Tobacco Cessation Programs Research Articles

Post-discharge tobacco abstinence in a Mumbai hospital after implementation of tobacco cessation counseling: A pragmatic evaluation of the LifeFirst program.

Hospitalization provides a key opportunity to address tobacco use. Few studies have examined cessation treatment in hospitals in low- and middle-income countries (LMIC). We aimed to measure tobacco abstinence among individuals discharged from a Mumbai hospital after the implementation of cessation counseling compared to abstinence among those discharged pre-implementation. Pre-post intervention study in the Prince Aly Khan Hospital, Mumbai pre- (11/2015-10/2016) and post-implementation (02/2018-02/2020) of LifeFirst counseling. LifeFirst is multi-session (up to six sessions) counseling extending from hospitalization up to six months post-discharge. Primary analyses compare self-reported 6-month continuous abstinence among hospitalized individuals post-implementation (intervention) with pre-implementation (comparator) using an intent-to-treat approach that includes all participants offered LifeFirst post-implementation in the intervention group. Secondary analyses compare those who received ≥ 1 LifeFirst session with the pre-implementation group. We enrolled n = 437 individuals pre-implementation (8.7% dual use, 57.7% smokeless tobacco, 33.6% smoking) and n = 561 post-implementation (8.6% dual use, 64.3% smokeless tobacco, 27.1% smoking). Post-implementation, 490 patients (87.3%) accepted ≥ 1 counseling session. Continuous abstinence 6-months post-discharge was higher post-implementation (post: 41.6% vs. pre: 20.0%; adjusted odds ratio [aOR]: 2.86, 95% confidence interval [CI] 1.94-4.21). Those who received LifeFirst had higher odds of continuous abstinence compared to pre-implementation (aOR: 2.95, 95% CI 1.98-4.40). Post-discharge abstinence was more common after implementation of a multi-session tobacco counseling program for hospitalized patients compared to abstinence among patients hospitalized before implementation. These findings represent observational evidence of a promising association between post-discharge abstinence and a hospital-based tobacco cessation program implemented within routine practice in an LMIC setting.

Smokeless tobacco use and its associated factors among secondary school students of Rangeli Municipality of Morang district, Nepal.

The tobacco epidemic is one of the biggest public health threats and the world's leading cause of preventable death which is responsible for killing 8 million people every year. Adolescents are the vulnerable age group and are at greater risk of any tobacco use including smokeless tobacco (SLT) and nicotine addiction. Tobacco use at a young age increases the risk of various non-communicable diseases (NCDs) such as respiratory illness, asthma, chronic obstructive respiratory disease (COPD), reduced pulmonary function, and cancers. This study aimed to determine the prevalence of smokeless tobacco and its associated factors among secondary school students of grades 11 and 12 in Rangeli Municipality, Nepal. A cross-sectional study was conducted among 355 students from the selected secondary schools. A self-administered questionnaire was used to collect the data. Data was cleaned and then exported to IBM SPSS Statistics 20 for analysis. Participants' characteristics were described using frequencies, percentages, mean, and standard deviation. Multivariate logistic regression was conducted to determine the association between individual characteristics and prevalence of smokeless tobacco. All the tests were performed at a 95% Confidence Interval (CI) and a p-value less than 0.05. The mean (±SD) age of the participants was 18.0±1.3 years. Most participants were female (61.1%). The majority of the participants were from grade 11 (58.3%), government schools (60%), and nuclear families (64.8%). This study found that 38.4% and 61.6% of the participants were SLT ever users and never users respectively. Among the ever users, 29.5% were current users and most tried (47.7%) at the age of 10-14 years. Most participants revealed that homes and public places were common sites for SLT use. Paan Masala and Gutkha were the most commonly preferrable SLTs. This study found that age (AOR = 1.5, CI: 1.2-2.2), sex (AOR = 2.6, CI:1.6-4.4), and school type (AOR = 1.8, CI:1.1-3.0) were significantly associated with the prevalence of SLT. This study found that the prevalence of current SLT users is higher than the national survey. This study concludes that males, young adolescents, and students from private schools are at greater risk of SLT use and are unaware of the consequences on their health. Concerned stakeholders must expand awareness and promote educational programs on the harmful use of tobacco targeting secondary school students. The government organizations, educational institutions, and private organizations jointly work to strengthen the implementation of tobacco cessation programs and tobacco control strategies.

