[Medical support of cessation for pregnant smokers]. / Dohányzó várandósok leszokásának orvosi támogatása.

Female smokers are most likely to quit using tobacco products during pregnancy. This period is an excellent chance for the health sector to achieve dual - maternal and fetal - health benefits with the professional support of the cessation attempt. In our review, we collected the practicalities of this specific cessation support. This review is based on publications available in the PubMed database as well as domestic and international guidelines and summaries, which were selected based on their practical importance. Quitting smoking during pregnancy is really important for both the foetus and the mother. Reframing the obstetric, neonatal and pediatric complications of smoking during pregnancy positively, and focusing on the benefits of quitting are recommended. Minimal intervention is advised to be complemented with counselling relating to the gestational age, referral to specialised care service and cessation support for the pregnant mother's partner. Non-pharmacological support is the primary recommended therapy for pregnant smokers. If it is not possible, or is unsatisfactory, the use of nicotine replacement therapy may be reasonable. Nicotine replacement therapy for pregnant smokers differs from the general nicotine replacement treatments in the following: use of oral formulations over transdermal nicotine intake; more cautious titration period; shorter treatment duration. Using behaviour interventions is also advised to support smoking cessation during pregnancy. The emphasis is on stress management, emotion regulation, behavioural and biological feedback, self-reward and use of external incentives. These methods are based on the cognitive behavioural therapy model and motivational interviewing techniques. Practical examples are presented in this summary. Orv Hetil. 2023; 164(30): 1194-1203.

Female Sexual Dysfunction in Association with Sexual History, Sexual Abuse and Satisfaction: A Cross-Sectional Study in Hungary.

Female sexual dysfunction (FSD) has a negative impact on women's quality of life, self-esteem, and physical health. The aim of the present study was to explore the prevalence and the factors associated with FSD using an online questionnaire. A cross-sectional survey was conducted among young adults (18-35 years old) in Hungary using the DSM-5 criteria. The participants (n = 5942) were divided into three major groups: FSD (20.3%), an intermediate group (43.9%), and a control group (35.6%). Most of the women showing FSD were affected with female orgasmic disorder (9.2%) and genito-pelvic pain/penetration disorder (4.6%), while female sexual interest/arousal disorder was found in altogether 100 women (1.7%); 4.8% of women were affected by more than one definite disorder. The occurrence of female sexual dysfunction was related to the women's previous sexual history (first sexual experience, sexual education, early encounter with pornographic content, and sexual abuse), their self-satisfaction (with their own body, genitalia, and sexual attraction), and their sexual orientation. Sexual dysfunction showed a strong association with abuse, sexually transmitted diseases, and self-esteem. The present study identified the relationship between sexual dysfunctions and other health conditions, which can be the basis for some form of screening and early assistance programs for FSD.

How to Avoid Lower Priority for Smoking Cessation Support Content on Facebook: An Analysis of Engagement Bait.

Facebook demotes "engagement bait" content that makes people interact. As a result of this sanctioning, public health content can reach fewer Facebook users. This study aims to determine the negative effect of engagement bait and find alternative techniques. In a three-year period, 791 smoking cessation support content was included (n = 791). The Facebook posts were classified into "engagement bait", "alternative techniques" and control groups. Facebook metrics were compared between the study and control groups. The reach of Facebook page fans was significantly lower in the engagement bait group compared to the control group. On the other hand, the alternative techniques had a significantly lower rate of negative Facebook interactions, as well as significantly higher click rates compared to the control group. This is the first study to reveal the sanctioning of engagement bait on smoking cessation support Facebook posts. "Engagement bait" content has a lower ranking on the Facebook Fans' Newsfeed page. Nevertheless, alternative techniques can circumvent the restrictions on engagement bait. At the same time, alternative techniques can stimulate the click rate and inhibit the rate of negative interactions.

Smokers' Engagement Behavior on Facebook: Verbalizing and Visual Expressing the Smoking Cessation Process.

