoperative complications. Pre-surgical smoking cessation remains a challenge. Our aim was to summarize pre-hospital smoking cessation interventions and impact on smoking cessation rates. MethodsIndependent review of English language articles identified from systematic searches of MEDLINE, PubMed, PsycInfo, Embase, Web of Science, and Cumulative Index to Nursing & Allied Health Literature databases from 1998 to 2019 was performed (PROSPERO registration number CRD42021247927). Studies of adult patients enrolled in a pre-hospital smoking cessation intervention were included. Studies with historical controls or only self-reported outcomes were excluded. ResultsNine articles including 1762 patients were identified. Exhaled CO was used to confirm cessation. Six studies reported smoking status day of surgery. Interventions included NRT, hand-held technology, e-cigarettes, decision aids/counseling and medications. Four studies demonstrated a difference in smoking cessation rates. Ethics and study appraisal were assessed using ROB2. ConclusionsBased on the variability of interventions, settings, and outcomes, best practice for successful pre-hospital smoking cessation in surgery clinics would benefit from ongoing investigation.

The impact of COVID-19 on smoking cessation in pregnancy.

A greater proportion of non-pregnant smokers attempted to stop smoking during compared to before the COVID-19 pandemic. The objective of this study was to determine if a greater proportion of pregnant women also attempted to stop smoking during the pandemic rather than before. The use of antenatal smoking cessation services and nicotine replacement therapies (NRT) in pregnant women was audited before (2019-2020) and during the COVID pandemic (2020-2021). Anonymised data from January 2019 to March 2021 were analysed from the Lambeth and Southwark smoking cessation service. A total of 252 pregnant women who smoked were referred to their local antenatal smoking cessation service, of which 90 (35.7%) (median age: 31 years [19-52 years]) chose to attend smoking cessation clinics. The COVID-19 pandemic was not associated with an increase in the number of women attending smoking cessation clinics, (2020-2021 n=46 [40.8%] of 110); compared to (2019-2020 n=44 [30.9%] of 142 referred pregnant women pre-pandemic) p=0.061. Eighty-two women utilised NRT to help them stop smoking and the frequency of NRT use didnot change during the pandemic (2019-2020 n=39, 2020-2021 n=43; p=0.420). No significant difference in smoking cessation rates between the two periods was observed at either the four-week (p=0.285) or twelve-week follow-up (p=0.829). Smoking cessation rates in pregnant women and the demand for antenatal smoking cessation services was unchanged during compared to before the COVID-19 pandemic.

Cigarettes Smoking Pattern in Patient with Urothelial Carcinoma of the Bladder after Smoking Cessation in Tertiary Hospital

Background: Urothelial carcinoma is the most widely recognized histologic type of bladder cancer. Smoking duration and intensity associated with tumour aggressiveness and recurrence. This study aims to examine smoking behavioural change in patients with bladder urothelial carcinoma who were given an intervention for smoking cessation. Methods: A cross-sectional study (2009 – 2019) was conducted. Subjects were divided into three groups: patients who had smoked <20 cigarettes per day for ≤30 years; patients who had smoked for 31–40 years or had smoked >20 cigarettes per day for ≤30 years; and patients who had smoked for >40 years. General characteristics, educational level and quit levels are noted. These data were obtained from the medical record and anamnesis by telephone. Result: A total of 325 patients with urothelial cancer between 2009-2019 were involved. 273 (84%) patients were male, aged 58.71 ± 12.8 years. 40.9% had a history of smoking for >40 years, 66.5% of patients did not quit smoking at all. There was a significant difference in smoking cessation rates between groups with a history of different smoking intensities (p = 0.000). Mann-Whitney U test showed that there was a significant difference between the group who had a history of smoking <20 cigarettes for ≤30 years and the group who smoked for 31-40 years or >20 cigarettes per day for ≤30 years with the group who smoked for >40 years (p = 0.000 on both comparisons). 135 (41.5%) patients were in the lower education group.Conclusion: The patient’s history of heavy smoking intensity and lower educational level was associated with a lower likelihood of smoking cessation. Urologists must play an important role in the education and intervention process to support patients to quit smoking. A guide/guideline is needed and it could be through a special smoking clinic for counselling or treatment.

