Motivation For Smoking Cessation Research Articles

Impact of Nicotine Replacement Therapy Sampling on Cessation-Related Processes.

Smoking prevalence remains high among low-income smokers. Understanding processes (eg, withdrawal, craving, motivation) in early smoking cessation is crucially important for designing effective interventions for this population. This is a secondary analysis of a novel, in-session sampling intervention (ie, In Vivo) as compared with standard care behavioral smoking cessation counseling (SC) among community-dwelling low-income smokers (n = 83). This analysis examined the effect of 5 in-session sampling interventions on cessation-related processes and perceived advantages or disadvantages of nicotine replacement therapy (NRT) products over time using daily diaries. The In Vivo treatment had an early positive impact in terms of decreasing withdrawal symptoms and cravings, and increasing perceived advantages to NRT, with moderate to large effect sizes. Results also showed that the treatment effectively reduced withdrawal symptoms and cravings in-session, with small-to-medium and medium-to-large effect sizes, respectively. In-session reduction of withdrawal symptoms and cravings did not occur for the SC group, with the exception of decreased withdrawal symptoms occurring during week 4. The In Vivo treatment did not impact quit goal, desire to quit, abstinence self-efficacy, perceived difficulty in quitting, motivational engagement, or perceived disadvantages to NRT. The In Vivo group reported less daily cigarette use relative to the SC group, in addition to reporting less cigarette use on days they reported greater combination NRT use. There is preliminary support for this In Vivo treatment over SC in reducing withdrawal, craving, and the number of cigarettes smoked per day, as well as promoting perceived advantages of NRT among low-income smokers.

How far does feedback on oral malodor assessment influence the decision to quit smoking?

A retrospective, uncontrolled, questionnaire-based, pre-post study involving adult male smoker volunteers who were invited to attend a one-day smoking cessation event at their workplace. To assess the effect of feedback on motivation for smoking cessation using oral-malodor measurements. At baseline, the participants attended a brief video presentation regarding various oral health-specific effects of smoking, joined a group introduction to smoking-cessation aids, and were given questionnaires that inquired information about smoking status including type, daily consumption, and duration. Subsequently, respiratory function and oral-malodor assessment were conducted using exhaled and oral cavity air, respectively. To measure oral-malodor, hydrogen sulfide, methyl mercaptan, and dimethyl sulfide concentrations were determined. Participants' intention for smoking cessation was evaluated through questionnaire before and after the event, classifying their intentions as aiming to quit within the next month, within the next 6 months, or having no intention to quit smoking. Immediate feedback on respiratory function and oral malodor measurements was provided by medical and dental blinded examiners, respectively. A total of 241 men, aged 20-54 years, were enrolled and included:169 (70.1%) exclusive cigarette smokers, 39 (16.2%) exclusive heated-tobacco product users, and 33 (13.7%) users of both. Prior to the health event, 8.7%, 17.0%, and 74.3% of smokers expressed intentions to quit within the next month, the next 6 months, or had no intention to quit, respectively. After the event, the corresponding percentages shifted to 17.8%, 26.6%, and 55.6%. In multivariable logistic regression analysis, the association with intention to quit in the next month was significant only for methyl mercaptan concentration in oral cavity air, with an adjusted odds ratio (AOR) of 4.24 (95% CI: 1.52-11.84; p = 0.006). Sensitivity analysis revealed that this association was concentration-dependent. On the other hand, higher daily tobacco consumption (≥ 15 pieces) was significantly associated with less likely intention to quit in the next 6 months (AOR = 0.37; 95% CI: 0.15-0.92, p = 0.032). Feedback on oral malodor measurement may support the motivation of men to quit smoking within the next month, rather than waiting for the next 6 months.

Concurrent E-cigarette Use While Enrolled in a Smoking Cessation Program: Associations between Frequency of use, Motives for Use and Smoking Cessation.

