WTS database

Title	Pub Year	Author Sort descending	SearchLink
Interventions for waterpipe tobacco smoking prevention and cessation: a systematic review	2016	Department of Primary Care and Public Health, Imperial College London, London, United Kingdom.; Academic Unit of Primary Care and Population Sciences, University of Southampton, Southampton, United Kingdom.; Nuffied Department of Primary Care Health Scien	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Scientific reports Periodical, Abbrev. Sci.Rep. Pub Date Free Form 11-May Volume 6 Issue Start Page 25872 Other Pages Notes LR: 20160524; JID: 101563288; OID: NLM: PMC4863147; 2015/12/07 [received]; 2016/04/22 [accepted]; epublish Place of Publication England ISSN/ISBN 2045-2322; 2045-2322 Accession Number PMID: 27167891 Language eng SubFile Journal Article; IM DOI 10.1038/srep25872 [doi] Output Language Unknown(0) PMID 27167891 Abstract Waterpipe tobacco smoking is growing in popularity despite adverse health effects among users. We systematically reviewed the literature, searching MEDLINE, EMBASE and Web of Science, for interventions targeting prevention and cessation of waterpipe tobacco smoking. We assessed the evidence quality using the Cochrane (randomised studies), GRADE (non-randomised studies) and CASP (qualitative studies) frameworks. Data were synthesised narratively due to heterogeneity. We included four individual-level, five group-level, and six legislative interventions. Of five randomised controlled studies, two showed significantly higher quit rates in intervention groups (bupropion/behavioural support versus placebo in Pakistan; 6 month abstinence relative risk (RR): 2.3, 95% CI 1.4-3.8); group behavioural support versus no intervention in Egypt, 12 month abstinence RR 3.3, 95% CI 1.4-8.9). Non-randomised studies showed mixed results for cessation, behavioural, and knowledge outcomes. One high quality modelling study from Lebanon calculated that a 10% increase in waterpipe tobacco taxation would reduce waterpipe tobacco demand by 14.5% (price elasticity of demand -1.45). In conclusion, there is a lack of evidence of effectiveness for most waterpipe interventions. While few show promising results, higher quality interventions are needed. Meanwhile, tobacco policies should place waterpipe on par with cigarettes. Descriptors Links Book Title Database Publisher Data Source Authors Jawad,M., Jawad,S., Waziry,R.K., Ballout,R.A., Akl,E.A. Original/Translated Title URL Date of Electronic 20160511 PMCID PMC4863147 Editors
The relationship between waterpipe and cigarette smoking in low and middle income countries: cross-sectional analysis of the global adult tobacco survey	2014	Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom.; Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom.; Department of	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full PloS one Periodical, Abbrev. PLoS One Pub Date Free Form 24-Mar Volume 9 Issue 3 Start Page e93097 Other Pages Notes LR: 20150514; JID: 101285081; OID: NLM: PMC3963998; 2014 [ecollection]; 2013/10/07 [received]; 2014/03/03 [accepted]; 2014/03/24 [epublish]; epublish Place of Publication United States ISSN/ISBN 1932-6203; 1932-6203 Accession Number PMID: 24664109 Language eng SubFile Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't; IM DOI 10.1371/journal.pone.0093097 [doi] Output Language Unknown(0) PMID 24664109 Abstract INTRODUCTION: Waterpipe tobacco smoking is receiving growing attention due to accumulating evidence suggesting increasing prevalence in some populations and deleterious health effects. Nevertheless, the relationship between waterpipe and cigarette smoking remain unknown, particularly in low and middle income countries. MATERIALS AND METHODS: We analysed waterpipe and cigarette smoking using data from Global Adult Tobacco Survey, a household survey of adults aged >/=15 years conducted between 2008-2010 in LMICs. Factors associated with waterpipe and cigarette use were assessed using multiple logistic regression. Factors associated with the quantity of waterpipe and cigarette smoking were assessed using log-linear regression models. RESULTS: After adjusting for age, gender, residence, education, occupation and smokeless tobacco use, waterpipe smoking was significantly higher among cigarette users than in non-cigarette users in India (5.6% vs. 0.6%, AOR 13.12, 95% CI 7.41-23.23) and Russia (6.7% vs. 0.2%, AOR 27.73, 95% CI 11.41-67.43), but inversely associated in Egypt (2.6% vs. 3.4%, AOR 0.21, 95% CI 0.15-0.30) and not associated in Vietnam (13.3% vs. 4.7%, AOR 0.96, 95% CI 0.74-1.23). Compared to non-cigarette smokers, waterpipe smokers who also used cigarettes had more waterpipe smoking sessions per week in Russia (1.3 vs. 2.9, beta coefficient 0.31, 95% CI 0.06, 0.57), but less in Egypt (18.2 vs. 10.7, beta coefficient -0.45, 95% CI -0.73, -0.17) and Vietnam (102.0 vs. 79.3, beta coefficient -0.31, 95% CI -0.56, -0.06) and similar amounts in India (29.4 vs. 32.6, beta coefficient -0.12, 95% CI -0.46, 0.22). CONCLUSIONS: Waterpipe smoking is low in most LMICs but important country-level differences in use, including concurrent cigarette smoking, should be taken into account when designing and evaluating tobacco control interventions. Descriptors Links Book Title Database Publisher Data Source Authors Jawad,M., Lee,J.T., Millett,C. Original/Translated Title URL Date of Electronic 20140324 PMCID PMC3963998 Editors
Pharmacological interventions for smoking cessation: an overview and network meta-analysis	2013	Department of Primary Care Health Sciences, University of Oxford, Oxford, UK. kate.cahill@phc.ox.ac.uk.	Read more...
