Search Results (88)

Background: Cardiovascular morbidity and mortality are alarmingly high in Bulgaria, partly due to behavioral risk factors such as smoking. Purpose: This study aimed to assess and compare smoking habits, second-hand smoke exposure, and attitudes of Bulgarian and foreign medical students to better understand smoking behavior in this population. Methods: A cross-sectional survey was conducted among 1063 medical students at the Medical University of Plovdiv (60.8% women; 53% Bulgarian). Results: More Bulgarian students were active smokers and ever-smokers than foreign students (24.7% vs. 14% and 29.3% vs. 18.8%, p < 0.001). Bulgarian women smoked nearly as much as Bulgarian men (24.1% vs. 25.6% for active smokers, p > 0.05), whereas foreign women smoked less than foreign men (15.7% vs. 23.7%, p = 0.034). Women more often replaced classic cigarettes with tobacco heating systems (THSs) than men (40.7% vs. 25.3%, p = 0.020). Nearly 85% of the respondents started smoking by the age of 19. Exposure to second-hand smoke among friends, among colleagues, and in the family was associated with a higher risk of being an ever-smoker (ORs ~8.9; 3.4 and 3.7, respectively). About 20% of students were unsure or disagreed that smoking fewer cigarettes, THSs, or e-cigarettes posed health risks. The majority (61.3%) of active smokers acknowledged negative health effects. Conclusions: These findings highlight a concerning smoking prevalence among Bulgarian medical students and emphasize the need to strengthen medical education and health policies with updated tobacco risk information and targeted prevention programs to reduce smoking and improve future physicians’ cessation counseling skills. Smoking likely contributes significantly to Bulgaria’s high cardiovascular morbidity. Full article

The nicotine metabolite ratio (NMR) has been informative in selecting treatment choices for nicotine dependence and increasing treatment efficacy in Western settings; however, the clinical utility of the NMR among smokers in low-resource settings remains unclear. Prospective analysis was conducted using data from a randomized controlled trial of smoking cessation among adults living with HIV, to examine the association between the NMR and response to smoking cessation treatment. NMR was assessed using bio-banked urine samples collected at baseline. Self-reported smoking at 6 months was verified using a urine cotinine test and exhaled breath carbon monoxide (CO). We found no associations between the NMR and smoking abstinence (adjusted risk ratio (aRR) = 0.82; 95% CI: 0.45, 1.49; p = 0.53). No evidence of effect modification by treatment conditions was observed on the multiplicative scale (aRR = 1.17; 95% CI: 0.32, 4.30; p = 0.81) or additive scale (adjusted relative excess risk due to interaction (aRERI) = 0.10; 95% CI: −1.16, 1.36; p = 0.44). Our results suggest that the NMR may not be a viable approach for selecting smoking cessation treatment in this setting, given the minimal variability in our sample and racial/ethnic makeup of this population. Full article

Background: Healthcare providers (HCPs) can play a pivotal role in providing vaping cessation support to adolescents. They can screen adolescents for vaping, offer interventions to quit, and educate adolescents about the dangers of vaping, including nicotine addiction. This review aims to assess the knowledge, attitudes, and practices of HCPs regarding vaping cessation promotion to adolescents. Methods: We conducted a scoping review following the Arksey and O’Malley framework and searched five databases, including MEDLINE, PubMed, PsycINFO, CINAHL, and Scopus, to identify relevant articles. We created a comprehensive search strategy using keywords relevant to healthcare providers, adolescents, practices, and vaping. Results: A total of 1387 articles were identified from the initial search, and 14 were included. There was considerable variation regarding the knowledge, attitudes, and practices of HCPs in supporting adolescents. Although 50–92% of HCPs reported some knowledge about vaping, significant gaps persisted, especially regarding health effects and cessation strategies. Many HCPs lacked confidence in discussing vaping with adolescent patients. While most of the HCPs, 86%, screened for cigarette smoking, only 14% routinely screened adolescents for vaping. They expressed concerns about vaping as a gateway to tobacco use and believed that it was less harmful than cigarettes. HCPs encountered barriers with a lack of time, knowledge, and screening tools in supporting adolescents to quit vaping, particularly related to counselling, treatment recommendations, and referral procedures. Conclusions: There is an urgent need for enhanced understanding, evidence-based guidelines, and clinical tools for HCPs to address the current vaping epidemic among adolescents. Full article

