Interest In Smoking Cessation Research Articles

ERRATUM to “Has interest in smoking cessation declined during the COVID-19 pandemic?”

ERRATUM to “Has interest in smoking cessation declined during the COVID-19 pandemic?”

Has interest in smoking cessation declined during the COVID-19 pandemic?

Has interest in smoking cessation declined during the COVID-19 pandemic?

Changes in prevalence and predictors of tobacco smoking and interest in smoking cessation in Turkey: Evidence from the Global Adult Tobacco Survey, 2008-2016.

INTRODUCTIONTurkey conducted three rounds of the Global Adult Tobacco Survey (GATS) in 2008, 2012, and 2016 to monitor tobacco use and key tobacco control indicators. The prevalence estimate of adult tobacco use was 31.2% in 2008 and it declined to 27.1% in 2012.METHODSGATS is a nationally-representative, cross-sectional household survey of tobacco-use and related behaviors among adults aged ≥15 years. Outcome measures were prevalence of current tobacco smoking and interest in quitting smoking. Multivariable logistic regression analyses assessed changes in the adjusted prevalence and predictors of the outcome variables.RESULTSThe unadjusted prevalence of tobacco smoking among adults was 31.6% in 2016; a significant increase in the adjusted prevalence of 4.5% from 2012 to 2016. A significant 19.4% decline was observed in interest in quitting smoking from 2012 to 2016. Tobacco smoking was lower among women (adjusted prevalence ratio, APR=0.38) and rural residents (APR=0.79), and higher among adults aged 25–64 years compared to those aged 15–24 years (APR=1.63), and those who lived with other adults who smoke tobacco (APR=1.55). Predictors of increased interest in quitting smoking included rural residence (APR=1.13), higher education level (APR=1.21–1.36), awareness of anti-tobacco warnings and advertisements (APR=1.30), and belief that smoking causes severe health consequences (APR=1.57).CONCLUSIONSThis study identified opportunities to reduce tobacco smoking and increase interest in quitting, including increasing awareness of the health consequences of smoking and of evidence-based cessation resources. This study highlights Turkey’s commitment to assessing or monitoring tobacco use and key tobacco indicators to inform their policies and programs in a changing tobacco landscape.

Heavy Smoking Patients Receiving a Lung Cancer Screen Want to Quit: A Call for Tailored Cessation Interventions.

BackgroundLung cancer screening for current or former heavy smokers is now recommended among all asymptomatic adults 50–80 years old with a 20 pack-year history of smoking. However, little is known about the smoking-related attitudes of this population.MethodAn assessment was conducted among 1,472 current smokers who presented for an annual lung cancer screen at one of 12 diagnostic imaging sites in Rhode Island between April 2019 and May 2020. Patients were asked about their use of smoking products, interest in quitting, and smoking-related attitudes.ResultsPatients smoked a median of 16 cigarettes per day; 86.6% were daily cigarette smokers and 30.1% were daily cigar smokers. In total, 91.4% of patients were, to some degree, interested in quitting smoking and 71.4% were seriously thinking about quitting in the next 6 months or sooner. Patients planned on smoking less regardless of whether their lung screen was positive or negative for cancer, though they were more likely to plan on smoking less if negative (on 0–3 pt Likert scale: 0.31, 95% CI [0.27, 0.34] vs. 0.77, 95% CI [0.72, 0.81]). Confidence in quitting and belief in one’s inherent ability to quit smoking varied substantially within the sample.ConclusionNearly all current smokers receiving a lung cancer screen have some interest in smoking cessation. Due to the heterogeneity in some smoking-related attitudes, tailored interventions for this population should be tested.

Differences in the Effectiveness of Health Promotion through Video and Interactive Dialogue on Smoking Cessation Interest Among Teenagers in Palembang

Cigarettes have long been recognized as a risk factor for various health problems, and are the world's largest preventable cause of death1. Teenagers are more easily influenced especially by social groups to do negative things, such as smoking2. Currently the trend to start smoking is increasing among teenagers. This study aims to compare the effectiveness of health promotion presented in the form of audio-visual and interactive dialogue on interest in quitting smoking in teens in Palembang. This research is an analytic study through a quasi-experimental approach with a pretest-posttest two group research design without control group. The research sample consisted of 206 teenage smokers, divided into 2 groups, namely 103 teenage in the video group and 103 teenage in the interactive dialogue group. This study uses paired t-test, Wilcoxon, and Mann Whitney test. This study reveals that health promotion through video media and interactive dialogue is effective to elevate the knowledge and interest in smoking cessation among teenagers (p = 0.000 α = 0.05). The mean value of knowledge and interest in the interactive dialogue group is higher than in the video group. However, there was no difference concerning effectiveness of health promotion through interactive dialogue and videos on the knowledge and interest in quitting smoking among teenagers. (p = 0.21 α = 0.05).

