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1.
BMC Public Health ; 21(1): 1633, 2021 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-34493239

RESUMO

BACKGROUND: Waterpipe is one of the oldest methods of tobacco smoking, which has become the public health challenge, especially in the Eastern Mediterranean countries such as Iran. This study aimed to investigate the waterpipe smoking (WPS) in the young people of Kermanshah in 2020, using a qualitative method. METHODS: This was a qualitative study conducted with the approach of content analysis. Participants were young waterpipe user aged 17 to 25 years selected by purposeful sampling method in Kermanshah city, located in the west of Iran. Data were collected through semi-structured interviews in face-to-face and audio-recorded methods based on an interview guideline during June to August 2020. Then researchers transcribed verbatim and analyzed the content of the interviews thematically. RESULTS: In this study, 23 young people who were waterpipe users at the time of the study participated. The results showed that social aspects in three sub-categories were involved in WPS including "socio-cultural aspects", "socio-environmental aspects", and "social relations". Individual aspects of waterpipe use as second category also consisted of two sub-categories including "motivational aspects" and "lack of psycho-protective aspects". CONCLUSIONS: It seems that the implementation of the policy of reducing access to waterpipe in public environments is effective in reducing waterpipe consumption. It is suggested that educational and interventions, based on targeted models and theories be implemented in order to increase young people's belief and perception on dangers of WPS, and to improve their self-efficacy to smoking cessation.


Assuntos
Abandono do Hábito de Fumar , Fumar Cachimbo de Água , Adolescente , Humanos , Irã (Geográfico)/epidemiologia , Pesquisa Qualitativa , Fumar Tabaco , Fumar Cachimbo de Água/epidemiologia
2.
J Addict Nurs ; 32(3): 188-196, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34473448

RESUMO

OBJECTIVE: This study aimed to develop a Transtheoretical-Model-based and WhatsApp-text-message-supported smoking cessation program for pregnant women and to evaluate its effectiveness. METHODS: This study is a pretest-posttest designed, randomized controlled and quasi-experimental intervention research. The study was conducted on 50 pregnant women, 25 of them in the intervention group and 25 of them in the control group. A theory-based motivational individual counseling initiative has been applied to the intervention group, and WhatsApp text messages have been sent 3 days a week, in accordance with the stages of change to support the interviews. RESULTS: In the final follow-up, 60% of pregnant women in the intervention group and 36% of pregnant women in the control group quit smoking. All participants indicated they would recommend the WhatsApp-text-message-supported smoking cessation program. Transtheoretical-Model-based and WhatsApp-text-message-supported smoking cessation programs were found to be effective in reducing nicotine dependency scores and carbon monoxide levels of pregnant women and quitting smoking. PRACTICE IMPLICATIONS: The smoking cessation program used in the research may be applied by midwives or nurses trained on the subject to help pregnant women quit smoking.


Assuntos
Abandono do Hábito de Fumar , Envio de Mensagens de Texto , Tabagismo , Feminino , Humanos , Gravidez , Gestantes , Fumar
3.
J Addict Nurs ; 32(3): 211-215, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34473451

RESUMO

ABSTRACT: The study aims to assess the effectiveness of telephone follow-ups combined with a smartphone app (e.g., WeChat [Tencent], which is one of the most widely used communication apps in China), as a smoking cessation intervention. Social volunteers were recruited on March 1, 2017, and randomized to supervision groups with five participants in each group. Every day, the specialists shared some information related to smoking cessation including the videos, songs, and scientific knowledge in WeChat groups and conducted telephone follow-ups on the third, fifth, seventh, ninth, 12th, 17th, 22nd, 27th, and 30th day in March and on April 1. Ultimately, a comparison was made of the self-reported smoking abstinence and self-reported average number of cigarettes smoked between the participants. One hundred ten volunteers participated in the study, with 105 who completed follow-up. Self-reported smoking abstinence in the past 7 days occurred in 65.7% of the participants (n = 69) compared with 34.3% (n = 36) in whom smoking abstinence did not occur. The mean age of those who failed was 40.15 years (range: 22-70 years), and 55.5% (n = 20) attributed their failure to personal reasons. However, the self-reported average number of cigarettes smoked every day was less than that before the study (on average, 10.34 ± 8.17 per day), and this difference was statistically significant (95% CI [8.312, 12.364], p < .01). It was effective to deliver a telephone follow-up combined with a smartphone app follow-up as an intervention for smoking cessation.


