Smoking cessation prior to elective total joint arthroplasty results in sustained abstinence postoperatively

BACKGROUND Tobacco use is a well-documented modifiable risk factor for perioperative complications.AIM To determine the tobacco abstinence rates of patients who made cessation efforts prior to a total joint arthroplasty(TJA)procedure.METHODS A retrospective evaluation was performed on 88 self-reported tobacco users who underwent TJA between 2014-2022 and had tobacco cessation dates within 3 mo of surgery.Eligible patients were contacted via phone survey to understand their tobacco use pattern,and patient reported outcomes.A total of 37 TJA patients participated.RESULTS Our cohort was on average 61-years-old,60%(n=22)women,with an average body mass index of 30 kg/m^(2).The average follow-up time was 2.9±1.9 years.A total of 73.0%(n=27)of patients endorsed complete abstinence from tobacco use prior to surgery.Various cessation methods were used perioperatively including prescription therapy(13.5%),over the counter nicotine replacement(18.9%),cessation programs(5.4%).At final follow up,43.2%(n=16)of prior tobacco smokers reported complete abstinence.Patients who were able to maintain cessation postoperatively had improved Patient-Reported Outcomes Measurement Information System(PROMIS)-10 mental health scores(49 vs 58;P=0.01),and hip dysfunction and osteoarthritis outcome score for joint replacement(HOOS.JR)scores(63 vs 82;P=0.02).No patients in this cohort had a prosthetic joint infection or required revision surgery.CONCLUSION We report a tobacco cessation rate of 43.2%in patients undergoing elective TJA nearly 3 years postoperatively.Patients undergoing TJA who were able to remain abstinent had improved PROMIS-10 mental health scores and HOOS.JR scores.The perioperative period provides clinicians a unique opportunity to assist active tobacco smokers with cessation efforts and improve postoperative outcomes.

Persuasive Technology for the Future of Smoking Cessation*

This paper explores the integration of persuasive technology into smoking cessation efforts through the development and evaluation of a mobile app, “No-Smoke.” Leveraging compelling features like social support, tracking, planning, and motivation, the app aims to augment user engagement and support the process of quitting smoking. The efficacy of these features has been substantiated through both automated testing and user feedback, highlighting their potential to enhance awareness, motivation, and behavior modification. Despite notable successes, limitations, including a limited user base and uncertainties regarding long-term efficacy, have been acknowledged, stemming from the inherent complexities of smoking cessation. Nevertheless, based on user experiences and feedback, “No-Smoke” represents a promising advancement in the use of technology for public health interventions, particularly in the realm of smoking cessation. To address existing challenges, future research is recommended to encompass a comprehensive, long-term study involving a larger and more diverse user base. Additionally, further investigation should focus on personalization enhancements and the integration of machine learning algorithms to better understand and respond to user behavior.

Supporting smoking cessation in healthcare: obstacles in scientific understanding and tobacco addiction management

Despite ongoing efforts to reduce tobacco smoking, the smoking prevalence in many countries has remained stable for years. This may be a consequence of either lack of knowledge about effective ways to reduce smoking, or failing treatment of tobacco addiction in healthcare. This study explored gaps in the current understanding of smoking cessation and the challenges facing tobacco addiction management in order to formulate recommendations for future research and healthcare practice. A narrative review was written to determine areas in which more research is needed as well as areas in which sufficient knowledge is already available. Recommendations for future research were prioritised using a Delphi-procedure. Recommendations for healthcare practice were confirmed by expert’s assessment. Smoking is not widely acknowledged as an addiction and a relatively small number of smokers ask help from a healthcare professional when trying to stop smoking. Most healthcare professionals recognise the importance of advising patients to stop smoking, but experience certain barriers to actually do this. Overall, healthcare professionals need to be convinced that tobacco smoking is an addiction and should be treated likewise. If all healthcare professionals systematically advise their patients to give up smoking, eventually more smokers will successfully stop smoking.