Call to quit: Results of a remote, longitudinal tobacco cessation program.

356 Background: Tobacco cessation counseling remains suboptimal for patients with cancer. The current iteration of the Dana-Farber Cancer Institute Tobacco Cessation Program was established in 2021 to provide virtual, longitudinal tobacco session counseling to patients with cancer. Here, we report the Program’s experience. Methods: The DFCI Tobacco Cessation Program data from 2021 to 2023 was analyzed. Descriptive statistics summarized demographics and tobacco cessation experiences from baseline and follow-up visits. Results: Of 227 patients referred to the Program and included in the analysis (Table 1), 161 declined participation. 63 participants attended a baseline visit, of whom the median age for first cigarette was 15 years (range: 10-32) and the median age for regular tobacco use was 17 years (range: 10-61). Prior to baseline, most participants (n=43) indicated using tobacco daily; the median number of daily cigarettes was 11-15. Many (n=41) reported smoking within 30 minutes of waking up, and most considered tobacco use to be an addiction (n=50). Though a considerable number of participants (n=27) reported quitting smoking to be extremely important to them, confidence in quitting varied; the most frequently selected confidence level was 5/10 (n=14). Past use of tobacco cessation drugs was reported by one-third of participants (n=22); past use of nicotine replacement therapy was reported by nearly half (n=30). The most frequently reported perceived benefit of quitting smoking was better health (n=48). 51 participants had at least one follow-up visit (median: 4, range: 1-23). At the time of first follow-up, 10 reported decreasing the number of cigarettes smoked per day, 20 reported no change, and 3 reported an increase. However, among 24 participants who attended a fifth visit, 8 reported a decrease and 6 reported no change. Of 11 patients who had attended at least 10 visits, 5 reported decreasing their number of daily cigarettes. 13/63 (20.6%) of all participants reported quitting smoking after enrolling, with a median time from baseline assessment to smoke-free status of 34 days. Conclusions: Remote, longitudinal tobacco cessation programs provide an effective way to increase access to tobacco cessation counseling for patients with cancer. However, limitations include high decline rates and loss to follow up. Future analysis of our program will help better understand tobacco cessation efforts. Demographics Approached (n=227) Attended Baseline (n=63) Median Age 60 62 Sex Female 130 (57.3%) | Male 94 (41.4%) |Prefer not to say/Unknown 3 (1.3%) Female 36 (57.1%) |Male 26 (41.3%) |Prefer not to say 1 (1.6%) Cancer Lung 80 (35.2%) |Breast 46 (20.3%) |Head & Neck 27 (11.9%) |GI 24 (10.6%) Lung 22 (34.9%) |Breast 9 (14.3%) |Head & Neck 11 (17.5%) |Lymphoma 6 (9.5%) Race: White 191 (84.1%) 52 (82.5%) Black 17 (7.5%) 4 (6.3%) Asian 4 (1.8%) 1 (1.6%) Other/Prefer not to say 15 (6.6%) 6 (9.5%) Hispanic 8 (3.6%) 3 (5.1%)

The influence of sociodemographic, tobacco use, and mental health characteristics on treatment adherence among adults enrolled in a community-based tobacco cessation program

BackgroundWhile counseling and pharmacological interventions are known to facilitate smoking cessation, poor adherence can impact their effectiveness. Therefore, this study aimed to identify personal and clinical factors that influenced adherence to smoking cessation treatment among socioeconomically disadvantaged adult Oklahomans enrolled in a publicly available tobacco treatment program and observational research study. MethodsAdult participants (N = 442) were enrolled in a community-based tobacco treatment program. Logistic regression models identified sociodemographic, mental health, and substance use characteristics associated with treatment adherence. Adherence was measured by counseling session attendance and weeks of moderate/high medication adherence assessed via the Medication Adherence Questionnaire. Analyses were conducted using SAS 9.4 with p < 0.05. ResultsParticipants (mean age of 53, 55 % female, and 42.3 % racially minoritized, smoked 16 (SD = 10) cigarettes/day for 30 years on average (SD = 15), and 44.8 % reported depression (Center for Epidemiological Studies Depression Scale [CESD] score ≥ 10). Self-efficacy, White race, increasing age, and years of smoking were positively associated with counseling adherence, while menthol use, being uninsured, and depression predicted lower counseling adherence. Medication adherence was lower among individuals who used menthol cigarettes, lived with someone who smoked, and had higher levels of expired carbon monoxide. ConclusionsThis study highlights key factors that influenced adherence to smoking cessation treatment in a socioeconomically disadvantaged population. Tailored interventions are needed to address social, behavioral, and environmental factors, such as living situations and mental health, in smoking cessation interventions to enhance treatment outcomes for underserved populations. Future tobacco cessation programs should consider these factors to improve adherence and, ultimately, success rates.

