Maintenance Of Cessation Research Articles

Integrating Social Determinants of Health With Tobacco Treatment for Individuals With Opioid Use Disorder: Feasibility and Acceptability Study of Delivery Through Text Messaging.

BackgroundIndividuals with opioid use disorder (OUD) have a high prevalence of smoking and frequently experience unmet social determinants of health (SDOH), which may be barriers to smoking cessation. Hospitalization is an opportunity to encourage smoking cessation. Unfortunately, many clinicians do not provide tobacco treatment to support the maintenance of cessation achieved during hospitalization. Interventions are required to support these high-risk individuals after hospital discharge.ObjectiveThis study aimed to test the feasibility and acceptability of a 28-day SMS text messaging program tailored to individuals with OUD, which provides smoking cessation support and addresses unmet SDOH needs.MethodsFrom July to December 2019, we enrolled 25 individuals who were hospitalized with tobacco dependence and OUD at our large safety net hospital. The SMS text messaging program was initiated during hospitalization and continued for 28 days. Participants were enrolled in either the ready to quit within 30 days or the not ready to quit within 30 days program based on their readiness to quit. Automated SMS text messages were sent twice daily for 4 weeks. The topics included health and cost benefits of quitting, both general and opioid specific (16 messages); managing mood and stress (8 messages); motivation, coping strategies, and encouragement (18 messages); addressing medication misconceptions (5 messages); links to resources to address substance use (2 messages providing links to the Massachusetts Substance Use Helpline and Boston Medical Center resources), tobacco dependence (1 message providing a link to the Massachusetts Quitline), and unmet SDOH needs (6 messages assessing SDOH needs with links to resources if unmet SDOH needs were identified). Questionnaires and interviews were conducted at baseline and at 2 and 4 weeks after enrollment.ResultsThe participants were 56% (14/25) female, 36% (9/25) African American, 92% (23/25) unemployed, and 96% (24/25) Medicaid insured. Approximately 84% (21/25) activated the program, and none of the participants unsubscribed. Approximately 57% (12/21) completed either the 2- or 4-week questionnaires. Program satisfaction was high (overall mean 6.7, SD 0.8, range 1-7). Many perceived that the SMS text messaging program provided social support, companionship, and motivation to stop smoking. Messages about the health benefits of quitting were well received, whereas messages on how quitting cigarettes may prevent relapse from other substances had mixed views, highlighting the importance of tailoring interventions to patient preferences.ConclusionsSMS text messaging to promote smoking cessation and address SDOH needs may be an effective tool for improving quit rates and health outcomes in individuals with tobacco dependence and OUD. Our study adds to the growing body of evidence that SMS text messaging approaches are feasible and acceptable for providing tobacco treatment to all individuals who smoke, even among low-income populations who have OUD and are not ready to quit.

Evaluating the impact of a prison smoking ban on the cardiovascular health of men in a UK prison

PurposeSmoking rates are known to be higher amongst those committed to prison than the general population. Those in prison suffer from high rates of comorbidities that are likely to increase their risk of cardiovascular disease (CVD), making it more difficult to manage. In 2016, a tobacco ban began to be implemented across prisons in England and Wales, UK. This study aims to measure the effect of the tobacco ban on predicted cardiovascular risk for those quitting smoking on admission to prison.Design/methodology/approachUsing data from a prevalence study of CVD in prisons, the authors have assessed the effect of the tobacco ban on cardiovascular risk, using predicted age to CVD event, ten-year CVD risk and heart age, for those who previously smoked and gave up on admission to prison.FindingsThe results demonstrate measurable health gains across all age groups with the greatest gains found in those aged 50 years and older and who had been heavy smokers. Quitting smoking on admission to prison led to a reduced heart age of between two and seven years for all participants.Originality/valueThe data supports tobacco bans in prisons as a public health measure to reduce risk of CVD. Interventions are needed to encourage maintenance of smoking cessation on release from prison for the full health benefits to be realised.

