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Yamamoto T, Abbas H, Kanai M, Yokoyama T, Tabuchi T. Factors associated with smoking behaviour changes during the COVID-19 pandemic in Japan: a 6-month follow-up study. Tob Control 2024; 33:287-294. [PMID: 37616062 DOI: 10.1136/tc-2022-057353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 08/10/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Smoking behaviour may have changed due to the COVID-19 pandemic, the April 2020 revised smoke-free policy and the high prevalence of heated tobacco product (HTP) use in Japan (10.9% in 2020). This study examined the association between these three events and smoking behaviour changes using 6-month follow-up data from before and during the pandemic. METHOD Using longitudinal data from an internet survey conducted in February 2020 (baseline) and follow-up in August to September 2020, prevalence ratios (PR) and 95% confidence intervals (95% CIs) for smoking behaviour changes (increase and quit) were calculated using multivariable Poisson regression with adjustments for potential covariates including three event-related five factors: fear of COVID-19, living in a COVID-19 endemic area, workplace smoking rules, self-imposed smoking rules at home and type of tobacco use (cigarette only/HTP only/dual use). A smoker who reported an increase in smoking intensity in the last month was defined as an increase. A smoker who had stopped both cigarettes and HTPs at follow-up was defined as a quit. RESULTS We analysed 1810 tobacco users (1448 males (80%); mean age 50.8 years±13.2 SD). At baseline, 930 participants used cigarettes only, 293 HTPs only and 587 both. While 214 (11.8%) users increased smoking intensity, 259 (14.3%) quit both tobacco products. Those who feared COVID-19 were less likely to quit (PR=0.77, 95% CI 0.68 to 0.95), while living in a COVID-19 endemic area was not associated with either smoking behaviour change. Workplace smoking rules were not associated with either smoking behaviour change, but those with no home smoking ban were less likely to quit. Compared with cigarette-only users, HTP-only users were more likely to quit (PR=1.57, 95% CI 1.17 to 2.11), while dual users were more likely to increase smoking intensity (PR=1.35, 95% CI 1.01 to 1.79). CONCLUSION During the pandemic, dual cigarette and HTP use increased smoking intensity, whereas HTP-only use was associated with quitting but fear of COVID-19 and not having a home smoking ban made it harder to quit.
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Affiliation(s)
- Takafumi Yamamoto
- Department of Health Promotion, National Institute of Public Health, Wako, Japan
| | - Hazem Abbas
- Department of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Makiko Kanai
- Respiratory Medicine, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Tetsuji Yokoyama
- Department of Health Promotion, National Institute of Public Health, Wako, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
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Brookfield S, Steadman KJ, Nissen L, Gartner CE. Pharmacist-only supply of nicotine vaping products: proposing an alternative regulatory model for Australia. Tob Control 2024:tc-2023-058414. [PMID: 38599788 DOI: 10.1136/tc-2023-058414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 04/03/2024] [Indexed: 04/12/2024]
Abstract
Regulation of nicotine vaping products (NVPs) is an ongoing challenge across the world. Australia currently has a globally unique NVP regulatory model that requires a medical prescription to purchase and use NVPs, with further restrictions in progress in response to evidence of widespread illicit NVP sales. Against this background, we examine the new measures and consider a modification of the model to pharmacist-only supply as an option for increasing access to NVPs for smoking cessation, while retaining health practitioner oversight of supply. We describe the strengths and challenges of implementing a pharmacist-only NVP supply option in Australia. Compared with the current prescription-only model, pharmacist-only supply could increase access to a lower exposure nicotine product in a highly regulated therapeutic context while addressing youth access and purchasing for non-therapeutic use, reduce demand for illicit products for smoking cessation purposes and avoid overburdening medical services with consultations to obtain NVP prescriptions. This approach can also accommodate current government goals such as eliminating NVP advertising, youth-focused branding and supply from grocery and convenience stores.
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Affiliation(s)
- Samuel Brookfield
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, The University of Queensland, Herston, Queensland, Australia
| | - Kathryn J Steadman
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, The University of Queensland, Herston, Queensland, Australia
- School of Pharmacy, Faculty of Health and Behavioural Sciences, The University of Queensland, Woolloongabba, Queensland, Australia
| | - Lisa Nissen
- Centre for the Business and Economics of Health, Faculty of Business Economics and Law, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Coral E Gartner
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, The University of Queensland, Herston, Queensland, Australia
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Obeid S, Idilbi N, Agbarya A, Admi H. Arab male physicians' perceptions about their own smoking behaviors: a qualitative study. Isr J Health Policy Res 2024; 13:15. [PMID: 38566238 PMCID: PMC10986019 DOI: 10.1186/s13584-024-00602-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 03/09/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Smoking remains the leading preventable cause of disease, disability, and death worldwide. Although physicians have high levels of health literacy with awareness of the consequences of smoking and their essential role in smoking cessation of patients, some physicians continue to smoke. Rates of smoking among Arab male physicians are high. This study aimed to gain insights into Arab male physician's perceptions of their own smoking behaviors and their professional role in health promotion. METHODS Using purposive sampling, we recruited 25 Arab male physicians working in hospital and community clinic settings who currently smoke. Semi-structured, hour-long, interviews were held during January-June 2022. We then performed a thematic analysis of the interview data. RESULTS The analysis revealed three categories, two sub-categories, and 15 emerging themes. The category 'Antecedents: prior to becoming a physician' revealed the themes: smoking experience during adolescence; social and ethnic culture; stress during medical studies; and on & off periods of quitting smoking. The category 'Physicians' perception of smoking' was sorted into two sub-categories: (1) Personal aspects, including the themes 'relaxation from stress', 'self-compensation', 'addiction', and 'enjoyable experience', and (2) Professional aspects, including the themes 'lack of knowledge about cessation', 'inadequate workplace support', 'motivation to consult patients', and 'awareness of their role as primary care physicians'. The category'Impacts' revealed the themes 'personal health and well-being', 'professional competence', and 'professional image in public'. CONCLUSIONS This study provides an in-depth understanding of the personal, socio-cultural, and professional aspects of the phenomenon of Arab male smoking physicians from their perspective. Based on this information, we recommend developing programs that support and empower all physicians to cope better with their personal and professional stress as well as instituting programs that will provide all physicians with specific knowledge and skills related to smoking cessation. These programs should improve the ability of physicians to serve as positive role models for their patients for preventing and ceasing smoking, thus enhancing the image of the medical profession and, most importantly, improving the health of the public.
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Affiliation(s)
- Samira Obeid
- Nursing Department, The Max Stern Yezreel Valley Academic College, D.N. Emek Yezreel, 1930600, Israel.
- Ministry of Health, Northern Region, Nof Hagalil, 1710602, Israel.
| | - Nasra Idilbi
- Nursing Department, The Max Stern Yezreel Valley Academic College, D.N. Emek Yezreel, 1930600, Israel
- Galilee Medical Center, Nahariya, 22100, Israel
| | - Abed Agbarya
- Bnai Zion Medical Center, Sderot Eliyahu Golomb 47, Haifa, Israel
| | - Hanna Admi
- Nursing Department, The Max Stern Yezreel Valley Academic College, D.N. Emek Yezreel, 1930600, Israel
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Lyons A, Bhardwaj N, Masalkhi M, Fox P, Frazer K, McCann A, Syed S, Niranjan V, Kelleher CC, Kavanagh P, Fitzpatrick P. Specialist cancer hospital-based smoking cessation service provision in Ireland. Ir J Med Sci 2024; 193:629-638. [PMID: 37740109 PMCID: PMC10961275 DOI: 10.1007/s11845-023-03525-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 09/12/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND While much progress has been made in reducing tobacco use in many countries, both active and passive smoking remain challenges. The benefits of smoking cessation are universally recognized, and the hospital setting is an ideal setting where smokers can access smoking cessation services as hospital admission can be a cue to action. Consistent delivery of good quality smoking cessation care across health services is an important focus for reducing the harm of tobacco use, especially among continued smokers. AIMS Our objective was to document the smoking cessation medication and support services provided by specialist adult cancer hospitals across Ireland, a country with a stated tobacco endgame goal. METHODS A cross-sectional survey based on recent national clinical guidelines was used to determine smoking cessation care delivery across eight specialist adult cancer tertiary referral university hospitals and one specialist radiotherapy center. Survey responses were collected using Qualtrics, a secure online survey software tool. The data was grouped, anonymized, and analyzed in Microsoft Excel. RESULTS All responding hospitals demonstrated either some level of smoking cessation information or a service available to patients. However, there is substantial variation in the type and level of smoking cessation information offered, making access to smoking cessation services inconsistent and inequitable. CONCLUSION The recently launched National Clinical Guideline for smoking cessation provides the template for all hospitals to ensure health services are in a position to contribute to Ireland's tobacco endgame goal.
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Affiliation(s)
- Ailsa Lyons
- Department of Preventive Medicine and Health Promotion, St. Vincent's University Hospital, Elm Park, Dublin 4, D04 T6F4, Ireland.
| | - Nancy Bhardwaj
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - Mouayad Masalkhi
- School of Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - Patricia Fox
- School of Nursing, Midwifery and Health Systems, Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland
| | - Kate Frazer
- School of Nursing, Midwifery and Health Systems, Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland
| | - Amanda McCann
- UCD Conway Institute of Biomolecular and Biomedical Research and UCD School of Medicine, College of Health and Agricultural Science (CHAS), University College Dublin, Belfield, Dublin 4, Ireland
| | - Shiraz Syed
- Department of Preventive Medicine and Health Promotion, St. Vincent's University Hospital, Elm Park, Dublin 4, D04 T6F4, Ireland
| | - Vikram Niranjan
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - Cecily C Kelleher
- Department of Preventive Medicine and Health Promotion, St. Vincent's University Hospital, Elm Park, Dublin 4, D04 T6F4, Ireland
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - Paul Kavanagh
- Health Service Executive Tobacco Free Ireland Programme, Strategy and Research, 4th Floor, Jervis House, Jervis Street, Dublin 1, D01 W596, Ireland
| | - Patricia Fitzpatrick
- Department of Preventive Medicine and Health Promotion, St. Vincent's University Hospital, Elm Park, Dublin 4, D04 T6F4, Ireland
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland
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McCuistian C, Lisha NE, Campbell B, Cheng C, Le J, Guydish J. Reducing tobacco use in substance use treatment: The California tobacco free initiative. Addict Behav 2024; 155:108025. [PMID: 38593596 DOI: 10.1016/j.addbeh.2024.108025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/12/2024] [Accepted: 03/29/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND People in substance use disorder (SUD) treatment have a smoking prevalence that is five times higher than the national average. California funded the Tobacco Free for Recovery Initiative, designed to support programs in implementing tobacco-free grounds and increasing smoking cessation services. In the first cohort of the initiative (2018-2020) client smoking prevalence decreased from 54.2% to 26.6%. The current study examined whether similar findings would be replicated with a later cohort of programs (2020-2022). METHOD Cross-sectional survey data were collected from clients in 11 residential SUD treatment programs at baseline (n = 185) and at post intervention (n = 227). Multivariate logistic regression assessed change over time in smoking prevalence, tobacco use behaviors, and receipt of cessation services across the two timepoints. RESULTS Client smoking prevalence decreased from 60.3 % to 40.5 % (Adjusted Odds Ratio [AOR] = 0.46, 95 % CI = 0.27, 0.78; p = 0.004). Current smokers and those who quit while in treatment reported an increase in nicotine replacement therapy (NRT)/pharmacotherapy from baseline to post intervention (31.9 % vs 45.6 %; AOR = 2.22, 95 % CI = 1.08, 4.58; p = 0.031). CONCLUSIONS Like the first cohort, the Tobacco Free for Recovery initiative was associated with decreased client smoking prevalence and an increase in NRT/pharmacotherapy. These findings strengthen the evidence that similar initiatives may be effective in reducing smoking prevalence among people in SUD treatment.
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Affiliation(s)
- Caravella McCuistian
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco 1001 Potrero Ave, San Francisco, CA 94110, United States.
| | - Nadra E Lisha
- Division of General Internal Medicine, School of Medicine University of California, San Francisco 530 Parnassus Ave, San Francisco, CA 94143, United States
| | - Barbara Campbell
- Division of General Internal Medicine & Geriatrics, Oregon Health and Science University 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, United States
| | - Christine Cheng
- Smoking Cessation Leadership Center, University of California, San Francisco 490 Illinois Street, 9216, San Francisco, CA 94158, United States
| | - Jennifer Le
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco 1001 Potrero Ave, San Francisco, CA 94110, United States
| | - Joseph Guydish
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 490 Illinois St., Floor 7, San Francisco, CA 94158, United States
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Van den Brand FA, Martinelli T, de Haan-Bouma CI, Meerkerk GJ, Winkens B, Nagelhout GE. How a 5-Day Stay in the Tobacco-Free Environment of the Stoptober House Supports Individuals to Quit Smoking: A Mixed Methods Pilot Study. Eur Addict Res 2024; 30:103-113. [PMID: 38527439 DOI: 10.1159/000537929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 02/15/2024] [Indexed: 03/27/2024]
Abstract
INTRODUCTION The Stoptober House is part of the annual national Stoptober smoking cessation campaign in the Netherlands. During the first week of October, 48 volunteers resided in the tobacco-free Stoptober House for 5 days and received smoking cessation counseling. This pilot study explored how the Stoptober House may have facilitated smoking cessation among participants. METHODS We included 48 individuals who were selected for the Stoptober House (intervention group) and 67 individuals who were not selected (control group). Surveys were conducted at baseline, immediately after 2 and 8 weeks of post-intervention. We compared self-reported abstinence, psychosocial mediators related to smoking cessation, and perceived active elements of the Stoptober House between the intervention and control groups using t/χ2 tests and linear mixed model (LMM) analysis. Sixteen semi-structured qualitative interviews were conducted to explore participants' perspectives on the elements contributing to their success in quitting smoking. RESULTS At 8 weeks of follow-up, a higher proportion of participants in the intervention group (24/48 [50%]) reported being abstinent compared to the control group (5/67 [7%]; p < 0.001). Among participants who reported making a quit attempt, 22/38 (57.9%) in the intervention group remained abstinent compared to 4/17 (23.5%) in the control group (p = 0.022). The intervention group also exhibited higher self-efficacy to quit smoking throughout the follow-up period and higher social support immediately after the Stoptober House. No significant differences were observed in other psychosocial factors. The interviews highlighted several perceived elements of the Stoptober House that contributed to smoking cessation success, including restricted smoking opportunities, access to smoking cessation counselors, and peer support. CONCLUSION This pilot study suggests that the Stoptober House provides support that can help people quit smoking. Further research is needed to confirm these findings and determine the cost-effectiveness of this intervention in promoting long-term abstinence among specific groups of smokers.
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Affiliation(s)
- Floor A Van den Brand
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | | | - Charlotte I de Haan-Bouma
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | | | - Bjorn Winkens
- Department of Methodology and Statistics, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Gera E Nagelhout
- IVO Research Institute, The Hague, The Netherlands
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
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7
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Morris D, Gillespie D, Dockrell MJ, Cook M, Horton M, Brown J, Langley TE. Potential smoke-free dividend across local areas in England: a cross-sectional analysis. Tob Control 2024:tc-2023-058264. [PMID: 38508755 DOI: 10.1136/tc-2023-058264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 01/09/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND The value that might be added to local economies each year through the money that people who smoke tobacco would save if everyone quit smoking is called the 'smoke-free dividend'. This study aimed to estimate the value of the smoke-free dividend across local areas in England, and how it relates to the average income in those areas. METHODS The study was a cross-sectional descriptive analysis of tobacco expenditure from the Smoking Toolkit Study (STS) matched to income and smoking prevalence data for English local authorities. The STS sample was from 2014 to 2020 and comprised 18 721 adults who smoke cigarettes. Self-reported expenditure estimates from the STS were adjusted for under-reporting. This adjustment aimed to align the total expenditure estimate with figures derived from government tax receipts and national estimates of illicit tobacco use. The smoke-free dividend is calculated as 93% of spending on legal tobacco, which is the percentage estimated to leave the local economy, plus 100% of spending on illicit tobacco. RESULTS The total dividend in England is estimated to be £10.9 billion each year, which equates to £1776 per person who smokes or £246 per adult regardless of smoking status. The estimated dividend is greater in areas with lower average income, with a correlation coefficient of -0.521 (95% CI -0.629, -0.392) between the average income of local areas and the dividend per adult. CONCLUSIONS This study has estimated that local economies could gain a substantial dividend if everybody stopped smoking, which is larger in lower income areas, meaning that geographical economic inequalities could be reduced.
