scholarly journals Smoking Cessation After Stroke: Education and its Effect on Behavior

Stroke ◽  
2001 ◽  
Vol 32 (suppl_1) ◽  
pp. 328-328
Author(s):  
Laura R Sauerbeck ◽  
Jane C Khoury ◽  
Daniel Woo ◽  
Brett M Kissela ◽  
Charles J Moomaw ◽  
...  

69 Background and Purpose: Smoking is a strong independent environmental risk factor for stroke. We sought to prospectively examine the impact of the diagnosis of stroke on smoking behavior at three months. Design : Patients admitted to 17 hospitals in the Greater Cincinnati area with a confirmed diagnosis of stroke were interviewed in the acute period after their event. A standardized questionnaire was utilized to collect detailed smoking history. Risk factor reduction was discussed with the patient and/or family members and printed risk reduction information was provided. Patients or their proxies were then contacted at three months and current smoking status was recorded. Results: Of 365 stroke patients, 99 were current smokers at baseline. There were no differences between the smokers and the non-smokers based on gender, race, age, and education. At three months, 44% of the baseline smokers had quit smoking (p<0.001), and the overall amount of daily cigarette use had decreased (p<0.001). Factors independently associated with reduction of smoking were white race(OR=2.3, 95% CI 1.0–5.5) and male gender (OR= 2.2, 95% CI 1.0–5.2). Conclusions: After a stroke, patients are motivated to change smoking behavior, as has been found with other life threatening diagnoses. Longer follow-up is needed to see if this behavior continues.

Author(s):  
Sumana M. ◽  
Sreelatha C. Y. ◽  
Sundar M. ◽  
Narottam Das

Background: Cessation of tobacco is important to prevent non-communicable diseases and mortality. Smokers frequently approach doctors for various health ailments. This opportunity can be utilized to give tobacco cessation advice. This study aims to assess the clinician’s practice perspectives barriers and need for the training related to tobacco cessation.Methods: A cross-sectional study was conducted to explore tobacco cessation practices of clinicians of a teaching hospital attached to Medical College in Hassan, Karnataka, India. Pre-tested, pre-structured self-administered questionnaire was distributed to all the clinicians in person. All the Professors, Associate Professors, Assistant Professors, Senior Residents and Junior Residents in the departments coming in contact with smokers were included in the study and patients were also interviewed to assess their smoking status, willingness to quit and counselling by physicians using pre-structured oral questionnaire.Results: Almost 84.4% of clinicians said they ask about smoking history but only 50.9% said they assess patients’ willingness to quit smoking. 37% assist patients to quit smoking and 29.8% arranged follow up visits. 25% of clinicians mentioned undergraduate and postgraduate training prepared them to help patients quit smoking. Remaining said it was inadequate. All agreed that it is their role to help, motivate, discuss, speak, refer and monitor patients who smoke to quit.Conclusions: Majority of the doctors believed that they play a very important role in tobacco cessation activities. There is a need for Undergraduate and postgraduate skill based training to assist patients quit the tobacco habit. The study showed a need for adherence and reinforcement of tobacco cessation guidelines. 


2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S150-S150
Author(s):  
H Li ◽  
M Arslan ◽  
Z Fu ◽  
H Lee ◽  
M Mikula

Abstract Introduction/Objective A subset of patients with an established diagnosis of UC develops signs of CD (de novo CD) following IPAA. While the etiology and risk factors of de novo CD remain largely unknown, preliminary studies have shown controversial results regarding family history of inflammatory bowel disease (IBD) and smoking history. Methods Patients that underwent IPAA for UC, with at least 1 year of follow-up, were identified (n=161; 1996 to 2018). We retrospectively reviewed the electronic medical records. Patients that were diagnosed with de novo CD during the follow-up period were further identified. Smoking history and family history of IBD were evaluated. Chi square test was performed to compare the frequencies. Odds ratio (OR) and 95% confidence intervals (CIs) were estimated by logistic regression model. P&lt;0.05 was considered statistically significant. Results 29 de novo CD were identified. At the time of proctocolectomy, the family history of IBD and smoking history was documented in 152 UC patients including 27 that subsequently developed de novo CD. 23 of 152 had a family history of IBD (12 UC, 9 CD and 2 IBD, NOS). 19/129 (14.7%) UC patients without a family history of any type of IBD, 4/9 (44.4%) with a family history of CD, and 4/12 (33.3%) with a family history of UC developed de novo CD. Patients with a family history of CD were more likely to develop de novo CD post IPAA than those without a family history of any type of IBD (OR 4.63, 95% CI 1.14-18.82, p=0.03). Family history of UC did not correlate with development of de novo CD (OR 2.90; 95% CI 0.79-10.57, p=0.108). At the time of proctocoletomy, 11 were current smokers, 25 were former smokers, and 116 never smoked. In de novo CD group, there were 4/27 (14.8 %) former smokers and 23/27 (85.2 %) never smokers. No de novo CD patient was current smoker. In the UC group that remained as UC following IPAA, 11/125 (8.8%) were current smokers, 21/125 (16.8 %) former smokers, and 93/125 (74.4 %) were never smokers. Current smoking status was not associated with development of de novo CD (p = 0.214). Conclusion Family history of CD may be a risk factor for developing de novo CD following IPAA for UC. Current smoking status was not associated with development of de novo CD following IPAA for UC.


