Quit Rates Research Articles

Impact of Low-Dose Computed Tomography Findings on Cigarette Smoking Cessation Among High-Risk Adults Participating in Lung Cancer Screening.

Integrating effective smoking cessation strategies for individuals undergoing lung cancer screening stands to significantly increase the impact of lung screening programmes. We assessed the impact of low-dose computed tomography (LDCT) findings on smoking cessation among high-risk adults who currently smoked. 13 035 individuals, aged 55-77 years, attended a lung health check appointment, as part of a prospective observational cohort study (the SUMMIT Study), prior to undergoing a baseline LDCT scan. Logistic regressions examined the likelihood of smoking cessation at a 1-year follow-up appointment and its association with LDCT findings. 12.6% (n = 647/5135) of individuals self-reported smoking cessation at 1-year follow-up. Higher odds of quitting were found in those receiving indeterminate pulmonary nodule findings requiring a 3-month interval LDCT (aOR = 1.27; 1.01, 1.61), those with urgent findings requiring referral to secondary care (aOR = 1.55; 1.05, 2.32), and those with a possible new chronic obstructive pulmonary disease diagnosis (aOR = 1.60; 1.23, 2.06), compared to those receiving no actionable LDCT findings. Older age, Asian ethnic background, current high smoking intensity, motivation and number of quit attempts, and low nicotine dependence were associated with increased odds of quitting. Individuals currently smoking, at high lung cancer risk, participating in LDCT screening, and receiving incidental findings requiring a 1-year interval LDCT or primary care follow-up might therefore need additional behavioral support to quit. Tailored communication strategies depending on the severity of the LDCT findings, including additional behavioral support for those with less clinical concerning or negative findings, could increase quit rates and reduce smoking-related morbidity. This study reports high odds of self-reported complete smoking cessation in adults who currently smoked after receiving their LDCT findings. Though the impact of specific types of LDCT findings on smoking cessation was positive for high lung cancer risk individuals, reception of incidental findings could potentially be perceived as less severe to encourage individuals who currently smoked to quit. Clearly communicating the severity of LDCT findings along with the delivery of behavioral smoking cessation support targeted to high-risk individuals may increase their chances of complete smoking cessation and reduce lung cancer mortality.

Effects of Employment Contract Duration and Wage Determination on Employment Fluctuations

This study investigates the effects of employment contract duration and wage determination on employment fluctuations using a dynamic model with long- and short-term employment contracts. The results demonstrate that fluctuations in short-term employment are smaller than those in long-term employment when wages are fixed during the contract periods for both types. Moreover, a higher quit rate and shorter employment period lead to reduced employment fluctuations amid shocks in productivity. However, fluctuations in short-term employment are more significant than in long-term employment when wages of long-term contracts can be changed each period, but that of short-term contracts is fixed during the contract periods without adjustment costs.

Interventions for smokeless tobacco use cessation.

