Search

Aims Active recruitment of smokers increases the reach of quitlines; however, some quitlines restrict proactive telephone counselling (i.e. counsellor-initiated calls) to smokers ready to quit within 30 days. Identifying characteristics associated with successful quitting by actively recruited smokers could help to distinguish those most likely to benefit from proactive telephone counselling. This study assessed the baseline characteristics of actively recruited smokers associated with prolonged abstinence at 4, 7 and 13 months and the proportion achieving prolonged abstinence that would miss out on proactive telephone counselling if such support was offered only to smokers intending to quit within 30 days at baseline. Design Secondary analysis of a randomized controlled trial in which the baseline characteristics associated with prolonged abstinence were examined. Setting New South Wales ( NSW) community, Australia. Participants A total of 1562 smokers recruited at random from the electronic NSW telephone directory. Measurements Baseline socio-demographic and smoking-related characteristics associated with prolonged abstinence at 4, 7 and 13 months post-recruitment. Findings Waiting more than an hour to smoke after waking and intention to quit within 30 days at baseline predicted five of the six prolonged abstinence measures. If proactive telephone counselling was restricted to smokers who at baseline intended to quit within 30 days, 53.8-65.9% of experimental group participants who achieved prolonged abstinence would miss out on telephone support. Conclusions Less addicted and more motivated smokers who are actively recruited to quitline support are more likely to achieve abstinence. Most actively recruited smokers reported no intention to quit within the next 30 days, but such smokers still achieved long-term abstinence. [ABSTRACT FROM AUTHOR]

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: Little research has examined issues surrounding employee smoking outside smoke-free workplaces. The study's aims were to: 1) document the proportion of NSW indoor employees covered by total workplace smoking bans; 2) examine community perceptions of employee smoking during working hours; 3) identify the characteristics of having a supportive attitude toward tobacco control in the workplace; and 4) describe relationships between smoking relapse and workplace-related smoking. Methods: Two cross-sectional, computer-assisted telephone interview surveys of randomly selected adults were conducted. Consent rates were 49.1% in 2004 and 45.8% in 2006, with sample sizes of 1,158 and 2,393 respectively. Results: Total workplace bans were reported by 92.9% of indoor employees. Community attitudes to smoking in working hours were highly negative: 77.7% agreed smoking breaks waste too much time and 85.1% opposed smoking near workplace doorways. Being female, born in Australia and a non-smoker were associated with more negative attitudes. A higher proportion of smokers (78.3%) perceived smoking was more common outside their place of work or study than at five other locations: rail/bus stop (60.2%), friends' houses (59.3%), own street (35.2%), parks (34.3%), and outside school (22.6%). Of smokers making a quit attempt in the past year, 42.1% relapsed at home, 22.1% at licensed premises and 18.7% at work. Conclusions: Findings emphasise the low support for smoking during or near work. Smoking outside workplaces is highly visible. Data on relapse suggest a modest relationship with workplace-related smoking. [ABSTRACT FROM AUTHOR]

Objectives Active telephone recruitment ('cold calling') can enrol almost 45 times more smokers to cessation services than media. However, the effectiveness of proactive telephone counselling with cold-called smokers from the broader community is unknown. This study examined whether proactive telephone counselling improved abstinence, quit attempts and reduced cigarette consumption among cold-called smokers. Methods From 48 014 randomly selected electronic telephone directory numbers, 3008 eligible smokers were identified and 1562 (51.9%) smokers recruited into the randomised controlled trial. Of these, 769 smokers were randomly allocated to proactive telephone counselling and 793 to the control (ie, mailed self-help) conditions. Six counselling calls were offered to intervention smokers willing to quit within a month and four to those not ready to quit. The 4-month, 7-month and 13-month follow-up interviews were completed by 1369 (87.6%), 1278 (81.8%) and 1245 (79.9%) participants, respectively. Results Proactive telephone counselling participants were significantly more likely than controls to achieve 7-day point prevalence abstinence at 4 months (13.8% vs 9.6%, p=0.005) and 7 months (14.3% vs 11.0%, p=0.02) but not at 13 months. There was a significant impact of telephone counselling on prolonged abstinence at 4 months (3.4% vs 1.8%, p=0.02) and at 7 months (2.2% vs 0.9%, p=0.02). At 4 months post recruitment, telephone counselling participants were significantly more likely than controls to have made a quit attempt (48.6% vs 42.9%, p=0.01) and reduced cigarette consumption (16.9% vs 9.0%, p=0.0002). Conclusions Proactive telephone counselling initially increased abstinence and quitting behaviours among cold-called smokers. Given its superior reach, quitlines should consider active telephone recruitment, provided relapse can be reduced. [ABSTRACT FROM AUTHOR]