The "processes of change" and "motivational language" are common in smoker Facebook users' comments under smoking cessation support contents. Smokers can combine this verbalization of the smoking cessation process with visual expression when they use comments and Facebook reactions at the same time. The aim of this study was to understand the relationship between processes of change, motivational language, and the Facebook reaction buttons. A total of 821 smokers' comments were analyzed in the current study (n = 821), which responded to image-based smoking cessation support contents. The processes of change and the motivational language used in the investigated comments were identified. These linguistic categories were compared with the usage of reaction buttons. The Facebook users who used the "Haha" reaction button wrote a significantly higher proportion of sustain talk than those who used the "Like" or "Love" reaction buttons. The Facebook users who combined the comment and "Love" reaction wrote significantly more change talk than those who did not utilize these buttons. We suggest that the "Haha" reaction may be a negative indicator, the "Like" reaction may be a neutral indicator, and the "Love" reaction may be a positive engagement indicator in terms of the smoking cessation process during Facebook-based interventions. These results may highlight how to evaluate Facebook reactions relating to smoking cessation support contents.

Actualities in first-line pharmacotherapy for smoking cessation support / A dohányzásleszokás-támogatás elso vonalbeli gyógyszeres terápiájának aktualitásai.

Összefoglaló. A dohányzás jelenleg is az egyik legjelentosebb népegészségügyi probléma hazánkban. Az orvosi szakterületek többségében elokerül a dohányzásleszokás-támogatás kérdése. Ezért az orvostársadalom számára az aktuális gyógyszeres terápiás ismeretek összefoglalása hasznos lehet. A jelen közleményben a leszokástámogatás elsodlegesen választandó gyógyszeres terápiáját tekintjük át a legújabb összefoglalók és irányelvek szerint. A gyógyszeres lehetoségek közül jelenleg a vareniklin és a nikotinpótló terápia választandó elsoként, nemcsak a leszokás, hanem az ártalomcsökkentés tekintetében is. A legújabb kutatási eredmények szerint a kis dózisú vareniklin hatékonysága megközelíti a standard adagolás hatékonyságát, ugyanakkor kevesebb mellékhatás jelentkezik. A nikotinpótló kezeléssel kapcsolatban ki kell emelni, hogy egyre több tudományos evidencia áll a transdermalis és oralis készítmények kombinálása mellett, szemben a monoterápiával. A kis dózisú vareniklin, illetve a nikotinpótló terápia akkor is segítséget nyújt a naponta elszívott cigaretták mérséklésében, ha a kliens nem kíván leszokni, de a dohányzás ártalmait csökkentené. A nikotinerg rendszeren kívül más módon ható gyógyszerek szerepe is felmerült. Egyre több összefoglaló támogatja az antidepresszívumok használatát a nikotinfüggoség kezelésében. Ezek közül a bupropion használatával kapcsolatban van a legtöbb adat, amelyrol tudjuk, hogy kombinálható a nikotinpótló terápiával és a vareniklinnel is. A gyógyszeres terápiát minden esetben tanácsos magatartásorvoslási módszerekkel, illetve adherenciát fokozó intervenciókkal kombinálni. Ezenkívül a szakellátási szint bevonása is javasolt, hogy a leheto legtöbb segítséget kapja meg a páciens a leszokáshoz. Orv Hetil. 2021; 162(40): 1610-1618. Summary. Smoking is still one of the most significant public health problems in Hungary. The issue of smoking cessation support comes up in most medical specialties. Therefore, a summary of the current pharmacotherapeutic knowledge may prove useful to the medical community. In this paper, we review the first-line pharmacotherapy for smoking cessation based on the latest summaries and guidelines. Regarding the smoking cessation agents, varenicline and nicotine replacement therapy are currently the primary choice, not only in terms of cessation but also in terms of harm reduction. The results of previous studies suggest that the efficacy of low dose varenicline is close to that of standard dosing, with fewer side effects. With regard to nicotine replacement therapy, it should be emphasized that there is an increasing scientific evidence for the combination of transdermal and oral formulations as opposed to monotherapy. Low dose varenicline and nicotine replacement therapy also help reduce the number of cigarettes smoked daily if the client does not want to quit but would reduce the harms of smoking. The role of medications acting in other ways than the nicotinergic system has also emerged. An increasing number of reviews support the use of antidepressants in the treatment of nicotine addiction. Of these, most data are available on the use of bupropion, which is known to be combined with nicotine replacement therapy and varenicline. In all cases, it is advisable to combine pharmacotherapy with behavioral therapy as well as interventions that increase adherence. In addition, it is also recommended to include specific therapeutic interventions in order to get as much help as possible for the patient to quit smoking. Orv Hetil. 2021; 162(40): 1610-1618.