P.095 Smoking behaviour change is associated with altered functional brain connectivity in older adults

Background: Smoking is the leading cause of preventable morbidity worldwide and therefore developing effective smoking cessation strategies is a public health priority. However, what brain networks support maintenance of smoking cessation in the long term remains unexplored. Methods: We analyzed the baseline resting-state fMRI data acquired in 23 smokers (Mage = 61.52 ± 3.7) who were followed longitudinally in a cohort of cognitively normal older adults. Self-reported smoking status and amount were recorded at baseline and repeated after 4 years. We investigated the effect of smoking behaviour change on functional brain connectivity using seed-to-voxel approach. We examined a-priori regions of interest (ROIs) including the reward network (ventromedial prefrontal cortex (vMPFC) and ventral striatum) and the right insula. These ROIs are promising target mechanisms given prior behavioural research linking it to smoking cessation. Results: Our results revealed that reduced smoking was associated with reduced connectivity between ventral striatum and middle frontal gyrus and enhanced connectivity between right insula and middle temporal gyrus (voxel p <0.001, cluster p<0.05 FDR corrected). However, change in smoking did not reveal any significant effects in the vMPFC. Conclusions: Our findings suggest that successful smoking behaviour change is associated with altered reward network and insular functional connectivity in the long term.

Diabetic distal polyneuropathy: prevention, treatment and rehabilitation (review)

Relevance. Due to lifestyle changes, the prevalence of diabetes mellitus is increasing worldwide. Diabetes can affect the nervous system in various forms in the form of cognitive disorders, mono- or polyneuropathies ending in trophic disorders and "diabetic foot"; and distal symmetrical sensory-motor polyneuropathy. In the modern literature there is a significant amount of research in the field of methods of prevention, treatment and rehabilitation of patients with diabetes mellitus, accompanied by damage to the nervous system, but there is no generalized information on a comprehensive analysis of currently available techniques.The purpose of study. To study the available and most modern methods of rehabilitation of patients with diabetic damage to the nervous system with subsequent systematization of information.Materials and methods. The most relevant domestic and foreign literature sources containing information on the types of diabetic lesions of the nervous system, pathogenesis and rehabilitation of patients with these pathologies were analyzed.Results. An analysis of modern literature has shown a great variability in the prevention, treatment and rehabilitation of patients with distal diabetic polyneuropathy. Drug therapy is effective, however, with long-term use, it can be accompanied by complications from the body systems. Physiotherapeutic therapy is not inferior in variety, affecting the nervous, vascular and epithelial tissue by various methods – electric current, magnetic field, laser beams or photochromo-radiation, you can get the desired analgesic effect. The need for lifestyle is also an important part of patient therapy: maintenance of normoglycemia, smoking cessation and special physical activity.Conclusion. Treatment and rehabilitation of patients with diabetic distal painful polyneuropathy is a big problem for a neurologist-clinician. In modern sources, there is a significant variety of methods for correcting this condition, both medication and physiotherapy. Drugs as the first line of correction of somatosensory disorders are a necessary point in the treatment plan, but it is necessary to remember the side effects of any prescribed drug, the slow onset of the desired analgesic effect. This is necessary for the competent preparation of the patient for a difficult and lengthy rehabilitation process. Among the most effective drugs are gabapentin and prebagalin, drugs of the anticonvulsant group and thioctic acid. A possible bypass of side effects from drug therapy is the appointment of physical therapy, adjusting drug treatment. A significant effect, based on the presented studies, is observed when using magnetotherapy in combination with infrared radiation, transcutaneous electrical nerve stimulation and impulse current with vacuum exposure.

Maintenance of smoking cessation in Korean single mothers

BackgroundSingle mothers in South Korea are vulnerable to developing smoking habits, due to many difficulties and limitations; however, they have often been overlooked by smoking cessation support services. Therefore, this study aimed to investigate the general and smoking-related characteristics of single mothers registered with the Visiting a Smoking Cessation Service in Seoul, South Korea, to identify factors associated with smoking cessation maintenance at 4 weeks and 24 weeks after they initially quit smoking.MethodsThe participants were 77 single mothers registered in the Smoking Cessation Service Program. Data were included from a three-year span (January 2017–December 2019). Smoking cessation counseling, motivational enhancement, and self-exploration counseling were provided for six months. The participants were evaluated on their smoking cessation status at 4 weeks and 24 weeks.ResultsMost participants were aged 22 years or younger. The rates of smoking cessation maintenance were 58.4 and 18% at 4 weeks and 24 weeks, respectively. The higher the number of counseling sessions, the higher the participants’ chances of maintaining smoking in all non-smoking periods, and whether pregnancy, CO level, and drinking were significant only in a short-term non-smoking period (4 weeks).ConclusionsOur results suggest that the number of smoking cessation counseling sessions is important for long-term smoking cessation beyond short-term cessation in single mothers. To increase the smoking cessation rate of single mothers, it is important to conduct customized smoking cessation counseling at the time of smoking cessation and continue such counseling in the long term.