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Affiliation(s)
- Damon Morris
- Sheffield Addictions Research Group, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK
- SPECTRUM Consortium, UK
| | - Duncan Gillespie
- Sheffield Addictions Research Group, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK
- SPECTRUM Consortium, UK
| | - Martin J Dockrell
- SPECTRUM Consortium, UK
- Office for Health Improvement and Disparities, London, UK
| | - Mark Cook
- Office for Health Improvement and Disparities, London, UK
| | - Marie Horton
- SPECTRUM Consortium, UK
- Office for Health Improvement and Disparities, London, UK
| | - Jamie Brown
- SPECTRUM Consortium, UK
- Behavioural Science and Health, University College London, London, UK
| | - Tessa Elisabeth Langley
- SPECTRUM Consortium, UK
- Nottingham Centre for Public Health and Epidemiology, University of Nottingham, Nottingham, UK
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Krishnan N, Berg CJ, Elmi AF, Klemperer EM, Sherman SE, Abroms LC. Trajectories of ENDS and cigarette use among dual users: analysis of waves 1 to 5 of the PATH Study. Tob Control 2024; 33:e62-e68. [PMID: 36601793 DOI: 10.1136/tc-2022-057405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 11/15/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Concurrent electronic nicotine delivery system (ENDS) and cigarette (dual) use is harmful. Identifying longitudinal trajectories of ENDS and cigarette use among dual users can help to determine the public health impact of ENDS and inform tobacco control policies and interventions. OBJECTIVES (1) To identify independent and joint trajectories of ENDS and cigarette use among wave (W) 1 adult dual users across W1 to W5 of the Population Assessment of Tobacco and Health (PATH) Study; and (2) identify W1 predictors of ENDS and cigarette joint trajectory group membership. METHODS We used group-based trajectory modelling to estimate independent and joint trajectories of ENDS and cigarette use from wave 1 (W1; 2013-2014) to wave 5 (W5; 2018-2019) among W1 adult established dual users of ENDS and cigarettes (n=545) from the PATH Study. We used multinomial logistic regression to identify W1 predictors of joint trajectories. RESULTS Two ENDS (early quitters=66.0%, stable users=34.0%) and three cigarette (stable users=55.2%, gradual quitters=27.3%, early quitters=17.5%) trajectories of W1 were identified. In joint trajectory analysis, 41.6% of participants were early ENDS quitters and stable cigarette users; 14.8% early ENDS quitters and gradual cigarette quitters; 14.6% stable ENDS users and stable cigarette users; 11.2% stable ENDS users and gradual cigarette quitters; 10.3% early ENDS quitters and early cigarette quitters; and 7.4% stable ENDS users and early cigarette quitters. Cigarette and ENDS use frequency, nicotine dependence, cannabis use and other non-combusted tobacco product use predicted trajectory group membership (p values <0.05). CONCLUSIONS Most dual users maintained long-term cigarette smoking or dual use, highlighting the need to address cessation of both products. Continued monitoring of trajectories and their predictors is needed, given ongoing changes to the ENDS marketplace.
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Affiliation(s)
- Nandita Krishnan
- Department of Prevention and Community Health, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA
| | - Carla J Berg
- Department of Prevention and Community Health, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA
| | - Angelo F Elmi
- Department of Biostatistics and Bioinformatics, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA
| | - Elias M Klemperer
- Department of Psychiatry, University of Vermont, Burlington, Vermont, USA
- Vermont Center on Behavior and Health, Burlington, Vermont, USA
| | - Scott E Sherman
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Lorien C Abroms
- Department of Prevention and Community Health, The George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA
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Graham-DeMello A, Hoek J. How do people who smoke perceive a tobacco retail outlet reduction policy in Aotearoa New Zealand? A qualitative analysis. Tob Control 2024; 33:e25-e31. [PMID: 36720649 PMCID: PMC10958291 DOI: 10.1136/tc-2022-057834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/20/2023] [Indexed: 02/02/2023]
Abstract
BACKGROUND Aotearoa New Zealand plans to greatly reduce tobacco retail outlets, which are concentrated in areas of higher deprivation and perpetuate health inequities caused by smoking and borne particularly by Māori. However, we lack in-depth analyses of how this measure could affect people who smoke. METHODS We undertook in-depth interviews with 24 adults from two urban areas who smoke. We used a novel interactive mapping approach to examine participants' current retail outlets and their views on a scenario where very few outlets would sell tobacco. To inform policy implementation, we probed participants' anticipated responses and explored the measure's wider implications, including unintended impacts. We used qualitative description to interpret the data. RESULTS Most participants anticipated accommodating the changes easily, by using alternative outlets or bulk-purchasing tobacco; however, they felt others would face access problems and increased costs, and greater stress. They thought the policy would spur quit attempts, reduce relapse among people who had quit and protect young people from smoking uptake, and expected more people to switch to alternative nicotine products. However, most foresaw unintended social outcomes, such as increased crime and reduced viability of local businesses. CONCLUSIONS Many participants hoped to become smoke-free and thought retail reduction measures would prompt quit attempts and reduce relapse. Adopting a holistic well-being perspective, such as those developed by Māori, could address concerns about unintended adverse outcomes and provide comprehensive support to people who smoke as they adjust to a fundamental change in tobacco availability.
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Affiliation(s)
| | - Janet Hoek
- Public Health, University of Otago, Wellington, New Zealand
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10
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Puljević C, Meciar I, Holland A, Stjepanović D, Snoswell CL, Thomas EE, Morphett K, Kang H, Chan G, Grobler E, Gartner CE. Systematic review and meta-analysis of text messaging interventions to support tobacco cessation. Tob Control 2024:tc-2023-058323. [PMID: 38448226 DOI: 10.1136/tc-2023-058323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 02/21/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE To review randomised controlled trials (RCTs) investigating the effectiveness of text message-based interventions for smoking cessation, including the effects of dose (number of text messages) and concomitant use of behavioural or pharmacological interventions. DATA SOURCES We searched seven databases (PubMed, CINAHL, PsycINFO, Scopus, EMBASE, Cochrane Library and Web of Science), Google Scholar and the reference lists of relevant publications for RCTs. Eligible studies included participants aged ≥15 years who smoked tobacco at enrolment. STUDY SELECTION One reviewer screened titles and abstracts and two reviewers independently screened full texts of articles. DATA EXTRACTION One of three reviewers independently extracted data on study and intervention characteristics and smoking abstinence rates using Qualtrics software. DATA SYNTHESIS 30 of the 40 included studies reported higher rates of smoking cessation among those receiving text messaging interventions compared with comparators, but only 10 were statistically significant. A meta-analysis of seven RCTs found that participants receiving text messages were significantly more likely to quit smoking compared with participants in no/minimal intervention or 'usual care' conditions (risk ratio 1.87, 95% CI 1.52 to 2.29, p <0.001). Three trials found no benefit from a higher dose of text messages on smoking cessation. Two trials that tested the added benefit of text messaging to pharmacotherapy reported outcomes in favour of adding text messaging. CONCLUSIONS Findings suggest that text messaging-based interventions are effective at promoting smoking cessation. Further research is required to establish if any additional benefit is gained from an increased number of text messages or concurrent pharmacotherapy or behavioural counselling.
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Affiliation(s)
- Cheneal Puljević
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Herston, Queensland, Australia
| | - Isabel Meciar
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Herston, Queensland, Australia
| | - Alice Holland
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Herston, Queensland, Australia
| | - Daniel Stjepanović
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Herston, Queensland, Australia
- National Centre for Youth Substance Use Research, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Centaine L Snoswell
- Centre for Online Health, Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Emma E Thomas
- Centre for Online Health, Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Kylie Morphett
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Herston, Queensland, Australia
| | - Heewon Kang
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Herston, Queensland, Australia
- Seoul National University Institute of Health and Environment, Seoul, South Korea
| | - Gary Chan
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Herston, Queensland, Australia
- National Centre for Youth Substance Use Research, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Etienne Grobler
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Coral E Gartner
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Herston, Queensland, Australia
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11
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Lin C, Mathur Gaiha S, Halpern-Felsher B. E-cigarette and combustible cigarette cessation patterns, reasons, and methods among adolescents, young adults, and adults. Addict Behav 2024; 150:107918. [PMID: 38070362 PMCID: PMC10845159 DOI: 10.1016/j.addbeh.2023.107918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 11/18/2023] [Accepted: 11/20/2023] [Indexed: 12/25/2023]
Abstract
Research is limited regarding adolescents' and young adults' (AYA) patterns, methods of, and reasons for cigarette or e-cigarette cessation. Further, while adults may try to use e-cigarettes to quit combustible cigarettes, little is known about how adults then quit e-cigarettes. This study utilizes a national, cross-sectional online survey of 6131 diverse participants aged 13-40 years to examine reasons for quitting e-cigarettes or cigarettes, quit methods, and quit attempt outcomes among AYAs and adults. In our sample, 3137 (51.2%) had ever used an e-cigarette, of whom 2310 (37.7%) were aged 13-24 years and 827 (13.5%) were 25-40 years old; 2387 (38.9%) had ever used a combustible cigarette (1440 [23.5%] were 13-24 years old and 947 [15.4%] were 25-40 years old). Among e-cigarette ever-users, 39.4% of 13-24-year-olds intended to quit in the next 6 months, and 36.9% had a serious plan for quitting in the next 30 days; 25.2% wanted to decrease the amount they used while 34.8% wanted to quit completely. Similar rates were found among e-cigarette ever users aged 25-40 years, as well as past 30-day e-cigarette users, cigarette ever-users, and past 30-day cigarette users across all ages. "Cold turkey" (41.0%) followed by "tried to cut down slowly by vaping/smoking less often or fewer puffs" (25.5%) was the most common quit method among e-cigarette ever-users and cigarette ever-users of all ages. Further study of effective tobacco cessation methods to help both AYAs and adults successfully quit nicotine, whether from cigarettes or e-cigarettes, is urgently needed.
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Affiliation(s)
- Crystal Lin
- Stanford School of Medicine, Stanford University, Palo Alto, CA, United States; REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, CA, United States
| | - Shivani Mathur Gaiha
- REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, CA, United States
| | - Bonnie Halpern-Felsher
- REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, CA, United States.
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12
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Zvolensky MJ, Shepherd JM, Clausen BK, Robison J, Cano MÁ, de Dios M, Correa-Fernández V. Posttraumatic stress and probable post traumatic stress disorder as it relates to smoking behavior and beliefs among trauma exposed hispanic persons who smoke. J Behav Med 2024:10.1007/s10865-024-00480-8. [PMID: 38409553 DOI: 10.1007/s10865-024-00480-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 02/09/2024] [Indexed: 02/28/2024]
Abstract
There has been little scientific effort to evaluate the associations between cigarette smoking and cessation-related constructs and exposure to traumatic events, posttraumatic stress, and Posttraumatic Stress Disorder (PTSD) symptoms among Hispanic persons who smoke in the United States (US). Such trauma-related factors may pose unique difficulties for Hispanic persons who smoke and possess a desire to quit. As such, the present investigation sought to fill this gap in the literature and examine posttraumatic stress and probable PTSD in terms of their relations with several clinically significant smoking constructs among trauma-exposed Hispanic persons who smoke from the United States. Participants included 228 Spanish-speaking Hispanic persons who endorsed prior traumatic event exposure and smoked combustible cigarettes daily (58.3% female, Mage= 32.1 years, SD = 9.65). Results indicated that posttraumatic stress symptoms were related to increased cigarette dependence, perceived barriers for smoking cessation, and more severe problems when trying to quit with effect sizes ranging from small to moderate in adjusted models. Additionally, Hispanic persons who smoke with probable PTSD compared to those without probable PTSD showcased a statistically effect for perceived barriers for cessation (p < .008) and a severity of problems when trying to quit (p < .001). No effect was evident for cigarette dependence after alpha correction. Overall, the present study offers novel empirical evidence related to the role of posttraumatic stress symptoms and PTSD among Hispanic persons who smoke in the US. Such findings highlight the need to expand this line of research to better understand the role of posttraumatic stress and PTSD among Hispanic persons who smoke which can inform smoking cessation treatments for Hispanic persons who smoke experiencing trauma-related symptomology.
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Affiliation(s)
- Michael J Zvolensky
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, 77204, Houston, TX, USA.
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
- HEALTH Institute, University of Houston, Houston, TX, USA.
| | - Justin M Shepherd
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, 77204, Houston, TX, USA
| | - Bryce K Clausen
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, 77204, Houston, TX, USA
| | - Jillian Robison
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, 77204, Houston, TX, USA
| | - Miguel Ángel Cano
- Peter O'Donnell Jr. School of Public Health, The University of Texas Southwestern Medical Center, Dallas, USA
| | - Marcel de Dios
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX, USA
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13
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Kasza KA, Tang Z, Xiao H, Marshall D, Stanton CA, Gross AL, Jackson KM, Kelley D, Schroeder MJ, Vivar JC, Hyland A. National longitudinal tobacco product cessation rates among US adults from the PATH Study: 2013-2019 (waves 1-5). Tob Control 2024; 33:186-192. [PMID: 35879095 PMCID: PMC10249338 DOI: 10.1136/tc-2022-057323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 07/12/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To report on longitudinal tobacco product cessation rates, by product type, among adults (ages 18+ years) in the USA between 2013 and 2019. METHODS The Population Assessment of Tobacco and Health Study, a nationally representative, longitudinal cohort study was used to report on annual and biennial rates of the following three cessation behaviours across 2013-2019: (1) discontinuing tobacco product use (ie, transition from past 30-day use to no past 30-day use), (2) attempting to quit tobacco product use and (3) quitting tobacco product use among those who attempted to quit. Each cessation behaviour was evaluated separately for cigarettes, electronic nicotine delivery systems (ENDS), cigars, hookah and smokeless tobacco. Generalised estimating equations were used to evaluate linear and nonlinear trends in cessation rates across the study period. RESULTS Between 2013 and 2019, rates of discontinuing cigarette smoking among adults in the USA statistically increased from 16% to 18%, though these were consistently lower than rates of discontinuing use of other tobacco products. Similarly, quit attempt rates and rates of quitting among attempters increased for cigarette smokers. However, rates of discontinuing ENDS use sharply declined across the study period, from 62% to 44%. CONCLUSIONS Findings show that tobacco product cessation rates have been changing in recent years in the USA alongside the changing tobacco product marketplace and regulatory environment, though rates of discontinuing cigarette smoking remain relatively low. Findings can serve as a benchmark against which future cessation rates can be compared to evaluate the impacts of future tobacco regulatory policies.
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Affiliation(s)
- Karin A Kasza
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Zhiqun Tang
- Behavioral Health and Health Policy Practice, Westat Inc, Rockville, Maryland, USA
| | - Haijun Xiao
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Daniela Marshall
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland, USA
- Axle Informatics, Rockville, MD, USA
| | - Cassandra A Stanton
- Behavioral Health and Health Policy Practice, Westat Inc, Rockville, Maryland, USA
| | - Amy L Gross
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Kathy M Jackson
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Dannielle Kelley
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Megan J Schroeder
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Juan C Vivar
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
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14
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Dixit A, Dhanalakshmi P, Rameshchandra PT, Chachlani KS, Dithi C, Dash KC, Obulareddy VT, Kamma PKG. Effect of Smoking Cessation Programs on Periodontal Disease Progression. J Pharm Bioallied Sci 2024; 16:S771-S773. [PMID: 38595512 PMCID: PMC11000958 DOI: 10.4103/jpbs.jpbs_1004_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 04/11/2024] Open
Abstract
Background In this research study, we delve into the effects of smoking cessation programs on the progression of periodontal disease, particularly focusing on the potential benefits experienced by individuals who successfully quit smoking. Materials And Methods The research involved the participation of 200 individuals, all of whom were active smokers and exhibited varying degrees of periodontal disease. These participants enrolled in a comprehensive smoking cessation program that included regular counseling sessions and, when necessary, the provision of nicotine replacement therapy to facilitate smoking cessation. Over a 12-month period, the progression of their periodontal disease was systematically monitored through a series of dental check-ups and measurements of critical clinical parameters. These parameters included probing depth (PD), which assesses the spaces between teeth and gums, and clinical attachment level (CAL), which evaluates the attachment of gum tissue to tooth surfaces. Results After 12 months of active participation in the smoking cessation program, several noteworthy results were observed among the participants. On average, participants experienced a reduction in PD by approximately 1.5 mm, indicating a shallower space between the teeth and gums and, thus, healthier periodontal tissues. In addition, the CAL improved by an average of 1.2 mm, signifying enhanced attachment of gum tissue to the tooth surface, which is essential for dental stability. Participants also exhibited a significant reduction in plaque accumulation on tooth surfaces, indicative of improved oral hygiene practices. Furthermore, gingival inflammation, a common symptom of periodontal disease, notably decreased among participants, suggesting an overall improvement in gum health. Conclusion In conclusion, this study provides compelling evidence supporting the positive impact of smoking cessation programs on the progression of periodontal disease.