Assuntos
Aplicativos Móveis , Abandono do Hábito de Fumar , Adulto , Idoso , Seguimentos , Humanos , Pessoa de Meia-Idade , Fumar , Telefone , Adulto Jovem
4.
Int J Chron Obstruct Pulmon Dis ; 16: 2433-2443, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34465989

RESUMO

Background: Chronic obstructive pulmonary disease (COPD) is a progressive lung disease that is mainly caused by smoking, and most patients with COPD are either former or current smokers. The optimal way to slow down disease progression and reduce overall mortality is for patients to stop smoking. Patients with COPD are known to have lower socio-economic status and to be more nicotine-dependent than most other smokers and therefore face difficulties when attempting to quit smoking. Pharmacological smoking cessation treatment is known to be the most effective. However, the extent to which this treatment is actually offered to Danish smokers with COPD is unknown. Aim: The aim of this study was to investigate if patients with COPD were more likely to redeem a prescription for smoking cessation medication compared with matched controls. Materials and Methods: The study was designed as a registry-based, non-interventional case-control study. All Danish patients with COPD (ICD-10-code J 44 chronic obstructive pulmonary disease) diagnosed between 2009 and 2015 were included (130,797 cases). Controls (252,216) were matched on age, gender and geography. Primary outcome was the number of redeemed prescriptions for smoking cessation medication. Results: We found that 12% of patients with COPD redeemed a prescription for smoking cessation medication during the eight-year study period. The odds ratio (OR) for redeeming a prescription on smoking cessation medicine was OR 6.22 for patients with COPD compared with their matched controls. We also found that patients with COPD were more likely to redeem smoking cessation medication if they were younger, female or single. Conclusion: There is substantial room for improvement with respect to pharmacological smoking cessation treatment in Danish patients with COPD. In-depth knowledge of factors contributing to the patients choice of smoking cessation treatment might allow for more personalized guidance of patients with COPD.


Assuntos
Doença Pulmonar Obstrutiva Crônica , Abandono do Hábito de Fumar , Estudos de Casos e Controles , Dinamarca/epidemiologia , Feminino , Humanos , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Dispositivos para o Abandono do Uso de Tabaco , Vareniclina
5.
Asia Pac J Public Health ; 33(5): 477-478, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34468241
8.
Front Public Health ; 9: 684683, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34497791

RESUMO

A growing body of scientific studies has been published to inform responses to the ongoing coronavirus pandemic, and some have claimed that cigarette smoking has a beneficial or mixed effect on the prevention and treatment of COVID-19. The presentation of such findings, unfortunately, has created an infodemic. This study integrated the theory of planned behavior and the health belief model and incorporated findings on addiction from the medical literature to predict cessation intention and support for tobacco control measures in the context of the COVID-19 infodemic. The study found that cessation intention partially mediated the effect of perceived severity and fully mediated the effects of perceived benefits, self-efficacy, and addiction on support for control measures. In addition, a positively-valenced message of the effect of smoking on the prevention and treatment of COVID-19 vs. a mixedly-valenced message was significant in predicting cessation intention, and the positively-valenced message of smoking indirectly predicted support for tobacco control measures. Perceived susceptibility, barriers, and subjective norms, however, exerted neither direct nor indirect effects on the two outcome variables.


Assuntos
COVID-19 , Abandono do Hábito de Fumar , Estudos Transversais , Humanos , Intenção , SARS-CoV-2 , Fumar/efeitos adversos , Inquéritos e Questionários
9.
Trials ; 22(1): 526, 2021 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-34376228

