Search Results (440)

To maintain relevance, youth tobacco control programs must leverage popular social media platforms and address evolving behaviors. Recognizing this, the South Carolina Department of Public Health and Rescue Agency implemented culturally tailored social media campaigns (Down and Dirty, Fresh Empire), a broad vaping social media campaign (Behind the Haze), and an Instagram-based vaping cessation program (Quit the Hit, QTH). This study examines program impact. The social media campaigns were evaluated via online cross-sectional surveys in 2019–2023. Analyses examined awareness and reception overall and among target audiences and compared knowledge, attitudes, and beliefs between campaign-aware and unaware participants. The impact of QTH was assessed via online baseline and follow-up surveys in 2021–2023. Analyses examined program feedback and changes in cessation confidence and tobacco use from baseline to follow-up. Over one-third of participants recalled the social media campaigns, and recall of featured facts was higher among the campaign-aware participants than the unaware participants. QTH participants’ confidence in quitting increased from baseline to follow-up, while any 30-day vaping and average number of days of vaping decreased. This innovative social media program reached high-risk youth with educational content and empowered teens to quit vaping, providing a model for comprehensive youth tobacco control programs. Full article

Children’s tobacco smoke exposure (CTSE) is a public health concern, particularly in low-income and minority communities. Interventions to reduce CTSE have had modest success, and so research must identify mechanisms to improve intervention efficacy. This study investigated mediators of CTSE reduction in an intervention designed to facilitate CTSE protection and maternal smoking abstinence. We analyzed data from the Babies Living Safe and Smokefree (BLiSS) trial, which evaluated the efficacy of a multilevel behavioral smoking intervention initiated in community clinics serving low-income mothers. We estimated direct and indirect effects to evaluate the role of two mediators of the intervention on CTSE at post-intervention follow-up: mothers’ skills in managing smoking urges and their protective behaviors to shield children from TSE. CTSE was measured using mothers’ reports and child cotinine (a CTSE biomarker). The BLiSS intervention was linked to statistically significant lower longitudinal reported CTSE directly and indirectly by increasing mothers’ urge management skills and CTSE protection behaviors (p-values < 0.05). The intervention was not directly linked to child cotinine. However, evidence of a statistically significant indirect effect (p-value = 0.028) suggested that the intervention reduced longitudinal child cotinine levels by increasing CTSE protection behaviors. Two non-program factors, nicotine dependence and total smokers in the home, also increased child cotinine and reported CTSE (p-values < 0.001). Interventions that improve maternal smokers’ urge management skills and CTSE protections can mitigate CTSE. In addition, it is essential to target barriers to CTSE reduction, such as nicotine dependence levels and the presence of other smokers in the home. Full article

Introduction: The success of clinical trials hinges on the effective recruitment and retention of participants, which remains a persistent challenge. Smoking has well-documented adverse effects on health and is a significant predictor of various chronic diseases. However, smoking status impact on the motivation to participate in clinical trials is less clear. Methods: This cross-sectional study, utilizing data from the Health Information National Trends Survey (HINTS) 5 Cycle 4 with a sample of 3793 participants, investigates how smoking status (current, former, and never smoker) influences motivation to participate in clinical trials using a structural equation model. Key predictors of trial participation include age, gender, education level, race/ethnicity, income, ethnicity, depression, and chronic respiratory conditions. Results: In the overall sample, 51.2% of the participants were females, 76.0% were White adults, 83.1% were non-Hispanic, 39.0% had some college education, and 42.5% had a household income of $75,000 or more. The mean age of the participants was 48.4 years, and the mean depression score was 2.2. Structural equation model results showed a significant positive association between female gender and motivation in clinical trial participation for current smokers. For former smokers, older age and Hispanic ethnicity showed negative associations, while education showed a positive association. For those who have never smoked, older age and other races showed negative associations. Conclusions: This study highlights the significant role of education, age, gender, and race/ethnicity among people with different smoking statuses in motivating clinical trial participation. Tailored strategies that address these barriers are essential for improving recruitment and retention in tobacco cessation trials. Full article

