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AimsTo assess level of compliance with national and local guidance with regards to the recording of service users smoking status and offering of interventions.BackgroundAcross the general population, prevalence of smoking is decreasing but in those with severe mental illness, the prevalence hasn't significantly changed. LYPFT are working towards becoming a smoke-free trust. The Trust Guidance expects that Trusts should ask 100% of service users if they smoke (which should be recorded on their physical health CQUIN) and of those that do, should be offered nicotine replacement therapy and cessation advice. Public Health England is working towards all hospital trusts across the UK being Smoke-free.MethodAll service users on each of the 4 adult inpatient wards at the Becklin Centre, Leeds, were included in the audit. A total of 78 service users were included in the audit.We reviewed the digital records for every service user, specifically looking at the physical health CQUIN. We recorded if smoking status had been documented and what interventions (if any) had been recorded as given. Possible interventions included offering brief advice and offering Nicotine replacement therapy. We then reviewed medication charts to see if any nicotine replacement therapy had been prescribed.ResultThe audit found that approximately half of all service users in our audit smoked cigarettes and that the vast majority of these had their smoking status documented in their digital medical records.Three quarters of those that smoked were offered brief cessation advice and half of them were offered Nicotine Replacement Therapy. Only a third of service users that smoked had NRT prescribed on their medication chart. This represented 65% of those recorded as being offered NRT.ConclusionThere are numerous possible reasons for the above outcomes. These include a lack of knowledge and confidence in delivering smoking cessation interventions, conversations having taken place but not recorded and confusion regarding the appropriate staff member to deliver the intervention. In addition, whilst only medical professionals typically prescribe NRT, the physical health CQUIN is recorded by nurses. Therefore, this may reflect a lack of communication between staff groups.Our trust will become smoke free in the near future. To facilitate this, we hope to reduce the discrepancy between the number of service users who smoke and the number prescribed NRT.

Introduction: Treatment completion is associated with abstinence outcomes in smoking cessation interventions. Previous research has stated that anxiety sensitivity (AS) is associated with smoking-related variables and smoking-cessation outcomes. To date, research has not examined the interaction between AS and treatment completion on smoking-cessation outcomes over time. This study aims to examine the main and the interactive effects of treatment completion and AS (total score and specific dimensions) on smoking-cessation outcomes at 3- , 6-, and 12-month follow-ups. Method: The sample consisted of 210 smokers enrolled in an eight-session smoking-cessation cognitivebehavioral treatment (62.1% women; Mage = 45.2, SD = 11.0). Participants were classified as completers (attended the eight treatment sessions) and non-completers (attended ≤ 7 sessions). Abstinence was biochemically confirmed. Results: Main effects indicated that completers had a higher likelihood of being abstinent over time when compared to non-completers. Regarding AS, those with greater AS-Physical Concerns had lower abstinence rates. Besides, a significant interaction between treatment completion, time and AS-Physical Concerns was found. Particularly, completers with greater AS-Physical Concerns had a higher likelihood of being abstainers than noncompleters over time, while no significant differences were found for those with lower AS-Physical Concerns. Conclusion: These data highlight the relevance of AS-Physical levels and smoking-cessation treatment completion on abstinence outcomes over time among treatment-seeking smokers Ruben Rodriguez-Cano is supported by the Cancer Prevention and Research Institute of Texas (CPRIT) Postdoctoral Fellowship in Cancer Prevention (RP 170259, Drs. Chang and Shete, PIs) and by MD Anderson’s Cancer Center Support Grant (CA016672) funded by the National Cancer Institute SI

Introduction:Understanding factors associated with increased use of nicotine replacement therapy (NRT) is critical to implementing cessation interventions for low-income individuals yet the factors associated with NRT use among low-income smokers are poorly understood.Aims:Assess factors associated with NRT use among low-income public housing residents.Methods: ‘Kick it for Good’ was a randomised smoking cessation intervention study conducted among residents of public housing sites in Boston, MA. Secondary, cross-sectional analyses were conducted on smokers from a community-based intervention cessation intervention who reported making a quit attempt and use of NRT in the past 12 months (n= 234).Results:Among smokers who made a quit attempt in the past year, 29% reported using NRT. Black (prevalence ratio, PR = 0.52, 95% CI: 0.38–0.71) and Hispanic (PR = 0.52, 95% CI: 0.31–0.88) participants were less likely to report use of NRT compared with Whites. The prevalence of recent NRT use was greatest among those both asking for and receiving provider advice (PR = 1.90, 95% CI: 0.96–3.78).Conclusions:Minority race and ethnicity and low provider engagement on NRT use were associated with lower NRT use. Providing barrier-free access to NRT and facilitating provider engagement with smokers regarding NRT use can increase NRT use among low-income populations.

