Association of e-cigarette use and smoking cessation among Canadian young adult smokers: secondary analysis of data from a randomised controlled trial

AbstractAimsThis 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.MethodsA 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.ResultsAt 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%).ConclusionsAmong 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.

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Relative effectiveness of a full versus reduced version of the ‘Smoke Free’ mobile application for smoking cessation: a randomised controlled trial

F1000Research ◽

10.12688/f1000research.16148.1 ◽

2018 ◽

Vol 7 ◽

pp. 1524 ◽

Cited By ~ 4

Author(s):

David Crane ◽

Harveen Kaur Ubhi ◽

Jamie Brown ◽

Robert West

Keyword(s):

Smoking Cessation ◽

Randomised Controlled Trial ◽

Controlled Trial ◽

Relative Effectiveness ◽

Behaviour Change Techniques ◽

Full Version ◽

Intention To Treat ◽

Support Programmes ◽

Randomised Controlled

Background: Smartphone applications (apps) are popular aids for smoking cessation. Smoke Free is an app that delivers behaviour change techniques used in effective face-to-face behavioural support programmes. The aim of this study was to assess whether the full version of Smoke Free is more effective than the reduced version. Methods: This was a two-arm randomised controlled trial. Smokers who downloaded Smoke Free were randomly offered the full or reduced version; 28,112 smokers aged 18+ years who set a quit date were included. The full version provided updates on benefits of abstinence, progress (days smoke free), virtual ‘badges’ and daily ‘missions’ with push notifications aimed at preventing and managing cravings. The reduced version did not include the missions. At baseline the app recorded users’: device type (iPhone or Android), age, sex, daily cigarette consumption, time to first cigarette of the day, and educational level. The primary outcome was self-reported complete abstinence from the quit date in a 3-month follow-up questionnaire delivered via the app. Analyses conducted included logistic regressions of outcome on to app version (full versus reduced) with adjustment for baseline variables using both intention-to-treat/missing-equals smoking (MES) and follow-up-only (FUO) analyses. Results: The 3-month follow-up rate was 8.5% (n=1,213) for the intervention and 6.5% (n=901) for the control. A total of 234 participants reported not smoking in the intervention versus 124 in the control, representing 1.6% versus 0.9% in the MES analysis and 19.3% versus 13.8% in the FUO analysis. Adjusted odds ratios were 1.90, 95%CI=1.53-2.37 (p<0.001) and 1.50, 95%CI=1.18-1.91 (p<0.001) in the MES and FUO analyses respectively. Conclusions: Despite very low follow-up rates using in-app follow up, both intention-to-treat/missing equals smoking and follow-up only analyses showed the full version of the Smoke Free app to result in higher self-reported 3-month continuous smoking abstinence rates than the reduced version.

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A randomised controlled trial to investigate the effectiveness of sustained photoprotective behaviour in xeroderma pigmentosum after intervention

BJPsych Open ◽

10.1192/bjo.2021.764 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S287-S287

Author(s):

Tamara Searle ◽

Jessica Walburn ◽

Sam Norton

Keyword(s):