Abstract B042: Gender-affirming cessation support for LGBTQ+ tobacco users: Establishing TheQuitAlliance

Abstract Background. The LGBTQ+ community faces various stressors, including stigma, discrimination, and harassment, which are linked to their sexual orientation or gender identity. Additionally, they are targeted by tobacco companies through marketing, which increases tobacco use and other health problems. LGB adults use commercial tobacco products at a higher rate than the general population (25.1% versus 18.8%), and tobacco use is even higher among transgender adults according to the CDC. Without peer support, counseling, nicotine replacement therapy (NRT), and community resources to address barriers to quitting, tobacco users are less likely to succeed in quitting. Research has shown that gender-affirming tobacco cessation interventions can be highly effective in helping LGBTQ+ individuals quit tobacco; however, little is known about its effectiveness in Latinx communities and other groups with intersectional identities. Methods. To improve access to culturally tailored and gender-affirming cessation resources that acknowledge the unique experiences and stressors faced by our community, Cedars-Sinai Cancer COE developed TheQuitAlliance, a LGBTQ+ focused tobacco cessation program. This multi-level approach involved web-based resources, information and presentation to the community. A series of gender affirming support groups facilitated by trained Spanish speaking tobacco cessation specialists who are members of the LGBTQ+ community was offered to tobacco users. The first steps involved improving their knowledge on how tobacco affects specific populations, such as transgender, non-binary, gender non-conforming individuals, people living with HIV, youth, and the types of nicotine replacement therapies available. RESULTS: In 2023, our partners The Wall Las Memorias and Latino Equality Alliance implemented a screening tool using the Ask, Advise, and Refer model, expanded outreach efforts, and successfully identified N=242 LGBTQ+ tobacco users who were referred to our virtual gender affirming support group. Among current smokers who participated in a series of three support groups, 85% (17 of 20) indicated positive attitudes towards the importance of changing their smoking behaviors, readiness to change, and having control over their ability to make positive change right now, while 90% are committed to taking steps towards change right now (18 of 20). In 2024, The Wall Las Memorias reached 500 LGBTQ+ community members and linked 70 tobacco users to cessation support groups. Conclusion. Our survey indicated that participating in a gender affirming cessation intervention can increase self-efficacy to take steps towards quitting tobacco. Through safe spaces created by The Quit Alliance, we found that LGBTQ+ tobacco users are also able to make connections with others to be supported in their journey to becoming tobacco free. Citation Format: Victor Crisanto, Alexandra Caro, Reener Balingit, Zul Surani. Gender-affirming cessation support for LGBTQ+ tobacco users: Establishing TheQuitAlliance [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B042.

School-based tobacco prevention and cessation program using psycho-education and counselling: a mixed method

