Significant Predictor Of Smoking Cessation Research Articles

Fagerstrom score predicts smoking status six months after hospitalization for acute myocardial infarction: a prospective study

BackgroundFagerstrom score is a validated marker of nicotine addiction in smokers. MethodsIn a prospective study, we investigated a) the predictive value of Fagerstrom score for the smoking status in patients early after acute myocardial infarction (AMI) and b) the effectiveness of medically assisted smoking cessation programs in the prevention of relapsing to smoking post discharge. In 103 smokers (58 ± 12 years, 79.6% males), we assessed Fagerstrom score during hospitalization for AMI. Patients filled a dedicated questionnaire including data on family, marital and educational status, habits related to smoking and were followed-up at 3 and 6 months after discharge. ResultsTwenty-eight patients (27.2%) did not quit smoking throughout the 6-months follow-up period (Fagerstrom score:8.1 ± 1.6), 39 patients (37.8%) ceased smoking at 3 months but relapsed to smoking at 6 months (score:6.8 ± 2.1), and only 34 patients (33%) had ceased smoking for 6 consecutive months (score:5.2 ± 2 p < 0.05 for all comparisons between subgroups). By multivariate analysis, Fagerstrom score remained a significant predictor of smoking cessation at 6 months (OR: 0.72, 95%CI: 0.60--0.86, p < 0.001). Out of 73 patients who abstained from smoking for the first 3 months post-AMI, those who participated in a smoking cessation program displayed lower rate of relapsing to smoking compared with those who opted to cease smoking without any support (33.3% vs 61.8% p = 0.012). ConclusionFagerstrom score is a useful predictor of smoking cessation 6 months post-AMI. Patients participating in a smoking cessation program display lower relapse rates post-discharge suggesting the need of well-organized smoking cessation clinics for secondary prevention of heart disease.

Determinants of Smoking Cessation in Palu City, Indonesia

Indonesia has one of the largest tobacco epidemics in Southeast Asia. According to the World Health Organization, smoking-related illnesses kill about 200,000 Indonesians annually. In Central Sulawesi, 26.1% are daily smokers and 6.0% are former smokers. The data show that a future burden of tobacco-related disease can be predicted if people still smoke. The objective of this study was to determine the factors related to smoking cessation in adults (aged 20-59 years old) in Palu City, Indonesia. The Health Belief Model was used as a conceptual framework to guide the study. This was a cross-sectional study and it was conducted with 183 adults. Data were collected by face-to-face interview using a structured questionnaire. Data were analyzed by using descriptive statistics, Chi-square, and logistic regression. The results revealed that significant predictors of smoking cessation included the perceived severity about the consequences of smoking (OR = 4.49, p &lt; 0.001), attempts to quit (OR = 0.93, p &lt; 0.001), and advice from peer/family/physician (OR = 0.32, p &lt; 0.001), with R2 = 0.38. Health care providers can use the findings from this study as an evidence base to develop health promotion and prevention programs to encourage adults to quit smoking and so avoid developing diseases related to smoking. Furthermore, enhancing smoking cessation efforts in young smokers can significantly improve the health of the public.&#x0D; Keywords: smoking cessation, adults, Health Belief Model

Motivational Factors for Smoking Behaviors in Individuals with Metabolic Syndrome.

