Successful Cessation Research Articles

The Effect of a Mobile Phone Application on Smoking Cessation

Objective: The aim of this study was to investigate whether these applications are effective in quitting smoking by using one of the smartphone applications in addition to motivational interviewing in patients who applied for giving up smoking.
 Materials and methods: A randomized controlled intervention study was between January and July 2020. Adults aged 18-65 years who smoke at least one cigarette a day were included in the study. In the prospective study, the patients were followed for 6 months and a total of ten interviews were made. A phone application was installed on the intervention group. Afterwards, the smoking status of the patients was evaluated by telephone or face-to-face. 
 Results: Sixty-three smokers participated in the study. Fifty patients completed the study, 25 controls and 25 interventions. Long-term smoking cessation findings at the first, third and sixth months were evaluated for both groups. Success rate in the first month was 64% for intervention group and 32% in the control group; for the third month it was 56% in the intervention group and 32% in the control group for the sixth month it was 44% in the intervention group and 24% in the control group.
 Conclusion: The smartphone mobile-application showed a positive effect in promoting the increase in the smoking quitting rate. The intervention was found to be effective in 30-day smoking cessation success. Despite higher smoking quitting rates at 3 and 6 months, the application was not effective.

Comparison of Motivational Short Interventions to Improve Smokers' Health Behavior (The COSMOS Study): A Pragmatic Cluster-Randomized Two-Arm Trial in General Practice.

Helping smokers to quit is an important task of general practitioners (GPs). However, achieving tobacco abstinence is difficult, and smokers who fail may still want to improve their health in other ways. Therefore, Swiss GPs developed a multithematic coaching concept that encourages health behavior changes beyond smoking cessation alone. To compare the effectiveness of such coaching with state-of-the-art smoking cessation counseling, we conducted a pragmatic cluster-randomized two-arm trial with 56 GPs in German-speaking Switzerland and 149 of their cigarette smoking patients. GPs were instructed in either multithematic health coaching or smoking cessation counseling. After 12 months, we compared their patients' improvements in cigarette consumption, body weight, physical inactivity, alcohol consumption, stress, unhealthy diet, and a health behavior of their own choice, using hierarchical logistic regression models and Fisher's exact and t tests. Over 95% of all participants achieved clinically relevant improvements in at least one health behavior, with no difference between study arms (health coaching vs. smoking cessation counseling: aOR = 1.21, 95% CI = [0.03-50.76]; and aOR = 1.78, 95% CI = [0.51-6.25] after non-responder imputation). Rates of clinically relevant improvements in the individual health behaviors did not differ between study arms either (they were most frequent in physical activity, achieved by 3 out of 4 patients), nor did the extent of the improvements. Multithematic health coaching and state-of-the art smoking cessation counseling were found to be comparable interventions, both in terms of smoking cessation success and, quite unexpectedly, their effects on other health behaviors. The findings of our study suggest that in general practice, multithematic health coaching is an effective smoking cessation intervention, and conversely, monothematic smoking cessation counseling also achieves the beneficial effects of a multithematic health behavior intervention. This opens up the possibility for GPs to support their smoking patients in improving their health behavior in additional and more flexible ways.

Termination of seizures in the paediatric age group, best benzodiazepine and route of administration: A network meta-analysis.

This network meta-analysis aims to compare various benzodiazepines and their route of administration using the data published exclusively in randomized controlled trials (RCTs). Two thousand two hundred sixty-three children presenting with an episode of seizure to ER or to a paramedic where they were administered a benzodiazepine as the first-line treatment were included. All the outcomes were measured for their mean with 95% CI and rank probability. The primary outcome was the number of successful seizure cessation. Secondary outcomes were the time interval between drug administration and seizure cessation, the time interval between patient arrival and seizure cessation and the number of episodes of seizure recurrence after drug administration. For the number of successful cessations, intramuscular midazolam showed the highest mean and best rank probability with a value of .881 (.065) and 57.9%, respectively. For the time of cessation, both intravenous lorazepam (IVL) and intravenous diazepam showed a mean of 3.30 (1.30) with IVL having the highest rank probability of 32%. For total time for cessation, intranasal midazolam showed the best mean and rank probability with a value of 4.3 (1.1) and 55%, respectively. Buccal midazolam showed the lowest mean with a value of .106 (.084) for rate of recurrence. Although there was no significant difference between the treatments, but based on the rank probability, IVL shows more promising results for patients who already have an established intravenous line, and for patients presenting in the ER without an intravenous line, the first line of treatment should be INM as it shows the highest rank probability in total time with second-highest successful cessation rate.

