Adolescent smoking: are infrequent and occasional smokers ready to quit?

We examined motivation for cessation and plans to quit among 945 high school students in 2001 at three levels of smoking frequency (regular, occasional, and infrequent). Surveys were completed at six Illinois high schools. In multivariate models, females (compared to males) and white students (compared to nonwhite students) were more likely to plan to quit, but plans to quit did not differ by smoking level. In multivariate models to predict motivation for cessation, regular smokers were significantly less motivated to quit than were occasional and infrequent smokers, and occasional smokers were less motivated than infrequent smokers; demographic variables were nonsignificant. Infrequent and occasional smokers are motivated to quit and intend to quit soon, making them an attractive target for cessation programs.     

Do indigenous helpers foster smoking cessation in adult smokers?

An intervention based on the Transtheoretical Model of behavior change (TTM) used an indigenous helper (a helping relationship) to promote smoking cessation. The research examined whether there was a difference in post-intervention smoking behavior between smokers who had an indigenous helper compared with those who did not among adult FreshStart participants. Smoking behavior was measured in two ways: forward movement along the TTM stages of change, and point prevalence. A two-group, two-time, five-week multi-site experimental design was used. Participants (N=111) completed instruments at baseline and four weeks. The findings did not support use of the TTM construct helping relationships for smoking cessation. The use of a helping relationship did not predict smoking cessation. Nicotine replacement therapy and/or bupropion predicted smoking behavior in all analyses.     

School-based smoking cessation programs: Do youth smokers want to participate in these programs?

The purpose of the present study was to examine characteristics that predict interest in school-based cessation programs among 3136 youth smokers with intentions to quit smoking. The majority of youth smokers report that they would not join a school-based smoking cessation program. However, improving awareness of these types of programs among students is important as sub-populations of youth smokers were more likely to be interested in school-based cessation initiatives when aware that such programs exist. Future school-based cessation intervention outcomes might be improved if programs are targeted to the youth that are most likely to use them, if more youth can be made aware of existing programs, and if the benefits of participating in such programs can be more adequately conveyed to youth smokers.     

What smoking cessation approaches will young smokers use?

The purpose of this study was to examine the attitudes of youth smokers toward nine common smoking cessation approaches. Attitudes were examined among 3660 youth smokers who intended to quit smoking. The majority of youth smokers report that they would never use the smoking cessation approaches that are commonly recommended for youth populations. The approaches that were appealing to youth are quitting on their own and using the advice of friends. Future initiatives need to more effectively communicate to youth the benefits of existing cessation approaches, make existing interventions more appealing, or develop new approaches that address youth needs.     

Do men outperform women in smoking cessation trials? Maybe,but not by much

Using data from 4 smoking cessation trials conducted from 1988 to 2000, the authors investigated whether men are more successful than women in quitting smoking. Odds ratios indicated that the abstinence rates were not significantly different for men and women. Thus, there may be little value to diverting research funds from efforts to develop more effective treatments for both men and women to efforts to explain a very small gender effect associated with existing treatments. However, it may be appropriate to make gender comparisons for new therapies for nicotine dependence. The authors recommend against analyses of gender differences in studies that do not account for gender in their research designs.     

Anti-Smoking therapies: is harm reduction a viable alternative to smoking cessation?

Smoking cessation should be proposed to all smokers by healthcare workers; however, severely dependent smokers are frequently unable or unwilling to quit smoking. For some of them, particularly if they have failed in previous cessation attempts and have smoking-related disorders, a long term reduction of tobacco consumption may be proposed as the 'second best' attitude and may offer a perspective for reduction of some of the risk factors associated with smoking. This attitude, which cannot be regarded as a general health policy, usually requires the prolonged use of nicotine replacement therapy. From available studies, it does not seem that a period of sustained smoking reduction decreases the chance of future cessation, it may even increase it.     

Do behavioral smoking reduction approaches reach more or different smokers? Two studies; similar answers

There is a need for innovative approaches capable of reaching smokers who would not otherwise participate in efforts to modify their smoking. This paper reports on two studies to determine whether a smoking reduction intervention would appeal to additional or different types of smokers than do cessation interventions. Study 1 attempted to contact 160 HMO smokers scheduled for outpatient surgeries. In Study 2, actual pilot reduction and cessation programs were offered to 531 smokers about to undergo out-patient surgeries or procedures. In Study 1, 39% of those eligible elected smoking reduction; and 38% selected cessation. In Study 2 of those eligible, 22% began participation in the smoking reduction program; 12% preferred a cessation approach; and 65% declined. There were few demographic or smoking history differences among those who elected smoking reduction, cessation, or declined. Among this understudied population, a sizable proportion in both studies agreed to participate in smoking reduction. If replicated, this suggests that comprehensive programs that include a smoking reduction component could substantially increase their reach.     