PurposeSmoking, which is one of the major risk factors for metabolic syndrome that causes cardiovascular disease or diabetes, is a crucial risk factor, which is modifiable. This study aimed to determine the factors that promote smoking behaviors according to smoking status among adults with metabolic syndrome.Patients and MethodsA survey of structured self-reported questionnaires was conducted on 152 adults with metabolic syndrome. Outcome variables included cognitive motivations (self-efficacy, and perceived benefits and barriers), emotional motivation (emotional salience), and autonomous and controlled motivation based on self-determination theory. The participants were categorized by their smoking status (never smoking, quit smoking, or current smoking). Their sociodemographic and motivational factors were examined using one-way analysis of variance, analysis of covariance, and multinomial logistic regression analysis.ResultsData on 152 individuals with metabolic syndrome with a mean age of 57.5 years were included. The findings indicated that the motivational factors for the never-smoking and quit-smoking groups significantly differed from those for the current-smoking group in terms of self-efficacy, perceived benefits, perceived barriers, and autonomous motivation. Based on multinomial logistic regression with current smoking as the reference group, sex (being female, OR=57.69) and perceived barriers (OR=0.39) were the significant predictors for the never-smoking group, while autonomous motivation (OR=1.96) was the significant predictor for the quit-smoking group.ConclusionThe motivational factors for smoking behaviors varied according to the smoking status of adults with metabolic syndrome. Autonomous motivation was the significant predictor of smoking cessation for individuals who successfully quit, whereas cognitive motivation was influential in the prevention of smoking by individuals who have never smoked. Further studies are warranted to develop smoking cessation strategies, which should focus on specific motivational factors to lead effective smoking prevention programs in this population.

Perceived partner responsiveness predicts smoking cessation in single-smoker couples

IntroductionRomantic partners are crucial to successful smoking cessation, but the mechanisms by which partners influence cessation is unclear. Research in this area has focused heavily on partner smoking status and support for quitting, but partner influence may not be limited to these two constructs. The current study examines the perceived responsiveness of the partner (i.e., the perception that the partner understands, approves of, and supports the self) as a predictor of smoking cessation in unassisted quitters, independent of smoking-specific support for quitting and more general relationship satisfaction. MethodsData were taken from a sample of smokers (N = 62) in relationships with never/former smokers (i.e., members of single-smoker couples) who completed a 21-day ecological momentary assessment study during an unassisted quit attempt. Measures of perceived responsiveness, support for quitting, and relationship satisfaction obtained at baseline were used to predict smoking outcomes over the course of the study. ResultsConsistent with our predictions, perceived responsiveness emerged as a significant predictor of smoking cessation over and above the effects of support for quitting and relationship satisfaction. Support for quitting only predicted self-reported relapse. Unexpectedly, once perceived responsiveness was considered, greater relationship satisfaction was associated with poorer smoking outcomes. ConclusionsThe current research suggests that perceived responsiveness is a more effective resource for smoking cessation than support specifically for quitting. These findings extend previous research by demonstrating that perceived responsiveness represents a distinct construct from smoking-specific support or relationship satisfaction, and that it is important for smokers during a quit attempt.

Factors associated with cessation of smoking among Swiss adults between 1991 and 2011: results from the SAPALDIA cohort

Smoking is still the most preventable cause of disease and premature death in Switzerland, as elsewhere. We aimed to assess the main determinants of smoking cessation in the population-based cohort of SAPALDIA (Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults). The SAPALDIA study was initiated in 1991 with 9651 participants aged 18 to 60 years from eight areas (S1). Follow-up assessments were conducted in 2002 (S2; 8047 participants) and 2010/11 (S3; 6088 participants). At each survey, detailed information on health and potential health-related factors was collected and lung function measured. Using logistic regression, we assessed predictors of smoking cessation between S1 and S2 and between S2 and S3. In both periods, highest educational level (summary odds ratio [OR] 1.49, 95% confidence interval [CI] 1.08-2.06; ref. lowest level), FEV1/FVC <0.5 (OR 6.19, 95% CI 2.44-15.7, ref. FEV1/FVC ≥0.7), higher age in men (OR 1.02, 95% CI 1.01-1.03, per year) and overweight (OR 1.38, 95% CI 1.16-1.64) were significant predictors of smoking cessation. Nicotine dependence (OR 0.97, 95% CI 0.96-0.98, per cigarette smoked a day) and female sex between age 45 and 60 (e.g., OR 0.74, 95% CI 0.61-0.91, at age 50) were negatively associated with smoking cessation. Moreover, smokers at S2 reporting a diagnosis of depression were less likely to quit smoking by S3 (OR 0.53, 95% CI 0.30-0.93). Prospective tobacco control policies in Switzerland should be addressed to women, younger persons and persons of lower education.

