• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.21 no.1
• /
• pp.247-257
• /
• 2020

Despite the various smoking cessation programs that are available for college students, students have lower rates of quitting smoking than do other age groups. This study identifies the variables associated with continuous abstinence from smoking among college students. This study used the data from the National Tobacco Control Center and 781 college students who participated in the program conducted by the Daejeon Tobacco Control Center from June, 2015 to December, 2016. The results showed that the expiration CO level and the frequency of attending smoking cessation counseling were the significant variables related to the continuous abstinence rate at 4, 12, and 24 weeks. Students who had a low expiration CO level (?10 ppm) had a higher abstinence rate than did the students who had a high expiration CO level (≥10ppm), and the OR was 2.53 at 4-week, 2.33 at 12-week, and 2.13 at 24-week. The ORs for the 4-week, 12-week, and 24-week abstinence rates with one additional counseling session were 12.39, 13.13, and 12.21, respectively. This study suggests the need to increase the number of smoking cessation counseling sessions for effective smoking cessation intervention among college students.

• Clinical and Molecular Hepatology
• /
• v.24 no.4
• /
• pp.358-366
• /
• 2018

Severe acute alcoholic liver disease (SAAH) unresponsive to medical therapy shows one-year-mortality rates of up to 90%. Most transplant centers request six months of alcohol abstinence prior to transplantation, the so-called "6-month rule." This regulation is not based on strong evidence, repeatedly making it a topic of controversial debates. The majority of patients with SAAH will die before fulfilling the 6-month rule. Therefore, liver transplantation (LT) protocols are becoming more flexible towards the rigid abstinence regulation, especially concerning SAAH patients. We conducted a literature review regarding LT in SAAH and its outcomes, including post-transplant mortality and recidivism. We studied available data on PubMed from 2011 and onwards whilst including articles dealing with genetic components, medical therapy and historic snapshots of alcoholism. Emerging studies recommend LT in SAAH not responding to medical therapies even without realizing the required abstinence period, since the majority of these patients would die within 6 months. SAAH without response to medical therapy has one-year-mortality rates of up to 90%. The 6-month rule is not based on strong evidence and is repeatedly a topic of controversial debates. There is genetic linkage to alcoholism and medical therapy is not as effective as estimated, yet. The 6-months-regulation has not shown to evidently decrease the risk of recidivism post-LT, which is a lifesaving treatment in SAAH patients. Insisting on rigid sobriety rules results in excluding patients with a low risk of recidivism from being transplanted. Moreover, the genetic linkage of alcoholism must be recognized.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.11
• /
• pp.6875-6881
• /
• 2013

Background: Studies evaluating smoking cessation treatment outcomes in cancer patients are scarce, despite smoking cessation importance in cancer care. We sought to add to the literature by evaluating smoking cessation in a challenging group of cancer patients (medium-to-heavy smokers) visiting an out-patient smoking cessation clinic (SCC) in a cancer center in Amman, Jordan. Materials and Methods: Patients smoking >9 cigarettes per day (CPD) and referred to the SCC between June 2009 and May 2012 were studied. Clinic records were reviewed to measure demographic and baseline clinical characteristics, and longitudinal (3-, 6- and 12- month) follow-up by phone/clinic visit was conducted. At each follow-up, patients were asked if they experienced medication side-effects, if they had returned to smoking, and reasons for failing to abstain. Descriptive and multivariable logistic regression analyses were performed. Results: A total of 201 smokers were included in the analysis. The 3-month abstinence was 23.4% and significantly associated with older age, being married, and presenting with lower (${\leq}10ppm$) baseline carbon monoxide (CO) levels. On a multivariable level, lower CO levels, a higher income (relative to the lowest income group), being older, and reporting severe dependence (relative to dependence reported as 'somewhat' or 'not') were significant predictors of higher odds of abstinence at three months. Reasons for failing to quit included not being able to handle withdrawal and seeing no value in quitting. Long-term ARs did not reach 7%. Conclusions: In a sample of Jordanian smokers (>9CPD) with cancer and receiving smoking cessation treatment, ARs were low and further declined with time. Results underscore the need for more aggressive patient management and rigorous follow-up during and after smoking cessation treatment, particularly when this takes place in challenging settings. Observed reasons for failure to abstain should be used to tailor counseling practices.

