Quit Tobacco Use Research Articles

Effects of Graphic Health Warning on Tobacco Packs: A Cross-Sectional Study among Low Socioeconomic Group in Bangladesh.

Background Tobacco use is a significant health concern in Southeast Asia, particularly in Bangladesh, where the greatest incidence of tobacco consumption occurs in a number of forms smoking, smokeless, and indigenous. The WHO Framework Convention on Tobacco Control (FCTC) requires tobacco product packaging to include adequate health warnings (text and visual). The study's objective is to investigate the effects of graphic health warnings on tobacco packs among Bangladeshi low socioeconomic groups. Study Design. Cross-sectional study. Methods The study was conducted with 400 participants (low socioeconomic people) by using the systematic sampling technique through a semistructured questionnaire in Demra and Tongi industrial areas of Dhaka city in Bangladesh during September 2019-November 2020. Descriptive statistics (frequencies, percentages, means, and standard deviations) and inferential analysis (i.e., chi-square tests) were performed by Statistical Package for Social Sciences (SPSS version 25.0) to explore the relationship between the graphic warning and the use of tobacco. Results This study illustrates that 89% of respondents smoke only cigarette or bidi, where 95.1% were daily smokers. About 72.2% reported pictorial warning message was more understandable while 90.8% reported the existing text warnings explicitly visualize the health harms. It has been found that there was a significant association between the respondent's opinion on the text warning that encouraged the respondent to quit tobacco use and the text messages “smoking causes throat and lung cancer” (p < 0.001) and “smoking causes respiratory problems” (p < 0.001). Around 96.7% knew about the graphic health warnings on the cigarette packets where 99.2% reported graphic warning explicitly visualizes the health harms. In graphical warnings, text messages have a great influence on quitting smoking where “smoking causes throat and lung cancer” (p < 0.001) and “smoking causes stroke” (p < 0.001). Nearly 79.2% of respondents thought the color of the graphic warning should be “Red” and a significant association between the color and the education level of the respondents explored here (p < 0.05). Conclusions GHWs are more understandable on tobacco packets, and it has significant impacts on being aware of health consequences from tobacco consumption.

Sociocultural factors contributing to waterpipe tobacco smoking among adolescents and young adult women: a qualitative study in Iran

ABSTRACT Purpose: Waterpipe tobacco smoking (WTS) is currently a serious and growing public health threat in the world, especially in adolescents and young women. The aim of the study was to explore sociocultural factors contributing to WTS among adolescents and young adult women in Iran. Methods: This qualitative study was conducted from August 2017 to January 2019 in Isfahan and Hamadan cities, Iran; it included 13–30-year-old females with experience of WTS. For data collection, in-depth semi-structured personal interviews were conducted at participants’ preferred time and place. Concurrent with data collection, data were analysed through conventional content analysis. Results: The study participants described the various sociocultural factors contributing to WTS. These factors were categorized into four following main categories: waterpipe glamorization by its producers and sellers, media advertisement or silence, common sociocultural traditions, and governmental policies and regulations. Conclusion: A wide range of sociocultural factors affects WTS among Iranian adolescents and young adult women. Therefore, interdisciplinary multidimensional strategies are needed for WTS management and prevention among these at-risk groups. Public education, strict supervision of tobacco import, export, and selling, ample employment opportunities for young people and effective leisure time management are essential to reduce WTS.Abbreviation WTS: Waterpipe Tobacco Smoking; MPOWER: Monitor tobacco use and prevention policies, Protect people from tobacco smoke, Offer help to quit tobacco use, Warn about the dangers of tobacco, Enforce bans on tobacco advertising, promotion and sponsorship, Raise taxes on tobacco

Socio-demographic correlates of quit attempts and successful quitting among smokers in India: Analysis of Global Adult Tobacco Survey 2016-17.

