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, tra...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.展开更多
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, ...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.展开更多
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 canc...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.展开更多
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 ...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.展开更多
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...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.展开更多
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...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.展开更多
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 th...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.展开更多
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 abstine...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.展开更多
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,S...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.展开更多
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 pr...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.展开更多
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 relat...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.展开更多
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 ...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.展开更多
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 ...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.展开更多
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 ...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.展开更多
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...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.展开更多
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 effective...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.展开更多
Objective:The 5As framework(ask,advise,assess,assist,arrange)is a recommended strat-egy for smoking cessation counseling in primary care.This study compares patient report with direct observation to assess the degree ...Objective:The 5As framework(ask,advise,assess,assist,arrange)is a recommended strat-egy for smoking cessation counseling in primary care.This study compares patient report with direct observation to assess the degree of recall bias for each of the 5As.Methods:Primary care visits by 107 adult smokers and 16 physicians were audio-recorded.Within 48 hours after the visit,patients completed a survey assessing whether or not smoking was discussed and items specific to each of the 5As.The audio recordings were evaluated to assess the presence of each A.The sensitivity,specificity,positive predictive value,and negative predictive value of patient report versus direct observation were computed.Results:The frequency of the 5As based on evaluation of the audio recording ranged from 13% (arrange)to 98% (ask).The sensitivity and specificity of patient report were 92% and not applicable for ask,90% and 50% for assess,94% and 33% for advise,90% and 50% for assist,and 85% and 67% for arrange follow-up.Positive predictive values ranged from 28% to 98%;negative predictive values ranged from 0% to 97% .Conclusion:Compared with the gold standard of direct observation,patient report of each of the 5As is reasonably sensitive but not specific.Patients overreport the occurrence of each of the 5As.展开更多
Objective Cigarette smoking is one of the established risk factors of atherosclerotic cardiovascular disease, however, its impact on lipids is not completely understood, especially in the Chinese population. Therefore...Objective Cigarette smoking is one of the established risk factors of atherosclerotic cardiovascular disease, however, its impact on lipids is not completely understood, especially in the Chinese population. Therefore, this study evaluated the impact of smoking status (non, former, and current smoking) on the distribution of lipoprotein subfractions in untreated patients with angina-like chest pain. Methods A total of 877 patients were consecutively enrolled and divided into nonsmoking (n = 528), former smoking (n = 103), and current smoking (n = 256) groups. Both low- and high-density lipoprotein cholesterol (LDL-C and HDL-C) subfractions were measured using the Quantimetrix Lipoprint System. The distributions of lipoprotein subfractions were evaluated among the groups. Results Compared with nonsmoking subjects, the current smoking group had significantly lower large/medium HDL-C (both P 〈 0.001) concentration and large HDL subfraction percentage but higher small HDL-C and medium LDL-C concentrations as well as medium LDL subfraction percentage. Importantly, former smoking subjects showed elevated levels of large HDL-C concentration, large HDL particle percentage, and mean LDL particle size and attenuation in small HDL/LDL percentages and small LDL-C concentration, but these levels did not reach the optimal status compared with those of the non-smoking group (data not shown). Conclusion Smoking has an adverse impact on the lipoprotein subfractions, presented as lower large HDL particles besides higher small HDL and medium LDL particles, whereas smoking cessation could reverse these change to a certain degree.展开更多
The purpose of this scoping review is to create a single narrative that describes the impact of smoking cessation on metabolic parameters in people with diabetes.It is generally well accepted that smoking enhances the...The purpose of this scoping review is to create a single narrative that describes the impact of smoking cessation on metabolic parameters in people with diabetes.It is generally well accepted that smoking enhances the harmful effects of elevated blood glucose levels,accelerating the vascular damage seen in patients with diabetes.Smoking cessation has clear benefits in terms of reducing cardiovascular morbidity and mortality.However,there is less evidence for the impact of smoking cessation on other diabetes-related complications.Studies in people with diabetes have shown improvement as well as temporary deterioration in glycemic control after ceasing smoking.Only a few studies have described the effect of quitting smoking on insulin resistance and lipid parameters,however,their results have been inconclusive.In this situation,healthcare professionals should not assume that cessation of smoking will improve metabolic parameters in patients with diabetes.It seems they should, first of all, emphasize the prevention of weight gain that may be associatedwith quitting smoking. The lack of data regarding the metabolic effects of smoking and smokingcessation in diabetes is very disappointing and this area needs to be addressed.展开更多
