Beyond “Safe and Effective”: The urgent need for high-impact smoking cessation medications

Rosen, Laura; Galili, Tal; Kott, J.; Rees, Vaughan W.

doi:10.1016/j.ypmed.2021.106567

Cited by 11 publications

(8 citation statements)

References 45 publications

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“…The association between using snus as a cessation aid and successful quits adds to previous findings from Norway [3,[37][38][39], and supports the notion that availability of snus might have facilitated a population-level decline in smoking [3,6]. The impact of a specific cessation aid is contingent on its efficacy and how extensively it is used in the population [40].…”

Section: Discussionsupporting

confidence: 78%

Smoking cessation aids and strategies: a population-based survey of former and current smokers in Norway

Lund

2022

BMC Public Health

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Background In Norway, tobacco consumption is equally divided between combustible (cigarettes) and non-combustible (snus) tobacco. In the process of quitting, people who smoke can choose between several smoking cessation aids and strategies based on what is available on the market or what are recommended as cessation aids. A quit attempt may be planned or unplanned and consist of a gradual decline in consumption or an abrupt quitting. This study explores smoking cessation aids and strategies used at the latest quit attempt among people who have ever smoked. How prevalent is the use of various cessation aids and strategies, and do they correlate with each other? Are there any differences in successful quits depending on the use of a specific cessation aid or strategy? Method We used repeated cross-sectional representative surveys in Norway for 2017, 2018, 2019 and 2020. The analytic sample consists of people aged 20 years or older who have ever smoked daily, more precisely current daily smokers with at least one quit attempt (n = 476), and former daily smokers who quit in 2012 or later (n = 397). Participants answered questions on cessation aids and strategies used at their last quit attempt. Logistic regression analysis was used to estimate the associations between cessation aids and strategies and sociodemographic and smoking-related variables and successful quit attempts. Results Fifty-six percent of people who ever smoked daily reported any use of cessation aids, and nicotine replacement therapy (NRT), snus and e-cigarettes were the most commonly used cessation aids. Snus and web/mobile use was associated with successful quits, while NRT was associated with unsuccessful quit attempts. When exclusive use was separated from the combined use of several aids, only snus was associated with successful quits. Conclusion Snus use was found to be a “stand-alone” cessation aid, and only weakly associated with the use of other cessation aids. Further investigation of cessation aid preferences is needed, especially among smokers with little or no contact with health services and/or for whom traditional cessation aids have no appeal.

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Section: Discussionsupporting

confidence: 78%

Smoking cessation aids and strategies: a population-based survey of former and current smokers in Norway

Lund

2022

BMC Public Health

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“…The population impact of an intervention is a function of its effectiveness as well as its reach [102]. Vaping is the most popular aid for quitting or reducing smoking in Australia [95], the United States [103] and England [100].…”

Section: Public Health Impactmentioning

confidence: 99%

A critique of the Australian National Health and Medical Research Council CEO statement on electronic cigarettes

Mendelsohn¹,

Hall

Borland

et al. 2023

Addiction

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This paper critically analyses a statement by Australia's National Health and Medical Research Council (NHMRC) on e‐cigarettes in May 2022 that will be used to guide national policy. We reviewed the evidence and the conclusions drawn in the NHMRC Statement. In our view, the Statement is not a balanced reflection of the benefits and risks of vaping because it exaggerates the risks of vaping and fails to compare them to the far greater risks of smoking; it uncritically accepts evidence of harms from e‐cigarettes while adopting a highly sceptical attitude towards evidence of their benefits; it incorrectly claims that the association between adolescent vaping and subsequent smoking is causal; and it understates the evidence of the benefits of e‐cigarettes in assisting smokers to quit. The Statement dismisses the evidence that vaping is probably already having a positive net public health effect and misapplies the precautionary principle. Several sources of evidence supporting our assessment were published after the NHMRC Statement's publication and are also referenced. The NHMRC Statement on e‐cigarettes does not present a balanced assessment of the available scientific literature and fails to meet the standard expected of a leading national scientific body.

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“…According to data from the Centers for Disease Control and Prevention, 12.5% of the US adults aged ≥ 18 years reported current use of cigarettes in 2020 [ 1 ]. While this figure represents a substantial decrease from over 40% of the adult population smoking in the 1960s, tobacco use is still the leading preventable cause of death in the US [ 2 ] with annual deaths directly attributable to tobacco use estimated to be at least 480,000 [ 3 ]. However, these devastating effects of tobacco use do not equally impact all population groups.…”

Section: Introductionmentioning

confidence: 99%

Implementing a tobacco-free workplace program at a substance use treatment center: a case study

Rogova,

Leal,

Britton

et al. 2024

BMC Health Serv Res

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Background People with substance use disorders smoke cigarettes at much higher rates than the general population in the United States and are disproportionately affected by tobacco-related diseases. Many substance use treatment centers do not provide evidence-based tobacco cessation treatment or maintain comprehensive tobacco-free workplace policies. The goal of the current work is to identify barriers and facilitators to a successful and sustainable implementation of a tobacco-free workplace program, which includes a comprehensive tobacco-free policy and evidence-based cessation treatment services, in a substance use treatment center. Methods This study is based on an ethnographic approach and uses a qualitative case study design. Data were collected via interviews with staff (n = 6) and clients (n = 16) at the substance use treatment center and site visits (n = 8). Data were analyzed using thematic analysis guided by the extended Normalization Process Theory designed to inform the implementation of innovations in healthcare practice. Results Staff at the substance use treatment center supported the implementation of the program and shared a good understanding of the purpose of the intervention and its potential benefits. However, the study identified significant challenges faced by the center during implementation, including widespread tobacco use among clients, contributing to attitudes among staff that tobacco cessation was a low-priority problem due to a perceived lack of interest in quitting and inability to quit among their clients. We identified several factors that contributed to changing this attitude, including provision of tobacco training to staff, active leadership support, low number of staff members who smoked, and access to material resources, including nicotine replacement products. The implementation and active enforcement of a comprehensive tobacco-free workplace program contributed to a gradual change in attitudes and improved the provision of evidence-based tobacco cessation care at the substance use treatment center. Conclusions Substance use treatment centers can integrate tobacco cessation practices in their daily operations, despite multiple challenges they face due to the complex behavioral health and socioeconomic needs of their clients. With proper support, substance use treatment centers can provide much needed tobacco cessation care to their clients who are disproportionately affected by tobacco-related health conditions and systemic health inequities.

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Beyond “Safe and Effective”: The urgent need for high-impact smoking cessation medications

Cited by 11 publications

References 45 publications

Smoking cessation aids and strategies: a population-based survey of former and current smokers in Norway

Smoking cessation aids and strategies: a population-based survey of former and current smokers in Norway

A critique of the Australian National Health and Medical Research Council CEO statement on electronic cigarettes

Implementing a tobacco-free workplace program at a substance use treatment center: a case study

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