Cessation

Research

Triple therapy boosts quit rates in sick smokers
A randomized clinical trial evaluated the use of multiple pharmaceutical products for smoking cessation among patients with tobacco-related health problems. Patients who received a triple combination of the nicotine patch, nicotine oral inhaler, and bupropion had higher seven-day quit rates after six months of treatment compared to those who received the nicotine patch alone. This finding is important because over half of cancer patients continue to smoke. Patients with serious illnesses who are able to quit smoking typically live longer and experience a better quality of life than those who smoke after their diagnosis. Click here to read more. Click here to read an abstract of the study in the journal Annals of Internal Medicine.

Nicotine replacement may help smokers quit gradually
A systematic review of randomized controlled trials found that nicotine replacement therapy (NRT) can help smokers decrease their smoking, even if they do not plan to quit altogether. The analysis included studies that compared quit rates among patients who used NRT (either with or without motivational counseling) to groups that received a placebo, other pharmacological treatment, no treatment, or motivational counseling. Compared to the placebo groups, smoking cessation and reduction were more common among patients who received NRT. Because most of the evidence for NRT use comes from studies that provided behavioral support along with NRT, it is unclear whether offering NRT alone would be as effective for gradual cessation. NRT is currently FDA-approved for tobacco cessation, but not for reducing smoking frequency. Click here to read more. Click here to read the abstract of the article in the British Medical Journal.

Newly pregnant smokers have a 15-week window to quit
Smoking during pregnancy is associated with a wide range of adverse outcomes for both mother and child. A study recently published in BMJ found that women who quit smoking by their fifteenth week of pregnancy are no more likely to have premature or small babies than nonsmokers. Women who did not quit by fifteen weeks were three times more likely to give birth prematurely and twice as likely to have small babies compared to those who stopped smoking. Although it is unknown whether cessation at fifteen weeks translates to better overall health outcomes, these findings should encourage healthcare providers to offer support for smoking cessation early on in pregnancy. Click here to read more. Click here to read an abstract of the study in the British Medical Journal.

Do ex-smokers report feeling happier following cessation? Evidence from a cross-sectional survey
Researchers in London conducted a study to assess the long-term impact of smoking cessation on happiness. A cross-sectional household survey was sent to a random sample of 879 former smokers. The researchers found that the majority of participants, 69.3%, reported feeling happier after quitting smoking compared to when they were smokers, while only 3.3% reporting feeling less happy. The researchers found that increased happiness following cessation was associated with being younger and having quit at least one year prior to the study. Sociodemographic factors, prior cigarette consumption, and previous enjoyment of smoking were not associated with happiness after cessation. Even controlling for other factors, a majority of respondents reported increased happiness after tobacco cessation. Click here to read an abstract of the study in the journal Nicotine & Tobacco Research.

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Reports

Counseling and interventions to prevent tobacco use and tobacco-caused disease in adults and pregnant women
The U.S. Preventive Services Task Force (USPSTF) released recommendations that instruct healthcare providers to ask all adults about tobacco use and to provide cessation interventions for those who use tobacco. Research suggests that a combination of behavioral counseling and pharmacotherapy is the most effective approach. For pregnant women, intensive pregnancy-tailored tobacco cessation counseling should be given. These recommendations were given a grade of “A,” which indicates that there is a significant amount of evidence in the scientific literature that the benefits of following these guidelines are substantial. Click here to read the recommendation statement, which also appears here in the April 21 issue of the Annals of Internal Medicine.

Not enough smokers find quit support at the doctor’s office
The American Legacy Foundation recently conducted a national survey of more than 1,000 current smokers that suggests smokers may be overlooking critical opportunities to talk to their healthcare providers about quitting smoking. Only 52% of patients felt that their healthcare provider should help them quit smoking. Missed opportunities for smoking cessation also included a lack of patient-provider communication, patients’ uneasiness with talking to providers about smoking, and providers’ underuse of cessation resources such as self-help materials and referrals to cessation programs. Click here to learn more about the survey. Legacy has also developed a downloadable guide for smokers on how to start an effective dialogue about quitting with a health care provider. Click here to download the discussion guide from the Printout Library on the Become an Ex website.

Stop-smoking lines flooded as tobacco tax rises
Quitlines across the country were overwhelmed by record call volumes prior to the federal cigarette tax hike. Two days before the tax took effect, the National Jewish Health quitline, which manages cessation hotlines in several states, received triple its usual number of calls. Michigan’s state quitline closed temporarily in March when the hotline could not financially support the volume of calls for free nicotine replacement therapy. Because of funding limitations, services in Michigan are currently restricted to low-income callers. The Arkansas quitline was receiving around 550 calls per week in January, but by mid-March, that number jumped to over 2000 calls per week. The demand for cessation services did not slow after the tax increase was enacted on April 1. Free and Clear, a company that runs quitlines for 17 states, saw more than a 300% increase in quitline calls from the same day last year. Click here to read about quitline demand prior to the tax, or click here for an update on quitline utilization following the April 1 tax.

1-800-Quit Now Data for US States: Call Attempts 2004-2009
The National Cancer Institute recently released state-by-state statistics on calls to the national 1-800-QUIT-NOW tobacco cessation quitline over the past five years. Because of increasing demand for tobacco cessation support following the recent Federal cigarette tax increase, the quitline may receive its two-millionth call in April 2009. The quitline provides free cessation assistance and resource information to all U.S. tobacco users. The quitline program was developed in collaboration with and is sponsored by states and the US Department of Health and Human Services. Click here to download the data sheet of quitline statistics.

