Pregnancy ebooksclub.org Tobacco or Health Physiological and Social Damages Caused by Tobacco Smoking Second Edition

10.13 E-Learning, Email and Internet for Smoking Cessation

In฀the฀past฀few฀years,฀internet฀or฀email-driven฀programmes฀for฀smoking฀cessation฀were฀ established฀ [111] .฀A฀study฀by฀Riley฀et฀al.฀sought฀to฀test฀the฀feasibility฀of฀two฀self-help฀ behavioural฀interventions฀to฀reduce฀and฀maintain฀a฀50฀reduction฀in฀smoking฀among฀ those฀unable฀or฀unwilling฀to฀quit,฀and฀to฀evaluate฀the฀impact฀of฀smoking฀reduction฀on฀ subsequent฀quit฀attempts฀ [112] .฀Ninety-three฀smokers฀who฀desired฀to฀reduce฀rather฀than฀ quit฀smoking฀were฀entered฀in฀the฀study฀and฀randomly฀assigned฀to฀either฀computerized฀ scheduled฀gradual฀reduction฀CSGR฀or฀a฀manual-based฀selective฀elimination฀reduction฀ SER.฀Both฀groups฀produced฀signiicant฀reductions฀in฀smoking฀approximately฀10฀ciga- rettesday,฀during฀the฀7-week฀treatment฀phase,฀which฀were฀maintained฀over฀1฀year.฀The฀ CSGR฀group฀reported฀greater฀mean฀percent฀reductions฀in฀smoking฀from฀pre-฀to฀post- treatment฀37฀for฀CSGR,฀20฀for฀SER฀and฀a฀greater฀percentage฀of฀subjects฀meeting฀ the฀50฀reduction฀goal฀30฀for฀CSGR,฀16฀for฀SER฀compared฀with฀the฀SER฀group.฀ The฀groups฀were฀comparable,฀however,฀on฀all฀other฀outcome฀measures฀at฀post-treatment฀ and฀at฀6-฀and฀12-month฀follow-up.฀Although฀subjects฀with฀a฀current฀desire฀for฀smoking฀ cessation฀were฀excluded฀from฀this฀study,฀one-third฀of฀the฀subjects฀reported฀a฀24-h฀quit฀ attempt฀in฀the฀year฀following฀study฀initiation,฀and฀8.6฀of฀the฀subjects฀met฀7-day฀point- prevalence฀criteria฀for฀abstinence฀CO฀validated฀at฀the฀12-month฀follow-up.฀The฀results฀ of฀this฀study฀lend฀support฀to฀the฀feasibility฀of฀self-help฀behavioural฀interventions฀to฀pro- duce฀sustained฀reductions฀in฀smoking฀rates฀without฀apparent฀negative฀impact฀on฀subse- quent฀quit฀attempts฀ [112] .

