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The importance of addressing waterpipe tobacco smoking: research and policy responses 2013
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Journal Article
Periodical, Full
Addiction
Periodical, Abbrev.
Addiction
Pub Date Free Form
Volume
108
Issue
11
Start Page
1887
Other Pages
8
Notes
ID: 24118757
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ISSN/ISBN
Accession Number
Language
en
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DOI
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Unknown(0)
PMID
Abstract
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http://dx.doi.org/10.1111/add.12341
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MEDLINE; http://www.globalhealthlibrary.net/
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Data Source
Authors
Jawad,Mohammed, McEwen,Andy, McNeill,Ann, Shahab,Lion
Original/Translated Title
URL
Date of Electronic
PMCID
Editors
Shisha smoking, nickel and chromium levels in Tunisia 2013
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Print(0)
Ref Type
Journal Article
Periodical, Full
Environ Sci Pollut Res Int
Periodical, Abbrev.
Environ.Sci.Pollut.Res.Int.
Pub Date Free Form
Volume
20
Issue
11
Start Page
8295
Other Pages
6
Notes
ID: 23807563
Place of Publication
ISSN/ISBN
Accession Number
Language
en
SubFile
DOI
Output Language
Unknown(0)
PMID
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http://dx.doi.org/10.1007/s11356-013-1935-z
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Database
MEDLINE; http://www.globalhealthlibrary.net/
Publisher
Data Source
Authors
Chaouachi,Kamal
Original/Translated Title
URL
Date of Electronic
PMCID
Editors
El arguille: la otra forma de consumir tabaco 2013
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Print(0)
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Journal Article
Periodical, Full
Periodical, Abbrev.
Av.cardiol
Pub Date Free Form
Volume
28
Issue
2
Start Page
119; 93
Other Pages
124; 93
Notes
ID: 607854; ID: 756075
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ISSN/ISBN
Accession Number
Language
es; pt
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DOI
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Unknown(0)
PMID
Abstract
Identify the characteristics and knowledge related to adolescents tabagism and the electronic media most used by this group. Exploratory study with interviews were done with 60 adolescents, smokers, ex-smokers or none smokers through specific interview approach with issues related to tabagism. In addition to questionnaire, the intensity of dependence was assessed through Fagerstrõm test, motivation stages through Prochaska and DeClemente model and the suggested anxiety and depression symptoms by the hospital anxiety and depression scale of Zigmond & Snaith. The adolescent average age was 15,8 ± 1,1 years, 65% were female, 41,7% active smokers (60% girls) and 28,3% ex-smokers. The adolescents used to be in high school with 46,7% during their first year. Most of the adolescent smokers and ex-smokers (73,8%) started tabagism with ages between 14 and 16 years and 26,2 % between 10 and 13 years. Hookah smoking is popular between the adolescents to the extent that 81% of the smokers and ex-smokers had some experience with this form of tobacco consumption from tasting to current use. Between adolescents that believe that people start to smoke to show off with relation to cigarette 75% were smokers and between that believe that people start to smoke to parental influence 83,3% were smoker. The cardiac negative effect were identified by just 5% the kids and, in addiction, considerable proportion (20%) connect tabagism with some “benefits”. The internet through computers (58,3%) is an electronic media more used to have fun by the kids. The knowledge of adolescents on tabagism, non conventional way of tobacco and nicotine chemical dependence are not standardized or complete and, sometimes controversial. With respect to the result of this trial, is necessary to develop content coverage that by pass the errors of the knowledge on adolescents about tabagism, using internet tool as preference...(AU)
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LILACS; http://www.globalhealthlibrary.net/; LILACS; http://www.globalhealthlibrary.net/
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Data Source
Authors
Souki Chmeit, Rami, Bertani,André Luís
Original/Translated Title
URL
Date of Electronic
PMCID
Editors
Nicotine receptor partial agonists for smoking cessation 2012 Department of Primary Care Health Sciences, University of Oxford, Oxford, UK. kate.cahill@phc.ox.ac.uk.
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Print(0)
Ref Type
Journal Article
Periodical, Full
The Cochrane database of systematic reviews
Periodical, Abbrev.
Cochrane Database Syst.Rev.
