Kentucky’s Smoking Cessation Quitline: Annual Estimated Return on Investment to Employers

2018 ◽  
Vol 33 (2) ◽  
pp. 285-288
Author(s):  
Nathan Pauly ◽  
Jeffrey Talbert ◽  
Shannon Parsley ◽  
Bobbye Gray ◽  
Ellen J. Hahn

Purpose: State-based smoking cessation telephone quitlines offer a cost-effective method of providing tobacco treatment at no cost to participants. The study objective was to assess the annual return on investment (ROI) to employers if they were to bear the entire responsibility from the Kentucky quitline. Design: A retrospective design was used to estimate the annual ROI to employers from the Kentucky quitline. Setting: The telephone quitline (1-800-QUIT-NOW) provided intake and follow-up data for all Kentucky participants who enrolled in the program from 2012 to 2014. Participants: All individuals aged 18+ who enrolled in the Kentucky quitline from 2012 to 2014. Measures: Successful tobacco cessation was assessed from follow-up surveys that took place after individuals completed the program. Cost savings to employers associated with tobacco cessation were gleaned from a published meta-analysis. The Kentucky quitline provided estimates for annual program expenses. Analysis: The annual ROI was calculated as the difference between estimated annual cost savings due to smoking cessation and annual program expenses. Results: From 2012 to 2014, 5425 individuals were enrolled in the quitline. The annual ROI to employers was estimated to be $998 680, with an ROI ratio of 6.2:1. Conclusions: Employers may receive a substantial ROI if they were to fund the Kentucky quitline. Study results may be used as evidence to support cost-sharing partnerships between public health agencies and employers to sustain funding for telephone quitlines.

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Oberndorfer ◽  
I Grabovac ◽  
S Haider ◽  
T E Dorner

Abstract Background Reports of the effectiveness of e-cigarettes (ECs) for smoking cessation vary across different studies making implementation recommendations hard to attain. We performed a systematic review and meta-analysis to synthesise the current evidence regarding the effectiveness of ECs for smoking cessation. Methods PubMed, PsycInfo and Embase databases were searched for randomized controlled trials comparing nicotine ECs with non-nicotine ECs or with established smoking cessation interventions (nicotine replacement therapy (NRT) and or counselling) published between 01/01/2014 and 01/05/2019. Data from eligible studies were extracted and used for random-effects meta-analyses. Results Our literature review yielded 13190 publications with 10 studies being identified as eligible for systematic review, covering 8362 participants, and 8 for meta-analyses (n = 30 - 6006). Using the last follow-up of eligible studies, the proportion of smokers achieving abstinence was 1.67 [95CI:0.99 - 2.81] times higher in nicotine EC users compared to non-nicotine EC users. The proportion of abstinent smokers was 1.69 [95CI:1.25 - 2.27] times higher in EC users compared to participants receiving NRT. EC users showed a 2.70 [95CI:1.15 - 6.30] times higher proportion of abstinent smokers in comparison to participants solely receiving counselling. Conclusions Our analysis showed modest effects of nicotine-ECs compared to non-nicotine ECs. When compared to NRT or counselling, results suggest that nicotine EC may be more effective for smoking cessation. As ECs also help maintaining routinized behaviour and social aspects of smoking, we hypothesise that this may explain their advantage as a tool for smoking cessation. However, given the small number of included studies, different populations, heterogeneous designs, and the overall moderate to low quality of evidence, it is not possible to offer clear recommendations. More comparable data is needed to strengthen confidence in the quality of evidence. Key messages The number of previous studies assessing the effectiveness of ECs for smoking cessation is limited. Further, comparability of these studies is restricted, weakening the quality of evidence. Although current evidence on the effectiveness of ECs for smoking cessation is inconclusive, our meta-analyses suggest that ECs could be a promising alternative tool in attempts to achieve abstinence.


