scholarly journals Pediatric Office Delivery of Smoking Cessation Assistance for Breast-Feeding Mothers

2018 ◽  
Vol 22 (3) ◽  
pp. 346-353 ◽  
Author(s):  
Jeremy E Drehmer ◽  
Deborah J Ossip ◽  
Emara Nabi-Burza ◽  
Bethany Hipple Walters ◽  
Julie A Gorzkowski ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Breast Feeding ◽  
Smoking Status ◽  
Controlled Trial ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
Breast Feed ◽  
Quitting Smoking ◽  
Cluster Randomized ◽  
Screening Interview

Abstract Introduction National and international organizations have done an excellent job of advocating and promoting breast feeding for all mothers. This study assessed to what extent an intervention increased delivery of cessation assistance to breast-feeding mothers who smoke. Methods Data were collected between April and October 2015 in five US states as part of a cluster randomized controlled trial in 10 pediatric practices. Practices were randomized to the Clinical Effort Against Secondhand Smoke Exposure (CEASE) intervention or usual care control arms. Mothers were asked about their smoking status and breast-feeding history during a screening interview upon exiting the practice and eligible mothers who agreed to participate in an enrollment interview were asked if they received smoking cessation assistance during their child’s visit. Mothers with a child 1 year old and younger were included in the analyses. Results Current breast feeding was associated with a reduced likelihood of current smoking (adjusted odds ratio [aOR] = 0.38, 95% confidence interval [95% CI] = 0.25 to 0.57) and a greater likelihood of quitting smoking (aOR = 2.33, 95% CI = 1.29 to 4.21) after controlling for known confounders. Mothers who concurrently smoked and breast-fed were more likely to be asked about smoking (66.7% vs. 28.6%, p = .01), advised to quit (61.1% vs. 21.4%, p < .01), prescribed nicotine replacement therapy (50.0% vs. 0%, p < .001), and enrolled into the quitline (27.8% vs. 0%, p < .01) at CEASE practices compared to control practices. Conclusion Breast-feeding mothers were less likely to be current smokers and more likely to have recently quit smoking. Among mothers who continue to smoke and breast feed, the CEASE intervention enhances delivery of smoking cessation assistance. Implications Breast feeding and eliminating infants’ exposure to tobacco smoke are important protective factors for serious pediatric health risks including sudden infant death. This study shows that breast feeding was positively associated with desirable tobacco control outcomes, specifically that breast feeding was associated with a lower likelihood of smoking among ever smokers and a greater likelihood of recently quitting smoking. This is also the first study to look specifically at delivery of smoking cessation assistance to breast-feeding mothers seen at pediatric offices and demonstrates the effectiveness of delivering evidence-based smoking cessation assistance to them in this context. Trial Registration www.ClinicalTrials.gov (identifier NCT01882348).

Pharmacist-Delivered Smoking Cessation Program in Community Pharmacy (The FINE Program) in Japan—The Development of a Training Course and a Feasibility Study

2019 ◽  
pp. 089719001988974
Author(s):  
Mitsuko Onda ◽  
Takashi Kuwanoe ◽  
Atsunori Hashimoto ◽  
Michiko Horiguchi ◽  
Masayuki Domichi ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Community Pharmacy ◽  
Feasibility Study ◽  
Smoking Status ◽  
Controlled Trial ◽  
Smoking Cessation Program ◽  
Community Pharmacies ◽  
The Family ◽  
Quitting Smoking ◽  
Continuous Abstinence

