Effectiveness of a Large, Nation-Wide Smoking Abstinence Campaign in the Netherlands: A Longitudinal Study

From 2014, the 28-day smoking abstinence campaign ‘Stoptober’ is held in the Netherlands. Each year, more than 50,000 people participate in what has become a nation-wide collective cessation attempt. This study aims to determine the short-term effects of ‘Stoptober’ on participants’ smoking behavior and behavioral determinants. Stoptober participants completed online surveys before the start of the campaign (n = 6856) and three months later (n = 1127). Descriptive statistics and t-tests were performed to determine changes in smoking and behavioral determinants. Logistic regression analyses were used to identify differences between subgroups. After three months, 71.8% of respondents had quit smoking and consumption was reduced among sustained smokers. Cessation rates were similar for subgroups by age, sex and educational level. Cessation was positively associated with confidence and self-efficacy at baseline and negatively associated with past year quit attempts and addiction level at baseline. For quitters, we found favorable changes in attitude towards cessation related stress, social norms, social pressure to smoke, self-efficacy to quit, smoking habit strength and smoker identity. For sustained smokers, we found favorable changes in attitude towards cessation related stress, self-efficacy and smoking habit strength. These results suggest that an abstinence campaign with a wide reach in a national population may be effective in decreasing smoking prevalence and cigarette consumption among a broad range of participants.

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Perceived Pain and Smoking Interrelations and Expectancies Are Associated With Pain and Smoking Cessation in Individuals With Mobility Impairments

Nicotine & Tobacco Research ◽

10.1093/ntr/ntz111 ◽

2019 ◽

Cited By ~ 2

Author(s):

Romano Endrighi ◽

Nicolle Rueras ◽

Shira I Dunsiger ◽

Belinda Borrelli

Keyword(s):

Chronic Pain ◽

Smoking Cessation ◽

Self Efficacy ◽

Smoking Behavior ◽

Lower Probability ◽

Smoking Abstinence ◽

Cross Sectional ◽

Mobility Impairments ◽

Quit Smoking ◽

Perceived Pain

Abstract Introduction Smoking and pain are highly prevalent among individuals with mobility impairments (MIs; use assistive devices to ambulate). The role of pain-related smoking motives and expectancies in smoking cessation is unknown. We examined cross-sectional and prospective associations between a novel measure of pain-related smoking motives (how smokers with pain perceive their pain and smoking to be interrelated) and pain and smoking behavior in smokers with MI. Methods This is a secondary data analysis of a smoking cessation induction trial (N = 263; 55% female) in smokers with MI. Participants did not have to want to quit to enroll. Pain-related smoking motives and expectancies were assessed at baseline with the pain and smoking inventory (PSI) which measures perceived pain and smoking interrelations in three distinct but related domains (smoking to cope with pain, pain as a motivator of smoking and as a barrier to cessation). Other measures included pain occurrence and interference, nicotine dependence, motivation and self-efficacy to quit smoking, and number of cigarettes per day. Biochemically verified smoking abstinence was assessed at 6 months. Results PSI scores were significantly higher among smokers with chronic pain occurrence compared to occasional and to no occurrence (p < .002) and were associated with greater pain interference (ps < .01) and lower self-efficacy to quit smoking (ps < .01). In prospective analyses adjusted for age, treatment group, and chronic pain, only expectancies of smoking to help cope with pain predicted lower odds of abstinence. Conclusions Targeting expectancies of smoking as a mechanism to cope with pain may be useful in increasing smoking cessation in pain populations. Implications Individuals with MI have a high prevalence of smoking and pain, yet the extent to which this population perceives pain and smoking to be interrelated is unknown. This is the first article to examine prospective associations between a novel measure of perceived pain and smoking interrelations (PSI) and smoking outcomes. The PSI was associated with greater pain and lower self-efficacy for quitting. Prospectively, the PSI subscale tapping into expectancies that smoking help coping with pain predicted a lower probability of smoking abstinence. In smokers with MI, expectancies of smoking as pain-coping mechanism may be an important clinical target.