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 31-May Volume (5):CD009329. doi Issue 5 Start Page CD009329 Other Pages Notes LR: 20160602; JID: 100909747; 0 (Alkaloids); 0 (Antidepressive Agents, Second-Generation); 0 (Azocines); 0 (Benzazepines); 0 (Nicotinic Agonists); 0 (Quinolizines); 0 (Quinoxalines); 01ZG3TPX31 (Bupropion); 53S5U404NU (cytisine); BL03SY4LXB (Nortriptyline Place of Publication England ISSN/ISBN 1469-493X; 1361-6137 Accession Number PMID: 23728690 Language eng SubFile Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review; IM DOI 10.1002/14651858.CD009329.pub2 [doi] Output Language Unknown(0) PMID 23728690 Abstract BACKGROUND: Smoking is the leading preventable cause of illness and premature death worldwide. Some medications have been proven to help people to quit, with three licensed for this purpose in Europe and the USA: nicotine replacement therapy (NRT), bupropion, and varenicline. Cytisine (a treatment pharmacologically similar to varenicline) is also licensed for use in Russia and some of the former socialist economy countries. Other therapies, including nortriptyline, have also been tested for effectiveness. OBJECTIVES: How do NRT, bupropion and varenicline compare with placebo and with each other in achieving long-term abstinence (six months or longer)? How do the remaining treatments compare with placebo in achieving long-term abstinence? How do the risks of adverse and serious adverse events (SAEs) compare between the treatments, and are there instances where the harms may outweigh the benefits? METHODS: The overview is restricted to Cochrane reviews, all of which include randomised trials. Participants are usually adult smokers, but we exclude reviews of smoking cessation for pregnant women and in particular disease groups or specific settings. We cover nicotine replacement therapy (NRT), antidepressants (bupropion and nortriptyline), nicotine receptor partial agonists (varenicline and cytisine), anxiolytics, selective type 1 cannabinoid receptor antagonists (rimonabant), clonidine, lobeline, dianicline, mecamylamine, Nicobrevin, opioid antagonists, nicotine vaccines, and silver acetate. Our outcome for benefit is continuous or prolonged abstinence at least six months from the start of treatment. Our outcome for harms is the incidence of serious adverse events associated with each of the treatments. We searched the Cochrane Database of Systematic Reviews (CDSR) in The Cochrane Library, for any reviews with 'smoking' in the title, abstract or keyword fields. The last search was conducted in November 2012. We assessed methodological quality using a revised version of the AMSTAR scale. For NRT, bupropion and varenicline we conducted network meta-analyses, comparing each with the others and with placebo for benefit, and varenicline and bupropion for risks of serious adverse events. MAIN RESULTS: We identified 12 treatment-specific reviews. The analyses covered 267 studies, involving 101,804 participants. Both NRT and bupropion were superior to placebo (odds ratios (OR) 1.84; 95% credible interval (CredI) 1.71 to 1.99, and 1.82; 95% CredI 1.60 to 2.06 respectively). Varenicline increased the odds of quitting compared with placebo (OR 2.88; 95% CredI 2.40 to 3.47). Head-to-head comparisons between bupropion and NRT showed equal efficacy (OR 0.99; 95% CredI 0.86 to 1.13). Varenicline was superior to single forms of NRT (OR 1.57; 95% CredI 1.29 to 1.91), and to bupropion (OR 1.59; 95% CredI 1.29 to 1.96). Varenicline was more effective than nicotine patch (OR 1.51; 95% CredI 1.22 to 1.87), than nicotine gum (OR 1.72; 95% CredI 1.38 to 2.13), and than 'other' NRT (inhaler, spray, tablets, lozenges; OR 1.42; 95% CredI 1.12 to 1.79), but was not more effective than combination NRT (OR 1.06; 95% CredI 0.75 to 1.48). Combination NRT also outperformed single formulations. The four categories of NRT performed similarly against each other, apart from 'other' NRT, which was marginally more effective than NRT gum (OR 1.21; 95% CredI 1.01 to 1.46). Cytisine (a nicotine receptor partial agonist) returned positive findings (risk ratio (RR) 3.98; 95% CI 2.01 to 7.87), without significant adverse events or SAEs. Across the 82 included and excluded bupropion trials, our estimate of six seizures in the bupropion arms versus none in the placebo arms was lower than the expected rate (1:1000), at about 1:1500. SAE meta-analysis of the bupropion studies demonstrated no excess of neuropsychiatric (RR 0.88; 95% CI 0.31 to 2.50) or cardiovascular events (RR 0.77; 95% CI 0.37 to 1.59). SAE meta-analysis of 14 varenicline trials found no difference between th Descriptors Links Book Title Database Publisher Data Source Authors Cahill,K., Stevens,S., Perera,R., Lancaster,T. Original/Translated Title URL Date of Electronic 20130531 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.	Read more...
