Addressing cigarette smoking cessation treatment challenges during the COVID-19 pandemic with social media

The role of nurses in smoking cessation interventions for patients: a scoping review

BACKGROUND

Smoking is a significant global public health concern, presenting substantial risks to individuals' health. Smoking cessation is essential for improving patients' well-being, and nurses play a critical role in assisting patients to quit smoking. However, there is a lack of research on nurses' specialized roles in smoking cessation interventions for patients.

OBJECTIVE

To define the specific responsibilities of nurses in facilitating smoking cessation among patients, and provide guidance for future nursing interventions in smoking cessation.

METHODS

The scoping review process was conducted for Arksey and O'Malley's framework. Based on the three-step search strategy of Joanna Briggs Institute (JBI), a comprehensive search was performed across ten databases including PubMed, CINAHL, Web of Science, Embase, Cochrane Library, OVID, PsycINFO, CNKI, Wan Fang Data Knowledge Service Platform, and VIP Database for Chinese Technical Periodicals, covering studies from the inception of the databases to February 2024. The inclusion and exclusion criteria were developed using the JBI (participants, content, and context) principle. Randomized controlled trials or quasi-experimental studies with nurse-led or involved smoking cessation interventions for patients were included. Data extraction was conducted independently by two reviewers. The findings were reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR).

RESULTS

In total, 53 studies were eligible for the final charting and synthesis. The analysis identified six key roles that nurses played in smoking cessation interventions: assessors, educators, practice facilitators, coordinating collaborators, organizers, and supervisors. Among these, the roles of assessors, educators, and practice facilitators were the most commonly reported. The motivation interview and 5A method were the predominant techniques employed for smoking cessation. Nurses primarily promoted smoking cessation through the distribution of pamphlets, face-to-face education, and the provision of smoking cessation guidance. The primary participants in these studies were patients with chronic obstructive pulmonary disease (COPD).

CONCLUSIONS

Nurses play an indispensable role in smoking cessation interventions, occupying multiple critical roles. However, this review identified a gap in the pre-intervention training of nurses, indicating a need for enhanced training programs to better prepare nurses for effective smoking cessation interventions.

Changes in the Success and Characteristics of Tobacco Dependence Treatment before and during the COVID-19 Pandemic: Clinical Sample Comparisons

Background and Objectives: There is little information on changes in the process and outcomes of intensive tobacco dependence treatment during the COVID-19 pandemic. The following characteristics were evaluated: interest in treatment, the number of face-to-face or telephone follow-ups, the duration of pharmacotherapy use, and the success rate. The aim of our study was to compare the number of patients who entered tobacco dependence treatment programmes and evaluate the one-year success rate in patients three years before and three years after the COVID-19 pandemic. Materials and Methods: A single-site retrospective cohort study using data from patients treated at the Centre for Tobacco Dependence in Prague, Czech Republic, between 2017 and 2022 (n = 2039) was performed. The one-year abstinence rate was validated by measuring carbon monoxide in exhaled air (6 ppm cut-off). Patients were divided into two groups: the group for which treatment was initiated in 2017-2019 (i.e., before the COVID-19 pandemic, BC; n= 1221) and the group for which treatment was initiated in 2020-2022 (i.e., during the COVID-19 pandemic, DC; n = 818). Results: No significant differences in the success rate of tobacco dependence treatment were found between the two groups (BC group, 40.5% (494/1221) vs. DC group, 42.2% (345/818)) (χ2 (1, N = 2.039) = 0.6, p = 0.440). Furthermore, differences were not found in sex, education level, age at first cigarette, the duration of pharmacotherapy use, or the number of in-person visits. In contrast, there was an increase in the number of telephone contacts between the groups (18.7% (SD = 17.5%) vs. 32.9% (SD = 18.2%), p < 0.001). Conclusions: The number of patients who started treatment during the COVID-19 pandemic decreased by one-third compared to that during the 3-year period before the pandemic. The overall treatment success rate did not change significantly even with the increase in the number of telephone visits with the therapist.