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Is self-efficacy for smoking abstinence a cause of, or a reflection on, smoking behavior change?

Experimental and Clinical Psychopharmacology ◽

10.1037/a0025482 ◽

2012 ◽

Vol 20 (1) ◽

pp. 56-62 ◽

Cited By ~ 20

Author(s):

Kenneth A. Perkins ◽

Craig Parzynski ◽

Melissa Mercincavage ◽

Cynthia A. Conklin ◽

Carolyn A. Fonte

Keyword(s):

Behavior Change ◽

Self Efficacy ◽

Smoking Behavior ◽

Smoking Abstinence

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Smoking Among Participants in the Childhood Cancer Survivors Cohort: The Partnership for Health Study

Journal of Clinical Oncology ◽

10.1200/jco.2003.06.130 ◽

2003 ◽

Vol 21 (2) ◽

pp. 189-196 ◽

Cited By ~ 70

Author(s):

Karen M. Emmons ◽

Rita M. Butterfield ◽

Elaine Puleo ◽

Elyse R. Park ◽

Ann Mertens ◽

...

Keyword(s):

Smoking Cessation ◽

Cancer Survivors ◽

Childhood Cancer ◽

Self Efficacy ◽

Childhood Cancer Survivors ◽

Smoking Rate ◽

Quit Smoking ◽

Quit Attempts ◽

Smoking Behaviors ◽

Readiness To Quit

Purpose: This article describes baseline data collection and the intervention design of Partnership for Health, a smoking cessation intervention for smokers in the Childhood Cancer Survivors Study. The purpose of this article is to evaluate demographic, psychosocial, and cancer-related factors that are associated with smoking behavior and mediators of smoking cessation. Patients and Methods: This study includes 796 smokers from the Childhood Cancer Survivors Study database who were diagnosed with cancer before the age of 21, had survived at least 5 years, and were at least 18 years of age at the time of the baseline survey. Correlates of smoking behaviors included smoking rate, number of recent quit attempts, and nicotine dependence; two key mediators of smoking cessation, readiness to quit smoking and self-efficacy, were also assessed. Results: Participants smoked, on average, 14 cigarettes/day; 53.2% were nicotine dependent, and 58% had made at least one quit attempt in the past year. Smoking behaviors were primarily associated with demographic variables; mediators of cessation were primarily associated with age at cancer diagnosis and perceived vulnerability to smoking-related illnesses. Severity of psychologic symptoms was associated with increased smoking rate, high nicotine dependence, and low self-efficacy. Support for quitting was related to smoking rate, number of quit attempts, readiness to quit smoking, and self-efficacy. Conclusion: These findings indicate that many cancer survivors who smoke are receptive to smoking cessation interventions. Factors related to mediators of smoking cessation might be particularly good targets for intervention.

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Increasing Quit Attempts by Transitioning to Very Low Nicotine Content Cigarettes Versus Reducing Number of Cigarettes Per Day: A Secondary Analysis of an Exploratory Randomized Trial

Nicotine & Tobacco Research ◽

10.1093/ntr/ntz145 ◽

2019 ◽

Vol 21 (Supplement_1) ◽

pp. S81-S87

Author(s):

Elias M Klemperer ◽

John R Hughes ◽

Peter W Callas

Keyword(s):

