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Cessation Attempts (cessation + attempt)
Selected AbstractsSmoking after the age of 65 years: a qualitative exploration of older current and former smokers' views on smoking, stopping smoking, and smoking cessation resources and servicesHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2006Susan Kerr BA MSc PhD RN HV Abstract The aim of this study was to explore older current/former smokers' views on smoking, stopping smoking, and smoking cessation resources and services. Despite the fact that older smokers have been identified as a priority group, there is currently a dearth of age-related smoking cessation research to guide practice. The study adopted a qualitative approach and used the health belief model as a conceptual framework. Twenty current and former smokers aged , 65 years were recruited through general practices and a forum for older adults in the West of Scotland. Data were collected using a semistructured interview schedule. The audio-taped interviews were transcribed and then analysed using content analysis procedures. Current smokers reported many positive associations with smoking, which often prevented a smoking cessation attempt. The majority were aware that smoking had damaged their health; however, some were not convinced of the association. A common view was that ,the damage was done', and therefore, there was little point in attempting to stop smoking. When suggesting a cessation attempt, while some health professionals provided good levels of support, others were reported as providing very little. Some of the participants reported that they had never been advised to stop smoking. Knowledge of local smoking cessation services was generally poor. Finally, concern was voiced regarding the perceived health risks of using nicotine replacement therapy. The main reasons why the former smokers had stopped smoking were health-related. Many had received little help and support from health professionals when attempting to stop smoking. Most of the former smokers believed that stopping smoking in later life had been beneficial to their health. In conclusion, members of the primary care team have a key role to play in encouraging older people to stop smoking. In order to function effectively, it is essential that they take account of older smokers' health beliefs and that issues, such as knowledge of smoking cessation resources, are addressed. [source] Behavioral intervention to promote smoking cessation and prevent weight gain: a systematic review and meta-analysisADDICTION, Issue 9 2009Bonnie Spring ABSTRACT Aims The prospect of weight gain discourages many cigarette smokers from quitting. Practice guidelines offer varied advice about managing weight gain after quitting smoking, but no systematic review and meta-analysis have been available. We reviewed evidence to determine whether behavioral weight control intervention compromises smoking cessation attempts, and if it offers an effective way to reduce post-cessation weight gain. Methods We identified randomized controlled trials (RCTs) that compared combined smoking treatment and behavioral weight control to smoking treatment alone for adult smokers. English-language studies were identified through searches of PubMed, Ovid MEDLINE, CINAHL, EMBASE, PsycINFO and Cochrane Central Register of Controlled Trials. Of 779 articles identified and 35 potentially relevant RCTs screened, 10 met the criteria and were included in the meta-analysis. Results Patients who received both smoking treatment and weight treatment showed increased abstinence [odds ratio (OR) = 1.29, 95% confidence interval (CI) = 1.01, 1.64] and reduced weight gain (g = ,0.30, 95% CI = ,0.57, ,0.02) in the short term (<3 months) compared with patients who received smoking treatment alone. Differences in abstinence (OR = 1.23, 95% CI = 0.85, 1.79) and weight control (g = ,0.17, 95% CI = ,0.42, 0.07) were no longer significant in the long term (>6 months). Conclusions Findings provide no evidence that combining smoking treatment and behavioral weight control produces any harm and significant evidence of short-term benefit for both abstinence and weight control. However, the absence of long-term enhancement of either smoking cessation or weight control by the time-limited interventions studied to date provides insufficient basis to recommend societal expenditures on weight gain prevention treatment for patients who are quitting smoking. [source] Association of tobacco dependence and quit attempt duration with Rasch-modeled withdrawal sensitivity using retrospective measuresADDICTION, Issue 6 2009Harold S. Javitz ABSTRACT Aim To examine whether Rasch modeling would yield a unidimensional withdrawal sensitivity measure correlating with factors associated with successful smoking cessation. Design The psychometric Rasch modeling approach was applied to estimate an underlying latent construct (withdrawal sensitivity) in retrospective responses from 1644 smokers who reported quitting for 3 or more months at least once. Setting Web-based, passcode-controlled self-administered computerized questionnaire. Participants Randomly selected convenience sample of 1644 adult members of an e-mail invitation-only web panel drawn from consumer databases. Measurements Lifetime Tobacco Use Questionnaire, assessing tobacco use across the life-span, including demographics and respondent ratings of the severity of withdrawal symptoms experienced in respondents' first and most recent quit attempts lasting 3 or more months. Findings Rasch-modeled withdrawal sensitivity was generally unidimensional and was associated with longer periods of smoking cessation. One latent variable accounted for 74% of the variability in symptom scores. Rasch modeling with a single latent factor fitted withdrawal symptoms well, except for increased appetite, for which the fit was marginal. Demographic variables of education, gender and ethnicity were not related to changes in sensitivity. Correlates of greater withdrawal sensitivity in