Incentives for smoking cessation

Cahill, Kate; Hartmann‐Boyce, Jamie; Perera, Rafael

doi:10.1002/14651858.cd004307.pub5

Cited by 200 publications

(177 citation statements)

References 180 publications

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“…6,7 Others are based on financial incentives [8][9][10] and nicotine replacement therapy. [11][12][13] While some of these interventions have improved cessation during pregnancy, they lack effectiveness for the prevention of postpartum relapse.…”

Section: Introductionmentioning

confidence: 99%

Progesterone and Postpartum Smoking Relapse: A Pilot Double-Blind Placebo-Controlled Randomized Trial

Allen

Lunos

et al. 2016

NICTOB

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Introduction: Pregnancy is a strong motivator to quit smoking, yet postpartum relapse rates are high. Growing evidence suggests a role of sex hormones in drug abuse behavior and given the precipitous drop in sex hormones at delivery, they may play a role in postpartum relapse. This pilot study evaluates the feasibility and potential role of exogenous progesterone in postpartum smoking relapse. Methods: This 12-week double-blind placebo-controlled randomized pilot trial randomized 46 abstinent postpartum women to active progesterone (PRO; 200 mg twice a day) versus placebo (PBO) for 4 weeks. Participants were followed for relapse for 12 weeks. Main study outcomes include abstinence (point prevalence), feasibility (compliance per number of clinic visits attended, pill counts and Electronic Data Capture [EDC] completed) and self-reported acceptability. Safety was also measured by depressive symptom scores, adverse events, and breastfeeding. Results: Overall retention rate was 87% at week 12. At week 4, abstinence rates were 75% in the PRO group and 68.2% in the PBO group (p = .75). Medication adherence was 68% and clinic visit attendance was 80%, with no differences by randomization. Depressive symptom scores, adverse events, and breastfeeding did not vary by randomization. Conclusions: Although the study was not powered to evaluate abstinence rates, we did observe a higher prevalence of abstinence at week 4 in the PRO group. Further, exogenous progesterone was well tolerated and did not adversely affect depressive symptoms or breastfeeding. Thus, the results of this pilot study indicate further investigation into progesterone as a postpartum relapse prevention strategy is warranted. Implications: This innovative pilot trial determined the feasibility of delivering exogenous progesterone as a potential prevention of postpartum smoking relapse. We observed high retention and moderate adherence rates, as well as high acceptability among participants. Further, though not statistically significant, more women in the treatment group remained abstinent from smoking during follow-up. This project adds to the growing body of literature on the role of sex hormones in smoking relapse and also provides support for a fully powered clinical trial.

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Section: Introductionmentioning

confidence: 99%

Progesterone and Postpartum Smoking Relapse: A Pilot Double-Blind Placebo-Controlled Randomized Trial

Allen

Lunos

et al. 2016

NICTOB

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“…Cash and vouchers as incentives are widely used to encourage smokers to quit. [33] Data were entered into SPSS-Version 20. Normality of data was examined.…”

Section: Methodsmentioning

confidence: 99%

Smoking behaviors and abstinence in low-income pregnant women

Kessler

Alverson

2016

JNEP

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Background: Despite efforts to educate individuals about the hazards of smoking, pregnant women continue to smoke. In the literature, there is less evidence about successful abstinence strategies for low-income women. The purpose of this pilot study was to assess smoking behaviors and factors that support smoking abstinence in low-income pregnant women. Methods: Using a longitudinal design, quantitative and qualitative data were collected from pregnant women at a low-income community prenatal clinic. Based on the Transtheoretical model, all subjects received information about the harmful effects of smoking and secondhand exposure, while current smokers were given a "quit kit" and contacted up to one year post-delivery to evaluate smoking behaviors. Results: All subjects (N = 135) ranged in age from 18 to 41; 75% were not married; 78% had household incomes < $30,000; and the majority were African American (40%). Fifty-five (40.7%) never smoked while 77(57%) had a smoking history, of these 18(23%) were spontaneous quitters. Data indicated that 36% reported smoking during pregnancy, with the majority in pre-contemplation. After one year, 18% of current smokers quit. Conclusions: Without a specific plan, the majority were unable to successfully abstain. Rate of abstinence may have been further influenced because subjects began smoking at an early age and were unsuccessful at previous quit attempts. Providers must continue to educate pregnant women but also evaluate strategies that require few provider visits, are cost effective, focus on relapse prevention, and can successfully influence smoking abstinence in low-income pregnant women.

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“…In addition, direct financial incentives to patients also improve rates of smoking cessation, at least for as long as the incentives are in place. 4 These incentives are typically provided by either the employer or the patient's health insurance carrier. Other studies have found that gaining insurance coverage leads to reduced rates of smoking.…”

mentioning

confidence: 99%

Capsule Commentary on Huskamp et al., Effects of Global Payment and Accountable Care on Tobacco Cessation Service Use: An Observational Study

Jackson

2016

J GEN INTERN MED

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Incentives for smoking cessation

Cited by 200 publications

References 180 publications

Progesterone and Postpartum Smoking Relapse: A Pilot Double-Blind Placebo-Controlled Randomized Trial

Progesterone and Postpartum Smoking Relapse: A Pilot Double-Blind Placebo-Controlled Randomized Trial

Smoking behaviors and abstinence in low-income pregnant women

Capsule Commentary on Huskamp et al., Effects of Global Payment and Accountable Care on Tobacco Cessation Service Use: An Observational Study

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