1
|
Doody P, Parkhouse T, Gao M, Haasova S, Livingstone-Banks J, Cheeseman H, Aveyard P, Lindson N. Opportunistic smoking cessation interventions for people accessing financial support settings: A scoping review. Addiction 2024. [PMID: 38802984 DOI: 10.1111/add.16533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 04/17/2024] [Indexed: 05/29/2024]
Abstract
AIM The aim of this work was to systematically scope the evidence on opportunistic tobacco smoking cessation interventions for people accessing financial support settings. METHODS We searched MEDLINE, Embase, PsycINFO and the Cochrane Tobacco Addiction Group specialized register to 21 March 2023. We duplicate screened 20% of titles/abstracts and all full texts. We included primary studies investigating smoking cessation interventions delivered opportunistically to people who smoked tobacco, within settings offering support for problems caused by financial hardship, for example homeless support services, social housing and food banks. Data were charted by one reviewer, checked by another and narratively synthesized. RESULTS We included 25 studies conducted in a range of financial support settings using qualitative (e.g. interviews and focus groups) and quantitative (e.g. randomized controlled trials, surveys and single arm intervention studies) methodologies. Evidence on the acceptability and feasibility of opportunistic smoking cessation advice was investigated among both clients and providers. Approximately 90% of service providers supported such interventions; however, lack of resources, staff training and a belief that tobacco smoking reduced illicit substance use were perceived barriers. Clients welcomed being asked about smoking and offered assistance to quit and expressed interest in interventions including the provision of nicotine replacement therapy, e-cigarettes and incentives to quit smoking. Six studies investigated the comparative effectiveness of opportunistic smoking cessation interventions on quitting success, with five comparing more to less intensive interventions, with mixed results. CONCLUSIONS Most studies investigating opportunistic smoking cessation interventions in financial support settings have not measured their effectiveness. Where they have, settings, populations, interventions and findings have varied. There is more evidence investigating acceptability, with promising results.
Collapse
Affiliation(s)
- Paul Doody
- Nuffield Department of Primary Care Health Sciences, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
- National Institute of Health Research Oxford and Thames Valley Applied Research Collaboration, Oxford, United Kingdom
| | - Thomas Parkhouse
- Nuffield Department of Primary Care Health Sciences, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
- School of Health and Social Care, University of Lincoln, Lincoln, United Kingdom
| | - Min Gao
- Nuffield Department of Primary Care Health Sciences, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
- National Institute of Health Research Oxford and Thames Valley Applied Research Collaboration, Oxford, United Kingdom
- National Institute of Health Research Oxford Health Biomedical Research Centre, Oxford, United Kingdom
| | - Simona Haasova
- Nuffield Department of Primary Care Health Sciences, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
| | - Jonathan Livingstone-Banks
- Nuffield Department of Primary Care Health Sciences, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
| | | | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
- National Institute of Health Research Oxford and Thames Valley Applied Research Collaboration, Oxford, United Kingdom
- National Institute of Health Research Oxford Health Biomedical Research Centre, Oxford, United Kingdom
- National Institute of Health Research Oxford Biomedical Research Centre, Oxford, United Kingdom
| | - Nicola Lindson
- Nuffield Department of Primary Care Health Sciences, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
2
|
Skelton E, Tzelepis F, Shakeshaft A, Guillaumier A, Wood W, Jauncey M, Salmon AM, McCrabb S, Palazzi K, Bonevski B. Integrating smoking cessation care into routine service delivery in a medically supervised injecting facility: An acceptability study. Addict Behav 2018; 84:193-200. [PMID: 29723802 DOI: 10.1016/j.addbeh.2018.04.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 03/27/2018] [Accepted: 04/02/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Among people who inject drugs (PWIDs) the prevalence of tobacco smoking exceeds 80%; making smoking cessation intervention a priority for this population. This study aims to examine staff and client perspectives from a supervised injecting facility regarding: i) whether an organizational change intervention increased rates of smoking cessation care delivery (pre- to post-intervention); and ii) acceptability of the intervention. METHODS A pre-and-post intervention pilot study in a supervised injecting facility was conducted in Sydney, Australia between July 2014-December 2015. The intervention employed an organizational change approach and included six components. Cross-sectional samples of staff (pre n = 27, post n = 22) and clients (pre n = 202, post n = 202) completed online surveys pre and post intervention. RESULTS From pre to post-intervention staff reported smoking cessation practices significantly increased for the provision of verbal advice (30% to 82%; p < 0.001), offer of free or subsidized nicotine replacement therapy (30% to 91%; p < 0.001), referral to a general practitioner (19% to 64%; p = 0.001), and follow-up to check on quit smoking progress (18.5% to 64%; p = 0.001). Significantly more clients reported receiving all smoking cessation strategies post-intervention. Over 85% of staff agreed that it was acceptable to address client smoking as part of usual care and 95% of clients agreed that it was acceptable to be asked by staff about their tobacco smoking. CONCLUSIONS Increasing the provision of smoking cessation care using an organizational change approach is both feasible for staff and acceptable to staff and clients of supervised injecting facilities.
