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2. Safety of Nonsteroidal Anti-inflammatory Drugs in Major Gastrointestinal Surgery: A Prospective, Multicenter Cohort Study
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Abbas, Z., Abburu, S., Abd Ghaffar, M. K., Abdelhadi, M., Abdikadir, H. R., Abdulmajid, A., Abid, H., Abid, A., Abuhussein, N., Abul, M. H., Acquaah, F., Acres, M., Adams, R., Adams, R. D., Adebayo, A. A., Adeleja, I., Adjei, H., Afzal, Z., Agarwal, V., Ahern, N., Ahmad, K., Ahmad, S., Ahmed, M., Ahmed, H., Ahmed, N., Ahmed, S., Ahmed, F., Ahn, J. S., Aidoo-Micah, G. E., Aildasani, L., Aithie, J. M., Akhtar, S., Ali, S., Ali, A., Ali, B., Ali, M., Ali, H., Alizadeh, M., Allan, C., Allen, J. L. Y., Allot, R., Al-Mousawi, A., Al-Obaedi, O., Al-Robeye, A., Amajuoyi, A., Amin, H., Amin, O., Amphlett, A. H., Anandarajah, C., Anderson, L., Anderson, L. B., Anderson, S. M., Ang, A., Angelov, S., Anilkumar, A., Anim-Addo, N., Ansari, N., Antoniou, I., Archer, C. H., Arif, T., Asbjoernsen, C. A., Ashfaq, U., Ashken, L., Ashraf, S. F., Ashraf, S., Ashton, A. J., Ashwood, J., Aslanyan, A., Asmadi, A., Assadullah, S., Atayi, A., Atraszkiewicz, B. A., Attalla, M., Austreng, L., Auyoung, E., Avery, P., Axelson, T., Aziz, H., Aziz, N., Baker, A. N., Bakewell, Z. R., Bakhsh, A., Balaji, S., Balian, V., Bamgbose, F. A., Barai, I., Barnes, J., Barrow, T. R., Barthorpe, A. E., Bartlett, J., Bartlett, R. D., Barton, E. C., Bassam, N., Bassett, J., Bassiony, S., Bath, M. F., Batho, A., Batt, E., Bazeer, H. Z., Beckett, J., Beecroft, S., Behar, N., Bell, N., Bell, L., Bell, A., Bemand, T. P., Bergara, T., Bernstein, I., Bethell, G. S., Bhanderi, S., Bhangu, A., Bhaskaran, G., Bhatt, N., Bhatti, M., Bhome, R., Bhudia, R., Bingham, G., Blege, H. K., Blessed, R., Bloomer, J., Bloomfield, T., Blore, C. D., Bolton, W., Bolton, L., Bonsu, S., Bookless, L. R., Bose, R., Botchey, S., Boulton, A. J., Boxall, N., Boyle, J., Braganza, L., Brathwaite-Shirley, C., Bravo, M., Brecher, J., Bremner, R. H., Brennan, C., Brennan, E., Brennan, K., Brent, G., Brewer, C. F., Brewster, O., Bright, M., Brown, D., Brown, E., Brown, F. S., Brown, E. J., Broyd, A., Brzyska, K., Buakuma, P., Buchan, A. M., Buckle, R. T., Bucko, A. M., Bulley, F., Bullman, L. M., Bullock, N. P., Burgess, A., Burke, J., Burke, D., Burke, E., Burney, L. J., Callan, R., Campbell, J., Canning, N., Canning, E., Cao, Y., Cardwell, A. E., Carr, L., Carr, R., Carroll, A. F., Carter, D., Carthew, L., Chamberlain, M., Chan, N., Chan, C., Chandan, N., Chapman, S. J., Charalambos, M. A., Charalambous, G., Charania, A., Charavanamuttu, V., Chaudhary, M., Chaudhry, F. I., Chaudhry, W. W., Cheema, H., Chen, J. H., Chen, X., Chen, M., Cheng, K., Chervenkoff, J., Cheskes, L., Cheung, F., Chew, L. S., Chew, L., Chhabra, A., Chhina, C., Chilima, C. P., Chillarge, G., Chilvers, N. J., Chin, H., Chin, R., Chisholm, E. G., Chitnis, A. R., Chiu, S. M., Chong, B. F., Chong, J., Choo, K. P., Chrastek, D., Chua, E. Y., Chung, A., Claireaux, H. A., Clark, I. J., Clarke, A. K., Cleere, J., Clement, K. D., Clesham, K., Coates, A., Cody, A., Cody, N., Coffey, D., Coffey, C. J., Coffin, J., Cole, S. J., Collier, H., Collins, A., Collins, D., Collinson, S., Cooper, G. E., Cooper, D., Copley, H. C., Copley, P. C., Cornish, E., Cotton, A., Coulson, R., Cox, S. E., Craig, A. R., Craig, E., Craig-McQuaide, A., Crewdson, J. A., Croall, A., Crozier, L., Cullen, C., Cullen, S., Culleton, G., Cumber, E., Cumber, E. M., Cumming, S., Cundy, O. J., Cunha, P., Curran, A., Cuthbert, G., Cymes, W., Daoub, A., Darr, S., Das, M., Datta, U., Davies, N., Davies, J., Davies, J. E., Davies, K., Davis-Hall, M., Dawar, R., Dawson, P. M., de Bernier, G. L., Deall, C., Dean, R., Dean, S., Dean, W., Dear, K., Deas, G., Debenham, R., Deekonda, P., Delport, A., Demetri, A. M., Dennis, Y. F., Dennis, R., Derbyshire, L., Devabalan, Y., Devlin, E., Dewdney, C. J., Dhanji, A., Dhar, M., Dhutia, A. J., Diaper, C., Dickson, J., Din, W., Dindyal, S., Dinsmore, L., Doan, L., Dobson, J., Dogra, T., Doherty, C., Dolaghan, M., Dolbec, K. S., Dorman, C., Drake, T. M., Drislane, C., Dube, P., Duffy, A., Duke, K., Duncumb, J. W., Dunn, C. E., Durr, A., Durrani, B., Dutt, S., Dyal, A. R., Dynes, K., Edison, M. A., Edozie, F., Egan, R. J., Egerton, C., Elangovan, V., Elf, D., Elkawafi, M., Elliott, L. E., Elseedawy, M., Empey, J., English, W., Entwisle, J. H., Eparh, K., Eragat, M., Eraifej, J., Esteve, L., Farmer, J. D., Fautz, T., Favero, N., Fawaz, A. S., Fergurson, P., Fern, J., Filby, J. J., Filipescu, T., Fitzgerald, J. E., FitzPatrick, D., Fleck, R., Fletcher, L., Fong, J., Forrest, P. R., Forte, B., Foster, N. L., Francescon, C. T., Frank, A. L., Fung, T. M. P., Gabriel, J., Gaffney, S., Galloway, E., Gandhi, K., Gardiner, N., Gardner, E., Gardner, H., Gatfield, W. A., Gauntlett, L., Gentry, S., George, D., Geraghty, J. M., Ghaffar, A., Gilbert, H., Giles, J. E., Gill, P., Gill, C. K., Girling, C., Glasbey, J. C., Glover, T. E., Goh, B., Goh, R. W., Gohil, K., Gokani, S., Gold, D., Golding, D. M., Goldsmith, T., Goodier, R., Goradia, H., Gouda, P., Gouldthrope, C., Govinden, S., Graham, C. J., Gratton, R., Gray, L., Greenhalgh, A. D., Greig, R. J., Griffin, E. J., Grossart, C. M., Grundy, L., Gulati, J., Gundogan, B., Gupta, V., Gwozdz, A. M., Siddiqui, Z. H., Hague, A., Hameed, M., Hanrahan, M., Haq, H., Harbhajan Singh, G. S., Hardie, J., Harding, F., Hardy, M. R., Harries, P., Harris, R. T., Harris, L. N., Harrison, E. M., Harrison, P. L. M., Hartley, J., Hartley, S., Harvey, J., Hassan, S., Hayat, M., Hayat, U., Hayes, J. D. B., He, A., Healy, L., Heathcote, E., Heer, R. S., Heminway, R., Henderson, I., Henderson, L. A., Henderson, C., Heneghan, H., Henson, A. D., Heppenstall-Harris, G., Herron, J., Heskin, J., Hester, E., Hewitt, C. M., Heywood, E. G., Hibberd, A., Hickling, S. L., Higgins, A., Higgs, L., Hill, A., Hindle Fisher, I., Hirani, S., Hirst, F., Hitchen, N., Ho, W., Ho, S., Hoban, K. A., Holliday, R. B. S., Holloway, C., Holmes, C., Holmes, M. J. V., Holton, P., Holyoak, H., Horne, L., Horst, C., Horth, D., Hoskins, T. C., Howells, L., Hu, L., Huang, H. C., Hudson-Phillips, S., Hughes, F., Hughes, B. A., Hughes, R. K., Hulley, K., Hung, G., Hurst, P. C., Husnoo, S. B., Hussain, N., Hussain, O., Ibrahim, I., Ibrahim, A., Ingham, R., Ingram, E., Iqbal, S., Iqbal, A., Isaac, A., Jackson, H. R., Jackson, S., Jacob, L., Jafree, D. J., Jaitley, A., Jalota, P., Jamal, N., Jathanna, N., Jawad, A. S., Jayakody, N., Jenkin, S. L., Jenvey, C., Jewell, P. D., Jhala, H., Jindal, A., Johnston, A., Johnston, J., Johnstone, M., Jordan, H. E. M., Joshi, K. R., Joshi, D., Joyce, H. L., Joyner, C., Jubainville, C. L., Jull, P., Kadicheeni, M., Kahar, A., Kalra, N., Kanabar, S., Kane, T., Karia, M., Karia, P., Karsan, R. B., Karunakaran, P., Kaushal, A., Kazmi, Z., Keane, P., Keane, C. P., Keane, N., Kee, J. Y., Keeling, R. E., Keelty, N., Keevil, H., Kelly, M., Kelly, M. E., Kelly, N., Kennedy, E. D., Kennedy, H. R., Kerai, A., Kerr, A. L., Khajuria, A., Khalid, H., Khan, T., Khan, M., Khan, S., Khan, U., Khan, A., Khangura, J., Khanijau, R., Khatri, C., Khattak, M., Khetarpal, A. A., Khokhar, H. A., Khonat, Z., Khonsari, P., Kiff, R., Kim, S., Kim, J. W., Kimani, L., King, M., Kishore, A., Kisyov, I., Kitt, H., Knight, C. L., Kong, C. Y., Kong, C., Kosasih, S. R., Koshy, R. M., Kotecha, D., Koumpa, F., Kow, K., Koysombat, K., Kreibich, A., Kretzmer, L., Kumar, A. N., Kumaran, G., Kwan, M. L., Kwang, P., Lakhani, M., Lakhani, S. M., Lakshmipathy, G., Lalor, P., Lamont, J., Lankage, C. M., Lavery, J., Lazenby, D., Ledsam, A., Lee, A. H. Y., Lee, S., Lees, D. M., Lek, C., Leong, S., Leslie, K. E., Leung, W., Lewis, T., Li, N., Li, M. M., Liew, Y., Liew, W., Lim, K., Lim, J., Lim, D., Lim, A. E., Lim, S. J., Lim, S., Lim, E., Linton, A., Liu, S., Liu, C., Livesey, A., Lo, T., Lockey, J. W., Logan, A. E., Loke, W., Long, F., Lopes, S., Lotfallah, A., Lou, C. N., Loughran, D., Loveday, J., Low, J. Y. L., Lu, Q., Lua Boon Xuan, J., de Carvalho, J. Lucas, Luhishi, A., Luk, C. Y., Lunawat, S., Lwin, K. N., Lykoudis, P. M., Lynch, A. S., Lynne, S., Lyons, R., Maamari, R., MacAskill, A., MacDonald, J., Mackin, S., Maclennan, D., Mah, J., Mahboob, S., Maheswaran, Y., Mahmood, J., Majid, S., Major, C., Malaj, M., Malik, A., Mallick, S., Malys, M. K., Manson, R., Mansoor, S., Maple, N., Marchal, S. T., Markham, R. M., Marsden, M., Marsh, A., Marshall, D. C., Martin, A. L., Martin, R., Maru, D., Mason, J. D., Masood, M., Mastan, A., Matheson, J., Matthams, J., Matthews, B. W., Matthews, J. H., Maxwell-Armstrong, C., Mazan, K., Mazumdar, E., McAleer, S., McAleer, E., McAllister, R., McAuley, D., McBride, A., McCabe, G., McCance, E., McCann, M., McClymont, L. F., McCormack, D. R., McCrann, C., McDowell, M., McEnhill, P. M., McFarlane, H., McGalliard, R. J., McGarrigle, C., McGarvie, S., Mcgenity, C., McGowan, C., McGrath, A., McGregor, R. J., McIntyre, C. J., Mckean, E., McKelvey, L. L., McKerr, C. N., McKevitt, K. L., McLaughin, C., McLean, R. C., McLure, S. W., McMenamin, M., McMullan, R., McNamee, L., McRobbie, H. D., Meek, J., Mehdi, A., Mehta, J. K., Menon, A., Mian, A., Mills, E. D., Mills, M., Mills, H., Milne, S., Minhas, M., Miranda, B. H., Mirdavoudi, V., Mirza, M., Mishra, A., Mistry, S., Mistry, B. D., Mitchell, H., Mitha, N., Mithrakumar, P., Mitrasinovic, S., Mittapalli, D., Mogan, Y. P., Mohamud, M., Mohan, M., Mohan, K., Mohite, A., Momoh, Z., Moody, N., Moon, R. D. C., Moradzadeh, J., Morgan, F., Morgan, C., Morley, R., Morris, F., Morris, S., Morrison, P., Morrison, C. J., Mortimer, A., Murkin, C., Murphy, L., Murray, S. E., Murtaza, A., Mushtaq, J., Nachiappan, R., Nadanakumaran, K., Naqib, S., Narain, A., Naran, P., Narang, Y., Narayan, P., Narramore, R., Narwani, V., Navayogaarajah, V., Naveed, H., Nayee, H., Nehikhare, I., Nelaj, S., Neo, Y. N., Neophytou, C., Nepogodiev, D., Nesargikar, P. N., Ng, K., Ng, J. C. K., Ng, G. S., Ng, J. Q., Ng, A. Y. L., Ng, S., Ng, L., Nicholls, K., Nixon, G., Norris, J. M., North, A. S., Norton, J., Ntala, C., O’Bryan, M., O’Carroll, O., O’Connell, C., O’Connor, A., O’Connor, S., O’Flynn, L. D., O’Kane, A., O’Loughlin, R. A., O’Neill, S., O’Neill, E. M., O’Reilly, D., O’Sullivan, D. A., O’Sullivan, K., Obute, R. D., Odeleye, A., Omar, A., Omara, S., Omer, H. M., Ong, K. K., Oremule, B., Osei-Kuffour, D., Osman, S., Owasil, R., Owczarek, S., Williams, R. P., Paine, H. R., Pal, S., Palkhi, E., Palmer, C., Pandey, A., Pandey, G., Paraoan, V., Park, J. H., Parker, O., Parker, J., Parkin, J., Parsons, S., Parthiban, S., Patel, P., Patel, M., Patel, T., Patel, S., Patel, N., Patel, J. B., Patel, V., Patel, B. Y., Patel, B., Patel, B. A., Patel, K., Paul, J., Pearce, J., Pearse, R. J., Peck, F. S., Perera, M., Pericleous, A., Peroos, S., Peters, M., Petra, H., Petrarca, M., Pezas, T. P., Phan, P. N., Phillips, C., Pickard, J., Pinto, R., Piquet, A., Pitts-Tucker, T., Pizzolato, A., Player, C., Ponweera, A., Poo, S. X., Pope, S., Prabhudesai, A., Prakash, E., Preece, R., Prest-Smith, J., Priestland, R., Prys-Jones, O., Ptacek, I. B., Puan, L., Punj, R., Punjabi, N., Qamar, M. A., Qureshi, S., Qureshi, U., Qureshi, A., Rabinthiran, S., Radotra, A., Rafiq, N. M., Raghuvir, V., Raghvani, T., Rajan, N., Raji, K., Raman, K. P., Ramjeeawon, N., Ramnarine, A., Rampal, R., Ramsay, N., Ramtoola, T., Rangan, T., Rangedara, A., Raphael, M., Rashid, S., Rashid, M., Rasiah, M. G., Ratnakumaran, R., Rattan, G., Ratu, S. G., Raut, P., Reakes, T., Redgrave, N. A., Reed, A., Reeder, C., Reehal, R. S., Rees, C., Reeves, T., Reid, N. B., Reid, R., Reid, K. G., Remedios, J., Rhema, I. A., Rinkoff, S., Roberts, E. J., Roberts, A. W., Roberts, H. F., Roberts, C., Robertson, K. L., Robertson, V., Robertson, D. T., Robinson, M., Robinson, C., Robson, J., Rocke, A. S., Rogers, J. E., Rogers, S., Rojoa, D., Rookes, C. W., Rosen O’Sullivan, H., Ross, T., Ross, H., Rothwell, L., Roy, C. S. D., Ruiz, E. M., Russell, G., Ryan, M., Sabine, L. M., Sagar, R., Sagmeister, M., Sahathevan, A., Sait, M. S., Sajjad, U., Salam, G. J., Sale, T., Salem, M., Salih, A. E., Salmon, D., Sanders, J. A., Sandhu, K. K., Sandhu, S., Sangal, P., Sarvanandan, T., Sarwar, S., Sasapu, K., Satterthwaite, L., Schulz, T. M., Scotcher, S. E., Seager, E., Seedat, M., Segall, E., Sellathurai, J., Selvachandran, H., Semana, A. D., Semnani, S. A., Semple, E., Seneviratne, N., Sethi, R. K., Shafi, A. M. A., Shafiq, N. M., Shah, A., Shah, J. P., Shah, R., Shah, S., Shaheen, H., Shahid, S., Shahidi, S., Shakweh, E., Shanahan, D., Sharifpour, M., Shatkar, V., Shaunak, R., Sheldon, A., Shepherd, R., Shepherd, P., Sherif, M. A., Sherliker, G. X. J., Sheth, S., Shoa, M., Shufflebotham, H., Shuker, B. A., Shukla, A., Shumon, S., Shurovi, B. N., Shuttleworth, R. H., Siddiqui, M., Sii, S., Sim, N. K., Sim, P., Sim, D., Simpson, R., Simpson, A., Singagireson, S., Singh, B., Singh, K., Singh, R., Singh, S., Sinha, Y., Sirakaya, M., Sitta, O., Slade, R., Smith, N., Smith, D. N. E., Smith, A. C. D., Sng, S., Soo, Y. H., Soon, W. C., Sorah, T., Spence, O., Spencer, T., Springford, L. R., Sreh, A., Srikantharajah, M., Sritharan, P., Stanger, S. A., Stanley, G. H., Stather, P. W., Steel, M., Stein, J., Stevens, S., Stewart, G. E., Stezaker, S., Stoddart, M. T., Stokes, S., Stone, E. J., Stott, G. D., Strange, E., Street, A. N., Sukkari, M., Sukumar, S., Suleman, Y. N., Sullivan, J. A. L., Sun, E., Sundar-Singh, M., Suresh, S., Suresh, R. S., Syeed, J. A., Sykes, M. C., Szczap, A., Tahir, M., Tahmina, A., Tai, A., Talukdar, S. S., Tan, Y. H., Tan, R., Tan, E. T., Tan, D., Tan, Y., Tan, S., Tan, E. S. M., Tay, A. Y., Tayeh, S., Tear, A. K., Telfer, R., Teng, V., Teoh, P. J., Thacoor, A., Thakker, C. E., Thakur, H., Tharakan, R. G., Tharmachandirar, T., Theodoreson, M. D., Theodoropoulou, K., Thethi, R., Thevathasan, A. A., Thirumal, V., Thomas, G., Thomas, D., Thompson, O. D., Thompson, J. D., Tilston, T. W., Toale, C., Toh, C., Toner, E., Tongo, F., Tonkins, M., Topham, C., Torlot, G. E., Torrance, H. D., Trail, M., Traynor, B. P., Trecarten, S., Trimble, A., Trist, A. J., Tsui, A. Y., Tung, L., Turaga, S., Turley, H., Turnbull, J. A., Turner, L., Turner, M., Turner, E. J. H., Turner, J., Ungcharoen, N., Uppal, E., Valli, A., Vanmali, P., Varley, R., Varma, R. K., Varma, D., Varma, N., Vaughan, R., Venn, M., Ventre, C. M., Verma, K., Verma, S., Vernon, O. K., Vithanage, N. A., Vivekanantham, S., Wadanamby, S., Waldron, R. M., Walford, R. A., Wali, A., Wall, C., Walsh, S. L., Wan, J. C., Wang, S., Wang, A., Ward, N., Ward, T., Ward, A. E., Warren, N., Warwick, H. L., Watson, N., Watson, R. P., Weaver, R., Webb, E., Weinberg, D., Wells, M., Weston, C., Wetherall, N., Whacha, C., Whatling, E. A., Whewell, H., White, A., White, C. J., White, U., Whitehurst, K., Whitham, R. D. J., Whittingham, H., Wijesekera, M., Wild, J. R. L., Wilkinson, D., Williams, M., Williams, M. R., Williams, P., Wills, J., Wilson, H. C. P., Wilson, H., Wilson, R., Wiltshire, J. J., Winarski, A., Wing, V. C., Wingfield, L. R., Winslow, F., Woin, E., Wong, V., Wong, E., Wood, A. D., Woodcock, N., Woodward, H., Woon, E., Wright, A., Wright, E. V., Wye, J., Wylam, D., Wylie, J., Wynell-Mayow, W. M., Xiao, C., Xu, G. X., Xylas, D., Yan, A., Yang, T., Yates, J. A., Yener, A., Yim, N., Yoganathan, S., Yong, C. S., Yong, N., Yousif, A., Yow, L., Yuen, R., Zegeye, M. I., Zhao, J., Ziff, O., Ziprin, P., Zuhair, M., and STARSurg Collaborative
