1442Implementation and outcomes of systematic approaches to tobacco treatment: the Ottawa Model for Smoking Cessation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Coja ◽  
K A Mullen ◽  
A L Pipe ◽  
R D Reid
Keyword(s):  
Primary Care ◽  
Smoking Cessation ◽  
Smoking Status ◽  
Evidence Based ◽  
Quit Attempt ◽  
Healthcare Settings ◽  
Tobacco Treatment ◽  
Quit Rate ◽  
Quitting Smoking

Abstract Background/Introduction Tobacco use is a major risk factor for the leading chronic diseases, is a leading cause of preventable death worldwide, and is a large cost driver of healthcare spending. Quitting smoking is the single most effective thing a patient can do to improve their health. The Ottawa Model for Smoking Cessation (OMSC) is a systematic, comprehensive approach to clinical tobacco dependence treatment. It provides support to healthcare settings in establishing a high quality tobacco treatment protocol and addressing common barriers to ensure optimal delivery of evidence-based smoking cessation interventions. Purpose The OMSC assists healthcare professionals to transform clinical practices through knowledge translation, implementation support, and quality evaluation. It promotes the delivery of evidence-based interventions to a greater number of smokers using a systematic approach, ultimately increasing cessation rates. The OMSC assists providers to identify smoking status, provide strategic advice to quit, support patients in making a quit attempt, and provide follow-up support. Methods OMSC Outreach Facilitators work with healthcare setting to assist with implementing evidence-based smoking cessation interventions. This is guided by an OMSC workplan which covers planning, implementing, evaluating and sustainability. Pre and post implementation along with program-level data is collected and used to determine rates of smoking status documentation, brief advice to stop smoking, delivery of cessation support and patient quit rates. Results The OMSC program has worked with approximately 450 healthcare settings, trained over 20,000 healthcare professionals, and supported approximately 500,000 patients with quitting smoking. Of those not ready to quit, 45% of patients seen in primary care were supported in reducing the amount they smoke. For OMSC hospital and specialty care patients receiving follow-up support, the six month responder-quit rate was 48%. For OMSC primary care patients, the two month responder-quit rate was 57%. Patients who had previously been supported by their OMSC primary care practice but had not presented to their provider in at least 6 months were contacted to assess their smoking status. Of those reached, 44% were smoke-free. Of those who relapsed, 53% indicated they would be willing to make another quit attempt, 37% of which went back to their healthcare provider to try again. Conclusion The OMSC has shown to be a simple, systematic step-by-step approach to addressing tobacco use in healthcare settings. It provides a way to create clinical efficiencies while increasing the rates at which evidence-based smoking cessation interventions are being delivered to patients, which leads to more patients making further quit attempts. The OMSC continues to expand across Canada and internationally in hopes of creating a wider smoking cessation network to support more patients with quitting smoking. Acknowledgement/Funding Ontario Ministry of Health and Long-Term Care

scholarly journals Change in smoking cessation stage over 1 year in patients with schizophrenia: a follow up study in Japan

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yuji Higuchi ◽  
Masaki Fujiwara ◽  
Naoki Nakaya ◽  
Maiko Fujimori ◽  
Chinatsu Hayashibara ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Smoking Status ◽  
Intention To Quit ◽  
Baseline Survey ◽  
Smoking Cessation Treatment ◽  
Follow Up Study ◽  
Quit Smoking ◽  
Quitting Smoking ◽  
Smoking Behaviors

Abstract Background We performed a follow up study about willingness and behaviors to quit smoking among smokers with schizophrenia in Japan. Methods Participants were outpatients with schizophrenia aged 20–69 years who had been visiting the hospital for ≥1 year as of April 1, 2016, and had visited the hospital more than once in the previous 6 months. A baseline survey on smoking behaviors including current smoking status and smoking cessation stage, was administered in 420 participants that were randomly extracted from a patient pool (n = 680) in 2016, and a follow-up survey was administered in 2017. We calculated the distribution and change in smoking cessation stage, number of smokers and nonsmokers after 1 year, and quitting rate from a naturalistic 1-year smoking-cessation follow up. Results The number of baseline respondents was 350; 113 current smokers and 68 former smokers. Among the 113 current smokers, 104 (92.0%) were followed for 1 year, 79 (70.0%) were interested in smoking cessation, and only 7 had received smoking cessation treatments at baseline. Among the tracked 104 participants, only 6 (5.8%) stopped smoking after 1 year. Among the 25 participants who had intentions to quit smoking within 6 months at baseline, 6 (24.0%) maintained their intention to quit smoking for 1 year, and 16 (64.0%) did not maintain their intention to quit smoking. Conclusions Our findings showed that many smokers with schizophrenia were interested in quitting smoking, but few patients received treatment and actually quit smoking. Timely intervention, including the option to receive smoking cessation treatment, is necessary for those patients with schizophrenia who smoke. Trial registration UMIN Clinical Trials Registry (UMIN000023874, registered on August 31, 2016).

