Tobacco Prevention & Cessation最新文献

Introduction: Smoking impairs the outcome of surgery for many reasons. This study aimed to determine the effect of smoking, smoking cessation intervention, and other factors on the incidence of postoperative complications after elective orthopedic and hand surgery directed at bone or cartilage attached at the bone.

Methods: Altogether 451 patients, aged 18 years, participated in this single-center interventional study in Finland between 2015 and 2019. Their smoking status was confirmed by laboratory tests. The study's outcome was the occurrence, number, and severity of complications. A complication was defined as a prolonged hospital stay or any additional treatment or visit to a healthcare unit within 12 months, and its severity was determined by a modified Clavien-Dindo-Sink (CDS) index.

Results: Nine out of 80 smokers stopped smoking with laboratory verification before surgery, and additionally, six smokers stopped smoking at or after surgery. In comparison to never smokers, continuing smokers had more often at least one complication (adjusted odds ratio, AOR=2.50; 95% confidence interval, CI: 1.23-5.09; p<0.05) and more complications (adjusted risk ratio, ARR=1.58; 95% CI: 1.08-2.30; p<0.05). Further, the odds of being in a higher CDS-index category compared to the lower category (AOR=2.19; 95% CI: 1.14-4.19; p<0.05) also increased. With decreasing age, the occurrence (AOR = 0.98; 95% CI: 0.96-1.00; p<0.05) and number of complications (ARR=0.98; 95% CI: 0.97-1.00; p<0.01) decreased. Additionally, the odds of being in a higher CDS-index category compared to a lower category increased (AOR=0.98; 95% CI: 0.96-1.00; p<0.05). In comparison to men, women were more likely to have at least one complication (AOR=1.68; 95% CI: 1.03-2.75; p<0.05). With increasing alcohol consumption, the occurrence of at least one complication increased (AOR=1.10; 95% CI: 1.02-1.19; p<0.05).

Conclusions: Continuing to smoke and decreasing age, the occurrence, number, and severity of complications increased. Alcohol consumption and female sex were linked to an elevated occurrence of complications. It is important to wean every smoking patient, especially young smokers, from smoking to reduce the occurrence and severity of complications.

Introduction: Implementing and maintaining smoking cessation requires high motivation. This study examines the role of Self-Determination Theory (SDT) in enhancing smoking cessation strategies by highlighting the significance of psychological needs for lasting behavioral change. We aimed to explore how participants perceive the importance of SDT's basic psychological needs - autonomy, competence, and relatedness - in the context of smoking cessation treatment and support (SCTS).

Methods: This qualitative study, employing SDT-driven content analysis, utilized a co-design workshop held in Finland in 2019, where 12 participants engaged in group dialogues. The workshop dialogues were examined to determine whether SDT influenced participants' responses regarding SCTS.

Results: The qualitative analysis emphasized the respondents' need for autonomous motivation. The study highlighted the importance of acknowledging individual differences and psychological needs for effective support in SCTS. We identified ten categories: Addiction, Aids and appliances, Characteristics, Collective quitting, Expert advice, Follow-up data, Personal experience, Rewards, Health political decision-making, Ways of quitting smoking. All were linked to basic psychological need. The desire for autonomy was the most common theme (41.2%) followed by competence (34.6%) and relatedness (24.2 %).

Conclusions: Health practitioners should recognize and address the basic psychological needs of autonomy, competence, and relatedness when assisting smokers in their cessation efforts. By offering meaningful choices to support autonomy and enhance competence, and by providing positive, informative feedback while empathizing with the smoker's situation, professionals can improve the effectiveness of SCTS interventions. To be truly effective, support must be tailored to individual differences and needs.

Introduction: Characterized by persistently high smoking prevalence, France nonetheless faces difficulties in implementing coherent and sustained tobacco control measures. To understand what sustains this situation, we explored how French parliamentarians perceive tobacco, tobacco control policies (with a focus on taxation), and the stakeholders they believe should inform policy decisions.

Methods: As all parliamentarians vote on tobacco control policies, between March and June 2022 we undertook 25 individual interviews with French senators and deputies representing diverse political affiliations and regions. Interviews were analyzed using reflexive thematic analysis, guided by Grounded Theory. The section on tax increases was analyzed deductively. We used NVivo 15 for data management.

Results: Among the 25 parliamentarians (17 senators, 8 deputies), they acknowledged the health and economic harms of tobacco, although some minimized its risks. They were more likely to consider media/educational campaigns and taxation as effective, and tobacco sales ban or plain packaging as not. Most accepted anti-tax arguments promoted by the tobacco industry (illicit trade, ineffectiveness, regressivity), and were more likely to engage with tobacconists than health stakeholders during consultations.

