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Objective: Despite a brief decline during the COVID‐19 pandemic, vaping behaviors among adolescents continue to be an international public health concern because of associated health risks and harms. A thorough investigation of existing interventions preventing adolescent vaping is needed to help address this public health crisis and reduce serious and avoidable vaping‐related health risks. We reviewed the literature to identify public health interventions aimed at preventing adolescent vaping and summarized their key components and outcome measures. Design: We conducted a scoping review of the literature using the Joanna Briggs Institute methodology searching in MEDLINE, CINAHL, Embase, PubMed, PsycINFO, ProQuest, and Web of Science. Two reviewers screened 589 records for relevance. Studies from any location, reported in English, and described vaping prevention interventions targeting adolescents were included. Records were excluded if they were reported in other languages, published outside the review timeframe, lacked an evaluation, focused on cessation‐based interventions, or were review articles. Data extracted included intervention type, key components, and outcome measures. Results: Thirty‐eight included articles were identified and categorized into three intervention categories: school‐based, public education/risk communication campaigns, and public policies/government regulations. Key components of the interventions included format, duration, and topics. Formats varied from single to multi‐sessions. Prominent topics covered included risks and harms associated with vaping, and the most frequently reported outcome measures used were knowledge, attitudes, and beliefs. Conclusion: Our findings summarize existing public health interventions found in the literature and insights into approaches used to address the global adolescent vaping crisis. [ABSTRACT FROM AUTHOR]

Aims: To determine whether nicotine mouth spray provides rapid and prolonged relief of urges to vape and measure the steady‐state plasma nicotine levels during vaping and ad libitum mouth spray usage in e‐cigarette users. Design: Randomized, parallel group, double‐blind trial. Setting: Single site at Hammersmith Medicines Research Ltd (HMR), London, UK. Participants: 216 (25.9% females, average age 27.6 ± 7.63 [standard deviation, SD]) exclusive vapers who used their e‐cigarette within 30 minutes of waking up and had vaped about 2 years on average. Interventions: Two sprays of 1 mg nicotine mouth spray (Nicorette QuickMist Freshmint, n = 109), or placebo (identical in appearance and presentation, n = 107). Measurements Urge to vape was rated on a 100 mm visual analogue scale before and repeatedly for 2 hours after administration. The primary outcome measured average change from baseline in urges to vape ratings during the first hour. Findings Nicotine mouth spray achieved statistically significantly greater reductions in urges to vape than placebo from the first assessment point at 30 seconds to 1 hour, when the estimated mean treatment difference was 11.90 mm (95% confidence interval [CI] = 6.86–16.95, P < 0.001). The integrated urge to vape over 11 hours ad libitum usage showed a statistically significant benefit compared with placebo (2.00 [0.88 SD] vs 2.51 [0.84 SD], P < 0.001). Mean steady‐state plasma nicotine concentrations were lower after nicotine mouth spray usage compared with vaping (6.22 [4.70 SD] ng/ml vs 9.91 [7.59 SD] ng/ml, respectively). Adverse events were more commonly reported in the nicotine mouth spray group and were mostly mild. Conclusions: Among regular e‐cigarette users, nicotine mouth spray provided statistically significant and fast relief of urges to vape one hour after dosing. Nicotine mouth spray showed statistically significant reductions in urges to vape as soon as 30 seconds and up to 2 hours after dosing compared with placebo, and nicotine mouth spray was well‐tolerated and safe. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the effectiveness of mobile smoking cessation (SC) treatment with 1‐week nicotine replacement therapy (NRT) sampling on recruitment and quitting outcomes. Design: Two‐arm cluster RCT (1:1 ratio), single‐blinded, at 244 recruitment sessions in Hong Kong outdoor smoking hotspots from October 2018–December 2019. Setting: Participant were recruited by ambassadors and treated at the mobile SC truck. Participants: 834 adult (≥18 years, male 81.3%) daily smokers, Chinese‐speaking, non‐NRT users in the past month, consented after nurse‐led intervention in mobile SC truck were randomized to the experimental (n = 482 male 79.5%) and the control group (n = 352, male 83.8%). Intervention and comparator: The experimental group received a 1‐week free NRT sample, an NRT instruction card, and mobile SC treatment including onsite nurse‐led brief medication advice (about 15 minutes) and referral to SC clinics. The control group received the same mobile SC treatment. Measurements Primary outcome was self‐reported quit attempts at 1‐month follow‐up. Secondary outcomes included SC service use at 1 month, and biochemically validated abstinence (exhaled carbon monoxide < 4 ppm; or saliva cotinine < 10 ng/ml) at 6‐month follow‐up. Additionally, a post‐hoc cost analysis was conducted. Findings By intention‐to‐treat, the two groups showed similar prevalence of quit attempts (44·4% versus 43·5%, risk ratio (RR) = 1·04, 95% confidence interval (CI) = 0·79–1·37, P = 0·79). Compared with the control group, the experimental group showed lower SC service use at clinics (32·4% versus 44·9%, RR = 0·72, 95%CI = 0·57–0·91, P = 0·006), but no significant difference in validated abstinence (4·6% versus 2·8%, RR = 1·64, 95%CI = 0·76–3·50, P = 0·21). The experimental recruitment sessions recruited more smokers for onsite medication advice than the control session (mean 6·7 vs 5·0, adjusted incident rate ratio = 1·30, 95%CI = 1·08–1·56, P = 0·005). Conclusions: Mobile smoking cessation treatment with 1‐week nicotine replacement therapy sampling did not increase quit attempts or abstinence outcomes among recruited daily smokers in Hong Kong. The intervention increased smokers' uptake of onsite medication advice but reduced subsequent smoking cessation service use at clinics. [ABSTRACT FROM AUTHOR]

Background and Aims: Pathways of transitioning from tobacco smoking to vaping after receiving an e‐cigarette‐based smoking cessation intervention have been minimally explored. Study aims: 1) identify pathways between intervention delivery and final follow‐up; 2) describe baseline and post‐intervention statistical data in relation to smoking/vaping behaviour of the different pathway groups; 3) explore qualitative participant perspectives contextualising pathway groups. Design: Embedded mixed‐methods analysis of data collected for the Cessation of Smoking Trial in the Emergency Department (COSTED) randomised controlled trial. Setting: Recruitment from 6 Emergency Departments (5 in England and 1 in Scotland) between January and August 2022. Participants: 366 adult smokers who were randomised to receive the COSTED intervention and provided data at 6‐month follow‐up. Qualitative subsample of 24 participants interviewed after follow‐up. Interventions: Brief smoking cessation advice, provision of an e‐cigarette starter kit and referral to the local Stop Smoking Service. Measurements: Descriptive statistical reporting of identified pathways and smoking/vaping behaviour at baseline and 6‐month follow‐up. Semi‐structured phone/video interviews analysed thematically. Findings 13.4% (n = 49) of participants quit smoking within 1 month of receiving the intervention, 19.1% (n = 70) quit between 1 and 6 months, 24.9% (n = 91) reduced cigarettes per day (CPD) by at least 50%, and 42.6% did not experience a significant smoking reduction. Approximately a third of participants who quit reported not vaping at follow‐up. Reporting dual use was associated with a reduction in CPD. Appoximately a third reported experimenting with a different device to the one provided as part of the intervention. Quitters reported themes of satisfaction with vaping, changes in environment facilitating quitting and motivation to quit. Conclusions: Dual use of cigarettes and e‐cigarettes can result in a reduction of smoking and may prelude quitting smoking. Sustained e‐cigarette use is not always necessary for quitting success. Success depends on personal context as well satisfaction with vaping. [ABSTRACT FROM AUTHOR]

Aims: To summarise systematic reviews on tobacco addiction published by the Cochrane Tobacco Addiction Group (CTAG) from 2021 to 2023. Methods: We identified all new and updated Cochrane Reviews published by CTAG between 2021 and 2023. We present key results from these reviews and discuss promising avenues for future research. Results: CTAG published five new reviews and one overview of reviews, and updated eight reviews. Review evidence showed that all main pharmacotherapies (varenicline, cytisine, bupropion and nicotine replacement therapy [NRT], especially when patches are combined with fast acting forms like gum) are effective for smoking cessation, as are nicotine e‐cigarettes. Evidence suggested similar magnitude of effects of varenicline, cytisine, and nicotine e‐cigarettes; these emerged as the most effective treatments. Evidence also supported behavioural counselling and financial incentives for smoking cessation. Secondary analyses of the Cochrane review of e‐cigarettes for smoking cessation showed over half of participants assigned to e‐cigarette conditions were still using them at six months or longer, that biomarkers of potential harm significantly reduced in people switching from smoking to vaping or to dual use, and that there was insufficient evidence to draw associations between e‐liquid flavours and smoking cessation. Findings on mindfulness‐based interventions, interventions delivered by dental and primary care professionals, interventions to prevent weight gain after smoking cessation, and interventions for waterpipe cessation were less certain. Reviews of observational evidence showed that smoking cessation reduced cardiovascular events and mortality in people living with cardiovascular disease, and improved mental health. Conclusions: Nicotine replacement therapy (especially patches combined with fast acting forms), varenicline, cytisine, bupropion, nicotine e‐cigarettes, behavioural counselling, and financial incentives are all effective ways to help people quit smoking. Quitting smoking improves mental health and reduces cardiovascular events and mortality in people living with cardiovascular disease. [ABSTRACT FROM AUTHOR]

