Smoking Cessation Intervention For Adolescents Research Articles

Smoking cessation influencing factors and interventions in adolescents

Smoking can negatively influence the development of the respiratory and cardiovascular systems of adolescents and increase the risk for chronic diseases in adulthood. Promotion smoking cessation in adolescents is important for the protection of adolescent health and reduction of smoking rate in adults. Although many foreign studies have explored the influencing factors and interventions for smoking cessation in adolescents, limited relevant studies have been conducted in China, especially the study of smoking cessation intervention, which is still in its infancy, so the research and practice in this field need to be strengthened. This paper summarizes the factors associated with smoking cessation in adolescents both at home and abroad from the perspective of individual, family, school, and social surrounding, and introduce existing smoking cessation interventions for adolescents to provide references for future studies.

A Brief Digital Screening and Intervention Tool for Parental and Adolescent Tobacco and Electronic Cigarette Use in Pediatric Medical Care in Canada: Protocol for a Pilot Randomized Controlled Trial.

Though rates of tobacco smoking have decreased consistently over the past 3 decades, cigarette use remains the top preventable cause of premature death in North America. The Clinical Effort Against Secondhand Smoke Exposure (CEASE) is a medical clinic-based intervention that systematically screens parents for tobacco use and offers them direct access to evidence-based smoking cessation services. While the effectiveness of CEASE for parents who smoke has already been demonstrated in the United States, the CEASE model has not yet been tested in Canada, among parents who use e-cigarettes, or among adolescents who use cigarettes and e-cigarettes. We aim to demonstrate the feasibility and evaluate the preliminary effectiveness of the CEASE program for parental smoking cessation and its adapted version for adolescent smoking cessation and adolescent and parental vaping cessation. We will approach parents or guardians of children aged between 0 and 17 years, as well as adolescent patients aged between 14 and 17 years, from a tertiary care pediatric hospital in Montreal, Quebec, Canada, for participation in this single-blinded, pilot randomized controlled trial. Eligible participants are those who report using tobacco cigarettes or e-cigarettes at least once in the last 7 days and present to an outpatient pediatric clinic for a scheduled appointment. Our recruitment target is 100 participants: 50 parents or guardians of children aged 17 years or younger, and 50 adolescents aged between 14 and 17 years. The feasibility of implementation of the CEASE model will be measured by recruitment and retention rates for all 4 participant groups (stratified as follows: parents who use cigarettes, parents who use e-cigarettes exclusively, adolescents who use cigarettes, and adolescents who use e-cigarettes exclusively). Parent and adolescent participants within each group are randomized to the intervention and control groups using a 1:1 ratio through a computer-generated randomization list. Preliminary effectiveness outcomes include self-reported smoking and e-cigarette cessation, use of cessation resources, changes in smoking and e-cigarette use, motivation to quit, and quit attempts among participants. Participants complete electronic questionnaires on a tablet in the clinic at baseline as well as electronic follow-up questionnaires at 1, 3, and 6 months. Individuals reporting successful quit attempts are invited to provide a urine sample for cotinine testing to biochemically confirm quit. Analyses include descriptive statistics as well as exploratory trajectory analyses of smoking, e-cigarette use, and motivation to quit. Research activities began in June 2022. Participant enrollment and data collection began in February 2023 and are expected to be completed in 15 months. There is a strong need for effective and cost-effective smoking and vaping cessation interventions for parents and adolescents. If successful, this study will help inform the preparation of a fully powered randomized controlled trial of CEASE in Canada in these populations. Clinicaltrials.gov NCT05366790; https://www.clinicaltrials.gov/study/NCT05366790. DERR1-10.2196/47978.