2005 ◽  
Vol 50 (2) ◽  
pp. 64-68 ◽  
Author(s):  
L Copeland ◽  
R Robertson ◽  
R Elton

Background and Aims: The high prevalence of smoking in disadvantaged communities gives serious cause for concern in terms of adverse effects on health and social outcomes. In Scotland, smoking—related lung cancer rates are particularly high and compare less favourably with the rest of the UK and Europe. GPs are increasingly being recognised as having an important role in smoking cessation and are allowed to prescribe NRT to those on a low income. This study aimed to follow up a group patients from a disadvantaged area who had been prescribed nicotine patches by their GP. Methods: An initial self-complete questionnaire gathered details on age, sex, motivation, marital status, employment history, contact with other smokers, concern about weight gain, and nicotine dependence. (Nicotine dependence was assessed by using the Tagerstrom Test). Follow up was carried out at three months after commencing NRT prescription. Data was also gathered from patient case notes as to whether the participant had a smoking-related diagnosis, periods of depression, drug and/or alcohol problems. Outcome was measured in terms of “smoke the same”, “smoke less” and “stopped”. The statistical methods used for testing each factor against smoking were Spearman rank correlation, chi-squared test for trend and Kruskal-Wallis test. Basic descriptive statistics were used to report general outcomes of the study. Results: The study enrolled 120 patients but 19 were lost to follow up. Out of 101 who used their prescription, 35 were smoking the same, 46 were smoking less and 20 had stopped. The variables most strongly affecting outcome were age, with older smokers having more success (p<0.001), and those who had a diagnosis of depression having a worse outcome in terms of smoking cessation (p<0.05). Conclusion: This study's findings indicate that encouraging GPs to take a proactive approach in prescribing NRT is effective, even in an area of socio-economic deprivation, and particularly with older smokers.


Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 2187-2187 ◽  
Author(s):  
Wendy Langeberg ◽  
Melissa Eisen ◽  
W. Marieke Schoonen ◽  
Laurence Gamelin ◽  
Scott Stryker

Abstract Abstract 2187 Introduction: A recent systematic review and meta-analysis of randomized controlled trials of thrombopoietin-receptor agonists (TPOr), romiplostim and eltrombopag, in adult thrombocytopenic patients found a numerically but non-statistically significant increase in the occurrence of thromboembolism (TE) among treated patients compared to those not treated with TPOr.1 To put these results into context and to estimate the baseline risk of TE in ITP patients, this study will summarize results of observational studies that reported the risk of venous thrombembolism (VTE) or arterial thrombembolism (ATE) in patients with ITP relative to comparable populations without ITP. Methods: We searched MEDLINE and EMBASE via Ovid and the Cochrane database for articles that included both terms relating to ITP (i.e., immune thrombocytopenia, idiopathic thrombocytopenia) and TE (i.e., thromboembolism, thrombosis, embolism). Articles were restricted to research on humans, published in English, January 1996 to July 2012. Only observational studies were included. We abstracted measures of relative risk (or rate ratio) comparing the incidence of TE in ITP patients with that in a comparable non-ITP population. The pooled relative risk and 95% confidence intervals (CIs) were calculated by taking a weighted average of individual study results using both fixed and random effects models using the META2 module for STATA 10. Results: Five observational studies met the inclusion criteria: two from Denmark and one each from Sweden, United Kingdom, and United States; all published 2010–2012. All studies completed patient follow-up before the commercial availability of TPOr. Studies varied in the duration of follow-up, choice of comparison group, and specific events reported. Some studies excluded patients with previous events. The relative risk of any VTE among patients with ITP compared to that in a non-ITP population ranged from 1.6 to 2.9 based on 3 studies that reported VTE. The pooled relative risk of any VTE was 1.9 (95%CI 1.4, 2.7) using a fixed-effect model and similar estimates using a random effect model (test for heterogeneity, p = 0.3). The relative risk of any ATE among patients with ITP compared to that in a non-ITP population ranged from 1.3 to 1.6 based on 3 studies that reported ATE. The pooled relative risk of any ATE was 1.5 (95%CI 1.3, 1.8) for both the random and fixed effects models (test for heterogeneity, p = 0.7). Conclusions: Five population-based observational studies have been published recently comparing the risk of thrombembolism among ITP patients to populations without ITP. The results of a meta-analysis showed nearly a 2-fold increased risk of VTE and a 50% increased risk of ATE among the general population of ITP patients not treated with TPOr. These ITP patients were likely to have less severe disease than those in experimental trials where entrance criteria may require significant thrombocytopenia, prior bleeding episodes, or failure of a previous therapy. However, the demonstrated elevated risk of TE among patients with ITP should be considered when evaluating the risk of TE ascribed to ITP treatments. Disclosures: Langeberg: Amgen: Employment, Equity Ownership. Eisen:Amgen: Employment, Equity Ownership. Schoonen:Amgen: Employment, Equity Ownership. Gamelin:Amgen: Employment, Equity Ownership. Stryker:Amgen: Employment, Equity Ownership.


