Population‐level predictors of changes in success rates of smoking quit attempts in England: a time series analysis

Beard, Emma; Jackson, Sarah E; West, Robert; Kuipers, Mirte A G; Brown, Jamie

doi:10.1111/add.14837

Cited by 25 publications

(18 citation statements)

References 54 publications

(86 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The results indicate that NVPs played an important role in reducing smoking prevalence in England in 2012–2019. Other studies have found significant impacts of NVPs on smoking cessation [52,57–63] and initiation [64] in England. Based on a time‐series analysis with a 34.3% quit attempt rate of which 35.2% used e‐cigarettes with a 6% increase in quit success rate and 5.4% increase in overall quit rate, Beard et al .…”

Section: Discussionmentioning

confidence: 99%

England SimSmoke: the impact of nicotine vaping on smoking prevalence and smoking‐attributable deaths in England

Levy

Sánchez-Romero

et al. 2020

Addiction

Self Cite

View full text Add to dashboard Cite

Background and Aims Whereas the use of nicotine vaping products (NVPs) is widespread, their impact on smoking prevalence is controversial. This study considered the potential impact of NVPs on smoking prevalence in England. Design Indirect simulation model. The England SimSmoke model is validated through 2012, before NVP use became more widely used by smokers. Because information on NVP‐related transitions is limited, an indirect method is used; the difference in observed smoking prevalence (reflecting NVPs) is compared with a 2012–2019 counterfactual No‐NVP scenario (without NVPs) to estimate the impact of NVPs on smoking and smoking‐attributable deaths. Setting England, 2000–2019. Participants Nationally representative sample of population. Measurements England's population, mortality rates and smoking prevalence estimates from three national surveys and tobacco control policies. Findings Between 2000 and 2012, SimSmoke projected a decline in age 18+ smoking prevalence of 23.5% in men and 27.0% in women. These projections, as well as those by specific age groups, were generally consistent with findings from the three national surveys. Comparing 2012–2019 relative reduction in age 18+ prevalence from the Annual Population Survey (males, 27.5%) with the model‐predicted No‐NVP reduction (males, 7.3%), the implied NVP‐attributable relative reduction in adult smoking prevalence was 20.2% (95% CI, 18.8%–22.0%) for males and 20.4% (18.7%–22.2%) for females. The NVP‐attributable reduction was 27.2% (22.8%–31.6%) for males and 31.7% (27.4%–36.5%) for females ages 18–24 and 18.6% (15.2%–21.8%) for males and 15.0% (11.1%–18.8%) for females ages 25–34, with similar reductions for ages 35+. The implied reduction in smoking prevalence between 2012 and 2019 equates to 165 660 (132 453–199 501) averted deaths by 2052. Other surveys yielded smaller, but relatively consistent results. Conclusions An indirect method of simulation modelling indicates that substantial reductions in smoking prevalence occurred in England from 2012–2019 coinciding with the growth in nicotine vaping product use.

show abstract

Section: Discussionmentioning

confidence: 99%

England SimSmoke: the impact of nicotine vaping on smoking prevalence and smoking‐attributable deaths in England

Levy

Sánchez-Romero

et al. 2020

Addiction

Self Cite

View full text Add to dashboard Cite

show abstract

“…supermarket) tobacco point-of-sale display ban introduced in England in April 2012 found evidence for a decline in smoking prevalence [21]. Licencing of nicotine replacement therapy for use in harm reduction, and higher expenditure on tobacco control mass media have been found to be associated with the success of quit attempts [26]. Time series analyses have also shown that cuts on tobacco mass media expenditure have been associated with a reduction in use of smoking cessation support [27,28].…”

Section: Covariatesmentioning

confidence: 99%

Long-term evaluation of the rise in legal age-of-sale of cigarettes from 16 to 18 in England: a trend analysis

Beard

Brown

Jackson

et al. 2020

BMC Med

Self Cite

View full text Add to dashboard Cite

Objective: To assess the long-term impact of the increase in age-of-sale of cigarettes from 16 to 18 in England in October 2007. Methods: Data were collected between November 2006 and September 2018 on 252,601 participants taking part in a nationally representative survey of adults aged 16+ in England, the Smoking Toolkit Study (STS). We assessed the impact of the introduction of the increase in age-of-sale on prevalence of ever smoking, current smoking, and quit attempts, among 16-17 year olds compared with 18-24 year olds. Results: Following the increase in age-of-sale, there was a declining trend in ever smoking that was greater among 16-17 year olds than 18-24 year olds (OR 0.990 versus OR 0.993; p = 0.019). Data on current smoking were insensitive to detect a difference between the age groups in a step-level change or change in trend following the increase in age-ofsale (Bayes factors (BFs) 0.75 and 2.10). Data on quit attempts were also insensitive to detect a change in trend (BF 0.71), and despite a greater step-level decline among those aged 16-17 (OR 0.311 versus OR 0.547, p = 0.025), quit attempts remained higher among those aged 16-17. Secondary analysis indicated that post-policy change, trends in current and ever smoking were linear for 16-17 year olds but quadratic for 18-24 year olds (slowing decline). Conclusion: There is some evidence from an assessment of long-term trends in the Smoking Toolkit Study that the increase in legal age-of-sale of cigarettes in England was associated with a greater long-term decline in ever smoking among those aged 16-17 compared with those aged 18-24.