scholarly journals Between Inhale and Exhale

2014 ◽  
Vol 19 (2) ◽  
pp. 144-149 ◽  
Author(s):  
Chia-Liang Dai ◽  
Manoj Sharma
Keyword(s):  
Smoking Cessation ◽  
Randomized Controlled Trials ◽  
English Language ◽  
Controlled Trials ◽  
Evidence Based ◽  
Inclusion Criteria ◽  
Randomized Controlled ◽  
Quitting Smoking ◽  
Quantitative Design

The current study provided a review of evidence-based yoga interventions’ impact on smoking cessation. The researchers reviewed articles obtained from MEDLINE (PubMed), EBSCOHOST, PROQUEST, MEDINDIA, CINAHL, Alt HealthWatch, and AMED databases. Inclusion criteria were as follows: ( a) study published between 2004 and 2013, ( b) study published in English language, ( c) study used yoga-based interventions, ( d) study involved smokers with varying level of smoking, ( e) study used any quantitative design, and ( f) study had physiological and/or psychological outcomes. A total of 10 studies met the inclusion criteria. Designs were 2 pre–post tests and 8 randomized controlled trials. Majority of the interventions were able to enhance quitting smoking rates in the participants under study. Yoga-based interventions hold promise for smoking cessation. Some of the limitations include short follow-up measurements and short duration of intervention.

Smoking cessation, weight gain and risk of cardiovascular disease

Heart ◽  
2021 ◽  
pp. heartjnl-2021-318972
Author(s):  
Xiaowen Wang ◽  
Jia-Yi Dong ◽  
Renzhe Cui ◽  
Isao Muraki ◽  
Kokoro Shirai ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Smoking Cessation ◽  
Weight Gain ◽  
Smoking Status ◽  
Cox Proportional Hazard ◽  
Quitting Smoking ◽  
Cox Proportional Hazard Models ◽  
Never Smokers

ObjectiveTo examine whether the relationship between smoking cessation and risk of cardiovascular disease (CVD) was modified by weight gain.MethodsA total of 69 910 participants (29 650 men and 46 260 women) aged 45–74 years were grouped into six groups by smoking status in the first and 5-year surveys: sustained smokers, recent quitters according to postcessation weight gain (no weight gain, 0.1–5.0 kg, >5.0 kg), long-term quitters and never smokers. Quitting smoking within and longer than 5 years were defined as recent and long-term quitters, respectively. We used Cox proportional hazard models to estimate the HR for incident CVD, coronary heart disease (CHD) and stroke.ResultsWe identified 4023 CVDs (889 CHDs and 3217 strokes) during a median of 14.8 years of follow-up. Compared with sustained smokers, the multivariable HR (95% CI) for CVD was 0.66 (0.52 to 0.83) for recent quitters without weight gain, 0.71 (0.55 to 0.90) for recent quitters with weight gain of 0.1–5.0 kg, 0.70 (0.44 to 1.10) for recent quitters with weight gain of >5.0 kg, 0.56 (0.49 to 0.64) for long-term quitters, and 0.60 (0.55 to 0.66) for never smokers. The analysis restricted to men showed a similar association. Prespecified analysis by age suggested that recent quitters overall had a lower HR for CVD among those aged <60 years vs ≥60 years. Similar patterns of association were observed in CHD and stroke.ConclusionsPostcessation weight gain did not attenuate the protective association between smoking cessation and risk of CVD.