Smoking cessation counseling in conjunction with low-dose computed tomography (LDCT) lung cancer screening is recommended in multiple clinical practice guidelines. The best approach for integrating effective smoking cessation interventions within this setting is unknown.To summarize evidence, identify research gaps, prioritize topics for future research, and propose standardized tools for use in conducting research on smoking cessation interventions within the LDCT lung cancer screening setting.The American Thoracic Society convened a multistakeholder committee with expertise in tobacco dependence treatment and/or LDCT screening. During an in-person meeting, evidence was reviewed, research gaps were identified, and key questions were generated for each of three research domains: (1) target population to study; (2) adaptation, development, and testing of interventions; and (3) implementation of interventions with demonstrated efficacy. We also identified standardized measures for use in conducting this research. A larger stakeholder panel then ranked research questions by perceived importance in an online survey. Final prioritization was generated hierarchically on the basis of average rank assigned.There was little consensus on which questions within the population domain were of highest priority. Within the intervention domain, research to evaluate the effectiveness in the lung cancer screening setting of evidence-based smoking cessation interventions shown to be effective in other contexts was ranked highest. In the implementation domain, stakeholders prioritized understanding strategies to identify and overcome barriers to integrating smoking cessation in lung cancer screening settings.This statement offers an agenda to stimulate research surrounding the integration and implementation of smoking cessation interventions with LDCT lung cancer screening.

Introduction Physical activity may hold promise as a potential smoking cessation tactic. Further, increasing activity levels in smokers may lead to additional physical and mental health benefits beyond smoking cessation. This study evaluated Run to Quit, a national initiative targeting smoking cessation through group-based running clinics. Methods Adult male and female smokers (N = 168) took part in running clinics in 21 locations across Canada. The program was investigated using a pre-post design. Participants completed questionnaires assessing physical activity, running, smoking, and other markers of health at weeks 1, 3, and 10 in the 10-week program as well as at 6-month follow up. Carbon monoxide (CO) testing at weeks 1 and 10 provided an objective indicator of smoking status and weekly coach logs were used to assess implementation. Results 50.8% of participants who completed the program achieved 7-day point prevalence (intent-to-treat = 19.6%), 90.8% reported reducing their smoking, and there was a significant decrease in CO ( p = 0.001). There was a significant increase in self-reported running frequency (times/week) and physical and mental health from baseline to end of program, p 's M = 3 times/week). Conclusions Although attrition was high and future program refinement is required, Run to Quit demonstrates potential as a multiple health behaviour change intervention that may improve both physical and mental health in individuals who smoke.

Background Previous analyses of Google search queries identified circaseptan (weekly) rhythms in smoking cessation information seeking, with Google searches for “quit” and “smoking” peaking early in the week. Similar patterns were observed for smoking cessation treatment seeking, such as calls to quitlines. These findings suggest that smoking cessation behaviors may have a weekly rhythm that could be leveraged to improve smoking cessation efforts. Aims To assess whether weekly enrollment and usage patterns exist for an Internet smoking cessation intervention. Methods We used process data from a large, longstanding Internet smoking cessation intervention (www.becomeanex.org). Pearson's chi-squared tests were performed to identify day-of-the week differences in enrollment, first visit to site community pages, and quit date. Differences were considered statistically significant at the 1% level if p, Highlights • Enrollment rates for an Internet smoking cessation intervention were highest on Mondays and Tuesdays. • Participants tended to select quit dates that fell on Sunday-Tuesday, though Thursday quit dates were also common. • Some website features were utilized at higher rates by users who enrolled early in the week compared to over the weekend. • Patterns of enrollment and engagement may indicate general fluctuations in smokers' interest in and commitment to quitting. • Internet interventions and public health campaigns could deliver strategic messaging when smokers may be more receptive.

