Archive for the ‘ Tobacco ’ Category

Phone counseling insufficient to help teen smokers

In a 14-year study involving more than 2,000 teen smokers in 50 Washington state high schools, a team of cancer prevention researchers at Fred Hutchinson Cancer Research Center has found that one year of telephone counseling using motivational interviewing and skills training delivered during the senior year of high school is insufficient to help the smokers quit and stay quit up to six years into young adulthood.

The finding is significant because previous results from the same study had indicated that the intervention did have a beneficial effect in helping smokers quit earlier, at one year after high school. This earlier finding was a research breakthrough: It was the first-ever demonstration of effectiveness of a smoking-cessation intervention in a population-based sample of teens.

But today the researchers report that, by the time the teens became young adults, the earlier effectiveness had completely faded. Two-thirds of the teen smokers who had quit earlier had gone back to smoking. These findings, by principal investigator Dr. Arthur V. Peterson Jr., database manager Patrick Marek, and colleagues in the Public Health Sciences Division at Fred Hutch, are reported in a paper published Feb. 1 in the peer-reviewed, open-access journal PLOS ONE.

Extended Interventions Needed

This new finding means that to help teen smokers quit and stay quit after high school and beyond, new extended interventions are needed: ones that stick with them longer than just one year, and that continue into young adulthood.

Telephone counseling was used because of its special appeal to teens. It provided private, confidential, one-to-one counseling and allowed the counselors to explore and focus on issues specific to the individual smoker. Telephone counseling also gave teens control over the timing and length of the counseling sessions.

The motivational interviewing approach, first described in the early ’80s by Dr. William R. Miller, seeks to learn from each client their thoughts, attitudes, and practices about smoking and non-smoking. This approach aims to explore and resolve the participants’ ambivalence about smoking and quitting, and to mobilize their inner resources to trigger a decision to quit.

Motivational Interviewing

“Motivational interviewing is very caring, nonjudgmental and respectful,” explained Kathleen Kealey, co-investigator and intervention manager of the study. “It is non-confrontational. A counselor would never say, ‘I want you to quit smoking.’ Instead the counselor would ask what the behavior means to the participant. What do they like about it? What don’t they like about it? In the end, it is the smoker’s own reasons and desire to quit that motivate the quit attempt.”

The deferential approach of motivational interviewing is especially appropriate for high school students, because teens in particular don’t want to be told what to do. Motivational interviewing puts them in the driver’s seat.

In the beginning, this approach worked. Smokers responded in large numbers to invitations from the telephone counselors to participate in the conversations. In the experimental telephone counseling group, 65 percent of the smokers agreed, with their parents’ permission, to participate during their senior year of high school. “To get this large amount of participation by teen smokers was a terrific vote of confidence in telephone counseling that uses the motivational interviewing approach,” said Peterson, lead author of the paper.

Worked in the Short Term

The findings were based on data from the Hutchinson Study of High School Smoking, the largest and longest randomized trial of teen smoking cessation ever conducted. “This study showed that most teens are interested in sharing their views and practices about smoking. The field has encountered great obstacles in recruiting teens to smoking-cessation programs. And so, the large participation rates accomplished in this study were a big breakthrough.”

There were good reasons to think that an expanded multi-year version of telephone counseling based on motivational interviewing might work to help teen smokers quit and stay quit for the long term. First of all, this study has shown that teens like the deferential approach of motivational interviewing. Indeed, two-thirds of smokers in the study were happy to accept the study’s invitation and participate in telephone conversations.

Also, the motivational interviewing approach worked in the short term: at one year post high school it led to increased six-month abstinences, a strict measure of quitting smoking. “But it is well known that individual motivations, and pressures to smoke, change substantially in the critical period after high school,” Peterson said. “So, a sustained intervention that sticks with them during this period of change, aimed at helping them address their changing motivations and new situations to help them avoid relapse to smoking, makes good sense.”

High Level of Interest in Quitting

Fifty high schools in Washington state collaborated with Peterson and colleagues on this long-term, randomized trial. Half of the schools were randomly assigned to the experimental intervention; teens in these schools were, with their parents’ permission, proactively contacted and invited to take part in confidential, personalized telephone counseling designed to help motivate them to quit. The remaining 25 schools served as a comparison group; teen smokers from these schools did not participate in the telephone intervention.

“It was only because of the tremendous cooperation from students, parents, teachers and administrators that this study was able to rigorously address the important question of how to help interested teen smokers to quit,” Peterson said. “Without such a high level of interest and cooperation this study could not have been done.”

