Predictors Of Successful Smoking Cessation Research Articles

Smoking Cessation Rate and Its Predictors among Heavy Smokers in a Smoking-Free Hospital in Taiwan.

Smoking poses critical risks for heart disease and cancers. Heavy smokers, defined as smoking more than 30 pack-year, are the most important target for smoking cessation. This study aimed to obtain the cessation rate and its predictors among heavy smokers. We collected data from heavy smokers who visited a smoking-free hospital in Taiwan during 2017. All patients were prescribed either varenicline or nicotine replacement therapy (NRT) for smoking cessation, and their smoking status was followed for six months. Successful smoking cessation was defined by self-reported no smoking over the preceding seven days (7-day point abstinence). In total, 280 participants with a mean aged of 53.5 years were enrolled, and 42.9% of participants successfully stopped smoking in 6 months. The results revealed that quitters were older, with hypertension, fewer daily cigarettes, and being prescribed with varenicline. Multiple logistic regressions analyses identified that fewer daily cigarettes and being prescribed with varenicline were predictors of successful smoking cessation. Therefore, we suggest that varenicline use may help heavy smokers in smoking cessation.

The Value of Biosamples in Smoking Cessation Trials: A Review of Genetic, Metabolomic, and Epigenetic Findings.

Human genetic research has succeeded in definitively identifying multiple genetic variants associated with risk for nicotine dependence and heavy smoking. To build on these advances, and to aid in reducing the prevalence of smoking and its consequent health harms, the next frontier is to identify genetic predictors of successful smoking cessation and also of the efficacy of smoking cessation treatments ("pharmacogenomics"). More broadly, additional biomarkers that can be quantified from biosamples also promise to aid "Precision Medicine" and the personalization of treatment, both pharmacological and behavioral. To motivate ongoing and future efforts, here we review several compelling genetic and biomarker findings related to smoking cessation and treatment. These Key results involve genetic variants in the nicotinic receptor subunit gene CHRNA5, variants in the nicotine metabolism gene CYP2A6, and the nicotine metabolite ratio. We also summarize reports of epigenetic changes related to smoking behavior. The results to date demonstrate the value and utility of data generated from biosamples in clinical treatment trial settings. This article cross-references a companion paper in this issue that provides practical guidance on how to incorporate biosample collection into a planned clinical trial and discusses avenues for harmonizing data and fostering consortium-based, collaborative research on the pharmacogenomics of smoking cessation. Evidence is emerging that certain genotypes and biomarkers are associated with smoking cessation success and efficacy of smoking cessation treatments. We review key findings that open potential avenues for personalizing smoking cessation treatment according to an individual's genetic or metabolic profile. These results provide important incentive for smoking cessation researchers to collect biosamples and perform genotyping in research studies and clinical trials.

Abstract A34: Understanding the Predictors of Smoking Cessation in a Culturally Tailored Smoking Cession Program Created for American Indians