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- 2017
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3. Ann McNeill and colleagues reply to Martin McKee and Simon Capewell
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McNeill, Ann, Brose, L S, Calder, R, Hitchman, S C, Hajek, P, and McRobbie, H
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- 2015
4. Longer-term use of electronic cigarettes when provided as a stop smoking aid: systematic review with meta-analyses
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Butler, AR, Lindson, N, Fanshawe, TR, Theodoulou, A, Begh, R, Hajek, P, McRobbie, H, Bullen, C, Notley, C, Rigotti, NA, and Hartmann-Boyce, J
- Subjects
Nicotine ,Epidemiology ,Smoking ,Public Health, Environmental and Occupational Health ,Tobacco Smoking ,Humans ,Smoking Cessation ,Electronic Nicotine Delivery Systems - Abstract
Moderate certainty evidence supports use of nicotine electronic cigarettes to quit smoking combustible cigarettes. However, there is less certainty regarding how long people continue to use e-cigarettes after smoking cessation attempts. We set out to synthesise data on the proportion of people still using e-cigarettes or other study products at 6 months or longer in studies of e-cigarettes for smoking cessation. We updated Cochrane searches (November 2021). For the first time, we meta-analysed prevalence of continued e-cigarette use among individuals allocated to e-cigarette conditions, and among those individuals who had successfully quit smoking. We updated meta-analyses comparing proportions continuing product use among individuals allocated to use nicotine e-cigarettes and other treatments. We included 19 studies (n = 7787). The pooled prevalence of continued e-cigarette use at 6 months or longer was 54% (95% CI: 46% to 61%, I2 86%, N = 1482) in participants assigned to e-cigarette conditions. Of participants who had quit combustible cigarettes overall 70% were still using e-cigarettes at six months or longer (95% CI: 53% to 82%, I2 73%, N = 215). Heterogeneity in direction of effect precluded meta-analysis comparing long-term use of nicotine e-cigarettes with NRT. More people were using nicotine e-cigarettes at longest follow-up compared to non-nicotine e-cigarettes, but CIs included no difference (risk ratio 1.15, 95% CI: 0.94 to 1.41, n = 601). The levels of continued e-cigarette use observed may reflect the success of e-cigarettes as a quitting tool. Further research is needed to establish drivers of variation in and implications of continued use of e-cigarettes.
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- 2022
5. Effectiveness, safety and cost-effectiveness of vaporized nicotine products versus nicotine replacement therapy for tobacco smoking cessation in a low-socioeconomic status Australian population: a study protocol for a randomized controlled trial
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Howard, BC, McRobbie, H, Petrie, D, Barker, D, Mendelsohn, C, Anderson, J, Borland, R, Naughton, F, Tutka, P, Zwar, N, Boland, VC, Aiken, A, Shakeshaft, A, Gartner, C, Richmond, RL, Hall, W, Mattick, RP, Farrell, M, Courtney, RJ, Howard, BC, McRobbie, H, Petrie, D, Barker, D, Mendelsohn, C, Anderson, J, Borland, R, Naughton, F, Tutka, P, Zwar, N, Boland, VC, Aiken, A, Shakeshaft, A, Gartner, C, Richmond, RL, Hall, W, Mattick, RP, Farrell, M, and Courtney, RJ
- Abstract
BACKGROUND: In Australia, tobacco smoking rates have declined but inequalities remain with significantly higher smoking prevalence among low-socioeconomic populations. Clinical trial data suggest vaporized nicotine products (VNPs) aid smoking cessation. Most VNP trials have used refillable tank systems, but newer generation (pod) devices now comprise the largest market share yet have limited clinical trial evidence on safety and effectiveness. This study evaluates the effectiveness, safety and cost-effectiveness of VNPs (pod and tank device) compared with nicotine replacement therapy ([NRT]-gum or lozenge) for smoking cessation. METHODS: This is a two-arm, open-label, superiority, parallel group, randomized controlled trial (RCT) with allocation concealment and blinded outcome assessment. The RCT is conducted at the National Drug and Alcohol Research Centre at the University of New South Wales, Sydney, Australia. Participants are people who smoke daily, are interested in quitting and receive a government pension or allowance (N = 1058). Participants will be randomized (1:1 ratio) to receive 8 weeks of free: VNPs, with pod (40 mg/mL nicotine salt) and tank device (18 mg/mL freebase nicotine) in mixed flavours; or NRT (gum or lozenge; 4 mg). All participants will receive daily text message behavioural support for 5 weeks. Assessments will be undertaken by telephone at baseline, with three follow-up calls (two check-in calls within the first month and final follow-up at 7 months post randomization) to ascertain smoking status, treatment adherence and adverse events. The primary outcome is 6-month continuous abstinence verified by carbon monoxide breath test of ≤5ppm at 7-month follow-up. Safety and cost-effectiveness of VNPs versus NRT will also be evaluated. DISCUSSION: Further data are required to strengthen certainty of evidence for VNPs aiding smoking cessation, particularly for newer generation pod devices. To our knowledge, this trial is the first to offer choice
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- 2022
6. TATTOOING IN THE COLON – IS THE DESIGN INFLUENCED BY OUTCOME?
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Khoo, C.H., additional, McRobbie, H., additional, and Patel, R., additional
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- 2022
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7. ‘DIRECT ACCESS’ ENDOSCOPY – CAN WE REDUCE OUTPATIENT BURDEN EVEN FURTHER?
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Hutchesson, I., additional, Ainsworth, L., additional, McRobbie, H., additional, and Patel, R., additional
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- 2022
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8. Effect of an electronic nicotine delivery device (e cigarette) on desire to smoke and withdrawal, user preferences and nicotine delivery: randomised cross-over trial
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Bullen, C, McRobbie, H, Thornley, S, Glover, M, Lin, R, and Laugesen, M
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- 2010
9. A Cluster-Randomised Controlled Trial of a Brief Training Session to Facilitate General Practitioner Referral to Smoking Cessation Treatment
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McRobbie, H., Hajek, P., Feder, G., and Eldridge, S.
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- 2008
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10. Smoking Cessation
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Glover, M., primary and McRobbie, H., additional
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- 2008
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11. Pregnant women’s use of e‐cigarettes in the UK: a cross‐sectional survey
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Bowker, K, primary, Lewis, S, additional, Phillips, L, additional, Orton, S, additional, Ussher, M, additional, Naughton, F, additional, Bauld, L, additional, Coleman, T, additional, Sinclair, L, additional, McRobbie, H, additional, Khan, A, additional, and Cooper, S, additional
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- 2020
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12. Cost-effectiveness of e-cigarettes compared with nicotine replacement therapy in stop smoking services in England (TEC study): a randomised controlled trial
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Li, J., Hajek, P., Pesola, F., Wu, Q., Phillips-Waller, A., Przuli, D., Myers Smith, K., Bisal, N., Sasieni, P., Dawkins, L., Ross, L., Goniewicz, M., McRobbie, H., and Parrott, S.
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health care economics and organizations - Abstract
Aim To evaluate the cost-effectiveness of e-cigarettes as a smoking cessation aid used in routine stop smoking service. Design Cost-effectiveness analysis was performed from the National Health Service (NHS) and Personal Social Services (PSS) perspective for 12 months period and lifetime. Costs, including that of both treatments, other smoking cessation help and healthcare services, and health benefits, estimated from EQ-5D-5L and measured in Quality-adjusted Life years (QALYs), for the 12-month analysis came from a randomised controlled trial. Lifetime analysis was model-based with input from both trial data and published secondary data sources. Cost-effectiveness was measured by an incremental cost-effectiveness ratio (ICER). Setting Three English Stop-Smoking Service sites in England Participants Adult smokers who sought help to quit in the participating sites Intervention and comparator An e-cigarette (EC) starter kit versus provision of nicotine replacement therapy (NRT) for up to three months, both with standard behavioural support. A total of 886 participants were randomised (439 in EC arm, 447 in NRT arm). Excluding one death in each arm, the one-year quit rate was 18.0% and 9.9%, respectively. Measurements Cost of treatments was estimated from treatment log. Costs of other smoking cessation help and healthcare services, and EQ-5D-5L were collected at baseline, six- and 12-month follow-ups. Incremental costs and incremental QALYs were estimated using regression adjusting for baseline covariates and their respective baseline values. Findings The ICER was £1,100 per QALY gained at the 12 months after quit date (87% - 90% probability of cost-effective between £20,000/QALY and £30,000/QALY). Markov model estimated the lifetime ICER of EC to be £65 per QALY (around 85% probability of cost-effective between £20,000/QALY and £30,000/QALY). Conclusion Using e-cigarette as a smoking cessation aid with standard behavioural support in an English Stop-Smoking Service is more cost-effective than using nicotine replacement therapy in the same setting.
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- 2019
13. Mobile phone text messaging and app-based interventions for smoking cessation
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Whittaker, R, McRobbie, H, Bullen, C, Rodgers, A, Gu, Y, Dobson, R, Whittaker, R, McRobbie, H, Bullen, C, Rodgers, A, Gu, Y, and Dobson, R
- Abstract
Background Mobile phone-based smoking cessation support (mCessation) offers the opportunity to provide behavioural support to those who cannot or do not want face-to-face support. In addition, mCessation can be automated and therefore provided affordably even in resource-poor settings. This is an update of a Cochrane Review first published in 2006, and previously updated in 2009 and 2012. Objectives To determine whether mobile phone-based smoking cessation interventions increase smoking cessation rates in people who smoke. Search methods For this update, we searched the Cochrane Tobacco Addiction Group's Specialised Register, along with clinicaltrials.gov and the ICTRP. The date of the most recent searches was 29 October 2018. Selection criteria Participants were smokers of any age. Eligible interventions were those testing any type of predominantly mobile phone-based programme (such as text messages (or smartphone app) for smoking cessation. We included randomised controlled trials with smoking cessation outcomes reported at at least six-month follow-up. Data collection and analysis We used standard methodological procedures described in the Cochrane Handbook for Systematic Reviews of Interventions. We performed both study eligibility checks and data extraction in duplicate. We performed meta-analyses of the most stringent measures of abstinence at six months' follow-up or longer, using a Mantel-Haenszel random-effects method, pooling studies with similar interventions and similar comparators to calculate risk ratios (RR) and their corresponding 95% confidence intervals (CI). We conducted analyses including all randomised (with dropouts counted as still smoking) and complete cases only. Main results This review includes 26 studies (33,849 participants). Overall, we judged 13 studies to be at low risk of bias, three at high risk, and the remainder at unclear risk. Settings and recruitment procedures varied across studies, but most studies were conducted in high-inco
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- 2019
14. ES13.04 Comparing ENDS to NRT for Smoking Cessation
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Mcrobbie, H., primary
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- 2019
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15. Pregnant women's use of e‐cigarettes in the UK: a cross‐sectional survey.