Background/Objectives: Rural populations in the US bear a disproportionate burden of cancer mortality, which may be partly due to their elevated tobacco use and the limited receipt of tobacco use interventions in rural healthcare settings. Here, we examine providers’ use of the 5As (Ask, Advise, Assess, Assist, and Arrange), a brief tobacco cessation intervention, with their patients to assess intervention gaps. Methods: Provider practices in substance use treatment centers (SUTCs) and medical healthcare centers (MHCs), each serving rural and/or medically underserved areas (MUAs) of Texas, were compared. In total, 347 providers from 10 SUTCs (n = 174) and 9 MHCs (n = 173) responded to an anonymized survey about their cigarette and non-cigarette screening and intervention delivery, along with their perceived importance and workforce’s preparedness to help patients stop using tobacco. Linear mixed and generalized linear mixed models were used to assess differences between practices at SUTCs and MHCs. Results: More MHC than SUTC providers reported that cigarette and non-cigarette tobacco use cessation intervention were (respectively) important parts of their job (p = 0.0009; p = 0.0023) and that their workforce was prepared to help their patients quit tobacco (p = 0.0275), although less than half of all respondents endorsed preparedness. Relative to those at SUTCs, MHC providers reported higher rates of asking (SUTCs = 59.57% and MHCs = 77.21%; p = 0.0182) and advising (SUTCs = 45.34% and MHCs = 72.35%; p = 0.0017) their patients to quit cigarette smoking and advising them to quit non-cigarette tobacco products (SUTCs = 43.94% and MHCs = 71.76%; p = 0.0016). Conclusions: Overall, providers in both settings may benefit from greater preparation to deliver tobacco cessation care; needs were more prevalent within SUTCs than MHCs. Our findings can inform strategic planning to improve centers’ capacity to comprehensively address their patients’ tobacco use in rural/MUAs of Texas, US. 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

Background/Objectives: Substance use during pregnancy is associated with adverse outcomes for both mother and child. This study aimed to determine the prevalence and determinants of alcohol, tobacco and illicit drug use before and during pregnancy in Belgium. Methods: An observational study was conducted using data from the longitudinal BELpREG registry. The study included women aged 18 years or older who completed at least one questionnaire on substance use during pregnancy between 2022 and 2024. Data were analyzed using descriptive statistics and logistic regressions. Results: In total, 1441 women were included. Preconception prevalences of alcohol, tobacco and illicit drug use were 82.2%, 10.0% and 4.2%. These self-reported prevalences dropped in the first trimester to 12.9%, 4.1% and 0.6%, respectively. Considering the rates of substance use in pregnancy but before pregnancy awareness, the overall prevalence of alcohol, tobacco and illicit drug use in the first trimester was 41.0%, 6.6% and 1.2%, respectively. Women with a higher education (aOR (adjusted odds ratio), 2.12; 95% CI (confidence interval): 1.14–3.96), unplanned pregnancies (aOR, 2.88; 95% CI: 1.77–4.67), spontaneous pregnancies (aOR, 2.94; 95% CI: 1.51–5.75), cohabitants drinking alcohol daily (aOR, 2.01; 95% CI: 1.09–3.70), and those using tobacco in the first trimester (aOR, 5.37; 95% CI: 2.70–10.66) were more likely to report alcohol use. In addition, women with a lower education (aOR, 7.67; 95% CI: 3.76–15.67), unplanned pregnancies (aOR, 3.31; 95% CI: 1.53–7.15), cohabitants using tobacco (aOR, 9.11; 95% CI: 4.48–18.52), and those who used alcohol (aOR, 6.67; 95% CI: 3.07–14.64) or illicit drugs (aOR, 39.03; 95% CI: 3.72–409.83) in the first trimester were more likely to report tobacco use. Conclusions: Despite a significant reduction in substance use in pregnancy compared to before pregnancy, a relevant portion of women continue to use substances, particularly in the early stages before pregnancy awareness. Targeted public health interventions and (more) awareness among caregivers are needed to further promote substance use cessation before conception. Full article

