Original Articles
A content analysis of free smoking cessation mobile applications in the USA
- JuHan Lee, Jesse Dallery, Antonio Laracuente, Ifeoma Ibe, Samantha Joseph, Jinhai Huo, Ramzi G. Salloum
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- Published online by Cambridge University Press:
- 23 April 2019, pp. 195-202
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Aims
To evaluate the quality and content of free smoking cessation apps and assess their adherence to the US Public Health Service guideline for treating tobacco use and dependence.
MethodsIn total 180 apps were downloaded from the App Store and Google Play Store in January 2018; the top-ranking 30 apps were retrieved for the search terms: ‘smoking cessation’, ‘quit smoking’, ‘stop smoking’. Technical quality was rated using the Mobile Application Rating Scale (MARS) and by assessing other characteristics, behavioral change strategies and adherence to the 5As.
Results/findingsA total 67 free-to-download apps were identified for full review (n = 40 from the Apple App Store and n = 27 from the Google Play Store). The average MARS score was 16.2/19.0: Engagement (3.3/5.0), Functionality (4.4/5.0), Aesthetics (4.0/5.0), and Information (2.6/5.0). Overall, 43 apps allowed sharing, 12 allowed for an app community, and five required a password. The following features were observed: assessment (n = 51), feedback (n = 38), information/education (n = 45), monitoring (n = 52), and goal setting (n = 23). Significant differences were found among apps adhering to the 5As: Ask (n = 44), Advise (n = 54), Assess (n = 30), Assist (n = 62), and Arrange (n = 0).
ConclusionsGiven the growth in smoking cessation apps, future efforts should focus on improving their technical quality and adherence to the 5As.
Developing a Worksite-based Culturally Adapted Smoking Cessation Intervention for Male Hispanic/Latino Construction Workers
- Noella A. Dietz, Taghrid Asfar, Alberto J. Caban-Martinez, Kenneth D. Ward, Katerina Santiago, Estefania C. Ruano-Herreria, Laura A. McClure, David J. Lee
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- Published online by Cambridge University Press:
- 11 May 2018, pp. 73-82
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Introduction: Over 2.6 million Hispanic/Latino construction workers (CWs) live in the US; 91% of South Florida CWs are Hispanic/Latino. CWs have higher smoking and lower cessation rates than other workers. Limited access to cessation services, worksite turnover, and lack of interventions tailored to culture/occupation hinder cessation. Partnering with worksite food trucks to deliver unique cessation interventions may improve these efforts.
Aims: To explore a novel cessation approach, assess worker/worksite acceptability, and seek input into intervention development.
Methods: In 2016, we conducted five semi-structured focus groups with 37 smoking Hispanic/Latino CWs. Constant comparative analysis was used to examine a priori themes regarding smoking behaviours, cessation treatments, intervention delivery, cultural adaptation, and quit interest.
Results: CWs reported tremendous job stress. Most smoking occurred during the workday and most CWs did not use nicotine replacement therapy with past quit attempts. Most CWs were open to a worksite face-to-face group cessation intervention before work (many underutilize breaks and feel pressure to keep working). CWs felt it unnecessary to tailor the intervention to Hispanics/Latinos indicating smokers are the same regardless of race/ethnicity.
Conclusions: Findings demonstrate the need to consider work environments, job demands/stress, and worker preferences when developing accessible and acceptable cessation interventions.
Pilot Study of an Internet-Based, Simulated Teachable Moment for Smoking Cessation
- Robin May, Frances Walker, Simon de Burgh, Roger Bartrop, (dec.), Geoffrey H Tofler
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- Published online by Cambridge University Press:
- 28 September 2018, pp. 139-148
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Introduction
The internet has the potential to overcome geographic limitations for smoking cessation interventions, but further telehealth-based studies of utility are required.
AimsTo investigate the efficacy of an internet-based version of a quit smoking approach using a personalised video to create a simulated teachable moment.