cessation attempts of at least 3 months included younger age at first quit attempt and indicators of tobacco dependence. Conclusion The relationship between tobacco dependence symptoms and Rasch-model withdrawal sensitivity defines further the relationship between sensitivity and dependence. The findings demonstrate the utility of modeling to create an individual-specific sensitivity measure as a tool for exploring the relationships among sensitivity, dependence and cessation. [source] Reduced affective symptoms during tobacco dependence treatment with vareniclineADDICTION, Issue 5 2009Martin Grosshans ABSTRACT Background The nicotinic acetylcholine receptor partial agonist varenicline has been shown to be effective in the treatment of tobacco dependence, but has been reported to induce exacerbations of psychiatric symptoms in subjects with pre-existing psychiatric disorders. Case description We report a tobacco-dependent patient who developed depression and suicidal tendencies during several cessation attempts, but was finally able to stay nicotine-abstinent by taking varenicline. Conclusion In this case varenicline did not lead to exacerbation but appeared to improve the affective symptoms. [source] Cost-effectiveness of pharmacy and group behavioural support smoking cessation services in GlasgowADDICTION, Issue 2 2009Kathleen A. Boyd ABSTRACT Aims Smokers attending group-based support for smoking cessation in Glasgow are significantly more likely to be successful than those attending pharmacy-based support. This study examined the cost-effectiveness of these two modes of support. Design Combination of observational study data and information from National Health Service (NHS) Greater Glasgow and Clyde smoking cessation services. Setting Glasgow, Scotland. Participants A total of 1979 smokers who accessed either of the cessation services between March and May 2007. Intervention Two smoking treatment services offering one-to-one support in pharmacies, and providing group counselling in the community. Measurements Routine monitoring data on resource use and smoking status (carbon monoxide-validated, self-reported, non-quitters and relapsers) at 4-week follow-up. Findings The incremental cost per 4-week quitter for pharmacy support was found to be approximately £772, and £1612 for group support, in comparison to self-quit cessation attempts. These findings compare favourably with previously published outcomes from cost-effectiveness smoking cessation studies. Assuming a relapse rate of 75% from 4 weeks to 1 year and a further 35% beyond 1 year, and combining this with an average of 1.98 quality adjusted life years (QALY) gained per permanent cessation, provides an estimated incremental cost per QALY of £4400 for the pharmacy service and £5400 for group support service. Conclusions Group support and pharmacy-based support for smoking cessation are both extremely cost-effective. [source] Reduced smoking: an introduction and review of the evidenceADDICTION, Issue 1s1 2000John R. Hughes The major questions about reductions in the number of cigarettesday as a treatment goal are (1) how many smokers can reduce and maintain such reduction, (2) how much compensation will occur, (3) will reduced smoking significantly decrease the risk of smoking and (4) will reduction promote or undermine cessation. Naturalistic studies of smokers who are not trying to stop smoking indicate that a substantial minority of smokers spontaneously reduce their number of cigarettesday and can maintain significant reductions (-7% to -43%) over long periods of time. Six experimental trials of smokers not interested in quitting were able to induce large reductions in cigarettesday (-15% to -63%) using behavioral therapy andor nicotine replacement. Reductions in toxin exposure (carbon monoxide) were not as large but still substantial (-21% to -35%). The three studies with long-term follow-ups found little loss of effects over 6-30 months. Although face-valid, there is no direct test of whether reduced smoking will decrease smoking risks and such a study would need to be very large and last for a long time. None of the above-cited studies indicate that reduction undermines the probability of future cessation attempts and several found reduction promotes future cessation. [source] Stopping antipsychotic drug therapy in demented nursing home patients: a randomized, placebo-controlled study,,The Bergen District Nursing Home Study (BEDNURS)INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 9 2008Sabine Ruths Abstract Background Despite modest efficacy, unpredictable individual utility, and a high rate of adverse effects, behavioural and psychological symptoms of dementia (BPSD) are common determinants for antipsychotic drug therapy in nursing home patients. Aims To explore the impact on BPSD of stopping long-term antipsychotic treatment in nursing home patients with dementia. Methods Fifty-five patients (43 women; mean age 84.1) taking haloperidol, risperidone, or olanzapine for BPSD were randomly assigned to cessation (intervention group, n,=,27) or continued treatment with antipsychotic drugs (reference group, n,=,28) for 4 consecutive weeks. The Neuropsychiatric Inventory (NPI) Questionnaire was used to examine changes in behavioural and psychological symptoms. Results By study completion, 23 of the 27 intervention group patients were still off antipsychotics. Symptom scores (NPI) remained stable or even improved in 42 patients (intervention group, 18 out of 27; reference group, 24 out of 28; p,=,0.18). As compared to patients with stable or improved symptom scores, patients with behavioural deterioration after antipsychotic cessation used higher daily drug doses at baseline (p,=,0.42). Conclusion A large share of elderly nursing home patients on long-term treatment with antipsychotics for BPSD, do well without this treatment. Standardized symptom evaluations and drug cessation attempts should therefore be undertaken at regular intervals. Copyright © 2008 John Wiley & Sons, Ltd. [source] | ||||||||||