Insights From the SmokeFree.gov Initiative Regarding the Use of Smoking Cessation Digital Platforms During the COVID-19 Pandemic: Cross-sectional Trends Analysis Study.

BackgroundSmoking is a plausible risk factor for COVID-19 progression and complications. Smoking cessation digital platforms transcend pandemic-driven social distancing and lockdown measures in terms of assisting smokers in their quit attempts.ObjectiveThis study aims to examine trends in the number of visitors, followers, and subscribers on smoking cessation digital platforms from January to April 2020 and to compare these traffic data to those observed during the same 4-month period in 2019. The examination of prepandemic and postpandemic trends in smoking cessation digital platform traffic can reveal whether interest in smoking cessation among smokers is attributable to the COVID-19 pandemic.MethodsWe obtained cross-sectional data from daily visitors on the SmokeFree website; the followers of six SmokeFree social media accounts; and subscribers to the SmokeFree SMS text messaging and mobile app interventions of the National Cancer Institute’s SmokeFree.gov initiative platforms, which are publicly available to US smokers. Average daily percentage changes (ADPCs) were used to measure trends for the entire 2020 and 2019 study periods, whereas daily percentage changes (DPCs) were used to measure trends for each time segment of change within each 4-month period. Data analysis was conducted in May and June 2020.ResultsThe number of new daily visitors on the SmokeFree website (between days 39 and 44: DPC=18.79%; 95% CI 5.16% to 34.19%) and subscribers to the adult-focused interventions QuitGuide (between days 11 and 62: DPC=1.11%; 95% CI 0.80% to 1.43%) and SmokeFreeTXT (between days 11 and 89: DPC=0.23%; 95% CI 0.004% to 0.47%) increased, but this was followed by declines in traffic. No comparable peaks were observed in 2019. The number of new daily subscribers to quitSTART (ie, the teen-focused intervention) trended downward in 2020 (ADPC=−1.02%; 95% CI −1.88% to −0.15%), whereas the overall trend in the number of subscribers in 2019 was insignificant (P=.07). The number of SmokeFree social media account followers steadily increased by <0.1% over the 4-month study periods in 2019 and 2020.ConclusionsPeaks in traffic on the SmokeFree website and adult-focused intervention platforms in 2020 could be attributed to an increased interest in smoking cessation among smokers during the COVID-19 pandemic. Coordinated campaigns, especially those for adolescents, should emphasize the importance of smoking cessation as a preventive measure against SARS-CoV-2 infection and raise awareness of digital smoking cessation platforms to capitalize on smokers’ heightened interest during the pandemic.

Electronic Smoking Behavior Among Adult Males in Jordan.

The use of Electronic cigarettes (E-cigarettes) has considerably expanded especially among adults. This paper highlights the behavior regarding E-cigarettes uses among adult males in Jordan. Moreover, we studied the electronic cigarette devices, the electronic cigarette liquids used in them, and the health-related complaints associated with e-smoking. Among smokers, we studied the association between E-cigarette use and their interest in smoking cessation. A questionnaire-based study regarding electronic cigarette prevalence and awareness among Jordanian individuals was conducted with a total sample size of 1536 participants. The questionnaire was distributed using Facebook and WhatsApp social groups. In this study, we included data of a total of 254 adult male participants after excluding non-E-cigarettes smokers, female smokers, and male smokers younger than 18years old from the previously published study (Electronic Cigarettes Prevalence and Awareness among Jordanian Individuals) to describe electronic smoking behavior among adult males in Jordan. We described smoking behavior, electronic smoking technologies and materials, source of knowledge, and believe regarding electronic smoking among participants. A total of 254 E-cigarette smokers have participated in this study. 104 participants (40.9%) were found to smoke both traditional and electronic cigarettes, 111 (43.7%) quit traditional cigarette smoking and switched to E-cigarettes, and 39 (15.3%) individuals are exclusively e-smokers. More than half of the participants (n = 144; 56.7%) believe E-smoking is not addictive, and 213 (83.8%) suppose that the overall health effects attributable to E-smoking are less severe and not as serious as those related to traditional smoking. The use of E-cigarettes increased both nationally and globally in the past few years and is considered an emerging modality of smoking among non-smokers. Social media and other internet websites are the main sources of knowledge regarding E-cigarettes. Health-related issues and addiction are thought to be less than traditional smoking in considerable percentages of E-smokers. A more comprehensive conception of E-smoking patterns in Jordan is required to approach this phenomenon. Health authorities in collaboration with governmental policymakers are obligate to adopt strict recommendations to control the promotion of E-smoking through social media and other internet websites to limit its distribution among people especially youths.