Trial evidence suggest that e-cigarettes may aid in quitting smoking, while observational studies have found conflicting results. However, many observational studies have not adjusted for important differences between e-cigarette users and non-users. We aimed to determine the association between e-cigarette use frequency and motivation to use e-cigarettes to quit smoking, and smoking cessation using data from Canada's largest smoking cessation program. Participants who completed a baseline assessment and 6-month follow-up questionnaire were divided post hoc into 4 groups based on their self-reported e-cigarette use during the 30 days before baseline: 1) non-users; 2) users of e-cigarettes not containing nicotine; 3) occasional users; and 4) frequent users. Occasional and frequent users were further divided into two groups based on whether they reported using e-cigarettes to quit smoking. Abstinence at 6-month follow-up (7-day point prevalence abstinence) was compared among groups. Adjusted quit probabilities were significantly higher (both p<0.001) for frequent baseline e-cigarette users (31.6%; 95% CI = 29.3%, 33.8%) than for non-users (25.8%; 25.3%, 26.3%) or occasional users (24.2%; 22.5%, 26.0%). Unadjusted proportions favoured non-users over occasional users (p<0.001), but this was not significant after adjustment (p=0.06). People using e-cigarettes to quit smoking were not likelier than other users to be successful, but were likelier to report frequent e-cigarette use during follow-up. Frequent baseline e-cigarette use predicted successful smoking cessation, compared to occasional and non-users. Use of e-cigarettes to quit did not predict smoking cessation, but was associated with continued use during follow-up, perhaps due in part to planned transitions to e-cigarettes. Prior observational studies investigating e-cigarettes use for smoking cessation have found that occasional users have poorer outcomes than either frequent or non-users. Consistent with these studies, occasional users in our data also had poorer outcomes. However, after adjustment for variables associated with cessation success we found that cessation probabilities did not differ between occasional and non-users. These findings are consistent with trial data showing a benefit of e-cigarette use among people trying to quit smoking. Results of this study suggest that differences between trials and previous observational studies may be due to unaddressed confounding in the latter.

Exploring the Incentive Function of Virtual Academic Degrees in a Chinese Online Smoking Cessation Community: Qualitative Content Analysis

Background Previous studies on online smoking cessation communities (OSCCs) have shown how such networks contribute to members’ health outcomes from behavior influence and social support perspectives. However, these studies rarely considered the incentive function of OSCCs. One of the ways OSCCs motivate smoking cessation behaviors is through digital incentives. Objective This study aims to explore the incentive function of a novel digital incentive in a Chinese OSCC—the awarding of academic degrees—to promote smoking cessation. It specifically focuses on “Smoking Cessation Bar,” an OSCC in the popular web-based Chinese forum Baidu Tieba. Methods We collected discussions about the virtual academic degrees (N= 1193) from 540 members of the “Smoking Cessation Bar.” The time frame of the data set was from November 15, 2012, to November 3, 2021. Drawing upon motivational affordances theory, 2 coders qualitatively coded the data. Results We identified five key topics of discussion, including members’ (1) intention to get virtual academic degrees (n=38, 2.47%), (2) action to apply for the degrees (n=312, 20.27%), (3) feedback on the accomplishment of goals (n=203, 13.19%), (4) interpersonal interaction (n=794, 51.59%), and (5) expression of personal feelings (n=192, 12.48%). Most notably, the results identified underlying social and psychological motivations behind using the forum to discuss obtaining academic degrees for smoking cessation. Specifically, members were found to engage in sharing behavior (n=423, 27.49%) over other forms of interaction such as providing recommendations or encouragement. Moreover, expressions of personal feelings about achieving degrees were generally positive. It was possible that members hid their negative feelings (such as doubt, carelessness, and dislike) in the discussion. Conclusions The virtual academic degrees in the OSCC created opportunities for self-presentation for participants. They also improved their self-efficacy to persist in smoking cessation by providing progressive challenges. They served as social bonds connecting different community members, triggering interpersonal interactions, and inducing positive feelings. They also helped realize members’ desire to influence or to be influenced by others. Similar nonfinancial rewards could be adopted in various smoking cessation projects to enhance participation and sustainability.