February 1st, 2016  in Tobacco No Comments »

Why many alcohol drinkers also are smokers

Alcohol and nicotine use have long been known to go hand in hand. Previous research shows that more than 85 percent of U.S. adults who are alcohol-dependent also are nicotine-dependent. Now, researchers from the University of Missouri School of Medicine have found that nicotine cancels out the sleep-inducing effects of alcohol. It’s a finding that sheds light on the reason alcohol and nicotine usage are so closely linked.

“We know that many people who drink alcohol also use nicotine, but we don’t know why exactly that is,” said Mahesh Thakkar, Ph.D., associate professor and director of research in the MU School of Medicine’s Department of Neurology and lead author of the study. “We have found that nicotine weakens the sleep-inducing effects of alcohol by stimulating a response in an area of the brain known as the basal forebrain. By identifying the reactions that take place when people smoke and drink, we may be able to use this knowledge to help curb alcohol and nicotine addiction.”

Tobacco Counteracts Sleepiness While Drinking

Thakkar has been studying the sleep-inducing effects of alcohol and nicotine for more than five years. His previous research has shown that when used in conjunction, nicotine and alcohol increase pleasurable side effects by activating an area of the brain known as the reward center, which can lead to increased alcohol consumption.

During the most recent study, rats were fitted with sleep-recording electrodes and given alcohol and nicotine. The researchers found that nicotine acts via the basal forebrain to suppress the sleep-inducing effects of alcohol.

“One of the adverse effects of drinking alcohol is sleepiness,” Thakkar said. “However, when used in conjunction with alcohol, nicotine acts as a stimulant to ward off sleep. If an individual smokes, then he or she is much more likely to consume more alcohol, and vice-versa. They feed off one another.”

Major Contributor for Alcoholism

Smoking is a major contributing factor to the development of alcoholism. According to the World Health Organization, more than 7 million deaths each year are attributed to alcohol and nicotine use.

This research has implications to improve health, not only for heavy drinkers and smokers, but also for individuals with mental health conditions such as schizophrenia, which often is associated with smoking.

November 8th, 2015  in Tobacco No Comments »

Social media helps young adults quit smoking

Young adults who use social media to quit smoking are twice as successful in their efforts as those who use a more traditional method, according to new research from the University of Waterloo.

The study, published last week in Nicotine & Tobacco Research, compared the success of the social media-based campaign Break It Off with Smokers’ Helpline, a telephone hotline for young adults looking to quit smoking.

Using Apps to Quit

After three months in the program, 32 per cent of smokers who used Break It Off apps and web tools had quit smoking, compared to 14 per cent of their peers who used the telephone-based support.

“These finding suggest that the creators of public health campaigns need to evaluate how they use social media channels and social networks to improve health, especially with regards to younger demographics,” said Bruce Baskerville, a senior scientist at the Propel Centre for Population Health Impact at Waterloo, who led the study.

In Canada, young adults aged 19 to 29 have the highest rate of smoking, but they report low use of traditional cessation services, such as helplines. Young adults make up the largest demographic of social media users, with 91 per cent using Facebook and one-third actively engaged in microblogging sites, such as Twitter.

Alternative Way to Reach Smokers

“Traditional cessation services can have limited reach and this reduced visibility lessens their impact in a digital era,” said Baskerville. “Because they are such heavy users of social media, these platforms provide an alternative and successful way of reaching smokers who are less likely to relate to other cessation programs.”

The Canadian Cancer Society launched Break It Off in January 2012 to engage young adults in smoking cessation through an interactive website and social media. The campaign, which compares quitting smoking with ending a romantic relationship, provides users with an interactive website and smartphone app to encourage smoking cessation.

June 12th, 2015  in Tobacco No Comments »

Total smoking bans work best

Completely banning tobacco use inside the home – or more broadly in the whole city – measurably boosts the odds of smokers either cutting back or quitting entirely, report University of California, San Diego School of Medicine researchers in the current online issue of Preventive Medicine.

“When there’s a total smoking ban in the home, we found that smokers are more likely to reduce tobacco consumption and attempt to quit than when they’re allowed to smoke in some parts of the house,” said Wael K. Al-Delaimy, MD, PhD, professor and chief of the Division of Global Health in the UC San Diego Department of Family and Preventive Medicine.

Effective Tobacco Bans

“The same held true when smokers report a total smoking ban in their city or town. Having both home and city bans on smoking appears to be even more effective.”

