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Nicotine replacement therapy sampling (NRTS) refers to providing all smokers, regardless of interest in quitting, with free samples of over-the-counter NRT. NRTS has been shown to increase quit attempts and abstinence.
Aims
We conducted a pilot trial with a goal to establish the feasibility and acceptability of NRTS in a dental clinic, where providing free samples is routine and universal.
Methods
Participants (N = 30) completed a baseline survey and were randomized to receive or not receive a 2-week supply of NRT samples (14 mg patches and 4 mg lozenges) in a 3:1 ratio.
Results
We enrolled 30 of 50 potentially eligible patients, of whom 26 completed a 4-week follow-up survey. At follow-up, 61% of the NRT group reported use of the samples and 26% said they used more NRT obtained on their own. In the No NRT group, only one patient reported using NRT. No patients reported past week abstinence, but 43% of the NRT group vs. 29% of the No NRT group reported making a quit attempt lasting longer than 24 h.
Conclusions
The pattern of results suggests that conducting a larger trial would be feasible and that the NRTS intervention was acceptable to dental patients.
Hard-core smokers have been identified as a potential public health challenge. The trans-theoretical model lacks the specificity to identify hard-core smokers. The precaution adoption process model (PAPM) is a stage-based behaviour change model which includes ‘no intent to quit’ as a distinct stage and so may be useful in identifying hard-core smokers.
Aims
The aim of this study was to apply the PAPM to a community based sample of smokers to determine whether it provides a useful approach to identifying hard-core smokers.
Methods
We surveyed smokers in Australia who were recruited through social media and an online data collection agency.
Results
The sample included 336 current smokers, 11.9% were in Stage 4 of the PAPM – i.e. had decided not to quit. Stage 4 smokers are more resistant to quitting and marked by their similarities to hard-core smokers. This is further amplified when addressing Stage 4 smokers with no previous quit attempt.
Conclusions
Stage 4 smokers with no previous quit attempts are aligned with a hard-core smoker profile with higher levels of nicotine dependence, greater cigarette consumption and low socio-economic status. Further research is required to determine if PAPM is a valid predictive model for identifying hard-core smokers in clinical practice.
Uninsured patients are more likely than the general population to use tobacco and less likely to quit.
Aims
To determine if the mode of delivering the PHS Guidelines influenced the effectiveness of smoking cessation among patients in a safety net setting.
Methods
Six free clinics were randomly assigned to a training program delivered by an academic physician or community partner plus video support. A repeated cross-sectional survey of patients was conducted at three waves to assess effectiveness to promote quitting.
Results
Tobacco use was triple the rate of the US population: 57.7% (Wave 1), 44.7% (Wave 2), and 48.9% (Wave 3). Patients were more likely to report receipt of at least one evidence-based strategy to promote quitting at Wave 2 (AOR = 2.33, 95% CI (1.18–4.58)). Patients treated in clinics trained by the community partner were significantly more likely to report receiving cessation assistance at Wave 2 (AOR 2.54, 95%CI 1.29–5.00) and the trend was similar, but not significant at Wave 3. Patients in the community partner-led arm were significantly less likely to report tobacco use at Wave 3 (AOR 0.59, 95% CI 0.35–0.99).
Conclusions
Implementation of the PHS Guidelines in free clinics demonstrates preliminary efficacy, with delivery by community partners offering greater scalability.
Studies have shown that Text2Quit and other mobile cessation programs increase quit rates in adult smokers, but the mechanism of effects and user experiences are not well understood.
Aims
This study reports on participants' experiences with the program and explores aspects of the program that they liked and disliked.
Methods
Self-reported experiences of the program were collected through a follow-up survey conducted 1 month after enrollment (n = 185). Participant responses to open-ended items were dual coded by independent coders.
Results
Overall participants agreed that they liked the program (4.2/5), that the program was helpful (4.1/5) and that they would recommend the program to a friend (4.3/5). Top reasons for liking the program included that it served as a constant reminder of quitting (17.8%), the content (16.7%), the encouragement provided (13.3%), and the on-demand tools (12.2%). Top reasons for disliking the program were message frequency (20.5%), content (7.0%), and the lack of personal interaction (7.0%).
Conclusions
The constancy of messaging was both liked as a reminder and disliked as an annoyance. Future programs might be improved by pre-testing and customizing the content based on user preferences, and by adding in human interactions, while keeping a supportive tone and offering on-demand tools.
Light and intermittent smokers (LITS) represent almost 50% of all current smokers. Research is needed to understand smoking motives among adult light smokers.
