Smoking Cessation Literature Research Articles

The measure of stage of readiness to change: Some psychometric considerations.

Previous research in the smoking cessation literature has shown that the key component of the transtheoretical model of change, the stage of readiness to change, is a valid independent measure (C. C. DiClemente & J. O. Prochaska, 1985; C. C. DiClemente et al., 1991; W. F. Velicer, J. S. Rossi, J. O. Prochaska, & C. C. DiClemente, 1996). Recently, however, other health service researchers (e.g., A. J. Farkas et al., 1996b) have begun to question the utility of this model; especially its predictive validity (e.g., A. J. Farkas et al., 1996a). However, no research to date has examined the reliability and stability of the stage of readiness to change measure. In this study, the longitudinal measurement of stage of readiness to change was treated as a quasi-simplex model (K. G. Joreskog, 1970). Estimates of the stability and reliability for 261 female smokers in a general community sample were obtained. Results indicate that the stage of change measure has desirable psychometric properties.

Will the nicotine patch really stick?

The recent study on the effectiveness of a 16-hour transdermal nicotine patch in a medical practice setting, without intensive group counseling, 1 serves to illustrate some issues about nicotine patch research that have been bothering me since I recently reviewed the smoking cessation literature. 2 Although this study is well designed and appears well executed, there are some subtle problems that cast doubt on the conclusion that the patch was superior to placebo at all follow-up assessment points. After 12 weeks of treatment, 26% of the placebo group was abstinent compared with 45% of the active patch group. However, cigarette abstinence during the nicotine patch administration is not equivalent to cigarette abstinence during placebo treatment. To consider them equivalent would be analogous to considering alcoholics abstinent if they were receiving intravenous alcohol, as long as they were not drinking. One could argue that the placebo patch group was much better

Will the Nicotine Patch Really Stick?

The recent study on the effectiveness of a 16-hour transdermal nicotine patch in a medical practice setting, without intensive group counseling, 1 serves to illustrate some issues about nicotine patch research that have been bothering me since I recently reviewed the smoking cessation literature. 2 Although this study is well designed and appears well executed, there are some subtle problems that cast doubt on the conclusion that the patch was superior to placebo at all follow-up assessment points. After 12 weeks of treatment, 26% of the placebo group was abstinent compared with 45% of the active patch group. However, cigarette abstinence during the nicotine patch administration is not equivalent to cigarette abstinence during placebo treatment. To consider them equivalent would be analogous to considering alcoholics abstinent if they were receiving intravenous alcohol, as long as they were not drinking. One could argue that the placebo patch group was much better

Counseling Medical Patients about Cigarette Smoking: A Comparison of the Impact of Training on Nurse Practitioners and Physicians

Health providers believe that eliminating smoking is an important health promotion goal, but physicians and nurse practitioners may differ in the implementation of that belief. To determine whether nurse practitioners or physicians were more likely to counsel smokers to quit smoking, 12 internal medicine nurse practitioners (100 percent female) and 40 internal medicine physicians (30 percent female) were studied at four San Francisco Bay-area Kaiser Permanente Medical Centers, both before and after training in smoking-cessation counseling. In addition, exit phone surveys of at least 15 smokers per participant were completed as soon as possible following an office visit to the participant (269 nurse practitioner patients; 948 physician patients). It was found that nurse practitioners discussed smoking with patients more often than did physicians (64 percent vs. 50 percent; p less than 0.001), asked patients more often whether they were interested in quitting (49 percent vs. 40 percent; p less than 0.01), distributed more smoking-cessation literature to patients (37 percent vs. 25 percent; p less than 0.001) and made more follow-up appointments about smoking (36 percent vs. 19 percent; p less than 0.001). These differences in counseling behavior between the two groups were not explained by differences in patient characteristics of the two groups. The authors concluded that, given the same training, nurse practitioners are more likely to counsel smokers about quitting than are physicians.

Worksite smoking modification programs: A state-of-the-art review and directions for future research

This article reviews the worksite smoking cessation literature. The evidence linking smoking and disease is outlined and reasons to quit smoking are presented. An overview of barriers to quitting smoking, or reasons why people continue to smoke, is also briefly presented. Worksite programs that have been evaluated to date are reviewed and summarized under the categories of self-help/bibliotherapy, multicomponent behavioral group approaches, physician advice, and competition/incentive programs. Methodological issues involved in conducting and evaluating worksite smoking modification programs are discussed in detail. It is concluded that worksite smoking cessation programs hold great promise for attracting and successfully treating smokers who otherwise might not seek treatment, but that there are several threats to successful program implementation and evaluation that need to be considered.