ORCID Profile
0000-0001-7378-3497
Current Organisations
INRA Centre de Jouy-en-Josas
,
University of Tasmania
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Publisher: Hindawi Limited
Date: 31-08-2016
DOI: 10.1017/JSC.2016.21
Abstract: Introduction: Both withdrawal severity and smoking cues can trigger lapses. However, the temporal relationship between these two sets of triggers is unknown. Aims: To explore the time course of lapse triggers during a quit attempt. Methods: Across two cessation studies, 186 lapsers monitored their smoking in real-time for up to 7 weeks over the course of a quit attempt. During lapses, participants were asked to report the primary trigger of the event this, including the time of the event relative to quit day, was logged by an electronic diary. Log multinomial regression was used to estimate the probability that each lapse would be withdrawal-triggered or cue-triggered. Results: Log multinomial regression showed that the probability of a first lapse being triggered by withdrawal rose in the initial days of a quit attempt before dropping as the quit attempt progressed ( P 0.01). The probability of a cue-triggered lapse rose over the course of a quit attempt ( P 0.05). Conclusions: The results are consistent both with the time course of withdrawal symptoms and with theoretical predictions about the relationship between nicotine dependence and stimulus control. The results have implications for tailoring smoking-cessation treatments in particular, for the stepwise provision of smoking-cessation assistance over the course of a quit attempt.
Publisher: Oxford University Press (OUP)
Date: 11-2007
DOI: 10.1080/14622200701648441
Abstract: In recent years the public health community has considered the risks and benefits of encouraging smokers to reduce their smoking, perhaps with the aid of nicotine replacement therapy (NRT). Little is known, however, about whether smokers themselves are interested in smoking reduction whether they see reduction as an endpoint, or primarily as a route to cessation or whether they are receptive to the notion of using NRT to achieve reduction. We conducted a population-based national telephone survey of 1,000 current daily cigarette smokers (499 male, 501 female). Most smokers (57%) reported previously trying to reduce their smoking, and many (26%) said that they plan to reduce within the next year. Almost half of those planning to quit in the next 12 months (44%) preferred to quit via gradual cessation and most (68%) indicated that they would consider using a reduction product or medication. Respondents reported that they would prefer a product with a cessation endpoint rather than a reduction endpoint (63% vs. 21%). Interest in reduction was highest among smokers who were less interested in quitting and among heavier smokers. We conclude that many smokers are interested in gradually reducing prior to quitting and that promoting reduction is unlikely to undermine motivation to quit smoking.
Publisher: Center for Open Science
Date: 25-01-2023
Abstract: Background: Behavioural non-pharmaceutical interventions (NPIs) such as social distancing and hygiene (masking, hand hygiene) were implemented widely during the COVID-19 pandemic to control infections. NPI adherence is crucial for effectiveness, but has also been implied in an increase in mental health problems. However, existing studies often have designs unsuited to understanding mechanistic relationships between NPI adherence, mental health symptoms, and health-related cognitions (risk perceptions, control beliefs). Understanding these mechanisms is crucial for the refinement of existing and the designs of effective future NPIs.Purpose: To separate between- and temporal within-person associations between mental health, risk cognitions and NPI adherence.Methods: Six-month ecological momentary assessment study with six 4-day assessment bouts in 397 German adults. Daily measurement of adherence, mental health symptoms and cognitions during bouts. We used dynamic temporal network analysis to estimate between- person, as well as contemporaneous and temporal within-person effects for distancing and hygiene NPIs.Results: Distinct networks of mental health, health cognitions and adherence emerged. Participants with higher control and higher susceptibility were also more adherent. Similar within-person contemporaneous patterns additionally, distancing and loneliness were associated. Temporally, better adherence to NPIs was associated with better mental health on subsequent days, whereas higher loneliness was associated with better subsequent hygiene adherence.Conclusion: Findings suggest no negative impact of NPI adherence on mental health or vice versa, but instead suggest that adherence might improve mental health symptoms. Control beliefs and risk perceptions are important covariates of adherence - both on between-person and within-person level.
Publisher: Informa UK Limited
Date: 31-12-2015
Publisher: Elsevier BV
Date: 09-2015
Publisher: Wiley
Date: 19-07-2017
DOI: 10.1111/BJHP.12259
Abstract: This study aims at testing predictions derived from temporal self-regulation theory (TST) in relation to discretionary food choices (snacks). TST combines a motivational sphere of influence (cognitions and temporal valuations resulting in intentions) with a momentary sphere (encompassing social and physical environmental cues). This dual approach differs from current health behaviour theories, but can potentially improve our understanding of the interplay of personal and environmental factors in health behaviour self-regulation. A mixed event-based and time-based (Ecological Momentary Assessment) study in 61 adults aged between 18 and 64, with a BMI range between 18.34 and 39.78 (M = 25.66, SD = 4.82) over two weeks. Participants recorded their food and drink intake for two weeks in real time using electronic diaries. Participants also responded to non-consumption assessments at random intervals throughout each day. Momentary cues (in idual, situational, and environmental factors) were assessed both during food logs and non-consumption assessments. Motivational factors, past behaviour, and trait self-regulation were assessed during baseline. Multilevel logistic regression analyses showed that across all snack types, environmental cues and negative affect were associated with an increased likelihood of snacking. Perceiving a cost of healthy eating to occur before eating was associated with an increased likelihood of snacking, whereas intentions and self-regulation were not. Discretionary food intake is largely guided by momentary cues, and motivational-level factors, such as intention and self-regulation, are less important in the initiation of discretionary food intake. Statement of contribution What is already known on this subject? Overweight and obesity are a result of prolonged periods of energy imbalance between energy intake and expenditure (Hill & Peters, ). One of the key behavioural determinants of energy imbalances results from food intake, specifically from discretionary food choices (snacking). Temporal self-regulation theory (Hall & Fong, ) takes into account both deliberate and momentary influences on health behaviour, which is especially relevant to exploring the drivers of snacking. What does this study add? Offers new insight into the application of TST in explaining momentary eating behaviours. Snacking initiation is guided by momentary cues, not person-level factors. Dietary interventions should acknowledge the momentary cues that are associated with snacking.
Publisher: Public Library of Science (PLoS)
Date: 05-03-2014
Publisher: American Psychological Association (APA)
Date: 12-2015
DOI: 10.1037/ADB0000105
Abstract: In the article "Stimulus Control in Intermittent and Daily Smokers" by Saul Shiffman, Michael S.Dunbar, and Stuart G. Ferguson (Psychology of Addictive Behaviors, Advance online publication.February 23, 2015. 0.1037/adb0000052), there was an error in the reported value in the Discussion section. The second sentence of the second paragraph should have read, “Notably,DS also showed strong stimulus control in this analysis, implying 85% accuracy in identifying smoking situations.” This was a result of a transcription error. All versions of this article have been corrected.
Publisher: Oxford University Press (OUP)
Date: 14-10-2013
DOI: 10.1093/NTR/NTT157
Abstract: The aim of the present study was to explore the viability of using social media as a recruitment tool in a clinical research trial. Sociodemographic data and smoking characteristics were assessed in 266 participants recruited to investigate the effectiveness of a behavioral support program for smoking cessation. For analysis, participants were separated into 2 groups based on whether they were recruited either using traditional means (flyers, word of mouth, or newspaper advertisement n = 125, 47.0%) or by advertisements in online social media (n = 138, 51.9%). Participants recruited via social media were significantly younger, but there were no differences in other socioeconomic variables or smoking characteristics compared with participants recruited via other traditional means. The findings of the present study suggest that using online social media is a viable recruitment method for smoking studies and compliments other more traditional recruitment methods.
Publisher: SAGE Publications
Date: 30-01-2019
Abstract: Administration of smoking cessation medications in anticipation of a nominated quit date can promote abstinence. How this occurs is not widely understood, but may be due to the disruption of contingencies between smoking behaviour and acute drug effects. The aim of this study was to explore this relationship, we examined the effect of pre-quit nicotine replacement therapy on susceptibility to relapse in an animal model of nicotine dependence. Rats were trained to intravenously self-administer nicotine across 20 days. Continuous low-dose nicotine was administered via a mini-osmotic pump either across the last 7 days of self-administration and across 6 days of extinction, or across extinction only. Cue- and drug-induced reinstatements of responding were then measured with mini-pumps retained, the day after mini-pump removal or one week later. Pre-quit nicotine administration markedly reduced self-administration across the last days of training as the response, and its associated cues, no longer reliably predicted an acute drug effect. Pre-quit, but not post-quit, nicotine administration significantly attenuated cue-induced reinstatement once mini-pumps were removed, indicating that the contingency disruption across training reduced the conditioned reinforcing properties of the cue at test. Both pre-quit and post-quit nicotine attenuated nicotine-primed reinstatement. Together these results suggest that administration of a nicotine replacement prior to a nominated quit date may enhance resistance to relapse via disruption of the contingency between a response, its associated cues, and a rewarding nicotine effect.
Publisher: Center for Open Science
Date: 21-12-2022
Abstract: Objectives: Adhering to behavioral recommendations and non-pharmaceutical interventions (NPIs) is key to control COVID-19 infection rates. However, rates have decreased globally, and potentially modifiable determinants of ongoing adherence and their interaction with social and physical momentary environments are still poorly understood. Here, we comprehensively examine within-person variations and between-person differences in known behavioral determinants (capability, motivation), as well as the moderating role of situationally variable environmental factors (opportunity) in predicting adherence to hygiene and social distancing behaviors. Methods: Ecological momentary assessment study over six months with monthly assessment bouts (four days each, five daily assessments) in 623 German adults. Repeated daily assessments of Capability-Opportunity-Motivation model of behavior (COM-B) factors. Bayesian multilevel logistic regression models were estimated to examine main effects of COM-B factors and moderating effects of momentary environmental factors. Results: Momentary adherence to NPIs was predicted by within-person changes in COM-B factors (motivation: intentions, goal conflict, control beliefs opportunities: regulations, norms). Between-person differences in capabilities (habit strength) and motivation (intentions, control beliefs) predicted adherence across situations. Situation-specific environmental factors moderated the motivation-behavior association (regulation measures increased goal conflict, and non-adherent others decreased the association). Conclusions: In idual momentary (within-person) and stable (between-person) motivation indicators predicted adherence. However, situational environmental factors such as regulations or norms have strong main effects and moderate the motivation-behavior translation. These findings have policy implications, supporting recent claims to not rely on the narrative of “personal responsibility”, but instead combine health education measures to increase in idual motivation with consistent regulation.
Publisher: Oxford University Press (OUP)
Date: 09-06-2009
DOI: 10.1093/NTR/NTP072
Abstract: Traditionally, smokers have been encouraged to prepare for cessation in advance of a preset quit date, with the expectation that preparation would improve their chance of success. However, a recent survey of U.K. smokers found that a substantial proportion of attempts involved no preplanning and that these spontaneous attempts were actually more likely to succeed. We set out to explore further the nature of unplanned quit attempts among U.S. smokers. Nine hundred smokers and 800 ex-smokers were recruited from a market research database for an online survey and asked about the planning involved in their most recent attempt. In all, 39.7% of subjects reported that their most recent quit attempt involved no preplanning (smokers: 29.5% ex-smokers: 52.4%). Subjects who made an unplanned quit attempt were more likely to be non-white, have no college education, report smoking their first cigarette of the day more than 30 min after waking, and report no use of pharmacotherapy during their quit attempt. Controlling for these variables, the odds of a "spontaneous" quit attempt lasting for 6 months or longer were twice that of preplanned attempts (71.7% vs. 45.6% adjusted odds ratio = 2.62, 95% CI = 1.99-3.45). Similar results were seen in a survival analysis. The results suggest, similar to previous research, that a substantial proportion of quit attempts are unplanned and that such attempts can be a successful route to cessation. Given the frequency of such attempts, methods of making treatment available to assist unplanned quitting should be considered.
Publisher: Elsevier BV
Date: 04-2007
DOI: 10.1016/J.ADDBEH.2006.06.021
Abstract: Nicotine patches and gum are now available without a prescription in many countries. Some have expressed concern that allowing access to these medications without a prescription may deprive smokers of the instruction and support they would otherwise have received from their physician. We assessed the value of physician involvement in NRT prescription. We analyzed data interviews from 993 subjects who had filled prescriptions for patch (n=669) or gum (n=324) about physician behavior when prescribing patch and gum when these were available only by prescription. 82% of smokers actually met with the physician however, only 67% received some instruction in using the medication only 50% were told about potential side effects and substantial fractions were prescribed a dose that differed from that recommended on the usage instructions (patch: 24% gum: 33%). Participants who received no intervention from their physicians were significantly more likely to be abstinent than those participants who received smoking cessation advice and support, likely because physicians offered help to those who most needed it, biasing the association. These findings suggest that physicians did not typically perform the helpful behaviors often expected of them or attributed to them.
Publisher: Springer Science and Business Media LLC
Date: 12-10-2019
DOI: 10.1186/S12889-019-7631-2
Abstract: There is a well-established social gradient in smoking, but little is known about the underlying behavioral mechanisms. Here, we take a social-ecological perspective by examining daily stress experience as a process linking social disadvantage to smoking behavior. A s le of 194 daily smokers, who were not attempting to quit, recorded their smoking and information about situational and contextual factors for three weeks using an electronic diary. We tested whether socioeconomic disadvantage (indicated by educational attainment, income and race) exerts indirect effects on smoking (cigarettes per day) via daily stress. Stress experience was assessed at the end of each day using Ecological Momentary Assessment methods. Data were analyzed using random effects regression with a lower-level (2-1-1) mediation model. On the within-person level lower educated and African American smokers reported significantly more daily stress across the monitoring period, which in turn was associated with more smoking. This resulted in a small significant indirect effect of daily stress experience on social disadvantage and smoking when using education and race as indicator for social disadvantage. No such effects were found when for income as indicator for social disadvantage. These findings highlight the potential for future studies investigating behavioral mechanisms underlying smoking disparities. Such information would aid in the development and improvement of interventions to reduce social inequality in smoking rates and smoking rates in general.
Publisher: Elsevier BV
Date: 11-2020
Publisher: JMIR Publications Inc.