Smoking Cessation Outcomes and Predictors Among Individuals With Co-occurring Substance Use and/or Psychiatric Disorders

Objective: Individuals with substance use and psychiatric disorders have a high prevalence of tobacco use disorders and are disproportionately affected by tobacco-related morbidity and mortality. However, it is unclear how having co-occurring disorders affects tobacco cessation. Our aim was to examine smoking cessation outcomes and relevant predictors of smoking cessation among smokers with substance use and/or psychiatric disorders. Methods: Data from medical records of 674 participants in a tobacco treatment program within mental health and addictions services in Vancouver, Canada, were analyzed. The 26-week treatment program included an 8-week structured behavioral counseling group, an 18-week support group, and 26 weeks of no-cost pharmacotherapy. Information on demographics, tobacco use and history, type of pharmacotherapy received, nicotine dependence, importance of and confidence in quitting smoking, expired carbon monoxide level, substance use and psychiatric disorder history, and total program visits were gathered. Results: Approximately 67% (n = 449) of participants had co-occurring substance use and psychiatric disorders, while 20% (n = 136) had substance use disorder only, 10% (n = 67) had psychiatric disorder only, and 3% (n = 22) had tobacco dependence only. Rates of tobacco cessation (i.e., 7-day point prevalence of abstinence verified by expired carbon monoxide of ≤8 ppm) by group in the 522 people who completed treatment were as follows: 38.2% for those with co-occurring disorders, 47.1% for those with tobacco dependence only, 47.1% for those with substance use disorder only, and 41.8% for those with psychiatric disorder only. Length of treatment was a significant predictor of smoking cessation for those with co-occurring disorders and substance use disorder only. In the final stratified multivariate analysis, for individuals with co-occurring disorders, having an opiate use disorder (as compared to an alcohol use disorder) and higher nicotine dependence scores at baseline were predictive of poor cessation outcomes, while greater length of treatment was predictive of successful smoking cessation. Conclusions: Tobacco cessation treatment for individuals with co-occurring substance use and psychiatric disorders is likely to be as effective as for smokers with either disorder alone. Treatment duration predicts success among these smokers so strategies to enhance engagement and retention are needed.

Effectiveness of individual counseling for smoking cessation in smokers with chronic obstructive pulmonary disease and asymptomatic smokers

Few studies have examined the effect of individual counseling for smoking cessation in China. The present study evaluated the efficacy of individual counseling in patients with chronic obstructive pulmonary disease (COPD) and asymptomatic smokers. This prospective randomized study evaluated 85 smokers with COPD and 105 asymptomatic smokers with normal lung function. The individuals were randomly allocated to intervention and control groups. Subjects in the intervention group were provided with individual cognitive counseling based on face-to-face individual consultation, self-help materials and nine telephone follow-ups. Subjects in the control group were provided with simple smoking cessation advice. The smoking status for all subjects and the St. George’s Respiratory Questionnaire (SGRQ) for COPD patients were assessed at baseline, week 4 and month 6. The COPD patient exacerbations during the 6 months were recorded. In the total study population, individual counseling resulted in higher abstinence rates compared with those in the control: Intervention vs. control, 23.4 vs. 10.4% (P=0.007), respectively. Similar results were observed in the smokers with COPD: Intervention vs. control, 40.5 vs. 18.6% (P=0.027), respectively. However, for asymptomatic smokers, the effect of individual counseling was identified to be statistically insignificant: Intervention vs. control, 9.6 vs. 3.8% (P=0.230), respectively. SGRQ scores and COPD exacerbations were significantly improved in patients who abstained from smoking compared with those in the patients who failed to stop smoking. Airway obstruction, quitting motivation and individual counseling were predictors associated with smoking cessation. Airway obstruction was the most significant predictor of smoking cessation (odds ratio, 4.215; 95% confidence interval, 2.215–7.865). The results of the present study show that individual counseling is an effective method for smoking cessation, particularly in COPD patients. However, its efficacy in asymptomatic smokers requires confirmation in further studies.

