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Ability to Reach Low-Income Smokers Enrolled in a Randomised Controlled Trial Varies with Time of Month. 参与随机对照试验的低收入吸烟者的接触能力随月份的不同而变化。
IF 0.9 Q4 SUBSTANCE ABUSE Pub Date : 2018-12-01 DOI: 10.1017/JSC.2017.23
K. Hawk, Ruizhi Shi, June Weiss, R. Makuch, B. Toll, S. Bernstein
IntroductionBecause of financial pressures, low-income individuals sometimes run out of cellphone service towards the end of the month.AimsTo determine if the time of month affects ability to reach low-income smokers by telephone.MethodsWe reviewed data from a completed trial in the United States of emergency department (ED)-initiated tobacco dependence treatment for low-income smokers at a busy, academic ED in an urban community. We recorded the date of each one-month follow-up call, and divided each month into four time blocks: Week 1, Week 2, Week 3, and Week 4.ResultsA total of 2,049 phone calls were made to reach 769 participants. Of these calls, 677 (33%) resulted in contact; 88% of all participants were contacted. Using generalised estimating equations with Week 4 as reference, the odds of a successful contact at Weeks 1, 2, and 3 were, respectively, 1.52 (95% CI 1.18, 1.96), 1.30 (95% CI 1.01, 1.66), and 1.37 (95% CI 1.07, 1.76).ConclusionsStudy participants became progressively difficult to reach. This result may reflect low-income smokers' decreased rates of active telephone service later in the month and suggests a mechanism to improve follow-up rates in future studies of low-income populations.
简介由于经济压力,低收入者有时会在月底用完手机服务。目的确定每月的时间是否影响通过电话联系低收入吸烟者的能力。方法我们回顾了一项在美国完成的试验数据,该试验是由急诊科(ED)在城市社区繁忙的学术急诊室为低收入吸烟者发起的烟草依赖治疗。我们记录了每个一个月随访电话的日期,并将每个月分为四个时间段:第1周、第2周、第3周和第4周。在这些电话中,677个(33%)接通了联系;88%的参与者得到了联系。使用以第4周为参考的广义估计方程,在第1、2和3周成功接触的几率分别为1.52(95%CI 1.18、1.96)、1.30(95%CI 1.01、1.66)和1.37(95%CI 1.07、1.76)。结论研究参与者越来越难以接触。这一结果可能反映了低收入吸烟者在本月晚些时候主动电话服务率的下降,并为未来对低收入人群的研究提供了一种提高随访率的机制。
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引用次数: 2
Motivational Benefits of Social Support and Behavioural Interventions for Smoking Cessation. 戒烟的社会支持和行为干预的动机效益。
IF 0.9 Q4 SUBSTANCE ABUSE Pub Date : 2018-12-01 Epub Date: 2018-01-21 DOI: 10.1017/jsc.2017.26
Julia N Soulakova, Chiung-Ya Tang, Selena A Leonardo, Lindsay A Taliaferro

This study examined the role of social support and behavioral interventions used during the last unsuccessful quit attempt for smokers' intentions to quit smoking within the next 6 months, and identified smokers' attributes associated with use of social support and behavioral interventions. The analytic sample included 7,195 adult daily smokers who responded to the 2010-2011 Tobacco Use Supplement to the Current Population Survey, conducted in the US, and indicated having a serious quit attempt in the past 12 months. Smokers who relied on social support from friends and family had higher odds of intending to quit than those who did not (OR= 1.39, 95% CI= 1.22:1.58), and smokers who used interventions had higher odds of intending to quit than those who did not (OR= 1.36, 95% CI= 1.07:1.74). These associations were similar for both sexes, all age groups, and nicotine dependence levels. Both, relying on social support and use of behavioral interventions were more common among smokers who were female, higher educated, residing in the Western US region, and those who used pharmacological aids for smoking cessation. Social support and behavioral interventions are associated with higher intentions to quit among attempters who relapsed and thus, may aid future smoking cessation.