Aims
To explore smoking cues and motivators among a racially diverse sample of adult LITS (≤10 CPD). In addition, we explored differences between native (always smoked ≤10), and converted (former heavier) LITS.
Methods
We used purposive sampling to recruit participants who were native and converted LITS and to include equal numbers of African Americans, Whites and Latinos. We coded and analyzed transcripts using a stage approach to identify themes.
Results
Four main themes emerged that may be unique to light smokers and suggests potential strategies for intervention: (1) smoking in response to cues and control, (2) identifying as a smoker, (3) concern about health consequences, and (4) other priorities influencing smoking. There were some differences among smoking cues and motivators by race and ethnicity, and differences between native and converted LITS.
Conclusions
Overall, LITS reported drivers of smoking that were unrelated to symptoms of nicotine withdrawal. Even when experiencing salient cues, our LITS cohort expressed the ability to assert control over smoking by abstaining when situational contexts made smoking inconvenient.
Cigarette smoking is highly prevalent among young people experiencing homelessness, and many of these smokers are motivated to quit. However, there is a lack of readily available cessation services for this population, which is highly mobile and can be challenging to engage in services.
Aims
We describe the development of a smoking cessation text messaging intervention (TMI) for homeless youth who are interested in quitting smoking.
Methods
Participants were 18–25 years old and recruited from drop-in centers serving homeless youth. Three focus groups (N = 18) were conducted with smokers to refine the TMI content, and a separate sample of smokers (N = 8) provided feedback on the TMI after using it for 1 week. Survey data assessed the TMI's acceptability and feasibility.
Results
Participants generally rated the TMI as helpful and relevant, and nearly all had cell phone plans that included unlimited texting and were able to view TMI content with few difficulties. Qualitative feedback on strengths/limitations of the TMI in terms of content, tone, and delivery parameters was used to finalize the TMI for a future evaluation.
Conclusions
Results suggest that a TMI is a feasible and acceptable option for young people experiencing homelessness who are interested in quitting smoking.
According to UK guidelines, stop smoking practitioners are expected to be open and supportive towards e-cigarette users. As adequate support from practitioners can be instrumental for smokers to successfully quit smoking, it is crucial to explore the challenges that stop smoking practitioners face when advising on e-cigarette use.
Aim
This qualitative study explores the challenges that stop smoking practitioners face when advising patients on e-cigarettes.
Methods
A qualitative study was conducted with semi-structured interviews with 10 stop smoking practitioners from four stop smoking services in London. Face to face interviews were recorded and transcribed verbatim. Inductive thematic analysis was conducted to explore practitioners' experiences when advising on e-cigarettes.
Findings
Two themes were noted: practitioners' concerns and practitioner–patient interactions. Practitioners were particularly concerned regarding the lack of information, safety issues and the maintenance of addiction linked with e-cigarettes. They emphasised the difficulty of advising on a product that they cannot prescribe. Overall, practitioners expressed the lack of confidence when advising on e-cigarettes since they were often unprepared and not able to answer patients' questions on e-cigarettes.
Conclusions
Stop smoking practitioners' lack of confidence and limited knowledge regarding e-cigarettes emphasises the necessity for training and guidance on e-cigarettes to improve their interactions with patients on this subject. In particular, practitioners need to be provided with clear guidance on how to counsel patients about how and where to buy e-cigarettes.
This study examined the reasons for e-cigarette (EC) use, changes in self-efficacy and association between EC use and cessation of tobacco among Canadian young adult smokers over a 6-month period.
Methods
A secondary analysis was conducted using data from a randomised controlled trial (RCT) of young adult Canadian smokers. EC exposure was defined as persistent, transient and non-use of ECs at baseline and follow-up. The association between EC exposure and cessation was examined using logistic regression and adjusting for co-variates.
Results
At 6-month follow-up, persistent EC use was associated with a lower cessation rate (13%) than transient (23%) or non-use (29%). After adjusting for covariates, non-use and transient use were associated with higher odds of cessation than persistent use (AOR = 3.23, 95% CI = 1.41–7.40, P < 0.01; AOR = 2.40, 95% CI = 1.01–5.58, P < 0.05). At 6-month follow-up, persistent users (68%) had high self-efficacy as compared to transient (15%) or non-use (12%). Top reasons for EC use included use as a quit aid (67%), perceived use as less harmful (52%) and taste (32%).
Conclusions
Among young adult Canadian smokers enrolled in a RCT of a cessation intervention, persistent and transient use of ECs was associated with a lower smoking cessation rate at 6 months.