ADHD symptoms and smoking outcomes in a randomized controlled trial of varenicline for adolescent and young adult tobacco cessation

BackgroundMost adult daily smokers try their first cigarette during adolescence. Attention-Deficit Hyperactivity Disorder (ADHD) in adolescents is associated with increased risk for cigarette smoking. The impact of ADHD symptoms on smoking cessation among adolescents has been less well-studied. The present secondary data analysis from a clinical trial of varenicline examined ADHD symptoms as a moderator of smoking cessation in adolescents and young adults. MethodsThe double-blind, placebo-controlled trial included treatment-seeking daily cigarette smokers ages 14 – 21 (N = 157) randomized to receive a 12-week course of varenicline or placebo, added to weekly smoking cessation counseling. At pre-treatment assessment, participants were administered a self-report measure of ADHD symptoms, the ADHD – Rating Scale (ADHD-RS). High (≥5) versus low (<5) and continuous ADHD-RS symptom counts in both hyperactive/impulsive (HI) and inattention (IA) domains were examined as predictors of smoking outcomes. ResultsParticipants with high IA symptoms at baseline were less likely to achieve 7-day point prevalence abstinence (PPA) at weekly visits (p = .001) during active treatment and end-of-treatment (p = .002) compared to those with low IA symptoms. In contrast, high HI symptoms did not predict differences in 7-day PPA or end-of-treatment abstinence versus low symptoms (p’s ≥ .07). These findings were not modified by varenicline versus placebo treatment assignment. ConclusionsADHD IA symptoms were associated with poorer cessation outcomes among adolescent smokers. These findings warrant additional investigation into how ADHD symptoms may be accounted for in smoking cessation interventions for adolescents and young adults.

Towards Healthy Adolescents: A Review of Smoking Impact According to Dental Perspectives

Nowadays, tobacco companies target to recruit new smokers among adolescents due to this age group was easy to be influenced by smoking behaviours. This narrative review aimed to explore the possible impact of smoking among adolescents. Knowing the negative impacts of smoking might result in avoiding continuing the habit or preventing from initiation of the habit. The literature search on PubMed, SCOPUS, and Epistemonikos database with related search terms of “adolescents”, “smoking” and “impact”. Only papers published within the year 2017 to 2021 and in the English language were included. However, articles without full text were excluded from this review. Fourteen articles were selected and divided impacts into three categories which are effect on oral health, effect on general health and other impacts. Possible impacts of smoking among adolescents were identified, and it could be beneficial in the development of customized smoking prevention or smoking cessation intervention for adolescents.

Smoking Cessation Interventions For Children and Adolescents

Smoking Cessation Interventions For Children and Adolescents

Behavioral interventions for smoking cessation among adolescents: a rapid review and meta-analysis for the Korea Preventive Services Task Force.

ObjectivesThe aim of this study was to evaluate the effectiveness of behavioral smoking cessation interventions among adolescents.Methods MEDLINE, CENTRAL, Embase, CINAHL, KoreaMed, and KMbase were searched from inception to June 2020. Systematic reviews (SRs) or meta-analyses of randomized controlled trials (RCTs) were initially searched to perform a rapid SR. After selecting the final SR, RCTs after the publication year of the selected SR were searched. The primary outcome was smoking status after at least 6 months of follow-up, and the secondary outcome was smoking status at 4 weeks. Two reviewers independently assessed the selected studies’ quality using the Cochrane risk of bias tool. The meta-analysis utilized a Mantel-Haenszel fixed-effect model reporting the relative risk (RR) and 95% confidence interval (CI). The subgroup analysis utilized Cochrane’s Q.Results Thirty-two RCTs (11,637 participants) from a single SR were meta-analyzed. After 6 months of follow-up, the intervention group had significantly higher abstinence rates (RR, 1.30; 95% CI, 1.20−1.41; I2=26.46%). At 4 weeks of follow-up, the intervention group also had significantly higher abstinence rates (RR, 1.92; 95% CI, 1.49–2.47; I2=0.00%). The subgroup analysis indicated a significant difference in the abstinence rate according to the study setting and the period between intervention completion and follow-up.Conclusion This review showed that adolescent behavioral smoking cessation intervention programs significantly increased abstinence rates compared to the usual care.

