ORCID Profile
0000-0001-5191-9517
Current Organisation
University of Reading
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Publisher: Oxford University Press (OUP)
Date: 17-05-2017
DOI: 10.1093/NTR/NTX105
Abstract: Little is known about effects of smoking cessation on alcohol consumption. Varenicline reduces enjoyment of smoking and cigarette consumption and may also reduce enjoyment and consumption of alcohol. We conducted the first prospective examination of the effects of stopping smoking on alcohol enjoyment and consumption and compared clients using varenicline and nicotine replacement treatment (NRT). Audit of records from clients undergoing routine smoking cessation treatment in three stop-smoking services in London, United Kingdom. The s le comprised smokers who consume alcohol and underwent smoking cessation treatment with either varenicline (N = 230) or NRT (N = 62). Alcohol enjoyment and consumption were reported before and on the target quit day (TQD) and 1 and 4 weeks post-TQD. Participants reduced their alcohol consumption in week 1 of their quit attempt (15.0-12.7 units per/week, p = .001).In heavy drinkers, the change remained significant at 4 weeks (32.2-24.8 units per/week, p = .004). The type of medication used had no significant impact on the change. Smokers treated with varenicline versus NRT were more likely to report reduced enjoyment of alcohol on TQD (20% vs. 10%, respectively, p < .001) and at 4 weeks post-TQD (20% vs. 6%, respectively, p = .014). Results were similar for abstainers and those who did not manage to stop smoking. Making a stop-smoking attempt is accompanied by a reduction in drinking. The finding has implications for policies concerned with effects of stopping smoking on alcohol use. Varenicline may affect enjoyment of drinking, but its potential to alter drinking behavior is small. The finding that smokers making a quit attempt reduce their alcohol consumption has practical implications for treatment providers who are concerned about the possible effects of smoking cessation on alcohol drinking. Although varenicline may reduce alcohol enjoyment compared to NRT, it does not appear to have a significant impact on alcohol consumption.
Publisher: National Institute for Health and Care Research
Date: 10-2016
DOI: 10.3310/HTA20790
Abstract: An increasing number of people require help to manage their weight. The NHS recommends weight loss advice by general practitioners and/or a referral to a practice nurse. Although this is helpful for some, more effective approaches that can be disseminated economically on a large scale are needed. To assess whether or not a task-based weight management programme [Weight Action Programme (WAP)] has better long-term effects than a ‘best practice’ intervention provided in primary care by practice nurses. Randomised controlled trial with cost-effectiveness analysis. General practices in east London, UK. Three hundred and thirty adults with a body mass index (BMI) of ≥ 30 kg/m 2 or a BMI of ≥ 28 kg/m 2 plus comorbidities were recruited from local general practices and via media publicity. Those who had a BMI of 45 kg/m 2 , had lost 5% of their body weight in the previous 6 months, were currently pregnant or taking psychiatric medications were excluded. Participants were randomised (2 : 1) to the WAP or nurse arms. The WAP intervention was delivered in eight weekly group sessions that combined dietary and physical activity, advice and self-monitoring in a group-oriented intervention. The initial course was followed by 10 monthly group maintenance sessions open to all participants in this study arm. The practice nurse intervention (best usual care) consisted of four one-to-one sessions delivered over 8 weeks, and included standard advice on diet and physical activity based on NHS ‘Change4Life’ materials and motivational support. The primary outcome measure was weight change at 12 months. Secondary outcome measures included change in BMI, waist circumference and blood pressure, and proportion of participants losing at least 5% and 10% of baseline body weight. Staff collecting measurements at the 6- and 12-month follow-ups were blinded to treatment allocation. The primary outcome measure was analysed according to the intention-to-treat principle, and included all participants with at least one recorded outcome at either 1, 2, 6 or 12 months. The analysis employed a mixed-effects linear regression model, adjusted for baseline weight, age, sex, ethnicity, smoking status and general practice. The European Quality of Life-5 Dimensions-5 Levels questionnaire was completed and used to estimate quality-adjusted life-years (QALYs) within the cost-effectiveness analysis. There were 330 participants (WAP arm, n = 221 nurse arm, n = 109 72% women). A total of 291 (88%) participants (WAP arm, n = 194 nurse arm, n = 97) were included in the main analysis for the primary outcome. Weight loss at 12 months was greater in the WAP arm than in the nurse intervention arm [–4.2 kg vs. –2.3 kg difference –1.9 kg, 95% confidence interval (CI) –3.7 to –0.1 kg p = 0.04]. Participants in the WAP arm were more likely than participants in the nurse arm to have lost at least 5% of their baseline body weight at 12 months (41% vs. 27% odds ratio 14.61, 95% CI 2.32 to 91.96 p = 0.004). The incremental cost-effectiveness ratio for WAP over and above the nurse arm is £7742 per QALY. A WAP delivered in general practice better promotes weight loss over 12 months than a best usual practice nurse-led weight loss programme. The trial recruited mostly women. Research is needed into factors that would make weight loss programmes more attractive to men. Current Controlled Trials ISRCTN45820471. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment Vol. 20, No. 79. See the NIHR Journals Library website for further project information.
Publisher: Elsevier BV
Date: 2021
Publisher: Wiley
Date: 02-11-2012
DOI: 10.1111/J.1360-0443.2012.04084.X
Abstract: The NHS Stop Smoking Service (NHS-SSS) helps approximately half its clients to quit for 4 weeks. However, most initially successful quitters relapse within 6 months. Short message service (SMS) texting has been shown to facilitate stopping smoking. We describe the development, implementation and subsequent evaluation, in terms of practicability and client response, of an SMS text-based relapse prevention intervention (RPI) delivered within routine community and specialist National Health Service (NHS) Stop Smoking Service (SSS) provision in four Primary Care Trusts. Text messages aimed at motivation to remain abstinent, preventing careless lapses and continuing the full course of medicine for smoking cessation were developed and sent weekly to clients' mobile phones for 12 weeks and fortnightly for 6 months. They were asked to respond to some of the texts and contact the NHS SSS if they lapsed. They were also offered free nicotine mini lozenges to be sent via the mail on three occasions. NHS SSS. 202 clients who had been abstinent for 4 weeks. Feasibility of introducing RPI into routine care response to interactive messages and requests for the medication rating of the helpfulness of RPI self-reported and carbon monoxide (CO)-validated smoking status for up to 26 weeks. A text-based RPI was easy to implement within the NHS SSS provided by specialist advisers, but enrollment of clients from services provided by a network of pharmacists was difficult because client contact details were often lacking. Where records of the number of people invited to RPI were available, 94% of eligible participants enrolled. The RPI was well received by both SSS clients and staff, with 70% (n = 63) of clients who completed follow-up considering the intervention helpful. Eighty-five per cent (n = 172) of clients responded to at least one of the nine interactive text messages. Sixty-four clients (32% of the total, 47% of those we managed to contact) reported continuous abstinence at 6 months. Eighteen (9%) clients who relapsed to smoking used the RPI to re-engage with the NHS SSS and 10 (5%) successfully re-established abstinence. In smokers attending National Health Service Stop Smoking Services who are abstinent 4 weeks after their quit date, a relapse prevention intervention based on SMS text messaging was well received, and can be implemented economically and rapidly. A controlled trial is needed to establish whether it has a significant impact on relapse.
Publisher: Springer Science and Business Media LLC
Date: 02-04-2001
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Sarah Snuggs.