scholarly journals Changes in carotid artery structure with smoking cessation

2019 ◽  
Vol 24 (6) ◽  
pp. 493-500 ◽  
Author(s):  
Carol Mitchell ◽  
Megan E Piper ◽  
Stevens S Smith ◽  
Claudia E Korcarz ◽  
Michael C Fiore ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Carotid Artery ◽  
Linear Models ◽  
Smoking Status ◽  
Secondary Analysis ◽  
Texture Features ◽  
Carotid Ultrasound ◽  
Longitudinal Effects ◽  
Status Interaction ◽  
The Impact

Carotid artery grayscale ultrasound echogenicity and texture features predict cardiovascular disease events. We evaluated the longitudinal effects of smoking cessation on four grayscale ultrasound measures. This was a secondary analysis of data from 188 age, sex, and body mass index (BMI)-matched smokers (94 eventual abstainers [EA], 94 continued smokers [CS]) from a smoking cessation trial that had carotid ultrasound examinations at baseline and after 3 years. General linear models that included time, smoking group (EA or CS), and a time*smoking interaction term were used to examine the impact of smoking abstinence on carotid artery grayscale marker values at year 3. Participants were mean (SD) 50.3 (11.4) years old (57% female, 86% white). The baseline grayscale median value (GSM) was inversely correlated with age, BMI, insulin resistance, and smoking pack-years ( r = −0.20 to –0.30, p < 0.007 for all). There was a significant time*smoking status interaction for predicting GSM at year 3: GSM decreased significantly in the EA group compared to the CS group (–3.63 [13.00] vs CS 0.39 [12.06] units; p = 0.029). BMI increased more in the EA than the CS group (2.42 [3.00] vs CS 0.35 [2.57] kg/m2; p < 0.001). After adjusting for changes in BMI, the time*smoking status interaction no longer was significant ( p = 0.138). From baseline to year 3, contrast increased similarly in both groups. Entropy and angular second moment did not change significantly in either group. Changes in carotid ultrasound echogenicity and grayscale texture features during a smoking cessation attempt are modest and mostly related to weight gain. Clinicaltrials.gov Identifier: NCT01553084

scholarly journals Systematic identification and referral of smokers attending HIV ambulatory care highlights the failure of current service provision in an at-risk population

2019 ◽  
Vol 6 (1) ◽  
pp. e000395
Author(s):  
James Brown ◽  
Christianna Kyriacou ◽  
Elisha Pickett ◽  
Kelly Edwards ◽  
Hemal Joshi ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Smoking Status ◽  
Healthcare Services ◽  
Lifestyle Changes ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Smoking Cessation Services ◽  
Living With Hiv ◽  
Systematic Identification ◽  
The Impact

IntroductionPeople living with HIV (PLWH) are more likely to smoke than the general population and are at greater risk of smoking-related illness. Healthcare services need to address this burden of preventable disease.MethodsWe evaluated the impact of a brief intervention that asked service users about smoking when they attended for ambulatory HIV care in London, UK, and offered referral to smoking cessation.ResultsOverall, 1548 HIV-positive individuals were asked about their smoking status over a 12-month period. Of this group, 385 (25%) reported that they were current smokers, 372 (97%) were offered referral to smoking cessation services and 154 (40%) accepted this. We established an outcome of referral for 114 (74%) individuals. A total of 36 (10% of smokers) attended stop smoking clinics and 16 (4%) individuals were recorded as having quit smoking.DiscussionThe simple intervention of asking PLWH about tobacco smoking and offering referral to smoking cessation services rapidly identified current smokers, 40% of whom accepted referral to smoking cessation services. This highlights the importance of promoting behaviour and lifestyle changes with every contact with health services. However, a large proportion of those referred were either not seen in local services or the outcome of referral could not be ascertained. If the risk of smoking-related morbidity among PLWH is to be reduced, more sustainable referral pathways and ways of improving uptake of smoking cessation services must be developed.

