Encouraging smokers to quit smoking tobacco using e-cigarettes could substantially reduce smoking-related diseases. Vape shops therefore have the potential to play an important role in supporting smoking cessation. The aim of this study was to explore how to deliver a vape shop-based smoking cessation intervention in the United Kingdom. Semi-structured telephone interviews were undertaken with four stakeholder groups: 20 stop smoking service (SSS) providers, seven tobacco control leads (TCL), seven smokers/vapers and five vape shop staff). Interviews were analysed thematically. Stakeholder groups were positive about the idea of delivering a vape shop-based intervention. Themes that were identified were the characteristics of the intervention (duration and timing; delivery; style and content; and product provisions); barriers to the intervention (challenges for new vapers; false information; tobacco company involvement; and conflicts of interest); facilitators to the intervention (positive views on vaping; cost-effectiveness; popularity; and accessibility); and considerations for the intervention (data protection and privacy; aesthetics; and regulation and management). The results suggest that the intervention should be delivered by vape shop workers with mandatory training with the support of SSS. Most stakeholders agreed quitting vaping was not a priority, but that information on how to reduce nicotine use should be given. Concerns around privacy, GDPR, misinformation about vaping and tobacco company involvement would need to be addressed. Stakeholders agree that vape shops should offer stop smoking interventions and hold similar opinions on how this should be delivered. This study suggests that smokers, vapers and other key stakeholders are positive about the idea of a stop smoking vape-shop based intervention and that they hold similar opinions on how this should be delivered. Most participants felt that this should be primarily delivered by trained vape shop staff and run with support from SSS. Participants agreed that a stop smoking vape shop-based intervention should be flexible in terms of the type, duration and frequency of support provided, and that the intervention should comprise both technical guidance on using a vape and behavioural support to prevent a return to smoking.
{"title":"How should a vape shop-based smoking cessation intervention be delivered? A qualitative study","authors":"Tessa Langley, Emily Young, Abby Hunter, Manpreet Bains","doi":"10.1093/ntr/ntad236","DOIUrl":"https://doi.org/10.1093/ntr/ntad236","url":null,"abstract":"\u0000 \u0000 \u0000 Encouraging smokers to quit smoking tobacco using e-cigarettes could substantially reduce smoking-related diseases. Vape shops therefore have the potential to play an important role in supporting smoking cessation. The aim of this study was to explore how to deliver a vape shop-based smoking cessation intervention in the United Kingdom.\u0000 \u0000 \u0000 \u0000 Semi-structured telephone interviews were undertaken with four stakeholder groups: 20 stop smoking service (SSS) providers, seven tobacco control leads (TCL), seven smokers/vapers and five vape shop staff). Interviews were analysed thematically.\u0000 \u0000 \u0000 \u0000 Stakeholder groups were positive about the idea of delivering a vape shop-based intervention. Themes that were identified were the characteristics of the intervention (duration and timing; delivery; style and content; and product provisions); barriers to the intervention (challenges for new vapers; false information; tobacco company involvement; and conflicts of interest); facilitators to the intervention (positive views on vaping; cost-effectiveness; popularity; and accessibility); and considerations for the intervention (data protection and privacy; aesthetics; and regulation and management). The results suggest that the intervention should be delivered by vape shop workers with mandatory training with the support of SSS. Most stakeholders agreed quitting vaping was not a priority, but that information on how to reduce nicotine use should be given. Concerns around privacy, GDPR, misinformation about vaping and tobacco company involvement would need to be addressed.\u0000 \u0000 \u0000 \u0000 Stakeholders agree that vape shops should offer stop smoking interventions and hold similar opinions on how this should be delivered.\u0000 \u0000 \u0000 \u0000 This study suggests that smokers, vapers and other key stakeholders are positive about the idea of a stop smoking vape-shop based intervention and that they hold similar opinions on how this should be delivered. Most participants felt that this should be primarily delivered by trained vape shop staff and run with support from SSS. Participants agreed that a stop smoking vape shop-based intervention should be flexible in terms of the type, duration and frequency of support provided, and that the intervention should comprise both technical guidance on using a vape and behavioural support to prevent a return to smoking.\u0000","PeriodicalId":19355,"journal":{"name":"Nicotine and Tobacco Research","volume":"20 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138585059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Judy A Andrews, Judith S. Gordon, Erika Westling, David Smith
Given the rapid increase in the prevalence of e-cigarette use among youth, we updated Click City®: Tobacco, an existing, efficacious, online tobacco prevention program for 5th graders with a 6th-grade booster, to also target e-cigarette use. To evaluate the effectiveness of the updated 5th-grade program within a “real world” setting, we conducted a pragmatic randomized trial with 5th grade students in 43 schools across Arizona and Oregon, assessing change in intentions and willingness to use e-cigarettes/cigarettes, from baseline to one-week post-intervention. Students in intervention schools (n = 1327) received the updated version of Click City®: Tobacco; students in control schools (n = 1346) received their usual tobacco prevention curriculum. Students in intervention schools significantly decreased their intentions and willingness to use e-cigarettes and cigarettes, compared to students in control schools. The intervention also significantly changed all targeted etiological mechanisms predictive of intentions and willingness. The intervention was more effective for at-risk students, as defined by student’s previous tobacco use, current family use of tobacco, and/or high in sensation-seeking. The effects of the intervention on all outcomes were similar as a function of state, gender, ethnicity, and historical timing (prior to COVID-19 pandemic school closures vs. after schools re-opened). Close to 90% of the students in the intervention condition completed the entire program, supporting fidelity of implementation, and teachers reported satisfaction with the program. Findings suggest that Click City®: Tobacco is effective for all 5th grade students and can be delivered with fidelity across school settings. The results of a randomized pragmatic effectiveness trial showed that the updated Click City®: Tobacco program decreased intentions and willingness to both vape e-cigarettes and smoke cigarettes among 5th grade students, particularly for those at high risk. Program effectiveness and lack of differences due to factors such as state, gender, ethnicity, and historical timing has universal implications, suggesting that all students can benefit from this program. Click City®: Tobacco received high ratings of program satisfaction from teachers and was implemented with fidelity. Findings suggest that Click City®: Tobacco is effective and can be easily implemented in schools.