Smoking Cessation and Preterm Birth in Second Pregnancy Among Women who Smoked in Their First.

The benefit of smoking cessation in reducing the risk of preterm birth is well established. Relatively less well understood is the prevalence of smoking cessation maintenance at the next pregnancy and the associated preterm risk reduction. The aim of this study was to estimate the prevalence of maintenance of smoking cessation at second pregnancy and the associated relative risk of preterm birth. This was a longitudinal study with retrospectively obtained records of births to multiparous women who smoked in the pregnancy of their first birth in New South Wales, 1994-2016 (N = 63 195 mothers). Relative risks (RR) of preterm birth of the second child were estimated for smoking cessation with adjustment for final gestational age of the first birth, maternal age at the first birth, change in socioeconomic disadvantage between the first and second pregnancy, interpregnancy interval, and calendar time. Approximately 34% (N = 21 540) of women who smoked during their first pregnancy did not smoke in the second pregnancy. Smoking cessation among women who smoked at first pregnancy was associated with a 26% (95% CI: 21%, 31%) decrease in risk of preterm birth at a second pregnancy. Despite smoking during the first pregnancy, smoking cessation was achieved and maintained by more than one-third of women in their second pregnancy with encouraging levels of preterm risk reduction. It is well-established that the period after birth provides an opportunity to reduce smoking-related morbidity for both the mother and neonate. Our results indicate that this period also offers an opportunity to prevent morbidity of future pregnancy. A considerable amount of research has been undertaken on the effects of smoking during pregnancy on birth outcomes, the influence of postpartum smoking on the health of the mother and newborn child, and postpartum smoking cessation. However, follow-up of women after giving birth does not tend to be long enough to observe smoking and outcomes of subsequent pregnancies. We show that smoking cessation in the subsequent pregnancy is achievable by a large proportion of women despite smoking in their first pregnancy, which translates to clear reductions in risk of preterm birth in the subsequent pregnancy.

Clinical, sociodemographic and tobacco-use factors associated with smoking cessation rates at three years follow-up, Ankara, Turkey.

INTRODUCTIONSmoking is a well-known major cause of early preventable mortality and morbidity. Maintenance of smoke-free status is important after a smoking cessation attempt. The present study aims to compare the sociodemographic and clinical characteristics of subjects participating in a smoking-cessation program, according to the duration of smoking cessation.METHODSA study was conducted in 261 smokers who had attended a smoking cessation clinic in a tertiary hospital, in Ankara, Turkey. The smoking status of the subjects at three years follow-up after participating in the smoking-cessation program was assessed. Sociodemographic, employment, environmental, smoking-related, health and clinical characteristics of subjects were compared according to the smoking cessation duration.RESULTSMarital status, having a child, absence of household smoking and lower levels of nicotine dependence were significantly higher in quitters, and anxiety was lower. Parameters that significantly differed between subjects that were and were not abstinent for >36 months were marital status (p<0.001), childbearing status (p=0.007), household smoking (p<0.001), age of smoking initiation (p=0.02), psychiatric illness history (p=0.01), and number of follow-up visits (p<0.001). The number of follow-up visits at the smoking cessation clinic was an important factor of quitting and maintenance of quit status.CONCLUSIONSFamily and home environment as well as smoking-related and mental health characteristics influenced maintenance of long-term smoking cessation. Characteristics such as sociodemographic, clinical and smoking-related conditions should be considered in smoking cessation interventions. Personalized treatment strategies and follow-up visits at the smoking cessation clinic should be planned for maintenance of smoking cessation.

Factors associated with maintenance of smoking cessation in adolescents after implementation of tobacco pricing policy in South Korea: Evidence from the 11th Youth Health Behavior Survey.