Background and Objectives: Smoking has adverse effects on both maternal and fetal health and its incidence varies among different countries. The aim of this study was to identify the prevalence of smoking during pregnancy and to identify factors associated with smoking. Materials and Methods: This was a retrospective study conducted at the Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece, during an 11-year period (2013–2023). All women receiving antenatal care in our unit were eligible to participate when they attended the prenatal unit for the first trimester nuchal translucency scan (11⁺⁰–13⁺⁶ weeks). Results: Of the 12,074 pregnant women included in the study, 5005 (41.5%) reported themselves as smokers before pregnancy; the smoking cessation rate due to pregnancy was 70.2% (3516/5005) and the prevalence of smoking in pregnancy was 12.3% (1489/12,074). Multiparity was associated with less odds of smoking before pregnancy (OR: 0.79; 95% CI: 0.73–0.85), whereas advanced maternal age (OR: 1.17; 95% CI: 1.07–1.27) and obesity (OR: 1.44; 95% CI: 1.29–1.6) were associated with higher odds of smoking before pregnancy. Smoking prevalence in pregnancy was lower in women that conceived via assisted reproductive techniques (ARTs) (OR: 0.52; 95% CI: 0.38–0.70) and higher in cases of multiparity (OR: 1.12; 95% CI: 1.008–1.26) and maternal obesity (OR: 1.55; 95% CI: 1.20–2.00). Conception via ARTs was associated with higher odds of smoking cessation (OR: 1.9; 95% CI: 1.38–2.69), whereas multiparous (OR: 0.7; 95% CI: 0.62–0.8) and obese women (OR: 0.72; 95% CI: 0.61–0.85) were less likely to quit smoking. Conclusions: Pregnancy is a strong motivator for women to quit smoking, especially in primiparous women and those undergoing ARTs. Our findings highlight the need for more consistent smoking prevention and health promotion strategies in Greece as a very high proportion of women smoke before pregnancy and a substantial proportion continue in pregnancy. Full article

Background/Objectives: Current scientific evidence shows both the relationship between good physical condition and a lower incidence of certain chronic diseases (including smoking), as well as the efficacy of cytisinicline. The aim of this protocol is to evaluate the efficacy of the synergistic effect of the combination of targeted physical exercise, together with brief advice and taking the drug cytisinicline, to achieve smoking cessation. Methods: We propose an experimental, multicentre, randomised, controlled study with two parallel arms to be carried out by a multidisciplinary team in the primary care setting of the Andalusian public health system (APHS) in Spain, with a follow-up of 12 months. The population sample will include people who are aged between 18 and 65 years and meet the criteria to be eligible for treatment with cytisinicline financed by the APHS: smokers of 10 or more cigarettes per day who are in the determination/action phase for smoking cessation of the transtheoretical model of Prochaska and Diclemente, willing to start anti-smoking treatment imminently and confirmed, with high dependence to nicotine (Fagerström’s test ≥ 7), with a motivation to quit smoking according to the Richmond test (≥6), and who have made a previous smoking cessation attempt in the last year. The study consists of two treatment arms. EXPERIMENTAL ARM: Smokers who are going to be prescribed targeted physical exercise and brief advice to stop smoking while receiving cytisinicline treatment (1.5 mg tablets) according to the care process. CONTROL ARM: Smokers will receive a standard leaflet explaining physical exercise to the general population and brief advice on smoking cessation when starting cytisinicline treatment, according to the care process. The calculated sample size is 75 participants per arm. Results: The primary results will allow us to estimate the efficacy of prescribing physical exercise as an adjuvant therapy to classic multicomponent treatment, incorporating it as an additional element to be considered when it is accepted by the smoker. Conclusions: This protocol (NCT06579846) evaluates the efficacy of combining physical exercise, brief advice, and cytisinicline to support smoking cessation, improve fitness, and reduce smoking-related comorbidities 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

Maternal smoking, including both traditional cigarettes and electronic ones, is a significant modifiable risk factor associated with adverse perinatal outcomes, especially in twin pregnancies. This narrative review aims to explore the impact of maternal smoking on obstetric and neonatal outcomes in twin pregnancies, which inherently carry a higher risk of complications. A literature search was conducted using the PubMed and EMBASE databases, selecting studies published between January 1994 and October 2024. The findings demonstrate a clear association between smoking and increased risks of preterm birth and fetal growth restriction (FGR) in twin pregnancies. These risks are exacerbated when smoking is combined with other factors, such as preeclampsia and elevated body mass index (BMI). Smoking was also associated with long-term post-natal complications, including respiratory problems like asthma, as well as cognitive and behavioral disorders. However, an association with preeclampsia was not found, and further studies are needed to clarify the relationship in the fields of preterm premature rupture of membranes (PPROM) and fetal death. The adverse effects of smoking are primarily due to reduced oxygen supply to the fetus, caused by nicotine-induced vasoconstriction and carbon monoxide exposure, leading to placental insufficiency and fetal hypoxia. These effects are amplified in twin pregnancies due to the increased physiological demands. The review highlights that smoking cessation interventions during pregnancy are crucial to mitigate these risks and improve maternal and neonatal health outcomes. Full article

