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  • 1
    Electronic Resource
    Electronic Resource
    Randomized controlled trial of a midwife-delivered brief smoking cessation intervention in pregnancy (2001)
    Oxford, UK : Carfax Publishing, part of the Taylor & Francis Group
    Addiction 96 (2001), S. 0 
    Details
    ISSN: 1360-0443
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Notes: Objective. To evaluate the efficacy of a brief smoking cessation intervention with pregnant women practicable routinely by midwives. Design. Midwives were randomized to deliver the experimental intervention or usual care. The 10-15-minute intervention was based on brief counselling, written materials, arrangements for continuing self-help support and feedback on expired-air carbon monoxide levels. The intervention was tailored to the women's needs: those who did not want to stop smoking received a brief motivational intervention, those who wanted to stop received an intervention designed to assist them and those that had stopped recently (recent ex-smokers) received a relapse prevention intervention. Setting. Booking interviews with pregnant women in nine hospital and community trusts. Subjects. A total of 1120 pregnant women in the third month of pregnancy (249 recent ex-smokers and 871 current smokers). Main outcome measures. Three indicators of biochemically validated abstinence were collected. Continuous abstinence for at least 3 months prior to delivery, point prevalence abstinence immediately post-delivery, and continuous abstinence from 3 months pre-delivery to 6 months post-delivery. Results. Only a small proportion of the women who would have been eligible to take part in the trial were actually recruited by 178 recruiting midwives, with lack of time being cited as the main barrier. The intervention and usual care groups differed in post-delivery point prevalence abstinence rates for recent ex-smokers (65% vs. 53%, p 〈 0.05, one-tailed), but not in other outcome measures. Overall, 54% of 'recent ex-smokers' at booking and 7% of 'current smokers' at booking had been abstinent for at least 3 months at the time of delivery, and 23% and 3%, respectively, were still abstinent by the time the child was 6 months old (i.e. 12 months post-intervention). Smoking status at follow-up was predicted by dependence indexed by time to first cigarette in the morning . Conclusions. A brief 'one-off' smoking cessation intervention by midwives does not seem to be a practicable or effective method of helping pregnant smokers to stop. Other options such as tailored self-help materials and telephone counselling and other specialist treatments should be examined. Current smoking cessation rates in pregnancy are very low.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1360-0443.2001.96348511.x
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  • 2
    Electronic Resource
    Electronic Resource
    Outcome criteria in smoking cessation trials: proposal for a common standard (2005)
    Oxford, UK : Blackwell Science Ltd
    Addiction 100 (2005), S. 0 
    Details
    ISSN: 1360-0443
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Notes: Smoking cessation treatment is now integrated into many health-care systems and a major research effort is under way to improve current success rates. Until now results from randomized clinical trials have been reported in many different ways, leading to problems of interpretation. We propose six standard criteria comprising the ‘Russell Standard’ (RS). These criteria are applicable to trials of cessation aids where participants have a defined target quit date and there is face-to-face contact with researchers or clinic staff, as follows. (1) Follow-up for 6 months (RS6) or 12 months (RS12) from the target quit date or the end of a predefined ‘grace period’; (2) self-report of smoking abstinence over the whole follow-up period allowing up to five cigarettes in total; (3) biochemical verification of abstinence at least at the 6-month or 12-month follow-up point; (4) use of an ‘intention-to-treat’ approach in which data from all randomized smokers are included in the analysis unless they have died or moved to an untraceable address (participants who are included in the analysis are counted as smokers if their smoking status at the final follow-up cannot be determined); (5) following-up ‘protocol violators’ and using their true smoking status in the analysis; and (6) collecting follow-up data blind to smokers’ allocation to trial group. We believe that these criteria provide the best compromise between practicability and surrogacy for long-term cessation and will enable meaningful comparison between studies. There may be good reasons why other outcome criteria would also be reported, and studies that involve interventions with special groups or where there is no designated target quit date or face to face contact would need to adapt these criteria accordingly.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1360-0443.2004.00995.x
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  • 3
    Electronic Resource
    Electronic Resource
    Nicotine replacement therapy in patients with cardiovascular disease: guidelines for health professionals (2001)
    Oxford, UK : Carfax Publishing, part of the Taylor & Francis Group
    Addiction 96 (2001), S. 0 
    Details
    ISSN: 1360-0443
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Notes: The causal relationship between cigarette smoking and cardiovascular disease (CVD) is well known and it is of great importance that smokers with CVD are encouraged to stop. Nicotine replacement therapy (NRT) is an effective aid to smoking cessation. However, its use in patients with CVD is often avoided because of warnings on product labelling. This is not justified, as NRT use in dependent smokers is much safer than smoking. Arguments are presented for the following guidelines which may be used when recommending NRT to patients with CVD; (i) NRT can normally be recommended to smokers with CVD who tried and failed to quit without such help; (ii) in patients who have experienced a serious cardiovascular event within the past 4 weeks, involve the patient's consulting physician. In less acute cases this is not needed; (iii) ensure dosing does not exceed the manufacturer's recommendation; (iv) warn patients to stop using NRT if they relapse to smoking; and (v) target motivated smokers (i.e. those seeking help), and where possible provide or arrange intensive behavioural support to accompany NRT. This advice is conservative, but will hopefully remove some obstacles faced by smoking cessation counsellors and other health professionals when considering the use of NRT in people with history of CVD.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1360-0443.2001.961115472.x