scholarly journals Longitudinal effects of smoking cessation on carotid artery atherosclerosis in contemporary smokers: The Wisconsin Smokers Health Study

2020 ◽  
Vol 315 ◽  
pp. 62-67
Author(s):  
James H. Stein ◽  
Stevens S. Smith ◽  
Kristin M. Hansen ◽  
Claudia E. Korcarz ◽  
Megan E. Piper ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Carotid Artery ◽  
Health Study ◽  
Carotid Artery Atherosclerosis ◽  
Longitudinal Effects

Impact of a Bladder Cancer Diagnosis on Smoking Behavior

2012 ◽  
Vol 30 (15) ◽  
pp. 1871-1878 ◽  
Author(s):  
Jeffrey C. Bassett ◽  
John L. Gore ◽  
Amanda C. Chi ◽  
Lorna Kwan ◽  
William McCarthy ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Smoking Cessation ◽  
General Population ◽  
Tobacco Use ◽  
Cancer Diagnosis ◽  
Smoking Status ◽  
Simple Random Sample ◽  
Cancer Risk Factors ◽  
History Of ◽  
The Impact

Purpose Bladder cancer is the second most common tobacco-related malignancy. A new bladder cancer diagnosis may be an opportunity to imprint smoking cessation. Little is known about the impact of a diagnosis of bladder cancer on patterns of tobacco use and smoking cessation among patients with incident bladder cancer. Patients and Methods A simple random sample of noninvasive bladder cancer survivors diagnosed in 2006 was obtained from the California Cancer Registry. Respondents completed a survey on history of tobacco use, beliefs regarding bladder cancer risk factors, and physician influence on tobacco cessation. Respondents were compared by smoking status. Those respondents smoking at diagnosis were compared with general population controls obtained from the California Tobacco Survey to determine the impact of a diagnosis of bladder cancer on patterns of tobacco use. Results The response rate was 70% (344 of 492 eligible participants). Most respondents (74%) had a history of cigarette use. Seventeen percent of all respondents were smoking at diagnosis. Smokers with a new diagnosis of bladder cancer were almost five times as likely to quit smoking as smokers in the general population (48% v 10%, respectively; P < .001). The bladder cancer diagnosis and the advice of the urologist were the reasons cited most often for cessation. Respondents were more likely to endorse smoking as a risk factor for bladder cancer when the urologist was the source of their understanding. Conclusion The diagnosis of bladder cancer is an opportunity for smoking cessation. Urologists can play an integral role in affecting the patterns of tobacco use of those newly diagnosed.

scholarly journals Algorithm for resolving discrepancies between claims for smoking cessation pharmacotherapies during pregnancy and smoking status in delivery records: The impact on estimates of utilisation

PLoS ONE ◽  
2018 ◽  
Vol 13 (8) ◽  
pp. e0202999 ◽  
Author(s):  
Lucinda Roper ◽  
Duong Thuy Tran ◽  
Kristjana Einarsdóttir ◽  
David B. Preen ◽  
Alys Havard
Keyword(s):  
Smoking Cessation ◽  
Smoking Status ◽  
The Impact

OP11 Structural Uncertainty In Economic Modelling For Smoking Cessation

2017 ◽  
Vol 33 (S1) ◽  
pp. 6-7
Author(s):  
Becky Pennington ◽  
Alex Filby ◽  
Matthew Taylor ◽  
Lesley Owen
Keyword(s):  
Smoking Cessation ◽  
Cost Effectiveness ◽  
Recurrent Events ◽  
Smoking Status ◽  
Discrete Event ◽  
Economic Models ◽  
Economic Modelling ◽  
Model Structure ◽  
Cohort Model ◽  
The Impact