Pub Date Free Form
18-Apr
Volume
(4):CD006103. doi
Issue
4
Start Page
CD006103
Other Pages
Notes
LR: 20160608; GR: Department of Health/United Kingdom; JID: 100909747; 0 (Alkaloids); 0 (Azepines); 0 (Azocines); 0 (Benzazepines); 0 (Heterocyclic Compounds with 4 or More Rings); 0 (Nicotinic Agonists); 0 (Quinolizines); 0 (Quinoxalines); 01ZG3TPX31 (Bu
Place of Publication
England
ISSN/ISBN
1469-493X; 1361-6137
Accession Number
PMID: 22513936
Language
eng
SubFile
Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review; IM
DOI
10.1002/14651858.CD006103.pub6 [doi]
Output Language
Unknown(0)
PMID
22513936
Abstract
BACKGROUND: Nicotine receptor partial agonists may help people to stop smoking by a combination of maintaining moderate levels of dopamine to counteract withdrawal symptoms (acting as an agonist) and reducing smoking satisfaction (acting as an antagonist). OBJECTIVES: The primary objective of this review is to assess the efficacy and tolerability of nicotine receptor partial agonists, including cytisine, dianicline and varenicline for smoking cessation. SEARCH METHODS: We searched the Cochrane Tobacco Addiction Group's specialised register for trials, using the terms ('cytisine' or 'Tabex' or 'dianicline' or 'varenicline' or 'nicotine receptor partial agonist') in the title or abstract, or as keywords. The register is compiled from searches of MEDLINE, EMBASE, PsycINFO and Web of Science using MeSH terms and free text to identify controlled trials of interventions for smoking cessation and prevention. We contacted authors of trial reports for additional information where necessary. The latest update of the specialised register was in December 2011. We also searched online clinical trials registers. SELECTION CRITERIA: We included randomized controlled trials which compared the treatment drug with placebo. We also included comparisons with bupropion and nicotine patches where available. We excluded trials which did not report a minimum follow-up period of six months from start of treatment. DATA COLLECTION AND ANALYSIS: We extracted data on the type of participants, the dose and duration of treatment, the outcome measures, the randomization procedure, concealment of allocation, and completeness of follow-up.The main outcome measured was abstinence from smoking at longest follow-up. We used the most rigorous definition of abstinence, and preferred biochemically validated rates where they were reported. Where appropriate we pooled risk ratios (RRs), using the Mantel-Haenszel fixed-effect model. MAIN RESULTS: Two recent cytisine trials (937 people) found that more participants taking cytisine stopped smoking compared with placebo at longest follow-up, with a pooled RR of 3.98 (95% confidence interval (CI) 2.01 to 7.87). One trial of dianicline (602 people) failed to find evidence that it was effective (RR 1.20, 95% CI 0.82 to 1.75). Fifteen trials compared varenicline with placebo for smoking cessation; three of these also included a bupropion treatment arm. We also found one open-label trial comparing varenicline plus counselling with counselling alone. We found one relapse prevention trial, comparing varenicline with placebo, and two open-label trials comparing varenicline with nicotine replacement therapy (NRT). We also include one trial in which all the participants were given varenicline, but received behavioural support either online or by phone calls, or by both methods. This trial is not included in the analyses, but contributes to the data on safety and tolerability. The included studies covered 12,223 participants, 8100 of whom used varenicline.The pooled RR for continuous or sustained abstinence at six months or longer for varenicline at standard dosage versus placebo was 2.27 (95% CI 2.02 to 2.55; 14 trials, 6166 people, excluding one trial evaluating long term safety). Varenicline at lower or variable doses was also shown to be effective, with an RR of 2.09 (95% CI 1.56 to 2.78; 4 trials, 1272 people). The pooled RR for varenicline versus bupropion at one year was 1.52 (95% CI 1.22 to 1.88; 3 trials, 1622 people). The RR for varenicline versus NRT for point prevalence abstinence at 24 weeks was 1.13 (95% CI 0.94 to 1.35; 2 trials, 778 people). The two trials which tested the use of varenicline beyond the 12-week standard regimen found the drug to be well-tolerated during long-term use. The main adverse effect of varenicline was nausea, which was mostly at mild to moderate levels and usually subsided over time. A meta-analysis of reported serious adverse events occurring during or after active treatment and not necessa
Descriptors
Links
Book Title
Database
Publisher
Data Source
Authors
Cahill,K., Stead,L.F., Lancaster,T.
Original/Translated Title
URL
Date of Electronic
20120418
PMCID
Editors
Combined pharmacotherapy and behavioural interventions for smoking cessation 2012 Department of Primary Care Health Sciences, University of Oxford, Oxford, UK. lindsay.stead@phc.ox.ac.uk.
Source Type
Print(0)
Ref Type
Journal Article
Periodical, Full
The Cochrane database of systematic reviews
Periodical, Abbrev.
Cochrane Database Syst.Rev.