Clinical indicators of gingival inflammation in smokers with periodontitis

Relevance. According to the latest international classification of periodontal diseases of 2018, smoking, along with diabetes mellitus, belongs to the main modifying factors of the periodontitis course. At the same time, the clinical signs of gingival inflammation in smokers are not very pronounced.The study aimed to determine significant clinical indicators of gingival inflammation in tobacco-dependent peri- odontal patients.Materials and methods. The study interviewed and examined 82 patients with generalized periodontitis aged 20 to 63 years. Patients with diabetes mellitus were excluded. The examination evaluated the caries prevalence (DMFT index), the degree of periodontal attachment loss, the periodontitis progression type by an indirect indicator, oral hygiene status (Green-Vermilion index), tooth mobility (D.A. Entin), bleeding on probing (Mühlemann modified by Cowell; Ainamo, Wow). Based on their attitude to smoking, patients were randomized into three groups: the first group consisted of 18 patients who smoked up to 10 cigarettes per day; the second group included 15 patients who smoked 10-20 or more cigarettes per day; and the third group (comparison group) consisted of 18 non-smokers.Results. The oral hygiene status, caries prevalence, the number of extracted teeth, the mobility of remaining teeth and the bleeding on probing score appeared to be the same in non-smoking and smoking periodontal patients. However, the number of patients with severe periodontitis was statistically significantly higher in heavy smokers with periodontitis (more than ten cigarettes per day); every other patient had comorbidity, rapid progression of the disease, and the clinical indicator of gingival inflammation based on the prevalence of bleeding on probing was at 100%.Conclusion. We believe that the prevalence of bleeding on probing should be the main parameter for gingival inflammation assessment in smokers, which allows for the objective follow-up of the process progression in such patients and motivation for treatment and smoking cessation.

Motivation, acceptability and attitudes toward lung cancer screening among persons who attend a tobacco cessation program: A multicenter survey in Italy

This study aimed to evaluate smoking cessation (SC) motivation and the acceptability of a lung cancer screening (LCS) program with low-dose computed tomography (LDCT) among people who attend SC programs. A multicenter survey was conducted in the period January-December 2021 involving 197 people who attended group or individual SC courses in Reggio Emilia and Tuscany. Questionnaires, information sheets, and decision aids about the potential benefits and harms of LCS with LDCT were distributed at different time points during the course. The wish to protect own health (66%) was the most frequent reason given for quitting smoking, followed by cigarette dependence (40.6%) and current health problems (30.5%). Half of the participants (56%) considered periodic health checks including LDCT, as an advantageous activity. The great majority of participants were in favor of LCS (92%), with only 8% being indifferent, and no one was against these programs. Interestingly, those with sufficiently high smoking-related LC risk to be eligible for LCS and those attending the individual course were less in favor of LCS but also less concerned about the possible harms associated with LCS. The type of counseling was a significant predictor for both LCS acceptability and perceived harm of LCS. The favorable perception of LCS in people attending SC courses, despite the considerable preoccupation with potential harms, is an important finding of this study. Introducing a discussion on the benefits and harms of LCS in SC programs may prepare persons who smoke to make informed decisions on utilizing LCS.

A Financial Incentives Program to Promote Smoking Cessation Among Recently Hospitalized Individuals: Feasibility and Acceptability Study