People who undergo lung cancer screening (LCS) and continue to smoke are at risk for negative clinical outcomes and lowered survival and need effective smoking cessation interventions. This pilot study tested an 8-week intervention for smoking cessation after LCS. The participants (N = 40) were randomized to the intervention group (combination nicotine replacement therapy [NRT] plus gain-framed text messaging for 8 weeks) or the control group (standard cessation counseling) after LCS. Assessments were completed at 8-week and 3-month follow-ups, including self-reported 7-day point prevalence abstinence. The mean age was 64.4 years old (SD = 6.2); 32.5% were Black or African American; and 55% were female. At Week 8, 14.3% (3/21) of the participants in the intervention group were abstinent versus 0% (0/19) in the control group (p > 0.05). At 3-month follow-up, 4.8% (1/21) of the participants in the intervention group were abstinent versus 0% (0/19) in the control group. Among the intervention group participants, up to 52.4% used the provided patches and up to 61.9% used the provided lozenges during the study period. This study demonstrated modest quit rates for LCS patients receiving gain-framed text messages and NRT. The results highlight the need for more effective smoking cessation interventions for this priority population. Full article

Background: Smoking during pregnancy is a significant issue because of its impact on maternal and fetal health. This study aimed to ascertain the effects of smoking cessation programs on the smoking abstinence rate and pregnancy outcomes. Methods: A meta-analysis of twenty-one RCTs was carried out in accordance with PRISMA standards. The meta-analysis comprised 8149 pregnant smokers. With RevMan (version 5.4), the pooled effect of RR for different smoking cessation interventions was determined. Using the GRADE approach, the certainty was evaluated. I² statistics and sensitivity analysis were utilized to measure heterogeneity. Egger’s test and funnel plot analysis were used to assess publication bias. Results: The pregnant women who received cognitive-behavioral counseling and financial incentives recognized a significant rise in their smoking abstinence rate (RR: 1.14, 95% CI: 1.02–1.28, p = 0.03 and RR: 2.37, 95% CI: 1.92–2.93, p < 0.001), but there was no significant difference observed among other behavioral approaches or pharmaceutical therapy. Fetuses born to women in the intervention group had significantly larger birth weights (MD = 94.73, 95% CI = (41.18–58.27), p < 0.001. Conclusions: Pregnant women respond well to cognitive-behavioral counseling and financial incentives for quitting smoking, which improve pregnancy outcomes like birth weight. Full article

Smoking is one of the strongest modifiable risk factors for coronary artery disease. It is the cause of approximately 10–30% of deaths due to cardiovascular disease around the world. There is a 50% reduction in the risk of myocardial infarction by one year for people who successfully quit smoking. Considering the risk associated with smoking and the benefits of smoking cessation, it is important to identify and implement effective smoking cessation strategies. There are pharmacological as well as non-pharmacological interventions to assist in smoking cessation. Pharmacological therapies including nicotine replacement therapy; bupropion and varenicline have generally been studied more in patients with cardiovascular disease than the non-pharmacological interventions. Non-pharmacological strategies for smoking cessation include behavioural interventions such as counselling sessions and cognitive behavioural therapy. Studies and randomised controlled trials have demonstrated the safety of most of the pharmacological interventions. Nonetheless, the success rates are variable for the different pharmacological options. Data suggest that greater success can be achieved in smoking cessation with a combination of pharmacological and non-pharmacological treatment. However, more studies are needed to explore the best therapeutic options to improve the success of smoking cessation. Full article

Vaping, particularly the use of nicotine vaping products (NVPs), has emerged as a public health concern. The regulatory environment surrounding NVPs in Australia has rapidly evolved, shifting from a prescription-only model to availability through community pharmacies. Pharmacists play a critical role in addressing vaping-related health concerns. This study explores Australian pharmacists’ perspectives on their professional roles and the support needed to manage vaping-related enquiries. Qualitative semi-structured interviews were conducted with 25 practicing pharmacists using a topic guide developed from the current literature and team expertise. The interviews were transcribed verbatim and analysed thematically using an inductive approach to identify key themes. Key themes included risk perception, professional vaping health-related services, professional practice and other support-related needs. Pharmacists expressed significant uncertainty about the risks and harms associated with vaping. There was apprehension around the regulatory complexity of supplying NVPs, and participants called for greater education and support, particularly around NVP’s place in smoking cessation and potential vaping cessation services. Effective public health messaging and risk communication about vaping are crucial. At the centre of recent legislative changes, pharmacists require training and professional support to address vaping-related scenarios and provide counselling that aligns with individual risk perceptions, ensuring NVP use is clinically appropriate. Full article