{"title":"Assessing the Pragmatic Effectiveness and Implementation of Click City®: Tobacco:A School-Based Prevention Program Targeting Youth Cigarette and E-cigarette Use","authors":"Judy A Andrews, Judith S. Gordon, Erika Westling, David Smith","doi":"10.1093/ntr/ntad244","DOIUrl":"https://doi.org/10.1093/ntr/ntad244","url":null,"abstract":"\u0000 \u0000 \u0000 Given the rapid increase in the prevalence of e-cigarette use among youth, we updated Click City®: Tobacco, an existing, efficacious, online tobacco prevention program for 5th graders with a 6th-grade booster, to also target e-cigarette use.\u0000 \u0000 \u0000 \u0000 To evaluate the effectiveness of the updated 5th-grade program within a “real world” setting, we conducted a pragmatic randomized trial with 5th grade students in 43 schools across Arizona and Oregon, assessing change in intentions and willingness to use e-cigarettes/cigarettes, from baseline to one-week post-intervention. Students in intervention schools (n = 1327) received the updated version of Click City®: Tobacco; students in control schools (n = 1346) received their usual tobacco prevention curriculum.\u0000 \u0000 \u0000 \u0000 Students in intervention schools significantly decreased their intentions and willingness to use e-cigarettes and cigarettes, compared to students in control schools. The intervention also significantly changed all targeted etiological mechanisms predictive of intentions and willingness. The intervention was more effective for at-risk students, as defined by student’s previous tobacco use, current family use of tobacco, and/or high in sensation-seeking. The effects of the intervention on all outcomes were similar as a function of state, gender, ethnicity, and historical timing (prior to COVID-19 pandemic school closures vs. after schools re-opened). Close to 90% of the students in the intervention condition completed the entire program, supporting fidelity of implementation, and teachers reported satisfaction with the program.\u0000 \u0000 \u0000 \u0000 Findings suggest that Click City®: Tobacco is effective for all 5th grade students and can be delivered with fidelity across school settings.\u0000 \u0000 \u0000 \u0000 The results of a randomized pragmatic effectiveness trial showed that the updated Click City®: Tobacco program decreased intentions and willingness to both vape e-cigarettes and smoke cigarettes among 5th grade students, particularly for those at high risk. Program effectiveness and lack of differences due to factors such as state, gender, ethnicity, and historical timing has universal implications, suggesting that all students can benefit from this program. Click City®: Tobacco received high ratings of program satisfaction from teachers and was implemented with fidelity. Findings suggest that Click City®: Tobacco is effective and can be easily implemented in schools.\u0000","PeriodicalId":19355,"journal":{"name":"Nicotine and Tobacco Research","volume":"9 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138585826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yingning Wang, H. Sung, Tingting Yao, J. Lightwood, W. Max
Introduction The proportion of smokers who do not smoke daily has increased over time, but nondaily smokers are a heterogeneous group. We compare characteristics and other tobacco product use of infrequent nondaily, frequent nondaily, and daily US adult smokers. Methods We analyzed data from the 1998, 2000, 2005, and 2010 National Health Interview Surveys. Current smokers were categorized as daily, infrequent nondaily (smoked 1-12 days in the past 30 days), and frequent nondaily (smoked 13-29 days in the past 30 days) smokers. Multinomial logistic regression analysis was used to analyze the correlates of infrequent nondaily, frequent nondaily, and daily smoking. Results Among current smokers, 8.3% were infrequent nondaily, 8.1% were frequent nondaily, and 83.6% were daily smokers. The prevalence of infrequent versus daily smoking increased over time, with a smaller increase among non-Hispanic Blacks than non-Hispanic Whites. The adjusted odds of both infrequent and frequent smoking versus daily smoking differed by age, race/ethnicity, education, poverty status, marital status, region, quit attempts in the past 12 months, and binge drinking. Snuff users (vs. non-snuff users) were 2.4 times as likely to be infrequent than daily smokers. There were also differences in race/ethnicity, education, marital status, region, quit attempts, and snuff use between infrequent versus frequent smokers. Conclusion Infrequent smokers differ from both frequent and daily smokers in socio-demographics, quit attempts, and snuff use. The heterogeneity of nondaily smokers should be considered in developing targeted tobacco control and smoking cessation programs. Implications Infrequent and frequent nondaily smokers were found to differ from daily smokers in age, race/ethnicity, education, poverty status, marital status, region, and quit attempts and they were different from each other in race/ethnicity, education, marital status, region, and quit attempts. Binge drinkers were more likely to be infrequent smokers and frequent smokers versus daily smokers. Current snuff users were found to have increased odds of infrequent smoking versus daily smoking and versus frequent smoking. These results highlight the importance of acknowledging the differences among nondaily smokers in smoking frequency in developing targeted tobacco control and smoking cessation programs.
