The internet has the potential to overcome geographic limitations for smoking cessation interventions, but further telehealth-based studies of utility are required.

To investigate the efficacy of an internet-based version of a quit smoking approach using a personalised video to create a simulated teachable moment.

Smokers within Australia were recruited through a dedicated website. After consent, eligible subjects, aged ≥30 years with a non-smoking partner, uploaded pictures of themselves, their partner and family, to be inserted into a video depicting the subject having a heart attack due to smoking, with consequences to them and their family. Nicotine replacement therapy (NRT) began prior to the quit attempt. The video was shown during two videoconference counselling sessions, with follow-up phone calls and text messaging support. Smoking status at 6 months by self-report (primary endpoint) was verified by partner/proxy and salivary cotinine (NicAlert™).

Seventy seven smokers were screened, of whom 50 were eligible, and 17 of these (34%) were enrolled; 11 men and 6 women, aged 41.5 ± 6.9 years, daily cigarette consumption 20.8 ± 8.9, Heaviness of Smoking Index score 3.7 ± 1.7. Participants reported feeling personally involved with the video (5.9 ± 1.1), which felt real (5.8 ± 1.1) and emotionally moving (5.6 ± 1.5) [7-point Likert Scale]. A similar video response was reported by the four participants (24%), who due to bandwidth limitations, watched the video after the counselling session instead of during it. Non-smoking rates at 6 months were 65% (11/17) by self-report with proxy confirmation, and 47% (8/17) by self-report with biologic confirmation. Three non-smokers by self-report could not provide a valid NicAlert™ result due to current NRT use. One participant who by self-report smoked once in the prior 14-days was assessed as a non-smoker by both proxy and NicAlert™.

This pilot study demonstrates efficacy for an internet-based version of a quit smoking program based on creating a simulated teachable moment. The findings provide support for further research into this technique, with the internet enabling greater reach than face-to-face.

Recently, smartphone applications (apps) have been used as smoking cessation aids. Interactive apps appear to more effective than non-interactive apps. SmokeBeat, a smartphone app used in conjunction with a smartwatch, aims to detect smoking events, interact with the user as they occur and potentially stop smoking events before they occur in the future.

The purpose of this feasibility study was to determine the sensitivity and specificity of SmokeBeat in detecting smoking events.

The feasibility of using the app as a smoking cessation aid was tested over a 2-week period by daily, dependent smokers. SmokeBeat's cigarette detection rate was measured in laboratory sessions both before and after the 2-week period. Fisher's exact test was used to compare detection rates from each session.

The detection rate was 22.5% during session 1 and 41.7% during session 2. Once technological issues were controlled for (i.e., signal loss between smartphone and smartwatch), SmokeBeat's detection rate improved over the 2-week period, resulting in a 100% detection rate.

Apps which can detect smoking events in real time present an opportunity for a proactive and interactive smoking cessation aid – a potentially useful tool for individuals attempting to quit smoking.

Despite declines in tobacco use during pregnancy and after childbirth, smoking remains unacceptably high among many parents. Smoking maintenance or relapse may be common in couple relationships when the other parent continues to smoke, when relationship satisfaction is low, or parental stress high.

To examine the longitudinal influence of partner tobacco use, relationship satisfaction and parental stress on tobacco use after childbirth.

Data was obtained from 115 Australian heterosexual adult couples (Mean age = 31.8) who reported being pregnant in the previous year and the female partner was a previous or current smoker. A household longitudinal survey was administered in which measures of tobacco use, relationship satisfaction and parental stress were assessed on four occasions over nine years.

Overall reductions in tobacco use occurred over the nine-year assessment period, although a small percentage (9.6%) of parents reported being daily smokers at every assessment. Similarly, a small proportion (13.1%) of parents relapsed to using tobacco during the assessment period. A random effects binary logit model indicated that mothers and fathers were more likely to continue or relapse to tobacco use if their partners smoked. Mothers were more likely to quit smoking if they became pregnant between the assessment waves, but for males, having a pregnant partner was not a significant predictor of tobacco cessation.

While pregnancy is associated with smoking cessation for mothers, both mothers and fathers are at elevated risk of continued tobacco smoking or relapse if their partner smokes during the first nine years after childbirth. For parents who continue to smoke cigarettes or relapse after childbirth, engagement of the partner in smoking cessation may be a key factor in promoting positive outcomes.

The US Navy utilizes numerous resources to encourage smoking cessation. Despite these efforts, cigarette smoking among service members remains high. Electronic cigarettes (EC) have provided an additional cessation resource. Little is known regarding the utilization efficacy of these cessation resources in the US Navy.

This study sought to explore the utilization and efficacy of ECs and other smoking cessation resources.

An anonymous cross-sectional survey was conducted at a military clinic from 2015 to 2016. Participants were active duty in the US Navy and reported demographics, smoking behaviors, and utilization of cessation resources.

Of the 977 participants in the study, 14.9% were current and 39.4% were former smokers. Most current smokers (83.6%) previously attempted cessation, smoked an average of 2–5 cigarettes per day (34.7%), and smoked every day of the month (26.4%). The number of daily cigarettes smoked and number of days cigarettes were smoked per month was not significantly different between cigarette-only smokers and EC dual users (p = 0.92, p = 0.75, respectively). Resources used by current and former smokers include: ‘cold turkey’ (44.6%, 57.1%, respectively), ECs (22.3%, 24.7%), nicotine patch (8.3%, 1.3%), medicine (6.6%, 3.9%), nicotine gum (5.8%, 10.4%), and quit programs (2.5%, 2.6).

