We assessed patient experience of care, comparing current and past smokers, and whether frequency of advice to quit smoking impacts patient rating of care.

Experience of care may be a concern for people who smoke and affect their partnership with healthcare providers.

We surveyed adults aged over 35 years who had visited a general practitioner (GP) for health care in the past year (n = 611 current and n = 275 ex-smokers). Questions assessed smoking history, experience of care, anticipation of stigma, and perceptions of smoking cessation advice received in general practice.

Fewer than half (48.8%) of current smokers reported ‘always’ or ‘usually’ being advised to quit smoking, or being advised in a way that motivated them to quit by a GP or other care provider at their GP practice. Current smokers tended to delay or avoid help seeking when needed and experienced more anticipation of stigma in healthcare settings. Conversely, respondents who reported being advised to quit more frequently rated overall quality of care more highly. These data show that asking about smoking and providing advice to quit smoking was acceptable to most respondents and associated with higher ratings of quality of care. However, advice should be provided in a way that motivates patients, without exacerbating the stigma associated with smoking, which may impact help seeking.

Smoking is a risk factor for head and neck cancer. Referral for suspected head and neck cancer can be an opportunity for reassessing smoking behaviour. This study examined attitudes towards smoking in patients referred urgently with suspected head and neck cancer.

A total of 98 smokers were referred urgently for suspected head and neck cancer. Patients completed the Fagerstrom Test for Nicotine Dependence and the Perceived Risk and Benefits Questionnaire.

In the Fagerstrom Test for Nicotine Dependence, higher education background (education beyond secondary or high school level) had a lower dependence score (p = 0.02) and men were more likely to have higher dependence scores (p = 0.02). In the Perceived Risk and Benefits Questionnaire, women scored higher for concerns regarding the negative effects of smoking cessation (p = 0.01) and the perceived health benefits of smoking cessation were greater in those with higher education (p = 0.03).

Men are more nicotine dependent. Women are concerned about perceived side effects of smoking cessation. Patients with a higher education background are more receptive to cessation interventions and should be identified early.

This study aimed to assess vaping prevalence, motivations and risk perceptions among adults attending ENT clinics in the East of England.

A survey was conducted with 284 adults (aged ≥18), gathering data on demographics, vaping habits, awareness of health risks and attitudes towards regulation.

A total of 24 per cent reported vaping, particularly among those aged 18–25 years and the unemployed (p = 0.027). The main motivation was smoking cessation (49 per cent), followed by stress relief and social factors. Vapers perceived vaping as less harmful, while 60 per cent of non-vapers considered it “very harmful.” Awareness of risks was low, especially among younger adults and the unemployed, with 83 per cent lacking sufficient information. Non-vapers (84 per cent) supported stricter regulations.

Vaping is currently a poorly defined health risk. There is a need for targeted education on vaping risks and enhanced regulation, particularly within ENT settings. Further research is required to explore vaping’s health impacts on ENT health.

To explore the views of tobacco-smoking chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap (ACO) patients on telehealth-based cessation programs and the role of e-cigarettes as an aid to quit smoking.

Tobacco smoking accelerates the progression of COPD. Traditional smoking cessation programs often do not entirely address the unique needs of COPD patients, leading to suboptimal effectiveness for this population. This research is aimed at describing the attitudes and preferences of COPD and ACO patients toward innovative, telehealth-based smoking cessation strategies and the potential application of e-cigarettes as a quitting aid.

A qualitative exploratory approach was adopted in this study, employing both focus groups and individual interviews with English-speaking adults with diagnosed COPD or ACO. Participants included both current smokers (≥ 5 cigarettes/day) and recent ex-smokers (who quit < 12 months ago). Data were systematically coded with iterative reliability checks and subjected to thematic analysis to extract key themes.