Self Efficacy ◽

Secondary Analysis ◽

Smoking Behavior ◽

Intention To Quit ◽

Nicotine Content ◽

Time Interaction ◽

Nicotine Patches ◽

Quit Attempts ◽

Self Reports ◽

Per Se

Abstract Introduction The Food and Drug Administration (FDA) has proposed reducing nicotine with very low nicotine content (VLNC) cigarettes. In contrast, reducing nicotine by reducing number of cigarettes per day (CPD) is common. Our prior findings demonstrate that VLNC cigarettes decreased dependence more and were more acceptable than reducing CPD. This secondary analysis explored which reduction strategy increased quit attempts (QA), self-efficacy, or intention to quit more. Methods This is a secondary analysis of 68 adult daily smokers not ready to quit randomized to smoke VLNC cigarettes versus reduce CPD over 5 weeks. All participants smoked study cigarettes with nicotine yield similar to most commercial cigarettes ad lib for 1 week (baseline). Participants were then randomized to gradually reduce to 70%, 35%, 15%, and 3% of baseline nicotine over 4 weeks by either (1) transitioning to lower nicotine VLNC cigarettes or (2) reducing the number of full nicotine CPD. All participants received nicotine patches to aid reduction. We assessed (1) QAs using nightly and weekly self-reports, (2) Velicer’s Self-Efficacy to Quit measure weekly, and (3) the Intention-to-Quit Ladder nightly. Results More CPD (41%) than VLNC (17%) participants made any QA (odds ratio = 3.4, 95% confidence interval = 1.1, 10.5). There was no difference in QAs ≥24 h. Self-efficacy increased for VLNC but not CPD participants (interaction: F = 3.7, p < .01). The condition by time interaction for intention-to-quit was not significant. Conclusions Reducing number of CPD increased QAs more than reducing nicotine via switching to VLNC cigarettes. The lack of difference in longer QAs suggests replication tests are needed. Implications Reducing the frequency of smoking behavior (ie, CPD) could be a more effective strategy to increase QAs than reducing the magnitude of nicotine in each cigarette (ie, VLNC) per se.

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A New Approach to Teen-age Smoking

PEDIATRICS ◽

10.1542/peds.57.4.465 ◽

1976 ◽

Vol 57 (4) ◽

pp. 465-466

Author(s):

Dale C. Garell ◽

Andrew Guthrie ◽

S. L. Hammar ◽

Felix P. Heald ◽

Adele D. Hofmann ◽

...

Keyword(s):

Smoking Habit ◽

Smoking Behavior ◽

Age Group ◽

New Approach ◽

Noticeable Increase ◽

Family Patterns ◽

Department Of Health ◽

Quit Smoking ◽

Per Capita ◽

Older Siblings

In January 1964, the Surgeon General's office released its report demonstrating the strong potential relationship between cigarette smoking and lung cancer as well as the pulmonary and cardiovascular diseases which afflict thousands each year.1 Since that time, an estimated 30 million Americans have quit smoking; but, during the last two years, there has been a noticeable increase in per capita cigarette consumption among women and teen-age girls.2 Every day 3,200 adolescents between the ages of 12 and 18 take up smoking (exclusive of those who are just experimenting with smoking, the 10- to 12-year-olds).3 The Bureau of Census estimates that the number of teen-agers smoking rose from 3 million to approximately 4 million between 1968 and 1972. The proportion of smokers in the 12 to 18 age group increased from 14.7% to 15.7% among boys and 8.4% to 13.3% among girls.4 Analysis of research by the Department of Health, Education, and Welfare on teen-age populations indicates there are many environmental factors that affect the initiation of the smoking habit; however, by far the strongest influence is the smoking behavior of parents and siblings.5 If both parents smoke, the teen-ager has about twice the likelihood of being a smoker than if neither parent smokes (the rates are 18.4% to 9.8% respectively). If an older brother or sister smokes, the teen-ager is twice as likely to become a smoker himself.5 When the combined effect of smoking of parents and older siblings is considered, the concept of family patterns is reinforced. The lowest level of smoking is found among teen-agers who live in nonsmoking households.

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Smoking-Related Stigma: A Public Health Tool or a Damaging Force?

Nicotine & Tobacco Research ◽

10.1093/ntr/nty151 ◽

2018 ◽

Vol 22 (1) ◽

pp. 96-103 ◽

Cited By ~ 3

Author(s):

Paula Lozano ◽

James F Thrasher ◽

Melinda Forthofer ◽

James Hardin ◽

Luz Myriam Reynales Shigematsu ◽

...