Al-Delaimy said the findings underscore the public health importance of smoking bans inside and outside the home as a way to change smoking behaviors and reduce tobacco consumption at individual and societal levels.

Positive Impact of Smoking Bans

“California was the first state in the world to ban smoking in public places in 1994 and we are still finding the positive impact of that ban by changing the social norm and having more homes and cities banning smoking,” he said.

“These results provide quantitative evidence that smoking bans that are mainly for the protection of nonsmokers from risks of secondhand smoke actually encourage quitting behaviors among smokers in California. They highlight the potential value of increasing city-level smoking bans and creating a win-win outcome.”

Al-Delaimy and colleagues surveyed 1,718 current smokers identified as a representative sample of the adult population in California. They found that total home smoking bans were significantly associated with reduced consumption and successful quitting, but partial bans were not.

Total Home Bans

Similarly, smokers who report smoking is broadly banned in their city were also more likely to attempt to quit and succeed than in places where smoking is not banned.

The researchers found that total home bans were more effective in reducing smoking among persons 65 years and older and among females, while city smoking bans were significantly associated with quit attempts in males, but not females. Total home bans were more effective in households without children, possibly reflecting the ultimate goal of cessation rather than primarily reducing children’s secondhand smoke exposure. Neither race nor income significantly modified relations between total home bans and smoking reductions.

December 19th, 2013  in Tobacco No Comments »

Cigarettes are gateway to marijuana

Teen smokers who rationalize their use of cigarettes by saying, “At least, I’m not doing drugs,” may not always be able to use that line.

New research to be presented Sunday, May 5, at the Pediatric Academic Societies (PAS) annual meeting in Washington, DC, supports the theory that cigarettes are a gateway drug to marijuana.

Smoking More Tobacco

“Contrary to what we would expect, we also found that students who smoked both tobacco and marijuana were more likely to smoke more tobacco than those who smoked only tobacco,” said study author Megan Moreno, MD, MSEd, MPH, FAAP, an investigator at Seattle Children’s Research Institute and associate professor of pediatrics at the University of Washington.

Dr. Moreno and her colleagues randomly selected incoming college students from two universities — one in the Northwest and one in the Midwest — to participate in the longitudinal study. Students were interviewed prior to entering college and again at the end of their freshman year regarding their attitudes, intentions and experiences with substances.

One-Third Smoke Tobacco

Specifically, students were asked if they had used tobacco or marijuana ever in their lives and in the past 28 days. Researchers also assessed the quantity and frequency of marijuana and tobacco use in the past 28 days.

Results showed that prior to entering college, 33 percent of the 315 participants reported lifetime tobacco use, and 43 percent of lifetime users were current users. In addition, tobacco users were more likely to have used marijuana than those who did not use tobacco.

By the end of their freshman year, 66 percent of participants who reported tobacco use prior to entering college remained current users with an average of 34 tobacco episodes per month. Of these, 53 percent reported concurrent marijuana use. Overall, users of both substances averaged significantly more tobacco episodes per month than current users of tobacco only (42 vs. 24).

Increased Use of Tobacco

“These findings are significant because in the past year we have seen legislation passed that legalizes marijuana in two states,” Dr. Moreno said. “While the impact of these laws on marijuana use is a critical issue, our findings suggest that we should also consider whether increased marijuana use will impact tobacco use among older adolescents.”

Future work should involve designing educational campaigns highlighting the increased risks of using these substances together, Dr. Moreno concluded.

May 9th, 2013  in Tobacco No Comments »

Smoking may worsen hangover after heavy drinking

People who like to smoke when they drink may be at greater risk of suffering a hangover the next morning, according to a study in the January 2013 issue of the Journal of Studies on Alcohol and Drugs.

For anyone who has ever had too much to drink, that day-after combination of headache, nausea and fatigue may be a familiar feeling. But some drinkers appear hangover-resistant: about one-quarter of people who drink enough to spur a hangover in most of us don’t actually develop one.

Smoking a Factor in Hangovers

No one is sure why that is. But the new study suggests that smoking could be one factor that boosts the hangover odds.

Researchers found that college students were more likely to report hangover symptoms after a heavy drinking episode if they smoked more heavily on the day they drank. And it wasn’t simply because they smoked more when they drank more.

“At the same number of drinks, people who smoke more that day are more likely to have a hangover and have more intense hangovers,” said researcher Damaris J. Rohsenow, Ph.D., of the Center for Alcohol and Addiction Studies at Brown University in Providence, Rhode Island.