Éducation thérapeutique chez les patients coronariens : impact sur le sevrage tabagique

Aim of the studyTo describe the results of a therapeutic education program (cessation rate and success factors) among smoking coronary patients followed in the smoking cessation clinic at Sahloul University Hospital in Sousse during the period from 2015 to 2020. Patients and methodsA descriptive cross-sectional study was conducted among smokers with coronary artery disease who presented to the smoking cessation clinic at Sahloul University Hospital during the period from 2015 to 2020. The data collection was done by reviewing the records of smokers. We defined cessation as complete and continuous abstinence at 1 week, at 3 months, at 6 months and at 12 months and more. The study of cessation success factors involved subjects whose cessation was maintained for 1 year or more. ResultsAmong 93 patients with coronary artery disease, the prevalences of smoking cessation rates were 54.8% (n = 51), 44.1% (n = 41), 35.5% (n = 33), 31.2% (n = 29), and 24.7% (n = 23) at 1 week, 1 month, 3 months, 6 months, and 12 months respectively.In univariate analysis, the number of visits greater than or equal to three (p = 0.000) and nicotine treatment (p = 0.018) were significantly associated with successful smoking cessation at 12 months. In multivariate analysis, being non-active (p = 0.028) with a Fagerstrom score <7 (p = 0.040) and three or more visits (p = 0.005) were the independent factors associated with successful smoking cessation at 12 months. ConclusionThe evaluation of the smoking cessation axis of therapeutic education of the coronary patient with tobacco addiction at the Sahloul University Hospital, allowed us to note that the cessation rate is comparable or even higher than that of other studies. However, the rate of maintenance of this cessation at 1 year and more proved to be low despite the strong motivation of the consultants. This observation allows us to better orientate the areas of improvement in the management of our consultants.

Abstract 3224: Perceptions of facilitators and barriers to smoking cessation among patients and providers in a cancer center: A single institution qualitative exploratory study

Abstract Cancer patients who continue to smoke during treatment have poorer outcomes for treatment tolerance and mortality; however, cessation after diagnosis is challenging. Our goal was to build a contextual understanding of the needs of patients and clinical staff in a large urban NCI-designated cancer center to inform strategies for creating smoking cessation services for all patients. During one-on-one interviews with patients (n=13) and clinical stakeholders (n=9), we asked about experiences receiving or providing cessation support during treatment, as well as views on patients’ readiness and needs regarding cessation. Transcribed interviews were coded thematically using Green’s predisposing, enabling, and reinforcing influences on cessation service delivery, uptake by patients, and successful cessation, identifying factors as having positive, negative, or mixed impact on each of these three influences. Patient-identified positive predisposing factors to cessation included cancer diagnosis as a wake-up call, health problems, persistent healthcare providers, and cost of cigarettes. Identified negative predisposing factors were excessive pestering by providers and the futility of quitting with an existing diagnosis. Family, friends, intrinsic motivation, and fear played a mixed role. Patients felt developing other ways to deal with stress, cessation programs, and laws and policies could enable them to quit. Negative enablers included cost and time commitment of cessation programs and busy healthcare providers. The role of medication was uncertain. Reinforcement for quit attempts came via societal disapproval of smoking, encouragement, and positive health effects. Negative reinforcers included addiction, anxiety relief via smoking, and triggers from other smokers. Providers identified similar positive predisposing factors as patients, but also felt that providers could be less predisposed to facilitate cessation due to its physical and psychological burden on patients, “therapeutic nihilism” in the medical community, and patients’ limited health literacy, with differing opinions on the role of cessation services in the cancer treatment process. Enabling barriers included lack of a standardized approach, limited time with patients, lack of training in cessation, and perceived barriers for patients in accessing cessation resources. NCI policies, as well as clinicians’ personal experiences with smoking could reinforce the value of cessation efforts but extra work and lack of follow-up when working with cessation programs, and a lack of readiness to quit in many patients served as negative reinforcement. Findings illustrate unmet needs for patients and providers related to cessation and provision of comprehensive cessation care. Results can inform development of improved cessation programs in cancer centers. Citation Format: Luke M. Shenton, Udara Perera, Amy Leader, Ann Klassen. Perceptions of facilitators and barriers to smoking cessation among patients and providers in a cancer center: A single institution qualitative exploratory study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3224.