Impacts of Preoperative Smoking and Smoking Cessation Time on Preoperative Peripheral Blood Inflammatory Indexes and Postoperative Hospitalization Outcome in Male Patients with Lung Cancer and Surgery Treatment

Objectives To investigate the effects of preoperative smoking and smoking cessation time on preoperative peripheral blood inflammatory indexes and postoperative hospitalization outcomes in male patients with lung cancer and surgery therapy.Methods We retrospectively enrolled 637 male patients who underwent curative-intent lung cancer resection between January 2014 and December 2016.Patients were classified as the current smokers,the never smokers,and the ex-smokers based on their smoking history,and the ex-smokers were allocated into five subgroups according to their smoking cessation times(CeT):CeT W6 weeks,6weeks<CeT W lyear,lyear<CeT<5years,5years<CeT<lOyears,CeT>10years.The preoperative peripheral blood white blood cells(WBCs),albumin,neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),intraoperative blood loss,30-day mortality,in-hospital days,hospitalization costs,intensive care un辻(ICU),admission days and placement time of closed thoracic drainage tube were compared among difTerent groups.Results There were significant differences in WBC(F=S.275,P<0.001)and albumin(F=2,470,P<0.05)among patients of current smokers,ex-smokers with different smoking cessation time,and never-smokers.The blood WBC count in current smokers(7.7 X 109/L)was significantly higher than that in ex・smokers(7.0 X 109/L)and never-smokers(5.9 X 109/L)(t=-2.145,P<0.05;t=-6.073,P<0.01,respectively).The level of peripheral blood albumin in current smokers(41.1 g/L)was lower than that in ex・smokers(42.1 g/L)and neve—smokers(43.2 g/L)(t=2.323,P<0.05;t=3.995,P<0.01,respectively).The level of peripheral blood NLR in current smokers(3.7)was higher than that in ex-smokers(3.1)and never smokers(2.8)(t—-1.836,P<0.05;t=-2.889,P<0.01,respectively).There was no significant difference in WBC,albumin and NLR among five subgroups of different smoking cessation time.No significant difference was observed in intraoperative blood loss,30-day mortality,hospitalization costs,hospital stay,ICU stay and placement time of closed thoracic drainage tube among groups either.Conclusion Smoking increases the preoperative inflammatory indexes in peripheral blood of lung cancer patients.Smoking cessation has beneficial effect on reducing levels of these inflammatory indexes,which may be not impacted by the time length of smoking cessation.Therefore,lung cancer patients should be encouraged to quit smoking at any time.

Motivations, Challenges and Coping Strategies for Smoking Cessation: Based on Multi-ethnic Pregnant Couples in Far Western China

The present study aimed to clarify the smoking cessation motivations, challenges and coping strategies among pregnant couples. A qualitative design using a grounded theory approach was applied. Data were collected by individual semi-structured interviews with 39 married individuals(21 non-smoking pregnant women and 18 smoking or ever-smoking men with a pregnant wife) and 3 imams in an ethnically diverse region of far western China. The most common theme for smoking cessation motivation was 'embryo quality'(i.e., a healthier baby), followed by family's health. Most interviewees reported that husband's withdrawal symptoms were the greatest challenge to smoking cessation, followed by the Chinese tobacco culture. Coping strategies given by the pregnant women typically involved combining emotional, behavioral and social interventions. Social interventions showed advantages in helping to quit smoking. Pregnancy appears to be a positive stimulus for pregnant couples' smoking cessation. Our results suggest that pregnancy, a highly important life event, may help to reduce barriers to smoking cessation at the social level(e.g., limiting access to cigarettes, avoiding temptation to smoke), but does little to help with the withdrawal symptoms. Professional guidance for smoking cessation is still necessary.

Mining twitter to understand the smoking cessation barriers

Smoking cessation is challenging and lack of positive support is a known major barrier to quitting cigarettes.Previous studies have suggested that social influences might increase smokers' awareness of social norms for appropriate behavior,which might lead to smoking cessation.Although social media use is increasing among young adults in the United States,research on the relationship between social media use and smoking cessation is lacking.Twitter has provided a rich source of information for researchers,but no overview exists as to how the field uses Twitter in smoking cessation research.To the best of our knowledge,this study conducted a data mining analysis of Twitter to assess barriers to smoking cessation.In conclusion,Twitter is a cost-effective tool with the potential to disseminate information on the benefits of smoking cessation and updated research to the Twitter community on a global scale.