While combustible tobacco has been the subject of a very large amount of research, smokeless tobacco products receive less attention. Most smokeless tobacco products are very harmful and cause global health inequality. It is therefore important to identify evidence-based cessation aids. To assess the effects of behavioural and pharmacological interventions for smokeless tobacco use cessation. We searched the following databases from inception to 16 February 2024: Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; Embase; PsycINFO; ClinicalTrials.gov (through CENTRAL); World Health Organisation International Clinical Trials Registry Platform (through CENTRAL). We also searched references of eligible studies. We included randomised controlled trials (RCTs) recruiting people of any age using smokeless tobacco, regardless of tobacco smoking status. Eligible studies could test any intervention designed to support people to quit smokeless tobacco use, and had to measure abstinence from either all tobacco use or smokeless tobacco use at six months or longer. The outcome of interest was abstinence from all tobacco use or from smokeless tobacco use at six months or longer. We used the Cochrane RoB 1 tool to assess bias in included studies. We followed standard Cochrane methods for screening and data extraction. We grouped studies by comparisons of eligible interventions and comparators, reporting individual study and pooled effects as appropriate. We used a random-effects Mantel-Haenszel model for analyses of behavioural interventions and a fixed effect Mantel-Haenszel model for analyses of pharmacotherapies to calculate risk ratios (RR) with 95% confidence intervals (CI). We assessed the certainty of evidence using GRADE. We included 43 trials of 20,346 people. Thirty-three trials were conducted in North America, five in India, two in Scandinavia, one in Pakistan and one in Turkey. One study was conducted across multiple sites in Bangladesh, India and Pakistan. Studies tested behavioural interventions (e.g. cessation counselling and brief advice) and pharmacotherapies (e.g. nicotine replacement therapy (NRT), varenicline, and bupropion). We judged five studies to be at low risk of bias overall, 22 at high risk of bias, and the remaining 16 at unclear risk of bias. We found moderate-certainty evidence of increased quit rates from counselling compared with minimal support (RR 1.76, 95% CI 1.44 to 2.16; I2 = 69%; 21 studies, n = 7417; downgraded because of heterogeneity), brief advice compared with no support (RR 1.24, 95% CI 1.03 to 1.48; I2 = 49%; 7 studies, n = 6271; downgraded because of imprecision), and varenicline compared with placebo (RR 1.35, 95% CI 1.08 to 1.68; I2 = 0%; 2 studies, n = 508; downgraded because of imprecision). We found low-certainty evidence (downgraded because of imprecision and risk of bias) of increased quit rates from NRT compared with placebo or no medication (RR 1.18, 95% CI 1.05 to 1.33; I2 = 39%; 11 studies, n = 2826). Low-certainty evidence (downgraded because of imprecision) did not show benefit from bupropion compared with placebo (RR 0.89, 95% CI 0.54 to 1.44; I2 = 0%; 2 studies, n = 293). We planned subgroup analyses to explore whether smokeless tobacco type affects intervention efficacy, but found insufficient data. Cessation counselling, brief advice, and varenicline each probably help more people to quit smokeless tobacco use than minimal or no support, or placebo. NRT may help more people to quit smokeless tobacco use than placebo or no medication. Low-certainty evidence does not currently support bupropion as a smokeless tobacco cessation intervention. Despite the majority of smokeless tobacco users living in South and Southeast Asia, only a minority of trials are conducted in those regions. Future trials should address this imbalance. None REGISTRATION: Protocol available via DOI: 10.1002/14651858.CD015314.

Effectiveness of nurse-initiated smoking cessation intervention: a systematic review and meta-analysis

BackgroundSmoking is a major preventable cause of death, associated with cancers and chronic diseases. Nurse-initiated smoking cessation programs have proven effective, providing counseling, education, and mental health support. These interventions increase quit rates by tackling nicotine addiction, emphasizing the important role of nurses and the need for targeted training. Systematic reviews and meta-analyses are essential for gaining a deeper understanding of the effectiveness of various cessation strategies.MethodsA literature search was conducted using eight electronic databases (CINAHL, EMbase, MEDLINE, Cochrane, RISS, KMbase, KISS, and NDSL). The literature search was conducted from March, 27, 2024, to August 1, 2024. All included studies were randomized controlled trials (RCTs). Quality assessment was conducted using the Risk of Bias (ROB) tool. RevMan 5.4 was used for qualitative analysis, with effect sizes measured as odds ratios (ORs) and 95% confidence intervals (CIs).ResultsThirteen studies, all published after 2005, were included in the evidence assessment of nurse-initiated smoking cessation programs. The interventions examined comprised 11 intensive or personalized counseling programs and 3 telephone-based approaches. The OR for self-reported quit success 7-day smoking cessation rate at 6-month follow-up was 1.43 (95% CI [1.08, 1.90]), indicating a significant difference in quit effectiveness (Z = 2.27, p =.01), with moderate heterogeneity observed across studies (I2 = 67.0%, p =.001). A meta-analysis of 7-day point abstinence rate at 12-month follow-up revealed a pooled OR of 1.18 (95% CI [0.96, 1.44]), showing no significant difference in quit effectiveness (Z = 1.58, p =.11) and moderate heterogeneity among the studies (I2 = 55.0%, p =.02).ConclusionsA comprehensive approach by trained nursing professionals is essential in addressing the complexities of smoking cessation. Further clinical trials are needed to assess intervention methods and follow-up strategies. Future research should emphasize long-term outcomes and ongoing support to sustain behavior change, contributing to more effective, tailored cessation programs and improved public health outcomes.

Gain-Framed Text Messages and Nicotine Replacement Therapy for Smoking Cessation Among Lung Cancer Screening Patients: A Brief Report of a Pilot Randomized Controlled Trial.

