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Cigarette smoking remains a leading cause of preventable disease and death worldwide. Due to the devastating negative health effects of smoking, many users attempt to quit, but few are successful in the long-term. Thus, there is a critical need for novel therapeutic approaches. In these investigations, we sought to examine whether cannabidiol (CBD) has the potential to be repurposed as a nicotine cessation therapeutic. In the first study, male and female mice were trained to respond for intravenous nicotine infusions at either a low or moderate nicotine dose and then were pretreated with CBD prior to their drug-taking session. We found that CBD produced a significant decrease in the number of nicotine rewards earned, and this effect was evidenced across CBD doses and with both the low and moderate levels of nicotine intake. These effects on drug intake were not due to general motor-related effects, since mice self-administering food pellets did not alter their behavior with CBD administration. The potential effects of CBD in mitigating nicotine withdrawal symptoms were then investigated. We found that CBD attenuated the somatic signs of nicotine withdrawal and prevented nicotine's hyperalgesia-inducing effects. Taken together, these results demonstrate that modulation of cannabinoid signaling may be a viable therapeutic option as a smoking cessation aid.

Aims Methods Results Conclusions To summarise systematic reviews on tobacco addiction published by the Cochrane Tobacco Addiction Group (CTAG) from 2021 to 2023.We identified all new and updated Cochrane Reviews published by CTAG between 2021 and 2023. We present key results from these reviews and discuss promising avenues for future research.CTAG published five new reviews and one overview of reviews, and updated eight reviews. Review evidence showed that all main pharmacotherapies (varenicline, cytisine, bupropion and nicotine replacement therapy [NRT], especially when patches are combined with fast acting forms like gum) are effective for smoking cessation, as are nicotine e‐cigarettes. Evidence suggested similar magnitude of effects of varenicline, cytisine, and nicotine e‐cigarettes; these emerged as the most effective treatments. Evidence also supported behavioural counselling and financial incentives for smoking cessation. Secondary analyses of the Cochrane review of e‐cigarettes for smoking cessation showed over half of participants assigned to e‐cigarette conditions were still using them at six months or longer, that biomarkers of potential harm significantly reduced in people switching from smoking to vaping or to dual use, and that there was insufficient evidence to draw associations between e‐liquid flavours and smoking cessation. Findings on mindfulness‐based interventions, interventions delivered by dental and primary care professionals, interventions to prevent weight gain after smoking cessation, and interventions for waterpipe cessation were less certain. Reviews of observational evidence showed that smoking cessation reduced cardiovascular events and mortality in people living with cardiovascular disease, and improved mental health.Nicotine replacement therapy (especially patches combined with fast acting forms), varenicline, cytisine, bupropion, nicotine e‐cigarettes, behavioural counselling, and financial incentives are all effective ways to help people quit smoking. Quitting smoking improves mental health and reduces cardiovascular events and mortality in people living with cardiovascular disease. [ABSTRACT FROM AUTHOR]

Aim: The use of tobacco is responsible for many preventable diseases and deaths worldwide. Digital interventions have greatly improved patient health and clinical care and have proven to be effective for quitting smoking in the general population due to their flexibility and potential for personalization. However, there is limited evidence on the effectiveness of digital interventions for smoking cessation in Asian countries. Methods: Three major databases - Web of Science (WOS), Scopus, and PubMed - for relevant studies published between 1 January 2010 and 12 February 2023 were searched for studies evaluating the effectiveness of digital intervention for smoking cessation in Asian countries. Results: A total of 25 studies of varying designs were eligible for this study collectively involving a total of n=22,005 participants from 9 countries. Among different digital tools for smoking cessation, the highest abstinence rate (70%) was reported with cognitive behavioural theory (CBT)-based smoking cessation intervention via Facebook followed by smartphone app (60%), WhatsApp (59.9%), and Pharmacist counselling with Quit US smartphone app (58.4%). However, WhatsApp was preferred over Facebook intervention due to lower rates of relapse. WeChat was responsible for 15.6% and 41.8% 7-day point prevalence abstinence. For telephone/text messaging abstinence rate ranged from 8-44.3% and quit rates from 6.3% to 16.8%. Whereas, no significant impact of media/multimedia messages and web-based learning on smoking cessation was observed in this study. Conclusion: Based on the study findings the use of digital tools can be considered an alternative and cost-effective smoking cessation intervention as compared to traditional smoking cessation interventions. [ABSTRACT FROM AUTHOR]

Introduction. This study aimed to assess the effectiveness of a multicomponent nursing intervention using mindfulness and brief advice for the reduction of tobacco use, anxiety, stress, depressive symptoms, and the improvement of self-efficacy. Method. This was a quasi-experimental study with 41 participants, and the treatment consisted of an intervention composed of two strategies: the protocol "Programa de Intervención Breve para Adolescentes que Inician el Consumo de Alcohol y otras Drogas" for the brief advice" while the Mindfulness Based Cognitive Therapy program was used for mindfulness. The intervention lasted 10 weekly sessions; participants received phone calls and were given an audio CD to perform the mindfulness practices at home and a work manual to conductself-records of consumption as well as guidance from reinforcement to help maintain motivation to behavior change. Results. The results show that these interventions were effective tools to reduce nicotine dependence (p=.001, d=1.14), the number of cigarettes smoked (p=.001, d=1.60), levels of cotinine in urine (p=.001), stress (p=.001, d=1.42), anxiety (p=.001, d=.90), and depressive symptoms (p=.001, d=.81), and increase self-efficacy (p=.001, d=1.48). Conclusions. The findings show that a multicomponent nursing intervention incorporating brief advice and mindfulness can be an effective treatmentfor people wishing to reduce or cease tobacco consumption. [ABSTRACT FROM AUTHOR]

Tobacco addiction is the primary preventable factor contributing to global mortality, and nicotine is one of the substances with the greatest potential for addiction. With a strong affinity for the α4β2 subtype receptor, cytisine (CYT) functions as a partial agonist of the acetylcholine nicotinic cholinergic receptor. It counteracts the effects of nicotine without causing any withdrawal symptoms. These features, combined with its limited mild adverse effects and minimal drug–drug interactions, make cytisine a cost-effective treatment for smoking cessation. The current protocol describes a prospective observational study on the safety and efficacy of CYT administered to inpatient smokers of the Integrated University Hospital of Verona (IUHVR), Veneto (Italy). This is a monocentric, observational, and prospective study on both sex smokers over the age of 18 years admitted to the IUHVR who meet the criteria for recruitment and have given their consent. Eligible participants will be assigned to the CYT intervention based on the West dosing schedule and will be followed up for 12 months from treatment initiation. Evaluation of safety, efficacy, and compliance will be assessed at 7 and 25 days, with follow-up at 3, 6, and 12 months from the start of the treatment (quit day). During each visit, any adverse events or adverse reactions reported by patients following the intake of CYT will be evaluated. This study will contribute, for the first time, to the knowledge about the use of CYT for smoking cessation in a hospital setting.