show abstract

“…This is particularly true of participants in the nicotine product arms, as e-cigarettes are readily available in England and are widely used without any structured support as an effective tool to quit smoking. 34,35 Recommendations for research…”

Section: Generalisabilitymentioning

confidence: 99%

Nicotine replacement treatment, e-cigarettes and an online behavioural intervention to reduce relapse in recent ex-smokers: a multinational four-arm RCT

McRobbie

Phillips-Waller

Zerbi

et al. 2020

Health Technol Assess

View full text Add to dashboard Cite

Background Relapse remains an unresolved issue in smoking cessation. Extended stop smoking medication use can help, but uptake is low and several behavioural relapse prevention interventions have been found to be ineffective. However, opportunistic ‘emergency’ use of fast-acting nicotine replacement treatment or electronic cigarettes may be more attractive and effective, and an online behavioural Structured Planning and Prompting Protocol has shown promise. The present trial aimed to evaluate the clinical effectiveness and cost-effectiveness of these two interventions. Design A randomised controlled trial. Setting English stop smoking services and Australian quitlines, Australian social media and St Vincent’s Hospital Melbourne, Fitzroy, VIC. Participants Ex-smokers abstinent for at least 4 weeks, with some participants in Australia also recruited from 1 week post quit date. The planned sample size was 1400, but the trial was curtailed when 235 participants were recruited. Interventions Participants were randomised in permuted blocks of random sizes to (1) oral nicotine replacement treatment/electronic cigarettes to use if at risk of relapse, plus static text messages (n = 60), (2) the Structured Planning and Prompting Protocol and interactive text messages (n = 57), (3) oral nicotine replacement treatment/electronic cigarettes plus the Structured Planning and Prompting Protocol with interactive text messages (n = 58) or (4) usual care plus static text messages (n = 59). Outcome measures Owing to delays in study set-up and recruitment issues, the study was curtailed and the primary outcome was revised. The original objective was to determine whether or not the two interventions, together or separately, reduced relapse rates at 12 months compared with usual care. The revised primary objective was to determine whether or not number of interventions received (i.e. none, one or two) affects relapse rate at 6 months (not biochemically validated because of study curtailment). Relapse was defined as smoking on at least 7 consecutive days, or any smoking in the last month at final follow-up for both the original and curtailed outcomes. Participants with missing outcome data were included as smokers. Secondary outcomes included sustained abstinence (i.e. no more than five cigarettes smoked over the 6 months), nicotine product preferences (e.g. electronic cigarettes or nicotine replacement treatment) and Structured Planning and Prompting Protocol coping strategies used. Two substudies assessed reactions to interventions quantitatively and qualitatively. The trial statistician remained blinded until analysis was complete. Results The 6-month relapse rates were 60.0%, 43.5% and 49.2% in the usual-care arm, one-intervention arm and the two-intervention arm, respectively (p = 0.11). Sustained abstinence rates were 41.7%, 54.8% and 50.9%, respectively (p = 0.17). Electronic cigarettes were chosen more frequently than nicotine replacement treatment in Australia (71.1% vs. 29.0%; p = 0.001), but not in England (54.0% vs. 46.0%; p = 0.57). Of participants allocated to nicotine products, 23.1% were using them daily at 6 months. The online intervention received positive ratings from 63% of participants at 6 months, but the majority of participants (72%) completed one assessment only. Coping strategies taught in the Structured Planning and Prompting Protocol were used with similar frequency in all study arms, suggesting that these are strategies people had already acquired. Only one participant used the interactive texting, and interactive and static messages received virtually identical ratings. Limitations The inability to recruit sufficient participants resulted in a lack of power to detect clinically relevant differences. Self-reported abstinence was not biochemically validated in the curtailed trial, and the ecological momentary assessment substudy was perceived by some as an intervention. Conclusions Recruiting recent ex-smokers into an interventional study proved problematic. Both interventions were well received and safe. Combining the interventions did not surpass the effects of each intervention alone. There was a trend in favour of single interventions reducing relapse, but it did not reach significance and there are reasons to interpret the trend with caution. Future work Further studies of both interventions are warranted, using simpler study designs. Trial registration Current Controlled Trials ISRCTN11111428. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 68. See the NIHR Journals Library website for further project information. Funding was also provided by the National Health and Medical Research Council, Canberra, ACT, Australia (NHMRC APP1095880). Public Health England provided the funds to purchase the nicotine products in England.

show abstract

Population‐level predictors of changes in success rates of smoking quit attempts in England: a time series analysis

Cited by 25 publications

References 54 publications

England SimSmoke: the impact of nicotine vaping on smoking prevalence and smoking‐attributable deaths in England

England SimSmoke: the impact of nicotine vaping on smoking prevalence and smoking‐attributable deaths in England

Long-term evaluation of the rise in legal age-of-sale of cigarettes from 16 to 18 in England: a trend analysis

Nicotine replacement treatment, e-cigarettes and an online behavioural intervention to reduce relapse in recent ex-smokers: a multinational four-arm RCT

Contact Info

Product

Resources

About