Aim: Although smoking cessation support has been recommended as a routine component of pharmacists’duties, there is limited evidence of smoking cessation being achieved successfully in community pharmacy. The aim of this study was to develop a new smoking cessation program for use in the community pharmacy setting and investigate its feasibility. Methods: A feasibility study (the Family pharmacist’s Intervention for Nicotine Elimination [FINE] program) was conducted using 8 pharmacists at 2 community pharmacies in Japan. The pharmacists recruited as subjects smokers 20 or more years of age who were taking medications such as antidiabetes drugs. The patients completed questionnaires assessing their smoking status, and the pharmacists provided them with smoking cessation support services. Participating patients met with the pharmacists or talked to them on the phone 5 times at 2- to 4-week intervals and received personalized and structured brief smoking cessation advice. The primary outcome was continuous abstinence determined by Micro Smokerlyzer carbon monoxide monitor at 3 months. Results: Of 5306 patients, 2296 patients were screened and the rate of smoking was found to be 12.7%. Five smoking patients received the FINE program from pharmacists who had received training. One of the 5 succeeded in quitting smoking after 3 months. Conclusions: This is the first study to target Japanese smoking patients in community pharmacies with a brief structured intervention. The results tentatively support the feasibility of the FINE program. Further research including a randomized controlled trial is required to confirm the effectiveness of the FINE program.

Challenges Experienced by Women Who Smoke During Pregnancy or Postnatally

2020 ◽  
Vol 10 (1) ◽  
pp. 24-44
Author(s):  
Sandra P. Small ◽  
Andrea Brennan-Hunter ◽  
Caroline Porr ◽  
Yanqing Yi
Keyword(s):  
Smoking Cessation ◽  
Maternal Smoking ◽  
Healthcare Providers ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
Smoking During Pregnancy ◽  
Quitting Smoking ◽  
Postnatal Women ◽  
Quantitative Descriptive ◽  
Descriptive Survey

Maternal smoking during pregnancy and maternal smoking postnatally are important public health concerns worldwide. Smoking adversely affects the woman's general health and is causally related to pregnancy complications and serious health outcomes for the child, such as stillbirth, preterm delivery, low birth weight, and sudden infant death. The purpose of this research was to examine maternal smoking through a quantitative descriptive survey of 164 women, 120 who were pregnant and 44 who were postnatal. Women experienced barriers to quitting smoking, including dealing with stress, being exposed to smokers, not being ready to quit, not knowing how to quit, not looking for or not being able to find information about smoking or quitting smoking, and lacking adequate social and healthcare provider support. On the other hand, women revealed characteristics that suggest they might have had improved potential for quitting smoking, including having negative feelings about smoking, having cut down on smoking, smoking at a low level, having made quit attempts, thinking it would not be hard to quit smoking, being in the preparation stage of behavioral change, and thinking their healthcare providers (HCPs) would help them if they decided to quit. Taken together, those findings suggest that HCPs could offer important assistance to help women achieve smoking cessation. However, more research needs to be conducted to clarify the role and effectiveness of various HCPs in smoking cessation interventions and to identify measures to strengthen their provision of such interventions.

scholarly journals Effects of smoking cessation on biological monitoring markers in urine

2020 ◽  
Vol 42 (1) ◽  
Author(s):  
Yuya Kawasaki ◽  
Yun-Shan Li ◽  
Yuko Ootsuyama ◽  
Kazuhiko Nagata ◽  
Hiroshi Yamato ◽  
...  
Keyword(s):  
Dna Damage ◽  
Smoking Cessation ◽  
Tobacco Smoke ◽  
Smoking Status ◽  
Smoking Cessation Program ◽  
Tobacco Smoke Exposure ◽  
Urinary Cotinine ◽  
Quit Smoking ◽  
Urinary Levels ◽  
Quitting Smoking

Abstract Introduction Urinary nicotine and cotinine levels are often measured as biomarkers for tobacco smoke exposure. However, these biomarkers are not appropriate to evaluate the effects of quitting smoking for several days, because of their short half-lives. In this study, we focused on the changes in the urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) levels of 55 patients in a smoking cessation program, because of the long half-life. At the same time, urinary 7-methylguanine (m7Gua) and 8-hydroxy-2′-deoxyguanosine (8-OHdG), as DNA damage markers of cigarette smoking, were also measured. Results In the subjects who completed the quit-smoking program (18 subjects out of 55), the urinary nicotine and cotinine levels decreased to 1.7 and 0.2% at 8 weeks after the first visit to the clinic. By contrast, the NNAL levels decreased to 12.3% at 8 weeks after quitting smoking. During the same period, the urinary m7Gua levels significantly decreased, from 27.32 μg/mg creatinine to 14.17 μg/mg creatinine by the elimination of subjects who showed increased levels of NNAL during the smoking cessation program. The 8-OHdG levels were also reduced within the same period, but were not significantly different. From the all data analysis, the urinary levels of cotinine and NNAL positively correlated with the level of m7Gua. Conclusions NNAL may be an appropriate exposure marker for evaluating the smoking status of patients in a smoking cessation program. The urinary cotinine and NNAL levels positively correlated with the m7Gua levels.

