scholarly journals An Open Trial of Metacognitive Remediation Therapy and Pharmacotherapy to Promote Smoking Cessation among Individuals with Psychotic-Spectrum Disorders

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Nicholas J. K. Breitborde ◽  
Brittney Keller-Hamilton ◽  
Aubrey M. Moe ◽  
Jacob G. Pine ◽  
Nicholas Nelson ◽  
...  

Introduction. Individuals with psychotic-spectrum disorders may smoke due to the ameliorating effect of nicotine on the cognitive deficits that accompany these illnesses. Metacognitive remediation therapy (MCR) has been shown to produce improvements in cognitive functioning among individuals with psychotic-spectrum disorders and provides a foundation for a novel smoking cessation intervention for this population. Aims. To complete an open investigation of pharmacotherapy and a modified version of MCR [MCR to Quit (MCR-Q)] in promoting smoking cessation among individuals with psychotic-spectrum disorders. Methods. Forty-nine individuals with a psychotic-spectrum disorder and who currently smoke cigarettes participated in MCR-Q while also receiving evidence-based smoking cessation pharmacotherapy. Tobacco use was assessed as follows: (i) prior to MCR-Q, (ii) immediately after completing MCR-Q, and (iii) six weeks after completion of MCR-Q. Results/Findings. During participation in MCR-Q, nearly 80% of participants made a 24-hour quit attempt. Following the completion of MCR-Q, participants experienced reductions in level of nicotine dependency and exhaled carbon monoxide, with reductions in nicotine dependency sustained six weeks after completion of MCR-Q. Over the course of their participation in MCR-Q, participants reported strong therapeutic alliance with their MCR-Q therapist and high levels of intrinsic motivation with regard to completing MCR-Q exercises. Conclusions. The results from the current study suggest cautious optimism with regard to the use of MCR-Q in combination with medication for individuals with psychotic-spectrum disorders who want to quit smoking.


2019 ◽  
Vol 19 (2) ◽  
pp. 163-172 ◽  
Author(s):  
Ernest Osei ◽  
Rahil Kassim ◽  
Kelly A. Cronin ◽  
Barbara-Anne Maier

AbstractBackground:Tobacco is a known addictive consumer product and its use has been reported to be associated with several health problems as well as the leading cause of premature, preventable mortality worldwide. For patients undergoing cancer treatment, tobacco smoking can potentially compromise treatment effectiveness; however, there is sufficient evidence suggesting numerous health benefits of smoking cessation interventions for cancer patients.Methods:The Grand River Regional Cancer Centre (GRRCC) smoking cessation program began in October 2013 to provide evidence-based intensive tobacco intervention to patients. All new patients are screened for tobacco use and those identified as active smokers are advised of the benefits of cessation and offered referral to the program where a cessation nurse offers counseling. Patients’ disease site, initial cessation goal, quit date, number of quit attempts and mode of contact are collected by the cessation nurse. This study reports on the initial evaluation of the smoking cessation program activities at GRRCC.Results:There are 1,210 patients who were screened, accepted a referral and counseled in the program. The referral pattern shows a modest increase every year and most of the patients (58%) indicated readiness to quit smoking. Overall, 29 and 26% of patients either quit or cut-back smoking, respectively. Among 348 patients who quit smoking, 300 (86%) were able to quit at the first attempt. The data indicated that 309 (44%) out of the 698 patients who indicated their initial intent to quit smoking were able to quit, whereas about 242 (35%) were able to cutback. A total of 15 patients out of 32 who indicated initial readiness to ‘cutback’ smoking were able to reduce tobacco use and three patients actually ended up quitting, although their initial goal was ‘ready-to-cut-back’.Conclusions:GRRCC smoking cessation program started in October 2013 to provide evidence-based intensive smoking cessation interventions for patients with cancer. Most patients referred to the program indicated a readiness to quit smoking affirming that if patients become aware of the various risks associated with continual smoking or if they are informed of the benefits associated with cessation with regard to their treatment, they will be more likely to decide to quit. Therefore, it is essential that patients, their partners and families are counseled on the health and treatment benefits of smoking cessation and sustainable programs should be available to support them to quit smoking. It is imperative then, that oncology programs should consistently identify and document the smoking status of cancer patients and support those who use tobacco at the time of diagnosis to quit. Evidence-based smoking cessation intervention should be sustainably integrated into the cancer care continuum in all oncology programs from prevention of cancer through diagnosis, treatment, survivorship and palliative care.