Background and Aims: Cytisine (also known as cytisinicline) is a low‐cost partial agonist of nicotinic acetylcholine receptors used to assist tobacco cessation. We aimed to review the effectiveness of cytisine for tobacco cessation and the effects of dose and co‐use of behavioural or other pharmacological interventions on cessation outcomes. Methods: We searched seven databases, Google Scholar, and reference lists of included publications for randomised controlled trials investigating use of cytisine as a tobacco cessation aid. Studies were eligible if participants were ≥15 years old and used tobacco upon study enrolment. We conducted four random effects meta‐analyses and sensitivity analyses with fixed effects models. We used the Cochrane risk‐of‐bias tool for randomised trials version 2 to assess risk of bias in included studies, with adjustments recommended by the Cochrane Tobacco Addiction Group. Results: Participants using cytisine were significantly more likely to quit tobacco than participants who received placebo/no intervention/usual care (risk ratio [RR] = 2.65, 95% confidence interval [CI] = 1.50–4.67, 6 trials, 5194 participants) or nicotine replacement therapy (RR = 1.36, 95% CI = 1.06–1.73, p = 0.0152, 2 trials, 1511 participants). The difference in cessation rates among participants receiving cytisine versus varenicline was not statistically significant (RR = 0.96, 95% CI 0.63–1.45, P = 0.8464, 3 trials, 2508 participants). Two trials examined longer versus shorter treatment duration, finding higher abstinence rates with longer treatment (RR = 1.29, 95% CI = 1.02–1.63, 2 trials, 1009 participants). The differences in the number of adverse events reported by participants who received cytisine versus placebo (RR = 1.19, 95% CI = 0.99–1.41, P = 0.0624; 6 trials; 4578 participants) or cytisine versus varenicline (RR = 1.37, 95% CI = 0.57–3.33, P = 0.4835; 2 trials; 1345 participants) were not statistically significant. Most adverse events were mild (e.g. abnormal dreams, nausea, headaches). Conclusions: Cytisine is an effective aid for tobacco cessation and appears to be more effective for tobacco cessation than placebo, no intervention, usual care and nicotine replacement therapy. [ABSTRACT FROM AUTHOR]

Background: Australia introduced a prescription only policy for e‐cigarettes in 2011 to prevent uptake among youth while allowing smokers to access e‐cigarettes for cessation. This is one of the restrictive forms of regulation for e‐cigarettes recommended by the World Health Organisation. Aims: To assess whether the policy has prevented e‐cigarette youth uptake and facilitated smokers' access to e‐cigarettes for cessation; and to examine a proposed toughening of the policy. Methods: An analysis of survey and administrative data on e‐cigarette use and smoking and a critical analysis of the contents of submissions to parliamentary inquiries into the policy. Results: E‐cigarette use among youth and young adults has increased steeply since 2016 but very few of these products have been obtained through the prescription system, because medical authorities discourage their use. A policy change in 2021 to increase the prescription of e‐cigarettes has not reduced e‐cigarette use among youth and only marginally increased rates of prescribing. Australian policy makers have nonetheless tightened the prescription system by banning any use of e‐cigarettes unless prescribed by a doctor and dispensed by a pharmacist. Implications: Australia's tightened prescription policy for e‐cigarettes may reduce adolescent vaping but at the risk of reducing smokers' access to e‐cigarettes and increasing the size of the illicit market for combustible cigarettes and e‐cigarettes. A more effective policy would allow vapes to be sold as consumer products by licensed tobacconists under regulations that require prior product approval, plain packaging, bans on their promotion and enforced age restrictions on purchases. [ABSTRACT FROM AUTHOR]

The effectiveness of mutual help groups (MHGs) in promoting addiction recovery has been widely acknowledged. However, the psychological mechanisms underlying the impact of MHGs remain somewhat uncertain. Drawing on a social identity perspective, this study investigated a sequential mediation model in which social support is posited as a driving factor that enhances abstinence maintenance through group identification, recovery identity, and self‐efficacy. A sample of 820 smokers, participating in a 6‐month collective smoking cessation programme which included access to an online help group, completed measures of social support, group identification, smoker/ex‐smoker identity, and self‐efficacy at the programme's outset. Smoking abstinence was assessed 6 and 9 months later. The findings supported the proposed model, indicating that social support was positively associated with MHG identification, which, in turn, was related to a stronger recovery identity. Subsequently, recovery identity was associated with increased self‐efficacy, and indirectly, with smoking abstinence at both measurement times. Additional analyses testing alternative mediation models further supported the validity of the proposed model. These findings suggest that social identity factors play significant roles in accounting for the effectiveness of MHGs for addiction recovery. [ABSTRACT FROM AUTHOR]

Background and aims: With the prevalence of e‐cigarette use among Australian youth increasing significantly in recent years, greater attention is being paid to encouraging and supporting cessation. However, research to inform such efforts is lacking. The present study sought to (i) measure desire to quit e‐cigarette use and actual quitting attempts among young Australians and (ii) explore correlates of quitting‐related cognitions and behaviours. Design, setting and participants: This was a cross‐sectional on‐line survey conducted in Australia. The participants were 14−25‐year‐old e‐cigarette users (n = 602; 53% women). Measurements: Desire to quit vaping and attempts to quit vaping were the primary dependent variables. The independent variables included several individual (e.g. harm perceptions, perceived appeal of vapes), social (descriptive norms) and environmental (e.g. ease of e‐cigarette access) factors. Findings A majority of respondents (61%) expressed a desire to quit vaping, and just over half (55%) had made a quit attempt. Finding vapes easy to access was associated with both a lack of desire [odds ratio (OR) = 0.71] and attempts to quit (OR = 0.77), while self‐reported addiction to vaping (OR = 1.42 and OR = 3.11) and perceiving vaping to be associated with mental health risks (OR = 1.30 and OR = 1.40) were positively correlated with these variables. Perceiving that vaping is common among people of one's age (OR = 0.82) and finding vapes appealing (OR = 0.55) were associated with a lack of desire to quit, while perceiving vaping to have physical health risks was positively associated with quitting desire (OR = 1.58). School‐based education on vaping was associated with reporting an attempt/s to quit (OR = 0.47). Conclusions: This survey of young Australian e‐cigarette users suggests a high level of desire to quit using e‐cigarettes and attempts to quit. Increasing knowledge regarding the physical and mental health risks associated with e‐cigarette use may assist with promoting quitting‐related intentions. Changing social norms, reducing the accessibility of e‐cigarettes and reducing the appeal of the products also constitute potential means of increasing the desire to quit. [ABSTRACT FROM AUTHOR]

Aims: The aim of this work was to measure the impact of P2P (i.e. peer‐to‐peer), a peer‐led smoking prevention intervention, on daily smoking prevalence of adolescents over 2 school years. Design: A cluster‐randomized controlled trial was performed over a 16‐month follow‐up (trial status: closed to follow‐up). P2P was implemented 1–3 and 13–15 months after baseline. Assessments took place at baseline and 4, 10 and 16 months after baseline. The research team, assessors and adolescents were blinded to the study‐arm assignment only at baseline. Setting: Fifteen vocational high schools in France were randomized into two clusters, using a 1:1 allocation ratio per French department (n intervention = 7, n control = 8). Participants: Participants comprised a sample of 2010 students in year 11 (i.e. 15–16 years) in vocational high schools. A total of 437 students could not be assessed at baseline (absent or left school), yielding a total sample of 1573 students (n intervention = 749, n control = 824). Intervention and comparator: The P2P programme trained voluntary students to become peer educators and design smoking prevention actions for their schoolmates in the intervention group (n = 945 students), compared with a passive control group (n = 1065 students). Measurements The primary outcome was change from baseline in the prevalence of self‐reported daily smoking (i.e. at least one cigarette per day) at 16 months. Findings The 'time × group' interaction indicated that, compared with the control group, the intervention group had statistically significantly fewer daily smokers after 16 months [odds ratio (OR) = 0.33, 95% confidence interval (CI) = 0.20, 0.53]. Similarly, compared with the control group, the intervention group had statistically significantly fewer daily smokers after 4 months (OR = 0.50, 95% CI = 0.30, 0.82) and 10 months (OR = 0.60, 95% CI = 0.37, 0.98). No adverse events of P2P2 were reported. Conclusions: A cluster‐randomized trial found evidence that the peer‐led P2P (peer‐to‐peer) smoking prevention intervention reduced the uptake of daily smoking among high school students in France over 16 months. [ABSTRACT FROM AUTHOR]

