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Introduction: Understanding the characteristics of smokers who enroll in a trial of quitline support and those who decline could guide recruitment approaches and service delivery to better engage smokers and increase successful quitting. However, it is unknown whether factors such as smokers’ perceived effectiveness of using quitting aids or self-exempting beliefs are associated with quitline uptake. We compared the sociodemographic characteristics, smoking behaviours, perceived effectiveness of using quitting aids, and self-exempting beliefs of participants and nonparticipants who were actively telephoned and offered quitline support as part of a randomized controlled trial. Methods: Overall, 48,014 telephone numbers were randomly selected from the electronic telephone directory and contacted. A total of 3,008 eligible smokers were identified and invited to participate in a trial of quitline support. Consenting trial participants (n = 1,562) and nonparticipants (n = 500) completed a baseline interview. Results: Multivariate analysis showed that the following factors were associated with trial participation: consumption of 21 or more cigarettes per day (odds ratio [OR] = 1.45 [1.07–1.99]), readiness to quit within 30 days (OR = 4.45 [3.20–6.19]) or 6 months (OR = 3.22 [2.46–4.23]), perceiving that calling the quitline was definitely (OR = 2.34 [1.62–3.39]) or partly effective (OR = 2.15 [1.63–2.83]), believing that using self-help materials was partly effective (OR = 1.50 [1.16–1.94]), thinking that nicotine replacement therapy was partly effective (OR = 1.38 [1.04–1.84]), perceiving that using willpower alone was partly (OR = 1.99 [1.48–2.67]) or not effective (OR = 2.60 [1.95–3.46]), and not holding a self-exempting belief (OR = 1.45 [1.11–1.89]). Conclusions: Increasing smokers’ utilization of quitlines is likely to require changing their perceptions of the effectiveness of quitting strategies compared with using willpower alone and addressing self-exempting beliefs. [ABSTRACT FROM PUBLISHER]

Introduction: Only 1%–7% of smokers use quitlines annually. Active telephone recruitment (“cold calling”) can enroll about 50% of community smokers to quitline services. However, whether cold-called smokers’ characteristics differ from traditional quitline clients is unknown. To assess whether active telephone recruitment reaches new groups of smokers, New South Wales (NSW) Quitline callers were compared with cold-called smokers who received telephone counseling as part of a randomized controlled trial. Methods: Data were extracted from the NSW Quitline database from September 13, 2005, to April 10, 2007, to coincide with the trial’s recruitment period. Records (n = 18,584) of first-time quitline callers, who smoked daily, resided in NSW, Australia, and received telephone counseling were included. Cold-called participants who received telephone counseling (n = 695) were recruited by telephone from the electronic NSW telephone directory. Eligibility requirements were daily tobacco use, aged 18 or older, NSW resident, and English speaking. Smokers were eligible regardless of their quitting intention. Results: Male smokers, older age groups, those living in nonmetropolitan areas, smokers who took longer to smoke their first cigarette after waking, consumed fewer cigarettes per day, and were less motivated to quit had greater odds of being referred to the quitline through cold calling. Conclusions: Active telephone recruitment enrolls new groups of smokers to quitlines. The reach of quitlines could be improved if quitlines incorporated cold calling into their recruitment strategies. [ABSTRACT FROM PUBLISHER]

Issue addressed: TAFE staff are likely to play a pivotal role in achieving smoke-free environments for vocational education. The aim of this survey was to explore staff experiences, behaviours and attitudes towards smoking and smoke-free policies for the TAFE setting. Method: A web-based survey that measured smoking behaviours, on-campus exposure to smoking, awareness of smoke-free policies and attitudes towards smoking and tobacco control was e-mailed to all staff at one TAFE New South Wales (NSW) institute. In total, 632 staff completed the survey. Results: Overall, 10% of staff reported to be current daily, weekly or occasional smokers. Most staff (76.2%) said that they saw someone smoking at TAFE every day and the most common location was 'outside buildings' (75.3%). A majority of staff (75.9%) said they avoided places at TAFE where they were exposed to other peoples' cigarette smoke. Only 26% said that existing smoking policies were always enforced. Non-smokers had a significantly higher (p<0.005) pro-tobacco control attitudes score mean of 4.2 (SD=1.8), compared with the mean of 2.3 (SD=1.4) for current smokers. Status as a non-smoker was the only statistically significant predictor of high pro-tobacco control attitude score. Conclusions: This study provides preliminary evidence that TAFE staff are likely to be supportive of smoke-free TAFE campuses. [ABSTRACT FROM AUTHOR]

Introduction:: Passive recruitment strategies relying on smoker-initiated contact probably contribute to particular groups of smokers using quitlines. Compared with the smoking population, smokers who call quitlines are more likely to be female, younger, higher educated, more addicted, quit previously, and motivated to quit. Quitlines could adopt new recruitment approaches such as active telephone recruitment involving recruiter-initiated contact, since this may enroll a broader representation of smokers. This study explored acceptability of active telephone recruitment to quitline support, smokers’ use, and acceptability of assistance and predictors of acceptability. [ABSTRACT FROM PUBLISHER]

