Persistent Barriers to Smoking Cessation Among Urban, Underserved Women: A Feasibility Study of Tailored Barriers Text Messages.

OBJECTIVES: Despite health risks for themselves and their children, urban underserved women smoke at high rates postpartum. The postpartum period is a stressful transition time that presents unique barriers to sustained cessation. There is limited extant evidence of efficacious psychosocial programs to maintain postpartum smoking cessation. METHODS: Guided by the Cognitive-Social Health Information Processing model, we explored the feasibility of TxT2Commit, a text-messaging intervention designed to prevent postpartum smoking relapse. Participants (n = 43) received supportive cessation-focused text messages for one month postpartum. Using a convergent mixed method design, surveys and interviews assessed changes in psychosocial factors and smoking status through a three month follow-up. RESULTS: Participants reported satisfaction with TxT2Commit, rating text messages as helpful, understandable, supportive, and not bothersome. However, a majority of women (n = 28, 65.1%) relapsed by three months. Participants who stayed smoke free (i.e., non-relapsers) reported significantly less temptation to smoke at one and three months postpartum compared to relapsers (ps < .01). While relapsers had significantly less temptation at one month compared to baseline, temptation increased by three months (p < .01). Consistent with the quantitative results, qualitative interviews identified informational and coping needs, with continued temptation throughout the three months. Non-relapsers were able to manage temptation and reported greater support. CONCLUSIONS FOR PRACTICE: TxT2Commit demonstrates preliminary feasibility and acceptability among urban, underserved postpartum women. However, most participants relapsed by three months postpartum. Additional research is needed to identify targeted messaging to best help women avoid temptation and bolster support to stay smoke free in this uniquely stressful period.

Effects of oral and intravenous defibrotide on blood viscosity in patients with peripheral obliterative arterial disease.

Patients with peripheral obliterative arterial disease received 400 mg of defibrotide intravenously (seven patients) or orally (nine patients). Blood and plasma viscosity were measured before therapy, at 30 minutes after and one hour after intravenous administration, and at 1, 2, 3, and 8 hours after oral administration. Thirty minutes after intravenous administration, blood viscosity at a shear rate of 30 sec-1 was reduced from 9.99 to 9.00 and at a shear rate of 180 sec-1 from 6.61 to 6.33 (P less than 0.05). Viscosity returned to baseline after 60 minutes. At 1, 2, and 3 hours after oral administration, blood viscosity at a shear rate of 30 sec-1 was reduced from 8.53 to 7.44, 6.88, and 7.19 (each P less than 0.01) and at a shear rate of 180 sec-1 from 5.88 to 5.51 (P less than 0.05), 5.14 (P less than 0.05), and 5.38 (P less than 0.01); the levels at eight hours were not significantly different from baseline values. Plasma viscosity was not affected by defibrotide. These data confirm previous evidence of a rheologic effect of defibrotide in patients with peripheral obliterative arterial disease and indicate that such an effect can be achieved with oral administration.