scholarly journals Barriers to Cigarette Smoking Cessation in Pakistan: Evidence from Qualitative Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Abdul Hameed ◽  
Daud Malik

Background. With over 25 million tobacco users, Pakistan has one of the largest smoking populations in the world. Tobacco addiction comes with grave health consequences, especially for the poor and marginalized. Objective. This study explores barriers to smoking cessation in marginalized communities of Islamabad and the possibility of their use of Harm Reduction Products (HRPs), primarily e-cigarettes. Methodology. The study has used primary data of 48 respondents from marginalized communities. Several domains have been employed to evaluate the barriers to smoking cessation in these communities. Using qualitative technique, data was organized and categorized into objective themes. Conclusion. The experience of combustible smoking usually occurs in the 10-20 years’ age bracket. Regular smokers in marginalized areas of Islamabad smoke 20 cigarettes or a pack per day. Their choice of cigarette brand is largely driven by affordability. Most smokers have made at least one attempt to quit smoking. Peer pressure and friendship are major barriers to smoking cessation. Lack of knowledge seems to be the major reason for not seeking medical assistance for quitting smoking. Knowledge about HRPs, especially e-cigarettes, can best be described as vague. Higher prices of the alternatives to combustible smoking are a major hurdle preventing their use for smoking cessation.

Author(s):  
Joan M. Brewster ◽  
Mary Jane Ashley ◽  
Claudine Laurier ◽  
Rachel Dioso ◽  
J. Charles Victor ◽  
...  

Background: Pharmacists can be effective in helping patients to quit smoking, and opportunities for such interaction have been facilitated by legislative change making nicotine replacement therapy (NRT) available without prescription in Canada. However, there are no previous studies of Canadian pharmacists' preparation for, perception of, or practices regarding their roles in smoking cessation. Methods: Practising community pharmacists in four Canadian provinces were surveyed about their tobacco-related education and knowledge, practice environment, perceptions of their roles and practices related to helping people quit smoking, and factors perceived to facilitate tobacco-related practice. Results: A corrected response rate of 72% was obtained, giving a weighted n of 960 responses. Most pharmacists reported good or excellent knowledge of the health effects of smoking and the use of NRT in smoking cessation. Fewer reported being knowledgeable about behavioural approaches to quitting smoking. Advising patients about NRT was seen as a more important role for pharmacists than giving patients pamphlets or behavioural counselling. Pharmacists' reported practices corresponded to their knowledge and judged importance of roles; pharmacists were not proactive in approaching patients about smoking, but when smokers were identified, pharmacists gave brief advice about the use of NRT. Respondents reported that their smoking cessation practice was facilitated by their own knowledge and skills, patients' interest in quitting, opportunities for patient interaction, and the support of pharmacy management for patient counselling. Conclusions: Improving pharmacist education in patient counselling and behavioural approaches to smoking cessation would help to develop skills in initiating discussions about smoking and would give pharmacists a wider range of options to help patients quit smoking.


2020 ◽  
Vol 42 (1) ◽  
Author(s):  
Yuya Kawasaki ◽  
Yun-Shan Li ◽  
Yuko Ootsuyama ◽  
Kazuhiko Nagata ◽  
Hiroshi Yamato ◽  
...  

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.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yuji Higuchi ◽  
Masaki Fujiwara ◽  
Naoki Nakaya ◽  
Maiko Fujimori ◽  
Chinatsu Hayashibara ◽  
...  

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).


2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 1012-1012
Author(s):  
C. D. Figueroa-Moseley ◽  
G. C. Williams ◽  
G. R. Morrow ◽  
P. Jean-Pierre ◽  
J. Carroll ◽  
...  