RESUMO

BACKGROUND: A healthy lifestyle can help prevent diseases that impair quality of life and lead to premature death. The Techniker health insurance fund offers a comprehensive online health program to support users in achieving their health goals of Increasing Fitness, Losing and Maintaining Weight, or Smoking Cessation. METHODS: The aim of this study is to test the long-term effectiveness of the web-based TK-HealthCoach with regard to the primary outcomes of increased physical activity, sustainable weight reduction, and smoking abstinence. We are conducting three interconnected, randomized controlled trials (RCT), one for each health goal, within which participants are allocated to an intervention group (interactive online health program) or a control group (non-interactive online health program). The effects of the intervention groups compared to the control groups will be analyzed by multi-level models for change. Participants' data are captured via online questionnaires before the program starts (baseline t0), again when it ends (t1), and later at two follow-up surveys (t2 and t3); the latter 12 months after t1. We are documenting socio-demographic, health-related, and psychological variables as well as usage behavior data of the programs. According to our sample size calculation, we have to enroll 1114 participants in each Losing and Maintaining Weight and Increasing Fitness RCT and 339 participants in the Smoking Cessation RCT. Additionally, 15-20 participants in the interactive smoking-cessation program will be invited to qualitative telephone interviews with the aim to obtain detailed information concerning utilization, compliance, and satisfaction. The online RCTs' inclusion criteria are: adults of each gender regardless of whether they are insured with Techniker health insurance fund. Persons with impairments or pre-existing conditions require a medical assessment as to whether the program is suitable for them. Specific exclusion criteria apply to each program/RCT. DISCUSSION: We assume that study participants will improve their health behavior by using the offered online health programs and that each health goal's intervention group will reveal advantages regarding the outcome variables compared to the control groups. Study enrollment started on January 1, 2020. TRIAL REGISTRATION: German Clinical Trials Register, Universal Trial Number (UTN): U1111-1245-0273 . Registered on 11 December 2019.


Assuntos
Atividade Extraespaçonave , Abandono do Hábito de Fumar , Adulto , Humanos , Internet , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
10.
Medicina (Kaunas) ; 57(8)2021 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-34440946

RESUMO

Recent studies have explored improvements in smoking prevention and cessation to reduce smoking prevalence, however, in Europe, only Finland has already set a date to become nicotine free. Studies reporting on central, eastern and southern Europe have mostly focused on combustible cigarettes up to now. In young people, correlations were found between traditional smoking, the "vaping" of e-cigarettes, experimentation with alcohol intoxication, and the use of illicit drugs. Prevention and cessation should include strategies against active and passive exposures to new nicotine products. This is a prerequisite for a successful public health policy and a future end-game against the business interests of the tobacco industry and its allies.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Abandono do Hábito de Fumar , Produtos do Tabaco , Adolescente , Humanos , Nicotina , Tabaco
11.
Nutr Metab Cardiovasc Dis ; 31(9): 2605-2611, 2021 08 26.
Artigo em Inglês | MEDLINE | ID: mdl-34348875

RESUMO

BACKGROUND AND AIMS: To analyze lifestyle habits and weight evolution during the COVID-19 pandemic-associated lockdown, in diabetes and overweight/obesity patients (body mass index (BMI) [25-29.9] and ≥30 kg/m2, respectively). METHODS AND RESULTS: We collected information on participants' characteristics and behavior regarding lifestyle before and during the lockdown, through the CoviDIAB web application, which is available freely for people with diabetes in France. We stratified the cohort according to BMI (≥25 kg/m2vs < 25 kg/m2) and examined the determinants of weight loss (WL), WL > 1 kg vs no-WL) in participants with a BMI ≥25 kg/m2, in both univariate and multivariate analyses. Of the 5280 participants (mean age, 52.5 years; men, 49%; diabetes, 100% by design), 69.5% were overweight or obese (mean BMI, 28.6 kg/m2 (6.1)). During the lockdown, patients often quit or decreased smoking; overweight/obese participants increased alcohol consumption less frequently as compared with normal BMI patients. In addition, overweight/obese patients were more likely to improve other healthy behaviors on a larger scale than patients with normal BMI: increased intake of fruits and vegetables, reduction of snacks intake, and reduction of total dietary intake. WL was observed in 18.9% of people with a BMI ≥25 kg/m2, whereas 28.6% of them gained weight. Lifestyle favorable changes characterized patients with WL. CONCLUSIONS: A significant proportion of overweight/obese patients with diabetes seized the opportunity of lockdown to improve their lifestyle and to lose weight. Identifying those people may help clinicians to personalize practical advice in the case of a recurrent lockdown.


