Smoking Relapse Prevention Research Articles

Assessment of Social Support and Quitting Smoking in an Online Community Forum: Study Involving Content Analysis

BackgroundA key factor in successfully reducing and quitting smoking, as well as preventing smoking relapse is access to and engagement with social support. Recent technological advances have made it possible for smokers to access social support via online community forums. While community forums associated with smoking cessation interventions are now common practice, there is a gap in understanding how and when the different types of social support identified by Cutrona and Suhr (1992) (emotional, esteem, informational, tangible, and network) are exchanged on such forums. Community forums that entail “superusers” (a key marker of a successful forum), like QuitNow, are ripe for exploring and leveraging promising social support exchanges on these platforms.ObjectiveThe purpose of this study was to characterize the posts made on the QuitNow community forum at different stages in the quit journey, and determine when and how the social support constructs are present within the posts.MethodsA total of 506 posts (including original and response posts) were collected. Using conventional content analysis, the original posts were coded inductively to generate categories and subcategories, and the responses were coded deductively according to the 5 types of social support. Data were analyzed using Microsoft Excel software.ResultsOverall, individuals were most heavily engaged on the forum during the first month of quitting, which then tapered off in the subsequent months. In relation to the original posts, the majority of them fit into the categories of sharing quit successes, quit struggles, updates, quit strategies, and desires to quit. Asking for advice and describing smoke-free benefits were the least represented categories. In relation to the responses, encouragement (emotional), compliment (esteem), and suggestion/advice (informational) consistently remained the most prominent types of support throughout all quit stages. Companionship (network) maintained a steady downward trajectory over time.ConclusionsThe findings of this study highlight the complexity of how and when different types of social support are exchanged on the QuitNow community forum. These findings provide directions for how social support can be more strategically employed and leveraged in these online contexts to support smoking cessation.

The Impact of the Tips from Former Smokers® Campaign on Reducing Cigarette Smoking Relapse.

Evidence-based mass-reach health communication campaigns can increase tobacco cessation, use of cessation resources such as quitlines, and change tobacco-related social norms. These interventions have been associated with a lower likelihood of cigarette smoking relapse in studies conducted internationally; however, no studies have assessed this outcome for a national campaign in the United States. This study examined the relationship between Tips from Former Smokers® (Tips®) campaign exposure and the odds of cigarette smoking relapse among adults who formerly smoked. Using data from the 2014 to 2019 Tips longitudinal campaign surveys, we estimated first episode of relapse (versus remaining a former smoker) as a function of Tips gross rating points (GRPs, a measure of media exposure). Higher levels of Tips GRPs were associated with lower odds of relapse (aOR = 0.63, 95% CI: 0.50-0.78). These results suggest that the Tips campaign may reduce smoking relapse, in addition to the established effect of increasing smoking cessation. Former smokers can be considered a secondary target audience for smoking cessation mass media campaigns, and mass media campaigns could be considered a component of smoking relapse prevention efforts.

Need for mindfulness-based relapse prevention strategies for postpartum smoking relapse prevention.

The health concerns for women are varied from that of men and are of higher concern. To increase this concern, women have recorded higher smoking relapse rates than men were an alarming 60% to 90% of the women who have attempted to quit relapse within their first year. Women who quit during pregnancy are seen to have higher rates of relapse than others. Such postpartum relapse has detrimental effects on the mother as well as the newborn. Mindfulness-based interventions have seen benefits in the areas of substance abuse and relapse prevention. Although research in the area of mindfulness and its benefits on smoking cessation has been limited, literature shows positive outcomes. This brief article examines the need for mindfulness-based relapse prevention strategies for women who are undergoing postpartum smoking relapses so that they could benefit from the same.

Evaluating Outcomes of a Social Media-Based Peer and Clinician-Supported Smoking Cessation Program in Preventing Smoking Relapse: Mixed Methods Case Study.