Pub Date Free Form
17-Oct
Volume
10
Issue
Start Page
CD008286
Other Pages
Notes
LR: 20160412; JID: 100909747; UIN: Cochrane Database Syst Rev. 2016;3:CD008286. PMID: 27009521; epublish
Place of Publication
England
ISSN/ISBN
1469-493X; 1361-6137
Accession Number
PMID: 23076944
Language
eng
SubFile
Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review; IM
DOI
10.1002/14651858.CD008286.pub2 [doi]
Output Language
Unknown(0)
PMID
23076944
Abstract
BACKGROUND: Both behavioural support (including brief advice and counselling) and pharmacotherapies (including nicotine replacement therapy (NRT), varenicline and bupropion) are effective in helping people to stop smoking. Combining both treatment approaches is recommended where possible, but the size of the treatment effect with different combinations and in different settings and populations is unclear. OBJECTIVES: To assess the effect of combining behavioural support and medication to aid smoking cessation, compared to a minimal intervention or usual care, and to identify whether there are different effects depending on characteristics of the treatment setting, intervention, population treated, or take-up of treatment. SEARCH METHODS: We searched the Cochrane Tobacco Addiction Group Specialised Register in July 2012 for records with any mention of pharmacotherapy, including any type of NRT, bupropion, nortriptyline or varenicline. SELECTION CRITERIA: Randomized or quasi-randomized controlled trials evaluating combinations of pharmacotherapy and behavioural support for smoking cessation, compared to a control receiving usual care or brief advice or less intensive behavioural support. We excluded trials recruiting only pregnant women, trials recruiting only adolescents, and trials with less than six months follow-up. DATA COLLECTION AND ANALYSIS: Search results were prescreened by one author and inclusion or exclusion of potentially relevant trials was agreed by both authors. Data was extracted by one author and checked by the other.The main outcome measure was abstinence from smoking after at least six months of follow-up. We used the most rigorous definition of abstinence for each trial, and biochemically validated rates if available. We calculated the risk ratio (RR) and 95% confidence interval (CI) for each study. Where appropriate, we performed meta-analysis using a Mantel-Haenszel fixed-effect model. MAIN RESULTS: Forty-one studies with a total of more than 20,000 participants met the inclusion criteria. A large proportion of studies recruited people in healthcare settings or with specific health needs. Most studies provided NRT. Behavioural support was typically provided by specialists in cessation counselling, who offered between four and eight contact sessions. The planned maximum duration of contact was typically more than 30 minutes but less than 300 minutes. Overall, studies were at low or unclear risk of bias, and findings were not sensitive to the exclusion of any of the three studies rated at high risk of bias in one domain. One large study (the Lung Health Study) contributed heterogeneity due to a substantially larger treatment effect than seen in other studies (RR 3.88, 95% CI 3.35 to 4.50). Since this study used a particularly intensive intervention which included extended availability of nicotine gum, multiple group sessions and long term maintenance and recycling contacts, the results may not be comparable with the interventions used in other studies, and hence it was not pooled in other analyses. Based on the remaining 40 studies (15,021 participants) there was good evidence for a benefit of combination pharmacotherapy and behavioural treatment compared to usual care or brief advice or less intensive behavioural support (RR 1.82, 95% CI 1.66 to 2.00) with moderate statistical heterogeneity (I(2) = 40%). The pooled estimate for 31 trials that recruited participants in healthcare settings (RR 2.06, 95% CI 1.81 to 2.34) was higher than for eight trials with community-based recruitment (RR 1.53, 95% CI 1.33 to 1.76). Pooled estimates were lower in a subgroup of trials where the behavioural intervention was provided by specialist counsellors versus trials where counselling was linked to usual care (specialist: RR 1.73, 95% CI 1.55 to 1.93, 28 trials; usual provider: RR 2.41, 95% CI 1.91 to 3.02, 8 trials) but this was largely attributable to the small effect size in two trials using specialist counsellors wher
Descriptors
Links
Book Title
Database
Publisher
Data Source
Authors
Stead,L.F., Lancaster,T.
Original/Translated Title
URL
Date of Electronic
20121017
PMCID
Editors
Interventions for preventing weight gain after smoking cessation 2012 Primary Care Clinical Sciences, University of Birmingham, Birmingham, UK.
Source Type
Print(0)
Ref Type
Journal Article
Periodical, Full
The Cochrane database of systematic reviews
Periodical, Abbrev.
Cochrane Database Syst.Rev.