1012 Background: Few studies have examined the potential influence of an empowering Self Determination Theory (SDT) intervention on reducing smoking behaviors and outcomes for Whites and Blacks. Objectives: To determine if empowerment to stop smoking is associated with smoking outcomes in Whites and Blacks, and to examine if empowerment to stop smoking improved under the SDT Intervention vs. Usual Care conditions. Methods: A longitudinal randomized trial study was conducted to examine the effect of a SDT and health behavior change intervention for tobacco cessation among adult smokers. Participants were randomized into the SDT Intervention or the Usual Care condition. The present study includes data from a sample of 821 Whites and 177 Blacks who completed anonymous surveys at 1, 6, and 18-months intervals on empowerment to stop smoking (Perceived Competence Scale, Treatment Self-Regulation Questionnaire), demographics, and smoking behaviors. Results: Stepwise logistic regressions showed that empowerment to stop smoking was associated with quitting smoking at 1, 6, and 18 month follow-up for both treatment conditions. At one month, participants in the SDT Intervention with the highest levels of empowerment were 6.3 times more likely to quit smoking as compared with those in the usual care condition who were only 3.15 times as likely to quit smoking. Similar findings were found at 6 months and at 18 months (6- month SDT Intervention Empowerment High: (OR = 8.66, 95% C.I. 4.6, 16.3); 6 month Usual Care Empowerment High: (OR = 3.10, 95% C.I. 1.4, 7.0); 18- month SDT Intervention Empowerment High: (OR = 4.10, 95% C.I. 2.2, 7.5); 18 month Usual Care Empowerment High: (OR = 3.11, 95% C.I. 1.3, 7.7). In the SDT Intervention at 6 months being Black increased successful quitting by 2.4 times. Conclusions: Findings indicate that at each time-point the SDT Intervention empowered more participants to stop smoking than usual care alone. Findings also suggest that Blacks may increase their ability to stop smoking in the SDT Intervention condition. These preliminary findings highlight the need to further investigate the possible roles of empowerment interventions in smoking cessation among Whites and Blacks, especially cancer patients. No significant financial relationships to disclose.


2020 ◽  
Author(s):  
Dingtao Hu ◽  
Xiaoqi Lou ◽  
Nana Meng ◽  
Qiaomei Xie ◽  
Man Zhang ◽  
...  

Abstract Background: The outcomes of smoking have generated considerable clinical interest in recent years. Although people from different countries are more interested in the topic of quit smoking during the winter, few studies have tested this hypothesis. The current study aimed to quantify public interest in quitting smoking via Google.Methods: We use Google Trends to obtain the Internet search query volume for terms relating to quit smoking in major northern and southern hemisphere countries in this research. Normally search volumes for the term “quit smoking + stop smoking + smoking-cessation” were retrieved within the USA, the UK, Canada, Ireland, New Zealand and Australia from January 2004 to December 2018. Seasonal effects were investigated using cosinor analysis and seasonal decomposition of time series models.Results: Significant seasonal variation patterns in those search terms were revealed by cosinor analysis and demonstrated by the evidence from Google Trends analysis in the representative countries including the USA (pcos = 2.36×10-7), the UK (pcos < 2.00×10-16), Canada (pcos < 2.00×10-16), Ireland (pcos <2.00×10-16) ,Australia (pcos = 5.13×10-6) and New Zealand (pcos = 4.87×10-7). Time series plots emphasized the consistency of seasonal trends with peaks in winter / late autumn by repeating in nearly all years. The overall trend of search volumes for quitting smoking, observed by dynamic series analysis, has declined from 2004 to 2018.Conclusions: The preliminary evidence from Google Trends search tool showed a significant seasonal variation and a decreasing trend for the RSV of quit smoking. Our novel findings in smoking-cessation epidemiology need to be verified with further studies, and the mechanisms underlying these findings must be clarified.


2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Muhammad Nazir ◽  
Hassan AlAbdullah ◽  
Muhanad Alhareky ◽  
Asim Al-Ansari ◽  
Jehan Alhumaid

Objective. To evaluate the association between oral health problems and sociodemographic factors with the intention to quit smoking and join the tobacco cessation program among schoolchildren. Materials and Methods. This cross-sectional study included a sample of 10–12 grade male students from public high schools in different cities of the Eastern province of Saudi Arabia. Schoolchildren responded to a pilot-tested questionnaire about self-reported oral health problems and the intention to quit smoking. Bivariate and multivariate logistic regression analyses were performed. Results. Out of 587 schoolchildren, 199 were smokers with a smoking prevalence of 33.9%. Significantly higher proportions of smokers than nonsmokers had tooth sensitivity (P = 0.029) and dryness of the mouth (P = 0.001). Most smokers (75.9%) had a family history of smoking, and 51.8% started smoking within the last two years. Tooth sensitivity (56.3%), dental cavities (52.8%), and dental pain (44.7%) were highly prevalent among smokers. About one-third of smokers expressed their intention to quit smoking (38.2%) and join a smoking cessation program (33.7%). Tooth sensitivity (OR = 3.7, P = 0.004) and dental pain (OR = 2.84, P = 0.014) were significantly associated with quitting smoking. In addition, smokers with tooth sensitivity (OR = 3.22, P = 0.007) had higher odds of joining a smoking cessation program than those without tooth sensitivity. The smokers who started smoking within the last two years (OR = 3.97, P = 0.002) were more likely to quit smoking than those who initiated smoking for more than two years. Conclusion. Oral health problems were highly prevalent among smokers. Tooth sensitivity was significantly associated with quitting smoking and joining a cessation program in children. The awareness about the adverse effects of smoking on oral health should be part of regional, national, and global tobacco prevention policies and programs.