Aim: The aim of this work was to systematically scope the evidence on opportunistic tobacco smoking cessation interventions for people accessing financial support settings. Methods: We searched MEDLINE, Embase, PsycINFO and the Cochrane Tobacco Addiction Group specialized register to 21 March 2023. We duplicate screened 20% of titles/abstracts and all full texts. We included primary studies investigating smoking cessation interventions delivered opportunistically to people who smoked tobacco, within settings offering support for problems caused by financial hardship, for example homeless support services, social housing and food banks. Data were charted by one reviewer, checked by another and narratively synthesized. Results: We included 25 studies conducted in a range of financial support settings using qualitative (e.g. interviews and focus groups) and quantitative (e.g. randomized controlled trials, surveys and single arm intervention studies) methodologies. Evidence on the acceptability and feasibility of opportunistic smoking cessation advice was investigated among both clients and providers. Approximately 90% of service providers supported such interventions; however, lack of resources, staff training and a belief that tobacco smoking reduced illicit substance use were perceived barriers. Clients welcomed being asked about smoking and offered assistance to quit and expressed interest in interventions including the provision of nicotine replacement therapy, e‐cigarettes and incentives to quit smoking. Six studies investigated the comparative effectiveness of opportunistic smoking cessation interventions on quitting success, with five comparing more to less intensive interventions, with mixed results. Conclusions: Most studies investigating opportunistic smoking cessation interventions in financial support settings have not measured their effectiveness. Where they have, settings, populations, interventions and findings have varied. There is more evidence investigating acceptability, with promising results. [ABSTRACT FROM AUTHOR]

The authors comment on an article by W. D. Hall which showed that Australia's 2011 electronic cigarette (e-cigarette) prescription-only model has not prevented many youth and young adults from vaping. They talk about the ban on the sale of e-cigarettes on the open consumer market, their agreement with Hall that restrictive forms of e-cigarette regulation may led to unintended consequences, and a balanced policy approach to e-cigarette regulation that supports the accessibility of e-cigarettes.

Objectives: To examine the effectiveness of a media literacy‐based smoking prevention program based on Ajzen's theory of planned behavior in female adolescents. Methods: This quasi‐experimental study was conducted with female high school students aged 16–17 years in Seoul, Republic of Korea. The program provided eight sessions over 4 weeks. Quantitative data were collected before and after online surveys in an intervention (n = 21) and control (n = 21) groups, and analyzed using mixed analysis of variance. Qualitative data on participation experiences was collected by requesting the participants to answer open‐ended questions once a week during the intervention and performing co‐occurrence analysis of specific terms in the responses was conducted through text mining. Results: Although the program decreased smoking intention and increased smoking media literacy in the intervention group, there were no significant differences between the groups. Qualitative results obtained from the intervention group showed cognitive and behavioral changes in the perception of the harmfulness of e‐cigarettes in the media and the expression of a willingness to overcome the temptation to smoke. Conclusions: Our findings show that the enhancement of smoking media literacy, specifically by correcting misconceptions regarding e‐cigarettes promoted by the new media, contributes smoking prevention in female adolescents. It supports calls for an expanded role of public health professionals in health education at the school level. [ABSTRACT FROM AUTHOR]

Adverse childhood experiences are a factor that can have a broad impact on different dimensions of health in different eras. This research aimed to investigate the relationship between adverse childhood experiences and smoking in children through a systematic review and meta‐analysis. Three databases, including PubMed, Web of Science and Scopus, were selected for manuscript searches. These three databases were searched until July 2022. This search was limited to English. For this study, the odds ratio or risk ratio and 95% confidence interval were extracted. The odds ratio pool was performed using the random‐effects method reported. An analysis was done based on the types of adverse childhood experiences and an analysis based on sex. The year of publication of the earliest and last publication included in this analysis was, respectively, 2003 and 2022. After screening the manuscripts, finally, 39 studies remained for this study. Adverse childhood experiences are associated with an increased risk of smoking in children [odds ratio 1.69; CI = 1.55–1.85; z = 11.80; p < 0.001; I2 = 92.6%]. Components of adverse childhood experiences, including emotional abuse, emotional neglect, physical abuse, physical maltreatment and physical neglect, were associated with increased smoking. The present study showed that adverse childhood experiences provide a context that increases the possibility of smoking in children. It is necessary to pay attention to the dimensions of health and behaviour in this group. Key Practitioner Messages: The evidence from this research showed that adverse childhood experiences are an important risk factor in increasing smoking.According to the evidence obtained from previous studies and their review in the current study, it is necessary that childhood conditions be screened, trained and given appropriate interventions to reduce their negative consequences on health in later periods of life. [ABSTRACT FROM AUTHOR]

Background and Aims: Standard approaches to smoking cessation may not be as effective for certain populations, and tailoring on cultural factors could improve their effectiveness. This systematic review measured the effectiveness of culturally tailoring smoking cessation interventions on quitting or reducing smoking combustible tobacco. Method: We searched MEDLINE, PsychInfo, Embase and Cochrane Central Register from inception to 21 June 2023 for randomized controlled trials (RCTs) of community‐based, primary care or web‐based interventions for smoking cessation in adults who smoked tobacco, with measurement of smoking abstinence or reduction at least 3 months following baseline. We examined comparisons between either an intensity‐matched culturally tailored intervention and a non‐tailored intervention or a standard non‐tailored intervention and the same intervention plus a culturally tailored adjunct. We sub‐grouped studies according to the level of tailoring and performed subgroup analyses where appropriate. We assessed risk of bias and certainty of evidence. Results: We identified 43 studies, 33 of which were meta‐analyzed (n = 12 346 participants). We found moderate certainty evidence, limited by heterogeneity, that intensity‐matched culturally tailored cessation interventions increased quit success when compared with non‐tailored interventions at 3‐month follow‐up or longer (n = 5602, risk ratio [RR] = 1.29 95% confidence interval [CI] 1.10, 1.51, I2 = 47%, 14 studies). We found a positive effect of adding a culturally tailored component to a standard intervention compared with the standard intervention alone (n = 6674, RR = 1.47, 95% CI 1.10, 1.95, I2 = 74%, 18 studies), but our certainty in this effect was low due to imprecision and substantial statistical heterogeneity. Conclusion: Culturally tailored smoking cessation interventions may help more people to quit smoking than a non‐tailored intervention. Adapting or adding cultural components to smoking cessation interventions originally developed for majority populations could improve cessation rates in populations who do not fully identify with majority cultural norms. [ABSTRACT FROM AUTHOR]

Background and aims: Smoking is considered the main cause of preventable death world‐wide. This study aimed to review the efficacy and safety of cytisine for smoking cessation. Methods: This review included an exhaustive search of databases to identify randomized controlled trials (RCTs) in health centers of any level with smokers of any age or gender investigating the effects of cytisine at standard dosage versus placebo, varenicline or nicotine replacement therapy (NRT). Results: We identified 12 RCTs. Eight RCTs compared cytisine with placebo at the standard dose covering 5922 patients, 2996 of whom took cytisine, delivering a risk ratio (RR) of 2.25 [95% confidence interval (CI) = 1.42–3.56; I2 = 88%; moderate‐quality evidence]. The greater intensity of behavioral therapy was associated directly with the efficacy findings (moderate‐quality evidence). The confirmed efficacy of cytisine was not evidenced in trials conducted in low‐ and middle‐income countries. We estimate a number needed to treat (NNT) of 11. Two trials compared the efficacy of cytisine versus NRT, and the combination of both studies yields modest results in favor of cytisine. Three trials compared cytisine with varenicline, without a clear benefit for cytisine. Meta‐analyses of all non‐serious adverse events in the cytisine group versus placebo groups yielded a RR of 1.24 (95% CI = 1.11–1.39; participants = 5895; studies = 8; I2 = 0%; high‐quality evidence). Conclusions: Cytisine increases the chances of successful smoking cessation by more than twofold compared with placebo and has a benign safety profile, with no evidence of serious safety concerns. Limited evidence suggests that cytisine may be more effective than nicotine replacement therapy, with modest cessation rates. [ABSTRACT FROM AUTHOR]

