Predictors Of Continued Smoking Research Articles

Predictors of cessation in smokers suspected of TB: Secondary analysis of data from a cluster randomized controlled trial

BackgroundSmoking cessation services are rarely found within health services in low income countries. Given the interactions between Tuberculosis (TB) and tobacco, including cessation support within TB programs offers a promising cost-effective solution. We conducted secondary analysis of data from a cluster randomized controlled trial of smoking cessation in health centers in Pakistan to identify predictors of continuous and short-term abstinence in smokers suspected of TB using cigarettes or hookah. MethodsPredictor variables of those continuously abstinent at 5 and 25 weeks post quit-date (continuous abstinence) and those abstinent only at 5 weeks (short-term abstinence) were compared with those who continued smoking and with each other. Self-reported abstinence at both time points was confirmed biochemically. ResultsData obtained from 1955 trial participants were analyzed. The factors that predicted continued smoking when compared to continuous abstinence were: being older RR 0.97 (0.95 to 0.98), smoking higher quantities of tobacco RR 0.975 (0.97 to 0.98) and sharing a workplace with other smokers RR 0.88 (0.77 to 0.99). Those with a confirmed TB diagnosis were more likely to remain continuously abstinent than those without RR 1.27 (1.10–1.47). ConclusionsThose diagnosed with TB are more likely to be abstinent than those diagnosed with other respiratory conditions. Beyond this, predictors of continued smoking in Pakistan are similar to those in high income contexts. Taking advantage of the ‘teachable moment’ that a TB diagnosis provides is an efficient means for resource-poor TB programs in low income settings to increase tobacco cessation and improve health outcomes.

MP9-09 PREDICTORS OF CONTINUED SMOKING AFTER THE DIAGNOSIS OF A GENITOURINARY MALIGNANCY

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Evidence-based Medicine & Outcomes II1 Apr 2015MP9-09 PREDICTORS OF CONTINUED SMOKING AFTER THE DIAGNOSIS OF A GENITOURINARY MALIGNANCY Stephen Hurley, Saumya Easaw, Andrew Drago, Christina Palmer, Tayna Uddin, Thomas O'Grady, Mark Wille, and Courtney Hollowell Stephen HurleyStephen Hurley More articles by this author , Saumya EasawSaumya Easaw More articles by this author , Andrew DragoAndrew Drago More articles by this author , Christina PalmerChristina Palmer More articles by this author , Tayna UddinTayna Uddin More articles by this author , Thomas O'GradyThomas O'Grady More articles by this author , Mark WilleMark Wille More articles by this author , and Courtney HollowellCourtney Hollowell More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.369AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Approximately half of patients who smoke at the time of their cancer diagnosis quit prior to treatment. However, a large percentage of patients continue to smoke or relapse after quitting. Genitourinary (GU) cancer patients who continue to smoke are at increased risk for recurrence, poor survival rates, treatment complications, second primary cancers, and other chronic smoking related illnesses. Smoking cessation after GU cancer diagnosis is a critical component of survivorship, however factors related to continued smoking are understudied. The purpose of this study is to identify the rates and clinical variables that are predictors for continued smoking among patients diagnosed with a GU malignancy. METHODS A cross-sectional study of a convenience sample was conducted with participants who either quit or continued to smoke after the diagnosis of a GU malignancy. Nonsmokers or past smokers who had quit smoking before their cancer diagnosis were excluded. A self-reported questionnaire included patient demographics, smoking behaviors, perceived social support (validated Duke-UNC Functional Social Support Questionnaire), fear of cancer recurrence (validated Cancer Worry Scale), and significant anxiety and depression (validated Hospital Anxiety and Depression Scale). Predictors of continued smoking were identified using multivariate logistic regression. RESULTS Among the 204 study participants who were active smokers at the time of GU cancer diagnosis, 90 (44%) were current smokers at the time survey completion. Cancer diagnoses included prostate 66 (32%), kidney 57 (28 %), bladder 57 (28%), testicular 15 (7%), penile 5 (3%), and upper GU tract 4 (2%). Several predictors of continued smoking status were identified, including concern for cancer recurrence (odds ratio (OR) 4.94, 95% confidence interval (CI) 1.81 to 14.97, p= 0.007), anxiety (OR 16.8, 95% CI 5.6 to 57.6, p=0.005), greater than 20-year smoking history (OR 66.5, 95% CI 5.15 to 141.5, p= <0.001), and second-hand smoke exposure in the home (OR 186.3, 95% CI 47.5 to 1279, p=<0.001). CONCLUSIONS Forty-four percent of patients with a GU malignancy who were active smokers at the time of diagnosis continue to smoke despite the associated health risks. Factors associated with continued smoking after diagnosis include anxiety, concern for cancer recurrence, greater than 20-year smoking history, and second-hand smoke exposure in the home. These findings highlight the need for comprehensive smoking cessation interventions for GU cancer patients. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byZhao C, Bjurlin M, Roberts T, Rink M, Shariat S and Matulewicz R (2021) A Systematic Review and Scoping Analysis of Smoking Cessation after a Urological Cancer DiagnosisJournal of Urology, VOL. 205, NO. 5, (1275-1285), Online publication date: 1-May-2021. Volume 193Issue 4SApril 2015Page: e105 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Stephen Hurley More articles by this author Saumya Easaw More articles by this author Andrew Drago More articles by this author Christina Palmer More articles by this author Tayna Uddin More articles by this author Thomas O'Grady More articles by this author Mark Wille More articles by this author Courtney Hollowell More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Predictors of Adverse Smoking Outcomes in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial

The impact of lung cancer screening on smoking behavior is unclear. The aims of this ancillary study of the Prostate Lung Colorectal and Ovarian Cancer Screening Trial were to produce risk prediction models to identify individuals at risk of relapse or continued smoking and to evaluate whether cancer-screening variables affect long-term smoking outcomes. Participants completed a baseline questionnaire at trial enrollment and a supplemental questionnaire 4-14 years after enrollment, which assessed several cancer-related variables, including family history of cancer, comorbidities, and tobacco use. Multivariable logistic regression models were used to predict smoking status at completion of the supplemental questionnaire. The models' predictive performances were evaluated by assessing discrimination via the receiver operator characteristic area under the curve (ROC AUC) and calibration. Models were internally validated using bootstrap methods. Of the 31&emsp14;694 former smokers on the baseline questionnaire, 1042 (3.3%) had relapsed (ie, reported being a current smoker on the supplemental questionnaire). Of the 6807 current smokers on the baseline questionnaire, 4439 (65.2%) reported continued smoking on the supplemental questionnaire. Relapse was associated with multiple demographic, medical, and tobacco-related characteristics. This model had a bootstrap median ROC AUC of 0.862 (95% confidence interval [CI] = 0.858 to 0.866) and a calibration slope of 1.004 (95% CI = 0.978 to 1.029), indicating excellent discrimination and calibration. Predictors of continued smoking also included multiple demographic, medical, and tobacco-related characteristics. This model had an ROC AUC of 0.611 (95% CI = 0.605 to 0.614) and a slope of 1.006 (95% CI = 0.962 to 1.041), indicating modest discrimination. Neither the trial arm nor the lung-screening result was statistically significantly associated with smoking outcomes. These models, if validated externally, may have public health utility in identifying individuals at risk for adverse smoking outcomes, who may benefit from relapse prevention and smoking cessation interventions.

Try and try again--qualitative insights into adolescent smoking experimentation and notions of addiction.

addiction is a relatively unexplored issue in youth tobacco control. Increasingly, there is recognition of addiction experiences in regular and irregular teenage smokers. Research was undertaken on behalf of the Smarter than Smoking (STS) project to probe young people's reasons for smoking uptake, their attitudes towards the social acceptability of smoking, predictors of continued smoking after trial and understandings and perceptions of addiction. twenty focus groups were conducted to collect qualitative data from young people (n=92) aged 13 to 15 years from metropolitan and regional areas of Western Australia (WA), from a variety of socioeconomic backgrounds, including young Aboriginal and Torres Strait Islander people. of the young people spoken to, 20% smoked regularly, 40% had tried smoking and 40% had never tried. Acceptability and normalcy of trialling smoking was a recurring theme, with little perceived risk of trial leading to regular smoking or becoming addicted. Even non-smokers accepted 'just having a try' in the context of curiosity, life experiences and 'informed choice'. preventing continuation after trial of smoking among young people needs to increase in importance, given the prevailing norms around 'trying it' and individual choice.