Randomised Controlled Trial ◽

Self Efficacy ◽

Xeroderma Pigmentosum ◽

Controlled Trial ◽

Premalignant Lesions ◽

Mental Wellbeing ◽

Group Effect ◽

Post Intervention ◽

Randomised Controlled

AimsThis study aimed to investigate whether an intervention designed to improve photoprotective behaviours is effective at changing behaviour and whether any change could be maintained.BackgroundXeroderma Pigmentosum (XP) is a rare condition in which patients are at risk of malignancies when exposed to ultra-violet radiation (UVR). Sufferers must take extra precautions to protect themselves from UVR. They must apply sunscreen to exposed skin, wear thick clothing, gloves, and a UVR-protective visor. Treatments include preventative photoprotective measures; the use of sunscreen and protective clothing. Additionally, frequent eye and skin examinations are required and swift removal of any premalignant lesions.MethodIn this randomised controlled trial, 16 participants with XP were given questionnaires at 4 time points; baseline, post-intervention, 5 months and 9 months post-intervention. The intervention involved 7 one-on-one counselling sessions, as well as telephone consultations. Counselling sessions encouraged photoprotection adherence, self-efficacy and discussions of any barriers to improving photoprotective behaviour. This study focused on psychosocial variables, attitudes and photoprotection. Questionnaires included the photoprotection self-efficacy questionnaire, Self-Reported Behavioural Automaticity Index, Short Warwick-Edinburgh Mental Wellbeing Scale, Quality of Life and Brief Photoprotection Adherence Questionnaire.ResultThe intervention was shown to have no significant effect on participants’ questionnaires scores. Univariate ANCOVA revealed a group effect between follow-up 1 (FU1) and follow-up 2 (FU2); η2 = 0.422 for self-efficacy in wearing photoprotective clothing. A group effect was identified from BL to FU1 and FU1 to FU2; η2 = 0.343 and η2 = 0.378 respectively in how often participants reapplied sunscreen to their face when outside for longer periods. Univariate ANCOVA revealed no group or time effect for the other outcome variables; for example, sunscreen self-efficacy.ConclusionThe intervention had no significant effect on photoprotective behaviour questionnaire scores. Future research could focus on recruiting more participants globally to generate more statistically powered results. Research should focus on producing a maintainable intervention so that any positive change would produce better long-term health outcomes. This study lays the foundations for future XP research, which will be vital to improve understanding and enhance photo protective behaviour.

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Effects of mental health self-efficacy on outcomes of a mobile phone and web intervention for mild-to-moderate depression, anxiety and stress: secondary analysis of a randomised controlled trial

BMC Psychiatry ◽

10.1186/s12888-014-0272-1 ◽

2014 ◽

Vol 14 (1) ◽

Cited By ~ 50

Author(s):

Janine Clarke ◽

Judith Proudfoot ◽

Mary-Rose Birch ◽

Alexis E Whitton ◽

Gordon Parker ◽

...

Keyword(s):

Mental Health ◽

Randomised Controlled Trial ◽

Mobile Phone ◽

Self Efficacy ◽

Controlled Trial ◽

Secondary Analysis ◽

Moderate Depression ◽

Randomised Controlled ◽

Web Intervention

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Relative effectiveness of a full versus reduced version of the ‘Smoke Free’ mobile application for smoking cessation: an exploratory randomised controlled trial

F1000Research ◽

10.12688/f1000research.16148.2 ◽

2019 ◽

Vol 7 ◽

pp. 1524 ◽

Cited By ~ 10

Author(s):

David Crane ◽

Harveen Kaur Ubhi ◽

Jamie Brown ◽

Robert West

Keyword(s):

Smoking Cessation ◽

Randomised Controlled Trial ◽

Controlled Trial ◽

Relative Effectiveness ◽

Behaviour Change Techniques ◽

Full Version ◽

Intention To Treat ◽

Support Programmes ◽

Randomised Controlled

Background: Smartphone applications (apps) are popular aids for smoking cessation. Smoke Free is an app that delivers behaviour change techniques used in effective face-to-face behavioural support programmes. The aim of this study was to assess whether the full version of Smoke Free is more effective than the reduced version. Methods: This was a two-arm exploratory randomised controlled trial. Smokers who downloaded Smoke Free were randomly offered the full or reduced version; 28,112 smokers aged 18+ years who set a quit date were included. The full version provided updates on benefits of abstinence, progress (days smoke free), virtual ‘badges’ and daily ‘missions’ with push notifications aimed at preventing and managing cravings. The reduced version did not include the missions. At baseline the app recorded users’: device type (iPhone or Android), age, sex, daily cigarette consumption, time to first cigarette of the day, and educational level. The primary outcome was self-reported complete abstinence from the quit date in a 3-month follow-up questionnaire delivered via the app. Analyses conducted included logistic regressions of outcome on to app version (full versus reduced) with adjustment for baseline variables using both intention-to-treat/missing-equals smoking (MES) and follow-up-only (FUO) analyses. Results: The 3-month follow-up rate was 8.5% (n=1,213) for the intervention and 6.5% (n=901) for the control. A total of 234 participants reported not smoking in the intervention versus 124 in the control, representing 1.6% versus 0.9% in the MES analysis and 19.3% versus 13.8% in the FUO analysis. Adjusted odds ratios were 1.90, 95%CI=1.53-2.37 (p<0.001) and 1.50, 95%CI=1.18-1.91 (p<0.001) in the MES and FUO analyses respectively. Conclusions: Despite very low follow-up rates using in-app follow up, both intention-to-treat/missing equals smoking and follow-up only analyses showed the full version of the Smoke Free app to result in higher self-reported 3-month continuous smoking abstinence rates than the reduced version.