MPOWER is a policy package of six components intended to assist in the country-level implementation of effective tobacco control interventions. One of the six components of MPOWER strategy is to offer help to quit tobacco use. Majority of the smokers want to quit, but quitting is difficult due to the addictiveness of nicotine. They make multiple quitting attempts with little success. There is a need to know what proportion of smokers make a quit attempt, and among those who make an attempt, how many become successful quitters and their sociodemographic correlates. Secondary analysis of data from the Global Adult Tobacco Survey (GATS-2) 2016-17, India was done. This nationally representative survey was conducted among persons aged 15 years or older. Weighted estimates were calculated after adjusting for clustering and stratification. A total of 35.5% adults who smoked tobacco during the past 12 months have made a quit attempt in the last 12 months. Around 14.2% of ever daily smokers currently do not smoke (which indicate successful quit rate). The study demonstrated strong associations of sociodemographic characteristics such as age group, educational attainment, caste, religion, geographic region, wealth quintiles, and visit to health care provider with the attempt to quit tobacco and successful quitting. The majority of quit attempts were made without any assistance (71.1%). The study provides robust national evidence on attempts to quit tobacco, the success rates of those attempts, and their sociodemographic correlates. The study highlights the need to provide more cessation support to young, less educated people in the northern part of India.

Tütün Bağımlılığının COVİD-19 Ağırlığı Üzerine Etkisi

INTRODUCTION: We aimed to investigate the relationship between smoking and the general characteristics, symptoms and clinical course of patients diagnosed with COVID-19 who were followed-up in the COVID ward in the first 2 months of the pandemic. METHODS: Patients over the age of 18 and diagnosed with COVID-19 were included retrospectively. The demographic data, symptoms, comorbidities of the patients, tobacco and tobacco-product use, disease severity, the patient's follow-up status in the ward or intensive care unit and the need for supportive treatment, and the relationship between tobacco-use and disease severity were evaluated. RESULTS: A total of 224 patients, 40.6% of whom were female, with a mean age of 57 years were included in the study. 32.6% of the patients were active smokers, 27.6% were quit-smoking, 13.4% passive-smokers and 26.3% never-smoked. Of the patients (n = 62) who quit smoking, 17 (27.4%) patients were quit smoking during the pandemic. The highest smoking rate was found in patients between the ages of 18-49 (44.7%). Dyspnea (45.2%), loss of smelling (31.5%), inability to taste (21.9%), chills-and-shivering (16.9%) were statistically higher in patients with active-smoking. Comparing the need for supportive treatments during the follow-up of the patients, the use of oxygen therapy was found to be significantly higher in patients with active-smoking and quit-tobacco use, while other supportive treatments were similar. When the rates of smoking status and death of the patients were compared, a proportionally higher mortality rate was found in active-tobacco users, but there was no significant difference. DISCUSSION AND CONCLUSION: While no significant difference on the effect of tobacco use on disease severity and mortality in our study, it is observed that the symptom of shortness of breath was higher in smokers in COVID-19 patients. Additionally, the need for oxygen treatment may increase significantly due to tobacco use in their life span.

Improving Inpatient Tobacco Treatment Measures: Outcomes Through Standardized Treatment, Care Coordination, and Electronic Health Record Optimization.

The Centers for Disease Control and Prevention states that tobacco use is the largest and most preventable cause of disease and mortality in the United States. The Joint Commission implemented inpatient tobacco treatment measures (TTMs) in 2012 to encourage healthcare systems to create processes that help patients quit tobacco use through evidence-based care. A tobacco cessation care delivery system was implemented at James A. Haley Veterans' Hospital and Clinics, which included: standardized pathways within the Veterans Health Administration (VHA) electronic health record system to improve nicotine replacement therapy ordering; evidence-based tobacco cessation counseling; and improved care coordination for tobacco cessation treatment through the use of technological innovation. Outcomes were obtained from the VHA quality metric reporting system known as Strategic Analytics for Improvement and Learning (SAIL). TOB-2 and TOB-3 (two Joint Commission inpatient TTMs) equivalent to tob20 and tob40 within SAIL improved by greater than 300% after implementation at James A. Haley Veterans' Hospital and Clinics. Implementation of a tobacco cessation care system at James A. Haley Veterans' Hospital and Clinics enhanced interdisciplinary coordination of tobacco cessation care and resulted in improvements of The Joint Commission inpatient TTMs by greater than threefold.