• Tuberculosis and Respiratory Diseases
• /
• v.76 no.6
• /
• pp.276-283
• /
• 2014

Background: We aimed to investigate the role of the physician in practice and the factors that influence the success rate of smoking cessation. Methods: This study retrospectively analyzed 126 adult smokers who had visited the outpatient department of pulmonology, and received motivational interviewing with or without supplement drugs. The findings include continuous smoking abstinence rate, which was evaluated at 6, 12 and 24 weeks, and the factors associated with continuous abstinence for 6 months or longer. Results: The patients with only motivational interviewing accounted for 57.9%, while the nicotine patch therapy was applied to 30.2%; and varenicline was prescribed to 11.9%. The smoking cessation success rates of at 6, 12, and 24 weeks were 55.6%, 47.6%, and 33.3%, respectively. However, even in the failure group at six months, tobacco consumption was decreased under 10 cigarettes per day in 42.1% (53/126). In multivariate logistic regression analysis, degree of Fagerst$\ddot{o}$m Test for Nicotine Dependence (p=0.034; odds ratio, 3.607; 95% confidence interval [CI], 1.102-1.807), the absence of smoking-related lung disease (p=0.008; odds ratio, 4.693; 95% CI, 1.497-14.707), and education level (p=0.001; odds ratio, 181.420; 95% CI, 8.414-3,911.502) were the predictors of successful smoking cessation. Conclusion: An improved continuous smoking abstinence rate can be obtained by motivational interviewing, regardless of the association with pharmacotherapy.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.12
• /
• pp.4963-4968
• /
• 2014

Background: We evaluated whether providing health risk appraisal for Koreans (KHRA) in terms of 'health age' during smoking cessation program would effectively help smokers quit smoking or not. Materials and Methods: A total of 332 male smokers aged between 30-65 years old, registered for a smoking cessation program in a public health center in a city, were recruited and underwent a baseline survey from January 2010 to February 2011. They were then prospectively randomized to a conventional counseling group (n=165) or a KHRA group (n=167), and received conventional counseling or KHRA-based counseling for six months. Abstinence rates were identified through carbon monoxide measurement (at the $4^{th}$ and $24^{th}$ weeks) or urinary cotinine level (at the $12^th$ week). Results: The abstinence rate confirmed by exhaled carbon monoxide was significantly higher in the KHRA group (61.1%) than the control group (49.1%) at the $4^{th}$ week (absolute difference 12.0%, 95% CI: 1.4%-22.6%). However, there was no difference in abstinence rates between the two groups at the 12th and 24th weeks. The predicting factors of 24 week's smoking cessation success were age, older than 50 years old (OR 2.02, 95% CI: 1.16-3.52), lower Fagerstr$\ddot{o}$m Test for Nicotine Dependence score less than 4 (OR 1.84, 95% CI: 1.03-3.29), and higher Self Efficacy/Temptation score (OR 1.79, 95% CI: 1.05-3.06). Conclusions: Smoking cessation counseling with KHRA could be effective compared to conventional counseling in the short period of smoking cessation. Further study is needed to evaluate the long-term efficacy of KHRA in tobacco dependence treatment and to establish the indication and target population of this tool.

• Journal of Korean Public Health Nursing
• /
• v.34 no.2
• /
• pp.263-276
• /
• 2020

Purpose: This paper systematically reviewed the effects of smoking cessation (SC) intervention among female smokers. Methods: A systematic search was performed targeting articles published on eight electronic databases, from January 1, 2010, to February 25, 2020. Nine studies were included in the systematic review. The risk of bias (RoB) tool was used to evaluate the quality of scientific evidence. Results: A randomized controlled trial (RCT) was performed in all nine studies. Interventions were classified as exercise (n=4), cognitive behavioral counseling (n=2), motivational counseling (n=1), group counseling with self-help group (n=1), and pharmacotherapy (n=1). The SC rates were measured using a 7-days point prevalence abstinence in 55.6% of the studies. Exercise studies showed higher SC rates in the experimental groups than control groups after the intervention, but the differences were not significant. Other interventions were employed in two or fewer studies or did not conduct long-term follow-up, thus we were unable to examine effects of these interventions. Conclusion: It is necessary to develop SC programs for female smokers by carefully considering the characteristics of female smokers. Further research will be needed to confirm the effects of SC programs in certain subgroups among females. Also more experimental studies on SC intervention should be carried out with scientific rigor.

• Journal of Preventive Medicine and Public Health
• /
• v.53 no.5
• /
• pp.381-386
• /
• 2020

Objectives: Few studies have been published regarding the relevance of the admission diagnosis to the smoking cessation rate. We studied smoking cessation rates in relation to admission diagnoses in our inpatient smoking cessation programmes. Methods: This retrospective study included all patients recruited into our inpatient smoking cessation programmes at 2 institutions in Singapore between June 2008 and December 2016. Patients were given individualized intensive counselling and were followed up via phone interviews for up to 6-month to assess their smoking status. Multivariable logistic regression was used to analyse potential associations between admission diagnoses and 6-month abstinence. Results: A total of 7194 patients were included in this study. The mean age was 54.1 years, and 93.2% were male. In total, 1778 patients (24.7%) were abstinent at the 6-month follow-up call. Patients who quit smoking tended to be of Chinese ethnicity, have initiated smoking at a later age, be better educated, and have lower Fagerström Test of Nicotine Dependence scores. After adjusting for these factors, patients with a cardiovascular admission diagnosis had a significantly higher probability of quitting tobacco use than patients with a respiratory or other diagnosis. Conclusions: In patients acutely admitted to the hospital, a diagnosis of cardiovascular disease was associated with the highest quit rate. Smoking cessation interventions need to be incorporated into all cardiovascular disease treatment pathways to leverage the patient's motivation and to improve the quit rate. In addition, patients in groups with lower quit rates may benefit from more intensive programmes to increase the rate of successful cessation.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.11
• /
• pp.6797-6802
• /
• 2013