Objective To compare alcohol-related intervention and general interactional skills performance of medical students from a traditional (Sydney) and a non-traditional (Newcastle) medical school, before and after participation in an alcohol education programme about brief intervention. Design In two controlled trials, students received either a didactic alcohol education programme or didactic input plus skills-based training. Prior to and after training, all students completed videotaped interviews with simulated patients. Setting The Faculties of Medicine at the University of Newcastle and the University of Sydney, Australia. Subjects Fifth-year medical students (n=154). Results Both alcohol-related intervention and general interactional skills scores of the Newcastle students were significantly higher than those of the Sydney students at pre-test but not after training. Although alcohol-related interactional skills scores improved after training at both universities, they did not reach a satisfactory level. The educational approach used had no effect on post-test scores at either university. Conclusions Significant baseline differences in interactional skills scores favouring non-traditional over traditional students were no longer evident after both groups had been involved in an alcohol education programme. Further research is required to develop more effective alcohol intervention training methods. [ABSTRACT FROM AUTHOR]

Aims. Two methods of dissemination (simple and intensive) were used to disseminate a smoking cessation programme to doctors and midwives working in antenatal clinics. This paper describes the differential uptake of the smoking cessation programme by doctors and midwives. It investigates whether the number of smoking cessation interventions used differ due to the type of dissemination. It also examines the frequency with which doctors and midwives provide smoking cessation interventions after dissemination. Design. Clinics were randomized to the method of dissemination (simple or intensive). Pre-post test design was used to examine the relationship between dissemination method and professional status at baseline and follow-up. A baseline survey collected data on the use of smoking cessation intervention in the clinics prior to dissemination. A follow-up survey was conducted 18 months after the dissemination. Setting. Twenty-three public hospital antenatal clinics in NSW. Participants. All clinical staff (midwives and doctors) working in the clinic during the 1-2-week survey period prior to dissemination and 18 months after the dissemination were asked to participate. The response rate was 63% (223) at baseline and 64% (182) at follow-up. Only 48% of midwives and doctors at follow-up were working in the original clinic. Measures. The proportion of clinicians who initially adopted the programme; the proportion of clinicians who had used one or more programme components in the last week); the number of types of smoking cessation intervention provided (maximum = 13), and the estimated proportion of clients offered smoking cessation intervention. Findings. More midwives than doctors 'ever used' the programme (76% vs. 25%) and continued to implement (58% vs. 22%) the programme 18 months after dissemination. Both midwives and doctors increased the number of types of smoking cessation intervention offered at follow-up compared to baseline (mean difference 2.8). Midwives provided more smoking cessation interventions than doctors at baseline (mean difference 0.9) and at follow-up (1.6), regardless of method used to disseminate the programme. Midwives' mean estimates of the proportion of clients offered interventions were greater than doctors' (midwives' 59% vs. doctors' 35%) at follow-up. Conclusion. The dissemination of a smoking cessation programme increased the level of smoking cessation interventions used by doctors and midwives. Doctors and midwives differ in their uptake of smoking cessation programmes. This information can be used to plan programme dissemination strategies in the future. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine recent levels of exposure to smoking in movies, how the community perceived the level of smoking they saw in recently-viewed movies and whether there was community support for any form of regulation. Methods: As part of a 2004 New South Wales survey of smoking-related perceptions and practices, 1,154 adults participated in a computer-assisted telephone interview about perceptions relating to smoking depiction in movies and television. Results: More than one-quarter of those who had seen a recent movie in the cinema (28.5%) or on DVD (33.9%) thought that the movie contained excessive or inappropriate smoking. More than half the sample (59.1%) considered it likely the tobacco industry played a role in the level of smoking depiction, although only 18% of those who thought a recent movie contained excessive smoking attributed this to the tobacco industry. Almost two-thirds of respondents favoured screening anti-tobacco advertisements prior to movies with smoking. Conclusion: Cinema and DVD movies commonly include scenes where there is excessive or inappropriate smoking. It is widely believed that the tobacco industry is contributing to this, and there is strong community support for action to curb the harmful influences this may be having. [ABSTRACT FROM AUTHOR]