People who undergo lung cancer screening (LCS) and continue to smoke are at risk for negative clinical outcomes and lowered survival and need effective smoking cessation interventions. This pilot study tested an 8-week intervention for smoking cessation after LCS. The participants (N = 40) were randomized to the intervention group (combination nicotine replacement therapy [NRT] plus gain-framed text messaging for 8 weeks) or the control group (standard cessation counseling) after LCS. Assessments were completed at 8-week and 3-month follow-ups, including self-reported 7-day point prevalence abstinence. The mean age was 64.4 years old (SD = 6.2); 32.5% were Black or African American; and 55% were female. At Week 8, 14.3% (3/21) of the participants in the intervention group were abstinent versus 0% (0/19) in the control group (p > 0.05). At 3-month follow-up, 4.8% (1/21) of the participants in the intervention group were abstinent versus 0% (0/19) in the control group. Among the intervention group participants, up to 52.4% used the provided patches and up to 61.9% used the provided lozenges during the study period. This study demonstrated modest quit rates for LCS patients receiving gain-framed text messages and NRT. The results highlight the need for more effective smoking cessation interventions for this priority population.

Comparative Evaluation of Cigarette Smoke and a Heated Tobacco Product on Corneal Oxidative Stress in an Air/Liquid Interface Model.

Tobacco smoke harbors toxic combustion by-products contributing to inflammatory diseases. Cigarette smoke's impact on ocular diseases has been poorly characterized, despite conjunctival mucosa's sensitivity to these toxicants. Of note, cigarette smoke triggers redness, tearing, and discomfort, accounting as a risk factor for glaucoma, macular degeneration, cataracts, and other eye conditions. Low quit rates of cessation highlight the need for alternatives. Heated tobacco products (HTPs), may represent a less toxic alternative for those smokers. This study evaluates cigarette smoke and HTPs effects on cornea under standard and clinically relevant conditions. Corneal tissues collected from donors and in vitro model in two different cell lines of corneal epithelium were exposed to cigarette (1R6F) smoke and HTPs vapor. Air exposure was included as a control. Tissue pathological evaluation was carried out by hematoxylin and eosin staining. Reactive oxygen species (ROS) were measured, and quantitative PCR assessed inflammatory and antioxidant genes expression. Proteome analysis was used to evaluate differentially expressed proteins related to the oxidative stress. Scratch assay measured smoke and HTPs impact on cells. Hematoxylin & eosin staining highlighted that cigarette smoke impairs corneal tissue integrity, leading to ROS accumulation and inflammation, as proved by qPCR analysis. Proteomic analysis showed that corneal tissue's proteins were differently oxidized by the different experimental conditions. HTP targeted structural intracellular proteins, whereas 1R6F affects different members of collagen family. Finally, cigarette smoke, but not HTPs, impairs epithelial cells wound closure. Smoking increases oxidative stress, leading to significant corneal damage and inflammation. HTPs may offer a less toxic alternative.

Gender Differences in Quit Rates in a Tobacco Cessation Program: In Search of Demographic, Socioeconomic, Health, or Behavioral Explanatory Mechanisms.

Women have consistently shown lower quit rates in tobacco cessation programs compared to men. This gender disparity persists despite comprehensive interventions and access to cessation resources. While prior studies suggest that factors such as social support, chronic disease burden, and socioeconomic status may contribute to these differences, there is limited empirical evidence to confirm these mechanisms. This study aimed to investigate potential mechanisms underlying gender differences in quit rates in a tobacco cessation program, testing whether demographic, socioeconomic, health, or behavioral factors explain the observed disparities. Participants were assigned to one of three smoking cessation interventions: an in-person program (CEASE), a self-help approach, or an online/hybrid program. The main outcome measured was smoking abstinence, evaluated three months after the intervention. Secondary analyses explored whether demographic, socioeconomic, health, or tobacco use-related factors mediated the association between gender and quit rates. Women had significantly lower quit rates than men (p < 0.01). This association remained significant after adjusting for demographic, socioeconomic, health, and addiction-related factors. While women reported higher social support and a higher prevalence of chronic cardiometabolic conditions, these factors did not explain the gender disparity in quit rates. Gender differences in quit rates persist despite controlling for known factors that could influence cessation success. Although women had higher social support, they had lower quit rate. Future research should explore unmeasured variables, such as psychological, biological, and structural influences, to develop more effective cessation strategies tailored for women.

Factors associated with smoking cessation in patients with peripheral arterial disease consulting French cessation services.