A Comparative Study for Successful Treatment per Gender in a Specialized Smoking Cessation Unit in the Albacete University Hospital during Two Years

Objective： Analysis of abstinence rates of smokers per gender at 3, 6, 9 and 12 months in a Smoking Cessation Unit from January 2008 to December 2009. Methods： Descriptive retrospective study. Analysis of socio-demographic variables, smoking patterns, associated comorbidities, continuous abstinence rates, success, relapses, failure and dropping out. Results： 278 smokers started treatment （33%）; 55.4% males and 44.6% females （mean age of 48.3 and 44.06 years, respectively）. The main associated comorbidities were： psychiatric （38.7%）, cardiovascular （dyslipemia 25%） and respiratory （COPD （chronic obstructive pulmonary disease） 9.7%） in females; cardiovascular （dyslipemia 34.4%）, psychiatric （34.4%） and respiratory （COPD 19.5%） in males. VRN （Varenicline） was prescribed in 40.2% males and 32.2% females; NRT （nicotine replacement therapy） was used in 46.6% and 38.7%, respectively; bupropion was employed in 6.5% and 21.8%, respectively. Psychological counseling was offered only to 7.8% males and 8.1% females. The continuous abstinence rates in males at 3, 6, 9 and 12 months were 51.3%, 37.7%, 32.5% and 30.5%, respectively, and were 45.2%, 29.8%, 25.0% and 24.2% for females. Failure was 9.7% for females and 18.8% for males. Success was more frequent for those on VRN （n = 41 males; n = 12 females）. No relapses were indicated for 42 females and 71 males. The percentage of relapses was higher at 3 months （29.0% females, 19.5% males）. Conclusions： The study observed differences in treating abstinence between genders （in the abstinence rates and failure index）. This implies having to consider incorporating the gender variable into the diagnosis, treatment and prevention of smoking.

Identifying Distinct Quitting Trajectories after an Unassisted Smoking Cessation Attempt: An Ecological Momentary Assessment Study

Objectives: This study aimed at identifying distinct quitting trajectories over 29 days after an unassisted smoking ces- sation attempt by ecological momentary assessment (EMA). In order to validate these trajectories we tested if they predict smoking frequency up to six months later. Methods: EMA via mobile phones was used to collect real time data on smoking (yes/no) after an unassisted quit attempt over 29 days. Smoking frequency one, three and six months after the quit attempt was assessed with online questionnaires. Latent class growth modeling was used to analyze the data of 230 self-quitters. Results: Four different quitting trajectories emerged: quitter (43.9%), late quitter (11.3%), returner (17%) and persistent smoker (27.8%). The quitting trajectories predicted smoking frequency one, three and six months after the quit attempt (all p < 0.001). Conclusions: Outcome after a smoking cessation attempt is better described by four distinct trajectories instead of a binary variable for abstinence or relapse. In line with the relapse model by Marlatt and Gordon, late quitter may have learned how to cope with lapses during one month after the quitting attempt. This group would have been allocated to the relapse group in traditional outcome studies.

Impact of smoking cessation counseling among acute myocardial infarction patients on post-hospitalization mortality rates:a systematic review

Objective:The current systematic review aimed to assess the impact of smoking cessation counseling(SCC)on patients’short-and long-term mor tality after acute myocardial infarction(AMI).Methods:The Cochrane guidelines were used to conduct a systematic review of Medline(Pub Med),Science Direct,CINAHL Cochrane database,and Google Scholar for studies on the impact of SCC on AMI patients’mor tality.Results:Five studies were found to meet the predefined inclusion criteria.Smoker patients were not routinely counseled to quit smoking during their post-AMI hospital stay.Studies showed a reduction in mor tality among AMI patients’who received SCC compared with patients who did not receive it.Conclusions:SCC during hospitalization and after discharge is a simple and cost-effective intervention that improves AMI patients’survival.