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 Impact of Smoking Cessation Interventions Initiated During Hospitalization Among HIV-Infected Smokers

2019 ◽  
Vol 22 (7) ◽  
pp. 1170-1177
Author(s):  
Virginia A Triant ◽  
Ellie Grossman ◽  
Nancy A Rigotti ◽  
Rekha Ramachandran ◽  
Susan Regan ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Controlled Trial ◽  
Smoking Cessation Intervention ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Urban Hospital ◽  
Randomized Controlled ◽  
Cessation Intervention ◽  
Quitting Smoking ◽  
Hospitalized Smokers

Abstract Introduction Smoking is a key determinant of mortality among people living with HIV (PLWH). Methods To better understand the effects of smoking cessation interventions in PLWH, we conducted a pooled analysis of four randomized controlled trials of hospital-initiated smoking interventions conducted through the Consortium of Hospitals Advancing Research on Tobacco (CHART). In each study, cigarette smokers were randomly assigned to usual care or a smoking cessation intervention. The primary outcome was self-reported past 30-day tobacco abstinence at 6-month follow-up. Abstinence rates were compared between PLWH and participants without HIV and by treatment arm, using both complete-case and intention-to-treat analyses. Multivariable logistic regression was used to determine the effect of HIV status on 6-month tobacco abstinence and to determine predictors of smoking cessation within PLWH. Results Among 5550 hospitalized smokers, there were 202 (3.6%) PLWH. PLWH smoked fewer cigarettes per day and were less likely to be planning to quit than smokers without HIV. At 6 months, cessation rates did not differ between intervention and control groups among PLWH (28.9% vs. 30.5%) or smokers without HIV (36.1% vs. 34.1%). In multivariable regression analysis, HIV status was not significantly associated with smoking cessation at 6 months. Among PLWH, confidence in quitting was the only clinical factor independently associated with smoking cessation (OR 2.0, 95% CI = 1.4 to 2.8, p < .01). Conclusions HIV status did not alter likelihood of quitting smoking after hospital discharge, whether or not the smoker was offered a tobacco cessation intervention, but power was limited to identify potentially important differences. Implications PLWH had similar quit rates to participants without HIV following a hospital-initiated smoking cessation intervention. The findings suggest that factors specific to HIV infection may not influence response to smoking cessation interventions and that all PLWH would benefit from efforts to assist in quitting smoking. Trial Registration (1) Using “warm handoffs” to link hospitalized smokers with tobacco treatment after discharge: study protocol of a randomized controlled trial: NCT01305928. (2) Web-based smoking cessation intervention that transitions from inpatient to outpatient: NCT01277250. (3) Effectiveness of smoking-cessation interventions for urban hospital patients: NCT01363245. (4) Effectiveness of Post-Discharge Strategies for Hospitalized Smokers (HelpingHAND2): NCT01714323.

Lung function and respiratory symptoms in a randomized smoking cessation trial of electronic cigarettes

2016 ◽  
Vol 130 (21) ◽  
pp. 1929-1937 ◽  
Author(s):  
Fabio Cibella ◽  
Davide Campagna ◽  
Pasquale Caponnetto ◽  
Maria Domenica Amaradio ◽  
Massimo Caruso ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Lung Function ◽  
Respiratory Symptoms ◽  
Electronic Cigarettes ◽  
Controlled Trial ◽  
Substantial Reduction ◽  
Cigarette Consumption ◽  
Phenotype Classification ◽  
Quitting Smoking