Background/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. 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. 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: Tobacco use remains a significant public health issue, particularly among individuals with low incomes, including Medicaid recipients who often face multiple barriers to quitting. This study aimed to identify barriers, from the perspective of Medicaid managed care organizations (MCOs), influencing Medicaid recipient participation in tobacco cessation programs. Methods: Focus group interviews were conducted with Florida Medicaid MCOs to elicit processes for case identification, outreach, referral, program participation, and incentives. Answers were synthesized into themes. Results: Medicaid recipients were primarily identified through nicotine dependency claim codes or Health Risk Assessments (HRAs). Individuals were referred to state and local community tobacco cessation programs through text messaging and outreach by MCO case managers. The MCOs identified the following as barriers: primary care physicians (PCPs) with limited knowledge about cessation programs and pharmacologic treatments for nicotine dependence, low availability of health coaches, long wait times for entry into cessation programs, weak coordination between MCOs and cessation programs, and insufficient incentives for individuals for program participation. Suggested strategies to overcome barriers were continuing medical education (CME) for PCPs about tobacco cessation programs and prescription therapies, increasing the training of health coaches, more investment in quitlines, increasing data sharing between MCOs and cessation programs, and increasing incentives for individuals. Conclusions: These findings highlight the importance of engaging MCOs in discussions about policy and program improvements, as their insights can drive meaningful changes in how tobacco cessation and other preventive health programs are structured and implemented. Targeted interventions are needed to enhance tobacco cessation program participation among Medicaid recipients. 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

Background. Causing approximately 8 million deaths each year, tobacco smoking represents a significant public health concern. Evidence shows that smoking significantly impairs antibody production and immune cell activity following vaccination. Objectives. This review aims to provide a comprehensive overview of the literature regarding how smoking reduces the effectiveness of active immunization by affecting vaccine-induced immune response. Methods. This study was performed according to the PRISMA guidelines, and the protocol was registered on the PROSPERO platform (ID: CRD42024582638). PubMed, Scopus and Web of Science were consulted as bibliographic and citation databases. Studies published in Italian and English and that aimed to investigate the effects of exposure to active and passive tobacco smoking on vaccine-induced immune response were included. Results. Thirty-four studies were selected. Overall, a decrease in antibody levels and avidity and in immune cell production were observed in individuals exposed to smoke. The meta-analysis showed a weighted mean difference between smokers and non-smokers equal to 0.65 (95% CI: 0.10–1.19, p = 0.02) for vaccinations against COVID-19, influenza, pneumococcus, HBV, HPV, tetanus, pertussis, polio, haemophilus influenzae type b, measles–mumps–rubella, and recurrent urinary tract infections. Conclusions. Smoking cessation campaigns should be considered in order to increase the effectiveness of vaccination programs. Furthermore, the opportunity to adopt different vaccine dosing schemes for smokers and non-smokers, especially in acute epidemics, should be considered. Full article

Background: Underweight is a prevalent condition among older adults in developing countries and poses a substantial burden on health, social, and aged-care systems. In this study, we examined the influence of tobacco use and food insecurity on the risk of being underweight among adults aged 60 or older in India. Methods: We used data from the 2017–2018 Longitudinal Aging Study in India. The sample size was 27,902 adults aged 60 years and above. We distinguished between smoking and smokeless tobacco use to examine how they may independently contribute to the outcome, while food insecurity was measured using the four-item version of the Food Insecurity Experience scale. Multivariable logistic regressions were conducted to assess the impact of tobacco use and food insecurity on the outcome. Additionally, we tested interactions between tobacco use and education, as well as between tobacco use and wealth. Results: The prevalence of underweight was 27% in the study population. Older adults who used smoking tobacco were twice more likely to be underweight than non-users (OR = 2.07, 95% CI = 1.79 to 2.40, p < 0.001), controlling for other confounders. The positive association between smokeless tobacco use and underweight was weaker but still significant (OR = 1.26, 95% CI = 1.11 to 1.42, p < 0.001). Food-insecure older adults were also more likely to be underweight (OR = 1.27, 95% CI = 1.10 to 1.48, p < 0.001). Other risk factors of underweight included males, rural residents, lower socioeconomic status (in terms of education, wealth, and caste), chewing disability, poor self-rated health, chronic lung disease, and tuberculosis. Interestingly, tobacco use moderated the relationship between wealth and underweight, such that smokers are more likely to be underweight as they become more affluent. Conclusions: Tobacco use and food insecurity have adverse implications on the nutritional status of the older persons in developing countries such as India. More targeted tobacco cessation measures and active food assistance programs for older adults are warranted to improve the overall health status of the older demographic. Full article