As a part of Korea's smoking cessation policy, the price of tobacco was increased in January 2015. Initially, the smoking rate among adolescents began to decrease. The current data, however, show that the adolescent smoking rate is on the rise. Alongside price policies, there is a need to further understand additional preventive measures that promote successful smoking cessation by identifying the factors that influence maintenance of smoking cessation in adolescents. This study aimed to identify the factors that influence smoking cessation in adolescents after attempting smoking cessation after increase in tobacco price. The study used large-scale, nationwide, secondary data obtained from the Korean Youth Risk Behavior Web-Based Survey. The sample included a total of 627 subjects who reported an attempt to quit smoking after the tobacco price increased. Descriptive statistics, t test, the χ2 test, and multiple logistic regression were used. The results showed that household economic status, school type, suicidal ideation, experience of exposure to secondhand smoke at home, and experience of witnessing teaching staff smoking were significant factors related to maintenance of smoking cessation among adolescents. To increase the success rate of smoking cessation, future intervention programs should include school environment structure and address emotional and psychological issues such as suicide.

Short-Term Success Rates of Smoking Cessation Support Programs and Factors Predicting Smoking Relapse: Using Data from a Smoking Cessation Clinic in a Hospital.

BackgroundAlthough the number of medical institutions running a smoking cessation clinic is on the rise, there remains a paucity of research on the long- and short-term success rates of smoking cessation programs, as well as on smoking relapse rates, before and after project implementation. This study assessed the general characteristics of patients visiting the smoking cessation clinic, success rate of smoking cessation in the short term, and risks of relapse.MethodsMedical records from March 2015 to April 2017 were analyzed and telephone surveys were conducted with 151 smokers who visited a hospital smoking cessation clinic from March 2015 to April 2017.ResultsOf the 139 smokers who were eligible for follow-up, 22 (15.8%) failed to quit smoking initially. The clinic’s 6-month success rate of smoking cessation was 64.83%. Those with higher medication compliance had a lower risk of primary failure (odds ratio, 0.056; 95% confidence interval, 0.005–0.609), whereas those with higher age (hazard ratio [HR], 0.128; P=0.0252) and a greater number of visits to the clinic (HR, 0.274; P=0.0124) had a lower risk of relapsing.ConclusionThe risk of primary failure to quit was higher with low medication compliance, and that of relapsing was higher with lower age and fewer number of clinic visits. Various evaluation and analysis methods can be carried out in the future based on the accumulated data for maintenance of smoking cessation and relapse prevention.

Evaluation of factors affecting the maintenance of smoking cessation among individuals in Japan

Evaluation of factors affecting the maintenance of smoking cessation among individuals in Japan

Applying Psychological Theories to Promote Long-Term Maintenance of Health Behaviors.

Behavioral health theory provides a framework for researchers to design, implement, and evaluate the effects of health promotion programs. However, limited research has examined theories used in interventions to promote long-term maintenance of health behaviors. The purpose of this review was to evaluate the available literature and identify prominent behavioral health theories used in intervention research to promote maintenance of health behaviors. We reviewed theories used in intervention research assessing long-term maintenance (≥ 6 months post-intervention) of physical activity, weight loss, and smoking cessation. Five prominent behavioral theories were referenced by the 34 studies included in the review: Self-Determination Theory, Theory of Planned Behavior, Social Cognitive Theory, Transtheoretical Model, and Social Ecological Model. Descriptions and examples of applications of these theories are provided. Implications for future research are discussed.

Depression and maintenance of smoking cessation after myocardial infarction with focus on education

Objective: The aim of the study was to investigate the association between depression and maintenance of smoking cessation at 1-year follow-up in patients admitted with first-incidence acute myocardial infarction (MI) with a focus on educational level. Methods: From the 1st of September 2002 to the 31st of December 2004, 388 patients < 75 years old were admitted at Aarhus University Hospital in Denmark with first-incidence MI. The patients were screened for depression 6 weeks after admission and offered cardiac rehabilitation (CR). Patients were included if they stopped smoking at admission or in the next 6 weeks, if they were screened for depression and if they gave information concerning smoking status. Results: A quarter of the patients were screened positive for depression. There was no significant difference in the participation at the smoking cessation part of the rehabilitation for patients screened positive or negative for depression, whether the results were adjusted for gender and educational level (OR = 0.84; p -value = .75) or not (OR = 0.75; p -value = .56). There was a significant association between a positive depression screening and failing to maintain a smoking cessation in men (OR = 7.67; p -value = .03) at 1-year follow-up. When adjusted for educational level a significant association was still seen (OR = 7.48; p -value = .01). Conclusions: There was a significant association between a positive depression screening and failing to maintain a smoking cessation in men at 1-year follow-up. The result was consistent after adjusting for educational level.