Introduction. In Malaysia, tobacco-related causes of death have claimed an estimated 27,400 lives annually, and that number is anticipated to climb in the coming years. Despite laws in Malaysia banning smoking in public areas, restrictions on tobacco sponsorship, promotion, and advertising in all media, as well as Graphic Warning Labels (GWLs) on cigarette packets and restricting the legal smoking age to 18 years, it is well-known that children and teenagers are involved and youth tobacco usage is rising. As there is a rise in the prevalence of tobacco use so is the call for effective school-based tobacco prevention and cessation program for children and teenagers. The study set out to understand the current level of knowledge, attitude, and behaviour of children and teenagers towards tobacco use and possible change through psycho-education and counselling towards prevention and cessation. Study participants and methods. This study adopted a pre and post Mixed Method Triangulation Design: Convergence Model. There was an independent and concurrent collection of quantitative and qualitative data from school children ages 11 to 18 years and 7 to 10 years respectively. A one-day four-module school-based prevention and cessation program was developed and carried out in five approved schools and data were collected before and after the program. The mean age for the quantitative study was 13 years, 66% were males and 34% were females. For the qualitative study, the mean age was 9 years, 54% were male and 46% were female A grand total of 131 students participated in the study. The data was analyzed using descriptive statistics, paired samples t-test thematic analysis. Results. The quantitative analysis showed a significant difference between knowledge test scores before psychoeducation intervention (M=.803; SD=.1793) and Knowledge test scores after the psycho-education intervention (M=.895; SD=.1193); [t (108) = -4.596, p = .000], attitude and behavior were insignificant Results from the thematic analysis on the qualitative results showed that the psychoeducation and counselling intervention had a significant impact only on knowledge. The children report on attitude and behaviour towards tobacco did not significantly change from before to after the program. The timing between the program and postdata may be a contributing factor but irrespective of the data collection method the outcome was similar for both children and teenagers. Practical Significance. Through psycho-education and counselling towards prevention and cessation the study set out to understand the current level of knowledge, attitude, and behaviour of children and teenagers towards tobacco use and possible change through psycho-education and counselling towards prevention and cessation. Therefore, intervention programme should include psychoeducation and counselling to improve the knowledge of students in school-based interventions.

Lung cancer screening: new frontiers

Lung cancer is the leading cause of cancer-related deaths worldwide. In early, asymptomatic stages, curative treatment is possible, but the disease is often diagnosed too late. Lung cancer screening (LCS) using low-dose computed tomography (LDCT) helps to detect potentially malignant lesions in early stages and to reduce lung cancer mortality. The application of artificial intelligence (AI) algorithms enables amore precise analysis of LDCT scans. Ameta-analysis of eight LCS studies revealed astatistically significant 12% relative reduction in lung cancer mortality. Based on strong scientific evidence, arecommendation for astructured lung cancer screening program using LDCT for the high-risk population in Germany was issued. The holistic LCS program requires aclear definition of the high-risk population, individual risk assessment, qualified personnel for conducting and reading examinations, verification of all diagnostic and therapeutic steps, central documentation and quality assurance, as well as the integration of tobacco cessation programs.

Efficacy of the QuitSure App for Smoking Cessation in Adult Smokers: Cross-Sectional Web Survey.

Cigarette smoking remains one of the leading causes of preventable death worldwide. A worldwide study by the World Health Organization concluded that more than 8 million people die every year from smoking, tobacco consumption, and secondhand smoke. The most effective tobacco cessation programs require personalized human intervention combined with costly pharmaceutical supplementation, making them unaffordable or inaccessible to most tobacco users. Thus, digital interventions offer a promising alternative to these traditional methods. However, the leading smartphone apps available in the market today have either not been studied in a clinical setting or are unable to match the smoking cessation success rates of their expensive offline counterparts. We would like to understand whether QuitSure, a novel smoking cessation app built by Rapidkart Online Private Limited, is able to bridge this efficacy gap and deliver affordable and effective smoking cessation at scale. Our objective was to do an initial exploration into the engagement, efficacy, and safety of QuitSure based on the self-reported experiences of its users. Outcomes measured were program completion, the effect of program completion on smoking behavior, including self-reported cessation outcomes, and negative health events from using the app. All QuitSure registered users who created their accounts on the QuitSure app between April 1, 2021, and February 28, 2022, were sent an anonymized web-based survey. The survey results were added to their engagement data on the app to evaluate the feasibility and efficacy of the app as a smoking cessation intervention. The data were analyzed using descriptive statistics (frequencies and percentages) and the χ2 test of independence. In total, 1299 users who had completed the QuitSure program submitted the survey and satisfied the inclusion criteria of the study. Of these, 1286 participants had completed the program more than 30 days before filling out the survey, and 1040 (80.1%, 95% CI 79.1%-82.6%) of them had maintained prolonged abstinence for at least 30 days after program completion. A majority of participants (770/891, 86.4%) who were still maintaining abstinence at the time of submitting the survey did not experience any severe nicotine withdrawal symptoms, while 41.9% (373/891) experienced no mild withdrawal symptoms either. Smoking quantity prior to completing the program significantly affected quit rates (P<.001), with heavy smokers (>20 cigarettes per day) having a lower 30-day prolonged abstinence rate (relative risk=0.91; 95% CI 90.0%-96.2%) compared to lighter smokers. No additional adverse events outside of known nicotine withdrawal symptoms were reported. The nature of web-based surveys and cohort selection allows for extensive unknown biases. However, the efficacy rates of survey respondents who completed the program were high and provide a case for further investigation in the form of randomized controlled trials on the QuitSure tobacco cessation program.

