Smoking Cessation Group Research Articles

Changes in smoking prevalence and cessation support, and factors associated with successful smoking cessation in Swedish patients with asthma and COPD

ABSTRACTIntroduction: Our aim was to investigate changes in smoking prevalence, smoking cessation support and factors associated with successful smoking cessation in patients with asthma and COPD.Methods: Questionnaires about available smoking cessation resources were completed by 54 primary health-care centers and 14 hospitals in central Sweden in 2005 and 2012. Patient data were collected using record reviews and patients questionnaires for two cohorts of randomly selected asthma and COPD patients in 2005 (n = 2306; with a follow up in 2012), and in 2014/2015 (n = 2620). Smoking prevalence, available individual and group smoking cessation support, and factors associated with successful smoking cessation were explored.Results: Smoking prevalence decreased from 11% to 6% (p < 0.0001) in patients with asthma but was almost unchanged in patients with COPD (28 to 26%, p = 0.37). Smoking cessation support increased from 53% to 74% (p = 0.01). A high cardiovascular risk factor level, including diabetes mellitus and hypertension was associated with improved smoking cessation in patients with asthma (OR (95% CI) 3.87 (1.04–14.4), p = 0.04). A higher magnitude success was observed in men with asthma (OR (95% CI) 27.9 (1.73–449), p = 0.02). More highly educated women with asthma had successful greater smoking cessation (4.76 (1.22–18.7), p = 0.04). No significant associations were found in COPD.Conclusions: The smoking prevalence in patients with asthma but not in COPD has almost halved in Sweden during a 7-year period. The availability of smoking cessation support has increased. Suggested factors related to successful smoking cessation are higher level of education in women with asthma and cardiovascular risk factors in men and women with asthma.

The development of a group smoking cessation intervention for offenders

As a requirement of the Stage 2 Health Psychology training, candidates must design, deliver, and evaluate a psychological intervention. For this, I worked with offenders from a prison in the North West of England, and produced a group intervention to help the offenders stop smoking, alongside the recent implementation of a prison smoking ban. This article summaries the intervention and provides a description of how I used the Behaviour Change Wheel to design my intervention, by matching the content to offenders’ needs. Reflections of my experience conducting this intervention are also highlighted.

Smoking abstinence rate and its associated factors between abrupt and gradual smoking cessation

Objective: To analyze and compare the abstinence rate of smoking quitting methods and its associated factors between abrupt and gradual smoking cessation in smokers with drug-based therapy. Methods: A prospective clinical study was conducted in patients undergoing quitting smoking intervention in Ruijin Hospital smoking cessation clinic between June 2013 and May 2016. All the subjects were randomized in a 1∶1 ratio into the abrupt smoking cessation group (smoking as usual over 3 weeks before a planned quit day, and then stopping smoking abruptly) and the gradual smoking cessation group (gradually reducing tobacco use over 3 weeks before a planned quit day, and then stopping smoking totally). The primary outcome was the complete abstinence rate, and the secondary outcomes included 1-month, 3-month and 6 month 7-day point prevalence of abstinence rates and 3 month sustained abstinence rates. Changes of body weight and drug adverse events were also compared. Results: A total of 314 moderate to severe nicotine-dependent patients were admitted in the study, including 157 patients in the abrupt smoking cessation and 157 patients in the gradual smoking cessation group. Fourteen patients fell off during the follow-up. For the complete abstinence rate, the gradual smoking cessation group was higher than the abrupt smoking cessation group(55.0% vs. 36.9%, χ(2)=9.841, P=0.002) .For 7-d smoking abstinence rate in the 1st, 3rd, 6th month, there was no significant difference between the 2 groups (all P>0.05). As for the 3-month sustained abstinence rate, a higher smoking quitting rate was seen in the gradual smoking cessation group compared to the abrupt smoking cessation group in the 6-month follow-up (17.9% vs.8.7%, χ(2)=5.441, P=0.020). The adverse drug reaction incidence was higher in the abrupt smoking cessation group than the gradual smoking cessation group (Gastrointestinal discomfort: 39.2% vs. 17.7%, χ(2)=12.336, P=0.000; Dreaminess: 40.2% vs. 13.3%, χ(2)=20.172, P=0.000). Conclusions: For moderate to severe nicotine-dependent patients, the gradual smoking cessation could serve to enhance the abstinence rate and mitigate the withdrawal symptoms.

A three-year national follow-up study on the development of community-level cancer rehabilitation in Denmark.