Purpose: This study investigated the attitude of patients, grouped by the Brinkman index, towards smoking by using the Kano Test for Social Nicotine Dependence (KTSND) and their knowledge of peri-implantitis. Methods:...Purpose: This study investigated the attitude of patients, grouped by the Brinkman index, towards smoking by using the Kano Test for Social Nicotine Dependence (KTSND) and their knowledge of peri-implantitis. Methods: The participants were 3093 new patients who visited the Tokyo Medical and Dental University Hospital from January 2012 to December 2013 for an oral implant. The methodology included a questionnaire about sex, age, smoking status, daily average number of cigarettes, years of smoking, knowledge of peri-implantitis, and the KTSND. The patients were grouped according to their smoking status by calculating their Brinkman index (over 200 or not): current smokers with the possibility of nicotine dependence (BI(+)CS), current smokers with no possibility of nicotine dependence (BI(-)CS), ex-smokers (ES), and non-smokers (NS). The Brinkman index is obtained by multiplying one’s daily average number of cigarettes by the number of years they have been smoking. Results: Data were collected from 2182 respondents (response rate = 71%). The KTSND scores of BI(+)CS (16.89 ± 4.26) were significantly higher than the scores of ES (11.99 ± 4.52) and NS (11.53 ± 5.01). In current smokers, there were no significant differences between BI(+)CS and BI(-)CS. The patients replied “I don’t know” about peri-implantitis most often in all groups;however, there were no significant differences between the groups. Discussion: BI(+)CS were more dependent on nicotine in social situations than the other groups were. In Japan, a Brinkman index over 200 is required for a nicotine-dependence management fee to be instituted for health insurance treatment. This is a major concern for young smokers, who may be excluded from treatment because their years of smoking are substantially less. Results revealed that there were no significant differences between BI(+)CS and BI(-)CS. Therefore, it was suggested that the Brinkman index did not sufficiently group the participants.展开更多
文摘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.
文摘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.
基金Fund supported by the National Key R&D Program of China(No.2018YFC2001800)~~。
文摘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.
基金supported by the National Philosophy and Social Science Foundation of China(No.15ZDC037)the National Natural Science Foundation of China(key program)(No.71333005)
文摘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.
基金thank the Swiss National Science Founda-tion for funding this study(grant number SNF 100014_126648/1).
文摘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.
文摘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.
文摘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.
基金Dan-ish Medical Research Council The Danish Centre for Evaluation and Health Technology Assessment+6 种基金 Novo Nordisk Copenhagen County Danish Heart Foundation The Danish Pharmaceutical Association Augustinus Foundation Becket Foundation Ib Henriksens Founda-tion
文摘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.
文摘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.
文摘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.
文摘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.
基金Supported by the Special Scientific Research Fund of Traditional Chinese Medicine of China(No.201307014)Fund of Department of Health of Hong Kong Special Administrative Region[Project No.(2)in DH/FU/4-55/99/12(15)]
文摘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.
基金supported by an educational grant from Pfizer,Inc.
文摘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.
文摘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.
文摘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.
文摘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.
基金This research was supported by a grant from the National Cancer Institute(PI:Flocke,NCI R03CA176132,R01CA105292)the Behavioral Measurement Shared Resource of the Case Comprehensive Cancer Center,NCI P30CA043703。
文摘Objective:The 5As framework(ask,advise,assess,assist,arrange)is a recommended strat-egy for smoking cessation counseling in primary care.This study compares patient report with direct observation to assess the degree of recall bias for each of the 5As.Methods:Primary care visits by 107 adult smokers and 16 physicians were audio-recorded.Within 48 hours after the visit,patients completed a survey assessing whether or not smoking was discussed and items specific to each of the 5As.The audio recordings were evaluated to assess the presence of each A.The sensitivity,specificity,positive predictive value,and negative predictive value of patient report versus direct observation were computed.Results:The frequency of the 5As based on evaluation of the audio recording ranged from 13% (arrange)to 98% (ask).The sensitivity and specificity of patient report were 92% and not applicable for ask,90% and 50% for assess,94% and 33% for advise,90% and 50% for assist,and 85% and 67% for arrange follow-up.Positive predictive values ranged from 28% to 98%;negative predictive values ranged from 0% to 97% .Conclusion:Compared with the gold standard of direct observation,patient report of each of the 5As is reasonably sensitive but not specific.Patients overreport the occurrence of each of the 5As.