Empirische Arbeit: A non-randomized controlled effectiveness study of a smoking cessation intervention for adolescents

Despite a remarkable decrease of smoking prevalence among German teenagers over the last 20 years, a substantial number of adolescents report current cigarette use, especially youth with low socioeconomic status. This study investigated the effectiveness of a school-based psychosocial adolescent smoking cessation intervention under real-world conditions. Methods: The intervention consisted of six sessions of school-based group counseling, using motivational enhancement and cognitive-behavioral content, along with 4 weeks of follow-up care by text messaging and phone calls. A total of 47 smoking cessation classes were implemented in secondary schools all over Germany. The intervention group (IG) consisted of 272 currently smoking students nested in 41 schools, and the control group (CG) comprised 240 currently smoking students nested in 10 schools. Assignment to IG and CG was non-randomized. Logistic regression analyses (complete case, intention to treat, and full-information-maximum-likelihood) were conducted to test group differences in past 30-day smoking abstinence at 6-month follow-up. Baseline differences between IG and CG and intraclass correlation were accounted for in the analyses. Results: There were no differences in school characteristics between IG and CG schools at baseline. At 6-month follow-up, the IG had a significantly higher abstinence rate than the CG (Intent-to-treat analysis: 14% IG vs. 5% CG; adjusted odds ratio=2.73; 95% confidence interval: 1.19–6.27). Results were consistent for complete case and full-information-maximum-likelihood analyses. Conclusions: Results suggest that school-based psychosocial interventions can be feasible and effective for smoking cessation among adolescents in schools with a higher proportion of youth with low socioeconomic status.

How to implement a successful smoking cessation intervention for adolescents?

Abstract Background Policies and programs implemented to promote smoking cessation among youth present disparate results. These variations are explained by interventions themselves but also by context, population and implementation characteristics. Our objective was to analyze these factors, related to enrollment and participation in a smoking cessation program, implemented in vocational or technical schools. Methods Population factors were studied by a systematic review about determinants of smoking cessation among 10-24 years old, updating a previous one. Contextual and implementation factors were identified by a qualitative multiple cases study. A smoking cessation program, TABADO, had been implemented in 3 regions in France, in 10 vocational or technical schools (1 school/1 case). Data collection included 51 observations, 46 semi-structured interviews, and 3 interdisciplinary seminars. Results The review identified 46 factors probably or possibly related to a successful smoking cessation, both individual (e.g. smoking frequency) and collective (e.g. relationship smoking status, anti-tobacco legislation). The case study allowed us to objectify positive or negative factors that influence the enrollment and the participation in the program (e.g. presence of a referent in the school, combination with the school program). Finally, we identified prerequisites to gather before starting such a program. Conclusions This mixt design highlights factors on which we must focus to increase the success of a smoking cessation program for youth. A key factor is to tailor intervention and implementation modalities to the local context. Results enabled us to product a pragmatic guide, TABADO 2, which is now used in a national scaling process. They also will be used to build an intervention theory, which could be used for any smoking cessation intervention for youth. Acknowledgments: The TABADO IDF study group, Inca, the région Lorraine and the ARS Nouvelle-Aquitaine for their financial support. Key messages A smoking cessation program must be a global strategy, considering contextual, population and organizational factors. Instead of trying to strictly apply a protocol, a complex intervention must be tailored to the context in which it is implemented.

Prevalence and factors associated with secondhand smoke exposure among Malaysian adolescents.

INTRODUCTIONExposure to secondhand smoke (SHS) has been proven to be detrimental to health. However, there is little information on SHS exposure among Malaysian adolescents. This study aims to assess the magnitude of and factors associated with SHS exposure among school-going adolescents in Malaysia.METHODSWe performed secondary analysis on data from 25461 respondents of the Global School Health Survey in Malaysia. Descriptive analyses and multivariable logistic regression were performed to determine factors associated with SHS exposure.RESULTSRespondents were adolescents of mean age 14.84 (SD=1.45) years, 50.2% of which were male and 49.8% female. Approximately four in ten respondents were exposed to SHS in the past week (41.5%). SHS exposure was significantly higher among respondents who smoked than among non-smokers (85.8% vs 35.7%, p<0.001). The likelihood of exposure to SHS was higher among smoking adolescents (Adjusted OR=1.66, 95% CI: 1.07–2.56) and non-smoking adolescents (AOR=3.15, 95% CI: 1.48–4.71) who had at least one smoking parent/guardian regardless of their own smoking status. Male adolescents had higher risk of SHS exposure compared to their female counterparts (current smoker AOR=1.66, 95% CI: 1.07–2.56; non-smoker AOR=1.50, 95% CI: 1.12–2.00) and increased with age, regardless of their smoking status.CONCLUSIONSOur findings suggest that prevalence of exposure to SHS among school-going adolescents in Malaysia is high. Parents should be advised to stop smoking or abstain from smoking in the presence of their children. Education programmes are recommended to increase awareness on avoidance of SHS as well as smoking cessation interventions for both adolescents and their parents.