Collapse
|
3
|
Bonevski B, Twyman L, Paul C, D'Este C, West R, Siahpush M, Oldmeadow C, Palazzi K. Smoking cessation intervention delivered by social service organisations for a diverse population of Australian disadvantaged smokers: A pragmatic randomised controlled trial. Prev Med 2018; 112:38-44. [PMID: 29626552 DOI: 10.1016/j.ypmed.2018.04.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 02/22/2018] [Accepted: 04/02/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVES There remains a need to identify effective smoking cessation interventions in severely disadvantaged populations. This trial aimed to examine the effectiveness of an intervention (Call it Quits) developed to promote smoking cessation and delivered by community social service case-workers. METHODS Call it Quits was a pragmatic, parallel randomised trial of a case-worker delivered smoking cessation intervention conducted in a non-government community social service organisation in New South Wales (NSW), Australia. Adult smokers requiring financial assistance were randomly assigned to the five-session Call it Quits intervention or usual care control group. Of the 618 eligible individuals, 300 were randomised to the intervention group, of whom 187 (62%) consented and 318 were randomised to the control group, of whom 244 (77%) consented, resulting in 431 participants. The primary outcome measure was self-reported continuous abstinence up to 6-month follow-up with biochemical verification. Primary analysis was performed using all the available data from participants under the assumption the data is missing completely at random, followed by sensitivity analyses. RESULTS No statistically significant differences in the primary outcome were found (1.4% in the control group versus 1.0% in the intervention group, OR = 0.77, p = 0.828). CONCLUSIONS A multi-component smoking cessation intervention delivering motivational interviewing-based counselling and free NRT by a trained case-worker within a community social service setting was not effective at achieving abstinence in a highly disadvantaged sample of smokers but increased attempts to stop and led to a reduction in number of cigarettes smoked daily.
Collapse
Affiliation(s)
- Billie Bonevski
- School of Medicine and Public Health, University of Newcastle, Callaghan 2308, NSW, Australia.
| | - Laura Twyman
- Cancer Council NSW, Dowling Street, Woolloomooloo 2011, NSW, Australia
| | - Christine Paul
- School of Medicine and Public Health, University of Newcastle, Callaghan 2308, NSW, Australia
| | - Catherine D'Este
- School of Medicine and Public Health, University of Newcastle, Callaghan 2308, NSW, Australia; National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 0200, ACT, Australia
| | - Robert West
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E, 6BT, United Kingdom
| | - Mohammad Siahpush
- College of Public Health, University of Nebraska Medical Center, 984365 Nebraska Medical Center, Omaha, NE 68198-4365, United States
| | | | - Kerrin Palazzi
- Hunter Medical Research Institute, Lookout Road, Lambton 2305, NSW, Australia
| |
Collapse
|
4
|
Wang MP, Suen YN, Li WHC, Lam COB, Wu SYD, Kwong ACS, Lai VW, Chan SS, Lam TH. Intervention With Brief Cessation Advice Plus Active Referral for Proactively Recruited Community Smokers: A Pragmatic Cluster Randomized Clinical Trial. JAMA Intern Med 2017; 177:1790-1797. [PMID: 29059277 PMCID: PMC5820734 DOI: 10.1001/jamainternmed.2017.5793] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Most smoking cessation (SC) clinics are costly, passive, and underused. OBJECTIVE To compare the SC effect of a combined intervention involving brief, model-guided SC advice plus active referral to SC services (active referral group) with those of brief, model-guided SC advice only (brief advice group) and general SC advice only (control group). DESIGN, SETTING, AND PARTICIPANTS A single-blind, 3-arm, pragmatic cluster randomized clinical trial was conducted including 1226 adult daily smokers in the general Hong Kong community proactively recruited to participate in the Quit-to-Win Contest held in 2015. The study was conducted from June 20 to September 24, 2015. Participants were randomly allocated to the active referral (n = 402), brief advice (n = 416), and control (n = 408) groups. Intention-to-treat analysis was used. INTERVENTIONS Brief telephone counseling was offered to the active referral and brief advice groups at 1 and 2 months. Interventions were delivered by SC ambassadors who had undergone a short training period. MAIN OUTCOMES AND MEASURES The primary outcome was the self-reported past 7-day point prevalence of abstinence (PPA) at 6 months. The secondary outcomes were carbon monoxide level-validated abstinence, smoking reduction, and SC service use. RESULTS Participants included 991 (80.8%) men; mean (SD) age was 42.0 (14.8) years. The response rate was 68.2% at 3 and 72.3% at 6 months. The corresponding PPAs were 18.9% and 17.2% in the active referral group-higher than in the brief advice (8.9% and 9.4%; both P ≤ .001) or control (14.0% and 11.5%; P = .03 at 6 months) groups. Compared with the other 2 groups, the active referral group had significantly higher validated abstinence rates (10.2% at 3 months and 9.0% at 6 months, all P < .05) with odds ratios of 2.84 (95% CI, 1.57-5.15) and 2.61 (95% CI, 1.46-4.68) at 3 months, and 1.85 (95% CI, 1.06-3.23) and 1.81 (95% CI, 1.04-3.16) at 6 months in the brief advice and control groups, respectively. The SC service use rate was significantly higher in the active referral group (25.1%) than in either brief advice (2.4%) or control (3.4%) groups at 6 months (P < .001). CONCLUSIONS AND RELEVANCE An intervention involving brief advice and active referral delivered to smokers in the community by volunteers can increase quitting in places where SC services are available but underused. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT02539875.