A total of 24 individuals participated in this study. The emergent themes were the perceived structure and elements of a successful smoking cessation program, the possible integration of telehealth with digital technologies, and the strategic use of e-cigarettes for smoking reduction or cessation. The participants stressed the importance of both social and professional support in facilitating smoking cessation, expressing a high value for insights provided by ex-smokers serving as mentors. A preference was observed for group settings; however, the need for individualized plans was also highlighted, considering the diverse motivations individuals had to quit smoking. The participants perceived online program delivery as potentially beneficial as it could provide immediate access to support during cravings or withdrawals and was accessible to remote users. Opinions on e-cigarettes were mixed; some participants saw them as a less harmful alternative to conventional smoking, while others were skeptical of their efficacy and safety and called for further research.

Tobacco smoking is the most common preventable cause of morbidity and mortality in the world. In an effort to counteract the harmful consequences of smoking, various tobacco control measures have been implemented, including the use of smoking cessation programmes to reduce the number of new smokers as well as helping current smokers to quit smoking. In Thailand, the SMART Quit Clinic Program (FAH-SAI Clinics) was launched in 2010 to provide smoking cessation services by a multidisciplinary team. There are currently 552 FAH-SAI Clinics established across all 77 provinces of Thailand.

This protocol describes a study aiming to evaluate the SMART Quit Clinic Program (FAH-SAI Clinics) in terms of programme performance and clinical outcomes. We hope that the results of the study could be used to improve the current service model and the programme’s success.

A multicentre prospective observational study will be conducted. The study will focus on 24 FAH-SAI Clinics across 21 provinces of Thailand. The primary outcomes are seven-day point prevalence abstinence rate and continuous abstinence rate at three and six months. The outcomes will be measured using a self-reported questionnaire and biochemical validated by exhaled carbon monoxide.

This study will be the first real-world study that reports the effectiveness of the well-established smoking cessation programme in Thailand. Findings from this study can help improve the quality of smoking cessation services provided by multidisciplinary teams and other smoking cessation services, especially those implemented in low- and middle-income countries.

Smoking is probably the one single factor with the highest impact on reducing the life expectancies of patients with mental illness. In Denmark, 38.8% of patients with persistent mental health problem are smoking. Patients may have problem in participating in ordinary smoking cession programs offered in the community, but they are concerned about the impact of tobacco use on their health and finances and are motivated to stop smoking.Videoconferencing addressing smoking cessation might be an alternative to ordinary consultation at the clinic because the patients can access the treatment at home.

Compare rates of smoking cessation in two interventions.

Patients diagnosed with schizophrenia, bipolar disorders or depression in 3 outpatient clinics are eligible for inclusion.Primary outcome is changes in number of cigarettes smoked pr. patients per day in at 6-month follow-up. Secondary outcome is abstinence from smoking at 6-month follow-up.This is a two-arm randomized controlled trial. 1. Daily video consultants at the start of smoking cessation and the months after. 2. Treatment as usual consistent of smoking cessation treatment in the community by weekly consultants.

By September 2021, we have included 64 patients. Among patients, receiving video 26% has stopped and 15% has stopped from treatment as usual.Many patients has reduced their smoking considerably. The patients in general express that they are satisfied with both interventions.

Smoking cessation delivered by daily short video consultants seems to be the best and most effective way to help patients with serious mental illness to stop smoking.

No significant relationships.

Nowdays there are different strategies for the treatment of smoking cessation. The treatment include drugs such as varenicline, which acts as a high-affinity partial agonist for the alpha-4 beta-2 nicotinic acetylcholine receptor subtype (nACh). We report a case of a suicidal behaviour in a 39 year-old woman with no previous history of mental illness, who was brought to the emergency department after intentional intoxication with benzodiazepines. The patient was on 10th day of treatment with varenicline.

To present a case of sucidal behavior that developed in a 39 year-old woman after starting varenicline. Review of literature and total number of cases reported in the european database of suspected adverse drug reactions (EudraVigilance).

We carried out a literature review in Pubmed electing those articles focused on mental disorders in those patients that have been taking varenicline. Review number of cases suicidal behavior reported by the European database of suspected adverse drug reactions.