Assuntos
COVID-19/prevenção & controle , Diabetes Mellitus Tipo 1/terapia , Diabetes Mellitus Tipo 2/terapia , Estilo de Vida Saudável , Obesidade/terapia , Comportamento de Redução do Risco , Perda de Peso , Adulto , Idoso , Índice de Massa Corporal , COVID-19/epidemiologia , COVID-19/transmissão , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 1/epidemiologia , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Dieta Saudável , Exercício Físico , Feminino , França/epidemiologia , Hábitos , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Valor Nutritivo , Obesidade/diagnóstico , Obesidade/epidemiologia , Prevalência , Medição de Risco , Fatores de Risco , Abandono do Hábito de Fumar , Fatores de Tempo , Ganho de Peso
12.
Int J Mol Sci ; 22(15)2021 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-34360698

RESUMO

Smoking-cessation drugs bind many off-target nicotinic acetylcholine receptors (nAChRs) and cause severe side effects if they are based on nicotine. New drugs that bind only those receptors, such as α6ß2* nAChR, implicated in nicotine addiction would avoid the off-target binding. Indolizidine (-)-237D (IND (-)-237D), a bicyclic alkaloid, has been shown to block α6ß2* containing nAChRs and functionally inhibit the nicotine-evoked dopamine release. To improve the affinity of indolizidine (-)-237D for α6ß2*, we built a library of 2226 analogs. We screened virtually the library against a homology model of α6ß2 nAChR that we derived from the recent crystal structure of α4ß2 nAChR. We also screened the crystal structure of α4ß2 nAChR as a control on specificity. We ranked the compounds based on their predicted free energy of binding. We selected the top eight compounds bound in their best pose and subjected the complexes to 100 ns molecular dynamics simulations to assess the stability of the complexes. All eight analogs formed stable complexes for the duration of the simulations. The results from this work highlight nine distinct analogs of IND (-)-237D with high affinity towards α6ß2* nAChR. These leads can be synthesized and tested in in vitro and in vivo studies as lead candidates for drugs to treat nicotine addiction.


Assuntos
Descoberta de Drogas , Indolizidinas/química , Simulação de Dinâmica Molecular , Receptores Nicotínicos/química , Humanos , Antagonistas Nicotínicos/química , Ligação Proteica , Receptores Nicotínicos/metabolismo , Abandono do Hábito de Fumar
13.
Lung Cancer ; 159: 153-161, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34352591

RESUMO

OBJECTIVES: Robust economic evaluations are needed to identify efficient strategies for lung cancer prevention that combine brief and intensive smoking cessation intervention programmes with screening using low-dose computed tomography (LDCT) at different ages, frequencies, and coverages. We aimed to assess the cost-effectiveness of smoking cessation approaches combined with lung cancer screening in the European context at a population level from a societal perspective. MATERIALS AND METHODS: A microsimulation model that describes the natural history of lung cancer and incorporates several prevention strategies was developed. Discounted lifetime QALYs and costs at a rate of 3% were used to calculate incremental cost-effectiveness ratios, defined as additional costs in 2017 Euros per QALY gained. RESULTS: Smoking cessation interventions reduce the incidence of lung cancer by 8%-46% and are consistently more effective and cost-effective when starting at younger ages. Screening reduces lung cancer mortality by 1%-24% and is generally less effective and more costly than smoking cessation interventions. The most cost-effective strategy would be to implement intensive smoking cessation interventions at ages 35, 40 and 45, combined with screening every three years between the ages of 55 and 65. CONCLUSIONS: Combining smoking cessation interventions with LDCT screening is a very attractive prevention strategy that substantially diminishes the burden of lung cancer. These combined prevention strategies, especially when providing several intensive interventions for smoking cessation at early ages, are more cost-effective than both approaches separately and allow for a more intensified LDCT without losing efficiency.


Assuntos
Neoplasias Pulmonares , Abandono do Hábito de Fumar , Adulto , Idoso , Análise Custo-Benefício , Detecção Precoce de Câncer , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/prevenção & controle , Pessoa de Meia-Idade , Anos de Vida Ajustados por Qualidade de Vida
14.
Artigo em Inglês | MEDLINE | ID: mdl-34444463