Incidence of Ischemic Heart Disease (IHD) in Smokeless Tobacco/Naswar Users Versus Non-Users Following Coronary Interventions

Background: Ischemic heart disease (IHD) is a significant health concern globally, with various risk factors affecting the outcomes of therapeutic interventions like percutaneous coronary interventions (PCIs) and coronary artery bypass grafting (CABG). The use of smokeless tobacco products such as SLT (snus, loose snuff) and Naswar is prevalent in South Asia and poses additional risks due to its cardiovascular implications. Objective: This study aims to assess the impact of smokeless tobacco (SLT/Naswar) use on the incidence of IHD following coronary interventions, highlighting the need for tailored healthcare strategies to address this modifiable risk factor. Methods: A prospective observational study was conducted from July 1, 2023, to January 1, 2024, involving 200 participants aged 18 to 80 years diagnosed with IHD. Data collection involved structured interviews and comprehensive reviews of health records. Statistical analyses included Chi-square tests and logistic regression to evaluate the association between SLT/Naswar usage and IHD incidence post-intervention, with SPSS software utilized for all computations. Results: Among the participants, 40.5% were users of SLT/Naswar. Post-coronary intervention, SLT/Naswar users showed a 66% incidence rate of IHD compared to 48% in non-users, with a statistically significant difference (P=0.032). Successful intervention rates were 62% in SLT/Naswar users versus 78% in non-users. Complication rates such as re-stenosis were higher in SLT/Naswar users (29% vs. 16%). Conclusion: The study demonstrates that SLT/Naswar use significantly impacts the outcomes of coronary interventions, with a higher incidence of IHD and complications among users. These findings underscore the importance of integrating smokeless tobacco cessation programs into cardiovascular care protocols.

Economic Considerations for Implementing Tobacco Cessation Programs in Cancer Care Settings.

Increasingly, research demonstrates economic benefits of tobacco cessation in cancer care, as seen in a new study by Kypriotakis and colleagues of the MD Anderson cessation program, demonstrating median health care cost savings of $1,095 per patient over 3 months. While the cost-effectiveness of tobacco cessation programs from a hospital perspective is important, implementation decisions in a predominantly fee-for-service system, such as in the United States, too often insufficiently value this outcome. Economic barriers, stakeholder disincentives, and payment models all impact program implementation. Combining economic evaluation with implementation research, including assessment of return-on-investment, may enhance sustainability and inform decision-making in cancer care settings. See related article by Kypriotakis et al., p. 217.

The effectiveness of a standardized tobacco cessation program on psychophysiological parameters in patients with addiction undergoing long-term rehabilitation: a quasi-experimental pilot study.

Although there is a very high comorbidity between tobacco dependence and other addictive disorders, there are only few studies examining the implementation and outcomes of a tobacco cessation program in patients with addictive diseases. Therefore, the aim of this study is to investigate to what extent a standardized tobacco cessation program leads to improvements regarding psychological/physical parameters in patients with addiction undergoing therapy and whether there is a reduction in tobacco consumption. The study took place in a therapeutic community specialized in addiction therapy. A total sample of 56 participants were non-randomly assigned to an intervention group (IG; n = 31) and a treatment as usual group (TAUG; n = 25). The IG participated in a 6-week tobacco cessation program, while the TAUG received no additional treatment. Both groups were assessed for changes in primary outcomes (tobacco dependence, smoked cigarettes per day (CPD), and general substance-related craving) and secondary outcomes (heart rate variability (HRV): root mean square of successive differences, self-efficacy, and comorbid psychiatric symptoms) at two measurement time points (pre- and post-treatment/6weeks). We observed significant improvements in self-efficacy (F(1,53) = 5.86; p < .05; ηp2 = .11) and decreased CPD in the IG (β = 1.16, ρ < .05), while no significant changes were observed in the TAUG. No significant interaction effects were observed in psychiatric symptoms, general substance-related craving, and HRV. The results highlight the potential benefit of an additional tobacco cessation program as part of a general addiction treatment. Although no improvements in the physiological domain were observed, there were significant improvements regarding self-efficacy and CPD in the IG compared to the TAUG. Randomized controlled trials on larger samples would be an important next step. ISRCTN15684371.

