Perception of pregnant individuals, health providers and decision makers on interventions to cease substance consumption during pregnancy: a qualitative study.

BACKGROUND: Despite multiple recommendations and strategies implemented at a national and international level, cigarette smoking, alcohol consumption, and cannabis use during pregnancy remains high in most countries. The objective of this study was to examine key stakeholders' perception of the treatment interventions adopted in Spain, to identify political, organizational and personal factors associated with successful implementation, and to propose strategies for improvement. METHODS: A qualitative study with a phenomenological approach was conducted in 2022. The target groups were: (1) clinical decision makers in the field of addiction science, (2) health professionals who carry out treatment interventions, and (3) pregnant individuals who use tobacco, alcohol or cannabis. Two focus groups and eight in-depth interviews were conducted, recorded, and transcribed. Exploratory analysis and inductive open coding was performed, codes were merged into categories, and subcategories were identified. RESULTS: The analysis resulted in 10 subcategories which were further merged into three main categories: (1) Degree of adoption and utility of treatment interventions implemented; (2) Needs and demands with respect to the organization of treatment interventions; and, (3) Personal barriers to and facilitators for treatment. Respondents reported that despite multiple national and regional cessation initiatives, treatment interventions were rarely adopted in clinical practice. Health care administrators demanded reliable records to quantify substance use for better planning of activities. Health care professionals advocated for additional time and training and both echoed the importance of integrating cessation interventions into routine prenatal care and creating in-house specialized units. The difficulty in quitting, lack of awareness of risk for foetus and child and the controversial advice were identified as barriers by pregnant individuals. CONCLUSIONS: Consistent with previous work, this study found that cessation strategies implemented by the health authorities are not effective if they are not accompanied by organizational and behavioral changes. The current study identifies a set of factors that could be pivotal in ensuring the success of treatment interventions targeting tobacco, alcohol and cannabis use among pregnant individuals.

Coping Strategies and Social Support in a Mobile Phone Chat App Designed to Support Smoking Cessation: Qualitative Analysis.

BACKGROUND: Smoking is one of the most significant factors contributing to low life expectancy, health inequalities, and illness at the worldwide scale. Smoking cessation attempts benefit from social support. Mobile phones have changed the way we communicate through the use of freely available message-oriented apps. Mobile app-based interventions for smoking cessation programs can provide interactive, supportive, and individually tailored interventions. OBJECTIVE: This study aimed to identify emotions, coping strategies, beliefs, values, and cognitive evaluations of smokers who are in the process of quitting, and to analyze online social support provided through the analysis of messages posted to a chat function integrated into a mobile app. METHODS: In this descriptive qualitative study, informants were smokers who participated in the chat of Tobbstop. The technique to generate information was documentary through messages collected from September 2014 through June 2016, specifically designed to support a smoking cessation intervention. A thematic content analysis of the messages applied 2 conceptual models: the Lazarus and Folkman model to assess participant's experiences and perceptions and the Cutrona model to evaluate online social support. RESULTS: During the study period, 11,788 text messages were posted to the chat by 101 users. The most frequent messages offered information and emotional support, and all the basic emotions were reported in the chat. The 3 most frequent coping strategies identified were physical activity, different types of treatment such as nicotine replacement, and humor. Beliefs about quitting smoking included the inevitability of weight gain and the notion that not using any type of medications is better for smoking cessation. Health and family were the values more frequently described, followed by freedom. A smoke-free environment was perceived as important to successful smoking cessation. The social support group that was developed with the app offered mainly emotional and informational support. CONCLUSIONS: Our analysis suggests that a chat integrated into a mobile app focused on supporting smoking cessation provides a useful tool for smokers who are in the process of quitting, by offering social support and a space to share concerns, information, or strategies.

[Sick leave due to tobacco use in workers aged 35-64. Catalonia, 2007-2016]. / La incapacidad temporal atribuible al consumo de tabaco en trabajadores de 35-64 años. Cataluña, 2007-2016.