{"title":"Infrequent and Frequent Nondaily Smokers and Daily Smokers: Their Characteristics and Other Tobacco Use Patterns","authors":"Yingning Wang, H. Sung, Tingting Yao, J. Lightwood, W. Max","doi":"10.1093/ntr/ntx038","DOIUrl":"https://doi.org/10.1093/ntr/ntx038","url":null,"abstract":"Introduction\u0000The proportion of smokers who do not smoke daily has increased over time, but nondaily smokers are a heterogeneous group. We compare characteristics and other tobacco product use of infrequent nondaily, frequent nondaily, and daily US adult smokers.\u0000\u0000\u0000Methods\u0000We analyzed data from the 1998, 2000, 2005, and 2010 National Health Interview Surveys. Current smokers were categorized as daily, infrequent nondaily (smoked 1-12 days in the past 30 days), and frequent nondaily (smoked 13-29 days in the past 30 days) smokers. Multinomial logistic regression analysis was used to analyze the correlates of infrequent nondaily, frequent nondaily, and daily smoking.\u0000\u0000\u0000Results\u0000Among current smokers, 8.3% were infrequent nondaily, 8.1% were frequent nondaily, and 83.6% were daily smokers. The prevalence of infrequent versus daily smoking increased over time, with a smaller increase among non-Hispanic Blacks than non-Hispanic Whites. The adjusted odds of both infrequent and frequent smoking versus daily smoking differed by age, race/ethnicity, education, poverty status, marital status, region, quit attempts in the past 12 months, and binge drinking. Snuff users (vs. non-snuff users) were 2.4 times as likely to be infrequent than daily smokers. There were also differences in race/ethnicity, education, marital status, region, quit attempts, and snuff use between infrequent versus frequent smokers.\u0000\u0000\u0000Conclusion\u0000Infrequent smokers differ from both frequent and daily smokers in socio-demographics, quit attempts, and snuff use. The heterogeneity of nondaily smokers should be considered in developing targeted tobacco control and smoking cessation programs.\u0000\u0000\u0000Implications\u0000Infrequent and frequent nondaily smokers were found to differ from daily smokers in age, race/ethnicity, education, poverty status, marital status, region, and quit attempts and they were different from each other in race/ethnicity, education, marital status, region, and quit attempts. Binge drinkers were more likely to be infrequent smokers and frequent smokers versus daily smokers. Current snuff users were found to have increased odds of infrequent smoking versus daily smoking and versus frequent smoking. These results highlight the importance of acknowledging the differences among nondaily smokers in smoking frequency in developing targeted tobacco control and smoking cessation programs.","PeriodicalId":19355,"journal":{"name":"Nicotine and Tobacco Research","volume":"61 1","pages":"741–748"},"PeriodicalIF":0.0,"publicationDate":"2018-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84214948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christine M. Daley, S. Daley, Christina M. Pacheco, T. E. Smith, Myrietta Talawyma, C. McCloskey, W. Choi, N. Nazir, Melissa K Filippi, Dona McKinney, Jordyn A. Gunville, K. Greiner
Introduction Prevalence of cigarette smoking is highest among American Indians, yet few culturally appropriate smoking cessation programs have yet been developed and tested for multi-tribal American Indian adult populations. This study examined implementation of the All Nations Breath of Life culturally tailored smoking cessation program in multi-tribal urban and suburban American Indian communities in seven locations across five states (N = 312). Methods This single-arm study used community-based participatory research to conduct a 12-week intervention whose primary purpose was to curb commercial tobacco use among American Indians. Participants were followed through month 6 in person and month 12 via telephone. The primary outcome was continuous abstinence from recreational cigarette smoking at 6 months post-baseline, verified through voluntary provision of salivary cotinine levels. Results At program completion (12 weeks post-baseline), 53.3% of program completers remained abstinent; labeling those lost to follow-up as smokers resulted in a 41.4% quit rate. At 6 months post-baseline (primary endpoint), 31.1% of retained participants quit smoking (p < .0001 compared to the highest quit rates among multi-tribal populations reported in the literature, 7%); final quit rate was 22.1% labeling those lost to follow-up as smokers (p = .002). Retention rate at endpoint was 71.2%. 12-month follow-up was attempted with all participants and had a retention rate of 49.0%. Of those participants reached, 34.0% were smoke-free. Conclusions All Nations Breath of Life shows promise as a smoking cessation program for multi-tribal urban American Indian communities. It can be successfully implemented in a variety of urban settings. Implications This is the first large feasibility study of a culturally tailored smoking cessation program for American Indians with good cessation and retention rates in a multi-tribal urban American Indian population. It shows that All Nations Breath of Life can be implemented in multiple urban settings across five states. To our knowledge, this is the first program of its kind to be implemented across multiple heterogeneous urban locations and to include salivary cotinine testing for verification of self-report data across these locations.