A Longitudinal Follow-up Study on Factors Associated With Smoking Relapse Among Adolescent Quitline Users in Korea

Background: Smoking among adolescent is one of the biggest alarming issues in tobacco control. Although smoking cessation interventions for adolescents have been implemented, 92% would be relapsed within one year. However, the information on factors associated with smoking relapse is insufficient among adolescents, although it looks necessary for understanding smoking behaviors of adolescents and applying more effective intervention program for them. Korea is one of the country having the highest adolescent smoking prevalence (9.6% in boys and 2.7% in girls aged 19 years or less) and in lack of information on smoking behaviors and factors associated with relapse or successful quit. Telephone-based cessation service (hereafter Quitline) has been available since 2006 regarding the confidentiality and accessibility of adolescent smokers and it has followed-up abstinence of users with intensive counseling for 1 year. Therefore, analysis on the adolescent smokers who used Quitline might be meaningful to understand adolescents' cessation behaviors and factors associated with. Aim: To identify the factors associated with smoking relapse among adolescent Quitline users in Korea. Methods: 2141 (1370 boys and 394 girls) adolescent smokers who registered at Quitline in Korea from January 2007 to December 2017 and attempted quit were included in the current study. The baseline information on sociodemographic characteristics, smoking and other health behaviors, nicotine dependency, and motivational factors for quit were collected. Cessation outcome and reason of relapse were identified during the 1 year follow-up of each individual. Multivariate logistic regression was performed to identify associated factors of smoking relapse. Results: The analysis on the data are undergoing and the result would be suggested in the conference with the further analysis. Conclusion: It will be suggested in the conference.

Engagement Within a Mobile Phone-Based Smoking Cessation Intervention for Adolescents and its Association With Participant Characteristics and Outcomes.

BackgroundAlthough mobile phone–delivered smoking cessation programs are a promising way to promote smoking cessation among adolescents, little is known about how adolescents might actually use them.ObjectiveThe aim of this study was to determine adolescents’ trajectories of engagement with a mobile phone–delivered smoking cessation program over time and the associations these trajectories have with baseline characteristics and treatment outcomes.MethodsWe performed secondary data analysis on a dataset from a study that compared a mobile phone–delivered integrated smoking cessation and alcohol intervention with a smoking cessation only intervention for adolescents recruited in vocational and upper secondary school classes (N=1418). Throughout the 3-month intervention, participants in both intervention groups received one text message prompt per week that either assessed smoking-related target behaviors or encouraged participation in a quiz or a message contest. Sequence analyses were performed to identify engagement trajectories. Analyses were conducted to identify predictors of engagement trajectory and associations between engagement trajectories and treatment outcomes.ResultsThree engagement trajectories emerged: (1) stable engagement (646/1418, 45.56%), (2) decreasing engagement (501/1418, 35.33%), and (3) stable nonengagement (271/1418, 19.11%). Adolescents who were younger, had no immigrant background, perceived more benefits of quitting smoking, and reported binge drinking preceding the baseline assessment were more likely to exhibit stable engagement. Due to different reach of more engaged and less engaged participants at follow-up, three statistical models (complete-cases, last-observation-carried-forward, and multiple imputation) for the associations of engagement trajectory and smoking outcome were tested. For 7-point smoking abstinence, no association was revealed to be statistically significant over all three models. However, decreasing engagement with the program was associated over all three models, with greater reductions in daily tobacco use than nonengagement.ConclusionsThe majority of tobacco-smoking adolescents engaged extensively with a mobile phone–based smoking cessation program. However, not only stable engagement but also decreasing engagement with a program might be an indicator of behavioral change. Measures to avoid nonengagement among adolescents appear especially necessary for older smokers with an immigrant background who do not drink excessively. In addition, future studies should not only examine the use of specific program components but also users’ engagement trajectories to better understand the mechanisms behind behavioral change.

