Objectives: Stopping smoking leads to greater happiness and life satisfaction. This raises the question as to whether harm reduction, i.e. smoking reduction (SR) and the use of Nicotine Replacement Therapy (NRT) for SR, might lead to a similar benefit. This is of importance, given that the National Institute of Clinical Excellence in the UK is due to release guidance on harm reduction in 2013.

Design: Data were collected from 1,532 smokers involved in the Smoking Toolkit Study.

Method: Participants were asked if they were cutting down and if they were using Nicotine Replacement Therapy (NRT). Smokers also rated happiness and life satisfaction.

Results: There was no evidence of an association between SR or use of NRT for SR and either reported ‘happiness’ or ‘life satisfaction’. Nor was there an association between measures of ‘happiness’ or ‘life satisfaction’ and cigarette consumption.

Conclusion: It appears that SR is not associated with mental health benefits. This suggests that complete cessation may be necessary for benefits to be incurred. Prospective studies are necessary to confirm these findings.

Introduction: Smokers with depressive and alcohol use disorders report more severe tobacco abstinence effects (e.g., tobacco withdrawal and craving, mood and sleep disturbance), but less is known about abstinence effects among smokers with subclinical features of these disorders.

Aims: The time-course and severity of acute abstinence effects were evaluated in smokers with and without subclinical depressive symptoms (DEP) and with and without subclinical alcohol consumption (ALC). Methods: Participants (N = 106) received smoking cessation counselling and were contingently compensated for biochemically-verified smoking abstinence. Abstinence effects were assessed pre-quit and daily for eight days post-quit.

Results/Findings: Seventy-four participants (70%) achieved eight-day continuous smoking abstinence. Generalised estimating equations revealed that time and DEP group significantly interacted to predict change in Wisconsin Smoking Withdrawal Scale (WSWS) Anxiety (Wald = 21.18, p < .01) and Questionnaire of Smoking Urges Relief from Negative Affect (Wald = 20.12, p < .01) subscale scores. Time and ALC group significantly interacted to predict change in Profile of Mood States (POMS) Fatigue subscale score (Wald = 19.78, p < .01). Compared to non-DEP smokers, DEP smokers reported higher mean post-quit scores on several measures of abstinence effects, including WSWS Sadness and POMS Total; however, pre-quit differences between DEP groups may have confounded post-quit differences.

Conclusions: Smokers with subclinical depressive symptoms endorsed high levels of abstinence effects, but it was unclear if these were related to the absence of tobacco. Smokers with subclinical alcohol consumption did not endorse high levels of abstinence effects but abstinence-related fatigue took longer to improve.

Introduction: Given the increased rates of nondaily smoking and the lack of validated measures to assess factors related to nondaily smoking, we aimed to develop a measure of reasons for nondaily smoking among young adults. Specifically, we developed a scale assessing reasons or triggers for nondaily smoking and examined its reliability, factor structure, and concurrent validity. Methods: We administered an online survey to 2,000 students at six colleges in the Southeastern US, and 718 (35.9%) returned a completed survey. The current analyses focused on the 95 participants who reported nondaily smoking (i.e., smoking between 1 and 29 days of the past 30 days). In addition to the items created for scale development, measures included socio-demographics, other measures of motivation and confidence/self-efficacy, past smoking/quitting history, readiness to quit, and other psychosocial factors related to smoking. Results: The 19-item Reasons for Nondaily Smoking Scale (RNS) demonstrated an average score of 45.36 (SD = 15.55) and internal consistency (Cronbach's alpha of 0.79). Factor analysis of the items extracted four factors which accounted for 57.4% of score variance: Social influences; Enhancing buzzes and positive affect; Negative affect regulation; and Lack of concern of addiction. Concurrent and discriminant validity were documented. Conclusions: Developing validated measures designed to assess factors associated with nondaily smoking will enhance our ability to address this growing public health concern. The development and validation of the RNS for young adults may be critical in informing our intervention strategies and potentially for effecting or predicting cessation among young adult nondaily smokers.

Introduction: This article describes the process and evaluation of a smoking cessation support programme for mental health clients in Sydney.

Aim: The objective of the study was to assess a group-based smoking cessation support model for community mental health clients.

Methods: Two community mental health services participated; 29 clients received free NRT products and weekly education for 12 weeks on: effects of smoking, nicotine dependence, NRT use, withdrawal process and the benefits of quitting. Evaluation included face-to-face interviews, telephone or postal survey using a semi-structured questionnaire.

Results: The baseline (n = 29) and follow-up (n = 14) surveys showed reduction in the number of cigarettes (30 to 21) smoked a day (55% vs. 36%). At one month 47% (n = 19) were confident about stopping smoking permanently whereas 19% (n = 14) reported the same after six months. Participants reported concerns of health effects, illness, physical symptoms (77% n = 27) and financial cost (93% n = 27) were the motivating factors in quitting. None of the findings was statistically significant.

Conclusions: Community based interventions to address the rate of smoking in this group is needed. Financial and health benefits can be used as motivating factors, and integration of smoking cessation assistance in treatment and rehabilitation of mental health consumers would be useful.

Introduction: Sleep disturbance is common among cigarette smokers and predicts smoking cessation failure. Aims: The purpose of this study was to conduct a pilot test of whether provision of a sleep intervention might bolster smoking cessation outcomes among this vulnerable group. Methods: Smokers with insomnia (N = 19) seeking smoking cessation treatment were randomly assigned to receive 8 sessions over 10 weeks of either: (1) cognitive-behavioural therapy for insomnia + smoking cessation counselling (CBT-I+SC; n = 9) or (2) smoking cessation counselling alone (SC; n = 10). Counselling commenced 4 weeks prior to a scheduled quit date, and nicotine patch therapy was also provided for 6 weeks starting on the quit date. Results: There was no significant effect of counselling condition on smoking cessation outcomes. Most participants had difficulty initiating and maintaining smoking abstinence in that 7-day point prevalence abstinence rates at end of treatment (CBT-I+SC: 1/7, 14%; SC: 2/10, 20%) and follow-up (CBT-I+SC: 1/7, 14%; SC: 0/10, 0%) were low for both conditions. CBT-I+SC participants reported improvements in sleep efficiency, quality, duration and insomnia symptoms. Sleep changes were not associated with the likelihood of achieving smoking abstinence. Conclusions: This randomised pilot study suggests that behavioural interventions may improve sleep among smokers with insomnia, but a larger sample is needed to replicate this finding and evaluate whether these changes facilitate smoking cessation.

Introduction: This study examined members of health issue-specific social networking sites (SNSs) for smoking cessation, applying Social Identity Theory (SIT).

Aims: The aim of the study was to test the relationships between perceived verbal, affective, cognitive and physical intimacy on the sites, participation level, social identification and smoking cessation self-efficacy.

Methods: An online questionnaire (N = 252) assessed members of SNSs for smoking cessation. Confirmatory factor analysis (CFA), structural equation modelling (SEM), mediation analysis, MANOVA and ANOVA tests were used to test the hypotheses.

Results/Findings: Verbal, affective, cognitive and physical intimacy significantly predicted participation; participation significantly predicted social identification and smoking cessation self-efficacy; and social identification mediated between participation and smoking cessation self-efficacy. Active participants and lurkers differed significantly on perceived verbal, affective, cognitive and physical intimacy, social identification, and smoking cessation self-efficacy.

Conclusions: Health issue-specific SNSs for smoking cessation have a positive impact on members’ smoking cessation self-efficacy. Higher perceived intimacy facilitates participation online, which in turn influences smoking cessation self-efficacy, with social identification mediating this relationship.