Smoking Cessation Clinic Research Articles

The relationship between smoking cessation success and health literacy in patients given cognitive behavioral therapy and medical treatment

ABSTRACT Objective Health literacy has been recognized as an important factor to reduce health inequality. The aim of this study is to examine the relationship between health literacy scales and smoking cessation success of patients who applied to the smoking cessation outpatient clinic. Methods 120 volunteer patients who applied to our Smoking Cessation Clinic and completed a six-month follow-up were included in the study. Appropriate medical treatment and cognitive behavioral therapy were given to the patients. Health literacy scales (ASOY-TR) of patients who quit smoking and those who did not quit were statistically compared. Results ASOY-TR index was 33 (13–50). ASOY-TR deficiency 14.2% (n = 17); limited 35.5% (n = 43); adequate 34.7% (n = 42) and excellent 14.9% (n = 18). At the sixth month, 31.7% (n = 38) of our patients had quit smoking. ASOY-TR increased, cumulative smoking burden decreased (r = −0.215 p = .019). It was observed that the better the ASOY-TR category, the higher the success of smoking cessation (p = .047, OD = 0.296 (0.089–0.984)). Conclusion Developing health literacy can be beneficial in terms of preventing smoking addiction and quitting success.

Emotional and Therapeutic Elements of Cigarette Smoking Control: A Cross Sectional Study

Aim: The aim of this study was to investigate the impact of services rendered by health professionals in reducing cigarette smoking at the smoking cessation centers.
 Methods: Through May 2020 and April 2021, data from hospitals connected with the University of Health Sciences, Lahore, have been collected. During the same time period, information from DHQ and Allied Hospitals Faisalabad were evaluated using a recent retrospective review. Statistical software was used to calculate the incidence and average values. Chi-square also student t tests remained utilized to evaluate associated variables; p 0.06 remained measured statistically.
 Results: The average age of entrance was 39.73 13.21 years (min 14; max 92). Women were older than males at time of admission, although men began smoking earlier. Individuals with fewer than a high school diploma began smoking at a younger age. Once cured through medication also behavioral treatment, the smoking cessation rate remained 38.4 percent (n = 218).
 Conclusion: Approximately 49 percent of smokers stopped smoking after receiving medication and behavioral counseling. The majority of smokers was between ages of 31 and 51. More smoking cessation clinics should be built to provide smoking cessation tools to more informed individuals.

Duration of varenicline prescription and efficacy of smoking cessation treatment: an observational study in Taiwan

Although varenicline has had a significant effect on smoking cessation in randomized clinical trials, the dose-effect of varenicline treatment for smoking cessation in real-world settings remains unclear. This study aimed to evaluate the association between the duration of varenicline prescription and smoking cessation in Taiwan after adjusting for potential confounding effects and endogeneity bias. A total of 5106 Taiwanese participants received varenicline monotherapy for smoking cessation between March 2012 and September 2016. Multinomial logistic regression (MLR) was used to analyze the association between varenicline prescription duration and smoking cessation, stratified by the frequency of smoking clinic visits and propensity scores of early stopping of smoking cessation treatment. Compared to the reference of nonquitting, longer durations of varenicline prescription were associated with the greater likelihood of immediate and complete quitting (OR = 1.08, 95% CI = 1.02–1.14) and late quitting (OR = 1.14, 95% CI = 1.07–1.20). Among those who were more likely to continue visiting smoking clinics, longer use of varenicline was significantly associated with an increase in immediate-and-complete quitting (OR = 1.19, 95% CI = 1.15–1.23) and late quitting (OR = 1.24, 95% CI = 1.20–1.28). Varenicline prescription duration was not associated with smoking cessation among smokers who visited smoking clinics once. The relationship between varenicline prescription duration and smoking cessation was modified by the frequency of smoking clinic visits and was dependent on quitting process patterns. Encouraging smokers to continue visiting the smoking cessation clinic and use medication will help smoking cessation efforts in Taiwan.