Objective: Oral cavity and oropharyngeal cancer (OOPC) is a devastating disease often caught in late stages. People who use tobacco are at higher risk of OOPC. Tobacco cessation discussions and OOPC screenings are important factors in decreasing the risk of OOPC or its late stage diagnosis. As research on sex differences has been increasing—from research on biomedical to psychological and sociological determinants—there is a potential difference, by sex, as to whom is more likely to have a tobacco cessation discussion and OOPC screening. The objective of this study is to determine if there is an association of sex with tobacco cessation discussions and OOPC screenings conducted by dental healthcare professionals among participants who currently use tobacco. Method: Data from 8 years of the National Health and Nutrition Examination Survey (2011–2018) were merged. Data from participants, ages 30 years and above, who self‐reported current use of tobacco, a dental visit within the previous year and responsed to questions about oral cancer screening were analysed for frequency determination and logistic regression analysis. Having the combination of neither OOPC screening nor discussion about the benefits of not using tobacco was the outcome in the analysis. Results: There were 22.1% who had an OOPC screening by a dental professional within the previous year. Of the 41% who reported having had a conversation with a dental professional within the previous year about the benefits of tobacco cessation, 9.8% reported having both the conversation and OOPC screening. Males were less likely than females to have the combination of neither OOPC screening nor advice about tobacco cessation than females (adjusted odds ratio: 0.74; 95%CI: 0.57, 0.96). Conclusion: There is an increased need for OOPC screening and the discussion of tobacco use by dental professionals among their patients who use tobacco, particularly for female patients. [ABSTRACT FROM AUTHOR]

Aims: Previous studies have indicated that smoking is linked to an increased risk of developing schizophrenia, and that individuals with schizophrenia are more prone to engaging in antisocial behavior. However, the causal effects of smoking behaviors on antisocial behavior and the potential mediating role of schizophrenia remains largely unclear. Methods: In the present study, using the summary data from genome wide association studies of smoking phenotypes (N = 323,386–805,431), schizophrenia (Ncases = 53,386, Ncontrols = 77,258), and antisocial behavior (N = 85,359), we assessed bidirectional causality between smoking phenotypes and schizophrenia by the Mendelian randomization (MR) approach. Using a two‐step MR approach, we further examined whether causal effects of smoking phenotypes/schizophrenia on antisocial behavior were mediated by schizophrenia/smoking phenotypes. Results: The results showed that smoking initiation (SmkInit) and age of smoking initiation (AgeSmk) causally increase the risk of schizophrenia (SmkInit: OR = 2.06, 95% CI = 1.77–2.39, p = 4.36 × 10−21; AgeSmk: OR = 0.32, 95% CI = 0.16–0.62, p = 8.11 × 10−4, Bonferroni corrected). However, there was no causal effect that liability to schizophrenia leads to smoking phenotypes. MR evidence also revealed causal influences of SmkInit and the amount smoked (CigDay) on antisocial behavior (SmkInit: OR = 1.28, 95% CI = 1.17–1.41, p = 2.53 × 10−7; CigDay: OR = 1.16, 95% CI = 1.06–1.27, p = 1.60 × 10−3, Bonferroni corrected). Furthermore, the mediation analysis indicated that the relationship between SmkInit and antisocial behavior was partly mediated by schizophrenia (mediated proportion = 6.92%, 95% CI = 0.004–0.03, p = 9.66 × 10−3). Conclusions: These results provide compelling evidence for taking smoking interventions as a prevention strategy for schizophrenia and its related antisocial behavior. [ABSTRACT FROM AUTHOR]

Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths in the United States and compiles the most recent data on population‐based cancer occurrence and outcomes using incidence data collected by central cancer registries (through 2020) and mortality data collected by the National Center for Health Statistics (through 2021). In 2024, 2,001,140 new cancer cases and 611,720 cancer deaths are projected to occur in the United States. Cancer mortality continued to decline through 2021, averting over 4 million deaths since 1991 because of reductions in smoking, earlier detection for some cancers, and improved treatment options in both the adjuvant and metastatic settings. However, these gains are threatened by increasing incidence for 6 of the top 10 cancers. Incidence rates increased during 2015–2019 by 0.6%–1% annually for breast, pancreas, and uterine corpus cancers and by 2%–3% annually for prostate, liver (female), kidney, and human papillomavirus‐associated oral cancers and for melanoma. Incidence rates also increased by 1%–2% annually for cervical (ages 30–44 years) and colorectal cancers (ages <55 years) in young adults. Colorectal cancer was the fourth‐leading cause of cancer death in both men and women younger than 50 years in the late‐1990s but is now first in men and second in women. Progress is also hampered by wide persistent cancer disparities; compared to White people, mortality rates are two‐fold higher for prostate, stomach and uterine corpus cancers in Black people and for liver, stomach, and kidney cancers in Native American people. Continued national progress will require increased investment in cancer prevention and access to equitable treatment, especially among American Indian and Alaska Native and Black individuals. [ABSTRACT FROM AUTHOR]

Background: Although many pregnant women accept referrals to stop‐smoking support, the uptake of appointments often remains low. Aim: The aim was to review the success of interventions to increase the uptake of external stop‐smoking appointments following health professional referrals in pregnancy. Materials and Methods: Embase, PubMed, Cochrane Central Register of Controlled Trials, Scopus and CINAHL were searched in February 2023 for studies with interventions to increase the uptake rates of external stop‐smoking appointments among pregnant women who smoke. Eligible studies included randomised, controlled, cluster‐randomised, quasi‐randomised, before‐and‐after, interrupted time series, case–control and cohort studies. Cochrane tools assessing for bias and Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were followed. Results: Two before‐and‐after studies were included, including a combined total of 1996 women who smoked during pregnancy. Both studies had a serious risk of bias, and meta‐analysis was not possible due to heterogeneity. One study testing carbon monoxide monitors and opt‐out referrals showed increased uptake of external stop‐smoking appointments, health professional referrals and smoking cessation rates compared to self‐identified smoking status and opt‐in referrals. Results were limited in the second study, which used carbon monoxide monitors, urinary cotinine levels and self‐disclosed methods to identify the smoking status with opt‐out referrals. Only post‐intervention data were available on the uptake of appointments to external stop‐smoking services. The number of health professional referrals increased, but change in smoking cessation rates was less clear. Conclusions: There is insufficient evidence to inform practice regarding strategies to increase the uptake of external stop‐smoking appointments by women during pregnancy. [ABSTRACT FROM AUTHOR]

This document provides summaries of various presentations and symposiums related to psychology and health. Topics discussed include the impact of COVID-19 on marginalized populations, the role of psychological associations in advocating for health equity, the concept of inner health in children and adults, cancer prevention, reading disorders in children, trust in social health, post-operative medical complications and posttraumatic stress symptoms in pediatric solid organ transplant patients, the use of ICD-11 diagnostic guidelines in psychology, body image satisfaction in Mexican overweight adolescents, methods for evaluating energy consumption during physical activities, the impact of peer acceptance and sense of community on smoking behavior among adolescents, the effectiveness of online health risk communication interventions, the influence of stress, coping strategies, and optimism on post-surgical recovery, factors contributing to depression in elderly individuals in long-stay institutions, the relationship between alexithymia and over-adaptation in students, and factors influencing successful smoking cessation for adult males. These summaries provide valuable insights into various aspects of psychology and health, highlighting the importance of addressing psychological factors in promoting well-being. [Extracted from the article]