Abstract The purpose of this study was to test the effectiveness of the All Nations Breath of Life program (ANBL); a 12-week culturally-tailored smoking cessation program designed for use in a heterogeneous urban and suburban American Indian (AI) population. Through this process we looked at the secondary outcome: predictors of successful smoking cessation. ANBL was developed, implemented, and tested using a community-based participatory research (CBPR) approach in which AI community members were involved in all phases of the research. Participants in ANBL (N=312) self-selected into the study. Participants self-identified as AI (tribal enrollment was not required). Additional inclusion criteria included being 18 years of age or older, cotinine verified current cigarette smoker, self-expressed interest in quitting smoking in the 30 days following the informed consent process. The vast majority of ANBL group sessions were located primarily in the Heartland/Midwest and surrounding areas. ANBL has five primary components, as follows: Group Support Sessions, Individual Telephone Counseling, Educational Curriculum, Pharmacotherapy, and Participant Incentives. The primary endpoint was salivary cotinine verified continuous abstinence at 6-months. Participants were asked to self-report smoking status, “Since your quit date in ANBL, have you ever smoked at least part of a cigarette?” Those participants answering “no” to this question were asked to provide saliva for cotinine verification. At program completion, 53.3% of program completers remained abstinent; using an intent-to-treat analysis labeling those lost to follow-up as smokers resulted in a 41.4% quit rate. At 6 months post-baseline, 31.1% of retained participants quit smoking (p<0.0001 compared to the highest quit rates among multi-tribal populations reported in the literature, 7%); final quit rate was 22.1% using an intent-to-treat analysis (p=0.002). Few items were found to be predictive of ability to quit at the primary endpoint. The most significant predictor of cessation was participation in one of the groups run in Mid-Missouri, all of which were run by one facilitator (OR=0.24, p=0.0005). An additional predictor of cessation included participants who had some form of home smoking rule (partial or full) (OR=0.35, p=0.0004). Other items that approached significance in relationship to quitting included use of traditional tobacco, which negatively impacted quit rates (OR=1.70, p=0.08), having higher self-confidence in one's ability to quit at baseline positively impacted quit rates (OR=2.20, p=0.16), and lack of use of other recreational tobacco products positively impacted quit rates (OR=2.42, p=0.07). Participants who had the longest history of smoking (greater than 20 years) were least likely to quit (OR=0.26; p=0.03). The data found will be incorporated into modifications to the program to assist other participants with successful cessation. Understanding the predictors of smoking cessation can ensure participant success in tailored smoking cession programs. Citation Format: Joseph A. Pacheco, Jordyn Gunville, Nazir Niaman, T. Edward Smith, Sean M. Daley, Won S. Choi, Christine M. Daley. Understanding the Predictors of Smoking Cessation in a Culturally Tailored Smoking Cession Program Created for American Indians. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A34.

Predictors of medication adherence and smoking cessation among smokers under community corrections supervision

IntroductionIndividuals in the U.S. criminal justice system now represent over 12% of all current U.S. smokers. With smoking banned in most U.S. jails and prisons, the cessation focus for this population has shifted to individuals who are under community correction supervision (e.g., probation, parole). The aim of this study was to examine predictors of successful smoking cessation among criminal justice individuals supervised in the community. MethodsFive hundred participants under community corrections supervision were randomized to receive either four sessions of smoking cessation counseling or no counseling in conjunction with 12weeks of bupropion treatment plus brief physician advice to quit. Logistic regression analyses examined associations of smoking variables with medication adherence and successful abstinence. Mediation analysis evaluated the indirect effects of medication adherence on smoking abstinence. ResultsThe strongest associate of medication adherence was previous use of bupropion, while the strongest associate of smoking abstinence was medication adherence. Mediation analysis indicated that previous use of bupropion indirectly increased cessation rates through the pathway of increased medication adherence. ConclusionsThese results highlight the importance of medication adherence for smoking cessation among community corrections smokers. Providing exposure to medication may be a promising intervention to increase medication adherence and subsequent cessation rates in this population.

Predictors of Successful Smoking Cessation after Inpatient Intervention for Stroke Patients.

BackgroundSmoking is a well-known risk factor of cancer, chronic disease, and cerebrovascular disease. Hospital admission is a good time to quit smoking but patients have little opportunity to take part in an intensive smoking cessation intervention. The purpose of this study was to identify the factors of successful smoking cessation among stroke patients who undergo an intensive cessation intervention during the hospitalization period.MethodsThirty-nine male smokers who were admitted with stroke were enrolled in the study. They participated in a smoking cessation intervention during hospitalization. Smoking status was followed up by telephone 3 months later. Nicotine dependence, sociodemographic factors, and other clinical characteristics were assessed.ResultsAfter 3 months post-intervention, the number of patients who stopped smoking was 27 (69.2%). In addition, there was no significant difference in nicotine dependence, sociodemographic factors, and clinical characteristics. Only the stages of readiness for smoking cessation were a significant predictor (odds ratio, 18.86; 95% confidence interval, 1.59–223.22).ConclusionThis study shows that a patient's willingness to quit is the most significant predictor of stopping smoking after Inpatient cessation Intervention for stroke Patients.