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

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

INFLUENCE OF DEPRESSION, ANXIETY, STRESS, SELF-EFFICACY AND SELF- ESTEEM ON SMOKING CESSATION ATTEMPTS AMONG HEAVY SMOKERS IN A SOUTH INDIAN ADULT POPULATION – A CROSS-SECTIONAL ANALYTICAL STUDY

Objectives - Despite making considerable strides in smoking cessation intervention programs, the high failure rates of these cessation methods have raised concerns and asserted the need to re-strategize these programs. There is a dearth of evidence regarding the role of depression, anxiety, stress, self-esteem, and self-efcacy in the determination of successful cessation attempts. This study aimed to investigate this association among heavy smokers in a south Indian adult population. Materials And Methods- A cross-sectional study was conducted on 557 heavy smokers, recruited from the OPD of KLE Institute of Dental Sciences, Bangalore over one year by convenience sampling. The Depression, Anxiety, and Stress status of the participants were assessed using the DASS-21 scale. Rosenberg Self-esteem Scale and General self-efcacy scale were used to assess the self-esteem and self-efcacy of the participants respectively. The Outcome variable was a self-reported Successful 24-hour abstinence from Smoking. The association between these variables was assessed using Multivariate logistic regression on SPSS 24 version, with a p-value set at 0.05 Results- Smokers with anxiety and stress were less likely to sustain a successful 24 hour quit attempt. Subjects with higher self-esteem were twice as likely to give a successful attempt at quitting the habit as opposed to those with low self-esteem. Conclusion - Anxiety, Stress, and Self-esteem inuence smoking cessation attempts in smokers, hence it warrants the need to factor in these variables while devising cessation therapies for better success.

Effect of Smoking Type, Smoking Cessation-related Psychological Factors and Nicotine Dependence on Smoking Cessation in Working Female Smokers

Objectives: Recently, female smokers are increasing in Korea. This study aims to report the dependence of nicotine and the type of smoking as a factor influencing the success of smoking cessation among female smokers.Methods: Data were collected from the Comprehensive information system for smoking cessation service, and data from 862 women who used the smoking cessation service by Gyeongnam Tobacco Control Center between June 2015, and December, 2018, were used. After controlling demographic and smoking-related variables, a multiple logistic regression analysis was performed on the relationship between nicotine dependence, smoking type, smoking cessation related psychological factors and smoking cessation.Results: The smoking cessation rate of female smokers was 7.8%. Smoking type and nicotine dependence were low in stimulus-seeking type, and high in addiction, habit type, and complex type. After controlling demographic, health behavior and disease variables, the factors affecting female smokers’ smoking cessation were nicotine dependence (odds ratio, OR = 0.49, p= 0.020), preparation (OR = 7.14, p= 0.015), confidence (OR = 7.14, p= 0.015) of smoking cessation. In other words, smoking cessation among women who smoked was higher in the high group than in the group with low anti-smoking preparation and confidence and smoking cessation was higher in the low group than in the high group of nicotine dependence.Conclusions: The actual smoking cessation strategy for women considering related factors of smoking cessation is to reconsider the content of counseling interventions according to the type of smoking and to reduce the dependence of nicotine through a treatment approach for each type, resulting in a higher smoking cessation rate.

Prevalence of tobacco dependence and associated factors in China: Findings from nationwide China Health Literacy Survey during 2018–19

