Nicotine dependence versus smoking prevalence: comparisons among countries and categories of smokers

Fagerström, Karl; Kunze, Michael; Schoberberger, Rudolf; Breslau, Naomi; Hughes, John R.; Hurt, R. Douglas; Puska, Pekka; Ramström, Lars; Zatoński, Witold

doi:10.1136/tc.5.1.52

Cited by 273 publications

(171 citation statements)

References 10 publications

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“…Fourth, as the smoking prevalence in Japanese men is still higher than that in populations in other developed countries (4,34), Japanese smokers may be more likely to quit smoking than those in other developed countries, although the level of motivation to quit smoking in Japanese smokers was lower compared to that in other developed countries (32,33). Successful tobacco control is thought to result in a higher dependence among the remaining smokers due to selective quitting by low-dependent smokers (35). At the level of countries, the degree of nicotine dependence was negatively correlated with the prevalence of smoking (35).…”

Section: Discussionmentioning

confidence: 98%

“…Successful tobacco control is thought to result in a higher dependence among the remaining smokers due to selective quitting by low-dependent smokers (35). At the level of countries, the degree of nicotine dependence was negatively correlated with the prevalence of smoking (35). In addition to the level of nicotine dependence, the relative proportion of other types of "hard-core smokers" with comorbid psychological or psychiatric conditions among the total smoking population may increase with the success of tobacco control at a national level (36).…”

Section: Discussionmentioning

confidence: 99%

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Effects of stage-matched repeated individual counseling on smoking cessation: A randomized controlled trial for the high-risk strategy by lifestyle modification (HISLIM) study

Nakamura¹,

Masui²,

Oshima

et al. 2004

Environ Health Prev Med

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Objective: The purpose of this study was to evaluate the effects of stage-matched repeated individual behavioral counseling as an intervention for the cessation of smoking.Methods: We conducted a multisite randomized controlled trial that enrolled smokers unselected for their readiness to quit. There were 979 smokers with hypertension or hypercholesterolemia recruited from 72 study sites and randomly allocated to the intervention or control group. Smokers in the intervention group received stage-matched individual counseling consisting of a 40 minute initial session and four 20-30 minute follow-up sessions. Smokers in the control group received individual behavioral counseling for hypertension or hypercholesterolemia.Results: The point prevalence abstinence rate at 6 months, validated by carbon monoxide testing, in the intervention group (13.6%) was 5.4 times higher (p<0.001) than that in the control group (2.5%). When the data were analyzed based on the baseline stage of change, there were significant differences in the abstinence rates at 6 months in smokers versus controls with each stage of change except in immotives. The odds ratio was 6.4 (p<0.001) in precontemplators, 6.7 (p<0.001) in contemplators, and 6.2 (p<0.01) in preparators. There was a positive, consistent effect of the intervention regardless of study site (worksite or community) or the presence of hypertension or hypercholesterolemia.Conclusions: We showed the effects of an intervention with repeated individual behavioral counseling on the cessation of smoking in smokers unselected for their readiness to quit. This result suggests that stage-matched individual counseling, based on the transtheoretical model, is effective in smokers with a lower motivation to quit as well as those ready to quit.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Effects of stage-matched repeated individual counseling on smoking cessation: A randomized controlled trial for the high-risk strategy by lifestyle modification (HISLIM) study

Nakamura¹,

Masui²,

Oshima

et al. 2004

Environ Health Prev Med

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“…Since dependence, motivational and behavioural attributes of tobacco use characterize hardcore smoking; it has implication for success of tobacco cessation interventions. Studies suggest that more intensive tobacco control interventions are required to influence hardcore smokers (Fagerstrom et al, 1996). Some authors argued that there is need of universal tobacco cessation approach along with targeted approach for the hardcore smokers (Docherty et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

Hardcore Smoking in Three South-East Asian Countries: Results from the Global Adult Tobacco Survey