Aims: To determine effects of concurrent smoking and nicotine replacement therapy (NRT) use on reported heaviness of smoking, nicotine (cotinine) body fluid and exhaled air carbon monoxide (CO) concentrations. Methods: Systematic review and meta-analysis of RCTs, which test interventions permitting concurrent NRT use and smoking and comparing, within participants, outcomes when smoking with those when smoking and using NRT concurrently. Measurements included reported number of cigarettes smoked per day (CPD), body fluid cotinine and expired air CO concentrations. Results: Twenty-nine studies were included in the review. Meta-analysis of nine showed that, compared with when solely smoking, fewer cigarettes were smoked daily when NRT was used (mean difference during concurrent smoking and NRT use, -2.06 CPD [95% CI = -3.06 to -1.07, P < 0.0001]). Meta-analysis of seven studies revealed a non-significant reduction in exhaled CO during concurrent smoking and NRT use (mean difference, -0.58 ppm [95% CI = -2.18 to 1.03, P = 0.48]), but in the three studies that tested NRT used in the lead-up to quitting (i.e. as preloading), a similar reduction in exhaled CO was statistically significant (mean difference, -2.54 ppm CO [95% CI = -4.14 to -0.95, P = 0.002]). Eleven studies reported cotinine concentrations, but metaanalysis was not possible because of data reporting heterogeneity; of these, seven reported lower cotinine concentrations with concurrent NRT use and smoking, four reported no differences, and none reported higher concentrations. Conclusions: People who smoke and also use nicotine replacement therapy report smoking less heavily than people who solely smoke. When nicotine replacement therapy is used in the lead-up to quitting (preloading), this reported smoking reduction has been biochemically confirmed. There is no evidence that concurrent smoking and nicotine replacement therapy use result in greater nicotine exposure than solely smoking. [ABSTRACT FROM AUTHOR]

Aims: By performing three transcranial magnetic stimulation (TMS) experiments, we measured the motor‐specific modulatory mechanisms in the primary motor cortex (M1) at both the intercortical and intracortical levels when smokers actively approach or avoid smoking‐related cues. Design, Setting and Participants: For all experiments, the design was group (smokers versus non‐smokers) × action (approach versus avoidance) × image type (neutral versus smoking‐related). The study was conducted at the Shanghai University of Sport, CHN, TMS Laboratory. For experiment 1, 30 non‐smokers and 30 smokers; for experiment 2, 16 non‐smokers and 16 smokers; for experiment 3, 16 non‐smokers and 16 smokers. Measurements: For all experiments, the reaction times were measured using the smoking stimulus–response compatibility task. While performing the task, single‐pulse TMS was applied to the M1 in experiment 1 to measure the excitability of the corticospinal pathways, and paired‐pulse TMS was applied to the M1 in experiments 2 and 3 to measure the activity of intracortical facilitation (ICF) and short‐interval intracortical inhibition (SICI) circuits, respectively. Findings Smokers had faster responses when approaching smoking‐related cues (F1,58 = 36.660, P < 0.001, ηp2 = 0.387), accompanied by higher excitability of the corticospinal pathways (F1,58 = 10.980, P = 0.002, ηp2 = 0.159) and ICF circuits (F1,30 = 22.187, P < 0.001, ηp2 = 0.425), while stronger SICI effects were observed when they avoided these cues (F1,30 = 10.672, P = 0.003, ηp2 = 0.262). Conclusions: Smokers appear to have shorter reaction times, higher motor‐evoked potentials and stronger intracortical facilitation effects when performing approach responses to smoking‐related cues and longer reaction times, a lower primary motor cortex descending pathway excitability and a stronger short‐interval intracortical inhibition effect when avoiding them. [ABSTRACT FROM AUTHOR]

The article focuses on pregnant and postnatal women's experiences when interacting with healthcare providers about their tobacco smoking. It highlights the significance of supportive interactions from healthcare providers in helping these women quit smoking. It emphasizes the importance of healthcare providers knowledge, skills, and adherence to guidelines in supporting smoking cessation during pregnancy and postnatally.

Aim: This study aims to describe smoking related characteristics among female call centre employees in South Korea and identify the factors influencing intention to quit smoking in the next 6 months. Design: This is a cross‐sectional study. Methods: An anonymous online survey was conducted at three call centres of credit card companies in South Korea. Female employees with at least 6 months of experience (n = 115) who were currently smoking were included in this study. Results: Overall, 20% of participants intended to quit within 6 months. Female call centre employees find it most difficult to resist the urge to smoke in negative mood situations. Factors affecting the quit intention were higher educational status, previous quit attempts lower perceived risk of craving and higher social support. Public Contribution: Measuring and monitoring craving as perceived risk and providing social support can be useful for designing smoking cessation interventions in this population. [ABSTRACT FROM AUTHOR]

Background: Smoking cessation is associated with weight gain, and the risk of weight gain is a common deterrent to quitting smoking. Thus, the identification of strategies for reducing post‐smoking cessation weight gain is critical. Objective: Conduct secondary analysis of data from the Fit & Quit trial to determine if greater frequency of self‐weighing is associated with less weight gain in the context of smoking cessation. Methods: Participants (N = 305) were randomized to one of three 2‐month weight interventions (i.e., Stability, Loss, Bibliotherapy), followed by a smoking cessation intervention. Stability and Loss conditions received different types of self‐weighing feedback. All participants received e‐scales at baseline, to capture daily self‐weighing data over 12 months. General linear models were applied to test the main objective. Results: Frequency of self‐weighing was (mean ± SD) 2.67 ± 1.84 days/week. The Stability condition had significantly higher self‐weighing frequency (3.18 ± 1.72 days/week) compared to the Loss (2.51 ± 1.99 days/week) and the Bibliotherapy conditions (2.22 ± 1.63 days/week). Adjusting for baseline weight and treatment condition, self‐weighing 3–4 days/week was associated with weight stability (−0.77 kg, 95% CI: −2.2946, 0.7474, p = 0.3175), and self‐weighing 5 or more days/week was associated with 2.26 kg weight loss (95% CI: −3.9249, −0.5953, p = 0.0080). Conclusions: Self‐weighing may serve as a useful tool for weight gain prevention after smoking cessation. Feedback received about self‐weighing behaviors and weight trajectory (similar to the feedback Stability participants received) might enhance adherence. [ABSTRACT FROM AUTHOR]

Introduction: Socioeconomically deprived populations are at greater risk for smoking‐induced diseases and death, such as cancers, and cardiovascular and respiratory illnesses. The initiation of a nurse‐led smoking cessation program in clinical practice is an effective method to enhance smoking cessation among cardiovascular and respiratory patients in Pakistan. This study aimed to evaluate the effectiveness of nurse‐led smoking reduction intervention performed at out‐patient clinics in Karachi, Pakistan. Methods: A single group pre‐and post‐test study was conducted on eligible patients (n = 83) with a typical profile of cardiovascular and respiratory diseases in a tertiary care hospital from December 2020 to July 2021. Intervention: The multi‐modal nurse‐led intervention consisted of two face‐to‐face motivational counseling (30‐min) and free nicotine replacement therapy with telephonic counseling and follow‐ups offered to all eligible patients for 2 months. Results: The nurse‐led intervention resulted in a significant decrease in daily cigarette consumption in most of the patients (75.9%) by 50% and 16.9% of the patients reported smoking abstinence (quitter) at 1‐week follow‐up (p <.001), verified by a CO breath test. Conclusion: A nurse‐managed smoking reduction intervention for even a short duration (2 months) in clinics is an effective approach in enhancing smoking abstinence and reduction among cardiovascular and respiratory patients. [ABSTRACT FROM AUTHOR]

The author offers a response to commentaries on his article about Australia's regulation on selling electronic cigarettes (e-cigarettes). These include the agreement by Sharon Cox that Australia's prescription mode has not achieved its aims, the reason that Australia's prescription mode has not worked according to Sharon Gravely and Geoff Fong, and the support of Becky Freeman and Christina Watts to Australia's prescription model.

The author comments on an article by W. D. Hall which offers evidence-based arguments that outline why Australia's electronic cigarette (e-cigarette) policy is failing to deliver equitable and effective public health policy. Topics include the urgent need to provide evidence-based support to all people who smoke, the rise in the number of young people using e-cigarettes in Australia despite restrictions, and the access of a high percentage of adults who smoke for e-cigarettes with prescription.