Factors associated with smoking cessation in patients with peripheral arterial disease consulting French cessation services.

Association of Tobacco Dependence Treatment Coverage Expansion with Smoking Behaviors among Medicaid Beneficiaries Living with Substance Use Disorder

Association of Tobacco Dependence Treatment Coverage Expansion with Smoking Behaviors among Medicaid Beneficiaries Living with Substance Use Disorder

Impact of Tobacco-21 Laws on Maternal Smoking Behavior.

This study employs a logit difference-in-differences model to estimate the extent to which raising the tobacco purchasing age to 21 (T-21) reduced the prevalence of smoking among mothers aged 18-20 both before and during their pregnancies. Using United States Vital Statistics data from 2012 to 2019, we estimate that counties which adopted T-21, whether individually or as part of a state-level policy, experienced small but statistically significant decreases in maternal smoking prior to and during their pregnancies. Our estimates also suggest that the decline in smoking during pregnancy is driven by fewer women smoking prior to pregnancy rather than increased quit rates during pregnancy. Finally, our estimation strategy also allows us to focus on the expansions in New York City and California, which are the locations with the largest number of impacted births in our sample. We estimate T-21 decreased maternal smoking both prior to and during pregnancy in California by up to 14% from baseline. Other studies which examined T-21 on a broader set of young adults have found larger reductions in smoking rates, suggesting that the subpopulation of young mothers who choose to smoke may be relatively less responsive to policies that raise the minimum purchase age of tobacco products.

Perioperative Intensive Smoking Cessation Intervention Among Smokers Who Underwent Transurethral Resection of Bladder Tumor (TURBT) in Two Different Settings: A Randomized Controlled Trial.

Background/Objective: Smoking is an individual risk factor for bladder cancer. Many patients are still smoking at the time of their diagnosis, yet few trials have examined smoking cessation interventions (SCIs) in relation to transurethral resection of the bladder tumor (TURBT). This study therefore aimed to compare the efficacy of a hospital-based 6-week intensive SCI with standard treatment among this patient group. Methods: A parallel-arm randomized controlled trial was conducted from December 2021 to March 2024 at two university hospital urology departments in Denmark. A total of 38 daily smokers undergoing TURBT were allocated to the hospital-based intensive SCI, including weekly meetings, patient education, motivational support, and complimentary nicotine replacement therapy or the standard treatment with very brief advice and referral to the same intensive SCI at a municipality clinic. The primary outcome was smoking cessation at the end of the intervention, assessed through participant interviews. The secondary outcomes included continuous abstinence at three and six months, quality of life, and frailty. Analyses were performed as intention-to-treat. Results: After six weeks, 37% in the hospital-based group and 6% in the standard group achieved smoking cessation (p = 0.042). At three and six months the quit rates were, 37% and 26% in the hospital-based group, compared to 0% and 0% in the standard group, respectively. No significant differences in quality of life or frailty were found. Conclusions: This trial found that hospital-based intensive SCI increased cessation rates compared to standard treatment. It would be valuable to evaluate the impact on postoperative complications, cancer prognosis, and long-term cessation in a sizeable new study.

Factors causing the development of quiet quitting in female employees and the role of motherhood: The case of Türkiye

Researchers aimed to determine the factors that cause the development of quiet quitting in female employees and the relationship between quiet quitting and the role of motherhood. Researchers the study is designed as a descriptive study. Researchers the study was conducted with 924 working mothers. Finding the received wages inadequate for the work performed was found to be the reason for quiet quitting in 92.2% of working mothers. The mean Quiet Quitting Symptoms Assessment Dimension (QQSAD) of the Mothers was found to be 3.94 ± 2.52, and the overall Myself as Mother Scale (MaMS) mean score was 46.16 ± 5.97. It was determined that there was a weak, significant, and negative relationship between the QQSAD and the MaMS mean scores. Researchers reveal, it was observed that many factors affected quiet quitting in working mothers, the rate of quiet quitting was high, and the acquisition of a motherhood role decreased as the symptoms of quiet quitting increased.

Uptake and 4-week outcomes of an ‘opt-out’ smoking cessation referral strategy in a London-based lung cancer screening setting

IntroductionLung cancer screening (LCS) enables the delivery of smoking cessation interventions to a population experiencing long-term tobacco dependence, but the optimal delivery method remains unclear. Here, we report uptake and...

