Tobacco Cessation Clinic Research Articles

TOBACCO USE BY FRIENDS AND FAMILY MEMBERS OF TOBACCO USERS: RESULT FROM CLIENTS ATTENDING TOBACCO CESSATION CLINIC AT URBAN PRIMARY HEALTHCARE SET UP IN MALDIVES

Objective: This study aimed to identify tobacco use among family members and friends of tobacco user who attended tobacco cessation clinic at an Urban Primary Healthcare set up in Male’, Maldives, starting from 2017 through 2023. Methods: A retrospective, quantitative, descriptive survey was employed utilizing secondary data extracted from tobacco cessation assessment forms at the Urban Primary Healthcare set up’s tobacco cessation clinic. The study utilized a census sampling approach, encompassing all available tobacco cessation forms, resulting in a total sample size of 544 participants. The primary researcher developed a data transfer sheet based on a review of the assessment forms, facilitating the systematic transfer of required data. Descriptive statistical analyses were conducted using SPSS version 21.0 to summarize and interpret the collected data. Results: Out of 544 tobacco users, 494 (90.8%) were male and 50 (9.2%) were female. Majority of the tobacco users reported that their friends and family members use tobacco. Huge amount of tobacco users reported tobacco use by nuclear family members while less than a quarter reported tobacco use among extended family members. Majority of tobacco users reported their coworkers or someone who lives together are non-tobacco users and majority of their class mates or best friends are tobacco users. Conclusion: The study concluded that majority of tobacco users reported about tobacco use among family members and friends This could be influencing factor for the tobacco users to continue tobacco use as tobacco use among parents or family member and friends has negative effects on tobacco users.

Nicotine Dependence and its Variation among Tobacco Users Who Visited the Tobacco Cessation Clinic in an Urban Primary Healthcare Center in Male' Maldives

Nicotine Dependence and its Variation among Tobacco Users Who Visited the Tobacco Cessation Clinic in an Urban Primary Healthcare Center in Male' Maldives

Characteristics of Tobacco Users who Visited the Tobacco Cessation Clinic in an Urban Primary Healthcare Center in Male' Maldives from 2017 - 2023: A Retrospective, Descriptive Cross - Sectional Study

Characteristics of Tobacco Users who Visited the Tobacco Cessation Clinic in an Urban Primary Healthcare Center in Male' Maldives from 2017 - 2023: A Retrospective, Descriptive Cross - Sectional Study

Changing pattern of tobacco use and effect of behavioral interventions on tobacco dependence during COVID-19 – Mixed-method study

Abstract Background: Tobacco is a risk factor for noncommunicable diseases, and its users are at an increased risk for developing severe illness if affected by COVID-19. Aims and Objectives: This study was conducted to report tobacco usage patterns and experiences during COVID-19 and assess changes in tobacco dependence following behavioral interventions. Methodology: A mixed-method study was conducted, and the details of individuals who visited the tobacco cessation clinic, psychiatric ward, and department of pulmonary medicine from September 2019 to February 2020 were obtained from the hospital records. These individuals were contacted by telephone and were requested to fill out the Google Forms. Results: Following the initial analysis of nicotine dependence among the participants, 12 individuals were shortlisted for the in-depth interview on tobacco use experience during COVID-19. After the qualitative component was over, the participants were divided into two groups based on the ratio of 1:1. A behavioral intervention using online group sessions (using WhatsApp and Google Meet) along with telephonic counseling was administered to group 2 while group 1 received only telephonic counseling. At the end of 1 month, the participants were again followed up. Analysis: Only one participant reported an increase in the frequency of habit during COVID-19 and the reason was lack of work engagement. Most of the participants were at home during the pandemic, and some of them reported not having felt the need to smoke at home, as there were other modes of spending time at home. A statistically significant difference was found in the comparison of the before and after Fagerstorm nicotine dependence score for smokers in group 1 participants. However, a statistically insignificant difference was found in the comparison of the Fagerstorm nicotine dependence score for smokeless tobacco (ST) postintervention in the group 1 participant. The group 2 participants showed a statistically significant difference in the nicotine dependence scores for both smokers and ST after the intervention.

Correlates of nicotine dependence among patients visiting a tobacco cessation centre in India: A retrospective analysis.