Occupational Factors and Smoking Cessation among Unionized Building Trades Workers

The purpose of this study was to estimate the contribution of occupational factors to smoking cessation among building trades workers. Longitudinal data came from the MassBUILT smoking cessation intervention study for unionized building trades workers. Multivariable logistic regression analyses were applied to identify the significant predictors of smoking cessation, which was defined as abstinence from smoking during the previous 7 days at the 1-month monitoring and prolonged abstinence for at least 6 months at the 6-month monitoring. Greater concern about exposure to occupational hazards was significantly associated with increased likelihood of smoking cessation at 1 month (odds ratio = 1.06; 95% confidence interval = 1.01-1.11). Additionally, smokers who had a more positive view of their unions had at least marginally increased likelihood of smoking cessation at 1 month. Furthermore, older age, higher levels of educational attainment and household income, and fewer cigarettes smoked per day were important covariates that predicted smoking cessation. Concerns about exposures to work hazards should be incorporated into comprehensive intervention approaches for building trades workers. Additionally, the findings emphasize that blue-collar workers with lower income and education levels and heavy smokers should be considered target groups for implementing cessation interventions.

Predictors of smoking reduction among Blacks.

Blacks who smoke have increased tobacco-related health risks. Cessation decreases the likelihood of many health problems. Smoking reduction may be important in the cessation process and potentially reduce health risks. Because little is known about specific predictors of smoking reduction, we investigated factors predicting reduction among Black light smokers enrolled in a 26-week cessation trial. Specifically, we compared (a) reducers (reduced cigarettes per day [cpd] >or=50%) with nonreducers and (b) reducers with quitters. Baseline demographic, smoking-related, and psychosocial variables were collected, and Week 26 smoking status was assessed. Among 539 participants, 41.0% (n = 221) reduced their smoking, 17.6% (n = 95) quit, and 41.4% (n = 223) did not reduce their smoking by >or=50%. In comparison with reducers, nonreducers were more likely to have their first cigarette within 30 min of waking (odds ratio [OR] = 2.4, 95% CI = 1.47-3.93), lower baseline cpd (OR = 0.84, 95% CI = 0.77-0.93), higher baseline cotinine levels (OR = 1.002, 95% CI = 1.000-1.003), lower perceived stress (OR = 0.86, 95% CI = 0.78-0.95), and higher Smoking Consequences Questionnaire (SCQ) negative social impression scores (OR = 1.04, 95% CI = 1.01-1.06), after controlling for treatment arm, gender, and age. Significant predictors of smoking cessation versus reduction included lower baseline cpd (OR = 0.85, 95% CI = 0.75-0.95), higher nicotine dependence (OR = 1.47, 95% CI = 1.09-1.98), lower baseline cotinine levels (OR = 0.996, 95% CI = 0.994-0.998), higher body mass index (OR = 1.05, 95% CI = 1.01-1.08), lower perceived stress (OR = 0.82, 95% CI = 0.72-0.95), and higher SCQ negative social impression scores (OR = 1.05, 95% CI = 1.01-1.08). Distinct predictors are associated with different trajectories of smoking behavior change (i.e., reduction vs. cessation vs. no change).

Smoking reduction and cessation among young adult women: a 7-year prospective analysis