Facebook Users' Interactions, Organic Reach, and Engagement in a Smoking Cessation Intervention: Content Analysis.

BACKGROUND: Facebook can be a suitable platform for public health interventions. Facebook users can express their reaction to the given social media content in many ways using interaction buttons. The analysis of these interactions can be advantageous in increasing reach and engagement of public health interventions. OBJECTIVE: This research aimed at understanding how Facebook users' interactions correlate with organic reach and engagement regarding the same smoking cessation support contents. METHODS: The study population consisted of Facebook users who were reached by a public smoking cessation support page without advertising. We included 1025 nonpaid Facebook posts (N=1025) which used smoking cessation strategies based on a motivational interviewing counseling style. The following data were collected from the "Post Details": the number of people who saw the given nonpaid content (organic reach) which consisted of fan and nonfan reach according to previous "page like" activity; each rate of "engagement indicators" (such as the symbols of "like," "love," "haha," "wow," "sad," "angry"; or other interactions: "shares," "comments," "clicks"); and the rate of negative Facebook interactions (eg, "post hides" or "unlike of page"). Overall, these data were analyzed with the Spearman correlation method. RESULTS: Surprisingly, we found a significant negative correlation between organic reach and the "like" reaction (rs=-0.418; P<.001). The strongest significant positive correlations of organic reach were observed with the "haha" reaction (rs=0.396; P<.001), comments (rs=0.368; P<.001), and the "love" reaction (rs=0.264; P<.001). Furthermore, nonfan reach correlated positively with "shares" (rs=0.388; P<.001) and clicks (rs=0.135; P<.001), while fan reach correlated positively with the "haha" reaction (rs=0.457; P<.001), comments (rs=0.393; P<.001), and the "love" reaction (rs=0.310; P<.001). Contrary to expectations, the "like" reaction was sharply separated by significant negative correlations from "wow" (rs=-0.077; P=.013), "sad" (rs=-0.120; P<.001), "angry" reactions (rs=-0.136; P<.001), and comments (rs=-0.130; P<.001). Additionally, a high rate of negative Facebook interactions was significantly associated with "wow" (rs=0.076; P=.016) and "sad" reactions (rs=0.091; P=.003). CONCLUSIONS: This study has shown that it is possible to hypothesize a disadvantage of the "like" reaction and advantages of other interactions (eg, the "haha" reaction or "comments") in content algorithmic ranking on Facebook. In addition, the correlational analysis revealed a need of a further categorization to fan-specific interactions (eg, "haha" or "love" reactions) and nonfan-specific interactions (eg, "shares" and "clicks"). Regarding the direction of the correlations, these findings suggest that some interactions (eg, negative Facebook interactions, "wow," "sad," and "angry" reactions) may decrease the engagement, while other interactions ("like," "love," "haha" reactions, "shares," and "clicks") may increase the engagement during Facebook-based smoking cessation interventions. This hypothesis-generating research offers an important insight into the relationship between organic reach, engagement, and Facebook users' interactions for public health professionals who design Facebook-based interventions.

[Tobacco reduction on Facebook among 14-35-year-olds]. / A dohányzás visszaszorítása a Facebook segítségével a 14­35 éves korosztály körében.

