scholarly journals A Pilot Randomized Clinical Trial of Brief Interventions to Encourage Quit Attempts in Smokers From Socioeconomic Disadvantage

2020 ◽  
Vol 22 (9) ◽  
pp. 1500-1508 ◽  
Author(s):  
Marc L Steinberg ◽  
Rachel L Rosen ◽  
Mark V Versella ◽  
Allison Borges ◽  
Teresa M Leyro
Keyword(s):  
Motivational Interviewing ◽  
Low Socioeconomic Status ◽  
Low Income ◽  
Local Community ◽  
Socioeconomic Disadvantage ◽  
Brief Interventions ◽  
Financial Strain ◽  
Quit Attempt ◽  
Quit Attempts

Abstract Introduction Cigarette smoking disproportionately affects communities of low socioeconomic status where greater smoking prevalence and poorer cessation rates have been observed. Utilizing brief evidence-based interventions to increase cessation attempts may be an effective and easily disseminable means by which to mitigate undue burden in this population. Aims and Methods The current intervention randomized daily smokers (N = 57) recruited from a local community soup kitchen to receive either Brief (eg, 30 m) Motivational Interviewing, Nicotine Replacement Therapy (NRT) sampling, or a Referral-Only intervention. Approximately half of participants (50.9%) reported not completing high school and many reported either just (41.4%) or not (40.4%) meeting basic expenses. Follow-up was completed approximately 1-month postintervention. Results Nonsignificant group differences indicated that participants randomized to the NRT sampling condition were more likely to make a quit attempt (moderate effect size). Approximately 40% of the sample reported making a serious quit attempt at follow-up. Significant differences in cigarettes per day at follow-up, controlling for baseline, were observed, with participants in the Motivational Interviewing condition, only, reporting significant reductions. Participants randomized to the NRT condition were significantly more likely to report using NRT patch and lozenge at follow-up (large effect). There were no differences between groups with respect to seeking behavioral support. Finally, we found that subjective financial strain moderated the effect of condition on change in cigarette consumption where NRT sampling was more effective for participants reporting less financial strain. Conclusions Findings provide initial evidence for personalizing brief interventions to promote quit attempts in low-income smokers. Implications While most clinical research on tobacco use and dependence focuses on successful sustained abstinence, the current study is novel because it examined three brief interventions designed to increase the number of quit attempts made by a nontreatment-seeking group suffering from health disparities (ie, smokers from socioeconomic disadvantage). These data suggest that nontreatment-seeking smokers from socioeconomic disadvantage can be influenced by Brief MIs and these interventions should be used to motivate smokers from socioeconomic disadvantage to make a quit attempt. Future studies should examine combined MIs including pharmacological and behavioral interventions.

Facebook Chat Application to Prompt and Assist Smoking Cessation Among Spanish-Speaking Young Adults in South Texas

2021 ◽  
pp. 152483992110262
Author(s):  
Patricia Chalela ◽  
Alfred L. McAlister ◽  
David Akopian ◽  
Edgar Munoz ◽  
Cliff Despres ◽  
...  
Keyword(s):  
Social Media ◽  
Smoking Cessation ◽  
Young Adults ◽  
South Texas ◽  
Spanish Speaking ◽  
Quit Attempt ◽  
Quit Attempts ◽  
Facebook Advertising

Given how smart phones, internet services, and social media have shown great potential for assisting smoking cessation, we constructed a Facebook chat application based on our previous work with SMS texting services. This report summarizes findings from 2,364 Spanish-speaking young adults recruited through Facebook advertising in South Texas during the 2020 New Year holiday season. Among these service users, 926 (39%) were ready to make a quit attempt, and 26 (3.1%) of those users reported that they were tobacco free 1 month later. There were no responses to a chat question survey 72 days after the dates selected for quitting. Although more research with longer follow up is needed, these findings show that social media chat applications may be helpful for at least prompting quit attempts and short-term cessation among young adult Spanish-speaking smokers. There is no evidence of an impact on long-term cessation, and more research is clearly needed.