A Direct Effect on Hangovers

Her team controlled for some other factors as well, such as whether students reported drug use in the past year. And smoking, itself, was linked to an increased risk of hangover compared with not smoking at all.

That raises the likelihood that there is some direct effect of tobacco smoking on hangovers, Rohsenow said.

The “how” isn’t fully clear. But other research has shown that nicotine receptors in the brain are involved in our subjective response to drinking, Rohsenow said. For example, smoking and drinking at the same time boosts the release of dopamine, a “feel-good” brain chemical.

So the fact that nicotine and alcohol are connected in the brain may explain why smoking is tied to hangover.

Higher Suffering

The findings are based on a Web survey of 113 college students who recorded their drinking and smoking habits, and any hangover symptoms, every day for eight weeks. Overall, when students drank heavily — the equivalent of five or six cans of beer in about an hour — those who’d smoked more on that same day had higher odds of suffering a hangover the next morning and suffered more when they did.

That leaves the question of “So what?” Hangovers may make you feel bad, but is there any more harm than that?

Reasons to Stop Smoking

There is evidence that a hangover affects your attention and reaction time in the short term, Rohsenow said. So it might be unwise to drive or work in safety sensitive occupations with a hangover, for instance. No one is sure yet whether hangovers may signal some type of damage to the brain, but smoking is already known from other studies to aggravate the ill effects on the brain caused by years of heavy drinking.

There are already plenty of reasons to avoid both smoking and heavy drinking. But Rohsenow said these findings suggest that if smokers are going to indulge in heavy alcohol use, it would be wise to at least cut down on cigarettes.

December 5th, 2012  in Tobacco No Comments »

Smoking in pregnancy tied to lower reading scores

Yale School of Medicine researchers have found that children born to mothers who smoked more than one pack per day during pregnancy struggled on tests designed to measure how accurately a child reads aloud and comprehends what they read.

The findings are published in the current issue of The Journal of Pediatrics.

Lead author Jeffrey Gruen, M.D., professor of pediatrics and genetics at Yale School of Medicine, and colleagues analyzed data from more than 5,000 children involved in the Avon Longitudinal Study of Parents and Children (ALSPAC), a large-scale study of 15,211 children from 1990-1992 at the University of Bristol in the United Kingdom.

Scored 21% Lower

Gruen and his team from Yale and Brock University in Canada, compared performance on seven specific tasks – reading speed, single-word identification, spelling, accuracy, real and non-word reading, and reading comprehension – with maternal cigarette smoking, after adjusting for socioeconomic status, mother-child interactions, and 14 other potential factors.

They found that on average, children exposed to high levels of nicotine in utero — defined as the minimum amount in one pack of cigarettes per day — scored 21 percent lower in these areas than classmates born to non-smoking mothers. The children were tested at age seven and again at age nine.

Among students who share similar backgrounds and education, a child of a smoking mother will, on average, be ranked seven places lower in a class of 31 in reading accuracy and comprehension ability.

A Significant Difference

“It’s not a little difference — it’s a big difference in accuracy and comprehension at a critical time when children are being assessed, and are getting a sense of what it means to be successful,” said Gruen, who also points out that the effects of smoking in pregnancy are especially pronounced in children with an underlying phonological (i.e., speech) deficit, suggesting an interaction between an environmental exposure (smoking) and a highly heritable trait (phonological ability).

“The interaction between nicotine exposure and phonology suggests a significant gene-by-environment interaction, making children with an underlying phonological deficit particularly vulnerable,” he said.

November 21st, 2012  in Tobacco No Comments »

Graphic warning labels improve smokers’ recall of warning

In a first of its kind study in the U.S., researchers at the Perelman School of Medicine at the University of Pennsylvania have shown that the addition of graphic warning labels on cigarette packaging can improve smokers’ recall of the warning and health risks associated with smoking. The new findings are published online-first in the American Journal of Preventive Medicine.

In past studies in Europe and Canada, graphic warning labels have proven to be effective in eliciting negative responses to smoking, increasing reported intention to quit smoking in smokers, and modifying beliefs about smoking dangers. However, these previous research results have generally been conducted using large, population-based studies that could be confounded by concurrent tax increases or anti-smoking media campaigns that coincide with the introduction of new warning labels.

Graphic Warning Labels

“An important first step in evaluating the true efficacy of the warning labels is to demonstrate if smokers can correctly recall its content or message,” said Andrew A. Strasser, PhD, associate professor, Department of Psychiatry at Penn and lead author of the new study. “Based on this new research, we now have a better understanding of two important questions about how U.S. smokers view graphic warning labels: do smokers get the message and how do they get the message.”

