scholarly journals Secure Asynchronous Communication Between Smokers and Tobacco Treatment Specialists: Secondary Analysis of a Web-Assisted Tobacco Intervention in the QUIT-PRIMO and National Dental PBRN Networks

10.2196/13289 ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. e13289
Author(s):  
Rajani Shankar Sadasivam ◽  
Ariana Kamberi ◽  
Kathryn DeLaughter ◽  
Barrett Phillips ◽  
Jessica H Williams ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Motivational Interviewing ◽  
Secondary Analysis ◽  
Asynchronous Communication ◽  
Evidence Based ◽  
Behavioral Strategies ◽  
Multivariable Model ◽  
Participant Engagement ◽  
Tobacco Treatment ◽  
Tobacco Intervention

Background Within a web-assisted tobacco intervention, we provided a function for smokers to asynchronously communicate with a trained tobacco treatment specialist (TTS). Previous studies have not attempted to isolate the effect of asynchronous counseling on smoking cessation. Objective This study aimed to conduct a semiquantitative analysis of TTS-smoker communication and evaluate its association with smoking cessation. Methods We conducted a secondary analysis of data on secure asynchronous communication between trained TTSs and a cohort of smokers during a 6-month period. Smokers were able to select their preferred TTS and message them using a secure web-based form. To evaluate whether the TTS used evidence-based practices, we coded messages using the Motivational Interviewing Self-Evaluation Checklist and Smoking Cessation Counseling (SCC) Scale. We assessed the content of messages initiated by the smokers by creating topical content codes. At 6 months, we assessed the association between smoking cessation and the amount of TTS use and created a multivariable model adjusting for demographic characteristics and smoking characteristics at baseline. Results Of the 725 smokers offered asynchronous counseling support, 33.8% (245/725) messaged the TTS at least once. A total of 1082 messages (TTSs: 565; smokers 517) were exchanged between the smokers and TTSs. The majority of motivational interviewing codes were those that supported client strengths (280/517, 54.1%) and promoted engagement (280/517, 54.1%). SCC code analysis showed that the TTS provided assistance to smokers if they were willing to quit (247/517, 47.8%) and helped smokers prepare to quit (206/517, 39.8%) and anticipate barriers (197/517, 38.1%). The majority of smokers’ messages discussed motivations to quit (234/565, 41.4%) and current and past treatments (talking about their previous use of nicotine replacement therapy and medications; 201/565, 35.6%). The majority of TTS messages used behavioral strategies (233/517, 45.1%), offered advice on treatments (189/517, 36.5%), and highlighted motivations to quit (171/517, 33.1%). There was no association between the amount of TTS use and cessation. In the multivariable model, after adjusting for gender, age, race, education, readiness at baseline, number of cigarettes smoked per day at baseline, and the selected TTS, smokers messaging the TTS one or two times had a smoking cessation odds ratio (OR) of 0.8 (95% CI 0.4-1.4), and those that messaged the TTS more than two times had a smoking cessation OR of 1.0 (95% CI 0.4-2.3). Conclusions Our study demonstrated the feasibility of using asynchronous counseling to deliver evidence-based counseling. Low participant engagement or a lack of power could be potential explanations for the nonassociation with smoking cessation. Future trials should explore approaches to increase participant engagement and test asynchronous counseling in combination with other approaches for improving the rates of smoking cessation.

Secure Asynchronous Communication Between Smokers and Tobacco Treatment Specialists: Secondary Analysis of a Web-Assisted Tobacco Intervention in the QUIT-PRIMO and National Dental PBRN Networks (Preprint)

2019 ◽  
Author(s):  
Rajani Shankar Sadasivam ◽  
Ariana Kamberi ◽  
Kathryn DeLaughter ◽  
Barrett Phillips ◽  
Jessica H Williams ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Motivational Interviewing ◽  
Secondary Analysis ◽  
Asynchronous Communication ◽  
Evidence Based ◽  
Behavioral Strategies ◽  
Multivariable Model ◽  
Participant Engagement ◽  
Tobacco Treatment ◽  
Tobacco Intervention