Date: 10-08-2016
DOI: 10.2196/RESPROT.5747
Publisher: Wiley
Date: 06-2021
DOI: 10.1111/AJR.12724
Abstract: Investigate the smoking‐related outcomes and feasibility of a pharmacy‐led financial incentive program for smoking cessation. Multi‐site single‐arm trial of the Tobacco Free Communities program. Community pharmacies within the Glamorgan Spring Bay (Site 1) and George Town (Site 2) municipalities of Tasmania. Adult smokers. Based on funding, the recruitment target was 76 smokers. Pharmacy staff provided quitting advice through 7 sessions over 3 months. At 6 sessions, abstinent participants (no cigarettes in the previous week and expired carbon monoxide ≤4 ppm) were rewarded with AU$50 vouchers. Smoking‐related outcomes were decreased smoking (self‐reported cigarettes per day and carbon monoxide levels) and abstinence rates. Feasibility outcomes were meeting the recruitment target, participant retention and participants' views of the program (measured by interview data from Site 2). Ninety in iduals enrolled. Sixty‐two participants were included in analyses remaining participants were excluded from analyses because they did not consent to use of their data within this study or had carbon monoxide ≤4 ppm at enrolment. Smoking (carbon monoxide and cigarettes per day) significantly decreased between enrolment and the first financial incentive session. Twelve participants (19.35%) were abstinent at the end of the program. Yet retention was poor only 13 participants (20.97%) attended all sessions. Interviews suggested participants found the program beneficial. Providing financial incentive within rural community pharmacies could be a viable method of encouraging smoking reductions and quit attempts. Additional work is needed to increase retention and compare effects to usual care pharmacy practices.
Publisher: American Psychological Association (APA)
Date: 03-2012
DOI: 10.1037/A0025204
Abstract: This study examined dynamic effects of daily variations in craving and negative affect on the next-day risk of the first lapse and relapse among 149 adolescent daily smokers who achieved at least 24 hr of abstinence. Participants completed real-time assessments of their smoking, craving, and negative affect 3 times per day during the 3 weeks after their quit attempt. The main outcome measures included the first lapse and relapse after at least 24 hr of abstinence from smoking. Cox regression analyses with time-varying covariates showed that daily increases in craving predicted the risk of lapsing and relapsing on the following day, even after accounting for concurrent smoking and baseline levels of craving and nicotine dependence. Day-to-day variations in negative affect did not predict time to first lapse or relapse. In idual differences in baseline craving, nicotine dependence, and depressive symptoms also did not predict the first lapse or relapse. The findings challenge the significance of adolescents' negative affect during cessation and emphasize the need to assess dynamic effects of craving in addition to baseline ratings of craving and nicotine dependence, as the latter may not be sufficient to explain adolescent smoking cessation outcomes.
Publisher: Springer Science and Business Media LLC
Date: 12-2015
Publisher: American Psychological Association (APA)
Date: 2006
Publisher: Oxford University Press (OUP)
Date: 24-04-2020
DOI: 10.1093/NTR/NTZ090
Abstract: Non-daily intermittent smokers (ITS) comprise 30% of US adult smokers. ITS smoke for nicotine and have trouble quitting, but tend to smoke in particular situations. This study tested the effect of nicotine gum, used to prevent or react to situational temptations, for helping ITS quit. ITS (smoking 4–27 days/month) seeking help quitting were randomized to 2 mg nicotine gum (n = 181) or placebo (n = 188), to be used to anticipate or react to temptations to smoke, for 8 weeks. Participants received up to six sessions of behavioral counseling. The primary outcome was 6-month biochemically verified continuous abstinence analyses also examined 14-day point-prevalence abstinence at multiple time points, and used event-history analyses to assess progression to abstinence, lapsing, and relapsing. Analyses adjusted for group differences in age and baseline smoking, and considered several potential moderators of treatment effects. Nicotine gum did not significantly improve outcomes on any measure. Biochemically verified 6-month continuous abstinence rates were 7.2% for active gum and 5.3% for placebo (AOR = 1.39, 0.58–3.29, p & .25). ITS with any degree of dependence (Fagerstrom Test of Nicotine Dependence scores & ) showed poorer outcomes on multiple endpoints, and did more poorly on active gum on some outcomes. Gum use was low, starting at 1 gum per day on average and declining over time. Nicotine gum (2 mg), used intermittently, did not improve cessation rates among ITS, including those demonstrating some degree of dependence. Nicotine replacement has been extensively tested with daily smokers, especially those who smoke relatively heavily. Nondaily smoking is now common, creating a need for treatment for ITS. Despite evidence that ITS’ smoking is motivated by nicotine-seeking, a theoretically and empirically derived situational approach to using acute nicotine replacement was not successful at helping ITS quit. Gum use was low whether higher or more frequent dosing is needed, or whether an entirely different approach is needed, is not clear. Effective treatment options are needed for ITS, especially those with some degree of dependence.
Publisher: Springer Science and Business Media LLC
Date: 12-2015
Publisher: Elsevier BV
Date: 10-2008
DOI: 10.1016/J.CLINTHERA.2008.09.016
Abstract: It has been reported that the efficacy of acute forms of nicotine replacement therapy, such as nicotine gum and lozenges, improves when sufficient quantities of medication are used. This analysis examined whether adherence with daily nicotine patch wear was associated with improved rates of smoking abstinence. This was a secondary analysis of data from a double-blind study in which subjects were randomized to receive either an active nicotine patch or a placebo patch under simulated over-the-counter conditions. Subjects were asked to complete a daily diary on their patch use and smoking. Logistic regression, controlling for smoking in the first 3 weeks of treatment, was used to evaluate the likelihood of abstinence at 6 weeks as a function of treatment assignment (active vs placebo) and adherence (ie, patch wear for >or=20 of the first 21 days of treatment). The relationship between reported adverse events and adherence was also examined. This analysis involved data from 371 subjects, 204 using the active patch and 167 using the placebo patch. The study population was mainly white (87.3%), had a mean age of 42.8 years, a mean weight of 77.3 kg, had been smoking for a mean of 24.4 years, and smoked a mean of 25.2 cigarettes per day. Two hundred fifty-three subjects were classified as adherent. Rates of adherence did not differ significantly between the active and placebo groups (139 [68.1%] and 114 [68.3%], respectively). The likelihood of experiencing an adverse event did not differ significantly between adherent and nonadherent subjects in either group. Among active patch users, 61.5% of nonadherent subjects experienced an adverse event, compared with 59.7% of adherent subjects among placebo patch users, the corresponding proportions were 41.5% and 43.9%. Among active patch users, the odds of abstinence at 6 weeks were more than 3 times greater for adherent versus nonadherent subjects (53.2% vs 21.5%, respectively adjusted odds ratio [OR] = 3.25 95% CI, 1.30-8.09 P = 0.011) no benefit of adherence over nonadherence was seen among users of the placebo patch (16.7% vs 15.1% adjusted OR = 0.60 95% CI, 0.16-2.31). The interaction between treatment group and adherence was statistically significant (P = 0.022). Under conditions simulating over-the-counter use, adherence to daily nicotine patch wear within the first 3 weeks of treatment was associated with an improved likelihood of achieving smoking abstinence at 6 weeks.
Publisher: American Psychological Association (APA)
Date: 12-2016
DOI: 10.1037/ADB0000231
Abstract: Previous laboratory studies have investigated associations between attentional bias and craving, but ecological momentary assessment (EMA) may provide ecologically-valid data. This study examines whether clinic-measured attentional bias is associated with noticing smoking cues, attention to smoking, and craving assessed by EMA and whether EMA-assessed cues and attention to smoking are associated with craving in a secondary analysis of data from 100 cigarette smokers attempting cessation. Two weeks before quitting, participants completed attentional bias assessments on visual probe (VP) and Stroop tasks and completed random EMA-assessments for seven weeks thereafter. Participants completed 9,271 random assessments, averaging 3.3 prompts/day. Clinic-measured attentional bias was not associated with cues seen (VP: OR = 1.00, 95% CI = [0.99, 1.01] Stroop: OR = 1.00, 95% CI [0.99, 1.00]), attention toward smoking (VP: OR = 1.00, 95% CI [0.99, 1.02] Stroop: OR = 1.00, 95% CI [0.99, 1.00]), or craving (VP: OR = 1.00, 95% CI [0.99, 1.02] Stroop: OR = 1.00, 95% CI [0.99, 1.01]). EMA responses to seeing a smoking cue (OR = 1.94, 95% CI [1.74, 2.16]) and attention toward smoking (OR = 3.69, 95% CI [3.42, 3.98]) were associated with craving. Internal reliability was higher for the Stroop (α = .75) than visual probe task (α = .20). In smokers attempting cessation, clinic measures of attentional bias do not predict noticing smoking cues, focus on smoking, or craving. However, associations exist between noticing smoking cues, attention toward smoking, and craving assessed in the moment, suggesting that attentional bias may not be a stable trait. (PsycINFO Database Record
Publisher: Wiley
Date: 10-11-2021
DOI: 10.1111/DAR.13215
Abstract: Comprehensively investigating alcohol‐related behaviours in the context of a dynamic multi‐day alcohol‐licensed event is important for understanding and minimising patron risk. We aimed to assess the measurement utility of implementing a multi‐dimensional alcohol assessment battery using biometric data collection, real‐time drink logs and retrospective self‐report measures over the course of a 4‐day music festival. Fourteen adults participated ( n = 7 male, mean age 21.9 years). Breath and transdermal alcohol concentration (BrAC and TAC, respectively) were measured using breathalysers and transdermal alcohol bracelets. A real‐time drink log was completed via smartphones on initiating each drink, and a retrospective questionnaire was administered up to twice daily throughout the event (6 timepoints total). While almost all participants (92.9%) logged significantly fewer drinks in real‐time than they retrospectively reported via the twice‐daily questionnaires, logs provided important contextual information including the types of drinks consumed and drinking intensity. Compared to BrAC, TAC provided a better understanding of the time course of intoxication, indicating highest alcohol consumption outside of static BrAC assessment windows. However, BrAC provided a better assessment of present state: all participants were 0.00% BrAC at departure despite over two‐fifths (42.9%) of the s le's last TAC reading exceeding 0.00%. As standalone assessments, each method possessed limitations. As a combined battery, they were successfully administered simultaneously, resulting in a more comprehensive overview of alcohol consumption/intoxication over the prolonged drinking session. However, the marked burden of simultaneous administration should be considered, and measures should be chosen judiciously based on research needs.
Publisher: Springer Science and Business Media LLC
Date: 10-01-2014
DOI: 10.1007/S00213-013-3429-6
Abstract: Nicotine patches have been reliably demonstrated to improve smoking cessation outcomes but most users still lapse, and then relapse, during treatment. While patch has been shown to alleviate background cravings, its effects on cue-induced cravings - which have been linked to the occurrence of lapse events - are poorly understood. Here we investigate the effect of nicotine patch on the intensity of craving and negative affect experienced during the hours immediately preceding lapse episodes. Participants were 185 smokers who had quit in the context of a randomized, double-blind trial of high-dose (35 mg) nicotine patch and who lapsed at least once during the first 5 weeks of treatment. Participants used electronic diaries to monitor their smoking, affect, and craving during their cessation attempt. The data suggest that developments on the lapse day - either external events or changes in internal states - caused craving and negative affect to rise, cumulating in the lapse. Nicotine is known to lower background craving and negative affect, but the difference between patch and placebo appeared to dissipate in the hours immediately preceding lapse episodes. Understanding the process by which these symptoms "spike" prior to a lapse - and developing treatments to counter it - are worthy research endeavors.
Publisher: Informa UK Limited
Date: 29-12-2010
DOI: 10.3109/10826084.2011.521399
Abstract: Ecological momentary assessment (EMA) is the name applied to any of a range of research methodologies that aim to assess participants in near real time as they go about their regular day-to-day activities. Such methods have particular utility for studying drug use and drug dependence. Using the area of nicotine dependence as a case study, this review highlights how EMA can be used to build upon the findings from more traditional research methods to enhance our understanding of drug use. Particular attention is given to the role that advances in technology have played in the adoption of EMA in drug dependence research.
Publisher: Informa UK Limited
Date: 11-2019
Publisher: Oxford University Press (OUP)
Date: 11-03-2015
DOI: 10.1093/NTR/NTU195
Publisher: Elsevier BV
Date: 07-2009
Publisher: Oxford University Press (OUP)
Date: 19-09-2013
DOI: 10.1093/NTR/NTT142
Abstract: Arguably, the greatest advantage of ecological momentary assessment (EMA) studies is that data are collected repeatedly in real-time and real-world situations, which reduces recall and situational biases and thus improves the accuracy and validity of the data collected. However, the validity of EMA data is contingent upon compliance rates. If participant characteristics are related to missing data, analyses should control for these factors, or they should be targeted in EMA training sessions. This study evaluates the impact of demographic and smoking-related participant characteristics on compliance to an EMA smoking study protocol. Prequit-day data were taken from the control arm of an ongoing randomized controlled trial of a smoking-cessation program. After training, 119 participants were asked to carry a mobile device with them at all times for ~6 days and to log every cigarette they smoked in addition to completing randomly scheduled assessments. Different types of compliance were assessed: the percentage of completed random prompts (signal-contingent compliance), the percentage of logged cigarettes per day compared to a timeline follow-back measure, and the correlation between logged cigarettes and a carbon monoxide assessment 2 hr later (both event-contingent compliance). Overall compliance rates were 78.48% for event-contingent and 72.17% for signal-contingent compliance. None of the demographic or smoking-related participant characteristics predicted signal-contingent compliance however, female participants showed higher event-contingent compliance than male participants, and Caucasian participants showed higher event-contingent compliance than non-Caucasian participants. Compliance did not depend on smoking-related characteristics. EMA is a valid method for assessing smoking behavior in real-time and real-world settings.