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Affiliation(s)
- Arti Dixit
- Associate Professor, Department of Public Health Dentistry, Vaidik Dental College and Research Centre, Daman (U.T.), India
| | - P Dhanalakshmi
- Assistant Professor, Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Bangalore, Karnataka, India
| | | | - Karina S. Chachlani
- Assistant Professor, Department of Public Health Dentistry, Pacific Dental College and Research Center, Udaipur, India
| | - C Dithi
- Assistant Professor, Department of Public Health Dentistry, Government Dental College, Thiruvananthapuram, India
| | - Kailash Chandra Dash
- Reader, Department of Oral and Maxillofacial Pathology, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Patia, Bhubaneswar, India
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15
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Arena G, Cumming C, Lizama N, Mace H, Preen DB. Hospital length of stay and readmission after elective surgery: a comparison of current and former smokers with non-smokers. BMC Health Serv Res 2024; 24:85. [PMID: 38233897 PMCID: PMC10792937 DOI: 10.1186/s12913-024-10566-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 01/05/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND The purpose of this study was to investigate differences between non-smokers, ex-smokers and current smokers in hospital length of stay (LOS), readmission (seven and 28 days) and cost of readmission for patients admitted for elective surgery. METHODS A retrospective cohort study of administrative inpatient data from 24, 818 patients admitted to seven metropolitan hospitals in Western Australia between 1 July 2016 and 30 June 2019 for multiday elective surgery was conducted. Data included smoking status, LOS, procedure type, age, sex and Indigenous status. LOS for smoking status was compared using multivariable negative binomial regression. Odds of readmission were compared for non-smokers and both ex-smokers and current smokers using separate multivariable logistic regression models. RESULTS Mean LOS for non-smokers (4.7 days, SD=5.7) was significantly lower than both ex-smokers (6.2 days SD 7.9) and current smokers (6.1 days, SD=8.2). Compared to non-smokers, current smokers and ex-smokers had significantly higher odds of readmission within seven (OR=1.29; 95% CI: 1.13, 1.47, and OR=1.37; 95% CI: 1.19, 1.59, respectively) and 28 days (OR=1.35; 95% CI: 1.23, 1.49, and OR=1.53; 95% CI: 1.39, 1.69, respectively) of discharge. The cost of readmission for seven and 28-day readmission was significantly higher for current smokers compared to non-smokers (RR=1.52; 95% CI: 1.1.6, 2.0; RR=1.39; 95% CI: 1.18, 1.65, respectively). CONCLUSION Among patients admitted for elective surgery, hospital LOS, readmission risk and readmission costs were all higher for smokers compared with non-smokers. The findings indicate that provision of smoking cessation treatment for adults undergoing elective surgery is likely to produce multiple benefits.
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Affiliation(s)
- Gina Arena
- School of Population and Global Health M431, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009, Australia.
| | - Craig Cumming
- School of Population and Global Health M431, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009, Australia
| | - Natalia Lizama
- Cancer Council Western Australia, Subiaco, Western Australia, Australia
- Curtin University, Bentley, Western Australia, Australia
| | - Hamish Mace
- Division of Emergency Medicine, The University of Western Australia, Perth, Western Australia, Australia
- Department of Anaesthesia and Pain Medicine, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - David B Preen
- School of Population and Global Health M431, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009, Australia
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16
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Lee HH, Lee H, Bhatt DL, Lee GB, Han J, Shin DW, Kang D, Youn JC, Guallar E, Cho J, Kim HC. Smoking habit change after cancer diagnosis: effect on cardiovascular risk. Eur Heart J 2024; 45:132-135. [PMID: 37260198 DOI: 10.1093/eurheartj/ehad199] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Affiliation(s)
- Hyeok-Hee Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
- Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Hokyou Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
- Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Deepak L Bhatt
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai Health System, 1 Gustave Levy Place, Box 1030, New York, NY 10029, USA
| | - Ga Bin Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Jiyen Han
- Department of Public Health, Yonsei University Graduate School, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Dong Wook Shin
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, 115 Irwon-ro, Gangnam-gu, Seoul 06355, Republic of Korea
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, 115 Irwon-ro, Gangnam-gu, Seoul 06355, Republic of Korea
| | - Danbee Kang
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, 115 Irwon-ro, Gangnam-gu, Seoul 06355, Republic of Korea
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea
| | - Jong-Chan Youn
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea
| | - Eliseo Guallar
- Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA
| | - Juhee Cho
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, 115 Irwon-ro, Gangnam-gu, Seoul 06355, Republic of Korea
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, 115 Irwon-ro, Gangnam-gu, Seoul 06355, Republic of Korea
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea
- Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
- Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
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17
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Vander Weg MW, Howren MB, Grant KM, Prochazka AV, Duffy S, Burke R, Cretzmeyer M, Parker C, Thomas EBK, Rizk MT, Bayer J, Kinner EM, Clark JM, Katz DA. A smoking cessation intervention for rural veterans tailored to individual risk factors: A multicenter randomized clinical trial. J Subst Use Addict Treat 2024; 156:209191. [PMID: 37866436 DOI: 10.1016/j.josat.2023.209191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/24/2023] [Accepted: 10/10/2023] [Indexed: 10/24/2023]
Abstract
INTRODUCTION Rates of cigarette use remain elevated among those living in rural areas. Depressive symptoms, risky alcohol use, and weight concerns frequently accompany cigarette smoking and may adversely affect quitting. Whether treatment for tobacco use that simultaneously addresses these issues affects cessation outcomes is uncertain. METHODS The study was a multicenter, two-group, randomized controlled trial involving mostly rural veterans who smoke (N = 358) receiving treatment at one of five Veterans Affairs Medical Centers. The study randomly assigned participants to a tailored telephone counseling intervention or referral to their state tobacco quitline. Both groups received guideline-recommended smoking cessation pharmacotherapy, selected using a shared decision-making approach. The primary outcome was self-reported seven-day point prevalence abstinence (PPA) at three and six months. The study used salivary cotinine to verify self-reported quitting at six months. RESULTS Self-reported PPA was significantly greater in participants assigned to Tailored Counseling at three (OR = 1.66; 95 % CI: 1.07-2.58) but not six (OR = 1.35; 95 % CI: 0.85-2.15) months. Post hoc subgroup analyses examining treatment group differences based on whether participants had a positive screen for elevated depressive symptoms, risky alcohol use, and/or concerns about weight gain indicated that the cessation benefit of Tailored Counseling at three months was limited to those with ≥1 accompanying concern (OR = 2.02, 95 % CI: 1.20-3.42). Biochemical verification suggested low rates of misreporting. CONCLUSIONS A tailored smoking cessation intervention addressing concomitant risk factors enhanced short-term abstinence but did not significantly improve long-term quitting. Extending the duration of treatment may be necessary to sustain treatment effects.
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Affiliation(s)
- Mark W Vander Weg
- Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, United States of America; Department of Community and Behavioral Health, University of Iowa College of Public Health, United States of America; Department of Internal Medicine, University of Iowa Carver College of Medicine, United States of America; Department of Psychological and Brain Sciences, University of Iowa, United States of America; VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Iowa City, United States of America.
| | - M Bryant Howren
- VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Iowa City, United States of America; Department of Behavioral Sciences and Social Medicine, Florida State University, United States of America; Florida Blue Center for Rural Health Research & Policy, United States of America
| | - Kathleen M Grant
- VA Nebraska-Western Iowa Health Care System, United States of America; University of Nebraska Medical Center Department of Medicine, United States of America
| | - Allan V Prochazka
- Primary Care, VA Eastern Colorado Health Care System, United States of America; Denver Seattle Center for Veteran-centric Value-based Research (DiSCoVVR), United States of America
| | - Sonia Duffy
- VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, United States of America; College of Nursing, Ohio State University, United States of America
| | - Randy Burke
- Mental Health Service, G.V. (Sonny) Montgomery VA Medical Center, United States of America; Department of Psychiatry, University of Mississippi School of Medicine, United States of America
| | | | - Christopher Parker
- Department of Pharmacy Practice and Science, University of Iowa College of Pharmacy, United States of America
| | - Emily B K Thomas
- Department of Psychological and Brain Sciences, University of Iowa, United States of America
| | | | - Jennifer Bayer
- Department of Psychological and Brain Sciences, University of Iowa, United States of America
| | - Ellen M Kinner
- Department of Psychological and Brain Sciences, University of Iowa, United States of America
| | - Jennifer M Clark
- Department of Neurology, University of Iowa, Carver College of Medicine, United States of America
| | - David A Katz
- Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, United States of America; Department of Internal Medicine, University of Iowa Carver College of Medicine, United States of America; Department of Epidemiology, University of Iowa College of Public Health, United States of America
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18
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Vila-Farinas A, Pérez-Rios M, Montes-Martinez A, Ruano-Ravina A, Forray A, Rey-Brandariz J, Candal-Pedreira C, Fernández E, Casal-Acción B, Varela-Lema L. Effectiveness of smoking cessation interventions among pregnant women: An updated systematic review and meta-analysis. Addict Behav 2024; 148:107854. [PMID: 37683574 DOI: 10.1016/j.addbeh.2023.107854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 08/08/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023]
Abstract
OBJECTIVE To carry out a systematic review of systematic reviews with an update of the existing evidence relating to a broad range of smoking cessation interventions, including psycho-social, digital and pharmacologic interventions, for pregnant women. DATA-SOURCES Search was conducted in March 2022 in PubMed, EMBASE, and Cochrane in two stages: 1) a search of systematic reviews and meta-analyses, published from January 2012 through January 2022; 2) an update of those that fulfilled eligibility criteria reproducing the primary search strategy. STUDY ELIGIBILITY CRITERIA We selected randomized clinical trials (RCTs) that evaluated the effectiveness of pharmacological, digital, and psychosocial interventions in aged 18 years and over who were daily smokers, and compared these with routine care, less intense interventions or placebo. STUDY APPRAISAL AND SYNTHESIS METHODS Data from eligible studies were manually extracted by two authors and reviewed by a third. The quality of the reviews was evaluated using the AMSTAR scale, and risk of bias was measured with the Rob-2 tool and GRADE level of evidence. RESULTS The meta-analysis included 63 RCTs (n = 19849 women). The interventions found to be effective were: financial incentives (RR:1.77; 95%CI:1.21-2.58), counseling (RR:1.27; 95%CI:1.13-1.43) and long-term nicotine replacement therapy (NRT) (RR:1.53; 95%CI:1.16-2.01). Short-term NRT, bupropion, digital interventions, feedback, social support, and exercise showed no effectiveness. The GRADE level of evidence was moderate-to-high for all interventions, with the exception of long-term NRT. CONCLUSIONS Non-pharmacological interventions for smoking cessation are the most effective for pregnant women. The moderator analysis suggests that pregnant women of low socioeconomic status might benefit less from smoking cessation interventions than women of a high socioeconomic status. These women are usually heavier smokers that live in pro-smoking environments and could require more intensive and targeted interventions.
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Affiliation(s)
- A Vila-Farinas
- Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - M Pérez-Rios
- Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Consortium for Biomedical Research in Respiratory Diseases (CIBER de Enfermedades Respiratorias/CibeRes), Madrid, Spain.
| | - A Montes-Martinez
- Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Consortium for Biomedical Research in Respiratory Diseases (CIBER de Enfermedades Respiratorias/CibeRes), Madrid, Spain
| | - A Ruano-Ravina
- Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Consortium for Biomedical Research in Respiratory Diseases (CIBER de Enfermedades Respiratorias/CibeRes), Madrid, Spain
| | - Ariadna Forray
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - J Rey-Brandariz
- Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - C Candal-Pedreira
- Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - E Fernández
- Tobacco Control Unit, WHO Collaborating Center for Tobacco Control, Institut Català d'Oncologia (ICO), Barcelona, Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain; School of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain; CIBER of Respiratory Diseases (CIBERES), Madrid, Spain
| | - B Casal-Acción
- Galician Agency for Health Knowledge Management (avalia-t; ACIS), Santiago de Compsotela, Spain
| | - L Varela-Lema
- Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Health Research Institute of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Consortium for Biomedical Research in Respiratory Diseases (CIBER de Enfermedades Respiratorias/CibeRes), Madrid, Spain
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Lambart L, Nollen NL, Mayo MS, Funk O, Leavens E, Cruvinel E, Brown A, Ahluwalia JS, Sanderson Cox L. The impact of blunt use on smoking abstinence among Black adults: Secondary analysis from randomized controlled smoking cessation clinical trial. Addict Behav 2024; 148:107877. [PMID: 37804748 DOI: 10.1016/j.addbeh.2023.107877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/20/2023] [Accepted: 10/02/2023] [Indexed: 10/09/2023]
Abstract
INTRODUCTION People who smoke cigarettes are more likely than people who do not to use cannabis, including blunts, a tobacco product containing nicotine and marijuana. Blunts represent a challenge for cessation trials because nicotine could make stopping cigarettes more difficult. Few studies have examined the impact of blunt use on individuals actively engaged in a cigarette quit attempt. METHODS Blunt use was assessed at baseline, Weeks 4, 8, 12, 16, and 26 among Black adult people who smoke enrolled in a double-blind, placebo-controlled, randomized trial of varenicline (VAR, n = 300) versus placebo (PBO, n = 200) for smoking cessation. Participants were categorized as ever blunt (blunt use reported at any timepoint) versus non-blunt (no blunt use reported). The primary outcome was salivary cotinine-verified 7-day point prevalence smoking abstinence at Weeks 12 and 26. Logistic regression examined the effects of treatment and blunt use on abstinence. RESULTS 75 participants (mean age 45.6 years (SD = 12.5, range: 22,80); 32 (42%) female) reported blunt use. Logistic regression analyses showed no treatment by blunt use interaction or significant main effect of blunt use on smoking abstinence at Weeks 12 or 26 (p > 0.05). After adjusting for treatment, those who used blunts had statistically similar odds of quitting at Week 12 (OR: 0.68, 95% CI: 0.31, 1.5) and Week 26 (OR: 0.84, 95% CI: 0.38, 1.87) as those who never used blunts during the study. DISCUSSION Blunt use had no statistically significant impact on cessation among participants in a smoking cessation clinical trial. Future trials are needed in which the target of cessation is all combustible products.
