CORK Bibliography: Smoking Cessation, Smoking Cessation in Recovering Alcoholics, Smoking Cessation.

Smoking Cessation

About 48 million Americans smoke cigarettes, but most smokers are either actively trying to quit or want to quit. Since 1965, more than 40 percent of all adults who have ever smoked have quit.
AHA Scientific Position

According to the 1990 Surgeon General's Report, The Health Benefits of Smoking Cessation, eliminating smoking can greatly reduce the occurrence of coronary heart disease and other forms of cardiovascular disease. The report also states that quitting smoking reduces the risk of repeat heart attacks and death from heart disease by 50 percent or more. Smoking cessation is important in the medical management of many contributors to heart attack. These include atherosclerosis (fatty buildups in arteries), thrombosis (blood clots), coronary artery spasm and cardiac arrhythmia (heart rhythm problems). Quitting smoking also can help manage several other disorders, especially arteriosclerotic peripheral vascular disease (fatty buildups in peripheral arteries) and chronic obstructive pulmonary disease.

According to the 2000 Surgeon General's Report, tobacco smoking remains the No. 1 cause of preventable disease and death in the United States.

About 23 percent of adults age 18 and older smoke. This figure is down considerably from 42 percent in 1965. Changes in smoking habits during the late 1960s, the 1970s and the 1980s have very likely contributed to the drop in cardiovascular deaths that occurred at the same time in the United States.

Source from: americanheart.org

Smoking Cessation

In America today, tobacco use stands out as one of the leading agents most responsible for avoidable illness and death. Tobacco use brings premature death to almost half a million Americans each year, and it contributes to profound disability and pain in many others. It is a testament to the power of tobacco addiction that millions of tobacco users have been unable to overcome their dependence.

Federal Regulations for smoke free federal buildings
Protecting Federal Employees and the Public From Exposure to Tobacco Smoke in the Federal Workplace (Executive Order 13058, Effective Date August 9, 1997)

Government smoking cessation Resources
AHCPR Clinic: Smoking Cessation - The chief purpose of this document is to provide clinicians, tobacco dependence specialists, health care administrators, insurers, purchasers, and even tobacco users with evidence-based recommendations regarding clinical and systems interventions that will increase the likelihood of successful quitting.

Other Smoking Cessation Resources
American Cancer Society Information on Quitting Smoking - A visit to this site is a good start for finding credible links to help you quit tobacco. Such names as the American Lung Association, American Heart Association, CDC, Mayo Health Clinic and National Cancer Institute are highlighted here.

American Heart Association: smoking cessation - A resource page for links to smoking cessation.
American Lung Association Program and Information on Smoking Cessation - The American Lung Association's free online smoking cessation program, Freedom from Smoking, helps you reach your smoke-free goal.

Centers for Disease Control and Prevention (CDC) - The 2004 Surgeon General's Report on the Health Consequences of Smoking on the Body outlines the effects of smoking on the different organs of the body. This interactive animation can be viewed on this site.

Free Quitline - In 2002, the Pennsylvania Department of Health in partnership with the American Cancer Society launched the Free Quitline for smokers interested in smoking cessation support. The program is based on state-of-the-art techniques that make use of psychological interventions shown to be effective in telephone-based counseling.

Source from: ohp.nasa.gov

Smoking Cessation, Quality of Life & Older Persons

This site is intended to provide information on and access to materials concerning smoking cessation, the effects of smoking cessation on the health of older persons, and the value of healthy lifestyles for older persons, which include not smoking or being subjected to secondhand smoke. Since this portion of this site has been created in August, 2000, we will largely be including materials and articles below which are published after this date; for references to materials on this subject published prior to this date, go to the section of this site titled Bibliography of Tobacco & Older Persons Articles. Additional materials will be added to this site on a regular basis.

Related information can be found on the following sections of this web site: Tobacco-related Health Problems & Older Persons; Tobacco & the Elderly Notes newsletters; and the Smoke-Free Environments Law Project site, particularly the ETS & Health Effects portion of that site.

Source from: tcsg.org

Smoking Cessation

Nicocure - The proprietary herbal formulation in Nicocure?Patch contains herbal ingredients that act as natural substitutes for nicotine and therefore satisfy the body抯 craving for this substance, but without all the negative side effects of the patches containing actual nicotine! The natural ingredients will make you crave fewer cigarettes every day. This gradual process makes you quit with no withdrawal symptoms and requires less will power and effort from your part.