{"title":"Feasibility of Implementing the All Nations Breath of Life Culturally Tailored Smoking Cessation Program for American Indians in Multi-Tribal Urban Communities","authors":"Christine M. Daley, S. Daley, Christina M. Pacheco, T. E. Smith, Myrietta Talawyma, C. McCloskey, W. Choi, N. Nazir, Melissa K Filippi, Dona McKinney, Jordyn A. Gunville, K. Greiner","doi":"10.1093/ntr/ntx030","DOIUrl":"https://doi.org/10.1093/ntr/ntx030","url":null,"abstract":"Introduction\u0000Prevalence of cigarette smoking is highest among American Indians, yet few culturally appropriate smoking cessation programs have yet been developed and tested for multi-tribal American Indian adult populations. This study examined implementation of the All Nations Breath of Life culturally tailored smoking cessation program in multi-tribal urban and suburban American Indian communities in seven locations across five states (N = 312).\u0000\u0000\u0000Methods\u0000This single-arm study used community-based participatory research to conduct a 12-week intervention whose primary purpose was to curb commercial tobacco use among American Indians. Participants were followed through month 6 in person and month 12 via telephone. The primary outcome was continuous abstinence from recreational cigarette smoking at 6 months post-baseline, verified through voluntary provision of salivary cotinine levels.\u0000\u0000\u0000Results\u0000At program completion (12 weeks post-baseline), 53.3% of program completers remained abstinent; labeling those lost to follow-up as smokers resulted in a 41.4% quit rate. At 6 months post-baseline (primary endpoint), 31.1% of retained participants quit smoking (p < .0001 compared to the highest quit rates among multi-tribal populations reported in the literature, 7%); final quit rate was 22.1% labeling those lost to follow-up as smokers (p = .002). Retention rate at endpoint was 71.2%. 12-month follow-up was attempted with all participants and had a retention rate of 49.0%. Of those participants reached, 34.0% were smoke-free.\u0000\u0000\u0000Conclusions\u0000All Nations Breath of Life shows promise as a smoking cessation program for multi-tribal urban American Indian communities. It can be successfully implemented in a variety of urban settings.\u0000\u0000\u0000Implications\u0000This is the first large feasibility study of a culturally tailored smoking cessation program for American Indians with good cessation and retention rates in a multi-tribal urban American Indian population. It shows that All Nations Breath of Life can be implemented in multiple urban settings across five states. To our knowledge, this is the first program of its kind to be implemented across multiple heterogeneous urban locations and to include salivary cotinine testing for verification of self-report data across these locations.","PeriodicalId":19355,"journal":{"name":"Nicotine and Tobacco Research","volume":"15 1","pages":"552–560"},"PeriodicalIF":0.0,"publicationDate":"2018-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81968938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. E. El Hajj, A. Awaisu, R. Saleh, Noora Mohammed Al Hamad, N. Kheir, R. Zeenny, Ahmed Ibrahim Fathelrahman
Background Lack of adequate tobacco-related content in pharmacy curricula can interfere with pharmacist's ability to provide tobacco cessation interventions. This study aims to determine the extent of tobacco-related content in pharmacy schools' curricula across the Middle East region, instructional methods used, perceived adequacy and importance of tobacco education, and barriers for inclusion of tobacco-related content in pharmacy curricula. Methods A web-based survey was sent to 120 schools of pharmacy in 13 Middle Eastern countries. Key faculty members were identified and sent an e-mail with an online link to the survey. Data were descriptively analyzed using Statistical Package for Social Sciences version 22. Results Of the 120 pharmacy schools contacted, 59 schools completed the survey (49.2% response rate). Of this, 44 (74.6%) reported including tobacco-related content in their undergraduate curricula. Nicotine pharmacology and principles of addiction (64.4%), pharmacologic aids for tobacco cessation (61%), and health effects of tobacco (61%) were the most commonly reported topics. The topics that were least perceived to be adequately covered were monitoring outcomes of tobacco cessation interventions (5.9%) and epidemiology of tobacco use (15.4%). The top barriers to inclusion of tobacco-related topics in the curriculum were lack of time (75.9%), lack of experiential training sites focusing on tobacco cessation interventions (72.2%), lack of faculty expertize (66%), and perceived lack of priority of tobacco related content in pharmacy schools (66%). Conclusions The current findings suggest that more efforts should be geared towards increasing content for tobacco education in schools of pharmacy across the Middle East and towards overcoming the identified barriers. Implications This study is the first to assess the extent of tobacco-related content in pharmacy schools curricula across the Middle East countries. If pharmacy students are expected to deliver effective tobacco cessation services when they graduate as pharmacists, then schools of pharmacy in the Middle East should consider providing adequate tobacco-related content and training in undergraduate curricula. Pharmacy schools have to work on circumventing the identified barriers including lack of time, lack of experiential training sites offering tobacco cessation interventions, shortage of faculty with relevant expertize and placing low priority on tobacco education in pharmacy schools.
{"title":"Tobacco-Related Education in Schools of Pharmacy in the Middle East: A Multinational Cross-Sectional Study","authors":"M. E. El Hajj, A. Awaisu, R. Saleh, Noora Mohammed Al Hamad, N. Kheir, R. Zeenny, Ahmed Ibrahim Fathelrahman","doi":"10.1093/ntr/ntx031","DOIUrl":"https://doi.org/10.1093/ntr/ntx031","url":null,"abstract":"Background\u0000Lack of adequate tobacco-related content in pharmacy curricula can interfere with pharmacist's ability to provide tobacco cessation interventions. This study aims to determine the extent of tobacco-related content in pharmacy schools' curricula across the Middle East region, instructional methods used, perceived adequacy and importance of tobacco education, and barriers for inclusion of tobacco-related content in pharmacy curricula.\u0000\u0000\u0000Methods\u0000A web-based survey was sent to 120 schools of pharmacy in 13 Middle Eastern countries. Key faculty members were identified and sent an e-mail with an online link to the survey. Data were descriptively analyzed using Statistical Package for Social Sciences version 22.\u0000\u0000\u0000Results\u0000Of the 120 pharmacy schools contacted, 59 schools completed the survey (49.2% response rate). Of this, 44 (74.6%) reported including tobacco-related content in their undergraduate curricula. Nicotine pharmacology and principles of addiction (64.4%), pharmacologic aids for tobacco cessation (61%), and health effects of tobacco (61%) were the most commonly reported topics. The topics that were least perceived to be adequately covered were monitoring outcomes of tobacco cessation interventions (5.9%) and epidemiology of tobacco use (15.4%). The top barriers to inclusion of tobacco-related topics in the curriculum were lack of time (75.9%), lack of experiential training sites focusing on tobacco cessation interventions (72.2%), lack of faculty expertize (66%), and perceived lack of priority of tobacco related content in pharmacy schools (66%).