Hospitalization is an opportunity to engage underserved individuals in tobacco treatment who may not otherwise have access to it. Tobacco treatment interventions that begin during hospitalization and continue for at least 1 postdischarge month are effective in promoting smoking cessation. However, there is low usage of postdischarge tobacco treatment services. Financial incentives for smoking cessation are an intervention in which participants receive incentives, such as cash payments or vouchers for goods, to encourage individuals to stop smoking or to reward individuals for maintaining abstinence. We sought to determine the feasibility and acceptability of a novel postdischarge financial incentive intervention that uses a smartphone application paired to measurements of exhaled carbon monoxide (CO) concentration levels to promote smoking cessation in individuals who smoke cigarettes. We collaborated with Vincere Health, Inc. to tailor their mobile application that uses facial recognition features, a portable breath test CO monitor, and smartphone technology to deliver financial incentives to a participant's digital wallet after the completion of each CO test. The program includes 3 racks. Track 1: Noncontingent incentives for conducting CO tests. Track 2: Combination of noncontingent and contingent incentives for CO levels <10 parts per million (ppm). Track 3: Contingent incentives only for CO levels <10 ppm. After obtaining informed consent, we pilot-tested the program from September to November 2020 with a convenience sample of 33 hospitalized individuals at Boston Medical Center, a large safety-net hospital in New England. Participants received text reminders to conduct CO tests twice daily for 30 days postdischarge. We collected data on engagement, CO levels, and incentives earned. We measured feasibility and acceptability quantitatively and qualitatively at 2 and 4 weeks. Seventy-six percent (25/33) completed the program and 61% (20/33) conducted at least 1 breath test each week. Seven patients had consecutive CO levels <10 ppm during the last 7 days of the program. Engagement with the financial incentive intervention as well as in-treatment abstinence was highest in Track 3 that delivered financial incentives contingent on CO levels <10 ppm. Participants reported high program satisfaction and that the intervention helped motivate smoking cessation. Participants suggested increasing program duration to at least 3 months and adding supplemental text messaging to increase motivation to stop smoking. Financial incentives paired to measurements of exhaled CO concentration levels is a novel smartphone-based tobacco cessation approach that is feasible and acceptable. Future studies should examine the efficacy of the intervention after it is refined to add a counseling or text-messaging component.

Effects of an Interactive Smoking Cessation Coaching Program on Smoking in Female College Students

Purpose: This study aimed to examine the effects of an interactive smoking cessation coaching program on smoking cessation motivation, smoking knowledge, smoking shame, urine cotinine levels, tobacco craving and smoking abstinence self-efficacy. The conceptual framework of the study applied Cox’s interaction model of client health behavior for female college students who smoked.Methods: This was a before-and-after experimental design study with a non-equivalent control group. The participants were smoking female college students, who were assigned either to an experimental group (n=22) or a control group (n=24). The interaction model of client health behavior was the theoretical basis. The core tactic of smart management and strategy for health was applied as a coaching technique. The experimental group attended 11 sessions of an interactive smoking cessation coaching program, (60 to 120 minutes per session) for 6 weeks, and the control group received education regarding smoking cessation after the program finished. The data collection period was from January 23, 2019 to March 7, 2019.Results: This study showed differences in smoking cessation motivation (F=71.09, &lt;i&gt;p&lt;/i&gt;&lt;.001), smoking knowledge (F=20.77, &lt;i&gt;p&lt;/i&gt;&lt;.001), smoking shame (t=5.11, &lt;i&gt;p&lt;/i&gt;&lt;.001), urine cotinine levels (t=-9.58, &lt;i&gt;p&lt;/i&gt;&lt;.001) and smoking abstinence self-efficacy (t=11.68, &lt;i&gt;p&lt;/i&gt;&lt;.001). However, no difference in tobacco cravings (t=-1.57, &lt;i&gt;p&lt;/i&gt;=.127) was found.Conclusion: As a result of the interactive smoking cessation coaching program, statistically significant differences were found in smoking cessation motivation, smoking knowledge, smoking shame, urine cotinine levels and smoking abstinence self-efficacy. However, further research is needed because there was no statistically significant difference in tobacco cravings.

When Cigarette Smoking Meets COVID-19: How the Two Types of Threat and Efficacy Perceptions Interactively Predict Danger Control and Fear Control Processes.