2015 ◽  
Vol 1 (1) ◽  
pp. 27-32
Author(s):  
Raúl H Sansores ◽  
◽  
Alejandra Ramírez-Venegas ◽  
Valeri Noé-Díaz ◽  
Leonor García-Gómez

Introduction: the desire to acquire promotional articles from tobacco companies (receptivity) is a risk factor associated with becoming an established smoker. There is a possibility that the perception of sexual content in tobacco advertising (PCS) may be part of that desire and act as an additional risk factor. Objective: the objective of this study was to determine the influence of receptivity and PCS in the smoking process. Method: in 1998, 1186 high school students were surveyed in order to determine their receptivity and PCS. After three years, 303 of them were followed through a telephone interview in order to correlate their current smoking status with the previously recorded antecedent of receptivity and PCS. Results: 62% of the subjects were receptive and 78% perceived some kind of sexual content in the advertising. Both receptivity and PCS were significantly associated with the probability of becoming an Established Smoker (ES) (OR 2.36 [95%CI 2.36-1.18] and OR 2.56 [1.02-6.42] respectively). Discussion and conclusions: receptivity and PCS are independent risk factors than can cause teenagers to become established smokers.


2020 ◽  
Vol 15 (4) ◽  
pp. 181-188
Author(s):  
Carly S. Priebe ◽  
Kelly Wunderlich ◽  
John Atkinson ◽  
Guy Faulkner

AbstractIntroductionWalk or Run to Quit was a national program targeting smoking cessation through group-based running clinics. Increasing physical activity may facilitate smoking cessation as well as lead to additional health benefits beyond cessation.AimTo evaluate the impact of Walk or Run to Quit over 3 years.MethodsAdult male and female participants (N = 745) looking to quit smoking took part in 156 running-based cessation clinics in 79 locations across Canada. Using a pre-post design, participants completed questionnaires assessing physical activity, running frequency and smoking at the beginning and end of the 10-week program and at 6-months follow-up. Carbon monoxide testing pre- and post- provided an objective indicator of smoking status and coach logs assessed implementation.Results55.0% of program completers achieved 7-day point prevalence (intent-to-treat = 22.1%) and carbon monoxide significantly decreased from weeks 1 to 10 (P < 0.001). There was an increase in physical activity and running from baseline to end-of-program (P's<0.001). At 6-month follow-up, 28.9% of participants contacted self-reported prolonged 6-month abstinence (intent-to-treat = 11.4%) and 35.6% were still running regularly.ConclusionsAlthough attrition was a concern, Walk or Run to Quit demonstrated potential as a scalable behaviour change intervention that targets both cessation and physical activity.


2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 12058-12058
Author(s):  
Lawson Eng ◽  
Katrina Hueniken ◽  
Todd A Norwood ◽  
Gerald J Romme ◽  
M. Catherine Brown ◽  
...  

12058 Background: Continued smoking after a cancer diagnosis is associated with poorer outcomes. We previously identified that tobacco retail outlet density is negatively associated with cessation in lung cancer survivors (ASCO 2019). However, the impact of tobacco retail density on survival has not been evaluated. We evaluated the impact of tobacco retail density on OS in lung cancer patients (pts). Methods: Lung cancer pts diagnosed from 2009-2012 were recruited at diagnosis and completed a baseline questionnaire on their socio-demographics, ECOG and smoking history. Clinicopathologic data including stage, histology and OS data were collected. Validated tobacco retail location data obtained from Ministry of Health and pt home addresses were geocoded using ArcGIS 10.6.1, which calculated tobacco outlet density within 250 meters (m) and 500m from pts. Multivariable Cox proportional hazard models evaluated the impact of tobacco outlet density on OS adjusted for significant clinicodemographic covariates. Results: Among 1411 pts, median age 66, 53% female, 8% small cell/56% adenocarcinoma/17% squamous/19% other, 28% stage 1/9% stage 2/20% stage 3/35% stage 4, 38% were current smokers at diagnosis and 40% were ex-smokers; median OS was 24 months. On average, there was one vendor (range 0-23) within 250m and four vendors (range 0-44) within 500m from pts; 33% and 60% of pts lived within 250m and 500m from at least one vendor respectively. The final baseline multivariable model consisted of age, gender, stage, smoking status, ECOG and neighbourhood marginalization index ( P< 0.05). Among all pts, not living within 250m to an outlet improved OS (aHR 0.84 [0.72-0.97] P= 0.02). Living near more outlets within 250 m (aHR 1.03 per outlet [1.00-1.05] P= 0.03) or 500 m (aHR 1.01 per outlet [1.00-1.02] P= 0.04) worsened OS. Subgroup analysis based on smoking status at diagnosis, identified that among current smokers, not living within 250m to an outlet improved OS (aHR 0.76 [0.60-0.97] P= 0.03), and among ex-smokers, living near more outlets within 500 m worsened OS (aHR 1.02 per outlet [0.99-1.03] P= 0.07); other associations showed similar directionality. Among 135 current smokers at diagnosis with follow-up smoking status, not living within 250m to an outlet continued to show a trend towards improved OS (aHR 0.57 [0.31-1.03] P= 0.06), after also adjusting for follow-up smoking status. Conclusions: Living near a greater density of tobacco outlets is associated with poorer OS among lung cancer pts. Reducing the density of tobacco outlets may be a strategy that can help improve lung cancer pt outcomes.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lars Lind ◽  
Johan Sundström ◽  
Johan Ärnlöv ◽  
Ulf Risérus ◽  
Erik Lampa