Background We did a retrospective secondary analysis of 1-year data of a tobacco cessation clinic (TCC) to assess correlates of nicotine dependence among tobacco users visiting the TCC at a tertiary care dental hospital. Methods Secondary data were obtained from the records of patients who had visited the TCC from January to December 2019. Of the 1436 records, 1144 were found to contain all the information needed for the study. Patient records were obtained from a pre-validated standard TCC patient assessment sheet (PAS), which included various sections: Sociodemo-graphic items, tobacco use profile items, nicotine dependence status, strategy used for cessation and follow-up details. Results Of the 1144 proformas, 97.1% (n=1111) were of men and 2.9% (n=33) were of women. Around 48.5% had medium nicotine dependence followed by high nicotine dependence (29.7%) and low nicotine dependence (21.8%). The mean (SD) age of initiation of tobacco use was 26.1 (9.44) years and a significantly lower age of initiation was observed in patients with high nicotine dependence. Greater number of years of tobacco use was significantly associated with high nicotine dependence. About 47% of patients had attempted to quit tobacco in the past and the quitting attempts were found to be significantly higher in patients with high dependence. Conclusion We explored crucial determinants of nicotine dependence among tobacco users reporting to the TCC. These factors may be incorporated in routine assessment of the tobacco use status and may be used in tailored cessation counselling strategies.

Barriers and facilitators for oral health screening among tobacco users: a mixed-methods study

ObjectivesTobacco consumption adversely affects general and oral health and is considered one of the significant public health burdens globally. The present study aims to assess the barriers and facilitators for attending oral and dental health screening among tobacco users who seek cessation advice.MethodologyThe present mixed-methods study used group concept mapping (GCM) to identify the facilitators/barriers to attending oral health screening among young adults attending face-to-face and virtual Tobacco Cessation Clinic at King Saud University (Riyadh, Saudi Arabia) between September 2022 and April 2023. Study investigators included healthcare social workers, dental interns, and oral and maxillofacial medicinists. Information about demographics, general health, oral/dental health and tobacco use were collected using self-completed questionnaires. The barriers and facilitators were assessed following GCM by brainstorming, sorting, rating, and interpretation activities. Descriptive, multidimensional scaling and hierarchical cluster analysis were used to describe the study participants and produce concept maps of the generated statements.ResultsThe study included 148 participants who generated 67 statements summarised into 28 statements as facilitators or barriers. Based on a 5-point importance scale, the participants indicated the importance of facilitators under health-related cluster [e.g. when I feel pain] as the highest, followed by personal [e.g. to maintain my mouth hygiene], social [e.g. the quality of treatment] and financial clusters [e.g. the reasonable cost]. Concerning barriers, financial factors [e.g. high cost] acted as the highest-rated barrier, followed by personal [e.g. lack of dental appointments] and health-related [e.g. worry that dental problems will worsen]. The social factors were the least considerable barrier [e.g. lack of time]. Clustering these facilitators/barriers on the concept map indicated their conceptual similarity by an average stress value of 0.23.ConclusionPain was the most important facilitator to attending oral health screening by young adults seeking tobacco cessation advice. Notable barriers included the high cost of dental treatment and the lack of scheduled appointments. Thus, oral health care providers need to consider scheduling periodic and timely dental check-ups to prevent and reduce the burden of tobacco-associated and pain-causing oral diseases.

Tobacco and its negative impact: a case report

One of the most valuable possessions one may have is good health. Nowadays, it is acknowledged that oral health and general health go hand in hand. Oral health can be characterized as a level of wellness for the mouth and associated tissues that enable someone to eat, speak, and interact socially without experiencing any active illness, discomfort, or embarrassment and that adds to overall well-being. Because of their widespread occurrence and major social impact, oral illnesses might be categorized as a public health issue. One strategy for the management of complicated health disorders is multidisciplinary collaborative care, which includes care coordination among clinicians. This case presentation describes a collaborative effort between healthcare providers and a patient enrolled in a tobacco cessation clinic. This is a case of a smoker aged 57 years, who started reducing cigarettes and had quit smoking 6 months prior based on the health belief model but his improvement in quality of life was not significant.