Abstract 13872: Cue Restricted Smoking Increases Quit Rates With Varenicline

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jaqueline Scholz ◽  
Tania O Abe ◽  
Patricia Gaya ◽  
Iana R Moraes ◽  
Bianca Bellini ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Relative Risk ◽  
Confidence Interval ◽  
Controlled Trial ◽  
Standing Position ◽  
Clinic Visit ◽  
Cessation Rate ◽  
Quit Attempt ◽  
Quit Rate

Introduction: Varenicline effectively helps smokers quit by reducing withdrawal symptoms and blocking the reward of smoking. However, most quitters return to smoking within 1 year. “Cue-restricted smoking” is a behavioral technique designed to increase quit rates by asking smokers attempting to quit to restrict smoking to the standing position, while alone, in an isolated area facing a wall, with the cigarette as the only stimulus. Hypothesis: We compared the effectiveness of cue-restricted smoking cessation advice versus standard target quit date advice from day 8 of initiating varenicline in smokers making a quit attempt at the Smoking Cessation Service at the Prevention Department of the Heart Institute, Sao Paulo, Brazil. Methods: Using retrospective clinic records we compared quit rates in 281 smokers (50% males) instructed in the cue-restricted smoking cessation method during 2016-18 to quit rates in 324 smokers (46% males) advised to completely stop smoking on the target quit date which we previously used during 2011-14. All were prescribed varenicline for 12 weeks alone, with the addition of bupropion if needed after 4 weeks. Follow-up consisted of behavioral support at 4-6 visits during active drug treatment and telephone counselling at 24 and 52 weeks. The smoking cessation rate was confirmed with expired carbon monoxide at the 12-week clinic visit and only by telephone at 52 weeks. Results: The mean age of smokers was 49 ±12 years both groups and the number of cigarettes smoked daily was similar (18/day in the cue-restricted versus 19/day in the target quit day group). The smoking cessation rate at 12 weeks was 75% in the cue-restricted versus 45% in the target quit day group (relative risk 1.8; 95% confidence interval 1.4-2.2; p<0.001). At 52 weeks the quit rate was 65% vs 34% respectively (relative risk 1.9; 95% confidence interval 1.5-2.4; p<0.001). Conclusion: Cue restricted smoking substantially increased the chance of quitting compared with standard advice during treatment with varenicline . These results should be further studied in a randomized controlled trial.

scholarly journals A Pilot Randomized Controlled Trial of Smoking Cessation in an Outpatient Respirology Clinic

2015 ◽  
Vol 22 (2) ◽  
pp. 91-96 ◽  
Author(s):  
Smita Pakhale ◽  
Justine Baron ◽  
Michael A Armstrong ◽  
Avanti Garde ◽  
Robert D Reid ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Standard Care ◽  
Smoking Status ◽  
Controlled Trial ◽  
Retention Rates ◽  
Face To Face ◽  
Quit Rate ◽  
Intervention Adherence ◽  
To Receive

OBJECTIVE: To assess the feasibility and potential effectiveness of a modified version of the Ottawa Model for Smoking Cessation in an outpatient respirology clinic.METHODS: Adult tobacco smokers attending the respirology clinic and willing to choose a quit date within one month of enrollment were randomly assigned to receive standard care or the intervention. Standard care participants received smoking cessation advice, a brochure and a prescription for smoking cessation medication if requested. Intervention participants received a $110 voucher to purchase smoking cessation pharmacotherapy and were registered to an automated calling system. Answers to automated calls determined which participants required nurse telephone counselling. Feasibility indicators included recruitment and retention rates, and intervention adherence. The effectiveness indicator was self-reported smoking status at 26 to 52 weeks.RESULTS: Forty-nine (54.4%) of 90 eligible smokers were randomly assigned to the intervention (n=23) or control (n=26) group. Self-reported smoking status at 26 to 52 weeks was available for 32 (65.3%) participants. The quit rate for intervention participants was 18.2% compared with 7.7% for controls (OR2.36 [95% CI 0.39 to 14.15]).CONCLUSION: It would be feasible to evaluate this intervention in a larger trial. Alternatives to face-to-face follow-up at the clinic are recommended.

scholarly journals Use of Smoking Cessation Interventions by Physicians in Argentina

2014 ◽  
Vol 11 (3) ◽  
pp. 188-197 ◽  
Author(s):  
Veronica Schoj ◽  
Raul Mejia ◽  
Mariela Alderete ◽  
Celia P. Kaplan ◽  
Lorena Peña ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Medical Training ◽  
Smoking Status ◽  
Perceived Quality ◽  
Evidence Based ◽  
Smoking Cessation Counselling ◽  
Quit Smoking ◽  
Clinical Systems