MethodsSmokers within Australia were recruited through a dedicated website. After consent, eligible subjects, aged ≥30 years with a non-smoking partner, uploaded pictures of themselves, their partner and family, to be inserted into a video depicting the subject having a heart attack due to smoking, with consequences to them and their family. Nicotine replacement therapy (NRT) began prior to the quit attempt. The video was shown during two videoconference counselling sessions, with follow-up phone calls and text messaging support. Smoking status at 6 months by self-report (primary endpoint) was verified by partner/proxy and salivary cotinine (NicAlert™).
Results/FindingsSeventy seven smokers were screened, of whom 50 were eligible, and 17 of these (34%) were enrolled; 11 men and 6 women, aged 41.5 ± 6.9 years, daily cigarette consumption 20.8 ± 8.9, Heaviness of Smoking Index score 3.7 ± 1.7. Participants reported feeling personally involved with the video (5.9 ± 1.1), which felt real (5.8 ± 1.1) and emotionally moving (5.6 ± 1.5) [7-point Likert Scale]. A similar video response was reported by the four participants (24%), who due to bandwidth limitations, watched the video after the counselling session instead of during it. Non-smoking rates at 6 months were 65% (11/17) by self-report with proxy confirmation, and 47% (8/17) by self-report with biologic confirmation. Three non-smokers by self-report could not provide a valid NicAlert™ result due to current NRT use. One participant who by self-report smoked once in the prior 14-days was assessed as a non-smoker by both proxy and NicAlert™.
ConclusionsThis pilot study demonstrates efficacy for an internet-based version of a quit smoking program based on creating a simulated teachable moment. The findings provide support for further research into this technique, with the internet enabling greater reach than face-to-face.
The Role of the Subjective Importance of Smoking (SIMS) in Cessation and Abstinence
- Daniel Rodriguez, Tiffanie Goulazian, Andrew A. Strasser, Jennifer O'Loughlin, Erika N. Dugas, Chol Kuoiloi, Brian L. Hitsman, Robert Schnoll
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- Published online by Cambridge University Press:
- 02 April 2018, pp. 1-11
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Introduction: Each year about two thirds of U.S. smokers make a quit attempt. Yet, less than 5% remain abstinent three months post-quit date. One factor that may affect abstinence is negative feelings about the self-associated with being a smoker (disequilibrium), particularly if smoking is important to the sense of self and one is trying to quit.
Aims: We evaluated a multivariate structural equation model proposing that smoking's subjective importance to a smoker would influence carbon monoxide verified smoking abstinence at 24 weeks (post-quit date). Further, we assessed whether the relation would be moderated by the smoker's experience of disequilibrium.
Methods: Participants were 440 regular smokers taking part in a clinical trial assessing the effectiveness of different durations of nicotine replacement therapy use. Participants completed the subjective importance of smoking survey at baseline and were assessed for carbon monoxide verified seven-day point prevalence abstinence at 24 weeks
Results: Using exploratory structural equation modelling, the subjective importance of smoking was associated with point prevalence abstinence at 24 weeks, but only for smokers with high disequilibrium.
Conclusions: The results of this study suggest that experiencing negative feelings about being a smoker could motivate smokers to remain abstinent, despite the importance of smoking to the smoker's sense of self.
Review Article
The Development and Evaluation of Online Smoking Cessation Services: A Narrative Literature Review
- Lewis Keane, Caroline Anderson, Donna Perez, Becky Freeman
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- Published online by Cambridge University Press:
- 15 March 2018, pp. 12-20
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Introduction: The use of quitlines for smoking cessation has contracted, with service providers adapting through the development of comprehensive interactive online smoking cessation services. The primary aim of this review is to investigate the continuum of online cessation services, innovations in design and service components, measures used in formative, process and outcome evaluations, as well as evidence of effectiveness.
Methods: This review includes the peer-reviewed literature, scholarly articles and the grey literature material. Databases searched included: PubMed, Google Scholar, SCOPUS and the Cochrane Collaboration.