Pattern of Tobacco Use among Children and Adolescents with comorbid Psychiatric Illnesses

IntroductionTobacco use is clearly harmful for mental as well as physical health especially among persons <18 yeards age. It is used in multiple forms in many countries such as, somoling chewing etc. It is impotant to know the pattern of tobacco use and the comorbid psychiatric illnesses inthis age group.ObjectivesTo identify the pattern of tobacco use among cases <18 years age with various psychiatric disorders.MethodsIt was a cross-sectional study conducted at a psychiatric clinic at Karachi, on all consecutive cases <18 years. Diagnostic criteria of ICD-10 were used.ResultsA total number of 700 consecutive cases below the age of 18 years reporting to psychiatric clinic were inducted in this study. Out of them 107 (15%) patients reported use of tobacco. Among them 83 (77% ) used pan with tobacco. The psychiatric illnesses identified were depressive disorder (39%) & conversion disorder (15%).ConclusionsTobacco use (predominantly in the form of chewing), is common amongst children and adolescents reporting for psychiatric consultation. It is important to develop strategies at a community level with legal restriction/implementation selling tobacco to children. Moreover, psychiatric evaluation should be done in all children and adolescents identified as using tobacco, and the term “smoking cessation clinic” should be replaced with “tobacco cessation clinic/ services”.DisclosureNo significant relationships.

Success Rate of Smoking Quitting in those who Attends Smoking Cessation Clinic: A Cross Sectional Study

Success Rate of Smoking Quitting in those who Attends Smoking Cessation Clinic: A Cross Sectional Study

Evaluation of Smoking Cessation Advice in a Maltese Mental Health Community Clinic

IntroductionTobacco smoking is one of the leading causes of preventable morbidity and mortality worldwide (WHO, 2020). Smoking cessation campaigns have been effective at reducing smoking in the general population, but not in individuals with mental illness (Lê Cook et al., 2014). A downward trend in smoking has been noted in EU countries but smoking rates have remained stable in Malta (Country Health Profile, 2019).ObjectivesThis audit aims to assess smoking status, provision of smoking cessation advice and psychotropic dose adjustment depending on smoking status by the Bormla Mental Health Team.MethodsPatient health records were reviewed for patient demographics, psychiatric diagnosis, medical co-morbidities, smoking status and cessation advice and changes in psychiatric medication according to smoking status.ResultsOf the 171 patients studied, 35% (n=61) were smokers, 33% (n=58) were non-smokers while in 30% (n=52) the smoking status was undocumented. Smokers had a mean age of 50 years with an almost equal gender distribution (49% (n=30) male and 51% (n=31) female). The most common documented psychiatric diagnoses were depression (52.5% (n=32)) and anxiety (34.5% (n=21)), while 59% (n=36) had documented medical co-morbidities. Only 14% (n=9) where given smoking cessation advice and one patient was referred to the smoking cessation clinic. One third of smokers (n=20) were prescribed psychotropic medications which are affected by smoking status but only two patients had their doses adjusted.ConclusionsImproved smoking cessation advice, referral to services, consideration of smoking cessation while prescribing and documentation are need to better patient care.DisclosureNo significant relationships.

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.

The impact of COVID-19 on smoking cessation in pregnancy.

A greater proportion of non-pregnant smokers attempted to stop smoking during compared to before the COVID-19 pandemic. The objective of this study was to determine if a greater proportion of pregnant women also attempted to stop smoking during the pandemic rather than before. The use of antenatal smoking cessation services and nicotine replacement therapies (NRT) in pregnant women was audited before (2019-2020) and during the COVID pandemic (2020-2021). Anonymised data from January 2019 to March 2021 were analysed from the Lambeth and Southwark smoking cessation service. A total of 252 pregnant women who smoked were referred to their local antenatal smoking cessation service, of which 90 (35.7%) (median age: 31 years [19-52 years]) chose to attend smoking cessation clinics. The COVID-19 pandemic was not associated with an increase in the number of women attending smoking cessation clinics, (2020-2021 n=46 [40.8%] of 110); compared to (2019-2020 n=44 [30.9%] of 142 referred pregnant women pre-pandemic) p=0.061. Eighty-two women utilised NRT to help them stop smoking and the frequency of NRT use didnot change during the pandemic (2019-2020 n=39, 2020-2021 n=43; p=0.420). No significant difference in smoking cessation rates between the two periods was observed at either the four-week (p=0.285) or twelve-week follow-up (p=0.829). Smoking cessation rates in pregnant women and the demand for antenatal smoking cessation services was unchanged during compared to before the COVID-19 pandemic.

Impact of the COVID-19 Pandemic on Tobacco Sales and National Smoking Cessation Services in Korea.

