Scientific basis for information related to smoking cessation
Cigarette Package Changes and Smoking Rates
The purpose of this research paper is to reduce the smoking rate by changing the cigarette package.
The studies
Fifty-one studies met the selection criteria and involved about 800,000 participants.
Few studies have assessed behavioral outcomes in youth and nonsmokers.
Five studies assessed the primary outcome. One observational study assessed smoking rates among 700,000 participants up to one year after standardized packaging in Australia. Four studies assessed consumption in 9,394 participants.
This included a series of Australian national cross-sectional surveys of 8811 current smokers, in addition to three smaller studies.
None of the studies assessed intake, cessation, or relapse prevention.
A study evaluating the impact of standardized cigarette packaging on smoking rates in Australia found a 3.7% reduction in odds or a 0.5% reduction in smoking rates when comparing before and after packaging changes when adjusted for confounders.
Conclusion.
The available evidence suggests that standardized packaging may reduce smoking rates. Since only one country had implemented standardized packaging at the time of this review, evidence is available from one large observational study that provides evidence of this effect. The reduction in smoking behavior is supported by data routinely collected by the Australian government. The data on the effect of standardized packaging on non-behavioral outcomes (e.g., complaints) is clearer and provides a plausible mechanism of effect consistent with the observed reduction in prevalence. As standardized packaging is implemented in different countries, research programs need to be initiated to understand the long-term effects on tobacco use, behavior, and intake. We did not find any evidence to suggest that standardized packaging may increase tobacco use.
McNeill A, Gravely S, Hitchman SC, Bauld L, Hammond D, Hartmann-Boyce J. Tobacco packaging design to reduce tobacco use.Cochrane Database of Systematic Reviews 2017, Issue4 . Art. No.: CD011244. doi: 10.1002 / 14651858.CD011244.pub2.
Change through community action
This study tried to create a social trend to quit smoking, but what are the results? That was the idea.
The study
Randomized and nonrandomized controlled trials that evaluated the effectiveness of multifactorial community interventions compared to no intervention or single-factor or school-based programs alone.
Reported results had to include smoking behavior among youth under the age of 25.
This method was used because the studies themselves were targeted at young people. Twenty-five studies were included in the review, and 68 studies did not meet all selection criteria. All studies used a controlled trial design, and 15 used random assignment of schools or communities. One study reported a reduction in short-term smoking rates (within 12 months), while nine studies detected significant long-term effects. Two studies reported significantly lower smoking rates in the control population, while the remaining 13 studies found no significant differences between groups. Improvements were found in secondary outcomes for smoking intention in six of the eight studies, attitude in five of the nine studies, perception in two of the six studies, and knowledge in three of the six studies.
Carson KV, Brin MP, Labiszewski NA, Estleman AJ, Chang AB, Smith BJ. community interventions for youth smoking prevention Cochrane Database of Systematic Reviews 2011, No. 7. Part number: CD001291 DOI: 10.1002 / 14651858.CD001291.pub2.
Hypnotherapy.
Research description.
A total of 1926 participants were included in the study.
The studies were so diverse that a single meta-analysis was not possible. No reliable evidence of specific effects of hypnotherapy compared to controls was available.
There was evidence of low certainty, limited by imprecision and risk of bias, and no statistically significant differences were shown between hypnotherapy and attention-matched behavioral therapy. When comparing hypnotherapy with intensive behavioral interventions, results were similarly imprecise and limited by the risk of bias (not consistent with contact time)
The results of one small study (40 participants) detected a statistically significant benefit of hypnotherapy compared to no intervention.
No significant differences were detected between hypnotherapy and a brief behavioral intervention.
Conclusion.
There is insufficient evidence to determine whether hypnotherapy is more effective for smoking cessation than other forms of behavioral support or unassisted smoking cessation. Where a benefit exists, current evidence suggests that the benefit is small at best. There is little evidence on whether hypnotherapy causes adverse effects, but existing data show no evidence that it does. There is a need for more large-scale, high-quality randomized controlled trials on this topic, as well as more comprehensive assessments of safety.
Barnes J, McRobbie H, Dong CY, Walker N, Hartman-Boyce J. Hypnotherapy for smoking cessation. Cochrane Database of Systematic Reviews 2019, No. 6. Number: CD001008. doi: 10.1002 / 14651858.CD001008.pub3.
Relying on Oriental Medicine.
What is the research?
38 studies were included, and based on three studies, showed no benefit of acupuncture over wait-list control for long-term abstinence with wide confidence intervals and evidence of heterogeneity.
(n = 393, risk ratio [RR] 1.79, 95% confidence interval [CI]] 0.98 to 3.28, I 2 = 57%)
Compared with sham acupuncture, the RR for the short-term effect of acupuncture was 1.22 (95% CI 1.08 to 1.38), and the
The RR for the long-term effect was 1.10 (95% CI 0.86-1.40).