SummaryBackgroundTobacco dependence is the key barrier to successful smoking cessation. However, little is known about its prevalence, sociodemographic characteristics and determinants. We aimed to estimate the prevalence, associated factors and burden of tobacco dependence in China.MethodsDuring 2018–2019, the nationally representative 2018 China Health Literacy Survey (2018 CHLS) invited 87,708 participants to participate using a multistage stratified sampling method from 31 provinces (or equivalent) in mainland China, and 84,839 participants aged 20–69 with valid data were included in the analysis. We diagnosed tobacco dependence based on international criteria (ICD-10, DSM-4) and tailored to Chinese population according to China Clinical Guideline for Tobacco Cessation (2015 version). The prevalence of tobacco dependence was estimated overall and by sociodemographic factors. The Logistic regression was conducted to estimate odds ratios (OR) and 95% confidence intervals (CIs) for tobacco dependence and success of smoking cessation (being ex-smokers), with different levels of adjustment. These were used to estimate the total number of adults who were tobacco dependent in China.FindingsIn China, the estimated prevalence of current smoking was 25.1%, significantly higher in men than in women (47.6% vs 1.9%). The prevalence of current smoking varied approximately 3-fold (12.9% to 37.9%) across 31 provinces of China. Among general population aged 20–69 years, the prevalence of tobacco dependence was 13.1% (95% CI:12.2–14.1). Among current smokers, the prevalence of tobacco dependence was 49.7% (46.5–52.9%), with no difference between men and women (49.7% vs 50.8%). The prevalence of tobacco dependence was associated significantly with smoking intensity, defined by pack-years (1.62 [1.54–1.70] per 10 pack-years), cigarettes smoked per day (2.01 [1.78, 2.27] per 10 cigarettes), and smoking starting age (0.93 [0.90, 0.97] per 5 years). Given smoking intensity, the prevalence of tobacco dependence also varied by age, gender, certain socioeconomic status and regions. Compared with those without tobacco dependence, ever smokers with tobacco dependence were less likely to be ex-smokers (2.88, 2.59–3.21). In China, 183.5 (170.4–197.4) million adults (177.5 million were men) were tobacco dependent in 2018.InterpretationIn China, tobacco dependence is highly prevalent, with approximately half of current smokers being addictive, highlighting the need for coordinated effort to improve awareness, diagnosis and treatment of tobacco dependence.FundingChinese Academy of Medical Sciences (CAMS) Initiative for Innovative Medicine (CAMS 2021-I2M-1-010), National Key R&D Program of China (grant no 2017YFC1309400), and National Natural Science Foundation of China (grant no 81720108001).NoteChinese translation of abstract is available in appendix section.

Association between Low-Dose Computed Tomography Results and 1-Year Smoking Cessation in a Residential Smoking Cessation Program.

The COVID-19 pandemic is a global health threat. Smoking and smoking-related lung diseases are risk factors for severe COVID-19 infection. This study investigated whether low-dose computed tomography (LDCT) scan results affected the success of 1-year smoking cessation. The Gyeonggi Southern Smoking Support Center performed the residential smoking cessation program from January to December 2018. During the program, LDCT was performed on 292 participants; 6 months later, follow-up via telephone or visit was conducted. Among the 179 participants who succeeded in smoking cessation for 6 months, telephone follow-up was conducted to determine whether there was a 12-month continuous smoking cessation. In order to evaluate the association between LDCT results and 12-month continuous abstinence rate (CAR), logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (CI). The CARs at 6 and 12 months were 61.3% and 31.5%, respectively. Indeterminate or suspicious malignant lung nodules were associated with a higher 12-month CAR (OR, 3.02; 95% CI, 1.15–7.98), whereas psychiatric history was associated with a lower 12-month CAR (OR, 0.06; 95% CI, 0.03–0.15). These results suggest that abnormal lung screening results may encourage smokers to quit smoking.

Effect of vaping on past-year smoking cessation success of Australians in 2019-evidence from a national survey.

Background and aimsPrevious analyses of the effect of e‐cigarettes on real world smoking cessation success have mainly been based on surveys undertaken in the United States and United Kingdom, where nicotine e‐cigarettes can be readily obtained. In Australia, regulations have made obtaining e‐cigarettes containing nicotine difficult. The effectiveness of e‐cigarette use as a smoking cessation aid in Australia might therefore be lower than survey‐based estimates published to date. This study aimed to estimate the effect of using e‐cigarettes for a smoking cessation attempt on past‐year smoking cessation success in Australia.DesignMultivariable logistic regression models for past‐year smoking cessation success.Setting and participantsRespondents to the 2019 wave of Australia's National Drug Strategy Household Survey who made a smoking cessation attempt in the 12 months leading up to the survey.MeasurementsPast‐year smoking cessation success was assumed if a smoking cessation attempt resulted in abstinence of more than a month at the time of the survey.FindingsIn 2019, Australians who attempted to quit smoking using e‐cigarettes achieved greater success than smokers attempting to quit without e‐cigarettes [adjusted odds ratio (aOR) = 1.68; 95% confidence interval (CI) = 1.09–2.60]. If people who only tried e‐cigarettes once or twice are considered not to have used e‐cigarettes, the estimated effect was slightly stronger (aOR = 1.98; 95% CI = 1.27–3.10). Also, the estimated odds ratio was higher among vapers who acquired their e‐cigarettes from overseas websites (aOR = 2.24; 95% CI = 1.02–4.93).ConclusionsUse of e‐cigarettes for a smoking cessation attempt appears to be associated with greater success among Australians who attempted to quit tobacco in 2019 compared with Australians attempting to quit without e‐cigarettes, after adjusting for confounding effects.