Abstract B62: Tailored parental cessation delivered concurrently with tobacco prevention in children enrolled in urban and rural southern elementary schools

Abstract Purpose: Socioeconomically disadvantaged populations have higher tobacco use rates resulting in more disparate cancer outcomes. The effectiveness of tailored cessation interventions in parent/caregiver smokers delivered within an elementary school setting while their child is concurrently enrolled in a smoking prevention program has been minimally explored. Procedures/Methods: During a randomized controlled trial (RCT) that included children and one parent/caregiver per child, parent/caregiver smokers were offered cessation in years 1 and 2 (if relapsed/refused in year 1) at their child's respective school or local community setting. Parent/caregiver smokers in the intervention group received tailored cessation including eight individual face-to-face motivational interviewing sessions with a matched gender and/or racial/ethnically similar counselor and eight weeks of nicotine replacement therapy. The control parents/caregivers who smoked received information for contacting the state toll-free Tobacco Quit Line and tailored (based on race/ethnicity) written materials to assist with cessation. Children in the intervention arm received concurrently a tobacco prevention curriculum, Botvin's LifeSkills Training, over the same time period in years 1 &amp; 2. The control group children received the standard health education curriculum for public school systems. This study reports on the effectiveness of the parent/caregiver cessation intervention including outcomes of self-reported smoking status (percentages) and the biological measure, salivary cotinine (ng/ml), both obtained at baseline, end of treatment (EOT)/year 2, and in year 4 follow-up. Results/Summary: Parent/Caregiver smokers (n=110) comprised 24.6% of the enrolled (n=447) parent/caregiver sample. The parent/caregiver smokers were predominantly female (81%), mean age 37.2 yrs. (SD 11.1); 37% Black; 54% had &amp;lt; a high school education; 54% earned &amp;lt; $20,000 annually; and 61% were covered by Medicaid and/or Medicare. Using repeated measures, binomial generalized estimating equation or mixed models, differences over time between parents/caregivers in the intervention and control groups were found for quitting smoking and cotinine levels. Parents/caregivers in the intervention group [EOT: 6.5% (SE=5.7%), Yr.4: 40.6%(SE=5.7%)] showed a larger increase in quitting smoking over time than the control group [EOT: 0.0%(SE=6.5%), Yr.4: 13.2%(SE=6.4%)] (F=4.82, p=0.0306). For cotinine (F=5.72, p=0.0039), the intervention group showed a decrease from baseline (239.9,[SE=1.3]) to EOT (99.3,[SE=1.4]) and then maintenance through Yr.4 (109.6,[SE=1.4]), while the control group showed increases from baseline (221.1,[SE=1.4]) to EOT (239.0,[SE=1.4]) to Yr.4 (325.8,[SE=14]). Conclusions: This study provides beginning evidence that tailored cessation offered to parents/caregivers in their child's school setting while their child is enrolled in tobacco prevention classes may be an avenue for more robust success in quitting smoking. Such a strategy may serve as an initial step for improving public health and for decreasing tobacco-related disparities and associated poor health outcomes among disadvantaged populations. By improving parent's/caregiver's success and maintenance of tobacco cessation, a joint program may reinforce the child's resistance to the lure of tobacco products and may also potentially decrease his or her secondhand smoke exposure within the home. Citation Format: Martha S. Tingen, Jeannette O. Andrews, Janie Heath, Lovoria B. Williams, Carsten Schroeder, Paul Dainer, Samir N. Khleif, Jennifer L. Waller. Tailored parental cessation delivered concurrently with tobacco prevention in children enrolled in urban and rural southern elementary schools. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr B62.

The CHANGE Study: Methods and Sample Description for a Cross-Sectional Study of Heroin Cessation in New York City.