Introduction:Emerging evidence suggests a heightened interest in healthy behaviour changes, including smoking cessation, at the beginning of the week. Evidence from Google searches, quitlines, and cessation websites show greater information-seeking and interest in early week quitting.Aims:This pilot assesses the comparative effectiveness of a smoking cessation intervention that encourages participants to use Mondays as a day to quit or recommit to quitting smoking.Methods:We partnered with existing smoking cessation group programs to conduct a quasi-experimental, pre–post study. Both comparison and intervention groups received the same standard-care curriculum from program instructors. Intervention group participants received Monday materials including a wallet card and a mantra card during enrolment. On Mondays, intervention participants received an emailed tip-of-the-week and were encouraged to quit or recommit to quitting. Quit buddies were recommended in both groups, but intervention participants were encouraged to check-in with quit buddies on Mondays. The outcomes of smoking abstinence, number and length of quit attempts, and self-efficacy were assessed at the final program session and three months later.Results:At the last session, intervention group participants who were still smoking had a higher self-efficacy of quitting in the future, rated their programs as more helpful in quitting smoking, and were more likely to rate quit buddies as very helpful. Differences in self-efficacy were no longer observed at the second follow-up. No differences were observed between intervention and standard group participants in abstinence, number of quits, length of quits, or self-efficacy of staying quit at either follow-up.Conclusions:Encouraging results from this pilot study indicate that further research is needed to explore how Monday messaging may improve smoking cessation programs.

Mobile-phone-based smoking cessation intervention has been shown to increase quitting among smokers. However, such intervention has not yet been applied to secondhand smoke (SHS) reduction programs that target smoking parents of newborns. This randomized controlled trial, undertaken in Changchun, China, assessed whether interventions that incorporate traditional and mobile-phone-based education will help create smoke-free homes for infants and increase quitting among fathers. The results showed that the abstinence rates of the fathers at 6 months (adjusted OR: 3.60, 95% CI: 1.41–9.25; p = 0.008) and 12 months (adjusted OR: 2.93, 95% CI: 1.24–6.94; p = 0.014) were both significantly increased in the intervention group compared to the control. Mothers of the newborns in the intervention group also reported reduced exposure to SHS at 12 months (adjusted OR: 0.53, 95% CI: 0.29–0.99; p = 0.046). The findings suggest that adding mHealth interventions to traditional face-to-face health counseling may be an effective way to increase male smoking cessation and reduce mother and newborn SHS exposure in the home.

Zusammenfassung. Einleitung: In der verhaltenstherapeutisch orientierten Raucherbehandlung spielt die Identifizierung von Auslösesituationen eines aufkommenden Rauchdrucks eine große Rolle. Im Rahmen der bisherigen Forschung konnte gezeigt werden, dass bildliche Darstellungen mit Nikotinthematik aus der Anfangsphase des Rauchrituals einen hohen Anreizwert besitzen, Bilder aus der Endphase eines Rauchvorgangs jedoch kaum Nikotincraving auslösen. Unsere Arbeit beschäftigt sich mit der Frage, ob bei Rauchern mit einer zusätzlichen Alkoholabhängigkeit auch die an sich wenig einladenden Darstellungen aus der Endphase anders als bei den bislang untersuchten Rauchern ohne Substanzabhängigkeiten ein hohes Rauchverlangen auslösen. Methode: In zwei Studien wurden jeweils 12 männliche und 12 weibliche Probanden mit einer kombinierten Alkohol- und Tabakabhängigkeit untersucht. Den Studienteilnehmern wurden auf einem Farbmonitor Bilder mit Nikotinthematik aus den verschiedenen Phasen des Rauchrituals präsentiert. Jedes Bild sollte in Hinblick auf das ausgelöste Rauchverlangen (Craving) sowie zu den beiden emotionalen Dimensionen Valenz und Arousal bewertet werden. Bildmaterial und Bildbeurteilung wurden bereits in einer Reihe von Studien eingesetzt. Ergebnisse: Auch bei unseren alkohol- und tabakabhängigen Probanden lösten Bilder aus der Anfangsphase des Rauchrituals ein höheres Rauchverlangen aus als Bilder aus der Endphase. Es zeigte sich aber auch ein geschlechtsspezifischer Interaktionseffekt: Frauen reagierten auf das wenig einladende Bildmaterial der Endphase mit einem höheren Rauchverlangen als Männer. Dabei schien die bei den Bildpräsentationen generierte Erregung (Arousal) die modulierende Größe bei der Entstehung dieses Befundes zu sein. Diskussion: Hier soll aufgezeigt werden, dass sich in Hinblick auf unsere Ergebnisse bei der Behandlung der Tabakabhängigkeit die Aufgabe stellt, in gemischtgeschlechtlichen Gruppenformaten frauenspezifische Auslösesituationen etwa im Bereich von Stress und Erregung explizit und ausführlich anzusprechen.

Behavioural economics – the study of human decision making and how it sometimes deviates systematically from the assumptions of standard economic theory – has attracted a lot of attention in the health policy discourse over recent years. Many appear to believe that behavioural economic findings can be used only to help inform policies that manipulate the choices made by citizens; i.e. so-called nudge policy. However, these findings can be used to inform several different policy frameworks, from seemingly innocuous liberty-preserving changes to the contexts people operate in, to the outlawing of certain corporate behaviours. This article depicts diagrammatically, with the aid of a ‘behavioural policy cube’ and in relation to smoking cessation interventions, the conceptual parameters of several behavioural economic-informed policy frameworks, which could be easily extended to other areas of health, and indeed broader public, policy.

