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Cessation Support (cessation + support)
Selected AbstractsPostgraduate education for doctors in smoking cessationDRUG AND ALCOHOL REVIEW, Issue 5 2009NICHOLAS A. ZWAR Abstract Introduction and Aims. Smoking cessation advice from doctors helps improve quit rates but the opportunity to provide this advice is often missed. Postgraduate education is one strategy to improve the amount and quality of cessation support provided. This paper describes a sample of postgraduate education programs for doctors in smoking cessation and suggests future directions to improve reach and quality. Design and Methods. Survey of key informants identified through tobacco control listserves supplemented by a review of the published literature on education programs since 2000. Programs and publications from Europe were not included as these are covered in another paper in this Special Issue. Results. Responses were received from only 21 key informants from eight countries. Two further training programs were identified from the literature review. The following components were present in the majority of programs: 5 As (Ask, Advise, Assess, Assist and Arrange) approach (72%), stage of change (64%), motivational interviewing (72%), pharmacotherapies (84%). Reference to clinical practice guidelines was very common (84%). The most common model of delivery of training was face to face. Lack of interest from doctors and lack of funding were identified as the main barriers to uptake and sustainability of training programs. Discussion and Conclusions. Identifying programs proved difficult and only a limited number were identified by the methods used. There was a high level of consistency in program content and a strong link to clinical practice guidelines. Key informants identified limited reach into the medical profession as an important issue. New approaches are needed to expand the availability and uptake of postgraduate education in smoking cessation.[Zwar NA, Richmond RL, Davidson D, Hasan I. Postgraduate education for doctors in smoking cessation. Drug Alcohol Rev 2009;28:466,473] [source] Unplanned attempts to quit smoking: a qualitative explorationADDICTION, Issue 7 2010Rachael L. Murray ABSTRACT Aims To gain a greater understanding of the process of unplanned attempts to quit smoking and the use of support in such attempts. Design Qualitative study using semi-structured interviews with 20 smokers and ex-smokers. Setting Twenty-four general practices in Nottinghamshire, UK. Participants Smokers and ex-smokers who reported that their most recent attempt to quit smoking was unplanned. Measurements Descriptions of the unplanned quit attempts and reported use of support within these. Findings Smokers who report making ,unplanned' quit attempts exhibit substantial variation in what they mean by this; many quit attempts reported as ,unplanned' were actually delayed and involved some planning and use of cessation support. Conclusions Reported ,unplanned' quit attempts often involve elements of planning and delay for quitters to access to cessation support. It is important, therefore, that smoking cessation services offer flexible and adaptable support which can be used readily by potential quitters. [source] If you try to stop smoking, should we pay for it?ADDICTION, Issue 6 2010The cost, utility of reimbursing smoking cessation support in the Netherlands ABSTRACT Background Smoking cessation can be encouraged by reimbursing the costs of smoking cessation support (SCS). The short-term efficiency of reimbursement has been evaluated previously. However, a thorough estimate of the long-term cost,utility is lacking. Objectives To evaluate long-term effects of reimbursement of SCS. Methods Results from a randomized controlled trial were extrapolated to long-term outcomes in terms of health care costs and (quality adjusted) life years (QALY) gained, using the Chronic Disease Model. Our first scenario was no reimbursement. In a second scenario, the short-term cessation rates from the trial were extrapolated directly. Sensitivity analyses were based on the trial's confidence intervals. In the third scenario the additional use of SCS as found in the trial was combined with cessation rates from international meta-analyses. Results Intervention costs per QALY gained compared to the reference scenario were approximately ,1200 extrapolating the trial effects directly, and ,4200 when combining the trial's use of SCS with the cessation rates from the literature. Taking all health care effects into account, even costs in life years gained, resulted in an estimated incremental cost,utility of ,4500 and ,7400, respectively. In both scenarios costs per QALY remained below ,16 000 in sensitivity analyses using a life-time horizon. Conclusions Extrapolating the higher use of SCS due to reimbursement led to more successful quitters and a gain in life years and QALYs. Accounting for overheads, administration costs and the costs of SCS, these health gains could be obtained at relatively low cost, even when including costs in life years gained. Hence, reimbursement of SCS seems to be cost-effective from a health care perspective. [source] Follow-Up Comparisons of Intervention and Comparison Schools in a State Tobacco Prevention and Control InitiativeJOURNAL OF SCHOOL HEALTH, Issue 3 2006Phyllis Gingiss The intervention, which was funded through the Texas Department of State Health Services, consisted of guidance, training, technical assistance, and reimbursement of approximately $2000 per year for program expenses. Self-administered written surveys for Principals and Health Coordinators, based on the School Health Education Profile Tobacco Module, were designed for periodic assessment of the status of school programs. Surveys were sent in 2002 to intervention (n = 74) and comparison (n = 60) schools. Response to the Principal Survey was received from 109 (81%) schools, and response to the Health Coordinator Survey was received from 84 (63%) schools. Survey analysis showed that intervention schools more frequently (p , .05) reported: (1) being extremely or moderately active in student cessation support, teacher training, policy development, family involvement, and assessment of the prevention program; (2) using recommended curricula, offering more tobacco-related lessons, involving more teachers, and using more recommended teaching methods such as role-playing, simulations or practice, and peer educators; and (3) having more interest in staff development and more funding to purchase release time. Similarities across schools are provided, as well as recommendations for future planning. (J Sch Health. 2006;76(3):98-103) [source] A Clinical Imperative: Assisting Patients Who Smoke to Reduce Their Risk of Cardiovascular DiseasePREVENTIVE CARDIOLOGY, Issue 2007Chris Bullen MBChB The role of tobacco smoking as a cause of cardiovascular disease is now unequivocal and well-documented in literally hundreds of epidemiologic and biomedical studies over the past 50 years. Cessation of smoking, on the other hand, swiftly and profoundly reduces the risks of a cardiovascular event. Thus, smoking cessation should be seen as perhaps the most effective lifesaving intervention in the physician's armamentarium. Despite this widely available knowledge, and evidence that most smokers want to quit, relatively few physicians offer cessation support to their smoking patients, even those at high risk for a cardiovascular event. This article reviews the links between tobacco smoking and cardiovascular disease, argues for a greater role for physicians in assisting smokers to quit, and highlights the most effective interventions currently available. [source] | ||||||||||