Factors Associated With Abstinence Among Young Adult Smokers Enrolled in a Real-world Social Media Smoking Cessation Program

OBJECTIVE

Social media platforms are promising to provide smoking cessation support. This study aimed to identify baseline factors associated with cigarette smoking abstinence among young adult smokers enrolled in a real-world social media-based smoking cessation program.

AIMS AND METHODS

We analyzed data from young adult smokers (aged 18-30 years) participating in a publicly available Facebook-based smoking cessation program serving the San Francisco Bay Area. The analytic sample consisted of 248 participants who completed both the baseline and follow-up surveys at 3 months. Multivariable logistic regression analysis determined baseline factors significantly associated with self-reported 7-day cigarette smoking abstinence at 3 months.

RESULTS

Participants were race/ethnically diverse, well-educated, and 47.6% reported LGB + sexual identity. Those who reported dual use of cigarettes and e-cigarettes in the past 30 days (vs. cigarette use only), current alcohol users (vs. non-users), and those aged 25-30 years (vs. 18-24 years) were significantly less likely to report 7-day abstinence at 3 months. Non-daily smokers (vs. daily smokers) and those with high desire to quit smoking (vs. low to moderate desire) were more likely to report abstinence. Results also showed reduction in the percentage of e-cigarette and other tobacco product use among participants.

CONCLUSIONS

Social media interventions may be more effective for young adult non-daily smokers and those with high desire to quit smoking. Smoking cessation programs may help reduce use of other tobacco products among treatment-seeking smokers. Smoking cessation interventions for young adults need to explicitly address dual use of cigarettes and e-cigarettes and use of alcohol.

IMPLICATIONS

Findings of this study highlight the need for future interventions to address dual use of cigarettes and e-cigarettes and use of alcohol to improve cigarette smoking abstinence outcomes. The reduction in the use of other tobacco products among program participants indicates that social media smoking cessation programs may exert a broader positive influence on overall tobacco consumption. The large number of LGB+ smokers participating in the program suggests social media is a promising cessation channel for this hard-to-reach group, warranting further study.

Effects on Cancer Prevention from the COVID-19 Pandemic

The COVID-19 pandemic led to disruption of health services around the world, including cancer services. We carried out a narrative review of the effect of the pandemic on cancer prevention services, including screening. Services were severely affected in the early months of the pandemic, and in some areas are still recovering. Large numbers of additional cancers or additional late-stage cancers have been predicted to arise over the coming years as a result of this disruption. To minimize the effects on cancer outcomes, it is necessary to return as quickly as possible to prepandemic levels of screening and prevention activity or indeed to exceed these levels. The recovery of services should address health inequalities.

Facebook Intervention to Connect Alaska Native People With Resources and Support to Quit Smoking: CAN Quit Pilot Randomized Controlled Trial

INTRODUCTION

There is some evidence that social media interventions can promote smoking cessation. This randomized controlled pilot study is the first to evaluate the feasibility and potential efficacy of a Facebook smoking cessation intervention among Alaska Native (AN) adults.

AIMS AND METHODS

Recruitment and data collection occurred from December 2019 to March 2021. Participants were recruited statewide in Alaska using Facebook advertisements with a targeted sample of 60 enrolled. Participants were stratified by gender, age, and rural or urban residence and randomly assigned to receive referral resources on evidence-based cessation treatments (EBCTs) (control, n = 30) or these resources plus a 3-month, closed (private), culturally tailored, Facebook group (intervention, n = 31) that connected participants to EBCT resources and was moderated by two Alaska Native Trained Tobacco Specialists. Assessments were conducted online post-randomization at 1, 3, and 6 months. Outcomes were feasibility (recruitment, retention, and intervention engagement), self-reported use of EBCTs, and biochemically confirmed seven-day point-prevalence smoking abstinence.