Assessment of Nicotine Dependence and Readiness to Change among Patients Attending Tobacco Cessation Clinic: A Cross-sectional Study

Background: Nicotine is the addictive substance present in tobacco which makes quitting tobacco difficult. Objective: This study was done to assess nicotine dependence and stage of readiness to change among tobacco users visiting the Tobacco Cessation Clinic (TCC) Lucknow. Materials and Methods: A cross-sectional study was performed in the TCC of a Government Dental College. The data were recorded in the tobacco cessation registration forms of tobacco users and then analyzed through statistical software using the Chi-square test. Results: The number of tobacco users was more in males (88%) than in females (12%) with a preference for smokeless type (63.4%) of tobacco usage. Most of the tobacco users were of 25–34 years of age group (34.9%). It was also observed that the maximum number of tobacco users was married (68.3%) and had graduate/postgraduate degree (62.3%). It was also seen that usually, the monthly expense on tobacco products by either gender was Rs. 1000–2400. More than 50% of the tobacco users had tried quitting before because of health issues and craving was the main reason for relapse. We also observed that the highest level of nicotine dependence was amongst the smokeless tobacco users with a history of 5–10 years of tobacco use (43.3%). Conclusion: It was found that most of the patients who attended the TCC had medium level of dependence on nicotine and where in the preparation phase to quit the habit.

Salivary oxidative stress level among tobacco chewers and smokers: A comparative Study.

Tobacco contains various toxic contents which produce oxygen-free radicals that damage oral tissues. Since saliva encounters tobacco, it has antioxidant defense system and also can serve as a biomarker for oral diseases. Thus, the present study aims to evaluate salivary oxidative stress levels among smokers and chewers. Unstimulated saliva from 240 males who visited tobacco cessation clinic for the first time was collected. Standard protocol was followed to collect saliva and assess salivary antioxidant levels from 80 participants with the habit of smoking, smokeless, and both (smoking and smokeless) tobacco users. The collected data were statistically analyzed. The mean salivary superoxide dismutase and malonyldialdehyde levels were significantly high for participants with both habits (P < 0.000). There was a significant high reduction of glutathione peroxidase and catalase in participants with both habits (P < 0.000). Both smoking and smokeless tobacco modify salivary antioxidant activity. The estimation of salivary oxidative stress can serve as a diagnostic and prognostic biomarker for oral tissue damage and dysplasia. Furthermore, they can function as early biomarkers in preventing dysplastic changes in the oral cavity.

Assessment of Knowledge, Attitude, and Practice among Subjects Visiting the Tobacco Cessation Clinic

Objectives: The study mainly aims to assess the knowledge, attitude, and practice of subjects who attend the smoking cessation clinic and thereby, study and document the drug management in smoking cessation. Material and Methods: This was an observational study conducted among 160 patients for 8 months. A knowledge, attitude, and practice questionnaire was prepared and validated. All the details and directions for filling out the questionnaire were explained to the patients by the investigator. The questionnaire was given to the patients and all the required data were collected and analyzed. Results: A total of 160 male patients were enrolled in the study. Majority of the participants had a good knowledge of the harmful effects of tobacco consumption. Around 96% knew that smoking could heighten their risk for different types of cancer and 93.8% were aware that smoking was a leading cause of many serious diseases. Majority of the patients (98.1%) had an attitude that quitting smoking was an individual choice and 96.3% were supportive of the fact that smoking in public places is an offense. Concerning their practice, 89.4% have attempted to quit smoking in the past and 78.8% have received advice from physicians earlier to cease smoking. Conclusion: The study revealed the good knowledge of patients and the majority of them tried to quit smoking as advised by their physician.

Pattern of Tobacco Use among Children and Adolescents with comorbid Psychiatric Illnesses