Keyword(s):

Smoking Cessation ◽

Tobacco Control ◽

Smoking Behavior ◽

Control Policy ◽

Quit Attempt ◽

Quit Smoking ◽

Tobacco Control Policies ◽

Quit Attempts ◽

Lower Likelihood ◽

Related Stigma

Abstract Background Tobacco control policies and other denormalization strategies may reduce tobacco use by stigmatizing smoking. This raises an important question: Does perceived smoking-related stigma contribute to a smoker’s decision to quit? The aim of this study was to evaluate if perceived smoking-related stigma was associated with smoking cessation outcomes among smokers in Mexico and Uruguay. Methods We analyzed prospective data from a panel of adult smokers who participated in the 2008–2012 administrations of the International Tobacco Control Policy Evaluation Surveys in Mexico and Uruguay. We defined two analytic samples of participants: the quit behavior sample (n = 3896 Mexico; n = 1525 Uruguay) and the relapse sample (n = 596 Mexico). Generalized estimating equations were used to evaluate if different aspects of perceived stigma (ie, discomfort, marginalization, and negative stereotype) at baseline were associated with smoking cessation outcomes at follow-up. Results We found that perceived smoking-related stigma was associated with a higher likelihood of making a quit attempt in Uruguay but with a lower likelihood of successful quitting in Mexico. Conclusions This study suggests that perceived smoking-related stigma may be associated with more quit attempts, but less successful quitting among smokers. It is possible that once stigma is internalized by smokers, it may function as a damaging force. Future studies should evaluate the influence of internalized stigma on smoking behavior. Implications Although perceived smoking-related stigma may prompt smokers to quit smoking, smoking stigma may also serve as a damaging force for some individuals, making quitting more difficult. This study found that perceived smoking-related stigma was associated with a higher likelihood of making a quit attempt in Uruguay but with a lower likelihood of successful quitting in Mexico.

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Behavioral and Subjective Effects of Reducing Nicotine in Cigarettes: A Cessation Commentary

Nicotine & Tobacco Research ◽

10.1093/ntr/ntz100 ◽

2019 ◽

Vol 21 (Supplement_1) ◽

pp. S19-S21 ◽

Cited By ~ 2

Author(s):

Megan E Piper ◽

David J Drobes ◽

Natalie Walker

Keyword(s):

Subjective Effects ◽

Smoking Behavior ◽

Limited Evidence ◽

Moderate Evidence ◽

Quit Attempt ◽

Quit Smoking ◽

Quit Attempts ◽

Motivation To Quit ◽

Cigarette Dependence ◽

The Impact

Abstract This commentary addresses critical questions regarding the impact of the reduction of nicotine on changes in smoking behavior. There appears to be moderate evidence that use of reduced nicotine cigarettes (RNC) increases the likelihood of making a quit attempt among smokers unmotivated to quit and among smokers motivated to quit who also used nicotine replacement therapy (NRT). There was limited evidence that RNC combined with NRT increased smoking abstinence, regardless of motivation to quit. Several plausible mechanisms via which RNC may influence smoking behavior, including reducing dependence, are reviewed. The moderate evidence that abrupt reduction in nicotine reduces self-reported dependence as well as smoking behavior and likelihood of relapse is also reviewed. The data reviewed here suggest that abrupt switching to, and extended use of, RNC can reduce cigarette dependence and several related constructs, including the ability to quit smoking. The data reviewed in this commentary suggest that abrupt reduction in the level of nicotine in combustible cigarettes could reduce smoking behavior, nicotine dependence, and other related constructs and increase quit attempts and eventual smoking cessation.