A 39-year-old female was brought to the emergency department after voluntary ingestion of Lorazepam 1mg (40 tablets) in a sucide attempt. The family reported the starting of thoughts of suicide after 1 week of treatment. No previous history of mental disorders. The patient reported low mood and drowsiness in the last 5 days not linked to any cause. After 5 days of discontinuation these mood symptoms and sucidal behavior remited.

Varenicline is associated with different neuropsychiatric sypmtoms. In patients with or without history of mental disorders we should warn about the symptoms for discontinuation of the treatment.

No significant relationships.

E-cigarettes (ECs) are gaining popularity in Turkey among smokers. With the rapid increase of EC consumption, it is important to ascertain how family physicians (FPs) perceive ECs as they play a key role in providing smoking cessation services.

Our main objectives were to determine FPs’ level of awareness and harm reduction perceptions of ECs and to delineate the factors associated with their counseling practices.

This was a cross-sectional study with descriptive and analytical components. Data were collected through questionnaires. Questions mainly focused on demographic characteristics, knowledge and own use of ECs, general attitudes towards ECs, and daily practices while performing counseling on tobacco use. In order to control confounding factors, logistic regression analysis was performed.

Among a total of 271 FPs, 49.1% (n = 133) were males and the median age (IQR) was 41 years (32–46). Almost one-fifth of the FPs (n = 52) reported that they did not provide counseling services to their smoking patients. Only 26.6% (n = 72) of the FPs stated that they felt confident enough to advise patients on smoking cessation. Of the FPs, 6.6% have stated that they have recommended ECs to their patients for smoking cessation with the strategy of harm reduction. Factors associated with providers’ recommendation of ECs to their patients as a harm reduction strategy included ‘believing that ECs help smokers to quit, ECs could be vaped in closed areas, and ECs were healthier than combustible tobacco products’.

In our study, FPs stated lack of confidence to advice patients on smoking cessation. Furthermore, they recommended ECs to their smoking patients as a harm reduction strategy. FPs’ confidence should be increased with the trainings based on recent evidence on ECs.

Attrition rates in smoking cessation treatments are high, particularly in persons with substance use disorders. It is estimated that about 55%% disengage prematurely at treatment, meaning that a large portion will not benefit from smoking abstinence. So far, no previous studies have examined predictors of dropouts in a smoking cessation treatment with persons with SUD.

The study was two-fold: 1) to analyze the percentage of early-, late-dropouts and completers, and 2) to examine sociodemographic, psychological, and substance-related predictors of dropouts.

A total of 86 participants (69.8% males; Mage=43.84, SD=9.917) were randomly assigned to two psychological smoking cessation treatment: cognitive-behavioral treatment (CBT) (n=51) or CBT + contingency management (CM) (n=35). Interventions were delivered during eight consecutive weeks

Of the 86 participants who completed the baseline assessment, 21 did not start treatment, 17 dropped out of treatment during treatment, and the remaining 48 completed the treatment. Predictors of early-dropout were younger age (B=-.234; p=.024; OR=.792) and lower number of days in SUD treatment (B= -.005; p=.026; OR=.995). Patients’ primary substance of use was associated with reduced early-dropouts; compared to cocaine users, alcohol (B=-1.827; p=.043; OR=.161) and opioids (B=-3.408; p=.018; OR=.033) related to improved attrition. Late dropout was directly related to higher number of tobacco use cessation attempts (B=.407; p=.039; OR=1.502).

Incorporating strategies to improve attendance and completion rates in SUD populations should be a priority. Mobile reminders, offering online therapies, or CM to reinforce attendance to therapy may be considered.

No significant relationships.

In February 2020, the Central Mental Hospital Dundrum moved to a complete ban on cigarette smoking. Concerns were raised that this might represent a ‘restrictive practice’ and that patients might gain weight or see changes in their blood pressure if they were not permitted to smoke.

The aim of the study was to ascertain if there were changes in the blood pressure readings or body mass index of a group of patients in a secure forensic hospital after the implementation of a complete campus-wide smoking ban

All patients (n=20) working with one medium cluster team were included in the study. Demographic details and data pertaining to legal status, diagnosis and length of stay in the hospital were obtained. BMI, blood pressure and medications were reviewed at the time of introduction of the smoking ban, 1st February 2020 and again 5 months later.

