Smoking Cessation for Smokers Not Ready to Quit: Meta-analysis and Cost-effectiveness Analysis

Ali, Ayesha; Kaplan, Cameron M.; Derefinko, Karen J.; Klesges, Robert C.

doi:10.1016/j.amepre.2018.04.021

Cited by 36 publications

(27 citation statements)

References 51 publications

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“…Growing evidence suggests that reduction treatment expands the reach of tobacco treatment by engaging smokers who might not otherwise enter cessation treatment (Petersen et al, 2017). Reduction treatment has also been shown to decrease smoking heaviness and increase abstinence (Ali et al, 2018;Cook et al, 2016;Moore et al, 2009). This study extends prior research by showing that nicotine gum per se increased the likelihood of making a quit attempt by end-of-treatment (6 weeks).…”

Section: Resultssupporting

confidence: 65%

Effects of motivation phase intervention components on quit attempts in smokers unwilling to quit: A factorial experiment

Engle

Mermelstein

Baker

et al. 2019

Drug and Alcohol Dependence

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Background: Smoking reduction treatment is a promising approach to increase abstinence amongst smokers initially unwilling to quit. However, little is known about which reduction treatment elements increase quit attempts and the uptake of cessation treatment amongst such smokers. Methods: This study is a secondary analysis of a 4-factor randomized factorial experiment conducted amongst primary care patients (N=517) presenting for regular healthcare visits in Southern Wisconsin who were unwilling to quit smoking but willing to cut down. We evaluated the main and interactive effects of Motivation-phase intervention components on whether participants: 1) made a quit attempt (intentional abstinence ≥ 24 hours) by 6-and 26-weeks poststudy enrollment and, 2) used cessation treatment. We also evaluated the relations of quit attempts with abstinence. The four intervention components evaluated were: 1) Nicotine Patch vs. None; 2) Nicotine Gum vs. None; 3) Motivational Interviewing (MI) vs. None; and 4) Behavioral Reduction

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Section: Resultssupporting

confidence: 65%

Effects of motivation phase intervention components on quit attempts in smokers unwilling to quit: A factorial experiment

Engle

Mermelstein

Baker

et al. 2019

Drug and Alcohol Dependence

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“…This is similar to or lower than that estimated for quitline‐based medication give‐away programs presumed to attract smokers wanting to quit. More recent evidence suggests potential cost‐effectiveness of medication distribution specifically for smokers not wanting to quit .…”

Section: Discussionmentioning

confidence: 99%

Nicotine replacement therapy sampling for smoking cessation within primary care: results from a pragmatic cluster randomized clinical trial

et al. 2020

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Background and Aims Within the context of busy clinical settings, health‐care providers need practical, evidence‐based options to engage smokers in quitting. Sampling of nicotine replacement therapy [i.e. provision of nicotine replacement therapy (NRT starter kits)] is a brief, pragmatic strategy to address this need. We aimed to compare the effects of NRT sampling plus standard care (SC), relative to SC alone, provided by primary care providers during routine clinic visits. Design Cluster‐randomized clinical trial. Setting Twenty‐two primary care clinics in South Carolina, USA. Participants Adult smokers [n = 1245; 61% female, mean age = 50.7, standard deviation (SD) = 13.5] both motivated and unmotivated to quit, seen during routine clinical visit. Interventions were provider‐delivered SC (n = 652, 12 clinics) cessation advice or SC + a 2‐week supply of both nicotine patch and lozenge, with minimal instructions on use (n = 593; 10 clinics). Measurements The primary outcome was 7‐day point prevalence smoking abstinence at 6‐month follow‐up, using intent‐to‐treat. Additional outcomes included NRT use and quit attempts, assessed at 1, 3 and 6 months following baseline. Findings Seven‐day point prevalence abstinence rates were significantly higher in the NRT sampling group throughout follow‐up, including at 6 months [12 versus 8%, odds ratio (OR) = 1.5, 95% confidence interval (CI) = 1.0–2.4]. NRT sampling increased prevalence of any use of NRT (65 versus 25%, OR = 5.8, 95% CI = 4.3–7.7), with higher prevalence of use at 6 months (25 versus 14%, OR = 2.0, 95% CI = 1.5–2.7). NRT sampling increased the rate of quit attempts in the initial month (24 versus 18%, OR = 1.5, 95% CI = 1.0–2.3) but had no significant effect on overall rate of quit attempts (48 versus 45%, OR = 1.2, 95% CI = 0.8–1.7). Conclusion Providing smokers with a free 2‐week starter kit of nicotine replacement therapy increased quit attempts, use of stop smoking medications and smoking abstinence compared with standard care in a primary care setting.

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“…12,15,16 Though considering all adverse health effects, advice for smoking cession is always the best possible approach. 2,17 Besides, these controversies may also suggest differences in pathogenesis of coronary diseases in smokers rather than any possible benefits. 8 Interestingly, in one report published by Alemu et al, smoking had increased the risk of inferior ST-segment elevation myocardial infarction (STEMI) more than anterior STEMI, which may suggest the predilection of harmful effects of tobacco to affect right coronary system more than left coronary system.…”

Section: Introductionmentioning

confidence: 99%

The impact of cigarette smoking on infarct location and in-hospital outcome following acute ST-elevation myocardial infarction

Toluey

Ghaffari

Tajlil

et al. 2019

J Cardiovasc Thorac Res

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Introduction: Smoking, which is a major modifiable risk factor for coronary artery diseases, affects cardiovascular system with different mechanisms. We designed this study to investigate the association of smoking with location of ST-segment elevation myocardial infarction (STEMI), and short-term outcomes during hospitalization. Methods: In 1017 consecutive patients with anterior/inferior STEMI, comprehensive demographic, biochemical data, as well as clinical complications and mortality rate, were recorded. Patients were allocated into two groups based on smoking status and compared regarding the location of myocardial infarction, the emergence of clinical complications and in-hospital mortality in univariate and multivariate logistic regression analysis. Results: Among 1017 patients, 300 patients (29.5%) were smoker and 717 patients (70.5 %) were non-smoker. Smokers were significantly younger and had lower prevalence of diabetes, hyperlipidemia and hypertension. Inferior myocardial infarction was considerably more common in smokers than in non-smokers (45.7% vs. 36%, P = 0.001). Heart failure was developed more commonly in non-smokers (33.9% vs. 20%, P = 0.001). In-hospital mortality was significantly lower in smokers (6.7% vs. 17.3%, P = 0.001). After adjustment for confounding variables, smoking was independently associated with inferior myocardial infarction and lower heart failure [odds ratio: 1.44 (1.06-1.96), P = 0.01 and odds ratio: 0.61 (0.40-0.92), P = 0.02, respectively]. However, in-hospital mortality was not associated with smoking after adjustment for other factors [odds ratio: 0.69 (0.36-1.31), P = 0.2]. Conclusion: Smoking is independently associated with inferior myocardial infarction. Although smokers had lower incidence of heart failure, in-hospital mortality was not different after adjustment for other factors.

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Smoking Cessation for Smokers Not Ready to Quit: Meta-analysis and Cost-effectiveness Analysis

Cited by 36 publications

References 51 publications

Effects of motivation phase intervention components on quit attempts in smokers unwilling to quit: A factorial experiment

Effects of motivation phase intervention components on quit attempts in smokers unwilling to quit: A factorial experiment

Nicotine replacement therapy sampling for smoking cessation within primary care: results from a pragmatic cluster randomized clinical trial

The impact of cigarette smoking on infarct location and in-hospital outcome following acute ST-elevation myocardial infarction

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