Evaluating the Impact of Pharmacotherapy in Augmenting Quit Rates Among Hispanic Adults in an App-Delivered Smoking Cessation Intervention: Secondary Analysis of a Randomized Controlled Trial.

Hispanic adults receive less advice to quit smoking and use fewer evidence-based smoking cessation treatments compared to their non-Hispanic counterparts. Digital smoking cessation interventions, such as those delivered via smartphone apps, provide a feasible and within-reach treatment option for Hispanic adults who smoke and want to quit smoking. While the combination of pharmacotherapy and behavioral interventions are considered best practices for smoking cessation, its efficacy among Hispanic adults, especially alongside smartphone app-based interventions, is uncertain. This secondary analysis used data from a randomized controlled trial that compared the efficacy of 2 smoking cessation apps, iCanQuit (based on acceptance and commitment therapy) and QuitGuide (following US clinical practice guidelines), to explore the association between pharmacotherapy use and smoking cessation outcomes among the subsample of 173 Hispanic participants who reported on pharmacotherapy use. Given the randomized design, we first tested the potential interaction of pharmacotherapy use and intervention arm on 12-month cigarette smoking abstinence. We then examined whether the use of any pharmacotherapy (ie, nicotine replacement therapy [NRT], varenicline, or bupropion) and NRT alone augmented each app-based intervention efficacy. Participants reported using pharmacotherapy on their own during the 3-month follow-up and cigarette smoking abstinence at the 12-month follow-up via web-based surveys. These data were used (1) to test the interaction effect of using pharmacotherapy to aid smoking cessation and intervention arm (iCanQuit vs QuitGuide) on smoking cessation at 12 months and (2) to test whether the use of pharmacotherapy to aid smoking cessation augmented the efficacy of each intervention arm to help participants successfully quit smoking. The subsample of Hispanic participants was recruited from 30 US states. They were on average 34.5 (SD 9.3) years of age, 50.9% (88/173) were female, and 56.1% (97/173) reported smoking at least 10 cigarettes daily. Approximately 22% (38/173) of participants reported using pharmacotherapy to aid smoking cessation at the 3-month follow-up, including NRT, varenicline, or bupropion, with no difference between intervention arms. There was an interaction between pharmacotherapy use and intervention arm that marginally influenced 12-month quit rates at 12 months (P for interaction=.053). In the iCanQuit arm, 12-month missing-as-smoking quit rates were 43.8% (7/16) for pharmacotherapy users versus 28.8% (19/16) for nonusers (odds ratio 2.21, 95% CI 0.66-7.48; P=.20). In the QuitGuide arm, quit rates were 9.1% (2/22) for pharmacotherapy users versus 21.7% (15/69) for nonusers (odds ratio 0.36, 95% CI 0.07-1.72; P=.20). Results were similar for the use of NRT only. Combining pharmacotherapy to aid smoking cessation with a smartphone app-based behavioral intervention that teaches acceptance of cravings to smoke (iCanQuit) shows promise in improving quit rates among Hispanic adults. However, this combined approach was not effective with the US clinical guideline-based app (QuitGuide). ClinicalTrials.gov NCT02724462; https://clinicaltrials.gov/study/NCT02724462. RR2-10.1001/jamainternmed.2020.4055.

P-1448. Targeting Smoking Among People with HIV (PWH): Does Intensive Group Therapy Reduce Mortality?

Abstract Background PWH in the United States smoke cigarettes at rates 2-3 times higher than the general population. Between 2014 and 2017 we conducted a randomized controlled trial (RCT) comparing Positively Smoke Free (PSF), an 8-session intensive group therapy intervention targeting HIV+ smokers, to brief advice to quit. Findings suggested that PSF conditioned participants had higher quit rates at both early and late (approximately 3-year) follow-up. In the present study, we sought to determine whether PSF conditioned participants had a significant difference in mortality compared to controls 7-10 years after study enrollment.Table 1.Baseline Characteristics of Study Participants. Methods Participants of the Bronx cohort of the original RCT (n=247) were chart reviewed for vital status. Participants were classified as “alive” if review indicated contact with the patient within six months of review. If no records were available within the prior six months, an attempt was made to contact the patient, pharmacy, or emergency contact as listed either in the medical chart or original study records. Dates of death were recorded for deceased participants. Data were analyzed using R 4.4.0. All identifying patient information was secured in a password-protected spreadsheet only accessible to study authors.Figure 1.Vital Status of Study Participants. Results There were no significant differences in baseline characteristics between treatment and control groups (Table 1). 14.2% of all participants were confirmed deceased at the time of data collection; vital status of 25.5% of participants could not be determined (Figure 1). Kaplan-Meier analysis was performed (Figure 2); log-rank test was significant for survival difference favoring the PSF vs control group (p = 0.03). Univariate Cox-proportional analysis showed a hazards ratio of 0.46 (0.23 - 0.94, p = 0.034).Figure 2.Kaplan-Meier Survival Analysis. Conclusion Follow-up analysis of Bronx participants in the original RCT suggests that there is a significant mortality benefit over 7-10 years for HIV+ smokers who received PSF intensive group therapy. Disclosures All Authors: No reported disclosures