AbstractThe impact of most, but not all, cardiovascular risk factors decline by age. We investigated how the metabolic syndrome (MetS) was related to cardiovascular disease (CVD) during 40 years follow-up in the Uppsala Longitudinal Study of Adult Men (ULSAM, 2,123 men all aged 50 at baseline with reinvestigations at age 60, 70, 77 and 82). The strength of MetS as a risk factor of incident combined end-point of three outcomes (CVD) declined with ageing, as well as for myocardial infarction, ischemic stroke and heart failure when analysed separately. For CVD, the risk ratio declined from 2.77 (95% CI 1.90–4.05) at age 50 to 1.30 (95% CI 1.05–1.60) at age 82. In conclusion, the strength of MetS as a risk factor of incident CVD declined with age. Since MetS was significantly related to incident CVD also at old age, our findings suggest that the occurrence of MetS in the elderly should not be regarded as innocent. However, since our data were derived in an observational study, any impact of MetS in the elderly needs to be verified in a randomized clinical intervention trial.


2021 ◽  
Vol 10 (4) ◽  
pp. 599
Author(s):  
Jan Zabrzyński ◽  
Gazi Huri ◽  
Maciej Gagat ◽  
Łukasz Łapaj ◽  
Alper Yataganbaba ◽  
...  

The purpose of this study was to investigate the association of smoking and functional outcomes after arthroscopic treatment of complex shoulder injuries: rotator cuff tears (RCTs) with biceps tendon (LHBT) tears. This retrospective case-control study has been conducted on a cohort of patients who underwent shoulder arthroscopy between 2015 and 2017 due to complex injury treatment. The outcomes were assessed using the American Shoulder and Elbow Surgeons Score (ASES), the University of California at Los Angeles (UCLA) Shoulder Score, need for non-steroid anti-inflammatory drugs (NSAIDs) consumption and the visual analog scale (VAS). Complications and changes in smoking status were also noted. A cohort of 59 patients underwent shoulder arthroscopy, due to complex LHBT pathology and RCTs, and were enrolled in the final follow-up examination; with mean duration of 26.03 months. According to smoking status, 27 of patients were classified as smokers, and the remaining 32 were non-smokers. In the examined cohort, 36 patients underwent the LHBT tenotomy and 23 tenodesis. We observed a relationship between smoking status and distribution of various RCTs (p < 0.0001). The mean postoperative ASES and UCLA scores were 80.81 and 30.18 in the smoker’s group and 84.06 and 30.93 in the non-smoker’s group, respectively. There were no statistically significant differences in pre/postoperative ASES and postoperative UCLA scores between smokers and non-smokers (p > 0.05). The VAS was significantly lower in the non-smokers’ group (p = 0.0021). Multi-tendon injuries of the shoulder are a serious challenge for surgeons, and to obtain an excellent functional outcome, we need to limit the negative risk factors, including smoking. Furthermore, there is a significant association between smoking and the occurrence of massive rotator cuff tears, and the pain level measured by the VAS. Simultaneous surgical treatment of RC and LHBT lesions in the smoker population allowed us to obtain the functional outcomes approximated to non-smokers in the long-term follow-up. Of course, we cannot assert that smoking is the real cause of all complications, however, we may assume that this is a very important, negative factor in shoulder arthroscopy.