基金partly supported by National Natural Scientific Foundation(81241121)Capital Special Foundation of Clinical Application Research(Z121107001012015)+1 种基金Capital Health Development Fund(2011400302,2016-1-4035)Beijing Natural Scientific Foundation(7131014)
文摘Objective Cigarette smoking is one of the established risk factors of atherosclerotic cardiovascular disease, however, its impact on lipids is not completely understood, especially in the Chinese population. Therefore, this study evaluated the impact of smoking status (non, former, and current smoking) on the distribution of lipoprotein subfractions in untreated patients with angina-like chest pain. Methods A total of 877 patients were consecutively enrolled and divided into nonsmoking (n = 528), former smoking (n = 103), and current smoking (n = 256) groups. Both low- and high-density lipoprotein cholesterol (LDL-C and HDL-C) subfractions were measured using the Quantimetrix Lipoprint System. The distributions of lipoprotein subfractions were evaluated among the groups. Results Compared with nonsmoking subjects, the current smoking group had significantly lower large/medium HDL-C (both P 〈 0.001) concentration and large HDL subfraction percentage but higher small HDL-C and medium LDL-C concentrations as well as medium LDL subfraction percentage. Importantly, former smoking subjects showed elevated levels of large HDL-C concentration, large HDL particle percentage, and mean LDL particle size and attenuation in small HDL/LDL percentages and small LDL-C concentration, but these levels did not reach the optimal status compared with those of the non-smoking group (data not shown). Conclusion Smoking has an adverse impact on the lipoprotein subfractions, presented as lower large HDL particles besides higher small HDL and medium LDL particles, whereas smoking cessation could reverse these change to a certain degree.
基金Department of Clinical and Experimental Medicine of the University of Catania,No.6C813202024/1_3_02_07_01/2020。
文摘The purpose of this scoping review is to create a single narrative that describes the impact of smoking cessation on metabolic parameters in people with diabetes.It is generally well accepted that smoking enhances the harmful effects of elevated blood glucose levels,accelerating the vascular damage seen in patients with diabetes.Smoking cessation has clear benefits in terms of reducing cardiovascular morbidity and mortality.However,there is less evidence for the impact of smoking cessation on other diabetes-related complications.Studies in people with diabetes have shown improvement as well as temporary deterioration in glycemic control after ceasing smoking.Only a few studies have described the effect of quitting smoking on insulin resistance and lipid parameters,however,their results have been inconclusive.In this situation,healthcare professionals should not assume that cessation of smoking will improve metabolic parameters in patients with diabetes.It seems they should, first of all, emphasize the prevention of weight gain that may be associatedwith quitting smoking. The lack of data regarding the metabolic effects of smoking and smokingcessation in diabetes is very disappointing and this area needs to be addressed.
文摘Purpose: This study investigated the attitude of patients, grouped by the Brinkman index, towards smoking by using the Kano Test for Social Nicotine Dependence (KTSND) and their knowledge of peri-implantitis. Methods: The participants were 3093 new patients who visited the Tokyo Medical and Dental University Hospital from January 2012 to December 2013 for an oral implant. The methodology included a questionnaire about sex, age, smoking status, daily average number of cigarettes, years of smoking, knowledge of peri-implantitis, and the KTSND. The patients were grouped according to their smoking status by calculating their Brinkman index (over 200 or not): current smokers with the possibility of nicotine dependence (BI(+)CS), current smokers with no possibility of nicotine dependence (BI(-)CS), ex-smokers (ES), and non-smokers (NS). The Brinkman index is obtained by multiplying one’s daily average number of cigarettes by the number of years they have been smoking. Results: Data were collected from 2182 respondents (response rate = 71%). The KTSND scores of BI(+)CS (16.89 ± 4.26) were significantly higher than the scores of ES (11.99 ± 4.52) and NS (11.53 ± 5.01). In current smokers, there were no significant differences between BI(+)CS and BI(-)CS. The patients replied “I don’t know” about peri-implantitis most often in all groups;however, there were no significant differences between the groups. Discussion: BI(+)CS were more dependent on nicotine in social situations than the other groups were. In Japan, a Brinkman index over 200 is required for a nicotine-dependence management fee to be instituted for health insurance treatment. This is a major concern for young smokers, who may be excluded from treatment because their years of smoking are substantially less. Results revealed that there were no significant differences between BI(+)CS and BI(-)CS. Therefore, it was suggested that the Brinkman index did not sufficiently group the participants.