The role of BMI change on smoking abstinence in a sample of HIV-infected smokers

ABSTRACTThe prevalence of cigarette smoking among persons living with HIV/AIDS (PLWHA) is approximately 40%, significantly higher than that of the general population. Identifying predictors of successful smoking cessation for PLWHA is necessary to alleviate the morbidity and mortality associated with smoking in this population. Weight gain has been associated with smoking relapse in the general population, but has not been studied among PLWHA. Data from 474 PLWHA enrolled in a smoking cessation randomized clinical trial were analyzed to examine the effect of BMI change, from baseline to 3-month follow-up, on smoking outcomes using multiple logistic regression. The odds of 7-day smoking abstinence at 3-month follow-up were 4.22 (95% CI = 1.65, 10.82) times higher for participants classified as BMI decrease and 4.22 (95% CI = 1.62, 11.01) times higher for participants classified as BMI increase as compared to participants with a minimal increase or decrease in BMI. In this sample, both weight gain and loss following smoking cessation were significantly associated with abstinence at 3-month follow-up among HIV-infected smokers. Further research and a better understanding of predictors of abstinence will encourage more tailored interventions, with the potential to reduce morbidity and mortality.

Predictors of smoking cessation behavior among Bangladeshi adults: findings from ITC Bangladesh survey.

BackgroundResearch findings on the predictors of smoking cessation behavior identified in Western countries may not be generalizable to smokers in the Southeast Asian countries (i.e., Bangladesh). This study examined the factors associated with smoking cessation behavior (quit attempts and smoking cessation) among a representative sample of Bangladeshi adults.MethodsData from Wave 1 (2009) and Wave 2 (2010) of the International Tobacco Control (ITC) Survey in Bangladesh, a face-to-face survey of adult smokers, were analysed. Households were sampled using a stratified multistage design and interviewed using a structured questionnaire. Respondents included in the study are 1,861 adult daily smokers (cigarette only or dual use of cigarette and bidi) in the Wave 1 survey who completed the Wave 2 follow up.ResultsOf the smokers (N = 1,861), 98 % were male, 18 % illiterate, 78 % married and 42 % were aged 40 or above; 89 % were cigarette smokers and 11 % were dual users (cigarette & bidi). Overall, 21.8 % of the baseline smokers made quit attempts (that is, making at least one quit attempt that lasted for at least 24 hours) during the 11- to 12-month interval between Waves 1 and 2 with only 4.1 % quitting successfully (that is, smokers who had stopped smoking for at least 6 months at the time of the Wave 2 survey). Significant predictors of attempts to quit included: residing areas outside Dhaka (OR = 3.41), being aged 40 or older (OR = 1.53), having a monthly income of above BDT10,000 (US$126) versus below BDT 5,000 (US$63) (OR = 1.57), intending to quit sometime in the future (OR = 1.73). Respondents not working indoors/outside the home were less likely to have made a quit attempt than those with no workplace restrictions on smoking (OR = 0.62). Predictors of successful smoking cessation included: being aged 40 or older (OR = 3.11), perceiving self-rated health as good or excellent (OR = 2.40), and an increased level of self-efficacy (OR = 1.75). Smokers who made a quit attempt not so recently (6 months ago or earlier) were less likely to quit than those who made a more recent (in last 6 months) quit attempt (OR = 0.23).ConclusionAmong Bangladeshi smokers, different factors were associated with quit attempt or successful cessation. Population based smoking cessation programs should take these factors into consideration in the design of smoking cessation interventions. At the same time, measures are necessary to encourage more smokers to make quit attempts.

Combining intensive practice nurse counselling or brief general practitioner advice with varenicline for smoking cessation in primary care: Study protocol of a pragmatic randomized controlled trial