In the study, 200 current smokers were randomized to view either a text-only warning label advertisement, which was unaltered and utilized the Surgeon General’s warning and Federal Trade Commission (FTC) testing information that has appeared on cigarette advertisements since 1985; or a graphic warning label version that contained a graphic image (depicting a hospitalized patient on a ventilator) and a health warning with larger text, similar to what has been proposed by the FDA to be adopted in the U.S.

Graphics Make a Difference

In order to gauge how the participants viewed the layout of the advertisements, the research team utilized sophisticated eye-tracking technology. With this equipment, they were able to measure dwell time (total time viewing various parts of the ad, including the text or graphic warning), time to first viewing of portions of the ad to assess how attention is drawn, and fixations or the number of times they viewed each area of the ad (including the text or graphic warning). After reading the ads, each study participant also had to rewrite the warning label text to demonstrate their recall of the information.

Researchers found a significant difference in percentage correct recall of the warning label between those in the text-only versus graphic warning label condition, 50 percent vs. 83 percent. In addition, the quicker a smoker looked at the large text in the graphic warning, and the longer they viewed the graphic image, the more likely they were at recalling the information correctly.

The researchers say that the new data demonstrates that drawing attention to the warning label can improve recall of health relevant information, which may extend to improving risk perception of smoking. Additionally, attracting attention to the warning before viewing the advertisement body may change the framing of the message in the advertisement body, causing viewers to approach it with greater caution. Finally, time to first viewing has practical application to real-world settings where people may allocate only a few seconds to a print advertisement. Further study on the size, font, color, and location of text may identify the most effective way to draw attention.

More Effective Labels

“In addition to showing the value of adding a graphic warning label, this research also provides valuable insight into how the warning labels may be effective, which may serve to create more effective warning labels in the future,” said Dr. Strasser. “We’re hopeful that once the graphic warning labels are implemented, we will be able to make great strides in helping people to be better informed about their risks, and to convince them to quit smoking.”

The 2009 Family Smoking Prevention and Tobacco Control Act mandated the FDA to require graphic warning labels on cigarette packages. Originally mandated to appear on cigarette packages in September 2012, the implementation of these warning labels has been held up in court.

Strasser and colleagues note that the current study was designed to gauge short-term recall of the graphic warning information and that additional research addressing long-term recall and behavior changes are currently underway at Penn.

June 26th, 2012  in Tobacco No Comments »

Apartment dwellers often subjected to neighbors’ smoke

Noisy neighbors and broken-down elevators are common downsides of apartment living. You also can add unwanted tobacco smoke to the list of hazards, according to research to be presented Sunday, April 29, at the Pediatric Academic Societies (PAS) annual meeting in Boston.

Studies have shown that tobacco smoke can seep from one apartment into another. The extent to which this happens, however, is unclear.

Unwanted Tobacco Smoke

Researchers from the American Academy of Pediatrics Julius B. Richmond Center of Excellence surveyed a nationally representative sample of adults living in apartments to examine factors associated with unwanted tobacco smoke. The center, named for a former U.S. surgeon general, is committed to protecting children from tobacco and secondhand smoke.

Apartment dwellers were asked whether they experienced smoke incursion, which was defined as smelling tobacco smoke in their building and/or unit. They also were asked if they had children and if their apartment building had any smoking restrictions. Only respondents who reported that no one had smoked in their home for the previous three months were included in the study.

Results showed that nearly one-third of the 323 eligible respondents reported smelling tobacco smoke in their buildings, and half of these residents reported smelling smoke in their own units. In particular, residents with children were more likely to smell smoke in their building than those with no children (41 percent vs. 26 percent).

Daily Exposure to Smoke

Survey results also showed that 38 percent of those who reported smelling smoke said they did so weekly, while 12 percent smelled smoke daily.

“A significant number of residents of multi-unit housing are being unwillingly exposed to tobacco smoke, in some cases on a daily basis, and children seem to be especially vulnerable,” said lead author Karen M. Wilson, MD, MPH, FAAP, section head, pediatric hospital medicine at Children’s Hospital Colorado and assistant professor of pediatrics, University of Colorado School of Medicine. “This exposure could put children at risk for respiratory diseases and illness if it is persistent or if the child has a significant respiratory illness such as asthma or cystic fibrosis.”