The first day you use Nicocure?Patch you will smoke up to half or less of what you usually smoke. You will break your habit gradually, with less physical and emotional stress and in a short period of time.

Withdrawal symptoms will be milder due to the natural nicotine substitute, which helps you shake the nicotine habit gradually. Furthermore, to help you in this process, the Nicocure?Patch herbal formulation contains herbal ingredients that also combat the anxiety and depression that affect most people who are trying to quit smoking.

The nicotine content in your body will gradually fade off as you wear the patch, and to help you speed up this process, Nicocure?Patch contains antioxidant herbal ingredients to help detoxify your body and get rid of the nicotine. The other good news is that most of the harmful effects of smoking for years will start to disappear gradually once you stop smoking completely and as the nicotine intoxication wears off.

Source from: healthylivingrx.net

Smoking Cessation / Quit Smoking

Smoking is an addictive habit which means that each time you take a cigarette, the cycle of pleasure and need go hand in hand. We also know that tobacco use is the most preventable cause of death in the United States. Smoking cigarettes, pipes, or cigars can cause heart attacks, strokes, emphysema, chronic bronchitis, and cancers of the lung, larynx, mouth, esophagus, bladder, pancreas, and cervix .

Clearly if you’ve found this page, something within you wants to quit. If you’ve made that decision, what we want to do is support your decision and offer you alternatives to consider.

Why even think of quitting?
You’ll be able to spend the entire night with your friends without sneaking outdoors to have a cigarette.
You will have extra money to spend on things other than cigarettes.
You’ll begin to feel so much better after awhile and soon your health will be so much improved.
Quitting will lower your chance of having a heart attack, stroke, or cancer.
The people you live with, especially your children, will be healthier and probably happier since they want you to quit so you’ll live longer and be healthier.
And then there’s your own determination to “break the habit.”
And think about those things that might not yet have crept into your consciousness: you’ll smell better, be easier to kiss, probably will have less bronchitis, and fewer cough attacks that overwhelm you.

Why is it so hard to quit?
Smoking cigarettes is addictive in two ways—physically and psychologically. When you stop smoking, the addictive drug in cigarettes, nicotine, causes a reaction in the body called withdrawal. These withdrawal symptoms can include:

restlessness
irritability
tiredness
trouble sleeping
difficulty concentrating
Psychologically, you need to break the strongly ingrained habit of smoking. You probably have certain times when you automatically reach for a cigarette – when you pick up the phone, or turn the key in your car, or pour a glass of wine. Maybe you smoke more when you're stressed out, or are used to smoking when you go out for fun. Perhaps friends and colleagues smoke. To quit successfully, both physical and psychological factors need to be addressed.

What’s the best way to quit smoking?
FIRST, BE REALISTIC!

Quitting is not an easy undertaking. It requires effort, determination and a commitment.

Know that you need to quit – this is half of the battle. This knowledge will help you be more able to deal with the symptoms of withdrawal.
Since nicotine is habit forming, just thinking about quitting may make you anxious – nearly all smokers have some feelings of nicotine withdrawal when they try to quit. Give yourself a month to get over these feelings.
Take quitting one day at a time, even one minute at a time—whatever you need to succeed.
Develop a quit plan that works best for your needs.
Talk to your doctor or health professional to help develop a plan.
Enlist the help of family and friends by telling them about your plans.
Ask others who have quit how they handled withdrawal symptoms – both psychological and physical.
There is no one best way to quit. You’ll have to decide what will work best for you. Some people are able to go “cold turkey,” just stopping altogether. Others find that cutting back little by little works better for them. Others need to use a nicotine replacement. There are several types of behavioral modification techniques in use. Many people find that a support group is helpful. Often a combination of approaches is most useful. Even if you think you have “failed” because you slipped, don’t give up – as with any addiction, it may take several tries before you are able to make it stick.

Quitting works best when you're prepared. SmokeFree.gov provides this overview of the basic steps to quitting:

S = Set a quit date.
T = Tell family, friends, and co-workers that you plan to quit.
A = Anticipate and plan for the challenges you'll face while quitting.
R = Remove cigarettes and other tobacco products from your home, car, and work.
T = Talk to your doctor about getting help to quit.

Source from: helpguide.org

Smoking Cessation in Recovering Alcoholics

Fiction #1
"Smoking isn't a bigger problem for people in recovery than it is for anyone else."