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Parents' Self-efficacy for Tobacco Exposure Protection and Smoking Abstinence Mediate Treatment Effects on Child Cotinine at 12-Month Follow-up: Mediation Results from the Kids Safe and Smokefree Trial

Nicotine & Tobacco Research ◽

10.1093/ntr/ntz175 ◽

2019 ◽

Vol 22 (11) ◽

pp. 1981-1988

Author(s):

Bradley N Collins ◽

Stephen J Lepore ◽

Jonathan P Winickoff ◽

David W Sosnowski

Keyword(s):

Behavior Change ◽

Tobacco Smoke ◽

Low Income ◽

Self Efficacy ◽

Disease Burden ◽

Underserved Populations ◽

Smoking Behavior ◽

Evidence Based ◽

Smoking Abstinence ◽

Behavioral Mechanisms

Abstract Introduction Compared with the general smoking population, low-income smokers face elevated challenges to success in evidence-based smoking cessation treatment. Moreover, their children bear increased disease burden. Understanding behavioral mechanisms related to successful reduction of child tobacco smoke exposure (TSE) could inform future smoking interventions in vulnerable, underserved populations. Methods Smoking parents were recruited from pediatric clinics in low-income communities and randomized into a multilevel intervention including a pediatric clinic intervention framed in best clinical practice guidelines (“Ask, Advise, Refer” [AAR]) plus individualized telephone counseling (AAR + counseling), or AAR + control. Mediation analysis included treatment condition (independent variable), 12-month child cotinine (TSE biomarker, criterion), and four mediators: 3-month end-of-treatment self-efficacy to protect children from TSE and smoking urge coping skills, and 12-month perceived program (intra-treatment) support and bioverified smoking abstinence. Analyses controlled for baseline nicotine dependence, depressive symptoms, child age, and presence of other residential smokers. Results Participants (n = 327) included 83% women and 83% African Americans. Multilevel AAR + counseling was associated with significantly higher levels of all four mediators (ps < .05). Baseline nicotine dependence (p < .05), 3-month self-efficacy (p < .05) and 12-month bioverified smoking abstinence (p < .001) related significantly to 12-month child cotinine outcome. The indirect effects of AAR + counseling intervention on cotinine via self-efficacy for child TSE protection and smoking abstinence (ps < .05) suggested mediation through these pathways. Conclusions Compared with AAR + control, multilevel AAR + counseling improved all putative mediators. Findings suggest that fostering TSE protection self-efficacy during intervention and encouraging parental smoking abstinence may be key to promoting long-term child TSE-reduction in populations of smokers with elevated challenges to quitting smoking. Implications Pediatric harm reduction interventions to protect children of smokers from tobacco smoke have emerged to address tobacco-related health disparities in underserved populations. Low-income smokers experience greater tobacco-related disease burden and more difficulty with smoking behavior change in standard evidence-based interventions than the general population of smokers. Therefore, improving knowledge about putative behavioral mechanisms of smoking behavior change that results in lower child exposure risk could inform future intervention improvements.

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Prevalence and determinants of smoking behavior among male school adolescents in Saudi Arabia

International Journal of Adolescent Medicine and Health ◽

10.1515/ijamh-2017-0180 ◽

2018 ◽

Vol 32 (4) ◽

Cited By ~ 5

Author(s):

Ali Saad R. Alsubaie

Keyword(s):