Smoking Cessation in the Middle East after Percutaneous Coronary Intervention. Results from the First Jordanian Percutaneous Coronary Intervention Registry (JoPCR1)

Background: Cigarette smoking (CS) is a major risk factor for cardiovascular disease (CVD) in the Middle East. Little is known about the rate of SC in patients following percutaneous coronary intervention (PCI) and the clinical and angiographic features and one-year outcome among quitters compared with persistent smokers. Methods and Results: Of 2425 patients enrolled in a prospective multicenter PCI registry, 1055 (43.5%) were smokers (mean age 53.7 + 5.7 years) and 94% were males. PCI was indicated for ACS in 862 patients (82%). The rate of CS was 33%, 30% and 31%, at 1, 6 and 12 months after discharge, respectively. Compared with persistent smokers, quitters were more likely to have diabetes (50.4% vs. 42.0%;p = 0.028), low left ventricular ejection fraction (18.1% vs. 9.3%;p = 0.0004), and heart failure (15.4% vs. 9.0%;p = 0.0008). There were no differences between quitters and persistent smokers in age, gender, or severity of coronary lesions. Assessing the major complications and cardiovascular events during the index admission and at one year in non-smokers, quitters and persistent smokers showed that the incidence rates of in-hospital major bleeding events and cardiovascular deaths differed significantly among the three groups of patients (p-value = 0.017 for major bleeding, and 0.012 for cardiovascular death). The rates of these two complications were significantly higher among non-smokers compared to quitters and persistent smokers, and the rate of major bleeding was almost double in quitters compared to persistent smokers. Moreover, the three groups differed significantly in the rates of major bleeding, cardiovascular death and coronary revascularization after one year of follow-up. The incidence rates of major bleeding and cardiovascular death after one year were the highest among non-smokers followed by quitters and persistent smokers. The rate of coronary revascularization was significantly higher in quitters compared to non-smokers and persistent smokers. Conclusion: The rate of CS among Middle Eastern patients who undergo PCI is around 30%. Comprehensive secondary prevention strategy in such patients should include an effective smoking cessation program that extends beyond hospital discharge. Larger studies that extend the follow-up for several years are needed to document a positive impact of SC on improving cardiovascular outcome.

Smoking reduction did not promote future smoking cessation in a general population

Introduction: Smoking reduction (SR) has been introduced as a strategy for smokers who are unwilling or unable to quit. We wanted to investi tigate whether SR at one-year follow-up increased the probability of abstinence from smoking at three and five-year follow-up. Methods: we included a random sample from a general population, the Inter99 study, Copenhagen, Denmark. A total of 1975 participants were daily smokers (from both the intervention and the control group) with information on tobacco consumption at both baseline and one-year follow-up (year 1999 to 2001). Of these, 112 had reduced their tobacco consumption substantially, by minimum 50%, at one-year follow-up. Information on tobacco consumption and smoking status was available on 1441 and 1308 participants at three-year and five-year follow-up, respectively. Outcome was self-reported point abstinence at three and five-year follow-up. Logistic regression analyses were adjusted for confounders. Results: One out of five smokers (20.5%) had maintained their reduced tobacco consumption at five-year follow-up. About twice as many reducers as non-reducers reported that they had tried to quit since baseline (p < 0.05). In adjusted logistic regression analyses we found no association between SR at one-year follow- up and being point abstinent at three-year (OR: 0.57;CI: 0.28 - 1.15) or five-year follow-up (OR: 1.08;CI: 0.56 - 2.09). Conclusions: Our study, including smokers from a general population found no association between substantial SR and future smoking cessation at three- and five-year follow-up. No studies so far have reported that SR undermines smoking cessation, but it is still controversial whether SR significantly increases future smoking cessation.

Net Effect of Short-Term Smoking Cessation on Mental Health Changes:Inverse Probability of Treatment Weighting and Difference-in-Differences Method

Background:In response to the need for research clearly demonstrating the net effect of smoking cessation on mental health status,considering the causal relationship between smoking cessation and changes in mental health status,this study was undertaken.Thus,this study aimed to examine the net effect of short-term smoking cessation on five specific mental health metrics and the overall mental health status score.Methods:We used data from the first wave of the Korean Health Panel(KHP)Survey(2011–2013,2016–2018)and focused on men aged 19 years and older,to explore the effects of smoking cessation.We compared mental health status before and after cessation among current non-smokers who had quit smoking and continuous smokers.We ensured homogeneity between the two groups via inverse probability of treatment weighting(IPTW)and employed a difference-in-differences(DID)analysis to assess changes in mental health status.This study controlled for factors that could influence mental health and explored the net effect of short-term smoking cessation through difference-in-differences model using multiple regression analysis.Results:The results showed that short-term smoking cessation significantly alleviated mental and physical stress(p<0.1),reduced experiences of frustration(p<0.01),and improved the overall mental health status score(p<0.1).Conclusion:Thus,these results highlight a meaningful link between positive health behavior changes,such as smoking cessation,and enhanced mental health.Moreover,the application of temporal variables further improved the understanding of the causal relationship between health behaviors and mental health.