Introduction: Smokers with respiratory diseases are less likely to quit than those without impaired lung function, yet few studies have investigated the effectiveness of smoking cessation interventions with this population, and none have used a computer-tailored approach.Aims: This paper aims to fill this gap in the literature by exploring smokers’ experiences when trying to quit and their perceptions of a computer-tailored intervention.Methods: Semi-structured interviews were conducted with 26 smokers recruited from six general practises in North London. Thematic analysis was conducted to examine participants’ previous experiences of quitting and their perceptions of receiving personal tailored feedback reports to aid smoking cessation.Results: Participants discussed how their positive smoking experiences coupled with their negative cessation experiences led to conflicts with quitting smoking. Although the computer-tailored intervention was key in prompting quit attempts and participants valued its personal approach; it was not sufficient as a stand-alone intervention.Conclusions: The results highlight the difficulties that smokers experience when quitting and the need for a more personalised stop smoking service in smokers with respiratory diseases. The study also demonstrates the application and potential for computer-tailored intervention as part of a wider programme of long-term smoking cessation.

Previous research has found that young women’s smoking relates to their performance of feminine gender identities. Using an intersectional approach, we explore in this study how young women’s smoking is implicated in the doing and undoing of femininities, as well as other intersecting identities. Discourse analysis was used to examine interviews and a photography activity conducted with young women, both current and ex-smokers. This analysis revealed four culturally dominant repertoires: “cigarettes and smoking styles as gendered”, “smoking as controlling weight”, “smoking as a sexual tool”, and “smoking as compromising appearance”. Young women’s experiences and negotiations of discourse surrounding smoking and femininity were shaped by intersecting social class and sexual identities. These findings can be used to inform the development of smoking cessation interventions which recognise the diversity in how young women perform femininity.

Background Tobacco use is the leading cause of preventable disease and death in Europe and worldwide. Nurses, if properly educated, can contribute to decreasing the burden of tobacco use in the region by helping smokers quit smoking. Aims To assess: (a) the feasibility of an online program to educate nurses in Czech Republic and Poland on evidence-based smoking cessation interventions for patients and (b) self-reported changes in practices related to consistently (usually or always) providing smoking cessation interventions to smokers, before and 3 months after participation in the program. Methods A prospective single-group pre-post design. Results A total of 280 nurses from Czech Republic and 156 from Poland completed baseline and follow-up surveys. At 3 months, nurses were significantly more likely to provide smoking cessation interventions to patients who smoke and refer patients for cessation services (p < .01). Nurses significantly improved their views about the importance of nursing involvement in tobacco control. Implications for Practice Education about tobacco control can make a difference in clinical practice, but ongoing support is needed to maintain these changes. Health system changes can also facilitate the expectation that delivering evidence-based smoking cessation interventions should be routine nursing care. Linking Evidence to Action Educating nurses on cessation interventions and tobacco control is pivotal to decrease tobacco-related disparities, disease, and death. Online methods provide an accessible way to reach a large number of nurses.

Background: In the past decade, several smoking cessation interventions have been developed and implemented through information and communication technology (ICT). Evidence suggests that they might be suitable for large-scale public health interventions, based on updated communication media characteristics in terms of interplay between technology and graphical user interface, reaching high numbers of individuals. Objectives: We aimed at estimating web/text-based interventions effectiveness as compared with approaches routinely used for general population, that is smoking assessment or non-electronic self-help materials. Methods: A systematic review and meta-analysis was performed searching through PubMed, Embase and PsycInfo databases, as well as references of relevant papers. Heterogeneity and risk of bias were evaluated following standard methods. In addition, we performed meta-regression analyses testing if candidate covariates moderate the overall effect. Results: Slight but significant effectiveness was found for eHealth interventions over control conditions (RR = 1.28, 95% CI: 1.14–1.45). Meta-regressions showed similar findings for web- and text-based interventions. The effect seemed moderated by the follow-up period, being higher at 3 months and lower at 6/7 months follow-up. Conclusions: Our results outline moderate effectiveness of web/text-based interventions. However, a paucity of properly controlled studies and lack of information on several effect modifiers still hamper the development and implementation of smoking cessation interventions through ICT.