Collapse
Affiliation(s)
- Man Ping Wang
- School of Nursing, University of Hong Kong, Hong Kong
| | - Yi Nam Suen
- Department of Psychiatry, University of Hong Kong, Hong Kong
| | | | | | | | | | - Vienna W Lai
- Hong Kong Council on Smoking and Health, Hong Kong
| | - Sophia S Chan
- School of Nursing, University of Hong Kong, Hong Kong
| | - Tai Hing Lam
- School of Public Health, University of Hong Kong, Hong Kong
| |
Collapse
|
5
|
Milcarz K, Makowiec-Dąbrowska T, Bak-Romaniszyn L, Kaleta D. Smoking Patterns and Smoking Cessation Willingness-A Study among Beneficiaries of Government Welfare Assistance in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14020131. [PMID: 28134802 PMCID: PMC5334685 DOI: 10.3390/ijerph14020131] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Accepted: 01/25/2017] [Indexed: 11/19/2022]
Abstract
This study examines the prevalence and tobacco use patterns among adult social assistance beneficiaries and their interest in quitting. The results are based on data collected in a cross-sectional survey conducted among adults in the Piotrkowski district. A sample of 3636 social assistance beneficiaries produced a total of 1817 respondents who completed face-to-face questionnaires. Overall, 37.1% of the respondents, including 52.8% men and 29.6% women, were current smokers. Over one third of the smokers reported their willingness to quit. In the study population, several characteristics were significantly associated with the current daily smoking: male gender, low educational attainment, unemployment or temporary employment, lack of awareness of smoking-associated health risks, use of e-cigarettes, and exposure to environmental tobacco smoke (ETS). The intention to quit smoking among the daily smokers was positively correlated with their awareness of smoking-associated health risks, lack of previous quit attempts, and low exposure to ETS. Smoking prevalence among social assistance recipients tends to be higher than in the general population, but more than half of the smokers are willing to quit. There is an urgency to develop policies tailored to the needs of these disadvantaged population groups.
Collapse
Affiliation(s)
- Katarzyna Milcarz
- Department of Tobacco Control, Preventive Medicine Department, Medical University of Lodz, Lodz, 90-752, Poland.
| | - Teresa Makowiec-Dąbrowska
- Department of Work Physiology and Ergonomics, Nofer Institute of Occupational Medicine, Lodz 91-348, Poland.
| | - Leokadia Bak-Romaniszyn
- Department of Nutrition in Digestive Tract Diseases, Medical University of Lodz, Lodz, 93-338, Poland.
| | - Dorota Kaleta
- Department of Tobacco Control, Preventive Medicine Department, Medical University of Lodz, Lodz, 90-752, Poland.
| |
Collapse
|
6
|
Christiansen BA, Reeder KM, TerBeek EG, Fiore MC, Baker TB. Motivating Low Socioeconomic Status Smokers to Accept Evidence-Based Smoking Cessation Treatment: A Brief Intervention for the Community Agency Setting. Nicotine Tob Res 2016; 17:1002-11. [PMID: 26180226 DOI: 10.1093/ntr/ntu345] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Individuals of low socioeconomic status (SES), smoke at very high rates but make fewer and less successful quit attempts than do other smokers. Low-SES smokers have specific beliefs about smoking and quitting that may serve as barriers to making quit attempts. The purpose of this study was to test the impact of a brief intervention addressing these beliefs on making calls to a telephone quit line. METHODS Of 522 smokers entering the study at 5 Wisconsin Salvation Army (SA) sites, 102 expressed motivation to quit and served as a comparison group. The remaining 420 smokers were not motivated to quit and were randomly assigned to 1 of 3 conditions: an intervention group who received brief counseling focused on cessation goals and beliefs, an attention-control group, and a low contact control group. The primary outcome was the rate at which smokers made a call to the Wisconsin tobacco quit line (WTQL) during their SA visit. Secondary outcome measures included motivational variables, stage of change, changes in beliefs about smoking and quitting, and self-reported abstinence. RESULTS Unmotivated participants in the intervention condition called the WTQL at a significantly higher rate (12.2%) than did those in the 2 control conditions (2.2% and 1.4%) (p < .01) and approached the rate of calling by participants who were initially motivated to quit (15.7%). Intervention condition participants also showed improved motivation to quit and stage of change. CONCLUSIONS A brief, targeted motivational intervention focusing on cessation goals and beliefs increased the initiation of an evidence-based tobacco cessation treatment by low-SES smokers.