Pharmacists are often the first point of contact for healthcare advice in rural communities, where access to healthcare is limited. Tobacco cessation rates improve with counseling from a pharmacist, and in many states, pharmacists can now prescribe medications for quitting. This study aimed to explore smoking behavior and cessation motivations among patients at a Federally Qualified Health Center (FQHC) clinic in rural Wyoming, estimate the prevalence of tobacco-related interventions by clinic staff, and assess patients’ interest in engaging in pharmacist-led cessation programs. A cross-sectional survey was administered over three months to clinic patients who self-identified as current tobacco users. Survey items assessed sociodemographics, tobacco use and vaping behaviors, previous cessation advice from pharmacists, and interest in pharmacist-led support for quitting. Of 63 respondents, 57 (90.5%) reported current tobacco use. Most were ready to quit within the next month (43.9%) or the next six months (33.3%), and 26.3% had previously received advice about quitting from a pharmacist. Most (59.6%) expressed interest in establishing care with a pharmacist for cessation support, and 45.3% requested to be contacted by a pharmacist for assistance with quitting. Interest did not differ by gender or age. The results indicate that rural patients are interested in engaging with pharmacists for quitting. Further research is needed to determine how pharmacy-led programs can complement existing healthcare resources to improve access to cessation support in underserved areas. Full article

Owing to the vital role played by dentists in patient education and due to the growing popularity of e-cigarette use among the younger population, this cross-sectional study aimed to assess the use, knowledge, beliefs, and attitudes toward e-cigarettes among dental students. A cross-sectional questionnaire was given between March and June of 2024 to undergraduate dental students in the Faculty of Dentistry at the Arab American University in Palestine. A 32-item questionnaire with five sections, namely demographics, smoking habits, knowledge, beliefs and attitude, and education about e-cigarettes was sent to all appropriate participants (N = 1050). The response rate was 31% (N = 325). About 11.7% of the respondents were current e-cigarette smokers. The two most commonly cited reasons for initial use of e-cigarettes were curiosity (52.8%) and a desire to quit conventional smoking (27.8%). The average knowledge score was 6.63 (3.08) out of 12, demonstrating a generally inadequate level of knowledge about e-cigarettes. Conventional cigarette smokers were more knowledgeable about e-cigarettes than non-smokers (OR = 1.928; 95% CI: 1.061–3.505; p-value = 0.031). The majority of students (92%) considered the level of education they received in the dental school about e-cigarettes as inadequate, and more than half (53.2%) received information from social media. In conclusion, the prevalence of e-cigarette use among Palestinian dental students is relatively high compared with that reported for other dental students worldwide. Since the students showed a generally inadequate level of knowledge about e-cigarettes, this study casts doubt on the competency of Palestinian dental students to offer cessation counseling, highlighting the necessity to revise the dental curricula to foster positive knowledge and belief conducive to ideal behaviors. Full article