Introduction: Smoking remains a pervasive and persistent health issue in Indonesia. Numerous studies have explored the impact of smoking and fractional exhaled nitric oxide (FeNO) levels on college students. However, none have been conducted in Indonesia. With a substantial number of smokers and teenage smokers in the country, there is a critical need to understand the implications of smoking. This study aimed to enhance the comprehension of the motivations behind smoking habits and, consequently, to devise more effective smoking cessation programs. It specifically sought to elucidate the relationship between smoking habits and exhaled nitric oxide (NO) levels among college students and to explore the reasons why students smoke. Methods: This study employed analytical and descriptive cross-sectional approaches. We interviewed 124 participants, 30 of whom were randomly selected for FeNO-level testing. Results: The mean age of the subjects was 20.1 ± 1.54 years. Of these, 48 (38.7%) were enrolled in science and technology programs and 76 (61.3%) in social sciences. The Brinkman index predominantly indicated a mild level of smoking (96.8%), with a moderate level observed in 3.2% of the subjects. The median FeNO level was 12 ppb. According to the Horn questionnaire, the most cited reasons for smoking were pleasure (71%), followed by stress relief (66.1%) and stimulation (38.7%). No significant correlation was found between the Brinkman index and FeNO levels. Conclusion: The primary factors influencing smoking habits among the subjects were stress relief and the pleasure derived from smoking. No correlation was observed between smoking habits and exhaled NO levels.

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Background: Nicotine, a psychoactive compound from the tobacco plant, produces a reward effect that potentially causes addiction. It is postulated that nicotine addiction occurs through increased reactive oxygen species production in nucleus accumbens, which causes damage to the endogenous antioxidant defense system resulting in an increased need for nicotine intake, which leads to addiction. The antioxidants, andrographolide and epigallocatechin gallate (EGCG), are expected as potential substances to decrease the risk of nicotine addiction. This study aimed to analyze the effect of andrographolide and EGCG on the risk of addiction induced by nicotine and cigarette smoke extract (CSE) in mice. Methods: Thirty-five Balb/c male mice, divided into seven groups, were used in this study. The administered drugs were normal saline 1.0 mL/kg BW as control group, nicotine 0.5 mg/kg BW, CSE 1.0 mg/kg BW, andrographolide 50 mg/kg BW, and EGCG 50 mg/kg BW as pre-treatment. Conditioned place preference (CPP) with a biased design method was used to evaluate the reward effects induced by nicotine and CSE. Several stages were carried out, namely pre-conditioning, conditioning, post-conditioning, extinction, and reinstatement tests. Results: Based on the CPP score, both nicotine (p

Introduction and purpose: The primary objective of this literature review is to thoroughly investigate the topic of nicotine replacement therapy, considering the latest discoveries and detailing various forms of available nicotine substitution. Materials and methods: Literature review of PubMed and Google Scholar databases. State of Knowledge: Tobacco smoking remains one of the leading causes of premature death worldwide, accounting for millions of deaths each year. Nicotine, the addictive component of tobacco, is responsible for sustaining cigarette smoking patterns and making smoking cessation particularly challenging. Nicotine replacement therapy (NRT) is now considered one of the primary methods to help individuals quit smoking by reducing withdrawal symptoms and cravings associated with cessation. Conclusions: Over the years, extensive research has confirmed the effectiveness and safety of NRT, resulting in the development of different forms of nicotine substitution. The outcomes of using these various forms are similar and premature discontinuation by patients remains a primary reason for NRT failure. Therefore, it is crucial for each patient to select the form of NRT that meets their individual preferences. The best results are obtained by combining multiple forms of substitution simultaneously, as well as integrating them with other therapeutic methods.

Resumen: El tabaquismo es una enfermedad adictiva, crónica y recidivante que, por su alta prevalencia, morbilidad y mortalidad, se ha convertido en uno de los principales problemas de salud pública a nivel mundial, afectando tanto a los fumadores como al resto de la población expuesta involuntariamente al humo del tabaco.Para superar esta pandemia es fundamental que todos los profesionales sanitarios intervengan sobre el problema de forma adaptada a su nivel asistencial, desde dar breves consejos para dejar de fumar hasta proponer un tratamiento intensivo cognitivo-conductual y farmacológico.Los tratamientos para dejar de fumar han demostrado ser seguros y efectivos, pero lamentablemente los recursos personales y económicos dedicados a la atención del fumador no son proporcionales a la magnitud del problema, con pocas consultas especializadas y falta de financiación para tratamientos farmacológicos.Además, debemos confrontar los argumentos de la industria tabacalera, que interfiere en la lucha contra el tabaquismo con nuevos productos que pretenden ofrecer como «estrategias de reducción de daños» cuando en realidad es su forma de atraer nuevos adictos a los productos del tabaco. Abstract: Smoking is an addictive, chronic and relapsing disease that, due to its high prevalence, morbidity and mortality, has become one of the main public health problems worldwide, affecting both smokers and rest of population involuntarily exposed to smoke tobacco.To overcome this pandemic, it is essential that all health professionals intervene on the problem in a manner adapted to their level of care, from giving brief advice for stop smoking to proposing intensive cognitive-behavioral and pharmacological treatment.Smoking cessation treatments have proven to be safe and effective, but unfortunately, the personal and economic resources dedicated to smoker care are not proportional to the magnitude of the problem, with few specialized consultations and lack of funding for pharmacological treatments.In addition, we must confront the arguments of the tobacco industry that interferes in the fight against smoking with new products that they pretend to offer as «harm reduction strategies» when really it is their way of attracting new addicts to tobacco products.