本研究考察了社会支持和行为干预在最后一次戒烟失败期间对吸烟者未来6个月内戒烟意图的作用,并确定了吸烟者使用社会支持和行为干预的相关属性。分析样本包括7195名每天吸烟的成年人,他们对2010-2011年美国当前人口调查的烟草使用补充进行了回应,并表示在过去12个月内有过认真的戒烟尝试。依赖朋友和家人社会支持的吸烟者比不依赖朋友和家人社会支持的吸烟者戒烟的几率更高(OR= 1.39, 95% CI= 1.22:1.58),使用干预措施的吸烟者比不使用干预措施的吸烟者戒烟的几率更高(OR= 1.36, 95% CI= 1.07:1.74)。这些关联在两性、所有年龄组和尼古丁依赖程度上都是相似的。依赖社会支持和使用行为干预在女性、受过高等教育、居住在美国西部地区以及使用药物辅助戒烟的吸烟者中更为常见。社会支持和行为干预与复吸者更高的戒烟意愿有关,因此可能有助于未来戒烟。
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引用次数: 28
Personalized Intervention Program: Tobacco Treatment for Patients at Risk for Lung Cancer. 个性化干预方案:烟草治疗肺癌高危患者。
IF 0.9 Q4 SUBSTANCE ABUSE Pub Date : 2018-12-01 Epub Date: 2017-12-11 DOI: 10.1017/jsc.2017.24
Krysten W Bold, Benjamin A Toll, Brenda Cartmel, Bennie B Ford, Alana M Rojewski, Ralitza Gueorguieva, Stephanie S O'Malley, Lisa M Fucito

Background: Lung cancer screening and tobacco treatment for patients at high-risk for lung cancer may greatly reduce mortality from smoking, and there is an urgent need to improve smoking cessation therapies for this population.

Aims: The purpose of this study is to test the efficacy of two separate, sequential interventions to promote tobacco cessation/reduction compared to standard care in smokers considered high-risk for lung cancer.

Methods: The study will recruit 276 current smokers attending a lung cancer screening clinic or considered high-risk for lung cancer based on age and smoking history across two sites. Patients first will be randomized to either standard tobacco treatment (8 weeks of nicotine patch and five individual counselling sessions) or standard tobacco treatment plus personalized gain-framed messaging. At the 8-week visit, all patients will be re-randomized to receive biomarker feedback or no biomarker feedback. Repeated assessments during treatment will be used to evaluate changes in novel biomarkers: skin carotenoids, lung function, and plasma bilirubin that will be used for biomarker feedback. We hypothesize that personalized gain-framed messages and receiving biomarker feedback related to tobacco cessation/reduction will improve quit rates and prevent relapse compared to standard care. Primary outcomes include 7-day point-prevalence abstinence verified with expired carbon monoxide at 8 weeks and mean cigarettes per day in the past week at 6 months.

Conclusions: Study findings will inform the development of novel interventions for patients at risk for lung cancer to improve smoking cessation rates.