The impact of drinking on smoking cessation outcomes among Hong Kong Chinese youth smokers

Drinking is a common unhealthy behaviour among youth smokers aged 25 or below. However, the effects of drinking on smoking cessation outcomes are not well understood. This study aimed to explore the impact of drinking on smoking cessation outcomes among Hong Kong Chinese youth smokers who received smoking cessation counselling. This study adopted a cross-sectional design at the Youth Quitline, which is the only government-funded hotline providing telephone smoking cessation counselling to Hong Kong smokers aged 25 or younger. Of the 142 participants at the six-month follow-up, 75 were in the drinking group and 67 in the non-drinking group. Multiple logistic regression analyses were performed to identify any significant differences in self-reported quit rates, smoking reduction by at least 50%, quit attempts, and biochemically validated quit rates between the drinking and non-drinking groups. The results showed a significant difference in self-reported quit rate between the two groups at 6-month, but no significant difference in smoking reduction by at least 50%, quit attempts, and biochemically validated quit rate. Alcohol drinking and male were identified as significant factors decreasing self-reported quit rate at 6 months. The study revealed that drinking could decrease quit rates among young smokers who received counselling, but not their smoking reduction or quit attempts. Given the negative impact of drinking on smoking abstinence and the increased popularity of drinking among the youth, assessment of alcohol use and brief advice on smoking are recommended to be an integral part of smoking cessation counselling for youth smokers.

Increasing a Quitline's Reach to Low-Income Tobacco Users Through 211 Agencies.

Low-income individuals bear a disproportionate share of the burden of tobacco use. This study tested the feasibility of increasing a quitline's reach to low-income tobacco users by collaborating with 211 information and referral agencies, which primarily serve people experiencing economic hardship. Study participants (N = 114888) were adult tobacco users referred to the California quitline by 211 agencies, referred by healthcare clinics, or self-referred from April 17, 2021 to December 31, 2023. All were offered telephone counseling. Those referred by 211 received $20 for completing one counseling session. A subset (n = 2021) was followed up at 7 months. Referral outcomes, baseline characteristics, counseling and quitting aid utilization, and quitting outcomes were analyzed by referral source in 2024. Over a 2.7-year period, 211 agencies referred 55151 clients to the quitline. Participants referred by 211 were more than twice as likely as healthcare-referred participants to enroll in quitline services (34.0% vs. 15.9%, p < .0001). They were more likely than healthcare- and self-referred participants to be female, lesbian, gay, bisexual, transgender, orqueer/questioning, Black or multiracial, younger, less educated, and Medicaid-insured; more likely to complete a first counseling session (64.2% vs. 59.7% and 55.7%; both ps < .0001); and completed a similar number of sessions, 2.4. They were less likely to use quitting aids. Quit rates (ie, 30-day point prevalence abstinence) at 7-month follow-up were similar for all three groups. A collaboration between a quitline and 211 agencies connected large numbers of underserved, low-income tobacco users to evidence-based cessation treatment. The study shows that quitlines and 211 agencies can collaborate effectively to help low-income tobacco users quit. It shows that when offered a modest incentive, 211-referred participants engage in counseling as much as healthcare- and self-referred participants and are as likely to quit. If 211 agencies across the US referred at the same rate as agencies in this study, an estimated 65000 additional tobacco users annually would receive treatment. Total reach at full implementation would likely be much higher. Quitline and 211 funders and other supporters should find ways to sustain these gains and expand their reach.

Longitudinal patterns in smoking abstinence in trials of e-cigarettes for smoking cessation: secondary analysis of data from a systematic review, with meta-analyses.