Tobacco addiction has been largely attributed to nicotine, a component in tobacco leaves and smoke. However, extensive evidence suggests that some non-nicotine components of smoke should not be overlooked when considering tobacco dependence. Yet, their individual effect and synergistic effect on nicotine reinforcement remain poorly understood. The study herein focused on the role of non-nicotine constituents in promoting the effects of nicotine and their independent reinforcing effects. Denicotinized cigarettes were prepared by chemical extracting of cut tobacco, and the cigarette smoke extracts (CSE, used as a proxy for non-nicotine ingredients) were obtained by machine-smoking the cigarettes and DMSO extraction. The compositions of harmful components, nicotine, and other minor alkaloids in both cut tobacco and the CSE of experimental denicotinized cigarettes were examined by GC-MS, and compared with 3R4F reference cigarettes. individually and in synergy with nicotine were determined by conditioned place preference (CPP), dopamine (DA) level detection, the open field test (OFT), and the elevated plus maze (EPM). Finally, the potential enhancement mechanism of non-nicotinic constituents was investigated by nicotine metabolism and monoamine oxidase A (MAOA) activity inhibition in the striatum of mice and human recombinant MAOA. Thenicotine content in smoke from the experimental denicotinized cigarettes (under ISO machine-smoking conditions) was reduced by 95.1% and retained most minor alkaloids, relative to the 3R4F reference cigarettes. It was found that non-nicotine constituents increased acute locomotor activities. This was especially pronounced for DA levels in NAc and CPP scores, decreased the time in center zone. There were no differences in these metrics with DNC group when compared to the NS group. Non-nicotine constituents alone did not show reinforcing effects in CPP or striatum DA levels in mice. However, in the presence of nicotine, non-nicotine constituents further increased the reinforcing effects. Furthermore, non-nicotine constituents may enhance nicotine's reinforcing effects by inhibiting striatum MAOA activity rather than affecting nicotine metabolism or total striatum DA content in mice. These findings expand our knowledge of the effect on smoking reinforcement of non-nicotine constituents found in tobacco products. [ABSTRACT FROM AUTHOR]

This study adopts a novel approach to assessing addiction to cigarettes, small and large cigars, e-cigarettes, smokeless tobacco, and loose smoking tobacco by decomposing tobacco demand into supernumerary and precommitted quantities. Supernumerary tobacco consumption represents a demand component that varies with prices and smoker income, while precommitted consumption is immune to changes in economic circumstances and thus may be reflective of addiction. By empirically estimating the supernumerary and precommitted demand components, we shed light on the severity of tobacco addiction and smoker price and income responsiveness in the United States, which may prove vital in refining various tobacco control policies. [ABSTRACT FROM AUTHOR]

Tobacco addiction is the primary preventable factor contributing to global mortality, and nicotine is one of the substances with the greatest potential for addiction. With a strong affinity for the α4β2 subtype receptor, cytisine (CYT) functions as a partial agonist of the acetylcholine nicotinic cholinergic receptor. It counteracts the effects of nicotine without causing any withdrawal symptoms. These features, combined with its limited mild adverse effects and minimal drug-drug interactions, make cytisine a cost-effective treatment for smoking cessation. The current protocol describes a prospective observational study on the safety and efficacy of CYT administered to inpatient smokers of the Integrated University Hospital of Verona (IUHVR), Veneto (Italy). This is a monocentric, observational, and prospective study on both sex smokers over the age of 18 years admitted to the IUHVR who meet the criteria for recruitment and have given their consent. Eligible participants will be assigned to the CYT intervention based on the West dosing schedule and will be followed up for 12 months from treatment initiation. Evaluation of safety, efficacy, and compliance will be assessed at 7 and 25 days, with follow-up at 3, 6, and 12 months from the start of the treatment (quit day). During each visit, any adverse events or adverse reactions reported by patients following the intake of CYT will be evaluated. This study will contribute, for the first time, to the knowledge about the use of CYT for smoking cessation in a hospital setting., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Torazzi, Tedesco, Ceccato, Santin, Campagnari, Losso, Toldo, Casari, Arzenton, Marini, Chiamulera and Lugoboni.)

Aims: To investigate the comparative and combined effectiveness of four types of components of behavioural interventions for cigarette smoking cessation: behavioural (e.g. counselling), motivational (e.g. focus on reasons to quit), delivery mode (e.g. phone) and provider (e.g. nurse). Design Systematic review and component network meta‐analysis of randomised controlled trials identified from Cochrane reviews. Interventions included behavioural interventions for smoking cessation (including all non‐pharmacological interventions, e.g. counselling, exercise, hypnotherapy, self‐help materials), compared with another behavioural intervention or no support. Building on a 2021 review (CD013229), we conducted three analyses, investigating: comparative effectiveness of the components, whether models that allowed interactions between components gave different results to models assuming additivity, and predicted effect estimates for combined effects of components that had showed promise but where there were few trials. Setting: Community and health‐care settings. Participants: Adults who smoke tobacco. Measurements Smoking cessation at ≥6 months, preferring sustained, biochemically validated outcomes where available. Findings Three hundred and twelve trials (250 563 participants) were included. Fifty were at high risk of bias using Cochrane risk of bias tool, V1 (ROB1); excluding these studies did not change findings. Head‐to‐head comparisons of components suggested that support via text message (SMS) compared with telephone (OR 1.48, 95% CrI 1.13–1.94) or print materials (OR 1.44, 95% CrI 1.14–1.83) was more effective, and individual delivery was less effective than delivery as part of a group (OR 0.78, 95% CrI 0.64–0.95). There was no conclusive evidence of synergistic or antagonistic interactions when combining components that were commonly used together. Adding multiple components that are commonly used in behavioural counselling suggested clinically relevant and statistically conclusive evidence of benefit. Components with the largest effects that could be combined, but rarely have been, were estimated to increase the odds of quitting between two and threefold. For example, financial incentives delivered via SMS, with tailoring and a focus on how to quit, had an estimated OR of 2.94 (95% CrI 1.91–4.52). Conclusions: Among the components of behavioural support for smoking cessation, behavioural counselling and guaranteed financial incentives are associated with the greatest success. Incorporating additional components associated with effectiveness may further increase benefit, with delivery via text message showing particular promise. [ABSTRACT FROM AUTHOR]

Background: There is still limited evidence on the effectiveness and implementation of smoking cessation interventions for people with severe mental illness (SMI) in Dutch outpatient psychiatric settings. The present study aimed to establish expert consensus on the core components and strategies to optimise practical implementation of a smoking cessation intervention for people treated by Flexible Assertive Community Treatment (FACT) teams in the Netherlands. Design: A modified Delphi method was applied to reach consensus on three core components (behavioural counselling, pharmacological treatment and peer support) of the intervention. The Delphi panel comprised five experts with different professional backgrounds. We proposed a first intervention concept. The panel critically examined the evolving concept in three iterative rounds of 90min each. Responses were recorded, transcribed verbatim and thematically analysed. Results: Overall, results yielded that behavioural counselling should focus on preparation for smoking cessation, guidance, relapse prevention and normalisation. Pharmacological treatment consisting of nicotine replacement therapy (NRT), Varenicline or Bupropion, under supervision of a psychiatrist, was recommended. The panel agreed on integrating peer support as a regular part of the intervention, thus fostering emotional and practical support among patients. Treatment of a co-morbid cannabis use disorder needs to be integrated into the intervention if indicated. Regarding implementation, staff's motivation to support smoking cessation was considered essential. For each ambulatory team, twomental health care professionals will have a central role in delivering the intervention. Conclusions: This study provides insight into expert consensus on the core components of a smoking cessation intervention for people with SMI. The results of this study were used for the development of a comprehensive smoking cessation program. [ABSTRACT FROM AUTHOR]