Fact: Almost 85% of people who are in recovery from alcohol are also smokers, compared with 25% of the general public. Smokers in alcohol recovery may be more addicted to nicotine and often smoke more cigarettes than smokers who aren't in recovery.

Fiction #2
"Quitting smoking will threaten my sobriety."

Fact: Until recently, it was thought that quitting smoking made it harder to stay sober. We now know that smokers who are in recovery from alcohol abuse can stop smoking without starting to drink again. Because smoking and drinking often go together, smoking can lead to a stronger craving for alcohol. So quitting smoking during or right after treatment for alcoholism can actually increase your chances of staying sober.

Fiction #3
"Alcohol addiction was the biggest threat to my life and my health, and I've quit drinking. Smoking won't hurt me that much."

Fact: Smoking is an addiction. It's as likely to kill you as any other addiction -- maybe even more so. People who have been in treatment for alcohol problems are more likely to die from tobacco-related diseases than from alcohol-related problems. In fact, recovering alcoholics who smoke are more likely to get heart disease, lung disease and cancers of the head, mouth and throat. They are also likely to die earlier than people in the general public.

Fiction #4
"I'm too addicted to quit smoking. I tried to quit before and failed."

Fact: You may be more addicted to nicotine than other smokers, but very few people succeed the first time they try to quit smoking. Part of the problem may be that you tried to stop smoking on your own. Lots of resources can help you quit. They include: your doctor, friends and family members, nicotine replacement therapy, Nicotine Anonymous, the American Cancer Society, the American Lung Association and stop-smoking support groups. All you have to do is ask for help.

When you stop smoking, you may experience withdrawal symptoms like irritability, nervousness, difficulty concentrating and constipation. Counseling, medicine or both may help you handle the withdrawal symptoms. Ask your doctor what treatment is right for you.

Fiction #5
"I'll fail -- I know I will. Quitting smoking will be harder for me than quitting drinking was."

Fact: There's a good chance that you felt this way about recovering from alcohol abuse at times. Feeling powerless and admitting you need help is the first step to kicking your smoking addiction. You need to approach quitting smoking the same way you approached quitting drinking -- one step at a time. What gave you the strength and courage to give up drinking? The same tools, such as treatment, therapy, group support, spirituality, friends and family, can help you quit smoking if you use them.

Fiction #6
"I could never quit. Most of my family members and friends smoke."

Fact: Being around smokers can make quitting harder. But giving up any addiction is hard and requires you to make your own choice about what's best for you and your loved ones. Asking family members and friends not to smoke around you gives them the opportunity to be supportive. At first it may help to stay away from other smokers. It also helps to practice what you'll do when you feel like smoking.

Source from: familydoctor.org

CORK Bibliography: Smoking Cessation

84 citations. January 2005 to present
Prepared: June 2005

Amodei N; Lamb RJ. Predictors of initial abstinence in smokers enrolled in a smoking cessation program. Substance Use & Misuse 40(2): 141-149, 2005. (25 refs.)

The present study examined the relative contribution of nicotine dependence, self-efficacy and stages of change variables in predicting the initial abstinence of 102 smokers enrolled in a smoking cessation program. Over half the participants were female, the majority were White, and about half were married or living with a partner. Data were collected between 2000 and 2002. When smoking abstinence was defined as having a breath carbon monoxide (CO) level < 4 ppm within 24 hours of enrollment in the study, low nicotine dependence and a higher level of contemplation both predicted abstinence. When other potentially confounding variables were included in the analysis, neither nicotine dependence nor contemplation was predictive of abstinence. When abstinence was defined as the number of study baseline days in which the participant had a breath CO level < 4 ppm, multiple-regression analysis revealed that self-efficacy predicted abstinence. Self-efficacy remained predictive when other potentially confound ing variables were included in the analysis. These results suggest that all three types of constructs are useful in predicting initial smoking abstinence.
Copyright 2005, Marcel Dekker, Inc

Bauld L; Coleman T; Adams C; Pound E; Ferguson J. Delivering the English smoking treatment services. Addiction 100(Supplement 2): 19-27, 2005. (14 refs.)

