A systematic review and narrative summary of couple-based smoking cessation interventions

Background: Smoking is formed and reinforced in social networks. Smoking interventions have incorporated social networks, especially partners, to promote smoking cessation. This review provides a synthesized review on the effectiveness of couple-based smoking cessation interventions. Methods: A systematic review of peer-reviewed studies of experimental, couple-based smoking cessation interventions, published in English, was conducted. Database searching of CINAHL, PubMed, and SCOPUS and citation review resulted in 2170 articles for reviews. Abstract and initial review screening excluded 2,126, leaving 44 for full-text review. Further exclusions based on type of intervention and reported outcomes left a total of 11 studies to be included in the analysis. Results: Two major outcomes were reported among the 11 studies: long-term quit rates (≥6 months post-intervention) and aspects of the couple’s relationship (e.g., satisfaction, adjustment, and partner support). Only two studies showed significant differences in long-term quit rates compared to control groups. Five studies reported outcomes of couples’ relationships, yet none of the five promoted partner support in the intervention, which may have limited the effectiveness of couple-based interventions. One study observed higher levels of partner support among quitters than continued smokers. A large heterogeneity of target populations was also observed. Conclusions: Current literature does not support the effectiveness of couple-based smoking interventions. Future studies need to re-evaluate the role of partners and partner support to facilitate effective partner support and increase the likelihood of success in smoking cessation among smoker couples. Limitations of the current literature and suggestions for future research are discussed.

Tobacco

Tobacco is the most important and avoidable public health problem, killing 5.4 million users per year. At least one in two and up to two in three smokers die prematurely from smoking. Such great and easily understood risks should be more effectively communicated to promote smoking cessation. This chapter describes how raising tobacco tax, banning smoking in public places, and forbidding tobacco advertising, promotion, and sponsorship have effectively reduced smoking rates in many countries. However, many low- and middle-income countries still lack the necessary resources or political will to implement tobacco control. Further progress may come from large and effective pictorial warnings; banning the display of tobacco products at retail outlets; extending smoking bans in public places; innovative use of the mass media; very brief warnings by doctors to promote cessation; telephone quitlines; and capitalizing on the risk perception towards third-hand smoke.

The Acceptability and Effectiveness of Videos Promoting Smoking Cessation Among Australians Experiencing Mental Illness

There are high rates of tobacco smoking among people who experience mental illness (MI). While videos are an effective method of disseminating health-related information, there is limited research investigating the effectiveness of video-delivered education promoting smoking cessation among people living with MI. This formative study aimed to investigate the effectiveness and acceptability of targeted video resources providing smoking cessation information and advice to smokers with MI. This study used a mixed-method design; 29 Australian smokers living with MI completed a preinterview survey including 12 questions assessing knowledge about smoking cessation, watched six videos developed by the research team providing information about smoking cessation, took part in semistructured interviews about the videos’ quality, content, and format, and then completed a postinterview survey identical to the preinterview survey to assess changes in smoking cessation-related knowledge. A Wilcoxon signed rank test was used to calculate changes in cessation-related knowledge, and thematic analysis was used to identify common themes in qualitative data. We found a statistically significant increase in participants’ smoking cessation-related knowledge scores after watching the videos. Participants indicated an overall high level of acceptability of the videos’ quality, content, and format, and findings from the semistructured interviews reflected these favorable views. This study’s findings provide a new understanding of the effectiveness and acceptability of customized video-based education to promote smoking cessation among people living with MI, and can be used to inform the content and focus of video resources aimed at increasing knowledge about smoking cessation for people experiencing MI.

An Open Trial of Metacognitive Remediation Therapy and Pharmacotherapy to Promote Smoking Cessation among Individuals with Psychotic-Spectrum Disorders

