Research

Media campaigns to promote smoking cessation among socioeconomically disadvantaged populations: what do we know, what do we need to learn, and what should we do now?
The effectiveness of media campaigns to promote smoking cessation in the general population has been well-researched. However, little is known about whether such campaigns prevent smoking among people with low socioeconomic status, or if campaigns might instead widen disparities in tobacco use. A literature review published in the November 2008 issue of Social Science & Medicine evaluated whether media campaigns targeting the general population were effective for low SES individuals. Nine of the eighteen media campaigns were less effective in low SES groups than in the general population, while six campaigns were equally effective, and three were more effective for low SES smokers. Differences in effectiveness could stem from three factors: differences in meaningful exposure to the campaign, differences in motivational response, or differences in opportunities to sustain cessation in the long-term. To better reach low SES individuals, it is recommended that cessation campaigns avoid solely promoting self-help materials or contests. Rather, media campaigns should join with other tobacco control program components including community mobilization, social support, quitlines, free NRT promotions, and policy changes. Click here to view the abstract of the article.

Helping hospitalized smokers to stay smoke-free by employing intensive support programs
A review of smoking cessation interventions found that ongoing cessation support and the use of nicotine replacement therapy significantly improve cessation rates among hospitalized smokers. Cessation counseling with supportive contacts for one month after hospital discharge increased the likelihood of long-term cessation (six or twelve months, depending on the study measures of cessation). The researchers conclude that to be effective in the hospital setting, smoking cessation programs should be intense, integrated, and sustained. It is recommended that cessation counseling should be offered to all hospital inpatients that smoke, and that nicotine replacement therapy should be used when clinically indicated for patients experiencing symptoms of nicotine withdrawal. Click here to read more. Click here to access an abstract of the research, which is published in the Archives of Internal Medicine.

Can cash for clinics snuff out smoking?
According to findings from a University of Minnesota and Blue Cross and Blue Shield of Minnesota study, cash incentives can encourage healthcare providers to make referrals to tobacco cessation quitlines. Over a one-year period, insurance company Blue Cross offered some medical clinics up to $100 per smoking cessation referral, while a comparison group of clinics was only given encouragement to make referrals, without the financial incentive. During that time, clinics receiving compensation referred 11% of smokers to the cessation hotline, and the uncompensated clinics referred only 4% of smoking patients—nearly a threefold difference in referral rates. A limitation of the study is that there is no data on whether the patients referred to the quitline were successful in quitting smoking. However, the study suggests that financial incentives encourage healthcare providers to discuss smoking cessation with their patients, which is a step in the right direction. Click here for more information. This research is published in the Archives of Internal Medicine.

Critical genetic link found between human taste differences and nicotine dependence
A recent study used a novel computer modeling method to study the interactions between multiple genetic and environmental factors. The researchers identified an interaction between two genes related to taste sensitivity, TAS2R16 and TAS2R38, and examined their role in nicotine dependence and smoking habits. Based on the model, these two genes, which are involved in sensitivity to bitter tastes, play an important role in nicotine dependence. Individuals with higher taste sensitivity are less likely become nicotine-dependant than individuals with less sensitive taste buds. The modeling tool is useful for assessing individuals’ genetic risk of nicotine dependence because the model can control for factors such as age and gender to evaluate either interactions between genes, or between genes and environmental factors. With a better knowledge of the genetics of nicotine dependence, researchers could develop more effective approaches to prevention and treatment. Click here for more details. The study is published in the American Journal of Human Genetics.

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Reports

American Cancer Society marks 33rd Great American Smokeout
This year’s Great American Smokeout will take place on Thursday, November 20. Since 1976, the Great American Smokeout has been held as an opportunity for smokers to commit to quitting for one day. Since 44.2% of smokers have attempted to quit for at least one day during the past year, this event could also be an opportunity to encourage these individuals to quit smoking permanently. The American Cancer Society provides free cessation resources, including quitline counseling and its website, www.cancer.org/GreatAmericans. The ACS emphasizes the importance of supportive social networks of friends, family, and coworkers in encouraging smokers to quit. Click here to navigate to the American Cancer Society website, which includes resources for local smokeout activities. Click here to view a press release from the Centers for Disease Control and Prevention that can be adapted for use in local newspapers.

FDA may revise warning for antismoking drug
The Food and Drug Administration has announced that warnings on the smoking cessation drug Chantix may be upgraded to reflect new concerns about adverse effects. Government safety data includes over 1000 reports submitted by physicians of serious incidents among Chantix users during the first quarter of 2008, including fifteen traffic incidents and 52 blackouts. Last year, Pfizer changed the Chantix warning label to warn of psychological side effects, and the latest concerns over losses of consciousness or vision have led to an ongoing FDA review to determine whether the labeling sufficiently addresses these risks. While it can be difficult to draw conclusions about a cause-and-effect link between a medication and adverse events, the amount of adverse events from Chantix has recently been greater than the total amount of adverse events from the top ten most prescribed medications. Experts speculate that negative publicity about Chantix may have contributed to the large amount of adverse event reports. Click here for more information.

Webcast alert: World Medical Association Tobacco Cessation Symposium In October 2008, physicians from around the world gathered at the World Medical Association’s 59th general assembly in Seoul, South Korea. At the meeting, a panel of experts gathered to discuss global tobacco cessation and prevention efforts. Available online are webcasts of three presentations, including a call to arms by Dr. Ron Davis, the immediate past president of the American Medical Association, which encourages physicians to speak with their patients about tobacco cessation. Click here to read a press release with more information about the meeting, or click here to view the webcasts.

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International

Voucher plan for pregnant smokers (UK)
Local proposals in the UK could result in pregnant women receiving financial rewards for successfully quitting smoking. Under the plan, women would receive a £5 voucher for maintaining their cessation over a certain period, which would be verified by tests for a biomarker of tobacco use, such as carbon monoxide breath tests. The rationale behind the financial prize is that simply telling women to quit smoking has not been enough motivation for some women, and that the tangible short-term benefit of a financial reward may be a stronger motivator than long-term health benefits. Focus group data revealed that 13 of 15 pregnant women believed the vouchers would be a good incentive for cessation. The proposal has been given preliminary approval, and will be presented in more detail later this year. Click here to learn more.

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