What motivates adolescent smokers to make a quit attempt?

A sample of 120 adolescent smokers (80 males, 40 females), most of whom were referred by school personnel after being caught with cigarettes at school (n=113), reported motivations for making a quit attempt during a smoking cessation project. Most students (n=76) were randomly assigned to a four session cessation program that included discussion of a number of motivational topics, and the remaining students were assigned to a self-help control group that received a pamphlet recommending strategies for quitting. Reported motivations for quitting did not differ significantly across the two treatment conditions. Concern about future health (73%) was the most popular reason given for making a quit attempt, followed by concern about current health (65%). Concerns about physical appearance (59%), the cost of cigarettes (52%), and athletic performance (51%) were also listed as motivators by a majority of the participants. Future health was the most popular choice for the most important motivator to quit (35%). Females and participants with fewer best friends smoking were more likely to report that the prevalence of non-smoking teenagers, the relationship between smoking and weight, and physical appearance concerns were motivators to quit. African Americans were more likely than Whites to list current health concern as the most important motivator.     

Contemplation of smoking cessation and quit attempts in human immunodeficiency virus–infected and uninfected veterans

ABSTRACT

Background: As antiretroviral treatments prolong life in human immunodeficiency virus (HIV)-infected patients, smoking cessation is now a top priority. However, studies of HIV-infected smokers have not been conducted with uninfected controls. In this study, researchers determined factors associated with contemplating smoking cessation and making a prior quit attempt among HIV-infected and uninfected smoking veterans. Methods: Between 2005 and 2007, 1,027 HIV-infected and 794 uninfected smokers were identified as part of the Veterans Aging Cohort Study (VACS). Stratifying by HIV status, adjusted odds ratios (AORs) were calculated using logistic regression to identify factors associated with contemplating smoking cessation and making a prior quit attempt. Results: Most participants (66 % of HIV-infected vs. 68 % of uninfected; P = .46) were contemplating cessation, and 56 % of both groups (P = .99) had attempted to quit in the last year. In stratified multivariable analyses, HIV-infected smokers with recent pulmonary disease diagnoses were more likely to have made a quit attempt (AOR = 4.93, 95 % confidence interval [CI] = 1.41–17.17). Both HIV-infected and uninfected patients with unhealthy alcohol use were less likely to be contemplating cessation (AOR = 0.66, 95 % CI = 0.49–0.90 and 0.71, 95 % CI = 0.50–1.00). HIV-infected smokers who reported unhealthy alcohol use were also less likely to have made a quit attempt in the last year (AOR = 0.68, 95 % CI = 0.51–0.91). Conclusions: Patient-level interest and motivation are not major barriers to smoking cessation among HIV-infected veterans. Targeting HIV-infected smokers with a recent pulmonary disease diagnosis may improve sustained smoking cessation. Unhealthy alcohol use appears to be a key modifiable risk factor. Smoking cessation rates may be improved by combining interventions for smoking and alcohol use for HIV-infected patients.     

Is it safe to use smoking cessation therapeutics during pregnancy?

Introduction: Worldwide, 10 to 35% of pregnant women smoke. It is clear that smoking cessation has positive impacts for both the mother and child, yet many women are still unable to quit due to the addictive properties of nicotine. There are limited data surrounding their safety and efficacy in pregnancy.

Areas covered: This review highlights evidence from clinical studies and animal experiments regarding the effects of smoking cessation therapeutics on pregnancy, neonatal and long-term postnatal outcomes.

Expert opinion: There are insufficient data at this time to recommend the use of varenicline and/or bupropion for smoking cessation during pregnancy. In addition, the efficacy and safety of nicotine replacement therapy use for smoking cessation in pregnant women has not been clearly demonstrated. Until further studies are completed, there will continue to be considerable uncertainty regarding the use of these drugs in pregnancy despite the well-documented benefits of smoking cessation.     

Do we have to document pharmacotherapeutic interventions?