S1265 Smoking Cessation Care in a Tertiary Center’s Gastroenterology (GI) Clinics: Role of the Electronic Health Record (EHR), Providers’ Practices and Barriers to Success

INTRODUCTION: Smoking has an unfavorable effect in various gastrointestinal ailments including peptic ulcer disease and Crohn's disease, and is a risk factor for multiple gastrointestinal cancers. Despite key recommendations for diagnosing and treating tobacco use disorder in healthcare settings, the degree to which this is implemented in GI clinics is unknown. We aim to study the smoking cessation care in our GI clinics across different timeframes with different EHRs, assess our providers' practices and identify perceived barriers for implementing smoking cessation treatments. METHODS: Retrospective cohort study of patients presenting to our institution's outpatient GI clinics. Data was extracted from the period 1–5/2018 while Allscripts was in place, and compared to the period 6–12/2018 after transitioning to EPIC. In addition, our GI attending physicians were invited to complete a survey regarding their smoking cessation care practices. RESULTS: Data for a total of 15,431 patients was extracted. 83% of patients were assessed for smoking pre-EPIC, in comparison to 98% of the patients who had visited our clinics post-EPIC (P < 0.0001). Although more smokers were identified in the cohort of patients pre-EPIC (15.7% vs 14.3%, P = 0.02), more patients were on treatment for smoking cessation post-EPIC (6.5% vs 2.7%, P < 0.0001). 77% attending GI physicians responded to the anonymous survey, and nearly half of them stated they always asked their patients if they smoked. However, 29% of the physicians stated they sometimes or often would assess their patients' willingness to quit at the time of the visit, and 58.8% had never assisted patients by prescribing smoking cessation medications. 82% of the providers reported “Patients not interested” as an extremely/very important barrier, followed by the “Lack of a systematic program to outreach,” reported by 76% of providers as an extremely/very important barrier. CONCLUSION: A significantly higher number of patients were assessed for smoking after the transition to EPIC EHR, largely attributable to EPIC's Best Practice Alert (BPA). Although patients' perceived lack of interest in smoking cessation was regarded as a major barrier to smoking cessation treatment among providers, about one third of providers have never or rarely assessed their patients' willingness to quit smoking. This study sheds light on an often under-recognized source of morbidity in our GI patients, and identifies potential avenues to improve smoking cessation care, including utilization of the EHR.Table 1.: Smoking prevalence and treatment among GI patients pre EPIC vs post EPICFigure 1.: Survey Question: In the past month, how frequently did you assess if patients are willing to attempt to quit at this time?Figure 2.: Survey Question: Please rate the importance of the following that might limit your smoking cessation treatment practice: Lack of a systematic program to outreach and offer help to patients who smoke.

Novel Application of Exhaled Carbon Monoxide Monitors: Smoking Cessation in Orthopaedic Trauma Patients