Results/findings: 56 academic journal articles and the 5 grey literature reports met the inclusion criteria for this review. Developmental stages of online/combination services included: static websites, tailored feedback, email and text services, interactive components, social media, pharmacological offers; as well as social and professional support mechanisms. Innovations in online smoking cessation include: chat rooms, new recruitment strategies, mobile apps, service tailoring and messaging support groups. Online cessation services were significantly cheaper and more popular than quitlines; however, abstinence rates appear higher amongst quitline users.
Conclusions: Three likely catalysts for the shift from quitlines to online services are the rapid development of technology, increased internet access and the general movement of the goods and services sector to digital channels. The challenge for online cessation service providers is to leverage their comparative cost advantage and develop strategies that keep pace, engage users and increase service effectiveness.
Implications: Our paper synthesises a wide-range of the literature that evaluates the effectiveness and scope of online smoking cessation programs. Through applying this literature to the stages of evaluation framework, we also provide one of the first detailed roadmaps towards developing comprehensive evaluation methodology for online smoking cessation services.
Original Articles
Pilot study of a mobile smoking cessation intervention for low-income smokers with serious mental illness
- Mary F. Brunette, Joelle C. Ferron, Pamela Geiger, Susan Guarino, Sarah I. Pratt, Sarah E. Lord, Kelly A. Aschbrenner, Anna Adachi-Mejia
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- Published online by Cambridge University Press:
- 05 June 2019, pp. 203-210
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Introduction
People with serious mental illness (SMI) have high rates of smoking and need better access to cessation treatment. Mobile behavioral interventions for cessation have been effective for the general population, but are not usable by many with SMI due to cognitive impairments or severe symptoms. We developed a tailored mobile cessation treatment intervention with features to reduce cognitive load.
MethodWe enrolled 20 smokers with SMI and showed them how to use the program on a device of their choice. They were assessed at 8 weeks for intervention use, usability, satisfaction, smoking characteristics, and biologically verified abstinence.
ResultsParticipants accessed an average of 23.6 intervention sessions (SD = 17.05; range 1–48; median = 17.5) for an average total of 231.64 minutes (SD = 227.13; range 4.89–955.21; median = 158.18). For 87% of the sessions, average satisfaction scores were 3 or greater on a scale of 1–4. Regarding smoking, 25% of participants had reduced their smoking and 10% had biologically verified abstinence from smoking at 8 weeks.
ConclusionHome and community use of this mobile cessation intervention was feasible among smokers with SMI. Further research is needed to evaluate such scalable approaches to increase access to behavioral treatment for this group.
Uptake and Perceptions of E-cigarette use in Vascular Patients
- Rachael Taylor, David Sidloff, Robert D. Sayers, Matthew J. Bown, Athanasios Saratzis
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- Published online by Cambridge University Press:
- 16 May 2018, pp. 83-87
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Introduction: Smoking is one of the most important risk factors for cardiovascular disease (CVD). Electronic cigarettes (e-cigarettes) are becoming increasingly popular. However, little is known regarding their patterns of use in patients with established CVD.
Aims: We aimed to assess the perceptions and patterns of use of e-cigarettes in patients presenting to a vascular clinic.
Methods: We performed a qualitative study to identify perceptions and beliefs about e-cigarettes. Semi-structured interviews of consecutive patients consenting to participate were performed over five-months. Individuals were recruited from a vascular surgery outpatient clinic. Initial interviews were based on a questionnaire. Further structured interviews were conducted with patients currently using e-cigarettes, which were transcribed and analysed to assess perceptions and patterns of use.
Results/Findings: Four overarching themes emerged: attraction to e-cigarettes as a harm reduction/smoking cessation strategy; uncertainty regarding the risks of e-cigarettes; use of various types of smoking cessation strategies; dual use and often complete relapse to tobacco products.
Conclusions: Patients with established CVD view e-cigarettes as a means of smoking cessation; however, many relapse to tobacco products or use both simultaneously. Further research is necessary regarding the role of e-cigarettes in smoking cessation in this high-risk group.