Time-varying effects of a text-based smoking cessation intervention for urban adolescents

IntroductionCraving to smoke is understood as an important mechanism for continued smoking behavior. Identifying how smoking interventions operate on craving with particular populations is critical for advancing intervention science. This study's objective was to investigate the time-varying effect of a text-delivered smoking cessation intervention. MethodsToward this end, we used ecological momentary assessment (EMA) data collected from a five-day, automated text-messaging smoking cessation randomized clinical trial with 200 urban adolescents. We employed a time-varying effect model (TVEM) to estimate the effects of stress (time-varying covariate) and baseline nicotine dependence level (time-invariant covariate) on craving over six months by treatment condition. The TVEM approach models behavioral change and associations of coefficients expressed dynamically and graphically represented as smooth functions of time. ResultsControlling for gender, age, and current smoking, differences in trajectories of craving between intervention and control conditions were apparent over the course of the study. During months 2 to 3, the association between stress and craving was significantly stronger among the control group, suggesting treatment dampens this association during this time period. The intervention also reduced the salience of baseline dependence among treatment adolescents, with craving being reduced steadily over time, while the control group increased craving over time. ConclusionsThese results provide insight into the time-varying nature of treatment effects for adolescents receiving a text-based smoking cessation intervention. The ability to specify when in the course of an intervention the effect is strongest is important in developing targeted and adaptive interventions that can adjust strategically with time.

Update of Adolescent Smoking Cessation Interventions: 2009-2014.

The treatment of adolescent tobacco dependence is an imperative public health goal. Adolescent-focused smoking cessation interventions have shown modest results at most, indicating the need for the development of innovative and effective interventions for this vulnerable population. This review aims to provide an update of smoking cessation interventions for youth by reviewing the literature published between 2009 and November 2014 evaluating psychosocial and pharmacological interventions. Based on this examination, future directions for research in advancing the development of adolescent-focused tobacco treatments are provided.

Cognitive bias modification combined with cognitive behavioral therapy: A smoking cessation intervention for adolescents

Aims: To describe deaths in prison in a cohort of opioiddependent people, and examine associations between receipt of opioid substitution therapy (OST) and risk of death while in prison. Methods: We linked state-wide OST data to incarceration and mortality data. We calculated crude mortality rates (CMR) for allcause and unnatural (suicide, drug-induced, violent and injury) deaths in prison, and used Cox regression to assess adjusted associations between death and receipt of OST. Rates and hazard ratios were calculated for the entirety of time in prison, and for the first four weeks in prison. Results: The cohort comprised 16,715 opioid-dependent people who had been incarcerated. Fifty-one people died in prison. Compared to periods of time in OST, all-cause and unnatural mortality rateswere significantly higherwhile not in OST (all-cause rate ratio (RR): 4.1; 95% confidence interval (CI): 2.1, 8.0; unnatural death RR: 6.7; 95% CI: 2.6, 17.3). Compared to time out of OST, the hazard of all-cause deathwas 74% lowerwhile in OST (adjusted hazard ratio (AHR): 0.26; 95% CI: 0.13, 0.50), and the hazard of unnatural death was 87% lower while in OST (AHR: 0.13; 95% CI: 0.05, 0.35). In the first fourweeks of incarceration, compared to periods in OST, all-cause mortality was 16.6 (95% CI: 2.2, 124.9) times higher, and unnaturalmortalitywas14.0 (95%CI: 1.8, 107.9) timeshigherwhen not in OST. Compared to periods not in OST, the hazard of all-cause death during the first 4weeks of incarcerationwas 94% lowerwhile in OST (AHR: 0.06; 95% CI: 0.01, 0.48), and the hazard of unnatural death was 93% lower while in OST (AHR: 0.07; 95% CI: 0.01, 0.53). Conclusions: Ensuring a high coverage of OST in correctional facilities will help to minimize deaths, particularly unnatural deaths, among opioid-dependent prisoners. Timely access to OST while incarcerated is critical to realizing this benefit. Financial Support:NationalHealthandMedicalResearchCouncil.