Publisher: Springer Science and Business Media LLC
Date: 12-2013
Publisher: Springer Science and Business Media LLC
Date: 11-11-2005
DOI: 10.1007/S00213-005-0175-4
Abstract: Smoking lapses represent an important juncture between smoking cessation and relapse. Nicotine replacement therapy (NRT) has been shown to decrease the risk of progression from lapse to relapse. We hypothesized that this effect might be mediated via decreases in reinforcement from smoking lapses. We assessed 169 subjects who lapsed during treatment in a double-blind placebo-controlled study of high-dose (35 mg) nicotine patch. Following their first lapse, using an electronic diary, subjects recorded the amount they smoked, and rated the pleasantness and satisfaction ("hedonic rating") and the aversiveness of smoking. Subjects were then followed and assessed for further lapses and relapses. Subjects who smoked more during the first lapse had greater risk of progression [second lapse: hazard ratio (HR)=1.16, confidence interval (CI)=1.01-1.32 relapse: HR=1.22, CI=0.97-1.54]. Subjects with higher hedonic ratings of the first lapse also had a greater risk of progression to the second lapse (HR=1.08, CI=1.02-1.14) and to relapse (HR=1.26, CI=1.11-1.41). Aversive ratings had no bearing on progression. As expected, active treatment reduced the risk of both a second lapse (HR=0.54, CI=0.39-0.78) and a relapse (HR=0.22, CI=0.11-0.45). Importantly, however, NRT had no effect on hedonic ratings, amount smoked during the first lapse, or aversive ratings. Hedonic response to an initial lapse predicted progression to relapse, but this did not mediate the effect of NRT on progression.
Publisher: Elsevier BV
Date: 02-2009
DOI: 10.1016/J.AMEPRE.2008.09.039
Abstract: Many smokers express a desire to quit smoking by gradually reducing the number of cigarettes they smoke until they stop completely. This study tested the efficacy of nicotine gum in facilitating cessation through gradual reduction. This was a multi-center, placebo-controlled, double-blind RCT of 2- and 4-mg nicotine gum versus placebo. 3297 smokers who were interested in quitting gradually. Subjects were instructed to gradually reduce their smoking while increasing their gum use over the course of up to 8 weeks. Once they had achieved initial abstinence (no smoking for 24 hours), gum was to be used in accordance with the current FDA-approved directions for cessation. The study was conducted under over-the-counter conditions, with no counseling provided. Continuous abstinence was assessed after 28 days and 6 months. Secondary measures of smoking reduction were also assessed. Analyses were conducted in 1999-2000 and 2007-2008. Smokers on active gum were significantly more likely to achieve initial cessation (2 mg: OR=1.42 4 mg: OR=1.90) 28-day continuous abstinence (2 mg: OR=2.01 4 mg: OR=4.66) and continuous abstinence at 6 months (2 mg: OR=1.80 4 mg: OR=5.96). During the reduction phase, active gum aided smoking reduction, and participants who reduced their smoking were more likely to achieve abstinence. These findings demonstrate that smokers who wish to quit smoking by gradual reduction can increase their success by using nicotine gum to facilitate reduction and cessation.
Publisher: Oxford University Press (OUP)
Date: 15-02-2022
DOI: 10.1093/NTR/NTAC042
Abstract: Financial incentive programs promote smoking cessation. However, the incentive amount which should be provided—and how this may interact with other program characteristics—is unknown. The objective of this study was to evaluate the influence of the design of incentive programs for smoking cessation on current smokers’ perceptions of programs and willingness to enroll. An online discrete choice experiment was conducted amongst adult current smokers residing in the United Kingdom (N = 430). Hypothetical incentive programs were described using five attributes (incentive amount, incentive type, frequency of sessions, reward schedules, program location). Participants responded to a series of choice sets comprised of two hypothetical programs. For each set, participants selected their preferred program. They then specified whether they would enroll in their preferred program if it were available. Analyses also considered the effect of participant income on preferences. Overall, participants preferred higher amounts over lower amounts, cash over vouchers, healthcare settings over workplaces, and consistent amounts over an escalating schedule. One session per week was the most preferred session frequency. Willingness to enroll increased quadratically with the incentive amount, although this increase slowed for higher amounts. Although middle- and high-income smokers preferred slightly higher amounts (cf. low-income participants), enrollment choices did not differ by income. The characteristics of incentive programs influence smokers’ perceptions of programs and willingness to enroll. Higher amounts may encourage greater enrollment rates, but there will likely be a ceiling point beyond which increasing the incentive amount does not meaningfully increase enrollments. There is increasing evidence incentive programs aid smoking cessation. Yet, the variety in previous program designs means how to best structure programs, including optimal incentive amount and the impact of the design on potential enrollment rates, remains unclear. This study suggests enrollments may be highest when incentive amounts are higher, rewards of a consistent amount in cash are provided, and sessions occur once per week in a healthcare setting. Although higher-income participants may desire higher incentive amounts compared to lower-income participants, this may not translate into differences in willingness to enroll.
Publisher: Center for Open Science
Date: 02-2022
Abstract: Influential psychological theories hypothesize that people consume alcohol in response to the experience of both negative and positive emotions. Despite two decades of daily diary and ecological momentary assessment research, it remains unclear whether people consume more alcohol on days they experience higher negative and positive affect in everyday life. In this preregistered meta-analysis, we synthesized the evidence for these daily associations between affect and alcohol use. We included in idual participant data from 69 studies (N = 12,394), which used daily and momentary surveys to assess affect and the number of alcoholic drinks consumed. Results indicate that people are not more likely to drink on days they experience high negative affect, but are more likely to drink and drink heavily on days high in positive affect. People self-reporting a motivational tendency to drink-to-cope and drink-to-enhance consumed more alcohol, but not on days they experienced higher negative and positive affect. Results were robust across different operationalizations of affect, study designs, study populations, and in idual characteristics. These findings challenge the long-held belief that people drink more alcohol following increases in negative affect. Integrating these findings under different theoretical models and limitations of this field of research, we collectively propose an agenda for future research to explore open questions surrounding affect and alcohol use.
Publisher: JMIR Publications Inc.
Date: 31-10-2017
DOI: 10.2196/RESPROT.7907
Publisher: Hindawi Limited
Date: 15-09-2014
DOI: 10.1017/JSC.2014.22
Abstract: Introduction: Results from observational studies suggest that smoking-related cues play a role in triggering relapse. Coping strategies are among the most commonly used cessation strategies, but little is known about how they aid quitting. Aims: The aim of this pilot study was to evaluate the effect of a suite of selected coping techniques on alleviating cue-induced cravings. Methods: Thirty-seven daily smokers (Intervention: 20 Control: 17) participated in two laboratory cue-reactivity sessions, separated by approximately one week, during which craving was assessed before and after exposure to smoking-related cues. Following the first session, participants in the Intervention Group were taught a suite of coping strategies. During the second session, participants in the Intervention Group were encouraged to use these strategies. Results: Participants in the Intervention Group reported a slight decrease in craving following the acute exposure manipulation at the second session, compared to an increase in craving among participants in the Control Group. Intervention Group participants also reported a decrease in craving following prolonged exposure to the smoking cues (compared to an increase in craving among Control Group participants). In both cases, the difference between groups was more pronounced among smokers who responded to the cue-reactivity manipulation. The observed differences were not significant. Conclusions: The results of this pilot study suggest that coping techniques may be beneficial in alleviating both the initial spike in craving observed following acute cue exposure, and aid recovery during prolonged exposure. These findings need to be replicated in a larger study.
Publisher: JMIR Publications Inc.
Date: 22-07-2020
DOI: 10.2196/15948
Abstract: It has been observed that eating is influenced by the presence and availability of food. Being aware of the presence of food in the environment may enable mobile health (mHealth) apps to use geofencing techniques to determine the most appropriate time to proactively deliver interventions. To date, however, studies on eating typically rely on self-reports of environmental contexts, which may not be accurate or feasible for issuing mHealth interventions. This study aimed to compare the subjective and geographic information system (GIS) assessments of the momentary food environment to explore the feasibility of using GIS data to predict eating behavior and inform geofenced interventions. In total, 72 participants recorded their food intake in real-time for 14 days using an ecological momentary assessment approach. Participants logged their food intake and responded to approximately 5 randomly timed assessments each day. During each assessment, the participants reported the number and type of food outlets nearby. Their electronic diaries simultaneously recorded their GPS coordinates. The GPS data were later overlaid with a GIS map of food outlets to produce an objective count of the number of food outlets within 50 m of the participant. Correlations between self-reported and GIS counts of food outlets within 50 m were only of a small size (r=0.17 P .001). Logistic regression analyses revealed that the GIS count significantly predicted eating similar to the self-reported counts (area under the curve for the receiver operating characteristic curve [AUC-ROC] self-report=0.53, SE 0.00 versus AUC-ROC 50 m GIS=0.53, SE 0.00 P=.41). However, there was a significant difference between the GIS-derived and self-reported counts of food outlets and the self-reported type of food outlets (AUC-ROC self-reported outlet type=0.56, SE 0.01 P .001). The subjective food environment appears to predict eating better than objectively measured food environments via GIS. mHealth apps may need to consider the type of food outlets rather than the raw number of outlets in an in idual’s environment.
Publisher: Wiley
Date: 15-01-2015
DOI: 10.1111/DAR.12238
Abstract: Alcohol consumption has a well-established relationship with mood, with higher positive and negative affect predicting alcohol use. More recently, researchers have explored whether alcohol consumption occurs as a response to affect variability as an attempt to self-medicate and stabilise affect. Studies have revealed a positive association between alcohol use and intra- and inter-in idual affect variability in clinical and university student s les however not much is known of this relationship among the general community. Ecological Momentary Assessment (EMA) methods were used to investigate the relationship between affect and arousal variability and alcohol use in 53 community volunteers. Participants self-reported affect and arousal at three to five randomly timed moments throughout the day, as well as every time they drank. On a day-to-day basis, higher positive affect was associated with increased alcohol consumption. When analyses were restricted to self-reported affect prior to alcohol consumption, only increased arousal and decreased variability in arousal predicted the likelihood of alcohol consumption. Mean level of arousal was associated with the extent of alcohol consumed. In this moderate drinking s le day-to-day affect and arousal, and arousal variability, were associated with alcohol consumption. Analyses restricted to pre-drinking observations provide further evidence that self-medication accounts of alcohol consumption may explain drinking initiation but that the relationship between affect factors and drinking behaviour may change around the point of first drink.
Publisher: Elsevier BV
Date: 02-2021
Publisher: American Psychological Association (APA)
Date: 06-2022
DOI: 10.1037/PHA0000449
Publisher: Oxford University Press (OUP)
Date: 05-07-2016
DOI: 10.1093/NTR/NTW167
Abstract: Emotive health messages are widely used tools in tobacco control. However, under some circumstances, they can be less effective than desired by eliciting defensive responses in smokers. This study tests whether enhancing a currently used emotive graphic smoking health warning with a self-affirmation component reduces cigarette consumption and whether potential effects are stronger in heavier smokers, as suggested by previous research. Participants (n = 265) were randomly allocated to a self-affirmation (reflecting on personal values and positive traits using a questionnaire) or matched control condition before viewing an emotive graphic health message from a current Australian government public health c aign. The primary outcome (cigarettes per day [CPD]) was assessed both before and a week following the intervention. No main effect of self-affirmation on smoking, but as hypothesized, a significant interaction between baseline smoking and self-affirmation was found that showed that heavier smokers (>21 CPD) who self-affirmed significantly reduced CPD compared to nonaffirmed smokers. These findings support the use of self-affirmation to enhance smoking awareness c aigns in heavier smokers. This study shows that enhancing emotive graphic smoking health messages with self-affirmation (the act of reflecting on positive aspects of oneself) increases their effectiveness in heavier smokers. This suggests that self-affirmation might be a particularly useful tool for health promotion targeting heavier smokers. This study adds to previous research in that it is the first to test the add-on effects of self-affirmation to current graphic health messages on smoking rather than smoking-related cognitions.
Publisher: Elsevier BV
Date: 07-2017
DOI: 10.1016/J.APPET.2017.03.012
Abstract: Discretionary food choices (snacks) contribute up to a third of the daily energy intake and potentially contribute to energy imbalance and weight gain. In idual snack intake behaviour is guided by internal and external cues, with social cues (seeing others eat, being alone) consistently showing large effects. A wide body of (mainly laboratory-based) research suggests marked differences in people's response to eating cues based on BMI. Here, we show that these BMI differences in cue responsiveness also pertain to everyday snacking behaviour. In two combined ecological momentary assessment studies, 122 participants with BMIs ranging from 18.34 to 45.71 kg/m
Publisher: American Psychological Association (APA)
Date: 05-2018
DOI: 10.1037/ADB0000368
Abstract: Research reports show increased prevalence of habitual khat chewing among various parts of the community in Ethiopia. Some users experience problems controlling their use withdrawal symptoms may be adding to difficulties with reducing or ceasing use. We aimed to describe the nature and the time course of any withdrawal syndrome in relation to the cessation of khat use over the first 2 weeks of a quit attempt. Fifty-nine participants between the ages of 18 and 35 and who have already chewed ≥1 bundle of khat in their life with a chewing frequency of ≥3 days per week were recruited from Adama Science and Technology University c us. Participants were predominantly male (n = 45, 75%) and had the mean age of 24.8 years (range = 20-32 SD = 2.8). Participants used smart phones to monitor withdrawal symptoms and cravings. The total assessments were ided in to 3 prequit and 14 postquit days. The development of withdrawal symptoms was evident, and all withdrawal symptoms followed similar overall patterns, with salient elevations after the quit day and curvatures around the first week of postquit period. Depression, craving, nervousness, tiredness, restlessness, poor motivation, irritability, and negative affect substantially increased and reached peak on the first week around Day 7 and remained higher compared with the level at baseline indicating the persistence and severity of these symptoms over time. In addition, craving, irritability, and restlessness had significantly reverted to their baseline level during the second week of the postquit duration. We have demonstrated low rates of success during unaided quite attempts from khat and that the withdrawal syndrome is not trivial. Interventions are necessary to support in iduals during the period of increased symptoms of dysphoria and to reduce the risk of relapse. (PsycINFO Database Record
Publisher: Oxford University Press (OUP)
Date: 11-03-2014
DOI: 10.1093/NTR/NTU023
Publisher: Oxford University Press (OUP)
Date: 28-08-2014
DOI: 10.1093/NTR/NTU147
Publisher: Elsevier BV
Date: 11-2016
DOI: 10.1016/J.JPBA.2016.08.013
Abstract: The tobacco-specific nitrosamine, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), is formed from nicotine and related compounds during tobacco curing and is classified as a human carcinogen. Its major metabolite, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), is thought to be useful in the assessment of cigarette smoking harm minimisation strategies. Urine s les were collected from 24 current Caucasian smokers participating in a smoking cessation study before and four weeks after a quit attempt. S les were spiked with NNAL-d Free NNAL levels (193.5±158.2pg/mL [mean±standard deviation]) measured in urine s les obtained at baseline (during ad lib smoking) were indicative of biological exposure to NNK. Free NNAL levels were significantly reduced four weeks after the quit attempt (64.5±77.6pg/mL p<0.002). Assay performance met acceptance criteria with mean recovery of 59±23%, intra-day accuracy was 3.7%, 3.7 and 3.6% and precision was 11.3%, 5.1% and 5.3% at 5pg/mL, 20pg/mL and 100pg/mL levels respectively. Enzymatic hydrolysis of NNAL-glucuronide proved unreliable with complete loss of NNAL aglycone in some subject s les following the hydrolysis procedure. Liquid-liquid extraction with UPLC-MS/MS is a convenient approach to measure low levels of NNAL in urine as a marker of biological NNK exposure, which can be used to assess the effectiveness of smoking reduction harm minimisation strategies. Enzymatic hydrolysis of NNAL-glucuronide and measuring the aglycone is not recommended.