Aims: Scandinavian cancer care policies emphasise community-level rehabilitation services, but little is known about changes in service provision over time. This follow-up study explores development in these services in Danish municipalities, focusing on availability, utilisation and organisation of services, including existing opportunities and challenges. Methods: A national survey among all 98 Danish municipalities was conducted in 2013 (baseline) and repeated in 2016 (follow-up). The electronic questionnaire comprised closed- and open-ended questions. Data were analysed using descriptive statistics and content analysis. Results: A total of 93 municipalities responded (95% response rate) and the services offered primarily comprised group physical activity, dietary advice, smoking cessation and individual counselling on physical activity. The number of patients enrolled was below the estimated number needing rehabilitation in Denmark. Inequality in utilisation by ethnicity, age and gender was reported. Key challenges for the delivery of services were: inadequate referral and recruitment procedures; lack of needs assessment tools; obstacles to ensuring collaboration and referral of patients between hospitals and municipalities; and inadequate evidence on the rehabilitation's effect. Key recommendations include ensuring collaboration between municipalities; provision of diagnosis-specific group-based activities; services focusing on physical activity; and gender-specific activities directed particularly at men. Conclusions: This study, which highlights improvements in the provision of community-level cancer rehabilitation, recommends that more effort be made to ensure equality in utilisation across patient groups, improved integration of municipal-level services into cancer care trajectories, more uniform documentation of service delivery and the enforcement of patient outcomes to gradually build a more robust evidence base for community-level cancer rehabilitation.

‘Quit and Stay Quit Monday’ as a Novel Approach to Smoking Cessation: A Pilot Experimental Study

Introduction:Emerging evidence suggests a heightened interest in healthy behaviour changes, including smoking cessation, at the beginning of the week. Evidence from Google searches, quitlines, and cessation websites show greater information-seeking and interest in early week quitting.Aims:This pilot assesses the comparative effectiveness of a smoking cessation intervention that encourages participants to use Mondays as a day to quit or recommit to quitting smoking.Methods:We partnered with existing smoking cessation group programs to conduct a quasi-experimental, pre–post study. Both comparison and intervention groups received the same standard-care curriculum from program instructors. Intervention group participants received Monday materials including a wallet card and a mantra card during enrolment. On Mondays, intervention participants received an emailed tip-of-the-week and were encouraged to quit or recommit to quitting. Quit buddies were recommended in both groups, but intervention participants were encouraged to check-in with quit buddies on Mondays. The outcomes of smoking abstinence, number and length of quit attempts, and self-efficacy were assessed at the final program session and three months later.Results:At the last session, intervention group participants who were still smoking had a higher self-efficacy of quitting in the future, rated their programs as more helpful in quitting smoking, and were more likely to rate quit buddies as very helpful. Differences in self-efficacy were no longer observed at the second follow-up. No differences were observed between intervention and standard group participants in abstinence, number of quits, length of quits, or self-efficacy of staying quit at either follow-up.Conclusions:Encouraging results from this pilot study indicate that further research is needed to explore how Monday messaging may improve smoking cessation programs.

A Perioperative Smoking Cessation Intervention With Varenicline, Counseling, and Fax Referral to a Telephone Quitline Versus a Brief Intervention: A Randomized Controlled Trial

The effectiveness of perioperative interventions to quit smoking with varenicline has not been compared with brief interventions. Our objective was to determine the efficacy of a comprehensive smoking cessation program versus a brief intervention for smoking cessation. In this prospective, multicenter study, 296 patients were randomized to participate in a smoking cessation program (one 10- to 15-minute counseling session, pharmacotherapy with varenicline, an educational pamphlet, and a fax referral to a telephone quitline); or brief advice and self-referral to a telephone quitline. The primary outcome was the 7-day point prevalence (PP) abstinence at 12 months after surgery. Secondary outcomes included abstinence at 1, 3, and 6 months. Multivariable generalized linear regression was used to identify independent variables related to abstinence. The 7-day PP abstinence for the smoking cessation program versus brief advice group was 42.4% vs 26.2% (relative risk [RR], 1.62; 95% confidence interval [CI], 1.16-2.25; P = .003) at 12 months. The 7-day PP abstinence at 1, 3, and 6 months was higher in the smoking cessation group versus the brief advice group: 45.7% vs 25.5% (RR, 1.79; 95% CI, 1.29-2.49; P < .001), 46.4% vs 26.9% (RR, 1.72; 95% CI, 1.25-2.37; P< .001), and 45.0% vs 26.2% (RR, 1.72; 95% CI, 1.24-2.38; P < .001), respectively. Participating in the smoking cessation group predicted abstinence at 12 months (RR, 1.58; 95% CI, 1.12-2.21; P = .0087). A perioperative smoking cessation program with counseling, pharmacotherapy with varenicline, an educational pamphlet, and a fax referral to a quitline increased abstinence from smoking 1, 3, 6, and 12 months after surgery versus a brief intervention.

