Tobacco Prevention & Cessation最新文献

Introduction: Participant recruitment is critical to the success of smoking cessation trials. However, recruitment feasibility studies for inclusion and exclusion criteria commonly used in smoking cessation research remain scarce. We assessed the feasibility of recruiting potential research volunteers (PRVs) under two sets of inclusion criteria to inform eligibility requirements for a smoking cessation mobile intervention trial.

Methods: We invited PRVs nationwide to participate in qualitative evaluation of a smoking cessation mobile application. To be eligible under Criteria I, participants were aged 18-29 years, neither four-year college graduates nor enrollees, exclusive cigarette smokers, willing to quit within 30 days, and not using cessation aids. Criteria II expanded eligibility to those using cigarettes and non-combustible tobacco products (e.g. e-cigarettes) and willing to quit within 6 months. We calculated recruitment yields and associated costs.

Results: Of 10533 PRVs screened for eligibility, 48 were enrolled. Only 54 (0.5%) participants qualified under Criteria I and 164 (1.6%) under Criteria II. Age ineligibility was the top reason for exclusion (66.7%), whereas lifetime smoking, quit timeframe, and other tobacco product use contributed to ineligibility rates ranging from 46.5% to 65.3%. Enrolled participants were equally split by sex and roughly reflected the racial/ethnic composition of the United States. American Indians, who have the highest smoking prevalence, were <5% of enrolled participants. Recruitment costs averaged $106 per PRV.

Conclusions: Eligibility requirements used in cessation trials were restrictive for recruitment efforts. Relaxing inclusion criteria will reflect current tobacco use patterns and facilitate the timely completion of trials within budgetary thresholds.

Introduction: Understanding the relationship between age at smoking initiation and later smoking intensity is crucial for assessing future health consequences of smoking early and informing strategies to prevent and reduce tobacco use. This study explores the relationship between the two smoking-related behaviors among Filipino daily smokers.

Methods: Secondary data analyses from the 2021 Global Adult Tobacco Survey Philippines were performed. This study covers those who were reported to be daily smokers. The outcome of interest was smoking intensity, measured as the number of manufactured cigarettes consumed per day, while the main predictor was age at smoking initiation. Data from 2260 participants were analyzed. Negative binomial regression was used to test for the relationship between age at smoking initiation and smoking intensity while controlling for sociodemographic variables and other smoking-related behaviors.

Results: The average age at which daily smoking commenced was 20.93 (SD=6.35) years, while the average number of manufactured cigarettes consumed per day was 9.50 (SD=7.26). Age at smoking initiation was a significant predictor of smoking intensity, even after controlling for potential confounders. Each additional year in the age at which smoking was initiated was associated with a 1.55% decrease in smoking intensity in the adjusted model (β= -0.0155, p<0.0001). Other predictors of smoking intensity were current age (β=0.0072; 95% CI: 0.0050-0.0094, p<0.0001), sex (β= -0.1146; 95% CI: -0.2157 - -0.0136, p=0.0262), and smoking rules at home (β=0.1807; 95% CI: 0.1175-0.2439, p<0.0001).

Conclusions: Greater smoking intensity may be linked to early smoking initiation among Filipino adult daily smokers. The results may support interventions that target younger ages to curb heavy tobacco use at later ages.

Introduction: Comprehensive legislation covering the use of all types of tobacco and nicotine products to provide a smoke- and aerosol-free environment (SAFE) should be part of strategies aimed at phasing out tobacco use. There is a need to identify challenges and opportunities for advancing SAFE policies and their implementation. This study aims to identify barriers and opportunities to extend, enforce, and comply with SAFE policies in Europe.

Methods: Within the Joint Action on Tobacco Control 2, a cross-sectional expert consultation was launched in 2022. Data obtained through an online questionnaire including closed and open-ended questions on barriers, opportunities, and interference by the tobacco and/or nicotine industry (TNI) on the extension, and compliance with/enforcement of SAFE policies, were analyzed thematically and descriptively.

Results: From 29 European countries, 61 experts (response rate: 55.5%) were included in our sample. The most commonly identified barriers for the extension of SAFE policies were tobacco industry lobbying and funding activities, while the most commonly reported opportunity was extending SAFE policies to specific outdoor public or private places, especially where children are present. In terms of compliance with/enforcement of SAFE policies, the lack of human and financial resources and capacity to monitor/enforce compliance were the most commonly identified barriers, while opportunities included more powerful enforcement authorities with increased capacity. The experts identified greater TNI interference on the extension than on the enforcement of SAFE policies.

Conclusions: Comprehensive regulation of TNI interference and allocation of human/financial resources for policy enforcement, should be a priority for the extension of SAFE policies in Europe.

Introduction: Smoking rates among low-income smokers are significantly elevated. State tobacco quitlines offer free and evidence-based treatments for smokers living in that state. This study investigated knowledge, attitudes, and beliefs associated with engagement with the Illinois Tobacco Quitline among confirmed smoking patients at a Federally Qualified Health Center (FQHC). Further goals were to obtain recommendations for strategies to improve patient awareness and engagement.