Growing evidence indicates that communicating the combined risk of smoking and COVID-19 encourages smoking cessation. Guided by the Extended Parallel Process Model (EPPM), we examined how perceived threats of smoking and COVID-19 independently and interactively predicted danger control responses (i.e., quit intentions and COVID-19-protective behavioral intentions) and fear control responses (i.e., fear and fatalism). We also explored the direct and interactive impacts of perceived efficacy of quitting smoking and COVID-protective behaviors on message outcomes. Structural equation modeling results (N = 747 U.S. adults who smoke) indicated that the perceived efficacy of COVID-protective behaviors positively predicted quit intentions. Higher perceived threat of COVID-19 and greater quitting efficacy predicted higher quit intentions directly and indirectly via fear. As perceived COVID-protective efficacy increased, the positive association between perceived quitting efficacy and quit intentions also increased. Smoking-related threat and efficacy perceptions did not predict COVID-protective behavioral intentions. This study added to EPPM by considering how threat and efficacy perceptions deriving from two different yet closely related risks affect protective behaviors. Thus, combining multiple threats in a single message might be a promising strategy to motivate smoking cessation amid the pandemic.

Knowledge about the relationship between smoking and blindness among the population in Jeddah, Saudi Arabia

Objective: To assess the level of awareness of visual loss and other smoking-related diseases and their impact on the motivation for smoking cessation among the general population in Jeddah, Saudi Arabia. Methods: This cross-sectional study was conducted on the general adult population in Jeddah, Saudi Arabia. The study was conducted using a questionnaire and Google Sheets to send the questionnaire to the individuals. Results: A total of 717 questionnaires were valid for analysis; there were 66.7% males, and 30.1% were in the age range of 18-25 years. There were 24.8% smokers, with 34.8% who smoked for more than 10 years. Around 55.1% participants had high knowledge, whereas 44.9% had insufficient knowledge. The level of knowledge was considerably associated with gender (p = 0.015), smoking status (p = 0.0001), and smoking duration (p = 0.036). Conclusion: A moderate level of knowledge was found among participants; gender, smoking status, and smoking duration were determinants of the level of knowledge.

Awareness and knowledge of the effects of smoking on oral health, and smoking cessation motivation among high school students in Jakarta

Awareness and knowledge of the effects of smoking on oral health, and smoking cessation motivation among high school students in Jakarta

Exploring the perceived effectiveness and cultural acceptability of COVID-19 relevant social media intervention content among Alaska Native people who Smoke: The CAN Quit study

Social media platforms have potential for reach and effectiveness to motivate smoking cessation and use of evidence-based cessation treatment, even during the worldwide COVID-19 pandemic. This study builds on our prior community participatory approach to developing content postings for the CAN Quit Facebook intervention among Alaska Native (AN) people who smoke. With input from a community advisory committee, we selected new content on COVID-19 preventive practices (e.g., masking) and evaluated them using a validated, six-item perceived effectiveness scale and a single item assessing cultural relevance. We obtained feedback on six content postings (two videos and four text/pictures) from an online survey administered to 41 AN people (14 men, 27 women; age range 22–61 years) who smoke in Alaska statewide with 49 % residing in rural Alaska. Perceived effectiveness scale scores were high across postings, ranging from 3.9 to 4.4 out of a maximum score of 5.0. Cultural relevance item scores ranged from 3.9 to 4.3. We found no appreciable differences by sex, age, or rural/urban location for either score. This study adds new information on the adaptation, acceptability, and perceived effectiveness of content on COVID-19 preventive practices for future inclusion in a social media-based intervention for smoking cessation specifically tailored for AN people.

Are Indonesian new pictorial health warnings more effective than the old ones?