Comparative Analysis of Three Different Drug Distribution Schemes for Smoking Cessation.

This study aimed to compare the success rate of 3 different drug prescription policies: Free drugs with online system prescription, free drugs with doctor's prescription, and drugs paid for by patients with doctor's prescription. The effect of 2 different Ministry of Health (MoH) projects with free-of-charge and self-payment pharmacotherapies for smoking cessation were compared. Patients who completed 6 months of pharmacotherapy and follow-up were evaluated. The first period was free-of-charge medication, which was determined by an online system, the following period was the self-payment period, and the third period was free medication, which was prescribed by a doctor. In all the groups, smoking habits in pack years and comorbidities of the patients were recorded, and pulmonary function tests (PFTs) and expiratory carbon dioxide (CO2) measurements were performed. Patients who had an expiratory CO2 level >5 ppm at the control visits were accepted as quitters. A total of 829 patients with 438 patients in the first free-of-charge period (group 1), 111 in the self-payment period (group 2), and 280 in the second free-of-charge period (group 3) were enrolled in the study. Smoking cessation rates were significantly higher in the self-payment medication group (25%) according to the MoH's free-of-charge project groups. There was no difference in smoking cessation rates between the 2 free-of-charge medication project groups (15% in group 1 and 11% of group 3). Among all the patients, we compared 124 patients who quit smoking with 705 patients who did not. The quitters were older, mostly male, and heavier smokers. In addition, the number of patients with chronic obstructive pulmonary disease and obstructive PFT rates were higher among the quitters. Their dependency score, PFTs, and the use of free medication was lower, and treatment duration was longer. Independent factors that increased smoking cessation success were longer treatment duration, lower dependency score, and self-payment of medication. Free medications provided via 2 different modalities did not increase the smoking cessation success. Paying for the medication, lower dependency score, and longer treatment duration increased smoking cessation success independently.

Efficacy of a Rheumatoid Arthritis-Specific Smoking Cessation Program: A Randomized Controlled Pilot Trial.

Smoking adversely influences comorbidities in rheumatoid arthritis (RA). The aim of this pilot study was to investigate whether smoking cessation is increased following a 3-month smoking cessation intervention tailored for people with RA. Thirty-nine current smokers with RA were recruited. Participants were randomized into the control group to receive the current local standard of care for smoking cessation (i.e., ABC = brief advice and subsidized nicotine replacement therapy [NRT], or into the intervention group to receive ABC plus additional smoking cessation advice for 3 months (ABC+), including face-to-face, telephone, and e-mail contact. Advice was tailored to the participants' specific needs from a range of intervention tools focused on education about smoking and RA, pain control, exercise, coping, and support. The primary outcome was smoking cessation at 6 months. The secondary outcome was sustained reduction in smoking at 6 months. Disease and psychosocial characteristics of quitters and nonquitters were examined. The overall smoking cessation rate was 24%. There was no significant difference in smoking cessation rates between the ABC and ABC+ groups (21% versus 26%; P = 0.70). The mean number of cigarettes smoked daily was reduced by 44% (P < 0.001) but did not differ between ABC and ABC+ groups (mean reduction 47% versus 41%; P = 0.72). Successful quitters had more years in education and had smoked less across their lifetime, but these differences were not statistically significant. Smoking cessation in RA may lead to a reduced comorbid burden. The lack of added benefit of the tailored intervention suggests that brief advice and NRT are currently the best practice for supporting people with RA who wish to quit smoking.

Lung Cancer Screening With Low-Dose CT: Its Effect on Smoking Behavior.

