“STOP the PUFF! Tayo’y mag bagong BAGA, SIGARILYO ay ITIGIL”: A Pilot Community-based Tobacco Intervention Project in an Urban Settlement

The success rate for smoking cessation in the country remain low despite the intensified efforts of the government to curb smoking. There is a need to support tobacco control policies with clinical interventions for smoking cessation. However, cessation experts in the country are few and healthcare workers with training on tobacco interventions are limited. The project aimed to address the clinical aspect of tobacco control by establishing tobacco cessation services in the community. This was done by providing brief tobacco intervention training among health workers and community leaders, thus allowing this intervention to be integrated in the existing programs of the community health center. This also led to the creation of possible referral mechanisms to cessation support providers. This was complemented with health education activities that promote smoke-free behavior. Keywords: tobacco; cigarette smoking; tobacco dependence; smoking cessation; brief advice; brief tobacco intervention​​​​​

Assessment of smoking susceptibility among Hanoi highschool-student and some related factors, 2019

Nowadays, the smoking rate among adolescents in Vietnam is still high regardless of many regulations have been implemented. One of the predictors for smoking behaviour in adolescents is smoking susceptibility. This study aimed to describe the rate of students smoking susceptibility and some associated factors. Method: This cross-sectional study was conducted to assess students from 14 randomly selected high schools in five districts in Hanoi. The questionnaire was developed based on “Youth Risk Behavior Surveillance System” (YRBSS) tool. Results: There were 3272 students completed the survey. 4.9% (95% CI: 4.2 – 5.8%) of the students were susceptible to smoking. In the urban areas, this rate was 7.7% and in the suburban areas was 3.4%. While being male (OR=2.79, 95% CI: 2.29 – 3.41), being 16-17 years old (OR=1.25, 95% CI: 1.01 – 1.56), studying in urban areas (OR=1.41, 95% CI: 1.15 – 1.74) and seeing other people smoke, including family members (OR=1.39, 95% CI: 1.14 – 1.70), teachers (OR=1.8, 95% CI: 1.23 – 2.63), friends (OR=2.33, 95% CI: 1.88 – 2.89), and school staffs (OR=1.63, 95% CI: 1.17 – 2.26) smoking was associated to susceptibility to smoking behavior, attending anti-tobacco course (OR=1.31, 95% CI: 1.06 – 1.62) or seeing anti-tobacco messages (OR=1,28, 95% CI: 1,005 – 1,63) reduced the likelihood of smoking susceptibility. Conclusion: Thus, it is necessary to initiate anti-tobacco intervention programs and implement more extreme regulations to reduce susceptibility to smoking rates in adolescents and diminish smoking prevalence in adolescents. Keywords: Susceptibility, smoking, adolescent, high-school, Ha Noi

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

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.

Effectiveness of ongoing face-to-face anti-tobacco intervention in children with asthma

Background: Interventions to help parents quit smoking may yield important benefits for children with asthma. Children’s exposure to environmental tobacco smoke can be measured by reporting of an adult in the household and testing the child’s biomarker, e.g., cotinine. Objective: The aim of the study was to assess the effectiveness of “face-to-face” intervention carried out since 2016 in families with children diagnosed with asthma 3 years after beginning the anti-tobacco intervention. Methods: This study was a follow-up to an interventional study that assessed the effectiveness of direct patient education versus educational leaflets alone about parental tobacco smoking. The patients with asthma (ages 4‐17 years) enrolled in our original intervention study conducted in 2016 were under the care of the allergy outpatient clinic. The active group was individually educated about the harmful effects of environmental tobacco smoke on their children. The control group included patients and parents, among whom only leaflets were distributed. After 3 years of ongoing intervention, in patients from both groups, exposure to tobacco smoking was evaluated with a questionnaire addressed to parents and/or caregivers and measurement of cotinine in children’s urine. The forced expiratory volume in the first second of expiration and fractional exhaled nitric oxide levels were measured. Results: Seventy participants completed the study: 37 in the active group and 33 in the control group. In the active group, 27% of the parents quit smoking entirely compared with 9.4% of parents in the control group. In the group of active intervention, a significant decrease in the cotinine level (p < 0 .001) and the number of cigarettes smoked daily were observed (p < 0.001) 3 years after the active intervention compared with values right after the intervention. In the control group, there were no significant changes in the above-mentioned parameters. Conclusion: “Face-to-face” intervention among families with smokers were effective and lowered cotinine levels in children with asthma and the number of cigarettes smoked assessed 3 years after the intervention.