BackgroundSmoking relapse prevention after completion of a smoking cessation program is highly germane to reducing smoking rates.ObjectiveThe purpose of this study was to evaluate the 1-year outcomes of a social media–based and peer and clinician-supported smoking cessation program on Facebook and examine communication patterns that could support smoking cessation and identify risk of relapse.MethodsWe used a mixed methods case study evaluation approach featuring a single-case holistic design. We recruited volunteers who signed up after successful completion of a 12-week clinical smoking cessation program in a general medicine department in Japan. Participants contemporaneously accessed a closed Facebook page, and we analyzed their posts including text and emoticons. We used joint display analysis, which involved iterative structuring and restructuring construct-specific tables with both types of data to find the most effective approach for integrating the quantitative results with the qualitative results of content analysis.ResultsOne successful participant and 2 relapsed participants were analyzed to explore the specific patterns of postings prior to relapse. Decisive comments about quitting smoking were common among participants, but encouraging messages for peers were more common from the successful participant. Comments seeking social support and reassurance were warning signs of relapse. Conflicted comments also may be a warning sign of relapse risk.ConclusionsThese findings based on a mixed methods case study of a social media platform supporting smoking cessation could be used to guide messaging in other online social networking service communities after a smoking cessation program to help reduce smoking relapse.Trial RegistrationUMIN Clinical Trials Registry UMIN000031172; https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000035595

Sense2Stop: A micro-randomized trial using wearable sensors to optimize a just-in-time-adaptive stress management intervention for smoking relapse prevention

BackgroundRelapse to smoking is commonly triggered by stress, but behavioral interventions have shown only modest efficacy in preventing stress-related relapse. Continuous digital sensing to detect states of smoking risk and intervention receptivity may make it feasible to increase treatment efficacy by adapting intervention timing. ObjectiveAims are to investigate whether the delivery of a prompt to perform stress management behavior, as compared to no prompt, reduces the likelihood of (a) being stressed and (b) smoking in the subsequent two hours, and (c) whether current stress moderates these effects. Study designA micro-randomized trial will be implemented with 75 adult smokers who wear Autosense chest and wrist sensors and use the mCerebrum suite of smartphone apps to report and respond to ecological momentary assessment (EMA) questions about smoking and mood for 4 days before and 10 days after a quit attempt and to access a set of stress-management apps. Sensor data will be processed on the smartphone in real time using the cStress algorithm to classify minutes as probably stressed or probably not stressed. Stressed and non-stressed minutes will be micro-randomized to deliver either a prompt to perform a stress management exercise via one of the apps or no prompt (2.5–3 stress management prompts will be delivered daily). Sensor and self-report assessments of stress and smoking will be analyzed to optimize decision rules for a just-in-time adaptive intervention (JITAI) to prevent smoking relapse. SignificanceSense2Stop will be the first digital trial using wearable sensors and micro-randomization to optimize a just-in-time adaptive stress management intervention for smoking relapse prevention.

Pattern and determinants of alcohol and tobacco co-use and its relationship with smoking cessation in Hong Kong.

INTRODUCTIONAlcohol and tobacco are often used together. Studies have shown that some biological factors contribute to the concurrent use of alcohol and nicotine. There have been comparatively few studies that document the concurrent prevalence and correlates of alcohol and tobacco use among adults. A better understanding of the smokers who also drink is needed to help them to quit smoking.METHODSA retrospective case review study on smokers who voluntarily joined our service in 2014–2017 was conducted. Characteristics of tobacco users only, and alcohol and tobacco co-users were reviewed. The quit rate of smoking related to alcohol use was analyzed. Participants were contacted by phone at week 26 and 52 to ascertain smoking status and abstinence.RESULTSThere were 4602 alcohol and tobacco co-users and 2732 tobacco only users. Co-users had higher education level and better income than tobacco only users. In all, 52.24% of co-users were aged 21–40 years. For the alcohol users, their mean AUDIT score was only 6.17 (SD: 5.67). Multivariate analysis showed that age and gender were associated with co-use while high personal income had lower odds of co-use. Quit rate decreased as the AUDIT score increased. Those who had binge drinking more than once a month had lower quit rate compared with binge drinking less than once a month at week 26 (34.2% vs 43.19%, p<0.0001).CONCLUSIONSAlcohol and tobacco co-users should acknowledge alcohol–tobacco interactions to reduce alcohol use and prevent smoking relapse. Healthcare providers should screen for alcohol use in smoking cessation interventions.