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Affiliation(s)
- Leah Lambart
- Department of Population Health, University of Kansas School of Medicine, Kansas City, USA.
| | - Nicole L Nollen
- Department of Population Health, University of Kansas School of Medicine, Kansas City, USA; The University of Kansas Comprehensive Cancer Center, USA
| | - Matthew S Mayo
- The University of Kansas Comprehensive Cancer Center, USA; Department of Biostatistics & Data Science, University of Kansas School of Medicine, Kansas City, USA
| | - Olivia Funk
- Department of Population Health, University of Kansas School of Medicine, Kansas City, USA
| | - Eleanor Leavens
- Department of Population Health, University of Kansas School of Medicine, Kansas City, USA; The University of Kansas Comprehensive Cancer Center, USA
| | - Erica Cruvinel
- Department of Population Health, University of Kansas School of Medicine, Kansas City, USA
| | - Alexandra Brown
- Department of Biostatistics & Data Science, University of Kansas School of Medicine, Kansas City, USA
| | - Jasjit S Ahluwalia
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island Legorreta Cancer Center at Brown University, Providence, RI, USA
| | - Lisa Sanderson Cox
- Department of Population Health, University of Kansas School of Medicine, Kansas City, USA; The University of Kansas Comprehensive Cancer Center, USA
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Jackson SE, Tattan-Birch H, Shahab L, Beard E, Brown J. Have there been sustained impacts of the COVID-19 pandemic on trends in smoking prevalence, uptake, quitting, use of treatment, and relapse? A monthly population study in England, 2017-2022. BMC Med 2023; 21:474. [PMID: 38093317 PMCID: PMC10720231 DOI: 10.1186/s12916-023-03157-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/06/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Studies conducted during the early stages of the pandemic documented mixed changes in smoking behaviour: more smokers quitting successfully but little change in prevalence. This study aimed to examine whether there have been sustained impacts of the COVID-19 pandemic on smoking patterns in England. METHODS Data were from 101,960 adults (≥ 18 years) participating in the Smoking Toolkit Study, a monthly representative household survey, between June 2017 and August 2022. Interviews were conducted face-to-face until March 2020 and via telephone thereafter. Generalised additive models estimated associations of the pandemic onset (March 2020) with current smoking, uptake, cessation, quit attempts, and use of support. Models adjusted for seasonality, sociodemographic characteristics, and (where relevant) dependence and tobacco control mass-media expenditure. RESULTS Before the COVID-19 pandemic, smoking prevalence fell by 5.2% per year; this rate of decline slowed to 0.3% per year during the pandemic (RRΔtrend = 1.06, 95% CI = 1.02, 1.09). This slowing was evident in more but not less advantaged social grades (RRΔtrend = 1.15, 1.08, 1.21; RRΔtrend = 1.00, 0.96, 1.05). There were sustained step-level changes in different age groups: a 34.9% (95% CI = 17.7, 54.7%) increase in smoking prevalence among 18-24-year-olds, indicating a potential rise in uptake, in contrast to a 13.6% (95% CI = 4.4, 21.9%) decrease among 45-65-year-olds. In both age groups, these step-level changes were followed by the pre-pandemic declines stopping, and prevalence remaining flat. There were sustained increases in quitting among past-year smokers, with a 120.4% (95% CI = 79.4, 170.9%) step-level increase in cessation and a 41.7% (95% CI = 29.7, 54.7%) increase in quit attempts. The main limitation was the change in modality of data collection when the pandemic started; while this may have contributed to the step-level changes we observed, it is unlikely to explain changes in the slope of trends. CONCLUSIONS In England, the rate of decline in adult smoking prevalence stagnated during the COVID-19 pandemic through to 2022. At the start of the pandemic, a potential reduction in smoking prevalence among middle-aged adults and increases in quitting among smokers may have been offset by an increase in smoking among young adults. The slowing in the rate of decline was pronounced in more advantaged social grades.
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Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
- SPECTRUM Consortium, London, UK.
| | - Harry Tattan-Birch
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- SPECTRUM Consortium, London, UK
| | - Lion Shahab
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- SPECTRUM Consortium, London, UK
| | - Emma Beard
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
- SPECTRUM Consortium, London, UK
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21
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Jones E, Endrighi R, Weinstein D, Jankowski A, Quintiliani LM, Borrelli B. Methods used to quit vaping among adolescents and associations with perceived risk, addiction, and socio-economic status. Addict Behav 2023; 147:107835. [PMID: 37598643 DOI: 10.1016/j.addbeh.2023.107835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 08/07/2023] [Accepted: 08/15/2023] [Indexed: 08/22/2023]
Abstract
Despite widespread evidence suggesting that e-cigarettes are harmful to youth, the prevalence of adolescent vaping continues to rise. The first aim of this cross-sectional study was to determine which methods adolescents have previously used to quit vaping and their interest in using various methods to quit vaping in the future. The second aim was to investigate the associations between vaping-related characteristics and (1) motivation to quit vaping and (2) previous use of pharmacological methods to quit vaping or previous use of unassisted quitting. Participants were 185 current or former vapers, aged 14-19 (M age = 16.9 years, SD = 1.1; 52% female), recruited online from different U.S. regions. Data were collected through online questionnaires. Most participants reported at least one prior attempt to quit vaping (81.3%). Unassisted quitting was the most prevalent method to quit vaping (78.4%), followed by "advice from a friend" (51.9%). Participants were interested in using a variety of methods for quitting vaping in the future, including medication (28.8%), and mobile apps (34.6%). Greater perceived harm of vaping was significantly associated with motivation to quit vaping, while greater perceived risk of addiction and higher SES were significantly associated with lifetimeuse of nicotine replacement to quit vaping. Adolescents may be open to trying methods to quit that are different from what they have used previously. These findings could help direct resources toward the development of vaping cessation programs that are acceptable to adolescents.
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Affiliation(s)
- Emily Jones
- Center for Behavioral Science Research, Boston University Henry M. Goldman School of Dental Medicine, USA
| | - Romano Endrighi
- Center for Behavioral Science Research, Boston University Henry M. Goldman School of Dental Medicine, USA
| | - Daniel Weinstein
- Center for Behavioral Science Research, Boston University Henry M. Goldman School of Dental Medicine, USA
| | - Alexis Jankowski
- Center for Behavioral Science Research, Boston University Henry M. Goldman School of Dental Medicine, USA
| | - Lisa M Quintiliani
- Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, USA; Section of General Internal Medicine, Boston Medical Center, USA
| | - Belinda Borrelli
- Center for Behavioral Science Research, Boston University Henry M. Goldman School of Dental Medicine, USA.
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22
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Zhang Z, Huang M, Chen T. Probability and predictors of long-term smoking relapse among Chinese adult smokers: A longitudinal study. Prev Med Rep 2023; 36:102482. [PMID: 37920593 PMCID: PMC10618515 DOI: 10.1016/j.pmedr.2023.102482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/15/2023] [Accepted: 10/16/2023] [Indexed: 11/04/2023] Open
Abstract
Numerous smokers attempt to quit smoking, but most cessation efforts prove unsuccessful. Scarce evidence exists regarding predictors of long-term relapse in China. This study aims to evaluate the probability of relapse and examine factors may contribute to relapse among Chinese adults. A dynamic cohort of 6,036 observations on 2,378 adult quitters was constructed from the China Family Panel Studies in 2010, 2012, 2014, 2016 and 2018. The life table method was employed to calculate the probability of relapse for long-term smoking abstinence. Multivariate complementary log-log survival models were developed to examine the predictors of smoking relapse. We found that the probability of relapse decreased as the duration of abstinence increased, with rates of 49.07 %, 20.05 %, 10.29 %, and 6.63 % at 2, 4, 6, and 8 years of abstinence, respectively. The cumulative probability of relapse within 8 years was 65.89 %. Age ≥65 years, higher educational attainment, respiratory disease, and a satisfying lifestyle were associated with a reduced likelihood of relapse. Conversely, higher occupational prestige, alcohol drinking, cohabitant smoking, and greater future confidence were associated with an increased risk of relapse. These findings demonstrated that the probability of relapse decreased progressively over time, with most relapses occurring in the initial two years following quit attempts. Predictors of Chinese quitters' relapse behavior in our study were similar to those in previous studies. Drinking and cohabitant smoking were identified as strong predictors of relapse in this population.
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Affiliation(s)
| | | | - Ting Chen
- School of Public Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
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23
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Do EK, Tulsiani S, Edwards G, Cha S, Amato MS, Hair EC. Treatment-seeking young people enrolled in a United States vaping cessation intervention trial report high frequency of use and nicotine dependence. Prev Med Rep 2023; 36:102533. [PMID: 38116264 PMCID: PMC10728452 DOI: 10.1016/j.pmedr.2023.102533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/29/2023] [Accepted: 12/01/2023] [Indexed: 12/21/2023] Open
Abstract
Objective This study examines characteristics of participants enrolled in a vaping cessation intervention trial and study generalizability of the treatment-seeking sample to the broader population of young people interested in quitting vaping to evaluate dissemination of an evidence-based treatment program. Methods Data was obtained from 697 treatment-seeking participants (aged 13-24 years) from a vaping cessation intervention trial conducted between February and March 2023 with This is Quitting and 665 participants who expressed intent to quit vaping in the Truth Longitudinal Cohort, a nationally representative longitudinal study of United States youth and young adults (aged 15-24 years), collected October 2022 to February 2023. Comparisons were made using two-sample Pearson Chi-square tests and t-tests. Results Treatment-seeking young people were younger, less racially diverse, more diverse in sexual orientation, and reported higher psychological distress, frequency of e-cigarette use, and nicotine dependence, relative to the nationally representative sample of young people expressing intentions to quit vaping. Conclusions Participants enrolled in treatment reported higher levels of dependence and use frequency than the broader population, suggesting that many young e-cigarette users with lower dependence who want to quit might not be reached by current treatment dissemination efforts. The implication of these findings is that communications for vaping cessation programs may need to be adjusted to have broader appeal among young people.
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Affiliation(s)
| | | | | | - Sarah Cha
- Innovations, Truth Initiative, Washington, DC, USA
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24
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Collins BN, Lepore SJ, Egleston BL. Eliminating children's tobacco smoke exposure: a pathway to bioverified abstinence among low-income maternal smokers in the Babies Living Safe and Smokefree (BLiSS) trial. J Behav Med 2023; 46:1042-1048. [PMID: 37285107 PMCID: PMC10591859 DOI: 10.1007/s10865-023-00423-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 05/19/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND Identifying behavioral pathways to smoking cessation in high-risk populations, such as low-income maternal smokers, could reduce tobacco disparities. The previous "BLiSS" multilevel intervention trial demonstrated efficacy of the BLiSS intervention in facilitating low-income maternal smokers' bioverified abstinence. This present study examined four putative pathways measured at 3-month end of treatment (Time 2) that could account for the observed intervention effect on smoking abstinence through 12 months (Time 2 - Time 3). METHODS Nutritionists in community clinics delivering safety net nutrition promotion programs across Philadelphia, Pennsylvania, USA, were trained by trial principal investigators to deliver a brief tobacco intervention informed by the American Academy of Pediatrics best practice guidelines ("Ask, Advise, Refer [AAR]"). After referral, 396 eligible participants were randomized to either a multimodal behavioral intervention (AAR + MBI) or a parallel attention control (AAR + control). Random effects regression analysis tested mediation. RESULTS Elimination of children's tobacco smoke exposure (TSE) at Time 2 was the only significant mediator of longitudinal smoking abstinence through Time 3. AAR + MBI mothers were more likely to eliminate their children's TSE by Time 2 (OR = 2.11, 95%CI 1.30, 3.42), which was significantly associated with Time 3 abstinence (OR = 6.72, CI 2.28, 19.80). Modeling showed a significant total effect of AAR + MBI on abstinence (OR = 6.21, CI 1.86, 20.71), a direct effect of AAR + MBI on abstinence (OR = 4.80, CI 1.45, 15.94) and an indirect effect through TSE elimination (OR = 1.29, CI 1.06, 1.57). CONCLUSIONS Integrating smoking cessation interventions with counseling prior to the quit attempt that is designed to facilitate adoption of smokefree home policies and efforts to eliminate children's TSE could enhance the likelihood of long-term abstinence in populations of smokers with elevated challenges quitting smoking.
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Affiliation(s)
- Bradley N Collins
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, 1301 Cecil B. Moore Ave, Ritter Annex 954, Philadelphia, PA, USA.
| | - Stephen J Lepore
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, 1301 Cecil B. Moore Ave, Ritter Annex 954, Philadelphia, PA, USA
| | - Brian L Egleston
- Biostatistics and Bioinformatics Facility, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA, USA
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25
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Hayes KA, Brown EM, Nonnemaker J, Juster H, Ortega-Peluso C, Farrelly MC, Davis K. Effectiveness of a media campaign promoting health care provider tobacco dependence treatment. Prev Med Rep 2023; 36:102403. [PMID: 37753382 PMCID: PMC10518602 DOI: 10.1016/j.pmedr.2023.102403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 09/05/2023] [Accepted: 09/06/2023] [Indexed: 09/28/2023] Open
Abstract
The New York State Department of Health (NYSDOH) developed a provider-focused media campaign to encourage provision of evidence-based, clinical tobacco dependence treatment (TDT). The purpose of this study was to assess providers' awareness of the campaign and the relationship between campaign awareness and changes in campaign-related beliefs and clinical TDT intervention. We conducted a longitudinal, mailed survey of health care providers in New York State (n = 851; AAPOR3 RR: 24.6%). We estimated descriptive statistics and used multivariable regression analyses to assess whether changes in key outcomes (campaign-related beliefs and clinical TDT) from pre- to post-campaign vary by self-reported campaign awareness. Approximately 12% of providers were aware of the campaign. In multivariable analyses, changes from pre- to post-campaign in provider beliefs that the nicotine patch and gum are very effective at helping patients quit were greater for providers aware of the campaign compared with those not aware of the campaign (For patch: OR 2.17, CI 1.06-4.45, p = 0.03; for gum: OR 2.78, CI: 1.24-6.27, p = 0.01), but not for provider behavior. After seeing the NYSDOH campaign, providers' beliefs about the effectiveness of the patch and gum increased. Many state tobacco control programs and health care organizations are implementing tobacco-related policies and systems to facilitate the provision of clinical TDT; this study suggests that a digital and print provider-focused media campaign has the potential to complement health systems change interventions. Future studies should seek to identify ways to modify ad delivery to increase campaign awareness to maximize potential campaign impact.
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Affiliation(s)
- Kim A. Hayes
- RTI International, 3040 E. Cornwallis Road, Research Triangle Park, NC 27709, USA
| | - Elizabeth M. Brown
- RTI International, 3040 E. Cornwallis Road, Research Triangle Park, NC 27709, USA
| | - James Nonnemaker
- RTI International, 3040 E. Cornwallis Road, Research Triangle Park, NC 27709, USA
| | - Harlan Juster
- New York State Department of Health, Empire State Plaza, Corning Tower, Albany, NY 12237, USA
| | - Christina Ortega-Peluso
- New York State Department of Health, Empire State Plaza, Corning Tower, Albany, NY 12237, USA
| | - Matthew C. Farrelly
- RTI International, 3040 E. Cornwallis Road, Research Triangle Park, NC 27709, USA
| | - Kevin Davis
- RTI International, 3040 E. Cornwallis Road, Research Triangle Park, NC 27709, USA
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26
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Westmaas JL, Kates I, Makaroff L, Henson R. Barriers to helping patients quit smoking: Lack of knowledge about cessation methods, E-cigarettes, and why nurse practitioners and physician assistants can help. Public Health Pract (Oxf) 2023; 6:100409. [PMID: 37554288 PMCID: PMC10405087 DOI: 10.1016/j.puhip.2023.100409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 06/06/2023] [Accepted: 07/18/2023] [Indexed: 08/10/2023] Open
Abstract
OBJECTIVES Health care settings are ideal for addressing patients' smoking and quitting, but barriers may limit providers' assistance with cessation, including lack of knowledge about newer devices being used by some smokers to quit (e.g., e-cigarettes). Cessation practices among nurse practitioners (NPs) and physician assistants (PAs) are also unknown. STUDY DESIGN Cross-sectional. METHODS Participants (N = 459) were 151 oncologists, 150 primary care physicians (PCPs), 98 nurse practitioners (NPs), and 60 physician assistants (PAs) recruited from a national online panel who completed an online survey. RESULTS Four barriers were common across specialties: "patient doesn't want to quit, and it is their decision," "smoking is not reason for patient's visit; must treat the immediate problem first," "patient wants to quit on their own," and "lack of effective methods available." While a majority of oncologists (58%) were aware of free telephone counseling for cessation, only 29% of NPs were aware. Perceived knowledge of e-cigarettes was low. Greater comfort treating patients' smoking predicted greater frequency of engagement in 4 of 5 general cessation practices (βs = 0.15-0.26, all p ≤ .001). NPs and PAs more frequently asked patients about smoking and e-cigarette use compared to oncologists, but oncologists more frequently referred patients to effective quitting resources (e.g., quitlines). CONCLUSIONS NPs and PAs may be uniquely positioned to provide cessation assistance, but providers need more education on currently available, effective cessation methods, and about e-cigarettes. Addressing patient resistance to offers of cessation services and improving clinical workflows to enhance cessation service provision should be investigated in future research.