IntroductionCombining behavioural support and pharmacotherapy is most effective for smoking cessation and recommended in clinical guidelines. Despite that smoking cessation assistance from the general practitioner can be effective, dissemination of clinical practice guidelines and efforts on upskilling has not lead to the routine provision of smoking cessation advice among general practitioners. Intensive counselling from the practice nurse could contribute to better smoking cessation rates in primary care. However, the effectiveness of intensive counselling from a practice nurse versus usual care from a general practitioner in combination with varenicline is still unknown. Materials and methodsA pragmatic randomized controlled trial was conducted comparing: (a) intensive individual counselling delivered by a practice nurse and (b) brief advice delivered by a general practitioner; both groups received 12-weeks of open-label varenicline. A minimum of 272 adult daily smoking participants were recruited and treated in their routine primary care setting. The primary outcome was defined as prolonged abstinence from weeks 9 to 26, biochemically validated by exhaled carbon monoxide. Data was analysed blinded according to the intention-to-treat principle and participants with missing data on their smoking status at follow-up were counted as smokers. Secondary outcomes included: one-year prolonged abstinence, short-term incremental cost-effectiveness, medication adherence, and baseline predictors of successful smoking cessation. DiscussionThis trial is the first to provide scientific evidence on the effectiveness, cost-effectiveness, and potential mechanisms of action of intensive practice nurse counselling combined with varenicline under real-life conditions. This paper explains the methodology of the trial and discusses the pragmatic and/or explanatory design aspects. Trial RegistrationDutch Trial Register NTR3067.

Predictors for Successful Smoking Cessation in Korean Adults

A better understanding of the factors contributing to smoking cessation would be of substantial benefit to public health. The purpose of this study was to identify significant predictors of successful smoking cessation in the Korean population. We compared 1,181 successful quitters with 940 current smokers who made a recent attempt to quit but failed in the past 12 months using the fourth Korea National Health and Nutrition Examination Survey. We examined the relationship of sociodemographic, behavioral and environmental characteristics, comorbid conditions, and quitting methods to successful smoking cessation. Older age, female, being married, having higher education, having a lower level of stress, having smoked 20 or more cigarettes per day, and one's own will for quitting have been identified as significant determinants of successful cessation. Frequency of alcohol consumption and trying numerous quitting methods was inversely related to stopping smoking. This study suggests that cessation programs need to take a holistic approach and should consider these factors in setting up.

Predictors of successful smoking cessation among hospitalized smokers

Objective To explore the characteristics of hospitalized smokers and determine the predictors of successful quitters. Methods During December 2010 to November 2012, a total of 240 hospitalized smokers at department of pulmonology and cardiology, including 228 males and 12 females, completed the standard questionnaires derived from Hong Kong Smoking Cessation Health Center. Being used 5A (ask, advice, assess, assist, and arrange follow-up) skills and 5R (relevance, risk, reward, roadblock and repetition) as quitting smoking counseling interventions, they received smoking cessation counseling from healthcare professionals. A 6-month telephone follow-up post-discharge was performed. According to the self-reported status, the 6-month continuous quitters and non-quitters were determined. Moreover, successful quitting predictors were analyzed. Results Among them, 65 cases successfully quitted, 175 cases were non-quitters and the successful cessation rate was 27%. Quitters and non-quitters showed no significant differences in gender, age, marital status, educational level, age at initiation of smoking, average cigarettes smoked daily, exhaled carbon monoxide values or nicotine dependence (P>0.05); while perceived confidence of quitting, 5 days pre-admission to quitting, perceived importance of quitting, cigarette smoking years had significant differences (P<0.05). Logistic regression analysis showed that 5 days pre-admission to quitting was a strongest successful quitting predictor [OR=2.78 (95%CI:1.52-5.15)]; the longer cigarette smoking year, the higher quitting rate [OR=2.10 (95%CI:1.15-3.85)]; the more perceived confidence of quitting, the higher quitting rate [OR=1.95(95%CI:1.06-3.59)]. Conclusion Five days pre-admission to quitting, longer cigarette smoking years and more perceived confidence of quitting are independent successful quitting predictors for hospitalized smokers. Key words: Inpatient; Smoking cessation; Factor analysis, statistical

PRS37 - Predictors Of Successful Smoking Cessation Among Smokers Who Made Quit Attempts During The Previous Year

PRS37 - Predictors Of Successful Smoking Cessation Among Smokers Who Made Quit Attempts During The Previous Year

‘It had to be my choice’ Indigenous smoking cessation and negotiations of risk, resistance and resilience