The CHANGE (Cessation of Heroin: A Neighborhood Grounded Exploration) Study aimed to understand factors associated with the initiation and maintenance of sustained heroin cessation from the perspective of users themselves and specifically set out to document the correlates of natural recovery. The CHANGE Study was a case-control study conducted in New York City from 2009 to 2011. Cases were former heroin users, abstinent for 1-5 years in the past 5 years. Controls used heroin at least weekly during the past 5 years and were (1) continuous heroin users without a quit attempt of ≥2 weeks' duration or (2) relapsed heroin users who were currently using and had a quit attempt of ≥2 weeks' duration during the past 5 years. Recruitment and data collection methods are described along with limitations and a brief description of the study sample. In contrast to many studies of drug use and cessation, the CHANGE Study was designed to model success (i.e., initiation and maintenance of heroin cessation) and not failure.

Factors Related to Relapse After 6 Months of Smoking Cessation Among Men in the Republic of Korea: A Cross-Sectional Study.

We identified factors associated with relapse after 6 months of smoking cessation (late relapse) among males of the Republic of Korea. Of the 222,707 smokers who visited public health center-based smoking cessation clinics (SCCs) between January 1, 2009 and mid-December 2009, we included 1720 individuals who successfully completed a 6-month smoking cessation program at an SCC. These participants were selected via a random stratified sampling design and completed an SCC user satisfaction survey between December 31, 2009 and January 6, 2010. Multiple logistic regression was used to identify factors associated with late relapse, and path analysis was employed to explore relationships among these factors. The frequency of late relapse was 21.6% (n = 372). Residence in a metropolitan area, low socioeconomic status, and the use of nicotine replacement therapy (NRT) were associated with statistically significant increases in late relapse, whereas greater access to counseling and more satisfaction with the SCC were associated with reduced late relapse. The path analysis showed that a greater number of cigarettes smoked daily and a younger age at smoking initiation exerted significant indirect effects on late relapse when NRT was employed. Residence in a metropolitan area indirectly prevented late relapse as counseling frequency increased. NRT use, counseling frequency, and SCC user satisfaction were affected by both smoking behavior and socioeconomic status. Relapse prevention efforts should concentrate on increasing both counseling frequency and SCC user satisfaction. Future studies should focus on the effect of NRT on the maintenance of long-term cessation at the population level in real-world settings.

Effects of Fatty Acid Amide Hydrolase (FAAH) Inhibitors in Non-Human Primate Models of Nicotine Reward and Relapse.

Inhibition of the enzyme fatty acid amide hydrolase (FAAH) counteracts reward-related effects of nicotine in rats, but it has not been tested for this purpose in non-human primates. Therefore, we studied the effects of the first- and second-generation O-arylcarbamate-based FAAH inhibitors, URB597 (cyclohexyl carbamic acid 3'-carbamoyl-3-yl ester) and URB694 (6-hydroxy-[1,1'-biphenyl]-3-yl-cyclohexylcarbamate), in squirrel monkeys. Both FAAH inhibitors: (1) blocked FAAH activity in brain and liver, increasing levels of endogenous ligands for cannabinoid and α-type peroxisome proliferator-activated (PPAR-α) receptors; (2) shifted nicotine self-administration dose-response functions in a manner consistent with reduced nicotine reward; (3) blocked reinstatement of nicotine seeking induced by reexposure to either nicotine priming or nicotine-associated cues; and (4) had no effect on cocaine or food self-administration. The effects of FAAH inhibition on nicotine self-administration and nicotine priming-induced reinstatement were reversed by the PPAR-α antagonist, MK886. Unlike URB597, which was not self-administered by monkeys in an earlier study, URB694 was self-administered at a moderate rate. URB694 self-administration was blocked by pretreatment with an antagonist for either PPAR-α (MK886) or cannabinoid CB1 receptors (rimonabant). In additional experiments in rats, URB694 was devoid of THC-like or nicotine-like interoceptive effects under drug-discrimination procedures, and neither of the FAAH inhibitors induced dopamine release in the nucleus accumbens shell--consistent with their lack of robust reinforcing effects in monkeys. Overall, both URB597 and URB694 show promise for the initialization and maintenance of smoking cessation because of their ability to block the rewarding effects of nicotine and prevent nicotine priming-induced and cue-induced reinstatement.