Lung cancer screening provides an opportunity for smoking cessation interventions. A review of the literature found that smokers who participated in lung cancer screening had a higher smoking cessation rate compared with smokers in the general population. However, the randomized controlled trials included in the review did not identify any difference in smoking cessation rates between the individuals who had a CT scan to screen for lung cancer and unscreened control groups. Multiple studies observed participants for lengths of time ranging from 1 to 36 months and concluded that individuals who received abnormal CT results had a higher smoking cessation rate compared with participants with normal CT results. A single study that observed participants for 6 years initially found similar increased cessation rates among those with abnormal CT results, but at the conclusion of the study the difference in cessation rates had dissipated. Lung cancer screening produces a teachable moment when individuals may be more receptive to smoking cessation interventions. Advanced practitioners should take an active role in promoting smoking cessation interventions and fostering this teachable moment created by lung cancer screening.

Gradual Reduction vs Abrupt Cessation as a Smoking Cessation Strategy in Smokers Who Want to Quit

Is gradual smoking cessation associated with poorer success rates than abrupt cessation in smokers who want to quit? Gradual reduction may not be associated with a clinically significant difference in smoking cessation rates compared with abrupt cessation.

Assessment of the Impact of Adjunctive Proactive Telephone Counseling to Promote Smoking Cessation among Lung Cancer Patients' Social Networks

When a patient is diagnosed with lung cancer, members of his/her social network may be more likely to engage in smoking cessation efforts. Proactive telephone counseling combined with a tailored self-directed intervention may be more effective at promoting smoking cessation than a tailored self-directed intervention alone. Randomized controlled trial. Four clinical sites. Current smokers who are family members and close friends of patients with lung cancer. Six counselor-initiated counseling calls using motivational interviewing techniques and focusing on teaching adaptive coping skills based on the transactional model of stress and coping along with tailored self-directed materials (including nicotine patches, if not contraindicated) (n = 245) vs. tailored self-directed materials (including nicotine patches, if not contraindicated) (n = 251). Participants were surveyed at baseline and at 2 weeks, 6 months, and 12 months postintervention. The outcome was 7-day point prevalent abstinence. The objective of this study was to test for arm differences in smoking cessation rates at 2 weeks and 6 months postintervention (primary) and at 12 months postintervention (secondary). We found no overall effect of the proactive intervention on cessation rates. Among younger participants (age <50), the cessation rate in the intervention group was higher than in the control group at 2 weeks postintervention (16% vs. 4%, p = .046). For older participants (age >50), there were no group differences. Proactive telephone counseling focusing on adaptive coping skills was difficult to implement among smokers in lung cancer patients' social network. Although this study did not demonstrate any added benefit to cessation rates, this null finding may be a result of an intervention that was weaker than intended, owing to difficulties in completing the counseling phone calls. We discuss lessons learned and areas for future research in this special population.

Smoking Cessation in Cancer Patients: A Systematic Review

Objective: Comprehensive treatment plans for oncology patients including tobacco smoking cessation interventions are essential, as smoking after the diagnosis of a smoking-related cancer negatively impacts many aspects of treatment in this patient population. The primary objective was to evaluate, through a systematic review, smoking cessation interventions and cessation rates in cancer patients. Method: The literature was searched using Medline, EMBASE, Google Scholar, and the Cochrane Library (inception to September 2011) by 3 independent review authors. Included studies described tobacco smoking cessation interventions with patients randomized to usual care or an intervention. The primary outcome measure was cessation rates. Two authors extracted data independently, and disagreements were resolved by consensus. Results: Eight randomized control trials (RCTs) investigating smoking cessation interventions in the oncology patient population were identified. Pooled relative risks were calculated from 2 groups of RCTs of smoking cessation interventions based on follow-up duration. In both groups, the pooled relative risk did not suggest a statistically significant improvement in tobacco cessation compared to usual care. However, a subgroup analysis looking at newer combination interventions within the last 10 years yielded a statistically significant difference in smoking cessation rates. Conclusion: Despite the importance of smoking cessation in oncology patients, there are a paucity of studies. The review suggests that newer combination interventions involving both nonphamacological and pharmacological approaches, in the last decade, yield a statistically significant difference in smoking cessation rates compared to usual care.