Publisher: Elsevier BV
Date: 2020
DOI: 10.1016/J.DRUGALCDEP.2019.107720
Abstract: Given the low efficacy of smoking cessation methods, an experimental medicine model indicating smoking abstinence would be of great benefit to the development of new treatments. Hence the sensitivity of cognitive tasks and ambulatory craving measures to smoking abstinence were investigated. Cognitive tasks and ambulatory ratings of craving were assessed for sensitivity to acute abstinence (experiment 1), and nicotine replacement therapy administration (NRT) (experiment 2). In experiment 1 go/no-go performance was improved (Mean Difference [MD] -0.99, 95% CI: -1.90 to -0.08) and craving was lower (Regression Coefficient [RC] -33.39, 95% CI: -39.96 to -26.82) in satiated compared with abstinent smokers. There was no clear evidence that N-back (MD 0.64, 95% CI: -0.42 to 2.51), delay discounting (MD 0.01, 95% CI: 0.001 to 0.005) or dot probe performance (MD 0.61, 95% CI: -0.87 to 1.54) were sensitive to acute abstinence. In experiment 2 go/no-go performance was improved (MD 1.12, 95% CI: 0.16-2.08) and craving was lower (RC -18.59, 95% CI: -24.63 to -12.55) smokers abstinent overnight receiving NRT compared with placebo. There was no clear evidence that N-back (MD -0.25, 95% CI: -1.45 to 0.94), delay discounting (MD 0.01, 95% CI: -0.002 to 0.004) or dot probe performance (MD -0.49, 95% CI: -1.61 to -0.64) were sensitive to NRT. Findings from two experiments converge to suggest that abstinence in smokers reliably increases ambulatory craving assessments and, to a lesser extent, decreases go/no-go task performance. These findings can be utilized in the development of an experimental medicine model to test novel treatments for smoking cessation.
Publisher: BMJ
Date: 02-2016
Publisher: Springer Science and Business Media LLC
Date: 24-03-2017
DOI: 10.1007/S00213-017-4604-Y
Abstract: In recent years, there has been growing research interest in using nicotine replacement medications to aid smoking reduction prior to a quit attempt. Gaining a better understanding of how treatments influence smoking reduction may allow for better tailoring of treatments and, ultimately, better cessation outcomes. The objective of the current study was to test the effects of the pre-quit use of varenicline and nicotine patch on smoking rate and satisfaction with smoking. All participants were required to attend up to five study visit sections. Participants (n = 213) who were interested in quitting were randomised (open-label) to receive either pre-quit patch or varenicline (both treatments started 2 weeks prior to an assigned quit day, followed by 10 weeks post-quit) or standard patch (10 weeks starting from an assigned quit day). Participants used modified smartphones to monitor their smoking in real time for 4 weeks. Participants in the two pre-quit treatment groups reported significant reductions in both their satisfaction with smoking (p < 0.001) and smoking rate (p < 0.001) from baseline to the end of pre-quit period participants in the standard patch group did not. The observed reduction of smoking rate was associated with the satisfaction with smoking (p < 0.01), although the mediation effect of satisfaction was small. Pre-quit treatment caused reductions in satisfaction with smoking and smoking rate. Satisfaction was associated with changes in smoking rate, but the relationship was weak. As such, monitoring reductions in satisfaction do not appear to be a viable method of evaluating responsiveness to treatment.
Publisher: Wiley
Date: 23-12-2010
DOI: 10.1111/J.1360-0443.2010.03244.X
Abstract: Using nicotine gum can reduce the amount of weight gained when quitting. Here we examine the relationship between weight gain and use of adequate amounts of gum. To mitigate the confounders associated with correlational analyses, we contrast the effects of active gum and placebo, and analyze outcomes prospectively. Randomized double-blind placebo-controlled trial of nicotine gum. Participants were instructed to use nine to 15 pieces of gum/day for the first 2 months of treatment. Participants (n = 103) were randomized to either active (2 mg or 4 mg) or placebo gum. We examined the effect on weight gain of the interaction between treatment (active versus placebo) and daily gum use [≥9 pieces/day (compliant use) versus < 9 pieces/day]. After 30 days of abstinence, smokers treated with active gum had not gained significantly less weight than those on placebo (1.1 kg versus 1.6 kg, P = 0.175). However, a significant compliance-treatment interaction was observed (P = 0.005): active gum users who used ≥9 pieces/day during the first 14 days of treatment had gained less weight at follow-up (0.6 kg versus 1.6 kg for those who used <9 pieces/day, P = 0.017), but participants randomized to the placebo group saw no such benefit from compliant use. A similar compliance-treatment interaction (P = 0.046) was also observed when the effect of compliance was examined within active treatment (2 mg versus 4 mg). When smokers are quitting, those who use more pieces of nicotine gum experience less weight gain in the first 30 days. This relationship is not seen for smokers on placebo gum.
Publisher: JMIR Publications Inc.
Date: 14-12-2020
DOI: 10.2196/23734
Abstract: Numerous mobile health (mHealth) apps have been developed to support smokers attempting to quit smoking. Although these apps have been reported to be successful, only modest improvements in the quit rate have been measured. It has been proposed that efforts to improve user engagement and retention may improve the quit rate further. Owing to the high cost of smoking-related disease, it is considered worthwhile to pursue even small improvements. The aim of this study was to test a novel smartphone app that leverages premium currency strategies developed by the mobile games industry in an attempt to improve engagement and retention with a smoking cessation intervention. We designed and developed a smoking cessation app called “Quittr” in line with previously developed smoking cessation mHealth apps. In addition to this established framework, we added a stand-alone fully featured city-building clicker-style game called “Tappy Town,” and a premium virtual currency called “QuitCoins.” The user earns QuitCoins for using the app in a way that contributes positively toward their quit attempt, and they can redeem these coins in Tappy Town for bonuses. To establish whether these features improved engagement and retention, we ran a 5-month randomized controlled trial where the intervention group had the full app with the extra games features, while the control group had the standard app only. Recruitment was performed via web-based advertising. Participants (N=175) had no direct contact with the researchers or other support staff. No significant differences in terms of engagement, retention, or smoking outcomes were found between the control and intervention groups. However, survey data indicated that the majority of the participants valued Tappy Town (10/17, 59%) and the QuitCoins rewards system (13/17, 77%). Usage data also suggested that Tappy Town was widely played and was generally appealing to users (mean total time spent in app, control group: 797 seconds vs intervention group: 3502 seconds, P .001). Analysis of the results suggests that users in the intervention group may have been negatively affected by the aspects of the chosen design, and some theories were explored to explain this unexpected outcome. Although the novel features of the Quittr app failed to improve the key outcomes measured in this study, there were enough positive indications to warrant further exploration of the concept. Additional research will be required to identify and correct any design flaws that may have adversely affected our participants before a follow-up study can be completed. Australian and New Zealand Clinical Trials Register ACTRN12617000491369 www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372661& isReview=true
Publisher: Hindawi Limited
Date: 11-02-2013
DOI: 10.1017/JSC.2013.2
Abstract: Since its launch as a smoking cessation aid, varenicline use has been linked to a number of serious adverse events, notably the exacerbation of pre-existing psychiatric illness, depressed mood and suicidal ideation. Regulators’ fears have been somewhat allayed by varenicline's status as a prescription only medication. The purpose of this study was to examine the care provided by physicians – or general practitioners – and pharmacists to varenicline users under real-world conditions. Participants were 141 patients who had filled a prescription for varenicline at a participating pharmacy within the previous six-months. Identified patients were mailed a survey to complete that included items on interactions with their physician and pharmacy staff, and knowledge of treatment side-effects. Most participants reported that their physician encouraged them to set a quit date (82.5%) and provided additional cessation materials (57.2%). While most (79.0%) physicians discussed whether varenicline was appropriate for the patient, fewer asked about psychiatric illness (40.1%), or asked to be informed about mood or behaviour change during treatment (48.1%). Participants (78.4%) reported that their physician had discussed a follow-up consultation, but only 59.4% of patients who had finished treatment at the time of the survey reported having one. Most reported discussing potential drug side-effects with their physician (71.0%) and or pharmacist (52.9%) when probed, knowledge was variable. These results suggest that many patients do not receive the level of support that physicians and pharmacists are assumed to provide.
Publisher: Wiley
Date: 07-02-2011
Publisher: Springer Science and Business Media LLC
Date: 07-07-2020
Publisher: S. Karger AG
Date: 18-10-2014
DOI: 10.1159/000363231
Abstract: b i Background: /i /b In this paper we describe a novel Internet-based cell phone-optimized assessment technique (ICAT) to conduct an ecological momentary assessment (EMA) study. Participants could access the assessment instrument via the web browsers of their mobile phones. b i Methods: /i /b We report results from 92 young adult smokers (18-25 years old) who completed the baseline assessment and the first of 4 waves (3 days/wave) of EMA. Random prompts were issued via text messages sent to the participants. The participants were also instructed to self-initiate reports of smoking situations. b i Results: /i /b Compliance with the study protocols was low. In total, the participants completed 885 assessments during the 3 days of monitoring. Only 50.2% of random prompts were responded to, and 52.4% of those were completed within the first 10 min after issuing. Furthermore, reports of smoking situations were rarely self-initiated. In a multivariate regression analysis, age (positively) and female gender (negatively) predicted the number of completed assessments. b i Conclusions: /i /b This study adds to the limited experiences made with ICAT in substance use research. Similar to the few prior ICAT studies, compliance was low compared to traditional EMA studies. While using ICAT is technically feasible, specific improvements should be implemented to tap ICAT's full potential in future studies.
Publisher: Oxford University Press
Date: 10-2020
DOI: 10.1093/OXFORDHB/9780190218058.013.24
Abstract: Ecological momentary assessment (EMA) methods provide a means by which researchers may attain highly detailed, ecologically valid, and contextually rich data on everyday experience and behavior. EMA methods are now widely used by researchers, particularly those studying health behaviors. A key reason for the popularity of EMA methods is that they allow researchers to examine both between- and within-in idual differences in treatment efficacy and to explore the temporal sequences related to events of interest. Until relatively recently, EMA methods have predominately been employed as assessment and research tools. However, in recent years clinicians and researchers have begun to explore the value of real-time data collection methods as the foundation for providing tailored interventions that can respond to a patient’s behaviors, moods, social context, and geographical location. This chapter discusses how EMA data can potentially be utilized to improve the delivery of health interventions. The authors conclude that while there are clearly potential benefits of utilizing real-time data collection methods for treatment delivery, considerable work remains to ensure that EMA-based interventions are appropriate, theoretically derived, and ethical in their effects on privacy and confidentiality.
Publisher: Wiley
Date: 30-10-2018
DOI: 10.1111/DAR.12622
Abstract: Despite the adverse effects of khat use and chewers interest in cessation, there are few studies that have reported on the outcome of khat cessation attempts, and limited resources available for potential quitters. We used electronic diaries to monitor the outcomes of an unassisted quit attempt among daily and near daily khat consumers, and examine predictors of success. Sixty participants between the ages of 18 and 35 years who regularly chewed khat and who were attempting to quit were purposively recruited from an Ethiopian University c us. Real-time prospective daily recording of khat use was obtained for an average of 10 days prior to quit day (range 6-13) and 28 post-quit days (range 9-31), using an electronic diary. Almost all (95%) achieved initial abstinence. Of these, 80% reached at least seven continuous days of abstinence 7% maintained continuous abstinence for 28 days post-quit. While 93% lapsed (average 11 days post-quit, SD = 7), only a smaller proportion relapsed (41%: chewed for at least three consecutive days after at least 5 days of abstinence). No demographic factors were predictive of successful abstinence. Regular khat chewers have difficulties in maintaining abstinence despite having motivation and desire to quit. This implies that treatment aids may be needed to assist chewers' in their quit attempts. Controlled experimental trial through the use of available low cost quit aids and behavioural resources is crucial in order to increase success rates for those seeking to desist from khat use.
Publisher: Wiley
Date: 03-2018
DOI: 10.1002/HUP.2653
Abstract: This study aimed to determine the efficacy of the Severity of Dependence Scale (SDS) as a screening tool for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition-defined khat use disorder. Cross-sectional, purposive s le of past-year khat consumers aged 16 and above were recruited from khat markets and cafes from university and general community in Adama, Ethiopia. Participants self-completed a survey comprising current substance use disorder. The SDS formed a unifactorial structure, consistent with the dependence construct. Almost three quarters (73%) of the s le were identified as experiencing Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition khat use disorder. The SDS demonstrated excellent discrimination (area under the curve = 0.92) and an optimal cut-off as a score of 3 or greater, with sensitivity of 81% and specificity of 96%. This classification validly identified a group with more frequent and higher dose khat use than participants that did not screen positive. Although khat is a mild stimulant, there is clear evidence that some consumers are both concerned with their use and experience problems associated with their use. Consistent with its application for other drugs, the SDS is a brief and simple screening tool that appears to validly identify in iduals experiencing a khat use disorder syndrome and experiencing high rates of adverse consequences in association with use.