Mobile text-messaging smoking cessation interventions have demonstrated their efficacy in increasing cessation rates. These interventions tend to be multifaceted and there is a need to specify their building blocks. The purpose of this study was to use the Behavioural Change Techniques Taxonomy V1 (BCTTv1) to systematically analyse the behaviour change techniques present in the SmokefreeTXT (SFTXT) adult programme. The entire SFTXT library was coded using the BCTTv1. Frequencies were calculated to assess the presence of BCT groups and unique BCTs in the entire programme. The mix of BCTs was also examined by programme week and during periods of high user dropout. Of the 16 groups of behavioural techniques, 14 were present in SFTXT. Of the 93 distinct BCTs, 41 were present in the full SFTXT message library. The most prevalent BCT groups were Feedback and Monitoring, Natural Consequences, Social Support, and Shaping Knowledge. There were differences in the mix of BCTs across the duration of the intervention. The results will enable us to test how changes in the use of specific BCTs and their frequency of use over time, impact (1) engagement with the programme (particularly during the days with high dropout rates), and (2) smoking cessation outcomes over time.

While many women quit smoking spontaneously before or during early pregnancy, information is limited about maternal smoking as pregnancy advances. This study examined the smoking behaviour of women throughout pregnancy and immediately after delivery. Women on the postnatal ward were consented for BCO testing and after completing this under supervision, they were asked to complete an accompanying questionnaire on smoking behaviour (unsupervised). In this small pilot study, we found BCO testing in an inpatient environment, not surprisingly, was ineffective in identifying current smokers. As reported in other studies, we found that few women quit smoking after the time of the first antenatal visit. This suggests that postnatal smoking cessation interventions should receive greater attention. We recommend that all women who identify themselves as current smokers at the first antenatal visit should complete a short questionnaire postnatally and should be offered support to quit smoking or maintain cessation after they bring their baby home.

The purpose of the present study was to investigate the effect of participation in a health motivation-based intervention program on college students’ smoking behavior. One hundred and seventy smokers (mean age = 19.0 years, 151 males) from nine colleges and universities in Chengdu, China were randomly assigned to one of 5 groups that received between one and four sessions of the intervention, or no intervention. The intervention sessions included sequential activities based on the stages of the process model of health motivation. Each group completed questionnaires assessing health motivation and smoking behaviors at pre-test, immediately post-intervention, and at one month follow-up. Analyses indicated that the intervention program did improve participants’ health motivation, and that was associated with reduced levels of smoking relative to baseline. The greater the number of sessions, the greater the reduction in smoking.

Background Policies and programs implemented to promote smoking cessation among youth present disparate results. These variations are explained by interventions themselves but also by context, population and implementation characteristics. Our objective was to analyze these factors, related to enrollment and participation in a smoking cessation program, implemented in vocational or technical schools. Methods Population factors were studied by a systematic review about determinants of smoking cessation among 10-24 years old, updating a previous one. Contextual and implementation factors were identified by a qualitative multiple cases study. A smoking cessation program, TABADO, had been implemented in 3 regions in France, in 10 vocational or technical schools (1 school/1 case). Data collection included 51 observations, 46 semi-structured interviews, and 3 interdisciplinary seminars. Results The review identified 46 factors probably or possibly related to a successful smoking cessation, both individual (e.g. smoking frequency) and collective (e.g. relationship smoking status, anti-tobacco legislation). The case study allowed us to objectify positive or negative factors that influence the enrollment and the participation in the program (e.g. presence of a referent in the school, combination with the school program). Finally, we identified prerequisites to gather before starting such a program. Conclusions This mixt design highlights factors on which we must focus to increase the success of a smoking cessation program for youth. A key factor is to tailor intervention and implementation modalities to the local context. Results enabled us to product a pragmatic guide, TABADO 2, which is now used in a national scaling process. They also will be used to build an intervention theory, which could be used for any smoking cessation intervention for youth. Acknowledgments: The TABADO IDF study group, Inca, the région Lorraine and the ARS Nouvelle-Aquitaine for their financial support. Key messages A smoking cessation program must be a global strategy, considering contextual, population and organizational factors. Instead of trying to strictly apply a protocol, a complex intervention must be tailored to the context in which it is implemented.

SummarySmoking contributes to health inequalities for people with severe mental illness (SMI). Although smoking cessation interventions are effective in the short term, there are few long-term trial-based estimates of abstinence. The SCIMITAR trials programme includes the largest trial to date of a smoking cessation intervention for people with SMI, but this was underpowered to detect anticipated long-term quit rates. By pooling pilot and full-trial data we found that quit rates were maintained at 12 months (OR = 1.67, 95% CI 1.02–2.73, P = 0.04). Policymakers can now be confident that bespoke smoking cessation interventions produce successful short- and long-term quitting.