Efficacy of digital therapeutics in smoking cessation: A systematic review and meta-analysis

Intervention based on“digital therapeutics”(DTs)to aid smoking cessation(SC)has developed in recent years.This systematic review and meta-analysis aimed to explore the efficacy of DTs in SC.Databases(PubMed,Embase,Scopus,Institute of Electrical and Electronics Engineers Xplore,ClinicalTrials,Science Direct,Web of Science,China National Knowledge Infrastructure,Chinese Science and Technology Periodical Database,Wanfang,Cochrane Central Register of Controlled Trials)from inception to June 27,2022 were searched to collect randomized controlled trials focusing on use of DTs for SC.Revman 5.3 and Stata16 were used for meta-analysis.After literature screening,data extraction,and quality assessment by two researchers.33 studies(19,749 participants)were included.Compared with the control group,DTs significantly increased the prevalence of abstinence of smokers[OR=1.77,95%CI[1.39,2.26],p=0],significantly increased the point prevalence abstinence(PPA)[OR=1.45,95%CI[1.18,1.78],p=0],and improved participation in SC programs[OR=1.12,95%CI[1.01,1.24],p=0.038].Subgroup analysis showed that,among different intervention groups,the prevalence of DTs-assisted SC in chronic obstructive pulmonary disease(COPD)smokers was higher than that in other groups[OR=5.18,95%CI[1.49,18.05],p=0.001],the prevalence of WeChat-assisted SC in smokers was higher than that in other groups[OR=4.37,95%CI[2.21,8.67],p=0].This meta-analysis showed that DTs-assisted SC improved the prevalence of abstinence,PPA,and increased the participation of smokers in SC programs.

CD8＋ Tc-lymphocytes immunodeviation in peripheral blood and airway from patients of chronic obstructive pulmonary disease and changes after short-term smoking cessation

Background Cigarette smoke induces an acute but persisting inflammation in peripheral blood and airway in chronic obstructive pulmonary disease （COPD）,and CD8＋ Tc-lymphocytes are considered as a key role in this process.We aimed to investigate the Tc-lymphocytes immunodeviation in system and local airway of COPD patients and changes of the immunodeviation after short-term smoking cessation.Methods Peripheral blood （PB） and bronchoalveolar lavage fluid （BALF） were collected from 42 patients （14 COPD patients,16 smokers with normal lung function and 12 nonsmokers）,while PB and induced sputum （IS） were obtained from other 19 patients （10 quitting smokers and 9 continuing smokers） at baseline and follow-up respectively of 4-week smoking cessation.Percentages of CD8＋ Tc-lymphocytes （%CD3＋） and Tc1/Tc2 ratios were measured by flow cytometry.Results Percentages of CD8＋ Tc-lymphocytes were higher in COPD patients than those in smokers and nonsmokers in both PB and BALF.Tc1/Tc2 ratio in PB and in BALF from COPD patients was greater than that from smokers and nonsmokers and negatively correlated with FEV1%pre.When comparing the ratios between PB and BALF,significantly positive correlation was found in COPD patients.Furthermore,after 4-week smoking cessation,percentages of CD8＋ Tc-lymphocytes in PB and IS in quitting smokers were decreased compared to that in baseline and continuing smokers,whereas Tc1/Tc2 ratios were not influenced.Conclusions CD8＋ Tc1-trend immunodeviation profiles occurred in both system and local airway of COPD patients.This exceptional immunodeviation could not be relieved by short-term smoking cessation.