Conclusions: In line with streams identified in the Kingdon's Multiple Streams Framework (problem, policy, political), this study suggests that competing framings of tobacco, weak support for evidence-based measures and a political environment favorable to the tobacco industry, weakened prospects for sustained tobacco control. Our findings highlight the need for further research exploring narratives likely to influence policymakers' support for tobacco control measures.

Introduction: Continued smoking increases the risk of all-cause and cancer-specific mortality and adversely affects treatment outcomes. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating the effectiveness of smoking cessation interventions in individuals diagnosed with cancer.

Methods: We conducted a systematic review across several databases, including PsychINFO, EMBASE (through OVID), PubMed (also through OVID), and CINAHL, of RCTs evaluating smoking intervention trials of adult cancer survivors regardless of cancer type, stage, or treatment received. The Cochrane Risk of Bias Tool 2 (ROB-2) evaluated the risk of bias. A meta-analysis was performed using fixed-effect models in R. The last database search was conducted in March 2025.

Results: The search yielded 984 publications. Twenty-three studies met the inclusion criteria. Smoking cessation interventions significantly enhanced cessation rates compared to control (risk ratio, RR=1.36; 95% CI: 1.22-1.51). Results did not show a difference between behavioral interventions alone versus control in the random-effects model (OR=1.08; 95% CI: 0.74-1.60). For studies using biochemical verification, the RR was stronger (RR=1.57; 95% CI: 1.32-1.87) than studies using self-report (RR=1.25; 95% CI: 1.09-1.42). In studies reporting higher success rates in the intervention group, there was a high number of contacts and follow-ups, averaging at least five times.

Conclusions: The present systematic review and meta-analysis provide robust evidence supporting the effectiveness of smoking cessation interventions in cancer patients, particularly when combining pharmacological and behavioral approaches. Cancer patients are capable of successfully quitting tobacco and should be encouraged by healthcare providers to initiate a smoking cessation effort that combines both approaches.

Introduction: People with HIV (PWH) are disproportionately affected by cigarette use, with a 40-60% prevalence rate. They achieve relatively low cessation rates following traditional interventions and often confront compounded challenges related to social factors. HIV care services have integrated Peer Navigators (PNs) into clinical care for many years, but not in the context of smoking cessation. The purpose of this study was to describe the experiences of PWH on a novel smoking cessation intervention that integrated PNs as part of a pilot randomized controlled trial.

Methods: This qualitative examination was conducted among PWH who smoke cigarettes and who participated in a randomized controlled trial between June 2020 and 2021 in Providence, Rhode Island, USA. A PN, defined as a PWH who smoked daily and successfully quit, was trained to provide cessation resources, encourage readiness to quit, and provide social support for quitting. Participants were randomized to either PN or usual care. Twenty-three participants assigned to a PN completed a semi-structured, in-depth qualitative interview. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis.

Results: Analysis revealed that participants valued the interaction with the PN and described feeling increased social support for quitting. They expressed that the use of storytelling by the PN was linked to a sense of success, and that certain traits of the PN were perceived as salient. Interacting with a PN enforced a sense of accountability, and lead to feelings of enhanced self-efficacy.

Conclusions: Integrating PNs to increase support for quitting seems to be highly acceptable among PWH who smoke. The findings underscore the significance of the lived experience of the peer navigator and the provision of social support.

Introduction: Electronic cigarettes (ECs) and heated tobacco products (HTPs) have gained popularity worldwide, despite concerns about their safety. In Italy, updated national data on these devices remain scarce. The aim of this study is to estimate prevalence, patterns, determinants and trends of EC and HTP use among Italian adults in 2024.

Methods: A face-to-face cross-sectional survey was conducted in 2024 on a representative sample of 3125 Italian individuals aged ≥15 years. Data were collected through interviewer-administered questionnaires and included self-reported information on conventional cigarette (CC), EC, and HTP use. We used multivariable logistic regression models to assess adjusted odds ratios (AOR) for EC and HTP use, including sex, age, education level, and smoking status as covariates. Trends (2022-2024) were assessed using analogous surveys.