Using ‘Smart’ Technology to Aid in Cigarette Smoking Cessation: Examining an Innovative Way to Monitor and Improve Quit Attempt Outcomes
- Carol Morriscey, Aaron Shephard, Anouk van Houdt, David Kerr, Sean P. Barrett
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- Published online by Cambridge University Press:
- 25 September 2018, pp. 149-154
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Introduction
Recently, smartphone applications (apps) have been used as smoking cessation aids. Interactive apps appear to more effective than non-interactive apps. SmokeBeat, a smartphone app used in conjunction with a smartwatch, aims to detect smoking events, interact with the user as they occur and potentially stop smoking events before they occur in the future.
AimsThe purpose of this feasibility study was to determine the sensitivity and specificity of SmokeBeat in detecting smoking events.
MethodsThe feasibility of using the app as a smoking cessation aid was tested over a 2-week period by daily, dependent smokers. SmokeBeat's cigarette detection rate was measured in laboratory sessions both before and after the 2-week period. Fisher's exact test was used to compare detection rates from each session.
Results/FindingsThe detection rate was 22.5% during session 1 and 41.7% during session 2. Once technological issues were controlled for (i.e., signal loss between smartphone and smartwatch), SmokeBeat's detection rate improved over the 2-week period, resulting in a 100% detection rate.
ConclusionsApps which can detect smoking events in real time present an opportunity for a proactive and interactive smoking cessation aid – a potentially useful tool for individuals attempting to quit smoking.
Workplace smoking restrictions and support for smoking cessation in the USA: state, region, and overall trends from 2010–11 to 2014–15
- Yujiao Mai, Trung Ha, Julia N. Soulakova
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- Published online by Cambridge University Press:
- 22 July 2019, pp. 211-220
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We discuss the most recent changes in smoking policies and support for smoking cessation offered to smokers at US workplaces. We used reports of employed adults (n = 112,008) regarding smoking restrictions and support for smoking cessation offered at their indoor workplaces from the 2010–11 and 2014–15 Tobacco Use Supplement–Current Population Survey. The percentage of adults who reported having workplace smoking restrictions was 94% in 2010–11 and 93% in 2014–15 (P = 0.001). There was a decrease in the Northeastern region (P < 0.001) and no significant changes in the other three US regions. The percentages decreased in Hawaii, New York, Oregon, Pennsylvania, and Tennessee and increased in Indiana, Nebraska, and Wyoming. The percentage of employees who reported having workplace support for smoking cessation increased from 24% to 29% (P < 0.001), which was uniform across all US regions but differed across the US states. The percentages decreased in Hawaii and increased in the majority of states. Analysis of smokers' reports (versus all reports) resulted in lower percentages of workplaces with smoking restrictions and support for smoking cessation. It is essential to further enhance support for smoking cessation offered to smokers at US workplaces.
The Influence of Partner Smoking, Relationship Satisfaction and Parental Stress on Tobacco Use
- Alexis R. Foulstone, Temesgen Kifle, Adrian B. Kelly
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- Published online by Cambridge University Press:
- 14 December 2018, pp. 155-160
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Introduction
Despite declines in tobacco use during pregnancy and after childbirth, smoking remains unacceptably high among many parents. Smoking maintenance or relapse may be common in couple relationships when the other parent continues to smoke, when relationship satisfaction is low, or parental stress high.
AimTo examine the longitudinal influence of partner tobacco use, relationship satisfaction and parental stress on tobacco use after childbirth.
MethodsData was obtained from 115 Australian heterosexual adult couples (Mean age = 31.8) who reported being pregnant in the previous year and the female partner was a previous or current smoker. A household longitudinal survey was administered in which measures of tobacco use, relationship satisfaction and parental stress were assessed on four occasions over nine years.
ResultsOverall reductions in tobacco use occurred over the nine-year assessment period, although a small percentage (9.6%) of parents reported being daily smokers at every assessment. Similarly, a small proportion (13.1%) of parents relapsed to using tobacco during the assessment period. A random effects binary logit model indicated that mothers and fathers were more likely to continue or relapse to tobacco use if their partners smoked. Mothers were more likely to quit smoking if they became pregnant between the assessment waves, but for males, having a pregnant partner was not a significant predictor of tobacco cessation.