Pub Date Free Form
18-Jan
Volume
1
Issue
Start Page
CD006219
Other Pages
Notes
LR: 20151119; JID: 100909747; 0 (Antidepressive Agents); 0 (Benzazepines); 0 (Nicotinic Agonists); 0 (Piperidines); 0 (Pyrazoles); 0 (Quinoxalines); 6M3C89ZY6R (Nicotine); epublish
Place of Publication
England
ISSN/ISBN
1469-493X; 1361-6137
Accession Number
PMID: 22258966
Language
eng
SubFile
Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review; IM
DOI
10.1002/14651858.CD006219.pub3 [doi]
Output Language
Unknown(0)
PMID
22258966
Abstract
BACKGROUND: Most people who stop smoking gain weight. There are some interventions that have been designed to reduce weight gain when stopping smoking. Some smoking cessation interventions may also limit weight gain although their effect on weight has not been reviewed. OBJECTIVES: To systematically review the effect of: (1) Interventions targeting post-cessation weight gain on weight change and smoking cessation.(2) Interventions designed to aid smoking cessation that may also plausibly affect weight on post-cessation weight change. SEARCH METHODS: Part 1 - We searched the Cochrane Tobacco Addiction Group's Specialized Register and CENTRAL in September 2011.Part 2 - In addition we searched the included studies in the following "parent" Cochrane reviews: nicotine replacement therapy (NRT), antidepressants, nicotine receptor partial agonists, cannabinoid type 1 receptor antagonists and exercise interventions for smoking cessation published in Issue 9, 2011 of the Cochrane Library. SELECTION CRITERIA: Part 1 - We included trials of interventions that were targeted at post-cessation weight gain and had measured weight at any follow up point and/or smoking cessation six or more months after quit day.Part 2 - We included trials that had been included in the selected parent Cochrane reviews if they had reported weight gain at any time point. DATA COLLECTION AND ANALYSIS: We extracted data on baseline characteristics of the study population, intervention, outcome and study quality. Change in weight was expressed as difference in weight change from baseline to follow up between trial arms and was reported in abstinent smokers only. Abstinence from smoking was expressed as a risk ratio (RR). We used the most rigorous definition of abstinence available in each trial. Where appropriate, we performed meta-analysis using the inverse variance method for weight and Mantel-Haenszel method for smoking using a fixed-effect model. MAIN RESULTS: Part 1: Some pharmacological interventions tested for limiting post cessation weight gain (PCWG) resulted in a significant reduction in WG at the end of treatment (dexfenfluramine (Mean difference (MD) -2.50 kg, 95% confidence interval (CI) -2.98 to -2.02, 1 study), phenylpropanolamine (MD -0.50 kg, 95% CI -0.80 to -0.20, N=3), naltrexone (MD -0.78 kg, 95% CI -1.52 to -0.05, N=2). There was no evidence that treatment reduced weight at 6 or 12 months (m). No pharmacological intervention significantly affected smoking cessation rates.Weight management education only was associated with no reduction in PCWG at end of treatment (6 or 12m). However these interventions significantly reduced abstinence at 12m (Risk ratio (RR) 0.66, 95% CI 0.48 to 0.90, N=2). Personalised weight management support reduced PCWG at 12m (MD -2.58 kg, 95% CI -5.11 to -0.05, N=2) and was not associated with a significant reduction of abstinence at 12m (RR 0.74, 95% CI 0.39 to 1.43, N=2). A very low calorie diet (VLCD) significantly reduced PCWG at end of treatment (MD -3.70 kg, 95% CI -4.82 to -2.58, N=1), but not significantly so at 12m (MD -1.30 kg, 95% CI -3.49 to 0.89, N=1). The VLCD increased chances of abstinence at 12m (RR 1.73, 95% CI 1.10 to 2.73, N=1). There was no evidence that cognitive behavioural therapy to allay concern about weight gain (CBT) reduced PCWG, but there was some evidence of increased PCWG at 6m (MD 0.74, 95% CI 0.24 to 1.24). It was associated with improved abstinence at 6m (RR 1.83, 95% CI 1.07 to 3.13, N=2) but not at 12m (RR 1.25, 95% CI 0.83 to 1.86, N=2). However, there was significant statistical heterogeneity.Part 2: We found no evidence that exercise interventions significantly reduced PCWG at end of treatment (MD -0.25 kg, 95% CI -0.78 to 0.29, N=4) however a significant reduction was found at 12m (MD -2.07 kg, 95% CI -3.78 to -0.36, N=3).Both bupropion and fluoxetine limited PCWG at the end of treatment (bupropion MD -1.12 kg, 95% CI -1.47 to -0.77, N=7) (fluoxetine MD -0.99 kg, 95% CI -1.36 to -
Descriptors
Links
Book Title
Database
Publisher
Data Source
Authors
Farley,A.C., Hajek,P., Lycett,D., Aveyard,P.
Original/Translated Title
URL
Date of Electronic
20120118
PMCID
Editors
Nicotine replacement therapy for smoking cessation 2012 Department of Primary Care Health Sciences, University of Oxford,Oxford,UK. lindsay.stead@phc.ox.ac.uk.
Source Type
Print(0)
Ref Type
Journal Article
Periodical, Full
The Cochrane database of systematic reviews
Periodical, Abbrev.
Cochrane Database Syst.Rev.