Sex-related differences in bronchial parameters and pulmonary function test results in patients with chronic obstructive pulmonary disease based on three-dimensional quantitative computed tomography.

ObjectiveThis study was performed to evaluate the effect of sex on bronchial parameters and the predicted forced expiratory volume in 1 s expressed as a percentage of the forced vital capacity (FEV1% pred) on pulmonary function testing.MethodsThe data of 359 patients with chronic obstructive pulmonary disease (COPD) with available FEV1% pred and computed tomography (CT) images were retrospectively reviewed. FACT-Digital lung TM software (DeXin, Xi’an, China) was used to perform fully automated three-dimensional CT quantitative measurements of the bronchi. Generation 5 to 7 bronchi were measured, and the parameters analyzed were the lumen diameter (LD), wall thickness (WT), lumen area (LA), and WA% [WA / (WA + LA) × 100%].ResultsIn the smoking, smoking cessation, and nonsmoking groups, women had a significantly larger WA% and smaller LD, WT, and LA than men. The FEV1% pred was significantly lower in women than men in the smoking and smoking cessation groups. The FEV1% pred was significantly higher in women than men in the nonsmoking group.ConclusionSex-related differences may partially explain why smoking women experience more severe pulmonary function impairment than men among patients with COPD.

Predictors of smoking cessation group treatment engagement among veterans with serious mental illness

High prevalence rates of tobacco use, particularly cigarettes, pose a serious health threat for individuals with serious mental illness (SMI), and research has demonstrated the effectiveness of pharmacotherapy and psychosocial interventions to reduce tobacco use in this group. However, few studies have considered predictors of tobacco cessation treatment engagement among individuals with SMI. The current study examined predictors of engagement in smoking cessation groups among veterans with SMI engaged in mental health services at three VA medical centers. All veterans were participating in a smoking cessation treatment study. Of 178 veterans who completed baseline assessments, 127 (83.6%) engaged in treatment, defined as attending at least three group sessions. Forty-one (N=41) predictors across five domains (demographics, psychiatric concerns, medical concerns, smoking history, and self-efficacy to quit smoking) were identified based on previous research and clinical expertise. Using backward elimination to determine a final multivariable logistic regression model, three predictors were found to be significantly related to treatment engagement: marital status (never-married individuals more likely to engage); previous engagement in group smoking cessation services; and greater severity of positive symptoms on the Brief Psychiatric Rating Scale. When included in the multivariable logistic regression model, the full model discriminates between engagers and non-engagers reasonably well (c statistic=0.73). Major considerations based on these findings are: individuals with SMI appear to be interested in smoking cessation services; and serious psychiatric symptomatology should not discourage treatment providers from encouraging engagement in smoking cessation services.

Smoking Cessation without Educational Instruction could Promote the Development of Metabolic Syndrome.

Aim: Smoking cessation is particularly important for maintaining health; however, the subsequent risk of an increased body weight is of major concern. The present study investigated the influence of smoking cessation on the incidence of metabolic syndrome and its components in the Japanese general population.Methods: This study enrolled individuals without metabolic syndrome or a history of smoking via our annual health checkup program (n = 5,702, 55.2 ± 11.5 years). Participants were divided into three groups mentioned below and followed up with the endpoint being the development of metabolic syndrome: (1) subjects who had never smoked and did not smoke during the observation period (non-smoker); (2) those who continued smoking during the observation period (continuous smoker); and (3) those who ceased smoking during the observation period (smoking cessation).Results: During the observation period (median 1,089 days), 520 subjects developed metabolic syndrome, and Kaplan–Meier analysis showed a higher incidence of metabolic syndrome in the smoking cessation group than in the other groups. Smoking cessation was confirmed as an independent predictor of the new onset of metabolic syndrome by multivariate Cox proportional hazard analysis after adjustment. Subjects only from the smoking cessation group showed a significant deterioration in metabolic factors during the study in correlation with an increased waist circumference after smoking cessation.Conclusions: Smoking cessation without instruction could be followed by the development of metabolic syndrome, and the incidence of metabolic syndrome might reduce the benefit obtained from smoking cessation. Therefore, further educational outreach is needed to prevent the progression of metabolic syndrome during the course of smoking cessation.