2009 ◽  
Vol 5 (1) ◽  
pp. 6-9 ◽  
Author(s):  
Lola Burke ◽  
Lesley-Ann Miller ◽  
Ayman Saad ◽  
Jame Abraham

Purpose: Smoking is a well-recognized risk factor for several cancers including cancers of the lung, bladder, and head and neck. Studies have shown that smoking can adversely affect the outcomes of different modalities of cancer treatment. This study examines smoking behaviors among cancer survivors to collect information necessary to create successful smoking cessation interventions. Methods: For this observational clinical study, questionnaires were sent to 1,000 randomly selected patients diagnosed with cancer between 2003 and 2007 in one cancer center. Data were statistically analyzed to determine the likelihood of a patient quitting smoking after being diagnosed with cancer. Results: We received 187 responses from the 1,000 surveys sent (18.7%). Of these, 166 were usable for analysis. The mean age of respondents was 64 (± 13) years. Men were more likely than women to be past smokers (55% of men and 32% of women respectively, P = .003). Fifty-two percent of respondents reported having a history of smoking. However, only 20% of patients reported having been active smokers at the time they were diagnosed with cancer. Furthermore, only 44% of these reported having quit smoking after their diagnosis with cancer. Only 62% of all respondents reported that they had been informed of the dangers of smoking by their health care provider during cancer treatment. Conclusion: In our study sample, less than one half (44%) of smoking cancer patients quit smoking after their cancer diagnosis, and only 62% of smoking cancer patients received smoking cessation counseling from their physicians. Intervention programs are needed to help cancer survivors to quit smoking. Prospective clinical trials may help identify the ideal intervention for smoking cessation.


2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 84s-84s
Author(s):  
M. Cedzyńska ◽  
M. Marta ◽  
P. Koczkodaj ◽  
I. Przepiorka

Background: Despite the fact that smoking has been linked not only to the development of cancer, but also to prognosis upon diagnosis and risk of death during treatment, many cancer patients continue to smoke. Quitting smoking can be beneficial also after cancer diagnosis, regardless of stage and prognosis. Those benefits are: improved survival outcomes, reduced risk of recurrence and second primary formation, increase treatment response to chemo and radiotherapy, reduced treatment-related complications, better self-reported quality of life related to disease and treatment than among smokers and less pain. The evidence is strong enough to incorporate tobacco dependence treatment into routine cancer care, but in majority of countries in central and eastern Europe (CEE) there are no actions taken to help cancer patients to quit smoking. Aim: To identify main barriers in providing smoking cessation to cancer patients in central and eastern Europe. Methods: Data were collected from participants of Workshop on Tobacco Control and Cessation organized by Cancer Center and Institute of Oncology, Poland and the National Cancer Institute, US. Following countries provided detailed data: Armenia, Georgia, Hungary, Kazakhstan, Kirgizstan, Lithuania, Poland, Macedonia, Serbia. The areas that were investigated: guidelines on smoking cessation dedicated to cancer patients, quit smoking programs for cancer patients, existing literature on barriers for delivery smoking cessation advice and personal opinion of tobacco control experts regarding those barriers. Results: I. Guidelines for smoking cessation among cancer patients have been published only in one country (Serbia) out of nine analyzed countries of the region. II. Programs on smoking cessation dedicated to cancer patients were implemented only in two countries: 1: Poland. Pilot program within National Health Program in 2015 (3 months in cancer centers in two cities). 2: Hungary. In 2012 pilot project. In 2017 National Institute for Pulmonology run 3 workshops on smoking cessation for cancer nurses. III. There is no literature on barriers in incorporating smoking cessation into cancer care in the CEE region. IV. Experts opinions are consistent with worldwide literature findings-the main barriers are lack of knowledge, lack of training, overloading with work focused on diagnosis and cancer treatment, difficulties in implementing systemic changes. Conclusion: There is a strong need to take action in central and eastern Europe to engage oncologists and other cancer healthcare providers into smoking cessation. It is crucial to increase the knowledge on benefits of quitting smoking for cancer patients' health and results of cancer treatment. Sustainable change can be achieved by publishing guidelines and implementing training programs that address the attitudes and beliefs. Implementing systemic changes within cancer centers might be required to improve survival and quality of life of cancer patients in central and eastern European region.