Smoking remains as a nation-wide health problem in Indonesia. Several measures had been conducted to motivate smoking cessation, among those is the use of pictorial health warnings (PHWs). PHWs have been implemented since 2014, and some of the pictures were revised in 2018. However, there was no evaluation regarding the effectivity to this date. This study compared the effectivity of the old and new versions of PHWs in promoting smoking cessation. This was a cross-sectional study conducted in one of the sub-districts in East Java, Indonesia, in February 2020. Study population were local villagers aged at least 18 years who visited the sub-district’s primary healthcare during the study period. Consecutive sampling was used as the sampling method. Respondents were interviewed using a pre-determined questionnaire. The old and new versions of PHWs were printed and showed to the respondent during the interview. Comparison between groups was analyzed using McNemar test. A total of 103 respondents participated in this study. More respondents agreed that the old version of PHWs was considered more effective to motivate smoking cessation as compared to the newer version (71.84% vs 64.08%), although the significance was marginal (p=0.077). Our study showed that both versions of PHWs were considered effective to promote smoking cessation. However, more respondents agreed that the old version of PHWs were more effective than the new PHWs. We recommend policymaker to conduct a field study to test the effectivity of the proposed PHWs before revising the legal regulation in the future.

Validation of the French Smoking Cessation Motivation Scale with French Smokers Using a Mobile App for Smoking Cessation.

To tailor and predict the outcomes of smoking cessation treatment, it is essential to identify the nature of motivation, as it is the basis for long-term change in healthy behaviors according to self-determination theory (SDT). The purpose of this study is to examine the psychometric properties of the French Smoking Cessation Motivation Scale (F-SCMS). The factorial structure and the psychometric properties were assessed with French-speaking users who had started a 9-step preparation program through a mobile app for smoking cessation (n = 13,044). The results of the present study confirmed content validity (CFI = 0.905, SRMR = 0.045, RMSEA = 0.087) and good internal consistency (α = 0.86, ωh = 0.7, ωt = 0.89) with CFA. The convergent validity was very small, but there were highly significant positive correlations between the willingness and readiness to quit with integrated and intrinsic subscales (rs = 0.25–0.37, p < 0.001). The amotivation subscale significantly had no correlation with any degree of willingness (r = 0.01, p < 0.001), ability (r = 0.01, p < 0.001), and readiness to quit (r = 0.02, p < 0.001). This scale facilitates future research regarding the nature of motivation to quit smoking in the French-speaking population.

Efektivitas Pesan Gambar Kemasan Rokok Terhadap Motivasi Berhenti Merokok Mahasiswa Ikom Untidar

The study was conducted to determine the effectiveness of picture messages on cigarette packages on motivation to stop smoking in Tidar University Communication Studies students. The purpose of this study was to find out how effective the picture messages on cigarette packages were on smoking cessation motivation among Tidar University Communication Studies students. The research was conducted using descriptive quantitative methods to describe the statistical test results of the data that had been collected. The collection of samples was obtained from a population with non-probability sampling purposive sampling with a total of 61 respondents. Then the test used is the correlation test Pearson Correlation Test which aims to find out the comparison of r count with r table. with the test results, namely based on the results of the significance of the correlation test conducted stating that the significance of variable X to variable Y is 0.000, which is 0.000 &lt;0.05. Based on t count &gt; t table (4.8 &gt; 2.001), it can be said that H0 is rejected, this indicates that there is a significant influence between warning images on cigarette packs on motivation to stop smoking in University Communication Studies students class of 2020. The magnitude of the impact the use of BTS as a Brand Ambassador is 85.1%. The conclusion is that the effectiveness of picture messages on cigarette packages on motivation to stop smoking in Communication Studies students at Tidar University has a magnitude of influence of 53.3%.