Effective Implementation of Culturally Appropriate Tools in Addressing Overweight and Obesity in an Urban Underserved Early Childhood Population in Pediatric Primary Care

2019 ◽  
Vol 58 (5) ◽  
pp. 511-520 ◽  
Author(s):  
Rachel Becker Herbst ◽  
Amrik Singh Khalsa ◽  
Haley Schlottmann ◽  
Mary Kathleen Kerrey ◽  
Katherine Glass ◽  
...  
Keyword(s):  
Motivational Interviewing ◽  
Low Income ◽  
Overweight And Obesity ◽  
Obese Children ◽  
Healthy Habits ◽  
Culturally Tailored ◽  
Increased Risk ◽  
Quasi Experimental ◽  
Urban Clinic

Overweight and obese children are at an increased risk of remaining obese. The American Academy of Pediatrics recommends addressing healthy habits at well-child checks, but this poses challenges, especially in low-income populations. A clinical innovation project was designed to adapt recommendations in a busy urban clinic and consisted of motivational interviewing, culturally tailored tools, and standardizing documentation. A quasi-experimental design examined innovation outcomes. Of 137 overweight and obese children aged 24 to 66 months, providers’ documentation of weight during well-child check visits improved post-innovation ( P < .01), as did development of healthy habits goals ( P < .001). Families were more likely to return for visits post-innovation ( P = .01). A logistic regression analysis showed that adding body mass index to the problem list and establishing a specific follow-up timeframe most predicted follow-up visits to assess progress ( P < .001). Comprehensive innovations consisting of motivational interviewing, implementation of culturally tailored tools, and standardized documentation can enhance engagement in an urban clinic setting.

Poor person and areal socioeconomic status is associated with increased diabetic retinopathy and visual impairment incidence and progression

2020 ◽  
pp. bjophthalmol-2020-316430
Author(s):  
Jin Rong Low ◽  
Alfred Tau Liang Gan ◽  
Eva K Fenwick ◽  
Preeti Gupta ◽  
Tien Y Wong ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Diabetic Retinopathy ◽  
Visual Impairment ◽  
Low Socioeconomic Status ◽  
Low Income ◽  
Vision Loss ◽  
Population Based ◽  
Housing Type ◽  
Incidence Risk

BackgroundTo investigate the longitudinal associations between person-level and area-level socioeconomic status (PLSES and ALSES, respectively) with diabetic retinopathy (DR) and visual impairment (VI) in Asians with diabetes mellitus (DM).MethodsIn this population-based cohort study, we included 468 (39.4%) Malays and 721 (60.6%) Indians with DM, with a mean age (SD) of 58.9 (9.1) years; 50.6% were female and the mean follow-up duration was 6.2 (0.9) years. Individual PLSES parameters (education, monthly income and housing type) were quantified using questionnaires. ALSES was assessed using the Socioeconomic Disadvantage Index derived from Singapore’s 2010 areal census (higher scores indicate greater disadvantage). Incident DR and VI were defined as absent at baseline but present at follow-up, while DR and VI progression were defined as a ≥1 step increase in severity category at follow-up. Modified Poisson regression analysis was used to determine the associations of PLSES and ALSES with incidence and progression of DR and VI, adjusting for relevant confounders.ResultsIn multivariable models, per SD increase in ALSES score was associated with greater DR incidence (risk ratio (95% CI) 1.27 (1.13 to 1.44)), DR progression (1.10 (1.00 to 1.20)) and VI incidence (1.10 (1.04 to 1.16)), while lower PLSES variables were associated with increased DR (low income: 1.68 (1.21 to 2.34)) and VI (low income: 1.44 (1.13 to 1.83); ≤4 room housing: 2.00 (1.57 to 2.54)) incidence.ConclusionsWe found that both PLSES and ALSES variables were independently associated with DR incidence, progression and associated vision loss in Asians. Novel intervention strategies targeted at low socioeconomic status communities to decrease rates of DR and VI are warranted.