Improving the effectiveness of tobacco use cessation (TUC)

This paper includes an update of a Cochrane systematic review on tobacco use cessation (TUC) in dental settings as well as narrative reviews of possible approaches to TUC and a more detailed discussion of referral for specialist TUC services. On the basis of these reviews we conclude that interventions for tobacco users in the dental setting increase the odds of quitting tobacco. However, the evidence is derived largely from patients using smokeless tobacco. Pharmacotherapy (such as nicotine replacements, bupropion and varenicline) is recommended for TUC in medical settings but has received little assessment in dental applications, although such evidence to date is promising. Whether the dental setting or referral to specialist TUC services is the most effective strategy to help people to quit tobacco use is unclear. An effective specialist service providing best available TUC care alone may not be the answer. Clearly, such services should be both accessible and convenient for tobacco users. Closer integration of specialist services with referrers would also be advantageous in order to guide and support oral health professionals make their referral and to maximise follow-up of referred tobacco users. Future research direction may consider investigating the most effective components of TUC in the dental settings and community-based trials should be a priority. Pharmacotherapy, particularly nicotine replacement therapy, should be more widely examined in dental settings. We also recommend that various models of referral to external and competent in-house TUC specialist services should be examined with both experimental and qualitative approaches. In addition to overall success of TUC, important research questions include facilitators and barriers to TUC in dental settings, preferences for specialist referral, and experiences of tobacco users attempting to quit, with dental professionals or specialist services, respectively.

Harms of Electronic Cigarettes: What the Healthcare Provider Needs to Know.

Electronic cigarettes (e-cigarettes) reached the market without either extensive preclinical toxicology testing or long-term safety trials that would be required of conventional therapeutics or medical devices. E-cigarettes are considered a tobacco product and as such have no manufacturing quality or safety standards. A growing body of evidence documents severe harms from e-cigarette use, including injuries from product explosions, nicotine poisoning, and severe lung diseases. Commonly used e-cigarette components have significant inhalation toxicity. Emerging evidence from laboratory studies suggests substantial reason for concern for long-term harms, including risk for cardiovascular disease, chronic obstructive lung disease, and cancer. Rather than helping people stop smoking, e-cigarette use is associated with reduced rates of smoking cessation among current smokers and an increased risk of relapse to smoking among former smokers. The World Health Organization advises, "Unlike the tried and tested nicotine and non-nicotine pharmacotherapies that are known to help people quit tobacco use, WHO does not endorse e-cigarettes as cessation aids." Careful evaluation of all the available research justifies a strong recommendation that healthcare providers should neither prescribe nor recommend e-cigarettes for persons who are tobacco dependent. If a patient is dependent on e-cigarettes, the healthcare provider should provide counseling and treatment (of nicotine dependence) to help the patient to stop their e-cigarette use.

Interventions to reduce tobacco use in people experiencing homelessness.

Interventions to reduce tobacco use in people experiencing homelessness.

Factors Affecting the Intention to Quit among Women Smokers in Turkey.

Objectives:Tobacco use is an important public health problem that affects adversely the quality of life. A person’s attitude toward quitting tobacco use can be reflected by the desire or intention to quit smoking. The aim of this study was to determine risk factors affecting women’s intention to quit tobacco in Turkey. Methods:In this study, the data obtained from the Global Adult Tobacco Survey (GATS) were used. The GATS is a standard method used in countries to monitor and evaluate the frequency of tobacco use in adults and tobacco control practices. The data used in the study was obtained from the GATS carried out in Turkey in 2008 and 2012. The data related to 1248 women smoking tobacco were used in the analysis. The relationship between women’s intention to quit tobacco use and socio-demographic and economic variables was examined. Results:Men were excluded from the analysis because the focus of the study was women. It was determined that 732 of 1248 women using tobacco intend to quit smoking tobacco. 40.4% of women smoking tobacco are primary school graduates. Women, who were aware of anti-smoking messages and exposed to stimulants that promote smoking, were 36.4% and 27% more likely to intend to stop tobacco use after the next month, respectively. It was observed that women living in a house, where smoking is allowed, are less likely to quit smoking than others (ME = -0.522). This shows the importance of domestic restrictions. Conclusion:Intending to quit is an important preliminary step to quit. Understanding the factors associated with the intention to quit smoking can help tobacco users to stop using it and shape effective policies to increase the quit rates.

Gabapentin for cessation of smoking and non-smoking tobacco habits in Indian population.