The Effect of Peer Group Support on Motivation to Quit Smoking Among Adolescents

Adolescents use cigarettes without considering the consequences and lack awareness about the dangers of using cigarettes. Peer group support potentially motivates to quit smoking in adolescents. It can empower group members by providing a role model to increase motivation. This paper analyzes the effect of peer group support on motivation to quit smoking among adolescents. It was quasi-experimental research with a post-test and pre-test one-group design. The population was smoking adolescents. In addition, there were 37 respondents with purposive sampling. The inclusion criteria were male teenagers aged 12-16 years and active smokers. The independent variable was peer group support, and the dependent variable was motivation to quit smoking. The instrument to assess motivation to quit smoking was the Richmond Test. Data analysis utilized paired t-test with α=0.05. There was an increase in the mean value of motivation to quit smoking before and after the intervention. In addition, paired t-tests obtained p=0.030 (p&lt; 0.05), indicating a significant difference in pre-test and post-test. Thus, there was an effect of peer group support on adolescents' motivation to quit smoking. In conclusion, peer group support can increase adolescents' motivation to quit smoking. Nurses could enhance motivation for smoking cessation through peer support interventions so there is a change in smoking behavior in adolescents. Further study should use a control group and a larger sample size.

Identifying prospective subpopulations of combustible and electronic cigarette dual users in the United States via finite mixture modeling.

To identify subpopulations of dual users of combustible and electronic cigarettes using current smoking and vaping behaviors. Secondary analysis of baseline data from a randomized controlled trial testing a smoking cessation intervention for dual users. Finite mixture modeling of frequency, quantity, and dependence on combustible and electronic cigarettes was used to identify classes. Demographics and additional smoking and vaping variables were used to further characterize the classes. United States. A total of 2896 adults who smoked weekly for the past year and vaped weekly for the past month. Self-report baseline measures assessed demographics and smoking and vaping behaviors and characteristics including days of use per week, frequency of use within a day, time to first use after waking, urges to smoke, smoking cessation motivation, self-efficacy to abstain from smoking, months since vaping initiation, reasons for initiating and maintaining vaping, and future plans to stop vaping. Eight probabilistic classes were identified and well-defined (relative entropy = 0.95, Lo-Mendell-Rubin adjusted likelihood ratio test P < 0.0001; class probabilities 0.89-0.97). In general, classes crossed two levels of smoking with four levels of vaping. The largest class (31%) had relatively high levels of smoking (72% daily, 56% 11+ cigarettes per day [CPD], 96% within 30 minutes of waking) and vaping (74% daily, 100% 20+ electronic-CPD, 74% <30 minutes). The next largest class (27%) had relatively high levels of vaping (93% daily, 100% 20+ electronic-CPD, 82% <30 minutes) and very low levels of smoking (28% daily, 12% 11+ CPD, 0% <30 minutes). The six smaller classes (3%-13%) also had distinct smoking and vaping behaviors. All eight classes exhibited distinguishing characteristics beyond current smoking and vaping behaviors. Dual users of combustible and electronic cigarettes are not a homogeneous population, having eight well-defined prospective subpopulations.

Consumption, nicotine dependence and motivation for smoke cessation during early stages of COVID-19 pandemic in Brazil: A cross-sectional study.

INTRODUCTIONThe COVID-19 pandemic may have changed smoking habits. For the smoking population, information regarding smoking habits and the pandemic could potentially aid COVID-19 prevention and control measures. Our study aimed to analyze the effects of the COVID-19 pandemic on tobacco consumption, nicotine dependence levels, and motivation for smoking cessation. We also collected information from smokers regarding their awareness of the consequences of tobacco use and the increased risks smokers have for severe complications from COVID-19.METHODSIn the survey for this observational cross-sectional study, 122 smokers responded to an online form. The participants provided general data about their smoking history, their smoking habits in the months of April and May 2020, and the effect of the pandemic on their smoking habits. They also completed a Fagerström test and were measured by the Wisconsin Smoking Withdrawal Scale.RESULTSWhen compared to pre-pandemic levels, the majority of smokers reported increased tobacco consumption of between 1 and 10 cigarettes per day (37.7%). Their motivation to quit smoking (59.8%) and desire to smoke (53.2%) were unchanged by the pandemic. Most participants demonstrated an awareness of the increased risks smokers have for severe COVID-19-related complications (p<0.001). We identified the following correlations: cigarettes/day before pandemic and motivation for smoking cessation (r=0.19; p=0.030), cigarettes/day and nicotine dependence level (r=0.61; p<0.001), and load consumption and nicotine dependence level (r=0.69; p<0.001). No significant correlations were observed between load consumption and motivation to quit (r=0.13; p=0.120).CONCLUSIONSMost smokers are well aware of their increased risks for severe COVID-19-related complications. In the early stages of the COVID-19 pandemic in Brazil, most smokers reported increased cigarette consumption. In addition, motivation to quit and desire to smoke were unchanged for the majority of smokers.