Methods: Data for this study were collected from August to October 2021 from patients receiving care in an FQHC in a large midwestern city in the USA. Clinic-based recruitment was used to enroll a sample of adult current smokers. In-depth interviews and brief surveys were completed with a volunteer sample of patients recruited from an FQHC. The interviews took approximately 60 minutes. Data analysis used descriptive statistics to summarize the responses to the study and deductive thematic analysis to analyze the qualitative interviews.

Results: Study participants (n=25) were primarily male, African American, and middle-aged (mean age: 52.5 years). The majority were daily smokers. Over half had heard about the Quitline from sources such as radio advertisements, but usage was low. Barriers to use included low motivation to quit, questions about effectiveness, and poor success with prior Quitline attempts. Participants described factors that would increase the appeal of the Quitline, including testimonials, personalization, and an empathetic approach. Participants were asked about the acceptability of receiving information about the Quitline via patient portals, and most were in support.

Conclusions: Interventions are needed to raise awareness and utilization of Quitlines among patients receiving care in FQHC settings. Distribution of Quitline information via patient portals is an acceptable strategy for increasing awareness of services.

[This corrects the article DOI: 10.18332/tpc/191843.].

[This corrects the article DOI: 10.18332/tpc/189769.].

Introduction: Federally qualified healthcare centers (FQHC) treat a large population of low-income patients disproportionately burdened by tobacco use. This study investigated healthcare providers' knowledge, attitudes, and referral patterns of patients who smoke to a state tobacco quitline.

Methods: The study used a descriptive-qualitative design. In-depth interviews were conducted in 2021 with a sample of healthcare providers recruited from a federally qualified healthcare center (FQHC) in a large city in the Midwest. The interviews were guided by a standardized moderator's guide and lasted 30-45 minutes. Written informed consent was obtained before each interview, and participants completed a brief self-administered survey.

Results: Among the 25 participants, 92% were female and 44% were Black. Participants included medical providers (52%), behavioral health providers (16%), and other types of providers (32%). Participants' age and work experience averaged 41.5 and 5.25 years, respectively. Only 32% of providers reported having specialty training in smoking cessation or addiction counseling. Over half (52%) of the participants never or rarely referred patients to the Illinois Tobacco Quitline (ITQL). Providers reported several barriers to referring patients to the ITQL, including limited knowledge about services offered, time constraints, difficulties with the referral process, and lack of feedback between providers and the ITQL. Further, providers described patient-related barriers, including low motivation to quit smoking, language barriers, and failure of patients to respond to calls from the quitline. Recommendations were described for improving patient and provider education, referral processes, and increasing bi-directional communication between providers and the quitline.

Conclusions: Providers identified numerous barriers to referring patients for smoking cessation treatment. Addressing the identified barriers requires a multi-faceted approach involving education, streamlined processes, supportive infrastructure, and patient-centered interventions to strengthen provider use and satisfaction with the available resources.

Introduction: E-cigarette and heated tobacco product (HTP) marketing often leverages digital media and points-of-sale (POS) and advertises risk reduction, including in Armenia and Georgia where male cigarette use rates are high.

Methods: Using 2022 survey data from Armenian and Georgian adults (n=1468, mean age=42.92 years, 51.4% female; and past-month use of e-cigarettes 3.2%, HTPs 2.7%, and cigarettes 31.6%), multivariable linear regression examined 4 outcomes - e-cigarette and HTP use intentions and perceived risk (1=not at all, to 7=extremely) - in relation to past-month e-cigarette or HTP advertisement exposure via digital media, traditional media, and POS, controlling for covariates (country, age, gender, education level, relationship status, children, past-month cigarette and e-cigarette/HTP use).

Results: E-cigarette and HTP use intentions were low (mean score=1.47, SD=1.39 each), while perceived risk was high (mean score=5.83, SD=1.6, and mean score=5.87, SD=1.56, respectively). Past-month exposure to e-cigarette and HTP advertisements, respectively, were 12.9% and 11.2% via digital media, 6.1% and 4.8% traditional media, and 22.5% and 21.1% POS. For e-cigarettes, ad exposure via digital media was associated with greater use intentions (β=0.24; 95% CI: 0.03-0.44), ad exposure via traditional media (β= -0.32; 95% CI: -0.55 - -0.09) and POS (β= -0.30; 95% CI: -0.60 - -0.004) was associated with lower risk perceptions. For HTPs, ad exposure via digital media (β=0.35; 95% CI: 0.14-0.56) and POS (β=0.21; 95% CI: 0.04-3.63) was associated with greater use intentions, and ad exposure at POS was associated with lower risk perceptions (β= -0.23; 95% CI: -0.42 - -0.03).

Conclusions: Tobacco control efforts should monitor and regulate e-cigarette and HTP marketing, particularly via digital media which may effectively promote use, and via POS which may target and influence risk perceptions.