10.14 Concluding Remarks

• ฀ The฀counselling฀of฀smokers฀by฀a฀physician฀or฀other฀trained฀health฀care฀professionals฀is฀ an฀essential฀component฀of฀smoking฀cessation. • ฀ Behavioural฀therapy฀programmes฀have฀proved฀effective฀in฀terms฀of฀non-pharmacolog- ical฀counselling฀and฀treatment,฀and฀these฀should฀also฀be฀used฀in฀pregnant฀women. • ฀ Mass฀media฀campaigns฀reach฀larger฀segments฀of฀the฀population,฀but฀differ฀widely฀in฀ terms฀of฀their฀effectiveness,฀and฀the฀inancial฀cost฀of฀the฀media฀spend฀can฀be฀consider- able.฀Projects฀of฀this฀kind฀should,฀therefore,฀be฀discussed฀on฀a฀case-to-case฀basis฀before฀ the฀decision฀is฀taken฀to฀implement฀them. • ฀ Like฀many฀other฀interventions,฀hypnotherapy฀and฀acupuncture฀may฀be฀effective฀in฀indi- vidual฀smokers.฀Overall,฀however,฀the฀results฀of฀treatment฀in฀the฀published฀literature฀do฀ not฀satisfy฀the฀efficacy฀criteria฀of฀evidence-based฀medicine. References ฀ 1.฀Velicer฀WF,฀Fava฀JL,฀Prochaska฀JO,฀Abrams฀DB,฀Emmons฀KM,฀Pierce฀JP฀1995฀Distribution฀ of฀smokers฀by฀stage฀in฀three฀representative฀samples.฀Prev฀Med฀244:401–411 ฀ 2.฀Kommission฀ der฀ Europäischen฀ Gemeinschaften฀ ed฀ 1988฀ Die฀ Europäer฀ und฀ die฀ Krebsverhütung:฀Eine฀Studie฀über฀Einstellung฀und฀Verhalten฀der฀Bevölkerung ฀ 3.฀Hajek฀P฀1994฀Treatments฀for฀smokers.฀Addiction฀8911:1543–1549 ฀ 4.฀Bock฀BC,฀Marcus฀BH,฀King฀TK,฀Borrelli฀B,฀Roberts฀MR฀1999฀Exercise฀effects฀on฀with- drawal฀and฀mood฀among฀women฀attempting฀smoking฀cessation.฀Addict฀Behav฀243:399–410 ฀ 5.฀Tölle฀R,฀Buchkremer฀G฀1989฀Zigarettenrauchen฀-฀Epidemiologie,฀Psychologie,฀Pharmakologie฀ und฀Therapie,฀2฀edn.Springer,฀Heidelberg ฀ 6.฀Prochaska฀JO,฀DiClemente฀CC฀1983฀Stages฀and฀processes฀of฀self-change฀of฀smoking:฀toward฀ an฀integrative฀model฀of฀change.฀J฀Consult฀Clin฀Psychol฀51:390–395 ฀ 7.฀Carlson฀LE,฀Taenzer฀P,฀Koopmans฀J,฀Casebeer฀A฀2003฀Predictive฀value฀of฀aspects฀of฀the฀ Transtheoretical฀Model฀on฀smoking฀cessation฀in฀a฀community-based,฀large-group฀cognitive฀ behavioral฀program.฀Addict฀Behav฀284:725–740 ฀ 8.฀Dino฀G,฀Kamal฀K,฀Horn฀K,฀Kalsekar฀I,฀Fernandes฀A฀2004฀Stage฀of฀change฀and฀smoking฀ces- sation฀outcomes฀among฀adolescents.฀Addict฀Behav฀295:935–940 ฀ 9.฀Haustein฀ KO฀ 2000฀ Pharmacotherapy฀ of฀ nicotine฀ dependence.฀ Int฀ J฀ Clin฀ Pharmacol฀ Ther฀ 386:273–290 10.฀US฀Department฀of฀Health฀and฀Human฀Services.฀Clinical฀practice฀guideline:฀Treating฀tobacco฀ use฀and฀dependence.฀2000.฀Report฀No.:฀Publication฀No.฀00–0032 11.฀Andrews฀JO,฀Heath฀J,฀Graham-Garcia฀J฀2004฀Management฀of฀tobacco฀dependence฀in฀older฀ adults:฀using฀evidence-based฀strategies.฀J฀Gerontol฀Nurs฀3012:13–24 12.฀Park฀EW,฀Schultz฀JK,฀Tudiver฀F,฀Campbel฀T,฀Becker฀L฀2002฀Enhancing฀partner฀support฀to฀ improve฀ smoking฀ cessation฀ Cockraine฀ Review.฀ Issue฀ 1.฀ Oxford,฀ Update฀ Software.฀ The฀ Cochrane฀Library 13.฀McBride฀CM,฀Curry฀SJ,฀Grothaus฀LC,฀Nelson฀JC,฀Lando฀H,฀Pirie฀PL฀1998฀Partner฀smoking฀ status฀and฀pregnant฀smoker’s฀perceptions฀of฀support฀for฀and฀likelihood฀of฀smoking฀cessation.฀ Health฀Psychol฀17:63–69 14.฀Hanson฀BS,฀Isacsson฀SO,฀Janzon฀L,฀Lindell฀SE฀1990฀Social฀support฀and฀quitting฀smoking฀for฀ good.฀Is฀there฀an฀association?฀Results฀from฀the฀population฀study,฀“Men฀born฀in฀1914,”฀Malmo,฀ Sweden.฀Addict฀Behav฀15:221–233 15.฀Waldron฀I,฀Lye฀D฀1989฀Family฀roles฀and฀smoking.฀Am฀J฀Prev฀Med฀5:136–141 16.฀Coppotelli฀HC,฀Orleans฀CT฀1985฀Partner฀support฀and฀other฀determinants฀of฀smoking฀cessa- tion฀maintenance฀among฀women.฀J฀Consult฀Clin฀Psychol฀53:455–460 17.฀Gulliver฀SB,฀Hughes฀JR,฀Solomon฀LJ,฀Dey฀AN฀1995฀An฀investigation฀of฀self-eficacy,฀part- ner฀support฀and฀daily฀stresses฀as฀predictors฀of฀relapse฀to฀smoking฀in฀self-quitters.฀Addiction฀ 90:767–772 18.฀Roski฀J,฀Schmid฀LA,฀Lando฀HA฀1996฀Long-term฀associations฀of฀helpful฀and฀harmful฀spousal฀ behaviors฀with฀smoking฀cessation.฀Addict฀Behav฀21:173–185 19.฀McIntyre-Kingsolver฀K,฀Lichtenstein฀E,฀Mermelstein฀RJ฀1986฀Spouse฀training฀in฀a฀multi- component฀smoking-cessation฀program.฀Behav฀Ther฀17:67–74 20.฀Ginsberg฀D,฀Hall฀SM,฀Rosinski฀M฀1992฀Partner฀support,฀psychological฀treatment,฀and฀nico- tine฀gum฀in฀smoking฀treatment:฀an฀incremental฀study.฀Int฀J฀Addict฀27:503–514 21.฀Fiore฀ MC฀ 2000฀ Treating฀ tobacco฀ use฀ and฀ dependence:฀ an฀ introduction฀ to฀ the฀ US฀ Public฀ Health฀Service฀Clinical฀Practice฀Guideline.฀Respir฀Care฀4510:1196–1199 22.฀May฀S,฀West฀R฀2000฀Do฀social฀support฀interventions฀“buddy฀systems”฀aid฀smoking฀cessa- tion?฀A฀review.฀Tob฀Control฀94:415–422