BACKGROUND Within a web-assisted tobacco intervention, we provided a function for smokers to asynchronously communicate with a trained tobacco treatment specialist (TTS). Previous studies have not attempted to isolate the effect of asynchronous counseling on smoking cessation. OBJECTIVE This study aimed to conduct a semiquantitative analysis of TTS-smoker communication and evaluate its association with smoking cessation. METHODS We conducted a secondary analysis of data on secure asynchronous communication between trained TTSs and a cohort of smokers during a 6-month period. Smokers were able to select their preferred TTS and message them using a secure web-based form. To evaluate whether the TTS used evidence-based practices, we coded messages using the Motivational Interviewing Self-Evaluation Checklist and Smoking Cessation Counseling (SCC) Scale. We assessed the content of messages initiated by the smokers by creating topical content codes. At 6 months, we assessed the association between smoking cessation and the amount of TTS use and created a multivariable model adjusting for demographic characteristics and smoking characteristics at baseline. RESULTS Of the 725 smokers offered asynchronous counseling support, 33.8% (245/725) messaged the TTS at least once. A total of 1082 messages (TTSs: 565; smokers 517) were exchanged between the smokers and TTSs. The majority of motivational interviewing codes were those that supported client strengths (280/517, 54.1%) and promoted engagement (280/517, 54.1%). SCC code analysis showed that the TTS provided assistance to smokers if they were willing to quit (247/517, 47.8%) and helped smokers prepare to quit (206/517, 39.8%) and anticipate barriers (197/517, 38.1%). The majority of smokers’ messages discussed motivations to quit (234/565, 41.4%) and current and past treatments (talking about their previous use of nicotine replacement therapy and medications; 201/565, 35.6%). The majority of TTS messages used behavioral strategies (233/517, 45.1%), offered advice on treatments (189/517, 36.5%), and highlighted motivations to quit (171/517, 33.1%). There was no association between the amount of TTS use and cessation. In the multivariable model, after adjusting for gender, age, race, education, readiness at baseline, number of cigarettes smoked per day at baseline, and the selected TTS, smokers messaging the TTS one or two times had a smoking cessation odds ratio (OR) of 0.8 (95% CI 0.4-1.4), and those that messaged the TTS more than two times had a smoking cessation OR of 1.0 (95% CI 0.4-2.3). CONCLUSIONS Our study demonstrated the feasibility of using asynchronous counseling to deliver evidence-based counseling. Low participant engagement or a lack of power could be potential explanations for the nonassociation with smoking cessation. Future trials should explore approaches to increase participant engagement and test asynchronous counseling in combination with other approaches for improving the rates of smoking cessation.

scholarly journals Smoking Cessation Interventions in Cancer Care: Opportunities for Oncology Nurses and Nurse Scientists

2009 ◽  
Vol 27 (1) ◽  
pp. 243-272 ◽  
Author(s):  
Mary E. Cooley ◽  
Rebecca Lundin ◽  
Lyndsay Murray
Keyword(s):  
Smoking Cessation ◽  
Cancer Care ◽  
Quality Care ◽  
Tobacco Dependence ◽  
Evidence Based ◽  
Theoretical Frameworks ◽  
Behavioral Counseling ◽  
Effective Interventions ◽  
Tobacco Treatment ◽  
Attitudes Toward Smoking

Smoking cessation is essential after the diagnosis of cancer to improve clinical outcomes. The purpose of this chapter is to provide a systematic review of research on smoking cessation in the context of cancer care with an emphasis on nursing contributions to the field. Data sources included research reports of smoking cessation interventions conducted in people with cancer. Nineteen primary studies were reviewed. High intensity interventions, targeting multiple behaviors, and/or using a multicomponent intervention that included pharmacotherapy, behavioral counseling, and social support were characteristics of the most successful treatments for tobacco dependence. The majority of interventions were conducted in adults with smoking-related malignancies during acute phases of illness. The most striking finding was that more than one half of the studies tested the efficacy of nurse-delivered interventions. Conceptual and methodological issues that can be improved in future studies include: using theoretical frameworks to specify how the intervention will affect outcomes, ensuring adequate sample sizes, using biochemical verification to monitor smoking outcomes, and using standardized outcome measures of abstinence. Although effective interventions are available for healthy populations, further research is needed to determine if tailored cessation interventions are needed for patients with cancer. To provide optimal quality care it is imperative that delivery of evidence-based smoking cessation interventions be integrated into the cancer treatment trajectory. Multiple barriers, including patient and nurse attitudes toward smoking and lack of knowledge related to tobacco treatment, prevent translating evidence-based tobacco dependence treatment into clinical practice. Further nursing research is needed to address these barriers.