To determine whether an in-office exhaled carbon monoxide (CO) monitor can increase interest in smoking cessation among the orthopaedic trauma population. Prospective. Level I trauma center. One hundred twenty-four orthopaedic trauma patients. In-office measurement of exhaled CO. Stage of change, Likert scale score on willingness to quit today, patient's request for referral to a quitline, and increase in readiness to quit. The use of an exhaled CO monitor increased willingness to quit in 71% of participants still smoking and increased willingness to quit on average by 0.8 points on a 10-point Likert scale (P < 0.001). Fifteen percent of patients modified their stage of change toward quitting. Forty percent of patients after exhaled CO monitor requested referral to a quitline, compared with 4% presurvey (P < 0.001). Anecdotally, most participants were very interested in the monitoring device and its reading, expressing concern with the result. The value of exhaled CO was not associated with any measured outcomes. The use of an exhaled CO monitor increased willingness to quit smoking in 71% of patients, but the effect size was relatively small (0.8 points on a 10-point Likert scale). However, use of the CO monitor resulted in a large increase (40% vs. 4%) in referral to the national Quitline. Use of the Quitline typically increases the chance of smoking cessation by 10 times the baseline rate, suggesting that this finding might be clinically important. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

Smoking cessation after hospitalization for myocardial infarction or cardiac surgery: Assessing patient interest, confidence, and physician prescribing practices.

BackgroundPrioritizing and managing multiple behavior changes following a cardiac hospitalization can be difficult, particularly among smokers who must also overcome a serious addiction.HypothesisHospitalized smokers will report a strong interest in smoking cessation (SC) but will receive little assistance from their physicians.MethodsWe asked current smokers hospitalized for an acute cardiac event to prioritize their health behavior priorities, and inquired about their attitude toward SC therapies. We also assessed SC cessation prescriptions provided by their physicians.ResultsOf the 105 patients approached, 81 (77%) completed the survey. Of these, 72.5% ranked SC as their greatest health change priority, surpassing all other behavior changes, including: taking medications, attending cardiac rehabilitation (CR), dieting, losing weight, and attending doctor appointments. Patients felt that SCM (44%), CR (41%), and starting exercise (35%) would increase their likelihood for SC. While most patients agreed that smoking was harmful, 16% strongly disagreed that smoking was related to their hospitalization. At discharge, medication was prescribed to ~32% of patients, with equal frequency among patients who reported interest and those who reported no interest in using medications.ConclusionThe majority of hospitalized smokers with cardiac disease want to quit smoking, desire help in doing so, and overwhelmingly rate cessation as their highest health behavior priority, although some believe smoking is unrelated to their disease. The period following an acute cardiac event appears to be a time of great receptivity to SC interventions; however, rates of providing tailored, evidence‐based interventions are disappointingly low.

Willingness-to-try various tobacco cessation methods among US adult cigarette smokers.

INTRODUCTIONLong-term smoking cessation success rates without substantive intervention remain low. Some studies suggest an association between sociodemographic factors and tobacco cessation success. We explored US adult tobacco cigarette users’ willingness-to-try diverse tobacco cessation methods by sociodemographics and tobacco use habits.METHODSWe electronically surveyed a convenience sample of 562 US adults to explore willingness-to-try various cessation methods among those who reported current tobacco cigarette use. Participants rated their willingness-to-try different cessation methods. Logistic regression models examined associations between willingness-to-try tobacco cessation methods based on sociodemographic and tobacco use characteristics.RESULTSNon-Whites were more likely to report willingness-to-try counseling (RR=1.32, 95% CI: 1.14–1.52) and those with high school education or less were less likely to report willingness-to-try counseling (RR=0.78, 95% CI: 0.64–0.95). Those with lower income were less likely to report willingness-to-try any medication (RR=0.84, 95% CI: 0.73–0.98) and any counseling (RR=0.82, 95% CI: 0.67–0.99). High nicotine dependence was associated with a high likelihood of reporting willingness-to-try any evidence-based method (RR=1.07, 95% CI: 1.04–1.10) and a history of quit attempts was associated with likelihood to report willingness-to-try any evidence-based method (RR=1.31, 95% CI: 1.10–1.56).CONCLUSIONSSociodemographics and nicotine dependence may affect preferences for tobacco cessation methods and should be considered when counseling patients on tobacco cessation.

Effect of a Smoking Cessation Program on Inpatients in the Largest Hospital in Southern Iran.