Tobacco addiction, which causes the death of more than 8.5 million people in the world every year, is a preventable global public health problem. There are 1.1 billion adult smokers worldwide and 60% of them desire or intend to quit but unfortunately, the tobacco industry continues to profit at the expense of people's lives by marketing electronic cigarettes and heated tobacco products as a smoking cessation method and they continue to poison young people with new threat tobacco products, promising a "smoke-free future" Turkish Thoracic Society is actively involved in the implementation of the National Tobacco Control Program to protect public health and has warned and raised awareness of new threats to the youth, such as electronic cigarettes and heated tobacco products. The purpose of this report is to provide information about electronic cigarettes and heated tobacco products and to present TTJ's position on the subject. [ABSTRACT FROM AUTHOR]

Background: The habit of smoking tobacco is a lifestyle that has become a necessity for some people. Sometimes, social needs is the main reason for someone to have a smoking habit. Based on this problem, the level of cigarette consumption in the community has increased. Nowadays, the total number of couples visiting an infertility clinic is on the rise. This have led to an assumption among the community that smoking tobacco is one of the main factors causing male infertility. Objective: to compare light smokers and heavy smokers towards the results of semen analysis in infertile male patients. Materials and Methods: This study was an observational analytics, with a retrospective-cross sectional. The instrument used in this study was taken from medical records of the patients who visited the Andrology Clinic of Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, for the period from January to December 2017. The observed semen analysis parameters were concentration, motility, and morphology for microscopic examination and liquefaction, pH, and volume for macroscopic examination, by following the inclusion and exclusion criteria. Results: Ninety-two samples of infertile male participants (50 light smokers and 42 heavy smokers) were included in this study. Semen analysis on its concentration, motility, spermatozoa morphology, as well as liquefaction, pH, and volume) towards the number of cigarette consumption showed no significant difference (p>0.05) between light smokers and moderate smokers. Conclusion: There was no significant difference between the light smoker and heavy smoker groups on the results of the semen analysis.

BackgroundDigital health interventions using hybrid delivery models may offer efficient alternatives to traditional behavioral counseling by addressing obstacles of time, resources, and knowledge. Using a computer-facilitated 5As (ask, advise, assess, assist, arrange) model as an example (CF5As), we aimed to identify factors from the perspectives of primary care providers and clinical staff that were likely to influence introduction of digital technology and a CF5As smoking cessation counseling intervention. In the CF5As model, patients self-administer a tablet intervention that provides 5As smoking cessation counseling, produces patient and provider handouts recommending next steps, and is followed by a patient-provider encounter to reinforce key cessation messages, provide assistance, and arrange follow-up.MethodsSemi-structured in-person interviews of administrative and clinical staff and primary care providers from three primary care clinics.ResultsThirty-five interviews were completed (12 administrative staff, ten clinical staff, and 13 primary care providers). Twelve were from an academic internal medicine practice, 12 from a public hospital academic general medicine clinic, and 11 from a public hospital HIV clinic. Most were women (91 %); mean age (SD) was 42 years (11.1). Perceived usefulness of the CF5As focused on its relevance for various health behavior counseling purposes, potential gains in counseling efficiency, confidentiality of data collection, occupying patients while waiting, and serving as a cue to action. Perceived ease of use was viewed to depend on the ability to accommodate: clinic workflow; heavy patient volumes; and patient characterisitics, e.g., low literacy. Social norms potentially affecting implementation included beliefs in the promise/burden of technology, priority of smoking cessation counseling relative to other patient needs, and perception of CF5As as just "one more thing to do" in an overburdened system. The most frequently cited facilitating conditions were staffing levels and smoking cessation resources and training; the most cited hindering factors were visit time constraints and patients' complex health care needs.ConclusionsIntegrating CF5As and other technology-enhanced behavioral counseling interventions in primary care requires flexibility to accommodate work flow and perceptions of overload in dynamic environments. Identifying factors that promote and hinder CF5As adoption could inform implementation of other CF behavioral health interventions in primary care.

BackgroundThere is still limited evidence on the effectiveness and implementation of smoking cessation interventions for people with severe mental illness (SMI) in Dutch outpatient psychiatric settings. The present study aimed to establish expert consensus on the core components and strategies to optimise practical implementation of a smoking cessation intervention for people treated by Flexible Assertive Community Treatment (FACT) teams in the Netherlands.DesignA modified Delphi method was applied to reach consensus on three core components (behavioural counselling, pharmacological treatment and peer support) of the intervention. The Delphi panel comprised five experts with different professional backgrounds. We proposed a first intervention concept. The panel critically examined the evolving concept in three iterative rounds of 90 min each. Responses were recorded, transcribed verbatim and thematically analysed.ResultsOverall, results yielded that behavioural counselling should focus on preparation for smoking cessation, guidance, relapse prevention and normalisation. Pharmacological treatment consisting of nicotine replacement therapy (NRT), Varenicline or Bupropion, under supervision of a psychiatrist, was recommended. The panel agreed on integrating peer support as a regular part of the intervention, thus fostering emotional and practical support among patients. Treatment of a co-morbid cannabis use disorder needs to be integrated into the intervention if indicated. Regarding implementation, staff's motivation to support smoking cessation was considered essential. For each ambulatory team, two mental health care professionals will have a central role in delivering the intervention.ConclusionsThis study provides insight into expert consensus on the core components of a smoking cessation intervention for people with SMI. The results of this study were used for the development of a comprehensive smoking cessation program.