IntroductionTobacco use is clearly harmful for mental as well as physical health especially among persons &lt;18 yeards age. It is used in multiple forms in many countries such as, somoling chewing etc. It is impotant to know the pattern of tobacco use and the comorbid psychiatric illnesses inthis age group.ObjectivesTo identify the pattern of tobacco use among cases &lt;18 years age with various psychiatric disorders.MethodsIt was a cross-sectional study conducted at a psychiatric clinic at Karachi, on all consecutive cases &lt;18 years. Diagnostic criteria of ICD-10 were used.ResultsA total number of 700 consecutive cases below the age of 18 years reporting to psychiatric clinic were inducted in this study. Out of them 107 (15%) patients reported use of tobacco. Among them 83 (77% ) used pan with tobacco. The psychiatric illnesses identified were depressive disorder (39%) &amp; conversion disorder (15%).ConclusionsTobacco use (predominantly in the form of chewing), is common amongst children and adolescents reporting for psychiatric consultation. It is important to develop strategies at a community level with legal restriction/implementation selling tobacco to children. Moreover, psychiatric evaluation should be done in all children and adolescents identified as using tobacco, and the term “smoking cessation clinic” should be replaced with “tobacco cessation clinic/ services”.DisclosureNo significant relationships.

Quit status and challenges of tobacco users from a tobacco cessation clinic in South India

In a given time, 55% of smokers and 50% of smokeless tobacco users think of quitting tobacco. However, only 3-5% successfully quit without professional support. This study aims to assess the quit status and challenges of tobacco users enrolled in tobacco cessation clinic at a regional cancer center. Totally, 171 tobacco users above 18 years were enrolled in the TCC between January 2015 and December 2015. All the users were contacted by a psychologist via telephone after 6 months from their first visit for gauging the status of tobacco use, associated challenges for quitting and reasons for not quitting. Nicotine dependence was assessed using the Fagerstrom scale for nicotine dependence for smokers and smokeless tobacco users, separately. Readiness to quit tobacco scale was used to assess the motivational stages of readiness to change. Based on level of nicotine dependence and motivational stage, cessation interventions were provided. On follow-up, 91 (53.2%) were successfully contacted, 72 (42.1%) could not be contacted and 8 (4.6%) had expired. Twenty-six (28.5%) tobacco users had quit and 15 (16.4%) were able to remain abstinent for less than 6 months. Only 5 (12.1%) reported physical challenges and 13 (31.7%) reported psychological challenges while reducing tobacco or quitting. Tobacco cessation provided by trained professionals in a cancer setting has been found to be highly effective in quitting. Close follow-up at regular intervals is mandated to help tobacco users manage cravings and withdrawal symptoms, to assist in achieving quit status.

Association between smoking cessation and alterations in forced expiratory volume in one second (FEV1). A Follow-Up Study from a Greek Tobacco Cessation Clinic.

Cigarette smoking is the most important preventable cause of several diseases such as malignancies, pulmonary and cardiovascular diseases. Smoking cessation is now supported by both behavioral counseling and medical pharmacotherapy and is the only effective approach for slowing down an accelerated decline in forced expiratory volume in one second (FEV1). Our study aims to examine changes in forced expiratory volume in one second (FEV1) after smoking cessation for smokers attending our smoking cessation clinic their correlation to smokers' demographic characteristics. 114 smokers (48 males and 66 females), with a mean age of 48.36±10.49 years, were enrolled. They were classified in 4 groups, according to their age; <40 years (Group Α), 41-50 years (Group Β), 51-60 years (Group C), >60 years (Group D) and underwent Spirometry on the 1st day of visit, one month (2nd visit) and, 3 months later (3rd visit). Statistically significant increase in FEV1 values at the 2nd and 3rd visit compared to the 1st visit was observed in smokers who quit smoking in Group Α, B and C (p<0.05). In addition, a statistically significant decrease in FEV1 values at the 2nd and 3rd visit compared to the 1st visit was noticed in smokers who continued smoking in Group B, C and D (p<0.05). Smoking cessation achieved through smoking cessation support led to the improvement of FEV1 values within 3 months. The greatest benefit was observed in smokers under the age of 60.

Failure to Quit Smoking Extent and Determinants among Attendees of Tobacco Cessation Clinic