ConclusionWhile pregnancy is associated with smoking cessation for mothers, both mothers and fathers are at elevated risk of continued tobacco smoking or relapse if their partner smokes during the first nine years after childbirth. For parents who continue to smoke cigarettes or relapse after childbirth, engagement of the partner in smoking cessation may be a key factor in promoting positive outcomes.
Stop Smoking Practitioners’ understanding of e-cigarettes’ use and efficacy with particular reference to vapers’ socioeconomic status
- Rosemary Hiscock, Deborah Arnott, Martin Dockrell, Louise Ross, Andy McEwen
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- Published online by Cambridge University Press:
- 20 April 2018, pp. 21-31
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Introduction: We have undertaken four online surveys of Stop Smoking Service (SSS) practitioners in England, between 2011 and 2016, in order to enhance our understanding of e-cigarettes: a fast moving new phenomenon. It is important to understand whether e-cigarettes can ameliorate or exacerbate health inequalities given that smoking is one of the most serious causes of excessive mortality and morbidity among disadvantaged groups globally.
Aims: To update findings of previous surveys and examine socioeconomic status differences in e-cigarette use and efficacy.
Methods: Analysis was undertaken of electronic surveys, particularly, the most recent 2016 survey (n = 514) and 2015/16 SSS client routine monitoring data.
Results: SSS practitioners were becoming more positive about e-cigarettes: 42% agreed that e-cigarettes were a good thing compared with 15% in 2011. Reported use of e-cigarettes among SSS clients was low (about 3%) despite higher quit rates (63% of clients reported being quit at four week follow-up, compared with 51% overall). Where socioeconomic differences in e-cigarettes’ efficacy for quitting were identified, affluent and working smokers were advantaged.
Conclusions: Low use of e-cigarettes by clients and practitioner opinions suggest that further education of SSS staff is needed if they are to adopt the current service recommendations about e-cigarettes.
Building Capacity for Global Tobacco Treatment: International Frontline Provider Perspectives
- Henrique P. Gomide, Kimber P. Richter, Erica Cruvinel, Leonardo Fernandes Martins, The International Relations Committee of ATTUD
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- Published online by Cambridge University Press:
- 27 June 2018, pp. 88-94
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Introduction: Many countries are enacting tobacco treatment training, guidelines and policies in order to fulfil Framework Convention on Tobacco Control (FCTC) treaty agreements. This study tapped the perspectives of international treatment providers to identify challenges and recommendations for improvement.
Methods: The cross-sectional survey included closed- and open-ended items. Distribution included professional listservs (ATTUD; Global Bridges; ENSH Global) and word-of-mouth. The survey collected data using an open-source platform (Enketo Smart Paper/Ona). We used R for quantitative analysis and Google Sheets to categorize open-ended responses.
Results: There were 155 respondents from 49 countries. Most (78.6%) provided direct services. Almost half (48.1%) reported receiving less than 6 hours of tobacco treatment training; respondents from low and lower-middle income countries (LMICs) received significantly less training (Fisher's p < 0.014). Likewise, among all respondents, 43% rated poor access to treatment; this rose to 100% among LMICs (Fisher's p < 0.001). To improve treatment and training, respondents suggested increasing government funding for pharmacotherapy and behavioural services; providing training in local languages and in the treatment of smokeless tobacco forms; trainee certification and access to online support for providers.
Conclusions: Globally, half of front-line treatment providers reported having poor access to training; this was true for all providers in LMICs and most in upper middle-income countries. Existing online trainings, available mainly in English, could be migrated to open-access formats to permit countries to tailor them to their local needs and languages. Countries in geographical proximity or historical linguistic/political alliances could forge cross-country mentoring relationships and mutual support for training.
Do Couple-Focused Cessation Messages Increase Motivation to Quit Among Dual-Smoker Couples?
- Michelle R. vanDellen, Megan A. Lewis, Benjamin A. Toll, Isaac M. Lipkus
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- Published online by Cambridge University Press:
- 28 June 2018, pp. 95-103
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Introduction: Dual-smoker couples are a highly prevalent group who report low motivation to quit smoking.