OBJECTIVE: Few recent studies have researched into the size and trends of the impact of tobacco use on productivity losses. The objective of this work was to describe the percentage of episodes and non work-related sick leave days with a duration over 5 days due to tobacco use in Catalonia in the period 2007-2016 in relation to the total sick-leave episodes and sick leave days in patients aged 35-64. METHODS: Descriptive study of 3,627,107 episodes and 237,219,230 days in sick-leave by any cause, except those work-related, in workers aged 35-64. Population etiological fractions were used. The annual percentage of number of episodes and sick-leave days due to tobacco use in relation with total episodes and sick-leave days was calculated and a trend test was performed. RESULTS: The percentage of sick-leave episodes and days due to tobacco use was higher in men (3.9%; 5.5% respectively) than in women (2.3%; 1.5% respectively). The trend for sick-leave due to tobacco use was positive, with a maximum OR in 2013. For the number of sick-leave episodes due to tobacco use, the corrected Z was 25.3 in men (p<0.001) and 49.4 in women (p<0.001). For sick-leave days due to tobacco use, the corrected Z was 36.9 in men (p<0.001) and 250.4 in women (p< 0.001). CONCLUSIONS: About 3% of sick-leave episodes with a duration over than 5 days are due to tobacco use, with a positive trend in both sexes. It is necessary to continue reinforcing the tobacco prevention and control policies in order to improve such trends for years to come.

OBJETIVO: Pocos estudios recientes han investigado en nuestro medio la magnitud y las tendencias del impacto del consumo de tabaco en la pérdida de productividad. El objetivo de este trabajo fue describir la proporción de episodios y de días en incapacidad temporal no profesional de duración superior a 5 días y atribuible al consumo de tabaco en Cataluña en el período 2007-2016, respecto del total de incapacidad temporal en trabajadores de 35-64 años. METODOS: Estudio descriptivo de 3.627.107 episodios y 237.219.230 días de incapacidad temporal por todas las causas, excepto las de origen profesional, en trabajadores de 35-64 años. Se aplicaron las fracciones etiológicas poblacionales. Se calculó la proporción anual de episodios y de días en incapacidad temporal atribuible (ITA) respecto de la incapacidad temporal (IT) por todas las causas y se realizó un test de tendencia. RESULTADOS: El porcentaje de episodios y de días en ITA por consumo de tabaco fue superior en hombres (3,9%; 5,5% respectivamente) que en mujeres (2,3%; 1,5% respectivamente). La tendencia de la ITA fue ascendente, con un OR máximo en 2013. Para los episodios de ITA, la Z corregida fue 25,3 en hombres (p<0,001) y 49,4 en mujeres (p<0,001). Para los días en ITA, la Z corregida fue 36,9 en hombres (p<0,001) y 250,4 en mujeres (p<0,001). CONCLUSIONES: Alrededor de un 3% de los episodios de IT de 5 días o más son atribuibles al tabaco, con una tendencia ascendente en ambos sexos. Es necesario continuar reforzando las políticas de prevención y control del tabaquismo para mejorar esta tendencia.

La incapacidad temporal atribuible al consumo de tabaco en trabajadores de 35-64 años. Cataluña, 2007-2016 / Sick leave due to tobacco use in workers aged 35-64. Catalonia, 2007-2016

Fundamentos: Pocos estudios recientes han investigado en nuestro medio la magnitud y las tendencias del impacto del consumo de tabaco en la pérdida de productividad. El objetivo de este trabajo fue describir la proporción de episodios y de días en incapacidad temporal no profesional de duración superior a 5 días y atribuible al consumo de tabaco en Cataluña en el período 2007-2016, respecto del total de incapacidad temporal en trabajadores de 35-64 años. Métodos: Estudio descriptivo de 3.627.107 episodios y 237.219.230 días de incapacidad temporal por todas las causas, excepto las de origen profesional, en trabajadores de 35-64 años. Se aplicaron las fracciones etiológicas poblacionales. Se calculó la proporción anual de episodios y de días en incapacidad temporal atribuible (ITA) respecto de la incapacidad temporal (IT) por todas las causas y se realizó un test de tendencia. Resultados: El porcentaje de episodios y de días en ITA por consumo de tabaco fue superior en hombres (3,9%; 5,5% respectivamente) que en mujeres (2,3%; 1,5% respectivamente). La tendencia de la ITA fue ascendente, con un OR máximo en 2013. Para los episodios de ITA, la Z corregida fue 25,3 en hombres (p<0,001) y 49,4 en mujeres (p<0,001). Para los días en ITA, la Z corregida fue 36,9 en hombres (p<0,001) y 250,4 en mujeres (p<0,001). Conclusiones: Alrededor de un 3% de los episodios de IT de 5 días o más son atribuibles al tabaco, con una tendencia ascendente en ambos sexos. Es necesario continuar reforzando las políticas de prevención y control del tabaquismo para mejorar esta tendencia