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Affiliation(s)
- J. Lee Westmaas
- American Cancer Society, 250 Williams St. NW, Atlanta, GA, 30312, USA
| | | | - Laura Makaroff
- American Cancer Society, 250 Williams St. NW, Atlanta, GA, 30312, USA
| | - Rosie Henson
- Emory University, 201 Dowman Drive, Atlanta, GA, 30322, USA
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Lee J, Chung C, Jung SS, Park HK, Lee SS, Lee KM, Min J. Do patients attempt and succeed in quitting smoking during tuberculosis treatment? A prospective cohort study. BMC Pulm Med 2023; 23:456. [PMID: 37990227 PMCID: PMC10664422 DOI: 10.1186/s12890-023-02693-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 10/03/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Despite a well-known relation between smoking tobacco and the tuberculosis epidemic, the factors associated with smoking cessation in tuberculosis patients are unclear. This study aims to examine the cascade of smoking cessation and the factors associated with persistent smoking among tuberculosis patients. METHODS We conducted a prospective cohort study enrolling adult patients with pulmonary tuberculosis between 2016 and 2019 in the Republic of Korea. We examined the smoking status at baseline, followed the current smokers, re-examined their smoking status after 6 months of anti-tuberculosis treatment, and identified the factors associated with persistent smoking. RESULTS Of the 419 enrolled patients, 109 (26.0%) were current smokers at baseline. Of the 79 current smokers who completed the 6-month survey, 24 (30.4%) succeeded in quitting smoking after 6 months of treatment. The adjusted odds ratio for persistent smoking was 6.57 (95% confidence interval [CI], 1.76-27.83) for drinking and 0.15 (95% CI, 0.03-0.68) for diabetes comorbidity. CONCLUSION Drinking alcohol and diabetes comorbidity were important factors in smoking cessation. Only one third of the tuberculosis patients in our study cohort succeeded in quitting smoking during the 6-month treatment period. More aggressive interventions for smoking cessation should be adopted within the national anti-tuberculosis program.
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Affiliation(s)
- Jiwon Lee
- College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chaeuk Chung
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Sung Soo Jung
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Hye Kyeong Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Sung-Soon Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Ki Man Lee
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Republic of Korea.
- Division of Pulmonary & Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea.
| | - Jinsoo Min
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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28
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Ki YJ, Han K, Kim HS, Han JK. Smoking and cardiovascular outcomes after percutaneous coronary intervention: a Korean study. Eur Heart J 2023; 44:4461-4472. [PMID: 37757448 DOI: 10.1093/eurheartj/ehad616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 08/02/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND AND AIMS The authors investigated the impact of smoking and its cessation after percutaneous coronary intervention (PCI) on cardiovascular outcomes. METHODS Using a nationwide database from the Korean National Health Insurance System, 74 471 patients undergoing PCI between 2009 and 2016 were classified as non-, ex-, or current smokers, depending on smoking status at the first health check-up within 1 year after PCI. The primary outcome was major adverse cardiovascular and cerebrovascular event (MACCE), a composite of all-cause death, myocardial infarction, coronary revascularization, and stroke. RESULTS During 4.0 years of follow-up, current smokers had a 19.8% higher rate of MACCE than non-smokers [adjusted hazard ratio (aHR) 1.198; 95% confidence interval (CI) 1.137-1.263], and ex-smokers tended to have a comparable rate with that of non-smokers (aHR 1.036; 95% CI .992-1.081). For 31 887 patients with both pre- and post-PCI health check-up data, the effects of smoking cessation were analysed. Among quitters who stopped smoking after PCI, quitters with cumulative smoking exposure of <20 pack-years (PYs) tended to have a comparable rate of MACCE with that of persistent non-smokers. However, the rate in quitters with cumulative exposure of ≥20 PYs was comparable with that of persistent smokers [aHR (95% CI) for <10 PY, 1.182 (.971-1.438); 10-20 PYs 1.114 (.963-1.290); 20-30 PYs 1.206 (1.054-1.380); ≥ 30 PYs 1.227 (1.113-1.352); persistent smokers 1.223 (1.126-1.328), compared with persistent non-smokers, respectively, P for interaction <.001]. CONCLUSIONS Smoking is associated with a higher risk of adverse outcomes in patients undergoing PCI. Quitters after PCI with <20 PYs were associated with a risk comparable with that of non-smokers.
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Affiliation(s)
- You-Jeong Ki
- Cardiovascular Center, Uijeongbu Eulji Medical Center, Uijeongbu-si, Gyeonggi-do, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Hyo-Soo Kim
- Cardiovascular Center, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
- Department of Internal Medicine, College of Medicine, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Jung-Kyu Han
- Cardiovascular Center, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
- Department of Internal Medicine, College of Medicine, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
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Chowdhury A, van Lutterveld R, Laukkonen RE, Slagter HA, Ingram DM, Sacchet MD. Investigation of advanced mindfulness meditation " cessation" experiences using EEG spectral analysis in an intensively sampled case study. Neuropsychologia 2023; 190:108694. [PMID: 37777153 PMCID: PMC10843092 DOI: 10.1016/j.neuropsychologia.2023.108694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 09/20/2023] [Accepted: 09/22/2023] [Indexed: 10/02/2023]
Abstract
Mindfulness meditation is a contemplative practice informed by Buddhism that targets the development of present-focused awareness and non-judgment of experience. Interest in mindfulness is burgeoning, and it has been shown to be effective in improving mental and physical health in clinical and non-clinical contexts. In this report, for the first time, we used electroencephalography (EEG) combined with a neurophenomenological approach to examine the neural signature of "cessation" events, which are dramatic experiences of complete discontinuation in awareness similar to the loss of consciousness, which are reported to be experienced by very experienced meditators, and are proposed to be evidence of mastery of mindfulness meditation. We intensively sampled these cessations as experienced by a single advanced meditator (with over 23,000 h of meditation training) and analyzed 37 cessation events collected in 29 EEG sessions between November 12, 2019, and March 11, 2020. Spectral analyses of the EEG data surrounding cessations showed that these events were marked by a large-scale alpha-power decrease starting around 40 s before their onset, and that this alpha-power was lowest immediately following a cessation. Region-of-interest (ROI) based examination of this finding revealed that this alpha-suppression showed a linear decrease in the occipital and parietal regions of the brain during the pre-cessation time period. Additionally, there were modest increases in theta power for the central, parietal, and right temporal ROIs during the pre-cessation timeframe, whereas power in the Delta and Beta frequency bands were not significantly different surrounding cessations. By relating cessations to objective and intrinsic measures of brain activity (i.e., EEG power) that are related to consciousness and high-level psychological functioning, these results provide evidence for the ability of experienced meditators to voluntarily modulate their state of consciousness and lay the foundation for studying these unique states using a neuroscientific approach.
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Affiliation(s)
- Avijit Chowdhury
- Meditation Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - Remko van Lutterveld
- Brain Research and Innovation Centre, Dutch Ministry of Defence and Department of Psychiatry, University Medical Center, Utrecht, the Netherlands.
| | - Ruben E Laukkonen
- Faculty of Health, Southern Cross University, Gold Coast, QLD, Australia.
| | - Heleen A Slagter
- Department of Experimental and Applied Psychology, Vrije Universiteit Amsterdam, the Netherlands; Institute for Brain and Behavior, Vrije Universiteit Amsterdam, the Netherlands.
| | | | - Matthew D Sacchet
- Meditation Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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Fong GT, Chung-Hall J, Meng G, Craig LV, Thompson ME, Quah ACK, Cummings KM, Hyland A, O'Connor RJ, Levy DT, Delnevo CD, Ganz O, Eissenberg T, Soule EK, Schwartz R, Cohen JE, Chaiton MO. Impact of Canada's menthol cigarette ban on quitting among menthol smokers: pooled analysis of pre-post evaluation from the ITC Project and the Ontario Menthol Ban Study and projections of impact in the USA. Tob Control 2023; 32:734-738. [PMID: 35483720 PMCID: PMC9613818 DOI: 10.1136/tobaccocontrol-2021-057227] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 04/14/2022] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Between 2015 and 2018, Canada banned menthol cigarettes. This study pooled data from two pre-post cohort studies (the Ontario Menthol Ban Study, and the International Tobacco Control Policy Evaluation (ITC) Canada Survey, conducted in seven provinces) to derive more precise estimates of the impact of Canada's menthol ban on quitting and to apply these estimates to project the impact of a menthol ban in the USA. METHODS Weighted multivariable logistic analyses compared post-ban quit success of menthol smokers with non-menthol smokers (for daily smokers and for all (daily + non-daily) smokers), controlling for sex, age, ethnicity, education, baseline smoking status, baseline cigarettes per day and study regions. Projections to the USA were created by multiplying the effect size of the Canadian menthol ban on quitting (percentage of increased quitting among menthol smokers) by the number of menthol smokers overall and among African Americans, from the 2019 National Survey on Drug Use and Health. RESULTS After the menthol cigarette ban, menthol smokers were more likely than non-menthol smokers to have quit smoking among daily smokers (difference=8.0%; 95% CI: 2.4% to 13.7%,p=0.005) and all (daily+non-daily) smokers (difference=7.3%; 95% CI: 2.1% to 12.5%,p=0.006). The projected number of smokers who would quit after a US menthol ban would be 789 724 daily smokers (including 199 732 African Americans) and 1 337 988 daily+non-daily smokers (including 381 272 African Americans). CONCLUSIONS This pooled analysis of Canada's menthol cigarette ban provides the foundation for estimating the impact of menthol bans in the USA and other countries. Projections suggest that a US menthol cigarette ban would have a substantial impact on increasing quitting.
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Affiliation(s)
- Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
- School of Public Health Systems, University of Waterloo, Waterloo, Ontario, Canada
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Janet Chung-Hall
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Gang Meng
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Lorraine V Craig
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Mary E Thompson
- Department of Statistics & Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Anne C K Quah
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - K Michael Cummings
- Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Richard J O'Connor
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - David T Levy
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA
| | - Cristine D Delnevo
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey, USA
| | - Ollie Ganz
- Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey, USA
| | - Thomas Eissenberg
- Psychology and Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Eric K Soule
- Department of Health Education and Promotion, East Carolina University, Greenville, North Carolina, USA
| | - Robert Schwartz
- Ontario Tobacco Research Unit, University of Toronto, Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - Joanna E Cohen
- Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Michael O Chaiton
- Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada
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Pahwa V, Pimple SA, Bhattacharjee A, Kuberkar D, Mishra GA, Chaturvedi P. Behavioural interventions for tobacco cessation in India: A systematic review and meta-analysis. J Family Med Prim Care 2023; 12:2542-2551. [PMID: 38186806 PMCID: PMC10771179 DOI: 10.4103/jfmpc.jfmpc_1017_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/16/2023] [Accepted: 09/04/2023] [Indexed: 01/09/2024] Open
Abstract
Tobacco consumption is an area of public health concern in India. One of the unmet needs of many low-resource countries is to provide cost-effective tobacco cessation interventions for reducing tobacco-related mortality. This article reviews studies on non-pharmacological interventions for tobacco cessation in India. A systematic review by PICO (population, intervention, comparison, outcome) of behavioural intervention-based tobacco cessation studies that met the inclusion criteria, with a minimum 1-month follow-up, reporting outcomes in terms of frequencies or percentages published between 2010 and 2020 was performed. Following the review stages, 16 studies comprising 9,613 participants were included in the review. A pooled estimate was derived using both fixed-effects and random-effects models. The intervention showed good overall efficacy for any tobacco user (relative risk [RR] = 1.73 [95% confidence interval [CI]: 1.58-1.90) (fixed-effect model)] and (RR = 2.02 [95% CI: 1.64-2.48] [random-effects model]). Behavioural intervention studies targeted towards only smokers (RR of 1.81 [95% CI: 1.55-2.11] and 1.96 [95% CI: 1.52-2.53]) and combined smoking and smokeless tobacco users (RR of 1.69 [95% CI: 1.50-1.90] and 2.12 [95% CI: 1.49-3.01]) were equally efficacious. The review provides the effectiveness of behavioural interventions in quitting tobacco among users of both smoking and smokeless forms of tobacco. The review findings are of particular significance to inform health policy decisions on the integration of cost-effective brief behavioural intervention into existing health care services in resource-constrained countries.
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Affiliation(s)
- Vandita Pahwa
- Department of Preventive Oncology, Homi Bhabha Cancer Hospital and Research Center, New Chandigarh, Punjab, India
| | - Sharmila A. Pimple
- Department of Preventive Oncology, Centre for Cancer Epidemiology (CCE), Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
| | - Atanu Bhattacharjee
- Section of Biostatistics, Centre for Cancer Epidemiology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Deepali Kuberkar
- Department of Library Science, Digital Library, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Gauravi A. Mishra
- Department of Preventive Oncology, Centre for Cancer Epidemiology (CCE), Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
| | - Pankaj Chaturvedi
- Department of Head Neck Surgery, Deputy Director, Centre for Cancer Epidemiology (CCE), Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra, India
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Schlier B, Buck L, Müller R, Lincoln TM, Bott A, Pillny M. Time-dependent effect of antipsychotic discontinuation and dose reduction on social functioning and subjective quality of life-a multilevel meta-analysis. EClinicalMedicine 2023; 65:102291. [PMID: 38021372 PMCID: PMC10663674 DOI: 10.1016/j.eclinm.2023.102291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 10/11/2023] [Accepted: 10/12/2023] [Indexed: 12/01/2023] Open
Abstract
Background Meta-analyses indicate superiority of antipsychotic maintenance treatment over discontinuation within up to 24 months after treatment initiation for patients with schizophrenia-spectrum disorders. In terms of functional recovery, long-term trials show improved functioning after discontinuation, suggesting a time-dependent effect of antipsychotic maintenance. However, these trials were not included in previous meta-analyses. We therefore investigated whether the effect of antipsychotic maintenance treatment vs. discontinuation on social functioning and quality of life varies by trial length. Methods The study was preregistered with PROSPERO (CRD42021248933). PubMed, PsycINFO, Web of Science, Embase and trial registers were systematically searched on 8th November 2021 and updated on 25th June, 2023 and 10th August, 2023 for studies that compared antipsychotic maintenance to discontinuation and reported data on social functioning or subjective quality of life in patients with schizophrenia-spectrum disorders. Risk of bias was assessed with the RoB 2, the ROBINS-I and the RoB-ME tools. Quality of evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation approach. Findings We included k = 35 studies (N = 5924) with follow-ups between one month and 15 years. Overall, maintenance and discontinuation did not differ on social functioning (k = 32; n = 5330; SMD = 0.204; p = 0.65; 95% CI [-0.69, 1.10]) or quality of life (k = 10; n = 943; SMD = -0.004; p = 0.97; 95% CI [-0.22, 0.21]), whilst subgroup analyses of middle- (2-5 years; k = 7; n = 1032; SMD = 0.68; 95% CI [0.06, 1.28]) and long-term follow-ups (>5 years; k = 2; n = 356; SMD = 1.04; 95% CI [0.82, 1.27]) significantly favoured discontinuation. However, the quality of evidence was rated as very low. Interpretation Although our findings suggest a time-dependent decrease in the effect of maintenance treatment on social functioning, interpretation of these findings is limited by the serious risk of bias in middle- and long-term trials. Therefore, any conclusions regarding the long-term benefits of antipsychotic treatment or discontinuation for functional recovery are premature and more high-quality trials tailored to comparing state of the art maintenance treatment vs. discontinuation are needed. Funding None.