Background: This paper describes how smoking treatment services in England were delivered beyond the initial set-up phase and explores key factors affecting their development. Services were expected to treat smokers in line with the evidence-base and were issued with government guidance regarding the type of interventions that should be offered. One factor complicating this was the issue of service funding. Funding was initially issued for a 3-year period and although this was extended on two occasions, these extensions were both announced close to the end of funding periods. Objectives To critically assess key elements in the delivery of the English cessation services, including the nature of treatments offered and the impact of short-term funding on staffing. Methods: A national postal survey of smoking cessation coordinators in April 2002. Semi-structured interviews with 50 smoking cessation staff in two health regions in autumn 200 1, followed by furthe r interviews with 2 8 staff in the same areas in t he autumn of 2002. Results: Treatment was delivered in a wide range of venues, ranging from primary care to local authority-owned premises such as town halls and libraries. Most services offered both one-to-one and group support, although interviewees reported an increase in demand for one-to-one support from clients. Pharmacotherapies were used widely; by 2002, 99% of coordinators reported that their advisers recommended nicotine replacement therapy (NRT) to clients, and 95%, bupropion. However, prior to April 2001. bupropion was available on prescription, but NRT was not and this variable access to pharmacotherapies posed problems for services. Coordinators reported that the short-term nature of funding made recruiting and retaining staff difficult and interviews revealed that they believed a longer period of protected funding was required for services to demonstrate their effectiveness. Conclusions: As English smoking treatment services developed, lessons were learned that could inform the development of s ervices in other health systems. First, early guidance from government can encourage services to adhere to evidence-based treatment. Secondly. treatment needs to be accessible to smokers and thus there must be a flexible approach to implementation at local level. Thirdly, the availability of nicotine addiction and behavioural therapies should be coordinated to minimize barriers and maximize uptake. Finally, fixed-term funding can exacerbate staff recruitment and retention difficulties and countries establishing treatment services need to consider carefully the initial funding period that is required for stable services to become established within their health systems.

Copyright 2005, Society for the Study of Addiction to Alcohol and Other Drugs

Bock BC; Niaura RS; Neighbors CJ; Carmona-Barros R; Azam M. Differences between Latino and non-Latino White smokers in cognitive and behavioral characteristics relevant to smoking cessation. Addictive Behaviors 30(4): 711-724, 2005. (43 refs.)
Adult smokers were recruited during routine health care visits at primary care clinics located in three urban hospitals and were given a brief intervention and nicotine replacement therapy. Analyses compared bicultural (BC: n=60) or less acculturated (LA: n=138) Latinos and non-Latino White (NL: n=417) participants. Both Latino groups were significantly different from NL subjects in smoking rate and nicotine dependence. However, BC and NL subjects differed significantly from LA subjects in perceived benefits of quitting, perceived risk from smoking, and negative affect smoking. LA subjects had higher cessation rates than either BC or NL groups. Regression analyses showed that nicotine dependence and confidence in quitting predicted cessation at month 6, and acculturation appeared to moderate the relationship between smoking cessation and both confidence in quitting and nicotine dependence. These results provide support for the viability of brief interventions for smoking provided through heal th care delivery systems. Results also suggest that characteristics previously shown to be predictive of successful cessation in mixed or non-Latino populations may not be equally predictive of cessation across members of diverse populations.
Copyright 2005, Elsevier Science Ltd.

Source from: projectcork.org

Discover everything you should know about quitting smoking.

At this site you will learn how to break down your smoking triggers, overcome your nicotine addiction, educate yourself about the health risks of smoking, and learn how to escape the cycle of quitting and then slipping up and smoking again. The key is making the effort to quit - and you should reward yourself for taking those steps to quit.

New - Quit Smoking Guide - click here

Participate in UBC Research on Cravings and smoking cessation

Here you can always come and find new tips, new smoking cessation methods, and new information that will help you quit smoking.

Our site has been proven to help people break free from nicotine addiction. Here you are equipped with all the valuable information you will need to quit smoking and you'll be ready to break free from smoking and start taking on new challenges in life. Don't waste your time and money on a few drags of a cigarette that lead to addiction. Gain your lungs back and decrease your cancer risk by quitting smoking. You will see results right away!

Learn: How you can break free from your nicotine addiction.

How to fight the power of nicotine.

What are the "true" consequences to your health of smoking?

Understand how to use nicotine replacement products.

Many more secret methods to fight and prevent slip-ups.

Improve your will power.

Deconstruct the psychological addiction that is created by habitually smoking cigarettes through cognitive therapy.