RESULTS

Of intervention participants, 90% engaged (eg posted, commented) more than once. Study retention was 57% at 6 months (no group differences). The proportion utilizing EBCTs was about double for intervention compared with the control group participants at 3 and 6 months. Smoking abstinence was higher for intervention than control participants at 3 months (6.5% vs. 0%, p = .16) but comparable at 6 months (6.4% vs. 6.7%, p = .97).

CONCLUSIONS

While additional research is needed to promote long-term cessation, this pilot trial supports recruitment feasibility during the Coronavirus Disease 2019 (COVID-19) pandemic, consumer uptake, and a signal for intervention efficacy on the uptake of cessation treatment and short-term smoking abstinence.

IMPLICATIONS

This study is the first evaluation of a social media intervention for smoking cessation among Indigenous people. We learned that statewide Facebook recruitment of AN adults who smoke was feasible and there was a signal for the efficacy of a Facebook intervention on the uptake of EBCT and short-term (3 months) biochemically verified smoking abstinence. Clinically, social media platforms may complement current care models by connecting AN individuals and others living in hard-to-reach communities to cessation treatment resources.

Computational analyses identify addiction help-seeking behaviors on the social networking website Reddit: Insights into online social interactions and addiction support communities

INTRODUCTION

Although social connection to others with lived addiction experiences is a strong predictor of long-term recovery from substance use disorders (SUD), the COVID-19 pandemic greatly altered global abilities to physically connect with other people. Evidence suggests online forums for people with SUD may serve as a sufficient proxy for social connection, however efficacy of online spaces as addiction treatment adjuncts remains empirically understudied.

PURPOSE

The purpose of this study is to analyze a collection of Reddit posts germane to addiction and recovery collected between March-August 2022.

METHODS

We collected (n = 9,066) Reddit posts (1) r/addiction; (2) r/DecidingToBeBetter, (3) r/SelfImprovement, (4) r/OpitatesRecovery, (5) r/StopSpeeding, (6) r/RedditorsInRecovery, and (7) r/StopSmoking subreddits. We applied several classes of natural language processing (NLP) methods to analyze and visualize our data including term frequency inverse document frequency (TF-IDF) calculations, k-means clustering, and principal components analysis (PCA). We also applied a Valence Aware Dictional and sEntiment [sic] Reasoner (VADER) sentiment analysis to determine affect in our data.

RESULTS

Our analyses revealed three distinct clusters: (1) Personal addiction struggle, or sharing one's recovery journey (n = 2,520), (2) Giving advice, or offering counseling based on first-hand experiences (n = 3,885), and (3) Seeking advice, or asking for support or advice related to addiction (n = 2,661).

DISCUSSION & CONCLUSION

Addiction, SUD, and recovery dialogue on Reddit is exceedingly robust. Much of the content mirrors tenets for established addiction-recovery programs, which suggests Reddit, and other social networking websites, may serve as efficient tools to promote social connection among people with SUD.

Exploring the perceived effectiveness and cultural acceptability of COVID-19 relevant social media intervention content among Alaska Native people who Smoke: The CAN Quit Study

Social media platforms have potential for reach and effectiveness to motivate smoking cessation and use of evidence-based cessation treatment, even during the worldwide COVID-19 pandemic. This study builds on our prior community participatory approach to developing content postings for the CAN Quit Facebook intervention among Alaska Native (AN) people who smoke. With input from a community advisory committee, we selected new content on COVID-19 preventive practices (e.g., masking) and evaluated them using a validated, six-item perceived effectiveness scale and a single item assessing cultural relevance. We obtained feedback on six content postings (two videos and four text/pictures) from an online survey administered to 41 AN people (14 men, 27 women; age range 22–61 years) who smoke in Alaska statewide with 49 % residing in rural Alaska. Perceived effectiveness scale scores were high across postings, ranging from 3.9 to 4.4 out of a maximum score of 5.0. Cultural relevance item scores ranged from 3.9 to 4.3. We found no appreciable differences by sex, age, or rural/urban location for either score. This study adds new information on the adaptation, acceptability, and perceived effectiveness of content on COVID-19 preventive practices for future inclusion in a social media-based intervention for smoking cessation specifically tailored for AN people.