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Affiliation(s)
- Björn Schlier
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Human Movement Science, Universität Hamburg, Germany
| | - Laura Buck
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Human Movement Science, Universität Hamburg, Germany
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Germany
| | - Rebecca Müller
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Human Movement Science, Universität Hamburg, Germany
| | - Tania M. Lincoln
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Human Movement Science, Universität Hamburg, Germany
| | - Antonia Bott
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Human Movement Science, Universität Hamburg, Germany
| | - Matthias Pillny
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Human Movement Science, Universität Hamburg, Germany
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Amin S, Pokhrel P, Elwir T, Mettias H, Kawamoto CT. A systematic review of experimental and longitudinal studies on e-cigarette use cessation. Addict Behav 2023; 146:107787. [PMID: 37393697 PMCID: PMC10527397 DOI: 10.1016/j.addbeh.2023.107787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/22/2023] [Accepted: 06/23/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND The present study addresses the need to synthesize the findings in the current literature on e-cigarette use cessation. METHODS PubMed, MEDLINE, and EMBASE databases were searched in November 2022 to systematically review studies focused on intentions, attempts, and successful e-cigarette use cessation. Three authors independently reviewed the full-texts of the initial pool of potentially eligible articles. Narrative data synthesis was conducted, and the risk of bias was evaluated. RESULTS A total of 12 studies were selected for review, 7 of which were experimental and 5longitudinal. The majority of the studies focused on participants' intentions to quit e-cigarette use. The experimental studies varied in sample size, intervention type, and length of participant follow-up. Findings across the experimental studies were mixed, with only one full-fledged trial having examined cessation as an outcome. The experimental studies that assessed cessation outcomes utilized mobile technology as an intervention tool. Results from longitudinal studies indicated sociodemographic characteristics (gender, race/ethnicity), vaping frequency, and cigarette smoking status as predictors of intentions, attempts and e-cigarette use cessation. CONCLUSION This review highlights the current paucity of methodologically rigorous research on e-cigarette use cessation. Our findings suggest that vaping cessation programs that employ mobile health technology to provide personalized cessation services may help promote intentions, attempts, and e-cigarette use cessation. Limitations of the current studies on vaping cessation include small sample sizes, heterogeneous cohorts that limit comparisons, and inconsistent ways of assessing vaping cessation. Future research needs to test long-term intervention effects using experimental and prospective designs among representative samples.
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Affiliation(s)
- Samia Amin
- Population Sciences Program, University of Hawai'i at Mānoa, 701 Ilalo St., Honolulu, HI 96813, United States.
| | - Pallav Pokhrel
- Population Sciences Program, University of Hawai'i at Mānoa, 701 Ilalo St., Honolulu, HI 96813, United States
| | - Taha Elwir
- Population Sciences Program, University of Hawai'i at Mānoa, 701 Ilalo St., Honolulu, HI 96813, United States
| | - Hannah Mettias
- Population Sciences Program, University of Hawai'i at Mānoa, 701 Ilalo St., Honolulu, HI 96813, United States
| | - Crissy T Kawamoto
- Population Sciences Program, University of Hawai'i at Mānoa, 701 Ilalo St., Honolulu, HI 96813, United States
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Wångby-Lundh M, Lundh LG, Claréus B, Bjärehed J, Daukantaitė D. Developmental pathways of repetitive non-suicidal self-injury: predictors in adolescence and psychological outcomes in young adulthood. Child Adolesc Psychiatry Ment Health 2023; 17:116. [PMID: 37833783 PMCID: PMC10571303 DOI: 10.1186/s13034-023-00660-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Much longitudinal research has been carried out on non-suicidal self-injury (NSSI) during the last decades, but there still is a lack of studies of the individual developmental pathways of NSSI from adolescence into young adulthood. The aim of the present study was to investigate individual developmental pathways of repetitive non-suicidal self-injury (repNSSI) from adolescence into young adulthood, including adolescent predictors and psychological outcomes in young adulthood. Three developmental pathways were targeted: stable adolescence-limited repNSSI; repNSSI prolonged into young adulthood; and late-onset repNSSI; with no repNSSI as comparison. METHODS Data were taken from a cohort of compulsory school students (N = 1064) in grades 7-8 in a Swedish municipality. The cohort was followed longitudinally, and this study included all individuals (n = 475) with NSSI data from three waves: T1 (when they were 13-15 years old); T2 (one year later); and T3 (ten years later). RepNSSI was operationalized as self-reports of at least 5 instances of NSSI during the past six/twelve months. RESULTS The two pathways that involved stable repNSSI were observed significantly more often than expected by chance, with the strongest overrepresentation for the Prolonged RepNSSI pathway. Still, most adolescents who engaged in stable repNSSI stopped this before reaching young adulthood. Those who stopped did not, however, show a significantly better psychological adjustment in young adulthood than those who continued. Compared to participants with no repNSSI, participants who had stopped still reported significantly more stress, anxiety, and emotional dysregulation. As to the prediction of late onset NSSI, the findings were less robust, but sporadic NSSI at T1 and poor sleep at T2 were significant predictors, whereas depressive symptoms fell just short of significance at both timepoints. CONCLUSIONS The present results indicate that among adolescents who engage in stable adolescent repNSSI (1) significantly more individuals than expected by chance still engage in repNSSI ten years later, and (2) those who stop engaging in repNSSI do not show significantly better psychological adjustment than those who still engage in it. The present findings also indicate that late onset of repNSSI as reported in young adulthood to some extent is predictable from symptom measures ten years earlier.
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Trigg J, Rich J, Williams E, Gartner CE, Guillaumier A, Bonevski B. Perspectives on limiting tobacco access and supporting access to nicotine vaping products among clients of residential drug and alcohol treatment services in Australia. Tob Control 2023:tc-2023-058094. [PMID: 37821220 DOI: 10.1136/tc-2023-058094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 09/25/2023] [Indexed: 10/13/2023]
Abstract
INTRODUCTION Tobacco endgame strategies aim to drive down population smoking rates, the success of which can be improved with public buy-in, including from populations with high smoking rates such as alcohol and other drug (AOD) service clients. This study aimed to explore acceptability of tobacco retail and nicotine reduction, and subsidised nicotine vaping to support AOD service clients following a smoking cessation attempt. METHODS We interviewed 31 Australian AOD service clients who currently or previously smoked, following a 12-week randomised trial comparing nicotine replacement therapy with nicotine vaping product (NVP) for smoking cessation. Participants were asked how effectively three scenarios would support tobacco cessation: tobacco retailer reduction, very low-nicotine cigarette standard and subsidised NVP access. We thematically analysed participant views on how each approach would support tobacco abstinence. RESULTS Tobacco retailer reduction raised concerns about increasing travel and accessing cigarettes from alternate sources, with generally lower acceptability, though a range of perspectives were provided. Reducing nicotine in tobacco products was described as reducing appeal of smoking and potentially increasing illicit purchases of non-reduced nicotine products. Clients of AOD services were highly accepting of subsidised NVP access for tobacco cessation, as this would partly address financial and socioeconomic barriers. CONCLUSIONS Australian tobacco control policy should consider how these approaches impact ease and likelihood of tobacco access by AOD service clients in relation to the general population. Understanding clients' acceptability of tobacco control and endgame measures can inform how to avoid potential unintended consequences for these clients.
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Affiliation(s)
- Joshua Trigg
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Jane Rich
- School of Medicine and Public Health, College of Medicine, Health and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Edwina Williams
- School of Medicine and Public Health, College of Medicine, Health and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Coral E Gartner
- School of Public Health, Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Ashleigh Guillaumier
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Billie Bonevski
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
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Rábade-Castedo C, de Granda-Orive JI, Riesco-Miranda JA, De Higes-Martínez E, Ramos-Pinedo Á, Cabrera-César E, Signes-Costa Miñana J, García Rueda M, Pastor-Esplá E, Jiménez-Ruiz CA. Clinical Practice Guideline of Spanish Society of Pneumology and Thoracic Surgery (SEPAR) on Pharmacological Treatment of Tobacco Dependence 2023. Arch Bronconeumol 2023; 59:651-661. [PMID: 37567792 DOI: 10.1016/j.arbres.2023.07.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023]
Abstract
INTRODUCTION There are multiple systematic reviews and meta-analyses on the efficacy and safety of pharmacological treatments against nicotine dependence. However, there are few guidelines to answer frequent questions asked by a clinician treating a smoker. Therefore, the aim of this paper is to facilitate the treatment of tobacco addiction. MATERIAL AND METHODS 12 PICO questions are formulated from a GLOBAL PICO question: "Efficacy and safety of pharmacological treatment of tobacco dependence". A systematic review was carried out to answer each of the questions and recommendations were made. The GRADE (Grading of Recommendations, Assessment, Development and Evaluation) system was used to grade the certainty of the estimated effects and the strength of the recommendations. RESULTS Varenicline, nicotine replacement therapy (NRT), bupropion and cytisine are more effective than placebo. Varenicline and combined nicotine therapy are superior to the other therapies. In smokers with high dependence, a combination of drugs is recommended, being more effective those associations containing varenicline. Other optimization strategies with lower efficacy consist of increasing the doses, the duration, or retreat with varenicline. In specific populations varenicline or NRT is recommended. In hospitalized, the treatment of choice is NRT. In pregnancy it is indicated to prioritize behavioral treatment. The financing of smoking cessation treatments increases the number of smokers who quit smoking. There is no scientific evidence of the efficacy of pharmacological treatment of smoking cessation in adolescents. CONCLUSIONS The answers to the 12 questions allow us to extract recommendations and algorithms for the pharmacological treatment of tobacco dependence.
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Affiliation(s)
- Carlos Rábade-Castedo
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, Spain.
| | - José Ignacio de Granda-Orive
- Servicio de Neumología, Hospital Universitario 12 de octubre Madrid, Spain; Universidad Complutense, Madrid, Spain
| | - Juan Antonio Riesco-Miranda
- Servicio de Neumología, Hospital Universitario de Cáceres, Cáceres, Spain; Centro de Investigación en Red de enfermedades respiratorias (CIBERES), Madrid, Spain; Instituto Universitario de Investigación Biosanitaria de Extremadura (INUBE), Spain
| | - Eva De Higes-Martínez
- Unidad de Neumología, Hospital Universitario Fundación Alcorcón, Spain; Universidad Rey Juan Carlos, Madrid, Spain
| | - Ángela Ramos-Pinedo
- Unidad de Neumología, Hospital Universitario Fundación Alcorcón, Spain; Universidad Rey Juan Carlos, Madrid, Spain
| | - Eva Cabrera-César
- Servicio de Neumología, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Jaime Signes-Costa Miñana
- Servicio de Neumología, Hospital Clínico Universitario de Valencia, Spain; Instituto de Investigación Sanitaria de Valencia (INCLIVA), Valencia, Spain
| | | | - Esther Pastor-Esplá
- Servicio de Neumología, Hospital Universitario San Juan de Alicante, Alicante, Spain
| | - Carlos A Jiménez-Ruiz
- Unidad Especializada en Tabaquismo de la Comunidad de Madrid, Hospital Clínico San Carlos, Madrid, Spain
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Nguyen TNP, Love J, Hunsberger M, Tran TPT, Nguyen TL, Phan TH, Luong NK, Hoang VM, Ng N. Individual-, social- and policy- factors associated with smoking cessation among adult male cigarette smokers in Hanoi, Vietnam: a longitudinal study. BMC Public Health 2023; 23:1883. [PMID: 37770890 PMCID: PMC10540420 DOI: 10.1186/s12889-023-16781-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 09/18/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Nearly one-in-two Vietnamese men smoke cigarettes placing them among the highest tobacco consumers in the world. Despite the need for smoking cessation to curb the burden of tobacco-related diseases in Vietnam, this rate remains at less than 30%. Therefore, this study examines individual-, social- and policy factors associated with smoking cessation among adult male smokers in Vietnam. METHODS We established a longitudinal International Tobacco Control study of male smokers in Hanoi, Vietnam, in September 2018. This paper analyses 1525 men who participated in baseline and one-year follow-up. We applied a weighted multivariable logistic regression to examine the association between smoking cessation and individual-, social- and policy predictors. RESULTS At follow-up, 14.8% of participants had quit smoking for at least 30 consecutive days during the last year. Among the persistent smokers, 56.6% expressed intention to quit smoking. Factors associated with smoking cessation included a lower number of cigarettes smoked per day (aOR = 0.96, 95% CI: 0.94, 0.99) and having several attempts to quit smoking (aOR = 2.16, 95% CI 1.13, 4.12). Intention to quit smoking was associated with multiple quit attempts, a chronic condition diagnosis, more tobacco-related knowledge, greater self-efficacy, and more worries about their future health. The perceived impact of smoke-free policy and health warning labels were positively associated with intention to quit at any stage. CONCLUSIONS Interventions aimed at increasing smoking cessation should focus on all aspects of individual, social, and policy factors. Persistent smokers are more motivated to quit if they have made multiple quit attempts, more self-efficacy of quitting and worried about their future health, indicating that increasing smokers' beliefs and knowledge may be important for behavioural change. Health warning labels and tobacco taxation policies should be maintained and promoted as they are perceived to be particularly useful for persistent smokers' intention to quit.
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Affiliation(s)
- Thi Ngoc Phuong Nguyen
- School of Public Health & Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 41390, Gothenburg, Sweden.
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam.
| | - Jesper Love
- School of Public Health & Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 41390, Gothenburg, Sweden
| | - Monica Hunsberger
- School of Public Health & Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 41390, Gothenburg, Sweden
| | - Thi Phuong Thao Tran
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | | | | | | | - Van Minh Hoang
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Nawi Ng
- School of Public Health & Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 41390, Gothenburg, Sweden
- Department of Epidemiology and Global Health, Faculty of Medicine, Umea University, Umea, Sweden
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Ibrahim KH, Ali AM, Wondimagegne ZT. Cessation of exclusive breastfeeding and predictors among infants aged 0-6 months in Ararso district of the Somali region, Ethiopia. A community-based cross-sectional study. PeerJ 2023; 11:e15963. [PMID: 37780392 PMCID: PMC10538283 DOI: 10.7717/peerj.15963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 08/03/2023] [Indexed: 10/03/2023] Open
Abstract
Background Exclusive breastfeeding (EBF) is the gold standard of child feeding practice in which the infant only receives breast milk without any additional food or drink, not even water and it lasts up to 6 months after delivery. In the study area, there is a lack of data on the prevalence of cessation of EBF. Methods Community-based cross-sectional study design was used among 292 mothers of infants aged 0-6 months. The data was collected using a pretested structured questionnaire. Bivariate and multivariate logistic regression analyses were carried out. An odds ratio with a 95% confidence interval was used to measure the strength of the association. Statistical significance was declared at P-value <0.05. Results The prevalence of cessation of EBF was 57.3% with 95% CI [50.9-62.6]. This study showed being employed (working outside the home) (AOR = 2.44; 95% CI [1.32-4.53]), being rural residence (AOR = 1.87; 95% CI [1.05-3.32]), and inadequate knowledge of EBF (AOR = 2:02; 95% CI [1.19-3.43]) were independent predictors of cessation of EBF. Conclusion and Recommendation Our data identified a higher prevalence of cessation of EBF in the study area compared to most studies in Ethiopia and elsewhere. Efforts on improving knowledge of the importance of EBF particularly in rural areas and support for breastfeeding-employed women are recommended.
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Affiliation(s)
- Kalid Hassen Ibrahim
- College of Dry Land Agriculture Food Science and Nutrition Program, Jigjiga University, Jigjiga, Somale Regional State, Ethiopia
| | - Abdulkarim Mohammed Ali
- College of Dry Land Agriculture Food Science and Nutrition Program, Jigjiga University, Jigjiga, Somale Regional State, Ethiopia
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Dadipoor S, Hemayatkhah M, Eshaghi Sani Kakhaki H, Mohseni S, Fattahi E, Shahabi N, El-Shahawy O. The role of intrapersonal and interpersonal factors in waterpipe cessation: a case-control study. BMC Public Health 2023; 23:1705. [PMID: 37667194 PMCID: PMC10476390 DOI: 10.1186/s12889-023-16597-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 08/23/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND The prevalence of waterpipe smoking among women in southern Iran is significantly higher than women in other regions of Iran. We aimed to explore the effect of several demographic factors, knowledge, attitude, self-efficacy and social norms on a successful cessation of waterpipe smoking in the marginalized women of Bandar Abbas city, in the south of Iran. METHODS This case-control study was conducted in 2022 among 731 women (246 subjects who successfully quit waterpipe smoking in the case group and 485 who smoked waterpipe in the control group). A cluster sampling method was used to collect the required data through face-to-face interviews and a researcher-made questionnaire. The questionnaire consisted of demographic information, behavioral information about waterpipe smoking and knowledge, attitude, self-efficacy and social norms. The data were analyzed in STATA 14 using univariate and multivariate regression analyses. RESULTS The mean and standard deviation of age was 39.24 ± 11.93 and 37.18 ± 13.57 in the control and case groups, respectively. With an increase of one score in social norm (OR: 1.046), the odds of cessation were increased for 4%. With an increase of one score in self-efficacy (OR: 1.152), the odds of cessation were increased for 15%. With an increase of one score in knowledge (OR: 1.064), the odds of cessation were increased for 6%. With an increase of one score in attitude (OR: 1.215) the odds of cessation were increased for 21%. CONCLUSION The present findings revealed personal and interpersonal influential factors in successful waterpipe cessation. Women's knowledge can be increased and their attitude can be changed. Important people in women's lives can be influenced to, consequently, affect women positively and improve their self-esteem.
