Very brief advice in smoking cessation

2021 ◽  
Author(s):  
Team DFTB
2021 ◽  
pp. jech-2020-216219
Author(s):  
Francisco Martin-Lujan ◽  
Josep Basora-Gallisa ◽  
Felipe Villalobos ◽  
Nuria Martin-Vergara ◽  
Estefania Aparicio-Llopis ◽  
...  

ObjectiveThis 12-month study in a primary healthcare network aimed to assess the effectiveness of usual smoking cessation advice compared with personalised information about the spirometry results.DesignRandomised, parallel, controlled, multicentre clinical trial.SettingThis study involved 12 primary healthcare centres (Tarragona, Spain).ParticipantsActive smokers aged 35–70 years, without known respiratory disease. Each participant received brief smoking cessation advice along with a spirometry assessment. Participants with normal results were randomised to the intervention group (IG), including detailed spirometry information at baseline and 6-month follow-up or control group (CG), which was simply informed that their spirometry values were within normal parameters.Main outcomeProlonged abstinence (12 months) validated by expired-CO testing.ResultsSpirometry was normal in 571 patients in 571 patients (45.9% male), 286 allocated to IG and 285 to CG. Baseline characteristics were comparable between the groups. Mean age was 49.8 (SD ±7.78) years and mean cumulative smoking exposure was 29.2 (±18.7) pack-years. Prolonged abstinence was 5.6% (16/286) in the IG, compared with 2.1% (6/285) in the CG (p=0.03); the cumulative abstinence curve was favourable in the IG (HR 1.98; 95% CI 1.29 to 3.04).ConclusionsIn active smokers without known respiratory disease, brief advice plus detailed spirometry information doubled prolonged abstinence rates, compared with brief advice alone, in 12-month follow-up, suggesting a more effective intervention to achieve smoking cessation in primary healthcare.Trial registration numberNCT01194596.


2020 ◽  
Vol 30 (1) ◽  
Author(s):  
Onno C. P. van Schayck ◽  
Lynn Bindels ◽  
Ancka Nijs ◽  
Bo van Engelen ◽  
Adrienne van den Bosch ◽  
...  

Abstract Although tobacco smoking is the world’s most important preventable cause of many chronic diseases (including COPD and asthma) and premature death, many physicians do not routinely apply smoking cessation in the daily health care of their patients. Two widely felt important concerns of physicians are that smoking cessation as part of a treatment is time-consuming and may jeopardize their relationship with patients. Very Brief Advice (VBA) is a non-confrontational method, which could assist general practitioners (GPs) as a simple, quick first step in getting patients to stop smoking. In this study, we investigated the opinions and experiences of GPs with VBA in their routine care in two rounds of telephone interviews with 19 GPs. The interviews were recorded and transcribed and subsequently analysed with NVivo12. We observed that the GPs had a very positive experience with using VBA. They found the method to be efficient as to the time involved, patient-friendly and easy to implement.


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.


Author(s):  
Sofia Belo Ravara ◽  
Dongbo Fu ◽  
Charlotta Pisinger ◽  
Vinayak M Prasad ◽  
Rosa Sandoval ◽  
...  

2020 ◽  
Vol 8 (E) ◽  
pp. 28-36
Author(s):  
Dragan Gjorgjievski ◽  
Radmila Ristovska ◽  
Katarina Stavrikj ◽  
Amanda Farley ◽  
Peymane Adab ◽  
...  

INTRODUCTION: In 2015, smoking prevalence in Republic of Macedonia was 36% in men and 21% in women We aim to assess the effectiveness and cost-effectiveness of two methods of motivating smokers to quit smoking compared with very brief advice (VBA) alone. Тo date, there are no studies investigating smoking cessation treatment in Republic of Macedonia. METHODS/DESIGN: RCT with process evaluation and cost-effectiveness analysis within 31 general practices in Republic of Macedonia recruiting smokers currently smoking >10 cigarettes per day, aged >35 years, attending primary care practices for any reason, regardless of motivation to quit smoking. Respondents will be randomized into one of three groups: (1) VBA and assessment and communication of lung age; (2) VBA and additional assessment and communication of exhaled carbon monoxide (CO) levels; or (3) control group – VBA. All participants who attempt to quit smoking will be offered behavioral support based on the UK standard program for smoking cessation. Primary outcome: Proportion of smokers who are quit at 4 weeks (7-day point prevalence, confirmed by salivary cotinine level). Secondary outcomes: Proportion who have attempted to quit smoking or have quit smoking, a proportion that has reduced the number of cigarettes and motivation to quit smoking; cost-effectiveness analysis calculating cost per quality-adjusted life year. We will evaluate the fidelity to the intervention and will explore patients’ and GPs’ experience and the acceptability of the study intervention by interview. DISCUSSION: The study will evaluate the effectiveness of combining feedback about lung age or exhaled CO levels with VBA and support for smoking cessation in primary care compared to giving VBA and support alone. It will explore how willing primary care physicians are to perform such interventions and the acceptability and effectiveness of such interventions to patients in Republic of Macedonia. TRIAL REGISTRATION: The study is registered on the ISRCTN registry (ISRCTN54228638).