Knowledge of Tobacco Cessation among Adult Patients Visiting a Rural Satellite Center: A Cross-Sectional Study

AbstractThe prevalence of all types of tobacco use among men has been reported to be high in most parts of India (generally exceeding 50%). Nearly 95 to 100% of tobacco users develop periodontal diseases that have a diminishing effect on oral health.A structured paper-based self-administered questionnaire comprising 15 close-ended questions was formulated for the purpose of data collection for this cross-sectional survey and a sample size of 323 was estimated. Total enumeration sampling method was followed. A significant gender-wise and socioeconomic-status-wise difference was observed based on the form of tobacco used. In this cross-sectional study, 54 (16.7%) individuals began the habit before the age of 15 years, of which 14.2% of the individuals used the smoked variant and 2.4% of the individuals used the smokeless variant of tobacco.Total 265 (82%) individuals were aware that the habit was injurious to their health, of which 90% males and 86.4% females were aware of the harmful effects of the habit. While the awareness among the upper socioeconomic group was higher, the lower socioeconomic group displayed a lower level of awareness.To advocate effective tobacco cessation programs, understanding the dependence on tobacco habit and their knowledge and attitude toward quitting tobacco plays a major role. Hence the present study was conducted with an objective to assess the knowledge and attitude of the patients toward tobacco cessation.

To Correlate the Oral Health-related Quality of Life Between Smokers and Smokeless Tobacco Users Among 35–44 Years Age Group Attending Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India

Background: Tobacco use poses severe health risks globally, affecting both young people and adults. It is highly addictive and a major contributor to various diseases, including cancer. This research at Teerthanker Mahaveer Dental College and Research Centre (TMDC and RC), Moradabad, focused on participants aged 35–44, highlighting the urgent need to address tobacco-related issues for public health and economic well-being. Aim: This study assesses the occurrence of smokers and smokeless tobacco and analyzes its correlation with the oral health-related quality of life (OHRQoL) among participants. Materials and Methods: A prevalence study was substantiated at TMDC and RC, Moradabad, involving 640 participants aged between 35 and 44 years. Informed assent was obtained from all participants. Sociodemographic information was collected, and their oral mucous lesions were assessed using the World Health Organization form. In addition, participants completed a validated Hindi version of the Oral Health Impact Profile-14 questionnaire to evaluate their OHRQoL. Results: The study revealed a higher prevalence of tobacco usage among males compared to females. Furthermore, the prevalence of smoking was established to be greater than that of smokeless tobacco. Consequently, a statistically apparent association was recognized between smokers and their OHRQoL, as well as between users of smokeless tobacco and their OHRQoL. However, no association was established between smokers, smokeless tobacco users, and OHRQoL when considering the significance value. Conclusion: The study indicates that individuals aged 35–44 years who use either smoked or smokeless tobacco experience similar impacts on their OHRQoL. Encouraging regular dental examinations, facilitating access to tobacco cessation programs, and extending support for individuals to sustain tobacco-free lifestyles are indispensable strategies for amplifying oral health outcomes besides the overall quality of life among individuals aged 35–44.

Evaluation of a smoking cessation program for adults with severe mental illness in a public mental health service.

Smoking rates have decreased in the general population but remain high among people with severe mental illness (SMI). An individualized smoking cessation program was tested with 99 adults with SMI. The program showed it is possible to help people with SMI smoke fewer cigarettes and reduce nicotine addiction. Customized smoking cessation programs are essential for those with high nicotine dependence and mental health challenges. Mental health services should offer tailored tobacco cessation programs because these programs can improve the health of people with mental illness who smoke. It is important for mental health services to follow government guidelines and provide evidence-based support. INTRODUCTION: Despite significant reductions in smoking rates in the general population over recent decades, smoking rates remain relatively unchanged among people with SMI. To evaluate the feasibility and preliminary effectiveness of the Keep Quitting in Mind pilot program, an individualized smoking cessation program for people experiencing SMI. In total, 99 adult participants with SMI and engaged with a community mental health service, participated in the intervention. The intervention included motivational interviewing and goal setting, in addition to provision of pharmaceutical aids (including nicotine replacement therapy). Analysis determined that the Keep Quitting in Mind pilot program was feasible in a public adult mental health service and participation in the program was associated with reductions in the number of cigarettes smoked daily and level of nicotine addiction. This real-world pilot program demonstrated feasibility and potential effectiveness in reducing smoking among adults with mental illness. Aligning with government guidelines, tailored smoking cessation programs are crucial due to high nicotine dependence and mental health complexities. Given the high rates of cigarette smoking by people with mental illness and the cardiometabolic health risks associated with this, mental health services should consider adding evidence-based and bespoke tobacco cessation programs as part of core business.