This study aimed to describe the effect of the COVID-19 pandemic, combined with the Korean government’s response to the pandemic on tobacco consumption and national smoking cessation services among the Korean population. We obtained tobacco sale data from the Ministry of Finance and analysed the data on smokers’ visits to national smoking cessation clinics during the pandemic from a member of the National Assembly. We also conducted an online search to understand smokers’ thoughts about their tobacco use during the pandemic. We found that after the emergence of COVID-19 in 2020, the sale of conventional cigarettes increased from 3063.70 to 3209.70 million packs (4.77%). The number of smokers who visited clinics sharply decreased in the first half of 2020. The six-month quit rate decreased from 38.5% in 2017 to 22.3% in early 2020. We also found that smokers increased their consumption and began to switch from conventional cigarettes to heated tobacco products. The COVID-19 pandemic has threatened tobacco control policies and programs in Korea in the last two years; however, based on our experience during this period and considering the WHO recommendation, we should sustain and reinforce tobacco control policies and national smoking cessation services today and in the future.

A CROSS SECTIONAL STUDY OF NICOTINE DEPENDENCE AND ITS DETERMINANTS IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AT INSTITUTE OF RESPIRATORY DISEASES, SAWAI MAN SINGH MEDICAL COLLEGE, JAIPUR, RAJASTHAN.

Background: Smoking cessation is the most powerful intervention to modify progression of chronic obstructive pulmonary disease (COPD), and nicotine dependence is one of the most important determinants of success or failure in smoking cessation. Thus, nicotine dependence status and factors associated with moderate to high nicotine Dependence in patients with COPD needs to be evaluated. Method: A hospital based cross-sectional observational study performed on 50 patients with COPD attending the outpatient department at smoking cessation clinic, Institute of Respiratory Diseases, SMS Medical College, Jaipur, Rajasthan during 2019-2020. Result: Multiple logistic regression analysis revealed that low education status,age 60 yrs.,and mild to moderate airflow obstruction were related to moderate to high nicotine dependence. Conclusion: Nicotine dependence does not correlate with smoking amount, but with education level, age, and severity of airflow obstruction. Physicians should provide different strategies of smoking cessation intervention for current smokers with COPD according to their education levels,age,and severity of airflow obstruction.

Impact of head-and-neck radiation oncology clinical fellowship on multidisciplinary assessment, radiation workflow, and survival of adult patients with nasopharyngeal carcinoma.

The purpose of the study wast to evaluate the influence of head-and-neck clinical fellowship training on multidisciplinary assessment, radiation workflow, and clinical outcomes of patients with nasopharyngeal carcinoma (NPC). This was a retrospective review of patients with NPC treated between 2010 and 2017. The study cohort was allocated into prefellowship cohort (pre-FSC) (January 2010-September 2014) and postfellowship cohort (post-FSC) (October 2014-December 2017). Patient demographics, tumor characteristics, multidisciplinary assessment, radiation workflow, and treatment were reviewed. Univariable, multivariable, and relapse-free survival (RFS) and overall survival (OS) were performed. One hundred and forty-three patients were included, 68 in the pre-FSC and 75 in the post-FSC. For the post-FSC versus pre-FSC, there were increased multidisciplinary referrals to dental (100% vs. 79.4%, P = 0.001), nutritional (94.7% vs. 70.6%, P = 0.0001), peg-tube insertion (84% vs. 64.7%, P = 0.0001), speech and swallow (94.7% vs. 13.2%, P = 0.0001), psychosocial (100% vs. 26.5%, P = 0.0001), and smoking cessation clinic (33.3% vs. 5.9%, P = 0.0001). For the post-FSC versus pre-FSC, there were statistically significant differences in the elements of radiation workflow; mean time required for contouring was 3.2 vs. 8.8 days (P = 0.0001), radiotherapy plan implementation: 1.9 vs. 4.8 days (P = 0.0001), and plan approval: 0.4 vs. 0.9 day (P = 0.00012). On multivariable analysis, smoking was associated with poor RFS (P = 0.04). There were no statistically significant differences in OS (94.7% vs. 87.2% at 3 years; P = 0.126) and RFS (88.4% vs. 84.4% at 3 years; P = 0.281) between post and pre-FSCs, respectively. Clinical fellowship training results in increase multidisciplinary referrals to supportive services, improves radiotherapy workflow, but had no significant impact on survival outcomes.

Association between smoking cessation and alterations in forced expiratory volume in one second (FEV1). A Follow-Up Study from a Greek Tobacco Cessation Clinic.