Objectives: People with HIV have a higher risk of myocardial infarction (MI) than the general population, with a greater proportion of type 2 MI (T2MI) due to oxygen demand–supply mismatch compared with type 1 (T1MI) resulting from atherothrombotic plaque disruption. People living with HIV report a greater prevalence of cigarette and alcohol use than do the general population. Alcohol use and smoking as risk factors for MI by type are not well studied among people living with HIV. We examined longitudinal associations between smoking and alcohol use patterns and MI by type among people living with HIV. Design and Methods: Using longitudinal data from the Centers for AIDS Research Network of Integrated Clinical Systems cohort, we conducted time‐updated Cox proportional hazards models to determine the impact of smoking and alcohol consumption on adjudicated T1MI and T2MI. Results: Among 13 506 people living with HIV, with a median 4 years of follow‐up, we observed 177 T1MI and 141 T2MI. Current smoking was associated with a 60% increase in risk of both T1MI and T2MI. In addition, every cigarette smoked per day was associated with a 4% increase in risk of T1MI, with a suggestive, but not significant, 2% increase for T2MI. Cigarette use had a greater impact on T1MI for men than for women and on T2MI for women than for men. Increasing alcohol use was associated with a lower risk of T1MI but not T2MI. Frequency of heavy episodic alcohol use was not associated with MI. Conclusions: Our findings reinforce the prioritization of smoking reduction, even without cessation, and cessation among people living with HIV for MI prevention and highlight the different impacts on MI type by gender. [ABSTRACT FROM AUTHOR]

This paper critically analyses a statement by Australia's National Health and Medical Research Council (NHMRC) on e‐cigarettes in May 2022 that will be used to guide national policy. We reviewed the evidence and the conclusions drawn in the NHMRC Statement. In our view, the Statement is not a balanced reflection of the benefits and risks of vaping because it exaggerates the risks of vaping and fails to compare them to the far greater risks of smoking; it uncritically accepts evidence of harms from e‐cigarettes while adopting a highly sceptical attitude towards evidence of their benefits; it incorrectly claims that the association between adolescent vaping and subsequent smoking is causal; and it understates the evidence of the benefits of e‐cigarettes in assisting smokers to quit. The Statement dismisses the evidence that vaping is probably already having a positive net public health effect and misapplies the precautionary principle. Several sources of evidence supporting our assessment were published after the NHMRC Statement's publication and are also referenced. The NHMRC Statement on e‐cigarettes does not present a balanced assessment of the available scientific literature and fails to meet the standard expected of a leading national scientific body. [ABSTRACT FROM AUTHOR]

Aims: For smokers unmotivated to quit, we assessed the effectiveness and cost‐effectiveness of behavioural support to reduce smoking and increase physical activity on prolonged abstinence and related outcomes. Design: A multi‐centred pragmatic two‐arm parallel randomised controlled trial. Setting: Primary care and the community across four United Kingdom sites. Participants: Nine hundred and fifteen adult smokers (55% female, 85% White), recruited via primary and secondary care and the community, who wished to reduce their smoking but not quit. Interventions: Participants were randomised to support as usual (SAU) (n = 458) versus multi‐component community‐based behavioural support (n = 457), involving up to eight weekly person‐centred face‐to‐face or phone sessions with additional 6‐week support for those wishing to quit. Measurements Ideally, cessation follows smoking reduction so the primary pre‐defined outcome was biochemically verified 6‐month prolonged abstinence (from 3–9 months, with a secondary endpoint also considering abstinence between 9 and 15 months). Secondary outcomes included biochemically verified 12‐month prolonged abstinence and point prevalent biochemically verified and self‐reported abstinence, quit attempts, number of cigarettes smoked, pharmacological aids used, SF12, EQ‐5D and moderate‐to‐vigorous physical activity (MVPA) at 3 and 9 months. Intervention costs were assessed for a cost‐effectiveness analysis. Findings Assuming missing data at follow‐up implied continued smoking, nine (2.0%) intervention participants and four (0.9%) SAU participants achieved the primary outcome (adjusted odds ratio, 2.30; 95% confidence interval [CI] = 0.70–7.56, P = 0.169). At 3 and 9 months, the proportions self‐reporting reducing cigarettes smoked from baseline by ≥50%, for intervention versus SAU, were 18.9% versus 10.5% (P = 0.009) and 14.4% versus 10% (P = 0.044), respectively. Mean difference in weekly MVPA at 3 months was 81.6 minutes in favour of the intervention group (95% CI = 28.75, 134.47: P = 0.003), but there was no significant difference at 9 months (23.70, 95% CI = −33.07, 80.47: P = 0.143). Changes in MVPA did not mediate changes in smoking outcomes. The intervention cost was £239.18 per person, with no evidence of cost‐effectiveness. Conclusions: For United Kingdom smokers wanting to reduce but not quit smoking, behavioural support to reduce smoking and increase physical activity improved some short‐term smoking cessation and reduction outcomes and moderate‐to‐vigorous physical activity, but had no long‐term effects on smoking cessation or physical activity. [ABSTRACT FROM AUTHOR]

Purpose: Smoking cessation interventions should be promoted in cancer centers to improve clinical outcomes among cancer patients and the quality of life of cancer‐free patients and survivors. The aim of the present study was to examine long‐term abstinence (1, 3, and 5 years) among smokers who received an intensive nurse‐led smoking cessation intervention. Design: A prospective follow‐up study was conducted in a smoking cessation clinic in Barcelona. Methods: The study included 479 smokers who received a nurse‐led smoking cessation intervention that included motivational interviewing, psychological support, behavioral change counseling, promotion of smoke‐free policies, and relapse‐prevention strategies, as well as pharmacotherapy if necessary, for 12 months. We calculated overall and sex‐specific 1‐, 3‐, and 5‐year abstinence probabilities (Kaplan–Meier curves) and adjusted hazard ratios (aHRs) of relapse with 95% confidence intervals (CIs) using Cox regression. Findings: The overall probability of abstinence at 1 and 5 years was 0.561 (95% CI: 0.516–0.606) and 0.364 (95% CI: 0.311–0.417), respectively. Females had a higher, but not significant, hazard ratio for relapse compared to males (aHR = 1.180; 95% CI: 0.905–1.538). Attending <5 visits was the most remarkable determinant of relapsing compared to attending 5–9 visits or ≥10 visits, both overall and by sex (p for trend: overall, p < 0.001; males, p = 0.007; and females, p < 0.001). Conclusions: Abstinence probability decreased over the 5‐year follow‐up but was relatively high. Males had higher abstinence rates than females in all follow‐up periods. Completeness of the intensive intervention was the main predictor of cessation. Clinical Relevance: Smoking cessation interventions should consider sex and incorporate strategies to increase adherence to obtain higher long‐term abstinence rates. [ABSTRACT FROM AUTHOR]

The article discusses a study by O. A. Wackowski et al which suggested opportunities that exist to educate adult smokers on the relative risks of tobacco products, particularly e-cigarettes. Topics include variation in the regulation of tobacco and nicotine products across countries, factors to consider when developing and implementing strategies to educate adult smokers on the risks of tobacco products, and opportunities that exist to educate adult smokers about the risks of tobacco products.

Despite efforts to create dedicated smoking areas and no‐smoking signs, many smokers continue to light their cigarettes in front of public building entrances—leading to concerns over health consequences for non‐smokers passing by. To increase compliance with no‐smoking requests, behavioral interventions that tap into habitual and automatic processes seem promising. A pseudo‐randomized controlled trial was conducted to assess the differential impact of seven behavioral interventions based on Cialdini's principles of persuasion. Over a period of 9 weeks, the number of smokers was counted (total n = 17,930 observations) in front of a German University Medical Center. Relative to a baseline and a control condition, interventions based on the principles of reciprocity, scarcity, and authority were most effective in reducing the number of observed smokers in front of the building entrance (41.5%, 45.7%, and 52.1% reduction rates, respectively). Having observed smokers' behavior in vivo, this study provides substantial evidence for the impact of persuasive strategies on outdoor smoking. In the future, this knowledge should be used to protect non‐smokers from second‐hand smoke by increasing the use of designated smoking areas, leave to another place to smoke, or not smoke at all. [ABSTRACT FROM AUTHOR]

Background. Smoking among adolescents and young adults is believed to be one of the most important preventable health problems. The etiology of smoking is one of the most pivotal activities in designing prevention programs. The aim of this study was to determine the correlates between components of empowerment in the context of smoking prevention in adolescents. Methods. This cross-sectional descriptive study was carried out on 422 high school male students in spring 2020. The data collection tool of this study was a valid and reliable researcher-made questionnaire containing demographic characteristics, items related to various components of empowerment, and items related to the smoking preventive behavior (SPB). A linear regression model was used, where the "SPB" outcome variable assumed three possible values: sensation seeking, problem-solving skills, self-efficacy, self-esteem, dependence on group, and attitude towards smoking reported in the previous literature were taken as independent variables, and smoking preventive behavior was considered as a dependent variable. Results. The results revealed that 10.42% of the students were active smokers and 40.75% of them had the experience of smoking. The results also showed a positive and significant relationship between problem-solving skills (r = 0.394, P < 0.001), self-efficacy (r = 0.340, P < 0.001), self-esteem (r = 0.310, P < 0.001), and attitude (r = 0.333, P < 0.001) with the SPB. In addition, a negative and significant correlation was observed between group dependence (r = -0.313, P < 0.001) and the SPB. Overall, the components of empowerment were able to explain 26.5% of the variance in the SPB. Among the components, problem-solving skills solely explained 15.5% of variance of the SPB. Conclusion. According to the results of this study, it can be said that most adolescents are at risk of smoking. Explanatory factors for adopting the SPB include improving problem-solving skills, creating a negative attitude towards smoking, increasing self-efficacy to prevent smoking, reducing group dependence, and increasing self-esteem in adolescents. Multilevel interventions and actions by policymakers, educators, and related organizations to prevent adolescent smoking and educate them about adolescent empowerment skills to prevent smoking should be considered. [ABSTRACT FROM AUTHOR]

The authors comment on a study by M. Ussher and colleagues which hypothesized that continuing to provide incentives postpartum to participants who had successfully quit smoking when offered incentives antepartum would maintain abstinence. Topics discussed include the evidence that financial incentives delivered to pregnant participants contingent on biochemically-validated abstinence prompts antepartum smoking cessation and importance of the use of the devices postpartum.