We set out to better understand patterns of smoking abstinence and relapse in trials of e-cigarettes for smoking cessation. Secondary analysis of studies from a Cochrane review. Studies had to test any type of e-cigarette intervention for smoking cessation. They had to follow-up for at least 6 months and report either: abstinence at multiple time points; abstinence using multiple definitions; relapse. We narratively synthesized data and conducted meta-analyses. We included 15 studies (n=7,233 participants). Using the Cochrane risk of bias tool v1, 5 were judged to be at high risk of bias, 8 were at low risk, and 2 at unclear risk. Absolute continuous abstinence rates tended to decline over time, but varying slopes. For absolute point prevalence abstinence, three studies demonstrated a shallow decline over time, two a steep decline, and three the opposite - an increase in abstinence over time. Data on relative abstinence rates (e-cigarettes versus control) were mixed. There were multiple instances of differences between point prevalence and continuous/sustained abstinence rates, both in trajectories over time and in terms of relative abstinence. The few studies addressing relapse highlighted mixed demographic and behavioural characteristics associated with relapse rates. Smoking trajectories vary between trials of e-cigarettes for smoking cessation. Risk ratios may not be stable over time and may increase or decrease in favor of e-cigarettes depending on the study. Further data are needed, especially on relapse rates in early quitters who use e-cigarettes versus those who use other or no stop-smoking aids. While some have posited e-cigarettes might increase smoking relapse when used as a cessation tool, others have posited that combustible cigarette quit rates may increase over time in the same studies due to 'accidental quitting'. We set out to investigate this empirically and found considerable variation in smoking trajectories in e-cigarette trials. Data suggest risk ratios may not be stable over time and may increase or decrease in favor of e-cigarettes depending on the study. Further data are needed, especially on relapse rates in early quitters who use e-cigarettes versus those who use other or no stop-smoking aids.

Lower Successful Quit Rate of Menthol Tobacco Users in a Tobacco Cessation Program: An Explanatory Analysis in Search of Potential Mechanisms.

Menthol-flavored tobacco products are disproportionately used in low-income African American communities, a result of decades of targeted marketing and systemic inequities. Menthol use has been associated with lower quit rates, often compounded by factors such as lower trust in healthcare systems, reduced access to cessation programs, and other structural barriers. Despite this, few studies have systematically examined the explanatory mechanisms that might clarify why menthol-flavored tobacco is linked to poorer cessation outcomes among participants in tobacco cessation programs. This study aimed to investigate the potential mechanisms by which menthol tobacco use is associated with lower quit rates across three types of smoking cessation interventions. Participants were randomized into one of three smoking cessation interventions: in-person (CEASE), self-help, or online/hybrid programs. Smoking abstinence was assessed three months post-intervention as the primary outcome. Secondary analyses explored whether demographic, socioeconomic, or behavioral factors mediated the association between menthol use and quit rates across the intervention arms. Menthol tobacco use was significantly associated with lower quit rates (p < 0.01). This association was not explained by demographic, socioeconomic, health, or addiction-related factors. While menthol use was associated with lower education and employment levels, demographic characteristics, physical or mental health, or addiction did not explain the effect of menthol on tobacco cessation. These findings suggest that the lower quit rates observed among menthol users cannot be attributed to any third factors assessed in this study. Menthol tobacco use independently predicts lower quit rates, and the mechanisms behind this disparity remain unclear. The consistent findings across different intervention types highlight the need for further research to uncover the underlying pathways and to design targeted strategies to improve cessation outcomes for menthol users.

Effect of various interventions for smoked tobacco cessation among Indians in Chhattisgarh.

A prospective, single-blind, randomized controlled trial was conducted among 150 adult tobacco users attending the Tobacco Cessation Centre, Government Dental College, Raipur and Chhattisgarh, India. Participants were randomized into three groups: Group I (NRT alone), Group II (NRT + counseling) and Group III (NRT + mCessation). Interventions lasted 12 weeks, with follow-ups at 1 and 3 months. The overall quit rate was 34%. Group II demonstrated the highest success rate (44%), followed by Group III (30%) and Group I (28%). Significant reductions in nicotine dependence, CO levels and cigarette consumption were observed in all groups, with Group II showing the most marked improvements. Behavioral counseling combined with pharmacotherapy is the most effective strategy for smoking cessation.