scholarly journals Outcomes of a tobacco treatment programme for individuals with severe and persistent mental illness attending a community mental health team

2013 ◽  
Vol 9 (2) ◽  
pp. 60-67 ◽  
Author(s):  
Joy E. Masuhara ◽  
Tom Heah ◽  
Chizimuzo T.C. Okoli
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Smoking Cessation ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Community Mental Health Services ◽  
Evidence Based ◽  
Persistent Mental Illness ◽  
Tobacco Treatment

Introduction: Individuals with severe and persistent mental illnesses have a greater prevalence of smoking than the general population and are disproportionately affected by tobacco-related morbidity and mortality. Evidence-based tobacco treatment can aid such populations in their efforts at smoking cessation. Few studies have examined the effectiveness of tobacco treatment programmes within Mental Health and Addictions Services in Canada.Aims: This study examines outcomes from an evidence-based tobacco treatment programme provided within community mental health services in Vancouver, Canada.Methods: A retrospective chart review was conducted of 134 participants (from June 2010 to February 2012). Information on demographics, tobacco use and cessation history, substance use history, psychiatric disorder diagnosis, expired carbon monoxide level, and duration of treatment in the programme were obtained. Programme completion and smoking cessation/reduction were examined.Results: Sixty-seven per cent completed the programme. Of those who completed, 26.7% were abstinent at the end-of-treatment and 50% (of those not achieving abstinence) reduced their consumption to at least 50% of their baseline cigarette consumption. Predictors of smoking cessation included having a social support for smoking cessation and lower nicotine dependence at baseline.Conclusions: Evidence-based tobacco treatment within community mental health services is well received by individuals with severe and persistent mental illness. Such treatment can aid in their efforts towards smoking cessation. Future studies may need to assess factors that can enhance the integration of tobacco treatment within mental health services while providing tailored treatment that addresses the unique needs of smokers who have severe and persistent mental illness.

scholarly journals Cannabis and Alcohol Co-Use in a Smoking Cessation Pharmacotherapy Trial for Adolescents and Emerging Adults

2019 ◽  
Vol 22 (8) ◽  
pp. 1374-1382 ◽  
Author(s):  
Erin A McClure ◽  
Nathaniel L Baker ◽  
Caitlyn O Hood ◽  
Rachel L Tomko ◽  
Lindsay M Squeglia ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Smoking Cessation ◽  
Emerging Adults ◽  
Secondary Analysis ◽  
Treatment Strategies ◽  
Cannabis Use ◽  
Daily Diaries ◽  
Tobacco Treatment ◽  
Prior Literature ◽  
The Impact

Abstract Introduction The co-use of cannabis and alcohol among tobacco-using youth is common. Alcohol co-use is associated with worse tobacco cessation outcomes, but results are mixed regarding the impact of cannabis on tobacco outcomes and if co-use leads to increased use of non-treated substances. This secondary analysis from a youth smoking cessation trial aimed to (1) evaluate the impact of cannabis or alcohol co-use on smoking cessation, (2) examine changes in co-use during the trial, and (3) explore secondary effects of varenicline on co-use. Methods The parent study was a 12-week, randomized clinical trial of varenicline for smoking cessation among youth (ages 14–21, N = 157; Mage = 19, 40% female; 76% White). Daily cigarette, cannabis, and alcohol use data were collected via daily diaries during treatment and Timeline Follow-back for 14 weeks post-treatment. Results Baseline cannabis co-users (68%) had double the odds of continued cigarette smoking throughout the trial compared with noncannabis users, which was pronounced in males and frequent cannabis users. Continued smoking during treatment was associated with higher probability of concurrent cannabis use. Baseline alcohol co-users (80%) did not have worse smoking outcomes compared with nonalcohol users, but continued smoking was associated with higher probability of concurrent drinking. Varenicline did not affect co-use. Conclusions Inconsistent with prior literature, results showed that alcohol co-users did not differ in smoking cessation, whereas cannabis co-users had poorer cessation outcomes. Youth tobacco treatment would benefit from added focus on substance co-use, particularly cannabis, but may need to be tailored appropriately to promote cessation. Implications Among youth cigarette smokers enrolled in a pharmacotherapy evaluation clinical trial, alcohol and/or cannabis co-use was prevalent. The co-use of cannabis affected smoking cessation outcomes, but more so for males and frequent cannabis users, whereas alcohol co-use did not affect smoking cessation. Reductions in smoking were accompanied by concurrent reductions in alcohol or cannabis use. Substance co-use does not appear to affect all youth smokers in the same manner and treatment strategies may need to be tailored appropriately for those with lower odds of smoking cessation.