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Bowker, K, Lewis, S, Phillips, L, Orton, S, Ussher, M, Naughton, F, Bauld, L, Coleman, T, Sinclair, L, McRobbie, H, Khan, A, and Cooper, S
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ELECTRONIC cigarettes ,PREGNANT women ,SMOKING cessation ,WOMEN'S attitudes ,MEDICAL personnel - Abstract
Objective: To estimate prevalence of vaping in pregnancy. Compare characteristics and attitudes between exclusive smokers and vapers, and between exclusive vapers and dual users (smoke and vape). Design: Cross‐sectional survey. Setting: Hospitals across England and Scotland. Population: Pregnant women attending antenatal clinics in 2017. Methods: Women at 8–24 weeks' gestation completed screening questions about their smoking and vaping. Current or recent ex‐smokers and/or vapers completed a full detailed survey about vaping and smoking. Main outcome measures: The prevalence of vaping, characteristics and attitudes of women who vape and/or smoke. Results: Of 3360 pregnant women who completed screening questions, 515 (15.3%, 95% CI 14.1–16.6) were exclusive smokers, 44 (1.3%, 95% CI 1.0–1.8) exclusive vapers and 118 (3.5%, 95% CI 2.9–4.2) dual users. In total, 867 (25.8%) women completed the full survey; compared with smokers (n = 434), vapers (n = 140) were more likely to hold higher educational qualifications (odds ratio [OR) 1.51, 95% CI 1.01–2.25). Compared with exclusive vapers (n = 33), dual users (n = 107) were younger (OR 0.91 95% CI 0.85–0.98) and less likely to hold high qualifications (OR 0.43, 95% CI 0.20–0.96). Compared with smokers, dual users were more likely to be planning to quit smoking (OR 2.27, 95% CI 1.24–4.18). Compared with smokers, vapers were more likely to think vaping was safer than smoking (78.6% versus 36.4%). Conclusions: One in 20 pregnant women report vaping, and most also smoke. Dual users are more motivated towards stopping smoking than smokers. Where women have tried but cannot stop smoking, clinicians could encourage them to consider vaping for smoking cessation. Tweetable extract: One in 20 women report vaping during pregnancy but of those that do vape, most also smoke, despite having intentions to quit. Tweetable extract: One in 20 women report vaping during pregnancy but, of those that do vape, most also smoke, despite having intentions to quit. [ABSTRACT FROM AUTHOR]
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- 2021
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16. The effectiveness, safety and cost-effectiveness of cytisine versus varenicline for smoking cessation in an Australian population: a study protocol for a randomized controlled non-inferiority trial
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Thomas, T, Farrell, M, McRobbie, H, Tutka, P, Petrie, D, West, R, Siahpush, M, Gartner, C, Walker, N, Mendelsohn, C, Hall, W, Paul, C, Zwar, N, Ferguson, S, Veronica, B, Richmond, R, Doran, C, Shakeshaft, A, Mattick, R, Courtney, R, Thomas, T, Farrell, M, McRobbie, H, Tutka, P, Petrie, D, West, R, Siahpush, M, Gartner, C, Walker, N, Mendelsohn, C, Hall, W, Paul, C, Zwar, N, Ferguson, S, Veronica, B, Richmond, R, Doran, C, Shakeshaft, A, Mattick, R, and Courtney, R
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- 2018
17. The Methodological Quality and Effectiveness of Technology-Based Smoking Cessation Interventions for Disadvantaged Groups: A Systematic Review and Meta-analysis
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Boland, VC, Stockings, EA, Mattick, RP, McRobbie, H, Brown, J, Courtney, RJ, Boland, VC, Stockings, EA, Mattick, RP, McRobbie, H, Brown, J, and Courtney, RJ
- Abstract
Aims: To assess the methodological quality and effectiveness of technology-based smoking cessation interventions in disadvantaged groups. Method: Four databases (EMBASE, Cochrane, Medline, and PsycInfo) were searched for studies conducted from 1980 to May 2016. Randomized controlled trials that compared a behavioral smoking cessation intervention delivered primarily through a technology-based platform (eg, mobile phone) with a no-intervention comparison group among disadvantaged smokers were included. Three reviewers assessed all relevant studies for inclusion, and one reviewer extracted study, participant and intervention-level data, with a subset crosschecked by a second reviewer. Results: Thirteen studies targeting disadvantaged smokers (n =4820) were included. Only one study scored highly in terms of methodological rigor on EPOC criteria for judging risk of bias. Of the 13 studies using a technology-based platform, most utilized websites (n = 5) or computer programs (n = 5), and seven additionally offered nicotine replacement therapy. Technology-based interventions increased the odds of smoking cessation for disadvantaged groups at 1 month (odds ratio [OR] 1.70, 95% confidence interval [CI] 1.10, 2.63), 3 months (OR 1.30, 95% CI 1.07, 1.59), 6 months (OR 1.29, 95% CI 1.03, 1.62), and 18 months post-intervention (OR 1.83, 95% CI 1.11, 3.01). Conclusion: Few methodologically rigorous studies were identified. Mobile phone text-messaging, computer-and website-delivered quit support showed promise at increasing quit rates among Indigenous, psychiatric and inpatient substance use disorder patients. Further research is needed to address the role technology-based interventions have on overcoming health inequalities to meet the needs of disadvantaged groups. Implications: This review provides the first quantitative evidence of the effectiveness of a range of technology-based smoking cessation interventions among disadvantaged smokers, with separate estimates on the basis
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- 2018
18. Body mass index and complications following major gastrointestinal surgery: A prospective, international cohort study and meta-analysis
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Blanco-Colino, R., Lee, S., Kamarajah, S. K., Vasko, P., Kuiper, S. Z., Farina, V., Chapman, S. J., Drake, T. M., Gavagna, L., Pasquali, S., Pata, F., Pellino, G., de la Rosa-Estadella, M., Stellingwerf, M. E., Stijns, R. C. H., Borrellas, A., Golding, D., Ngaage, M., Van Tol, R. R., de Groof, J., de Wilt, H., Bemelman, W. A., Mcnamee, L., Espin-Basany, E., Emre Baki, B., Gecim, I. E., Can Tatar, O., Bach, S., Bhangu, A., Bresges, K., Burke, J., Claireaux, H. A., Fearnhead, N., Fitzgerald, J. E., Gallagher, S., Glasbey, J. C., Gundogan, B., Harrison, E. M., Hernon, J., Khatri, C., Kong, C. Y., Lyons, A., Mohan, M., Morton, D., Pinkney, T. D., Arezzo, A., Foppa, C., Morino, M., Rubbini, M., Selvaggi, F., Sensi, B., Sica, G., Orhalmi, J., Naccari, P., Sgro, A., Burger, B. H. C. M., Fares, D. A., Spijkerman, R., van Elst, T. R., Wiersema, R., Stassen, L. P. S., Rodriguez Garcia, R., Ozkan, B. B., Tavuz, A. I., Demirci, Z. S., Baki, B. E., Choi, P. J., O'Sullivan, H., Salman, M., Simioni, A., Colombo, F., Turati, L., Cazzola, F. E., Gallo, G., Perrotta, G., Papandrea, M., Naccari, P. M., Menduni, N., Rossi, E., Chetta, N., Romeo, F., Giordano, F., Randisi, B., Curletti, G., Kuiper, J., Costa, A., Marcos Rodrigo, A., Sanchez, A., Varo Munoz, A., Martinez Rios, C. E., Aliseda-Jover, D., Fernandez Nieto, D., Alvarez Reyes, I., Dominguez Rodriguez, L. M., Hernandez Ros, M. I., Esteban Sinovas, O., Bartrina Soler, P., Villarejo Campos, P., Laguna Roman, S., Fontanet-Soler, S., Raurich-Leandro, J., Dominguez-Prieto, V., Segura-Sampedro, J. J., Alconchel-Gago, F., Salazar-Garcia, C., Gezen, A. E., Sahin, A., Atasoy, H., Yuksek, B., Arslan, E., Ozmen, B. B., Sen, A. Y., Erol, H. I., Ucar, E., Aktas, M. K., Yurdaor, S. S., Mermer, S., Seyhan, U., Tosun, V., Gunaydin, Y., Ekinci, Z. B., Yazkan, Z., Choi, J., Yeoh, T. S. L., Jones, C. S., Venturini, S., Saat, M. I., Loo, J., Pike, G., Davies, S. C., Kabariti, R., Olivier, J., Hurny, M., Zebrak, R., Machacova, A., Schulzova, M., Smolak, P., Siroka, M., Palyzova, H., Jaros, J., Dusek, T., Simackova, B., Bartos, M., Sotona, O., Pos, M., Karasek, D., Higgins, P., Hacking, S., Arora, E., Coughlan, G., Palanivail, N., Quill, S., Zhang, A. A., Malak, M., Maan, D. S., Cheema, J., Goh, A. W. J., Shamsul Badrin, A. K., Guinness, F., Howard James, N., Neary, A., Sebaoui, S., Gilroy, D., Petrov, G., Craven, K., Macdonald, A., Redmond, A., Brennan, D., Roche, D., O'Dwyer, M., Collins, P., Edwards, S., Doyle, J., Tiedt, L., Arthurs, B., O'Byrne, L., Kiely, A., Glynn, M., Sproule, L., Heaney, A., Li Hi Shing, S., Goh, W., Al-Nasser, Z., Al-Nasser, A., Teh, J. W., De Boni, D., Goldin, E., Ciccioli, E., Vendramin, E., Marchese, N., Bruno, M., Vinci, A., Harder, G., Morandi, V., Magnoli, M., Suppa, A., Palmieri, A., Martorana, M., Sette, M., Balagna, P., Cruciani, C., Corte, M., Ciano, P., Bagaglini, G., Montuori, M., Di Benedetto, L., Arcudi, C., Pezzuto, R., Saraceno, F., Milana, F., Franceschilli, M., Rizzi, A., Sampietro, G., Rampulla, V., Bianco, F., Boschetti, M. E., Ghignone, F., Bianchini, S., Esposto, R., Riva, L., Riva, M., Cannavo, M., Arrigo, A., Giavarini, L., Colombo, E. M., Trompetto, M., Clerico, G., Catalano, M., Dosa, T., El Mabruk, M., Barone, V., Pallara, E., Pasqualoni, M., Caudullo, G., Mastandrea Bonaviri, G. N., Muro, M., Pistola, I., Verardi, L., Ferrara, D., Gerardi, S., Remore, L. M., Belia, F., Del Coco, F., Larotonda, C., Botrugno, E. M., Cammarota, A., Di Girolami, L., Laterza, V., Laurino, A., Paolo, G., Santocchi, P., Puccioni, C., Truma, A., Giardino, F. R., Giuffrida, A., Ripa, M., Cautiero, R., Patturelli, M., Capozzolo, A., Selvaggi, L., Facchiano, A., Milazzo, L. F., Papazachariou, S. K., Pattapola, V., Anania, G., Feo, C., Bellinato, M., Priani, P., Zigiotto, D., Troia, A., Vable, T., Piran, G., Targa, S., Pulpito, S., Tagariello, F., Fasano, A., Anconelli, D., Castiglione, F., Tognolo, L., Lopez, G., Campion, A., Tarantino, M., Sacco, R., Sammarco, G., Palmisano, S., Giacca, M., Rocco, I., Bellio, G., Favero, A., Raimondi, P., Pantalone, M. R., De Nardi, P., Notarnicola, M., Picciariello, A., Licari, L., Parinisi, Z., Fazzotta, S., Ciciliot, M., Reggiani, L., Mariani, F., Aonzo, P., Checcacci, P., Montanelli, P., Guerra, F., Skalamera, I., Staderini, F., Grandi, S., Nelli, T., de Boer, D. V., van der Pool, A. E. M., Janssen, T. L., El-Atmani, S., van Verschuer, V. M. T., Poelman, M., Dronkers, W. J., van Steensel, L., Toorenvliet, B. R., Duinhouwer, L. E., Vermaas, M., Ter Bruggen, F. F. J. A., Hogendoorn, W., van der Harst, E., van Rijckevorsel, V. A. J. I. M., Bayoumy, A. B., Lap, C. R., Gooszen, J. A. H., Abdulrahman, N., de Roy van Zuidewijn, D., de Groof, E. J., Zijlmans, J. L., van Dalen, A. S. H. M., Bos, K., Musters, G. D., Looijen, R. C., Fliers, J. M., Oostendorp, S. E., Mosterd, C. M., Blonk, L., Jurgens, J., Ribbink, M. E., Boom, M. S., Boersma, A. M., Hidding, E., Schmidt, P. A., Mensink, G., Graus, S. A., Gastel, M. D. A., Veenker, C. G. H., Van Heumen, T. M., Slieker, F. J. B., Sedee, W. J. A., Lowensteyn, Y. N., Amelung, F. J., de Guerre, L. E. V. M., Nota, C. L. M. A., Van Dijck, W. P. M., van Wijnbergen, J. W. M., Pronk, A., Kip, M., van der Zee, C., Heiloo, S., Muller, S., Verboeket, B., Oudman, T. S., Zope, S., Gilissen, V., Gommers, J., Cremers, D., Van der Lubbe, M., Smet, M., Ter Weele, K., de Bruin, M., Geerlings, M., Ter Horst, L., Kerimova, N., Pesser, N., Heesakkers, H., de Mees, T., de Gooyer, J. M., Willems, L., Gawria, L., Bonouvrie, D., Harms, J., Eggen, Y., Hengeveld, E., Smeets, H. J., Hoffman, R. P. C., Detmers Blom, F. P. N., Van Bruggen, D., Steup, W. H., Gooiker, G. A., Willems, Y. R., van der Hoeven, A. C., Vallve-Bernal, M., Perez-Gandara, B., Perez, J. L., Caballero Rodriguez, E., Perez Febles, M., Protti Ruiz, G. P., Hidalgo Pujol, M., Alberti Delgado, P., Gil Barrionuevo, E., Anabitarte, O., Caballero, L., Poyato Nunez, F. J., Prado Perez, R., de la Portilla de Juan, F., Fulgencio Barbarin, J., Elorza Echaniz, G., Mitxelena Elosegi, L., Delgado, A. T., Marti Gelonch, L., Gonzalez Arribas, M., De Serra Tejada, I., Alberdi San Roman, I., de Andres Olabarria, U., Fernandez-Domper, L., Perez Costoya, C., Perez Arias, H., Fa Binefa, M., Becerra Nieves, M., Escalona Canal, M. G., Aldrey, I., Vazquez-Gonzalez, I., Falcon Cazas, A., Amarelo Garcia, M., Gonzalez Ruiz, A. A., Garcia Garrido, M., Simon Frapolli, V., Martinez Diaz, J. M., De la Torre Conde, C., Rodrigues Silva, K., Hernandez Kakauridze, S., Lopez Garcia, M. C., Flores Funes, D., Gomez-Lopez de San Roman, C., San Martin Bragado, M., Tejero Pintor, F. J., Pando Ruiz, B., Sanchez Estebanez, E., Roquet Puignero, E., Pla Sero, S., Vela Polanco, F. F., Mirallas Vinas, O., Caro Gonzalez, M. P., Bertelli Puche, J. L., Gonzalez-Martinez, A., Sanchez Cambronero, M., Garcia Torres, A., Dominguez Jimenez, M., de Jesus Rodriguez Perdomo, M., Echazarreta-Gallego, E., Sanchez-Blasco, L., Del Mar Lopez-Cuevas, M., Latras-Cortes, I., Lopez-Vendrell, L., Diaz Padillo, A., Mestres Petit, N., Cruz Reyes, J. A., Fernandez, C., Posada, M., Moratilla Lapena, L., Martin Morales, E., Mate-Mate, P., Garcia Cruz, G., Gorini, L., Rubio-Perez, I., Soldevila-Verdeguer, C., Jimenez-Vinas, C., Luehrman, A., Sena-Ruiz, F., Garcia-Perez, J. M., Plomer-Sanchez, M., Pujol-Cano, N., Jimenez-Segovia, M., Diaz-Jover, P., Pineno-Flores, C., Ambrona-Zafra, D., Gonzalez-Argente, X. F., Jimenez-Morillas, P., Lopez-Marmol, R., Duran-Martinez, M., Gonzalez-Crespo, A., Checa Guillen, M., Valderrama Perez, A., Claramonte Bellmunt, O., Marti