These studies were not judged to be free of bias, and there was evidence of asymmetry in the funnel plots, with larger studies showing smaller effects.
Heterogeneity between studies was not explained by the technique used.
Acupuncture was less effective than nicotine replacement therapy (NRT).
There was no evidence that acupuncture was superior to psychological interventions in the short or long term. Although there is limited evidence that acupressure is superior to sham acupressure in short-term outcomes.
(3 trials, n = 325, RR 2.54, 95% CI 1.27 to 5.08) no trials have reported long-term effects.
Interventions including continuous cardiopulmonary stimulation suggested a short-term benefit compared to sham stimulation.
(14 trials, n = 1155, RR 1.69, 95% CI 1.32 to 2.16)
Subgroup analysis showed that continuous acupressure
(14 studies, n = 1155, RR 1.69, 95% CI 1.32 to 2.16) A subgroup analysis showed an effect for continuous acupressure (7 studies, n = 496, RR 2.73, 95% CI 1.78 to 4.18), but
Acupuncture with indwelling needles was not used.
(6 studies, n = 659, RR 1.24, 95% CI 0.91-1.69)
Conclusions.
Although pooled estimates suggest the possibility of short-term effects, there is no consistent, unbiased evidence that acupuncture, acupressure, or laser therapy has a sustained benefit on smoking cessation beyond 6 months. However, the lack of evidence and methodological problems mean that no firm conclusions can be drawn. Electrical stimulation is not effective for smoking cessation. Well-designed studies on acupuncture, acupressure, and laser stimulation are justified because they are common interventions and are safe when applied correctly.
White AR, Rampez H, Liu JP, Stead LF, Campbell J. Acupuncture and related interventions for smoking cessation. Cochrane Database of Systematic Reviews 2014, No. 1. Number: CD000009. doi: 10.1002 / 14651858.CD000009.pub4.
Relationship to allergic rhinitis.
In this article, we will discuss allergic rhinitis and smoking.
The study
Tobacco smoke has been described as causing an increase in the prevalence of rhinitis symptoms and a decrease in atopy.
Furthermore, these nasal symptoms and quality of life of smokers with allergic rhinitis (AR) were not significantly different from non-smokers.
As a result of this duality, a comparative study between quality of life and inflammatory markers of atopy between active smokers with AR and non-smokers was proposed and thus the content of the study conducted. A cross-sectional study of adult smokers and non-smokers with a clinical diagnosis of AR and a positive prick test (SPT) was conducted.
Smoking status was confirmed by salivary cotinine measurement.
Functional breathing assessments were performed and the Mini-RQLQ questionnaire was used to compare quality of life between groups.
Serum and immunological markers (IgE, IL-4, IL 5, IL 13, IL 17, IL 33) in nasal lavage fluid were evaluated, and samples from a third group of passive smokers were included in serological comparisons only. Statistical analysis included Student's t-test, x2, Mann-Whitney U (Anova 2-way), and Kruskal-Wallis for 3-group analysis.
Values of P <0.05 were considered significant.
A total of 22 patients per group with similar demographics and allergen sensitivity were studied. With regard to inflammatory markers, the decrease in IL 33 in the serum of smokers (P <0.001) was the only statistically significant different parameter revealed, indicating a significant trend of nasal washing.
Salivary cotinine levels were completely different (P <0.0001), but respiratory function assessment was not statistically significant after multiple adjustments. There were no significant differences in quality of life parameters.
In our AR study, active smokers show no nose-related reduction in quality of life or impact on atopic inflammatory parameters compared to nonsmokers.
Decreased levels of IL33 may explain the lack of symptoms that alert smokers to the harmful consequences of smoking.
Commentary
As shown in the results, there was no evidence of increased allergy sensitivity due to cigarette smoke. The subjects showed an increase in IL17 and IgE, with a significant decrease in IL33 in smokers.
In the experiment with the rats, the function of IL33 was confirmed in the nasal mucosa, and its action was confirmed to be a defense mechanism against infectious external enemies and allergens. In other words, they're saying that they've confirmed that one part of the immune system is functionally impaired.
Since the subject is based on animal experiments, it is unclear if the same is true for humans, but it is said that there are negative effects of smoking.
However, this effect does not seem to be an allergen caused by smoke, so it is difficult to encourage smokers to quit without understanding, right? He said.
Gómez RM, Croce VH, Zernotti ME, Muiño JC. Active smoking effect in allergic rhinitis. World Allergy Organ J. 2021;14(2):100504. Published 2021 Jan 17. Published 2021 Jan 17. doi:10.1016/j.waojou.2020.100504
Mental Health Impacts
I've heard that if you stop smoking, you'll have other stresses...but what about it? I would like to introduce a study that investigates this question.