The role of participants’ self-selected future smoking goals in adolescent smoking cessation interventions

BackgroundThere is an implicit assumption that abstinence is the treatment goal of young smokers that deliberately participate in cessation interventions, but this may not always be the case. To gain information on subgroups of adolescent intervention participants, we compare participants who want to achieve smoking abstinence (Abst) with those stating a non-abstinence future smoking goal (NAbst), with regard to baseline characteristics, reasons for participation, quit motivation, retention, goal attainment, and smoking abstinence. MethodsThe sample consisted of 202 adolescent smokers (49.5% female). At baseline, 118 (58.4%) indicated abstinence as future smoking goal and 84 (41.6%) indicated non-abstinence. All participants received a behavioral smoking cessation intervention. Assessments took place before, during, and after treatment, and at 6-month follow-up. Regression analyses were conducted. ResultsAbst and NAbst participants reported similar baseline characteristics. Abst participants, however, were more likely to report a previous quit attempt and indicated a higher quit motivation before and during treatment. Abst participants were more likely to participate based on own initiative and NAbst participants because of participating friends. Both groups attended a similar number of intervention sessions and were equally likely to attain their self-selected smoking goal. However, more Abst participants reported a successful quit attempt during treatment and abstinence at post-treatment and follow-up. ConclusionsNAbst participants may represent a substantial subgroup in smoking cessation interventions for adolescents. Results indicate that future smoking goals can influence treatment outcomes. NAbst participants in treatment may benefit from additional information on the negative health consequences of light smoking.

Predictors of adolescent smoking cessation and smoking reduction

ObjectiveTo investigate the processes of change, demographic, health- and smoking-related predictors of both smoking cessation and smoking reduction in adolescents. MethodsData were drawn from a sample of 755 adolescent smokers who participated in a study testing the efficacy of a text messaging-based intervention for smoking cessation. Demographic, health- and smoking-related variables were assessed at baseline. Five processes of smoking cessation, derived from the Transtheoretical Model and the Social Cognitive Theory, as well as outcome measures were assessed at 6-month follow up. Univariate and multivariate regression analyses were conducted to identify baseline and process variables to predict smoking abstinence and smoking reduction. ResultsMale gender (OR=0.43, p<.01), lower alcohol consumption (OR=0.90, p=.05) and a lower number of cigarettes smoked per day at baseline (OR=0.87, p<.01) predicted smoking abstinence. Baseline physical activity predicted smoking reduction (OR=1.04, p=.03). None of the examined process variables significantly predicted smoking abstinence. The process variable “counter-conditioning” predicted smoking reduction (OR=1.46, p=.03). ConclusionsBaseline predictors of smoking cessation differ from predictors of smoking reduction. Dynamic or modifiable variables play an important role in predicting adolescent smoking cessation. Practice implicationsCounter-conditioning might be an important element in adolescent smoking cessation interventions.

In the heat of the moment: Alcohol consumption and smoking lapse and relapse among adolescents who have quit smoking

BackgroundThe present study tested the co-occurrence of alcohol use and the first lapse and relapse into smoking among daily smoking adolescents who quit smoking. MethodsIn this ecological momentary assessment study, participants completed web-based questionnaires three times a day during one week prior to and three weeks after a quit attempt in their own natural environments. Participants were 134 daily smoking adolescents in the aged 15–19. Hierarchical linear modeling was applied to test whether alcohol use was related to the first lapse and relapse. Lapse was defined as the first incidence of smoking after achieving 24-h abstinence, relapse was defined as smoking at least five cigarettes on three consecutive days. ResultsThe first lapse was strongly associated with alcohol use. Individual characteristics (age, sex, and baseline smoking status) did not predict the first lapse nor did they moderate the association between alcohol use and the first lapse. Progression from lapse to relapse did not seem to be associated with alcohol consumption, although this association appeared to be moderated by baseline smoking status. More specifically, alcohol use only posed a significant risk factor for relapse among those who smoked less frequently before the start of the study than others who relapsed. Intermittent smoking between the first lapse and relapse (or end of data) was strongly associated with alcohol use. ConclusionsAdolescent drinking during smoking cessation seems to be associated with the first lapse into smoking after quitting and subsequent intermittent smoking and should be targeted in adolescent smoking cessation interventions.