Pub Date Free Form
14-Nov
Volume
11
Issue
Start Page
CD000146
Other Pages
Notes
LR: 20151119; JID: 100909747; 0 (Chewing Gum); 0 (Nicotinic Agonists); 0 (Tablets); 6M3C89ZY6R (Nicotine); epublish
Place of Publication
England
ISSN/ISBN
1469-493X; 1361-6137
Accession Number
PMID: 23152200
Language
eng
SubFile
Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review; IM
DOI
10.1002/14651858.CD000146.pub4 [doi]
Output Language
Unknown(0)
PMID
23152200
Abstract
BACKGROUND: The aim of nicotine replacement therapy (NRT) is to temporarily replace much of the nicotine from cigarettes to reduce motivation to smoke and nicotine withdrawal symptoms, thus easing the transition from cigarette smoking to complete abstinence. OBJECTIVES: The aims of this review were: To determine the effect of NRT compared to placebo in aiding smoking cessation, and to consider whether there is a difference in effect for the different forms of NRT (chewing gum, transdermal patches, oral and nasal sprays, inhalers and tablets/lozenges) in achieving abstinence from cigarettes. To determine whether the effect is influenced by the dosage, form and timing of use of NRT; the intensity of additional advice and support offered to the smoker; or the clinical setting in which the smoker is recruited and treated. To determine whether combinations of NRT are more likely to lead to successful quitting than one type alone. To determine whether NRT is more or less likely to lead to successful quitting compared to other pharmacotherapies. SEARCH METHODS: We searched the Cochrane Tobacco Addiction Group trials register for papers mentioning 'NRT' or any type of nicotine replacement therapy in the title, abstract or keywords. Date of most recent search July 2012. SELECTION CRITERIA: Randomized trials in which NRT was compared to placebo or to no treatment, or where different doses of NRT were compared. We excluded trials which did not report cessation rates, and those with follow-up of less than six months. DATA COLLECTION AND ANALYSIS: We extracted data in duplicate on the type of participants, the dose, duration and form of nicotine therapy, the outcome measures, method of randomization, and completeness of follow-up. The main outcome measure was abstinence from smoking after at least six months of follow-up. We used the most rigorous definition of abstinence for each trial, and biochemically validated rates if available. We calculated the risk ratio (RR) for each study. Where appropriate, we performed meta-analysis using a Mantel-Haenszel fixed-effect model. MAIN RESULTS: We identified 150 trials; 117 with over 50,000 participants contributed to the primary comparison between any type of NRT and a placebo or non-NRT control group. The risk ratio (RR) of abstinence for any form of NRT relative to control was 1.60 (95% confidence interval [CI] 1.53 to 1.68). The pooled RRs for each type were 1.49 (95% CI 1.40 to 1.60, 55 trials) for nicotine gum; 1.64 (95% CI 1.52 to 1.78, 43 trials) for nicotine patch; 1.95 (95% CI 1.61 to 2.36, 6 trials) for oral tablets/lozenges; 1.90 (95% CI 1.36 to 2.67, 4 trials) for nicotine inhaler; and 2.02 (95% CI 1.49 to 2.73, 4 trials) for nicotine nasal spray. One trial of oral spray had an RR of 2.48 (95% CI 1.24 to 4.94). The effects were largely independent of the duration of therapy, the intensity of additional support provided or the setting in which the NRT was offered. The effect was similar in a small group of studies that aimed to assess use of NRT obtained without a prescription. In highly dependent smokers there was a significant benefit of 4 mg gum compared with 2 mg gum, but weaker evidence of a benefit from higher doses of patch. There was evidence that combining a nicotine patch with a rapid delivery form of NRT was more effective than a single type of NRT (RR 1.34, 95% CI 1.18 to 1.51, 9 trials). The RR for NRT used for a short period prior to the quit date was 1.18 (95% CI 0.98 to 1.40, 8 trials), just missing statistical significance, though the efficacy increased when we pooled only patch trials and when we removed one trial in which confounding was likely. Five studies directly compared NRT to a non-nicotine pharmacotherapy, bupropion; there was no evidence of a difference in efficacy (RR 1.01; 95% CI 0.87 to 1.18). A combination of NRT and bupropion was more effective than bupropion alone (RR 1.24; 95% CI 1.06 to 1.45, 4 trials). Adverse effects from using NRT are related to th
Descriptors
Links
Book Title
Database
Publisher
Data Source
Authors
Stead,L.F., Perera,R., Bullen,C., Mant,D., Hartmann-Boyce,J., Cahill,K., Lancaster,T.
Original/Translated Title
URL
Date of Electronic
20121114
PMCID
Editors
Behavioural interventions as adjuncts to pharmacotherapy for smoking cessation 2012 Department of Primary Care Health Sciences, University of Oxford, Oxford, UK. lindsay.stead@phc.ox.ac.uk.