Cigarette smoking is the most important preventable cause of several diseases such as malignancies, pulmonary and cardiovascular diseases. Smoking cessation is now supported by both behavioral counseling and medical pharmacotherapy and is the only effective approach for slowing down an accelerated decline in forced expiratory volume in one second (FEV1). Our study aims to examine changes in forced expiratory volume in one second (FEV1) after smoking cessation for smokers attending our smoking cessation clinic their correlation to smokers' demographic characteristics. 114 smokers (48 males and 66 females), with a mean age of 48.36±10.49 years, were enrolled. They were classified in 4 groups, according to their age; <40 years (Group Α), 41-50 years (Group Β), 51-60 years (Group C), >60 years (Group D) and underwent Spirometry on the 1st day of visit, one month (2nd visit) and, 3 months later (3rd visit). Statistically significant increase in FEV1 values at the 2nd and 3rd visit compared to the 1st visit was observed in smokers who quit smoking in Group Α, B and C (p<0.05). In addition, a statistically significant decrease in FEV1 values at the 2nd and 3rd visit compared to the 1st visit was noticed in smokers who continued smoking in Group B, C and D (p<0.05). Smoking cessation achieved through smoking cessation support led to the improvement of FEV1 values within 3 months. The greatest benefit was observed in smokers under the age of 60.

Prevalence of Smoking and Beliefs and Attitude Toward Smoking Habit and Smoking Cessation Methods Among Pharmacy Students: A Cross-Sectional Study in Saudi Arabia.

ObjectiveThe impact of pharmaceutical services on public health especially in regards to smoking cessation counseling can influence the rate of smoking cessation. The present study aims to evaluate prevalence, beliefs, and attitude of pharmacy students toward smoking habit and SC methods.MethodsAn online cross-sectional survey was conducted among pharmacy students at King Saud University, Riyadh, Saudi Arabia over 4-month period from May to August 2021. The survey consisted of 22-items focused on evaluating the prevalence, belief, and attitude toward smoking habits and smoking cessation methods. Data was descriptively analyzed using a statistical package for social science version 26 (SPSS).ResultsA total of 675 students completed the survey, among which 78.7 % were non-smokers and only 31.7% received education on the dangers of smoking. The most common methods of smoking cessation they heard of were consultation (58.6%), followed by use of electronic cigarettes (41.92 %) and Nicotine patch (40.7%). One-third of the surveyed students (36.8 %) agreed that specialized smoking cessation clinics enhance the efficacy of smoking cessation methods. The majority of students (80.6%) agreed to ban smoking in public places and 92.2% believed that tobacco sales to adolescents should be forbidden. Health professionals should actively participate and advise their patients to quit smoking as 89.8 % students agreed on that. Age and gender of students had significantly influenced the prevalence of smoking, history of smoking, frequency of smoking, efforts to quit smoking among smokers (p = 0.0001).ConclusionThe prevalence of non-smokers among pharmacy students is encouraging, yet level of awareness about and usefulness of smoking cessation methods is unsatisfactory. Therefore, the study clearly highlights a great need for integrating smoking cessation programs in their academic curricula to prepare them for real-world practice.

Time-Varying Mediation of Pharmacological Smoking Cessation Treatments on Smoking Lapse via Craving, Cessation Fatigue, and Negative Mood.

The addictive nature of nicotine makes smoking cessation an extremely challenging process. With prolonged exposure, tobacco smoking transforms from being a positive reinforcer to a negative one, as smoking is used to mitigate aversive withdrawal symptoms. Studying the variations in withdrawal symptoms, especially during their peak in the first week of a quit attempt, could help improve cessation treatment for the future. The time-varying mediation model effectively studies whether altering withdrawal symptoms act as mediators in the pathway between treatment and cessation. This secondary data analysis of a randomized clinical smoking cessation trial of three pharmacotherapy regimens (nicotine patch, varenicline, and nicotine patch + mini-lozenge) analyzes ecological momentary assessment (EMA) data from the first 4 weeks post-target quit day (TQD). We assess whether withdrawal symptoms (eg, negative mood, cessation fatigue, and craving) mediate the pathway between pharmacotherapy and daily smoking status and whether this effect varies over time. We found a statistically significant time-varying mediation effect of varenicline on smoking status through craving, which shows decreasing risk of lapse via reduction in craving. We did not find significant time-varying mediation effects through negative mood and cessation fatigue. This study supports the importance of craving suppression in the smoking cessation process. It also helped identify specific timepoints when withdrawal symptoms increased that would likely benefit from targeted cessation intervention strategies. This study aimed to understand the underlying dynamic mechanisms of the smoking cessation process using a new analytical approach that capitalizes on the intensive longitudinal data collected via EMAs. The findings from this study further elucidate the smoking cessation process and provide insight into behavioral intervention targets and the timing of such interventions through the estimation of time-varying mediation effects.