RESUMO

BACKGROUND: Tobacco use remains one of the world's greatest preventable causes of death and disease. While most smokers want to quit, few are successful, highlighting a need for novel therapeutic approaches to support cessation efforts. Lower delay discounting (DD) rates are associated with increased smoking cessation success. Future thinking priming (FTP) reliably reduces DD rates in large populations. Smokers consistently discount more than nonsmokers, and evidence suggests that changes in DD rates are rate dependent. This study examined whether smoking status moderated the effect of FTP on DD rates and, if so, if the moderation effect could be attributed to differences in baseline rates of DD. METHODS: Moderation analysis was conducted to determine whether the effect of FTP, versus neutral priming (NP), on DD differed among smokers and nonsmokers. RESULTS: Smoking status moderated the effect of condition (FTP vs. NP) on post-intervention DD scores (b = -0.2919, p = 0.0124) and DD change scores (b = -0.2975, p = 0.0130). There was no evidence of rate dependence effects in the current sample. CONCLUSIONS: FTP had a greater effect on decreasing DD rates among smokers than nonsmokers. FTP is effective and simple to administer, which makes it a promising therapeutic approach for aiding smoking cessation.


Assuntos
Desvalorização pelo Atraso , Abandono do Hábito de Fumar , Produtos do Tabaco , Humanos , Fumantes , Fumar
15.
BMJ Open ; 11(8): e053075, 2021 08 26.
Artigo em Inglês | MEDLINE | ID: mdl-34446503

RESUMO

OBJECTIVES: The COVID-19 pandemic has changed patterns of smoking, other substance use and other health-related behaviours, leading to a virtualisation of non-urgent medical care. In this study, we examine associated changes in outcomes of smoking-cessation treatment. DESIGN: Observational study. SETTING: Data are drawn from 221 physician-led primary care practices participating in a smoking cessation program in Ontario, Canada. PARTICIPANTS: 43 509 patients (53% female), comprising 35 385 historical controls, 6109 people enrolled before the pandemic and followed up during it, and 1815 people enrolled after the pandemic began. INTERVENTION: Nicotine-replacement therapy with counselling. PRIMARY OUTCOME MEASURE: 7-day self-reported abstinence from cigarettes at a follow-up survey 6 months after entry. RESULTS: For people followed up in the 6 months (6M) after the pandemic began, quit probability declined with date of enrolment. Predicted probabilities were 31.2% (95% CI 30.0% to 32.5%) for people enrolled in smoking cessation treatment 6 months prior to the emergency declaration and followed up immediately after the state of emergency was declared, and 24.1% (95% CI 22.1% to 26.2%) for those enrolled in treatment immediately before the emergency declaration and followed up 6M later (difference=-6.5%, 95% CI -9.0% to -3.9%). Seasonality and total treatment use did not explain this decline. CONCLUSION: The probability of successful smoking cessation following treatment fell during the pandemic, with the decline consistent with an effect of 'exposure' to the pandemic-era environment. As many changes happened simultaneously, specific causes cannot be identified; however, the possibility that virtual care has been less effective than in-person treatment should be explored.


Assuntos
COVID-19 , Abandono do Hábito de Fumar , Feminino , Humanos , Masculino , Ontário/epidemiologia , Pandemias , Atenção Primária à Saúde , SARS-CoV-2 , Dispositivos para o Abandono do Uso de Tabaco
17.
Ugeskr Laeger ; 183(30)2021 07 26.
Artigo em Dinamarquês | MEDLINE | ID: mdl-34356027

RESUMO

The subject of this review is alpha-1-antitrypsin deficiency (A1AD), which is a rare hereditary disease with great impact in adults, especially smokers, quality of life and longevity. Early diagnosis is crucial for treatment outcome. The primary care physician should refer patients younger than 50-years-old with COPD or emphysema, familiar accumulation of A1AD or liver cirrhosis of unknown cause. Most important treatment is smoking cessation, pulmonary rehabilitation and inhaled medication according to current guidelines. Substitution treatment with alpha-1-antitrypsin is now an option after its approval by the Danish medical council in January 2020.


Assuntos
Enfisema Pulmonar , Abandono do Hábito de Fumar , Deficiência de alfa 1-Antitripsina , Adulto , Humanos , Cirrose Hepática , Pessoa de Meia-Idade , Enfisema Pulmonar/etiologia , Qualidade de Vida , Deficiência de alfa 1-Antitripsina/complicações , Deficiência de alfa 1-Antitripsina/diagnóstico , Deficiência de alfa 1-Antitripsina/genética
18.
Cien Saude Colet ; 26(8): 3065-3076, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34378698

RESUMO

Cigarette consumption is a worldwide epidemic and its reduction is one of the major public health concerns. In Brazil, although there is a wide literature on smoking cessation it is restricted to experimental studies. Based on data from the 2013 National Health Survey (PNS), this study uses the survival methodology and use population data and consumer's profile to investigate which characteristics will affect smoking cessation hazard. The results showed that the people who are less likely to quit smoking are older, single men, with low income and fewer education years. They also do not practice physical exercise. The findings of cigarette cessation hazard to Brazilian population are similar of experimental studies with smokers and ex-smokers in country. Therefore, in order to decrease public health spending, Brazilian health policies regarding tobacco cessation could focus on those groups who will likely smoke for a long time.