Integration of a Tobacco Cessation Program into a Rural Community-Based Maternal and Child Health Program in India: A Stakeholders' Perspective on Task Shifting.

According to the Global Adult Tobacco Survey-2, India, 7.5% of pregnant women are tobacco users with a high prevalence of smokeless tobacco use in rural India. Although pregnant women may receive advice to quit tobacco, lack of knowledge on providing cessation support among healthcare workers results in missed opportunities. Community Health Workers (CHWs) play a significant role in maternal and child health (MCH) programs. Thus, task-shifting for providing cessation support by CHWs was planned and the perceptions and attitudes of concerned stakeholders were explored. A pre-implementation qualitative study was conducted in four states of India within existing rural, community-based MCH program settings. Implementation research frameworks were used to develop data collection tools and for inductive and deductive thematic analysis. In-depth interviews were conducted with stakeholders (n = 28) like coordinators, pregnant women, and village functionaries of the government health system. Four focus groups were conducted with female CHWs (n = 24). Stakeholders intended to adopt the intervention as objectives of the cessation intervention were aligned with the aims of the MCH program. CHWs related to their role in task-shifting and understood the context for implementing the intervention within the MCH program. Pregnant women expressed openness to receiving cessation support from CHWs acting as a facilitator for task-shifting. Barriers anticipated were the additional workload and time required for CHWs to implement the intervention. Task-shifting to female CHWs for screening tobacco users, providing brief advice and cessation support within the MCH program was perceived to be acceptable, adoptable, and feasible. The study builds insight into the process of developing a grounded approach for the integration of tobacco cessation intervention into a rural, community-based antenatal care setting by task shifting to female CHWs for providing cessation support to pregnant women. The study fills gaps in the literature related to establishing tobacco cessation interventions for pregnant women. The delineated efforts in integration of the intervention and task shifting can be replicated in other developing countries, especially in rural communities within South Asian and Southeast Asian regions having cultural practices, community-based healthcare structures, and tobacco consumption patterns that are comparable to India.

Effect of an intensive tobacco cessation program on the smoker narrative: A content analysis and grounded theory.

The smoker's narrative during smoking quitting provides insight into aspects not fully explored in daily clinical practice. The aim of the study was to analyze the smoker narrative using two types of methodologies: content analysis and grounded theory, before and after smoking cessation intervention, provided to the smoker in a specialized Smoking Cessation Unit accredited by the Spanish Society of Pneumology and Thoracic Surgery. A prospective observational study of current smokers included in a tobacco cessation program between 2017 and 2020 was conducted at the Smoking Cessation Unit of Santiago de Compostela Health Area, Spain. Routine clinical variables and patient narrative data were collected. A descriptive analysis of the sample, the content of the textual corpus, and a grounded theory were performed in semi-structured interviews at baseline and at follow-up at 6 months. A total of 116 patients were included (mean age 55.6 ± 10.6 years; 56.9% male; mean nicotine dependence score 5.7 ± 1.6). Quantitative analysis of the narrative shows that the most frequent phrases and words are associated with smoking, nicotine craving, and predisposition for smoking cessation. After the intervention, phrases related to the manifestation of abstinence, response to pharmacological treatment, and self-perception of smoking cessation were predominant. In the qualitative analysis, the most frequent categories in the smoker's textual corpus were dependence, motivation, and emotionality, which decreased after the intervention (11.4%, 21.4%, and 9.9%, respectively) accompanied by increased satisfaction (19.2%) and the manifestation of abstinence (21.5%). Motivation, nicotine dependence, and sensitivity to emotions are all closely intertwined in the current smoker narrative and can be modified as a consequence of treatment.