Impact of weight gain following smoking cessation on one-year outcome after drug-eluting stent implantation

Background Weight gain following smoking cessation increases cardiovascular risk, but its effects on prognosis after percutaneous coronary intervention （PCI） remain unclear. This study aimed to investigate the relationship between weight gain post smoking cessation and one-year clinical outcome in patients who underwent PCI with drug-eluting stent （DES）. Methods A total of 895 consecutive male smoking patients were divided into quitters （n=437） and continuers （n=458） according to their smoking status after PCI. Weight gain, major adverse cardiac events （MACE, including cardiac deaths, myocardial infarction and revascularization）, and recurrent angina were recorded during follow-up for one year. Results Average weight gain in quitters was more than that in continuers （1.5 kg vs. -0.03 kg, P〈0.001）. Weight was unchanged or increased by more than 1.5 kg in 78.17% of continuers, while 50.57% of quitters had a weight gain of less than 1.5 kg. Compared with continuers, MACE in quitters was significantly reduced after PCI （6.12% vs. 4.81%, P=0.049）, especially recurrent angina （13.97% in continuers vs. 9.84% in quitters, P=0.027）. After adjusting for weight gain and other factors, smoking cessation was independently associated with a lower risk of MACE and recurrent angina （0R=0.73, P=0.035）. However, weight gain 〉1.5 kg （OR=1.55, P=0.026） could curtail the benefits from smoking cessation. Conclusions Weight gain may reduce the benefits of smoking cessation after PCI with DES implantation. Thus, although smoking cessation is recommended after PCI, weight control should also be highly encouraged for these patients.

Effect of smoking cessation on airway inflammation of rats with chronic bronchitis

Background Smoking is the major cause of airway inflammation in chronic obstructive pulmonary disease （COPD）, and smoking cessation is regarded as one of the important strategies for prevention and treatment of the inflammation. The inflammation of the chronic airway may be present and deteriorated even if the COPD patients stop smoking. Whether and how early smoking cessation affects the progress of inflammation is still obscure. This study was conducted to find the appropriate time for smoking cessation to terminate the airway inflammation in rats with smoke-induced chronic bronchitis. Methods A rat model of COPD was established by passively inhaling smoke mixture. Fifty-four young male Sprague-Dawley rats were randomly divided into 9 groups with different periods of smoke exposure and different time points of cessation. The inflammation markers to be detected included inflammatory cells in the bronchoalveolar lavage fluid （BALF）, the myeloperoxidose （MPO） activity, the morphologic changes and the expression of ICAM-1 on the airway epithelium. Results When smoking was terminated at early stage, the inflammatory markers and related indexes were different from those of the typical chronic bronchitis group （group M7） （P〈0.01）. The pathologic score of group SC7 （2 weeks of smoking cessation after occurrence of typical chronic bronchitis ） was not different from that of group M7, and the level of ICAM-1 was still up-regulated （compared to group M7, P〉0.05）. Meanwhile, most of inflammatory cells in BALF were neutrophils compared to other groups （P〈0.01）.When smoking was terminated, the MPO activity was significantly lower than that of group M7 （P〈0.01）. Conclusions Smoking cessation at early stage can effectively inhibit the inflammatory reaction of COPD. Once chronic bronchitis occurs, little could be improved by smoking cessation.

Evaluation of 3-day smoking cessation training course for doctors from 38 cities in China

Background The World Health Organization＇s ＂Framework Convention on Tobacco Control＂ came into effect in China in 2006. Since then, a series of tobacco control measures has been undertaken, including the first step to establish a coordinated network of stop-smoking clinics in Chinese hospitals. Training for stop-smoking specialists has been traditionally provided via printed materials. This study evaluated the outcomes of the first two intensive 3-day courses in smoking cessation in China run in collaboration with experts who provide training to UK Specialist Stop Smoking Service. Methods Eighty-four doctors from 38 cities in China responsible for stop-smoking treatment in 20 provinces and four autonomous regions participated in the training courses. Participants＇ knowledge competencies and self-efficacy were assessed before and after the authentication training. Results The training significantly improved participants＇ knowledge, skills and self-efficacy across different domains. Forty-eight participants were finally certified as ＂smoking cessation specialist＂. Conclusions The UK model of face-to-face training was acceptable and effective in China. A relatively brief intensive training program can generate significant improvements in skills, knowledge, and readiness to engage in smoking cessation activities.