2017 ◽  
Vol 32 (5) ◽  
pp. 1257-1263 ◽  
Author(s):  
Kim A. Hayes ◽  
Christine Jackson ◽  
Denise M. Dickinson ◽  
Audra L. Miller

Purpose: To test whether an antismoking parenting program provided to parents who had quit smoking for ≥24 hours increased parents’ likelihood of remaining abstinent 2 and 3 years postbaseline. Design: Two-group randomized controlled trial with 3-year follow-up. Setting: Eleven states (Colorado, Indiana, Michigan, Minnesota, Montana, New York, Ohio, Pennsylvania, South Dakota, Utah, and Vermont). Participants: Five hundred seventy-seven adults (286 treatment and 291 control) who had smoked ≥10 cigarettes daily at baseline, had quit smoking for ≥24 hours after calling a Quitline, and were parents of an 8- to 10-year-old child; 358 (62%) completed the 2-year follow-up interview, and 304 (53%) completed the 3-year follow-up interview. Intervention: Theory-driven, home-based, self-help parenting program. Measures: Sociodemographic, smoking history, and 30-day point prevalence. Analysis: Multivariable regression analyses tested for group differences in 30-day abstinence. Attriters were coded as having relapsed. Results: Between-group differences in abstinence rates were 5.6% and 5.9% at 2 and 3 years, respectively. Treatment group parents had greater odds of abstinence, an effect that was significant only at the latter time point (odds ratio [OR] = 1.49, P = .075 at 2 years; OR = 1.70, P = .026 at 3 years). Conclusions: This study obtained preliminary evidence that engaging parents who recently quit smoking as agents of antismoking socialization of children has the potential to reduce the long-term odds of relapse.


Cancers ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 2423
Author(s):  
Marion Nicolas ◽  
Beatriz Grandal ◽  
Emma Dubost ◽  
Amyn Kassara ◽  
Julien Guerin ◽  
...  

Breast cancer (BC) is the most commonly diagnosed type of cancer and the leading cause of cancer deaths in women. Smoking is the principal modifiable risk factor for cancers and has a negative influence on long-term survival. We conducted a retrospective study on consecutive BC survivors seen at follow-up consultations between 3 June and 30 October 2019 at Institut Curie, Paris, France. Smoking behaviors were evaluated prospectively via interviewer-administered questionnaires. The aim of this study was to describe smoking-related patient care at diagnosis and smoking cessation patterns in women with a history of BC. A total of 1234 patients were included in the study. Smoking status at diagnosis was missing from electronic health records in 32% of cases, including 13% of patients who smoke. Only 20% of the 197 patients currently smoking at diagnosis recalled having a discussion about smoking with a healthcare professional. Radiotherapists and surgeons were more likely to talk about complications than other practitioners. The main type of information provided was general advice to stop smoking (n = 110), followed by treatment complications (n = 48), while only five patients were referred to tobaccologists. Since diagnosis, 33% (n = 65) of the patients currently smoking had quit. Patients who quit had a lower alcohol consumption, but no other factor was associated with smoking cessation. The main motivation for tobacco withdrawal was the fear of BC relapse (63%). This study highlights room for improvement in the assessment of smoking behavior. Our data raise important perspectives for considering BC treatment and follow-up as a window of opportunity for smoking cessation.


SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A180-A180
Author(s):  
Victoria Pak ◽  
David Maislin ◽  
Brendan Keenan ◽  
Raymond Townsend ◽  
Bryndis Benediktsdottir ◽  
...  

Abstract Introduction Continuous positive airway pressure (CPAP) therapy may improve insulin sensitivity and glucose tolerance seen in individuals with obstructive sleep apnea (OSA), however there is a lack of studies on whether obesity modifies the effect. We examined the baseline and follow-up levels of insulin and glucose following 4 months of CPAP treatment among participants with body mass index (BMI) &lt;30, 30≤ BMI&lt;35, and BMI≥35 kg/m2. Methods We identified 221 adults (84% males) with newly diagnosed OSA in the Penn Icelandic Sleep Apnea (PISA) Study, with a mean (±SD) BMI 31.7 +- 4.2 kg/m2 and apnea-hypopnea index (AHI) of 35.7+-15.6 events/hour. Associations between changes in natural log of the biomarkers within BMI groups were explored, controlling for a priori baseline covariates of age, baseline BMI, race, sex, site, and current smoking status. Results The mean proportional change (from baseline to follow-up) in log-transformed glucose in CPAP adherent participants was significantly larger in the BMI ≥35 and 30≤ BMI&lt;35 groups compared to BMI &lt;30. Within the BMI ≥35 group, the baseline to follow up increase in glucose post-CPAP was 1.08 (95% CI 1.01–1.15), while there were no significant changes in the other 2 BMI groups. A mediation analysis was performed with models including BMI change, and glucose was found to be significantly different between groups. There was no statistically significant association for insulin. Conclusion Our findings show that obesity modifies the effect of four months of CPAP on glucose levels. Support (if any) 1P01-1HL094307


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