Message Frame-Tailoring in Digital Health Communication: Intervention Redesign and Usability Testing.

BackgroundMessage frame–tailoring based on the need for autonomy is a promising strategy to improve the effectiveness of digital health communication interventions. An example of a digital health communication intervention is Personal Advice in Stopping smoking (PAS), a web-based content-tailored smoking cessation program. PAS was effective in improving cessation success rates, but its effect sizes were small and disappeared after 6 months. Therefore, investigating whether message frame–tailoring based on the individual’s need for autonomy might improve effect rates is worthwhile. However, to our knowledge, this has not been studied previously.ObjectiveTo investigate whether adding message frame–tailoring based on the need for autonomy increases the effectiveness of content-tailored interventions, the PAS program was redesigned to incorporate message frame–tailoring also. This paper described the process of redesigning the PAS program to include message frame–tailoring, providing smokers with autonomy-supportive or controlling message frames—depending on their individual need for autonomy. Therefore, we aimed to extend framing theory, tailoring theory, and self-determination theory.MethodsExtension of the framing theory, tailoring theory, and self-determination theory by redesigning the PAS program to include message frame–tailoring was conducted in close collaboration with scientific and nonscientific smoking cessation experts (n=10), smokers (n=816), and communication science students (n=19). Various methods were used to redesign the PAS program to include message frame–tailoring with optimal usability: usability testing, think-aloud methodology, heuristic evaluations, and a web-based experiment.ResultsThe most autonomy-supportive and controlling message frames were identified, the cutoff point for the need for autonomy to distinguish between people with high and those with low need for autonomy was determined, and the usability was optimized.ConclusionsThis resulted in a redesigned digital health communication intervention that included message frame–tailoring and had optimal usability. A detailed description of the redesigning process of the PAS program is provided.Trial RegistrationNetherlands Trial Register NL6512 (NRT6700); https://www.trialregister.nl/trial/6512

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

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

User Experiences With an SMS Text Messaging Program for Smoking Cessation: Qualitative Study.

BackgroundMobile health strategies for smoking cessation (eg, SMS text messaging–based interventions) have been shown to be effective in helping smokers quit. However, further research is needed to better understand user experiences with these platforms.ObjectiveThis qualitative study aims to explore the experiences of real-world users of a publicly available smoking cessation program (SmokefreeTXT).MethodsSemistructured phone interviews were conducted with 36 SmokefreeTXT users between March and July 2014. Of these 36 participants, 50% (18/36) of participants completed the SmokefreeTXT program (ie, did not opt out of the program before the 6- to 8-week completion period), and 50% (18/36) did not complete the program (ie, requested to opt out of the program before the completion period). Interview questions focused on smoking behaviors, quitting history, opinions on the program’s content and structure, answering assessment questions, using keywords, reasons for opting out, and perceived usefulness of the program for quitting smoking. A thematic content analysis was conducted, with a focus on themes to increase program engagement and optimization.ResultsThe findings highlighted features of the program that participants found beneficial, as well as some elements that showed opportunities for improvement to boost program retention and successful cessation. Specifically, most participants found the SmokefreeTXT program to be convenient and supportive of cessation; however, some found the messages to be repetitive and reported a desire for more flexibility based on their readiness to quit and cessation progress. We also found that program completion did not necessarily indicate successful smoking cessation and that program opt out, which might be interpreted as a less positive outcome, may occur because of successful cessation. Finally, several participants reported using SmokefreeTXT together with other evidence-based cessation methods or non–evidence-based strategies.ConclusionsQualitative interviews with real-world SmokefreeTXT users showed high program acceptability, engagement with program features, and perceived utility for smoking cessation. Our findings directly informed several program updates, such as adding an adaptive quit date feature and offering supplemental information on live support services for users who prefer human interaction during the cessation process. The study has implications for other digital tobacco cessation interventions and highlights important topics that warrant future research, such as the relationship between program engagement (eg, opt out and retention) and successful cessation.