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-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.	Read more...
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
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.	Read more...
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
Effectiveness of a web-based cognitive-behavioral tool to improve mental well-being in the general population: randomized controlled trial	2012	Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom. john.powell@phc.ox.ac.uk	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Journal of medical Internet research Periodical, Abbrev. J.Med.Internet Res. Pub Date Free Form 31-Dec Volume 15 Issue 1 Start Page e2 Other Pages Notes LR: 20151119; ISRCTN/ISRCTN48134476; GR: PDA/02/06/096/Department of Health/United Kingdom; JID: 100959882; OID: NLM: PMC3636304; 2012/06/26 [received]; 2012/10/04 [accepted]; 2012/10/02 [revised]; epublish Place of Publication Canada ISSN/ISBN 1438-8871; 1438-8871 Accession Number PMID: 23302475 Language eng SubFile Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; IM DOI 10.2196/jmir.2240 [doi] Output Language Unknown(0) PMID 23302475 Abstract BACKGROUND: Interventions to promote mental well-being can bring benefits to the individual and to society. The Internet can facilitate the large-scale and low-cost delivery of individually targeted health promoting interventions. OBJECTIVE: To evaluate the effectiveness of a self-directed Internet-delivered cognitive-behavioral skills training tool in improving mental well-being in a population sample. METHODS: This was a randomized trial with a waiting-list control. Using advertisements on a national health portal and through its mailing list, we recruited 3070 participants aged 18 or over, resident in England, and willing to give their email address and access a fully automated Web-based intervention. The intervention (MoodGYM) consisted of 5 interactive modules that teach cognitive-behavioral principles. Participants in the intervention arm received weekly email reminders to access the intervention. The control group received access to the intervention after the trial was completed and received no specific intervention or email reminders. Outcomes were assessed by using self-completion questionnaires. The primary outcome was mental well-being measured with the Warwick-Edinburgh Mental Well-being Scale (WEMWBS). Secondary outcomes were Center for Epidemiologic Studies Depression scale (CES-D) depression scores, Generalized Anxiety Disorder 7-item scale (GAD-7) anxiety scores, EuroQol Group 5-Dimension Self-Report Questionnaire (EQ-5D) quality of life scores, physical activity, and health service use. All outcomes were measured at baseline, and at 6- and 12-week follow-ups. RESULTS: A total of 1529 (49.80%) participants completed final follow-up at 12 weeks. Retention was 73.11% (1123/1536) in the control arm and 26.47% (406/1534) in the intervention arm. No relationship between baseline measures and withdrawal could be established. The analysis of WEMWBS mental well-being scores using a linear mixed model for repeated measures showed no difference between intervention and control group at baseline (difference -0.124 points, 95% CI -0.814 to 0.566), and significant improvements for the intervention group at 6 weeks (2.542 points, 95% CI 1.693-3.390) and at 12 weeks (2.876 points, 95% CI 1.933-3.819). The model showed a highly significant (P<.001 intervention="" by="" time="" interaction="" effect.="" there="" were="" also="" significant="" improvements="" in="" self-rated="" scores="" of="" depression="" and="" anxiety.="" given="" the="" high="" level="" attrition="" a="" sensitivity="" analysis="" with="" imputed="" missing="" values="" was="" undertaken="" that="" showed="" positive="" effect="" intervention.="" conclusions:="" participants="" allocated="" to="" arm="" had="" an="" average="" increase="" approximately="" points="" on="" wemwbs="" scale="" compared="" no="" for="" control="" group.="" three="" this="" is="" one-third="" standard="" deviation.="" low-cost="" automated="" designed="" shift="" population="" distribution="" mental="" well-being="" small="" difference="" per="" individual="" could="" yield="" major="" benefit="" terms.="" common="" other="" web-based="" interventions="" rates="" attrition.="" further="" work="" needed="" improve="" acceptability="" evaluate="" against="" placebo="" disaggregate="" from="" trial="" registration:="" international="" randomised="" controlled="" number="" register="" isrctn="" http:="" webcite="" at=""> Descriptors Links Book Title Database Publisher Data Source Authors Powell,J., Hamborg,T., Stallard,N., Burls,A., McSorley,J., Bennett,K., Griffiths,K.M., Christensen,H. Original/Translated Title URL Date of Electronic 20121231 PMCID PMC3636304 Editors
Telephone counselling for smoking cessation	2013	Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, UK, OX2 6GG.	Read more...