Effect of acupuncture treatment on smoking cessation in smokers from Hong Kong

OBJECTIVE: To analyze the characteristics of smokers treated with acupuncture for smoking cessation in Hong Kong.METHODS: A total of 2051 subjects were recruited in a clinical pilot research project "acupuncture for smoking cessation", which was conducted jointly by Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences and Hong Kong Pok Oi Hospital from January of 2011 to December of 2013. The characteristics of study subjects, including baseline information, smoking background, intention to quit and influencing factors were analyzed.RESULTS: The majority of subjects treated with acupuncture for smoking cessation in Hong Kong was male(66.7%), but the proportion of female smokers in this study(33.3%) was higher than that of female smokers in Hong Kong population(13.8%, P <0.05). Subjects were at the mean age of 43.83 years old, of which the percentage of females aged 31-40 years was the highest(38.8%, P < 0.05). The mean duration of smoking was 25.49 years. The number of cigarettes smoked per day was 17.57 cigarettes.Fagerstrom Test for Nicotine Dependence(FTND)was 5.29 points. Most of the subjects had attempted quitting smoking(81.42%). The confidence index(7.44 points) and the readiness to quit smoking(8.13 points) were high. Subjects quitting smoking were mostly due to health cause(81.91%). The majority of subjects were at the level of middle school(61.63%). The higher the educational level was, the lower the tobacco dependence was and the higher the confidence in successfully quitting smoking was. 50.27% of subjects chose acupuncture for smoking cessation mainly through friends, television and network publicity. Subjects who had received acupuncture had the highest confidence index, while those who wanted to try a new method had the lower confidence index.CONCLUSION: Acupuncture for smoking cessation was more popular in female smokers, especially those aged 31-40 years. The effectiveness of acupuncture-smoking cessation was most significant in the smokers over 60.

Effectiveness of an employment-based smoking cessation assistance program in China

Objective:The objective of this study was to adapt an evidence-based smoking cessation intervention initially developed in the United States to the Chinese context and evaluate the ef-fectiveness of this intervention in China.Method:A smoking cessation program from United States was adapted and implemented through an Employee Assistance Program(EAP)in China.The intervention consisted of recom-mending medication and psychological counseling.Local EAP counselors received training on the program and delivered the intervention to clients.Program evaluation examined the intervention's effectiveness in helping clients quit or reduce the amount of smoking and nicotine dependence.Results:Ninety-day follow-up showed that those who had completed the program were more likely to remain abstinent,or stop smoking daily and have lower levels of nicotine dependence(p<0.05)than those who had dropped out.Conclusions:The evidence-based cessation program is effective in helping Chinese smok-ers quit or reduce the amount of smoking.Moreover,implementing such programs in an EAP setting is a practical approach to providing a wider spectrum of smokers with access to cessation assistance in China.

Nicotine gum or patch treatment for smoking cessation and smoking reduction： a multi-centre study in Chinese physicians

In China, around 23% of physicians （41% male, 3% female） currently smoke. Pharmacotherapy for tobacco dependence is available, but is not widely used in China. The purpose of this study was to estimate the effectiveness and the safety on smoking cessation of nicotine gum and nicotine patch in Chinese healthcare professionals. Three hundred regular smokers motivated to quit were recruited from six hospitals in China. All subjects were accepted nicotine replacement therapy, and they could choose nicotine gum （2 mg or 4 mg, depending on baseline smoking level） or nicotine patch （15 mg/16 h） for 12 weeks, with a 12-week follow-up. Limited behavioural support was provided. At Week 24, the 2-24 weeks continuous abstinence rate （verified by expired carbon monoxide） was 17%, the point prevalence abstinence rate （no smoking since the previous visit） was 35%, and 38% of subjects had continuously reduced their daily cigarette consumption by at least 50% versus baseline. Compliance with treatment was good, particularly with patch. No serious adverse event was reported, and most adverse events were mild or moderate. The most common treatment-related adverse events were gastro- intestinal （both gum and patch） and local irritation symptoms. Nicotine patch and gum were well tolerated in Chinese smokers. Abstinence rates were comparable to those previously reported with nicotine replacement therapy, and many smokers who did not quit substantially reduced their cigarette consumption.