Aim: The use of tobacco is responsible for many preventable diseases and deaths worldwide. Digital interventions have greatly improved patient health and clinical care and have proven to be effective for quitting smoking in the general population due to their flexibility and potential for personalization. However, there is limited evidence on the effectiveness of digital interventions for smoking cessation in Asian countries., Methods: Three major databases - Web of Science (WOS), Scopus, and PubMed - for relevant studies published between 1 January 2010 and 12 February 2023 were searched for studies evaluating the effectiveness of digital intervention for smoking cessation in Asian countries., Results: A total of 25 studies of varying designs were eligible for this study collectively involving a total of n  = 22,005 participants from 9 countries. Among different digital tools for smoking cessation, the highest abstinence rate (70%) was reported with cognitive behavioural theory (CBT)-based smoking cessation intervention via Facebook followed by smartphone app (60%), WhatsApp (59.9%), and Pharmacist counselling with Quit US smartphone app (58.4%). However, WhatsApp was preferred over Facebook intervention due to lower rates of relapse. WeChat was responsible for 15.6% and 41.8% 7-day point prevalence abstinence. For telephone/text messaging abstinence rate ranged from 8-44.3% and quit rates from 6.3% to 16.8%. Whereas, no significant impact of media/multimedia messages and web-based learning on smoking cessation was observed in this study., Conclusion: Based on the study findings the use of digital tools can be considered an alternative and cost-effective smoking cessation intervention as compared to traditional smoking cessation interventions.

The purpose of this work is to analyze the regulatory environment for tobacco use, with particular reference to changes made in the last 10 years. An attempt was made to answer the question of the extent to which the regulatory environment has a real impact on the achievement of the objective set out in the existing legal provisions, which is to protect the health and rights of the persons concerned. An analytical method was used in the work to assess the application of legal principles. A method of analyzing the current line of jurisprudence was also used. In the process of final evaluation of public utilities, certain functional methods were used. The assessment was subjected to Polish law, within the scope of the currently binding Act on Health Protection Against the Consequences of Using Tobacco and Tobacco Products of 1995. The study states that the provisions of this Act are only a formal guarantee of protection. The liability arising from the application of its standard is illusory because the procedure for imposing penalties is ineffective. The pursuit of any property claims related to violation of the rights of related entities, as envisaged in this Act, is complicated. This does not apply to a case which is not affected by the decision. Int J Occup Med Environ Health. 2020;33(5):599–610

В научном обзоре с целью обобщения результатов исследования организационно-методического аспекта лечения табачнои зависимости рассмотрены данные о распространенности этого явления среди населения, а также обсуждены тематически связанные вопросы диагностики, лечения и профилактики. установлено, что исследования в основном сосредоточены на эпидемиологии явления и изучении эффективности применения лекарственных средств. не выявлено имеющих высокую степень доказательности публикации по применению нелекарственных методик. Не выявлено также описания оригинальных методик медицинскои профилактики, имеющих высокую степень доказательности нет исследовании в области организационных медицинских технологии слабо изучен медикосоциальныи аспект формирования никотиновои зависимости у больных с психическими расстроиствами. Эти исследовательские направления требуют большего внимания и дальнеишеи разработки.

Background: Preclinical studies suggested the exposure to environmental enrichment (EE) as an intervention able to prevent or reduce nicotine-taking and nicotine-seeking behaviors. Virtual reality (VR) may help to test the effects of EE in smokers in a reproducible and feasible manner. Materials and Methods: In the present study, 31 smokers (14 women) were divided into two groups: (1) exposure to a virtual EE (VR-EE) and (2) exposure to a virtual neutral environment (VR-NoEE). Cigarette craving was assessed as basal and evoked, at different timepoints during the session. Behavior activity during VR exposure, mood, and subjective measures were also collected. Results: EE exposure in VR significantly reduced craving scores from basal timepoint. This was not observed in the VR-NoEE group, which significantly increased craving compared with values at neutral scenario. When both groups were exposed to smoking-related VR scenario, the VR-EE group showed an increased craving compared with previous timepoint up to score values not different from those in the VR-NoEE group. A significant positive correlation between basal craving scores and interactive behavior with virtual smoking cues was observed in the VR-NoEE but not in the VR-EE group. Conclusion: These findings suggest that virtual EE might have an inhibitory effect in smokers on basal, but not on evoked cigarette craving. Noteworthily, the interactive activity correlation to craving scores in the VR-NoEE participants was not observed in the VR-EE group, adding further evidence that the enrichment simulation was nonetheless able to modify behavior in the smoking-related scenario.

Objectives: To determine the prevalence, patterns and behavioural attributes of tobacco abuse in patients of acute coronary syndrome (ACS). Furthermore, to assess the interaction of tobacco abuse with other conventional risk factors of cardiovascular disease (CVD). Methodology: This observational study included 230 consecutive patients with ACS. Data was collected regarding total duration and extent of tobacco consumption, "tobacco addiction" and various behavioural patterns related to it. Risk factors profile was acquired for hypertension, diabetes, obesity, family history of premature CVD and dyslipidemia. Odds ratios (OR) with 95% confidence intervals (CI) for these risk factors were calculated for tobacco abusers compared to non-abusers. Results: Among the study population, 63(27.4%) were active tobacco users. Urban residents had lesser odds of being tobacco abusers compared to non-urban residents (0.49, [0.27 - 0.89]). Tobacco abusers had a lower prevalence of hypertension compared to non-abusers (0.44 [0.24 - 0.81]). A similar trend was observed for diabetes, obesity and dyslipidemia, however, the differences could not reach significance thresholds. Cigarette smoking was the commonest mode of tobacco consumption (90.5%). "Tobacco addiction" could be attributed to 84.1% of abusers. Most (82.5%) were willing to give up tobacco abuse and 63.3% had already made attempts at quitting. Conclusion: About one-third of ACS patients were tobacco abusers with the majority being tobacco addicts. Tobacco abuse was observed to be independently implicated as a risk factor in ACS patients. Furthermore, tobacco abuse was inversely related to hypertension trans lating into a sub-multiplicative / additive impact of hypertension as a risk factor. [ABSTRACT FROM AUTHOR]

Tobacco addiction is one of the biggest health emergencies in the world, Antismoking Public Service Announcements (PSAs) represent the main public tool against smoking; however, smoking-related cues (SCs) often included in PSAs can trigger ambiguous cerebral reactions that could impact the persuasiveness and efficacy of the antismoking message. This study aimed to investigate the electroencephalographic (EEG) response in adult smokers and non-smokers during the exposure to SCs presented in antismoking PSAs video, in order to identify eventual neurophysiological features of SCs' 'boomerang effect' elicited in smokers. EEG frontal Alpha asymmetry and frontal Theta were analyzed in 92 adults (30 no smokers, 31 low smokers, 31 high smokers) from EEG recorded during the vision of 3 antismoking PSAs, statistical analysis was conducted using ANOVA. Main results showed a significant interaction between smoking cue condition (Pre and Post) and smoking habit (in particular for female heavy smokers) for the frontal Alpha asymmetry. Since the relative higher right frontal Alpha activity is associated with approach towards a stimulus, it is suggested that the relative left frontal Alpha increase in response to SCs might reflect an appetitive approach in response to it. In the light of the Incentive Sensitization Theory, this pattern can be interpreted as a neurophysiological signal in response to SCs that could undermine the message's effectiveness contributing to the maintenance of the addiction. • Tobacco addiction predicted several EEG activity patterns to smoking cues exposure. • Heavy smokers women exhibited higher approach tendency in response to smoking cues. • Smoking cues into antismoking PSAs can elicit harmful boomerang effect. [ABSTRACT FROM AUTHOR]