Aims: This study tested the effect of a messaging intervention (couples- vs. individual-focused smoking outcomes) on motivation to quit among dual-smoker couples and examined the moderating effect of perceived support.
Methods: A total of 202 individuals in 101 dual-smoker couples were randomized by dyad using a 2 (frame: gain/loss) by 2 (outcome focus: individual/couple) factorial design. Participants reviewed scenarios of either positive or negative outcomes of quitting versus not quitting as they applied to either the individual or the couple. Participants then reported their own motivation to quit and motivation for their partner to quit. The main outcome was motivation to quit smoking.
Results: No main effects of framing or message focus emerged. Significant interactions between message focus and negative support predicted motivation for self and partner to quit. Individuals who reported lower negative support reported greater motivation for self to quit and less motivation for partner to quit after reviewing couple- (vs. individual-) focused messages.
Conclusions: Individuals in dual-smoker couples typically report low motivation to quit smoking. Couple-focused messages may increase motivation to quit among individuals who are not receiving negative support from their partners.
Examining E-Cigarette Purchases and Cessation in a Consumer Panel of Smokers
- Zachary Cahn, Regine Haardörfer, Michael Lewis, Yanwen Wang, Carla J. Berg
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- Published online by Cambridge University Press:
- 05 April 2018, pp. 32-41
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Objectives: Examine correlates of initiation of e-cigarette use among smokers and determine the impact of e-cigarette use on cessation among smokers in a national U.S. consumer panel.
Methods: This study used the Nielsen Homescan Panel data from 2011 to 2013, augmented with state-specific measures of tobacco control activities, to examine (1) correlates of single and repeat e-cigarette purchasing among panellists currently purchasing cigarettes; and (2) correlates of ‘cessation’. Participating panellists scanned all retail purchases, and Nielsen recorded over 3 million product types. The key explanatory variable for cessation was e-cigarette purchase. Parallel analysis was conducted for conventional nicotine replacement therapy (NRT) purchase. Cessation was defined as no purchases for at least 6 months and no subsequent purchases until the end of 2013. Analysis was conducted in 2015. E-cigarettes tracked by Nielsen during this period were cig-a-like products resembling tobacco cigarettes in appearance.
Results: Single e-cigarette purchase was associated with whether the panellist resided in a single person male household and bought a higher volume of cigarettes. Repeat purchase was associated with higher state cigarette taxes, less stringent state public smoke-free policies, lower cigarette prices, and more frequent cigarette purchasing. Cessation was associated with repeat e-cigarette purchasing, repeat NRT purchasing, younger age, lower monthly cigarette volume, less frequent purchasing of cigarettes, less recent cigarette purchase at baseline, and single e-cigarette purchase before baseline.
Conclusions: Both individual and policy variables were associated with e-cigarette use. Repeat e-cigarette purchase was associated with cigarette purchase discontinuation, as were various smoking intensity measures.
Tobacco cessation behaviors among a sample of US Navy personnel
- Matthew T. Hall, Ryan P. Austin, Tai A. Do, Alec G. Richardson
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- Published online by Cambridge University Press:
- 26 December 2018, pp. 161-167
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Introduction
The US Navy utilizes numerous resources to encourage smoking cessation. Despite these efforts, cigarette smoking among service members remains high. Electronic cigarettes (EC) have provided an additional cessation resource. Little is known regarding the utilization efficacy of these cessation resources in the US Navy.
AimsThis study sought to explore the utilization and efficacy of ECs and other smoking cessation resources.
MethodsAn anonymous cross-sectional survey was conducted at a military clinic from 2015 to 2016. Participants were active duty in the US Navy and reported demographics, smoking behaviors, and utilization of cessation resources.
ResultsOf the 977 participants in the study, 14.9% were current and 39.4% were former smokers. Most current smokers (83.6%) previously attempted cessation, smoked an average of 2–5 cigarettes per day (34.7%), and smoked every day of the month (26.4%). The number of daily cigarettes smoked and number of days cigarettes were smoked per month was not significantly different between cigarette-only smokers and EC dual users (p = 0.92, p = 0.75, respectively). Resources used by current and former smokers include: ‘cold turkey’ (44.6%, 57.1%, respectively), ECs (22.3%, 24.7%), nicotine patch (8.3%, 1.3%), medicine (6.6%, 3.9%), nicotine gum (5.8%, 10.4%), and quit programs (2.5%, 2.6).