Background The effectiveness of gabapentin in tobacco dependence has been evaluated by many researchers. The randomized control trials, testing the efficacy of gabapentin in quitting the habit in smokers and users of smokeless tobacco, have not been published yet. We attempted to address this lacuna in knowledge in reducing dependence on tobacco use by gabapentin. Methods Our study involves 150 study subjects, 75 of whom were identified as chronic users of tobacco and assigned randomly to one of the three groups consisting of 25 subjects each. Gabapentin in tablet form was prescribed thrice a day for 8 weeks wherein group 1 received a dose of 300mg, group 2 received 600 mg, and group 3 was prescribed 900 mg. An age and sex matched control group have received calcium tablets as placebo in three times daily dose for a period of 8 weeks. Results Among the three doses of gabapentin, stoppage of habit was reported to be highest in the group-2 followed by group 1 and group 3 respectively. In our study, we found differences in response to quitting tobacco use between duration of habit prior to pharmacologic intervention amongst both smokers and the users of smokeless tobacco. Conclusions Gabapentin at dose of 600 mg TDS has optimum effect. Smokers having smoking for more than ten years showed notable benefit with gabapentin. Among smokeless tobacco users who quit tobacco dependence was better having history of habit less than 2 years.

Tobacco Use: The Current State of Affairs and How Nurses Can Help Patients Quit

Tobacco use is at epidemic levels and a leading cause of disability and premature death in the United States, disproportionately affecting vulnerable populations and minority groups. While cigarette consumption is at an all-time low, electronic cigarette use has soared, especially in teenagers, who are at the highest risk for lifelong tobacco dependence. This article first offers a brief history of tobacco use and discusses nicotine prevalence and pathogenesis of tobacco dependence. Following this information, the author discusses various tobacco concerns and the benefits of quitting tobacco use. Nurses are vital partners in the war against tobacco through proactive patient education, successful cessation treatment and counseling, and advocacy for policy change.

COVID-19 pandemic: time to focus quitting tobacco use in Nepal and globally

1. Hu Y, Sun J, Dai Z, et al. Prevalence and severity of corona virus disease 2019 (COVID-19): A systematic review and meta-analysis. J Clin Virol. 2020;127:104371. doi:10.1016/j.jcv.2020.104371 CrossRef Google Scholar

Negative affect and the utilization of tobacco treatment among adult smokers with cancer.

We investigated the patterns of tobacco treatment utilization among US adult smokers with cancer and the role of negative affect as potential individual-level psychosocial barriers and facilitators influencing quit attempts and tobacco treatment utilization. We analyzed data from the adult sample in Wave 1 (2013-2014) of the Population Assessment of Tobacco and Health (PATH) Study. Using structural equation modeling, we examined (1) the association between cancer diagnosis and negative affect (e.g., depressive mood, anxiety, and distress) and (2) the associations between negative affect and smoking cessation behaviors (i.e., quit attempts and tobacco treatment utilization). Compared to adults without cancer, cancer survivors were more likely to have attempted to quit tobacco use in the past 12 months (p < 0.05) and experienced increased negative affect (p < 0.01). However, negative affect appeared to be a psychological barrier to quit attempts, as it was associated with lower likelihood of attempting to quit (p < 0.05). On the other hand, among past-12-month quit attempters, negative affect was related to higher likelihood of using any type of tobacco treatment (p < 0.001). Negative affect may be a potential underlying mechanism in the relationship between cancer diagnosis status and quit attempts and tobacco treatment utilization, influencing the utilization of tobacco treatment among smokers with cancer. Research is needed to investigate whether integrating emotional management in the oncology setting may effectively aid smoking cessation among patients with cancer.

Port Site Hernias Following Laparoscopic Ventral Hernia Repair.