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-Aug Volume (8):CD002850. doi Issue 8 Start Page CD002850 Other Pages Notes LR: 20160602; JID: 100909747; epublish Place of Publication England ISSN/ISBN 1469-493X; 1361-6137 Accession Number PMID: 23934971 Language eng SubFile Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review; IM DOI 10.1002/14651858.CD002850.pub3 [doi] Output Language Unknown(0) PMID 23934971 Abstract BACKGROUND: Telephone services can provide information and support for smokers. Counselling may be provided proactively or offered reactively to callers to smoking cessation helplines. OBJECTIVES: To evaluate the effect of proactive and reactive telephone support via helplines and in other settings to help smokers quit. SEARCH METHODS: We searched the Cochrane Tobacco Addiction Group Specialised Register for studies of telephone counselling, using search terms including 'hotlines' or 'quitline' or 'helpline'. Date of the most recent search: May 2013. SELECTION CRITERIA: randomized or quasi-randomised controlled trials in which proactive or reactive telephone counselling to assist smoking cessation was offered to smokers or recent quitters. DATA COLLECTION AND ANALYSIS: One author identified and data extracted trials, and a second author checked them. The main outcome measure was the risk ratio for abstinence from smoking after at least six months follow-up. We selected the strictest measure of abstinence, using biochemically validated rates where available. We considered participants lost to follow-up to be continuing smokers. Where trials had more than one arm with a less intensive intervention we used only the most similar intervention without the telephone component as the control group in the primary analysis. We assessed statistical heterogeneity amongst subgroups of clinically comparable studies using the I(2) statistic. We considered trials recruiting callers to quitlines separately from studies recruiting in other settings. Where appropriate, we pooled studies using a fixed-effect model. We used a meta-regression to investigate the effect of differences in planned number of calls, selection for motivation, and the nature of the control condition (self help only, minimal intervention, pharmacotherapy) in the group of studies recruiting in non-quitline settings. MAIN RESULTS: Seventy-seven trials met the inclusion criteria. Some trials were judged to be at risk of bias in some domains but overall we did not judge the results to be at high risk of bias. Among smokers who contacted helplines, quit rates were higher for groups randomized to receive multiple sessions of proactive counselling (nine studies, > 24,000 participants, risk ratio (RR) for cessation at longest follow-up 1.37, 95% confidence interval (CI) 1.26 to 1.50). There was mixed evidence about whether increasing the number of calls altered quit rates but most trials used more than two calls. Three studies comparing different counselling approaches during a single quitline contact did not detect significant differences. Of three studies that tested the provision of access to a hotline two detected a significant benefit and one did not.Telephone counselling not initiated by calls to helplines also increased quitting (51 studies, > 30,000 participants, RR 1.27; 95% CI 1.20 to 1.36). In a meta-regression controlling for other factors the effect was estimated to be slightly larger if more calls were offered, and in trials that specifically recruited smokers motivated to try to quit. The relative extra benefit of counselling was smaller when it was provided in addition to pharmacotherapy (usually nicotine replacement therapy) than when the control group only received self-help material or a brief intervention.A further eight studies were too diverse to contribute to meta-analyses and are discussed separately. Two compared different intensities of counselling, both of which detected a dose response; one of these detected a benefit of multiple counselling sessions over a single call for people prescribed bupropion. The others tested a variety of interventions largely involving offering telephone counselling as part of a referral or systems change and none detected evidence of effect. AUTHORS' CONCLUSIONS: Proactive telephone counselling aids smokers who seek help from quitlines. Telephone quitlines provide an important route of access to support for smokers, and call- Descriptors Links Book Title Database Publisher Data Source Authors Stead,L.F., Hartmann-Boyce,J., Perera,R., Lancaster,T. Original/Translated Title URL Date of Electronic 20130812 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.	Read more...