Collapse
Affiliation(s)
- Bruce A Christiansen
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, WI;
| | - Kevin M Reeder
- Social Services Department, Salvation Army of Wisconsin and Upper Michigan, Wauwatosa, WI
| | - Erin G TerBeek
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, WI
| | - Michael C Fiore
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, WI
| | - Timothy B Baker
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, WI
| |
Collapse
|
7
|
Twyman L, Bonevski B, Paul C, Bryant J, West R, Siahpush M, D'Este C, Oldmeadow C, Palazzi K. Factors Associated With Concurrent Tobacco Smoking and Heavy Alcohol Consumption Within a Socioeconomically Disadvantaged Australian Sample. Subst Use Misuse 2016; 51:459-70. [PMID: 26942661 DOI: 10.3109/10826084.2015.1122065] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Tobacco use and heavy alcohol consumption occur more frequently in socioeconomically disadvantaged groups. Little is known about the sociodemographic and psychosocial factors associated with use of alcohol and tobacco in disadvantaged groups in comparison to low-risk users. OBJECTIVES This study aimed to compare the characteristics of low-risk users with: disadvantaged smokers only; disadvantaged heavy drinkers only; and disadvantaged concurrent smokers and heavy drinkers. METHODS A cross-sectional survey of socioeconomically disadvantaged adult clients attending a community welfare agency assessed tobacco use, alcohol use, demographic, and psychosocial variables. Multivariable analysis using multinomial logistic regression was carried out. RESULTS The sample consisted of 835 participants; 40% (n = 331) were concurrent users, 31% were smokers only (n = 252), 11% were heavy drinkers only (n = 93), and 18% were low-risk users (n = 149). Compared with those who neither smoked nor consumed alcohol heavily, concurrent users were more likely to be younger, have only some contact with family, have more friends and family who were smokers, have no fixed home address, live alone, and have higher levels of financial stress. Most of these factors were shared by individuals who were smokers only. Factors associated with heavy drinkers only were frequent contact with family and having more friends and family who were smokers. CONCLUSION Among those Australians who suffer severe economic hardship, being a concurrent smoker and heavy drinker appears to be associated with more isolated living conditions and financial stress but some contact with family.
Collapse
Affiliation(s)
- Laura Twyman
- a School of Medicine and Public Health, University of Newcastle , Newcastle , Australia
| | - Billie Bonevski
- a School of Medicine and Public Health, University of Newcastle , Newcastle , Australia
| | - Christine Paul
- a School of Medicine and Public Health, University of Newcastle , Newcastle , Australia.,b Hunter Medical Research Institute , Newcastle , Australia
| | - Jamie Bryant
- c Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute , Newcastle , Australia
| | - Robert West
- d Department of Epidemiology and Public Health , University College London , London , United Kingdom
| | - Mohammad Siahpush
- e Department of Health Promotion, Social and Behavioral Health , University of Nebraska Medical Center , Omaha , Nebraska , USA
| | - Catherine D'Este
- f National Centre for Epidemiology and Population Health, Australian National University , Canberra , Australia
| | - Christopher Oldmeadow
- a School of Medicine and Public Health, University of Newcastle , Newcastle , Australia.,b Hunter Medical Research Institute , Newcastle , Australia
| | - Kerrin Palazzi
- b Hunter Medical Research Institute , Newcastle , Australia
| |
Collapse
|
8
|
Twyman L, Bonevski B, Paul C, Bryant J. Perceived barriers to smoking cessation in selected vulnerable groups: a systematic review of the qualitative and quantitative literature. BMJ Open 2014; 4:e006414. [PMID: 25534212 PMCID: PMC4275698 DOI: 10.1136/bmjopen-2014-006414] [Citation(s) in RCA: 286] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES To identify barriers that are common and unique to six selected vulnerable groups: low socioeconomic status; Indigenous; mental illness and substance abuse; homeless; prisoners; and at-risk youth. DESIGN A systematic review was carried out to identify the perceived barriers to smoking cessation within six vulnerable groups. DATA SOURCES MEDLINE, EMBASE, CINAHL and PsycInfo were searched using keywords and MeSH terms from each database's inception published prior to March 2014. STUDY SELECTION Studies that provided either qualitative or quantitative (ie, longitudinal, cross-sectional or cohort surveys) descriptions of self-reported perceived barriers to quitting smoking in one of the six aforementioned vulnerable groups were included. DATA EXTRACTION Two authors independently assessed studies for inclusion and extracted data. RESULTS 65 eligible papers were identified: 24 with low socioeconomic groups, 16 with Indigenous groups, 18 involving people with a mental illness, 3 with homeless groups, 2 involving prisoners and 1 involving at-risk youth. One study identified was carried out with participants who were homeless and addicted to alcohol and/or other drugs. Barriers common to all vulnerable groups included: smoking for stress management, lack of support from health and other service providers, and the high prevalence and acceptability of smoking in vulnerable communities. Unique barriers were identified for people with a mental illness (eg, maintenance of mental health), Indigenous groups (eg, cultural and historical norms), prisoners (eg, living conditions), people who are homeless (eg, competing priorities) and at-risk youth (eg, high accessibility of tobacco). CONCLUSIONS Vulnerable groups experience common barriers to smoking cessation, in addition to barriers that are unique to specific vulnerable groups. Individual-level, community-level and social network-level interventions are priority areas for future smoking cessation interventions within vulnerable groups. TRIAL REGISTRATION NUMBER A protocol for this review has been registered with PROSPERO International Prospective Register of Systematic Reviews (Identifier: CRD42013005761).