Publisher: Wiley
Date: 15-07-2008
DOI: 10.1111/J.1360-0443.2008.02268.X
Abstract: Nicotine replacement therapy (NRT) is effective for smoking cessation, but most smokers try to quit without using it. We examined the impact of misperceptions of NRT safety and efficacy on its use. A total of 3203 current and former US smokers completed a national mail-out survey of issues and attitudes related to smoking cessation. Two-thirds (66%) of respondents either agreed that 'Stop-smoking products with nicotine are just as harmful as cigarettes' or were unsure whether the statement was true. These respondents were less likely to have used NRT in the past [30% versus 49% odds ratio (OR) = 0.45, 95% confidence interval (CI): 0.39-0.53] and less likely to consider using NRT during future quit attempts (40% versus 53% OR = 0.60, 95% CI = 0.51-0.71). Additionally, of the respondents who had used nicotine gum in the past 12 months (n = 407), those who had concerns about the safety of NRT reported using fewer pieces of gum per day during treatment (six versus eight pieces/day P < 0.05), and were less likely to report that they used the gum for greater than 4 weeks (28.5% versus 46.8% OR = 0.45, 95% CI: 0.27-0.76). A large proportion of the respondents also stated that they did not believe NRT to be efficacious. The findings suggest that many smokers are misinformed about the health risks of NRT and that these misperceptions impede not only the adoption of NRT but also compliance during treatment. Misperception of NRT safety is one barrier to effective use of NRT and probably reduces success in quitting.
Publisher: Oxford University Press (OUP)
Date: 30-08-2023
DOI: 10.1093/ABM/KAAD050
Abstract: To control infections, behavioral non-pharmaceutical interventions (NPIs) such as social distancing and hygiene measures (masking, hand hygiene) were implemented widely during the COVID-19 pandemic. At the same time, adherence to NPIs has also been implied in an increase in mental health problems. However, the designs of many existing studies are often poorly suited to disentangle complex relationships between NPI adherence, mental health symptoms, and health-related cognitions (risk perceptions, control beliefs). To separate between- and temporal within-person associations between mental health, health-related cognitions, and NPI adherence. Six-month ecological momentary assessment (EMA) study with six 4-day assessment bouts in 397 German adults. Daily measurement of adherence, mental health symptoms, and cognitions during bouts. We used dynamic temporal network analysis to estimate between-person, as well as contemporaneous and lagged within-person effects for distancing and hygiene NPIs. Distinct network clusters of mental health, health cognitions, and adherence emerged. Participants with higher control beliefs and higher susceptibility were also more adherent (between-person perspective). Within-person, similar findings emerged, additionally, distancing and loneliness were associated. Lagged findings suggest that better adherence to NPIs was associated with better mental health on subsequent days, whereas higher loneliness was associated with better subsequent hygiene adherence. Findings suggest no negative impact of NPI adherence on mental health or vice versa, but instead suggest that adherence might improve mental health symptoms. Control beliefs and risk perceptions are important covariates of adherence—both on between-person and within-person level.
Publisher: Wiley
Date: 15-12-2014
DOI: 10.1111/ADD.12795
Abstract: Modelling the population impact and cost-effectiveness of smoking cessation aids is limited by lack of knowledge about how the use of aids changes across quit attempts. Here we test whether the quit method used in a previous attempt influences (i) future decisions to quit and/or (ii) treatment/s used during subsequent attempts. Data came from the Smoking Toolkit Study, a United Kingdom national household survey. Smokers (n = 5489) who completed a baseline and 6-month follow-up questionnaire. Respondents were asked what treatment/s, grouped as: prescription medication/s [bupropion, varenicline or nicotine replacement therapy (NRT)], over-the-counter NRT or unaided that they had used in their most recent quit attempt (at baseline), and any use of treatment/s for a quit attempt in the last 3 months at follow-up. Smokers who had tried to quit at baseline were more likely to report having tried to quit again prior to follow-up [all odds ratios ≥ 2.19 relative to no attempt at baseline, P < 0.001]. Smokers who tried to quit using pharmacological aids were more likely to try to quit again at follow-up (all ORs ≥ 2.19 relative to no attempt at baseline, P < 0.001). Smokers tended to re-try aids used in baseline attempts in future attempts (all ORs ≥ 1.48 relative to no attempt at baseline, P < 0.01). Smokers who have tried to quit in the past year are more likely to try to quit again within 6 months regardless of whether they used a pharmacological aid, and they are more likely to re-try aids they had used previously.
Publisher: Wiley
Date: 09-12-2020
DOI: 10.1111/BJHP.12402
Abstract: Objectives Health behaviour theories outline how cognitions predict behaviours, but rarely specify the temporal relation between cognitions and behaviours. It is not known whether these predictive relationships vary depending on temporal resolution or whether the relative influence of cognitions varies with measurement schedules. The current exploratory study therefore investigates whether the associations between behavioural cognitions (self-efficacy, intention, and risk perception) and smoking vary when measured momentarily, at day level, or using the more common baseline-follow-up design. Design EMA study involving 36 continuing smokers over 17 days. Participants logged cigarettes and reported their cognitions at baseline, daily (evening), and in response to momentary surveys. Methods Random-effects models were used to compare the effects of cognitions measured at different time points on (1) the number of cigarettes smoked daily and (2) the time interval until the next cigarette smoked. Results Self-efficacy and risk perception measured at baseline significantly predicted cigarettes smoked each day, but this effect became non-significant when daily measurements of cognitions were included in the model. Momentary smoking behaviour was predicted by momentary measurements of risk perception, with no significant effects of social cognitions at baseline. Conclusions Relationships between cognitions and behaviours vary according to the temporal resolution of the measurement schedule. Ensuring that the temporal resolution of assessment is appropriate for the temporal dynamics of the behaviour being assessed is important. Future research is needed to investigate the potential for leveraging specific cognitive processes depending on temporal importance in order to increase health-promoting behaviours. Statement of contribution What is already known on this subject? Social cognitions including intentions, risk perception, and self-efficacy have been observed to predict smoking. Little is known about the role of time in the cognition-behaviour relationship. Cognitions have been observed to fluctuate, but instability is typically not considered in research design. What does this study add? Daily measurement of social cognitions predicts behaviour better than measurements taken at baseline. Momentary smoking behaviour is predicted by momentary cognitions at the intra-in idual level. Temporal resolution of measurement should be considered when investigating cognition-behaviour relationships.
Publisher: Oxford University Press (OUP)
Date: 06-12-2014
DOI: 10.1093/NTR/NTU253
Abstract: Smokers and nonsmokers can encounter a variety of antismoking messages in their everyday life. Antismoking warnings often involve fear appeals to which particularly smokers may react in a defensive manner by avoiding or derogating the messages, or downplaying their personal risk. However, previous studies testing the effects of antismoking warnings have either been retrospective or lab-based, thus introducing potential recall biases and yielding limited ecological validity. We used ecological momentary assessment (EMA) to give an overview on the number, type, and locations where in iduals encounter such messages and to examine their immediate reactions. In an EMA study, 33 smokers and 37 never-smokers logged every encounter with antismoking warnings during 2.5 weeks (1,237 participant days of monitoring). After randomly selected encounters, several markers of defensiveness were assessed. On average, nonsmokers reported noticing significantly fewer warnings than smokers (M = 0.49/day vs. M = 2.14/day). Both groups saw the majority of warnings on cigarette packages. Smokers reported a significantly higher level of message derogation and a significantly lower level of message acceptance than nonsmokers. There were no differences in feelings of vulnerability between smokers and nonsmokers upon encountering the warnings. The overall number of encounters with antismoking warnings in people's everyday life is relatively low, particularly among smokers. Smokers are likely to avoid messages and respond defensively, thus limiting their potential effectiveness.
Publisher: American Psychological Association (APA)
Date: 03-2016
DOI: 10.1037/ADB0000134
Publisher: Elsevier BV
Date: 04-2015
Publisher: American Psychological Association (APA)
Date: 08-2015
DOI: 10.1037/ABN0000063
Publisher: Wiley
Date: 22-03-2012
DOI: 10.1111/J.1360-0443.2012.03801.X
Abstract: Smokers who lapse during a cessation attempt are at particularly high risk of relapse, so interventions to help smokers recover from lapses are urgently needed. Two recent studies have suggested continuing to use nicotine patches following a lapse may be a beneficial relapse prevention strategy. However, to date no study that uses approved doses of nicotine patches under real-world conditions has tested this hypothesis. Clinical trial conducted across eight US study sites. Using data from 509 subjects (240 active 269 placebo) who lapsed during weeks 3-5 of treatment in a randomized, double-blind placebo-controlled trial of 21-mg nicotine patches, we examined whether active nicotine patch use improved the chances of recovering abstinence (7-day point-prevalence) at weeks 6 and 10. Active patch use (versus placebo) increased the likelihood of recovery from a lapse both at 6 weeks [8.3% versus 0.8% relative risk (RR) = 11.0, P < 0.001] and at 10 weeks (9.6% versus 2.6% RR = 3.7, P < 0.001). Continuing treatment to aid smoking cessation with active patches promotes recovery from lapses. Smokers should be encouraged to persist with patch treatment if they lapse to smoking.
Publisher: Springer Science and Business Media LLC
Date: 11-2005
DOI: 10.1007/S00213-005-0184-3
Abstract: Decreasing withdrawal and craving during smoking cessation is a major aim of cessation medications. Prior studies have shown that Nicotine Replacement Therapy (NRT) decreases withdrawal symptom severity but have relied on retrospective reports and lacked robust measures of baseline symptoms or symptoms during unmedicated abstinence. We tested the effect of high-dose (35 mg) nicotine patch on withdrawal and craving during abstinence using real-time assessment with electronic diaries during ad libitum smoking, a brief period of experimentally directed trial abstinence, and the first 3 days of cessation. Subjects were 324 smokers randomized to high-dose nicotine patches or placebo. Treatment with active patches reduced withdrawal and craving during cessation and completely eliminated deprivation-related changes in affect or concentration. High-dose NRT reduces withdrawal symptoms and craving and can eliminate some symptoms entirely.
Publisher: Springer Science and Business Media LLC
Date: 11-11-2012
Publisher: American Medical Association (AMA)
Date: 06-07-2021
Publisher: Informa UK Limited
Date: 15-06-2015
Publisher: Oxford University Press (OUP)
Date: 11-04-2017
DOI: 10.1093/NTR/NTW222
Abstract: Smoking remains the single-most significant preventable cause of poor pregnancy outcomes, yet around 12% of Australian women smoke during pregnancy. Many women are motivated to quit when they find out they are pregnant, yet few are successful. While previous studies have examined the profile of the maternal smoker compared to her nonsmoking counterpart (Aim 1), little is known about what differentiates women who quit during pregnancy to those who do not (Aim 2). Here, we present results from a study investigating the characteristics of women who were able to quit during pregnancy. Data were drawn from the Tasmanian Population Health database of women who had received antenatal care between 2011 and 2013 (n = 14300). Data collected included age, relationship status and ethnicity of expectant mothers, antenatal details, mental health conditions, and drug use. Independent s les t tests were used to compare differences between women who had, and those who had not, quit during pregnancy. The 19.4% of women who self-reported as smoking in the first half (first 20 weeks) of their pregnancy were further grouped and analyzed comparing those who reported still smoking in the second half of their pregnancy (smokers: n = 2570, 92.4%) to those who quit (quitters: n = 211, 7.6%). Quitters (57.8%) were more likely to be in a relationship than their non-quitting counterparts (49.6%, p = .022) and were less likely to suffer from postnatal depression (2.4% vs. 6.0%, p = .029). No other differences between quitters and smokers were observed. Determining the profile of women who are able to quit during pregnancy may be important to improve the relatively poor cessation rates among maternal smokers and may assist in more effectively targeting at-risk women. Smoking cessation interventions have traditionally targeted socially disadvantaged women, for good reason: the majority of smoking pregnant women fall into this category. However, despite the significant attention and resources dedicated to antenatal smoking cessation interventions, most are ineffective with only 7.6% of the present s le quitting smoking during pregnancy. This paper may assist in developing more effective antenatal smoking cessation interventions by more clearly describing the profile of maternal smokers who successfully quit during pregnancy. Specifically, this paper highlights the need to acknowledge and address women's relationship status and mental health in order to promote smoking cessation in pregnancy.
Publisher: Oxford University Press (OUP)
Date: 18-09-2019
DOI: 10.1093/NTR/NTZ179
Abstract: To assess trends in daily smokers' social norms and opinions of smoking between 2002 and 2015 in Canada, the United States, the United Kingdom, and Australia. Data were from wave 1 (2002) to wave 9 (2013–2015) of the longitudinal International Tobacco Control Four Country Survey (Canada, the United States, the United Kingdom, Australia), involving 23 831 adult daily smokers. Generalized estimating equation logistic regression models, adjusted for demographics and survey design effects, assessed associations of wave and country with outcomes: (A) over half of five closest friends smoke, (B) agreeing that people important to you believe you should not smoke, (C) agreeing that society disapproves of smoking, and (D) negative opinion of smoking. Between 2002 and 2015, adjusting for covariates, (A) over half of five closest friends smoke did not change (56% vs. 55% adjusted odds ratio [AOR] = 0.95 [95% Confidence Interval = 0.85–1.07]), (B) agreeing that people important to you believe you should not smoke generally decreased (89% vs. 82% AOR = 0.54 [0.46–0.64]) despite an increase around 2006–2007, (C) agreeing that society disapproves of smoking increased between 2002 and 2006–2007 (83% vs. 87% AOR = 1.38 [1.24–1.54]) then decreased until 2013–2015 (78% AOR = 0.74 [0.63–0.88]), and (D) negative opinion of smoking decreased between 2002 and 2010–2011 (54% vs. 49% AOR = 0.83 [0.75–0.91]) despite an increase around 2005–2006 and at the final wave (2013–2015). Except friend smoking, Canada had the greatest, and the United Kingdom the lowest, antismoking social norms and opinions. Except friend smoking and opinion of smoking, daily smokers' social norms became less antismoking between 2002 and 2015 despite increases around 2006–2007. Several potential explanations are discussed yet remain undetermined. Increasingly comprehensive tobacco control policies alongside decreasing smoking prevalence in Canada, the United States, the United Kingdom, and Australia have led to the assumption that smoking has become denormalized in these countries. Absent from the literature is any formal assessment of social norms towards smoking over time. Contrary to our hypotheses, this study found that the injunctive social norms of daily smokers became less antismoking between 2002 and 2015, despite increases around 2006–2007. There was no change over time in the proportion of daily smokers who report that over half of their five closest friends smoke.