Predictors of continued smoking over 25 years of follow-up in the normative aging study.

This study tested the hypothesis that high daily cigarette consumption and addiction to smoking are risk factors for the long-term continuation of smoking. Using longitudinal data from 986 male smokers, we entered cigarettes per day, psychological addiction, age, and education into a survival analysis as predictors of continued smoking over a 25-year period. Younger men and those who smoked more cigarettes per day were more likely to remain smokers in the long term. Addiction and education level were not significant predictors of continued smoking. Heavier smokers are more at risk than lighter smokers for long-term smoking. It is therefore very important to provide smoking cessation treatments for heavy smokers as early as possible after the initiation of smoking.

Predictors of Smoking Cessation After Percutaneous Coronary Revascularization

To identify factors predictive of smoking cessation after successful percutaneous coronary revascularization. We undertook a case-control study of the smoking status of all patients at Mayo Clinic Rochester from September 1979 through December 1995 who were smokers at the time of an index percutaneous coronary revascularization procedure in the non-peri-infarction setting (no myocardial infarction within 24 hours). Maximal duration of prospective follow-up was 16 years. Patients were classified into those who permanently quit smoking immediately after the procedure (N = 435; mean follow-up, 5.1 +/- 3.7 years) or those who continued to smoke at some time during follow-up (N = 734; mean follow-up, 5.3 +/- 3.7 years). Logistics regression models were formulated to determine independent predictors of smoking cessation. Predictors of continued smoking were greater prior cigarette consumption (odds ratio [OR] = 1.009 for each pack-year; 95% confidence interval [CI] = 1.004 to 1.014) and having one or more risk factors for coronary artery disease other than cigarette smoking (OR = 1.49; 95% CI = 1.15 to 1.93). Older age (OR = 0.98 for each additional year; 95% CI = 0.97 to 0.99) and unstable angina at time of initial assessment (OR = 0.69; 95% CI = 0.52 to 0.91) were associated with less likelihood of continued smoking. Younger patients with a worse risk profile and greater prior cigarette consumption were more likely than other patients to continue smoking after percutaneous coronary revascularization in the non-peri-infarction setting. Patients who had unstable angina were more likely to quit smoking than those who had stable angina. Despite the proven benefits of smoking cessation after percutaneous coronary revascularization, a substantial proportion of smokers (63%) continue to smoke; thus, smoking-cessation counseling should be addressed in this population.

Antecedents of vulnerability and resilience to smoking among adolescents

Studies of adolescent smoking have concentrated on factors that are associated with smoking (vulnerability), but have tended not to examine whether these factors also describe adolescents who have been at risk of becoming smokers but have not succumbed, for example, to the social pressure of having friends who smoke (resilience). Results from a longitudinal study were used to examine the predictors of resilience to social influence from among a selected group of factors associated with adolescent smoking. Among these with no recent history of smoking, the predictor variables for vulnerability and resilience were different across age. However, for adolescents who had a recent history of smoking there were no predictors of continued smoking or of stopping, apart from whether or not a friend smoked. Resilience factors against smoking show the characteristics of those who have successfully resisted the social influence to smoke. Identification of further predictors of resilience would help in the development of intervention programs and should include a reexamination of factors not usually correlated with smoking status.

Longitudinal changes in adolescent cigarette smoking behavior: onset and cessation.

Employing a 1-year longitudinal design, this study examined factors related to change in adolescent smoking. Predictors of smoking onset differed from predictors of continued smoking, underscoring the importance of studying factors related to adolescent smoking onset separately from mechanisms associated with changes in smoking among current smokers. Peer smoking predicted continuation of smoking after smoking initiation. Smokers received over 26 times more offers to smoke than did nonsmokers, suggesting that smokers attempting to quit need effective refusal skills to be successful. Habitual smoking was found to develop slowly, providing a substantial time window for refusal skill training and other prevention efforts. Predictors of smoking onset differed by developmental level. Peer smoking, and marijuana use were stronger predictors of smoking onset for high-school students, and number of cigarette offers predicted better among middle-school students. Parent variables were not significant predictors of later smoking. Intention to smoke was unrelated to onset and was redundant with pretest smoking behavior in predicting cessation.