Background:There is evidence that cessation programs can be effective for hospital inpatients. Hence, the aim of this study was to investigate the effects of such programs and factors that may affect success.Methods:This study was carried out on in-patient users of tobacco in Shiraz Hospital, Iran in 2015. After implementing the inclusion criteria, a study population was selected using a convenience sampling method. Participants were contacted monthly by study personnel concerning certain aspects of their tobacco cessation program. The study lasted 6 months. Data analyses involved survival analysis using Kaplan–Meier analysis, log-rank test, and multivariate Cox regression modeling.Results:The study included 425 in-patient smokers of which 328 (77.2%) were male. Median follow-up time was 96 days (interquartile range: 20–150). Cessation survival rates were 76% at 1 month, 63% at 2 months, and 61% at 3 months. From the 4th month onward rates remained unchanged at 60%. Univariate analyses with variables such as time since last smoking, consumption type, interval between wake-up and consumption, the severity of dependence and interest in smoking cessation were statistically significant as to cessation survival rate (P < 0.05). After adjusting the confounding variables based on multivariable analyses, results indicated that consumption type, the severity of dependence and interest in smoking cessation were the most important predictors of cessation survival rates among in-patient smokers.Conclusions:Findings indicated that application of the cessation program among our group of inpatients appears to have been an effective intervention that produced an extended period of no smoking.

Effect of Smoking Status on Exercise Perception and Intentions for Cardiac Rehabilitation Enrollment Among Patients Hospitalized With an Acute Cardiac Condition.

Cardiac rehabilitation (CR) attendance has been associated with higher smoking cessation (SC) rates. However, for unclear reasons, smokers are consistently less likely to enroll in CR than nonsmokers, and it is uncertain what might encourage them to attend. We surveyed patients eligible for CR who were cigarette smokers at the time of hospital admission. We assessed patient intention to quit smoking, start exercising, and enroll in CR. We also measured anxiety and depression levels. Of the 105 patients approached, 81 (77%) completed the survey (69% males, aged 57 ± 10 y, 72% white). Most patients reported interest in SC (80%) and attending CR (78%). Many felt that SC medications (41%), stress management programs (35%), and an exercise program with SC counseling (30%) would increase their likelihood to attend CR; however, 30% stated that they would be less likely to enroll in CR if they continued smoking following discharge. Many patients indicated high levels of anxiety (51%) and depression (27%); many desired to reduce stress following discharge (73%), with 35% stating that stress management programs would increase their likelihood to attend CR. Hospitalized smokers eligible for CR report significant interest in SC, attending CR, and beginning an exercise program. These patients show high levels of anxiety and depression and indicate a strong interest in stress management programs. These results suggest that messages emphasizing the role of CR in the treatment of depression, anxiety, and stress are likely to resonate with smokers, increase their enrollment in CR, and support long-term SC.

Tobacco Price Increases and Population Interest in Smoking Cessation in Japan Between 2004 and 2016: A Google Trends Analysis.

Tobacco price increases can generate increased public interest in smoking cessation, but it is not clear how long this interest lasts. Our objective was to evaluate the duration of the impact of cigarette price increase in Japan using Google search data. Monthly or daily aggregated Google search volume for smoking cessation in Japan from 2004 to 2016 was collected in terms of relative search volume (RSV) ranging from 0 to 100. Using monthly RSV data, we evaluated possible relationships between the RSVs and tobacco control measures in Japan. Time periods within which the impact of search volume significantly increased were identified by cluster detection test, using daily RSV data. A spike in RSV preceding the enforcement of a cigarette price increase revealed an anticipation effect. Between 2004 and 2016, the three highest monthly RSV spikes were observed in July 2006 (RSV = 66), when cigarette prices increased by 11%, and in September (RSV = 90) and October 2010 (RSV = 100), when cigarette prices increased by 37%. Regarding daily RSV, the detected cluster size around the price increase in 2010 (52 days) was longer than that in 2006 (17 days). In 2010, a cluster period of 25 days before the date of the price increase was observed, suggesting an anticipation effect. After the onset of the price increase, a cluster of 27 days was detected. When the cigarette price increased due to consumption tax in April 2014, almost no anticipation effect was observed. The population impact of tobacco price increases on smoking cessation may be assessed using Google Trends data. The cluster indicates that a higher cigarette price increase had a higher and longer lasting effect on population interest in cessation, but the impact may continue for a relatively short time. To examine the duration of the impact of cigarette price increases on population interest in smoking cessation in Japan, Google search data for smoking cessation were analyzed. Between 2004 and 2016, the three highest spikes of monthly RSV were observed in October 2010, when cigarette prices increased by 37%. Analyzing daily RSV data, the detected cluster size around the price increase in 2010 was 52 days, and a cluster period of 25 days before the date of the price increase was observed, suggesting an anticipation effect. The cluster indicates that a higher cigarette price increase had a higher and longer lasting effect, but the population impact continues for a relatively short time. Further increases in the price of cigarettes are necessary.