Saudi Arabia ◽

Smoking Habit ◽

Smoking Behavior ◽

Public Health Problem ◽

Binary Logistic Regression ◽

Cross Sectional Study ◽

Considerable Proportion ◽

Cross Sectional ◽

Adolescent Students ◽

Quit Smoking

AbstractObjectiveSmoking and tobacco use is a growing public health problem, with often begins in adolescence. This study aims to estimate the prevalence of smoking behavior and the associated determinants among adolescents.MethodsA cross-sectional study was conducted using a self-administered questionnaire with 453 male adolescent students in Riyadh, the capital of Saudi Arabia. Descriptive and binary logistic regression analyses were performed to aggregate the findings and examine associations.ResultsThe prevalence of smoking was 24.3% among adolescents. The main predictors of smoking behavior were found to be age (OR = 1.6; 95% CI: 1.3–2.0; p < 0.001), studying in private schools (OR = 1.4; 95% CI: 1.2–1.5; p < 0.001), having friends who smoke (OR = 13.9; 95% CI: 6.6–29.9; p < 0.001), smoking parent (OR = 18.1; 95% CI: 8.8–37.1; p < 0.001), perceived poor health (OR = 2.9; 95% CI: 1.9–3.9; p = 0.041) and perceived dissatisfaction with life (OR = 4.1; 95% CI: 1.33–13.3; p = 0.017). Smokers were more likely to believe that it is difficult to quit smoking (OR = 3.0; 95% CI: 1.6–5.5; p < 0.001). The top reasons for smoking were having smoker friends (78.2%), family neglect (45.5%), having smoker parents (41.8%), family problems (37.3%), enjoyment, and having smoker relatives.ConclusionThis study concluded that a considerable proportion of adolescents are smokers. Adolescents with a smoking habit report poorer health and lower life satisfaction than non-smokers. Several personal and social factors were identified as important determinants for smoking.

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Association of smoking behavior among Chinese expectant fathers and smoking abstinence after their partner becomes pregnant: A cross-sectional study

10.21203/rs.3.rs-22493/v2 ◽

2020 ◽

Author(s):

Wei Xia ◽

William Ho Cheung Li ◽

Wenzhi Cai ◽

Peige Song ◽

Laurie Long Kwan Ho ◽

...

Keyword(s):

Smoking Cessation ◽

Smoking Behavior ◽

Health Hazards ◽

Smoking Abstinence ◽

Lasso Regression ◽

Cross Sectional Survey ◽

Multivariable Logistic Regression Model ◽

Cross Sectional ◽

Quit Smoking ◽

Expectant Fathers

Abstract Background: Exposure to secondhand smoke (SHS) during pregnancy can cause pregnancy complications and adverse birth outcomes. About 40% of Chinese expectant fathers are smokers and they rarely attempt to quit smoking. There is a paucity of effective smoking cessation services targeting this population. In this study, we assessed the smoking behavior of Chinese expectant fathers and examined its association with smoking abstinence after their partner became pregnant, which is an essential prerequisite for designing effective smoking cessation interventions.Methods: We conducted a cross-sectional survey in the obstetrics and gynecology clinic of three tertiary hospitals in China. Expectant fathers who smoked at least one cigarette per day for 1 month within the past 12 months were invited to participate in this study. The participants were asked to complete a structured questionnaire that assessed their smoking behaviors before and after their partner became pregnant. Results: From December 2017 to March 2018, we recruited a total of 466 eligible expectant fathers, among whom 323 (69.3%) were identified as current smokers and 143 (30.7%) were ex-smokers. Using lasso regression, 19 features were selected from among 27 independent variables. The results of the selected multivariable logistic regression model showed that knowledge about the health hazards of smoking among smokers (odds ratio (OR) 1.39; 95% confidence interval (CI) 1.24 to 1.58; p<0.001), knowledge about the health hazards of SHS to pregnant women (OR 1.46; 95% CI 1.09 to 1.97; p<0.001), knowledge about harm to the fetus and newborn (OR 1.58; 95% CI 1.25 to 2.03; p<0.001), and being a first-time expectant father (OR 2.08; 95% CI 1.02 to 3.85; p=0.046) were significantly positively associated with smoking abstinence among expectant fathers after their partner became pregnant. Significantly negative associations were found for severe dysfunctionality in terms of family support (OR 0.48; 95% CI 0.24 to 0.95; p=0.036) and smoking only outside the home (OR 0.81; 95% CI 0.26 to 0.98; p<0.001). Conclusions: In this study, we identified several factors associated with smoking abstinence among expectant fathers after their partner became pregnant. These findings can guide the development of effective interventions targeting expectant fathers, to help them quit smoking.

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