Smoking cessation and severity of disease: The Coronary Artery Smoking Intervention Study.

Ockene, Judith K.; Kristeller, Jean L.; Goldberg, Robert J.; Ockene, Ira S.; Merriam, Philip A.; Barrett, Susan V.; Pekow, Penelope S.; Hosmer, David W.; Gianelly, Ralph E.

doi:10.1037/0278-6133.11.2.119

Cited by 178 publications

(118 citation statements)

References 18 publications

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“…Otra debilidad que pudiera ser aludida es la ausencia de un método objetivo de validación de la abstinencia, ya sea con medición de metabolitos de la nicotina o la medición de monóxido de carbono espirado (CO) mediante cooxímetro. En relación a esto, existen trabajos que demuestran una alta correlación entre la respuesta verbal del paciente y la medición del CO espirado, confirmando la fiabilidad de los datos expresados por los pacientes que, en definitiva, no mienten cuando adhieren a los controles 13,23 . En un estudio español de 904 pacientes, no se observaron diferencias significativas entre la respuesta del paciente y la medición de CO 24 .…”

Section: Discussionunclassified

Resultados de un programa multidisciplinario para el control del hábito tabáquico

Peña

Zagolin

Acuña³

et al. 2013

Rev. méd. Chile

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Results of a multidisciplinary program to quit smoking (odds ratio = 4 (95% confidence intervals 1.23-38.33). The main side effects associated to varenicline and bupropion were nausea in 37 and 23%, sleep disorders in 20 and 19% and headache in 12 and 0%, respectively. Conclusions: A multidisciplinary program to quit smoking achieved a 49% of abstinence during a year of follow up. (Rev Med Chile 2013; 141: 345-352).

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Section: Discussionunclassified

Resultados de un programa multidisciplinario para el control del hábito tabáquico

Peña

Zagolin

Acuña³

et al. 2013

Rev. méd. Chile

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“…10,30 Because alcohol and drug use are so common among hospitalized smokers, it is unfortunate that there is little evidence from clinical trials to inform intervention strategies for patients with concurrent use. The clinical trials that form the evidence base for intervention among hospitalized smokers 10 either have explicitly excluded patients who reported substance use, 10,15,[31][32][33] did not assess baseline substance use, 34,35 or were underpowered to perform subgroup analyses on this population. 36 Awaiting better evidence, we have chosen to routinely screen hospital patients for tobacco, alcohol, and drug use.…”

Section: Discussionmentioning

confidence: 99%

Tobacco, alcohol, and drug use among hospital patients: Concurrent use and willingness to change

Katz

Goldberg

Smith

et al. 2008

Journal of Hospital Medicine

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BACKGROUND:Data are limited on concurrent smoking and substance use among hospital patients. To better inform hospital‐based intervention strategies, we evaluated the prevalence and concurrent use of these behaviors. This study evaluated the association between tobacco, alcohol, and other drug use, compared willingness to quit smoking among patients with and without substance use, and evaluated the relationship between willingness to quit smoking and readiness to change substance use.METHODS:This study was a cross‐sectional survey of non–Intensive Care Unit hospital patients at 2 public hospitals (a 464‐bed tertiary‐care hospital and a 100‐bed community hospital) by bedside interview. Severity of use and willingness to change behavior was determined. We evaluated the association between smoking and substance use by multivariable methods.RESULTS:Of 7,391 patients with known smoking status, 2,684 (36%) were current smokers. Among them, 1,376 hospitalized smokers (51%) had concurrent substance use. Among the 1,972 patients with at‐risk alcohol or drug use, the prevalence of smoking was 70% compared to 24% for non‐substance users (P < .01). Compared to other patients who smoked, substance‐dependent patients were more likely (Prevalence Rate Ratio = 1.4, 95% Confidence Interval = 1.1‐1.9) to be moderate to heavy smokers. Regardless of substance use pattern, most patients (60%) expressed a desire to immediately quit smoking.CONCLUSION:Hospital patients who describe at‐risk substance use are likely to smoke and express willingness to quit smoking. Given the prevalence of concurrent smoking and substance use and patients' desire to change both behaviors, there is a need for coordination of substance use and smoking cessation interventions. Journal of Hospital Medicine 2008;3:369–375. © 2008 Society of Hospital Medicine.

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“…In 570 smokers randomly assigned to four different self-help treatments, the stage effect was seen over 18 months with 25% abstinence in smokers in the preparation stage at baseline, 15% in those in the contemplation stage, and only about 8% in those originally in precontemplation. 12 This stage effect with smokers has been replicated with Mexican Americans in small towns in Texas; 13 cardiovascular patients entering the hospital for surgery; 14 middle-aged men in Finland at risk for cardiovascular disease; 15 and patients with head and neck cancer in California. 16 In a recent health maintenance organization (HMO) population of smokers, the stage effect was replicated in 66 of 70 predictions.…”

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confidence: 99%

Integrating Population Smoking Cessation Policies and Programs

Prochaska

Velicer

2004

Public Health Rep

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Historically, clinical trials for smoking cessation were evaluated by their efficacy, measured as the percentage of participants who were abstinent at long-term follow-up. If one smoking cessation program generated abstinence rates of 30%, it would be judged to be 50% more efficacious than a program generating only 20% abstinence. The problem was that the best practices in smoking cessation as measured by efficacy typically generated 1% or less participation, even when offered for free.1 Such programs could have little impact on the overall population smoking rates, one of the most important behaviors for chronic disease prevention and control.Impact is defined as the participation rate multiplied by efficacy. 2,3 If a program resulting in 30% abstinence generates 5% participation, its impact is 1.5% (30% ϫ 5% ϭ 1.5%). This impact translates into a 1.5% reduction in smoking prevalence rates if the program is offered to the entire at-risk population. If an alternative program with 20% abstinence generates 75% participation, its impact is 15% (20% ϫ 75% ϭ 15%). The program with the lower abstinence rate actually has 10 times the impact in reducing the population prevalence of smoking. Comprehensive tobacco control policies and programsWhen the U.S. Centers for Disease Control and Prevention (CDC) issued recommendations for how states should allocate tobacco settlement funds for comprehensive tobacco control policies and programs, traditional efficacy data were used to evaluate telephone-based quit lines for smoking cessation.4 Not surprisingly, the quit lines with the highest efficacy rates were actionoriented programs designed for smokers who were prepared to quit smoking in the next week or two. 5 The problem with these programs is that they are designed for only 5% to 10% of smokers, since less than 20% of all smokers in the United States are in the preparation stage (prepared to quit in the next month).6 Less than 8% of daily smokers are prepared to quit in the next month.

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Smoking cessation and severity of disease: The Coronary Artery Smoking Intervention Study.

Cited by 178 publications

References 18 publications

Resultados de un programa multidisciplinario para el control del hábito tabáquico

Resultados de un programa multidisciplinario para el control del hábito tabáquico

Tobacco, alcohol, and drug use among hospital patients: Concurrent use and willingness to change

Integrating Population Smoking Cessation Policies and Programs

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