Quitting smoking is the most important step smokers can take to improve their health. Nonetheless, there is little information on long-term improvements in lung function and/or respiratory symptoms after smoking cessation. Here we illustrate long-term changes in spirometric indices as well as in respiratory symptoms in smokers invited to quit or reduce their cigarette consumption by switching to electronic cigarettes (ECs). Prospective evaluation of cigarette consumption, spirometry and symptoms was performed in a 1-year randomized controlled trial of smokers receiving EC containing 2.4%, 1.8% or 0% nicotine. Spirometric data are presented on the basis of participants’ pooled continuous smoking phenotype classification (Quitters, Reducers, Failures), whereas respiratory symptoms on the basis of their point prevalence-smoking phenotype. Smoking phenotype classification (Quitters, Reducers, Failures) had no significant effect on spirometric indices (FEV1, FVC and FEV1/FVC) with the exception of FEF25–75%, which significantly (P  =0.034) increased over the time among Quitters; their FEF25–75% (% predicted) improving from (means±S.D.) 85.7±15.6% at baseline (BL) to 100.8±14.6%. High prevalence of cough/phlegm (43.1%) and shortness of breath (SoB; 34.8%) was reported at BL with substantial reduction in their frequency at subsequent follow-up visits. These symptoms virtually disappeared very quickly in both quitters and reducers. Smokers invited to switch to ECs who completely abstained from smoking showed steady progressive improvements in their FEF25–75%. Normalization of peripheral airways function was associated with improvement in respiratory symptoms, adding to the notion that abstaining from smoking can reverse tobacco harm in the lung.

scholarly journals Varenicline and Bupropion for Long-Term Smoking Cessation (the MATCH Study): Protocol for a Real-World, Pragmatic, Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Laurie Zawertailo ◽  
Tara Mansoursadeghi-Gilan ◽  
Helena Zhang ◽  
Sarwar Hussain ◽  
Bernard Le Foll ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Smoking Cessation ◽  
Real World ◽  
Smoking Status ◽  
Controlled Trial ◽  
Health Study ◽  
Open Label ◽  
Randomized Controlled

BACKGROUND Varenicline and bupropion are efficacious, prescription-only pharmacotherapies for smoking cessation; however, their real-world impact is limited by prescriber knowledge, affordability, and accessibility. OBJECTIVE The primary objective of the MATCH (Medication Aids for Tobacco Cessation Health) study was to evaluate the real-world, long-term effectiveness of mailed bupropion and varenicline in a sample of interested smokers with the utilization of Web-based recruitment and follow-up. In addition, the study aims to investigate the genotypic and phenotypic predictors of cessation. METHODS This is a two-group, parallel block, randomized (1:1) open-label clinical trial. This study will be conducted online with the baseline enrollment through the study’s website and follow-up by emails. In addition, medication prescriptions will be filled by the study contract pharmacy and couriered to participants. Individuals who smoke ≥10 cigarettes per day and intend to quit within the next 30 days will be recruited through Public Health Units and Tobacco Control Area Networks throughout Ontario by word-of-mouth and the internet. Eligible participants will receive an email with a prescription for 12-week assigned medication and a letter to take to their physician. The recruitment and randomization will continue until 500 participants per arm have received medication. All participants will receive weekly motivational emails during the treatment phase. The primary outcome measure is the smoking status after 6 months, biochemically confirmed by mailed-in salivary cotinine. Follow-ups will be conducted through emails after 4, 8, 12, 26, and 52 weeks of starting the treatment to assess the smoking prevalence and continuous smoking abstinence. In addition, mailed-in saliva samples will be used for genetic and nicotine metabolism analyses. Furthermore, personality characteristics will be assessed using the Big Five Aspect Scales. RESULTS The project was funded in 2014 and enrollment was completed in January 2017. Data analysis is currently underway. CONCLUSIONS To the best of our knowledge, this is the first randomized controlled trial to mass distribute prescription medications for smoking cessation. We expect this method to be logistically feasible and cost effective with quit outcomes that are comparable to published clinical trials. CLINICALTRIAL ClinicalTrials.gov NCT02146911; https://clinicaltrials.gov/ct2/show/NCT02146911 (Archived by WebCite at http://www.webcitation.org/72CZ6AvXZ) REGISTERED REPORT IDENTIFIER RR1-10.2196/10826

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