2019 ◽  
Vol 49 (1-2) ◽  
pp. 114-120
Author(s):  
Shuang Wang ◽  
Fang Wei ◽  
Haiyan Chen ◽  
Zhe Wang ◽  
Ruining Zhang ◽  
...  

Background: Much controversy remains in the literature with respect to whether soluble suppression of tumorigenicity 2 (sST2) can serve to predict all-cause death in patients undergoing maintenance hemodialysis (MHD). This meta-analysis therefore sought to analyze extant datasets exploring the association between these 2 variables in MHD patients in order to draw relevant conclusions. Methods: Articles published through December 2018 in PubMed and Embase were independently reviewed by 2 authors to identify relevant articles, and STATA 12.0 was used for statistical analyses of relevant results and study parameters. Results: In total, we identified 4 relevant studies that were incorporated into this meta-analysis. These studies included a total of 1,924 participants (60% male, mean follow-up 911 days). The combined study results suggested that increased levels of sST2 were significantly linked to a 2.23 fold rise in all-cause mortality (hazard ratio [HR] 2.23, 95% CI 1.81–2.75). Subgroup analyses confirmed that this same association was true in patients undergoing hemodialysis (HR 2.17, 95% CI 1.74–2.71), which indicated that the increased levels of sST2 were significantly linked to a 2.17 fold rise in all-cause mortality. Conclusions: This analysis suggests that there is a significant link between elevated levels of sST2 and death in patients undergoing MHD. Further large-scale trials, however, will be needed to fully validate these findings and their clinical relevance.


2021 ◽  
Vol 30 (9) ◽  
pp. 68-82
Author(s):  
Do Thi Thanh Toan ◽  
Chun Huang- Erick Wan ◽  
Nguyen Thu Anh ◽  
Pham Ngoc Yen ◽  
Luu Ngoc Minh ◽  
...  

The level of smoking cessation support in hospitals are low, especially in resource limited settings. Current healthcare systems are not well organized to address the issue. This review aimed to evaluate the effectiveness of smoking cessation interventions initiated in health facilities in resource-limited settings. A systematic review using meta-analysis techniques was applied. Bibliographic databases included PubMed, Medline, LILACS, the United States Clinical Trials and the Cochrane Collaboration Library. Eligibility criteria included smoking cessation intervention studies were published in English or Vietnamese, from the year 1990 to 2018. Study designs were randomized controlled trials, quasi-randomized controlled trials, cohort studies and before and after studies. Populations were limited to those in low and middle-income countries. Interventions were limited smoking cessation programs conducted in health facilities. 17 studies had included for the reviewing. 12 studies had been assessed to the meta-analysis. The proportion of successful smoking cessation in 6 months follow-up were range from 11.7% to 62.2% for the intervention group. In 12 months, follow-up, the abstinence rate ranges from 13.6% to 73%. The popularly of medical staff support the intervention was the physicians (8/17, 47.1%) and doctor (5/17, 29.4%). The evidence from our study suggests that the abstinence rate can be affected by the supporting of medical staff follow the smoking cessation (SC) program.


2016 ◽  
Vol 36 (3) ◽  
pp. 315-325 ◽  
Author(s):  
Seyed-Foad Ahmadi ◽  
Golara Zahmatkesh ◽  
Elani Streja ◽  
Rajnish Mehrotra ◽  
Connie M. Rhee ◽  
...  

Background Although higher body mass index (BMI) is associated with better outcomes in hemodialysis patients, the relationship in peritoneal dialysis (PD) patients is less clear. We aimed to synthesize the results from all large and high-quality studies to examine whether underweight, overweight, or obesity is associated with any significantly different risk of death in peritoneal dialysis patients. Methods We searched MEDLINE, EMBASE, Web of Science, CINAHL, and Cochrane CENTRAL, and screened 7,123 retrieved studies for inclusion. Two investigators independently selected the studies using predefined criteria and assessed each study's quality using the Newcastle-Ottawa Quality Assessment Scale. We meta-analyzed the results of the largest studies with no overlap in their data sources. Results We included 9 studies ( n = 156,562) in the systematic review and 4 studies in the meta-analyses. When examined without stratifying studies by follow-up duration, the results of the studies were inconsistent. Hence, we pooled the study results stratified based upon their follow-up durations, as suggested by a large study, and observed that being underweight was associated with higher 1-year mortality but had no significant association with 2- and 3- to 5-year mortalities. In contrast, being overweight or obese was associated with lower 1-year mortality but it had no significant association with 2-, and 3- to 5-year mortalities. Conclusion Over the short-term, being underweight was associated with higher mortality and being overweight or obese was associated with lower mortality. The associations of body mass with mortality were not significant over the long-term.


