Secondary analysis of an RCT on Emergency Department- Initiated Tobacco Control: Repeatedly assessed point-prevalence abstinence up to 12 months and extension of results through a 10-year follow-up

Abstract

INTRODUCTIONEmergency departments (EDs) are opportune places for tobacco control interventions. The ‘Tobacco Control in an Urban Emergency Department’ (TED) study, ISRCTN41527831, originally evaluated the effect of motivational interviewing on-site plus up to four booster telephone calls on 12-month abstinence. This study’s aim was to evaluate the effect of the intervention on 7-day point-prevalence abstinence at 10 years follow-up (primary outcome) as well as on repeated point-prevalence abstinence at 1, 3, 6, 12 months and at 10 years (continual smoking abstinence, secondary outcome).METHODSAt the 10 years follow-up and after informed consent, study participants responded to a mailed questionnaire. The primary outcome was analyzed in observed-only and in all-cases analyses. The secondary outcomes were analyzed using a multiple adjusted GLMM for binary outcomes.RESULTSOut of 1012 TED-study participants, 986 (97.4%) were alive and 231 (23.4% of 986) responded to the follow-up at 10 years. For observed-only and all-cases analyses, the effect of the baseline intervention on 7-day point-prevalence abstinence at the 10 years follow-up was statistically non-significant. However, when taking into account all repeated measures, the intervention significantly influenced continual abstinence with odds ratio 1.32 (95% CI: 1.01–1.73; p=0.042). Baseline motivation, perceived self-efficacy to stop smoking, and nicotine dependency were independently associated with long-term continual smoking abstinence (all p<0.05).CONCLUSIONSA conventional analysis failed to confirm a significant effect of the ED-initiated tobacco control intervention on the point-prevalence abstinence at 10 years. Results from a more integrative analysis nonetheless indicated an enduring intervention effect on continual abstinence among smokers first encountered in the emergency department setting 10 years earlier.

The association between the retail price of manufactured cigarettes and bidis on current smoking status in India

“…We conducted descriptive analysis, summarizing the average age of current smokers at the time of the survey, and the proportion of current smokers by the GATS derived sociodemographic variables, separately for bidis and manufactured cigarettes. To take into account the variation between states and GATS waves and predictors on both state-level and individuallevel, we used Generalized Linear Mixed Models (GLMM) to analyze the association between retail price and current smoking status across the two GATS survey time points for bidis and cigarettes separately, controlling for sociodemographic variables, with states and GATS waves as random effect to account for clustering effect on state level and survey level 33 .…”

Impact of the ENSP eLearning platform on improving knowledge, attitudes and self-efficacy for treating tobacco dependence: An assessment across 15 European countries

“…However, implementation of tobacco dependence treatment for healthcare professionals has been shown to increase their cessation efforts significantly with their patients and quit attempts 19,20 , as well as improve trainees' attitudes and perceived behavioral control in providing tobacco dependence services 21 . The importance of continuing medical education training programs to address this gap in knowledge and skills has also been acknowledged and can significantly impact healthcare professional competence, future clinical practice and patient outcomes if embedded into the healthcare system [22][23][24][25][26] . Based on all the aforementioned, time and distance saving and cost-effective training programs that provide new knowledge and skills are essential to ensure that healthcare professionals are confident to deliver smoking cessation interventions to all their patients who smoke.…”