Background: Physician-implemented interventions for smoking cessation are effective but infrequently used. We evaluated smoking cessation practices among physicians in Argentina.Methods: A self-administered survey of physicians from six clinical systems asked about smoking cessation counselling practices, barriers to tobacco use counselling and perceived quality of training received in smoking cessation practices.Results: Of 254 physicians, 52.3% were women, 11.8% were current smokers and 52% never smoked. Perceived quality of training in tobacco cessation counselling was rated as very good or good by 41.8% and as poor/very poor by 58.2%. Most physicians (90%) reported asking and recording smoking status, 89% advised patients to quit smoking but only 37% asked them to set a quit date and 44% prescribed medications. Multivariate analyses showed that Physicians' perceived quality of their training in smoking cessation methods was associated with greater use of evidence-based cessation interventions. (OR = 6.5; 95% CI = 2.2–19.1); motivating patients to quit (OR: 7.9 CI 3.44–18.5), assisting patients to quit (OR = 9.9; 95% CI = 4.0–24.2) prescribing medications (OR = 9.6; 95% CI = 3.5–26.7), and setting up follow-up (OR = 13.0; 95% CI = 4.4–38.5).Conclusions: Perceived quality of training in smoking cessation was associated with using evidence-based interventions and among physicians from Argentina. Medical training programs should enhance the quality of this curriculum.

scholarly journals Association between educational level and smoking cessation in an 11-year follow-up study of a national health survey

2021 ◽  
pp. 140349482199372
Author(s):  
Otto Ruokolainen ◽  
Tommi Härkänen ◽  
Jouni Lahti ◽  
Ari Haukkala ◽  
Markku Heliövaara ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Basic Education ◽  
Smoking Status ◽  
Adult Population ◽  
Population Based ◽  
National Health Survey ◽  
Outcome Variable ◽  
Quitting Smoking ◽  
Plasma Cotinine

Aims: There is a lack of longitudinal, population-based studies on the association between education and smoking cessation. A more thorough examination of this association is needed to address inequalities in smoking. Methods: The longitudinal Health 2000 Survey and Health 2011 Survey, representing the Finnish population aged ⩾30 years, were analysed. Of the 1352 baseline daily smokers, 945 (70%) provided a smoking status at the follow-up. The analytic sample size was 884 (excluding the follow-up occasional smokers). Self-reported questionnaire data and measurements (e.g. plasma cotinine) from the baseline were utilised. The outcome variable was smoking cessation at the follow-up, and the main explanatory variable was education. Logistic regression was the main method for statistical analyses. All of the analyses accounted for the sampling design. Results: At the follow-up, 28% of the baseline daily smokers had quit smoking. An adjusted regression model showed that highly educated respondents had a higher likelihood of quitting smoking compared with those with basic education. Controlling for demographic and health-related variables had a modest effect on this association. Higher scores for plasma cotinine, symptoms of depression and heavy alcohol use were associated with a lower likelihood of quitting smoking. The association between education and smoking cessation was weaker for women than it was for men. Conclusions: High education is associated with smoking cessation among the general adult population, especially among men. A higher plasma cotinine level is strongly associated with continued smoking among both sexes. Background variables only modestly affected the association between education and smoking cessation.

scholarly journals Correlates of Cessation Success among Romanian Adults

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Dorota Kaleta ◽  
Bukola Usidame ◽  
Elżbieta Dziankowska-Zaborszczyk ◽  
Teresa Makowiec-Dąbrowska
Keyword(s):  
Smoking Cessation ◽  
Public Health Problem ◽  
Household Survey ◽  
Evidence Based ◽  
Cross Sectional ◽  
Factors Associated ◽  
Quit Rate ◽  
Quitting Smoking ◽  
Nationally Representative