scholarly journals Early-Life Adversities and Recalcitrant Smoking in Midlife: An Examination of Gender and Life-Course Pathways

2020 ◽  
Vol 54 (11) ◽  
pp. 867-879
Author(s):  
Chioun Lee ◽  
Lexi Harari ◽  
Soojin Park
Keyword(s):  
Life Course ◽  
Low Socioeconomic Status ◽  
Early Life ◽  
Financial Strain ◽  
Low Ses ◽  
Family Instability ◽  
Family Problems ◽  
Low Socioeconomic ◽  
Logistic Regression Models

Abstract Background Little is known about life-course factors that explain why some individuals continue smoking despite having smoking-related diseases. Purpose We examined (a) the extent to which early-life adversities are associated with the risk of recalcitrant smoking, (b) psychosocial factors that mediate the association, and (c) gender differences in the associations. Methods Data were from 4,932 respondents (53% women) who participated in the first and follow-up waves of the Midlife Development in the U.S. National Survey. Early-life adversities include low socioeconomic status (SES), abuse, and family instability. Potential mediators include education, financial strain, purpose in life, mood disorder, family problems/support, and marital status. We used sequential logistic regression models to estimate the effect of early-life adversities on the risk of each of the three stages on the path to recalcitrant smoking (ever-smoking, smoking-related illness, and recalcitrant smoking). Results For women, low SES (odds ratio [OR] = 1.29; 1.06–1.55) and family instability (OR = 1.73; 1.14–2.62) are associated with an elevated risk of recalcitrant smoking. Education significantly reduces the effect of childhood SES, yet the effect of family instability remains significant even after accounting for life-course mediators. For men, the effect of low SES on recalcitrant smoking is robust (OR = 1.48; 1.10–2.00) even after controlling for potential mediators. There are noteworthy life-course factors that independently affect recalcitrant smoking: for both genders, not living with a partner; for women, education; and for men, family problems. Conclusions The findings can help shape intervention programs that address the underlying factors of recalcitrant smoking.

scholarly journals Understanding the Association Between Spontaneous Quit Attempts and Improved Smoking Cessation Success Rates: A Population Survey in England With 6-Month Follow-up

2019 ◽  
Vol 22 (9) ◽  
pp. 1460-1467 ◽  
Author(s):  
Claire Garnett ◽  
Lion Shahab ◽  
Tobias Raupach ◽  
Robert West ◽  
Jamie Brown
Keyword(s):  
Regression Models ◽  
Population Survey ◽  
Adult Population ◽  
Success Rates ◽  
Logistic Regression Models ◽  
The Past ◽  
Quit Attempt ◽  
Quit Attempts ◽  
Adjusted Model

Abstract Introduction Almost half of smoking quit attempts are “spontaneous” (initiated as soon as the decision to quit has been made) and are associated with increased success rates. This study aimed to assess to what extent other factors may account for this association. Methods Data were used from respondents to a survey representative of the adult population in England from 2006 to 2016. We included 2018 respondents who were current smokers at baseline and had attempted to quit between baseline and 6-month follow-up. Logistic regression models assessed the association between quit success and spontaneous quit attempts while adjusting for smoking, sociodemographic, and quit attempt characteristics. Results Spontaneous quit attempts were associated with greater odds of quit success (OR = 1.31, 95% CI = 1.07 to 1.60) but the association was not significant in the fully adjusted model (ORadj = 1.19, 95% CI = 0.95 to 1.49). In this adjusted model, those who attempted to quit without cutting down first (ORadj = 3.08, 95% CI = 2.46 to 3.88) and were male (ORadj = 1.44, 95% CI = 1.16 to 1.80) had greater odds of success; although a greater number of attempts in the past 6 months, stronger urges to smoke (strong vs. none), higher daily cigarette consumption, and lower social grade (E vs. AB) were associated with lower odds of success (ORadj range = 0.32–0.98, p &lt; .030). Quit attempts made without cutting down first were correlated with spontaneous quit attempts (r = .150, p &lt; .001) and appeared to account for the diminished association between spontaneous quitting and success (ORadj = 1.18, 95% CI = 0.96 to 1.46). Conclusions The increased success rate of spontaneous quit attempts appears to be because spontaneous quit attempts are more likely to be made without cutting down first. Implications The apparent benefit of spontaneous over planned quit attempts may be attributable to the former being more likely to involve quitting without cutting down first (ie, abrupt cessation) than cutting down first (ie, gradual cessation) and so this may be a more useful target for advice to improve the chances of successful quitting.