\u0000\u0000\u0000Conclusions\u0000The current findings suggest that more efforts should be geared towards increasing content for tobacco education in schools of pharmacy across the Middle East and towards overcoming the identified barriers.\u0000\u0000\u0000Implications\u0000This study is the first to assess the extent of tobacco-related content in pharmacy schools curricula across the Middle East countries. If pharmacy students are expected to deliver effective tobacco cessation services when they graduate as pharmacists, then schools of pharmacy in the Middle East should consider providing adequate tobacco-related content and training in undergraduate curricula. Pharmacy schools have to work on circumventing the identified barriers including lack of time, lack of experiential training sites offering tobacco cessation interventions, shortage of faculty with relevant expertize and placing low priority on tobacco education in pharmacy schools.","PeriodicalId":19355,"journal":{"name":"Nicotine and Tobacco Research","volume":"15 1","pages":"561–567"},"PeriodicalIF":0.0,"publicationDate":"2018-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81968437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. N. McGinty, Delphine M Goulding, Marie J McCarthy, Sandra M Moloney, D. Costello, B. Plant
In Ireland, where the overall prevalence of cigarette smoking is estimated at 19.5%,1 the standard of care for nicotine replacement therapy (NRT) has traditionally been monotherapy in the form of prolonged-release transdermal nicotine patches. In keeping with international evidence-based best practice,2–5 recent guidelines from the Irish Health Service Executive6 advise the use of dual NRT (ie, a nicotine patch combined with an immediaterelease nicotine preparation for relief from breakthrough cravings). The systematic implementation of these guidelines nationally has not yet occurred and it is widely acknowledged that the usual standard of prescribing NRT monotherapy prevails. Although the underlying reasons are not clear, and existing prevalence studies are difficult to compare for methodological reasons, smoking is believed to be more common among people with epilepsy than the general population.7,8 A study in French-speaking Switzerland, for example, found 32.1% of people with epilepsy in a selected cohort were daily smokers, while the prevalence of smoking in the general population in the same region was estimated at 19%.7 Hospitalization is recognized as a potential opportunity for smoking cessation interventions.9 In-patient video-electroencephalography (EEG) monitoring on an epilepsy monitoring unit (EMU) can be performed to distinguish epileptic seizures from seizure mimics, to better characterize epileptic seizures in cases of known epilepsy and as part of the evaluation process prior to respective epilepsy surgery. EMU admission involves continuous recording from scalp electrodes and video cameras for days at a time, with cumulative seizure-provocation measures employed to induce events in a closely observed, controlled and safe environment. All seizure data is highly valuable. Clinical practices vary between EMUs. In order to aid tolerability of the monitoring process, some EMUs permit patients to leave for smoking breaks during their hospital stay. However, this may lead to missed seizures or suboptimal recordings, and can be associated with increased length of EMU stay, as demonstrated by a study of smoking breaks on a Canadian EMU which found that those who smoked had almost four times more missed seizures and stayed on average 1.5 days longer than nonsmokers.10 Some EMUs which accommodate smoking breaks transfer patients temporarily to portable EEG equipment (without video recording) but such EEG traces tend to contain more muscle artifact that can obscure clinically useful information and, in the absence of video, render the captured seizure uninterpretable. Of greatest concern is that leaving the controlled and closely-observed environment of the EMU to smoke in an unsupervised area with multiple potential hazards in the context of drug withdrawal and sleep deprivation—methods routinely used to induce seizures—places patients at increased risk of injury and death.11 Cork University Hospital, a tertiary epilepsy centre in the Rep
{"title":"Clinical Effectiveness of Dual Nicotine Replacement Therapy in Planned Hospital Admissions to an Epilepsy Monitoring Unit: An Irish Perspective","authors":"R. N. McGinty, Delphine M Goulding, Marie J McCarthy, Sandra M Moloney, D. Costello, B. Plant","doi":"10.1093/ntr/ntx029","DOIUrl":"https://doi.org/10.1093/ntr/ntx029","url":null,"abstract":"In Ireland, where the overall prevalence of cigarette smoking is estimated at 19.5%,1 the standard of care for nicotine replacement therapy (NRT) has traditionally been monotherapy in the form of prolonged-release transdermal nicotine patches. In keeping with international evidence-based best practice,2–5 recent guidelines from the Irish Health Service Executive6 advise the use of dual NRT (ie, a nicotine patch combined with an immediaterelease nicotine preparation for relief from breakthrough cravings). The systematic implementation of these guidelines nationally has not yet occurred and it is widely acknowledged that the usual standard of prescribing NRT monotherapy prevails. Although the underlying reasons are not clear, and existing prevalence studies are difficult to compare for methodological reasons, smoking is believed to be more common among people with epilepsy than the general population.7,8 A study in French-speaking Switzerland, for example, found 32.1% of people with epilepsy in a selected cohort were daily smokers, while the prevalence of smoking in the general population in the same region was estimated at 19%.7 Hospitalization is recognized as a potential opportunity for smoking cessation interventions.9 In-patient video-electroencephalography (EEG) monitoring on an epilepsy monitoring unit (EMU) can be performed to distinguish epileptic seizures from seizure mimics, to better characterize epileptic seizures in cases of known epilepsy and as part of the evaluation process prior to respective epilepsy surgery. EMU admission involves continuous recording from scalp electrodes and video cameras for days at a time, with cumulative seizure-provocation measures employed to induce events in a closely observed, controlled and safe environment. All seizure data is highly valuable. Clinical practices vary between EMUs. In order to aid tolerability of the monitoring process, some EMUs permit patients to leave for smoking breaks during their hospital stay. However, this may lead to missed seizures or suboptimal recordings, and can be associated with increased length of EMU stay, as demonstrated by a study of smoking breaks on a Canadian EMU which found that those who smoked had almost four times more missed seizures and stayed on average 1.5 days longer than nonsmokers.10 Some EMUs which accommodate smoking breaks transfer patients temporarily to portable EEG equipment (without video recording) but such EEG traces tend to contain more muscle artifact that can obscure clinically useful information and, in the absence of video, render the captured seizure uninterpretable. Of greatest concern is that leaving the controlled and closely-observed environment of the EMU to smoke in an unsupervised area with multiple potential hazards in the context of drug withdrawal and sleep deprivation—methods routinely used to induce seizures—places patients at increased risk of injury and death.11 Cork University Hospital, a tertiary epilepsy centre in the Rep","PeriodicalId":19355,"journal":{"name":"Nicotine and Tobacco Research","volume":"1 1","pages":"656–658"},"PeriodicalIF":0.0,"publicationDate":"2018-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89599079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Hinds, Xiaoyin Li, A. Loukas, K. Pasch, C. Perry