All those included in the study were male. The median age was 35 years, most common diagnosis was schizophrenia and mean length of stay was 4.23 years. 20% of patients were prescribed anti-hypertensives at the time of introduction of the smoking ban. All of the patients on anti-hypertensives were overweight. At follow up there was no increase in BMI noted in the patient group. Two patients had dose reductions in anti-hypertensives, three had discontinuation of bronchodilators.

Introducing a campus wide smoking ban in a secure forensic psychiatric hospital is both clinically positive and practically possible. There was no noted increase in incidents in the hospital during this period.

Smoking rates are quite high among overweight and obese individuals. Many smokers with excess weight are at increased risk for health complications and report that concern about post-cessation weight gain is a barrier to quitting. It is necessary to perform studies to assess the efficacy of interventions for smoking cessation among individuals with excess weight.

To describe in-treatment behaviors, in terms of smoking and weight, in an integrated intervention for smoking cessation and weight gain management.

A total of 16 smokers (37.5% females, Mage=52.31, SD=9.58) were randomly assigned to one of the two following 8-week smoking cessation conditions: 1) Cognitive-Behavioral Treatment (CBT) for gradual smoking cessation + a Weight Gain Prevention (WGP) module for weight stability (n=7); 2) the same treatment alongside Contingency Management (CM) for smoking abstinence (n=9). Smoking behavior (cigarettes per day, carbon monoxide (CO) in expired air and urine cotinine) and weight were tracked at every visit from baseline through the end of treatment.

Cigarettes per day significantly decreased in both conditions (p≤.028), as well as CO (p≤.018) and cotinine (p≤.043). Regarding body weight gain, participants maintained their body weight (Kg) from baseline to the end of treatment (CBT+WGP: Δkg= .671, CBT+WGP+CM: Δkg= .667, p≥.058) and their BMI (CBT+WGP: 30.56 vs. 30.85, CBT+WGP+CM: 29.74 vs. 29.85, p≥.139).

Preliminary data indicated that a multicomponent intervention to promote gradual smoking cessation and prevent weight gain facilitates in-treatment tobacco reduction and weight stability. CM procedures improved in-treatment smoking behaviors.

No significant relationships.

Treating addiction is more challenging when there are co-addictions. Tobacco smoking is commonly associated with substance abuse, alcohol use disorders, excessive caffeine intake and pathological gambling among other addictions. Smoking reduction and cessation programmes´ objectives benefit from interventions targeting co-addictions.

Difficulties arising from smoking reduction and cessation in the context of co-use of cannabis prompt literature review and reflection of a smoking cessation programme team.

Pubmed and Google Scholar literature search using terms smoking cessation / tobacco cessation and cannabis.

Co-use of tobacco and cannabis is: 1) very common, 2) associated with greater prevalence of morbidity and social problems, 3) associated with greater dependence of the other substances, 4) negatively influences quit outcomes of either, 5) increases the risk of relapse. Co-users are more likely to perceive the harmful effects of tobacco, have greater motivation and are more likely to quit tobacco than cannabis, which may be perceived as low risk. Treatment of either tobacco smoking or cannabis use may lead to compensatory increase in use of the other substance. There is a significant lack of literature on co-use treatment strategies.

Co-use of tobacco and cannabis makes cessation and relapse prevention of either addiction more difficult and should be taken into account in smoking reduction and cessation programmes and in cannabis treatment interventions. Treatment targetting both tobacco and cannabis use, either simultaneously or sequentially, is likely more successful than interventions targeting only either one. Much remais to be studied on how to treat co-use of tobacco and cannabis.

Persons with substance use disorders (SUD) smoke at strikingly high rates and tobacco use cessation rates are notably low in this population. Contingency Management (CM) is effective to promote substance abstinence, including tobacco, in a large range of populations. CM is scarcely implemented in clinical settings mainly due to barriers at the therapist and organizational levels.