Introduction: Despite the well-documented benefits of smoking cessation interventions, the implementation and success of these programs in primary care settings often encounter significant barriers. A primary care provider’s personal smoking status has been identified as a potential barrier to tobacco treatment delivery. The aim of this qualitative study is to explore the experiences and perspectives of primary care providers regarding their role in delivering smoking cessation interventions to patients based on their personal smoking status. Specifically, the study seeks to examine providers’ thoughts, emotions, and behaviors concerning their own smoking behavior and to understand their attitudes and actions when supporting patients who smoke and to explore their perspectives on the effectiveness of training programs designed to promote tobacco treatment. Materials and Methods: Semi-structured interviews were conducted with 22 primary care providers from six public primary care units in the Central Macedonia Region, Greece. Thematic analysis was used to analyze data. Results: Healthcare providers who are current smokers may face unique challenges in effectively counseling patients on smoking cessation. On the contrast, non-smoking and especially previous smoking healthcare providers were noted to exhibit greater confidence and efficacy in delivering cessation support, often serving as role models for patients aiming to quit smoking. Participating in structured cessation training programs often led healthcare professionals to reflect and reevaluate their own smoking behaviors. Conclusions: Personal smoking status of primary care providers impacts the delivery of tobacco treatment, affecting their credibility and effectiveness in providing cessation support. Educational programs positively impact attitudes and behaviors, underscoring their importance in improving both PCPs’ professional effectiveness and personal health outcomes. These findings suggest that addressing PCPs’ smoking habits and enhancing training opportunities are critical for optimizing smoking cessation services. Full article

Introduction: The impact of multidisciplinary supervised cardiac rehabilitation programs on reducing the risk of having heart problems in the future is well documented. However, little is known about nurse-led post-coronary heart disease (post-CHD). Purpose: Our aim was to evaluate the effectiveness of an educational and counseling-structured nurse-led post-CHD support program by assessing the prediction of psychological, behavioral and dietary variables in relation to adherence to a care plan in a single hospital in Athens (Greece). Method: A prospective follow-up comparative approach in a single group of CHD patients was applied. The structured nurse-led program included eight topics (management of anxiety, physical activity, dietary habits, weight control, smoking cessation, alcohol moderation, family engagement and adherence to a care plan). Participants received tailored nursing interventions focused on psychological and behavioral needs and dietary habits by a CHD-specialized nurse based on patients’ medical prescriptions and/or instructions. A modified clinical assessment questionnaire by the European Society of Cardiology was applied to identify pre–post clinical baseline measurements. A nurse-led post-coronary Heart Disease Support Program was evaluated by assessing the predictivity (effect) of specific interventions on adherence to a care plan by employing a logistic regression beta coefficient (Generalized Estimating Equations model). Results: The sample consisted of 275 patients (66.2% male), with a mean age of 68.5 ± 12.5 years old. CHD patients presented significantly lower anxiety rates (54.27 [1st m] vs. 49.63 [2nd m], p < 0.05). In addition, significant differences were observed between the first and the second measurements of total cholesterol (163.27 [1rst m] vs. 134.44 [2nd m], p < 0.001), BMI (obesity) (33.69 [1rst m] vs. 32.79 [2nd m], p < 0.001), smoking (42.18 [1rst m] vs. 22.55 [2nd m], p < 0.001) and adherence to a care plan (78.90 [1rst m] vs. 89.10 [2nd m], p < 0.001). A Generalized Estimating Equations model revealed that participants with higher levels of anxiety showed significantly lower adherence to a care plan (beta −0.10, p < 0.001) and those with family history of CHD (beta −0.71, p = 0.04) in comparison to those with no CHD history. No significant differences were observed in the predictive variables of smoking (beta 0.08, p = 0.69), alcohol consumption (beta 0.09, p = 0.79) and family engagement (beta −0.11, p = 069) with respect to adherence to a care plan, even after adjusting for age, sex and history of CHD. Conclusion: Our findings indicate that the nurse-led post-CHD support program was found to be partially feasible and effective in our single-group study, emphasizing the need for effective training and retention strategies to enhance the specialization of nurses providing post-CHD care and support. Full article

Background and Objectives: Tobacco smoking is the most important cause of chronic diseases and premature death worldwide. Very brief advice (VBA) and brief advice (BA) represent evidence-based interventions designed to increase quit attempts. These are appropriate for all smokers, regardless of their motivation to quit, and involve several steps regarding the assessment, advice, and action. This review aimed to evaluate the effectiveness of these brief interventions offered by general practitioners (GPs) in smoking cessation. Materials and Methods: A systematic search for articles that presented these interventions as an aid to support smoking cessation was conducted. The rate of successful smoking cessation was evaluated following interventions offered by general practitioners, regardless of the patients’ present motivation to quit. Results: We have checked if these interventions can be used as an innovative method to help active smokers make an informed decision regarding their behaviour. Conclusions: Assisted/supported/guided by a general practitioner, current cigarette smokers can decide to quit smoking and identify the best way of cessation. We processed relevant data where brief interventions were used as the main counselling method to aid smoking cessation, regardless of using nicotine replacement therapy (NRT), heated tobacco products (HTPs), or vaping. Full article