Collapse
Affiliation(s)
- Laura Twyman
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Billie Bonevski
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Christine Paul
- Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Jamie Bryant
- Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| |
Collapse
|
9
|
Christiansen B, Reeder K, Fiore MC, Baker TB. Changing low income smokers' beliefs about tobacco dependence treatment. Subst Use Misuse 2014; 49:852-63. [PMID: 24502374 PMCID: PMC4358750 DOI: 10.3109/10826084.2014.880724] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This field study tested an intervention that challenged beliefs about the effectiveness of various quit methods held by Salvation Army client smokers from two urban locations (N = 245). Data (surveys administered immediately after and one month post-intervention) were collected 2009-2010 and analyzed using primarily χ(2) and t-tests. The intervention changed client perceptions about the effectiveness of quitting methods. Compared to no-intervention controls, intervention participants reported significantly greater smoking reduction and greater likelihood of contacting the Wisconsin Tobacco Quit Line. Study implications/limitations are discussed and future research directions noted. This research was supported by grant UL1TR000427 from the Clinical and Translational Science Award (CTSA) program of the National Center for Advancing Translational Sciences, NIH.
Collapse
Affiliation(s)
- Bruce Christiansen
- 1Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | | | | | | |
Collapse
|
10
|
Bonevski B, Regan T, Paul C, Baker AL, Bisquera A. Associations between alcohol, smoking, socioeconomic status and comorbidities: evidence from the 45 and Up Study. Drug Alcohol Rev 2013; 33:169-76. [PMID: 24372899 DOI: 10.1111/dar.12104] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Accepted: 11/20/2013] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND AIMS Understanding how tobacco, alcohol and mental health are related is important for developing population-level policies and individual-level treatments that target comorbidities. The current study aimed to examine sociodemographic characteristics and mental health comorbidities associated with the odds of using tobacco and harmful levels of alcohol concurrently. DESIGN AND METHODS Data were drawn from the 45 and Up Study, a large cohort study with 267 153 adults aged 45 years and over in New South Wales, Australia. Participants completed a survey assessing alcohol, smoking, psychological distress, treatment for depression and anxiety, and a range of socioeconomic status indicators. Univariate analyses and three multiple-logistic regression models were used to determine associations with (i) tobacco but not alcohol use; (ii) alcohol but not tobacco use; and (iii) concurrent tobacco and risky levels of alcohol use. RESULTS Being female, younger, lower individual and area-level socioeconomic status (SES) and depression and psychological distress were associated with tobacco use alone. Factors associated with alcohol use alone were older age, male gender, higher SES, and lower psychological distress and no recent depression treatment. Factors associated with concurrent risky alcohol consumption and tobacco use included being 45-64, being male, less education, earning <$30 000, being employed, and living in lower-SES areas, treatment for depression, and high distress on the Kessler-10. DISCUSSION AND CONCLUSIONS Results suggest strong links between SES, treatment for depression, psychological distress, and concurrent tobacco and alcohol use. This has implications for public health policies and clinical treatment for tobacco and alcohol use, suggesting greater emphasis on addressing multiple health and social concerns. [Bonevski B, Regan T, Paul C, Baker AL, Bisquera A. Associations between alcohol, smoking, socioeconomic status and comorbidities: Evidence from the 45 and Up Study. Drug Alcohol Rev 2014;33:169-176].