1442Implementation and outcomes of systematic approaches to tobacco treatment: the Ottawa Model for Smoking Cessation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Coja ◽  
K A Mullen ◽  
A L Pipe ◽  
R D Reid
Keyword(s):  
Primary Care ◽  
Smoking Cessation ◽  
Smoking Status ◽  
Evidence Based ◽  
Quit Attempt ◽  
Healthcare Settings ◽  
Tobacco Treatment ◽  
Quit Rate ◽  
Quitting Smoking

Abstract Background/Introduction Tobacco use is a major risk factor for the leading chronic diseases, is a leading cause of preventable death worldwide, and is a large cost driver of healthcare spending. Quitting smoking is the single most effective thing a patient can do to improve their health. The Ottawa Model for Smoking Cessation (OMSC) is a systematic, comprehensive approach to clinical tobacco dependence treatment. It provides support to healthcare settings in establishing a high quality tobacco treatment protocol and addressing common barriers to ensure optimal delivery of evidence-based smoking cessation interventions. Purpose The OMSC assists healthcare professionals to transform clinical practices through knowledge translation, implementation support, and quality evaluation. It promotes the delivery of evidence-based interventions to a greater number of smokers using a systematic approach, ultimately increasing cessation rates. The OMSC assists providers to identify smoking status, provide strategic advice to quit, support patients in making a quit attempt, and provide follow-up support. Methods OMSC Outreach Facilitators work with healthcare setting to assist with implementing evidence-based smoking cessation interventions. This is guided by an OMSC workplan which covers planning, implementing, evaluating and sustainability. Pre and post implementation along with program-level data is collected and used to determine rates of smoking status documentation, brief advice to stop smoking, delivery of cessation support and patient quit rates. Results The OMSC program has worked with approximately 450 healthcare settings, trained over 20,000 healthcare professionals, and supported approximately 500,000 patients with quitting smoking. Of those not ready to quit, 45% of patients seen in primary care were supported in reducing the amount they smoke. For OMSC hospital and specialty care patients receiving follow-up support, the six month responder-quit rate was 48%. For OMSC primary care patients, the two month responder-quit rate was 57%. Patients who had previously been supported by their OMSC primary care practice but had not presented to their provider in at least 6 months were contacted to assess their smoking status. Of those reached, 44% were smoke-free. Of those who relapsed, 53% indicated they would be willing to make another quit attempt, 37% of which went back to their healthcare provider to try again. Conclusion The OMSC has shown to be a simple, systematic step-by-step approach to addressing tobacco use in healthcare settings. It provides a way to create clinical efficiencies while increasing the rates at which evidence-based smoking cessation interventions are being delivered to patients, which leads to more patients making further quit attempts. The OMSC continues to expand across Canada and internationally in hopes of creating a wider smoking cessation network to support more patients with quitting smoking. Acknowledgement/Funding Ontario Ministry of Health and Long-Term Care

Post creation strategies in a smoking cessation intervention based on motivational interviewing using Facebook: a mixed-methods content analysis (Preprint)

2019 ◽  
Author(s):  
David Pócs ◽  
Tímea Óvári ◽  
Csaba Hamvai ◽  
Oguz Kelemen
Keyword(s):  
Smoking Cessation ◽  
Motivational Interviewing ◽  
Tobacco Use ◽  
Negative Feedback ◽  
Smoking Cessation Intervention ◽  
Control Group ◽  
Tobacco Use Cessation ◽  
Web Based ◽  
Cessation Intervention ◽  
Significant Difference