The study sought to examine the additive effectiveness of CM on Cognitive-Behavioral Therapy (CBT) over long-term smoking abstinence in persons undergoing SUD treatment.

A total of 54 smokers (75.9% males, Mage=46.19, SD=9.21) were randomly assigned to CBT (n=30) or to CBT+CM (n=24). Interventions consisted of eight weeks of group-based therapy. Participants were instructed to gradually reduce their nicotine intake by 20% weekly. The CM arm was voucher-based, and the primary outcome was biochemically verified tobacco abstinence (CO≤4ppm, and urine cotinine≤80ng/ml).

A total of 42/54 (77.78%) participants completed the treatment (73.33% in CBT and 83.33% in CBT+CM; p=.380). At the end of treatment, participants in CBT+CM showed higher 24-hour smoking abstinence (50% vs. 20%, p=.032); however, both treatment conditions show equal abstinence rates in the remaining follow-ups (CBT1month= 13.33% vs. CBT+CM1month= 25%; CBT2months= 10% vs. CBT+CM2months= 16.66%; CBT3months= 10% vs. CBT+CM3months= 16.66%; CBT6months= 10% vs. CBT+CM6months= 8.33%; all p-values ≥ .244).

CM facilitates early abstinence outcomes in smokers with SUD more than CBT only does. However, no additive effects of CM were observed at long-term, suggesting the convenience to intensify CM schedules or using technology platforms for incentives delivery.

No significant relationships.

To expedite the use of evidence-based smoking cessation interventions (EBSCIs) in primary care and to thereby increase the number of successful quit attempts, a referral aid was developed. This aid aims to optimize the referral to and use of EBSCIs in primary care and to increase adherence to Dutch guidelines for smoking cessation.

Practice nurses (PNs) will be randomly allocated to an experimental condition or control condition, and will then recruit smoking patients who show a willingness to quit smoking within six months. PNs allocated to the experimental condition will provide smoking cessation guidance in accordance with the referral aid. Patients from both conditions will receive questionnaires at baseline and after six months. Cessation effectiveness will be tested via multilevel logistic regression analyses. Multiple imputations as well as intention to treat analysis will be performed. Intervention appreciation and level of informed decision-making will be compared using analysis of (co)variance. Predictors for appreciation and informed decision-making will be assessed using multiple linear regression analysis and/or structural equation modeling. Finally, a cost-effectiveness study will be conducted.

This paper describes the study design for the development and evaluation of an information and decision tool to support PNs in their guidance of smoking patients and their referral to EBSCIs. The study aims to provide insight into the (cost) effectiveness of an intervention aimed at expediting the use of EBSCIs in primary care.

Patients with schizophrenia spectrum disorders (SSD) have worse physical health and reduced life expectancy compared to the general population. In 2009, the European Psychiatric Association, the European Society of Cardiology and the European Association for the Study of Diabetes published a position paper aimed to improve cardiovascular and diabetes care in patients with severe mental illnesses. However, the initiative did not produce the expected results. Experts in SSD or in cardiovascular and metabolic diseases convened to identify main issues relevant to management of cardiometabolic risk factors in schizophrenia patients and to seek consensus through the Delphi method.

The steering committee identified four topics: 1) cardiometabolic risk factors in schizophrenia patients; 2) cardiometabolic risk factors related to antipsychotic treatment; 3) differences in antipsychotic cardiometabolic profiles; 4) management of cardiometabolic risk. Twelve key statements were included in a Delphi questionnaire delivered to a panel of expert European psychiatrists.

Consensus was reached for all statements with positive agreement higher than 85% in the first round. European psychiatrists agreed on: 1) high cardiometabolic risk in patients with SSD, 2) importance of correct risk management of cardiometabolic diseases, from lifestyle modification to treatment of risk factors, including the choice of antipsychotic drugs with a favourable cardiometabolic profile. The expert panel identified the psychiatrist as the central coordinating figure of management, possibly assisted by other specialists and general practitioners.

This study demonstrates high level of agreement among European psychiatrists regarding the importance of cardiovascular risk assessment and management in subjects with SSD.