Introduction This study examined the association of sociodemographic characteristics, tobacco and substance use behaviors, and reasons to use cigars in young adults' flavored and non-flavored cigar use. Methods Participants were 523, 18- to 29- year-old young adult college students (60.4% male; 40.9% non-Hispanic white) who reported current (past 30-day) cigar use. Results Almost 75% of the sample regularly chose flavored cigar products. Multilevel logistic regression analyses indicated that younger, female, and racial/ethnic minority cigar users had significantly greater odds of using flavored cigars than their counterparts. Current marijuana smokers, ever-blunt smokers, and students who reported using cigars because they were affordable and/or available in flavors they liked had a greater odds of flavored cigar use compared to their counterparts. Moreover, among dual users of cigars and cigarettes, those who cited using cigars because they were cheaper than cigarettes and because cigars felt like smoking regular cigarettes had greater odds of using flavored cigars compared to their peers. Number of days cigars were smoked and current use of other tobacco products were not associated with flavored cigar use. Conclusions Appealing attributes of flavored cigars have the potential to contribute to the tobacco use and subsequent nicotine addiction of younger, female, and racial/ethnic minority young adults. The wide variety of cigar flavors, their attractive price, and similarity to cigarette smoking underscore the need for additional research that links these unique traits to sustained tobacco use, and underscore the need for regulation of flavored products. Implications This study extends the current literature by finding that younger, female, and racial/ethnic minorities have greater odds of flavored cigar use than their peers. Flavored cigars have characteristics that appeal to members of these populations, which can contribute to their long-term use and potential for addiction.
{"title":"Flavored Cigars Appeal to Younger, Female, and Racial/Ethnic Minority College Students","authors":"J. Hinds, Xiaoyin Li, A. Loukas, K. Pasch, C. Perry","doi":"10.1093/ntr/ntx041","DOIUrl":"https://doi.org/10.1093/ntr/ntx041","url":null,"abstract":"Introduction\u0000This study examined the association of sociodemographic characteristics, tobacco and substance use behaviors, and reasons to use cigars in young adults' flavored and non-flavored cigar use.\u0000\u0000\u0000Methods\u0000Participants were 523, 18- to 29- year-old young adult college students (60.4% male; 40.9% non-Hispanic white) who reported current (past 30-day) cigar use.\u0000\u0000\u0000Results\u0000Almost 75% of the sample regularly chose flavored cigar products. Multilevel logistic regression analyses indicated that younger, female, and racial/ethnic minority cigar users had significantly greater odds of using flavored cigars than their counterparts. Current marijuana smokers, ever-blunt smokers, and students who reported using cigars because they were affordable and/or available in flavors they liked had a greater odds of flavored cigar use compared to their counterparts. Moreover, among dual users of cigars and cigarettes, those who cited using cigars because they were cheaper than cigarettes and because cigars felt like smoking regular cigarettes had greater odds of using flavored cigars compared to their peers. Number of days cigars were smoked and current use of other tobacco products were not associated with flavored cigar use.\u0000\u0000\u0000Conclusions\u0000Appealing attributes of flavored cigars have the potential to contribute to the tobacco use and subsequent nicotine addiction of younger, female, and racial/ethnic minority young adults. The wide variety of cigar flavors, their attractive price, and similarity to cigarette smoking underscore the need for additional research that links these unique traits to sustained tobacco use, and underscore the need for regulation of flavored products.\u0000\u0000\u0000Implications\u0000This study extends the current literature by finding that younger, female, and racial/ethnic minorities have greater odds of flavored cigar use than their peers. Flavored cigars have characteristics that appeal to members of these populations, which can contribute to their long-term use and potential for addiction.","PeriodicalId":19355,"journal":{"name":"Nicotine and Tobacco Research","volume":"20 1","pages":"347–354"},"PeriodicalIF":0.0,"publicationDate":"2018-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85221280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction China has the world's greatest number of smokers but theory-based smoking interventions are rare. To develop an effective intervention, understanding the determinants of Chinese adolescent smoking is crucial. The Theory of Planned Behavior (TPB) is empirically supported to predict and assist in informing intervention strategies to change health-related behaviors. Based on the TPB, the elicitation of shared smoking beliefs among adolescents can inform future intervention designs among this at-risk population. Methods We investigated the beliefs from six focus groups (N = 30) of one senior secondary school in Kunming, Yunnan Province, China. We used semi-structured questions based on the TPB framework, including prompts about behavioral (advantages and disadvantages), normative (important referents), and control (barriers and facilitators) beliefs. Following the Consensual Qualitative Research (CQR) methodology, data were discussed until consensus was reached. Auditing was undertaken by an external researcher. Results Seven domains (advantages, disadvantages, approvers, disapprovers, facilitators, barriers, and smoker images) were examined. Smoking as a gendered behavior, smoking as influenced by cultural and environmental contexts, smoking as a strategy to cope with stress, and awareness of the harm of smoking, are highlighted themes across domains. Data suggested an extended-TPB framework as an appropriate approach to adopt when addressing smoking beliefs among the target population. Conclusions These beliefs can be utilized to inform future school-based interventions and public health campaigns targeting smoking among Chinese adolescents. Implications A modified TPB approach has potential for future smoking interventions among Chinese adolescents. Beliefs elicited in this study form a strong basis for designing a location- and population-specific antismoking programme.