Smoking is a global health risk factor despite the efforts to control and the existance of tobacco cessation program. The objective of this study was to measure the proportion of people who failed to quit smoking at the end of six months after attending the smoking cessation clinic and to identify the factors associated with failure to quit. We used an analytical cross-sectional design which was conducted at Taif city, Saudi Arabia between January 2019 and March 2020. The attendees of smoking cessation clinic were invited to participate in the study. We used a questionnaire as the data collection too. The statistical package for the social sciences (IBM Corp. Released 2020. IBM SPSS Statistics for Windows, Version 27.0. Armonk, NY: IBM Corp ) was used to analyze the data. The total responses was 393, out of them 201 (51.1%) failed to quit smoking after six months. Age, marital status, income, and occupation were significantly associated with the outcome variable (quit or not). Even before attending the clinic (62.3%) have indicated previous failed attempts. Among the different types of smoking, hookah showed a significant association with failure, while nicotine dependence did not showed any significance. Failure to quit was associated with advanced age, smoking hookah, while those who indicated the price of tobacco products as a reason to quit were more prone to fail in quitting smoking. In conclusion, smoking cessation can be influenced by a sociodemographic factors, willingness and family support. Smoking hookah is associated with higher rates of failure to quit smoking.

Impact of tobacco cessation clinic based “brief advice” on quitting among patients of a tertiary cardiac care hospital in Bangladesh

Impact of tobacco cessation clinic based “brief advice” on quitting among patients of a tertiary cardiac care hospital in Bangladesh

Abstract 2550: Participant's satisfaction with the cancer community awareness access research and education (C-CARE) project at urban and rural sites

Abstract Introduction: The cancer-Community Awareness Access Research &amp; Education (c-CARE) project includes a series of cancer-related educational sessions that focus on educating the enrolled participants about cancers that are either preventable or have the potential for early detection to positively impact cancer outcomes. One of the important indicators of success is the level of satisfaction with the program expressed by the study participants who were navigated to needed medical or non-medical community resources through the program. Methods: The study (n=548, 98 rural (17.9%),450 urban (82.1%), provided education, cancer screening, and addressed perceived barriers and self-efficacy to accessing early cancer detection resources, while providing a list of community-based resources. Inclusion criteria included adults with 21-80 years of age primarily living in small urban and rural GA or SC counties. The study occurred in 9 urban AA churches, 3 rural AA churches, 3 community clinics and one Community Center. The responses to each question in the satisfaction survey were summarized using descriptive analysis (frequency, percent, and p-value). Results: A majority of respondents reported satisfaction with the program (86.5%) and that they would recommend the program to others (99.8%). Approximately, one-third (31.1%) stated that they used one or more of the c-CARE community resources provided. Of those who used c-CARE resources, 74.3% participated in Lung Cancer Screening, 58.3% used the Tobacco Cessation Clinic, and 44.3% used Community Resources. Almost all of the respondents stated that they were satisfied with the c-CARE resources (82.3%). Significantly, more rural participants reported accessing Lung Cancer Screening (100%, p &amp;lt; 0.03), the Tobacco Cessation Clinic (100%, p &amp;lt; 0.04), and community resources (100%, p &amp;lt; 0.01). There were no significant differences between the rural and urban cohorts in program satisfaction, if they would recommend the program to others, used one or more of the c-CARE resources provided, or were satisfied with the resources provided. Conclusion: These results demonstrate increased need in both rural and urban communities for access to cancer screening and resources. Participant satisfaction is an important outcome measure for vulnerable population needs and experiences within their community. The c-CARE project was able to successfully provide education, cancer screening, and navigation to community cancer prevention and support resources to both urban and rural populations with demonstrated satisfaction and success. Citation Format: Ghadeer Albashir, Samantha Sojourner, Marlo Vernon, Justin Moore, Stephen Looney, Martha Tingen. Participant's satisfaction with the cancer community awareness access research and education (C-CARE) project at urban and rural sites [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 2550.

A study to evaluate availability of tobacco cessation services in Bengaluru, India.

In India, 28.6 % of the population use tobacco products. To evaluate the availability of tobacco cessation services in 101 hospitals in Bengaluru. Only 4 out of 101 hospitals evaluated had a separate Tobacco Cessation Clinic; 24 % provided minimal services for people with addiction related problems; 28 % had at least one resident counsellor; additional 10 % had a visiting counsellor. All four of them provided counselling and medication. Availability of tobacco cessation services in Bengaluru is minimal. It is important to upscale availability of cessation services both for tobacco and other substance use.

Applicability of Data Mining and Predictive Analysis for Tobacco Cessation: An Exploratory Study.