State releases data showing smoking rates in California continue to decline as calls to the state’s quit line reach record highs (CA)
To celebrate its twentieth anniversary, the California Tobacco Control Program released data comparing state smoking prevalence from 1988 to 2008 and showing a 43% decline in adult smoking rates. In 1988, the overall adult smoking prevalence in California was 22.7%, compared to 13.3% in 2008. The state’s per-person cigarette consumption rate declined by 67% since the program’s inception, and the youth smoking prevalence was at 14.6% in 2008--one of the lowest in the nation. The state of California was the first to establish a free telephone counseling program to help people quit tobacco. The state’s quitlines were bombarded during the first three months of 2009, with call volume up 25% from the same time period last year. Click here to read more from the California Department of Public Health.

Clark Memorial Hospital: Smokers take program or pay up (IN)
Clark Memorial Hospital of Jeffersonville, Indiana is taking what some would consider a drastic measure to ensure that its employees participate in the state smoking cessation program. Those who have not completed the program by May will be charged a tobacco use fee of $25 every two weeks. The surcharge will be deducted from smokers’ paychecks until they complete the cessation program. Hospital employees were made aware of the new policy in advance so that they would have ample time to complete the program prior to the implementation of the surcharge policy. While the ultimate goal of the program is for employees to quit smoking, there is no requirement that participants actually quit; the surcharge is ended upon completion of the cessation program. Rather than mandating that all employees quit tobacco, the hospital’s strategy is to provide the education and resources to empower employees to quit. Click here to read more.

Taking a page, and a pen, from makers of medicines (NY)
Pharmaceutical companies are known for giving away branded trinkets such as pens to market their products to physicians. This practice, called academic detailing, is a marketing strategy honed by drug companies to entice physicians to promote certain medications. The New York City Health Department has started using a similar strategy to teach physicians how to promote healthy behaviors among their patients including smoking cessation, healthy eating, and even how to spot intimate partner violence. The city officials offer “freebies” branded with the Department of Health logo, and cultivate relationships with physicians through regular visits and short education sessions. City health workers have also educated local retailers about the penalties for selling cigarettes to minors. Since the goal of the health department’s marketing strategy is to encourage healthy behaviors rather than to increase profits, the strategy has been well received. Click here to read more.

Health department airs new campaign targeting parents who smoke: Smokers are reminded of the children and families left behind when smoking claims a life (NY)
A controversial Australian smoking advertisement that featured a frightened child has been replicated by the New York Health Department to target smoking parents. The ad tugs at smokers’ heartstrings by posing the question of how children would feel if they lost a parent due to smoking related illness. The ad is being simultaneously aired with an equally innovative and dramatic presentation portraying the effects of secondhand smoke titled, “Cigarettes are Eating You and Your Kids Alive.” Click here to read more. Click here to see the smoking cessation commercials.

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International

China tells doctors to quit smoking to set example to patients (China)
The health ministry in China has launched a campaign to encourage Chinese physicians and medical workers to quit smoking. Currently, over half of male Chinese doctors are smokers, and China is the world’s biggest cigarette producer. Ten medical schools and ten medical associations have pledged to make their premises smoke-free and to promote smoking cessation among their students and doctors. The ultimate goals of the campaign are to reduce smoking among medical experts who can serve as role models for their patients, and to train tobacco control professionals within the medical community to help promote tobacco cessation. Click here to read more.

European Commission will look at which pictures work best to help smokers quit (Europe)
The European Commission is planning a study for the development of graphic images and warnings to appear on cigarette packaging. The study will identify the messages and pictures that are most effective in encouraging smokers to quit. The study is being conducted with hopes of encouraging more European Union countries to add pictorial warnings to their cigarette packages. Only three EU countries, the United Kingdom, Belgium and Latvia, have used the library of pictorial messages that the commission developed in 2005. To ensure that the findings of the study will be relevant to all EU countries, the images will be tested in all 27 member states among current smokers, potential smokers and former smokers. The commission will choose a research team by June, and study results are anticipated by early 2010. Click here to read more about the plans for the study in BMJ.

Cash incentives seen as helping nation’s health (Scotland)
Several cities in Scotland are enticing their smoking residents to quit with financial incentives. In Dundee, smokers are being offered the equivalent of $18 per week to quit, if their nonsmoking status is confirmed through carbon monoxide testing. In Essex, the National Health Service gives pregnant smokers who quit for one week a $30 food voucher. After quitting for four weeks, the women receive another voucher worth $60, and an additional $60 is offered after one year of not smoking. Other cities are offering incentives to obese patients who lose weight. Opponents of the financial incentives claim that the strategy rewards people for unhealthy behavior, and promotes a paternalistic patient-provider relationship. However, some recent evidence has shown that financial incentives can be powerful tools to promote tobacco cessation and mitigate the long-term costs associated with chronic diseases. Click here to read more about the health incentives being used in Scotland. Click here to read a synthesis of the scientific literature on the use of financial incentives and disincentives to encourage healthy behaviors that appeared in the April 2009 issue of BMJ.

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