Introduction Smoking is a key determinant of mortality among people living with HIV (PLWH). Methods To better understand the effects of smoking cessation interventions in PLWH, we conducted a pooled analysis of four randomized controlled trials of hospital-initiated smoking interventions conducted through the Consortium of Hospitals Advancing Research on Tobacco (CHART). In each study, cigarette smokers were randomly assigned to usual care or a smoking cessation intervention. The primary outcome was self-reported past 30-day tobacco abstinence at 6-month follow-up. Abstinence rates were compared between PLWH and participants without HIV and by treatment arm, using both complete-case and intention-to-treat analyses. Multivariable logistic regression was used to determine the effect of HIV status on 6-month tobacco abstinence and to determine predictors of smoking cessation within PLWH. Results Among 5550 hospitalized smokers, there were 202 (3.6%) PLWH. PLWH smoked fewer cigarettes per day and were less likely to be planning to quit than smokers without HIV. At 6 months, cessation rates did not differ between intervention and control groups among PLWH (28.9% vs. 30.5%) or smokers without HIV (36.1% vs. 34.1%). In multivariable regression analysis, HIV status was not significantly associated with smoking cessation at 6 months. Among PLWH, confidence in quitting was the only clinical factor independently associated with smoking cessation (OR 2.0, 95% CI = 1.4 to 2.8, p < .01). Conclusions HIV status did not alter likelihood of quitting smoking after hospital discharge, whether or not the smoker was offered a tobacco cessation intervention, but power was limited to identify potentially important differences. Implications PLWH had similar quit rates to participants without HIV following a hospital-initiated smoking cessation intervention. The findings suggest that factors specific to HIV infection may not influence response to smoking cessation interventions and that all PLWH would benefit from efforts to assist in quitting smoking. Trial Registration (1) Using “warm handoffs” to link hospitalized smokers with tobacco treatment after discharge: study protocol of a randomized controlled trial: NCT01305928. (2) Web-based smoking cessation intervention that transitions from inpatient to outpatient: NCT01277250. (3) Effectiveness of smoking-cessation interventions for urban hospital patients: NCT01363245. (4) Effectiveness of Post-Discharge Strategies for Hospitalized Smokers (HelpingHAND2): NCT01714323.

Introduction: In a developing country like India, patients of pulmonary Tuberculosis (TB) form an important subset of individuals requiring smoking cessation counselling and pharmacotherapy. Smoking increases risk of Mycobacterium Tuberculosis (MTB) infection, the risk of progression from infection to disease and the risk of death from TB. Smoking cessation counselling and pharmacological therapy help in improving outcomes of TB treatment, reduce transmission of TB and improve the quality of life of TB patients. Aim: To assess the effectiveness of smoking cessation counselling combined with bupropion in patients of pulmonary tuberculosis using urinary cotinine levels. The study was a prospective interventional study, carried out at Out Patient Department (OPD) and inpatient setting of a tertiary care respiratory centre in an urban setting between the period of July 2016 to June 2019. Materials and Methods: Seventy-six pulmonary TB patients who were active tobacco smokers and fulfilled the inclusion criteria were recruited for the study. Subjects received smoking cessation counselling for one year along with tab bupropion for first three months. Effectiveness of the interventions was assessed by regular follow-up visits at one month, three months, six months and twelve months post-initiation of therapy. Data analysis was done by using SPSS version 17.0 and Microsoft Excel. Chi-square test was used and p-value

Background Recruitment of participants into community randomised controlled trials (RCTs) is problematic; however, recruitment of participants from disadvantaged backgrounds to community smoking cessation trials is especially challenging. This paper will present recruitment and retention rates, successes and challenges in the We Can Quit2 (WCQ2) community intervention trial of smoking cessation in disadvantaged women. Methods We Can Quit, is a smoking-cessation behavioural support intervention delivered by community facilitators through 12-weekly group sessions, with free Nicotine Replacement Therapy, against a form of usual care. Sample size was estimated at 194 in total (97 per arm). Four matched pairs of districts of approximately 10,000 women in each (eight clusters) were identified from which eligible women could be recruited. The recruitment target was 24-25 per cluster. Consent was obtained prior to cluster randomisation. Individual participants were recruited via print media such as leaflets, posters, information stands in local facilities e.g. creches as well as through local and social media e.g. radio and targeted Facebook advertisements. A small financial incentive was provided to aid retentions. Results 208 women registered for the study. Women heard about WCQ2 mainly via Facebook or Twitter (30.4%), and personal networks (16%) 184 (84.5%) were eligible with living outside the area being the most common reason for ineligibility. 125 (67.9% of eligible women; 65.5% of target) consented. Retention rates will be presented. Barriers to recruitment included time of year. Successful strategies included application of in-depth knowledge of local communities to target eligible women. Social media helped target younger women. Recruitment occurred over four waves, allowing for the application of iterative learning. Conclusions Recruitment to a community based RCT was challenging however, local community engagement, use of social media, and personal networks were successful strategies. Early and active engagement with local stakeholders with in-depth knowledge of the community is important. Key messages Intense planned community mobilisation is needed to recruit disadvantaged women to smoking cessation trials. Social media an important route to recruitment of younger women.