2020 ◽  
Author(s):  
Qianying Jin ◽  
Xingming Li ◽  
Han Liu ◽  
Hanqiao Ma ◽  
Kun Qiao ◽  
...  

Abstract Objective To understand the reasons for failure of smoking cessation among community smokers in Beijing, and analyze the influencing factors of the reasons for failure to quit, in order to provide a reference for providing smoking cessation guidance services. Method Based on a cross-sectional study, a one-to-one questionnaire was used. The survey included basic demographic information, tobacco use, and past attempts to quit. And descriptive analysis was used to analyze the distribution of the reasons for the failure of smoking cessation. c2 test or Fisher's exact probability method were used to analyze the causes of smoking cessation failure, demographic indicators, tobacco use and other factors. Correspondence analysis was used to further explore the relationship between each factor and the reasons for smoking cessation failure. Result A total of 442 smokers who had tried to quit smoking were investigated. The top three reasons for failure to quit were difficulty in controlling addiction, insufficient self-willingness (54.3%), the effects of other smokers(35.3%), and lack of smoke-free support environment(26.0%). There were statistically significant differences in the distribution of the reasons for failure of smoking cessation among different ages, occupations, and discomforts during smoking cessation(All P<0.05). Correspondence analysis results show that the reasons for failure of smoking cessation among smokers aged 19-30 are mainly work or study stress. There are differences in the reasons why smokers in different occupations fail to quit smoking; The influence of other smokers and the lack of a smoke-free support environment are closely related to the desire to quit during the process of quitting. Conclusion Work or study pressure, the influence of other smokers and the lack of smoke-free support environment are the main reasons for the failure of smoking cessation attempts. Therefore, it is suggested to strengthen education in different occupational places and implement personalized smoking cessation education. It is recommended to provide tips on coping with smoking cessation and alleviating peer pressure in social situations, as well as help for stress coping and negative emotion relief in smoking cessation guidance. At the same time, it is essential to strengthen the shaping of a smoke-free support environment.


Author(s):  
Spencer Kaspick ◽  
BCIT School of Health Sciences, Environmental Health ◽  
Helen Heacock

  Background: Electronic cigarettes are a widely-used, yet still emerging technology. As such, there is relatively little data regarding the reasons why people take up their use. Many claim to use them as a smoking-cessation method. Concern exists that experimentation in non-smokers may lead to nicotine addiction and subsequent smoking. The purpose of this study was to determine the primary reasons for the commencement of electronic cigarette use, and to suggest way in which these findings could affect current policies and regulations pertaining to electronic cigarettes. Methods: A survey examining electronic cigarette use was prepared. The survey contained questions respecting primary motivation for use, frequency of use, present and former smoking status as well as agreement with common perception about electronic cigarettes. Basic demographic information was also collected. The survey was posted to “www.reddit.com” and was accessible to users who used electronic cigarettes themselves via the “/r/electronic_cigarettes” sub-Reddit for a period of five days. Once responses were collected, Chi-square tests of independence were run to determine if any associations existed. Responses were also compared to previous studies of a similar nature to see if any similarities existed. Results: In total, 155 responses were received. The majority of the respondents were males (89.7%) between the ages of 19 and 28 (47.7%). 30.32% listed their occupation as “student”, and almost three-quarters of the respondents had some post-secondary experience. 78.1% of respondents were former smokers, and 61.3% identified their primary reason for electronic cigarette use as “to quit smoking.” Chi-squared tests for association between responses yielded statistically-significant associations between being a previous smoker and believing that electronic-cigarettes are healthier than conventional cigarettes, and between gender (specifically being male) and reasons for electronic cigarette use (specifically “to quit smoking”). However, the latter result was possibly skewed by a higher response rate from males as opposed to females. Conclusion: The high proportion of previous smokers among electronic cigarette users suggested that quitting smoking was the most common reason individuals take up electronic cigarette usage. It is therefore suggested that studies be done to determine if their use is less harmful than that of conventional cigarettes, and that existing legislation regarding their use in public be modified in light of this evidence. It is also suggested that they be given consideration as a legitimate means of smoking cessation.  


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