Assuntos
Abandono do Hábito de Fumar , Produtos do Tabaco , Brasil/epidemiologia , Humanos , Masculino , Fumar/epidemiologia , Análise de Sobrevida
19.
Ned Tijdschr Geneeskd ; 1652021 06 17.
Artigo em Holandês | MEDLINE | ID: mdl-34346630

RESUMO

Smoking cessation yields large health gains, especially in times of COVID-19. Compared to measures to stop COVID-19, tobacco control is lagging behind. We studied smoking-cessation-care in the Netherlands, using qualitative interviews with physicians (N=55) and questionnaires among physicians and other healthcare providers (HCPs; N=883) in 2017. Who is responsible for what? Three actors emerged: the patient who smokes (end responsible for quitting), the HCP (quit-advice, counseling or referral) and the government (create a society that stimulates "smoke-free"). Many HCPs do not ask about smoking, nor advise to quit. The task-division is unclear, as smoking causes multiple diseases that are part of multiple disciplines and specializations. HCPs that see smoking as a serious addiction are more inclined to ensure adequate smoking-cessation-care for their patients. Fortunately, there are positive developments as well, both within healthcare as society, and ways in which you can contribute.


Assuntos
COVID-19 , Abandono do Hábito de Fumar , Aconselhamento , Pessoal de Saúde , Humanos , SARS-CoV-2
20.
Trials ; 22(1): 512, 2021 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-34340694

RESUMO

BACKGROUND: Financial incentives are an effective way of helping women to stop smoking during pregnancy. Unfortunately, most women who stop smoking at this time return to smoking within 12 months of the infant's birth. There is no evidence for interventions that are effective at preventing postpartum smoking relapse. Financial incentives provided after the birth may help women to sustain cessation. This randomised controlled trial will assess the effectiveness and cost-effectiveness of financial incentives to help women who are abstinent from smoking at end-of-pregnancy to avoid return to smoking up to 12 months postpartum. METHODS: This is a UK-based, multi-centre, three-arm, superiority, parallel group, individually randomised controlled trial, with 1:1:1 allocation. It will compare the effectiveness of two financial incentive interventions with each other (one intervention for up to 3 months postpartum offering up to £120 of incentives (£60 for the participant and £60 for a significant other support); the other for up to 12 months postpartum with up to £300 of incentives (£240 for the participant and £60 for a significant other support) and with a no incentives/usual care control group. Eligible women will be between 34 weeks gestation and 2 weeks postpartum, abstinent from smoking for at least 4 weeks, have an expired carbon monoxide (CO) reading < 4 parts per million (ppm), aged at least 16 years, intend remaining abstinent from smoking after the birth and able to speak and read English. The primary outcome is self-reported, lapse-free, smoking abstinence from the last quit attempt in pregnancy until 12 months postpartum, biochemically validated by expired CO and/or salivary cotinine or anabasine. Outcomes will be analysed by intention-to-treat and regression models used to compare the proportion of abstinent women between the two intervention groups and between each intervention group and the control group. An economic evaluation will assess the cost-effectiveness of offering incentives and a qualitative process evaluation will examine barriers and facilitators to trial retention, effectiveness and implementation. DISCUSSION: This pragmatic randomised controlled trial will test whether offering financial incentives is effective and cost-effective for helping women to avoid smoking relapse during the 12 months after the birth of their baby. TRIAL REGISTRATION: International Standard Randomised Controlled Trial Number 55218215 . Registered retrospectively on 5th June 2019.


Assuntos
Motivação , Abandono do Hábito de Fumar , Feminino , Humanos , Lactente , Estudos Multicêntricos como Assunto , Período Pós-Parto , Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Retrospectivos , Fumar/efeitos adversos
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