Background The integration of Behavioral Activation Treatment for Depression (BAT-D) into smoking cessation interventions is a promising approach to address depression as a barrier to quitting. However, this approach has only been tested as a face-to-face intervention, which has low reach. Objective The aims of the study were to develop a BAT-D mobile health app with high potential reach and determine its feasibility, acceptability, and preliminary effects on theory-based behavioral processes of behavioral activation, reduced depressive symptoms, and smoking cessation. Methods Following a user-centered design process consisting of competitive analysis, focus groups, and prototype testing, we conducted a single-arm pilot trial of Actify!, a BAT-D app for depressed smokers. Participants used SmokefreeTXT along with Actify! to provide cessation content that had not yet been built into the app for this initial phase of pilot testing. Participants in the trial were current, daily smokers with mild to moderate depressive symptoms. We examined use outcomes for all enrolled participants and process and cessation outcomes at 6 weeks postenrollment for study completers (16/17, 94% retention). Results Regarding acceptability, average number of log-ins per participant was 16.6 (SD 13.7), and 63% (10/16) reported being satisfied overall with the app. Posttreatment interviews identified some usability challenges (eg, high perceived burden of planning and scheduling values-based activities). There was a significant decrease in depressive symptoms from baseline to follow-up (mean change in Patient Health Questionnaire–9 scores was –4.5, 95% CI –7.7 to –1.3; P=.01). Additionally, carbon monoxide (CO)-confirmed, 7-day point prevalence abstinence (PPA) at 6-week follow-up was 31% (5/16), and the 30-day PPA was 19% (3/16). Conclusions Results demonstrate promising engagement with Actify! and potential for impact on theory-based change processes and cessation outcomes. Preliminary quit rates compare favorably to previous trials of smoking cessation apps for the general population (ie, short-term, self-reported 30-day quit rates in the 8% to 18% range) and a previous trial of face-to-face BAT-D for depressed smokers (ie, CO-confirmed, 7-day PPA rate of 17% at end of treatment).

El objetivo de este trabajo es identificar las limitantes y oportunidades para el desarrollo de intervenciones de cesación del uso de tabaco en farmacias de comunidad de Costa Rica. En total se desarrollaron tres grupos focales, entre los meses de noviembre de 2014 y junio de 2015, donde se recolectó información que, posteriormente se clasificó en cuatro categorías principales: tratamiento, conocimiento y creencias, apoyo al paciente y espacio laboral. Las reuniones fueron grabadas, transcritas verbatim y analizadas utilizando ATLAS.ti 7. Los farmacéuticos que participaron en los grupos focales (n = 22) mostraron interés por las diferentes opciones de tratamiento, farmacológico y no farmacológico, disponibles para la cesación del uso del tabaco que se pueden utilizar en las farmacias de comunidad. Los participantes también se enfocaron en la necesidad de mejorar sus habilidades de comunicación y su conocimiento sobre la dependencia a la nicotina, así como desarrollar mejores herramientas para interactuar con los pacientes fumadores. El grupo de farmacéuticos costarricenses participantes es consciente de su importante papel en brindar intervenciones de cesación del uso del tabaco. Intervenciones breves, de 3-5 minutos, deben ser presentadas como estrategias efectivas para farmacéuticos de comunidad con carga laboral alta. The aim of this study was to identify limitations and opportunities for providing brief smoking cessation interventions in Costa Rican community pharmacies. A total of three focus groups were conducted between November 2014 and June 2015. Information collected was classified into four main categories: treatment, knowledge and beliefs, patient support, and work transcribed verbatim, and analyzed using ATLAS.ti 7. Pharmacists who participated in the focus groups (n = 22) were concerned with different aspects of pharmacological and non-pharmacological smoking cessation treatment options they can use to address tobacco consumption. Participants also focused on the need to improve their communication skills and nicotine dependence knowledge, and to have better tools to interact with smokers. Participants were aware of their important role in providing smoking cessation interventions. Brief, 3-5 minute, smoking cessation interventions must be presented as an effective strategy for busy community pharmacists. Universidad de Costa Rica/[]/UCR/Costa Rica UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias de la Salud::Instituto de Investigaciones Farmacéuticas (INIFAR) UCR::Vicerrectoría de Docencia::Ciencias Sociales::Facultad de Ciencias Sociales::Escuela de Psicología