Background: Only 1%–7% of adult smokers use quitlines annually. Active telephone recruitment may increase utilization and enroll new groups of quitline users. Purpose: This study aimed to (1) determine the proportion of adult daily smokers actively recruited by telephone to quitline support; (2) calculate the cost per smoker recruited; and (3) compare the characteristics of participants to smokers in the New South Wales (NSW, Australia) general population. Methods: Between September 2005 and April 2007, 1562 adult daily smokers randomly selected from the electronic NSW telephone directory were recruited into an RCT. The proportion of smokers and the cost per smoker recruited were examined. Participants were compared to NSW adult daily smokers from the NSW Population Health Survey and the Centre for Health Research & Psycho-oncology Smoking Community Survey. Analysis was completed in 2008. Results: More than half (52%) of eligible smokers contacted by telephone were recruited into cessation support. The cost per smoker recruited was AU$71 (US$59). Active telephone recruitment successfully enrolled smokers who are currently under-represented among quitline users. For instance, more than two thirds (68%) of participants were not intending to quit within 1 month. Compared with NSW adult daily smokers, participants were significantly more likely to be older; more highly educated; married/living with partner or divorced/separated; a nonmetropolitan resident; more nicotine dependent; more ready to quit; and have fewer household members. Participants were significantly less likely to live with a smoker than were NSW adult daily smokers. Conclusions: Active telephone recruitment has the potential to substantially increase the proportion of smokers using quitline services at a reasonable cost. This method also engages smokers currently under-represented in quitline populations. [Copyright &y& Elsevier]

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]

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., Methods: Smokers (N = 1,562) randomly selected from the New South Wales telephone directory were actively recruited by telephone into a randomized controlled trial that offered proactive telephone counseling (n = 769) or self-help materials (control: n = 793). Overall, 1,369 completed the 4-month postrecruitment interview, which examined acceptability., Results: More than 90% of 4-month interview respondents found active telephone recruitment to cessation assistance acceptable. Of smokers allocated to proactive telephone counseling (n = 769), 90% accepted at least one and 65% three or more counseling calls. Of control participants who completed the 4-month interview, 84% read at least some self-help materials. Proactive telephone counseling recipients were significantly more likely than self-help material users to find the advice useful. Few characteristics predicted acceptability of proactive telephone counseling or self-help materials, suggesting that many types of smokers actively recruited by telephone are receptive to support., Discussion: Active telephone recruitment could potentially enroll a broader representation of smokers to quitline services. Given these smokers are receptive to cessation assistance, quitlines should consider active telephone recruitment.

Unlabelled: AIMS, DESIGN AND INTERVENTION: Smoking care provision to in-patients is important in assisting smoking cessation and for management of nicotine withdrawal. Limited studies have reported the effectiveness of interventions designed to increase the hospital-wide provision of such care. A quasi-experimental matched-pair trial, involving two intervention and two control hospitals in NSW, Australia, investigated whether a multi-strategic intervention increased hospital-wide smoking care provision., Participants and Measurements: Patient surveys (n = 274-347 per experimental condition), medical notes audits (n = 181-228) and health professional surveys (n = 229-302) were used to collect outcome data at baseline and follow-up., Findings: Significantly greater increases in intervention hospitals compared to control hospitals were found for patient-reported offer of nicotine replacement therapy (NRT) (intervention 34% versus control 12%), provision of NRT (16% versus 4%) and provision of written resources (11% versus 2%), and for the recording in medical notes of smoking management discussion (13% versus 3%), offer of NRT (24% versus 3%) and provision of NRT (21% versus 5%). Intervention group health professionals reported significantly greater increases in the mean estimate of patients who: had their smoking management discussed (30% versus 17%); were offered or provided with NRT (30% versus 18%); were asked their intention to smoke post-discharge (22% versus 10%); and were provided with discharge NRT (21% versus 4%)., Conclusions: Implementation of a multi-strategic intervention is effective in increasing hospital smoking care delivery, particularly the provision of NRT. Research is required to identify methods to increase further the delivery of this and other forms of smoking care.

Adolescent smoking prevalence is usually assessed via self-complete questionnaires. However, concern has been expressed about the validity of such self-report. One approach to increase validity involves the threat of biological validation, known as the bogus pipeline method (BPL).This study aimed to assess the effects of BPL, using an expired air carbon monoxide monitor, and of questionnaire anonymity on student smoking self-report data. High school students (n=801) were randomly allocated to one of four conditions: anonymous questionnaire+BPL, named questionnaire+BPL, anonymous questionnaire without BPL and named questionnaire without BPL. Overall, 37% of students agreed that questionnaires were a good way to obtain honest answers. In a logistic regression analysis, students in the BPL condition had significantly higher odds of reporting weekly smoking (OR=1.83 95% CI 1.27-2.65) and monthly smoking (OR=1.66 95% CI 1.21-2.28) but not of lifetime smoking compared with non-BPL students. Students in the named questionnaire condition had a significantly higher odds of reporting lifetime smoking (OR=1.49 95% CI 1.08-2.04) compared with anonymous students. Studies assessing current smoking patterns in adolescents should consider incorporating a BPL method.