{"title":"Smoking Beliefs Among Chinese Secondary School Students: A Theory-Based Qualitative Study","authors":"Xiang Zhao, K. White, R. Young, Patricia L. Obst","doi":"10.1093/ntr/ntx012","DOIUrl":"https://doi.org/10.1093/ntr/ntx012","url":null,"abstract":"Introduction\u0000China has the world's greatest number of smokers but theory-based smoking interventions are rare. To develop an effective intervention, understanding the determinants of Chinese adolescent smoking is crucial. The Theory of Planned Behavior (TPB) is empirically supported to predict and assist in informing intervention strategies to change health-related behaviors. Based on the TPB, the elicitation of shared smoking beliefs among adolescents can inform future intervention designs among this at-risk population.\u0000\u0000\u0000Methods\u0000We investigated the beliefs from six focus groups (N = 30) of one senior secondary school in Kunming, Yunnan Province, China. We used semi-structured questions based on the TPB framework, including prompts about behavioral (advantages and disadvantages), normative (important referents), and control (barriers and facilitators) beliefs. Following the Consensual Qualitative Research (CQR) methodology, data were discussed until consensus was reached. Auditing was undertaken by an external researcher.\u0000\u0000\u0000Results\u0000Seven domains (advantages, disadvantages, approvers, disapprovers, facilitators, barriers, and smoker images) were examined. Smoking as a gendered behavior, smoking as influenced by cultural and environmental contexts, smoking as a strategy to cope with stress, and awareness of the harm of smoking, are highlighted themes across domains. Data suggested an extended-TPB framework as an appropriate approach to adopt when addressing smoking beliefs among the target population.\u0000\u0000\u0000Conclusions\u0000These beliefs can be utilized to inform future school-based interventions and public health campaigns targeting smoking among Chinese adolescents.\u0000\u0000\u0000Implications\u0000A modified TPB approach has potential for future smoking interventions among Chinese adolescents. Beliefs elicited in this study form a strong basis for designing a location- and population-specific antismoking programme.","PeriodicalId":19355,"journal":{"name":"Nicotine and Tobacco Research","volume":"90 1","pages":"321–331"},"PeriodicalIF":0.0,"publicationDate":"2018-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83921290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elizabeth Antognoli, David N Cavallo, Erika S. Trapl, Mary M. Step, Sarah Koopman Gonzalez, Rose Perez, S. Flocke
Introduction Cigarillo use is increasing, particularly among young adults. Nicotine dependence (ND) is important for understanding smoking behavior and cessation, but the development of measures of ND has focused almost exclusively on cigarette smokers. We examined smoking patterns, preferences, and beliefs of cigarillo users to better understand their experience of addiction and expression of ND symptoms. Methods Using purposive sampling, we conducted in-depth interviews between June 2015 and January 2016 with 30 young adults aged 18-28 who reported smoking ≥1 cigarillo per week. Interviews were based on a semi-structured guide designed to capture participants' smoking levels and patterns as well as their experiences of smoking and addiction. Interviews were audio-recorded and transcribed. Analysis was guided by a phenomenological approach designed to identify emergent themes. Results Participants had a mean age of 23, with a majority being female (56%) and African American (80%). The median number of cigarillos smoked per week was 20; 70% also smoked cigarettes, and 43% also smoked marijuana blunts. Our analysis highlighted the complexity of measuring cigarillo use due to product manipulation, sharing, and multiple product use. Participants expressed a preference for smoking in a social group where cigarillos were shared, and not smoking an entire cigarillo at once when alone. Most cigarillo users did not consider themselves to be addicted. Conclusions Cigarillo users express unique smoking practices and beliefs that signify the need for a more product-inclusive measure of ND, and can inform the development of tobacco cessation interventions tailored to cigarillo users. Implications The increasing use of cigarillos among young adults has significant public health consequences. Addressing this issue requires accurate measurement and effective treatment of dependence on cigarillo products. The results of this study directly inform the development of a revised measure of ND, and can contribute to the efficacy of cessation interventions for cigarillo users.