This study examined transitions in smoking behavior and attributes associated with reductions in daily smoking and subsequent cessation over a 7-year period. Data came from the Australian Longitudinal Study on Women's Health. Women aged 18-23 years in 1996 were randomly selected from the national health insurance database. Mailed questionnaires were distributed in 1996 (survey 1), 2000 (survey 2), and 2003 (survey 3). The analysis sample was all 972 women who were daily smokers with complete data on smoking at survey 1, and who participated in all three surveys. The main outcome variable was transitions in smoking behavior between surveys 1, 2, and 3, which included changes in the number of cigarettes smoked, changes to nonsmoking, and changes to nondaily smoking. Explanatory variables included prior smoking history, sociodemographic, lifestyle, psychosocial, and health-related characteristics. Over the 7-year period, one-quarter of daily smokers reduced and maintained a lower level of smoking. Reducers were most likely to have been heavy smokers and to have used illicit drugs, compared with those who stopped smoking. A change from daily to nondaily smoking at survey 2 predicted cessation at survey 3 when compared with no change in baseline smoking rate. Baseline smoking level was not a significant predictor of smoking cessation, while becoming married, having a higher physical health score, and not using illicit drugs increased the odds of cessation. Our study suggests that reducing from daily to nondaily smoking may promote smoking cessation among daily smokers. This observation warrants verification in other populations and in experimental studies.

Randomized trial of a smoking cessation intervention in hospitalized patients

A hospitalization is a time when perceived vulnerability to dangers from smoking and quitting motivation may be at their peak. Aim was to determine whether a smoking cessation intervention of moderate intensity would increase the smoking cessation rate in hospitalized smokers. Design was randomized trial, conducted in a university-affiliated cardio-pulmonary tertiary care center. Participants were hospitalized smokers aged < or =70 years. Intervention was a smoking cessation intervention consisting of education and psychological support, with or without pharmacological therapy, associated with follow-up phone calls. Patients assigned to the control group received usual care. Measurement was point prevalence cessation rate at 1-year follow-up. A total of 468 patients were screened; 196 were randomized. Although the smoking cessation rates at 12-month follow-up were higher than expected, we found no significant difference between the study groups (intervention: 30.3%; control: 27.8%). Similar results were obtained in patients whose smoking status was validated by urinary cotinine assay. Length of stay and dependence to nicotine were the only significant predictors of smoking cessation. A smoking cessation intervention of moderate intensity delivered in a tertiary cardio-pulmonary center did not increase the smoking cessation rate at 1-year follow-up. The results of this trial should not divert those who deliver care to inpatients from delivering a brief smoking cessation intervention.

Does smoking cessation improve Quality of Life in patients with coronary heart disease?

Objective. To evaluate whether smoking cessation after a coronary event improves quality of life, and to assess whether quality of life is a predictor of smoking cessation. Design. Health-related quality of life at baseline and at 12 months follow up were measured in a randomised smoking cessation trial of 240 smokers aged under 76 years admitted for myocardial infarction, unstable angina or coronary bypass surgery. At 12 months follow up 101 had managed to give up smoking (quitters), and 117 were smokers (sustained smokers). Results. The quitters and sustained smokers had similar improvements in all quality of life domains from baseline to 12 months follow up. Further, after adjustment for differences in baseline characteristics, the quality of life was not significantly different in the quitters compared to the sustained smokers neither at baseline nor at 12 months follow up. Conclusions. Smoking cessation did not improve quality of life compared to sustained smoking after a coronary event in a 12 month follow up. Quality of life was not a significant predictor of smoking cessation.

Age at smoking onset and its effect on smoking cessation

The aim of this study was to examine the relationship between cessation and age at which person starts smoking. Data from a survey of nine neighborhoods in Philadelphia (1985–1987) were analyzed. Interviews were conducted in the home using a structured questionnaire. Participants were from a probability sample ( n = 1,700) of males aged 35 years or older. Sixty-six percent of the smokers in this series started smoking before 18 years of age. Smoking cessation rate was 58.1% in Whites and 38.8% in Blacks. Age, race, marital status, education, health condition, amount smoked, and duration of smoking were significant predictors of smoking cessation. Age at initiation of smoking was a significant factor for continuation of smoking. Men who started smoking before 16 years of age had an odds ratio of 2.1 (95% confidence interval: 1.4–3.0) for not quitting smoking compared to those who started at a later age. These findings emphasize the need for prevention program targeted to children below 16 years of age.