Introduction. Individuals with psychotic-spectrum disorders may smoke due to the ameliorating effect of nicotine on the cognitive deficits that accompany these illnesses. Metacognitive remediation therapy (MCR) has been shown to produce improvements in cognitive functioning among individuals with psychotic-spectrum disorders and provides a foundation for a novel smoking cessation intervention for this population. Aims. To complete an open investigation of pharmacotherapy and a modified version of MCR [MCR to Quit (MCR-Q)] in promoting smoking cessation among individuals with psychotic-spectrum disorders. Methods. Forty-nine individuals with a psychotic-spectrum disorder and who currently smoke cigarettes participated in MCR-Q while also receiving evidence-based smoking cessation pharmacotherapy. Tobacco use was assessed as follows: (i) prior to MCR-Q, (ii) immediately after completing MCR-Q, and (iii) six weeks after completion of MCR-Q. Results/Findings. During participation in MCR-Q, nearly 80% of participants made a 24-hour quit attempt. Following the completion of MCR-Q, participants experienced reductions in level of nicotine dependency and exhaled carbon monoxide, with reductions in nicotine dependency sustained six weeks after completion of MCR-Q. Over the course of their participation in MCR-Q, participants reported strong therapeutic alliance with their MCR-Q therapist and high levels of intrinsic motivation with regard to completing MCR-Q exercises. Conclusions. The results from the current study suggest cautious optimism with regard to the use of MCR-Q in combination with medication for individuals with psychotic-spectrum disorders who want to quit smoking.

I Keep Looking at What I’m Doing to My Organs: Samoans’ Responses to Adapted Anti-Tobacco Television Advertisements

There has been an increase of adapted tobacco control media campaigns in low- and middle-income countries. Adapting existing material offers many benefits especially to countries with limited resources. We adapted 3 television advertisements for the Tu’u Nei Loa Le Ulaula Tapa’a (Stop Smoking Now) campaign in Samoa. Adaption included rigorous efforts to ensure advertisements were culturally appropriate. To determine audiences’ perception of anti-tobacco television advertisements to promote smoking cessation, we conducted 8 talanoa, a Pacific Islands research methodology, among 54 smokers and nonsmokers in Apia, Samoa. The talanoa were transcribed, translated, and thematically coded. Results suggest that the advertisements raised awareness on the negative health impacts of tobacco use, especially to the internal organs. Graphic and emotionally evocative advertisements, especially those that have an impact on the family, have greater potential to motivate Samoans to quit.

Family Support and Readiness to Consider Smoking Cessation among Chinese and Vietnamese American Male Smokers

Introduction. Smoking prevalence is disproportionately high among Asian American immigrant men with limited English proficiency. Understanding the role of family support may provide insights into culturally acceptable strategies to promote smoking cessation. Aims. This study examined how family support was associated with readiness to consider smoking cessation among Chinese and Vietnamese American male daily smokers. Methods. We analyzed baseline data ( N = 340 ) from a cluster randomized trial of a family-based healthy lifestyle intervention. We assessed the frequency of receiving family support in various forms (encouraging use of cessation resources, praising efforts, checking in, and reminding of familial role). Multiple regression analysis was used to determine associations between family support areas and readiness to consider smoking cessation, controlling for covariates. Results/Findings. Reporting a higher frequency of receiving praise and encouragement for one’s efforts to quit was positively associated with readiness to consider cessation. Other areas of family support were not significant. Conclusions. These findings provide evidence to explore specific areas of family support in enhancing Asian American smokers’ readiness to consider cessation. As there is high interest from Asian American family members to support their smokers for quitting, culturally specific and acceptable strategies are needed to promote smoking cessation among Asian Americans.

Evaluating Cigarette Pack Insert Messages with Tips to Quit

Objectives: Canada is the only country that currently uses cigarette pack inserts to communicate health messages to smokers, including tips to quit. Messages about strategies for quitting smoking are also central to the US Food and Drug Administration's (FDA) Every Try Counts (ETC) campaign. This study assessed US smokers' responses to Canadian and ETC-based messages formatted for pack inserts. Methods: US adult smokers (N = 524) were recruited from an online consumer panel and rated 8 insert messages: 4 based on Canadian inserts and 4 based on ETC. Participants randomly viewed each message accompanied by an image of either a person or a symbolic representation of the topic. Participants rated the perceived effectiveness (PE) of each message. Paired t-tests were used to assess mean differences in PE across topics, image types, and quit intentions. Results: ETC messages were consistently rated as more effective than Canadian messages regardless of quit intentions. Image types did not significantly influence PE. Conclusions: Messages from ETC are perceived as more effective than messages used in Canada. The FDA has the authority to communicate with smokers through inserts and should consider adopting inserts to promote smoking cessation.