Attitudes towards the integration of smoking cessation into lung cancer screening in the United Kingdom: A qualitative study of individuals eligible to attend.

IntroductionThere is limited research exploring how smoking cessation treatment should be implemented into lung cancer screening in the United Kingdom. This study aimed to understand attitudes and preferences regarding the integration of smoking cessation support within lung cancer screening from the perspective of those eligible.MethodsThirty‐one lung cancer screening eligible individuals aged 55–80 years with current or former smoking histories were recruited using community outreach and social media. Two focus groups (three participants each) and 25 individual telephone interviews were conducted. Data were analysed using the framework approach to thematic analysis.ResultsThree themes were generated: (1) bringing lung cancer closer to home, where screening was viewed as providing an opportunity to motivate smoking cessation, depending on perceived personal risk and screening result; (2) a sensitive approach to cessation with the uptake of cessation support considered to be largely dependent on screening practitioners' communication style and expectations of stigma and (3) creating an equitable service that focuses on ease of access as a key determinant of uptake, where integrating cessation within the screening appointment may sustain increased quit motivation and prevent loss to follow‐up.ConclusionsThe integration of smoking cessation into lung cancer screening was viewed positively by those eligible to attend. Screening appointments providing personalized lung health information may increase cessation motivation. Services should proactively support participants with possible fatalistic views regarding risk and decreased cessation motivation upon receiving a good screening result. To increase engagement in cessation, services need to be person‐centred.Patient or Public ContributionThis study has included patient and public involvement throughout, including input regarding study design, research materials, recruitment strategies and research summaries.

Can chatbots help to motivate smoking cessation? A study on the effectiveness of motivational interviewing on engagement and therapeutic alliance

BackgroundCigarette smoking poses a major threat to public health. While cessation support provided by healthcare professionals is effective, its use remains low. Chatbots have the potential to serve as a useful addition. The objective of this study is to explore the possibility of using a motivational interviewing style chatbot to enhance engagement, therapeutic alliance, and perceived empathy in the context of smoking cessation.MethodsA preregistered web-based experiment was conducted in which smokers (n = 153) were randomly assigned to either the motivational interviewing (MI)-style chatbot condition (n = 78) or the neutral chatbot condition (n = 75) and interacted with the chatbot in two sessions. In the assessment session, typical intake questions in smoking cessation interventions were administered by the chatbot, such as smoking history, nicotine dependence level, and intention to quit. In the feedback session, the chatbot provided personalized normative feedback and discussed with participants potential reasons to quit. Engagement with the chatbot, therapeutic alliance, and perceived empathy were the primary outcomes and were assessed after both sessions. Secondary outcomes were motivation to quit and perceived communication competence and were assessed after the two sessions.ResultsNo significant effects of the experimental manipulation (MI-style or neutral chatbot) were found on engagement, therapeutic alliance, or perceived empathy. A significant increase in therapeutic alliance over two sessions emerged in both conditions, with participants reporting significantly increased motivation to quit. The chatbot was perceived as highly competent, and communication competence was positively associated with engagement, therapeutic alliance, and perceived empathy.ConclusionThe results of this preregistered study suggest that talking with a chatbot about smoking cessation can help to motivate smokers to quit and that the effect of conversation has the potential to build up over time. We did not find support for an extra motivating effect of the MI-style chatbot, for which we discuss possible reasons. These findings highlight the promise of using chatbots to motivate smoking cessation. Implications for future research are discussed.