SDG3 emphasizes "Good Health and Well-being", however amid COVID-19, SDG 3 is challenged, one of the primary reasons for the existence of tobacco smoking culture and climate prevailing in our society. Tobacco Smoking weakens the immunity system and thus clears the way for COVID-19 infection. Smoking is injurious to health; however, the surrounding beings also get impacted along with the smoker. Research data reveal that Mindfulness meditation is essentially a "mini-retreat" in which people learn how to separate themselves from their emotions and pay attention to what is going on around them; there has been researched to help in stopping smoking or nicotine addiction; to understand further the reality of the impact of MM, a systematic review of the literature on tobacco addiction and mindfulness is conducted, It is found that some literature contradicts the opinion that mindfulness is an effective way to treat nicotine addiction, some of the research has proposed that high powered RCTs should be performed. Overall, Mindfulness intervention did not significantly influence abstinence or achieve minimal, infrequent cigarette intake. Mindfulness Meditation needs integration furthermore to be more effective for Recovery from Tobacco Addiction. The effectiveness of such an intervention is subjected to further research. [ABSTRACT FROM AUTHOR]

Cigarette smoking remains a leading cause of preventable disease and death worldwide. Due to the devastating negative health effects of smoking, many users attempt to quit, but few are successful in the long-term. Thus, there is a critical need for novel therapeutic approaches. In these investigations, we sought to examine whether cannabidiol (CBD) has the potential to be repurposed as a nicotine cessation therapeutic. In the first study, male and female mice were trained to respond for intravenous nicotine infusions at either a low or moderate nicotine dose and then were pretreated with CBD prior to their drug-taking session. We found that CBD produced a significant decrease in the number of nicotine rewards earned, and this effect was evidenced across CBD doses and with both the low and moderate levels of nicotine intake. These effects on drug intake were not due to general motor-related effects, since mice self-administering food pellets did not alter their behavior with CBD administration. The potential effects of CBD in mitigating nicotine withdrawal symptoms were then investigated. We found that CBD attenuated the somatic signs of nicotine withdrawal and prevented nicotine's hyperalgesia-inducing effects. Taken together, these results demonstrate that modulation of cannabinoid signaling may be a viable therapeutic option as a smoking cessation aid. • Acute CBD decreases nicotine self-administration at a high and low nicotine dose. • Acute CBD ameliorates withdrawal symptoms after chronic nicotine exposure. • Similar CBD treatment effects were found in both male and female mice. [ABSTRACT FROM AUTHOR]

Abstract Background The German clinical guideline on tobacco addiction recommends that general practitioners (GPs) provide brief stop-smoking advice to their patients according to the “5A” or the much briefer “ABC” method, but its implementation is insufficient. A lack of training is one barrier for GPs to provide such advice. Moreover, the respective effectiveness of a 5A or ABC training regarding subsequent delivery of stop-smoking advice has not been investigated. We developed a training for GPs according to both methods, and conducted a pilot study with process evaluation to optimize the trainings according to the needs of GPs. This study aims at evaluating the effectiveness of both trainings. Methods A pragmatic 2-arm cluster randomised controlled trial with a pre-post data collection will be conducted in 48 GP practices in North Rhine-Westphalia (Germany). GPs will be randomised to receive a 3.5-h-training in delivering either 5A or ABC, including peer coaching and intensive role plays with professional actors. The patient-reported primary outcome (receipt of GP advice to quit: yes/no) and secondary outcomes (recommendation rates of smoking cessation treatments, group comparison (5A versus ABC): receipt of GP advice to quit) will be collected in smoking patients routinely consulting their GP within 4 weeks prior, and 4 weeks following the training. Additional secondary outcomes will be collected at 4, 12 and 26 weeks following the consultation: use of cessation treatments during the last quit attempt (if so) since the GP consultation, and point-prevalence abstinence rates. The primary data analysis will be conducted using a mixed-effects logistic regression model with random effects for the cluster variable. Discussion If the training increases the rates of delivery of stop-smoking advice, it would offer a low-threshold strategy for the guideline implementation in German primary care. Should one method prove superior, a more specific guideline recommendation can be proposed. Trial registration German Clinical Trials Register (DRKS00012786); registered on 22th August 2017, prior to the first patient in.

Tobacco use remains the single most preventable cause of death and disability worldwide. In the Philippines, 28.3% of the people are current tobacco smokers, which is one of the highest smoking rates in Asia. The World Health Organization estimates that 10 Filipinos die every day from cancer, stroke, and lung and heart disease caused by cigarette smoke and approximately 24 million Filipinos are exposed to secondhand smoke in the home. Although there are quit lines in all 50 U.S. states and territories, there was no access to this smoking cessation program in the Philippines before the initiation of the international collaboration described in this article. In 2012, a Filipino-American nurse with extensive quit line expertise initiated collaboration between the United States and Philippine smoking cessation experts to plan the creation of a quit line at the Lung Center of the Philippines. The Conceptual Model for Partnership and Sustainability in Global Health was used as a foundation for the planning, implementation, and evaluation of the Philippine Quit Line project, which was funded in 2017 by the World Health Organization and the Philippine Department of Health. This funding and other outcomes related to nursing education about tobacco addictions in the Philippines suggest that the Partnership and Sustainability in Global Health Model can provide a blueprint for international collaboration on health projects that are rooted in real collaborative and sustainable partnerships. [ABSTRACT FROM AUTHOR]

In the article, the analysis provided, of the literary data on smoking and smoking cessation influence on coronary bypass surgery efficacy and life duration of the patients. Most scientific articles provide data on the increase of both the mortality and complications number in smokers. Meta-analysis of 564 works on the influence of smoking on coronary bypass outcomes, convincing evidence was provided on the necessity to quit smoking. Ten, 20- and 30-year lasting observations post coronary bypass surgery demonstrate the benefits of smoking cessation for life duration increase in coronary heart disease. Meta-analysis of the various approaches efficacy in cardiovascular patients has been done in 2017 and shows the efficacy of medication therapy. Among the drugs for nicotin addiction treatment in cardiovascular patients, the most effective is varenicline, with confirmed safety in chronic stable cardiovascular disorders patients, as in acute coronary heart disease patients. To overcome the psychological component of the addiction it is worthy to conduct cognitive-behavioral therapy that can be done by the specialists of Call Center for smoking cessation organized by the Ministry of Health of Russian Federation.