Results: In 2024, 2.3% (95% CI: 1.7-2.8) of Italian adults used EC, and 4.5% (95% CI: 3.7-5.2) HTP. Use of both products declined with age (p for trend <0.001). Dual use with CCs was prevalent among EC (87.8%; 95% CI: 80.1-95.4) and HTP (92.5%; 95% CI: 88.1-96.8) users. Compared with current CC smokers, odds of EC and HTP use were lower in never (EC: AOR=0.04; 95% CI: 0.02-0.09; HTP: AOR=0.01, 95% CI: 0.00-0.03) and former smokers (EC: AOR=0.14; 95% CI: 0.04-0.48; HTP: AOR=0.18; 95% CI: 0.08-0.41). Use of HTP increased by 40% over two years (p for trend = 0.085). Use of EC did not substantially change.

Conclusions: The widespread dual use and the increasing prevalence of HTP use in Italy highlight growing public health concerns. Instead of serving as cessation aids for smokers, these devices are frequently used by youth and alongside CCs.

[This corrects the article DOI: 10.18332/tpc/208691.].

[This corrects the article DOI: 10.18332/tpc/208884.].

Introduction: Flavored e-cigarette use among US youth remains prevalent, prompting regulatory action by the Food and Drug Administration (FDA). On 2 January 2020, the FDA announced a federal ban on flavored e-cigarettes, which may be circumvented through unregulated do-it-yourself (DIY) methods shared in online communities. Understanding discourse within these communities is essential to understanding unintended policy effects. This study's primary aim was to describe discourse in a DIY e-cigarette subreddit, with a secondary aim of examining how discussions shifted following the 2020 flavor ban.

Methods: We conducted a mixed-methods study of posts from the subreddit r/DIY_eJuice, an online community focused on DIY e-liquid mixing. A total of 5110 posts were extracted between January 2019 and January 2021, with posts before 2 January 2020 defined as the pre-ban period and those after as the post-ban period. From this dataset, we randomly selected 800 posts (17% of the total; 400 pre-ban and 400 post-ban), which were coded by three trained human coders using a systematically developed codebook with 12 thematic categories. Chi-squared tests were applied to compare thematic distributions between periods.

Results: DIY mixing methods (76%, n=605) and discussions about flavors (49%, n=390) were the most frequent topics across both periods, despite the flavor ban. Policy-related discussions significantly increased from 3.5% (n=14) pre-ban to 8.3% (n=33) post-ban (p=0.004). Posts related to safety concerns remained infrequent in both pre- and post-ban period. The proportion of beginner users was constant at 22% across both periods (n=90 at pre-ban, and n=88 at post-ban), while discussions by experienced users increased from 35.3% (n=141) to 41.5% (n=166).

Conclusions: Regulatory action on flavored e-cigarettes influenced community discourse, increasing conversations about policy and DIY mixing techniques, but not significantly affecting discussions of safety. Continued surveillance of DIY communities is necessary to inform future public health strategies.

Introduction: Tobacco use imposes substantial global economic costs - estimated at $1803 to $1899 billion annually (1.76-1.85% of global gross domestic product) - through healthcare expenditures and productivity losses. In 2019, it contributed to approximately 8.70 million deaths and 229.77 million disability-adjusted life years (DALYs); secondhand smoke exposure added 1.31 million deaths and 37.01 million DALYs. While tobacco control efforts continue, evidence on the economic impacts of interventions remains limited. This study systematically reviews the cost-effectiveness of smoke-free interventions to inform policy.

Methods: A systematic literature review was conducted following PRISMA guidelines and registered with PROSPERO (CRD42024521198). Searches conducted in January 2024 in PubMed, Web of Science, and Cochrane databases identified English-language economic evaluations of smoke-free interventions. Data were extracted using pre-defined checklists, and results were summarized using narrative synthesis. Studies were further assessed using the Consensus Health Economic Criteria (CHEC) and Consolidated Health Economic Evaluation Reporting Standards (CHEERS) tools. Studies scoring <60% on CHEERS were excluded.

Results: Of 639 articles, 9 met the inclusion criteria. Most used healthcare or government perspectives (56%), 33% adopting a societal perspective. Interventions included public (44%), workplace, and school-based smoking bans. Studies were conducted in Vietnam, the US, Indonesia, Tanzania, Estonia, Denmark, India, and EU countries, employing economic models such as Markov models (44%). Time horizons ranged from one year to lifetime. Incremental cost-effectiveness ratios (ICERs) ranged from $7 per DALY averted to $17056 per life year gained. Most interventions were found to be cost-effective or dominant.

Conclusions: Public smoking bans consistently saved healthcare costs; workplace and school-based bans were also cost-effective, though context-dependent. This review suggests that smoking bans, particularly comprehensive smoke-free policies, should be prioritized by decision-makers as they demonstrate both health and economic benefits, proving to be cost-effective or even cost-saving public health interventions.