Collapse
Affiliation(s)
- Billie Bonevski
- Faculty of Health and Medicine, School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia
| | | | | | | | | |
Collapse
|
11
|
Paul CL, Turon H, Bonevski B, Bryant J, McElduff P. A cross-sectional survey of experts' opinions about the relative effectiveness of tobacco control strategies for the general population versus disadvantaged groups: what do we choose in the absence of evidence? BMC Public Health 2013; 13:1144. [PMID: 24314097 PMCID: PMC3890507 DOI: 10.1186/1471-2458-13-1144] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 11/27/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a clear disparity in smoking rates according to social disadvantage. In the absence of sufficiently robust data regarding effective strategies for reducing smoking prevalence in disadvantaged populations, understanding the views of tobacco control experts can assist with funding decisions and research agendas. METHODS A web-based cross-sectional survey was conducted with 192 respondents (response rate 65%) sampled from the Australian and New Zealand Tobacco Control Contacts list and a literature search. Respondents were asked to indicate whether a number of tobacco control strategies were perceived to be effective for each of: the general population; Aboriginal and Torres Strait Islander people; those with a low income; and people with a mental illness. RESULTS A high proportion of respondents indicated that mass media and increased tobacco taxation (84% and 89% respectively) were effective for the general population. Significantly lower proportions reported these two strategies were effective for sub-populations, particularly Aboriginal and Torres Strait Islanders (58% and 63% respectively, p's < .0001). Subsidised medication was the only strategy associated with a greater proportion of respondents perceiving it to be effective in disadvantaged sub-populations compared to the general population. Tailored quit programs and culturally relevant programs were nominated as additional effective strategies for disadvantaged populations. CONCLUSIONS Views about subsidised medications in particular, suggest the need for robust cost-effectiveness data relevant to disadvantaged groups to avoid wastage of scarce tobacco control resources. Strategies perceived to be effective for disadvantaged populations such as tailored or culturally relevant programs require rigorous evaluation so that potential adoption of these approaches is evidence-based.
Collapse
Affiliation(s)
- Christine L Paul
- Priority Research Centre for Health Behaviour (PRCHB), School of Medicine and Public Health, University of Newcastle, Newcastle, Australia.
| | | | | | | | | |
Collapse
|
12
|
Bryant J, Bonevski B, Paul CL, Lecathelinais CL. A cross-sectional survey of health risk behaviour clusters among a sample of socially disadvantaged Australian welfare recipients. Aust N Z J Public Health 2013; 37:118-23. [DOI: 10.1111/1753-6405.12028] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
13
|
Bonevski B, O'Brien J, Frost S, Yiow L, Oakes W, Barker D. Novel setting for addressing tobacco-related disparities: a survey of community welfare organization smoking policies, practices and attitudes. HEALTH EDUCATION RESEARCH 2013; 28:46-57. [PMID: 22798564 PMCID: PMC3549586 DOI: 10.1093/her/cys077] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Accepted: 05/30/2012] [Indexed: 06/01/2023]
Abstract
Research in the United States and Australia acknowledges the potential of non-government social and community service organizations (SCSOs) for reaching socially disadvantaged smokers. This study aimed to describe SCSO smoking policies and practices, and attitudes of senior staff towards smoking and cessation. It also investigated factors associated with positive tobacco control attitudes. In 2009, a cross-sectional telephone survey was undertaken of senior staff in Australian SCSOs, 149 respondents representing 93 organizations completed the survey (response rate=65%; 93/142). Most service clients (60%) remained in programs for 6 months plus, and 77% attended at least weekly. Although 93% of respondents indicated they had an organizational smoking policy, it often did not include the provision of smoking cessation support. Most respondents indicated that client smoking status was not recorded on case notes (78%). Attitudes were mostly positive towards tobacco control in SCSOs, with a mean (standard deviation) score of 8.3 (2.9) of a possible 13. The practice of assessing clients' interest in quitting was the only statistically significant factor associated with high tobacco control attitude scores. The results suggest that SCSOs are appropriate settings for reaching socially disadvantaged smokers with cessation support. Although generally receptive to tobacco control, organizations require further support to integrate smoking cessation support into usual care. In particular, education, training and support for staff to enable them to help their clients quit smoking is important.
Collapse
Affiliation(s)
- B Bonevski
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia.
| | | | | | | | | | | |
Collapse
|
14
|
Lynagh M, Bonevski B, Sanson-Fisher R, Symonds I, Scott A, Hall A, Oldmeadow C. An RCT protocol of varying financial incentive amounts for smoking cessation among pregnant women. BMC Public Health 2012. [PMID: 23181988 PMCID: PMC3520690 DOI: 10.1186/1471-2458-12-1032] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Smoking during pregnancy is harmful to the unborn child. Few smoking cessation interventions have been successfully incorporated into standard antenatal care. The main aim of this study is to determine the feasibility of a personal financial incentive scheme for encouraging smoking cessation among pregnant women. Design A pilot randomised control trial will be conducted to assess the feasibility and potential effectiveness of two varying financial incentives that increase incrementally in magnitude ($20 vs. $40AUD), compared to no incentive in reducing smoking in pregnant women attending an Australian public hospital antenatal clinic. Method Ninety (90) pregnant women who self-report smoking in the last 7 days and whose smoking status is biochemically verified, will be block randomised into one of three groups: a. No incentive control group (n=30), b. $20 incremental incentive group (n=30), and c. $40 incremental incentive group (n=30). Smoking status will be assessed via a self-report computer based survey in nine study sessions with saliva cotinine analysis used as biochemical validation. Women in the two incentive groups will be eligible to receive a cash reward at each of eight measurement points during pregnancy if 7-day smoking cessation is achieved. Cash rewards will increase incrementally for each period of smoking abstinence. Discussion Identifying strategies that are effective in reducing the number of women smoking during pregnancy and are easily adopted into standard antenatal practice is of utmost importance. A personal financial incentive scheme is a potential antenatal smoking cessation strategy that warrants further investigation. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR) number: ACTRN12612000399897
Collapse
Affiliation(s)
- Marita Lynagh
- Priority Research Centre for Health Behaviour, The University of Newcastle & Hunter Medical Research Institute, Callaghan, NSW, Australia.