An Evaluation of Evidence Underpinning Management Recommendations in Tobacco Use Disorder Clinical Practice Guidelines.

Clinical practice guidelines(CPGs) are important tools for medical decision-making. Given the high prevalence and financial burden associated with tobacco use disorder(TUD), it is critical that recommendations within CPGs are based on robust evidence. Systematic reviews(SRs) are considered the highest level of evidence, thus, we evaluated the quality of SRs underpinning CPG recommendations for TUD. We used PubMed to search for CPGs relating to TUD published between January 1, 2010 and May 21, 2021. SRs were extracted from CPG references and evaluated using Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA) and A MeaSurement Tool to Assess Systematic Reviews(AMSTAR-2) tools. We then compared SRs conducted by the Cochrane Collaboration with non-Cochrane SRs using a Mann-Whitney U test and determined associations between PRISMA and AMSTAR-2 extracted characteristics using multiple regression. Our search generated 10 CPGs with 98 SRs extracted. Mean PRISMA completion was 74.7%(SD = 16.7) and mean AMSTAR-2 completion was 53.8%(SD = 22.0) across all guidelines. Cochrane SRs were more complete than non-Cochrane studies in the PRISMA and AMSTAR-2 assessments. The regression model showed a statistically significant association between PRISMA completion and AMSTAR-2 rating, with those classified as "low" or "moderate" quality having higher PRISMA completion than those with "critically low" ratings. We found substandard adherence to PRISMA and AMSTAR-2 checklists across SRs cited in TUD CPGs. A lack of recent SRs in CPGs could lead to outdated recommendations. Therefore, frequent guideline updates with recently published evidence may ensure more accurate clinical recommendations and improve patient care. Systematic reviews used to underpin clinical practice guideline recommendations influence treatment decisions and, ultimately, patient outcomes. We found that many systematic reviews underpinning tobacco use disorder guideline recommendations were out of date and unsatisfactory in reporting and quality. Thus, including newer systematic reviews containing more recently conducted trials and better reporting could alter recommendations and improve the rate of successful tobacco cessation attempts.

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

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

Smoking Cessation Among U.S. Adult Smokers With and Without Chronic Obstructive Pulmonary Disease, 2018

More than 3 of 5 U.S. adults who have ever smoked cigarettes have quit. This study assesses the latest estimates of smoking cessation among U.S. adults with and without chronic obstructive pulmonary disease who have ever smoked cigarettes (ever smokers). Data from 161,233 ever smokers (12.8% with chronic obstructive pulmonary disease) in the 2018 Behavioral Risk Factor Surveillance System were analyzed in 2020. Weighted percentages of quit ratios (percentage of ever smokers who quit smoking), past-year quit attempts (≥1 day), and recent successful cessation (quit ≥6 months ago) by self-reported physician-diagnosed chronic obstructive pulmonary disease status were obtained from multivariable logistic regression analyses, with adjustment for sociodemographic characteristics, health risk behaviors, depression, and asthma. Adults with chronic obstructive pulmonary disease who smoked had greater age-adjusted past-year quit attempts (68.8% vs 64.3%) but lower recent successful cessation (4.5% vs 5.8%) and quit ratio (53.2% vs 63.9%) than those without chronic obstructive pulmonary disease. After adjusting for covariates, adults with chronic obstructive pulmonary disease who smoked had a significantly higher percentage of past-year quit attempts but similar recent successful cessation and a significantly lower lifetime quit ratio than their counterparts without chronic obstructive pulmonary disease. These findings suggest that individuals with chronic obstructive pulmonary disease who try to quit smoking may be less likely to succeed than those without chronic obstructive pulmonary disease. Evidence-based treatments for smoking cessation remain an important component of a comprehensive approach to helping all adults to quit and are a particularly important element of chronic obstructive pulmonary disease management and care.