ConclusionCurrent and former cigarette smokers utilized similar resources to quit smoking. Electronic cigarettes are being used for cessation but do not significantly reduce the number of cigarettes smoked on a daily or monthly basis. Future studies may benefit from exploring the use of cessation resources and ECs within the military as a whole.
A brief tobacco dependence intervention for people living with HIV in Nepal: results of a quasi-experimental study
- Krishna C. Poudel, Kalpana Poudel-Tandukar, Basu Dev Pandey, Erica Letson, Paula H. Palmer
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- Published online by Cambridge University Press:
- 24 June 2019, pp. 221-228
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Introduction
There is evidence of increased morbidity, decreased quality of life, and premature mortality in people living with HIV (PLHIV) who smoke tobacco compared to PLHIV who do not smoke tobacco. Evidence-based screening for tobacco dependence, pharmacological treatment, and treatment monitoring and education into relapse prevention are not readily available in low- and middle-income countries (LMIC). We evaluated the effects of a brief tobacco dependence intervention in improving knowledge on the health effects of smoking and intention to quit smoking in PLHIV in Nepal, a low-income country in south Asia.
MethodsUsing a quasi-experimental design, we assigned 59 smokers to participate in the intervention and 67 in the control group. The 1.5 h smoking cessation intervention emphasized harms of smoking, reasons for smoking and quitting, causes of relapse in previous quit attempts, and quitting strategies. We collected data at baseline and immediately post-intervention.
ResultsFindings indicate that a brief smoking cessation intervention produced a significant increase in smoking-related knowledge and intention to quit among PLHIV. The positive effects of our intervention remained significant after adjusting for potential confounders.
ConclusionsOur brief tobacco dependence intervention was effective in improving knowledge on the health effects of smoking and intention to quit among PLHIV. Further studies are required to evaluate the effectiveness of our intervention in increasing smoking cessation among PLHIV in LMIC.
A cross-sectional study of the relationship of proximal smoking environments and cessation history, plans, and self-efficacy among low-income smokers
- Rachel Widome, Patrick J Hammett, Anne M Joseph, Diana J Burgess, Janet L Thomas, Jessie E Saul, Barbara Clothier, Steven S Fu
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- Published online by Cambridge University Press:
- 22 July 2019, pp. 229-238
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Introduction
Proximal environments could facilitate smoking cessation among low-income smokers by making cessation appealing to strive for and tenable.
AimsWe sought to examine how home smoking rules and proximal environmental factors such as other household members' and peers' smoking behaviors and attitudes related to low-income smokers' past quit attempts, readiness, and self-efficacy to quit.
MethodsThis analysis used data from Offering Proactive Treatment Intervention (OPT-IN) (randomized control trial of proactive tobacco cessation outreach) baseline survey, which was completed by 2,406 participants in 2011/12. We tested the associations between predictors (home smoking rules and proximal environmental factors) and outcomes (past-year quit attempts, readiness to quit, and quitting self-efficacy).
ResultsSmokers who lived in homes with more restrictive household smoking rules, and/or reported having ‘important others’ who would be supportive of their quitting, were more likely to report having made a quit attempt in the past year, had greater readiness to quit, and greater self-efficacy related to quitting.
ConclusionsAdjustments to proximal environments, including strengthening household smoking rules, might encourage cessation even if other household members are smokers.
An Interpretative Phenomenological Analysis of Discontinued Use of the E-Cigarette
- Camille Alexis-Garsee, Stephanie Meehan, Olga van den Akker
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- Published online by Cambridge University Press:
- 02 July 2018, pp. 104-111
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Introduction: Many UK smokers use e-cigarettes as a quitting aid; however, a substantial number discontinue use of the e-cigarette and revert to smoking. Understanding why this may happen is important both for individuals and for stop smoking services.