10.2196/16255 ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. e16255
Author(s):  
Amika Shah ◽  
Michael Chaiton ◽  
Dolly Baliunas ◽  
Robert Schwartz

Background The increasing number of internet users presents an opportunity to deliver health interventions to large populations. Despite their potential, many web-based interventions, including those for smoking cessation, face high rates of attrition. Further consideration of how intervention features impact attrition is needed. Objective The aim of this systematic review is to investigate whether tailored web-based smoking cessation interventions for smokers are associated with reduced rates of attrition compared with active or passive untailored web-based interventions. The outcomes of interest were dropout attrition at 1-, 3-, 6-, and 12-month follow-ups. Methods Literature searches were conducted in May 2018 and updated in May 2020 on MEDLINE (Medical Literature Analysis and Retrieval System Online), PsycINFO (Psychological Information), EMBASE (Excerpta Medica dataBASE), CINAHL (Cumulated Index to Nursing and Allied Health Literature), Scopus, and the Cochrane Tobacco Addiction Group Specialized Register with the following search terms: smoking cessation, tailored, or web- or internet-based. Included studies were published in English before or in May 2020 using a randomized controlled trial design. Studies were restricted to those with web-based delivery, a tailored intervention group, an untailored control group, and a reported outcome of smoking cessation. Studies were assessed for methodological quality using the Cochrane Risk of Bias tool. Two reviewers independently extracted the study characteristics and the number of participants lost to follow-up for each treatment group. Results A total of 13 studies were included in the systematic review, of which 11 (85%) were included in the meta-analysis. Tailoring had no statistically significant effect on dropout attrition at 1-month (risk ratio [RR]=1.02, 95% CI 0.95-1.09; P=.58; I2=78%), 3-month (RR=0.99, 95% CI 0.95-1.04; P=.80; I2=73%), 6-month (RR=1.00, 95% CI 0.95-1.05; P=.90; I2=43%), or 12-month (RR=0.97, 95% CI 0.92-1.02; P=.26; I2=28%) follow-ups. Subgroup analyses suggested that there was a statistically significant effect of tailoring between the active and passive subgroups at 1-month (P=.03), 3-month (P<.001), and 6-month (P=.02) follow-ups but not at 12-month follow-up (P=.25). Conclusions The results suggest that tailoring of web-based smoking cessation interventions may not be associated with reduced rates of dropout attrition at 1-, 3-, 6-, or 12-month follow-ups. Significant differences between studies that include untailored active and passive control groups suggest that the role of tailoring may be more prominent when studies include a passive control group. These findings may be because of variability in the presence of additional features, the definition of smokers used, and the duration of smoking abstinence measured. Future studies should incorporate active web-based controls, compare the impact of different tailoring strategies, and include populations outside of the Western countries.


2021 ◽  
Vol 4 (2) ◽  
pp. 371-379
Author(s):  
Olayinka Stephen Ilesanmi ◽  
Victoria Ifeoma Agwai ◽  
Aanuoluwapo Adeyimika Afolabi

Background: Tobacco smoking is a global public health challenge, resulting in an estimated loss of 1.4 trillion United States Dollars (USD), a preventable risk that can be achieved through tobacco cessation services. The study, therefore, aimed to review the most frequently used methods employed by healthcare workers (HCWs) in providing tobacco cessation services and reported challenges in Africa. Methods: A systematic review was conducted using five electronic databases (PubMed, Base, PsychInfo, Google Scholar, and African Journal Online) for published studies on HCW’s practices and challenges on tobacco cessation in Africa. We adopted a three-stage methodology to conduct the study, which identified articles using pre-defined key terms, screened articles to remove duplicates, and excluded irrelevant articles after reading the manuscripts’ titles and abstracts. Results: We reviewed articles and found that 35.0% to 83.0% of HCWs frequently asked their patients to quit smoking. Also, 14.9% of HCWs assisted smoking cessation among their patients, among whom 3.9% prescribed oral depressants and 2.8% prescribed Nicotine Replacement Therapy (NRT). Further, 17.0% of HCWs had guidelines to help patients to cease smoking. Challenges were lack of efficacy and training, lack of system support, low sense of responsibility by some physicians to incorporate the smoking cessation therapy to their patients, lack of attractive educational resources on smoking cessation, limited knowledge on effective intervention strategies, lack of guidelines, lack of specialists for smoking cessation, and unavailability of NRT. Conclusion: Follow-up should be commenced and intensified by HCWs for smoking cessation among tobacco smokers.