While Australia is considered a world leader in tobacco control, smoking rates within the Aboriginal and Torres Strait Islander population have not declined at the same rate. This failure highlights an obvious shortcoming of mainstream anti-smoking efforts to effectively understand and engage with the socio-cultural context of Indigenous smoking and smoking cessation experiences. The purpose of this article is to explore the narrative accounts of 20 Indigenous ex-smokers within an urban community and determine the motivators and enablers for successful smoking cessation. Our findings indicated that health risk narratives and the associated social stigma produced through anti-smoking campaigns formed part of a broader apparatus of oppression among Indigenous people, often inspiring resistance and resentment rather than compliance. Instead, a significant life event and supportive relationships were the most useful predictors of successful smoking cessation acting as both a motivator and enabler to behavioural change. Indigenous smoking cessation narratives most commonly involved changing and reordering a person's life and identity and autonomy over this process was the critical building block to reclaiming control over nicotine addiction. Most promisingly, at an individual level, we found the important role that individual health professionals played in encouraging and supporting Indigenous smoking cessation through positive rather than punitive interactions. More broadly, our findings highlighted the central importance of resilience, empowerment and trust within health promotion practice.

High smoking cessation rate in Crohn's disease patients after physician advice – The TABACROHN Study

IntroductionTobacco smoking has a significant impact on the development of Crohn's disease (CD) and its clinical course, making smoking cessation one of the main goals in CD therapeutic strategy. AimsTo evaluate the effectiveness of an advice-based smoking cessation strategy among CD patients. MethodsWe have performed a prospective multicenter study which enrolled 408 CD smokers. At inclusion all patients were instructed about the risks of smoking and subsequently followed every 3months. Each center used additional smoking cessation strategies based on available resources. Urinary cotinine and exhaled carbon monoxide levels were evaluated in a subgroup of patients. ResultsMedian study follow up was 18 months. 31% of the patients achieved complete smoking cessation and 23% were smoking-free at the end of their follow up with 8% of smoking relapse. Most patients not achieving smoking cessation did not change their smoking habit with only 5% presenting a decrease in tobacco load. 63% of patients willing to quit smoking received help from another specialist, most frequently the pulmonologist (47%). Surprisingly, most patients (88%) tried to quit smoking with no pharmacological therapy and bupropion, varenicline and nicotine replacement treatment were used in few patients. Urinary cotinine and exhaled CO levels tested in a subgroup of patients proved to have a good correlation with the self-reported smoking habit. No predictors of successful smoking cessation were identified. ConclusionOur results underline that an anti-tobacco strategy mostly based on CD patients´s education and counseling is feasible and effective in helping patients reach complete abstinence.

Predictors of Early Versus Late Smoking Abstinence within a 24-month Disease Management Program

Standard smoking cessation treatment studies have been limited to 6- to 12-month follow-up, and examination of predictors of abstinence has been restricted to this timeframe. The KanQuit study enrolled 750 rural smokers across all stages of readiness to stop smoking and provided pharmacotherapy management and/or disease management, including motivational interviewing (MI) counseling every 6 months over 2 years. This paper examines differences in predictors of abstinence following initial (6-month) and extended (24-month) intervention. Baseline variables were analyzed as potential predictors of self-reported smoking abstinence at Month 6 and at Month 24. Chi-square tests, 2-sample t tests, and multiple logistic regression analyses were used to identify predictors of abstinence among 592 participants who completed assessment at baseline and Months 6 and 24. Controlling for treatment group, the final regression models showed that male gender and lower baseline cigarettes per day predicted abstinence at both 6 and 24 months. While remaining significant, the relative advantage of being male decreased over time. Global motivation to stop smoking, controlled motivation, and self-efficacy predicted abstinence at 6 months but did not predict abstinence at Month 24. In contrast, stage of change was strongly predictive of 24-month smoking status. While the importance of some predictors of successful smoking cessation appeared to diminish over time, initial lack of interest in cessation and number of cigarettes per day strongly predicted continued smoking following a 2-year program.