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Affiliation(s)
- Sara Dadipoor
- Tobacco and Health Research Centre, Hormozgan University of Medical Sciences, Bandar Abbas, Bandar Abbas, Iran
| | | | - Hadi Eshaghi Sani Kakhaki
- Tobacco and Health Research Centre, Hormozgan University of Medical Sciences, Bandar Abbas, Bandar Abbas, Iran
| | - Shokrollah Mohseni
- Determinants in Health Promotion Research Centre, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Esmaeil Fattahi
- Department of Health Education and Promotion, School of Health, Guilan University of Medical Sciences, Rasht, Iran
| | - Nahid Shahabi
- Tobacco and Health Research Centre, Hormozgan University of Medical Sciences, Bandar Abbas, Bandar Abbas, Iran.
| | - Omar El-Shahawy
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
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Nam JK, Piper ME, Tong Z, Li R, Yang JJ, Jorenby DE, Buu A. Dependence motives and use contexts that predicted smoking cessation and vaping cessation: A two-year longitudinal study with 13 waves. Drug Alcohol Depend 2023; 250:110871. [PMID: 37406572 PMCID: PMC10623667 DOI: 10.1016/j.drugalcdep.2023.110871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/10/2023] [Accepted: 06/19/2023] [Indexed: 07/07/2023]
Abstract
INTRODUCTION Prior studies examining the impact of e-cigarette use, dependence, cessation motivation/goals, and environmental restriction on smoking cessation were based on cross-sectional or shorter-term longitudinal data with binary outcomes. There is also a critical knowledge gap in corresponding impact on vaping cessation. This study aims to fill in these gaps by investigating these factors' effects on speed of progression to smoking and vaping cessation. METHODS This study conducted secondary analysis of data from 13 waves of assessment of adult cigarette users in Wisconsin from October 2015 through July 2019. Cox regression was employed to examine baseline predictors' effects on speed of progression to smoking cessation (past-month abstinence) among 405 exclusive combustible cigarette users and dual users of combustible and electronic cigarettes, as well as progression to vaping cession among 178 dual users. RESULTS Dual use of e-cigarettes with cigarettes, lower primary dependence motives of smoking, higher secondary dependence motives of smoking, higher motivation to quit smoking, more ambitious future goals to quit smoking, and more restrictive environment for smoking all contributed to quicker progression to smoking cessation. Dual users with higher secondary dependence motives of smoking or with lower primary dependence motives of vaping progressed faster to vaping cessation. CONCLUSIONS The findings support that nicotine dependence is product-specific with two distinct constructs: the primary dependence motives are associated with more difficulty to quit, whereas the secondary dependence motives have the opposite effect. Dual users with strong instrumental reasons for smoking may not find e-cigarettes as an effective substitute for cigarettes.
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Affiliation(s)
- Joon Kyung Nam
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center, 7000 Fannin St.Houston, TX77030USA
| | - Megan E Piper
- Center for Tobacco Research & Intervention, University of Wisconsin, 1930 Monroe Street, Suite 200Madison, WI53711USA
| | - Zhaoxue Tong
- Department of Statistics, Pennsylvania State University, 413 Thomas Building, University Park, PA16802-2111USA
| | - Runze Li
- Department of Statistics, Pennsylvania State University, 413 Thomas Building, University Park, PA16802-2111USA
| | - James J Yang
- Department of Biostatistics and Data Science, University of Texas Health Science Center, 1200 Pressler St.Houston, TX77030USA
| | - Douglas E Jorenby
- Center for Tobacco Research & Intervention, University of Wisconsin, 1930 Monroe Street, Suite 200Madison, WI53711USA
| | - Anne Buu
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center, 7000 Fannin St.Houston, TX77030USA.
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McKee SA, Lawrence DE, Saccone P, McRae T, Anthenelli RM. Sex effects in predictors of smoking abstinence and neuropsychiatric adverse events in the EAGLES trial. Drug Alcohol Depend Rep 2023; 8:100177. [PMID: 37520849 PMCID: PMC10372180 DOI: 10.1016/j.dadr.2023.100177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 07/03/2023] [Accepted: 07/05/2023] [Indexed: 08/01/2023]
Abstract
Significance There are sex effects in abstinence outcomes across all smoking cessation medications, but there is limited information regarding sex effects on cessation-related neuropsychiatric adverse events (NPSAEs) or interactions with psychiatric status. METHODS Secondary analysis of data from EAGLES of 8144 adults who smoke cigarettes randomized to varenicline, bupropion, nicotine patch or placebo. Design characteristics included region (within/outside US), psychiatric cohort (absent/present), and treatment. Baseline variables included demographics, smoking history, prior use of study treatments, lifetime suicide-related history, and prior psychiatric co-morbidities and medication use. Design characteristics were forced into logistic regressions models, and then interactions among sex, design elements, and baseline characteristics were evaluated for NPSAEs and 6-month cessation outcomes. RESULTS Findings demonstrated a significant interaction of sex and race (p < 0.02); Black women were more likely to report NPSAEs than Black men. For cessation outcomes, there were no significant interactions with psychiatric cohort and sex. Women vs men with higher baseline levels of smoking had lower odds of continuous abstinence. Women vs men who used varenicline previously had lower odds of continuous abstinence. For 6-month point prevalence, sex interacted with baseline cigarettes per day (p < 0.01) similar to the interaction for continuous abstinence. Sex interacted with medication (p < 0.03), such that women vs men had relatively greater success at achieving point prevalence abstinence on varenicline. CONCLUSIONS Overall, results demonstrated important sex and racial differences in the incidence of NPSAEs, but psychiatric status did not interact with sex on cessation outcomes. Findings did support prior work demonstrating relative increased efficacy of varenicline for women.
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Jackson SE, Cox S, Brown J. Trends in cross-border and illicit tobacco purchases among people who smoke in England, 2019-2022. Tob Control 2023:tc-2023-057991. [PMID: 37463758 DOI: 10.1136/tc-2023-057991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/15/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVES The last 5 years have seen substantial changes in England's social and economic landscape as a result of Brexit, the COVID-19 pandemic and cost of living crisis. We aimed to examine changes in cross-border and illicit tobacco purchasing over this period. DESIGN Nationally representative monthly cross-sectional survey. SETTING England, 2019-2022. PARTICIPANTS 11 232 adults (≥18 years) who smoked in the past year. MAIN OUTCOME MEASURES We estimated time trends in the proportion reporting purchasing tobacco from (1) cross-border and (2) illicit sources in the past 6 months. RESULTS Between February 2019 and October 2022, there was a non-linear increase in the proportion of participants reporting cross-border tobacco purchases (from 5.2% to 16.1% overall; prevalence ratio (PR)=3.10, 95% CI 2.03-4.73). Prevalence first increased from 5.2% to 15.4% between February 2019 and April 2020, before falling to 7.8% between April 2020 and September 2021 during the COVID-19 pandemic, and then increasing again to 16.1% by the end of the period. Changes in cross-border tobacco purchasing were more pronounced among participants from more advantaged (from 6.6% to 23.3%; PR=3.52, 95% CI 2.05-5.91) compared with less advantaged (4.4% to 11.5%; PR=2.61, 95% CI 1.17-5.20) social grades (pinteraction=0.034). There was no overall change in the proportion reporting illicit tobacco purchases (from 9.2% to 8.5%; PR=0.92, 95% CI 0.70-1.21), nor any significant difference in trends by social grade (pinteraction=0.783). CONCLUSIONS Despite a fall in cross-border tobacco purchasing during the first year of the COVID-19 pandemic among adults in England who smoke, the proportion reporting cross-border tobacco purchases is now three times higher than it was at the start of 2019. The proportion reporting illicit tobacco purchases has not changed substantially.
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Affiliation(s)
| | - Sharon Cox
- Behavioural Science and Health, UCL, London, UK
| | - Jamie Brown
- Behavioural Science and Health, UCL, London, UK
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Amin S, Kawamoto CT, Pokhrel P. Exploring the ChatGPT platform with scenario-specific prompts for vaping cessation. Tob Control 2023:tc-2023-058009. [PMID: 37460216 PMCID: PMC10792116 DOI: 10.1136/tc-2023-058009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 06/28/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVE To evaluate and start a discussion on the potential usefulness of applying Artificial Intelligence (AI)-driven natural language processing technology such as the ChatGPT in tobacco control efforts, specifically vaping cessation. METHOD Ten real-world questions about vaping cessation were selected from a Reddit forum and used as ChatGPT prompts or queries. Content analysis was performed on the ChatGPT responses to identify the thematic aspects of vaping cessation support represented in the responses. Next, the responses were empirically evaluated by five experts in tobacco control on accuracy, quality, clarity, and empathy. RESULT The following themes related to vaping cessation support were identified: understanding nicotine withdrawal symptoms, self-regulation, peer support, motivational support, and Nicotine Replacement Therapy (NRT). The experts judged the ChatGPT responses to be 'satisfactory' to 'excellent' in areas of accuracy, quality, clarity, and empathy. CONCLUSION If managed by a group of experts, including clinicians, and behavioral and computer scientists, a platform such as the ChatGPT may be leveraged to design tailored interventions for tobacco use cessation, including vaping cessation.
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Affiliation(s)
- Samia Amin
- Population Sciences in the Pacific Program, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
| | - Crissy Terawaki Kawamoto
- Population Sciences in the Pacific Program, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
| | - Pallav Pokhrel
- Population Sciences in the Pacific Program, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
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Atiah WA, Johnson R, Muthoni FK, Mengistu GT, Amekudzi LK, Kwabena O, Kizito F. Bias correction and spatial disaggregation of satellite-based data for the detection of rainfall seasonality indices. Heliyon 2023; 9:e17604. [PMID: 37449185 PMCID: PMC10336502 DOI: 10.1016/j.heliyon.2023.e17604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 06/22/2023] [Accepted: 06/22/2023] [Indexed: 07/18/2023] Open
Abstract
Like many other African countries, Ghana's rain gauge networks are rapidly deteriorating, making it challenging to obtain real-time rainfall estimates. In recent years, significant progress has been made in the development and availability of real-time satellite precipitation products (SPPs). SPPs may complement or substitute gauge data, enabling better real-time forecasting of stream flows, among other things. However, SPPs still have significant biases that must be corrected before the rainfall estimates can be used for any hydrologic application, such as real-time or seasonal forecasting. The daily satellite-based rainfall estimate (CHIRPS-v2) data were bias-corrected using the Bias Correction and Spatial Disaggregation (BSCD) approach. The study further investigated how bias correction of daily satellite-based rainfall estimates affects the identification of seasonality and extreme rainfall indices in Ghana. The results revealed that the seasonal and annual rainfall patterns in the region were better represented after the bias correction of the CHIRPS-v2 data. We observed that, before bias correction, the cessation dates in the country's southwest and upper middle regions were slightly different. However, they matched those of the gauge well after bias correction. The novelty of this study is that, in addition to improving rainfall using CHIRPS data, it also enhances the identification of seasonality indices. The paper suggests the BCSD approach for correcting rainfall estimates from other algorithms using long-term historical records indicative of the rainfall variability area under consideration.
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Affiliation(s)
- Winifred Ayinpogbilla Atiah
- Kwame Nkrumah University of Science and Technology (KNUST), Department of Physics, Meteorology and Climate Science Unit, Kumasi, Ghana
| | - Robert Johnson
- Kwame Nkrumah University of Science and Technology (KNUST), Department of Physics, Meteorology and Climate Science Unit, Kumasi, Ghana
| | - Francis Kamau Muthoni
- International Institute of Tropical Agriculture (IITA), Duluti, Arusha, P.O. Box 10, Tanzania
| | - Gizaw Tsidu Mengistu
- Botswana International University of Science and Technology (BIUST), Department of Earth and Environmental Science, Palapye, Botswana
| | - Leonard Kofitse Amekudzi
- Kwame Nkrumah University of Science and Technology (KNUST), Department of Physics, Meteorology and Climate Science Unit, Kumasi, Ghana
| | - Osei Kwabena
- Kwame Nkrumah University of Science and Technology (KNUST), Department of Physics, Meteorology and Climate Science Unit, Kumasi, Ghana
| | - Fred Kizito
- International Institute of Tropical Agriculture, Accra GA-184, Ghana
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Kreuter MW, Garg R, Fu Q, Caburnay C, Thompson T, Roberts C, Sandheinrich D, Javed I, Wolff JM, Butler T, Grimes LM, Carpenter KM, Pokojski R, Engelbrecht K, Howard V, McQueen A. Helping low-income smokers quit: findings from a randomized controlled trial comparing specialized quitline services with and without social needs navigation. Lancet Reg Health Am 2023; 23:100529. [PMID: 37408953 PMCID: PMC10319314 DOI: 10.1016/j.lana.2023.100529] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 05/23/2023] [Accepted: 05/24/2023] [Indexed: 07/07/2023]
Abstract
Background Quitting smoking is especially challenging for low-income smokers due to high stress, high smoking prevalence around them, and limited support for quitting. This study aimed to determine whether any of three interventions designed specifically for low-income smokers would be more effective than standard tobacco quitline services: a specialized quitline, the specialized quitline with social needs navigation, or the standard quitline with social needs navigation. Methods Using a randomized 2 × 2 factorial design, low-income daily cigarette smokers (n = 1944) in Missouri, USA who called a helpline seeking assistance with food, rent or other social needs were assigned to receive Standard Quitline alone (n = 485), Standard Quitline + Social Needs Navigation (n = 484), Specialized Quitline alone (n = 485), or Specialized Quitline + Social Needs Navigation (n = 490). The target sample size was 2000, 500 per group. The main outcome was 7-day self-reported point prevalence abstinence at 6-month follow-up. Multiple imputation was used to impute outcomes for those missing data at 6-month follow-up. Binary logistic regression analyses were used to assess differences between study groups. Findings Participants were recruited from June 2017 to November 2020; most were African American (1111 [58%]) or White (666 [35%]), female (1396 [72%]), and reported <$10,000 (957 [51%]) or <$20,000 (1529 [82%]) annual pre-tax household income. At 6-month follow-up (58% retention), 101 participants in the Standard Quitline group reported 7-day point prevalence abstinence (20.8% of those assigned at baseline, 38.1% after imputation). Quit rates in the Specialized Quitline (90 quitters, 18.6%, 38.1%) and Specialized Quitline + Social Needs Navigation (103 quitters, 21.0%, 39.8%) were not different from the Standard Quitline. Quit rates for Standard Quitline + Social Needs Navigation (74 quitters, 15.3%, 30.1%) were significantly lower than Standard Quitline (OR = 0.70, 95% CI = 0.50-0.98). Interpretation A specialized version of a state tobacco quitline was no more effective than standard quitline services in helping low-income smokers quit. Adding social needs navigation to a standard quitline decreased its effectiveness. Trial registration ClinicalTrials.gov Identifier: NCT03194958. Funding National Cancer Institute: R01CA201429.