Differences Between Latino Daily Light and Heavier Smokers in Smoking Attitudes, Risk Perceptions, and Smoking Cessation Outcome

Daily light smoking is increasing and disproportionately represented among Latinos. The current study examines differences in smoking attitudes, psychosocial characteristics, risk perceptions, and cessation rates between Latino daily light (3-9 cigarettes/day) and heavier smokers (≥ 10 cigarettes/day). Participants (N = 131; M(age) = 36.8, 73.3% female, 53.1% light smokers) were enrolled in a study focused on motivating smokers to quit. Cessation was biochemically verified at 2 and 3 months after end of treatment. Heavier smoking was more prevalent among males (65.7%) and those from Puerto Rico (69.0%). Compared with heavier smokers, light smokers were less nicotine dependent (p < .001), reported fewer pros of smoking (p ≤ .001), less perceived stress (p ≤ .001), had fewer friends who smoked (p ≤ .005), were more likely to live in a household with an indoor smoking ban (p ≤ .001), and self-reported better health (p < .05). Regarding risk perceptions, Latino light smokers reported less perceived vulnerability for the health effects from smoking on their child's health (p < .05). There were no significant differences in smoking cessation rates between daily light and heavier smokers at either 2- or 3-month follow-up. Belief that quitting would improve "their own health," however, significantly predicted smoking cessation at both 2- and 3-month follow-up, but only among heavier smokers. Latino light smokers do not seem to be more likely to quit smoking than Latinos who smoke at heavier rates. Differences between Latino light and heavier smokers in demographics, smoking attitudes, and psychosocial factors may need to be considered when developing cessation programs and mass media campaigns. Future research should continue to explore whether Latino light smokers need different or more targeted treatments.

Results of a Randomized Controlled Trial of Intervention to Implement Smoking Guidelines in Veterans Affairs Medical Centers

The AHRQ Clinical Practice Guideline for Treating Tobacco Use and Dependence recommends screening and treatment of all tobacco users. Effective methods to implement recommendations are needed because simple guideline dissemination does not necessarily result in changes in practice. The Guideline Implementation for Tobacco (GIFT) study tested an organizational intervention to improve Guideline implementation. GIFT randomized 20 Veterans Affairs medical centers to intervention or control conditions. We trained prime movers at each site to improve identification of smoking status, promote primary care interventions and increase availability of smoking cessation medications. Sites and patients were evaluated before and after intervention. GIFT included 20 Veterans Affairs medical centers and 5678 subjects. Data regarding smoking status, delivery of treatment, medication use, and smoking cessation were collected from participant surveys, medical record review, survey of site leaders, and Pharmacy Benefits Management. The intervention did not increase participant report of being asked about smoking status or receipt of counseling. It did increase the rate of identification of smoking status in the medical record (P = 0.0001) but did not increase the rate of counseling to stop smoking. Site level data showed no increase in the number of patients receiving smoking cessation medications or dollars spent on medications. Individual smoker data showed a significant increase in the use of medications for smoking cessation in intervention sites (odds ratio = 6.89, P < 0.0001); however, only a small minority of smokers received medication even after the intervention. There was no difference in smoking cessation rates between participants at the intervention and treatment sites. We conclude that improvements in smoking cessation rates are likely to require more intensive intervention in this population.

Nicotine Patch for Smoking Cessation-Reply

In Reply. —Dr Lahad's letter discusses the possible role that univariate disparities in various baseline factors might have in explaining the difference in smoking cessation rates in our double-blind, placebo-controlled, randomized trial. Adjustment for such factors is more critical in epidemiologic retrospective, nonrandomized studies where various biases may distort the findings. Two points are noteworthy. First, our results showing the efficacy of transdermal nicotine replacement therapy are consistent with other randomized trials where, in general, active treatment results in a doubling of the smoking cessation rate. 1-3 Second, using logistic regression, we reanalyzed the 8-week and 1-year cessation rates, adjusting for the six baseline variables mentioned by Dr Lahad (employed, depressed or down, previously treated for depression, pack-years of cigarette smoking, serum cotinine level, and baseline withdrawal symptom score). Assignment to active patch treatment was still a significant predictor of cessation adjustment for these after 8 weeks (two-tail P