2020 ◽  
Author(s):  

UNSTRUCTURED Tuberculosis and tobacco smoking are two largely preventable public health concerns that independently pose a considerable threat to global health. The current estimates put the annual global mortality from the two epidemics at over six million. It is remarkable to note that TB and tobacco use are co-prevalent in many developing nations and these are said to be overburdened by the collision of the two epidemics. This study aims to determine the effectiveness of nicotine replacement therapy on smoking cessation among the pulmonary tuberculosis patients undergoing Directly Observed Therapy- Short Course. This is a randomized, placebo-controlled, two-arm, single blinded trial being conducted in Mangaluru, India. The total sample size including both the arms is 300. This study will be conducted between January 2019 and August 2020. Extra-pulmonary TB, smokeless tobacco users, patients with contraindications for NRT such as recent MI, angina pregnancy & lactation will be excluded from the study.Block Randomization will be done to obtain the two groups using a permuted The experimental group will be given nicotine replacement therapy and brief advice and the control group will be given brief advice and sugar-free chewing gum as a placebo for 3 months on a tapering dosage basis. The smoking status of the patients will be confirmed by urine cotinine test at the baseline and endline. Carbon monoxide monitoring and Fagerstom score will be recorded on a monthly basis.The participants will be followed for another 3 months to obtain a binary variable of smoking cessation status as "Quitter" or Non-quitter". The study also determines the TB outcome between tobacco quitters and non-quitters. Ethical clearance is obtained from the Institutional Ethics Committee of Nitte (deemed to be University) and the trial is registered with Clinical Trials Registry of India.


BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S311-S311
Author(s):  
Katie Blissard Barnes ◽  
Richard Westmoreland

AimsTo assess level of compliance with national and local guidance with regards to the recording of service users smoking status and offering of interventions.BackgroundAcross the general population, prevalence of smoking is decreasing but in those with severe mental illness, the prevalence hasn't significantly changed. LYPFT are working towards becoming a smoke-free trust. The Trust Guidance expects that Trusts should ask 100% of service users if they smoke (which should be recorded on their physical health CQUIN) and of those that do, should be offered nicotine replacement therapy and cessation advice. Public Health England is working towards all hospital trusts across the UK being Smoke-free.MethodAll service users on each of the 4 adult inpatient wards at the Becklin Centre, Leeds, were included in the audit. A total of 78 service users were included in the audit.We reviewed the digital records for every service user, specifically looking at the physical health CQUIN. We recorded if smoking status had been documented and what interventions (if any) had been recorded as given. Possible interventions included offering brief advice and offering Nicotine replacement therapy. We then reviewed medication charts to see if any nicotine replacement therapy had been prescribed.ResultThe audit found that approximately half of all service users in our audit smoked cigarettes and that the vast majority of these had their smoking status documented in their digital medical records.Three quarters of those that smoked were offered brief cessation advice and half of them were offered Nicotine Replacement Therapy. Only a third of service users that smoked had NRT prescribed on their medication chart. This represented 65% of those recorded as being offered NRT.ConclusionThere are numerous possible reasons for the above outcomes. These include a lack of knowledge and confidence in delivering smoking cessation interventions, conversations having taken place but not recorded and confusion regarding the appropriate staff member to deliver the intervention. In addition, whilst only medical professionals typically prescribe NRT, the physical health CQUIN is recorded by nurses. Therefore, this may reflect a lack of communication between staff groups.Our trust will become smoke free in the near future. To facilitate this, we hope to reduce the discrepancy between the number of service users who smoke and the number prescribed NRT.


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