Background. Tobacco smoking and its consequences are a serious public health problem in Romania. Evidence-based data on factors associated with successful smoking cessation are crucial to optimize tobacco control. The aim of the study was to determine the sociodemographic and other factors associated with smoking cessation success among adults.Materials and Methods. Data was from a sample of 4,517 individuals derived from the Global Adult Tobacco Survey (GATS). GATS is a cross-sectional, nationally representative household survey implemented in Romania in 2011. Data was analyzed with logistic regression.Results. Among females, the quit rate was 26.3% compared with 33.1% in males (P<0.02). We found disparities in cessation success among the analyzed groups of respondents. Being economically active, being aged 40 and above, and having an awareness of smoking health consequences were associated with long-term quitting smoking among men, while initiating smoking at a later age increased the odds of quitting smoking among women. However, cohabitation with nonsmokers was the strongest predictor of successful cessation among both genders.Conclusion. Programs increasing quit rates and encourage cessation among groups less likely to quit, adopting voluntary smoke-free homes, and increasing the awareness of smoking and tobacco pollution risks are needed.

scholarly journals Dental Students as Smoking Cessation Counsellors: Patients’ and Providers’ Perspective

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Nor Azlida Mohd Nor ◽  
Marvin Costher Repen ◽  
Zakuan Zakaria ◽  
Norintan Ab-Murat ◽  
Roslan Saub ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Dental Students ◽  
Smoking Cessation Counselling ◽  
Quit Smoking ◽  
Positive Attitudes ◽  
Quit Rate ◽  
Quitting Smoking ◽  
The University

Introduction: This study assesses dental students’ and patients’ perceptions on the role of dental students as smoking cessation counsellors as well as the patient’s quit rate at the University of XX. Materials and methods: Self-administered questionnaires were distributed to all senior dental students (n=154) in XX University and telephone call interviews were conducted on their patients (n=169) who received smoking cessation counselling from September 2010 to June 2013. Results: Response rates for dental students and patients were 68.2% and 67.3% respectively. Most of the dental students in this study were females (72.3%) whereas the majority of patients were males (97.6%). An average of six months follow up indicated that 22.5% of patients had quit smoking, 65.3% reduced the number of cigarettes smoked and 6.5% had relapsed. About a third of patients surveyed (33.1%) believed that smoking cessation counselling was extremely helpful compared to what students perceived (5.7%, p<0.01). A higher percentage of patients (89.9%) rated the smoking cessation counselling performance as “excellent”, as compared to students’ rating (58.1%, p<0.01). The majority of the dental students and patients agreed that students should enquire about patients tobacco usage, information regarding the effects of smoking on oral health should be transmitted to patients and that quit smoking assistance should be offered. Conclusion: Smoking cessation counselling conducted by dental students seemed to be effective in assisting patients to reduce the number of cigarettes smoked and in quitting smoking. To some extent, both patients and students had positive attitudes towards smoking cessation counselling.

scholarly journals Cigarette smoking after surviving breast cancer: A pilot study

2021 ◽  
Vol 3 (1) ◽  
pp. 124-127
Author(s):  
Ban A. Majeed ◽  
◽  
Deepak Nag Ayyala ◽  
Steven S. Coughlin ◽  
◽  
...  
Keyword(s):  
Breast Cancer ◽  
Smoking Cessation ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Low Income ◽  
Smoking Status ◽  
Current Smoker ◽  
Cross Sectional ◽  
Tobacco Treatment ◽  
Quitting Smoking

Background: Quitting smoking improves cancer survival and improves symptoms of cancer and its treatment. Cancer diagnosis presents a powerful motivation for leading a healthier lifestyle and embracing behavioral changes, such as quitting smoking. Many smokers quit after a cancer diagnosis, but some survivors continue to smoke. This study examined the characteristics associated with being a former rather than a current smoker among women treated for breast cancer. Methods: In this pilot, cross-sectional study, data were collected via postal surveys in women who had a history of smoking and breast cancer (N = 69). Descriptive and logistic regression analyses were conducted to identify factors associated with smoking status. Results: Of this sample, 13 were current smokers and 56 were former smokers. Age, race, education, and employment status were not associated with smoking status. Women with a higher income were significantly more likely to have successfully quit smoking (former smoking OR = 5.94, p < 0.05). Most women were light smokers and reported intentions to quit. Conclusion: The study attests to the addictive nature of smoking and the difficulty in achieving successful quitting even after breast cancer diagnosis. Results highlighted the role of low income as a barrier in smoking cessation. A follow up study is warranted to uncover potential barriers to smoking cessation in order to individualize tobacco treatment to meet the needs of motivated light smoking cancer patients. Intensive innovative tobacco treatment approaches are warranted, to reach successful cessation particularly among cancer patients with lower income.

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