Associations of Smoking Behaviors and Body Mass Index Among American Participants of a Clinical Tobacco Cessation Program: A Pilot Study.

Tobacco usage and obesity remain critical public health issues in the United States. This study examined the relationship between smoking behaviors, specifically-cigarettes per day (CPD) and motivations to smoke-and body mass index (BMI). We hypothesized that motivations related to food or stress, as well as a higher CPD, will be positively associated with BMI. We analyzed the electronic medical records of 204 patients from the Johns Hopkins' Tobacco Treatment and Cancer Screening Clinic (TTCSC) between January and April 2022. Demographic information, smoking behavior, CPD, and motivations to smoke were recorded. Multiple linear regression analysis was performed. We found no statistical significance between motivations to smoke, CPD, and BMI. However, the age at a patient's first visit to the TTCSC was negatively associated with BMI (B = -0.152, P < 0.001). Smoking behaviors were not significantly related to BMI in our sample. It is advisable for clinicians working in tobacco cessation clinics to consider the BMI of individuals who present for cessation services, especially for younger individuals who smoke. They may be more likely to have an elevated BMI at presentation.

Implementation of Tobacco Cessation Program for Dental Undergraduates in their Curriculum: The Need and Suggested Plan

Implementation of Tobacco Cessation Program for Dental Undergraduates in their Curriculum: The Need and Suggested Plan

Perception of tobacco hazards on general and periodontal health and tobacco cessation counseling among dental students.

Tobacco use is one of the leading worldwide health risk factors and a primary cause of premature death and disability. Tobacco cessation programs might work well if provided by all healthcare providers. This study aimed to evaluate dental students' knowledge, attitudes, beliefs, and practices towards tobacco hazards on general and periodontal health and tobacco cessation councling. A descriptive cross-sectional study was conducted among dental students who were in their clinical years (the fourth, fifth and sixth year of study), in Saudia Arabia in 2022. A self-administered questionnaire derived from the TCC questionnaire survey was carried out among 315 dental students. Knowledge was considered poor if correct answers were below the median value. Attitude was on a five-point Likert scale. Adjusted logistic regression analyses were performed. The study revealed that about 52% have poor knowledge, 64% have negative attitudes, 69% have negative beliefs, and 44% poor practice. All these ratings were below median values. It also showed that younger dental students were 2 times more likely to have poor knowledge (AOR=1.97; 95% CI: 1.1-3.53) and smokers were less likely to have poor knowledge (AOR=0.34; 95% CI: 0.12-0.95). One third of students perceived patient resistance as a barrier to TCC while 50% reported lack of knowledge, 32% lack of time, and 24% lack of materials. The study findings urge the inclusion of programs to encourage dental students to help patients quit tobacco use and to make educational material available to them.

The association between childhood trauma and tobacco smoking in patients with psychosis, unaffected siblings, and healthy controls.

In patients with psychosis, rates of tobacco smoking and childhood trauma are significantly higher compared to the general population. Childhood trauma has been proposed as a risk factor for tobacco smoking. However, little is known about the relationship between childhood trauma and smoking in psychosis. In a subsample of the Genetic Risk and Outcome of Psychosis study (760 patients with psychosis, 991 unaffected siblings, and 491 healthy controls), tobacco smoking was assessed using the Composite International Diagnostic Interview and childhood trauma was measured with the Childhood Trauma Questionnaire. Logistic regression models were used to assess associations between trauma and smoking, while correcting for confounders. Positive associations were found between total trauma, abuse, and neglect, and an increased risk for smoking in patients, while correcting for age and gender (ORtrauma 1.77, 95% CI 1.30-2.42, p < 0.001; ORabuse 1.69, 95% CI 1.23-2.31, p = 0.001; ORneglect 1.48, 95% CI 1.08-2.02, p = 0.014). In controls, total trauma and abuse were positively associated with smoking, while correcting for age and gender (ORtrauma 2.40, 95% CI 1.49-3.88, p < 0.001; ORabuse 2.02, 96% CI 1.23-3.32, p = 0.006). All associations lost their significance after controlling for additional covariates and multiple testing. Findings suggest that the association between childhood trauma and tobacco smoking can be mainly explained by confounders (gender, cannabis use, and education) in patients with psychosis. These identified aspects should be acknowledged in tobacco cessation programs.