Reduced Smoking 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.