Objectives:Predictive analysis can be used to evaluate the enormous data generated by the healthcare industry to extract information and establish relationships amongst the variables. It uses artificial intelligence to reveal associations not suspected by the healthcare professionals. Tobacco cessation is clearly beneficial; however, many tobacco users respond differently as it is based on multitude of factors. Our objectives were to assess the data mining techniques using the WEKA tool, evaluate its role in predictive analysis, and to predict the quit status of patients using prediction algorithms in tobacco cessation.Materials and Methods:WEKA, a data mining tool, was used to classify the data and evaluate them using 10-fold cross-validations. The various algorithms used in this tool are Naïve Bayes, SMO, Random Forest, J-48, and Decision Stump to further analyze its role in determining the quit status of patients. For this, secondary data of 655 patients from a tobacco cessation clinic were utilized and described using 20 different attributes for prediction of quit status.Results:The Decision Stump and SMO were found to be having the best prediction and accuracy for prediction of the quit status. Out of 20 attributes, previous quitting attempt, type of intervention, and number of years since the habit was initiated were found to be associated with early quitting rate.Conclusion:This study concluded that data mining and predictive analytical models like WEKA tool will not only improve patient outcomes but identify variables or a combination of variables for effective interventions in tobacco cessation.

Proactive Telephonic Follow-up Calls by a Tobacco Cessation Clinic (TCC): Optimization for the Number of Calls.

Background: Despite specific national effort for over a decade, in published reports on tobacco cessation from India, the quit rate has ranged from 2.6% to 28.6%. One of their challenges has been an inability to follow-up all those treated comprehensively. Objective: It was to determine an optimum number of follow-up telephonic calls to be made proactively post the cessation treatment. Methods: This study was conducted for a period of one year w.e.f. 5th September 2017 at a Tobacco Cessation Clinic (TCC) of a private health sector tertiary care hospital to 296 patients currently using tobacco treated by counselling with/ without pharmacotherapy; and integration of the quitline methodology with follow ups at 3rd and 7th days, and thereafter at the end of 1st, 3rd, 6th and 12th months respectively, i.e., until 4th September 2019. Results: As per study protocol, the TTC could follow up 91.2% patients telephonically to achieve a quit rate of 42.9% while those who failed to quit and relapsed were 37.7% and 19.9% respectively. Staying on with the quit date set at the outset and adequacy of three follow-up calls have emerged as the statistically significant outcomes for p values of 0.000 and 0.001 respectively. Conclusion: Achieving a quit rate of 42.9% through the proactive follow-up calls reinforces its perceived utility in tobacco cessation. Making at least 3 follow-up calls after primary intervention (on 3rd, 7th and at 1 month) is recommended to achieve a satisfying outcome. For an optimal outcome, the study recommends follow-ups until 6 months. Keywords Tobacco, Cessation, Follow up, Telephonic calls, Quitline, Smoking, Smokeless tobacco

Evaluation of cessation services provided at a tobacco cessation clinic in a teaching dental hospital.

Tobacco cessation interventions provided in a dental office or hospital settings are beneficial in helping patients to quit tobacco. Regular monitoring of these interventions is required to assess their success rate and factors hindering its improvement. This study evaluated cessation services provided through a Tobacco Cessation Clinic (TCC) established in a government teaching dental hospital in Delhi, India. Patients visiting the TCC from April 2016 to March 2018 were contacted to participate in this study. All the willing participants were administered a structured questionnaire telephonically or in person. The questionnaire focused on gathering information on patients' current tobacco use status, feedback on intervention provided at TCC and reasons for missing TCC appointments. Bivariate and multivariate analysis was performed to assess the effect of socio-demographic factors, nicotine dependence and interventions at TCC on current tobacco use status of participants. Of the 309 participants, 60 (19.4%) reported complete tobacco abstinence and 78 (22.3%) reduced consumption by more than half from their first visit to TCC. Most of the participants (81.5%) were satisfied with the tobacco cessation interventions provided at the TCC. Multivariate analysis shows that odds of quitting were higher in participants with low tobacco dependence (OR 3.03, CI 0.98,9.35) and those who were satisfied with counselling method at TCC (OR 8.8, CI 2.05, 38.35). Interventions provided at our TCC were found beneficial by the study participants to reduce tobacco consumption or achieve total tobacco abstinence. A timely reminder can be provided to increase patients' compliance.