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Cognitive complexity of clients and counsellors during motivation-based treatment for smoking cessation: an observational study on occasional smokers in a US college sample

BMJ Open ◽

10.1136/bmjopen-2017-015849 ◽

2017 ◽

Vol 7 (10) ◽

pp. e015849 ◽

Cited By ~ 4

Author(s):

Lucian Gideon Conway ◽

Kari Jo Harris ◽

Delwyn Catley ◽

Laura Janelle Gornick ◽

Kathrene Renee Conway ◽

...

Keyword(s):

Smoking Cessation ◽

Randomised Controlled Trial ◽

Observational Study ◽

Confidence Interval ◽

Cognitive Complexity ◽

Controlled Trial ◽

Secondary Analysis ◽

Secondary Outcome ◽

Integrative Complexity ◽

Randomised Controlled

ObjectiveMotivational interviewing (MI) is a widely used and promising treatment approach for aiding in smoking cessation. The present observational study adds to other recent research on why and when MI works by investigating a new potential mechanism: integrative complexity.SettingThe study took place in college fraternity and sorority chapters at one large midwestern university.ParticipantsResearchers transcribed MI counselling sessions from a previous randomised controlled trial focused on tobacco cessation among college students and subsequently scored clients’ and counsellors’ discussions across four counselling sessions for integrative complexity.InterventionsThis is an observational secondary analysis of a randomised controlled trial that tested the effectiveness of MI. We analysed the relationship between integrative complexity and success at quitting smoking in the trial.Primary and secondary outcome measuresSuccess in quitting smoking:Participants were categorised into two outcome groups (successful quitters vs failed attempters), created based on dichotomous outcomes on two standard variables: (1) self-reported attempts to quit and (2) number of days smoked via timeline follow-back assessment procedures that use key events in participants’ lives to prompt their recall of smoking.ResultsWe found (1) significantly higher complexity overall for participants who tried to quit but failed compared with successful quitters (standardised β=0.36, p<0.001, (Lower Confidence Interval.)LCI=0.16, (Upper Confidence Interval)UCI=0.47) and (2) the predictive effect of complexity on outcome remains when controlling for standard motivational and demographic variables (partialr(102)=−0.23, p=0.022).ConclusionsTaken together, these results suggest that cognitive complexity is uniquely associated with successful quitting in MI controlled trials, and thus may be an important variable to more fully explore during treatment.

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A randomised controlled trial of a theory-based interactive internet-based smoking cessation intervention (‘StopAdvisor’): Study protocol

The Journal of Smoking Cessation ◽

10.1017/jsc.2013.21 ◽

2013 ◽

Vol 8 (2) ◽

pp. 63-70 ◽

Cited By ~ 2

Author(s):

Susan Michie ◽

Jamie Brown ◽

Adam W. A. Geraghty ◽

Sascha Miller ◽

Lucy Yardley ◽

...

Keyword(s):