背景:肺癌高危患者的肺癌筛查和烟草治疗可以大大降低吸烟死亡率,迫切需要改善这一人群的戒烟治疗。目的:本研究的目的是测试两种独立的、顺序的干预措施的效果,以促进戒烟/减少与标准治疗相比,被认为是肺癌高风险的吸烟者。方法:该研究将招募276名目前在肺癌筛查诊所或根据年龄和吸烟史被认为是肺癌高危人群的吸烟者。首先,患者将随机接受标准烟草治疗(8周尼古丁贴片和5次个人咨询会议)或标准烟草治疗加上个性化的增益框架信息。在8周的随访中,所有患者将被重新随机分组,接受生物标志物反馈或没有生物标志物反馈。治疗期间的重复评估将用于评估新的生物标志物的变化:皮肤类胡萝卜素、肺功能和血浆胆红素,这些将用于生物标志物反馈。我们假设,与标准治疗相比,个性化的增益框架信息和接收与戒烟/减少相关的生物标志物反馈将提高戒烟率并防止复发。主要结果包括7天的点流行性戒烟,在8周时通过一氧化碳过期验证,在6个月时过去一周平均每天吸烟。结论:研究结果将为肺癌高危患者开发新的干预措施以提高戒烟率提供信息。
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引用次数: 4
Pilot Study of an Internet-Based, Simulated Teachable Moment for Smoking Cessation 基于互联网的模拟戒烟教育时刻试点研究
IF 0.9 Q4 SUBSTANCE ABUSE Pub Date : 2018-09-28 DOI: 10.1017/JSC.2018.32
Robin May, F. Walker, Simon de Burgh, R. Bartrop, G. Tofler
The internet has the potential to overcome geographic limitations for smoking cessation interventions, but further telehealth-based studies of utility are required.To investigate the efficacy of an internet-based version of a quit smoking approach using a personalised video to create a simulated teachable moment.Smokers within Australia were recruited through a dedicated website. After consent, eligible subjects, aged ≥30 years with a non-smoking partner, uploaded pictures of themselves, their partner and family, to be inserted into a video depicting the subject having a heart attack due to smoking, with consequences to them and their family. Nicotine replacement therapy (NRT) began prior to the quit attempt. The video was shown during two videoconference counselling sessions, with follow-up phone calls and text messaging support. Smoking status at 6 months by self-report (primary endpoint) was verified by partner/proxy and salivary cotinine (NicAlert™).Seventy seven smokers were screened, of whom 50 were eligible, and 17 of these (34%) were enrolled; 11 men and 6 women, aged 41.5 ± 6.9 years, daily cigarette consumption 20.8 ± 8.9, Heaviness of Smoking Index score 3.7 ± 1.7. Participants reported feeling personally involved with the video (5.9 ± 1.1), which felt real (5.8 ± 1.1) and emotionally moving (5.6 ± 1.5) [7-point Likert Scale]. A similar video response was reported by the four participants (24%), who due to bandwidth limitations, watched the video after the counselling session instead of during it. Non-smoking rates at 6 months were 65% (11/17) by self-report with proxy confirmation, and 47% (8/17) by self-report with biologic confirmation. Three non-smokers by self-report could not provide a valid NicAlert™ result due to current NRT use. One participant who by self-report smoked once in the prior 14-days was assessed as a non-smoker by both proxy and NicAlert™.This pilot study demonstrates efficacy for an internet-based version of a quit smoking program based on creating a simulated teachable moment. The findings provide support for further research into this technique, with the internet enabling greater reach than face-to-face.