Smoking Cessation after Myocardial Revascularization Procedures

Introduction: Smoking is associated with the development of coronary artery disease and influences negatively the prognosis of patients undergoing myocardial revascularization procedures. However, the rate of smoking cessation after these procedures is not well established in the literature. We aimed to evaluate the rate of smoking cessation in patients undergoing revascularization procedures, immediately and after 12 months of follow-up.Methods: We examined smoking patients from a unique cardiology center who underwent myocardial revascularization procedures between January 2010 and December 2011. These patients were allocated to two groups according to the revascularization procedure performed: Coronary Artery Bypass Grafting (CABG) and Percutaneous Coronary Interventions (PCI). Data related to cessation or maintenance of smoking were obtained at subsequent clinical appointments or telephone calls.Results: Among 173 patients selected, 118 (68.2%) underwent PCI and 55 (31.8%) underwent CABG. After revascularization procedures, the total rate of smoking cessation was 79.3%. Furthermore, there was no significant difference between the two groups (83.6% – CI 95%: 71.2–92.2% for CABG, and 79.3% – CI 95%: 70.8–86.3% for PCI). The maintenance of smoking cessation after one year was 53.2%, similar between groups (52.7% for CABG and 53.4% for PCI). Nevertheless, the average time of smoking cessation was significantly higher in the CABG group (6.9 months versus 4.5 months for PCI).Conclusions: Coronary interventions add important value to smoking cessation, and the smoking cessation rates were similar, independent of the procedure executed.

The Effects of Smoking Urges and Withdrawal Symptoms on Maintenance of Smoking Cessation: The Moderating Effects of Coping and Perceived Smoking Cessation Effects

The Effects of Smoking Urges and Withdrawal Symptoms on Maintenance of Smoking Cessation: The Moderating Effects of Coping and Perceived Smoking Cessation Effects

Maintenance of Smoking Cessation in the Postpartum Period: Which Interventions Work Best in the Long-Term?

Smoking during pregnancy has been linked to a variety of adverse outcomes for both maternal and child health. Decades of studies have sought to increase cessation antepartum and reduce relapse postpartum. A number of effective interventions exist to significantly reduce smoking rates during pregnancy; however, less is known about how to prevent relapse in the postpartum period. This review investigates interventions to prevent relapse in the long-term postpartum period. We focus specifically on nonspontaneous quitters (individuals who quit smoking as a result of an external intervention) to reveal differences in long-term response to interventions for this population compared to spontaneous quitters. A systematic literature search yielded 32 relevant studies of pharmacological, behavioral, and incentives-based interventions. Results were compiled, analyzed, and compared in order to evaluate success factors in maintaining cessation postpartum. Though intervention groups showed consistently higher quit rates during pregnancy than control groups, none of the intervention types were effective at preventing relapse in the longer-term postpartum period. One study maintained significantly higher abstinence in the longer-term period postpartum using a mix of behavioral and incentives strategies. Additional research in this area is needed to identify optimal intervention strategies to reduce long-term postpartum relapse, particularly for nonspontaneous quitters.

Long-Term Maintenance of Smoking Cessation in Pregnancy: An Analysis of the Birth Cohort Generation XXI

Pregnancy affords opportunities for health promotion and disease prevention. We worked with a population-based cohort of women who gave birth in Portugal to quantify the proportion of women who quit smoking during pregnancy, the proportion of these women who continued to abstain 4 years after delivery, and the determinants of these outcomes. A birth cohort was assembled in public maternity units of Porto, Portugal, in 2005-2006, and all women were reevaluated at an average of 4 years after delivery. A total of 5,420 mothers were included in the analysis. Smoking status at baseline and at follow-up was ascertained by interview. Adjusted prevalence ratios and 95% CIs were computed using robust Poisson regression. Overall, 47.4% of women who smoked ceased smoking and 41.7% reduced cigarette consumption during pregnancy. Four years after delivery, 32.1% of those who stopped smoking during pregnancy continued to abstain. Older women, first-time mothers, light smokers, those who were living with a partner at the time of follow-up, those who became pregnant again after the index pregnancy, those who breast fed for more than 52 weeks, and those with a child diagnosed with asthma and/or rhinitis were more likely to abstain from smoking. Approximately half of all women stopped smoking during pregnancy and, among these, approximately one third continued to abstain 4 years after delivery. The high proportion of relapse may be attributable to poor awareness or skepticism regarding the adverse effects of secondhand smoke on children or physiological and psychological dependence on nicotine.