Fernandez, R. M., Kasap, S., Soylemez, Z. O. B. B., Bolat, A. B., Aydar, S. E. Y. I., Birgin, B. Z., Coskun, O., Cakir, S. G., Belibagli, Z. O., Herken, M., Erdem, S., Kayacan, S., Kelesoglu, Y., Moran, D., Atalay, H., Kucukdiler, E., Demirci, A., Buyukkasap, C., Kuzey, A., Emral, C., Dogan, H., Cok, H., Durmaz, H., Asma, A., Ergul, B., Kaya, A., Bilicen, G., Gunay, M., Senturk, E., Baskoy, L., Besisik, H. M., Topalan, K., Piraliyev, E., Danalioglu, A. N., Ilbak, A., Yigman, S., Kara, C., Guzel, M., Inci, E. T., Onsal, U., Erel, T., Cetin, S. K., Yekenkurul, E., Kasar, P., Saglam, Z. A., Gursoy, F., Cetinkaya, M., Aktekin, H., Bober, D. N., Mugurtay, Y. S., Koksal, G., Celik, S., Bektur, G., Yildirim, R., Ankarali, T., Guven, H., Yuksel, A., Semiz, A., Cise, S., Tomas, K., Ulusahin, M., Akbulut, F., Tulum, H., Bodur, S., Isler, V. C., Pektas, A. M., Mutlu, D., Mericliler, M., Tansoker, I., Polat, Z. P., Seyrek, N., Beyatli, S., Toto, O. F., Cakaloglu, H. C., Sapci, I., Akpunarli, B., Adiyaman, C., Kobal, B. B., Gok, Z., Benli, S., Turpan, M., Kocapinar, S., Parimli, H., Acar, S., Eger, M., Yilmaz, I., Cengiz, U., Yoruk, I., Mutlu, B., Ulkucu, A., Arukan, C., Kara, B., Gokce, K., Calisgan, B., Demirci, K., Elkatroushi, T., Ayaz, B., Uzun, B., Sivrikaya, T., Goksoy, B., Eroz, E., Celik, B., Canbay Torun, B., Ekin, B., Senay, B. B., Temiz, C., Yilmaz, M., Yasar, C., Cakir, E., Subasi, A., Celik, K., Aksoy, K., Karabulut, E., Altintas, O., Bali, A. N., Ciftci, E., Babaoglu, H., Aljbour, A., Aljbour, I., Akcaoglu, T., Kakil, E., Taskin, O., Taskin, R. B., Topal, U., Huzmeli, E., Caliskan, T., Unal, A. G., Yurekli, A. M., Sari, V., Tutam, D. N., Celen, D., Posteki, G., Demirtas, B., Yildiz, S., Kilic, E., Yalcin, Y., Kurt, A., Gozubuyuk, Y., Huseynova, S., Cinar, S., Calar, S. N., Kurklu, O., Binbuga, M., Ceylan, C., Yavuz, G., Alim, Y. E., Yildirim, N., Yilmaz, S., Onar, D., Aray, E., Ozsipahi, A. C., Koc, G. E., Yetiskin, E., Kocer, M. D., Ozgencil, B., Bahcecioglu, B., Hacioglu, A. D., Bilici, O., Cin, S., Uzunoglu, E. C., Cumen, E. C., Aslan, L., Erozgur, B., Yildiz, S. S., Zengin, T., Kullac, S., Mizan, S. R., Baykan, B., Kopac, O., Karabacak, U., Aytekin, A., Deliktas, T. S., Buyukkarabacak, Y., Uzun, O., Karahan, B., Turkmen, M., Akdogan, A., Uctepe, F., Bandirmali, O., Erdogan, P., Demir, F., Bozkurt, G. K., Yilmaz, T., Sheikh, I. M. I., Orhan, K., Balci, B., Keyif, M. F., Bilgin, S., Cantimer, E., Yaman, S., Akkaya, E., Atesavci, S. N., Arslan, U., Asik, M., Koksal, S., Murtaza, M. I., Mustafa, S., Oun, H., Sam, Z. H., Brogan, A., Zaidi, R., Quinn, K., Taylor, F., Pang, G., Heath, H., Smart, N. J., Home, J., Mauro, D., Noone, T. M., Fenn, J., Sinha, A., Lowe, R., Hutchings, I., Longstaff, L., Smith, A. G., Edwards, J. A., Alcocer, B. P., Oakley, T., Thomas-Davies, M., Hourston, G. J. M., Kankam, H. K. N., Ramana, A., Baker, C., Endo, Y., Wong, C., Anderson, R. G. J., Badran, A., Ali, A., Myers, L., Tippins, F., Stanley, S., Sandison, L., Schofield, E., Delf, J., Rees, S., Anyan-Brown, J., Long, K., Archer, M., Anakwenze, V., Goel, S., Sharma Khatiwada, A., Khan, S., Leafe, O., Lee, J., Embury-Young, Y., Edwards, L., Hazenberg, P., Agrawal, M., Guerero, D., Britton, F., Rejayee, M., Mahesh, S., Khaing, P. H., Baldwin, A., Iyer, S., Gaskell, P., Adlan, A., Cuckow, L., Barmayehvar, B., Rob, T., Ciurleo, C., Mural-Krishnan, S., Jong, N., Carlson, S., Abdelgalil, R., Goble, M., Doshi, A., Ogunleye, O., Marsh, L., Bagley, J., Poacher, A., Cantelo, J., Wylie, J., Govil, S., Hill, F., Beaver, D., Urquhart, A., Rakhimov, I., Raina, V., Clifford, T., Iorga, R., Cartwright, E., Harris, A. J., Shurovi, B., Wadanamby, S., Brown, E., Bradley, C., Ahmad, A., Jeyabraba, S., Hardaman, B., Truss, A., Mohamed, U. S., Kerin, M. 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C., Kabariti, R., Olivier, J., Hurny, M., Zebrak, R., Machacova, A., Schulzova, M., Smolak, P., Siroka, M., Palyzova, H., Jaros, J., Dusek, T., Simackova, B., Bartos, M., Sotona, O., Pos, M., Karasek, D., Higgins, P., Hacking, S., Arora, E., Coughlan, G., Palanivail, N., Quill, S., Zhang, A. A., Malak, M., Maan, D. S., Cheema, J., Goh, A. W. J., Shamsul Badrin, A. K., Guinness, F., Howard James, N., Neary, A., Sebaoui, S., Gilroy, D., Petrov, G., Craven, K., Macdonald, A., Redmond, A., Brennan, D., Roche, D., O'Dwyer, M., Collins, P., Edwards, S., Doyle, J., Tiedt, L., Arthurs, B., O'Byrne, L., Kiely, A., Glynn, M., Sproule, L., Heaney, A., Li Hi Shing, S., Goh, W., Al-Nasser, Z., Al-Nasser, A., Teh, J. W., De Boni, D., Goldin, E., Ciccioli, E., Vendramin, E., Marchese, N., Bruno, M., Vinci, A., Harder, G., Morandi, V., Magnoli, M., Suppa, A., Palmieri, A., Martorana, M., Sette, M., Balagna, P., Cruciani, C., Corte, M., Ciano, P., Bagaglini, G., Montuori, M., Di Benedetto, L., Arcudi, C., Pezzuto, R., Saraceno, F., Milana, F., Franceschilli, M., Rizzi, A., Sampietro, G., Rampulla, V., Bianco, F., Boschetti, M. E., Ghignone, F., Bianchini, S., Esposto, R., Riva, L., Riva, M., Cannavo, M., Arrigo, A., Giavarini, L., Colombo, E. M., Trompetto, M., Clerico, G., Catalano, M., Dosa, T., El Mabruk, M., Barone, V., Pallara, E., Pasqualoni, M., Caudullo, G., Mastandrea Bonaviri, G. N., Muro, M., Pistola, I., Verardi, L., Ferrara, D., Gerardi, S., Remore, L. M., Belia, F., Del Coco, F., Larotonda, C., Botrugno, E. M., Cammarota, A., Di Girolami, L., Laterza, V., Laurino, A., Paolo, G., Santocchi, P., Puccioni, C., Truma, A., Giardino, F. 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A., Hogendoorn, W., van der Harst, E., van Rijckevorsel, V. A. J. I. M., Bayoumy, A. B., Lap, C. R., Gooszen, J. A. H., Abdulrahman, N., de Roy van Zuidewijn, D., de Groof, E. J., Zijlmans, J. L., van Dalen, A. S. H. M., Bos, K., Musters, G. D., Looijen, R. C., Fliers, J. M., Oostendorp, S. E., Mosterd, C. M., Blonk, L., Jurgens, J., Ribbink, M. E., Boom, M. S., Boersma, A. M., Hidding, E., Schmidt, P. A., Mensink, G., Graus, S. A., Gastel, M. D. A., Veenker, C. G. H., Van Heumen, T. M., Slieker, F. J. B., Sedee, W. J. A., Lowensteyn, Y. N., Amelung, F. J., de Guerre, L. E. V. M., Nota, C. L. M. A., Van Dijck, W. P. M., van Wijnbergen, J. W. M., Pronk, A., Kip, M., van der Zee, C., Heiloo, S., Muller, S., Verboeket, B., Oudman, T. S., Zope, S., Gilissen, V., Gommers, J., Cremers, D., Van der Lubbe, M., Smet, M., Ter Weele, K., de Bruin, M., Geerlings, M., Ter Horst, L., Kerimova, N., Pesser, N., Heesakkers, H., de Mees, T., de Gooyer, J. M., Willems, L., Gawria, L., Bonouvrie, D., Harms, J., Eggen, Y., Hengeveld, E., Smeets, H. J., Hoffman, R. P. C., Detmers Blom, F. P. N., Van Bruggen, D., Steup, W. H., Gooiker, G. A., Willems, Y. R., van der Hoeven, A. C., Vallve-Bernal, M., Perez-Gandara, B., Perez, J. L., Caballero Rodriguez, E., Perez Febles, M., Protti Ruiz, G. P., Hidalgo Pujol, M., Alberti Delgado, P., Gil Barrionuevo, E., Anabitarte, O., Caballero, L., Poyato Nunez, F. J., Prado Perez, R., de la Portilla de Juan, F., Fulgencio Barbarin, J., Elorza Echaniz, G., Mitxelena Elosegi, L., Delgado, A. T., Marti Gelonch, L., Gonzalez Arribas, M., De Serra Tejada, I., Alberdi San Roman, I., de Andres Olabarria, U., Fernandez-Domper, L., Perez Costoya, C., Perez Arias, H., Fa Binefa, M., Becerra Nieves, M., Escalona Canal, M. G., Aldrey, I., Vazquez-Gonzalez, I., Falcon Cazas, A., Amarelo Garcia, M., Gonzalez Ruiz, A. A., Garcia Garrido, M., Simon Frapolli, V., Martinez Diaz, J. M., De la Torre Conde, C., Rodrigues Silva, K., Hernandez Kakauridze, S., Lopez Garcia, M. C., Flores Funes, D., Gomez-Lopez de San Roman, C., San Martin Bragado, M., Tejero Pintor, F. J., Pando Ruiz, B., Sanchez Estebanez, E., Roquet Puignero, E., Pla Sero, S., Vela Polanco, F. F., Mirallas Vinas, O., Caro Gonzalez, M. P., Bertelli Puche, J. L., Gonzalez-Martinez, A., Sanchez Cambronero, M., Garcia Torres, A., Dominguez Jimenez, M., de Jesus Rodriguez Perdomo, M., Echazarreta-Gallego, E., Sanchez-Blasco, L., Del Mar Lopez-Cuevas, M., Latras-Cortes, I., Lopez-Vendrell, L., Diaz Padillo, A., Mestres Petit, N., Cruz Reyes, J. A., Fernandez, C., Posada, M., Moratilla Lapena, L., Martin Morales, E., Mate-Mate, P., Garcia Cruz, G., Gorini, L., Rubio-Perez, I., Soldevila-Verdeguer, C., Jimenez-Vinas, C., Luehrman, A., Sena-Ruiz, F., Garcia-Perez, J. M., Plomer-Sanchez, M., Pujol-Cano, N., Jimenez-Segovia, M., Diaz-Jover, P., Pineno-Flores, C., Ambrona-Zafra, D., Gonzalez-Argente, X. F., Jimenez-Morillas, P., Lopez-Marmol, R., Duran-Martinez, M., Gonzalez-Crespo, A., Checa Guillen, M., Valderrama Perez, A., Claramonte Bellmunt, O., Marti Fernandez, R. M., Kasap, S., Soylemez, Z. O. B. B., Bolat, A. B., Aydar, S. E. Y. I., Birgin, B. Z., Coskun, O., Cakir, S. G., Belibagli, Z. O., Herken, M., Erdem, S., Kayacan, S., Kelesoglu, Y., Moran, D., Atalay, H., Kucukdiler, E., Demirci, A., Buyukkasap, C., Kuzey, A., Emral, C., Dogan, H., Cok, H., Durmaz, H., Asma, A., Ergul, B., Kaya, A., Bilicen, G., Gunay, M., Senturk, E., Baskoy, L., Besisik, H. M., Topalan, K., Piraliyev, E., Danalioglu, A. N., Ilbak, A., Yigman, S., Kara, C., Guzel, M., Inci, E. T., Onsal, U., Erel, T., Cetin, S. K., Yekenkurul, E., Kasar, P., Saglam, Z. A., Gursoy, F., Cetinkaya, M., Aktekin, H., Bober, D. N., Mugurtay, Y. S., Koksal, G., Celik, S., Bektur, G., Yildirim, R., Ankarali, T., Guven, H., Yuksel, A., Semiz, A., Cise, S., Tomas, K., Ulusahin, M., Akbulut, F., Tulum, H., Bodur, S., Isler, V. C., Pektas, A. M., Mutlu, D., Mericliler, M., Tansoker, I., Polat, Z. P., Seyrek, N., Beyatli, S., Toto, O. F., Cakaloglu, H. C., Sapci, I., Akpunarli, B., Adiyaman, C., Kobal, B. B., Gok, Z., Benli, S., Turpan, M., Kocapinar, S., Parimli, H., Acar, S., Eger, M., Yilmaz, I., Cengiz, U., Yoruk, I., Mutlu, B., Ulkucu, A., Arukan, C., Kara, B., Gokce, K., Calisgan, B., Demirci, K., Elkatroushi, T., Ayaz, B., Uzun, B., Sivrikaya, T., Goksoy, B., Eroz, E., Celik, B., Canbay Torun, B., Ekin, B., Senay, B. B., Temiz, C., Yilmaz, M., Yasar, C., Cakir, E., Subasi, A., Celik, K., Aksoy, K., Karabulut, E., Altintas, O., Bali, A. N., Ciftci, E., Babaoglu, H., Aljbour, A., Aljbour, I., Akcaoglu, T., Kakil, E., Taskin, O., Taskin, R. B., Topal, U., Huzmeli, E., Caliskan, T., Unal, A. G., Yurekli, A. M., Sari, V., Tutam, D. N., Celen, D., Posteki, G., Demirtas, B., Yildiz, S., Kilic, E., Yalcin, Y., Kurt, A., Gozubuyuk, Y., Huseynova, S., Cinar, S., Calar, S. N., Kurklu, O., Binbuga, M., Ceylan, C., Yavuz, G., Alim, Y. E., Yildirim, N., Yilmaz, S., Onar, D., Aray, E., Ozsipahi, A. C., Koc, G. E., Yetiskin, E., Kocer, M. D., Ozgencil, B., Bahcecioglu, B., Hacioglu, A. D., Bilici, O., Cin, S., Uzunoglu, E. C., Cumen, E. C., Aslan, L., Erozgur, B., Yildiz, S. S., Zengin, T., Kullac, S., Mizan, S. R., Baykan, B., Kopac, O., Karabacak, U., Aytekin, A., Deliktas, T. S., Buyukkarabacak, Y., Uzun, O., Karahan, B., Turkmen, M., Akdogan, A., Uctepe, F., Bandirmali, O., Erdogan, P., Demir, F., Bozkurt, G. K., Yilmaz, T., Sheikh, I. M. I., Orhan, K., Balci, B., Keyif, M. F., Bilgin, S., Cantimer, E., Yaman, S., Akkaya, E., Atesavci, S. N., Arslan, U., Asik, M., Koksal, S., Murtaza, M. I., Mustafa, S., Oun, H., Sam, Z. H., Brogan, A., Zaidi, R., Quinn, K., Taylor, F., Pang, G., Heath, H., Smart, N. J., Home, J., Mauro, D., Noone, T. M., Fenn, J., Sinha, A., Lowe, R., Hutchings, I., Longstaff, L., Smith, A. G., Edwards, J. A., Alcocer, B. P., Oakley, T., Thomas-Davies, M., Hourston, G. J. M., Kankam, H. K. N., Ramana, A., Baker, C., Endo, Y., Wong, C., Anderson, R. G. J., Badran, A., Ali, A., Myers, L., Tippins, F., Stanley, S., Sandison, L., Schofield, E., Delf, J., Rees, S., Anyan-Brown, J., Long, K., Archer, M., Anakwenze, V., Goel, S., Sharma Khatiwada, A., Khan, S., Leafe, O., Lee, J., Embury-Young, Y., Edwards, L., Hazenberg, P., Agrawal, M., Guerero, D., Britton, F., Rejayee, M., Mahesh, S., Khaing, P. H., Baldwin, A., Iyer, S., Gaskell, P., Adlan, A., Cuckow, L., Barmayehvar, B., Rob, T., Ciurleo, C., Mural-Krishnan, S., Jong, N., Carlson, S., Abdelgalil, R., Goble, M., Doshi, A., Ogunleye, O., Marsh, L., Bagley, J., Poacher, A., Cantelo, J., Wylie, J., Govil, S., Hill, F., Beaver, D., Urquhart, A., Rakhimov, I., Raina, V., Clifford, T., Iorga, R., Cartwright, E., Harris, A. J., Shurovi, B., Wadanamby, S., Brown, E., Bradley, C., Ahmad, A., Jeyabraba, S., Hardaman, B., Truss, A., Mohamed, U. S., Kerin, M. J., Reynolds, J., Ridgway, P., Pietrabissa, A., Foschi, D., Sgroi, G., Rosati, G., Benevento, A., Coco, Claudio, Persiani, R., Vasquez, G., Messina, F., De Manzini, N., Innocenti, P., Rosati, R., Altomare, D. F., Sartori, A., Salamone, G., Galleano, R., Cianchi, F., Wijnhoven, B. P. L., van de Ven, A. W. H., de Vos Tot Nederveen Cappel, R. J., de Castro, S. M. M., Meijerink, W. J. H. J., Mulder, I. M., Acherman, Y. I. Z., van Leeuwen, B. L., Schasfoort, R. A., Kloppenberg, F. W. H., Wiezer, R., Consten, E. C. J., Van Grevenstein, W. M. U., Schiphorst, A., Wijffels, N., Uittenbogaart, M., Klinkert, M., Koppe, M., de Hingh, I., Konsten, J., Polat, F., Berends, F., Langenhoff, B., Zimmerman, D., van Engelenburg, T., Vries, J. J. M., Baeten, C. I. M., Bastiaansen, A. J. N. M., van Geloven, A., Khan, I., Girones, J., Barrera Gomez, M., Sanz Ortega, G., Duran Munoz-Cruzado, V. M., Ruiz Montesinos, I., Enriquez-Navascues, J. M., Portugal Porras, V., Baixauli, J., Garcia Florez, L. 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B., Beecroft, S., Sarvanandan, T., Weston, C., Bassam, N., Rabinthiran, S., Hayat, U., Ng, L., Varma, D., Sukkari, M., Mian, A., Omar, A., Kim, J. W., Sellathurai, J., Mahmood, J., O'Connell, C., Bose, R., Heneghan, H., Lalor, P., Matheson, J., Doherty, C., Cullen, C., Cooper, D., Angelov, S., Drislane, C., Smith, A. C. D., Kreibich, A., Palkhi, E., Durr, A., Lotfallah, A., Gold, D., Mckean, E., Dhanji, A., Anilkumar, A., Thacoor, A., Siddiqui, Z. H., Lim, S., Piquet, A., Anderson, S. M., Mccormack, D. R., Gulati, J., Ibrahim, A., Murray, S. E., Walsh, S. L., Mcgrath, A., Ziprin, P., Chua, E. Y., Lou, C. N., Bloomer, J., Paine, H. R., Osei-Kuffour, D., White, C. J., Szczap, A., Gokani, S., Patel, K., Malys, M. K., Reed, A., Torlot, G. E., Cumber, E. M., Charania, A., Ahmad, S., Varma, N., Cheema, H., Austreng, L., Petra, H., Chaudhary, M., Zegeye, M. I., Cheung, F., Coffey, D., Heer, R. S., Singh, S., Seager, E., Cumming, S., Suresh, R. S., Verma, S., Ptacek, I. B., Gwozdz, A. M., Yang, T., Khetarpal, A. A., Shumon, S., Fung, T. M. P., Leung, W., Kwang, P., Chew, L., Loke, W., Curran, A., Chan, C., Mcgarrigle, C., Mohan, K., Cullen, S., Wong, E., Toale, C., Collins, D., Keane, N., Traynor, B. P., Shanahan, D., Yan, A., Jafree, D. J., Topham, C., Mitrasinovic, S., Omara, S., Bingham, G., Lykoudis, P. M., Miranda, B. H., Whitehurst, K., Kumaran, G., Devabalan, Y., Aziz, H., Shoa, M., Dindyal, S., Yates, J. A., Bernstein, I., Rattan, G., Coulson, R., Stezaker, S., Isaac, A., Salem, M., Mcbride, A., Mcfarlane, H., Yow, L., Macdonald, J., Bartlett, R. D., Turaga, S., White, U., Liew, W., Yim, N., Ang, A., Simpson, A., Mcauley, D., Craig, E., Murphy, L., Shepherd, P., Kee, J. Y., Abdulmajid, A., Chung, A., Warwick, H. L., Livesey, A., Holton, P., Theodoreson, M. D., Jenkin, S. L., Turner, J., Entwisle, J. H., Marchal, S. T., O'Connor, S., Blege, H. K., Aithie, J. M., Sabine, L. M., Stewart, G. E., Jackson, S., Kishore, A., Lankage, C. M., Acquaah, F., Joyce, H. 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A., Hoban, K. A., Nesargikar, P. N., Kennedy, H. R., Grossart, C. M., Tan, E. S. M., Roy, C. S. D., Sim, P., Leslie, K. E., Sim, D., Abul, M. H., Cody, N., Tay, A. Y., Woon, E., Sng, S., Mah, J., Robson, J., Shakweh, E., Wing, V. C., Mills, H., Li, M. M., Barrow, T. R., Balaji, S., Jordan, H. E. M., Phillips, C., Naveed, H., Hirani, S., Tai, A., Ratnakumaran, R., Sahathevan, A., Shafi, A. M. A., Seedat, M., Weaver, R., Batho, A., Punj, R., Selvachandran, H., Bhatt, N., Botchey, S., Khonat, Z., Brennan, K., Morrison, C. J., Devlin, E., Linton, A., Galloway, E., Mcgarvie, S., Ramsay, N., Mcrobbie, H. D., Whewell, H., Dean, W., Nelaj, S., Eragat, M., Mishra, A., Kane, T., Zuhair, M., Wells, M., Wilkinson, D., Woodcock, N., Sun, E., Aziz, N., Abd Ghaffar, M. K., Bath, M. F., Nepogodiev, D., and Coco C. (ORCID:0000-0002-4713-7093)