互联网有可能克服戒烟干预的地理限制,但还需要进一步的基于远程健康的效用研究。研究基于互联网的戒烟方法的效果,使用个性化视频创建模拟可教时刻。澳大利亚通过一个专门的网站招募吸烟者。在征得同意后,年龄≥30岁且伴侣不吸烟的符合条件的受试者上传了自己、伴侣和家人的照片,并将其插入视频中,视频描述了受试者因吸烟而心脏病发作,对他们和家人造成的后果。尼古丁替代疗法(NRT)在戒烟前开始。该视频在两次视频会议咨询会议上播放,并提供后续电话和短信支持。通过伴侣/代理人和唾液可替宁(NicAlert™).对77名吸烟者进行了筛查,其中50人符合条件,其中17人(34%)入选;11名男性和6名女性,年龄41.5±6.9岁,每日吸烟量20.8±8.9,重度吸烟指数得分3.7±1.7。参与者报告称,他们对视频有切身感受(5.9±1.1),感觉真实(5.8±1.1)和情感感人(5.6±1.5)[7分Likert量表]。四名参与者(24%)报告了类似的视频反应,由于带宽限制,他们在咨询后而不是在咨询期间观看了视频。通过代理确认的自我报告,6个月时的无烟率为65%(11/17),通过生物确认的自报,无烟率为47%(8/17)。三名非吸烟者通过自我报告无法提供有效的NicAlert™ 由于当前使用NRT导致的结果。一名参与者通过自我报告在前14天内吸烟一次,被代理人和NicAlert评估为非吸烟者™.这项试点研究证明了基于互联网的戒烟计划在创建模拟可教时刻的基础上的有效性。这些发现为这项技术的进一步研究提供了支持,因为互联网比面对面更具影响力。
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引用次数: 1
Using ‘Smart’ Technology to Aid in Cigarette Smoking Cessation: Examining an Innovative Way to Monitor and Improve Quit Attempt Outcomes 使用“智能”技术帮助戒烟:研究一种监测和改善戒烟效果的创新方法
IF 0.9 Q4 SUBSTANCE ABUSE Pub Date : 2018-09-25 DOI: 10.1017/JSC.2018.33
Carol Morriscey, Aaron Shephard, Anouk van Houdt, David Kerr, S. Barrett
Recently, smartphone applications (apps) have been used as smoking cessation aids. Interactive apps appear to more effective than non-interactive apps. SmokeBeat, a smartphone app used in conjunction with a smartwatch, aims to detect smoking events, interact with the user as they occur and potentially stop smoking events before they occur in the future.The purpose of this feasibility study was to determine the sensitivity and specificity of SmokeBeat in detecting smoking events.The feasibility of using the app as a smoking cessation aid was tested over a 2-week period by daily, dependent smokers. SmokeBeat's cigarette detection rate was measured in laboratory sessions both before and after the 2-week period. Fisher's exact test was used to compare detection rates from each session.The detection rate was 22.5% during session 1 and 41.7% during session 2. Once technological issues were controlled for (i.e., signal loss between smartphone and smartwatch), SmokeBeat's detection rate improved over the 2-week period, resulting in a 100% detection rate.Apps which can detect smoking events in real time present an opportunity for a proactive and interactive smoking cessation aid – a potentially useful tool for individuals attempting to quit smoking.
最近,智能手机应用程序被用作戒烟辅助工具。交互式应用程序似乎比非交互式应用程序更有效。SmokeBeat是一款与智能手表结合使用的智能手机应用程序,旨在检测吸烟事件,在发生时与用户互动,并可能在未来发生吸烟事件之前停止吸烟。本可行性研究的目的是确定SmokeBeat在检测吸烟事件方面的敏感性和特异性。每天依赖吸烟者在两周的时间里测试了将该应用程序用作戒烟辅助工具的可行性。SmokeBeat的香烟检出率是在两周前后的实验室中测量的。Fisher精确检验用于比较每次会话的检测率。第1阶段的检测率为22.5%,第2阶段为41.7%。一旦技术问题得到控制(即智能手机和智能手表之间的信号丢失),SmokeBeat的检测率在两周内有所提高,检测率达到100%。可以实时检测吸烟事件的应用程序为主动和交互式戒烟辅助提供了机会,这对试图戒烟的个人来说是一个潜在的有用工具。
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引用次数: 6
Triple Smoking Cessation Therapy with Varenicline, Nicotine Patch and Nicotine Lozenge: A Pilot Study to Assess Tolerability, Satisfaction, and End-of-Treatment Quit Rates. 瓦伦尼克兰、尼古丁贴片和尼古丁含片三重戒烟治疗:一项评估耐受性、满意度和治疗结束戒烟率的初步研究。
IF 0.9 Q4 SUBSTANCE ABUSE Pub Date : 2018-09-01 Epub Date: 2017-09-25 DOI: 10.1017/jsc.2017.18
Kristin M Berg, Douglas E Jorenby, Timothy B Baker, Michael C Fiore