Port site hernias (PSH) are underreported following laparoscopic ventral hernia repair (LVHR). Most occur at the site of laterally placed 10-12-mm ports used to introduce large pieces of mesh. One alternative is to place the large port through the ventral hernia defect; however, there is potential for increased risk of surgical site infection (SSI). This study evaluates the outcomes when introducing mesh through a 10-12-mm port placed through the hernia defect. This was a retrospective case series of patients who underwent LVHR in three prospective trials from 2014-2017 at one institution. All patients had mesh introduced through a 10-12-mm port placed through the ventral hernia defect. The primary outcome was SSI. Secondary outcomes were hernia occurrences including recurrences and PSH. A total of 315 eligible patients underwent LVHR with a median (range) follow-up of 21 (11-41) months. Many patients were obese (66.9%), recently quit tobacco use (8.8%), or had diabetes (18.9%). Most patients had an incisional hernia (61.2%), and 19.2% were recurrent. Hernias were on average 4.8 ± 3.8cm in width. Two patients (0.6%) had an SSI. Fourteen patients had a hernia occurrence-13 (4.4%) had a recurrent hernia, and one patient (0.3%) had a PSH. During LVHR, introduction of mesh through a 10-12-mm port placed through the hernia defect is associated with a low risk of SSI and low risk of hernia occurrence. While further studies are needed to confirm these results, mesh can be safely introduced through a port through the defect.

A review of the effects of tobacco smoking on the treatment of prostate cancer

AbstractBackground:Prostate cancer is the most commonly diagnosed malignancy and the third leading cause of death among Canadian men. The standard treatment modalities for prostate cancer include prostatectomy, radiation therapy, hormonal therapy and chemotherapy or any combination depending on the stage of the tumour. However, several studies have reported that tobacco smoking at the time of diagnosis and during treatment can potentially impact treatment efficacy, outcome and patients quality of life after treatment.Materials and methods:This narrative literature review elucidates the impacts of tobacco smoking on prostate cancer progression, treatment efficacy, including its effects on prostatectomy, radiation therapy and chemotherapy, risk of cancer recurrence and mortality and quality of life after treatment. Furthermore, we discuss the importance of integrating a smoking cessation programme into the treatment regimen for prostate cancer patients in order to yield more favourable treatment outcomes, reduce risk of recurrence and mortality and increase the quality of life after treatment for prostate cancer patients.Conclusions:Smoking cessation is one of the most important interventions to prevent cancer and it is also essential after the diagnosis of prostate cancer to improve clinical outcomes. All prostate cancer patients should be advised to quit tobacco use since it can potentially improve treatment response rates and survival, as well as reduce the risk of developing treatment complications and potentially improve the quality of life after treatment. There are several benefits to smoking cessation and it should become an important component of the cancer care continuum in all oncology programmes, starting from prevention of cancer through diagnosis, treatment, survivorship and palliative care. Evidence-based smoking cessation intervention should be sustainably integrated into any comprehensive cancer programme, and the information should be targeted to the specific benefits of cessation in cancer patients.

Global Study on Tobacco Use among Youth in the Kyrgyz Republic Republic (GYTS, 2019)

The aim of the study was to assess the situation related to tobacco consumption among adolescents aged 13 – 15 in the Kyrgyz Republic.Materials and Methods. The study used a two-stage selection of schoolchildren in grades 7 – 9 (teenagers 13 – 15 years old) to conduct the survey. At the 1st stage, information was collected about all schools of the republic, where children of the target group study. the schools in which the survey was subsequently conducted were selected by the statistical sampling method according to the number of students in grades 7 – 9. The grades whose students participated in the questionnaire were set at stage 2 by random sampling in each school The survey includes 43 questions from the Standard main Questionnaire of the Global Youth Tobacco Survey (GYTS) and 30 supplementary questions (73 in total) with multiple choice of answers. The statistical processing was performed using the SUDAAN software package (US Centers for Disease Control and Prevention); a 95% confidence interval was calculated to calculate weighted prevalence estimates and standard errors (SE).Results. The survey found that 6.0% of schoolchildren (9.5% of boys and 2.4% of girls) currently use various types of tobacco; 4.4% of schoolchildren currently use tobacco (6.8% of boys and 2.0% of girls); 2.4% of schoolchildren smoke cigarettes; 2.4% use smokeless tobacco, 2.8% use other tobacco products (hookah); 2.8% of schoolchildren smoke electronic cigarettes (3.9% of boys and 1.7% of girls). Tobacco use most often begins before age 7 or after age 12. 16.8% of schoolchildren are exposed to tobacco smoke at home, of which 14.2% are in closed places and 14.8% in open public places. 87.2% of schoolchildren purchase cigarettes in a shop, kiosk, from a street vendor, and in the market. During the visit to the point of sale 26.7% noticed tobacco advertising and promotions; 49.7% saw anti-tobacco messages in the mass media. Definitely think that smoking tobacco by other people is bad for them, 71.2% of schoolchildren.Conclusion. A high percentage of teenagers consuming e-cigarettes, hookah, and smokeless tobacco products has been noted, although &gt; 50% of them are aware of the dangers of tobacco use. Every 6th student is a passive smoker. The vast majority of schoolchildren aged 13 – 15 who try to quit smoking do not receive professional help in quitting tobacco use, and are exposed to protobacco media marketing campaigns.