We have suggested that some pharmacotherapists may resist documentation because they view it as administrative intrusion rather than an essential component of continuity of care. In the final analysis, it is also a matter of the pharmacotherapist's belief. Pharmacists must understand what it is that they contribute, and must believe that it is both valuable and unique. It is not just an information management function--they are making patient-specific decisions and must be willing to be held accountable for their outcome. The pharmacy manager must also believe that such a responsible decision-making role represents that preferred future for the profession. Unfortunately, because many pharmacy managers have never truly functioned in such a role, developing such a belief system is difficult at best. The hospital administrator must also be made to believe that the contribution of the pharmacist to patient care not only extends beyond materials management but represents an entirely separate professional function. This will not occur simply through documentation of interventions. Yes, we believe that it is necessary to document pharmacotherapeutic interventions, however, not for the reasons that it is most frequently demanded.     

What motivates daily cigarette smokers to quit? Retrospective annual discrete duration analysis

This article analyzes retrospective information reported in an individual specific cross-sectional data set to examine who among daily cigarette smokers is likely to quit. In general, current quitting information is quite different from retrospective information. Cigarette price parameter estimates suggest that females are more forward looking than males and that males who start smoking daily at a young age are unlikely to quit. Furthermore, the birth of a child seems to encourage a mother and father to quit, and when a person receives some postsecondary education, they to are more likely to quit.     

Smoking cessation,smoking reduction,and delayed quitting among smokers given nicotine patches and a self‐help pamphlet

Over‐the‐counter nicotine replacement raises questions regarding its “real world”; efficacy. This was an open‐label, prospective study of 223 smokers who received 42 free nicotine patches and a self‐help booklet via shopping mall distribution. The overall quit rate 6 months following distribution of the nicotine patches was 22% (50/223), almost the same quit rate found 6 weeks following patch distribution (21%, 47/223). Twelve percent (27/223) were abstinent at both 6 weeks and 6 months. Among the 83 participants who did not quit, cigarettes smoked per day dropped from 28 to 18. A substantial subgroup of quitters (14%) who, although still smoking at 6 weeks, were smoke free at 6 months, and it appears they had purposefully delayed a serious quit attempt. These results support the usefulness of nicotine patches in helping smokers quit, even with only minimal intervention such as a self‐help manual.     

Butt Why? Exploring factors associated with cigarette scavenging behaviors among adult smokers enrolling in a clinical trial for smoking cessation

IntroductionCigarette smoking is associated with many adverse health effects and is an important public health concern. Increased understanding of smokers' behavior is central to developing effective interventions. Cigarette scavenging, a behavior that involves smoking shared or previously used cigarettes has thus far only been shown to be prevalent among homeless or incarcerated populations. The current study examines whether cigarette scavenging is prevalent in a more general population of adult smokers enrolling in a smoking cessation clinical trial, and whether engagement in this behavior is associated with demographic or smoking-related psychosocial factors.MethodsBaseline data was obtained from adult smokers (N = 227) enrolling in a randomized clinical trial for smoking cessation. Cigarette scavenging was assessed using three items: a) sharing a cigarette with a stranger; b) smoking a “found” cigarette and c) smoking a previously used cigarette “butt”. Participants who endorsed engaging in at least one of these three behaviors were categorized as a scavenger.ResultsApproximately 32% of participants endorsed at least one cigarette scavenging behavior. A multiple logistic regression analysis found that scavengers were more likely to be: men (p < 0.001), of younger age at smoking onset (p = 0.012), unemployed (p = 0.003), more likely to have used marijuana in the past 30 days (p = 0.005), single or living alone (p = 0.003), and to have experienced higher withdrawal symptoms during previous quit attempts (p = 0.044) as compared to non-scavengers.ConclusionsScavenging is common among adult smokers. Interventions that address cigarette scavenging behaviors may better meet the needs of this unique smoking subgroup.     

Young smokers’ adaptation to higher cigarette prices: How did those daily smokers who did not quit react? The case of students of South-Eastern France

Aims: We present the results of a cross-sectional survey that investigates young smokers’ reactions to an increase in cigarette prices in France, and the factors associated with these reactions.

Methods: This survey was carried out in 2005–2006, in South-Eastern France, among first-year university students (response rate: 71%, N = 1723).

Findings: Among the 427 current daily smokers, 32% did not react to the increase, 33% reduced the cost of smoking (they purchased cigarettes in foreign countries or smuggled cigarettes, turned to a cheaper brand or to hand-rolled cigarettes) and 35% reduced their consumption or tried to quit. Daily smokers with low-educated parents were less likely to react to the price increase, as well as those with psychological distress. Students with financial difficulties were more prone to diminish the cost of smoking, while students who suffered from being apart from family were less likely to reduce their consumption.

Conclusions: Further research is needed to better understand the diversity and heterogeneity of young smokers’ reaction to cigarette price increase, in relation to their socio-economic background and their motivations for smoking.