The Use of Self-Directed Relapse Prevention Booklets to Assist in Maintaining Abstinence After a 6-Week Group Smoking Cessation Treatment Program: A Randomized Controlled Trial.

Identifying effective relapse prevention interventions is a vital step to help smokers maintain abstinence for the long term. The purpose of this study is to determine if providing recently quit smokers with self-directed relapse prevention booklets is effective at maintaining abstinence after intensive group smoking cessation treatment. Two hundred and twenty-five participants were randomized to receive Forever Free (FF) relapse prevention booklets or a control booklet (Surgeon General's report, SG) at the end of a 6-week group treatment program. Participants were then contacted by phone to assess whether they had read the materials. Smoking status was assessed 6 months after their target quit date. Primary analyses focused on the 115 participants who quit at the end of treatment. There was no difference in the 6-month quit rate between groups (40.7% quit FF vs. 44.6% quit SG, p = .67). The FF group read a significantly smaller proportion of the materials versus the control booklet (20.0% read most or all of FF vs. 72.0% of SG, p < .001). Forever Free self-directed relapse prevention booklets did not reduce relapse or enhance cessation over general tobacco and health information when added to intensive group smoking cessation treatment. However, this study lacked power to detect a small but clinically meaningful positive effect.

First person: Jimmie Holland, MD

First person: Jimmie Holland, MD

Socioeconomic class in smoking cessation groups- who perseveres?

Socioeconomic class in smoking cessation groups- who perseveres?

Maintenance following smoking cessation groups: a comparison between Arab and Jewish ex-smokers

Maintenance following smoking cessation groups: a comparison between Arab and Jewish ex-smokers

Is this for real?! Smoking cessation groups for Muslim women in Baka-El-Gharbie

1. “We cannot stop smoking”: Female university students' experiences and perceptions Ahlam Al-Natour, Gordon Gillespie, Fatmeh Alzoubi Applied Nursing Research CrossRef

Effectiveness of a Culturally-Tailored Smoking Cessation Intervention for Arab-American Men.

To date, no smoking cessation programs are available for Arab American (ARA) men, who are a vulnerable population with high rates of smoking. Thus, the primary aim of this one group pre-test/post-test study was to assess the effectiveness of Sehatack—a culturally and linguistically tailored smoking cessation program for ARA men. The study sample was 79 ARA men with a mean age of 43 years who smoked between 5 and 40 cigarettes (mean = 19.75, SD = 9.1) per day (98.7%). All of the participants reported more interest in smoking cessation post-intervention and many of the participants in the baseline (38.5%) and post-intervention phases (47.7%) wanted to quit smoking ”very much”. For daily smokers who completed the smoking cessation program, the median number of cigarettes smoked daily was significantly lower than those in the post-intervention phase (Z = −6.915, p < 0.001). Results of this preliminary study indicate that: (a) Sehatack may be a promising way for ARA men to quit smoking, and (b) culturally relevant smoking cessation counselors can be trained to recruit and retain ARA smokers in an intensive group smoking cessation program. Strengths of this study were community engagement and rapport between three faith organizations and the University of Florida College of Nursing. However, a larger trial is needed to address study limitations and to confirm benefits in this population.

LGBTQ Youth and Young Adult Perspectives on a Culturally Tailored Group Smoking Cessation Program.

IntroductionThe prevalence of smoking among LGBTQ youth and young adults (YYAs) is much higher than that of non-LGBTQ young people. The current study explored LGBTQ YYA perceptions of a culturally tailored group smoking cessation counselling program, along with how the intervention could be improved.MethodsWe conducted focus groups (n = 24) with 204 LGBTQ YYAs in Toronto and Ottawa, Canada. Open-ended questions focused on their feelings, likes and dislikes, concerns and additional ideas for a culturally tailored group cessation counselling intervention. Focus group transcripts were coded thematically and analyzed.ResultsOverall, YYAs were ambivalent towards the concept of a culturally tailored, group cessation counselling program. Although several participants were attracted to the LGBTQ friendly and social benefits of such a program (eg, good support system), many also had concerns. Particularly, the possibility that other group members might trigger them to smoke was a frequently stated issue. Focus group members also noted lack of motivation to attend the group, and that the group program may be inaccessible depending on where and when the program was offered. Several suggestions were made as to how to ameliorate the expressed issues related to inaccessibility or lack of attractiveness.ConclusionsThis study is among the first to gain the perspectives of LGBTQ YYAs on culturally tailored group cessation strategies in Canada. We identified components of group cessation programs that are both favored and not favored among LGBTQ YYAs, as well as suggestions as to how to make group cessation programs more appealing.ImplicationsThis study is particularly relevant as smoking cessation programs are one of the most commonly offered and published cessation interventions for the LGBTQ community, yet little is understood in terms of preferences of LGBTQ YYA smokers. Given the disparity in the prevalence of smoking among LGBTQ young people compared to their non-LGBTQ peers, research on effective intervention strategies for this population is needed. Findings from this study can assist practitioners and researchers in designing interventions.