2021 ◽  
Vol 6 (3) ◽  
pp. 135-140
Author(s):  
Shital Bhimsingbhai Gamit ◽  
Jayshree M. Sutaria Sutaria

Background: Cerebral palsy describes a group of disorders of development of movement and posture, causing activity limitation, that are attributed to non- progressive disturbances that occurred in developing fetal or infant brain. Spider therapy is an intensive treatment approach which was originally developed in Poland. It involves suspending the child in the Centre of universal exercise unit by using a number of elastic bungee cords of different elasticity. These cords are attached to specific points on special belt around the child’s waist, forming a unique spider web around the child which provides them essential support. Purpose: The purpose is to study the scientific evidences regarding the effect of the spider therapy on motor functions and balance in cerebral palsy Methodology: A search for relevant articles was carried out using key words- cerebral palsy, spider therapy, motor functions and balance and search engines-Google Scholar, PubMed, PEDro, Science Direct, Research Gate and CINAHL. Studies were selected from year 2005-2020. eleven studies were included in which there were 1 Meta-analysis, 2 Systematic reviews and 4 Randomized controlled trials,1Quasi- Experimental study, 1 case study, 1 interventional study and 1 retrospective study. Results: 11 studies were reviewed from which 6 studies concluded that spider therapy is more effective than a control group receiving conventional treatment, 2 study highlighted MFR to be equally effective to alternative treatment and 3 studies concluded that spider therapy have significant but small effects on functioning at post-treatment and follow-up Conclusion: Based on the analysis of these 11 articles, it can be concluded that spider therapy is an effective treatment regimen in cerebral palsy. Clinical Implication: Spider therapy is found to be effective in improving balance and motor functions in s cerebral palsy, therefore spider therapy can be considered as an adjunctive treatment in cerebral palsy. Keywords: cerebral palsy, spider therapy, motor functions and balance.


2018 ◽  
Vol 21 (11) ◽  
pp. 1473-1479 ◽  
Author(s):  
Seung-Kwon Myung ◽  
Joo-Young Park

Abstract Introduction This study aimed to evaluate the efficacy of pharmacotherapy for smoking cessation among adolescent smokers by using a meta-analysis of randomized controlled trials (RCTs). Methods PubMed, EMBASE, and Cochrane Library were searched from the inception to January 20, 2018. We included RCTs of pharmacotherapy for smoking cessation among adolescent smokers aged less than 20 years. Data were pooled using a random-effects meta-analysis. The primary outcome measures were a smoking abstinence rate and its relative risk (RR) at the longest follow-up period in each study validated by biochemical markers. Results Among a total of 1035 articles searched, nine RCTs, which involved 1188 adolescent smokers aged 12–20 years with 627 in the intervention group and 561 in the control group, were included in the final analysis. In the random-effects meta-analysis of all the nine trials, pharmacotherapy showed a increased abstinence rate (RR = 1.62; 95% confidence interval [CI] = 1.08 to 2.44, I2 = 0.0%), compared with the control group. Subgroup meta-analyses by follow-up period showed an increased abstinence rate at 4 weeks (RR = 1.87; 95% CI = 1.22 to 2.87; n = 4) and a nonsignificantly increased abstinence rate during the longer term follow-up periods at 8, 12, 24, and 52 weeks. Conclusions The current meta-analysis suggests that pharmacotherapy can be considered as an aid for smoking cessation in the short-term period among adolescent smokers. However, further large RCTs are warranted to determine its long-term efficacy and safety. Implications In this meta-analysis of nine RCTs with 1188 adolescent smokers aged 12–20 years, pharmacotherapy showed an increased abstinence rate, compared with the control group. In the subgroup meta-analyses by follow-up period, it showed the increased abstinence rate at 4 weeks and no efficacy on abstinence during the longer term follow-up periods up to 52 weeks. Further large RCTs are warranted to determine the long-term efficacy and safety of pharmacotherapy in adolescent smokers.


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