scholarly journals Switching to Progressively Reduced Nicotine Content Cigarettes in Smokers with Low Socioeconomic Status: A Double-Blind Randomized Clinical Trial

2020 ◽  
Author(s):  
Nicolle M Krebs ◽  
Junjia Zhu ◽  
Emily Wasserman ◽  
Robin Kuprewicz ◽  
Diane J Martinez ◽  
...  
Keyword(s):  
Low Socioeconomic Status ◽  
Washington Dc ◽  
Post Intervention ◽  
Double Blind ◽  
Low Socioeconomic ◽  
Nicotine Content ◽  
Quit Attempt ◽  
Cigarette Dependence ◽  
Product Standard

Abstract Introduction The Food and Drug Administration issued an advanced notice of proposed rulemaking for setting a product standard for nicotine levels in cigarettes, with an emphasis on minimally or non-addicting very low nicotine content (VLNC). Methods A 33-week, two-arm, double-blind randomized trial conducted in Hershey, Pennsylvania, USA and Washington, DC, USA included adult daily cigarette smokers (≥5 cigarettes per day) with less than a college degree, and who had no plans to quit within the next 6 months. Participants were randomized to either Reduced Nicotine Content (RNC) study cigarettes tapered every 3 weeks to a final VLNC (0.2 mg/cigarette) for six weeks or to Usual Nicotine Content (UNC) study cigarettes (11.6 mg/cigarette). Outcomes included acceptability of study cigarettes measured by attrition (primary outcome), compliance, reduction in cigarette dependence and tobacco biomarkers, and post-intervention cessation. Results The RNC (n= 122) vs. UNC (n=123) group had higher attrition (adjusted Hazard Ratio 3.4; 95% confidence interval [CI] 1.99-5.81). At the end of the intervention, cotinine levels were 50% lower in the RNC group (mean group difference -137 ng/mL; 95% CI -172, -102). The RNC group smoked fewer CPD (-4.1; 95% CI -6.44, -1.75) and had lower carbon monoxide levels (-4.0 ppm; 95% CI -7.7, -0.4). Forty seven percent (29/62) of the RNC group were biochemically-confirmed compliant with smoking VLNC cigarettes (mean cotinine= 8.9 ng/ml). At three month follow-up, only compliant VLNC smokers quit with an assisted quit attempt (N=6/22, 27%). Conclusions This study supports a VLNC standard in cigarettes. Implications Differential dropout and noncompliance indicate some smokers had difficulty transitioning to cigarettes with reduced nicotine. These smokers will benefit from supplemental nicotine in medicinal or noncombustible tobacco products if a nicotine reduction standard is established. Other smokers in the study were able to successfully transition to VLNC cigarettes exclusively and substantially reduced their exposure to nicotine.