Publisher: American Psychological Association (APA)
Date: 03-2016
DOI: 10.1037/ADB0000146
Abstract: The purpose of this study is to examine the immediate, everyday impact of health warnings on cigarette packages on potential smoking cessation mediators and to test for differences in immediate reactions to branded and plain tobacco packaging during the transition phase when plain packs where first introduced in Australia. Two Ecological Momentary Assessment studies tested whether smokers report higher risk appraisals, self-efficacy, and quitting intentions immediately after seeing a warning compared to random times of the day (Study 1), and whether smoking from plain packs results in higher quitting intention, risk appraisal, and self-efficacy than smoking from branded packs (Study 2). There was no immediate increase in self-efficacy, risk appraisal, or intention after encountering health warnings, and no differences in cognitions when using plain compared with branded packs. Moreover, cognitions were not different when warnings were encountered in proximity to smoking compared to nonsmoking events. However, self-efficacy and risk appraisal were significantly associated with quitting intention. Current health warnings do not seem to have an immediate impact on important predictors of quitting intention and might benefit from including messages that place a stronger focus on increasing smokers' confidence that they can quit. Replication of the results with larger s le and cluster sizes is warranted.
Publisher: Springer Science and Business Media LLC
Date: 12-05-2020
Publisher: American Psychological Association (APA)
Date: 03-2016
DOI: 10.1037/ADB0000149
Publisher: Hindawi Limited
Date: 06-2012
DOI: 10.1017/JSC.2012.11
Abstract: The majority of smokers indicate that they would like to quit. It has been estimated that approximately three quarters of Australian smokers have tried to change their behaviour in the last 12 months (Scollo & Winstanley, 2008) similarly, more than half of US smokers report having tried to quit in the last year (Centers for Disease Control and Prevention [CDC], 2011). Despite their interest in quitting, the proportion of smokers who successfully quit each year is very low (CDC, 2011). While other factors are also important, poor cessation rates can partly be attributed to the low uptake of efficacious smoking cessation methods, particularly pharmacotherapies (Shiffman, Brockwell, Pillitteri, & Gitchell, 2008).
Publisher: Oxford University Press (OUP)
Date: 13-12-2017
Publisher: Wiley
Date: 13-03-2008
DOI: 10.1111/J.1360-0443.2008.02138.X
Abstract: To evaluate the incremental efficacy of starting nicotine patch treatment prior to quitting compared to the current regimen of starting patch treatment on the target quit day. Meta-analysis of four eligible studies using pre-cessation patch treatment, located by database search and contacts with cessation researchers. The studies all compared starting treatment with nicotine patch prior to the target quit date to starting active treatment at the quit date, some in the context of concurrent mecamylamine treatment. The primary end-point for the analysis was continuous abstinence for at least 28 days assessed at 6 weeks following quit day 6-month outcomes were also examined. Compared to starting active patch treatment on quit day, pre-cessation treatment with nicotine patches was found to double the odds of quitting. This was true both at 6 weeks [pooled odds ratio (OR) = 1.96, 95% confidence interval (CI): 1.31-2.93] and 6 months (pooled OR = 2.17, 95% CI: 1.46-3.22) treatment outcomes. Mecamylamine co-treatment did not modify these effects. Across the four studies analyzed, pre-cessation patch treatment was found to produce a robust increase in quit rates compared to current regimens starting patch at quit day. Pre-cessation patch use represents a promising innovation in smoking cessation therapy with potential beneficial implications for improved public health by further increasing quitting success.
Publisher: Elsevier BV
Date: 09-2009
DOI: 10.1016/J.CLINTHERA.2009.08.029
Abstract: Smoking cessation outcomes are calculated as the probability of abstinence at follow-up among all enrolled smokers, but it is also useful to estimate the probability of success for those who experienced success or failure at earlier time points. The primary aims were to estimate the probability of maintaining abstinence through week 10 among subjects who were abstinent at week 2, and to assess the effect of active treatment with a nicotine patch. We also examined outcomes at week 6 and, among subjects who smoked during the first 2 weeks of treatment, the probability of reestablishing abstinence later, as well as the effect of active treatment on this outcome. We analyzed pooled data from 2 previously published, parallel, double-blind studies in which subjects were initially randomized to receive an active nicotine patch (starting at 21 mg) or a placebo patch. Subjects randomized to active treatment followed a double-blind step-down dosing regimen: 24-h/21-mg patches for the first 6 weeks of treatment, followed by 14- and 7-mg patches for successive 2-week periods. Biochemically verified abstinence (exhaled carbon monoxide <or=8 ppm) was assessed during laboratory visits. Most subjects were white (94.8%) and female (61.6%), with a mean (SD) age of 43.1 (10.2) years. Subjects had been smoking for a mean of 24.5 (10.2) years and smoked a mean of 30.6 (10.4) cigarettes per day. In both the nicotine (n = 249) and placebo (n = 253) groups, all subjects who were abstinent during the first 2 weeks had a high probability of maintaining abstinence through week 10, but subjects treated with the active patch were significantly more likely to remain abstinent (active: 79.8% [67/84], placebo: 52.6% [20/38] relative risk [RR] = 1.52 [95% CI, 1.10-2.09]). Also, at week 6, subjects receiving active treatment had a greater chance of remaining abstinent (active: 94.3% [82/87], placebo: 78.0% [32/41] RR = 1.21 [95% CI, 1.02-1.43]). To assess the effect of treatment on recovery from smoking lapses, we examined the probability of abstinence during week 10 among subjects who smoked during the first 2 weeks of treatment. Among them, treatment was associated with a greater probability of later success: 31.4% (50/159) of those treated with the active patch and 12.5% (26/208) of those receiving placebo were abstinent at week 10 (RR = 2.52 [95% CI, 1.64-3.85]). Similar results were observed at week 6 (49.4% [80/162] vs 21.2% [45/212] RR = 2.33 [95% CI, 1.72-3.15]). More than two thirds (71.3%) of subjects who were abstinent 2 weeks into a quit attempt maintained that abstinence through the end of 10 weeks of treatment. Use of a nicotine patch was significantly associated with maintaining abstinence and with recovering abstinence after an early lapse.
Publisher: Elsevier BV
Date: 06-2009
Publisher: Springer Science and Business Media LLC
Date: 10-01-2014
DOI: 10.1007/S00213-013-3430-0
Abstract: Patches are traditionally started on the day a quit attempt begins. Recently, a number of studies have established that the patch's effectiveness is improved by starting the treatment before quitting [pre-quit patch (PQP) use]. In an exploratory study, we investigate a proposed mechanism through which PQP use might promote abstinence: that PQP reduces satisfaction with smoking (either directly or via craving), which in turn leads to reduction and that smoking reduction promotes abstinence. Fifty-seven interested quitters used handheld computers to monitor their smoking satisfaction, withdrawal and smoking in real time for 17 days, leading up to a quit attempt. All participants received 21 mg/24 h patches for 2 weeks before and for up to 10 weeks after quitting. Carbon dioxide (CO)-verified 28-day abstinence was assessed. During PQP treatment, participants reported significant reductions in both the satisfaction gained from smoking (p < 0.001) and their daily cigarette consumption (p < 0.001). Craving did not decrease however, there was an interaction between time and nicotine dependence craving decreased only among low dependent participants. Multilevel structural equation modelling revealed a direct effect of satisfaction on smoking rate. Craving did not mediate this relationship. Smoking reduction during the PQP treatment phase was not significantly associated with abstinence. The real-time data collection protocol utilised allowed for a fine-grained examination of smoking during PQP treatment. The results suggest that the reduction in daily cigarette smoking typically observed during PQP treatment is due to reductions in satisfaction with smoking. Unlike previous studies, however, smoking reduction was not significantly related to later abstinence, even though the odds ratio was comparably. Potential clinical implications of these findings are discussed.
Publisher: Hindawi Limited
Date: 12-2010
DOI: 10.1375/JSC.5.2.115
Abstract: The hypotheses that smokers hold misconceptions around nicotine replacement therapy (NRT) safety, and that these concerns limit the use of NRT, was tested with two large face-to-face surveys of current smokers in Great Britain in 2004 ( N = 605) and 2006 ( N = 1,434). In both studies, participants were questioned regarding the safety of nicotine and NRT products, their past experience with NRT and anticipated future use. Across both surveys, approximately two thirds of smokers believed that, or were unsure whether, NRT was as harmful as cigarette smoking. Combining information across surveys, smokers with safety misconceptions reported being less likely to want to quit in the future (63% vs. 73% p .001), and, among those who were interested in quitting, were less likely to report an intention to use NRT during their next quit attempt. The majority of smokers were misinformed about the safety of NRT products, and smokers with safety misconceptions were less likely to report that they plan to use NRT during future quit attempts, suggesting that safety concerns are a barrier to NRT utilisation.
Publisher: Informa UK Limited
Date: 27-04-2016
Publisher: Wiley
Date: 04-06-2014
DOI: 10.1111/DAR.12164
Abstract: Antecedents of smoking have been widely researched in studies with older adults. However, less is known about the smoking patterns and antecedents of smoking in young adult smokers. In this study, we used ecological momentary assessment collected with an Internet-based survey instrument and used the participants' own mobile phones to contrast the smoking patterns of young adult light and intermittent smokers (n = 23) with heavy smokers (n = 18). Overall, 1543 smoking and non-smoking situations were analysed. By means of generalised estimating equations, we used a range of situational characteristics to predict smoking in both groups. Craving and smoking of others increased the odds of smoking, and smoking bans were associated with a decreased probability of smoking among both light and intermittent smokers and heavy smokers. Situational antecedents differed between both groups. Cue-associated smoking played a bigger role for light and intermittent smokers than for heavy smokers. Situational antecedents, such as craving, being at the home of others, drinking alcohol and smoking by others, were more strongly associated with the smoking of light and intermittent smokers compared with heavy smokers. Smoking among young adults is associated with both internal and external situational characteristics. Compared with heavy smokers, light and intermittent smoking seems to be under more stimulus control and more characterised by social smoking. These results are consistent with several findings from previous studies and provide further information on different subgroups of smokers in early adulthood.
Publisher: E.U. European Publishing
Date: 21-09-2018
DOI: 10.18332/TID/94460
Publisher: JMIR Publications Inc.
Date: 12-2016
DOI: 10.2196/GAMES.6258
Publisher: Informa UK Limited
Date: 29-09-2018
Publisher: American Psychological Association (APA)
Date: 2010
DOI: 10.1037/A0019367
Abstract: Nicotine patch improves treatment outcomes, but lapses are still common. To understand the process of relapse on patch, we investigated differences in the antecedents (withdrawal, setting, triggers) of lapse episodes experienced on high-dose (35 mg) nicotine patches versus placebo. Participants were smokers who lapsed during a randomized, double-blind trial of active patches (n = 100) versus placebo (n = 85). Participants used electronic diaries to monitor their smoking, affect, and activities in real time for 5 weeks during their cessation attempt. We analyzed 490 lapse episodes (active: 266 placebo: 224). Lapses on nicotine patch were characterized by significantly lower positive affect and higher negative affect than placebo lapses. Participants treated with high-dose patch were also significantly more likely to lapse in situations involving little or no craving. Situational antecedents of lapses on patch resembled those on placebo. The results suggest that treatment with patch may set a higher threshold for affective stimuli to provoke lapses, but does not change the proximal cues that trigger lapses. This suggests that behavioral relapse-prevention strategies developed for unmedicated smokers should also apply to those treated with nicotine patch.
Publisher: Cambridge University Press
Date: 02-04-2020
Publisher: Elsevier BV
Date: 07-2011
DOI: 10.1016/J.ADDBEH.2011.02.002
Abstract: Previous studies have reported that smokers who are misinformed about the safety of Nicotine Replacement Therapy (NRT) are less likely to report using it. In this study, we examined whether providing information that counters these concerns might impact on intentions to use NRT. 900 smokers recruited from a market research database. Participants completed an online survey that asked about their views about NRT. Smokers with safety and efficacy concerns were queried to determine whether accurate information might increase their interest in using NRT. Misperceptions of NRT safety were common: 93% of smokers did not know that smoking while wearing the nicotine patch does not cause heart attacks 76% that nicotine gum/lozenge are not as addictive as cigarettes and 69% that NRT products are not as dangerous as cigarettes. Over half of the smokers with misperceptions reported that they would be more likely to use NRT to help them quit smoking if they were exposed to information correcting their concerns (53%, 58% and 66%, respectively, for each of the misperceptions). These data suggest that while a sizeable proportion of smokers are still misinformed about the safety of NRT, misinformed smokers would increase consideration of NRT if these misperceptions are addressed by corrective information.
Publisher: Wiley
Date: 02-06-2016
DOI: 10.1111/ADD.13421
Abstract: This study aimed to validate the presence of a khat use disorder syndrome using DSM-5 criteria and to examine its relationship with increased experience of harms. Cross-sectional, purposive s le of current khat-chewers, recruited from khat markets and cafes. Participants were recruited from the general community and from Adama Science and Technology University in Ethiopia. A total of 400 current khat consumers aged 16 and above were recruited between September 2014 and January 2015 MEASURES: Survey comprising current clinical symptoms (using a modified Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV), and validated measures of health, psychological distress, quality of life and academic functioning. A third [35.5% 95% confidence interval (CI) = 31.0-40.3] of respondents reported daily khat use and a quarter (25.4% 95% CI = 21.4-30.0) using three times or more per week. Using DSM-5 criteria, 10.5% (95% CI = 7.9-13.9) were categorized as experiencing mild, 8.8% (95% CI = 6.4-12.0) moderate and 54.5% (95% CI = 49.6-59.3) severe khat use disorder. Confirmatory factor analysis demonstrated a good fit of symptoms to a single underlying construct, consistent with other substance use disorders. In iduals categorized as experiencing khat use disorder demonstrated significantly greater frequency [odds ratio (OR) = 45.29 95% CI = 10.97-19.01) and quantity of khat use (OR = 2.35 95% CI = 1.29-4.29). They also demonstrated increased financial problems associated with use, greater problems with academic functioning and higher rates of self-reported mental health problems, higher psychological distress and poorer quality of life. Treatment access was poor, with only one-third (32.9%) of in iduals with khat use disorder reporting life-time access, near-exclusively related to help-seeking from friends and relatives. The construct of a substance use disorder syndrome for khat using DSM-5 criteria appears valid and performs in a manner consistent with other substances of dependence. In iduals with khat use disorder experience substantial problems in association with khat use. Despite this, there are low levels of help-seeking for these problems.