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Affiliation(s)
- Matthew W. Kreuter
- Health Communication Research Laboratory, Brown School at Washington University in St. Louis, St. Louis, MO, USA
| | - Rachel Garg
- Health Communication Research Laboratory, Brown School at Washington University in St. Louis, St. Louis, MO, USA
| | - Qiang Fu
- Department of Community Health, Tufts University, Medford, MA, USA
| | - Charlene Caburnay
- Health Communication Research Laboratory, Brown School at Washington University in St. Louis, St. Louis, MO, USA
| | - Tess Thompson
- Health Communication Research Laboratory, Brown School at Washington University in St. Louis, St. Louis, MO, USA
| | - Christina Roberts
- Health Communication Research Laboratory, Brown School at Washington University in St. Louis, St. Louis, MO, USA
| | - Dominique Sandheinrich
- Health Communication Research Laboratory, Brown School at Washington University in St. Louis, St. Louis, MO, USA
| | - Irum Javed
- Health Communication Research Laboratory, Brown School at Washington University in St. Louis, St. Louis, MO, USA
| | - Jennifer M. Wolff
- Health Communication Research Laboratory, Brown School at Washington University in St. Louis, St. Louis, MO, USA
| | - Taylor Butler
- Health Communication Research Laboratory, Brown School at Washington University in St. Louis, St. Louis, MO, USA
| | - Lauren M. Grimes
- Health Communication Research Laboratory, Brown School at Washington University in St. Louis, St. Louis, MO, USA
| | | | - Robin Pokojski
- Community Partnerships, United Way of Greater St. Louis, St. Louis, MO, USA
| | | | - Valerie Howard
- Tobacco Prevention and Control Program, Missouri Department of Health and Senior Services, Jefferson City, MO, USA
| | - Amy McQueen
- Health Communication Research Laboratory, Brown School at Washington University in St. Louis, St. Louis, MO, USA
- Division of General Medical Sciences, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
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Abstract
BACKGROUND Despite the elevated prevalence of smoking among gender minority adults, little is known about the factors that influence their tobacco use and cessation. PURPOSE We identified and examined factors that influence tobacco use and cessation for gender minority adults, using a conceptual framework based on the Model of Gender Affirmation and Gender Minority Stress Model. METHODS Nineteen qualitative, semi-structured in-depth interviews were conducted with gender minority adults who smoke or no longer smoke and were recruited from the Portland, OR metropolitan area. Interviews were audio-recorded, professionally transcribed, and analyzed utilizing thematic analysis. RESULTS Four main themes were generated. Gender minority adults smoke to cope with general and gender minority-specific stressors. Smoking was described as a social behavior that was influenced and sustained by community and interpersonal relationships. Smoking cessation was motivated by health concerns (both general and gender minority-specific) and moderated by conducive life circumstances. Recommendations for tobacco cessation interventions highlighted the importance and role of social support. Participants expressed a strong desire for gender minority-specific tobacco cessation programs. There are unique and complex factors that contribute to the higher prevalence of smoking observed among gender minority adults. CONCLUSIONS Tobacco cessation interventions are urgently needed for this population and should be tailored to address the unique factors that impact tobacco use and cessation among gender minority people to increase the likelihood of success.
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Affiliation(s)
- Christina J Sun
- Division of Behavioral, Family, and Population Health, College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Kye M Doran
- Oregon Health and Science University-Portland State University School of Public Health, Portland, OR, USA
| | - Jae M Sevelius
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Steffani R Bailey
- Department of Family Medicine, Oregon Health and Science University, Portland, OR, USA
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Xie Y, Li M, Ou X, Zheng S, Gao Y, Xu X, Yang Y, Ma A, Li J, Nan Y, Zheng H, Liu J, Wei L, Feng B. Lower end of treatment HBsAg and HBcrAg were associated with HBsAg loss after nucleos(t)ide analog cessation. BMC Gastroenterol 2023; 23:224. [PMID: 37386460 DOI: 10.1186/s12876-023-02852-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/13/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Since hepatitis B surface antigen (HBsAg) loss is rarely achieved with nucleos(t)ide analog (NA) treatment, most patients require life-long NA treatment. Previous studies have shown that some patients remain virologically responsive even after NA cessation. However, there is still controversy surrounding whether NA discontinuation increases the HBsAg loss rate. Therefore, this study aimed to assess the cumulative rate of HBsAg loss and identify the predictors of HBsAg loss after NA discontinuation. METHODS This multicenter prospective study included HBV e antigen (HBeAg)-positive patients without cirrhosis from 12 hospitals in China who met the inclusion criteria. The enrolled patients stopped NA and were followed up with clinical and laboratory assessments every 3 months for 24 months after NA cessation or until clinical relapse (CR) occurred. RESULTS Overall, 158 patients were classified into two groups. Group A included patients with HBsAg positivity at NA cessation (n = 139), and Group B included patients with HBsAg negativity at NA cessation (n = 19). In Group A, the 12-month and 24-month cumulative rates of HBsAg loss were4.3%and 9.4%, respectively. End of treatment (EOT) HBsAg (hazard ratio (HR) = 0.152, P < 0.001) and EOT hepatitis B core-related antigen (HBcrAg) (HR = 0.257, P = 0.001) were associated with HBsAg loss. The areas under the receiver operating characteristic curves for EOT HBsAg and HBcrAg levels were 0.952 (P < 0.001) and 0.765 (P < 0.001), respectively. Patients with EOT HBsAg ≤ 135 IU/mL (59.2% vs. 1.3%, P < 0.001) or HBcrAg ≤ 3.6 logU/mL (17% vs. 5.4%, P = 0.027) had a higher 24-month cumulative HBsAg loss rate. In Group B, none of the patients experienced virological relapse after NA cessation. Only 1 (5.3%) patient had HBsAg reversion. CONCLUSIONS EOT HBsAg ≤ 135 IU/mL or HBcrAg ≤ 3.6 logU/mL can be used to identify patients with a higher likelihood of HBsAg loss after NA cessation. Patients with HBsAg negativity after NA cessation have favorable clinical outcomes, and HBsAg loss was durable in most cases.
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Affiliation(s)
- Yandi Xie
- Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Peking University People's Hospital, Peking University Hepatology Institute, Beijing International Cooperation Base for Science and Technology on NAFLD Diagnosis, Beijing, 100044, China
| | - Minghui Li
- Department of Hepatology Division, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China
| | - Xiaojuan Ou
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Sujun Zheng
- Complicated Liver Diseases and Artificial Liver Treatment and Training Center, Beijing Municipal Key Laboratory of Liver Failure and Artificial Liver Treatment and Research, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Yinjie Gao
- Department of Infectious Diseases, The Fifth Medical Center, General Hospital of PLA, Beijing, 100039, China
| | - Xiaoyuan Xu
- Department of Infectious Diseases, Peking University First Hospital, Beijing, 100034, China
| | - Ying Yang
- Department of Infectious Diseases, The Second Hospital of Xingtai, Xingtai, Hebei, 054001, China
| | - Anlin Ma
- Department of Infectious Disease, Friendship Hospital, Beijing, 100029, China
| | - Jia Li
- Department of Liver Disease, Tianjin Second People's Hospital, Tianjin, 300192, China
| | - Yuemin Nan
- Department of Traditional and Western Medical Hepatology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, China
| | - Huanwei Zheng
- Department of Liver Disease, Shijiazhuang Fifth Hospital, Shijiazhuang, Hebei, 050021, China
| | - Juan Liu
- Research Center for Technologies in Nucleic Acid-Based Diagnostics, Changsha, Hunan, 410205, China
| | - Lai Wei
- Department of Hepatopancreatobiliary Disease, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, 102218, China
| | - Bo Feng
- Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Peking University People's Hospital, Peking University Hepatology Institute, Beijing International Cooperation Base for Science and Technology on NAFLD Diagnosis, Beijing, 100044, China.
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Yamada K, Imano H, Tabuchi T, Shimizu Y, Kubota Y, Muraki I, Umesawa M, Yamagishi K, Okada T, Kiyama M, Sankai T, Iso H. Longitudinal trajectories of smoking status using 25 year annually-updated data and all-cause mortality followed over 30 years: A community-based prospective cohort study. Prev Med 2023:107575. [PMID: 37328036 DOI: 10.1016/j.ypmed.2023.107575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 06/11/2023] [Accepted: 06/13/2023] [Indexed: 06/18/2023]
Abstract
We aimed to evaluate the long-term risk of smoking for all-cause mortality according to smoking status trajectories using 25-year annually-repeated input, traced by group-based trajectory modeling with an extension to account for non-random participant attrition or truncation due to death. We examined 2682 men and 4317 women aged 40 to 59 years who participated in annual health checks for the community-based prospective cohort study, 1975-1984 enrollment in Japan. The main outcome measure was all-cause mortality (follow-up period: median 30.2 years in men and 32.2 years in women). We traced annual smoking trajectories, stratified by sex and smoking status at baseline. For smokers at baseline, we identified five trajectories in both sexes, with different patterns of smoking cessation (e.g., early quitters and lifelong smokers). We calculated HRs and 95% CI of all-cause mortality using Cox proportional hazards regression modeling adjusted for age, body mass index, alcohol intake, blood pressure category, dyslipidemia and glucose category. Compared with one-time-point-based smokers, trajectory-based lifelong smokers had an increased risk of all-cause mortality; HRs were 1.31 (95% CI, 1.18-1.46) in men and 1.26 (95% CI, 0.91-1.73) in women. Among community residents aged 40 to 59 years, 25-year-trajectory-based lifelong smokers had an approximately 30% increased risk for all-cause mortality compared to one-time-point-based smokers. Risk of all-cause mortality among smokers with earlier cessation varied materially. It is necessary to consider the trajectories of smoking status to clarify the long-term excess risk of smoking.
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Affiliation(s)
- Keiko Yamada
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan; Osaka Center for Cancer and Cardiovascular Diseases Prevention, 1-6-107 Morinomiya, Jyoto-ku, Osaka 536-8588, Japan; Pain Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan; Department of Anesthesiology and Pain Medicine, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
| | - Hironori Imano
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan; Osaka Center for Cancer and Cardiovascular Diseases Prevention, 1-6-107 Morinomiya, Jyoto-ku, Osaka 536-8588, Japan; Department of Public Health, Kindai University Faculty of Medicine, 377-2 Onohigashi, Osakasayama 589-8511, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 540-0008, Japan
| | - Yuji Shimizu
- Osaka Center for Cancer and Cardiovascular Diseases Prevention, 1-6-107 Morinomiya, Jyoto-ku, Osaka 536-8588, Japan; Department of Community Medicine, Nagasaki University, Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8523, Japan
| | - Yasuhiko Kubota
- Osaka Center for Cancer and Cardiovascular Diseases Prevention, 1-6-107 Morinomiya, Jyoto-ku, Osaka 536-8588, Japan
| | - Isao Muraki
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan; Osaka Center for Cancer and Cardiovascular Diseases Prevention, 1-6-107 Morinomiya, Jyoto-ku, Osaka 536-8588, Japan
| | - Mitsumasa Umesawa
- Osaka Center for Cancer and Cardiovascular Diseases Prevention, 1-6-107 Morinomiya, Jyoto-ku, Osaka 536-8588, Japan; Dokkyo Medical University, School of Medicine, 880 Kitakobayashi, Mibumachi, Shimotsuga, Tochigi 321-0293, Japan; Department of Public Health Medicine, Faculty of Medicine and Health Services Research and Development Center, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Kazumasa Yamagishi
- Osaka Center for Cancer and Cardiovascular Diseases Prevention, 1-6-107 Morinomiya, Jyoto-ku, Osaka 536-8588, Japan; Department of Public Health Medicine, Faculty of Medicine and Health Services Research and Development Center, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan; Ibaraki Western Medical Center, 555 Otsuka, Chikusei, Ibaraki 308-0813, Japan
| | - Takeo Okada
- Osaka Center for Cancer and Cardiovascular Diseases Prevention, 1-6-107 Morinomiya, Jyoto-ku, Osaka 536-8588, Japan
| | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Diseases Prevention, 1-6-107 Morinomiya, Jyoto-ku, Osaka 536-8588, Japan
| | - Tomoko Sankai
- Osaka Center for Cancer and Cardiovascular Diseases Prevention, 1-6-107 Morinomiya, Jyoto-ku, Osaka 536-8588, Japan; Department of Public Health and Nursing, Faculty of Medicine, University of Tsukuba, 2 Amakubo, Tsukuba, Ibaraki 305-0005, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan; Osaka Center for Cancer and Cardiovascular Diseases Prevention, 1-6-107 Morinomiya, Jyoto-ku, Osaka 536-8588, Japan; Department of Public Health Medicine, Faculty of Medicine and Health Services Research and Development Center, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan; Institute for Global Health Policy Research (iGHP), Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1 Toyama Shinjuku-ku, Tokyo 162-8655, Japan
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Vu GT, Stjepanović D, Sun T, Leung J, Chung J, Connor J, Thai PK, Gartner CE, Tran BX, Hall WD, Chan G. Predicting the long-term effects of electronic cigarette use on population health: a systematic review of modelling studies. Tob Control 2023:tc-2022-057748. [PMID: 37295941 DOI: 10.1136/tc-2022-057748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 05/29/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To systematically review and synthesise the findings of modelling studies on the population impacts of e-cigarette use and to identify potential gaps requiring future investigation. DATA SOURCE AND STUDY SELECTION Four databases were searched for modelling studies of e-cigarette use on population health published between 2010 and 2023. A total of 32 studies were included. DATA EXTRACTION Data on study characteristics, model attributes and estimates of population impacts including health outcomes and smoking prevalence were extracted from each article. The findings were synthesised narratively. DATA SYNTHESIS The introduction of e-cigarettes was predicted to lead to decreased smoking-related mortality, increased quality-adjusted life-years and reduced health system costs in 29 studies. Seventeen studies predicted a lower prevalence of cigarette smoking. Models that predicted negative population impacts assumed very high e-cigarette initiation rates among non-smokers and that e-cigarette use would discourage smoking cessation by a large margin. The majority of the studies were based on US population data and few studies included factors other than smoking status, such as jurisdictional tobacco control policies or social influence. CONCLUSIONS A population increase in e-cigarette use may result in lower smoking prevalence and reduced burden of disease in the long run, especially if their use can be restricted to assisting smoking cessation. Given the assumption-dependent nature of modelling outcomes, future modelling studies should consider incorporating different policy options in their projection exercises, using shorter time horizons and expanding their modelling to low-income and middle-income countries where smoking rates remain relatively high.
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Affiliation(s)
- Giang T Vu
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Queensland, Australia
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Daniel Stjepanović
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Tianze Sun
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Queensland, Australia
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Janni Leung
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Queensland, Australia
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Jack Chung
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Queensland, Australia
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Jason Connor
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Queensland, Australia
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
- Discipline of Psychiatry, The University of Queensland, Brisbane, Queensland, Australia
| | - Phong K Thai
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Coral E Gartner
- NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Wayne D Hall
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Queensland, Australia
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Gary Chan
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Queensland, Australia
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50
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Abstract
Cigarette smoking has been associated with epigenetic alterations that may be reversible upon cessation. As the most-studied epigenetic modification, DNA methylation is strongly associated with smoking exposure, providing a potential mechanism that links smoking to adverse health outcomes. Here, we reviewed the reversibility of DNA methylation in accessible peripheral tissues, mainly blood, in relation to cigarette smoking cessation and the utility of DNA methylation as a biomarker signature to differentiate current, former, and never smokers and to quantify time since cessation. We summarized thousands of differentially methylated Cytosine-Guanine (CpG) dinucleotides and regions associated with smoking cessation from candidate gene and epigenome-wide association studies, as well as the prediction accuracy of the multi-CpG predictors for smoking status. Overall, there is robust evidence for DNA methylation signature of cigarette smoking cessation. However, there are still gaps to fill, including (1) cell-type heterogeneity in measuring blood DNA methylation; (2) underrepresentation of non-European ancestry populations; (3) limited longitudinal data to quantitatively measure DNA methylation after smoking cessation over time; and (4) limited data to study the impact of smoking cessation on other epigenetic features, noncoding RNAs, and histone modifications. Epigenetic machinery provides promising biomarkers that can improve success in smoking cessation in the clinical setting. To achieve this goal, larger and more-diverse samples with longitudinal measures of a broader spectrum of epigenetic marks will be essential to developing a robust DNA methylation biomarker assay, followed by meeting validation requirements for the assay before being implemented as a clinically useful tool.
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Affiliation(s)
- Fang Fang
- GenOmics, Bioinformatics, and Translational Research Center, RTI International, 3040 East Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, USA
| | - Allan M. Andersen
- Department of Psychiatry, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA
| | - Robert Philibert
- Department of Psychiatry, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA
- Behavioral Diagnostics LLC, 2500 Crosspark Rd, Coralville, IA 52241, USA
- Department of Biomedical Engineering, 5601 Seamans Center for the Engineering Arts and Sciences, University of Iowa, Iowa City, IA 52242, USA
| | - Dana B. Hancock
- GenOmics, Bioinformatics, and Translational Research Center, RTI International, 3040 East Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, USA
- Corresponding author. (D.B. Hancock)
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