Status of social capital and its relationship with the success rate of smoking cessation in patients referred to the smoking cessation clinic of Farshchian Cardiovascular Hospital in Hamadan

ABSTRACT Background and Objective Several studies showed the effect of social capital on smoking cessation. The present study examined this issue. Materials and Methods One hundred eleven smokers admitted to the smoking cessation clinic were consecutively included in a cross-sectional study in 2019. The data were collected using a checklist of demographic characteristics, nicotine dependency (Fagerström questionnaire) and social capital scale (Bullen). The success rate for smoking cessation was determined for smokers at 1-, 3- and 6-month intervals. Data were analyzed by SPSS 22 software. Result Of the 111 participants, 107 were males. The mean age of participants was 47.42 ± 12.66 years. The minimum score of social capital was 63 and the maximum was 172. Of all the patients admitted to the clinic, only 43 (38.7%) completed the cessation sessions (at least 4 sessions), with the mean score of social capital having no significant differences between the two groups (107.97 ± 17.93, 107.58 ± 19.95, respectively, p: NS) Conclusion Given the lack of a significant relationship between social capital and successful smoking cessation in the study, studying other factors like socioeconomic conditions and social norms that affect social capital and smoking cessation seems to be advisable to consider in future studies.

Tobacco Taxation Influences the Smoking Habits of Adult Smokers Attending Smoking Cessation Clinic in Saudi Arabia.

ObjectivesTo determine whether the increased tobacco price due to tax implementation on tobacco products (including cigarettes) has a significant effect on smoking cessation among Saudi Arabian adult smokers.MethodsAn interviewer-administered questionnaire was used to obtain data from adult Saudi smokers and recent quitters attending smoking cessation clinics between January 2018 and September 2019. The responses of the participants were summarized and analyzed.ResultsIn total, 660 participants were interviewed, of which 98% were men who resided in the western region (33%). Taxation had no effect on smoking in 387 participants [58.6%; 95% confidence interval (CI): 54.9, 62.4], some effect in 220 participants (33.3%; 95% CI: 29.7, 36.9), and a substantial effect in 50 participants (7.6%; 95% CI: 5.6, 9.6). Strategies adopted to cope with the tax implementation included cutting down on the number of cigarettes smoked (302; 45.8%), changing to a cheaper brand of cigarette (151; 22.9%), purchasing in bulk (105; 15.9%), attempting to quit (453; 68.6%), and doing nothing (108; 16.4%). The rate of quitting smoking after attending the clinic was 20.7% (95% CI: 17.7, 23.9). Occupation (P = 0.003), education (P = 0.03), and current smoking habit (P = 0.07) were significantly associated with the impact of tobacco taxation. The strategies adopted in response to tax implementation on cigarettes were significantly associated with occupation (χ2 = 30, degrees of freedom = 12, P < 0.001).ConclusionsTobacco taxation influenced 40% of the participants. Their attempts to opt for alternatives should be recognized in evaluating policies to reduce adverse health impacts caused by tobacco abuse.

Factors related to the success of smoking cessation: A retrospective cohort study in Korea.

INTRODUCTIONEvery year, at least half of the smokers in South Korea attempt to quit smoking. However, the Korean smoking rate remains still high among OECD countries. This study aimed to identify the factors that influence the success of smoking cessation efforts.METHODSThe study included 1395 smokers, who participated in a 12-week program comprising doctor counseling and pharmacological treatment (i.e. varenicline), conducted at smoking cessation clinics in two general hospitals from 2015 to 2019. The participants responded to a survey questionnaire inquiring about their smoking behaviors at the first visit to the clinic. After completing the program, they were asked whether they succeeded in smoking cessation. Based on participants’ reported success or failure, multivariable logistic regression analyses were conducted to obtain adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for factors related to smoking cessation success.RESULTSFollowing the 12-week program, 39.6% of the participants (n=553) succeeded in smoking cessation. Lower rates of nicotine dependence (AOR=0.73; 95% Cl: 0.54–0.98) and lower total amounts of smoking (AOR=0.67; 95% Cl: 0.47–0.95) were significantly associated with higher success rates in smoking cessation. In addition, smokers who participated in the program for at least 8 weeks (AOR=7.16; 95% Cl: 5.57–9.20) and smokers who had hypertension (AOR=1.40; 95% Cl: 1.07–1.85) or a cardiovascular disease (AOR=1.68; 95% Cl: 1.03–2.75) achieved higher success rates.CONCLUSIONSSmokers’ success in smoking cessation was influenced by the period of visits to the smoking cessation clinic, the severity of nicotine dependence, and the presence of a cardiovascular disease including hypertension. Using these factors, smoking cessation strategy may be improved and personalized for individuals.