Impact of Admission Diagnosis on the Smoking Cessation Rate: A Brief Report From a Multi-centre Inpatient Smoking Cessation Programme in Singapore.

ObjectivesFew studies have been published regarding the relevance of the admission diagnosis to the smoking cessation rate. We studied smoking cessation rates in relation to admission diagnoses in our inpatient smoking cessation programmes.MethodsThis retrospective study included all patients recruited into our inpatient smoking cessation programmes at 2 institutions in Singapore between June 2008 and December 2016. Patients were given individualized intensive counselling and were followed up via phone interviews for up to 6-month to assess their smoking status. Multivariable logistic regression was used to analyse potential associations between admission diagnoses and 6-month abstinence.ResultsA total of 7194 patients were included in this study. The mean age was 54.1 years, and 93.2% were male. In total, 1778 patients (24.7%) were abstinent at the 6-month follow-up call. Patients who quit smoking tended to be of Chinese ethnicity, have initiated smoking at a later age, be better educated, and have lower Fagerström Test of Nicotine Dependence scores. After adjusting for these factors, patients with a cardiovascular admission diagnosis had a significantly higher probability of quitting tobacco use than patients with a respiratory or other diagnosis.ConclusionsIn patients acutely admitted to the hospital, a diagnosis of cardiovascular disease was associated with the highest quit rate. Smoking cessation interventions need to be incorporated into all cardiovascular disease treatment pathways to leverage the patient’s motivation and to improve the quit rate. In addition, patients in groups with lower quit rates may benefit from more intensive programmes to increase the rate of successful cessation.

E-cigarettes, nicotine, the lung and the brain: multi-level cascading pathophysiology.

Tobacco smoking is highly addictive and causes respiratory disease, cardiovascular disease and multiple types of cancer. Electronic-cigarettes (e-cigarettes) are non-combustible tobacco alternatives that aerosolize nicotine and flavouring agents in a propylene glycol-vegetable glycerine vehicle. They were originally envisaged as a tobacco cessation aid, but whether or not they help people to quit tobacco use is controversial. In this review, we have compared and contrasted what is known regarding the effects of nicotine on the lungs vs. the effects of nicotine in the brain in the context of addiction. Critically, both combustible tobacco products and e-cigarettes contain nicotine, a highly addictive, plant-derived alkaloid that binds to nicotinic acetylcholine receptors (nAChRs). Nicotine's reinforcing properties are primarily mediated by activation of the brain's mesolimbic reward circuitry and release of the neurotransmitter dopamine that contribute to the development of addiction. Moreover, nicotine addiction drives repeated intake that results in chronic pulmonary exposure to either tobacco smoke or e-cigarettes despite negative respiratory symptoms. Beyond the brain, nAChRs are also highly expressed in peripheral neurons, epithelia and immune cells, where their activation may cause harmful effects. Thus, nicotine, a key ingredient of both conventional and electronic cigarettes, produces neurological effects that drive addiction and may damage the lungs in the process, producing a complex, multilevel pathological state. We conclude that vaping needs to be studied by multi-disciplinary teams that include pulmonary and neurophysiologists as well as behaviourists and addiction specialists to fully understand their impact on human physiology.

Questioning the regressivity of tobacco taxes: a distributional accounting impact model of increased tobacco taxation

BackgroundTobacco taxes, as with other ‘sin taxes’, are generally regarded as a highly cost-effective mechanism to reduce consumption but are often considered by policymakers to be regressive, undermining efforts to...

Social responsibility during the COVID-19 pandemic: Tobacco industry's trojan horse in Europe.

1. World Health Organization. WHO Report on the Global Tobacco Epidemic, 2019: Offer help to quit tobacco use. The MPOWER package. https://apps.who.int/iris/bits.... Accessed May 4, 2020. Google Scholar