Takore i te Kai Ava’ava (Quit smoking), a mCessation Program Adapted for the Cook Islands: Indicators of Potential for Tobacco Control

2021 ◽  
Vol 33 (6-7) ◽  
pp. 714-720
Author(s):  
Teinatangi Ringi ◽  
Josephine Aumea Herman ◽  
Maina Tairi ◽  
Rosie Dobson ◽  
Vili Nosa ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Smoking Behavior ◽  
Text Message ◽  
Value Added ◽  
Cost Effective ◽  
Cook Islands ◽  
Quit Attempt ◽  
Quit Attempts ◽  
Evidence Of Impact

Mobile phone–based smoking cessation interventions (mCessation) are an established evidence-based intervention designed to support smokers to quit. Evidence of impact to date is modestly positive but skewed in favor of high-resourced countries, with less evidence of value added to low-resourced settings. Takore i te Kai Ava’ava, a text message–based smoking cessation program, was delivered to smokers living on the island of Rarotonga in 2019. Eighty-eight smokers consented to take part. Participants completed a baseline questionnaire about current smoking behavior and previous quit attempts; follow-up measures at 2 months assess quit attempts feedback on the program. Thirty-two people completed the follow-up interviews; 10 (31%) had not smoked in the past 7 days, 23 (72%) reported a serious quit attempt, and 29 (91%) felt the program was effective for the Cook Islands. Takore i te Kai Ava’ava was deemed to be highly acceptable and potentially cost-effective.

Associations of rural residence and low socioeconomic status on the risk of new onset cardiovascular disease (CVD) in cancer patients.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 90-90
Author(s):  
Atul Batra ◽  
Shiying Kong ◽  
Rodrigo Rigo ◽  
Winson Y. Cheung
Keyword(s):  
Socioeconomic Status ◽  
Educational Attainment ◽  
Cancer Patients ◽  
Low Socioeconomic Status ◽  
Low Income ◽  
Low Ses ◽  
Rural Residence ◽  
Low Socioeconomic ◽  
Low Education

90 Background: Cancer patients are predisposed to CVD due to cancer treatments and shared risk factors (smoking/physical inactivity). We aimed to assess if rural residence and low socioeconomic status (SES) modify the risk of developing CVD. Methods: Patients diagnosed with non-metastatic solid organ cancers without baseline CVD in a large Canadian province from 2004 to 2017 were identified using the population-based registry. Postal codes were linked with Census data to determine rural residence as well as neighborhood-level income and educational attainment. Low income was defined as <46000 CAD/annum; low education was defined as a neighborhood in which <80% attended high school. Myocardial infarction, congestive heart failure, arrythmias and cerebrovascular accident constituted as CVD.We performed logistic regression analyses to examine the associations of rural residence and low SES with the development of CVD, adjusting for measured confounding variables. Results: We identified 81,275 patients diagnosed with cancer without pre-existing CVD. The median age was 62 years and 54.2% were women. The most prevalent cancer types included breast (28.6%), prostate (23.1%), and colorectal (14.9%). At a median follow-up of 68 months, 29.4% were diagnosed with new CVD. The median time from cancer diagnosis to CVD was 29 months. Rural patients (32.3 vs 28.4%,P < .001) and those with low income (30.4% vs 25.9%,P < .001) or low educational attainment (30.7% vs 27.6%,P < .001) experienced higher rates of CVD. After adjusting for baseline factors and treatment, rural residence (odds ratio[OR], 1.07; 95% confidence interval[CI], 1.04-1.11;P < .001), low income (OR,1.17;95%CI,1.12-1.21;P < .001) and low education (OR,1.08;95%CI,1.04-1.11;P < .001) continued to associate with higher odds of CVD. Further, patients with colorectal cancer were more likely to develop CVD compared with other tumors (OR,1.12;95% CI,1.04-1.16;P = .001). A multivariate Cox regression model showed that patients with low SES were more likely to die, but patients residing rurally were not. Conclusions: Approximately one-third of cancer survivors develop CVD on follow-up. Despite universal healthcare, marginalized populations experience different CVD risk profiles that should be considered when operationalizing lifestyle modification strategies and cardiac surveillance programs. [Table: see text]

Associations of Socioeconomic Status and Rurality With New-Onset Cardiovascular Disease in Cancer Survivors: A Population-Based Analysis