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
Nicotine vaccines for smoking cessation	2012	Department of Primary Care Health Sciences, University ofOxford, Oxford, UK. jamie.hartmann-boyce@phc.ox.ac.uk.	Read more...
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 15-Aug Volume (8):CD007072. doi Issue 8 Start Page CD007072 Other Pages Notes LR: 20160602; JID: 100909747; 0 (NicVAX); 0 (Vaccines); 0 (nicotine Qbeta vaccine); epublish Place of Publication England ISSN/ISBN 1469-493X; 1361-6137 Accession Number PMID: 22895958 Language eng SubFile Journal Article; Meta-Analysis; Review; IM DOI 10.1002/14651858.CD007072.pub2 [doi] Output Language Unknown(0) PMID 22895958 Abstract BACKGROUND: By reducing the amount of nicotine that reaches the brain when a person smokes a cigarette, nicotine vaccines may help people to stop smoking or to prevent recent quitters from relapsing. OBJECTIVES: The aims of this review are to assess the efficacy of nicotine vaccines for smoking cessation and for relapse prevention, and to assess the frequency and type of adverse events associated with the use of nicotine vaccines. SEARCH METHODS: We searched the Cochrane Tobacco Addiction Review Group specialised register for trials, using the term 'vaccine' in the title or abstract, or in a keyword (date of most recent search April 2012). To identify any other material including reviews and papers potentially relevant to the background or discussion sections, we also searched MEDLINE, EMBASE, and PsycINFO, combining terms for nicotine vaccines with terms for smoking and tobacco use, without design limits or limits for human subjects. We searched the Annual Meeting abstracts of the Society for Research on Nicotine and Tobacco up to 2012, using the search string 'vaccin'. We searched Google Scholar for 'nicotine vaccine'. We also searched company websites and Google for information related to specific vaccines. We searched clinicaltrials.gov in March 2012 for 'nicotine vaccine' and for the trade names of known vaccine candidates. SELECTION CRITERIA: We included randomized controlled trials of nicotine vaccines, at Phase II and Phase III trial stage and beyond, in adult smokers or recent ex-smokers. We included studies of nicotine vaccines used as part of smoking cessation or relapse prevention interventions. 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, blinding of participants and personnel, reporting of outcomes, and completeness of follow-up.Our primary outcome measure was a minimum of six months abstinence from smoking. We used the most rigorous definition of abstinence, and preferred cessation rates at 12 months and biochemically validated rates where available. We have used the risk ratio (RR) to summarize individual trial outcomes. We have not pooled the current group of included studies as they cover different vaccines and variable regimens. MAIN RESULTS: There are no nicotine vaccines currently licensed for public use, but there are a number in development. We found four trials which met our inclusion criteria, three comparing NicVAX to placebo and one comparing NIC002 (formerly NicQbeta) to placebo. All were smoking cessation trials conducted by pharmaceutical companies as part of the drug development process, and all trials were judged to be at high or unclear risk of bias in at least one domain. Overall, 2642 smokers participated in the included studies in this review. None of the four included studies detected a statistically significant difference in long-term cessation between participants receiving vaccine and those receiving placebo. The RR for 12 month cessation in active and placebo groups was 1.35 (95% Confidence Interval (CI) 0.82 to 2.22) in the trial of NIC002 and 1.74 (95% CI 0.73 to 4.18) in one NicVAX trial. Two Phase III NicVAX trials, for which full results were not available, reported similar quit rates of approximately 11% in both groups. In the two studies with full results available, post hoc analyses detected higher cessation rates in participants with higher levels of nicotine antibodies, but these findings are not readily generalisable. The two studies with full results showed nicotine vaccines to be well tolerated, with the majority of adverse events classified as mild or moderate. In the study of NIC002, participants receiving the vaccine were more likely to report mild to moderate adverse events, most commonly flu-like symptoms, whereas in the study of NicVAX there was no significant difference between the two arms. Information on adverse events wa Descriptors Links Book Title Database Publisher Data Source Authors Hartmann-Boyce,J., Cahill,K., Hatsukami,D., Cornuz,J. Original/Translated Title URL Date of Electronic 20120815 PMCID Editors

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