Smoking Cessation ◽

Logistic Regression ◽

Randomised Controlled Trial ◽

Primary Outcome ◽

Outcome Measure ◽

Controlled Trial ◽

Primary Outcome Measure ◽

The Social ◽

Randomised Controlled

Background: Internet-based interventions can help smokers to quit compared with brief written materials or no intervention. However, they are not widely used, particularly by more disadvantaged smokers, and there is significant variation in their effectiveness. A new smoking cessation website (‘StopAdvisor’) has been systematically developed on the basis of PRIME theory, empirical evidence, web-design expertise and user-testing with socio-economically disadvantaged smokers. This paper reports the protocol of a randomised controlled trial to evaluate the efficacy of StopAdvisor and determine whether it translates across the social spectrum.Methods: The trial has two arms with participants randomised to the offer of the interactive ‘StopAdvisor’ website (intervention condition) or a non-interactive, static website (control condition). Participants are adults from the UK, who smoke every day and are willing to make a serious quit attempt within a month of enrolment. At least 4260 participants will be recruited with a minimum of 2130 in each of two socio-economic sub-groups. The intervention comprises a structured quit plan and a variety of theory- and evidence-based behaviour change techniques for smoking cessation. Tailored support is offered in the form of a series of tunnelled sessions and a variety of interactive menus for use up to a month before, and then for one month after quitting (http://www.lifeguideonline.org/player/play/stopadvisordemonstration). The control is a static website that presents brief and standard advice on smoking cessation. Assessments are at baseline and 2-, 4- and 7-months post-enrolment. The primary outcome measure will be Russell Standard 6-months sustained abstinence, defined as self-reported continuous abstinence verified by saliva cotinine or anabasine at 7-month follow-up. Secondary outcome measures will include 7-day point-prevalence abstinence at 7-month follow-up, self-reported abstinence at 2- and 4-month follow-ups, satisfaction ratings of the website and quantitative indices of website interaction. All analyses will be by intention to treat and the main analysis will compare the two conditions on the primary outcome measure using a logistic regression model, adjusted for baseline characteristics. The efficacy of the intervention across the social spectrum will be assessed by a logistic regression focusing on the interaction between condition and socio-economic disadvantage.Trial registration: ISRCTN99820519.

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Early preterm nutrition and the urinary metabolome in young adult life: follow-up of a randomised controlled trial

BMJ Paediatrics Open ◽

10.1136/bmjpo-2017-000192 ◽

2017 ◽

Vol 1 (1) ◽

pp. e000192

Author(s):

James R C Parkinson ◽

Anisha D Wijeyesekera ◽

Matthew J Hyde ◽

Atul Singhal ◽

Alan Lucas ◽

...

Keyword(s):

Young Adult ◽

Randomised Controlled Trial ◽

Controlled Trial ◽

Adult Life ◽

Randomised Controlled

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Effect of a maternal counselling intervention delivered by community health workers on child nutrition: secondary analysis of a cluster randomised controlled trial in India

BMC Public Health ◽

10.1186/s12889-021-11998-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Israa Alzain Ali ◽

Arun Shet ◽

Maya Mascarenhas ◽

Maria Rosaria Galanti

Keyword(s):

Randomised Controlled Trial ◽

Health Workers ◽

Controlled Trial ◽

Secondary Analysis ◽

Cluster Randomised Controlled Trial ◽

Control Group ◽

Cluster Randomised ◽

Randomised Controlled ◽

Counselling Intervention

Abstract Background India suffers from a double burden of malnutrition and anaemia. The Karnataka anaemia project indicated that a counselling intervention delivered by community health workers improved anaemia cure rates. Objective To evaluate the effect of maternal counselling on nutritional aspects of anaemia prevention. Methods Secondary analysis of a cluster randomised controlled trial (55 simultaneously randomised villages using random number generator in Chamrajnagar district, Northern India). In the intervention group mothers of anaemic children received five monthly counselling sessions plus usual care (iron and folic acid supplements), while mothers of anaemic children in the control group received usual care alone. Daily intake of nutrients related to anaemia prevention, i.e. iron (mg) and vitamin C (mg), was estimated using the 24-h dietary recall method at baseline and 6 months follow-up. Linear and logistic mixed regression models were used to assess between-groups difference in changes in nutrients intake from baseline to end of follow-up. Data collectors and analysts were blinded to the group assignment. Results Participants were 534 (intervention n = 303; usual treatment n = 231) anaemic children, aged 1 to 5 years and their caregivers, of whom 521(intervention n = 299 from 28 villages; usual treatment n = 222 from 27 villages) were retained at 6 months follow-up and included in the analysis. This study provides inconclusive evidence of improvement in the intake of nutrients that prevent anaemia from baseline to follow-up among the intervention compared to the control group; increase in iron intake was 0.24 mg/day (95% CI -0.67; 1.15) and increase in vitamin C intake was 4.61 mg/day (95% CI -0.69, 9.91). Although encouraging, it is notable that the overall intake of nutrients that prevent anaemia remained well below the national recommended daily allowance. Conclusion This study provides inconclusive evidence of the effect of parental counselling on nutritional aspects of anaemia prevention. The results highlight the need to devise multi-component anaemia-prevention interventions that include facilitators of the availability of nutritious food and should be evaluated in studies that are adequately powered to detect nutritional changes. Trial registration International Standard Randomized Controlled Trial Number ISRCTN68413407, prospectively registered on 17/12/2013.

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