INTRODUCTION: The possibility of successful smoking cessation is increased by early initiation. Therefore, promoting smoking cessation at early age (especially among 14-35-year-olds) has a key role in reducing tobacco use prevalence. Facebook is one of the most popular websites among adolescents and young adults which can be used for age-specific smoking cessation support. AIM: Our research seeks to reveal the effects of a Facebook page on smoking habits, smoking cessation knowledge and attitudes among 14-35-year-olds. METHOD: An online survey was conducted among the 3278 followers of the author's Facebook page. The questionnaire was completed by 332 people among 14-35-year-olds. We analysed demographic data, smoking habits, the usage frequency and duration of the Facebook page as well as changes in smoking habits, smoking cessation knowledge and attitudes. RESULTS: The average age was 22.57 ± 5.08 years. The examined population consisted of 65% currently smokers, 12% former smokers and 23% non-smokers. Significantly more people reported a positive change in their smoking habits and smoking cessation attitudes among smokers who used the Facebook page more frequently and with longer duration (p<0.05). The habit and attitude changes were significantly higher among smokers who plan to quit smoking (p<0.01). Nevertheless, we also observed attitude changes between 12-25% among smokers who did not plan to quit. Among non-smokers, the positive attitude changes were significantly higher in the low-educated population who live in villages (p<0.01). CONCLUSION: This Facebook page had a positive effect on smoking habits, smoking cessation knowledge and attitudes among 14-35-year-olds. The contents of the Facebook page could be used to prevent smoking and support smoking cessation among 14-35-year-olds. Orv Hetil. 2019; 160(6): 220-227.

[Interventions in medical practice to reduce tobacco use among adolescents]. / Intervenciók az orvosi gyakorlatban a serdülokori dohányzás visszaszorítására.

Interventions to facilitate prevention of tobacco use and smoking cessation are the most cost-effective health care measures. They are invaluable among adolescents, since adult smokers start smoking in adolescence. There is evidence that early smoking initiation makes cessation difficult and it is associated with lifelong health risks. Our study aims at reviewing current approaches and interventions that can help health care professionals involved in paediatric care to reduce tobacco use in adolescence. International guidelines include short, practical interventions that are easy to apply by health care professionals in the primary and paediatric care. In tobacco use prevention, the role of health care professionals is of special importance. They have social respect, therefore they can provide credible information on tobacco use and cessation. Studies have found that short, goal-oriented counselling can further reduce the prevalence of smoking among adolescents presenting to their health care professional. Reduction of tobacco use is one of the primary health care goals in the 21st century, which should be started as early as childhood and adolescence. There have been several evidence-based approaches, which are essential for health care professionals involved in adolescent care. Orv Hetil. 2018; 159(15): 593-602.

[Health behavior change: motivational interviewing]. / Magatartás-változtatás az egészségügyben: a motivációs interjú.

Public health data show that early mortality in Hungary could be prevented by smoking cessation, reduced alcohol consumption, regular exercise, healthy diet and increased adherence. Doctor-patient encounters often highlight these aspects of health behavior. There is evidence that health behavior change is driven by internal motivation rather than external influence. This finding has led to the concept of motivational interview, which is a person-centered, goal-oriented approach to counselling. The doctor asks targeted questions to elicit the patient's motivations, strengths, internal resources, and to focus the interview around these. The quality and quantity of the patient's change talk is related to better outcomes. In addition, the interview allows the patient to express ambivalent feelings and doubts about the change. The doctor should use various communication strategies to resolve this ambivalence. Furthermore, establishing a good doctor-patient relationship is the cornerstone of the motivational interview. An optimal relationship can evoke change talk and reduce the patient's resistance, which can also result in a better outcome. The goal of the motivational interview is to focus on the 'why' to change health behavior rather than the 'how', and to utilize internal motivation instead of persuasion. This is the reason why motivational interview has become a widely-accepted evidence based approach. Orv Hetil. 2017; 158(34): 1331-1337.