Introduction: The majority of attempts to stop smoking end in failure. One way to improve success may be to explore different combinations of existing cessation medications.

Aims: This observational study examined "triple therapy" (varenicline + nicotine patch + nicotine lozenge) in 36 smokers trying to quit.

Methods: A 12-week, observational study exploring tolerability, via adverse events (AEs) elicited at each of 9 phone assessments. Secondary outcomes included satisfaction rates, medication changes, and self-reported quit rates at week 12.

Results: 35 of 36 participants reported at least one AE. Insomnia (75%), abnormal dreams (72%) and nausea (64%) were most common. Most were mild to moderate. No deaths, hospitalizations, cardiovascular events, or suicidality were reported. Six participants (17%) decreased the dose of at least one medication, 5 (14%) decreased the dose then discontinued at least one medication, and 13 (36%) discontinued at least one medication without trying a lesser dose. Participants were highly satisfied with their medications, and 58% reported quitting at 12 weeks, with 38% reporting prolonged abstinence.

Conclusion: Despite high rates of AEs and medication changes, high rates of satisfaction and self-reported quitting, with no serious AEs, were observed with triple therapy. Additional data on tolerability and efficacy are needed.

Trial registration: clinicaltrials.gov number NCT02681510.

引言:大多数试图戒烟的人都以失败告终。提高成功率的一种方法可能是探索现有戒烟药物的不同组合。目的:本观察性研究考察了36名试图戒烟的吸烟者的“三联疗法”(伐尼克兰+尼古丁贴片+尼古丁含片)。方法:一项为期12周的观察性研究,通过9次电话评估中每次引发的不良事件(ae)来探索耐受性。次要结果包括满意度、药物变化和第12周自我报告的戒烟率。结果:36例参与者中有35例报告了至少一次AE。最常见的是失眠(75%)、异梦(72%)和恶心(64%)。大多数是轻度到中度的。无死亡、住院、心血管事件或自杀报告。6名参与者(17%)减少了至少一种药物的剂量,5名参与者(14%)减少了剂量,然后停止了至少一种药物,13名参与者(36%)停止了至少一种药物,但没有尝试更小的剂量。参与者对他们的药物非常满意,58%的人报告在12周后戒烟,38%的人报告长期禁欲。结论:尽管不良事件发生率和药物改变率很高,但三联疗法的满意度和自我报告戒烟率很高,没有严重的不良事件。需要关于耐受性和疗效的更多数据。试验注册:clinicaltrials.gov号码NCT02681510。
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引用次数: 1
Tobacco Use in Adults With Mental Illness: An Overview of One State-Wide Tobacco Cessation Program 患有精神疾病的成年人吸烟:一项全州范围的戒烟计划综述
IF 0.9 Q4 SUBSTANCE ABUSE Pub Date : 2018-07-25 DOI: 10.1017/JSC.2018.27
Noeen Sarfraz, Yvon Fils-Aime, Michael W. Brand, S. Vesely, L. Beebe
Even though one of the public health's top achievements of the 20th century involves tobacco cessation, a disproportionate burden of tobacco-related comorbidity still affects those with mental illness (Centers for Disease Control and Prevention, 2017; Cook et al., 2014). There is evidence suggesting that psychiatric disorders are associated with an increased prevalence in cigarette smoking (Tsoi, Porwa, & Webster, 2013). One explanation for this is the potentiating effect of nicotine on dopamine receptors (Mao, Gallagher, & McGehee, 2011). Other explanations include poverty, educational advancement and industry bias in tobacco marketing (MMWR Vital Signs: Current Cigarette, 2016; CDC Morbidity and Mortality, 2013). We know that adults with mental illness smoke at rates twice that of the general population, and are nicotine-dependent at rates up to three times higher than the general population (Cook et al., 2014; Grant, Hasin, Chou, Stinson, & Dawson, 2004). Adults with mental illness comprise about 19% of the population, but smoke approximately one-third of all the cigarettes smoked (MMWR Vital Signs: Current Cigarette, 2016). In the United States, the national tobacco use prevalence is estimated at 19%; however, prevalence among those with bipolar disorder is 51%–70% and 36%–80% among those with major depressive disorder (Grant et al., 2004; King, Dube, & Tynan, 2012; Lasser et al., 2000). Despite these high rates, recent studies suggest that smokers with mental illness are highly motivated to quit (Cook et al., 2014). However, it remains rare for mental and behavioural health professionals to offer tobacco cessation pharmacotherapy and counselling to clients with psychiatric disorders.