Analysis of Factors Associated with Smoking Relapse.

It is reported that 3 months of professional smoking cessation treatment achieves an initial smoking cessation rate of 80 %. However, a 1 year cessation rate decreases to approximately 50 %. The most common causes of relapse are weight gain, stress, and nicotine withdrawal symptoms. Relapse prevention is important in smoking cessation treatment. The aim of the present study was to investigate the differences between those who continued smoking cessation (group A) and those who resumed (group B) at 1 year after smoking cessation.

Do cigarette graphic warnings encourage smokers to attend a smoking cessation programme: a quasi-experimental study

ObjectiveThis study assessed whether exposure to cigarette graphic warning labels (GWLs) increased attendance to a smoking cessation programme.MethodFrom 2014 to 2016, alternating cohorts of smokers in 3 residential drug treatment...

People with mental illness can tackle tobacco.

To evaluate a smoking reduction and cessation intervention tailored for people with significant disability associated with mental illness. The intervention was a 10 week group programme, which tailored smoking cessation interventions to the needs of people living with mental illness. It was facilitated by mental health workers and peer workers and was promoted through mental health services, general practitioners and the Quitline phone service. Participants were people living with mental illness who had asked for help to quit or reduce their tobacco use. Participants were interviewed before starting the course, twice during the course and at 3, 6 and 12 months post course completion. Overall, 226 people expressed interest, 183 attended at least one session of the course and 105 attended at least 10 sessions. Of the 183 participants, 79.8% reported they did not smoke for at least 24 hours, with 30.6% stopping for at least 30 days. At the 12 month follow up 16.6% of participants reported they were not smoking. Of the 105 participants who attended at least 10 sessions of the course, 85.7% reported they did not smoke for at least 24 hours and 37.1% stopping for at least 30 days. At 12 month follow up 21.3% reported they were not smoking. Cigarettes smoked per day declined among those who did not quit, and was still significantly lower after 12 months. Motivation to try to quit was high among those still smoking at 12 months, with 83.9% wanting to try again to quit. This programme has shown many people with significant disability associated with mental illness are motivated to attend a smoking reduction and cessation group programme. A programme tailored to meet the specific needs of this group can be effective in helping many to quit or reduce their tobacco use.

The effect of financial incentives on top of behavioral support on quit rates in tobacco smoking employees: study protocol of a cluster-randomized trial.

BackgroundStimulating successful tobacco cessation among employees has multiple benefits. Employees who quit tobacco are healthier, more productive, less absent from work, and longer employable than employees who continue to use tobacco. Despite the evidence for these benefits of tobacco cessation, a successful method to stimulate employees to quit tobacco is lacking. The aim of this study is to evaluate whether adding a financial incentive to behavioral support (compared with no additional incentive) is effective and cost-effective in increasing abstinence rates in tobacco smoking employees participating in a smoking cessation group training.Methods/designIn this cluster-randomized trial employees in the intervention and control group both participate in a smoking cessation group training consisting of seven weekly counseling sessions of ninety minutes each. In addition to the training, employees in the intervention group receive a voucher as an incentive for being abstinent from smoking at the end of the training (€50), after three months (€50), after six months (€50), and after one year (€200). The control group does not receive any incentive. The primary outcome is carbon monoxide validated 12-month continuous abstinence from smoking (Russel’s standard). Additionally, an economic evaluation is performed from a societal and an employer perspective.DiscussionThe present paper describes the methods and design of this cluster-randomized trial in detail. We hypothesize that the financial incentive for abstinence in the form of vouchers increases abstinence rates over and above the group training. The results of this study can provide important recommendations for enhancement of employee tobacco cessation.Trial registrationDutch Trial Register: NTR5657. First received 27-01-2016.