Source from: smoking-cessation.org

Cigarettes Linked to Late-Life Blindness

Researchers Find Smoking Raises Risk of Age-Related Macular Degeneration

By Salynn Boyles
WebMD Medical News

Sept. 7, 2005 - Need another reason to stop smoking? Cigarette smokers are far more likely than nonsmokers to go blind late in life, but few people are aware of the risk, new research suggests.

Smoking was associated with a two- to threefold increase in the risk of developing age-related macular degeneration (AMD) in a review of studies conducted by researchers in the U.K.

AMD is the most common cause of legal blindness in people over the age of 55; it occurs in nearly one out of three people over the age of 75. Roughly 200,000 new cases are diagnosed each year in the U.S. Approximately 10 million people in the U.S. are affected by the condition.

The condition is largely irreversible and difficult to treat. AMD blurs the sharp central vision, affecting visual acuity, our most detailed, vision which we use for skills like reading, driving, or activities that require fine, sharp, or straight-ahead vision.

"The studies confirmed that smokers were significantly more likely to develop AMD than nonsmokers and that heavy smokers had the highest risk," ophthalmic surgeon and study co-researcher Simon P. Kelly, MD, tells WebMD.

Patient Survey on Smoking and Health

In addition to reviewing the studies, Kelly and colleagues conducted a survey to determine if people knew that smoking was associated with blindness. Roughly 400 adult patients being treated at ophthalmology, general surgery, and orthopaedic clinics answered questions about smoking and health.

"Our hypothesis was that few patients would be aware of the risk of eye disease (associated with) smoking, but that awareness of the risks to eyesight from smoking would be a strong stimulus for smokers to quit," the researchers wrote in the latest issue of the journal Eye.

As expected, few patients knew that smoking posed a risk to their eyesight. Only about one in 10 believed that smoking was a definite or probable cause of blindness, while nine out of 10 knew that smoking was a major cause of lung cancer and heart disease.

About half of the smokers interviewed said they would definitely or probably quit smoking if they developed early signs of blindness. About the same number said they would quit if they suspected heart disease or lung cancer.

"What this says to us is that this is an important public health message that hasn't gotten out," Kelly says.

Source from: my.webmd.com

Smoking Cessation: Integration of Behavioral and Drug Therapies

ROBERT MALLIN, M.D., Medical University of South Carolina, Charleston, South Carolina

Family physicians should take advantage of each contact with smokers to encourage and support smoking cessation. Once a patient is identified as a smoker, tools are available to assess readiness for change. Using motivational interviewing techniques, the physician can help the patient move from the precontemplation stage through the contemplation stage to the preparation stage, where plans are made for the initiation of nicotine replacement and/or bupropion therapy when indicated. Continued motivational techniques and support are needed in the action stage, when the patient stops smoking. Group or individual behavioral counseling can facilitate smoking cessation and improve quit rates. Combined use of behavioral and drug therapies can dramatically improve the patient's chance of quitting smoking. A plan should be in place for recycling the patient through the appropriate stages if relapse should occur. (Am Fam Physician 2002;65:1107-14,1117. Copyright? 2002 American Academy of Family Physicians.)

Despite increased research on smoking, heightened awareness of the consequences of smoking, and considerable publicity about litigation against tobacco companies, statistics published within the past five years indicate that 23.5 percent of adults in the United States continue to smoke.1 Even more alarming is the increase in smoking among persons 18 to 24 years of age, almost 33 percent of whom currently use tobacco. In this age group, smoking rates increased by 32 percent between 1991 and 1997.2

Although 70 percent of patients who smoke say they would like to quit, only 7.9 percent are able to do so without help.3 The advice of a physician alone can improve the smoking cessation rate to 10.2 percent.4 The combined use of nicotine replacement, bupropion (Zyban), and social or behavioral support can increase the quit rate to 35 percent.5

Source from: aafp.org

PRODIGY Guidance - Smoking cessation

Have I got the right guidance ?
Applies to all ages

This guidance covers advice on smoking cessation, use of nicotine replacement therapy and bupropion. The guidance is primarily concerned with cigarette smoking, and is based on evidence regarding cigarette smoking, but may be extrapolated to include cigar and pipe smoking.

This guidance does not cover education or prevention of smoking in non-smokers.

The target audience for this guidance is healthcare professionals working within the NHS in England, and providing first contact or primary health care. Patient information leaflets (PILs) are intended to be printed and given to people with this condition. The Shared decision making sections are designed to provide a focus for discussion during the consultation about the treatment options.