Source Type
Print(0)
Ref Type
Journal Article
Periodical, Full
The Cochrane database of systematic reviews
Periodical, Abbrev.
Cochrane Database Syst.Rev.
Pub Date Free Form
12-Dec
Volume
12
Issue
Start Page
CD009670
Other Pages
Notes
LR: 20151119; JID: 100909747; 0 (Antidepressive Agents); 0 (Benzazepines); 0 (Nicotinic Agonists); 0 (Quinoxalines); 01ZG3TPX31 (Bupropion); BL03SY4LXB (Nortriptyline); W6HS99O8ZO (Varenicline); UIN: Cochrane Database Syst Rev. 2015;10:CD009670. PMID: 264
Place of Publication
England
ISSN/ISBN
1469-493X; 1361-6137
Accession Number
PMID: 23235680
Language
eng
SubFile
Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review; IM
DOI
10.1002/14651858.CD009670.pub2 [doi]
Output Language
Unknown(0)
PMID
23235680
Abstract
BACKGROUND: Effective pharmacotherapies are available to help people who are trying to stop smoking, but quitting can still be difficult and providing higher levels of behavioural support may increase success rates further. OBJECTIVES: To evaluate the effect of increasing the intensity of behavioural support for people using smoking cessation medications, and to assess whether there are different effects depending on the type of pharmacotherapy, or the amount of support in each condition. SEARCH METHODS: We searched the Cochrane Tobacco Addiction Group Specialised Register in July 2012 for records with any mention of pharmacotherapy, including any type of NRT, bupropion, nortriptyline or varenicline that evaluated the addition of personal support or compared two or more intensities of behavioural support. SELECTION CRITERIA: Randomized or quasi-randomized controlled trials in which all participants received pharmacotherapy for smoking cessation and conditions differed by the amount of behavioural support. Controls could receive less intensive personal contact, or just written information. We did not include studies that used a contact matched control to evaluate differences between types or components of support. We excluded trials recruiting only pregnant women, trials recruiting only adolescents, and trials with less than six months follow-up. DATA COLLECTION AND ANALYSIS: Search results were prescreened by one author and inclusion or exclusion of potentially relevant trials was agreed by both authors. Data were extracted by one author and checked by the other.The main outcome measure was abstinence from smoking after at least six months of follow-up. We used the most rigorous definition of abstinence for each trial, and biochemically validated rates if available. We calculated the risk ratio (RR) and 95% confidence interval (CI) for each study. Where appropriate, we performed meta-analysis using a Mantel-Haenszel fixed-effect model. MAIN RESULTS: Thirty-eight studies met the inclusion criteria with over 15,000 participants in the relevant arms. There was very little evidence of statistical heterogeneity (I(2) = 3%) so all studies were pooled in the main analysis. There was evidence of a small but statistically significant benefit from more intensive support (RR 1.16, 95% CI 1.09 to 1.24) for abstinence at longest follow-up. All but two of the included studies provided four or more sessions of support. Most trials used nicotine replacement therapy. Significant effects were not detected for studies where the pharmacotherapy was nortriptyline (two trials) or varenicline (one trial), but this reflects the absence of evidence. In subgroup analyses, studies that provided at least four sessions of personal contact for the intervention and no personal contact for the control had slightly larger effects (six trials, RR 1.25, 95% CI 1.08 to 1.45), as did studies where all intervention counselling was via telephone (six trials, RR 1.28, 95% CI 1.17 to 1.41). Weaker evidence for a benefit of providing additional behavioural support was seen in the trials where all participants, including those in the control condition, had at least 30 minutes of personal contact (18 trials, RR 1.11, 95% CI 0.99 to 1.25). None of the differences between subgroups were significant, and the last two subgroup analyses were not prespecified. No trials were judged at high risk of bias on any domain. AUTHORS' CONCLUSIONS: Providing behavioural support in person or via telephone for people using pharmacotherapy to stop smoking has a small but important effect. Increasing the amount of behavioural support is likely to increase the chance of success by about 10 to 25%, based on a pooled estimate from 38 trials. A subgroup analysis of a small number of trials suggests the benefit could be a little greater when the contrast is between a no contact control and a behavioural intervention that provides at least four sessions of contact. Subgroup analysis also suggest
Descriptors
Links
Book Title
Database
Publisher
Data Source
Authors
Stead,L.F., Lancaster,T.
Original/Translated Title
URL
Date of Electronic
20121212
PMCID
Editors
Interventions for tobacco cessation in the dental setting 2012 Department of Dental Specialities, Mayo Clinic, Rochester, USA.Carr.Alan@mayo.edu.
Source Type
Print(0)
Ref Type
Journal Article
Periodical, Full
The Cochrane database of systematic reviews
Periodical, Abbrev.