| | | | | | | | | | | | | |
Collapse
|
15
|
O'BRIEN JON, BONEVSKI BILLIE, SALMON ALLISON, OAKES WENDY, GOODGER BRENDAN, SOEWIDO DIAS. An evaluation of a pilot capacity building initiative for smoking cessation in social and community services: The Smoking Care project. Drug Alcohol Rev 2012; 31:685-92. [DOI: 10.1111/j.1465-3362.2012.00464.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
16
|
BRYANT JAMIE, BONEVSKI BILLIE, PAUL CHRISTINE, HULL PHILIP, O'BRIEN JON. Implementing a smoking cessation program in social and community service organisations: A feasibility and acceptability trial. Drug Alcohol Rev 2011; 31:678-84. [DOI: 10.1111/j.1465-3362.2011.00391.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
17
|
Bryant J, Bonevski B, Paul C. A survey of smoking prevalence and interest in quitting among social and community service organisation clients in Australia: a unique opportunity for reaching the disadvantaged. BMC Public Health 2011; 11:827. [PMID: 22026718 PMCID: PMC3210182 DOI: 10.1186/1471-2458-11-827] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Accepted: 10/26/2011] [Indexed: 11/23/2022] Open
Abstract
Background Social and community service organisations (SCSOs) are non-government, not-for-profit organisations that provide welfare services to disadvantaged individuals. SCSOs hold considerable potential for providing smoking cessation support to disadvantaged smokers. This study aimed to establish the prevalence of smoking, interest in quitting and interest in receiving cessation support amongst clients accessing SCSOs. Methods Clients seeking financial or material assistance from three SCSOs in NSW, Australia, between February and October 2010 were invited to complete a 60-item general health touch screen computer survey. This included questions about smoking status, past quit attempts and interest in receiving support to quit smoking from SCSO staff. Results A total of 552 clients were approached to participate during the study period, of which 383 provided consent and completed the survey (69% consent rate). Daily smoking was reported by 53.5% of participants. Occasional smoking (non-daily smoking) was reported by a further 7.9% of participants. Most participants had tried to quit smoking in the past (77%) and had made an average of two quit attempts (SD = 3.2) lasting longer than 24 hours in the previous 12 months. More than half of all participants (52.8%) reported that they would like help from SCSO staff to quit smoking. For those interested in receiving help, the preferred types of help were access to free NRT (77%), cash rewards (52%) and non-cash rewards (47%) for quitting, and to receive support and encouragement from SCSO staff to quit (45%). Conclusions Smoking rates among clients accessing SCSO are substantially higher than the general population rate of 15.1%. A substantial proportion of clients are interested in quitting and want support from the SCSO to do so.
Collapse
Affiliation(s)
- Jamie Bryant
- Priority Research Centre for Health Behaviour, School of Medicine & Public Health, University of Newcastle, Hunter Medical Research Institute, Room 230A, Level 2, David Maddison Building, Callaghan, NSW 2308, Australia.