Evaluating the Effects of a Brief Tobacco Intervention in the US Air Force

Introduction Military personnel have among the highest rates of tobacco use in the United States. Unfortunately, there are few interventions aimed at reducing tobacco use among this vulnerable population. The current study addresses this need by evaluating the short-term effectiveness of a Brief Tobacco Intervention (BTI), a 40-min group-based intervention designed to reduce contemporary patterns of tobacco use among a sample of US military enlistees during an 11-week period of involuntary tobacco abstinence. Aims and Methods Participants were 2999 US Air Force Technical Trainees at Joint Base San Antonio-Lackland Air Force Base in San Antonio, Texas from April 2017 through January 2018. Participants were cluster randomized to three conditions: (1) BTI + Airman’s Guide to Remaining Tobacco Free (AG), (2) AG intervention, or (3) standard smoking cessation intervention. The primary analysis was a comparison of the interventions’ efficacies in preventing tobacco use during Technical Training, conducted using a generalized estimating equations logistic regression model controlling for covariates. Multiple imputation was used to account for loss to follow-up. Results There was not a significant difference by condition in the use of tobacco products at follow-up (p = .454). The BTI + AG condition did produce short-term changes in perceived harm, intentions to use tobacco, knowledge about tobacco products, and normative beliefs. Conclusions These findings suggest that while the intervention was effective in the short term, it was not potent enough over a 12-week period to prevent Airmen from initiating tobacco use. Future studies should examine whether adding a booster session or media campaign enhances the effectiveness of the intervention. Implications Despite the fact that most Airmen believe they will remain tobacco free following the ban in Technical Training, a large percentage of these Airmen resume and initiate tobacco use during this high-risk period. As a result, there is a need for interventions targeting the range of tobacco available to military trainees during a teachable moment when they report intentions to remain tobacco free. The current study shows that a BTI has promise in reducing long-term tobacco use, when coupled with additional interventions, such as a booster session or a media campaign.

ASSOCIATIONS BETWEEN SMOKING CONSUMPTION, TOBACCO CESSATION ATTITUDES, AND AGE AMONG LATINO HEALTHCARE PROVIDERS

Hospitalization is a good opportunity to offer smoking cessation programs to smokers. Healthcare providers′ (HCP) tobacco consumption and cessation attitudes are known to affect the provision of cessation interventions. Lesser known are Latino HCP’s tobacco intervention attitudes. This study aimed to examine the associations between tobacco cessation attitudes (TCA), levels of consumption, and demographics among Latino HCP’s. A quantitative, correlational, cross-sectional design was used. 66 HCP’s working in a public hospital in Santiago, Chile self-reported demographics (age, gender, profession), tobacco consumption, and TCA. TCA’s include questions regarding Acceptability of Brief Counseling (ABC), belief whether smoking is harmful for patients, and duty to aid patients quit smoking. Majority of HCP’s (34 years old, 83% female, 58.5% technical nurses, 38.5% nurses, 3.1% Kinesiologists) did not consume tobacco (67%). Pearson’s correlation revealed that greater HCP age was significantly associated with less belief that smoking is harmful for their patients (r = -.36, p. = .004). ABC (M = 22, SD = 5.5) was positively associated with the belief that smoking is harmful for patients (r = .306, p = .016) and duty to help patients quit smoking (r = .574, p = .000). Findings provide evidence that HCP’s TCA’s are important factors to consider during implementation of a brief counseling for tobacco cessation. Further research should focus on increasing HCP’s acceptability of providing cessation care to their patients. Specifically, tailoring education and interventions by age might serve useful to address the differences in TCA’s which may subsequently influence their tobacco cessation practices.

Design and Validation of an Instrument to Evaluate the Learning Acquired by Nursing Students from a Brief Tobacco Intervention (BTI-St©)

The aim of this study was to design and validate an instrument, based on the WHO 5As+5Rs model, to test the acquisition by nursing students of a brief tobacco intervention (BTI) learning. A validation design of an instrument following the criterion referenced tests model using videos of simulated BTIs in the primary care setting was carried out. The study included 11 experts in smoking prevention/care and 260 second-year nursing students. The study was in two stages: (1) selection and recording of clinical simulations (settings), and (2) test construction. Content was validated by applying the Delphi consensus technique and calculating the Content Validity Ratio (CVR) and Content Validity Index (CVI). A pilot test was conducted for item analysis. Reliability was evaluated as internal consistency (Kuder-Richardson [KR-20]) and test-retest temporal stability (intraclass correlation coefficient [ICC]). Three simulation settings were recorded. An instrument (BTI-St®) was developed with 23 items for dichotomous (yes/no) response. CVR was >70% for all items, KR-20 of 0.81–0.88, and ICC between 0.68 and0.73 (p < 0.0001). The BTI-St® is a robust and reliable instrument that is easily and rapidly applied. It follows the WHO 5As+5Rs model and offers objective criterion-referenced evaluation of BTI learning in nursing students.