Bupropion for postpartum smoking relapse: A remote protocol for a two-arm, double-blind, placebo-controlled randomized clinical trial

Cigarette smoking among postpartum women remains a significant public health problem despite known health risks to women and their newborns. It is estimated that over 50% of women quit smoking during pregnancy but 90% relapse by one year. Safe and effective postpartum relapse prevention strategies are urgently needed. In an attempt to address this deficit, we will investigate the efficacy of bupropion vs. placebo as a smoking relapse prevention aid in postpartum women. The objective of this paper is to detail an approach to investigate bupropion's efficacy for preventing postpartum smoking relapse among women who quit smoking during pregnancy. Specifically, we designed a two-arm, double-blind, placebo-controlled randomized trial testing the efficacy of bupropion vs. placebo as a relapse prevention tool. Mothers of healthy infants who quit smoking while pregnant will be stratified based on current or past history of major depressive disorder or persistent depressive disorder and randomized to receive either active (bupropion XL 300 mg/day) or placebo medication for 12 weeks. To respond to safety concerns associated with participant and staff exposure to COVID-19, we revised our original protocol and present procedures which allow our trial to be conducted entirely remotely. Primary and secondary outcomes will be assessed at weeks 12, 24, 36 and 52 post-randomization. The primary outcome is 7-day point prevalence abstinence at 24 weeks. Results of this work have the potential to positively impact women and their children by promoting lifelong cessation, eliminating secondhand smoke exposure, and modelling of abstinence to children.

Learner Verification: A Methodology to Create Suitable Education Materials

Background:Learner verification and revision (LV&R) is a research methodological approach to inform educational message design with the aim of producing suitable, actionable, and literacy appropriate messages to aid in awareness, adoption of healthy behaviors, and decision-making. It consists of a series of participatory steps that engage users throughout materials development, revision, and refinement. This approach is congruent with Healthy People 2030 communication objectives to improve access to information among diverse, multicultural, multilingual populations, and enhance health care quality toward health equity.Brief description of activity:To illustrate LV&R, we describe its use in three cancer education projects that produced targeted information about (1) inherited breast cancer among African Americans (brochure); (2) colorectal cancer screening among Latinos (photo novella and DVD); and (3) smoking-relapse prevention among patients receiving cancer treatment (video). We discuss rationale for its application in the three exemplars and extrapolate lessons learned from our experiences when using this approach.Implementation:A qualitative approach entailing individual or group-based discussions helped to examine the elements of learner verification (i.e., attraction, comprehension, self-efficacy, cultural acceptability, persuasion). The following steps are reported: (1) preparation of materials, interview guide, and recruitment; (2) interviewing of participants; and (3) evaluation of responses. Data were analyzed by use of a coding system that placed participant responses from each of the elements into data summary matrices. Findings informed revisions and refinement of materials.Results:LV&R was effectively applied across the three cancer education projects to enhance the suitability of the materials. As a result, the materials were improved by using clearer, more salient language to enhance comprehension and cultural acceptability, by integrating design elements such as prompts, headers, and stylistic edits to reduce text density, incorporating preferred colors and graphics to improve aesthetic appeal, and including actionable terms and words to bolster motivation and self-efficacy.Lessons learned:Results suggest that LV&R methodology can improve suitability of education materials through systematic, iterative steps that engage diverse, multicultural, multilingual populations. This approach is a critical participa-tory strategy toward health equity, and is appropriate in a variety of education, research, and clinical practice settings to improve health communications. [HLRP: Health Literacy Research and Practice. 2021;5(1):e49–e59.]Plain Language Summary:This article describes the use of a systematic approach called “learner verification” used for developing educational materials. This approach involves obtaining feedback from audience members to ensure that the information is understandable, attractive in design, motivating, and culturally relevant.