Practice, barriers, and facilitators of healthcare providers in smoking cessation in Mexico

ObjectiveTo assess the clinical practice, barriers, and facilitators in promoting smoking cessation in primary healthcare clinics in Mexico City. Materials and methodsA mixed method design was used. Surveys (n = 70) and semi-structured interviews (n = 9) were conducted with health personnel involved in smoking cessation clinics. ResultsQuantitative data revealed that physicians were more likely than nurses to 1) ask patients if they smoke (57.9% vs 34.5%, p = .057), 2) ask patients if they are interested in quitting smoking (65.7% vs 26.9%, p = .003), 3) provide advice to quit smoking (54.3% vs 29.2%, p = .056), and 4) assess whether pharmacotherapy is needed (21.9% vs 10%, p = .285). Qualitative data showed that nurses were more likely than physicians to report lack of resources to refer patients to smoking cessation services, lack of pharmacotherapy availability, and lack of provider training in smoking cessation. Reported barriers include lack of motivation among patients, lack of time for assessment, long appointment wait times, and lack of training. Reported facilitators include existence of smoking cessation programmes and pharmacotherapy at no cost to the patient, and having a multidisciplinary team. ConclusionsDue to numerous barriers, smoking cessation interventions are partially implemented in primary care clinics in Mexico City. A restructuring of services is necessary, and nurses should be given a more prominent role.

Gingival bleeding and pocket depth among smokers and the related changes after short-term smoking cessation

Background Smoking is associated with the deteriorating health of the gingiva and periodontium. The long-term beneficial effects of smoking cessation on oral health are well known. However, the effects of short-term smoking cessation on gingival bleeding and periodontal pocket depth are unknown. The purpose of the present study was to determine the effects of short-term smoking cessation on gingival bleeding and periodontal pocket depth. Methods Dentate smokers with a mean age of 56.9 ± 14.4 years at an outpatient smoking cessation clinic participated in this study. A professional dentist checked the periodontal pocket depth and gingival bleeding. Patients visited the smoking cessation clinic on their first visit and 2, 4, 8, and 12 weeks (three months). The gingival assessment was re-performed in those who succeeded in smoking cessation 3 months after the baseline. Results The baseline data of 83 patients showed that an increase in pocket depth was associated with increasing age and the amount of smoking. A significant increase in gingival bleeding (p = .031) and increase in pocket depth (p = .046) were observed 3 months after the baseline in patients who successfully quit smoking (n = 14). Conclusion Short-term smoking cessation increased periodontal pocket depth and gingival bleeding. These findings may reflect healing processes that occur in the healthy gingiva. Implications Study findings will be useful to advise patients during smoking cessation programs. Dentists can inform patients that an initial increase in gingival bleeding and pocket depth could be associated with smoking cessation. Such advice will prevent patients from any apprehension that may cause them to recommence smoking.

Efficacy of nicotine-replacement therapy, bupropion, and a combination of both for treating nicotine addiction

Background Most of the studies about the efficacy of smoking-cessation medication and its side effects were conducted in developed countries on participants who differ from Arab population in sociocultural and genetic factors. Patients and methods A randomized controlled trial was conducted on a convenient sample of 100 smokers at the smoking-cessation clinic. The participants were allocated into four groups: nicotine-replacement therapy (NRT), bupropion (BPP), combination of NRT+BPP, and placebo. Counseling was offered to all participants. Outcomes: self-reported smoking status with biochemical verification (success to stop smoking, lapse, relapse, or failure to stop smoking) at 3 and 6 months from starting treatment. Results The total success rate in four studied groups was 14% at 3 months and 8% at 6 months. There was no evidence of any statistically significant difference between any of the interventional groups (NRT, BPP, or their combination) and placebo group at 3 and 6 months as regards success rate (8, 12, 8, and 28%, respectively, at 3 months and 8, 12, 0, and 12%, respectively, at 6 months). There were no serious adverse events in the studied groups. Headache was more significantly reported by placebo group compared with all other groups (P=0.01), and urgency was more significantly reported by placebo group compared with NRT group (P=0.001). Conclusion The study found no evidence of the superior effect of NRT, BPP, or their combination over placebo in helping smokers quit smoking at 3 and 6 months. However, more withdrawal symptoms were reported by the placebo group.