Background: Few recent studies have researched into the size and trends of the impact of tobacco use on productivity losses. The objective of this work was to describe the percentage of episodes and non work-related sick leave days with a duration over 5 days due to tobacco use in Catalonia in the period 2007-2016 in relation to the total sick-leave episodes and sick leave days in patients aged 35-64. Methods: Descriptive study of 3,627,107 episodes and 237,219,230 days in sick-leave by any cause, except those work-related, in workers aged 35-64. Population etiological fractions were used. The annual percentage of number of episodes and sick-leave days due to tobacco use in relation with total episodes and sick-leave days was calculated and a trend test was performed. Results: The percentage of sick-leave episodes and days due to tobacco use was higher in men (3.9%; 5.5% respectively) than in women (2.3%; 1.5% respectively). The trend for sick-leave due to tobacco use was positive, with a maximum OR in 2013. For the number of sick-leave episodes due to tobacco use, the corrected Z was 25.3 in men (p < 0.001) and 49.4 in women (p < 0.001). For sick-leave days due to tobacco use, the corrected Z was 36.9 in men (p < 0.001) and 250.4 in women (p < 0.001). Conclusions: About 3% of sick-leave episodes with a duration over than 5 days are due to tobacco use, with a positive trend in both sexes. It is necessary to continue reinforcing the tobacco prevention and control policies in order to improve such trends for years to come

Effectiveness of a brief primary care intervention to reduce passive smoking in babies: a cluster randomised clinical trial.

BACKGROUND: Tobacco smoke pollution (TSP) has major negative effects on infant health. Our objectives were to determine the effectiveness of a brief primary care intervention directed at parents who smoke in reducing babies' TSP exposure, and to establish variables related to greater exposure. METHOD: A multicentre, open, cluster-randomised clinical trial in Catalonia. The 83 participating primary health paediatric teams of the Catalan Health Service recruited 1101 babies whose parents were smokers. The intervention group (IG) received a brief TSP intervention; the control group (CG) received the usual care. Outcomes were measured by parents' reported strategies to avoid TSP exposure. Baseline clinical data and characteristics of each baby's TSP exposure were collected, along with infant hair samples and parents' tobacco use and related attitudes/behaviours. At 3-month and 6-month follow-up, behavioural changes to avoid TSP exposure were recorded; the association between reported parental behaviours and nicotine concentration in infant hair samples was tested in a random sample of 253 babies at baseline and 6 months. RESULTS: During follow-up, TSP-avoidance strategies improved more in the IG than in the CG: 35.4% and 26.9% ( p=0.006) at home, and 62.2% and 53.1% in cars (p=0.008). Logistic regression showed adjusted ORs for appropriate measures in the IG versus CG of 1.59 (95% CI 1.21 to 2.09) at home and 1.30 (95% CI 0.97 to 1.75) in cars. Hair samples showed that 78.7% of the babies tested were exposed. Reduced nicotine concentration was associated with improved implementation of effective strategies reported by parents at home (p=0.029) and in cars (p=0.014). CONCLUSIONS: The intervention produced behavioural changes to avoid TSP exposure in babies. The proportion of babies with nicotine (>=1ng/mg) in hair samples at baseline is a concern. TRIAL REGISTRATION NUMBER: Clinical Trials.gov Identifier: NCT00788996.