Background: Prevalence of tobacco use is higher in the rural than urban areas of India. Unlike tobacco cessation clinics located in urban areas, community-based smoking cessation intervention has the potential to reach a wider section of the community to assist in smoking cessation in the rural setting. The present study aimed to assess the effectiveness of a cessation intervention in rural Kerala state, India. Materials and Methods: Current daily smoking resident males in the age group 18-60 years from four community development blocks in rural Kerala were randomly allocated to intervention and control groups. The intervention group received multiple approaches in which priority was given to face-to-face interviews and telephone counselling. Initially educational materials on tobacco hazards were distributed. Further, four rounds of counselling sessions were conducted which included a group counselling with a medical camp as well as individual counselling by trained medical social workers. The control group received general awareness training on tobacco hazards along with an anti-tobacco leaflet. Self-reported smoking status was assessed after 6 and 12 months. Factors associated with tobacco cessation were estimated using binomial regression method. Results: Overall prevalence of smoking abstinence was 14.7% in the intervention and 6.8% in the control group (Relative risk: 1.85, 95% CI: 1.05, 3.25). A total of 41.3% subjects in the intervention area and 13.6% in the control area had reduced smoking by 50% or more at the end of 12 months. Lower number of cigarettes/ bidi used, low nicotine dependence and consultation with a doctor for a medical ailment were the statistically significant predictors for smoking cessation. Conclusions: Rigorous approaches for smoking cessation programmes can enhance quit rates in smoking in rural areas of India.

• Journal of Korean Academy of Nursing
• /
• v.37 no.7
• /
• pp.1139-1148
• /
• 2007

Purpose: The purpose of this study was to investigate the effects of a community-based group smoking cessation program among adult smokers in a rural community. Method: The study design was quasi-experimental with a pre and posttest. A total of 55 adult smokers participated in the study. They were evaluated 1, 3, and 6 months after the program to identify the long-term effectiveness of the program. The program consisted of a total of 5 sessions provided twice a week. To test the effectiveness of the program, urine creatinine, expired air carbon monoxide, nicotine dependence, and smoking-related knowledge were used as dependent variables. Data was analyzed with the SPSS 10.0 program with a t-test, paired t-test, and Scheffe test. Result: Urine creatinine, expired air carbon monoxide, and nicotine dependence were significantly decreased after the program. Also, the rates of continuous abstinence were 81.8% at posttest, 65.5% at 1 month, 54.5% at 3 months, and 54.5% at 6 months follow-up. Conclusion: This community-based group smoking cessation program implemented by a nurse and smoking cessation counselors was effective for quitting smoking and decreasing urine creatinine and nicotine dependence. Therefore, this smoking cessation program could be recommended to induce smoking cessation as health promotion management in the rural community.

• Tuberculosis and Respiratory Diseases
• /
• v.72 no.5
• /
• pp.426-432
• /
• 2012

Background: Varenicline is an effective smoking cessation aid. However, smokers prescribed with varenicline do not always receive varenicline for 12 weeks, as recommended. This study analyzed the subjects who received varenicline and investigated the effect of varenicline treatment duration on the success rate of 6-month smoking cessation. Methods: This study retrospectively analyzed 78 subjects, who received varenicline, out of the 105 smokers that had visited the smoking cessation clinic after medical examination from September 2007 to December 2009. Results: The subjects were all males. Twenty-two subjects (28.2%) had varenicline treatment for 12 weeks or longer; 18 subjects (23.1%) for 8~12 weeks; 22 subjects (28.2%) for 4~8 weeks; and 16 subjects (20.5%) for less than 4 weeks. The total success rate of the 6-month smoking cessation was 47.4%. The success rate of the 6-month smoking cessation was 63.6% in the group that received varenicline for 12 weeks or longer, which was higher than 41.1% of the group that early terminated the varenicline treatment (p=0.074). The period of varenicline treatment was extended for one more week, the odds ratio of the 6-month smoking cessation success increased to 1.172-folds (p=0.004; 95% confidence interval, 1.052~1.305). Adverse events occurred in 30.8% of the subjects who received varenicline, but no serious adverse events were found. Conclusion: If varenicline treatment period is extended, the odds ratio of the success rate for the 6-month smoking cessation increases. Therefore, an effort to improve drug compliance for varenicline in clinical practices could be helpful for the long-term success of smoking cessation.