2021 ◽  
pp. OP.20.01053
Author(s):  
Atul Batra ◽  
Shiying Kong ◽  
Winson Y. Cheung
Keyword(s):  
Cardiovascular Disease ◽  
Socioeconomic Status ◽  
Cancer Survivors ◽  
Low Socioeconomic Status ◽  
Low Income ◽  
Population Based ◽  
Rural Residence ◽  
Low Socioeconomic ◽  
New Onset

PURPOSE: Patients with cancer are predisposed to develop new-onset cardiovascular disease (CVD). We aimed to assess if rural residence and low socioeconomic status modify such a risk. METHODS: Patients diagnosed with solid organ cancers without any baseline CVD and on a follow-up of at least 1 year in a large Canadian province from 2004 to 2017 were identified using the population-based registry. We performed logistic regression analyses to examine the associations of rural residence and low socioeconomic status with the development of CVD. RESULTS: We identified 81,418 patients eligible for the analysis. The median age was 62 years, and 54.3% were women. At a median follow-up of 68 months, 29.4% were diagnosed with new CVD. The median time from cancer diagnosis to CVD diagnosis was 29 months. Rural patients (32.3% v 28.5%; P < .001) and those with low income (30.4% v 25.9%; P < .001) or low educational attainment (30.7% v 27.6%; P < .001) experienced higher rates of CVD. After adjusting for baseline factors and treatment, rural residence (odds ratio [OR], 1.07; 95% CI, 1.04 to 1.11; P < .001), low income (OR, 1.17; 95% CI, 1.12 to 1.21; P < .001), and low education (OR, 1.08; 95% CI, 1.04 to 1.11; P < .001) continued to be associated with higher odds of CVD. A multivariate Cox regression model showed that patients with low socioeconomic status were more likely to die, but patients residing rurally were not. CONCLUSION: Despite universal health care, marginalized populations experience different CVD risk profiles that should be considered when operationalizing lifestyle modification strategies and cardiac surveillance programs for the growing number of cancer survivors.

Interpersonal Communication in Response to an Intervention and Its Impact on Smoking Cessation Within a Low-Income Population

2017 ◽  
Vol 45 (4) ◽  
pp. 550-558 ◽  
Author(s):  
Michael J. Parks ◽  
Soyoon Kim
Keyword(s):  
Smoking Cessation ◽  
Interpersonal Communication ◽  
Low Income ◽  
Population Level ◽  
Population Based ◽  
Effect Sizes ◽  
Full Spectrum ◽  
Quit Attempt ◽  
Quasi Experimental

Background. It is a priority to develop population-based strategies for reducing barriers to smoking cessation among low-income populations. Harnessing secondary transmission such as interpersonal communication (IC) has helped to reduce tobacco use, but there is a dearth of quasi-experimental research that examines IC and the full spectrum of smoking cessation behaviors, particularly in the context of population-level programs. Aims. Using quasi-experimental methods, we examined IC in response to a population-level intervention and its impact on the full spectrum of smoking cessation outcomes among low-income smokers. Method. We used propensity score matching; three different propensity score matching procedures were used to estimate and approximate experimental effects. We assessed four cessation outcomes: utilization of a free tobacco quitline (QL), making a quit attempt, and being smoke-free for 7 and 30 days at follow-up. We also examined predictors of IC. Results. IC was significantly related to QL utilization (effect sizes ranging from 0.135 to 0.166), making a quit attempt (effect sizes ranging from 0.115 to 0.147), being smoke-free for 7 days (effect sizes ranging from 0.080 to 0.121), and being smoke-free for 30 days at follow-up (effect sizes ranging from 0.058 to 0.082). Program-related and participant characteristics predicted IC, such as receiving emotional direct mail materials and living with a fellow smoker. Discussion. IC in response to a population-based program affected the cessation process, and IC had a marked impact on sustained cessation. Conclusion. Population-based programs should aim to harness psychosocial dynamics such as IC to promote sustained cessation among low-income populations.

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