Our results suggest that social media depictions of tobacco use predict future smoking tendency, over and above the influence of TV and movie depictions of smoking. This is the first known study to specifically assess the role of social media in informing tobacco behavior.
Treatment center, work-site, helpline, and Web site programs differ in their reach, effectiveness, and estimated cost per quit. Each program plays a part in assisting populations of tobacco users in quitting.
Whole-person care is a new paradigm for serious illness, but few programs have been
robustly studied. We sought to test the effect of LifeCourse (LC), a person-centered
program for patients living with serious illness, on health-care utilization, care
experience, and quality of life, employing a quasi-experimental design with a Usual Care
(UC) comparison group. The study was conducted 2012 to 2017 at an upper-Midwest
not-for-profit health-care system with outcomes measured every 3 months until the end of
life. Enrolled patients (N = 903) were estimated to be within 3 years of end of life and
diagnosed with 1+ serious illness. Exclusion criteria included hospice enrollment at time
of screening or active dying. Community health workers (CHWs) delivered standardized
monthly 1-hour home visits based on palliative care guidelines and motivational
interviewing to promote patients’ physical, psychosocial, and financial well-being.
Primary outcomes included health-care utilization and patient- and caregiver-experience
and quality of life. Patients were elderly (LC 74, UC 78 years) and primarily
non-Hispanic, white, living at home with cardiovascular disease as the primary diagnosis
(LC 69%, UC 57%). A higher proportion of LC patients completed advance directives (N =
173, 38%) than UC patients (N = 66, 15%;
P
< .001). LifeCourse
patients who died spent more days in hospice (88 ± 191 days) compared to UC patients (44 ±
71 days;
P
= .018). LifeCourse patients reported greater improvements
than UC in communication as part of the care experience (
P
= .016).
Implementation of person-centered programs delivered by CHWs is feasible; inexpensive
upstream expansion of palliative care models can yield benefits for patients and
caregivers. Trial Registration: Trial NCT01746446 was registered on November 27, 2012 at
ClinicalTrials.gov
.
Cigarette tax increases result in a reduced demand for cigarettes and increased efforts by smokers to reduce their cost of smoking. Less is known about how smokers think about their expenditures for cigarettes and the possible mechanisms that underlie price-minimizing behaviors. In-depth longitudinal interviews were conducted with Minnesota smokers to explore the factors that influence smokers’ decisions one month prior to a $1.75 cigarette tax increase and again one and three months after the increase. A total of 42 were sampled with 35 completed interviews at all three time points, resulting in 106 interviews across all participants at all time points. A qualitative descriptive approach examined smoking and buying habits, as well as reasons behind these decisions. A hierarchy of ways to save money on cigarettes included saving the most money by changing to roll your own pipe tobacco, changing to a cheaper brand, cutting down or quitting, changing to cigarillos, and buying online. Using coupons, shopping around, buying by the carton, changing the style of cigarette, and stocking up prior to the tax increase were described as less effective. Five factors emerged as impacting smokers’ efforts to save money on cigarettes after the tax: brand loyalty, frugality, addiction, stress, and acclimation.
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