Issue Addressed: Quitting intentions and behaviours of smokers require monitoring. In particular, assessment of the distribution of smokers on the quitting continuum and of the proportion of hard-core smokers has implications for the design of future quit campaigns., Methods: Cross-sectional survey of 1,509 persons (74.4% consent rate) randomly selected from the New South Wales Electronic White Pages. 1,431 respondents were eligible (aged 18 and over)., Results: Current smokers comprised 19.1% (n=274) and former smokers 28.0% (n=400). Sixty-one per cent of current smokers had quit for at least one day in the last year and 67.1% were in the intermediate or advanced preparation levels of the quitting continuum. Half of the smokers (46.7%) recalled receiving cessation advice during a past-year medical visit. Sixty-four point five per cent (64.5%) of smokers and 63.4% of former smokers reported no use of assistance in their quit attempts. Five point five per cent (5.5%) of smokers aged 26 and over met the hard-core criteria., Conclusion: Most smokers want to quit but when making a quit attempt do not use proven, effective strategies. Relapse rates are high in the immediate post-cessation period.

In Australia, the prevalence of smoking is higher among certain sub-populations compared to the general population. These sub-populations include Aboriginal and Torres Strait Islander people, people from culturally and linguistically diverse backgrounds, as well as people with mental and substance use disorders and prisoners. The aims of this paper are to: describe the high prevalence of smoking among these particular sub-populations and harms associated with smoking; explore possible reasons for such high prevalence of smoking; review the evidence regarding the efficacy of existing smoking cessation interventions; and make recommendations for smoking interventions and further research among these groups. In addition to low socio-economic status, limited education and other factors, there are social, systems and psychobiological features associated with the high prevalence of smoking in these sub-groups. General population-based approaches to reducing smoking prevalence have been pursued for decades with great success and should be continued with further developments that aim specifically to affect Aboriginal and Torres Strait Islander people and some cultural groups. However, increasing attention, more specific targeting and flexible goals and interventions are also required for these and other distinct sub-populations with high smoking prevalence. Recommendations include: more funding and increased resources to examine the most appropriate education and treatment strategies to promote smoking cessation among people from Aboriginal and Torres Strait Islander and some culturally and linguistically diverse backgrounds; larger and better-designed studies evaluating smoking cessation/reduction interventions among distinct sub-groups; and system-wide interventions requiring strong leadership among clients and staff within mental health, drug and alcohol and prison settings.

Objective: To assess community attitudes and practices in relation to fake tanning lotions., Methods: 1,509 New South Wales residents aged 15 years and over, selected at random, completed a computer-assisted telephone survey., Results: Thirty-three per cent of respondents thought fake tanning lotions were unsafe. In relation to The Cancer Council marketing fake tanning lotions, more than three-fifths thought The Cancer Council would be promoting tans, although 62% thought it would be a good thing as fake tans are safer than tanning in the sun. Nine per cent of respondents had used fake tanning lotions in the past 12 months. Almost half (48%) of female current users used fake tanning lotions occasionally or only for special occasions during the past summer. In particular settings, the sunscreen and hat-wearing practices of female users and non-users of fake tanning lotions differed significantly., Conclusion: There appears to be no consistent data to suggest that fake tanning lotions may be used as a safer alternative to sun tanning. However, there is a responsibility to at least disseminate accurate information on these products.

Objective: To assess community knowledge, attitudes and practices in relation to environmental tobacco smoke (ETS) especially in homes, private motor vehicles and licensed premises, and to document levels of support for further government legislation., Methods: 656 persons aged 18 years and over, a sub-sample in a computer-assisted telephone survey of 2,087 randomly selected respondents across NSW, answered 12 ETS-specific questions. The whole sample was asked demographic, smoking status and household membership questions. The overall response rate was 61.4% (consent rate 75.4%)., Results: Overall, 32.8% (95% CI 27.8-37.8) of children aged 0-4 years in the households surveyed were reported to live with at least one smoker. Agreement about ETS hazards was lowest in relation to child ear problems (31.2%) and sudden infant death syndrome (50.6%). Complete bans on smoking were reported in 69.9% of homes and 77.1% of private motor vehicles. The percentages favouring total bans in homes (p < 0.001) and private motor vehicles (p < 0.001) were significantly lower among smokers than non-smokers. Overall, 55.8% supported legislation to ban smoking in private vehicles carrying children. The majority support restrictions on smoking in non-eating areas of licensed clubs (88.7%) and hotels (84.8%). Overall, the data indicate a ban on smoking in licensed premises is likely to increase business., Conclusion: Smoking is banned in most NSW homes and private motor vehicles. Acceptance of ETS risks is high but there are important knowledge gaps. Considerable support exists for further government regulation of ETS. Media campaigns are likely to reinforce a public environment already receptive of the need for more government ETS restrictions.