Factors Related to Smoking Recurrence within Six-months Smoking Cessation among Employees in Enterprises with Smaller than 300 Workers

Purpose: The purpose of this study is to identify factors associated with smoking relapse within six months after quit attempts among workers in small and medium-sized enterprises in South Korea. Methods: The analysis was conducted for a total of 194 people who attempted to quit smoking by applying for a smoking cessation support service at the Regional Tobacco Control Center. The data used in the study were extracted from the Smoking Cessation Service Integrated Information System. Kaplan-Meier estimator and Cox proportional hazards regression model were used to identify variables associated with smoking relapse within six months’ time period. Results: Smoking relapse rate within six months was 66.0%, and variables associated with relapse included the cases such as carbon monoxide (CO) at the time of registration (HR: 2.15, 95% CI: 1.10~4.22 for CO ≥20 ppm or more vs.CO ＜10 ppm), the average number of cigarettes smoked per day (HR: 1.04, 95% CI: 1.00~1.07), and the number of counseling(HR: 0.60, 95% CI: 0.54~0.67). Conclusion: Smoking characteristics and counseling showed one of the strongest correlations with relapse within six months. This implies that it is necessary to understand the smoking characteristics and patterns of workers and to provide continuous smoking cessation counseling tailored to individual characteristics for effective smoking relapse prevention.

A randomised controlled trial of motivational interview for relapse prevention after release from smoke-free prisons in Australia.

This paper aims to determine whether a single session of a motivational interview (MI) reduces smoking relapse amongst people released from smoke-free prisons. This study sought to recruit 824 ex-smokers from 2 smoke-free prisons in the Northern Territory, Australia. Participants were randomised to receive either one session (45-60 min) face-to-face MI intervention 4-6 weeks prior to release or usual care (UC) without smoking advice. The primary outcome was continuous smoking abstinence verified by exhaled carbon monoxide test (<5 ppm) at three months post-release. Secondary outcomes included seven-day point-prevalence, time to the first cigarette and the daily number of cigarettes smoked after release. From April 2017 to March 2018, a total of 557 participants were randomised to receive the MI (n = 266) or UC (n = 291), with 75% and 77% being followed up, respectively. There was no significant between-group difference in continuous abstinence (MI 8.6% vs UC 7.4%, risk ratio = 1.16, 95%CI 0.67∼2.03). Of all participants, 66.9% relapsed on the day of release and 90.2% relapsed within three months. On average, participants in the MI group smoked one less cigarette daily than those in the UC within the three months after release (p < 0.01). A single-session of MI is insufficient to reduce relapse after release from a smoke-free prison. However, prison release remains an appealing time window to build on the public health benefit of smoke-free prisons. Further research is needed to develop both pre- and post-release interventions that provide continuity of care for relapse prevention. This study is the first Australian randomised controlled trial to evaluate a pre-release MI intervention on smoking relapse prevention amongst people released from smoke-free prisons.

Two-Hour Tobacco Abstinence Has No Effect on Cognitive Control in Male Patients With Nicotine Dependence: An ERP Study.

The average nicotine half-life in body tissues is 2 h. Understanding the influence of pure nicotine abstinence on cognitive control may be helpful in eliminating nicotine dependence (ND) and preventing smoking relapse. This study was to investigate the effects of 2-h tobacco abstinence on cognitive control in patients with ND. Twenty-five patients with ND completed event-related potential (ERP) P300 measurements at the normality state and the abstinence state. Twenty-five healthy controls (HCs) were measured with P300 twice with a 2-h time interval. HAMD and HAMA were used to assess the emotional state. Results showed that there were significant differences in Carbon monoxide (CO) levels between the abstinence state and the normality state in the ND group. There were no significant differences in HAMD and HAMA scores for the abstinence state in the ND group or the normality state in the ND group and the HC group. For P3a, P3b amplitude, and P3a latency, the main effect for ND group was significant. For P3a, P3b amplitude, and latency, the interaction effect for group × time point was not significant, and the main effect for time point was not significant. It concluded that patients with ND present cognitive control deficits, and 2-h tobacco abstinence has no effect on cognitive control deficits in male patients with ND. Our findings may be helpful in eliminating nicotine dependence and preventing smoking relapse.

Results of a Feasibility Study of Helpers Stay Quit Training for Smoking Relapse Prevention.