Publisher: Oxford University Press (OUP)
Date: 22-04-2012
DOI: 10.1093/NTR/NTS097
Publisher: American Psychological Association (APA)
Date: 02-2018
DOI: 10.1037/HEA0000568
Abstract: Social factors are among the most powerful and pervasive influences on eating behavior, snacking in particular. Previous research has shown that being in the presence of people who are eating significantly increases the likelihood of eating and affects the types as well as the amount of food consumed. Much less is known about the processes underlying social influence, but previous research has suggested social norms as mediators. In this study, we extended this perspective to everyday settings and examined whether the presence of other people eating leads to a change in perceived momentary norms, and whether this change predicts snack consumption in real life. We applied ecological momentary assessment to study 61 in iduals in the normal-obese weight range (M BMI = 24.97 kg/m² SD = 4.07) over a 14-day monitoring period. We used a combination of event-based snacking reports and randomly timed assessments. The presence of others eating and momentary perceptions of injunctive norms (facets of perceived appropriateness and encouragement) were measured for both assessment types. Mediated, multilevel logistic regression showed that social cues predict snacking (OR = 3.06), and that momentary perceptions of appropriateness (a*b = 0.14) and encouragement (a*b = 0.18) partially mediated these effects. Perceptions of momentary norms mediated the effects of social influence on everyday snacking, which highlights the importance of the social environment for understanding eating behavior. (PsycINFO Database Record
Publisher: Elsevier BV
Date: 10-2015
Publisher: ACM Press
Date: 2016
Publisher: Springer Science and Business Media LLC
Date: 18-01-2015
Publisher: Wiley
Date: 04-01-2021
DOI: 10.1111/BJHP.12505
Abstract: ‘Comfort eating’ has been used to explain real‐world food choices, suggesting that in iduals are drawn to energy‐dense (‘unhealthy’) snacks when experiencing negative affect. However, this concept has rarely been studied, particularly in real‐world settings. Similarly, the effects of snacking on subsequent affect are also poorly understood. The present study aimed to examine the association between affect and snacking in daily life. One hundred and forty‐one adults recorded their food intake in real time for ~14 days using a study issued mobile phone. Participants also responded to randomly timed assessments. During both types of assessments, participants indicated their current level of affect. By anchoring off snacking events, the trajectory of affect in the hours leading up to – and following – snacking was explored. In the three hours leading up to a healthy snack, affect was stable. In contrast, affect fell during the hours leading up to an unhealthy snack. The interaction between snack type and time was significant. A similar, but opposite, pattern was seen following snacking: where affect decreased after unhealthy snacking, affect increased following healthy snack intake. The findings are consistent with the hypothesis of comfort eating, with unhealthy snacking being preceded by worsening affect. Unhealthy snacking did not, however, lead to affect improvements afterwards, which questions the ‘effectiveness’ of comfort eating. The intake of healthy snacks however was associated with positive affective experiences. These findings could function as a component of interventions aiming at improving dietary behaviours.
Publisher: Oxford University Press (OUP)
Date: 23-02-2021
DOI: 10.1093/NTR/NTAB031
Abstract: Studies demonstrate that financial incentive programs increase smoking cessation. However, there is little guidance on which incentive magnitudes will ensure optimal enrollment and motivation levels. This study investigates current smokers’ perceptions of varying incentive magnitudes to identify whether there is evidence for optimal amount(s) and whether perceptions differ by income group. Studies 1 (N = 56) and 2 (N = 147) were conducted online via Prolific.co. Current smokers were randomly shown multiple hypothetical incentive programs that differed only in the incentive amount offered. For each program, smokers rated its appeal and their likelihood of enrolling and predicted their motivation to quit if enrolled. Growth models were used to investigate the relationship between perspectives and the incentive amount. An increasing quadratic trend in smokers’ perceptions of programs as the incentive amount increased was identified. Incentive amounts beyond approximately £50–75 per week (£500–£750 total) did not significantly alter perceptions of programs. In Study 2, high-income smokers found programs significantly less appealing and motivating than low-income smokers, although no significant between-group differences were observed in the likelihood of enrollment. No significant differences were observed between low- and middle-income smokers. Increasing the incentive amount increased smoker’s perceptions of programs. This relationship was curvilinear, meaning there may be a point beyond which further increasing the amount will not improve enrollment or motivation levels. Incentives appear equally appealing to low- and middle-income smokers the population among whom smoking is most prevalent. Future research could explore other elements of program design and whether findings hold under real-world conditions. While acknowledging that they work, policymakers frequently request information about the monetary amount needed for incentive programs to be effective, and if this differs by income level. We investigated these questions using smokers’ perceptions of hypothetical cessation programs that differed in the amount offered. An increasing quadratic trend in perceptions of programs by the amount and potential cut points was observed, suggesting a point may exist beyond which increasing the incentive will not improve perceptions of programs or enrollment levels. High-income smokers may not perceive incentives to be as appealing as other income groups, but appear equally willing to enroll.
Publisher: National Institute for Health and Care Research
Date: 12-2020
DOI: 10.3310/HTA24680
Abstract: Relapse remains an unresolved issue in smoking cessation. Extended stop smoking medication use can help, but uptake is low and several behavioural relapse prevention interventions have been found to be ineffective. However, opportunistic ‘emergency’ use of fast-acting nicotine replacement treatment or electronic cigarettes may be more attractive and effective, and an online behavioural Structured Planning and Prompting Protocol has shown promise. The present trial aimed to evaluate the clinical effectiveness and cost-effectiveness of these two interventions. A randomised controlled trial. English stop smoking services and Australian quitlines, Australian social media and St Vincent’s Hospital Melbourne, Fitzroy, VIC. Ex-smokers abstinent for at least 4 weeks, with some participants in Australia also recruited from 1 week post quit date. The planned s le size was 1400, but the trial was curtailed when 235 participants were recruited. Participants were randomised in permuted blocks of random sizes to (1) oral nicotine replacement treatment/electronic cigarettes to use if at risk of relapse, plus static text messages ( n = 60), (2) the Structured Planning and Prompting Protocol and interactive text messages ( n = 57), (3) oral nicotine replacement treatment/electronic cigarettes plus the Structured Planning and Prompting Protocol with interactive text messages ( n = 58) or (4) usual care plus static text messages ( n = 59). Owing to delays in study set-up and recruitment issues, the study was curtailed and the primary outcome was revised. The original objective was to determine whether or not the two interventions, together or separately, reduced relapse rates at 12 months compared with usual care. The revised primary objective was to determine whether or not number of interventions received (i.e. none, one or two) affects relapse rate at 6 months (not biochemically validated because of study curtailment). Relapse was defined as smoking on at least 7 consecutive days, or any smoking in the last month at final follow-up for both the original and curtailed outcomes. Participants with missing outcome data were included as smokers. Secondary outcomes included sustained abstinence (i.e. no more than five cigarettes smoked over the 6 months), nicotine product preferences (e.g. electronic cigarettes or nicotine replacement treatment) and Structured Planning and Prompting Protocol coping strategies used. Two substudies assessed reactions to interventions quantitatively and qualitatively. The trial statistician remained blinded until analysis was complete. The 6-month relapse rates were 60.0%, 43.5% and 49.2% in the usual-care arm, one-intervention arm and the two-intervention arm, respectively ( p = 0.11). Sustained abstinence rates were 41.7%, 54.8% and 50.9%, respectively ( p = 0.17). Electronic cigarettes were chosen more frequently than nicotine replacement treatment in Australia (71.1% vs. 29.0% p = 0.001), but not in England (54.0% vs. 46.0% p = 0.57). Of participants allocated to nicotine products, 23.1% were using them daily at 6 months. The online intervention received positive ratings from 63% of participants at 6 months, but the majority of participants (72%) completed one assessment only. Coping strategies taught in the Structured Planning and Prompting Protocol were used with similar frequency in all study arms, suggesting that these are strategies people had already acquired. Only one participant used the interactive texting, and interactive and static messages received virtually identical ratings. The inability to recruit sufficient participants resulted in a lack of power to detect clinically relevant differences. Self-reported abstinence was not biochemically validated in the curtailed trial, and the ecological momentary assessment substudy was perceived by some as an intervention. Recruiting recent ex-smokers into an interventional study proved problematic. Both interventions were well received and safe. Combining the interventions did not surpass the effects of each intervention alone. There was a trend in favour of single interventions reducing relapse, but it did not reach significance and there are reasons to interpret the trend with caution. Further studies of both interventions are warranted, using simpler study designs. Current Controlled Trials ISRCTN11111428. 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. 24, No. 68. See the NIHR Journals Library website for further project information. Funding was also provided by the National Health and Medical Research Council, Canberra, ACT, Australia (NHMRC APP1095880). Public Health England provided the funds to purchase the nicotine products in England.
Publisher: Elsevier BV
Date: 04-2009
DOI: 10.1016/J.JSAT.2008.06.005
Abstract: Craving to smoke is often conceptualized and measured as a tonic, slowly changing state induced by abstinence. In this article, we review the literature on the existence, causes, and treatment of cue-induced cravings: intense, episodic cravings typically provoked by situational cues associated with drug use. In laboratory research, smokers exposed to smoking-related cues demonstrate increased craving as well as distinct patterns of brain activation. Observational field studies indicate that such cue-induced cravings are substantially responsible for relapse to smoking but that smoking can often be averted by coping responses. The effects of pharmacological interventions are mixed. Steady-state medications (bupropion, varenicline, nicotine patch) do not appear to protect smokers from cue-induced cravings. However, acutely administered nicotine medications (such as nicotine gum and lozenge), used after cue exposure as "rescue medications," can help a smoker's recovery from cue-induced cravings. Cue-induced craving plays an important role in smoking and relapse and likely in other addictions as well. Treatments to mitigate the effect of cue-induced craving are both important and needed.
Publisher: Oxford University Press (OUP)
Date: 04-10-2023
DOI: 10.1093/NTR/NTAC229
Abstract: Smokers can respond defensively to health risk communication such as on-pack warning labels, potentially reducing their effectiveness. Theory suggests that risk perception together with self-efficacy reduces defensive responses and predicts target behaviors. Currently, tobacco warning labels globally predominantly target risk and do not explicitly consider efficacy. This study explores the effectiveness of combining Australian tobacco warning labels with efficacy content to increase quitting intentions. RCT in 83 smokers over 3 weeks. After a seven-day baseline phase (smoking from usual tobacco packaging), participants were randomized to one of two adhesive labels groups for the remaining 14 days: Standard health warning labels (HWLs) featuring enhanced efficacy messages (experimental group) or unmodified standard HWLs (control group). Participants attached these labels to their tobacco packaging and recorded their cognitions and smoking behavior once daily using Smartphones. Multilevel structural equation modeling was used to test theorized effects of the labels on self-efficacy, risk perception, and intentions to quit. There was no effect of exposure to efficacy messages on either self-efficacy, risk perceptions, or intentions to quit. However, self-efficacy and risk perceptions were positively associated with quitting intentions at the within-person level. The predictive relationships between self-efficacy, risk perception, and intention to quit were supported, however, supplementing standard warning labels with efficacy messages had no effect on these cognitions. Whether this is due to conditioned avoidance of HWLS, characteristics of the messages, or limitations imposed by format are unclear. Self-efficacy and risk perception predict intentions to quit smoking. Adding efficacy content to tobacco health warnings may have the potential to bolster these cognitions but more research is required to determine the contexts in which this would be effective and who would be likely to benefit. The time course by which exposure to efficacy content might influence cessation self-efficacy and downstream quitting intentions also needs to be investigated.
Publisher: Elsevier BV
Date: 11-2020
Publisher: Oxford University Press (OUP)
Date: 14-07-2023
DOI: 10.1093/HER/CYAD030
Abstract: While many countries require prominent pictorial health warning labels (PHWLs) on the outside of cigarette packs to communicate the harms of smoking, there is evidence that cigarette pack inserts that contain efficacy messages may enhance the effectiveness of PHWLs. The US Food and Drug Administration (FDA) has regulatory authority to communicate with smokers through inserts. While current labeling regulations do not require inclusion of inserts, the FDA could implement them in the future. This study assesses US smokers’ perceptions of cigarette package inserts at the conclusion of a two-week randomized trial on cigarette labeling where half of participants were exposed to insert messages (two response-efficacy messages and two self-efficacy messages) in their packs. Participants (n = 359) completed a 30- to 60-min interview with both quantitative and qualitative assessments, including measures of recall and perceived message effectiveness (PME) for specific inserts. Correlates of recall and PME were estimated using mixed-effects regression models. Qualitative responses to PME items were analyzed using thematic analysis. Response-efficacy messages had higher PME and recall than self-efficacy messages. People had erse responses to the inserts, including that they were positive, thought-provoking, and helpful. Reactions to and perceptions of the inserts indicate potential benefits of integrating efficacy messages into labeling policies.
Publisher: Informa Healthcare
Date: 25-08-2008
DOI: 10.1185/03007990802380341
Abstract: The objective of this analysis was to assess the efficacy of a 21 mg/24-h nicotine patch for the reduction of craving throughout the waking day, compared both to placebo, and to a 15 mg/16-h patch differing pharmacokinetic profile over the day. The primary end-point was craving during the evening hours, because previous research suggested that smoking relapse was particularly likely at that time. Data were drawn from two similar randomized clinical trials among nicotine-dependent smokers who were quitting smoking: Study 1 compared the 21 mg/24-h patch to a placebo patch, while Study 2 compared the 21 mg/24-h patch to a 15 mg/16-h nicotine patch. In both studies, subjects (Study 1: n = 102 Study 2: n = 244) were prompted by an electronic diary to rate their craving multiple times per day during a 1 week baseline period, and for up to 2 weeks after quitting. For analysis, the day was ided into five blocks: morning (up to 10:59 a.m.), mid-day (11:00 a.m.-1:59 p.m.), afternoon (2:00 p.m.-4:59 p.m.), evening (5:00 p.m.-8:59 p.m.), and late night (9:00 p.m. onwards). The in idual craving ratings were ided into three intervals based on time since quitting: Days 1-3, 4-7, and 8-14. The 21 mg/24-h nicotine patch resulted in significantly lower craving during all post-quit intervals, at each time of day, both compared to placebo (Study 1), and compared to the 15 mg/16-h nicotine patch (Study 2). Study 2 saw a significant treatment by interval interaction: in later time intervals, the difference in craving experience between 24- and 16-h patch conditions shrunk--while remaining significantly different--as overall levels of craving experienced by subjects in the two groups dropped. Adverse events reported in both studies tended to be mild and transient, consistent with the well characterized adverse event profile of nicotine patches. Study 1 demonstrated that a 21 mg/24-h patch was effective in reducing craving throughout the day, including the evening period when relapse risk is heightened. A further study comparing the 21 mg/24-h patch to a 15 mg/16-h nicotine patch found that craving was significantly lower at all times of day for smokers using the 21 mg/24-h patch. The studies were limited in that craving was only monitored for the first 2 weeks of quitting (when craving is most prominent), and cannot elucidate the impact of patch use on craving outside of this time. Also, there was substantial attrition of the s le over time, partly due to relapse in all conditions.