尽管20世纪公共卫生的最高成就之一涉及戒烟,但与烟草相关的合并症的不成比例的负担仍然影响着那些患有精神疾病的人(疾病控制和预防中心,2017;库克等人,2014年)。有证据表明,精神障碍与吸烟患病率的增加有关(Tsoi,Porwa,&Webster,2013)。对此的一种解释是尼古丁对多巴胺受体的增强作用(Mao,Gallagher,&McGehee,2011)。其他解释包括贫困、教育进步和烟草营销中的行业偏见(MMWR生命体征:当前香烟,2016;美国疾病控制与预防中心发病率和死亡率,2013)。我们知道,患有精神疾病的成年人吸烟率是普通人群的两倍,对尼古丁的依赖率高达普通人群的三倍(Cook等人,2014;Grant、Hasin、Chou、Stinson和Dawson,2004年)。患有精神疾病的成年人约占总人口的19%,但吸烟量约占所有吸烟量的三分之一(MMWR生命体征:当前吸烟量,2016)。在美国,全国烟草使用率估计为19%;然而,双相情感障碍患者的患病率为51%-70%,重度抑郁障碍患者的发病率为36%-80%(Grant等人,2004;King、Dube和Tynan,2012年;Lasser等人,2000年)。尽管吸烟率很高,但最近的研究表明,患有精神疾病的吸烟者戒烟的积极性很高(Cook等人,2014)。然而,心理和行为健康专业人员为精神障碍患者提供戒烟药物治疗和咨询的情况仍然很少。
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引用次数: 0
Predicting Engagement in Smoking Cessation Treatment Following a Brief Telephone Evaluation and Referral Session 在简短的电话评估和转介会议后预测戒烟治疗的参与度
IF 0.9 Q4 SUBSTANCE ABUSE Pub Date : 2018-07-11 DOI: 10.1017/JSC.2018.24
Angela Petersen, Suraya Jabaiah, Timothy F. Chen, Neal Doran, M. Myers
Introduction: Smoking cessation treatment combining medication and counselling yields the best outcomes; however, few smokers employ both modalities.Aims: The purpose of this study was to examine variables predicting treatment attendance.Methods: This was a chart review of US military Veterans (N = 340; 89% male, 59% non-Hispanic white) referred for smoking cessation, who completed a telephone call to encourage treatment utilization. Treatment engagement was defined as attending a smoking cessation session within 30 days following telephone contact. A logistic regression analysis examined predictors (demographics, smoking variables, and psychiatric diagnoses) of treatment engagement.Results/Findings: Greater age (Odds Ratio [OR] = 1.04, 95% confidence interval [CI] 1.01–1.06), more cigarettes (OR = 1.03, 95% CI 1.00–1.06), and higher perceived importance of quitting (OR = 1.11, 95% CI 1.00–1.23) predicted engaging in treatment within 30 days (all p values < 0.05).Conclusion: Veterans who attended treatment were older, smoked more cigarettes, and perceived quitting as more important than those who did not attend. These findings are consistent with prior studies examining factors associated with treatment utilization. Results highlight the need to identify strategies for engaging into treatment smokers who are younger, smoke fewer cigarettes, and view quitting as less important.
前言:戒烟治疗结合药物和咨询产生最好的结果;然而,很少有吸烟者同时使用这两种方式。目的:本研究的目的是检验预测治疗出勤率的变量。方法:对美国退伍军人(N = 340;(89%为男性,59%为非西班牙裔白人),他们通过电话鼓励戒烟。治疗参与被定义为在电话联系后30天内参加戒烟会议。逻辑回归分析检验了治疗参与的预测因素(人口统计、吸烟变量和精神诊断)。结果/发现:年龄越大(优势比[OR] = 1.04, 95%可信区间[CI] 1.01-1.06)、吸烟越多(OR = 1.03, 95% CI 1.00-1.06)和戒烟的重要性越高(OR = 1.11, 95% CI 1.00-1.23)预测在30天内参与治疗(p值均< 0.05)。结论:参加治疗的退伍军人年龄更大,吸烟更多,并且认为戒烟比没有参加治疗的退伍军人更重要。这些发现与先前调查与治疗利用相关因素的研究一致。研究结果强调,有必要为年轻、吸烟较少、认为戒烟不那么重要的吸烟者确定治疗策略。
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引用次数: 1
A Collaborative Model for Facilitating the Delivery of Smoking Cessation Treatments to Cancer Patients: Results From Three Oncology Practices in South Carolina 促进向癌症患者提供戒烟治疗的合作模式:来自南卡罗来纳州三种肿瘤实践的结果
IF 0.9 Q4 SUBSTANCE ABUSE Pub Date : 2018-07-10 DOI: 10.1017/JSC.2018.23
Daniel J Kilpatrick, Kathleen B. Cartmell, A. Diédhiou, K. Cummings, G. Warren, Kathleen L. Wynne, Sharon Biggers, P. M. Gillam
Introduction: Continued smoking by cancer patients causes adverse cancer treatment outcomes, but few patients receive evidence-based smoking cessation as a standard of care.Aim: To evaluate practical strategies to promote wide-scale dissemination and implementation of evidence-based tobacco cessation services within state cancer centers.Methods: A Collaborative Learning Model (CLM) for Quality Improvement was evaluated with three community oncology practices to identify barriers and facilitate practice change to deliver evidence-based smoking cessation treatments to cancer patients using standardized assessments and referrals to statewide smoking cessation resources. Patients