Hospitals are key settings for the provision of smoking cessation care. Limited data are available that describe the prevalence and type of such care delivered routinely in this setting. We reviewed studies conducted in hospitals and published between 1994 and 2005 that reported levels of smoking care delivery. This review describes the proportion of patients receiving, and the proportion of health professionals providing, various smoking cessation care practices. We used both descriptive and meta-analytic methods. According to the meta-analysis, smoking status was assessed in 60% of patients, 42% were advised or counseled to quit, 14% were provided with or advised to use nicotine replacement therapy (NRT), and 12% received referrals or follow-up. Significantly fewer patients received follow-up or referrals than were assessed for smoking status or received advice or counseling to quit. Some 81% of health professionals reported they assessed smoking status, 70% advised or counseled patients to quit, 13% provided NRT or advised its use, and 39% provided referrals or follow-up. Significantly fewer health professionals advised or prescribed NRT than assessed smoking status or advised or counseled patients to quit. Statistical heterogeneity was indicated for all smoking care practices. Levels of smoking cessation care are less than optimal in hospitals, and the levels of some important care practices are particularly low. Future research should identify effective methods for increasing smoking care provision in this setting. In addition, standardized measures of smoking care should be developed. Hospital organizations should enhance and continue to monitor their delivery of smoking care. [ABSTRACT FROM AUTHOR]

A selective review of the literature was conducted to provide evidence-based recommendations for the clinical management of hospitalized smokers. The Cochrane library, in particular the Cochrane review of 'Interventions for smoking cessation in hospitalised patients', was the basis for the review and was supplemented with other clinical and non-clinical literature where the review did not inform clinicians sufficiently. Evidence was reviewed on issues considered by the authors to be of importance to health professionals interested in providing a smoking cessation intervention to their patients. The review suggests that effective hospital interventions: incorporate an in-patient intervention lasting greater than 20 minutes in duration with extended post discharge follow-up; consist of at least five intervention contacts; and be delivered over at least a 3-month period. Furthermore, interventions should include in-patient advice and counselling, the provision of nicotine replacement therapy and extended proactive post discharge telephone support. The review also indicates that cessation interventions are particularly effective when delivered to patients with a cardiovascular diagnosis. All health professionals may be effective in providing cessation treatments; however, the addition of a specialist smoking cessation counsellor appears to improve interventions in this setting. Finally, without the development of supportive systems, routine intervention with smoking patients by health professionals is unlikely. Recommendations for the delivery of effective smoking cessation interventions in hospitals are provided. [Wolfenden L, Campbell E, Walsh RA, Wiggers J. Smoking cessation interventions for in-patients: a selective review with recommendations for hospital-based health professionals. Drug Alcohol Rev 2003;22:437 - 452] [ABSTRACT FROM AUTHOR]

Editorial. Comments on the effectiveness of nicotine replacement therapy (NRT) as part of a smoking cessation program. Public policy with respect to NRT; Justification for deregulating the sale of NRT; Likelihood of quitting of smoking among NRT users against placebo groups.

Objectives. A randomized trial evaluated the impact of smoking cessation interventions on point prevalence and consecutive quit rates at an Australian public prenatal clinic. Methods. Self-reports and urine cotinine tests confirmed patients' smoking status at the midpoint and end of pregnancy and 6 weeks postpartum. Results. At all points, validated abstinence rates were significantly higher in the experimental group than in the control group. The rate of failed biochemical validation was significantly higher in the control group than in the experimental group. Conclusions. Prenatal clinic staff can significantly increase quit rates by using cognitive-behavioral strategies. Brief advice appears to be ineffective. [ABSTRACT FROM AUTHOR]

Abstract: Relatively little attention has been given to the retail availability of tobacco products despite the likelihood that ubiquitous supply may represent a primary form of tobacco promotion in Australia. This study aimed to explore the number and distribution of tobacco outlets, smokers’ perceptions about the availability of tobacco and the role availability may play in tobacco consumption and quitting attempts in Australia. The study comprised two parts: Part A involved mapping retail tobacco outlets in the Hunter Region of NSW, Australia. Part B involved a statewide telephone survey of 539 current smokers aged 18 years and over in NSW. Part A identified 1270 retail tobacco outlets, giving a density of one outlet per 384 persons aged over 15 years, or one outlet per 77 smokers. Associations between socioeconomic status of areas and retail availability of tobacco were not found. Of the survey respondents in Part B, 87.5% indicated that they would be within walking distance of a retail tobacco outlet during their daily activities. Those who were younger, male and single were more likely to purchase tobacco at convenience-type outlets. We therefore conclude that some groups of smokers appear vulnerable to the availability of tobacco and a reduction in the availability of tobacco is likely to benefit smokers who wish to quit. [ABSTRACT FROM AUTHOR]