Smoking and Co-occurring Disorders: Implications for Smoking Cessation Interventions for Adolescents in Residential Addiction Treatment

Objective: Co-occurring disorders are important to consider in planning smoking cessation interventions with adolescents. We identify factors associated with smoking and predictors for smoking cessation readiness in a group of adolescents in a residential addiction treatment program. Methods: We conducted a chart review study of 400 clinical records of adolescents aged 13 to 18 at a short-term residential addiction treatment program. We examined the relationships of smoking with use of other drugs, psychiatric disorders, and adverse events. Results: The rate of smoking in the total sample was 79%. Smoking onset was positively associated with the onset of alcohol and other drugs of abuse but followed the onset of cannabis use for over half the sample. Heavy smoking, defined as smoking 10 cigarettes per day on average, was correlated with cocaine and opiate addiction. Over half of the sample (56%) was precontemplative about smoking cessation, whereas 30% were in the contemplative stage (ready to stop in 6 months); 12% were in preparation stage (ready to stop in 30 days); and 2% reported that they already had stopped. Heavy smoking was associated with being precontemplative as was earlier onset of drinking relative to smoking and bipolar diagnosis. Conclusions: Smoking is common in adolescents seeking drug and alcohol treatment and is correlated with the onset and progression of other drug use. Increasing motivation for change and addressing the interface of nicotine, other drugs, and mental health are important for smoking cessation interventions for adolescents in residential addiction treatment settings.

A cluster randomised controlled trial of an adolescent smoking cessation intervention: Short and long-term effects

There is a lack of effective smoking cessation interventions which have a high reach among adolescent smokers. We conducted a randomised controlled trial of an adolescent smoking cessation intervention for students aged 15-21 at 22 continuation schools in Denmark. The intervention was a minimal intervention based on events with short counselling and a range of self-help materials. Our 1-month follow up consisted of 514 baseline daily smokers and the 14-month follow up of 369 daily smokers. We found positive short-term effects regarding smoking cessation (adjusted OR 4.50, 95% CI 1.20-16.86), self-efficacy (p=0.01), and intentions to quit (p=0.004). However, none of these effects were maintained at 1-year follow up. The intervention was successful in reaching more than half of all daily smokers in the target group with more than 30% receiving counselling at least once in the intervention period. This trial shows that a "minimal" intervention can produce short-term effects but that this approach is insufficient in producing long-term effects.

Efficacy of a text messaging (SMS) based smoking cessation intervention for adolescents and young adults: Study protocol of a cluster randomised controlled trial

BackgroundParticularly in groups of adolescents with lower educational level the smoking prevalence is still high and constitutes a serious public health problem. There is limited evidence of effective smoking cessation interventions in this group. Individualised text messaging (SMS) based interventions are promising to support smoking cessation and could be provided to adolescents irrespective of their motivation to quit. The aim of the current paper is to outline the study protocol of a trial testing the efficacy of an SMS based intervention for smoking cessation in apprentices.Methods/DesignA two-arm cluster-randomised controlled trial will be conducted to test the efficacy of an SMS intervention for smoking cessation in adolescents and young adults compared to an assessment only control group. A total of 910 daily or occasional (≥ 4 cigarettes in the preceding month and ≥ 1 cigarette in the preceding week) smoking apprentices will be proactively recruited in vocational school classes and, using school class as a randomisation unit, randomly assigned to an intervention group (n = 455) receiving the SMS based intervention or an assessment only control group (n = 455). Individualised text messages taking into account demographic data and the individuals' smoking behaviours will be sent to the participants of the intervention group over a period of 3 months. Participants will receive two text messages promoting smoking cessation per week. Program participants who intend to quit smoking have the opportunity to use a more intensive SMS program to prepare for their quit day and to prevent a subsequent relapse. The primary outcome measure will be the proportion of participants with 7-day point prevalence smoking abstinence assessed at 6-months follow-up. The research assistants conducting the baseline and the follow-up assessments will be blinded regarding group assignment.DiscussionIt is expected that the program offers an effective and inexpensive way to promote smoking cessation among adolescents and young adults including those with lower educational level and independent of their motivation to quit.Trial registration numberISRCTN: ISRCTN19739792