BACKGROUND Smoking cessation support on Facebook (FB) is a cost-effective and extensible way to reduce tobacco use among young people. Motivational interviewing (MI) is a practical counselling style in face-to-face smoking cessation support and can be useful in web-based interventions as well. OBJECTIVE This study aimed at identifying which post creation strategies based on MI could achieve positive changes in FB post characteristics and FB users’ comments. METHODS We included MI-adherent posts (N=701) which were not boosted and were targeted at tobacco users. These FB posts have been categorized into five different groups according to specific MI strategies. The control group comprised entertaining and informative posts. Primary outcomes seem to highlight how the content has stimulated interactions (engagement rate), inhibited interactions (negative feedback) or appealed to the audience of the FB page (fan-total reach ratio). The first comments received on the FB posts were evaluated and used as secondary outcomes. We applied the classification of MI approach: change talk (CT), sustain talk (ST), desire, ability, reason, need (DARN), and commitment, activation, taking steps (CAT). RESULTS FB posts which used MI strategies were associated with significantly higher engagement rate (p=.010), higher fan-total reach ratio (p<.001), and more CT (p<.001), DARN (p=.005), or CAT comments (p=.003) compared to the control group. ‘Elaborating CT’ strategies elicited considerably more CT (p<.001) and DARN comments (p=.020). ‘Affirming CT’ strategies obtained higher fan-total reach ratio (p=.011) and generated significantly more CT (p=.006) and CAT comments (p<.001). ‘Reflecting CT’ strategies received significantly higher fan-total reach ratio (p<.001). Finally, ‘relational MI’ strategies achieved significantly higher engagement rate (p<.001) compared to the control group. It should be noted that we did not find significant difference in negative feedback and the number of ST comments. CONCLUSIONS Post creation strategies based on MI stimulated interactions with FB users and generated conversation about tobacco use cessation without relevant negative feedback. Our findings suggest that MI strategies may play a remarkable role in post creation within a web-based smoking cessation intervention. In the future, these strategies could be applicable to other online platforms, such as public health websites, health blogs, mobile applications or social networking groups.

Has the SARS-CoV-2 outbreak had an impact on uptake of digital cessation support in UK smokers? An interrupted time series analysis (Preprint)

2020 ◽  
Author(s):  
Olga Perski ◽  
Aleksandra Herbec ◽  
Lion Shahab ◽  
Jamie Brown
Keyword(s):  
Time Series ◽  
Smoking Cessation ◽  
Secondary Analysis ◽  
Interrupted Time Series ◽  
Step Change ◽  
Outcome Variable ◽  
Primary Analysis ◽  
Increasing Trend ◽  
The Uk ◽  
Temporary Closure

BACKGROUND The SARS-CoV-2 outbreak may motivate smokers to attempt to stop in greater numbers. However, given the temporary closure of UK stop smoking services and vape shops, smokers attempting to quit may instead seek out digital support, such as websites and smartphone apps. OBJECTIVE We examined, using an interrupted time series approach, whether the SARS-CoV-2 outbreak has been associated with a step change or increasing trend in UK downloads of an otherwise popular smoking cessation app, Smoke Free. METHODS Data were from daily and non-daily adult smokers in the UK who had downloaded the Smoke Free app between 1 January 2020 and 31 March 2020 (primary analysis) and 1 January 2019 and 31 March 2020 (secondary analysis). The outcome variable was the number of downloads aggregated at the 12-hourly (primary analysis) or daily level (secondary analysis). The explanatory variable was the start of the SARS-CoV-2 outbreak, operationalised as 1 March 2020 (primary analysis) and 15 January 2020 (secondary analysis). Generalised Additive Mixed Models adjusted for relevant covariates were fitted. RESULTS Data were collected on 45,105 (primary analysis) and 119,881 (secondary analysis) users. In both analyses, there was no evidence for a step change or increasing trend in downloads attributable to the start of the SARS-CoV-2 outbreak. CONCLUSIONS In the UK, between 1 January 2020 and 31 March 2020, and between 1 January 2019 and 31 March 2020, there was no evidence that the SARS-CoV-2 outbreak has been associated with a surge in downloads of a popular smoking cessation app. CLINICALTRIAL osf.io/zan2s

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