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Abstract: Background: Both alcohol and tobacco consumption during pregnancy present significant health risks to the unborn child, including developmental disorders and cognitive deficits. By abstinence from alcohol and tobacco during pregnancy these risks can be completely avoided. Aim: The article provides an overview of prevention and intervention methods, such as education, brief interventions, and treatment and provision of support. It also highlights the importance of systematic screening in health care facilities to identify pregnant women at an early stage and to facilitate access to support services. Conclusions: However, serious gaps in the German care system hinder adequate guideline-based prevention and treatment. Lastly, the article underscores the responsibility of society and health policy to create an environment where abstaining from alcohol and tobacco is the norm, thereby promoting the choice of a smoke-free and alcohol-free life in pregnancy and beyond. [ABSTRACT FROM AUTHOR]

Abstract:Background: Smoking during pregnancy poses a major health risk to pregnant smokers and their children. Pregnancy could be an opportune moment for cessation. Yet many smokers do not quit during pregnancy. This study aims to explore potential influencing factors for successful smoking cessation in pregnancy. Methods: Cross-sectional data was collected in an anonymous online survey (n=358). Data of n=60 women between the 24th week of pregnancy and four months postpartum was analysed. Variables showing significant differences between women who successfully quit smoking during pregnancy ("ex-smokers", n=40) and women who were still smoking at the time of the survey ("smokers", n=20) were included in a logistic regression to identify potentially important influencing factors. Results: Ex-smokers showed higher education levels, were employed, had a planned pregnancy, abstained from alcohol during pregnancy, and scored lower on the Fagerström test for cigarette dependence. They showed greater satisfaction with life and higher scores on the personality trait "agreeableness". In the regression model, a planned pregnancy, alcohol abstinence and higher agreeableness scores increased the odds of being an ex-smoker. Conclusions: Planned pregnancies could be particularly suitable for smoking cessation. Alcohol should be considered, as abstinence could contribute to smoking cessation. A personality characterised by high agreeableness could be beneficial at least in addition to other factors. [ABSTRACT FROM AUTHOR]

Introduction: In addition to the prevention of tobacco consumption, the establishment and assurance of high-quality treatment for harmful use and dependance on tobacco products remains an important health-related task in Germany. Regular updating of the AWMF-S3-Guideline „Smoking and Tobacco Dependence: Screening, Diagnosis and Treatment" (Tobacco Guideline) offers a sustainable and reputable source of knowledge on smoking cessation. Methods: Under the auspices of the German Society for Psychiatry, Psychotherapy, Psychosomatics and Neurology (DGPPN) and the German Society for Addiction Research and Addiction Therapy (DG-Sucht), the Tobacco Guideline was revised in 2019–2020 by 63 people, who were involved in the development process of the text, in 11 working groups. Through careful COI management, the influence of conflicts of interest could be minimised. Delegates from 50 professional societies discussed the 80 guideline recommendations and voted online. Results: In addition to recommendations for screening and diagnostics, the Tobacco Guideline takes a positive stance towards the use of low-threshold counselling and support services. If, due to the severity of the tobacco-related disorder, brief counselling, telephone counselling or internet- or smartphone-based methods are not sufficiently effective, individual or group behavioural therapy, possibly in combination with medication, is indicated. If nicotine replacement therapy is not effective, varenicline or bupropion should be offered. Alternative strategies with a lower level of recommendation are hypnotherapy, mindfulness-based treatments or cytisine. In adolescents and pregnant women, the use of medication should be limited to well-specified exceptions and nicotine replacement. The mean agreement with the recommendations reaches a value of 98 %. A general overview of the treatment recommendations of the Tobacco Guideline is provided by three clinical algorithms. [ABSTRACT FROM AUTHOR]

Aims: The chronic obstructive pulmonary disease (COPD) is mainly caused by smoking tobacco. About 33--50 % of COPD patients are active smokers and show a considerably higher than average psychological comorbidity compared to the general population. Possible links between depression, tobacco smoking and cessation success amongst COPD patients are examined employing a prospective cohort design following a complex smoking cessation intervention. Method: Using a partial sample (N = 209) of the ATEMM-study (AOK PLUS-study for structured smoking cessation by pulmonary practices and psychotherapists in Saxony and Thuringia with minimal vs. maximal intervention), analysis examined whether patients with depressive comorbidity display more pronounced tobacco smoking behaviors as well as higher tobacco dependence and failure rate than mentally healthy patients. Results: Among patients with a suspected depressive syndrome (PHQ-D) was a significant larger proportion of a long cumulative smoke exposure (96 % = 20 Pack-Years) than among those without comorbidity (74 %, p = 0.045). Depressiveness is associated with a higher tobacco dependence. There was no significant link between depressive symptomatology and 12-month abstinence. Conclusions: The hypothesized link between depressive comorbidity, tobacco dependence and smoking intensity as well as cessation success could largely be supported. Patients with depressive comorbidity were heavier smokers with higher rates of dependence. Higher-than average failure rates (relapse or no sustained abstinence) were only found in patients with a higher severity of depression. A continuous psychological treatment could enhance the success of cessation efforts. [ABSTRACT FROM AUTHOR]