- Abstract
Aim Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a metaanalysis of all available prospective data. Methods This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien–Dindo Grades III–V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results. Results This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery formalignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49–2.96, P < 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46–0.75, P < 0.001) compared to normal weight patients. Conclusions In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease.
- Published
- 2018
19. 'I'm not strong enough; I'm not good enough. i can't do this, I'm failing'- A qualitative study of low-socioeconomic status smokers' experiences with accesssing cessation support and the role for alternative technology-based support
- Author
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Boland, VC, Mattick, RP, McRobbie, H, Siahpush, M, Courtney, RJ, Boland, VC, Mattick, RP, McRobbie, H, Siahpush, M, and Courtney, RJ
- Abstract
© 2017 The Author(s). Background: The social gradient in smoking rates persist with an overrepresentation of smoking and its associated harms concentrated within lower socioeconomic status (SES) populations. Low-SES smokers are motivated to quit but face multiple barriers when engaging a quit attempt. An understanding of the current treatment service model from the perspectives of treatment-seeking low-SES smokers is needed to inform the design of alternative smoking cessation support services tailored to the needs of low-SES populations. This qualitative study aimed to: i) explore low-SES smokers' recent quitting experiences; ii) assess factors that impact treatment engagement; and iii) determine the acceptability and feasibility of alternative approaches to smoking cessation. Method: Low-SES participants (n = 24) previously enrolled in a smoking cessation RCT participated in either a semi-structured focus group or in-depth telephone interview. Data was obtained and analysed using thematic analysis from October 2015 to June 2016. Analysis was deductive from the interview guide and supplemented inductively. Results: Participants expressed feelings of guilt and shame around their smoking behaviour and experienced stigmatisation for their smoking. Guilt, shame, and stigmatisation negatively impacted treatment seeking behaviours with most avoiding current quit services. Costs of pharmacotherapy and treatment adherence were commonly cited barriers to treatment success. Electronic-cigarettes were perceived to be unsafe due to uncertainty on their legal status and regulatory restrictions. Technology-based text-messaging quit support was endorsed as a more favourable alternative compared to existing behavioural treatment services. Conclusion: Stigmatisation was commonly endorsed and acted as an impediment to current treatment utilisation. Electronic-cigarettes may present a viable harm reduction alternative, but their likely uptake in socioeconomically disadvantaged groups
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- 2017
20. Helping pregnant smokers quit: a multi-centre randomised controlled trial of electronic cigarettes versus nicotine replacement therapy
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Przulj Dunja, Pesola Francesca, Myers Smith Katie, McRobbie Hayden, Coleman Tim, Lewis Sarah, Griffith Christopher, Walton Robert, Whitemore Rachel, Clark Miranda, Ussher Michael, Sinclair Lesley, Seager Emily, Cooper Sue, Bauld Linda, Naughton Felix, Sasieni Peter, Manyonda Isaac, and Hajek Peter
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e-cigarettes ,smoking ,smoking cessation ,pregnancy ,nicotine replacement treatment ,vaping ,randomised controlled trial ,Medical technology ,R855-855.5 - Abstract
Background Some pregnant smokers try e-cigarettes, but effectiveness and safety of such use are unknown. Objectives To compare effectiveness and safety of nicotine patches and e-cigarettes in pregnancy. Design A pragmatic multi-centre randomised controlled trial. Setting Twenty-three hospitals across England, and a Stop Smoking Service in Scotland. Participants One thousand one hundred and forty pregnant daily smokers (12–24 weeks’ gestation) motivated to stop smoking, with no strong preference for using nicotine patches or e-cigarettes. Interventions Participants in the e-cigarette arm were posted a refillable e-cigarette device with two 10 ml bottles of tobacco-flavoured e-liquid (18 mg nicotine). Participants in the nicotine patches arm were posted a 2-week supply of 15 mg/16-hour nicotine patches. Supplies were provided for up to 8 weeks. Participants sourced further supplies themselves as needed. Participants in both arms received support calls prior to their target quit date, on the quit date, and weekly for the next 4 weeks. Outcome measures The primary outcome was validated prolonged abstinence at the end of pregnancy. Participants lost to follow-up or not providing biochemical validation were included as non-abstainers. Secondary outcomes included self-reported abstinence at different time points, treatment adherence and safety outcomes. Results Only 55% of self-reported abstainers mailed back useable saliva samples. Due to this, validated sustained abstinence rates were low (6.8% vs. 4.4% in the e-cigarettes and nicotine patches arms, respectively, risk ratio = 1.55, 95% confidence interval 0.95 to 2.53; Bayes factor = 2.7). In a pre-specified sensitivity analysis that excluded abstainers using non-allocated products, the difference became significant (6.8% vs. 3.6%, risk ratio = 1.93, 95% confidence interval 1.14 to 3.26; Bayes factor = 10). Almost a third of the sample did not set a target quit date and the uptake of support calls was low, as was the initial product use. At end of pregnancy, 33.8% versus 5.6% of participants were using their allocated product in the e-cigarettes versus nicotine patches arm (risk ratio = 6.01, 95% confidence interval 4.21 to 8.58). Regular use of e-cigarettes in the nicotine patches arm was more common than use of nicotine replacement products in the e-cigarette arm (17.8% vs. 2.8%). Rates of adverse events and adverse birth outcomes were similar in the two study arms, apart from participants in the e-cigarette arm having fewer infants with low birthweight (
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- 2023
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21. Electronic cigarettes: review of use, content, safety, effects on smokers and potential for harm and benefit
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Hajek, P, Etter, JF, Benowitz, N, Eissenberg, T, and Mcrobbie, H
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Nicotine ,Harm reduction ,Smoking Prevention ,Electronic Nicotine Delivery Systems ,Smoking cessation ,Risk Assessment ,Article ,Electronic cigarettes ,Prevalence ,Humans ,Safety ,Product safety ,ddc:613 ,Regulation - Abstract
© 2014 Society for the Study of Addiction. Aims: We reviewed available research on the use, content and safety of electronic cigarettes (EC), and on their effects on users, to assess their potential for harm or benefit and to extract evidence that can guide future policy. Methods: Studies were identified by systematic database searches and screening references to February 2014. Results: EC aerosol can contain some of the toxicants present in tobacco smoke, but at levels which are much lower. Long-term health effects of EC use are unknown but compared with cigarettes, EC are likely to be much less, if at all, harmful to users or bystanders. EC are increasingly popular among smokers, but to date there is no evidence of regular use by never-smokers or by non-smoking children. EC enable some users to reduce or quit smoking. Conclusions: Allowing EC to compete with cigarettes in the market-place might decrease smoking-related morbidity and mortality. Regulating EC as strictly as cigarettes, or even more strictly as some regulators propose, is not warranted on current evidence. Health professionals may consider advising smokers unable or unwilling to quit through other routes to switch to EC as a safer alternative to smoking and a possible pathway to complete cessation of nicotine use.
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- 2014
22. Health-care interventions to promote and assist tobacco cessation: a review of efficacy, effectiveness and affordability for use in national guideline development
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West, R, Raw, M, McNeill, A, Stead, L, Aveyard, P, Bitton, J, Stapleton, J, McRobbie, H, Pokhrel, S, Lester-George, A, Borland, R, West, R, Raw, M, McNeill, A, Stead, L, Aveyard, P, Bitton, J, Stapleton, J, McRobbie, H, Pokhrel, S, Lester-George, A, and Borland, R
- Abstract
AIMS: This paper provides a concise review of the efficacy, effectiveness and affordability of health-care interventions to promote and assist tobacco cessation, in order to inform national guideline development and assist countries in planning their provision of tobacco cessation support. METHODS: Cochrane reviews of randomized controlled trials (RCTs) of major health-care tobacco cessation interventions were used to derive efficacy estimates in terms of percentage-point increases relative to comparison conditions in 6-12-month continuous abstinence rates. This was combined with analysis and evidence from 'real world' studies to form a judgement on the probable effectiveness of each intervention in different settings. The affordability of each intervention was assessed for exemplar countries in each World Bank income category (low, lower middle, upper middle, high). Based on World Health Organization (WHO) criteria, an intervention was judged as affordable for a given income category if the estimated extra cost of saving a life-year was less than or equal to the per-capita gross domestic product for that category of country. RESULTS: Brief advice from a health-care worker given opportunistically to smokers attending health-care services can promote smoking cessation, and is affordable for countries in all World Bank income categories (i.e. globally). Proactive telephone support, automated text messaging programmes and printed self-help materials can assist smokers wanting help with a quit attempt and are affordable globally. Multi-session, face-to-face behavioural support can increase quit success for cigarettes and smokeless tobacco and is affordable in middle- and high-income countries. Nicotine replacement therapy, bupropion, nortriptyline, varenicline and cytisine can all aid quitting smoking when given with at least some behavioural support; of these, cytisine and nortriptyline are affordable globally. CONCLUSIONS: Brief advice from a health-care worker, telep
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- 2015
23. Research Priorities for Article 14--Demand Reduction Measures Concerning Tobacco Dependence and Cessation
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McRobbie, H., primary, Raw, M., additional, and Chan, S., additional
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- 2012
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24. Non-nicotine pharmacotherapies for smoking cessation
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McRobbie, H., primary, Lee, M., additional, and Juniper, Z., additional
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- 2005
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25. Smoke free hospitals: Rising to the challenge
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McRobbie, H., primary
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- 2003
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26. Stopping Smoking Shortly Before Surgery and Postoperative Complications: A Systematic Review and Meta-analysis.