The study
This is a review of 102 studies involving more than 169,500 people.
In some of the studies, the number of people who participated was not clearly reported. The studies used a variety of rating scales to measure people's mental health symptoms.
Most studies included people in general, and 23 studies (53 studies) included people with mental disorders. Other studies included people who had recently undergone surgery or become pregnant, had a physical or mental health condition, or a long-term physical condition.
Results from 63 studies that measured changes in mental health symptoms were combined and compared with results from 10 studies that measured the number of people who developed a mental health disorder during the study.
The results showed that compared to those who continued to smoke, those who were able to quit showed significant reductions in the following areas
Anxiety (evidence from 3141 people in 15 studies)
Depression (7156 people in 34 studies)
Anxiety and depression (2829 people in 8 studies)
Confidence in results was very low (for depression), low (for anxiety), and moderate (for a mix of anxiety and depression).
Confidence declined as we found limitations in the way the studies were designed and conducted. Compared to those who continued to smoke, those who were able to quit showed greater improvement in the following areas
Stress symptoms (evidence from four studies of 1792 people)
Positive feelings (13 studies with 4,880 participants)
Mental health (19 studies in 18,034 people)
There was also evidence that those who were able to quit smoking did not have a decrease in social well-being and may have had a slight increase. (9 studies with 14,673 people)
There were fewer new cases of mixed anxiety and depression in those who were able to quit smoking than in those who continued to smoke. (Evidence from three studies with 8,685 people)
Reviewer's conclusion
In summary, these data provide evidence that mental health does not worsen as a result of smoking cessation, and evidence of very low to moderate certainty that smoking cessation is associated with small to moderate improvements in mental health. These improvements are seen both in unselected samples and in subpopulations that include people diagnosed with mental health conditions. Additional studies that use more sophisticated methods to overcome time-variant confounding would strengthen the evidence in this area.
Taylor GMJ, Lindson N, Farley A, Leinberger-Jabari A, Sawyer K, te Water Naudé R, Theodoulou A, King N, Burke C, Aveyard P. Smoking cessation for improving Cochrane Database of Systematic Reviews 2021, Issue 3. Art. No.: CD013522. DOI: 10.1002/14651858.CD013522.pub2.
Smoking cessation is possible if incentives are paid.
Studies.
Thirty-three mixed population studies covered more than 21,600 participants.
The studies were conducted in a variety of settings, including community settings, clinics or health centers, workplaces, and outpatient clinics.
Twenty-four studies were in the United States
2 in Thailand
One was conducted in the Philippines, and the remainder were European.
The incentives offered included cash payments or vouchers for goods and groceries, which could be provided directly or collected and redeemed online.
Pooled RR of discontinuing incentives at longest follow-up (>6 months) compared to control was 1.49 (95% CI 1.28-1.73; 31 RCT, adjusted N = 20,097; I = 33%)
Results were not sensitive to the exclusion of the six studies that provided incentives for discontinuation at long-term follow-up. (Results excluding these studies: RR 1.40, 95% CI 1.16 to 1.69; 25 RCTs; adjusted N = 17,058; I 2 = 36%)
suggesting that the effects of incentives persist at least for some time after the incentives cease.
Although not always explicitly reported.
The total monetary value of incentives varied considerably from zero (own deposit) to between US$45 and US$1185 per trial.
Neither the value of the incentives nor the encouragement of redeemable self-deposits is available.
Conclusions.
There is credible evidence that incentives improve smoking cessation rates with long-term follow-up in a combined population study. The effectiveness of the incentives appears to persist even if the last follow-up study is conducted after the incentives are withdrawn.
Notley C, Gentry S, Livingstone-Banks J, Bauld L, Perera R, Hartmann-Boyce J. Incentives for smoking cessation. A Cochrane Database of Systematic Reviews 2019, Issue 7. Number: CD004307. doi: 10.1002 / 14651858.CD004307.pub6.
Smoking behavior increases after disaster
In the areas affected by the tsunami of the Great East Japan Earthquake, smoking behavior may have worsened due to high stress and rapid changes in the living environment. A survey was conducted to identify the changes in smoking behavior among the victims.
In 2012.
A population-based random sample home interview survey of 1978 victims in Iwate and Miyagi prefectures was conducted in 2012, and a population-based national survey was conducted in 2013. 2014 panel survey was conducted among respondents of the 2012 survey to identify factors associated with post-disaster smoking status. The 2014 panel survey was conducted among respondents from the 2012 survey, and multiple logistic regression analysis was performed to identify factors associated with post-disaster smoking status.