Publisher: Wiley
Date: 14-05-2020
DOI: 10.1111/ADD.15083
Publisher: Springer Science and Business Media LLC
Date: 19-02-2018
DOI: 10.1038/S41588-018-0056-5
Abstract: Stature is affected by many polymorphisms of small effect in humans
Publisher: Elsevier
Date: 2013
Publisher: Wiley
Date: 04-06-2013
DOI: 10.1111/ADD.12241
Abstract: To assess the incidence of long-term smoking cessation as a function of age, gender, social grade and their interactions. Cross-sectional surveys of population representative s les of smokers in England. A total of 24 094 ever smokers (≥21 and ≤60 years of age) participating in household surveys between November 2006 and February 2011. The ratio of long-term (>1 year) ex-smokers to ever-smokers was calculated for each age. Regression analyses were used to model the association between age and quit ratio, with the change in quit ratio by year of age n years versus all years up to n-1 years, yielding an estimate of the quitting incidence at that age. Analyses were conducted for the entire s le and then for the s le stratified by gender and social grade, and interactions assessed between these variables. A cubic trend was needed to fit the data. The estimated quitting incidence between ages 21 and 30 was 1.5% (95% CI: 1.0%-2.0%), between 31 and 50 it was 0.3% (95% CI: 0.2%-0.5%) and between 51 and 60 it was 1.2% (95% CI: 0.7%-1.7%). Age interacted with gender and social grade: women and smokers from higher social grades had a higher incidence of quitting than men and those from lower social grades specifically in young adulthood. CONCLUSIONS : The incidence of smoking cessation in England appears to be greater in young and old adults compared with those in middle age. Women and higher social grade smokers show a greater incidence of quitting than men and those from lower social grades specifically in young adulthood.
Publisher: American Psychological Association (APA)
Date: 04-2017
DOI: 10.1037/HEA0000439
Abstract: In idual eating behavior is a risk factor for obesity and highly dependent on internal and external cues. Many studies also suggest that the food environment (i.e., food outlets) influences eating behavior. This study therefore examines the momentary food environment (at the time of eating) and the role of cues simultaneously in predicting everyday eating behavior in adults with overweight and obesity. Intensive longitudinal study using ecological momentary assessment (EMA) over 14 days in 51 adults with overweight and obesity (average body mass index = 30.77 SD = 4.85) with a total of 745 participant days of data. Multiple daily assessments of eating (meals, high- or low-energy snacks) and randomly timed assessments. Cues and the momentary food environment were assessed during both assessment types. Random effects multinomial logistic regression shows that both internal (affect) and external (food availability, social situation, observing others eat) cues were associated with increased likelihood of eating. The momentary food environment predicted meals and snacking on top of cues, with a higher likelihood of high-energy snacks when fast food restaurants were close by (odds ratio [OR] = 1.89, 95% confidence interval [CI] = 1.22, 2.93) and a higher likelihood of low-energy snacks in proximity to supermarkets (OR = 2.29, 95% CI = 1.38, 3.82). Real-time eating behavior, both in terms of main meals and snacks, is associated with internal and external cues in adults with overweight and obesity. In addition, perceptions of the momentary food environment influence eating choices, emphasizing the importance of an integrated perspective on eating behavior and obesity prevention. (PsycINFO Database Record
Publisher: Wiley
Date: 03-02-2019
DOI: 10.1111/ADD.14541
Abstract: Smoking cessation medications are effective, but often underutilized because of costs and side effects. Cytisine is a plant-based smoking cessation medication with more than 50 years of use in central and eastern Europe. While cytisine has been found to be well-tolerated and more effective than nicotine replacement therapy, direct comparisons with varenicline have not been conducted. This study evaluates the effectiveness, safety and cost-effectiveness of cytisine compared with varenicline. Two-arm, parallel group, randomized, non-inferiority trial, with allocation concealment and blinded outcome assessment. Australian population-based study. Adult daily smokers (n = 1266) interested in quitting will be recruited through advertisements and Quitline telephone-based cessation support services. Eligible participants will be randomized (1 : 1 ratio) to receive either cytisine capsules (25-day supply) or varenicline tablets (12-week supply), prescribed in accordance with the manufacturer's recommended dosing regimen. The medication will be mailed to each participant's nominated residential address. All participants will also be offered standard Quitline behavioural support (up to six 10-12-minute sessions). Assessments will be undertaken by telephone at baseline, 4 and 7 months post-randomization. Participants will also be contacted twice (2 and 4 weeks post-randomization) to ascertain adverse events, treatment adherence and smoking status. The primary outcome will be self-reported 6-month continuous abstinence from smoking, verified by carbon monoxide at 7-month follow-up. We will also evaluate the relative safety and cost-effectiveness of cytisine compared with varenicline. Secondary outcomes will include self-reported continuous and 7-day point prevalence abstinence and cigarette consumption at each follow-up interview. If cytisine is as effective as varenicline, its lower cost and natural plant-based composition may make it an acceptable and affordable smoking cessation medication that could save millions of lives world-wide.
Publisher: Informa UK Limited
Date: 06-11-2014
Publisher: Elsevier BV
Date: 04-2015
DOI: 10.1016/J.APPET.2015.01.002
Abstract: Dietary behaviours are substantially influenced by environmental and internal stimuli, such as mood, social situation, and food availability. However, little is known about the role of stimulus control for eating in non-clinical populations, and no studies so far have looked at eating and drinking behaviour simultaneously. 53 in iduals from the general population took part in an intensive longitudinal study with repeated, real-time assessments of eating and drinking using Ecological Momentary Assessment. Eating was assessed as main meals and snacks, drinks assessments were separated along alcoholic and non-alcoholic drinks. Situational and internal stimuli were assessed during both eating and drinking events, and during randomly selected non-eating occasions. Hierarchical multinomial logistic random effects models were used to analyse data, comparing dietary events to non-eating occasions. Several situational and affective antecedents of dietary behaviours could be identified. Meals were significantly associated with having food available and observing others eat. Snacking was associated with negative affect, having food available, and observing others eat. Engaging in activities and being with others decreased the likelihood of eating behaviours. Non-alcoholic drinks were associated with observing others eat, and less activities and company. Alcoholic drinks were associated with less negative affect and arousal, and with observing others eat. RESULTS support the role of stimulus control in dietary behaviours, with support for both internal and external, in particular availability and social stimuli. The findings for negative affect support the idea of comfort eating, and results point to the formation of eating habits via cue-behaviour associations.
Publisher: JMIR Publications Inc.
Date: 21-08-2020
Abstract: umerous mobile health (mHealth) apps have been developed to support smokers attempting to quit smoking. Although these apps have been reported to be successful, only modest improvements in the quit rate have been measured. It has been proposed that efforts to improve user engagement and retention may improve the quit rate further. Owing to the high cost of smoking-related disease, it is considered worthwhile to pursue even small improvements. he aim of this study was to test a novel smartphone app that leverages premium currency strategies developed by the mobile games industry in an attempt to improve engagement and retention with a smoking cessation intervention. e designed and developed a smoking cessation app called “Quittr” in line with previously developed smoking cessation mHealth apps. In addition to this established framework, we added a stand-alone fully featured city-building clicker-style game called “Tappy Town,” and a premium virtual currency called “QuitCoins.” The user earns QuitCoins for using the app in a way that contributes positively toward their quit attempt, and they can redeem these coins in Tappy Town for bonuses. To establish whether these features improved engagement and retention, we ran a 5-month randomized controlled trial where the intervention group had the full app with the extra games features, while the control group had the standard app only. Recruitment was performed via web-based advertising. Participants (N=175) had no direct contact with the researchers or other support staff. o significant differences in terms of engagement, retention, or smoking outcomes were found between the control and intervention groups. However, survey data indicated that the majority of the participants valued Tappy Town (10/17, 59%) and the QuitCoins rewards system (13/17, 77%). Usage data also suggested that Tappy Town was widely played and was generally appealing to users (mean total time spent in app, control group: 797 seconds vs intervention group: 3502 seconds, i P& /i .001). Analysis of the results suggests that users in the intervention group may have been negatively affected by the aspects of the chosen design, and some theories were explored to explain this unexpected outcome. lthough the novel features of the Quittr app failed to improve the key outcomes measured in this study, there were enough positive indications to warrant further exploration of the concept. Additional research will be required to identify and correct any design flaws that may have adversely affected our participants before a follow-up study can be completed. ustralian and New Zealand Clinical Trials Register ACTRN12617000491369 www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372661& isReview=true
Publisher: Elsevier BV
Date: 12-2019
Publisher: Elsevier BV
Date: 08-2018
Publisher: Elsevier
Date: 2017
Publisher: Frontiers Media SA
Date: 07-01-2021
DOI: 10.3389/FPSYG.2020.590497
Abstract: Many discretionary foods (“snacks”) contribute both to in idual health risks and to global issues, in particular through high carbon footprints and water scarcity. Snacking is influenced by the presence of snacking cues such as food availability, observing others eating, and negative affect. However, less is known about the mechanisms underlying the effects of negative affect. This study examines whether the in idual odds of consuming high-calorie snacks as a consequence to being exposed to known snacking cues were moderated by experiencing (i) higher or lower total negative affect per day or (ii) higher or lower negative affect variability per day. Secondary analysis of an ecological momentary assessment study of 60 participants over 14 days with food logs and randomly timed assessments of known snacking cues. High total daily negative affect levels (daily within-participant means) and negative affect variability (daily within-participant SDs) were examined as moderators to predict high-calorie snacking in three-level hierarchical random effects logistic regressions. Consistent with previous studies, the odds of snacking increased when food was available (OR = 5.05, 95% CI 3.32, 7.66), when others were eating (OR = 5.11, 95% CI = 3.73, 6.99), and when participants experienced more negative affect (OR = 1.02, 95% CI = 1.01, 1.03). Associations for food availability (OR = 0.92, 95% CI 0.86, 0.99) and others eating (OR = 0.95, 95% CI 0.91, 0.99) were significantly moderated by negative affect variability such that associations between cues and high-calorie snacking were weaker on days with higher negative affect variability, but not negative affect levels. The relationship between cues to high-calorie snacking and snacking behavior varies with variability in negative affect, suggesting a complex relationship between affect and high-calorie snacking. Clearer conceptualizations on the relation between affect and eating are needed.
Publisher: American Psychological Association (APA)
Date: 12-2015
DOI: 10.1037/ADB0000052
Publisher: Springer Science and Business Media LLC
Date: 22-01-2016
Publisher: American Psychological Association (APA)
Date: 05-2010
DOI: 10.1037/A0018812
Abstract: The present study examined whether dynamic day-to-day variations in self-efficacy predicted success in quit attempts among daily smoking adolescents. A s le of 149 adolescents recorded their smoking and self-efficacy three times per day during 1 week prior to and 3 weeks after a quit attempt. The first lapse, second lapse, and relapse after at least 24 hours of abstinence from smoking were the main outcome measures. Self-efficacy was relatively high and moderately variable prior to the first lapse, but decreased and became more variable thereafter. Lower self-efficacy as measured at the lapse assessment significantly increased the risk that a second lapse and relapse would occur. In idual differences in baseline self-efficacy did not predict any of the treatment outcomes. The time-varying analyses, however, showed that lower self-efficacy on a given day predicted the first lapse, the second lapse, and relapse on the succeeding day. Daily concomitant smoking (any smoking on the preceding day) was not significantly related to relapse. The present results emphasize the importance of self-efficacy among adolescents in cessation and highlight the need for dynamic formulations and assessments of adolescents' self-efficacy and relapse.
Publisher: Springer Science and Business Media LLC
Date: 11-2009
Publisher: Wiley
Date: 06-07-2019
DOI: 10.1111/ADD.14656
Publisher: Wiley
Date: 05-08-2011
Publisher: Informa UK Limited
Date: 06-2011
DOI: 10.2147/PROM.S11545
Publisher: JMIR Publications Inc.
Date: 21-08-2019
Abstract: t has been observed that eating is influenced by the presence and availability of food. Being aware of the presence of food in the environment may enable mobile health (mHealth) apps to use geofencing techniques to determine the most appropriate time to proactively deliver interventions. To date, however, studies on eating typically rely on self-reports of environmental contexts, which may not be accurate or feasible for issuing mHealth interventions. his study aimed to compare the subjective and geographic information system (GIS) assessments of the momentary food environment to explore the feasibility of using GIS data to predict eating behavior and inform geofenced interventions. n total, 72 participants recorded their food intake in real-time for 14 days using an ecological momentary assessment approach. Participants logged their food intake and responded to approximately 5 randomly timed assessments each day. During each assessment, the participants reported the number and type of food outlets nearby. Their electronic diaries simultaneously recorded their GPS coordinates. The GPS data were later overlaid with a GIS map of food outlets to produce an objective count of the number of food outlets within 50 m of the participant. orrelations between self-reported and GIS counts of food outlets within 50 m were only of a small size ( i r /i =0.17 i P /i & .001). Logistic regression analyses revealed that the GIS count significantly predicted eating similar to the self-reported counts (area under the curve for the receiver operating characteristic curve [AUC-ROC] self-report=0.53, SE 0.00 versus AUC-ROC 50 m GIS=0.53, SE 0.00 i P /i =.41). However, there was a significant difference between the GIS-derived and self-reported counts of food outlets and the self-reported type of food outlets (AUC-ROC self-reported outlet type=0.56, SE 0.01 i P /i & .001). he subjective food environment appears to predict eating better than objectively measured food environments via GIS. mHealth apps may need to consider the type of food outlets rather than the raw number of outlets in an in idual’s environment.
Start Date: 2011
End Date: 2013
Funder: National Health and Medical Research Council
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End Date: 2023
Funder: National Cancer Institute
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End Date: 2019
Funder: National Health and Medical Research Council
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End Date: 2019
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2011
End Date: 2014
Funder: Cancer Council Tasmania
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