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Myers K, Hajek P, Hinds C, and McRobbie H
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- 2011
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27. Using nicotine replacement therapy to assist in reducing cigarette consumption before quitting: another strategy for smoking cessation?
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McRobbie H, Whittaker R, and Bullen C
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Stopping smoking is the most important action that all smokers can take to improve their current and future health. Current smoking cessation treatments produce only modest long-term abstinence rates, and so new cessation methods are required if more smokers are to quit and to avoid relapse. Although most smokers want to quit, only a third make an attempt each year; however, many smokers are interested in reducing their cigarette consumption, and approximately 50% try this approach each year. Such a reduction has questionable health gains; however, it can result in an increase in the likelihood of making a quit attempt and stopping smoking. Results from randomized, placebo-controlled trials in smokers who were not motivated to quit at the time have demonstrated that nicotine replacement therapy (NRT) effectively assists cigarette reduction and, subsequently, helps a small proportion of smokers to eventually quit. Complete smoking cessation remains the ultimate goal, but an NRT-aided reduction strategy may provide a helpful alternative to smokers who want to change their smoking behavior but are not yet ready to stop. [ABSTRACT FROM AUTHOR]
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- 2006
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28. Stopping smoking can cause constipation.
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Hajek P, Gillison F, and McRobbie H
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SETTING: Constipation is mentioned occasionally as a possible tobacco withdrawal symptom, but no systematic data have been published on this issue. DESIGN: Smokers' clinic patients provided ratings of their level of constipation on three occasions prior to their quit date, and then weekly after they stopped smoking. The total of 1067 participants maintained at least 1 week of continuous abstinence and provided usable data. FINDINGS: The three precessation ratings of constipation were stable. After cessation of smoking, the ratings increased significantly (P < 0.01). In 514 patients who maintained continuous abstinence for 4 weeks and provided complete data, constipation peaked at 2 weeks but remained elevated over the whole period. The net proportion of patients affected was 17%, including 9% who were symptom-free at baseline and became very or extremely constipated. In patients on nicotine replacement the increase in constipation, although significant, was less than in patients on bupropion. CONCLUSIONS: Clinicians treating smokers need to be aware of a possibility that one in six quitters develop constipation, and that for about one in 11 the problem can be severe. Descriptions of tobacco withdrawal syndrome should include constipation. [ABSTRACT FROM AUTHOR]
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- 2003
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29. Study protocol for a non-inferiority trial of cytisine versus nicotine replacement therapy in people motivated to stop smoking
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Walker Natalie, Howe Colin, Bullen Chris, McRobbie Hayden, Glover Marewa, Parag Varsha, Williman Jonathan, Veale Reon, Nosa Vili, and Barnes Joanne
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Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Smokers need effective support to maximise the chances of successful quit attempts. Current smoking cessation medications, such as nicotine replacement therapy (NRT), bupropion, nortriptyline or varenicline, have been shown to be effective in clinical trials but are underused by smokers attempting to quit due to adverse effects, contraindications, low acceptability and/or high cost. Cytisine is a low-cost, plant-based alkaloid that has been sold as a smoking cessation aid in Eastern Europe for 50 years. A systematic review of trial evidence suggests that cytisine has a positive impact on both short- and long-term abstinence rates compared to placebo. However, the quality of the evidence is poor and insufficient for licensing purposes in many Western countries. A large, well-conducted placebo-controlled trial (n = 740) of cytisine for smoking cessation has recently been published and confirms the findings of earlier studies, with 12-month continuous abstinence rates of 8.4% in the cytisine group compared to 2.4% in the placebo group (Relative risk = 3.4, 95% confidence intervals 1.7-7.1). No research has yet been undertaken to determine the effectiveness of cytisine relative to that of NRT. Methods/design A single-blind, randomised controlled, non-inferiority trial has been designed to determine whether cytisine is at least as effective as NRT in assisting smokers to remain abstinent for at least one month. Participants (n = 1,310) will be recruited through the national telephone-based Quitline service in New Zealand and randomised to receive a standard 25-day course of cytisine tablets (Tabex®) or usual care (eight weeks of NRT patch and/or gum or lozenge). Participants in both study arms will also receive a behavioural support programme comprising an average of three follow-up telephone calls delivered over an eight-week period by Quitline. The primary outcome is continuous abstinence from smoking at one month, defined as not smoking more than five cigarettes since quit date. Outcome data will also be collected at one week, two months and six months post-quit date. Discussion Cytisine appears to be effective compared with placebo, and given its (current) relative low cost may be an acceptable smoking cessation treatment for smokers, particularly those in low- and middle-income countries. Cytisine's 'natural' product status may also increase its acceptability and use among certain groups of smokers, such as indigenous people, smokers in countries where the use of natural medicines is widespread (e.g. China, India), and in those people who do not want to use NRT or anti-depressants to help them quit smoking. However it is important to ascertain the effectiveness of cytisine compared with that of existing cessation treatments. Trial registration Australian New Zealand Clinical Trials Registry (ACTRN12610000590066)
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- 2011
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30. Study protocol for a randomised trial of nicotine-free cigarettes as an adjunct to usual NRT-based cessation practice, in people who wish to stop smoking
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McRobbie Hayden, Glover Marewa, Grigg Michele, Bullen Chris, Howe Colin, Walker Natalie K, Laugesen Murray, Vander Hoorn Stephen, and Whittaker Robyn
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Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Current smoking cessation treatments focus on addressing the pharmacological dependence of smokers on nicotine. However, new strategies are needed that address both nicotine dependence and the psychological dependence on cigarettes as the source of nicotine. Evidence from a number of small smoking cessation studies suggests that the use of cigarettes with reduced nicotine content, in combination with nicotine replacement therapy (NRT), may help reduce withdrawal symptoms and increase quit rates. This paper describes the protocol for a large randomised-controlled trial to test the effect of using nicotine-free cigarettes together with NRT on long-term quit rates. Methods/design This single-blind, randomised trial aims to recruit 1,410 participants through the national telephone-based Quitline service in New Zealand. Participants in the treatment arm will be asked to stop smoking nicotine-containing cigarettes on their chosen Quit day and smoke ad libitum nicotine-free (Quest 3) cigarettes for six weeks. At the same time people in this group will be asked to start using NRT patches, gum and/or lozenges (as recommended by Quitline) for eight weeks. Participants in the control arm will be asked to stop smoking completely on their chosen Quit day and start using NRT patches, gum and/or lozenges (as recommended by Quitline) for eight weeks. Data collection will occur at baseline, three and six weeks, and three and six months after Quit day. The primary outcome is the proportion of participants who self-report seven-day point prevalence abstinence at six months since Quit date. Discussion Smoking prevalence in New Zealand has changed little in recent years (particularly in Māori, the indigenous people of New Zealand) and additional options for smokers who want to quit are needed. Although a variety of methods are available to help, many are expensive, have side effects, and despite their use most quit attempts still fail. This trial will test the balance of benefits and risks of a new strategy for people to overcome nicotine dependence. Since smoking is the leading cause of lost healthy life years in New Zealand, if proven effective this strategy is likely to have substantial public health benefits. Trial registration Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12608000410358
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- 2011
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31. Using group support to complement a task-based weight management programme in multi-ethnic localities of high deprivation.
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Hajek P, Humphrey K, and McRobbie H
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OBJECTIVE: Two pilot studies were undertaken to assess the efficacy and potential reach of a weight management programme in two inner-city areas of East London. METHODS: The programme provides a 6 weekly group sessions combining a task-based cognitive-behavioural intervention with interactive group support to increase client engagement and retention. Treatment outcome was assessed at end of treatment and at 2 and 3 months by objective markers including pedometer readings, improvements in knowledge of healthy eating, and weight change. RESULTS: A total of 162 people (mean BMI 35 kg/m(2)) participated. Forty-one started the first pilot and 21 (51%) completed it, losing on average 3.0 kg. In the second pilot 121 participants started the course and 75 (62%) completed it, losing on average 2.6 kg. A total of 62 and 39 participants completed 2- and 3-month follow-up, with average weight loss of 3.8 and 4.5 kg. There were significant increases in mean daily pedometer readings and improvements in objectively assessed knowledge of caloric intake. CONCLUSIONS: A task-based lifestyle-modification programme complemented by social support proved attractive to inner-city residents and generated significant short-term effects comparable to those achieved by intensive interventions with more traditional target groups. [ABSTRACT FROM AUTHOR]
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- 2010
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32. Randomized controlled trial of a social support ('buddy') intervention for smoking cessation.
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May S, West R, Hajek P, McEwen A, and McRobbie H
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OBJECTIVE: To assess the effectiveness of including a social support intervention ('buddy system') in a group treatment programme to aid smoking cessation. METHODS: Five hundred and sixty-three smokers attended groups at a smokers' clinic. These groups were randomized either to be (a) groups in which smokers were paired with another person to provide mutual support (buddy condition: n=237 in 14 groups) or (b) to receive the same treatment without the buddy component (control: n=326 in 20 groups). Participants were seen weekly for the first 4 weeks after stopping then followed up again after 26 weeks. RESULTS: Smokers in the buddy condition were no more likely than smokers in the control condition to stay abstinent at 1, 4 or 26 weeks. The effect was in the right direction at week one post-quit but after controlling for potential confounders the difference was not significant (odds ratio=1.45 (95% CI; 0.92-2.29), p=0.06). CONCLUSIONS: We were unable to show that a buddy system improved abstinence rates of group treatment programmes. This might be due to the high level of social support already achieved through the groups. PRACTICE IMPLICATIONS: The buddy system is a simple and very low cost addition to a group treatment programme; but the results from this study suggest that the kind of buddy system tested may not add substantially to the success rates. However there may be merits in a more intensive or protracted form of buddying. [ABSTRACT FROM AUTHOR]
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- 2006
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33. Methanation of overshifted feed
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McRobbie, H
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- 1977
34. Receipt of the 5As intervention for smoking cessation among people with and without mental health disorders.
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Talukder S, Lappin JM, Boland VC, Weaver N, McRobbie H, and Courtney RJ
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- Humans, Male, Female, Middle Aged, Adult, Australia, Young Adult, Smoking Cessation statistics & numerical data, Mental Disorders therapy, Mental Disorders epidemiology
- Abstract
Brief interventions for smoking cessation, such as the 5As (ask, assess, advise, assist, arrange) are effective, but limited data are available regarding their delivery to smokers with mental health disorders (MHDs), and whether a disparity in care exists. This study explored the difference in the self-reported receipt of 5As between smokers with and without MHDs in a community setting. Baseline data from 1452 (1206 without and 246 with self-reported MHDs) Australian smokers who participated in a smoking cessation trial were analysed. Participants reported interactions with healthcare providers and receipt of the 5As over the past 12 months. Multivariate logistic regression analysis was employed to investigate the association between receipt of the 5As and MHD status. Smokers with MHDs were significantly more likely to be asked, assessed, advised, and assisted compared to those without MHDs, but arranging follow-up was very low in both groups (7.7% with MHDs and 4.1% without MHDs). This is particularly concerning for vulnerable population like smokers with MHDs, who may struggle more in their quit attempt. The findings highlight the need to enhance the implementation of the 'arrange follow-up' component to improve cessation outcomes and reduce health disparities., Competing Interests: Declaration of competing interest Declaration of interests: none., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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- 2024
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35. Tailored text-messaging versus standard Quitline telephone counselling for smoking cessation among people who smoke from a low-socio-economic status background in Australia: A study protocol for a non-inferiority randomized controlled trial (The Quit By Phone Study).
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Howard BC, Donnelly S, McRobbie H, Barker D, Petrie D, Stockings E, Brown J, Naughton F, Whittaker R, Shakeshaft A, Patel K, Anderson J, Thomas D, West R, and Courtney RJ
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Background and Aims: Signficant inequalities in tobacco smoking exist, with higher smoking rates among people from low-socio-economic status (low-SES) populations. Tailored technology-based programs for low-SES smoking populations have the potential for high reach, but require effectiveness data from large-scale trials. This trial among Australians who smoke from a low-SES background will determine the effectiveness and cost-effectiveness of tailored text-message (TTM) support compared with standard Quitline (SQL) telephone support service., Design, Setting and Participants: This is a two-arm, parallel group, randomized, non-inferiority trial with allocation concealment and blinded outcome assessment in an Australian population within the greater Sydney region in New South Wales. Participants are adults who smoke daily (n = 1246), are interested in quitting and currently receiving a government pension or allowance, and will be recruited via advertisements., Intervention and Comparator: Participants will be randomized (1:1 ratio) to receive either 12 months of TTM quit support or enrolment in SQL telephone support., Measurements: Assessments will be completed at baseline (telephone interview), within 1 month (check-in call), at 3 months (on-line questionnaire) and 12 months (telephone interview) post-randomization. The primary outcome will be 6-month continuous abstinence verified by carbon monoxide breath test at 12-month follow-up. The study will test whether TTM is non-inferior to SQL by a non-inferiority margin of 2%, i.e. the quit rate in the TTM group will be no worse than 2% less than the quit rate in the SQL group. Secondary outcomes will include self-reported continuous and point prevalence abstinence and acceptability and cost-effectiveness of TTM versus SQL., Conclusion: Should the tailored text-message support prove non-inferior and more cost-effective than Quitline for this population, this will provide an opportunity for the upscaling of an effective, inexpensive and tailored quit support service. The trial findings will inform cessation treatment policy for priority populations in Australia and globally., (© 2024 The Author(s). Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.)
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- 2024
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36. Pregnant smokers can be encouraged to switch to vaping.
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Pesola F, Smith KM, Phillips-Waller A, Przulj D, Walton R, McRobbie H, Coleman T, Lewis S, Clark M, Ussher M, Naughton F, and Hajek P
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- Humans, Pregnancy, Female, Electronic Nicotine Delivery Systems, Adult, Pregnancy Complications, Smokers, Smoking Cessation methods, Vaping
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- 2024
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37. Safety of e-cigarettes and nicotine patches as stop-smoking aids in pregnancy: Secondary analysis of the Pregnancy Trial of E-cigarettes and Patches (PREP) randomized controlled trial.