Awareness of harm to others from secondhand smoke and smokers' interest in smoking cessation

Objectives Because smoking presents various health hazards, smoking cessation is important for health promotion. It is known that awareness of the harm of smoking to smokers themselves is associated with attempts to quit. However, the association between smoking cessation and awareness of harm to others from secondhand smoke has not been well examined. Therefore, in this research, we examined the association between smokers' awareness of the harm to others from secondhand smoke and their interest in smoking cessation, focusing on current smokers in an Internet survey of the general population of Japan.Methods We conducted a cross-sectional Internet survey of the general population of Japan between January 27 and March 13, 2017. A total of 1,586 respondents aged 15-71 years (1,128 men and 458 women) who were current smokers were analyzed. We used multivariable-adjusted logistic regression to examine the association among awareness of smoking's harm to smokers themselves, awareness of harm to others from secondhand smoke, and the smokers' interest in smoking cessation.Results Of current smokers, 81.6% of men and 88.2% of women were aware of the harm caused to others by secondhand smoke; 52.7% of men and 64.6% of women were interested in smoking cessation. Using awareness of harm to smokers themselves and awareness of harm to others from secondhand smoke as predictor variables in multivariable-adjusted logistic regression, odds ratios were 2.53 and 2.92, respectively. In the model using both awareness of harm to smokers themselves and harm to others from secondhand smoke, both have a significant independent positive association with smokers' interest in quitting.Conclusions Current smokers aware of the harm caused to others by secondhand smoke were more interested in quitting than those who were not. Awareness of the harm caused to smokers themselves by smoking and awareness of the harm caused to others by secondhand smoke have a significant independent positive association with smokers' interest in quitting. Although this study is a cross-sectional study and did not investigate causal relationships, the findings suggest that raising awareness of the harm to other people from secondhand smoke may lead to more interest in smoking cessation, and the data can be used to promote tobacco control in the future.

Changes of Interest in Smoking Cessation Due to Guidance Once a Year : Analysis of Effectiveness of Guidance Based on Improvements in Behavior Change Stage

Changes of Interest in Smoking Cessation Due to Guidance Once a Year : Analysis of Effectiveness of Guidance Based on Improvements in Behavior Change Stage

Interest in Smoking Cessation and Its Related Factors in Male Smokers

Interest in Smoking Cessation and Its Related Factors in Male Smokers

Examining the effects of illicit drug use on tobacco cessation outcomes in the Helping HAND 2 randomized controlled trial

BackgroundIndividuals with substance use disorders (SUD) smoke at higher rates and have higher tobacco-related mortality than the general population. Despite having an interest in smoking cessation, smokers with SUDs may have greater difficulty quitting. MethodsAnalysis of data from a RCT testing a post-discharge smoking cessation intervention for hospitalized cigarette smokers interested in quitting. Past 7day tobacco abstinence was self-reported at 1, 3, and 6 months and biochemically confirmed at 6 months post-discharge. Other drug use was assessed at baseline by self-report or a past-year discharge diagnosis of SUD. Multiple logistic regression compared tobacco cessation outcomes among participants with no recreational drug use (NDU; n=942) vs. marijuana only (MU; n=284) vs. other illicit drugs (IDU; n=131). ResultsGroups differed at baseline on age, gender, race, education, other household smokers, alcohol use, and anxiety/depression (all p<0.05). Confirmed 6-month tobacco abstinence was lower among IDU than NDU participants (9% vs 18%, p=0.01; AOR=0.43, CI: 0.22–0.84) after adjustment for study arm, smoking characteristics, demographics, quality of life, alcohol use and MU. Confirmed 6-month abstinence did not differ significantly between MU vs. NDU participants (14% vs 18%, p>0.05; AOR=0.77, CI:0.51–1.14). Counseling and medication use did not differ significantly among groups at any follow-up. ConclusionsHospitalized smokers who planned to stop smoking after discharge and used cessation assistance were less successful if they had used illicit drugs in the past year, but not if they had only used marijuana. More intensive or tailored interventions may be required to address smoking in this population.