In the tsunami-affected areas, smoking rates were higher among both men and women.
In the tsunami-affected areas, smoking rates were higher among both men and women, and a lower prevalence of non-smokers was observed among men. The prevalence of nicotine dependence as assessed by the FTND (Fagerström Test of Nicotine Dependence) in coastal areas was also higher than in inland areas or other parts of Japan, and the smoking behavior of the survivors worsened after the disaster and did not improve even three years after the disaster.
Post-disaster factors associated with smoking were living in coastal areas, complete destruction of houses, and living in temporary housing.
In conclusion, three years after the disaster, smoking rates and levels of nicotine dependence were still high.
Osaki, Y., Maesato, H., Minobe, R. et al. Changes in smoking behavior among victims after the great East Japan earthquake and tsunami. Med 25, 19 (2020). Available at: https://doi.org/10.1186/s12199-020-00858-5
Telephone consultation
A number of participants and studies have concluded that telephone counseling is highly effective in helping people quit smoking.
A few details
Review of 104 studies involving 111,653 participants
Most of the participants were adults, but some studies included teenagers, pregnant women, and people with poor mental health.
100/104 studies evaluated proactive as opposed to reactive forms of telephone counseling. Smokers who received multiple preventive counseling sessions had higher quit rates. Some results cannot be attributed to telephone counseling alone.
Some comment that it is up to the individual to decide whether or not to quit smoking. In the meta-regression analysis, telephone counseling showed greater results when combined with written support and assistance from medical professionals.
In the meta-regression analysis, telephone counseling showed greater results when combined with written support and assistance from medical professionals.
There was also a higher rate of smoking cessation after three to five counseling sessions than after one session. (RR 1.27)
Matkin W, Ordóñez-Mena JM, Hartmann-Boyce J. Telephone smoking cessation consultations. A Cochrane Database of Systematic Reviews 2019, Issue 5 Number: CD002850. doi: 10.1002 / 14651858.CD002850.pub4.
Risk factors for COVID-19 infection
Medication
Nicotine replacement therapy (NRT) is used because it reduces smoking cravings and nicotine withdrawal symptoms, and may be the medication of choice for temporary tobacco replacement. This medication can make the transition from smoking to complete cessation easier.
NRT is a safe and effective medication that is easy to purchase and can be found in the form of patches, gum, lozenges, and sprays.
These forms have also been shown to have the same effect as smoking cessation medications.
Behavioral support
Behavioral support for smoking cessation provided through printed materials (such as those published by medical or reputable information providers), telephone, Internet programs, and text message programs have all been found to have positive results.
Quitting on your own, gradually
The COVID-19 pandemic is unprecedented and stressful, and it may seem difficult to make significant behavioral changes during this time. An option for those who cannot quit smoking immediately is to reduce the number of cigarettes they smoke.
Some studies suggest that people who gradually reduce the number of cigarettes they smoke are just as likely to quit smoking successfully as those who quit suddenly. However, there is no clear evidence that reducing the number of cigarettes smoked without quitting altogether has beneficial effects on health.
It is always beneficial to quit smoking sooner rather than later in order to reduce the health risks associated with smoking as much as possible.
For this reason, people who want to gradually reduce the number of cigarettes they smoke should do so for a short period of time.
Specifically, a few days or weeks instead of months.
Studies from the Cochrane Review have also shown that this gradual smoking is less effective than other approaches.
1. Centers for Disease Control and Prevention. Health Effects of Indirect Smoking, February 27, 2020. www.cdc.gov/ tobacco / data_statistics / fact_sheets / secondhand_smoke / health_effects
2. Simons D, Shahab L, Brown J, Perski O. (2020). Association of smoking status with SARS-CoV-2 infection, hospitalization and mortality from COVID-19: a living rapid evidence review. qeios. https://doi.org/10.32388/UJR2AW
3. World Health Organization. Tobacco-free initiative: tobacco and water tobacco use increases the risk of suffering from COVID-19. www.emro.who.int/tfi/know-the-truth/tobacco-and-waterpipe-users-are-at-increased-risk-of-covid-19-infection.html (accessed March 19, 2020).
4. Stead LF, Koilpillai P, Fanshawe TR, LancasterT. Combining pharmacotherapy and behavioral therapy for smoking cessation. Cochrane database of systematic reviews. 2016; (3): CD008286. https://doi.org/10.1002/14651858.CD008286.pub3
5. cahill K, stevens S, Perera R, Lancaster T. Pharmacological interventions for smoking cessation: overview and network meta-analysis. Cochrane Database of Systematic Reviews 2013, No. 5. Art. No.: CD009329. https://doi.org/10.1002/14651858.CD009329.pub2