Background: The prevalence of tobacco smoking among people with severe mental illness (SMI) substantially exceeds smoking rates in the general population and has been identified as the largest contributor to health inequalities in this group. Historically deeply embedded in the culture of mental health treatment environments, smoking until very recently was the norm in inpatient settings and still prevails in many settings internationally. In England however, mental health Trusts are currently implementing recent national guidance, according to which mental health settings will become entirely smokefree, with no exemptions, providing comprehensive evidence-based support to patients for smoking cessation and smoking abstinence during the inpatient stay. Aim: The aim of this article is to summarise the rationale for and the debate surrounding smokefree mental health inpatient settings, and to review and discuss the evidence on challenges, opportunities and impact of smokefree policy implementation in these settings, with a focus on the English debate and experience to date. [ABSTRACT FROM AUTHOR]

Aims: With the aim to influence social norms, school classes participating in the non-smoking competition "Be Smart - Don't Start" commit themselves to abstain from smoking for six months. The aim of the study was to investigate the long-term effectiveness of this preventive measure. Methods: In 2006 a total of 3,490 7th graders from 84 schools of the German State Saxony-Anhalt took part in a cluster-randomized study to test the effectiveness of the competition. This sample was contacted again in 2015, nine years after baseline, and surveyed about their smoking behavior. The endpoints of the study were never smoking, daily smoking, initiation of smoking, and smoking cessation. Results: Fifty-eight schools (69.0 % of the initial sample) were willing to participate in the follow-up, resulting in 688 (19.7 %) student questionnaires that could be matched with baseline data (mean age in 2015: 21.2 years). Participants with a low risk for smoking had a higher likelihood to be reached at follow-up. Furthermore, participants from Gymnasium schools were more frequently reached in the control group. In almost all analyses, there was a numerical difference in favor of the intervention group in terms of smoking behavior; for the quit date this difference was statistically significant. Conclusions: Due to the small sample size and the selective attrition, general conclusions about the long-term effects of the participation in the competition can only be drawn with great caution. [ABSTRACT FROM AUTHOR]

Smoking in Oscar and Lola nominated films Abstract. Aim: To study the frequency of smoking in films which have been nominated for a film award. Testing the association between smoking in films and age classification of the films. Methods: All films (n=81) which have been nominated for the "Oscars”, or the German Film Awards ("Lolas”) in 2016 and 2017 were content-coded according to whether or not they portrayed smoking. The age classification of the films according to the „Freiwillige Selbstkontrolle der Filmwirtschaft" (FSK) and the "Motion Picture Association of America” (MPAA) was also recorded. Results: Sixty of 81 films (74%) portrayed smoking. Smoking occurred more often in films which have been nominated for the Lolas in comparison with films which have been nominated for the Oscars (p=0.037). There was no association between smoking in films and FSK age rating (p=0.648). FSK classified 22% of the films with smoking as appropriate for young people aged 16 years or above, in the USA 63% of the films with smoking received an R-rating (17 years or above). Conclusions: Three quarters of films portrayed smoking. Smoking occurred more often in German compared to American films. The US rating system for films sets stricter standards and leads to the fact, that adolescents are less often able to watch films that portray smoking. Increasing the FSK age classification for films that portray smoking would decrease the exposure of smoking in films to youth and would be in line with recommendations of the World Health Organization. [ABSTRACT FROM AUTHOR]

Aim: Both the percentage of smokers and number of women among the nursing professions is disproportionally high. In this study we test whether male and female nursing students differ with regard to their smoking behavior, smoking-related risk factors, and attitudes toward behavioral and environmental measures. We compare nursing students and employees to determine whether a high smoking rate can be observed already at the beginning of the nursing career. Method: Within the framework of a controlled intervention study, we tested baseline questionnaire data of 357 nursing students for gender effects. The rates reported by a representative survey with nursing employees were then compared to the students' rates. Results: Gender differences were observed with regard to risk factors but not with tobacco use and preparedness to change. Resistance efficacy was higher among female students. Men who smoked perceived fewer smokers among their colleagues, tended to judge smoking as more compatible with the nursing profession, and were more willing to utilize a smoking-cessation group format. In general, nursing students (52.8% smokers) had a 1.5 times higher risk of smoking compared to their employed colleagues. Conclusions: Because of a potentially selective sampling procedure, the results should be interpreted cautiously. However, they point to the fact that there is a need for tobacco intervention among both female and male nursing students since about half of them are smokers even at the beginning of nurse training. An intervention should comprise behavioral and setting-related components. Its implementation faces the challenge of a currently smoking-supportive educational context. [ABSTRACT FROM AUTHOR]