Barriers to Smoking Cessation Among Drug-Resistant Tuberculosis Patients in South Africa

BackgroundDrug-resistant tuberculosis (DR-TB) remains a significant cause of morbidity and mortality. The long-term health effects of smoking and the risk of adverse TB outcomes, including increased periods of infectiousness, have been reported among DR-TB patients in South Africa. ObjectivesThis study aimed to identify the barriers to smoking cessation among DR-TB inpatients at a hospital in Durban, South Africa. MethodsA qualitative design using in-depth interviews with a purposive sample of 20 DR-TB inpatients was employed. The sample included 15 men and 5 women aged 18-70 years who self-identified as smokers. Open-ended questions were used to explore barriers militating against smoking cessation among this sample. Data were analyzed with the aid of the software QSR NVivo10. FindingsPersonal and structural-level barriers (factors) to smoking cessation were identified. Personal factors included addiction and non–addiction-related barriers. Addiction-related barriers included smoking history, cravings for a cigarette, smoking as part of a daily routine, and failed quit attempts. Non–addiction-related barriers included lack of knowledge about quit strategies, psychosocial stress, lack of the willpower to quit smoking, and the influence of peers. Structural barriers included ineffective health education programs, lack of extramural activities when on admission in hospital leading to a lot of spare time, lack of smoking cessation interventions, and access to cigarettes within and around the hospital environment. Patients expressed interest in smoking cessation and conveyed their frustration at the lack of appropriate support to do so. ConclusionsThe findings reiterate the need for smoking cessation intervention to be incorporated as an integral component of DR-TB management in South Africa. Many patients expressed an interest in pharmacological aids and psychological support to help them to quit smoking. Additionally, offering extramural activities and enforcing smoke-free policies in hospital facilities will help to reduce patients' access to cigarettes while at the hospital.

Awareness among patients with cancer of the harms of continued smoking.

179 Background: Smoking cessation is becoming an integral part of cancer survivorship. To help improve survivorship education, clinicians need an understanding of patient knowledge of the harms of continued smoking. Methods: Patients with various cancer subtypes were surveyed with respect to self-awareness of the harms of continued smoking on cancer outcomes. Multivariable logistic regression models assessed factors associated with the level of awareness. Results: Among 985 patients, 23% smoked at diagnosis; 34% quit &gt; 1 year prior to diagnosis; 25% had lung, 30% had head and neck cancers; 77% received curative therapy. Many patients reported being unaware that smoking can negatively impact cancer surgery (65%), radiation (74%), chemo outcomes (64%), treatment efficacy (70%), cancer prognosis (54%) and second primary development (52%). Among all patients, those smoking at diagnosis were significantly more likely to be unaware of radiation (aOR = 1.73, 95% CI [1.16-2.57]) and chemo (aOR = 2.10 [1.17-3.79]) toxicities, cancer prognosis (aOR = 1.63 [1.16-2.29]) and second primary risk (aOR = 1.61 [1.14-2.26]). Those with poorer health status were more likely unaware of effects on prognosis (aOR = 1.56 [1.18-2.08]) and second primaries (aOR = 1.54 [1.14-2.08]). Patients with non-tobacco related cancers (non-TRCs) were more likely unaware smoking impacts cancer surgery (aOR = 1.45 [1.04-2.04]) and radiation (aOR = 1.37 [1.01-1.85]). Among smokers at diagnosis, those with non-TRCs (aOR = 4.00 [1.45-11.11]) were more likely unaware smoking can impact chemo outcomes. Awareness was not associated with stage, second-hand smoke exposure, cessation or interest in a smoking cessation program (SCP), but was associated with patients believing that a SCP would be beneficial to their health (aORs = 2.33-4.35, P &lt; 0.03). Among smokers at diagnosis, believing that a SCP is beneficial (51%) was associated with both interest in an in-patient (aOR = 4.65 [2.15-10.03]) and ambulatory (aOR = 4.08 [2.14-7.79]) SCP. Conclusions: Many cancer patients were unaware of the harms of continued smoking; mainly smokers at diagnosis and those with non-TRCs. Patient education should focus on emphasizing awareness, which may help improve patient interest in smoking cessation.