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  • 4
    Electronic Resource
    Electronic Resource
    Treatments for smokers (1994)
    Oxford, UK : Blackwell Publishing Ltd
    Addiction 89 (1994), S. 0 
    Details
    ISSN: 1360-0443
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Notes: Research in treatments for smokers benefits from the feasibility of relatively large samples and well developed evaluative methodology. The field is currently dominated by nicotine replacement methods, for which some degree of efficacy has been clearly demonstrated, A number of psychological methods are widely used as well, although there is little consistent evidence that one specific method is better than any other. Two approaches 10 treating smokers can be distinguished, i.e. intensive clinic-based treatments and brief community-orientated interventions, e.g. in primary health care. The latter are applicable on a large scale, and aim to affect overall smoking prevalence. Among intensive treatments, the current state of the an would include nicotine replacement and group support of several weeks’ duration. In primary health care, simple routine interventions are the preferred option.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1360-0443.1994.tb03756.x
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  • 5
    Electronic Resource
    Electronic Resource
    Stopping smoking can cause constipation (2003)
    Oxford, UK : Blackwell Publishing Ltd.
    Addiction 98 (2003), S. 0 
    Details
    ISSN: 1360-0443
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Notes: Setting  Constipation is mentioned occasionally as a possible tobacco withdrawal symptom, but no systematic data have been published on this issue.Design  Smokers’ clinic patients provided ratings of their level of constipation on three occasions prior to their quit date, and then weekly after they stopped smoking. The total of 1067 participants maintained at least 1 week of continuous abstinence and provided usable data.Findings  The three precessation ratings of constipation were stable. After cessation of smoking, the ratings increased significantly (P 〈 0.01). In 514 patients who maintained continuous abstinence for 4 weeks and provided complete data, constipation peaked at 2 weeks but remained elevated over the whole period. The net proportion of patients affected was 17%, including 9% who were symptom-free at baseline and became very or extremely constipated. In patients on nicotine replacement the increase in constipation, although significant, was less than in patients on bupropion.Conclusions  Clinicians treating smokers need to be aware of a possibility that one in six quitters develop constipation, and that for about one in 11 the problem can be severe. Descriptions of tobacco withdrawal syndrome should include constipation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1360-0443.2003.00497.x
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  • 6
    Electronic Resource
    Electronic Resource
    A randomized controlled trial of a "buddy" system to improve success at giving up smoking in general practice (1998)
    Oxford, UK : Carfax Publishing Limited
    Addiction 93 (1998), S. 0 
    Details
    ISSN: 1360-0443
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Notes: Aims. To assess the effect on abstinence rates of pairing up smokers attending a general practice smokers, clinic to provide mutual support between clinic sessions. Design. Randomized controlled trial comparing a "buddy" condition with a "solo condition" in which smokers received the same treatment but were not paired up. Setting. A general practice smokers' clinic in London. Participants. One hundred and seventy-two smokers recruited by mailshot. Intervention. Smokers attended a nurse-led smokers clinic 1 week prior to their quit date, on the quite date, 1 week later and 3 weeks after that. Smokers in the buddy condition were paired with another smoker trying to give up at the same time to provide mutual support between clinic sessions. Measurements. The main outcome measure was the percentage of smokers still abstinent from cigarettes at end of treatment (4 weeks from quit date), verified by expired air carbon monoxide concentration. Findings. The percentage of smokers still abstinent at the end of treatment was significantly higher in the buddy condition than the solo condition (27% vs. 12%). Conclusions. A buddy system can provide an effective element of a smoking cessation intervention at minimal cost. Further research is needed to establish the long-term efficacy of this approach and examine the effectiveness of incorporating social support into other types of smoking cessation programmes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1360-0443.1998.93710075.x
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  • 7
    Electronic Resource
    Electronic Resource
    Time course of cigarette widhdrawal symptoms while using nicotine gum (1989)
    Springer
    Psychopharmacology 99 (1989), S. 143-145 
    Details
    ISSN: 1432-2072
    Keywords: Smoking ; Withdrawal symptoms ; Timecourse ; Nicotine gum
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Ratings of withdrawal symptoms were provided at weekly intervals by 147 smokers clinic clients who managed complete abstinence for 4 weeks. The ratings followed a similar temporal pattern regardless of amount of nicotine gum used. Irritability, depression, difficulty concentrating and restlessness peaked in the 1 st week or two and returned to baseline by week 4. Hunger was more persistent. Craving was reported to be the most troublesome withdrawal symptom at first, although by the 4th week hunger was cited almost as often. Across all subjects,e venings were cited most often as the worst time of day for craving but among heavier smokers and those who used more nicotine gum mornings were considered worst.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00634470