Smoking Cessation Outcomes among Individuals with Substance Use and/or Psychiatric Disorders

Objectives: The population of individuals with substance use (SUD) and/or psychiatric disorders (PD) has a high prevalence of smoking and a consequent increase in tobacco-related morbidity and mortality when compared to the general population. The aim of this study is to examine the outcomes of a program in a real-life setting which takes a tailored approach to smoking cessation among individuals with SUD and/or PD. Methods: A retrospective chart review of tailored tobacco dependence treatment was performed on individuals with histories of SUD and/or PD attending a Tobacco Dependence Clinic (TDC) program in Vancouver, British Columbia, Canada. Participants of the TDC received a combination of behavioural counselling and pharmacotherapy for smoking cessation. Data from 540 participants enrolled in the TDC between September 2007 and May 2011 was reviewed. Outcome measures included seven-day point-prevalence abstinence (validated by expired carbon monoxide) and program completion rates. Results: For individuals who completed the program the abstinence rate was 41.1% (167/406). Significant predictors of successful smoking cessation were: a) a lower expired carbon monoxide level at baseline (OR=.98, 95%CI=.96-1.00), and b) a longer duration of treatment (OR=1.09, 95%CI=1.05-1.12). Significant predictors of program completion were: a) being female (OR=1.86, 95%CI=1.21-2.87). Discussion: Tailored smoking cessation among individuals with SUD and/or PD yields modest end-of-treatment smoking cessation rates and can be an effective approach to reducing the burden of tobacco use in substance use and mental health treatment settings.

Predictors of Successful Smoking Cessation in a Family Practice-Based Cardiovascular Risk Factor Intervention Program: ‘Real-World’ Experience From the Heartwatch Program

AbstractHeartwatch is an Irish primary care-delivered secondary prevention program for patients with established coronary artery disease (CAD). We aimed to describe the patterns of smoking cessation in Heartwatch and examine the associates of successful smoking cessation. Participants with established CAD were invited to baseline and three-monthly clinic visits. Data on all persons reporting tobacco use at baseline were examined. Associations between smoking cessation and baseline factors were examined using logistic regression models. Data were available on 1,679 Heartwatch patients who were smoking at first visit. One third of smokers (581 participants: 34.6%) achieved smoking cessation during the study period (2003 to 2007), 80.4% of whom remained nonsmokers at end of follow-up. Positive associates of successful smoking cessation included increasing age, male sex, a body mass index &gt; 25 and increasing number of study visits. Negative associates included having a means-tested general medical services allocation, being unemployed, and documentation of stop-smoking advice. All factors except employment status retained statistical significance when examined in a multivariable model. In conclusion, high levels of smoking cessation were achieved in this secondary prevention population of persistent smokers. Associates of successful smoking cessation were identified. Specific stop-smoking strategies should be considered for those subpopulations less likely to quit.

Stop smoking clinics in Malaysia: characteristics of attendees and predictors of success

Introduction As Stop Smoking Clinics (SSCs) become more common across the globe, it is important to know how far one can make broad generalisations concerning characteristics of smokers who attend these clinics and factors that predict their success. This involves accumulation of data from different countries. Objective The aim of this study was to identify characteristics of smokers and factors leading up to quitting with clinics in Malaysia. Method Records from 629 smokers who had sought help from five selected SSCs in Malaysia from January 2006 to June 2007 were analysed. Results The characteristics of smokers attending Malaysian smoking clinics were broadly similar to those in Western countries. Consistent with the findings from other countries, older age and longest duration of previous quit attempts were associated with successful smoking cessation. Greater baseline carbon-monoxide readings (OR 0.96, 95% CI 0.93–0.99; p = 0.013), but not Fagerstrom Test for Nicotine Dependence (FTND), predicted failure to quit at six-month in multivariate analysis. Success rates varied greatly between clinics even after adjusting for all other predictors. Conclusion In these rare data from a non-Western culture some predictors of successful smoking cessation appeared to generalise from Western smokers but the universal validity of the FTND in particular needs to be examined further.