{"title":"Understanding Nicotine Dependence and Addiction Among Young Adults Who Smoke Cigarillos: A Qualitative Study","authors":"Elizabeth Antognoli, David N Cavallo, Erika S. Trapl, Mary M. Step, Sarah Koopman Gonzalez, Rose Perez, S. Flocke","doi":"10.1093/ntr/ntx008","DOIUrl":"https://doi.org/10.1093/ntr/ntx008","url":null,"abstract":"Introduction\u0000Cigarillo use is increasing, particularly among young adults. Nicotine dependence (ND) is important for understanding smoking behavior and cessation, but the development of measures of ND has focused almost exclusively on cigarette smokers. We examined smoking patterns, preferences, and beliefs of cigarillo users to better understand their experience of addiction and expression of ND symptoms.\u0000\u0000\u0000Methods\u0000Using purposive sampling, we conducted in-depth interviews between June 2015 and January 2016 with 30 young adults aged 18-28 who reported smoking ≥1 cigarillo per week. Interviews were based on a semi-structured guide designed to capture participants' smoking levels and patterns as well as their experiences of smoking and addiction. Interviews were audio-recorded and transcribed. Analysis was guided by a phenomenological approach designed to identify emergent themes.\u0000\u0000\u0000Results\u0000Participants had a mean age of 23, with a majority being female (56%) and African American (80%). The median number of cigarillos smoked per week was 20; 70% also smoked cigarettes, and 43% also smoked marijuana blunts. Our analysis highlighted the complexity of measuring cigarillo use due to product manipulation, sharing, and multiple product use. Participants expressed a preference for smoking in a social group where cigarillos were shared, and not smoking an entire cigarillo at once when alone. Most cigarillo users did not consider themselves to be addicted.\u0000\u0000\u0000Conclusions\u0000Cigarillo users express unique smoking practices and beliefs that signify the need for a more product-inclusive measure of ND, and can inform the development of tobacco cessation interventions tailored to cigarillo users.\u0000\u0000\u0000Implications\u0000The increasing use of cigarillos among young adults has significant public health consequences. Addressing this issue requires accurate measurement and effective treatment of dependence on cigarillo products. The results of this study directly inform the development of a revised measure of ND, and can contribute to the efficacy of cessation interventions for cigarillo users.","PeriodicalId":19355,"journal":{"name":"Nicotine and Tobacco Research","volume":"16 1","pages":"377–382"},"PeriodicalIF":0.0,"publicationDate":"2018-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86682097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction Few longitudinal studies have examined how awareness, use of, and beliefs about electronic cigarettes (e-cigarettes) and snus change over time. We assessed these trends in a cohort of young adults from the US Midwest. Methods Data were from the Minnesota Adolescent Community Cohort (MACC) Study, collected annually during 2010-2013 when participants were 21-29 years old (n = 2622). Participants were asked if they had heard of and ever used e-cigarettes and snus, and the number of days they used these products in the past 30 days. Beliefs about whether these products are less harmful than cigarettes, less addictive than cigarettes, and could help people quit smoking were assessed. Repeated measures multiple linear and logistic regression models, adjusting for demographics, peer smoking and smoking status, were used to assess trends. Results Compared to 2010-2011, participants in 2012-2013 were five times more likely to be aware of e-cigarettes, report ever used them, and report using them in the past 30-days. Increases in e-cigarette use were observed in all smoking status. Participants were also increasingly likely to believe that e-cigarettes are less harmful than combustible cigarettes and could help people quit smoking. There was only a modest increase in awareness of and ever using snus, as well as believing snus is less harmful than combustible cigarettes. These trends did not differ by smoking status. Conclusions The increasingly favorable beliefs about e-cigarettes may explain the increasing prevalence of their use particularly among young adults, both among smokers and nonsmokers. Implications Awareness and use of e-cigarettes have increased substantially over the past few years, and positive beliefs of e-cigarettes have also become more prevalent among young adults. Meanwhile, little changes in awareness, use of, and beliefs about snus among young adults. Given the potential of these products to have both positive and negative impact on public health depending on who use them and how they are used, strategically communicating the risks associated with e-cigarettes and snus use may help minimize the burden of tobacco use at the population level.
{"title":"Trends in Awareness, Use of, and Beliefs About Electronic Cigarette and Snus Among a Longitudinal Cohort of US Midwest Young Adults","authors":"Kelvin Choi, J. Bestrashniy, J. Forster","doi":"10.1093/ntr/ntx042","DOIUrl":"https://doi.org/10.1093/ntr/ntx042","url":null,"abstract":"Introduction\u0000Few longitudinal studies have examined how awareness, use of, and beliefs about electronic cigarettes (e-cigarettes) and snus change over time. We assessed these trends in a cohort of young adults from the US Midwest.\u0000\u0000\u0000Methods\u0000Data were from the Minnesota Adolescent Community Cohort (MACC) Study, collected annually during 2010-2013 when participants were 21-29 years old (n = 2622). Participants were asked if they had heard of and ever used e-cigarettes and snus, and the number of days they used these products in the past 30 days. Beliefs about whether these products are less harmful than cigarettes, less addictive than cigarettes, and could help people quit smoking were assessed. Repeated measures multiple linear and logistic regression models, adjusting for demographics, peer smoking and smoking status, were used to assess trends.\u0000\u0000\u0000Results\u0000Compared to 2010-2011, participants in 2012-2013 were five times more likely to be aware of e-cigarettes, report ever used them, and report using them in the past 30-days. Increases in e-cigarette use were observed in all smoking status. Participants were also increasingly likely to believe that e-cigarettes are less harmful than combustible cigarettes and could help people quit smoking. There was only a modest increase in awareness of and ever using snus, as well as believing snus is less harmful than combustible cigarettes. These trends did not differ by smoking status.\u0000\u0000\u0000Conclusions\u0000The increasingly favorable beliefs about e-cigarettes may explain the increasing prevalence of their use particularly among young adults, both among smokers and nonsmokers.\u0000\u0000\u0000Implications\u0000Awareness and use of e-cigarettes have increased substantially over the past few years, and positive beliefs of e-cigarettes have also become more prevalent among young adults. Meanwhile, little changes in awareness, use of, and beliefs about snus among young adults. Given the potential of these products to have both positive and negative impact on public health depending on who use them and how they are used, strategically communicating the risks associated with e-cigarettes and snus use may help minimize the burden of tobacco use at the population level.","PeriodicalId":19355,"journal":{"name":"Nicotine and Tobacco Research","volume":"31 1","pages":"239–245"},"PeriodicalIF":0.0,"publicationDate":"2018-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91382719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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