Current and former cigarette smokers utilized similar resources to quit smoking. Electronic cigarettes are being used for cessation but do not significantly reduce the number of cigarettes smoked on a daily or monthly basis. Future studies may benefit from exploring the use of cessation resources and ECs within the military as a whole.

Disparities exist among Latino smokers with respect to knowledge and access to smoking cessation resources. This study tested the feasibility of using case management (CM) to increase access to pharmacotherapy and quitlines among Latino smokers.

Latino smokers were randomized to CM (n = 40) or standard care (SC, n = 40). All participants received educational materials describing how to utilize pharmacy assistance for cessation pharmacotherapy and connect with quitlines. CM participants received four phone calls from staff to encourage pharmacotherapy and quitline use. At 6-months follow-up, we assessed the utilization of pharmacotherapy and quitline. Additional outcomes included self-reported smoking status and approval for pharmacotherapy assistance.

Using intention-to-treat analysis, CM produced higher utilization than SC of both pharmacotherapy (15.0% versus 2.5%; P = 0.108) and quitlines (12.5% versus 5.0%; P = 0.432), although differences were not statistically significant. Approval for pharmacotherapy assistance programs (20.0% versus 0.0%; P = 0.0005) was significantly higher for CM than SC participants. Self-reported point-prevalence smoking abstinence at 6-months were 20.0% and 17.5% for CM and SC, respectively (P = 0.775).

CM holds promise as an effective intervention to connect Latino smokers to evidence-based cessation treatment.

Evidence is mixed on e-cigarette's effectiveness as a tobacco cessation aid. Research suggests that e-cigarette users face greater barriers to quitting tobacco.

To examine the association between e-cigarette use and tobacco cessation outcomes among quitline callers.

We examined 2,204 callers who enrolled and completed 7-month follow-up surveys between April 2014 and January 2017. We examined the association between any e-cigarette use and tobacco cessation. We also evaluated these relationships by e-cigarette use patterns between enrollment and 7-month follow-up: sustained, adopted, discontinued, and non-use. We used multivariable logistic regression to control for caller characteristics, tobacco history, and program utilization.

Overall, 18% of callers reported using e-cigarettes at enrollment, follow-up, or both. Compared to non-users, e-cigarette users were more likely to be younger, non-Hispanic, and report a mental health condition. The adjusted odds of tobacco cessation were not statistically different for callers who used e-cigarettes compared to those who did not (adjusted odds ratios = 1.02, 95% confidence interval 0.79–1.32). Results were similar when examining cessation by patterns of e-cigarette use.

E-cigarette use was not associated with tobacco cessation. This suggests that e-cigarette use may neither facilitate nor deter tobacco cessation among quitline callers. Future research should continue exploring how e-cigarette use affects quitting.

Roles for pharmacists in general practice are developing in Australia. It is known that pharmacists can provide effective smoking cessation services in other settings but evidence in general practice is lacking.

To determine whether a pharmacist can provide effective smoking cessation services within general practice.

Data from smoking cessation consultations were obtained for 66 consecutive patients seen by one practice pharmacist. The pharmacist tailored interventions to the individual. Medication was offered in collaboration with community pharmacists and general practitioners. Quit coaching, based on motivational interviewing, was conducted. Smoking status was ascertained at least 6 months after the intended quit date and verified by a carbon monoxide breath test where possible.

The patients’ median age was 43 years (range 19–74 years); 42 were females (64%). At baseline, the median (i) number of pack years smoked was 20 (range: 1–75); (ii) Fagerstrom Test of dependence score was 6 (1–10); and (iii) number of previous quit attempts was 3 (0–10). Follow-up after at least 6 months determined a self-reported point prevalence abstinence rate of 30% (20/66). Of all patients who reported to be abstinent, 65% (13/20) were tested for carbon monoxide breath levels and were all below 7 ppm. The biochemically verified smoking abstinence rate was therefore 20% overall (13/66). Successful quit attempts were associated with varenicline recommendation (69% v 25%), increased median number of practice pharmacist consultations (4 v 2 per patient) and mental health diagnosis (85% v 51%).

Our observed abstinence rate was comparable or better than those obtained by practice nurses, community pharmacists and outpatient pharmacists, indicating the general practice pharmacist provided an effective smoking cessation intervention. A larger randomised trial is warranted.

Very Brief Advice (VBA) on smoking is an evidence-based intervention and a recommended clinical practice for all healthcare professionals in the UK.

We report on experience from the FRESH AIR project in adapting the VBA model and training in three low-resource settings: Greece, Vietnam and Kyrgyzstan.

Using a participatory research process, UK experts and local stakeholders conducted an environmental scan and needs assessment to examine the VBA intervention model, training materials and recommend adaptations to the local context. Two VBA training sessions were piloted in each country to inform adaptation. A final training tool kit was developed in the local language.

In each country, the VBA on smoking intervention model remained primarily intact. The lack of a formal smoking cessation system to refer motivated clients in two countries required adaptation of the ACT component of the model. A range of local adaptations to the training resources were made in all three countries to ensure cultural appropriateness as well as enhance key messages including expanding training on nicotine addiction, second-hand smoke and pharmacotherapy.

Implementation of VBA requires sensitive, collaborative, local and cultural adaptation if it is to be achieved successfully.

Trial ID# NTR5759

The Standards for Reporting Implementation Studies (StaRI) statement: https://www.equator-network.org/reporting-guidelines/stari-statement/