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  • 8
    Electronic Resource
    Electronic Resource
    A comparison of the abuse liability and dependence potential of nicotine patch, gum, spray and inhaler (2000)
    Springer
    Psychopharmacology 149 (2000), S. 198-202 
    Details
    ISSN: 1432-2072
    Keywords: Key words Nicotine replacement therapy ; Dependence ; Abuse liability
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Rationale: Nicotine replacement therapy (NRT) in varying forms is becoming widely used. Clinicians, therapists and regulatory authorities are interested in the abuse liability and dependence potential of the different forms. Objectives: To compare the abuse liability and dependence potential of nicotine gum, transdermal patch, spray and inhaler. Methods: 504 male and female smokers seeking help with stopping smoking were randomly allocated to the four products. Measures were taken at the designated quit date, then 1 week, 4 weeks, 12 weeks and 15 weeks later. Smokers were advised to use the product for up to 12 weeks. Those still using the product at the 12-week visit were advised to cease use by week 14. Measures included: pleasantness and satisfaction ratings at weeks 1 and 4 (used as a marker of abuse liability); ratings of feeling dependent on NRT at weeks 1, 4, 12 and 15 (used as a marker of subjective dependence); mood and physical symptoms ratings at weeks 12 and 15 (the change being used to assess physical dependence on NRT), continued usage of NRT at week 15 (used as an marker of behavioural dependence). Results: Average ratings of pleasantness were low. The nicotine patch was rated as less unpleasant to use than all other products. There were no significant differences between the products in terms of satisfaction or subjective dependence except at week 15 when no patch users rated themselves as dependent. Continued use of NRT at week 15 was related to rate of delivery of nicotine from the products – 2% for patch, 7% for gum and inhaler, 10% for spray (P〈0.05 for linear association). Among those abstinent for 15 weeks, the figures were: 8%, 25% and 37%, respectively. Stopping NRT use between weeks 12 and 15 was not accompanied by withdrawal discomfort or increased frequency of urges to smoke although subjects stopping inhaler use experienced a mild increase in strength of urges to smoke. We conclude that abuse liability from all four NRT products was low. Subjective dependence was moderate and did not differ across products. Behavioural dependence was modest and was positively related to rate of nicotine delivery. Physicians can reassure their patients that most are able to come off NRT as recommended without discomfort.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002130000382
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  • 9
    Electronic Resource
    Electronic Resource
    Effect of buspirone on cigarette withdrawal symptoms and short-term abstinence rates in a smokers clinic (1991)
    Springer
    Psychopharmacology 104 (1991), S. 91-96 
    Details
    ISSN: 1432-2072
    Keywords: Buspirone ; Smokers ; Withdrawal
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This paper reports on a double blind trial of the effect of buspirone, 15 mg per day, on cigarette withdrawal symptoms and ability of smokers to maintain abstinence during treatment. A total of 61 smokers were randomly assigned to active or placebo conditions. They were maintained on their drug for 2 weeks prior to attempting abstinence and then for a further 4 weeks of abstinence. Subjects attended weekly group sessions of a psychological treatment programme. There was no evidence that the side effects in the active drug group were worse than those in the placebo group. Although there was no significant difference between active and placebo conditions on withdrawal symptoms, smokers in the active drug condition were more than twice as likely to maintain abstinence for the duration of the study than those in the placebo condition (47% versus 16%, chi square = 5.3,P〈0.025). The results provide preliminary evidence for short-term efficacy of buspirone as an aid to smoking cessation at a low dose. They also provide evidence of a dissociation between withdrawal symptoms and successful abstinence.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02244560
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  • 10
    Electronic Resource
    Electronic Resource
    Effect of smoke-free cigarettes on 24 h cigarette withdrawal: a double-blind placebo-controlled study (1989)
    Springer
    Psychopharmacology 97 (1989), S. 99-102 
    Details
    ISSN: 1432-2072
    Keywords: Smoking ; Cigarette withdrawal ; Smoke-free cigarettes
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In a double-blind randomised trial, 40 cigarette smokers used either nicotine-containing or placebo smoke-free cigarettes during 24 h abstinence from smoking. Subjects in the nicotine group experienced smaller increases in irritability and difficulty concentrating and fewer urges to smoke than those who received placebo. Nicotine smoke-free cigarettes were rated as more satisfying, more helpful and more effective in relieving craving than placebo. After 24 h use nicotine smoke-free cigarettes provided average blood nicotine levels of 6.3 ng/ml, i.e., 29.2% of smoking levels. The most frequent side effects were irritation of the throat and coughing. Overall, side effects were rated as not serious. Although the smoke-free cigarette in its present form is not very efficient in delivering nicotine, it was effective in alleviating initial tobacco withdrawal. It is possible that by providing both nicotine and “behavioural” replacement it may be particularly useful in the first stages of stopping smoking. The product is worth further investigation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00443421
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