The article features Robert West, former editor of the journal. West began studying medicine at St. George's in London, England in 1973 and did his pre-clinical training at University College London (UCL). He took a post-doctoral position at the Institute of Psychiatry's Addiction Research unit where he joined a smoking research team led by Mike Russell. He was invited to participate in a committee advising the United Kingdom government on behavioral issues in controlling the pandemic in 2020.

The article highlights the health effect of smoking from the U.S. Surgeon General report in 1964. Topics mentioned include the method use in the creation of the advisory committee to the U.S. Surgeon General, the criteria used in the assessment of the epidemiology of the link of smoking and a disease, the definition of causality, the mortality ratios for smokers, and the impact on tobacco smokers' beliefs and behavior.

Background: Hospital environment is generally propitious to smoking cessation for several reasons, such as a legal ban on smoking in hospital facilities, greater vulnerability facing acute illness and the continuous contact with healthcare professionals. Aims: To evaluate the effectiveness of intensive smoking cessation intervention during hospital admission due to acute respiratory disease and a 6-month follow up after hospital discharge. Methods: This prospective study included patients admitted at our Pulmonology Department due to acute respiratory disease – active smokers who consented to participate in smoking cessation counselling programme – between January and December 2019. After hospital discharge, the patients completed a 6-month follow up. Statistical analysis was performed with SPSS system version 24.0, using univariate analysis with Chi-squared and t-test. Results: We included 30 patients, 86.7% male, with a mean age of 58.6 13.6 years. The mean length of stay was 10 11 days. The mean smoking time was 40.3 14.4 years and the mean smoking load 40 26 pack-year units. The mean level of nicotine dependence, measured by the Fagerström test, was 4.3 2.8. None of the patients accepted smoking cessation pharmacological therapy. After hospital discharge, 19 patients were seen in consultation, 11 of whom maintained smoking cessation at 6 months, determining an overall smoking cessation rate of 36.7%. There was a statistically significant difference in the smoking cessation successful group regarding the motivation to quit smoking and the Richmond test compared to the unsuccessful group. Conclusion: Smoking cessation counselling behaviour programmes during hospitalisation, with regular follow up after hospital discharge, contribute to an increase in smoking cessation rate. [ABSTRACT FROM AUTHOR]

Smoking cessation seems to be a weak link in the struggle against tobacco epidemic in Pakistan. Awareness regarding nicotine is lacking not only in the general population but also among public health practitioners. This lack of knowledge is one of the key barriers to bringing down the prevalence of smoking. Using primary survey data and nonparametric econometric techniques, this study assesses the knowledge of nicotine and harm reduction among public health practitioners in Pakistan. Results indicate physicians have misconceptions about nicotine. The majority of the medical professionals associate nicotine use with birth defects, cancer, cardiovascular illness, and chronic obstructive pulmonary disease (COPD). More than two-thirds of doctors (70%) strongly agreed and 17.9% somewhat agreed with the statement that nicotine causes cancer. This study suggests physicians need to be better informed about the fact that nicotine in tobacco products is addictive while chemicals, particularly those causing combustion, are the primary risk sources for tobacco-related illnesses. Misconceptions regarding nicotine can be quickly remedied with communication interventions. This study also suggests that alternative nicotine delivery systems can help smoking cessation and reduce the consumption of combustible tobacco in Pakistan. [ABSTRACT FROM AUTHOR]

Background and Aims: Previous economic evaluations of smoking cessation interventions for pregnant women are limited to single components, which do not in isolation offer sufficient potential impact to address smoking cessation targets. To inform the development of more appropriate complex interventions, we (1) describe the development of the Economics of Smoking in Pregnancy: Household (ESIP.H) model for estimating the life‐time cost‐effectiveness of smoking cessation interventions aimed at pregnant women and (2) use a hypothetical case study to demonstrate how ESIP.H can be used to identify the characteristics of optimum smoking cessation interventions. Methods: The hypothetical intervention was based on current evidence relating to component elements, including financial incentives, partner smoking, intensive behaviour change support, cigarettes consumption and duration of support to 12 months post‐partum. ESIP.H was developed to assess the life‐time health and cost impacts of multi‐component interventions compared with standard National Health Service (NHS) care in England. ESIP.H considers cigarette consumption, partner smoking and some health conditions (e.g. obesity) that were not included in previous models. The Markov model's parameters were estimated based on published literature, expert judgement and evidence‐based assumptions. The hypothetical intervention was evaluated from an NHS perspective. Results: The hypothetical intervention was associated with an incremental gain in quitters (mother and partner) at 12 months postpartum of 249 [95% confidence interval (CI) = 195–304] per 1000 pregnant smokers. Over the long‐term, it had an incremental negative cost of £193 (CI = –£779 to 344) and it improved health, with a 0.50 (CI = 0.36–0.69) increase in quality‐adjusted life years (QALYs) for mothers, partners and offspring, with a 100% probability of being cost‐effective. Conclusions: The Economics of Smoking in Pregnancy: Household model for estimating cost‐effectiveness of smoking cessation interventions aimed at pregnant women found that a hypothetical smoking cessation intervention would greatly extend reach, reduce smoking and be cost‐effective. [ABSTRACT FROM AUTHOR]

Aim: This study attempted to provide basic data for future smoking cessation policies and anti‐smoking programs by analyzing related factors of hardcore smokers. Methods: This study is a cross‐sectional, descriptive survey of the 2019 Community Health Survey conducted by the Korean Ministry of Health and Welfare. There were 11,817 smokers, and the propensity matching method was used based on factors related to hardcore smokers in previous studies. Results: Consequently, a higher probability to be included as hardcore smokers was observed in subjects who had a higher level of stress perception (odds ratio [OR] = 17.59, 95% CI [10.18, 30.38]), perceived their body shape as chubby (OR = 12.84, 95% CI [8.39, 19.66]) or obese (OR = 7.03, 95% CI [4.90, 10.09]), walking participation rate for more than 10 min a day (OR = 1.09, 95% CI [1.03, 1.15]), and had a high degree of depression (OR = 1.43, 95% CI [1.37, 1.49]). Conclusion: It is necessary to approach smoking‐related policies separately between general and hardcore smokers. Finally, more effective smoking cessation policies must be found by identifying the characteristics of hardcore smokers. [ABSTRACT FROM AUTHOR]

Summary: Preventing smoke back‐layering in longitudinal‐ventilated tunnels is an important topic in handling with fires safety issues. Previous studies focused on the critical velocity, while only very few of them paid attention to how to realize this parameter, that is, in a critical state, to overcome the resistance of the tunnel and the fire source to the airflow, the required driving force provided by the ventilation equipment installed in the tunnel. This study addressed this problem in the situation where the coupling effect of blockage and throttling effect was highlighted by conducting theoretical analysis and numerical simulations. The results showed that the presence of metro train blockage reduces the effective cross‐sectional area of the tunnel near the fire source and decreases the critical velocity. On the other hand, the blockage of trains also increases the resistance to the ventilation airflow and exacerbates the throttling effect, leading to the increase of the critical driving force. In such conditions, a stronger driving force to approach the critical velocity was needed. Besides, the length of train blockage was verified to exert limited influence on the value of critical velocity while it significantly affected the critical driving force. Furthermore, the calculated formula for the critical driving force was proposed with the prevention of smoke back‐layering considering the blockage effect to be emphasized. [ABSTRACT FROM AUTHOR]

A correction to the article "Opportunistic smoking cessation interventions for people accessing financial support settings: A scoping review," published online is presented.