Cochrane Database Syst.Rev.
Pub Date Free Form
13-Jun
Volume
(6):CD005084. doi
Issue
6
Start Page
CD005084
Other Pages
Notes
LR: 20160602; GR: 1R21DE016024/DE/NIDCR NIH HHS/United States; GR: R01 CA096881/CA/NCI NIH HHS/United States; GR: R21 DE016024/DE/NIDCR NIH HHS/United States; JID: 100909747; NIHMS548637; OID: NLM: NIHMS548637; OID: NLM: PMC3916957; epublish
Place of Publication
England
ISSN/ISBN
1469-493X; 1361-6137
Accession Number
PMID: 22696348
Language
eng
SubFile
Journal Article; Meta-Analysis; Research Support, N.I.H., Extramural; Review; IM
DOI
10.1002/14651858.CD005084.pub3 [doi]
Output Language
Unknown(0)
PMID
22696348
Abstract
BACKGROUND: Tobacco use has significant adverse effects on oral health. Oral health professionals in the dental office or community setting have a unique opportunity to increase tobacco abstinence rates among tobacco users. OBJECTIVES: This review assesses the effectiveness of interventions for tobacco cessation delivered by oral health professionals and offered to cigarette smokers and smokeless tobacco users in the dental office or community setting. SEARCH METHODS: We searched the Cochrane Tobacco Addiction Group Specialized Register (CENTRAL), MEDLINE (1966-November 2011), EMBASE (1988-November 2011), CINAHL (1982-November 2011), Healthstar (1975-November 2011), ERIC (1967-November 2011), PsycINFO (1984-November 2011), National Technical Information Service database (NTIS, 1964-November 2011), Dissertation Abstracts Online (1861-November 2011), Database of Abstract of Reviews of Effectiveness (DARE, 1995-November 2011), and Web of Science (1993-November 2011). SELECTION CRITERIA: We included randomized and pseudo-randomized clinical trials assessing tobacco cessation interventions conducted by oral health professionals in the dental office or community setting with at least six months of follow-up. DATA COLLECTION AND ANALYSIS: Two authors independently reviewed abstracts for potential inclusion and abstracted data from included trials. Disagreements were resolved by consensus. The primary outcome was abstinence from smoking or all tobacco use (for users of smokeless tobacco) at the longest follow-up, using the strictest definition of abstinence reported. The effect was summarised as an odds ratio, with correction for clustering where appropriate. Heterogeneity was assessed using the I(2) statistic and where appropriate a pooled effect was estimated using an inverse variance fixed-effect model. MAIN RESULTS: Fourteen clinical trials met the criteria for inclusion in this review. Included studies assessed the efficacy of interventions in the dental office or in a community school or college setting. Six studies evaluated the effectiveness of interventions among smokeless tobacco (ST) users, and eight studies evaluated interventions among cigarette smokers, six of which involved adult smokers in dental practice settings. All studies employed behavioral interventions and only one required pharmacotherapy as an interventional component. All studies included an oral examination component. Pooling all 14 studies suggested that interventions conducted by oral health professionals can increase tobacco abstinence rates (odds ratio [OR] 1.71, 95% confidence interval [CI] 1.44 to 2.03) at six months or longer, but there was evidence of heterogeneity (I(2) = 61%). Within the subgroup of interventions for smokers, heterogeneity was smaller (I(2) = 51%), but was largely attributable to a large study showing no evidence of benefit. Within this subgroup there were five studies which involved adult smokers in dental practice settings. Pooling these showed clear evidence of benefit and minimal heterogeneity (OR 2.38, 95% CI 1.70 to 3.35, 5 studies, I(2) = 3%) but this was a posthoc subgroup analysis. Amongst the studies in smokeless tobacco users the heterogeneity was also attributable to a large study showing no sign of benefit, possibly due to intervention spillover to control colleges; the other five studies indicated that interventions for ST users were effective (OR 1.70; 95% CI 1.36 to 2.11). AUTHORS' CONCLUSIONS: Available evidence suggests that behavioral interventions for tobacco cessation conducted by oral health professionals incorporating an oral examination component in the dental office or community setting may increase tobacco abstinence rates among both cigarette smokers and smokeless tobacco users. Differences between the studies limit the ability to make conclusive recommendations regarding the intervention components that should be incorporated into clinical practice, however, behavioral counselling (typically brief) in c
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Book Title
Database
Publisher
Data Source
Authors
Carr,A.B., Ebbert,J.
Original/Translated Title
URL
Date of Electronic
20120613
PMCID
PMC3916957
Editors
Interventions for smoking cessation in hospitalised patients 2012 Tobacco Research and Treatment Center, Department of Medicine, Massachusetts General Hospital and Harvard Medical School,Boston,Massachusetts, USA. nrigotti@partners.org.