Most smoking quit attempts end in relapse, and interventions focused on relapse prevention are lacking. Helpers Stay Quit (HSQ) is a novel behavioral relapse prevention intervention that teaches newly abstinent smokers to offer a "helping conversation" (HC) to help others quit tobacco. Pre-post intervention feasibility study with state quitline participants ≥14 days abstinent. Measures at baseline, 3 months, and 6 months included smoking status, offering HCs, and cessation self-efficacy. Primary outcomes: self-reported 7-day point prevalence abstinence; offering HCs. Cox models explored association of HCs with relapse. Preliminary effects analysis using propensity score matching compared 30-day abstinence of quitline clients with study sample at 7 months. Participants (N = 104) were as follows: mean age of 53 years (SD 13.9 years), 48.1% male, mean of cigarettes smoked/day of 16.2 (SD 9.7). Compared with participants who remained abstinent (n = 82), relapsers (n = 22) had fewer HCs over 6 months (2.6 vs 7.2; 95% confidence interval [CI]: 1.4, 7.8, p = .006). Using adjusted Cox regression, the hazard ratio of relapse for each HC was 0.85 (95% CI: 0.74, 0.99, p = .03). Compared with a matched sample of quitline clients not exposed to HSQ, study participants were 49% more likely to report 30-day abstinence at 7-month quitline follow-up (95% CI: 40%, 59%, p < .0001). HSQ, delivered to newly abstinent smokers who received standard quitline treatment, was associated with less self-reported relapse. These promising preliminary study results warrant further research to evaluate HSQ as a novel behavioral intervention to prevent smoking relapse. To date, behavioral interventions for smoking relapse prevention that teach abstainers cessation skills to apply to themselves have not shown effectiveness. This feasibility study examines the preliminary efficacy of a conceptually novel, "help others" behavioral intervention approach for relapse prevention in newly abstinent smokers recruited from a state quitline. HSQ teaches the newly abstinent smoker communication and listening skills to encourage other smokers in their personal social network to quit. Exploratory analysis using propensity score matching suggests that participants exposed to HSQ were significantly more likely to self-report 30-day abstinence at quitline 7-month follow-up than other quitline clients.

User pathways of e-cigarette use to support long term tobacco smoking relapse prevention: a qualitative analysis.

E-cigarettes are the most popular consumer choice for support with smoking cessation in the United Kingdom. However, there are concerns that long-term e-cigarette use may sustain concurrent tobacco smoking or lead to relapse to smoking in ex-smokers. We aimed to explore vaping trajectories, establishing e-cigarette users' perspectives on continued e-cigarette use in relation to smoking relapse or abstinence. Qualitative longitudinal study collecting detailed subjective data at baseline and ~12months later. United Kingdom. E-cigarette users (n=37) who self-reported that they had used e-cigarettes to stop smoking at baseline. Semi-structured qualitative interviews (face-to-face or telephone) collected self-reported patterns of e-cigarette use. Thematic analysis of transcripts and a mapping approach of individual pathways enabled exploration of self-reported experiences, motives, resources, and environmental and social influences on vaping and any concurrent tobacco smoking. Three broad participant pathways were identified: 'maintainer' (e-cigarette use and not smoking), 'abstainer' (neither smoking nor using e-cigarettes), and 'relapser' (dual-using, or relapsed back to tobacco smoking only). In each pathway, individual experiences with vaping nicotine appeared to play an important role and appeared to be related to psychological and social factors. A social context supportive of vaping was important for the maintainers, as was a belief in the need to overcome nicotine addiction for the abstainers, and dislike of the 'vaping culture' expressed by some in the relapser group. Dual-users held beliefs such as a need for cigarettes at time of acute stress that affirmed dependence on tobacco. In a sample of UK e-cigarette users who report having used e-cigarettes to quit smoking, a social context that supports continued vaping was perceived to be helpful in preventing relapse to smoking.

Preventing smoking relapse in patients with cancer: A randomized controlled trial

Abstaining from smoking after a cancer diagnosis is critical to mitigating the risk of multiple adverse health outcomes. Although many patients with cancer attempt to quit smoking, the majority relapse. The current randomized controlled trial evaluated the efficacy of adapting an evidence-based smoking relapse prevention (SRP) intervention for patients with cancer. The trial enrolled 412 patients newly diagnosed with cancer who had recently quit smoking. Participants were randomized to usual care (UC) or SRP. Participants in the UC group received the institution's standard of care for treating tobacco use. Participants in the SRP group in addition received a targeted educational DVD plus a validated self-help intervention for preventing smoking relapse. The primary outcome was smoking abstinence at 2 months, 6 months, and 12 months. Abstinence rates for participants in the SRP and UC groups were 75% versus 71% at 2 months and 69% versus 64% at 6 months (Ps>.20). At 12 months, abstinence rates among survivors were 68% for those in the SRP group and 63% for those in the UC group (P=.38). Post hoc analyses revealed that across 2 months and 6 months, patients who were married/partnered were more likely to be abstinent after SRP than UC (P=.03). A smoking relapse prevention intervention did not reduce relapse rates overall, but did appear to have benefited those participants who had the social support of a partner. Future work is needed to extend this effect to the larger population of patients.