There is evidence that social media offer a great field for successful health interventions through enhancement of commitment and social support. FΒ was shown to be a feasible and acceptable environment to achieve smoking cessation interventions. We present the case of 12 smokers attending the SC outpatient clinic that additionally created a FB closed-group, in a self-motivated attempt to support each other. All smokers (characteristics shown at table 1), attended 4 behavioral counseling sessions and 91% used pharmaceutical treatment and followed for additionally 3 months. They all consider themselves to be skilled FB users with 66% reporting daily use of social media. 53% of the participants mentioned that they attended the closed-group daily, while the rest around 3 times a week, all of them both sharing posts and “liking” others’ posts. 83% succeeded in quitting in 4 months and still are participating at the group. All of the members reported that participation in such a group can play a supplemental role to the outpatient clinic, but all rejected replacement of in person visits. 58% believe that this could substitute some visits saving time, though not at the beginning of their attempt. All of them believe that their engagement to this group reinforced their attempts for smoking cessation. This case further supports evidence that FB-group based interventions enhance engagement to smoking cessation.

There were high smoking rates among young male college students in Korea. We aimed to investigate the prevalence of and factors affecting abstinence from smoking following smoking cessation service attendance in this population. Data were collected between 1 August 2015 and 20 August 2018. Participants were administered more than nine face-to-face and telephone counseling sessions by trained tobacco cessation specialists for six months. Follow-up assessments were conducted at 4, 6, and 12 weeks, and 6 months after the quit date. A total of 3978 male college student smokers were enrolled, their mean age was 23.17 (&plusmn, 3.45) years. Almost one-third of the participants (64.9%) reported that they had attempted to quit during the past year. The number of cigarettes smoked per day, CO ppm, and Fagerstr&ouml, m Test of Nicotine Dependence score at the baseline were negatively associated with abstinence, while motivational variables&mdash, importance, confidence, and readiness&mdash, were positively associated with abstinence. Our results suggest that provision of visiting smoking cessation services can be an active intervention platform for college student smokers who need professional assistance or support. Active and accessible support should be provided to such people. Visiting a smoking cessation service may result in increased long-term abstinence rates in such students.

Physicians play a key role in combating tobacco use. This study aims to evaluate the knowledge, attitude, and behaviors toward smoking cessation and vaping cessation interventions among physicians in Poland, to identify factors shaping physicians&rsquo, behaviors toward smoking and vaping cessation interventions, and to assess differences in the tobacco cessation interventions recommended for cigarette smokers and users of electronic cigarettes (e-cigarettes). A questionnaire-based survey was conducted in 2018 among physicians attending mandatory public health training courses delivered at the School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland. The questionnaire included 25 questions related to tobacco product use and smoking cessation interventions. Data were obtained from 423 physicians (64.3% female, mean age 32.0 &plusmn, 5.8 years) with response rate of 84.6%. Current cigarette smoking was declared by 7.8% of participants, 1.9% of participants were e-cigarette users and 1.9% used heated tobacco. Smoking cessation interventions were offered more often to patients who smoked cigarettes than those who used e-cigarettes (p &lt, 0.001). Physicians&rsquo, behaviors toward smoking cessation and vaping cessation interventions were associated with (p &lt, 0.05) physicians&rsquo, smoking status and self-declared knowledge about smoking cessation methods. Among physicians in Poland, discussion of smoking cessation was not common behavior and limited mainly to identification of smoking status.

International audience; The growing field of mHealth has often dealt with the modification of harmful behaviors, such as smoking, that are associated with medical conditions. Smoking behavior has been targeted by numerous mHealth smoking cessation interventions with the help of a wide range of behavior change support (BCS) techniques. However, the exploitation of the established BCS technique of social comparison by mHealth research on smoking cessation has been limited. Based on up-to-date BCS theory and following a user-centered design, we have developed a novel smartphone application, namely QuitIT!, for smoking behavior modification with the help of social comparison. This paper presents the development of QuitIT! as well as its preliminary evaluation through a small pilot study. The latter has yield encouraging initial results concerning the feasibility and the effectiveness of QuitIT! as an mHealth tool for smoking BCS.