Aims: To explore young adult smokers’ experiences of use and discontinued use of the e-cigarette.
Methods: Semi-structured interviews were conducted with six participants who tried e-cigarettes for at least seven days and returned to smoking. Data was transcribed and analysed using interpretative phenomenological analysis.
Results: Findings suggested participants held conflicting attitudes about using e-cigarettes, which undermined attempts to quit smoking, and led to the discontinuation of the e-cigarette. These conflicts centred on participants’ discomfort with the e-cigarette or vaping identity, lack of abstinence self-efficacy and navigation of barriers to e-cigarette use. The complex interplay of these factors may have led to an underestimation of the individual effort required to continue vaping and reinforced participants’ perception of the e-cigarette as an inferior product to the cigarette.
Conclusions: Future research should focus on the role of identity, self-efficacy, control and smokers’ expectations of e-cigarettes on smoking cessation as these may be important factors to consider for a more tailored service for e-cigarette users.
Increasing access to smoking cessation treatment among Latino smokers using case management
- Francisco Cartujano-Barrera, Jaime Perales, Evelyn Arana, Lisa Sanderson Cox, Hung-Wen Yeh, Edward F. Ellerbeck, Kimber P. Richter, Ana Paula Cupertino
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- Published online by Cambridge University Press:
- 11 March 2019, pp. 168-175
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Introduction
Disparities exist among Latino smokers with respect to knowledge and access to smoking cessation resources. This study tested the feasibility of using case management (CM) to increase access to pharmacotherapy and quitlines among Latino smokers.
MethodsLatino smokers were randomized to CM (n = 40) or standard care (SC, n = 40). All participants received educational materials describing how to utilize pharmacy assistance for cessation pharmacotherapy and connect with quitlines. CM participants received four phone calls from staff to encourage pharmacotherapy and quitline use. At 6-months follow-up, we assessed the utilization of pharmacotherapy and quitline. Additional outcomes included self-reported smoking status and approval for pharmacotherapy assistance.
ResultsUsing intention-to-treat analysis, CM produced higher utilization than SC of both pharmacotherapy (15.0% versus 2.5%; P = 0.108) and quitlines (12.5% versus 5.0%; P = 0.432), although differences were not statistically significant. Approval for pharmacotherapy assistance programs (20.0% versus 0.0%; P = 0.0005) was significantly higher for CM than SC participants. Self-reported point-prevalence smoking abstinence at 6-months were 20.0% and 17.5% for CM and SC, respectively (P = 0.775).
ConclusionsCM holds promise as an effective intervention to connect Latino smokers to evidence-based cessation treatment.
Trait Persistence Moderates the Association between Gender and Change in Smoking Urge Across Repeated Cue Exposure Trials
- Bradley N. Collins, Uma S. Nair, Eugene Komaroff, Maria Karekla, Georgia Panayiotou, Sean McCormick, Samantha Davis
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- Published online by Cambridge University Press:
- 30 April 2018, pp. 42-51
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Previous research suggests that persistence, an individual difference characteristic representing the ability and willingness to maintain engagement in challenging or aversive contexts, may relate to smoking relapse. Improving understanding of the persistence-relapse risk association could guide improvements in behavioural interventions. We explored whether persistence and gender related to change in smoking urges across multiple cue exposure trials (an analogue of extinction learning and relapse risk). Participants included abstinent smokers who completed 12 massed, 5-minute smoking cue exposure trials using guided imagery as well as olfactory, tactile, visual and motor cues associated with smoking. We used multilevel logistic growth curve modelling to explore predictor associations with change in urge. Results suggested that gender related to urge whereby males showed greater initial and sustained reactivity than females. Persistence was not associated with female urge trajectories. However, compared to males with high persistence, males with low persistence evidenced sustained urge reactivity over time. Results suggest that greater persistence relates to reduction of conditioned responding (e.g., urges) among abstinent male smokers when exposure trials include complex cues most closely related to nicotine self-administration. Because persistence is modifiable, males with low persistence may benefit from interventions that include elements designed to increase persistence in urge eliciting situations.