Co-designing a mHealth intervention to prevent smoking relapse after birth

Background: Smoking during pregnancy is a well-known risk factor for both the mother and the baby. mHealth offers novel ways to implement smoking-cessation interventions with broader reach and the potential to be more successful. Methods: We conducted twelve semi-structured interviews in November-December 2017 with women who just gave birth and quit smoking before or during pregnancy. A thematic analysis was conducted to explore women’s views on the two components. Results: Most women found the text messages easy to understand and virtually all women rated their content as relevant for preventing smoking relapse. Also, they expressed interest in using the proposed relapse prevention app and, in general, appreciated the app positively. Some women, however, felt that the smoking relapse decision is highly personal and cannot be influenced by text messages or other types of assistance programs. Conclusions: Stay Quit Together is, to our knowledge, the first postpartum tobacco smoking relapse prevention program combining an app and text messages. This study suggests that Stay Quit Together would be accepted and used postpartum by women who spontaneously quit smoking during or before pregnancy.

An mHealth intervention to prevent postnatal smoking relapse: The RESPREMO study protocol.

Up to 70% of women who quit smoking relapse after birth, usually within 3 months postpartum. The wide adoption of mobile technologies, especially smartphones, in recent years in low- and middle-income countries (LMICs) offers the possibility of low-cost, novel, and innovative mobile phone-based interventions for smoking relapse prevention. This study presents the protocol of the RESPREMO clinical trial for postnatal smoking relapse prevention for enrolled women, who recently gave birth and quit tobacco smoking before or during pregnancy, and their life partners.This work relies on data collected in two of the largest government-owned obstetrics and gynecology clinics in Cluj-Napoca, Romania. Seventy-five couples were randomized into one of three groups: a) 24 couples were allocated to the first intervention group and asked to install and use the xSmoker app; b) 26 couples were randomized to the second intervention group, who, in addition to the use of the xSmoker app, received text messages with content focused on motivation, problem solving, and dyadic efficacy; and c) 25 couples were randomized into a control group.Several measures of engagement with the xSmoker app were assessed, including duration of app use, the frequency of utilizing the tool to calculate savings from quitting, number of app-delivered challenges accepted by users, and number of app-delivered cessation and abstinence tips.If effective, RESPREMO is expected to have a sustainable impact on the prevention of postnatal relapse tobacco smoking with positive effects for both the mother and the newborn. The implications are beyond tobacco control, and relevant to the design and implementation of other mHealth behavioral interventions focused on the pregnancy and reproductive years in general.

Exploring mindfulness and its psychosocial correlates in a population of low-income, female, tobacco smokers with young children