Kishore

Jena²,

Bandyopadhyay³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Background: Hardcore smoking is represented by a subset of daily smokers with high nicotine dependence, inability to quit and unwillingness to quit. Estimating the related burden could help us in identifying a high risk population prone to tobacco induced diseases and improve cessation planning for them. This study assessed the prevalence and associated factors of hardcore smoking in three South-East Asian countries and discussed its implication for smoking cessation intervention in this region. Materials and Methods: Global Adult Tobacco Survey (GATS) data of India, Bangladesh and Thailand were analyzed to quantify the hardcore smoking prevalence in the region. On the basis of review, an operational definition of hardcore smoking was adopted that includes (1) current daily smoker, (2) no quit attempt in the past 12 months of survey or last quit attempt of less than 24 hours duration, (3) no intention to quit in next 12 months or not interested in quitting, (4) time to first smoke within 30 minutes of waking up, and (5) knowledge of smoking hazards. Logistic regression analysis was carried out using hardcore smoking status as response variable and gender, type of residence, occupation, education, wealth index and age-group as possible predictors. Results: There were 31.3 million hardcore smokers in the three Asian countries. The adult prevalence of hardcore smoking in these countries ranges between 3.1% in India to 6% in Thailand. These hardcore smokers constitute 18.3-29.7% of daily smokers. The logistic regression model indicated that age, gender, occupation and wealth index are the major predictors of hardcore smoking with varied influence across countries. Conclusions: Presence of a higher number of hardcore smoking populations in Asia is a major public health challenge for tobacco control and cancer prevention. There is need of intensive cessation interventions with due consideration of contextual predictors.

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“…Participants completed the Fagerström Test of Nicotine Dependence (FTND), a 6-item self-report measure of nicotine dependence (Heatherton, Kozlowski, Frecker & Fagerström, 1991). A score of ≥6 indicates a high level of nicotine dependence (Fagerström et al, 1996). Race/ethnicity was assessed with self-report, using categories defined by study personnel, to assess potential variation in treatment response due to this variable.…”

Section: Methodsmentioning

confidence: 99%

Can the blind see? Participant guess about treatment arm assignment may influence outcome in a clinical trial of bupropion for smoking cessation

Schnoll

Epstein

Audrain

et al. 2008

Journal of Substance Abuse Treatment

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In a placebo-controlled bupropion smoking cessation trial, we examined blind integrity, the link between blind integrity and quit rates, and whether side effects and changes in nicotine withdrawal symptoms or mood were mechanisms through which blind integrity is threatened. At a 12-month follow-up, 498 participants indicated whether they thought they received bupropion, placebo, or were not sure. Potential mediators of treatment effects on treatment arm guess (i.e., side effects, withdrawal, and mood) were measured during treatment and 7-day point prevalence cessation was assessed at the end of treatment (EOT) and at 6-and 12-months post quit date. Overall, 55% of participants guessed their randomization correctly. Compared to guessing not sure, participants who guessed they were taking bupropion were more than twice as likely to have been randomized to bupropion. Similarly, participants who guessed placebo were twice as likely to have been randomized to placebo. Treatment arm guess was associated with quit rates. Including treatment arm guess with actual treatment arm in models of quit rates significantly reduced the odds ratio for bupropion efficacy at EOT and at 6-and 12-months post quit date. There was no evidence for mediation. In bupropion smoking cessation trials, blind failure may occur and participant guess about treatment arm assignment is associated with quit rates.

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Nicotine dependence versus smoking prevalence: comparisons among countries and categories of smokers

Abstract: Successful tobacco control may result in a higher dependence among the remaining smokers (due to selective quitting by low-dependent smokers). The remaining highly dependent smokers may need more intensive treatment.

Cited by 273 publications

References 10 publications

Effects of stage-matched repeated individual counseling on smoking cessation: A randomized controlled trial for the high-risk strategy by lifestyle modification (HISLIM) study

Effects of stage-matched repeated individual counseling on smoking cessation: A randomized controlled trial for the high-risk strategy by lifestyle modification (HISLIM) study

Hardcore Smoking in Three South-East Asian Countries: Results from the Global Adult Tobacco Survey

Can the blind see? Participant guess about treatment arm assignment may influence outcome in a clinical trial of bupropion for smoking cessation

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