PREVENTING SMOKING RELAPSE IN THE CAROLINAS

A recent article by Lee and Kahende1 identified predictors of successful smoking cessation to assist practitioners in tailoring programs for clients at high risk of relapse. These researchers found that cessation was significantly associated with the following factors: having rules against smoking in the home and a tobacco-free workplace; being at least 35 years of age, married or living with a partner, and of non-Hispanic White race or ethnicity; and having only 1 lifetime quit attempt and not having switched to low-tar or low-nicotine products. Research conducted by FirstHealth of the Carolinas, a not-for-profit health care system based in Pinehurst, NC,2–5 both supports these findings and identifies other factors to consider toward preventing smoking relapse. FirstQuit is our comprehensive, evidence-based cessation program that provides individual and group counseling to clients who smoke and are referred for treatment from provider offices in our rural, tobacco-growing service region. Program data corroborate the role of stress and addiction in hindering the cessation efforts of clients (Table 1). Stress played a large role in smoking relapse over time, as close to 50% of smokers identified stress as the reason for relapse up to 1 year after cessation (Table 1). This suggests the utility of incorporating on-going stress management components into tobacco cessation programs. Addiction, as indicated by physical urges or withdrawals, influenced relapse most particularly during the first 3 months after the initial quit date (Table 1). As expected, there was a decrease in reported symptoms of withdrawal over time. On the basis of these findings, FirstQuit has tailored its program to address stress and addiction by adding a component to educate clients about the symptoms of nicotine withdrawal, the reasons for their occurrence, and specific coping strategies. Clients are reminded that withdrawal symptoms are temporary and a sign that the body is healing itself. Ensuring access to nicotine replacement therapies and cessation medications to overcome physical addiction is now focused on the time period closest to the quit date and continued according to each client’s needs. In addition, stress is addressed continually throughout follow-up. Clients receive a stress management guide and relaxation CD, are invited to attend ongoing weekly support groups, obtain a trial membership to a fitness center, and are connected to additional local resources for mental health assistance (if necessary). Enhancing cessation interventions with timely, tailored resources that address stress and addiction may enhance efforts to prevent relapse in the Carolinas and elsewhere.

Effectiveness of Proactive Quitline Service and Predictors of Successful Smoking Cessation: Findings from a Preliminary Study of Quitline Service for Smoking Cessation in Korea

This study was to evaluate the effectiveness of the first proactive Quitline service for smoking cessation in Korea and determine the predictors of successful smoking cessation. Smoking participants were voluntarily recruited from 18 community health centers. The participants were proactively counseled for smoking cessation via 7 sessions conducted for 30 days from November 1, 2005 to January 31, 2006. Of the 649 smoking participants, 522 completed 30 days at the end of the study and were included in the final analysis. The continuous abstinence rate at 30 days of follow-up was found to be 38.3% (200/522), in the intention-to-treat analysis. Compared with non-quitters, quitters were mostly male, smoked <20 cigarettes/day, had started smoking at the age of ≥20 yr, and were less dependent on nicotine. Based on the stepwise multiple logistic regression analysis, the significant predictors of successful smoking cessation were determined to be male sex, low cigarette consumption, and older age at smoking initiation. We investigated the short-term effectiveness of the Quitline service and determined the predictors of successful smoking cessation.

Sociodemographic and Smoking Behavioral Predictors Associated with Smoking Cessation According to Follow-up Periods: A Randomized, Double-blind, Placebo-controlled Trial of Transdermal Nicotine Patches

This study investigated sociodemographic and smoking behavioral factors associated with smoking cessation according to follow-up periods. In this randomized, double-blind, placebo-controlled trial of transdermal nicotine patches, subjects were a total of 118 adult male smokers, who were followed up for 12 months. Univariable logistic regression analysis and stepwise multiple logistic regression analyses were performed to identify the predictors of smoking cessation. The overall self-reported point prevalence rates of abstinence were 20% (24/118) at 12 months follow-up, and there was no significant difference in abstinence rates between placebo and nicotine patch groups. In the univariable logistic regression analysis, predictors of successful smoking cessation were the low consumption of cigarettes per day and the low Fagerstrom Test for Nicotine Dependence (FTND) scores (p<0.05) at 3, 6, and 12 months follow-up. In the stepwise multiple logistic regression analyses, predictors of successful smoking cessation, which were different according to the follow-up periods, were found to be the low consumption of cigarettes per day at the short-term and midterm follow-up (≤6 months), older age, and the low consumption of cigarettes per day at the long-term follow-up (12 months).