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Pesola F, Smith KM, Phillips-Waller A, Przulj D, Griffiths C, Walton R, McRobbie H, Coleman T, Lewis S, Whitemore R, Clark M, Ussher M, Sinclair L, Seager E, Cooper S, Bauld L, Naughton F, Sasieni P, Manyonda I, and Hajek P
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- Pregnancy, Female, Humans, Nicotine, Cotinine, Birth Weight, Smoking adverse effects, Recurrence, Electronic Nicotine Delivery Systems, Smoking Cessation
- Abstract
Aims: The aim of this study was to examine the safety of e-cigarettes (EC) and nicotine patches (NRT) when used to help pregnant smokers quit., Design: A recent trial of EC versus NRT reported safety outcomes in the randomized arms. We conducted a further analysis based on product use., Setting: Twenty-three hospitals in England and a stop-smoking service in Scotland took part., Participants: The participants comprised 1140 pregnant smokers., Interventions: We compared women using and not using EC and NRT regularly during pregnancy., Measurements: Measurements included nicotine intake compared with baseline, birth weight, other pregnancy outcomes, adverse events, maternal respiratory symptoms and relapse in early abstainers., Findings: Use of EC was more common than use of NRT (47.3% vs 21.6%, P < 0.001). Women who stopped smoking (abstainers) and used EC at the end-of-pregnancy (EOP) reduced their salivary cotinine by 45% [49.3 ng/ml, 95% confidence interval (CI) = -79.8 to -10]. Only one abstainer used NRT at EOP. In dual users, cotinine increased by 19% (24 ng/ml, 95% CI = 3.5-68). In women reporting a reduction of at least 50% in cigarette consumption, cotinine levels increased by 10% in those using nicotine products and by 9% in those who did not. Birth weights in dual users and exclusive smokers were the same (3.1 kg). Birth weight in abstainers using either nicotine product was higher than in smokers [3.3 kg, standard deviation (SD) = 0.7] versus 3.1 kg, SD = 0.6; difference = 0.15 kg, 95% CI = 0.05-0.25) and not different from abstainers not using nicotine products (3.1 kg, SD = 0.8). Abstainers and smokers using nicotine products had no worse pregnancy outcomes or more adverse events than abstainers and smokers not using them. EC users reported more improvements than non-users in cough [adjusted relative risk (aRR) = 0.59, 95% CI = 0.37-0.93] and phlegm (aRR = 0.53, 95% CI = 0.31-0.92), controlling for smoking status. EC or NRT use had no association with relapse., Conclusions: Regular use of e-cigarettes or nicotine patches by pregnant smokers does not appear to be associated with any adverse outcomes., (© 2024 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.)
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- 2024
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38. Electronic cigarettes for smoking cessation.
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Lindson N, Butler AR, McRobbie H, Bullen C, Hajek P, Begh R, Theodoulou A, Notley C, Rigotti NA, Turner T, Livingstone-Banks J, Morris T, and Hartmann-Boyce J
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- Humans, Nicotine adverse effects, Nicotine Replacement Therapy, Randomized Controlled Trials as Topic, Network Meta-Analysis, Electronic Nicotine Delivery Systems, Smoking Cessation
- Abstract
Background: Electronic cigarettes (ECs) are handheld electronic vaping devices which produce an aerosol by heating an e-liquid. People who smoke, healthcare providers and regulators want to know if ECs can help people quit smoking, and if they are safe to use for this purpose. This is a review update conducted as part of a living systematic review., Objectives: To examine the safety, tolerability and effectiveness of using electronic cigarettes (ECs) to help people who smoke tobacco achieve long-term smoking abstinence, in comparison to non-nicotine EC, other smoking cessation treatments and no treatment., Search Methods: We searched the Cochrane Tobacco Addiction Group's Specialized Register to 1 February 2023, and Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and PsycINFO to 1 July 2023, and reference-checked and contacted study authors., Selection Criteria: We included trials in which people who smoke were randomized to an EC or control condition. We also included uncontrolled intervention studies in which all participants received an EC intervention as these studies have the potential to provide further information on harms and longer-term use. Studies had to report an eligible outcome., Data Collection and Analysis: We followed standard Cochrane methods for screening and data extraction. Critical outcomes were abstinence from smoking after at least six months, adverse events (AEs), and serious adverse events (SAEs). We used a fixed-effect Mantel-Haenszel model to calculate risk ratios (RRs) with a 95% confidence interval (CI) for dichotomous outcomes. For continuous outcomes, we calculated mean differences. Where appropriate, we pooled data in pairwise and network meta-analyses (NMA)., Main Results: We included 88 completed studies (10 new to this update), representing 27,235 participants, of which 47 were randomized controlled trials (RCTs). Of the included studies, we rated ten (all but one contributing to our main comparisons) at low risk of bias overall, 58 at high risk overall (including all non-randomized studies), and the remainder at unclear risk. There is high certainty that nicotine EC increases quit rates compared to nicotine replacement therapy (NRT) (RR 1.59, 95% CI 1.29 to 1.93; I
2 = 0%; 7 studies, 2544 participants). In absolute terms, this might translate to an additional four quitters per 100 (95% CI 2 to 6 more). There is moderate-certainty evidence (limited by imprecision) that the rate of occurrence of AEs is similar between groups (RR 1.03, 95% CI 0.91 to 1.17; I2 = 0%; 5 studies, 2052 participants). SAEs were rare, and there is insufficient evidence to determine whether rates differ between groups due to very serious imprecision (RR 1.20, 95% CI 0.90 to 1.60; I2 = 32%; 6 studies, 2761 participants; low-certainty evidence). There is moderate-certainty evidence, limited by imprecision, that nicotine EC increases quit rates compared to non-nicotine EC (RR 1.46, 95% CI 1.09 to 1.96; I2 = 4%; 6 studies, 1613 participants). In absolute terms, this might lead to an additional three quitters per 100 (95% CI 1 to 7 more). There is moderate-certainty evidence of no difference in the rate of AEs between these groups (RR 1.01, 95% CI 0.91 to 1.11; I2 = 0%; 5 studies, 1840 participants). There is insufficient evidence to determine whether rates of SAEs differ between groups, due to very serious imprecision (RR 1.00, 95% CI 0.56 to 1.79; I2 = 0%; 9 studies, 1412 participants; low-certainty evidence). Due to issues with risk of bias, there is low-certainty evidence that, compared to behavioural support only/no support, quit rates may be higher for participants randomized to nicotine EC (RR 1.88, 95% CI 1.56 to 2.25; I2 = 0%; 9 studies, 5024 participants). In absolute terms, this represents an additional four quitters per 100 (95% CI 2 to 5 more). There was some evidence that (non-serious) AEs may be more common in people randomized to nicotine EC (RR 1.22, 95% CI 1.12 to 1.32; I2 = 41%, low-certainty evidence; 4 studies, 765 participants) and, again, insufficient evidence to determine whether rates of SAEs differed between groups (RR 0.89, 95% CI 0.59 to 1.34; I2 = 23%; 10 studies, 3263 participants; very low-certainty evidence). Results from the NMA were consistent with those from pairwise meta-analyses for all critical outcomes, and there was no indication of inconsistency within the networks. Data from non-randomized studies were consistent with RCT data. The most commonly reported AEs were throat/mouth irritation, headache, cough, and nausea, which tended to dissipate with continued EC use. Very few studies reported data on other outcomes or comparisons, hence, evidence for these is limited, with CIs often encompassing both clinically significant harm and benefit., Authors' Conclusions: There is high-certainty evidence that ECs with nicotine increase quit rates compared to NRT and moderate-certainty evidence that they increase quit rates compared to ECs without nicotine. Evidence comparing nicotine EC with usual care/no treatment also suggests benefit, but is less certain due to risk of bias inherent in the study design. Confidence intervals were for the most part wide for data on AEs, SAEs and other safety markers, with no difference in AEs between nicotine and non-nicotine ECs nor between nicotine ECs and NRT. Overall incidence of SAEs was low across all study arms. We did not detect evidence of serious harm from nicotine EC, but the longest follow-up was two years and the number of studies was small. The main limitation of the evidence base remains imprecision due to the small number of RCTs, often with low event rates. Further RCTs are underway. To ensure the review continues to provide up-to-date information to decision-makers, this review is a living systematic review. We run searches monthly, with the review updated when relevant new evidence becomes available. Please refer to the Cochrane Database of Systematic Reviews for the review's current status., (Copyright © 2023 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.)- Published
- 2024
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39. Author Correction: Electronic cigarettes versus nicotine patches for smoking cessation in pregnancy: a randomized controlled trial.
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Hajek P, Przulj D, Pesola F, Griffiths C, Walton R, McRobbie H, Coleman T, Lewis S, Whitemore R, Clark M, Ussher M, Sinclair L, Seager E, Cooper S, Bauld L, Naughton F, Sasieni P, Manyonda I, and Myers Smith K
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- 2023
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40. E-cigarette support for smoking cessation: Identifying the effectiveness of intervention components in an on-line randomized optimization experiment.
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Kimber C, Sideropoulos V, Cox S, Frings D, Naughton F, Brown J, McRobbie H, and Dawkins L
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- Humans, Female, Male, Bayes Theorem, Smoking, Tobacco Smoking, Smoking Cessation, Electronic Nicotine Delivery Systems
- Abstract
Aims, Design and Setting: The aim of this study was to determine which combination(s) of five e-cigarette-orientated intervention components, delivered on-line, affect smoking cessation. An on-line (UK) balanced five-factor (2 × 2 × 2 × 2 × 2 = 32 intervention combinations) randomized factorial design guided by the multi-phase optimization strategy (MOST) was used., Participants: A total of 1214 eligible participants (61% female; 97% white) were recruited via social media., Interventions: The five on-line intervention components designed to help smokers switch to exclusive e-cigarette use were: (1) tailored device selection advice; (2) tailored e-liquid nicotine strength advice; (3): tailored e-liquid flavour advice; (4) brief information on relative harms; and (5) text message (SMS) support., Measurements: The primary outcome was 4-week self-reported complete abstinence at 12 weeks post-randomization. Primary analyses were intention-to-treat (loss to follow-up recorded as smoking). Logistic regressions modelled the three- and two-way interactions and main effects, explored in that order., Findings: In the adjusted model the only significant interaction was a two-way interaction, advice on flavour combined with text message support, which increased the odds of abstinence (odds ratio = 1.55, 95% confidence interval = 1.13-2.14, P = 0.007, Bayes factor = 7.25). There were no main effects of the intervention components., Conclusions: Text-message support with tailored advice on flavour is a promising intervention combination for smokers using an e-cigarette in a quit attempt., (© 2023 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.)
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- 2023
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41. Inequity in smoking cessation clinical trials testing pharmacotherapies: exclusion of smokers with mental health disorders.
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Talukder SR, Lappin JM, Boland V, McRobbie H, and Courtney RJ
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- Humans, Mental Health, Smokers, Tobacco Use Cessation Devices, Smoking Cessation psychology
- Abstract
Objectives: People suffering from mental health disorder (MHDs) are often under-represented in clinical research though the reasons for their exclusion are rarely recorded. As they have higher rates of smoking and nicotine dependence, it is crucial that they are adequately represented in clinical trials of established pharmacotherapy interventions for smoking cessation. This review aims to examine the practice of excluding smokers with MHDs and reasons for such exclusion in clinical trials evaluating pharmacotherapy treatments for smoking cessation., Data Source: The Cochrane database of systematic reviews was searched until September 2020 for reviews on smoking cessation using pharmacotherapies., Study Selection: Randomised controlled trials (RCTs) within the selected Cochrane reviews were included., Data Extraction: Conducted by one author and independently verified by three authors., Data Synthesis: We included 279 RCTs from 13 Cochrane reviews. Of all studies, 51 (18.3%) explicitly excluded participants with any MHDs, 152 (54.5%) conditionally excluded based on certain MHD criteria and 76 (27.2%) provided insufficient information to ascertain either inclusion or exclusion. Studies of antidepressant medications used for smoking cessation were found to be 3.33 times more likely (95% CI 1.38 to 8.01, p=0.007) to conditionally exclude smokers with MHDs than explicitly exclude compared with studies of nicotine replacement therapy., Conclusion: Smokers with MHDs are not sufficiently represented in RCTs examining the safety and effectiveness of smoking cessation medications. Greater access to clinical trial participation needs to be facilitated for this group to better address access to appropriate pharmacotherapeutic interventions in this vulnerable population., Competing Interests: Competing interests: HM has received honoraria for speaking at smoking cessation meetings and attending advisory board meetings that have been organised by Pfizer. SRT, JML, VB and RJC have no conflicts of interest to declare., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2023
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42. Study protocol of the Our Futures Vaping Trial: a cluster randomised controlled trial of a school-based eHealth intervention to prevent e-cigarette use among adolescents.
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Gardner LA, Rowe AL, Stockings E, Champion KE, Hides L, McBride N, Allsop S, O'Dean S, Sunderland M, Lee YY, Mihalopoulos C, Freeman B, Leung J, McRobbie H, Stapinski L, Lee N, Thornton L, Debenham J, Teesson M, and Newton NC
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- Humans, Adolescent, Australia, Quality of Life, Schools, Randomized Controlled Trials as Topic, Electronic Nicotine Delivery Systems, Vaping prevention & control
- Abstract
Background: Effective and scalable prevention approaches are urgently needed to address the rapidly increasing rates of e-cigarette use among adolescents. School-based eHealth interventions can be an efficient, effective, and economical approach, yet there are none targeting e-cigarettes within Australia. This paper describes the protocol of the OurFutures Vaping Trial which aims to evaluate the efficacy and cost-effectiveness of the first school-based eHealth intervention targeting e-cigarettes in Australia., Methods: A two-arm cluster randomised controlled trial will be conducted among Year 7 and 8 students (aged 12-14 years) in 42 secondary schools across New South Wales, Western Australia and Queensland, Australia. Using stratified block randomisation, schools will be assigned to either the OurFutures Vaping Program intervention group or an active control group (health education as usual). The intervention consists of four web-based cartoon lessons and accompanying activities delivered during health education over a four-week period. Whilst primarily focused on e-cigarette use, the program simultaneously addresses tobacco cigarette use. Students will complete online self-report surveys at baseline, post-intervention, 6-, 12-, 24-, and 36-months after baseline. The primary outcome is the uptake of e-cigarette use at 12-month follow-up. Secondary outcomes include the uptake of tobacco smoking, frequency/quantity of e-cigarettes use and tobacco smoking, intentions to use e-cigarettes/tobacco cigarettes, knowledge about e-cigarettes/tobacco cigarettes, motives and attitudes relating to e-cigarettes, self-efficacy to resist peer pressure and refuse e-cigarettes, mental health, quality of life, and resource utilisation. Generalized mixed effects regression will investigate whether receiving the intervention reduces the likelihood of primary and secondary outcomes. Cost-effectiveness and the effect on primary and secondary outcomes will also be examined over the longer-term., Discussion: If effective, the intervention will be readily accessible to schools via the OurFutures platform and has the potential to make substantial health and economic impact. Without such intervention, young Australians will be the first generation to use nicotine at higher rates than previous generations, thereby undoing decades of effective tobacco control., Trial Registration: The trial has been prospectively registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12623000022662; date registered: 10/01/2023)., (© 2023. The Author(s).)
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- 2023
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43. Household Composition and Smoking Behavior in a Prospective Longitudinal Australian Cohort.
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Saxby K, Ireland A, Ghijben P, Sweeney R, Sia KL, Chen E, Farrell M, McRobbie H, Courtney R, and Petrie D
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- Humans, Prospective Studies, Australia epidemiology, Recurrence, Smoking epidemiology, Smoking Cessation
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Introduction: This study estimates the extent to which individuals' smoking cessation and relapse patterns are associated with the smoking behavior of their household members., Aims and Methods: Longitudinal data on household members' smoking behavior was sourced from a representative sample of 12 723 Australians who ever reported smoking between 2001 and 2019. Controlling for a rich set of confounders, multivariate regression analyses were used to predict the likelihood of smoking cessation and relapse given other household members' smoking status and their relationship type. The models were then used to forecast smoking prevalence over 10 years across different household types., Results: Individuals living with a smoking spouse were less likely to quit (OR 0.77 [95% CI 0.72;0.83]) and more likely to relapse (OR 1.47 [95% CI 1.28;1.69]) compared to those living with nonsmoking spouses. Subsequently, the proportion of smokers living with other smoking household members increased by 15% between 2011 and 2019. A 10-year forecast using the smoking cessation and relapse models predicts that, on average, smokers living with nonsmokers will reduce by 43%, while those living alone or with a smoking partner will only reduce by 26% and 28% respectively., Conclusions: Over time, those who are still smoking are more likely to live with other smokers. Therefore, the current cohort of smokers is increasingly less likely to quit and more likely to relapse. Smoking projection models that fail to account for this dynamic risk may overstate the downstream health benefits and health cost savings. Interventions that encourage smoking cessation at the household level, particularly for spouses, may assist individuals to quit and abstain from smoking., Implications: The current and future paradigm shift in the smoking environment suggests that smoking cessation and relapse prevention policies should consider household structure. Policies designed to affect smoking at the household level are likely to be particularly effective. When estimating the long-term benefits of current smoking policies intrahousehold smoking behavior needs to be considered., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
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- 2023
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44. Corrigendum to "Longer-term use of electronic cigarettes when provided as a stop smoking aid: Systematic review with meta-analyses" [Preventive Medicine, Volume 165, Part B, December 2022, 1-12/107182].