2020 ◽  
Author(s):  
Mi-Ji Lee ◽  
Kang-Sook Lee

Abstract Background: Single mothers in South Korea are vulnerable to developing smoking habits, due to many difficulties and limitations; however, they have often been overlooked by smoking cessation support services. Therefore, this study aimed to investigate the demographic and smoking-related characteristics of single mothers registered with the Seeking Smoking Cessation Services Program in Seoul, South Korea, to identify factors associated with smoking cessation maintenance at 4, 6, 12, and 24 weeks after the they initially quit smoking.Methods: The participants were 77 single mothers registered at the Seeking Smoking Cessation Services Program. Data were included from a three-year span (January 2017 to December 2019). Smoking cessation counseling, motivational enhancement, and self-exploration counseling were provided for six months. The participants were evaluated on their smoking cessation status at 4, 6, 12, and 24 weeks.Results: Most participants were aged 22 years or younger. The rates of smoking cessation maintenance were 58.4%, 39%, 28%, and 18% at 4, 6, 12, and 24 weeks, respectively. The rate of smoking cessation maintenance increased as the number of counseling sessions attended increased. Smoking cessation maintenance was also significantly associated with pregnancy status, exhaled carbon monoxide level, and drinking. Conclusion: A counseling program to effectively promote smoking cessation and enhance motivation to maintain smoking cessation should be developed and provided to single mothers. Smoking cessation counselors have an important role as sources of support for those who want to quit smoking, and should aim to reduce the rate of smoking among single mothers by providing them with consistent counseling.



2020 ◽  
Vol 18 (2) ◽  
Author(s):  
Muhammad Adil Zainal Abidin ◽  
Hayati Kadir @ Shahar ◽  
Rosliza Abdul Manaf

Introduction: Carbon monoxide measurement is one of the biomedical risk assessments in smoking cessation. With the advancement in medical devices, risk assessment among smoker using carbon monoxide can be an effective intervention for quit smoking. A systematic review was conducted on the effectiveness of using carbon monoxide measurement in smoking cessation intervention. Material and methods: A systematic review and narrative synthesis were done using PRISMA guideline. A broad database search on English literature was conducted including Medline, PubMed, Scopus and Science Direct from 2008 till 2017. Additional studies were also searched through snowballing technique by searching the bibliographies of selected studies. Five studies met the criteria with two studies were done in clinical settings while the other was done at population settings. The studies were conducted in the United States of America, United Kingdom and South Korea. All study were two-arm randomized controlled trials with variation in the outcome measurement mainly intention to quit, quit attempt and smoking abstinence. There was also variation in the duration of follow up ranging from 1 week to 12 months. Results: Only three studies found statistically significant increased in motivation or intention to quit smoking but only at 1 month follow up. All five study found no significant difference in frequency of quit attempt or smoking abstinence. Most of the studies recruited participants based on voluntary participation thus limiting the generalizability of the results. Conclusions: The present review has found limited studies on the effect of carbon monoxide measurement intervention for quit smoking. It may only be beneficial at the motivational level and not translated into behavioural changes. However, the effect too was short term and not sustained in the long term.



Author(s):  
Sunee Lertsinudom ◽  
Pentipa Kaewketthong ◽  
Tamonwan Chankaew ◽  
Dujrudee Chinwong ◽  
Surarong Chinwong

This study aimed to report the effectiveness of community pharmacy smoking cessation services in 13 health regions in Thailand using a retrospective data-collecting method from the Foundation of Community Pharmacy database. The participants were smokers aged at least 18 years. The outcomes were the abstinence of smoking at least 30 consecutive days by self-report only and self-report with exhaled CO level <7 ppm (if available), the number of cigarettes smoked daily, exhaled carbon monoxide (exhaled CO), and % peak expiratory flow rate (%PEFR); smokers measured these outcomes before and after receiving the smoking cessation services. Of 58 community pharmacies, 532 smokers (93% male, mean age of 42.4 ± 14.9 years) received smoking cessation services from community pharmacists. Of 235 smokers with complete data, 153 (28.8%, 153/532) smokers reported smoking abstinence by self-report. The mean number of cigarettes smoked daily reduced from 15.3 ± 8.7 to 1.9 ± 3.8 cigarettes, p-value < 0.001. The exhaled CO levels of smokers significantly reduced from 11.7 ± 5.9 ppm to 7.2 ± 4.4 ppm, p-value < 0.001. The %PEFR also significantly increased from 84.2 ± 19.4 to 89.5 ± 19.5, p-value < 0.001. In conclusion, Thai community pharmacy smoking cessation services could aid smokers to quit smoking. This study is the outcome of the real-world community pharmacy smoking cessation service; policymakers should consider this service to be included in the national healthcare policy.



2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 90s-90s
Author(s):  
M. Halligan ◽  
D. Keen