Predictors of smoking cessation in a cohort of adult smokers followed for five years.

OBJECTIVE: To identify variables predictive of smoking cessation in a cohort of cigarette smokers followed for five years. DESIGN: Data analysed in this paper come from a cohort tracking telephone...

Predicting Smoking Cessation Outcome in a Medical Center from Stage of Readiness: Contemplation Versus Action

Background. This study shows the clinical utility of Prochaska and DiClemente′s stages of readiness for treating nicotine dependence in a medical center. Methods. Six hundred forty-eight patients were retrospectively studied in either the contemplation or the action stage of readiness. Results. Statistical analysis showed the action stage to be the most significant predictor of smoking cessation at 6 months. Individuals in the action stage had twice the 6-month cessation rate as those in the contemplation stage (41.5% versus 20.3%, P < 0.001). Other significant predictors of smoking cessation included a low Fagerström Tolerance Questionnaire score (≤6) and the patient′s report of a current disease but no past history of disease worsened by smoking. Conclusions. This study shows the potential clinical application of this theoretical model for providing treatment for smokers.

The Impact of Pregnancy on Women’s Prenatal and Postpartum Smoking Behavior

We report patterns of prenatal smoking cessation and postpartum relapse for a large urban population of pregnant women. We examined associations between sociodemographic factors and prepregnancy, pregnancy, and early postpartum smoking behavior. Forty-one percent of women smoking before pregnancy quit smoking during pregnancy. Sociodemographic factors important in predicting smoking cessation during pregnancy, as determined through logistic regression analyses, differed significantly for white and black women. Among white women, education, age, and parity were important predictors of cessation, whereas among black women, only intention to breastfeed was a significant predictor of smoking cessation during pregnancy. Early postpartum smoking relapse rates differed by ethnicity. Twenty-eight percent of white women and 46% of black women who had quit during pregnancy relapsed within 6-12 weeks postpartum. Using logistic regression, we found formula feeding to be the most important predictor of early postpartum smoking relapse for both white and black women.

Do weight concerns hinder smoking cessation efforts?

This study examined the hypothesis that weight concerns interfere with smoking cessation efforts. Four hundred fifty-nine women screened for participation in a smoking cessation treatment program completed Stunkard's Three Factor Eating Questionnaire (1981), measures of smoking-specific weight gain concern, and smoking history measures. Success in current cessation efforts was assessed 6 months following treatment. The restraint subscale of the TFEQ was associated with lower baseline level of nicotine dependence, a history of smoking fewer cigarettes, and longer prior periods of successful smoking abstinence. Baseline level of nicotine dependence and treatment group were significant predictors of smoking cessation at 6 months posttreatment. Restraint score was marginally predictive of higher rates of abstinence from smoking at 6 months when baseline level of nicotine dependence and treatment group were controlled. These results do not support the hypothesis that weight concerns interfere with smoking cessation attempts.

Early predictors of smoking cessation after myocardial infarction

The determinants of long-term smoking cessation were evaluated in 80 patients who smoked cigarettes and survived a myocardial infarction. All patients underwent a program of rehabilitation and secondary prevention including in-hospital counseling and physician-guided reinforcing sessions at 1, 3, and 6 months after discharge. At 18 months of follow-up, 53 patients (66.3%) had quit smoking. Variables associated with smoking cessation were duration of hospital stay greater than or equal to 19 days (79 vs. 48%; p less than 0.005) and peak creatine phosphokinase (CPK) elevation greater than or equal to 500 U/l (76 vs. 54%; p less than 0.05). Males tended to quit in higher proportion than females (68 vs. 44%). Age, prior myocardial infarction, other cardiovascular risk factors, infarction location, Killip class at entry, and duration of stay in coronary care unit did not significantly affect the quitting rates. Logistic regression analysis singled out the duration of hospital stay as a significant predictor of smoking cessation (p less than 0.005). Early and intensive secondary prevention during the hospital stay is crucial in promoting sustained smoking cessation after myocardial infarction.