Background: Tobacco use is the leading preventable cause of disease and death in the US and smoking rates are high in low-income populations (28% vs. 17% of those living above the poverty line).1,2 Consequently, low-income groups have elevated tobacco-related disease risk exacerbating health disparities.3,4 Mindfulness has been associated with positive effects on psychosocial, physical and mental health outcomes, which has increased interest in using mindfulness as an adjunctive treatment for smoking cessation and relapse prevention.5,6 However, research on mindfulness in relation to such factors in underserved populations is lacking.&#x0D; Purpose/Hypothesis: The purpose of this research is to investigate the psychometric qualities and correlates of the Cognitive and Affective Mindfulness Scale (CAMS-R)7 in a sample of low-income, mostly minority women who smoke cigarettes. It is hypothesized that the CAMS-R will be reliable, and mindfulness will be associated with known barriers to cessation.&#x0D; Methods: Secondary analysis of self-report data from 12-month follow-up in a large, randomized smoking cessation trial, Babies Living Safe and Smokefree,8 was used to explore mindfulness and its relationship to known cessation barriers and facilitators. Temple University IRB approval was received before data collection. CAMS-R items were summed to create a composite score.&#x0D; Results: The sample of women (N=187) was mostly (72%) African American, average age was 30 years old, ~28% had less than a high school degree/GED and on average smoked ~9 cigarettes/day. The CAMS-R was reliable (α=.74). Zero-order correlations showed higher mindfulness was significantly correlated with greater social support (p &lt; .01). Higher mindfulness was significantly correlated with lower depressive symptoms, social constraints, household chaos, sleep disturbances, childhood trauma, life stressors, and chronic mental, and physical health conditions (p's &lt; .01 except physical health p &lt; .05).&#x0D; Conclusions/Relevance: The sample had higher CAMS-R scores compared to central tendency scores in broader populations. The high scores may indicate an amenable characteristic of mindfulness that could be trained for interventions. Yet, more research is needed on feasibility/acceptability in this population. Higher mindfulness is inversely related to many negative health and psychosocial factors which are known barriers to cessation, as well as positively related to social support, an important facilitator of cessation. The interplay between social support and mindfulness should be explored, as each is theorized as a “stress buffer.” research should investigate psychosocial factors as potential mediators in mindfulness interventions for smoking cessation targeting vulnerable female smokers.

Factors associated with smoking cessation in patients with coronary heart disease: a cohort analysis of the German subset of EuroAspire IV survey

BackgroundTobacco smoking is one of the most important risk factors of coronary heart disease (CHD). Hence, smoking cessation is considered pivotal in the prevention of CHD. The current study aimed to evaluate smoking cessation patterns and determine factors associated with smoking cessation in patients with established CHD.MethodsThe fourth European Survey of Cardiovascular Disease Prevention and Diabetes investigated quality of CHD care in 24 countries across Europe in 2012/13. In the German subset, smoking cessation patterns and clinical characteristics were repetitively assessed a) during index event due to CHD by medical record abstraction, b) as part of a face-to-face interview 6 to 36 months after the index event (i.e. baseline visit), and c) by telephone-based follow-up interview two years after the baseline visit. Logistic regression analysis was performed to search for factors determining smoking status at the time of the telephone interview.ResultsOut of 469 participants available for follow-up, 104 (22.2%) had been classified as current smokers at the index event. Of those, 65 patients (62.5%) had quit smoking at the time of the telephone interview, i.e., after a median observation period of 3.5 years (quartiles 3.0, 4.1). Depressed mood at baseline visit and higher education level were less prevalent amongst quitters vs non-quitters (17.2% vs 35.9%, p = 0.03 and 15.4% vs 33.3%, p = 0.03), cardiac rehabilitation programs were more frequently attended by quitters (83.1% vs 48.7%, p < 0.001), and there was a trend for a higher prevalence of diabetes at baseline visit in quitters (37.5% vs 20.5%, p = 0.07). In the final multivariable model, cardiac rehabilitation was associated with smoking cessation (OR 5.19; 95%CI 1.87 to 14.46; p = 0.002).DiscussionAttending a cardiac rehabilitation program after a cardiovascular event was associated with smoking cessation supporting its use as a platform for smoking cessation counseling and relapse prevention.

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.

The Changing Process of Women's Smoking Status Triggered by Pregnancy.

Although pregnancy is the trigger for many women to stop smoking, often they are unable to maintain cessation, undoing any health benefits for themselves and their children. Smoking is a complex phenomenon both before and after pregnancy, influenced by social background, relationships, and the specific experience of pregnancy and delivery. Therefore, it is necessary to clarify the experience and process of changes in women’s smoking status from pregnancy to after delivery. To explore possibilities for better smoking cessation support, the objective of this study was to clarify the changing process of smoking status from pregnancy to after delivery in women for whom pregnancy triggered a smoking cessation. We analyzed data obtained through semi-structured interviews with 31 women, using the grounded theory approach. Women reconsidered their smoking status, either quitting or smoking fewer cigarettes, because of externally motivated changes due to concerns regarding the influence of smoking on pregnancy and children. To prevent smoking relapse, it is important for the women themselves, as well as those around them, to appreciate their cessation, facilitating internal motivation and assessment of the situation. Furthermore, it is important to provide support, by implementing the process revealed in this study, not only during pregnancy but for an entire lifetime.