Studies show that smokers have a lower work performance due to time spent smoking, increased fatigue perception and are more absent from work due to smoking-related diseases. The workplace could represent an important location to promote smoking cessation. This study is a multi-center, controlled trial for smoking cessation counseling at the participants' workplace, where 656 randomized participants received four sessions of group motivational interviewing or four sessions of very brief advice and were followed up for 52 weeks. The Continuous Quit Rate (CQR) was higher for the smoking cessation counseling group than for the very brief advice group during weeks 9 to 12 (17.5% vs. 3.6%) weeks 9 to 24 (13.4% vs. 3.4%) and weeks 9 to 52 (10.3% vs. 3.1%). This study demonstrated that motivational interviewing is an efficacious smoking cessation approach for smokers at their workplace. The short-term and long-term cessation rate of the intervention of the smoking cessation counseling group exceeded that of very brief advice. [ABSTRACT FROM AUTHOR]

This study aimed to test the effectiveness of the Addiction Prevention Training Program (APTP) of Turkey, (Türkiye Bağımlılıkla Mücadele Programı) and gather the perspectives of students and stakeholders about the program. APTP is an intervention program designed and implemented by the Turkish Green Crescent Society, which aims to increase knowledge and emotional awareness about addiction among primary, secondary, and high school students. APTP consists of 4 modules: tobacco, alcohol, drug, and technology addiction, and the knowledge and emotional awareness of each of these were tested. In the first phase of this mixed-method study, 2x3 Split Plot Factorial Design was used. A total of 5451 randomly assigned students (primary=600, secondary=2496, and high school=2355) participated in the experimental and control groups. In the second phase, focused group interviews with students (n=55), parents (n=26), and branch teachers (n=18); and individual interviews with school counselors (n=3) and principals (n=3) were conducted. The opinions of the participants regarding the training were analyzed using descriptive analysis. Results of the Two-way Analysis of Variance (ANOVA) revealed that receiving APTP had a significant effect, mostly on improving the knowledge level of students about tobacco, alcohol, drug, and technology addiction. Qualitative findings supported the quantitative results that parents, teachers, school counselors, and school principals reflected the increased knowledge of students about addiction. [ABSTRACT FROM AUTHOR]

The purpose of this work is to analyze the regulatory environment for tobacco use, with particular reference to changes made in the last 10 years. An attempt was made to answer the question of the extent to which the regulatory environment has a real impact on the achievement of the objective set out in the existing legal provisions, which is to protect the health and rights of the persons concerned. An analytical method was used in the work to assess the application of legal principles. A method of analyzing the current line of jurisprudence was also used. In the process of final evaluation of public utilities, certain functional methods were used. The assessment was subjected to Polish law, within the scope of the currently binding Act on Health Protection Against the Consequences of Using Tobacco and Tobacco Products of 1995. The study states that the provisions of this Act are only a formal guarantee of protection. The liability arising from the application of its standard is illusory because the procedure for imposing penalties is ineffective. The pursuit of any property claims related to violation of the rights of related entities, as envisaged in this Act, is complicated. This does not apply to a case which is not affected by the decision. Int J Occup Med Environ Health. 2020;33(5):599-610. [ABSTRACT FROM AUTHOR]

Cigarette smoking is a complex phenomenon and its consequences for human body are increasingly known. Basing on the results from previous research on relationship between Mindfulness and smoking abstinence in which it emerged that subjects who had high levels of dispositional Mindfulness had a greater chance of success in a smoking cessation program, the aim of the present study was to extend the analysis in a larger group of individuals subjected to pharmacological treatment and motivational counselling, which were monitored both at the first 24-h of complete abstention and at the follow-up. The study involved 53 individuals who participated to a smoke cessation program completing the Fagerström Test of Nicotine Dependence (FTND), the Mindful Attention Awareness Scale (MAAS) and the General Health Questionnaire (GHQ-12). Abstinence was recorded in several sessions also through the quantitative determination of the value of carbon monoxide on the expired air (CO) from the lungs that contributes to a greater objectivity of the outcome measure. Data did not confirm the role of Mindfulness as a predictor of abstinence. MAAS and GHQ-12 scores did not result in relationship with the outcome of nicotine cessation program. Therefore, Mindfulness construct would seem not to be a predictor of success in a smoking cessation program. The use of more sensitive tools in detecting the Mindfulness trait could lead to appropriate results as a more structured cognitive behavioural treatment could be contributing to support habitual smokers quit. [ABSTRACT FROM AUTHOR]

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Introduction Providing comprehensive tobacco addiction treatment to smokers admitted to acute care settings represents an opportunity to realise major health resource savings and population health improvements. Methods The CURE project is a hospital-wide tobacco addiction treatment service piloted in Wythenshawe Hospital, Manchester, UK. The core components of the project are electronic screening of all patients to identify smokers; the provision of brief advice and pharmacotherapy by frontline staff; opt-out referral of smokers to a specialist team for inpatient behavioural interventions; and continued support after discharge. Results From 01 October 2018 to 31 March 2019, 92% (13,515/14,690) of adult admissions were screened for smoking status, identifying 2,393 current smokers. Of these, 96% were given brief advice to quit by the admitting team. Through the automated 'opt-out' referral process, 61% patients completed inpatient behavioural interventions with a specialist cessation practitioner (69% within the first 48 hours of admission). Overall, 66% of smokers were prescribed pharmacotherapy. Over one in five of all smokers admitted during this pilot reported that they were abstinent from smoking 12 weeks after discharge (22%) at a cost £183 per quit. Discussion National implementation of this cost-effective programme would be likely to generate substantial benefits to public health. [ABSTRACT FROM AUTHOR]