Background/objectives: Smoking increases the risk for multiple lifestyle-related diseases. In Japan, consumption of heated tobacco products (HTPs), a novel cigarette type, is rising. However, no studies have yet compared dietary habits among HTP smokers. This study assessed food and nutrient intake and alcohol consumption by smoking status (non-smokers, cigarette smokers, HTP smokers). Methods: This cross-sectional study included 237 HTP smokers, 242 cigarette smokers, and 178 non-smokers (50% each male and female). The Brief Self-Administered Diet History Questionnaire was administered as a nutritional survey, and smokers were asked about their smoking status, including smoking history and the number of puffs smoked per day. Results: A significantly higher intake of meat was seen in HTP smokers than in cigarette smokers (p = 0.038), and HTP smokers showed the lowest intake of vitamin D in all groups. HTP and cigarette smokers had a lower intake of certain vitamins, minerals, and dietary fiber compared with non-smokers. The rate of habitual drinkers (at least one drink a month) and their alcohol consumption (g/day) were significantly lower in non-smokers (58%, 1.3 g) than in HTP smokers (67%, 4.8 g) and cigarette smokers (70%, 7.1 g) (p = 0.031). Additionally, after adjusting for sex and smoking status in a multiple regression analysis, the number of puffs was a significant contributor to alcohol intake in HTP smokers (β = 0.296, p < 0.001). Conclusions: This study identified significant dietary, nutritional, and alcohol consumption differences based on smoking status, underscoring the need to consider both diet and smoking type in nutritional counseling and smoking cessation guidance. Full article

This is a quasi-experimental study applying a nonequivalent control group pre-test–post-test design with the control of exogenous variables to compare the research variables among experimental groups. Participants totaled 67 and were divided into three groups, each participating in a different training program (lecture, online video, and case-based peer role-play). There were significant increases in attitudes toward smoking cessation interventions in Experiment 2 (online video) (t = −2.48, p = .021) and Experiment 3 (case-based peer role-play) (t = −2.69. p = .013), efficacy of smoking cessation interventions in Experiment 2 (−2.06, p = .052), and intention to deliver smoking cessation intervention in all experimental groups (Exp 1 t = −5.54, p < .001; Exp 2 t = −2.83, p = .010; Exp 3 t = −3.50, p = .002). All three programs of smoking cessation counseling education (lecture, online video, and case-based peer role-play) used in this study showed meaningful results on the study variables. In conclusion, all of the approaches of this study were found to be effective on the intention to deliver smoking cessation intervention, and it is important to creatively apply counseling programs that include essential elements of smoking cessation interventions in nursing education settings. Full article

Background: Community pharmacists’ interventions have been found to be highly effective. However, to date, there has been little information about pharmacists’ potential roles and perceived barriers to providing smoking cessation. This study aimed to assess the potential role of community pharmacists in supporting their patients to quit smoking by summarizing their self-reported level of current activities, confidence, and perceived barriers; Methods: A self-administered questionnaire was used for a cross-sectional study in Saudi Arabia. As part of the questionnaire, demographic characteristics were measured, as well as confidence, perceived berries, and level of smoking cessation activities (asking, advising, assessing, assisting, and arranging, including follow-up).; Results: 370 community pharmacists practicing responded to the survey. Pharmacists indicated high activity rates about advising and assessing patients in quitting smoking, with lower rates of assisting and arranging, including following up. The rate of recording smoking status was very low. There were significant differences between gender, source of education, years practicing as a licensed pharmacist, attended an education or training program on smoking cessation, and interest in providing smoking and perceived practice of smoking cessation. Pharmacists are confident about providing smoking cessation activities. Barriers to providing smoking cessation services include unable to follow up, lack of counseling space, lack of educational materials, and lack of time.; Conclusions: Saudi Arabian community pharmacists actively offer smoking cessation services, which may reduce smoking-related health issues. It appears that pharmacists need to be empowered by team-based, systematic, comprehensive approaches to overcome barriers and enhance their confidence. Full article