Source Type
Print(0)
Ref Type
Journal Article
Periodical, Full
The Cochrane database of systematic reviews
Periodical, Abbrev.
Cochrane Database Syst.Rev.
Pub Date Free Form
16-May
Volume
(5):CD001837. doi
Issue
5
Start Page
CD001837
Other Pages
Notes
LR: 20160602; GR: K24 HL004440/HL/NHLBI NIH HHS/United States; JID: 100909747; CIN: Evid Based Nurs. 2013 Jan;16(1):21-2. PMID: 22961882; CIN: Evid Based Med. 2013 Jun;18(3):e25. PMID: 23002093; NIHMS704512; OID: NLM: NIHMS704512; OID: NLM: PMC4498489; ep
Place of Publication
England
ISSN/ISBN
1469-493X; 1361-6137
Accession Number
PMID: 22592676
Language
eng
SubFile
Journal Article; Meta-Analysis; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review; IM
DOI
10.1002/14651858.CD001837.pub3 [doi]
Output Language
Unknown(0)
PMID
22592676
Abstract
BACKGROUND: Smoking contributes to reasons for hospitalisation, and the period of hospitalisation may be a good time to provide help with quitting. OBJECTIVES: To determine the effectiveness of interventions for smoking cessation that are initiated for hospitalised patients. SEARCH METHODS: We searched the Cochrane Tobacco Addiction Group register which includes papers identified from CENTRAL, MEDLINE, EMBASE and PsycINFO in December 2011 for studies of interventions for smoking cessation in hospitalised patients, using terms including (hospital and patient*) or hospitali* or inpatient* or admission* or admitted. SELECTION CRITERIA: Randomized and quasi-randomized trials of behavioural, pharmacological or multicomponent interventions to help patients stop smoking, conducted with hospitalised patients who were current smokers or recent quitters (defined as having quit more than one month before hospital admission). The intervention had to start in the hospital but could continue after hospital discharge. We excluded studies of patients admitted to facilities that primarily treat psychiatric disorders or substance abuse, studies that did not report abstinence rates and studies with follow-up of less than six months. Both acute care hospitals and rehabilitation hospitals were included in this update, with separate analyses done for each type of hospital. DATA COLLECTION AND ANALYSIS: Two authors extracted data independently for each paper, with disagreements resolved by consensus. MAIN RESULTS: Fifty trials met the inclusion criteria. Intensive counselling interventions that began during the hospital stay and continued with supportive contacts for at least one month after discharge increased smoking cessation rates after discharge (risk ratio (RR) 1.37, 95% confidence interval (CI) 1.27 to 1.48; 25 trials). A specific benefit for post-discharge contact compared with usual care was found in a subset of trials in which all participants received a counselling intervention in the hospital and were randomly assigned to post-discharge contact or usual care. No statistically significant benefit was found for less intensive counselling interventions. Adding nicotine replacement therapy (NRT) to an intensive counselling intervention increased smoking cessation rates compared with intensive counselling alone (RR 1.54, 95% CI 1.34 to 1.79, six trials). Adding varenicline to intensive counselling had a non-significant effect in two trials (RR 1.28, 95% CI 0.95 to 1.74). Adding bupropion did not produce a statistically significant increase in cessation over intensive counselling alone (RR 1.04, 95% CI 0.75 to 1.45, three trials). A similar pattern of results was observed in a subgroup of smokers admitted to hospital because of cardiovascular disease (CVD). In this subgroup, intensive intervention with follow-up support increased the rate of smoking cessation (RR 1.42, 95% CI 1.29 to 1.56), but less intensive interventions did not. One trial of intensive intervention including counselling and pharmacotherapy for smokers admitted with CVD assessed clinical and health care utilization endpoints, and found significant reductions in all-cause mortality and hospital readmission rates over a two-year follow-up period. These trials were all conducted in acute care hospitals. A comparable increase in smoking cessation rates was observed in a separate pooled analysis of intensive counselling interventions in rehabilitation hospitals (RR 1.71, 95% CI 1.37 to 2.14, three trials). AUTHORS' CONCLUSIONS: High intensity behavioural interventions that begin during a hospital stay and include at least one month of supportive contact after discharge promote smoking cessation among hospitalised patients. The effect of these interventions was independent of the patient's admitting diagnosis and was found in rehabilitation settings as well as acute care hospitals. There was no evidence of effect for interventions of lower intensity or shorter duration. This update
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Book Title
Database
Publisher
Data Source
Authors
Rigotti,N.A., Clair,C., Munafo,M.R., Stead,L.F.
Original/Translated Title
URL
Date of Electronic
20120516
PMCID
PMC4498489
Editors