Considerable progress has been made in elucidating the relationships between early life psychobiological and environmental risk factors and the development of tobacco addiction. However, a comprehensive understanding of the heterogeneity in tobacco addiction phenotypes requires integrating research findings. The probabilistic epigenesis meta-theory offers a valuable framework for this integration, considering systemic, multilevel, developmental, and evolutionary perspectives. In this paper, we critically review relevant research on early developmental risks associated with tobacco addiction and highlight the integrative heuristic value of the probabilistic epigenesis framework for this research. For this, we propose a four-level systems approach as an initial step towards integration, analyzing complex interactions among different levels of influence. Additionally, we explore a coaction approach to examine key interactions between early risk factors. Moreover, we introduce developmental pathways to understand interindividual differences in tobacco addiction risk during development. This integrative approach holds promise for advancing our understanding of tobacco addiction etiology and informing potentially effective intervention strategies. • Considerable progress in early risk factors for tobacco abuse requires integration. • The probabilistic epigenesis meta-theory is valuable for this integration. • A critical and integrative review informed by this theory is performed. • The proposed integrative advances could enhance tobacco abuse etiology understanding. [ABSTRACT FROM AUTHOR]

The author comments on an article by B. M. Meier and colleagues about the utility of using the human rights-based approach (HRBA) to tobacco control. She talks about the agreement that declares and outlines the highest attainable standard of physical and mental health as a human right, cessation as a neglected aspect of tobacco control, and examples that are reflective of the poor standing that the U.S. accords to human rights.

We designed the synthesis of a small library of 3-substituted-3,6-diazabicyclo[3.1.1]heptanes whose affinity on neuronal nicotinic receptors (nAChRs) was evaluated. Among the synthesized compounds, the 5-(3,6-diazabicyclo[3.1.1]heptane-3-yl)- N -(2-fluorophenyl)nicotinamide 43 proved to be the most interesting compound with α 4 β 2 Ki value of 10 pM and a very high α 7 /α 4 β 2 selectivity. Furthermore, compounds 35 , 39 and 43 elicited a selective partial agonist activity for α 4 β 2 nAChR subtype. Finally, in this paper we also report the conclusions on the 3,6-diazabicyclo[3.1.1]heptanes as ligands for nAChRs, resulting from our consolidated structure activity relationship (SAR) studies on this template. Image 1 • Synthesis and characterization of 3,6-diazabicyclo[3.1.1]heptane heteroaryl amides. • α 4 β 2 , α 3 β 4 and α 7 ligands binding studies. • Intrinsic α 4 β 2 receptor mediated activity. [ABSTRACT FROM AUTHOR]

Within sight of the number more and more crescent of the cases of cancers among smokers of cigarette, WHO required at the firms manufacturing the cigarette to place warnings written on the latter in order to discourage the consumers and to decrease by this fact the cases of cancers related to the tobacco addiction throughout the world. The town of Kananga to Central Kasaï, one of the twenty-six Provinces of the Democratic republic of Congo abounds a growing number of the smokers in cigarette in all the layers of the population, from the intellectuals warned with the young people of less than 20 years, each day which passes, the number of smokers does not cease increasing whereas he is written warnings of any kind on the cigarettes to persuade the smokers to give up smoking. This situation shows that health warnings on cigarette packages do not attract the attention of cigarette consumers, are not read by many of the active or former smokers and therefore do not encourage consumers to change the behavior of the genre "stop smoking" or "decrease the rate of cigarette consumption". [ABSTRACT FROM AUTHOR]

Objective: Among the more than thousands of papers, reviews, commentaries and editorials published on the theme of ill health due to smoking tobacco products, I present an overview of the literature mostly published since 1980. Commentary: In 1908, less than 10 chemical compounds were identified from tobacco smoke. Now, this number has increased to over 8,000. Literature on the reviews in 30 inter-related themes covering the pathophysiology of smoking and representative studies that had focused on the damage to reproductive and other sensory systems due to nicotine use and tobacco smoke inhalation are presented in two tables. Recent revelations on the tobacco industry's nefarious links to the Hollywood movie industry as well as the expose of the research funding offered by the tobacco industry to leading medical researchers Hans Selye and Ernst Wynder are also highlighted. Conclusion: With the rising popularity of electronic cigarettes to a new generation of smokers in the past decade, services of specialty journals such as Tobacco Control, Tobacco Induced Diseases, as well as Nicotine and Tobacco Research becomes vital to combat the abuse of nicotine. [ABSTRACT FROM AUTHOR]

Many psychological, neurobiological and social factors are involved in tobacco abuse. Research on nicotine addiction has achieved partial results in identifying useful variables as indicators of treatment outcomes of tobacco smoking cessation. The aim of our research is to analyse the relationships between the mindfulness construct and smoking abstinence in individuals subjected to pharmacological treatment and motivational counselling, exploring whether the mindful construct is associated with increased likelihood of smoking cessation. In this paper, preliminary data from a pilot study carried out in Northern Italy with a sample of 25 smokers enrolled from a smoking cessation programme are described. Participants were evaluated with the Fagerström Test of the Nicotine Dependence (FTND), the General Health Questionnaire (GHQ-12), the Mindful Attention Awareness Scale (MAAS) and had a target-quit date of 24-h, which represented the first day of complete abstinence. Results indicated that the Mindful score appears as a salient factor for abstinence. More research is warranted in order to confirm our findings and identify the most effective ways to modify pre-quit characteristics that may help smokers to achieve the first smoking cessation milestone. In this way, it will possible to design training addressed to increasing awareness levels that could improve the outcome of smoking cessation programmes and prevent patient relapse. [ABSTRACT FROM AUTHOR]

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

Aims: Clinical guidelines recommend to routinely offer brief physician advice on smoking cessation. Representative data on the implementation of this recommendation in Germany and on associations with sociodemographic data or smoking behaviour of smokers will be collected. Methods: The German Study on Tobacco Use (DEBRA) collects data on tobacco and e-cigarette consumption in representative samples of the population every other month (~2,000 persons, =14 years). During the first five study waves since June 2016 (10,225 respondents), smokers were asked about the receipt of brief physician advice to quit smoking at their last visit with a general practitioner (A) or a different specialist (B). Associations with sociodemographic data and smoking behaviour were analysed. Results: According to own reports of 2,910 smokers, 72.8 % (95 %CI= 71--74 %) had visited a physician of specialisation A and/or B during the previous year. Of these, 80.7 % (95 %CI= 79--82 %) had not received advice to quit, 3.6 % (95 %CI= 3--5 %) had been offered an evidence-based cessation method. Heavy cigarette consumption and increasing age were associated with the receipt of advice (P<0.001), but not education and income. Differences between medical specialisation A and B were small. Conclusion: The receipt of brief physician advice on smoking cessation according to clinical guidelines is rarely reported by smokers in Germany. There is an urgent need for action to improve the implementation of the guideline recommendation. [ABSTRACT FROM AUTHOR]