| | | | | |
Collapse
|
18
|
Bryant J, Bonevski B, Paul C, McElduff P, Attia J. A systematic review and meta-analysis of the effectiveness of behavioural smoking cessation interventions in selected disadvantaged groups. Addiction 2011; 106:1568-85. [PMID: 21489007 DOI: 10.1111/j.1360-0443.2011.03467.x] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS A systematic review and meta-analysis was conducted to assess the methodological quality and effectiveness of behavioural smoking cessation interventions targeted at six disadvantaged groups; the homeless, prisoners, indigenous populations, at-risk youth, individuals with low socio-economic status and individuals with a mental illness. METHODS Medline, EMBASE, the Cochrane Library and PsycInfo databases were searched using MeSH and keywords for studies conducted in developed countries prior to October 2010. Included studies were assessed for methodological quality. A DerSimonian and Laird random effects meta-analysis was conducted where possible to explore the effectiveness of interventions for the different subgroups. A narrative review was conducted for studies unable to be included in the meta-analysis. Outcomes examined were abstinence rates at short-term (up to 3 months) and long-term (6 months or the longest) follow-up. RESULTS Thirty-two relevant studies were identified. The majority (n = 20) were rated low in methodological quality. Results of the meta-analysis showed a significant increase in cessation for behavioural support interventions targeted at low-income female smokers at short-term follow-up [relative risk (RR) 1.68, confidence interval (CI) 1.21-2.33], and behavioural support interventions targeted at individuals with a mental illness at long-term follow-up (RR 1.35, CI 1.01-1.81). Results of the narrative review showed several promising interventions that increased cessation rates at 6-month or longer follow-up. CONCLUSIONS Few well-controlled trials have examined the most effective smoking cessation strategies for highly disadvantaged groups, especially among the homeless, indigenous smokers and prisoners. The use of behavioural smoking cessation interventions for some socially disadvantaged groups appears promising; however, overall findings are inconsistent. Further research is needed to establish the most effective interventions for vulnerable high-risk groups. Special attention should be given to increasing sample size and power, and to sound evaluation methodology to overcome methodological limitations of conducting research with these high-risk groups.
Collapse
Affiliation(s)
- Jamie Bryant
- Centre for Health Research and Psycho-oncology (CHeRP), The Cancer Council NSW, University of Newcastle and Hunter Medical Research Institute, Callaghan, NSW, Australia.
| | | | | | | | | |
Collapse
|
19
|
Bryant J, Bonevski B, Paul C, O'Brien J, Oakes W. Developing cessation interventions for the social and community service setting: a qualitative study of barriers to quitting among disadvantaged Australian smokers. BMC Public Health 2011; 11:493. [PMID: 21699730 PMCID: PMC3135539 DOI: 10.1186/1471-2458-11-493] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Accepted: 06/24/2011] [Indexed: 11/21/2022] Open
Abstract
Background Smoking rates remain unacceptably high among individuals who are socially disadvantaged. Social and community service organisations (SCSO) are increasingly interested in providing smoking cessation support to clients, however little is known about the best way to assist disadvantaged smokers to quit in this setting. This study aimed to explore barriers and facilitators to quitting within the conceptual framework of the PRECEDE model to identify possible interventions appropriate to the social and community service setting. Methods Semi-structured focus groups were conducted with clients attending five community welfare organisations located in New South Wales, Australia. Thirty-two clients participated in six focus groups. A discussion guide was used to explore the barriers and facilitators to smoking and smoking cessation including: current smoking behaviour, motivation to quit, past quit attempts, barriers to quitting and preferences for cessation support. Focus groups were audio-taped, transcribed and analysed using thematic analysis techniques. Results Participants were current smokers and most expressed a desire to quit. Factors predisposing continued smoking included perceived benefits of smoking for stress relief, doubting of ability to quit, fear of gaining weight, and poor knowledge and scepticism about available quit support. The high cost of nicotine replacement therapy was a barrier to its use. Continual exposure to smoking in personal relationships and in the community reinforced smoking. Participants expressed a strong preference for personalised quit support. Conclusions Disadvantaged smokers in Australia express a desire to quit smoking, but find quitting difficult for a number of reasons. SCSOs may have a role in providing information about the availability of quit support, engaging disadvantaged smokers with available quit support, and providing personalised, ongoing support.
Collapse
Affiliation(s)
- Jamie Bryant
- Centre for Health Research and Psycho-oncology, Cancer Council New South Wales, Priority Research Centre for Health Behaviour, University of Newcastle, Hunter Medical Research Institute, Callaghan, NSW, 2308, Australia.
| | | | | | | | | |
Collapse
|
20
|
Bonevski B, Bowman J, Richmond R, Bryant J, Wye P, Stockings E, Wilhelm K, Butler T, Indig D, Wodak A. Turning of the tide: changing systems to address smoking for people with a mental illness. ACTA ACUST UNITED AC 2011. [DOI: 10.1080/17523281.2011.555073] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
21
|
Building consumer demand for tobacco-cessation products and services: The national tobacco cessation collaborative's consumer demand roundtable. Am J Prev Med 2010; 38:S307-11. [PMID: 20176301 DOI: 10.1016/j.amepre.2009.12.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2009] [Revised: 05/29/2009] [Accepted: 12/02/2009] [Indexed: 11/24/2022]
|
22
|
Orleans CT, Mabry PL, Abrams DB. Increasing tobacco cessation in America: A consumer demand perspective. Am J Prev Med 2010; 38:S303-6. [PMID: 20176300 DOI: 10.1016/j.amepre.2010.01.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2010] [Revised: 01/14/2010] [Accepted: 01/14/2010] [Indexed: 11/17/2022]
Affiliation(s)
- C Tracy Orleans
- Robert Wood Johnson Foundation, Princeton, New Jersey 08543, USA.
| | | | | |
Collapse
|