A REVIEW ON SMOKING CESSATION TECHNIQUES IN PATIENTS WITH MENTAL ILLNESS

The current literature review aimed to find out effective strategies for smoking cessation in a patient with mental illness. Smoking is one of the primary causes of death worldwide. Patients with mental illness have a high rate of smoking. In General, patients with depression have a high level of nicotine addiction and after quitting smoking have more depressing moods and a greater risk than before of major depression. This review captured smoking cessation techniques from different literature which includes Cognitive Behavioral Mood Management, Nicotine Replacement Therapy (NRT), Varenicline, and Bupropion. Additional support and a longer course of treatment may also be recommended. Readiness to quit and awareness of smoking cessation are low among smokers. Concerted efforts through awareness programs, educational programs, strict regulation policies for tobacco use, increase cost of cigarettes, and substitution of smoking with other foods and drinks were also the factor that helped them to achieve successful cessation. Among all strategies, the 5R program is the best, which focused on Relevance, Risk, Rewards, Roadblocks, and Repetition. Varenicline and Bupropion are more effective in Schizophrenics and bipolar maniac patients with nicotine replacement therapy in combination rather than alone.

Comparison of water vapor thermal therapy and prostate artery embolization for fragile patients with indwelling urinary catheters: Preliminary results from a multi-institutional study.

To report our preliminary experience with water vapor thermal therapy with the Rezūm™ System and Prostate Artery Embolization (PAE) for treatment of medically refractory, complete urinary retention to achieve successful cessation of catheter dependency in frail-patients. A multi-institutional study was conducted including all patients who underwent Rezūm™ procedure and PAE between October 2017 and June 2020. The included population focused on frail-patients unsuitable for conventional surgery with complete urinary retention. Rezūm™ patients were identified and matched (1:1) with patients who underwent PAE. The matching criteria were age, Charlson score, prostate volume and duration of follow-up. The primary outcome was catheter-free survival, defined as spontaneous voiding and release from catheter dependence. Eleven patients from the Rezūm™ group were matched to 11 embolized patients. PAE and Rezūm™ patients were comparable in age (median: 77 vs. 75 years), Charlson score (median: 6 vs. 6) and prostate volume (74 vs. 60 cc). Procedures were significantly longer in the PAE group compared to the Rezūm™ procedures (median: 148 vs. 8min, P<0.001). After a median follow-up of 12 months, spontaneous voiding was conserved in all cases (100%) after the Rezūm™ procedure and in 5 cases (45.4%) after PAE (P=0.01). In catheter-free patients, the rate of benign prostatic hyperplasia medication use after procedure was 40% for PAE and 18.2% for Rezūm™ patients (P=0.54). Our preliminary experience for treatment of complete urinary retention in frail-patients shows the feasibility of PAE and Rezūm™ to restore spontaneous urination without being associated with the occurrence of major complications. Early data suggests that Rezūm™ may provide superior results in terms of cessation of catheter dependence. Future studies are needed to definitively assess which treatment would be best suited for each patient. 3.

Predictors of perceived success in quitting smoking by vaping: A machine learning approach.

Prior research has suggested that a set of unique characteristics may be associated with adult cigarette smokers who are able to quit smoking using e-cigarettes (vaping). In this cross-sectional study, we aimed to identify and rank the importance of these characteristics using machine learning. During July and August 2019, an online survey was administered to a convenience sample of 889 adult smokers (age ≥ 20) in Ontario, Canada who tried vaping to quit smoking in the past 12 months. Fifty-one person-level characteristics, including a Vaping Experiences Score, were assessed in a gradient boosting machine model to classify the status of perceived success in vaping-assisted smoking cessation. This model was trained using cross-validation and tested using the receiver operating characteristic (ROC) curve. The top five most important predictors were identified using a score between 0% and 100% that represented the relative importance of each variable in model training. About 20% of participants (N = 174, 19.6%) reported success in vaping-assisted smoking cessation. The model achieved relatively high performance with an area under the ROC curve of 0.865 and classification accuracy of 0.831 (95% CI [confidence interval] 0.780 to 0.874). The top five most important predictors of perceived success in vaping-assisted smoking cessation were more positive experiences measured by the Vaping Experiences Score (100%), less previously failed quit attempts by vaping (39.0%), younger age (21.9%), having vaped 100 times (16.8%), and vaping shortly after waking up (15.8%). Our findings provide strong statistical evidence that shows better vaping experiences are associated with greater perceived success in smoking cessation by vaping. Furthermore, our study confirmed the strength of machine learning techniques in vaping-related outcomes research based on observational data.