Introduction: There is limited research exploring how smoking cessation treatment should be implemented into lung cancer screening in the United Kingdom. This study aimed to understand attitudes and preferences regarding the integration of smoking cessation support within lung cancer screening from the perspective of those eligible. Methods: Thirty‐one lung cancer screening eligible individuals aged 55–80 years with current or former smoking histories were recruited using community outreach and social media. Two focus groups (three participants each) and 25 individual telephone interviews were conducted. Data were analysed using the framework approach to thematic analysis. Results: Three themes were generated: (1) bringing lung cancer closer to home, where screening was viewed as providing an opportunity to motivate smoking cessation, depending on perceived personal risk and screening result; (2) a sensitive approach to cessation with the uptake of cessation support considered to be largely dependent on screening practitioners' communication style and expectations of stigma and (3) creating an equitable service that focuses on ease of access as a key determinant of uptake, where integrating cessation within the screening appointment may sustain increased quit motivation and prevent loss to follow‐up. Conclusions: The integration of smoking cessation into lung cancer screening was viewed positively by those eligible to attend. Screening appointments providing personalized lung health information may increase cessation motivation. Services should proactively support participants with possible fatalistic views regarding risk and decreased cessation motivation upon receiving a good screening result. To increase engagement in cessation, services need to be person‐centred. Patient or Public Contribution: This study has included patient and public involvement throughout, including input regarding study design, research materials, recruitment strategies and research summaries. [ABSTRACT FROM AUTHOR]

Background and aims: Nicotine is a highly addictive substance in tobacco products that dysregulates several neurotransmitters in the brain and impairs executive function. Non‐invasive brain stimulation (NIBS) methods such as repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are promising treatments for nicotine dependence. We investigated the efficacy and acceptability of NIBS in managing smoking cessation through a systematic review and network meta‐analysis (NMA). Methods: We conducted a systematic review to identify randomized controlled trials (RCTs) that investigated the efficacy of NIBS for smoking cessation. All pairwise meta‐analyses and NMA procedures were conducted using random‐effects and frequentist models. The co‐primary outcomes were (1) the change in number of cigarettes smoked per day (change in frequency of smoking) in patients with nicotine dependence after NIBS and (2) acceptability (the dropout rate). The effect sizes for co‐primary outcomes of change in frequency of smoking and acceptability were assessed according to standardized mean difference (SMD) and odds ratio, respectively. Results: Twelve RCTs with 710 participants (mean age: 44.2 years, 31.2% female) were included. Compared with the sham control, 10‐Hz rTMS over the left dorsolateral prefrontal cortex (DLPFC) was associated with the largest changes in smoking frequency [SMD = −1.22, 95% confidence interval (95% CI) = −1.77 to −0.66]. The 2‐mA bifrontal tDCS (SMD = −0.97, 95% CI = −1.32 to −0.62) and 10‐Hz deep rTMS over the bilateral DLPFC with cue provocation (SMD = −0.77, 95% CI = −1.20 to −0.34) were associated with a significantly larger decrease in smoking frequency versus the sham. None of the investigated NIBSs was associated with dropout rates significantly different from those of the sham control groups. Conclusion: Prefrontal non‐invasive brain stimulation interventions appear to reduce the number of cigarettes smoked with good acceptability. [ABSTRACT FROM AUTHOR]

BACKGROUND: Despite recent tobacco control efforts, adolescent vaping remains an epidemic in the United States. The purpose of our study was to understand high school student vaping behaviors using the perceptions of Massachusetts school personnel during the critical window from when the Massachusetts statewide flavor ban legislation was passed in November 2019 through the first year of the COVID‐19 pandemic. METHODS: High school personnel throughout Massachusetts were invited to complete a cross‐sectional survey. Analysis of survey responses was conducted in R. RESULTS: A total of 162 respondents completed the survey representing 137 schools that draw enrollments from 216 (61%) of the 352 cities and towns in Massachusetts. The most popular products that respondents believed their students were using were JUULs (95.7%), other e‐cigarettes (85.3%), and disposable vapes (79.6%). Following the flavor ban, the majority (90.7%) did not report an increase in combusted tobacco product use. All participants (100%) reported wanting more access to prevention and treatment resources. CONCLUSIONS: Our findings suggest that a comprehensive flavor ban may be an effective tobacco control policy that does not appear to promote student switching from vaping products to combusted tobacco products. These data also indicate that schools report needing additional resources to address the vaping epidemic. [ABSTRACT FROM AUTHOR]

Aims: To summarize evidence on tobacco addiction interventions published by the Cochrane Tobacco Addiction Group (CTAG) from 2019 to 2020. Methods: Narrative summary of all new and updated Cochrane Reviews published by CTAG in 2019 and 2020, outlining key results and promising avenues for future research. Results: CTAG published six new reviews and updated 15 reviews. There is high‐certainty evidence that combining fast‐acting nicotine replacement therapy (NRT) with transdermal patches helped more people to quit than single‐form NRT [risk ratio (RR) = 1.25, 95% confidence interval (CI) = 1.15–1.36, 14 studies, n = 11 356; I2 = 4%] and moderate‐certainty evidence that using NRT before quitting can increase quit rates more than using NRT from quit day onwards (RR = 1.25, 95% CI = 1.08–1.44, nine studies, n = 4395; I2 = 0%). Reducing smoking in order to quit completely results in similar quit rates to abrupt quitting (RR = 1.01, 95% CI= 0.87–1.17; I2 = 29%; 22 studies, n = 9219; moderate‐certainty). Electronic cigarettes may help more people quit than NRT (RR = 1.53, 95% CI = 1.21–1.93; I2 = 0%; four studies, n = 1924; moderate certainty), nicotine‐free electronic cigarettes (RR = 1.94, 95% CI = 1.21–3.13; I2 = 0%; five studies, n = 1447; moderate‐certainty) and behavioural/no support (RR = 2.61, 95% CI = 1.44–4.74; I2 = 0%; six studies, n = 2886; very low‐certainty). Varenicline may help prevent relapse in abstainers (RR = 1.23, 95% CI = 1.08–1.41; I2 = 82%; 11 studies, n = 1297; moderate‐certainty), but behavioural support did not prevent relapse (RR = 0.98, 95% CI = 0.87–1.11; I2 = 52%; 11 studies, n = 5523; moderate‐certainty). Financial incentives increased quit rates in the general population (RR = 1.49, 95% CI = 1.28–1.73; I2 = 33%; 30 studies, adjusted n = 20 097; high‐certainty) and during pregnancy (RR = 2.38, 95% CI = 1.54–3.69; I2 = 41%; nine studies, n = 2273; moderate‐certainty). This overview also provides detail on a wider range of interventions. Conclusions: There is high certainty that using nicotine replacement therapy from quit day increases smoking abstinence and no further research is required. Evidence is less certain that nicotine replacement increases abstinence when used in higher doses tailored to particular groups of smokers or use prior to quit day, and further research would be helpful. There is moderate‐certainty evidence to support the use of e‐cigarettes as cessation aids, but research on their role in preventing relapse would be particularly helpful. [ABSTRACT FROM AUTHOR]

Background and Aims: Clinicians could promote e‐cigarettes for harm reduction to people who smoke but cannot stop, but many clinicians feel uneasy doing so. In a randomized controlled trial (RCT), primary care clinicians offered free e‐cigarettes and encouraged people with chronic diseases who were unwilling to stop smoking to switch to vaping. We interviewed clinicians and patients to understand how to adopt harm reduction in routine practice. Design Qualitative analysis nested within an RCT, comprising thematic analysis of semi‐structured interviews with primary care clinicians who delivered the trial intervention, and patients who took part. Setting: Primary care clinics in England. Participants/Cases: Twenty‐one patients and 11 clinicians, purposively sampled from an RCT. Measurements We qualitatively explored patients' and clinicians' experiences of: being offered/offering an e‐cigarette, past and current perceptions about e‐cigarettes and applying a harm reduction approach. Findings Four themes captured clinicians' and patients' reported perspectives. These were: (1) concepts of safety/risk, with clinicians concerned about recommending a product with unknown long‐term risks and patients preferring the known risks of cigarettes; (2) clinicians felt they were going out on a limb by offering these as though they were prescribing them, whereas patients did not share this view; (3) equating quitting with success, as both patients and clinicians conceptualized e‐cigarettes as quitting aids; and (4) unchanged views, as clinicians reported that training did not change their existing views about e‐cigarettes. These themes were united by the higher‐order concept: 'The old and familiar meets the new and unknown', as a contradiction between this new approach and long‐established methods underpinned these concerns. Conclusions: A qualitative analysis found barriers obstructing clinicians and patients from easily accepting e‐cigarettes for harm reduction, rather than as aids to support smoking cessation: clinicians had difficulty reconciling harm reduction with their existing ethical models of practice, even following targeted training, and patients saw e‐cigarettes as quitting aids. [ABSTRACT FROM AUTHOR]