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Butler AR, Lindson N, Fanshawe TR, Theodoulou A, Begh R, Hajek P, McRobbie H, Bullen C, Notley C, Rigotti NA, and Hartmann-Boyce J
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- 2023
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45. Longer-term use of electronic cigarettes when provided as a stop smoking aid: Systematic review with meta-analyses.
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Butler AR, Lindson N, Fanshawe TR, Theodoulou A, Begh R, Hajek P, McRobbie H, Bullen C, Notley C, Rigotti NA, and Hartmann-Boyce J
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- Humans, Smoking epidemiology, Nicotine adverse effects, Tobacco Smoking, Electronic Nicotine Delivery Systems, Smoking Cessation
- Abstract
Moderate certainty evidence supports use of nicotine electronic cigarettes to quit smoking combustible cigarettes. However, there is less certainty regarding how long people continue to use e-cigarettes after smoking cessation attempts. We set out to synthesise data on the proportion of people still using e-cigarettes or other study products at 6 months or longer in studies of e-cigarettes for smoking cessation. We updated Cochrane searches (November 2021). For the first time, we meta-analysed prevalence of continued e-cigarette use among individuals allocated to e-cigarette conditions, and among those individuals who had successfully quit smoking. We updated meta-analyses comparing proportions continuing product use among individuals allocated to use nicotine e-cigarettes and other treatments. We included 19 studies (n = 7787). The pooled prevalence of continued e-cigarette use at 6 months or longer was 54% (95% CI: 46% to 61%, I
2 86%, N = 1482) in participants assigned to e-cigarette conditions. Of participants who had quit combustible cigarettes overall 70% were still using e-cigarettes at six months or longer (95% CI: 53% to 82%, I2 73%, N = 215). Heterogeneity in direction of effect precluded meta-analysis comparing long-term use of nicotine e-cigarettes with NRT. More people were using nicotine e-cigarettes at longest follow-up compared to non-nicotine e-cigarettes, but CIs included no difference (risk ratio 1.15, 95% CI: 0.94 to 1.41, n = 601). The levels of continued e-cigarette use observed may reflect the success of e-cigarettes as a quitting tool. Further research is needed to establish drivers of variation in and implications of continued use of e-cigarettes., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)- Published
- 2022
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46. Is opt-out enrolment acceptable for low-risk digital health services?
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Dobson R, Uri A, Whittaker R, Evison K, Umali E, and McRobbie H
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- Child, Humans, Retrospective Studies, Health Promotion, Family, Text Messaging, Telemedicine
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Introduction Digital health programmes not only complement existing services, but have the potential to reach populations that existing services are not reaching. Many of these services require people to opt-in to receive them, which presents significant barriers to access. An alternative is to make low-risk digital services opt-out, ensuring appropriate members of the target audience are signed up for a service unless they select to not receive it. Aim This study aimed to investigate how changing enrolment in a low-risk digital health programme from opt-in to opt-out would impact on enrolment and dropout rates. Methods This study involved the retrospective analysis of registration data from txtpēpi, a maternal and child health text-message programme. System-recorded data from enrolments during a 12-month period were obtained. In the first 6 months, users had to opt-in to the service (Period 1), but in the following 6 months, an opt-out process was implemented (Period 2). Results There was a 77% increase in enrolments in Period 2 (n = 113) compared to Period 1 (n = 64) and no significant change in the proportion of enrolments of Māori between time periods (P = 0.508). There was no significant difference in withdrawal rates between time periods at either 2 weeks (5% vs 6%, P = 0.676) or 1 month (9% vs 9%, P = 0.907). Discussion This study has shown switching from an opt-in to an opt-out option resulted in an increase in enrolments in an mHealth programme, but had no impact on withdrawals. This indicates that employing opt-out enrolment for low-risk evidence-based interventions is acceptable and a potential way to make these services more accessible.
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- 2022
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47. Electronic cigarettes for smoking cessation.
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Hartmann-Boyce J, Lindson N, Butler AR, McRobbie H, Bullen C, Begh R, Theodoulou A, Notley C, Rigotti NA, Turner T, Fanshawe TR, and Hajek P
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- Humans, Tobacco Use Cessation Devices, Nicotinic Agonists therapeutic use, Systematic Reviews as Topic, Nicotine adverse effects, Randomized Controlled Trials as Topic, Smoking Cessation methods, Electronic Nicotine Delivery Systems
- Abstract
Background: Electronic cigarettes (ECs) are handheld electronic vaping devices which produce an aerosol by heating an e-liquid. Some people who smoke use ECs to stop or reduce smoking, although some organizations, advocacy groups and policymakers have discouraged this, citing lack of evidence of efficacy and safety. People who smoke, healthcare providers and regulators want to know if ECs can help people quit smoking, and if they are safe to use for this purpose. This is a review update conducted as part of a living systematic review., Objectives: To examine the effectiveness, tolerability, and safety of using electronic cigarettes (ECs) to help people who smoke tobacco achieve long-term smoking abstinence., Search Methods: We searched the Cochrane Tobacco Addiction Group's Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and PsycINFO to 1 July 2022, and reference-checked and contacted study authors. SELECTION CRITERIA: We included randomized controlled trials (RCTs) and randomized cross-over trials, in which people who smoke were randomized to an EC or control condition. We also included uncontrolled intervention studies in which all participants received an EC intervention. Studies had to report abstinence from cigarettes at six months or longer or data on safety markers at one week or longer, or both., Data Collection and Analysis: We followed standard Cochrane methods for screening and data extraction. Our primary outcome measures were abstinence from smoking after at least six months follow-up, adverse events (AEs), and serious adverse events (SAEs). Secondary outcomes included the proportion of people still using study product (EC or pharmacotherapy) at six or more months after randomization or starting EC use, changes in carbon monoxide (CO), blood pressure (BP), heart rate, arterial oxygen saturation, lung function, and levels of carcinogens or toxicants, or both. We used a fixed-effect Mantel-Haenszel model to calculate risk ratios (RRs) with a 95% confidence interval (CI) for dichotomous outcomes. For continuous outcomes, we calculated mean differences. Where appropriate, we pooled data in meta-analyses., Main Results: We included 78 completed studies, representing 22,052 participants, of which 40 were RCTs. Seventeen of the 78 included studies were new to this review update. Of the included studies, we rated ten (all but one contributing to our main comparisons) at low risk of bias overall, 50 at high risk overall (including all non-randomized studies), and the remainder at unclear risk. There was high certainty that quit rates were higher in people randomized to nicotine EC than in those randomized to nicotine replacement therapy (NRT) (RR 1.63, 95% CI 1.30 to 2.04; I
2 = 10%; 6 studies, 2378 participants). In absolute terms, this might translate to an additional four quitters per 100 (95% CI 2 to 6). There was moderate-certainty evidence (limited by imprecision) that the rate of occurrence of AEs was similar between groups (RR 1.02, 95% CI 0.88 to 1.19; I2 = 0%; 4 studies, 1702 participants). SAEs were rare, but there was insufficient evidence to determine whether rates differed between groups due to very serious imprecision (RR 1.12, 95% CI 0.82 to 1.52; I2 = 34%; 5 studies, 2411 participants). There was moderate-certainty evidence, limited by imprecision, that quit rates were higher in people randomized to nicotine EC than to non-nicotine EC (RR 1.94, 95% CI 1.21 to 3.13; I2 = 0%; 5 studies, 1447 participants). In absolute terms, this might lead to an additional seven quitters per 100 (95% CI 2 to 16). There was moderate-certainty evidence of no difference in the rate of AEs between these groups (RR 1.01, 95% CI 0.91 to 1.11; I2 = 0%; 5 studies, 1840 participants). There was insufficient evidence to determine whether rates of SAEs differed between groups, due to very serious imprecision (RR 1.00, 95% CI 0.56 to 1.79; I2 = 0%; 8 studies, 1272 participants). Compared to behavioural support only/no support, quit rates were higher for participants randomized to nicotine EC (RR 2.66, 95% CI 1.52 to 4.65; I2 = 0%; 7 studies, 3126 participants). In absolute terms, this represents an additional two quitters per 100 (95% CI 1 to 3). However, this finding was of very low certainty, due to issues with imprecision and risk of bias. There was some evidence that (non-serious) AEs were more common in people randomized to nicotine EC (RR 1.22, 95% CI 1.12 to 1.32; I2 = 41%, low certainty; 4 studies, 765 participants) and, again, insufficient evidence to determine whether rates of SAEs differed between groups (RR 1.03, 95% CI 0.54 to 1.97; I2 = 38%; 9 studies, 1993 participants). Data from non-randomized studies were consistent with RCT data. The most commonly reported AEs were throat/mouth irritation, headache, cough, and nausea, which tended to dissipate with continued EC use. Very few studies reported data on other outcomes or comparisons, hence evidence for these is limited, with CIs often encompassing clinically significant harm and benefit., Authors' Conclusions: There is high-certainty evidence that ECs with nicotine increase quit rates compared to NRT and moderate-certainty evidence that they increase quit rates compared to ECs without nicotine. Evidence comparing nicotine EC with usual care/no treatment also suggests benefit, but is less certain. More studies are needed to confirm the effect size. Confidence intervals were for the most part wide for data on AEs, SAEs and other safety markers, with no difference in AEs between nicotine and non-nicotine ECs nor between nicotine ECs and NRT. Overall incidence of SAEs was low across all study arms. We did not detect evidence of serious harm from nicotine EC, but longest follow-up was two years and the number of studies was small. The main limitation of the evidence base remains imprecision due to the small number of RCTs, often with low event rates, but further RCTs are underway. To ensure the review continues to provide up-to-date information to decision-makers, this review is a living systematic review. We run searches monthly, with the review updated when relevant new evidence becomes available. Please refer to the Cochrane Database of Systematic Reviews for the review's current status., (Copyright © 2022 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.)- Published
- 2022
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48. Effectiveness, safety and cost-effectiveness of vaporized nicotine products versus nicotine replacement therapy for tobacco smoking cessation in a low-socioeconomic status Australian population: a study protocol for a randomized controlled trial.
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Howard BC, McRobbie H, Petrie D, Barker D, Mendelsohn C, Anderson J, Borland R, Naughton F, Tutka P, Zwar N, Boland VC, Aiken A, Shakeshaft A, Gartner C, Richmond RL, Hall W, Mattick RP, Farrell M, and Courtney RJ
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- Australia, Cost-Benefit Analysis, Humans, Nicotine adverse effects, Randomized Controlled Trials as Topic, Social Class, Nicotiana, Tobacco Use Cessation Devices adverse effects, Treatment Outcome, Alcoholism, Smoking Cessation methods
- Abstract
Background: In Australia, tobacco smoking rates have declined but inequalities remain with significantly higher smoking prevalence among low-socioeconomic populations. Clinical trial data suggest vaporized nicotine products (VNPs) aid smoking cessation. Most VNP trials have used refillable tank systems, but newer generation (pod) devices now comprise the largest market share yet have limited clinical trial evidence on safety and effectiveness. This study evaluates the effectiveness, safety and cost-effectiveness of VNPs (pod and tank device) compared with nicotine replacement therapy ([NRT]-gum or lozenge) for smoking cessation., Methods: This is a two-arm, open-label, superiority, parallel group, randomized controlled trial (RCT) with allocation concealment and blinded outcome assessment. The RCT is conducted at the National Drug and Alcohol Research Centre at the University of New South Wales, Sydney, Australia. Participants are people who smoke daily, are interested in quitting and receive a government pension or allowance (N = 1058). Participants will be randomized (1:1 ratio) to receive 8 weeks of free: VNPs, with pod (40 mg/mL nicotine salt) and tank device (18 mg/mL freebase nicotine) in mixed flavours; or NRT (gum or lozenge; 4 mg). All participants will receive daily text message behavioural support for 5 weeks. Assessments will be undertaken by telephone at baseline, with three follow-up calls (two check-in calls within the first month and final follow-up at 7 months post randomization) to ascertain smoking status, treatment adherence and adverse events. The primary outcome is 6-month continuous abstinence verified by carbon monoxide breath test of ≤5ppm at 7-month follow-up. Safety and cost-effectiveness of VNPs versus NRT will also be evaluated., Discussion: Further data are required to strengthen certainty of evidence for VNPs aiding smoking cessation, particularly for newer generation pod devices. To our knowledge, this trial is the first to offer choice of VNPs and no comparative effectiveness trial data exists for new pod devices. If effective, the findings can inform wider implementation of VNPs to aid smoking cessation in a priority group., Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12621000076875. Registered on 29 January 2021. https://www.anzctr.org.au., (© 2022. The Author(s).)
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- 2022
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49. Revised Guidelines for smoking cessation in New Zealand, 2021.
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McCormack J, Walker N, McRobbie H, Wright K, Nosa V, Fernandes B, and Bullen C
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- Delivery of Health Care, Female, Humans, New Zealand, Pregnancy, Tobacco Use Cessation Devices, Varenicline therapeutic use, Smoking Cessation
- Abstract
Aims: To summarise the literature underpinning key recommendations made in the 2021 revision of the Ministry of Health's New Zealand Guidelines for Helping People to Stop Smoking., Methods: A comprehensive literature review of smoking cessation interventions was undertaken in July 2021. Recommendations were formulated from the findings of the literature review and expert advice., Results: Healthcare professionals should ask and briefly advise all people who smoke to stop smoking, regardless of whether they say they are ready to stop smoking or not. They should offer smoking cessation support, which includes both behavioural and pharmacological (e.g., nicotine replacement therapy, nortriptyline, bupropion or varenicline) interventions. The Guidelines also include advice around the use of vaping in smoking cessation. Recommendations are also formulated for priority populations of smokers: Māori, Pacific, pregnant women, and people with mental illness and other addictions., Conclusions: The guidelines will assist healthcare professionals in providing evidence-based smoking cessation support to people who smoke. To be effective and equitable, the ABC model requires organisational commitment, integration into routine practice, and increased attention to the upstream determinants of smoking and quitting., Competing Interests: Nil.
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- 2022
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50. Electronic cigarettes versus nicotine patches for smoking cessation in pregnancy: a randomized controlled trial.
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Hajek P, Przulj D, Pesola F, Griffiths C, Walton R, McRobbie H, Coleman T, Lewis S, Whitemore R, Clark M, Ussher M, Sinclair L, Seager E, Cooper S, Bauld L, Naughton F, Sasieni P, Manyonda I, and Myers Smith K
- Subjects
- Female, Humans, Nicotine adverse effects, Pregnancy, Tobacco Use Cessation Devices adverse effects, Electronic Nicotine Delivery Systems, Smoking Cessation
- Abstract
Nicotine replacement therapy, in the form of nicotine patches, is commonly offered to pregnant women who smoke to help them to stop smoking, but this approach has limited efficacy in this population. Electronic cigarettes (e-cigarettes) are also used by pregnant women who smoke but their safety and efficacy in pregnancy are unknown. Here, we report the results of a randomized controlled trial in 1,140 participants comparing refillable e-cigarettes with nicotine patches. Pregnant women who smoked were randomized to e-cigarettes (n = 569) or nicotine patches (n = 571). In the unadjusted analysis of the primary outcome, validated prolonged quit rates at the end of pregnancy in the two study arms were not significantly different (6.8% versus 4.4% in the e-cigarette and patch arms, respectively; relative risk (RR) = 1.55, 95%CI: 0.95-2.53, P = 0.08). However, some participants in the nicotine patch group also used e-cigarettes during the study. In a pre-specified sensitivity analysis excluding abstinent participants who used non-allocated products, e-cigarettes were more effective than patches (6.8% versus 3.6%; RR = 1.93, 95%CI: 1.14-3.26, P = 0.02). Safety outcomes included adverse events and maternal and birth outcomes. The safety profile was found to be similar for both study products, however, low birthweight (<2,500 g) was less frequent in the e-cigarette arm (14.8% versus 9.6%; RR = 0.65, 95%CI: 0.47-0.90, P = 0.01). Other adverse events and birth outcomes were similar in the two study arms. E-cigarettes might help women who are pregnant to stop smoking, and their safety for use in pregnancy is similar to that of nicotine patches. ISRCTN62025374., (© 2022. The Author(s).)
- Published
- 2022
- Full Text
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