were enrolled and tracked through an automated data system and received follow-up cessation support post-enrollment. Monthly quantitative reports and qualitative data gathered through interviews and collaborative learning sessions were used to evaluate meaningful quality improvement changes in each cancer center.Results: Baseline practice evaluation for the CLM identified the lack of tobacco use documentation, awareness of cessation guidelines, and awareness of services for patients as common barriers. Implementation of a structured assessment and referral process demonstrated that of 1,632 newly registered cancer patients,1,581 (97%) were screened for tobacco use. Among those screened, 283 (18%) were found to be tobacco users. Of identified tobacco users, 207 (73%) were advised to quit. Referral of new patients who reported using tobacco to an evidence-based cessation program increased from 0% at baseline across all three cancer centers to 64% (range = 30%–89%) during the project period.Conclusions: Implementation of quality improvement learning collaborative models can dramatically improve delivery of guideline-based tobacco cessation treatments to cancer patients.
癌症患者持续吸烟会导致不良的癌症治疗结果,但很少有患者接受循证戒烟作为标准治疗。目的:评估在州癌症中心促进大规模传播和实施以证据为基础的戒烟服务的实用策略。方法:采用三个社区肿瘤学实践对质量改进的协作学习模型(CLM)进行评估,以确定障碍并促进实践变革,通过标准化评估和转介到全州戒烟资源,为癌症患者提供基于证据的戒烟治疗。通过自动数据系统对患者进行登记和跟踪,并在登记后接受随访戒烟支持。通过访谈和协作学习会议收集的月度定量报告和定性数据用于评估每个癌症中心有意义的质量改进变化。结果:CLM的基线实践评估发现,缺乏烟草使用记录、对戒烟指南的认识和对患者服务的认识是常见的障碍。结构化评估和转诊过程的实施表明,在1,632名新登记的癌症患者中,1,581名(97%)接受了烟草使用筛查。在接受筛查的人中,发现283人(18%)是烟草使用者。在已确定的烟草使用者中,207人(73%)被建议戒烟。在所有三个癌症中心,报告使用烟草的新患者转介到基于证据的戒烟计划的比例从基线时的0%增加到项目期间的64%(范围= 30%-89%)。结论:实施质量改进学习协作模式可以显著改善基于指南的癌症患者戒烟治疗的交付。
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引用次数: 3
An Interpretative Phenomenological Analysis of Discontinued Use of the E-Cigarette 电子烟停用现象的解释性现象学分析
IF 0.9 Q4 SUBSTANCE ABUSE Pub Date : 2018-07-02 DOI: 10.1017/JSC.2018.21
C. Alexis-Garsee, S. Meehan, O. Akker
Introduction: Many UK smokers use e-cigarettes as a quitting aid; however, a substantial number discontinue use of the e-cigarette and revert to smoking. Understanding why this may happen is important both for individuals and for stop smoking services.Aims: To explore young adult smokers’ experiences of use and discontinued use of the e-cigarette.Methods: Semi-structured interviews were conducted with six participants who tried e-cigarettes for at least seven days and returned to smoking. Data was transcribed and analysed using interpretative phenomenological analysis.Results: Findings suggested participants held conflicting attitudes about using e-cigarettes, which undermined attempts to quit smoking, and led to the discontinuation of the e-cigarette. These conflicts centred on participants’ discomfort with the e-cigarette or vaping identity, lack of abstinence self-efficacy and navigation of barriers to e-cigarette use. The complex interplay of these factors may have led to an underestimation of the individual effort required to continue vaping and reinforced participants’ perception of the e-cigarette as an inferior product to the cigarette.Conclusions: Future research should focus on the role of identity, self-efficacy, control and smokers’ expectations of e-cigarettes on smoking cessation as these may be important factors to consider for a more tailored service for e-cigarette users.
引言:许多英国吸烟者使用电子烟作为戒烟辅助手段;然而,相当多的人停止使用电子烟,转而吸烟。了解为什么会发生这种情况对个人和戒烟服务都很重要。目的:探讨年轻成年吸烟者使用和停止使用电子烟的经历。方法:对六名尝试电子烟至少七天并重新吸烟的参与者进行半结构化访谈。使用解释性现象学分析对数据进行转录和分析。结果:研究结果表明,参与者对使用电子烟持有相互矛盾的态度,这削弱了戒烟的努力,并导致电子烟的停用。这些冲突集中在参与者对电子烟或电子烟身份的不适、缺乏禁欲自我效能感以及电子烟使用障碍。这些因素的复杂相互作用可能导致低估了继续吸电子烟所需的个人努力,并强化了参与者对电子烟不如香烟的看法。结论:未来的研究应侧重于身份、自我效能、控制和吸烟者对电子烟的期望在戒烟中的作用,因为这些可能是为电子烟用户提供更具针对性的服务所需考虑的重要因素。
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引用次数: 0
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Journal of Smoking Cessation
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