Background: Evidence indicates that smoking cessation improves the effectiveness of treatment and likelihood of survival among all cancer patients, not just those with tobacco-related disease, yet smoking is rarely addressed in oncology practice. Prior to 2016, only 3 provinces in Canada (out of a total of 10 provinces and three territories) reported implementation of smoking cessation for ambulatory cancer patients. Aim: Based on this evidence, the Canadian Partnership Against Cancer (CPAC) implemented a systems change initiative to promote adoption of evidence-based smoking cessation within provincial and territorial cancer systems across Canada. Methods: In 2016, CPAC funded seven provinces and two territories over a 15-month period to plan, implement or evaluate integration of evidence-based smoking cessation for ambulatory cancer patients within cancer systems. Funds were used to plan (2 provinces and 2 territories), implement (3 provinces) or evaluate (2 provinces) systematic, evidence-based approaches to smoking cessation within ambulatory cancer care settings (e.g., establishing routine systems for identification of smoking cancer patients and system to support patients to quit). Funds could not be used for direct service delivery (e.g., cessation counseling). Results: After 15-months of funding from CPAC, 6 provinces reported implementation of smoking cessation for ambulatory cancer patients. The remaining province and 2 territories funded by CPAC reported development of plans for adoption of smoking cessation for cancer patients in the future. Within provinces reporting implementation of smoking cessation for cancer patients, between 65%-97% of ambulatory cancer patients were screened for smoking status; 22%-80% of these patients were offered a referral to cessation services, and 21%-45% of cancer patients accepted a referral. Conclusion: Despite provincial and territorial variations in readiness to uptake evidence-based smoking cessation for cancer patients, CPAC's approach has led to substantial progress in adoption of this approach across Canada. While progress has been made, adoption of smoking cessation and relapse prevention by cancer systems is not yet widespread in Canada. Scale-up to remaining provinces and territory, and spread within existing provinces and territories is required to reach all cancer patients and families who require support to quit smoking. Framing smoking cessation as a therapeutic intervention, not prevention, and a routine part of cancer treatment will be critical for sustainability of this work.





2020 ◽  
Vol 15 (4) ◽  
pp. 214-218
Author(s):  
Keshia R. De Guzman ◽  
Centaine L. Snoswell ◽  
Cheneal Puljevic ◽  
Deepali Gupta

AbstractIntroductionDue to the burden of tobacco-related illnesses among hospital inpatients, an evidence-based smoking cessation brief intervention tool was developed for clinicians working in hospitals in Queensland, Australia. The tool, called the Smoking Cessation Clinical Pathway (SCCP), is used by clinicians to support inpatient smoking cessation and manage nicotine withdrawal in hospital.AimsTo investigate the impact of completed SCCP on nicotine replacement therapy (NRT) prescribing and use, and to explore clinician involvement in smoking cessation interventions.MethodsA retrospective review was conducted to examine data regarding SCCP responses and NRT offering, prescribing and use. The statistical significance of the results was assessed using chi-squared and Fisher's exact tests.ResultsPatients with a completed SCCP were more likely to be offered NRT (P < 0.0001). NRT prescribing on admission and discharge was higher in patients with a completed SCCP (P = 0.001 and P = 0.027). Intention to quit had no effect on whether NRT was offered (P = 0.276) and NRT acceptance was higher for patients that intended to quit smoking (P < 0.0001).ConclusionsThe SCCP prompted clinicians to offer NRT to patients, leading to increased NRT prescribing and use. These findings demonstrate the utility of the SCCP to assist clinicians to promote smoking cessation among hospital inpatients.



2019 ◽  
Author(s):  
Alla Machulska ◽  
Kristian Kleinke ◽  
Tanja Joan Eiler ◽  
Armin Grünewald ◽  
Rainer Brück ◽  
...  

Abstract Background: Automatic tendencies to approach drug-related cues have been linked to the development and maintainance of harmful drug taking behavior. Recent studies have demonstrated that these automatic approach tendencies can be targeted directly by means of Cognitive Bias Modification (CBM) approaches. Moreover, changing those approach tendencies may enhance treatment outcomes. However, training and therapy effects tend to be rather small and adherence to the training might be impaired by time-consuming multiple lab-training sessions. Here, we present a protocol for a randomized control design to improve CBM training efficiency and facilitate access to the training by providing mobile phone-based training sessions at home to current smokers motivated to quit smoking. Methods: Participants (n = 100) are current smokers who smoke at least 6 cigarettes per day for at least 6 months and are willing to quit smoking. All participants attend a brief behavioral smoking cessation intervention (TAU) and are randomly assigned either to an experimental (TAU + training) or a control group. Participants in the experimental condition are given access to a training app aimed at retraining automatic approach biases for smoking cues. Participants are instructed to perform the app-training outside the laboratory context on a daily basis for 14 consecutive days. Participants in the control group do not receive the training. Primary outcome measures are changes in smoking-related approach biases and reductions in daily nicotine consumption as assessed at baseline, post-training and at a six-week follow-up. Secondary outcome measures include approach biases for alternative stimuli or smoking stimuli to which participants were not exposed during training, attentional and association biases, biochemical outcomes, and self-reported smoking behavior, also measured at three different time points (baseline, post-training, follow-up). After completion of the study, smokers in the control condition will receive access to the training app. Discussion: This RCT is the first to test the effectiveness of an app-based CBM intervention as an adjunct to a brief smoking cessation intervention in smokers motivated to quit smoking. The results of this study can inform future research in the optimisation and advancement of CBM treatment for addiction. Trial registration: Registered with Current Controlled Trials: study ID ISRCTN15690771. Registered on 20 November 2018; http://www.isrctn.com/ISRCTN15690771 Key words: Approach Bias, Cogitive Bias Modification, cigarette smoking, nicotine addiction, Randomized Control Trial, smartphone apps



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