“A smoke-free building protects the shared indoor air that all residents, including infants and children, are forced to breathe. Every parent needs to hear about this research because it could be their infant or child who is exposed next,” said Jonathan P. Winickoff, MD, MPH, FAAP, associate professor in pediatrics, MassGeneral Hospital for Children, Boston.

Residents receiving government housing subsidies also were more likely to smell smoke.

Options Are Limited

“Options for such housing are limited, and residents forced to experience smoke exposure in their buildings may not have the option to move to a smoke-free complex,” Dr. Wilson added.

Partial measures, such as limiting common area smoking, appeared to be ineffective at protecting nonsmokers from exposure in their own units. As long as smoking was allowed in the individual units of a building, higher rates of exposure were reported. Only completely smoke-free buildings were associated with lower incursion rates.

“This finding supports grassroots efforts by multi-unit housing resident groups, apartment managers and owners to make buildings smoke-free for the comfort, health and safety of their residents, and because of the far lower costs associated with managing nonsmoking apartments,” Dr. Wilson concluded.

May 3rd, 2012  in Tobacco No Comments »

Poorest Smokers Face Toughest Odds

Quitting smoking is never easy. However, when you’re poor and uneducated, kicking the habit for good is doubly hard, according to a new study by a tobacco dependence researcher at The City College of New York (CCNY).

Christine Sheffer, associate medical professor at CCNY’s Sophie Davis School of Biomedical Education, tracked smokers from different socioeconomic backgrounds after they had completed a statewide smoking cessation program in Arkansas.

Whether rich or poor, participants managed to quit at about the same rate upon completing a program of cognitive behavioral therapy, either with or without nicotine patches. But as time went on, a disparity between the groups appeared and widened.

Hardest Time With Cravings

Those with the fewest social and financial resources had the hardest time staving off cravings over the long run. “The poorer they are, the worse it gets,” said Professor Sheffer, who directed the program and was an assistant professor with the University of Arkansas for Medical Sciences at the time.

She found that smokers on the lowest rungs of the socioeconomic ladder were 55 percent more likely than those at the upper end to start smoking again three months after treatment. By six months post-quitting, the probability of their going back to cigarettes jumped to two-and-a-half times that of the more affluent smokers. The research will be published in the March 2012 issue of the “American Journal of Public Health” and will appear ahead-of-print online under the journal’s “First Look” section.

More Poor People Smoke

In their study, Professor Sheffer and her colleagues noted that overall, Americans with household incomes of $15,000 or less smoke at nearly three times the rate of those with incomes of $50,000 or greater. The consequences are bleak. “Smoking is still the greatest cause of preventable death and disease in the United States today,” noted Professor Sheffer. “And it’s a growing problem in developing countries.”

Professor Sheffer suggested reasons it may be harder for some to give up tobacco forever.

Smoking relieves stress for those fighting nicotine addiction, so it is life’s difficulties that often make them reach for the cigarette pack again. Unfortunately, those on the lower end of the socioeconomic scale suffer more hardships than those at the top – in the form of financial difficulties, discrimination, and job insecurity, to name a few. And for those smokers who started as teenagers, they may have never learned other ways to manage stress, said Professor Sheffer.

For people with lower socioeconomic status (SES), it can be tougher to avoid temptation as well. “Lower SES groups, with lower paying jobs, aren’t as protected by smoke-free laws,” said Sheffer, so individuals who have quit can find themselves back at work and surrounded by smokers. Also fewer of them have no-smoking policies in their homes.

Not Addressed in Treatment

These factors are rarely addressed in standard treatment programs. “The evidence-based treatments that are around have been developed for middle-class patients,” Professor Sheffer pointed out. “So (in therapy) we talk about middle-class problems.”

Further research would help determine how the standard six sessions of therapy might be altered or augmented to help. “Our next plan is to take the results of this and other studies and apply what we learned to revise the approach, in order to better meet the needs of poor folks,” she said. “Maybe there is a better arrangement, like giving ‘booster sessions’. Not everybody can predict in six weeks all the stresses they will have later on down the road.”

“Some people say [quitting] is the most difficult thing in their life to do,” said Sheffer. “If we better prepare people with more limited resources to manage the types of stress they have in their lives, we’d get better results. “

The research was funded by National Institutes of Health National Cancer Institute (R03 CA141995–01A1) and the National Center for Research Resources (RR 020146). The treatment program was funded by the Arkansas Department of Health.

January 22nd, 2012  in Tobacco No Comments »