INTRODUCTION:Guidance for developing economic models recommend that model structure is carefully considered, and assumptions varied in sensitivity analysis (1). Models in smoking cessation have typically used cohort-level approaches, although recently discrete event simulations (DESs) have been developed (2). DESs allow additional flexibility such as modelling changing risk over time, and recurrent events. Our aim was to explore the impact of varying model structure and assumptions on the cost-effectiveness of smoking cessation programs.METHODS:We built a cohort state-transition model which related mortality to smoking status and considered the prevalence (based on smoking status) of five comorbidities associated with smoking, each of which has an associated cost and quality of life decrement. We additionally built a patient-level DES, using the Discretely Integrated Condition Event framework (3). The DES used the same data as the cohort model, except considering incidence for comorbidities rather than prevalence. We considered a population of smokers aged 16 years old and an intervention costing GBP827 on which 27 percent of people quit, compared with no treatment. We produced results using the two models for comparable scenarios, and ran additional scenarios considering different assumptions.RESULTS:In the cohort model, the incremental cost-effectiveness ratio (ICER) for intervention versus no treatment was GBP4,000/quality-adjusted life year (QALY). In the DES, modelling mortality linked to smoker status produced an ICER of GBP1,000/QALY and modelling mortality linked to comorbidities produced an ICER of GBP6,000/QALY. In the DES with mortality linked to comorbidities, varying the relative risk of comorbidities with time since quitting gave an ICER of GBP3,000/QALY. Including relapse increased the ICER to GBP21,000/QALY.CONCLUSIONS:The ICER for the smoking cessation program changes when model assumptions are varied, although the choice of DES versus cohort model appears to make a relatively small difference. Inclusion of relapse substantially changes the ICER, demonstrating the importance of long-term effects in economic models.

scholarly journals Impact of marginalization on tobacco use in individuals diagnosed with head and neck Cancer

2019 ◽  
Vol 48 (1) ◽  
Author(s):  
Grace Margaret Scott ◽  
Corliss Best ◽  
Kevin Fung ◽  
Michael Gupta ◽  
Doron D. Sommer ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Smoking Cessation ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Nicotine Dependence ◽  
Tobacco Use ◽  
Neck Cancer ◽  
Census Data ◽  
Smoking Status ◽  
The Impact

Abstract Background Considerable evidence now indicates that individuals living in underprivileged neighbourhoods have higher rates of mortality and morbidity independent of individual-level characteristics. This study explored the impact of geographical marginalization on smoking cessation in a population of individuals with a diagnosis of head and neck cancer. The aims of this study were twofold: (1) assess the prevalence of smoking cessation in those with a previous diagnosis of head and neck cancer, (2) analyze the determinants of smoking alongside area-based measures of socioeconomic status. Methods This was a cross-sectional study. We administered a self-reported nicotine dependence package to participants between the ages of 20–90 with a previous mucosal head and neck cancer diagnosis and with a history of tobacco use. Using the Canadian Marginalization (CAN-Marg) Index tool based on 2006 Canada Census data we compared the degree of marginalization to the smoking status. For those individuals who were currently smoking, nicotine dependence and readiness to quit were assessed. A summative score of marginalization was compared to smoking status of individuals. Results The results from this study indicate that the summative level of marginalization developed from the combined factors of residential instability, material deprivation, ethnic concentration and dependency may be important factors in smoking cessation. Conclusions This analysis of determinants of smoking alongside area-based measures of socioeconomic status may implicate the need for targeted population-based smoking cessation interventions.

scholarly journals Cannabis and Alcohol Co-Use in a Smoking Cessation Pharmacotherapy Trial for Adolescents and Emerging Adults

2019 ◽  
Vol 22 (8) ◽  
pp. 1374-1382 ◽  
Author(s):  
Erin A McClure ◽  
Nathaniel L Baker ◽  
Caitlyn O Hood ◽  
Rachel L Tomko ◽  
Lindsay M Squeglia ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Smoking Cessation ◽  
Emerging Adults ◽  
Secondary Analysis ◽  
Treatment Strategies ◽  
Cannabis Use ◽  
Daily Diaries ◽  
Tobacco Treatment ◽  
Prior Literature ◽  
The Impact

Abstract Introduction The co-use of cannabis and alcohol among tobacco-using youth is common. Alcohol co-use is associated with worse tobacco cessation outcomes, but results are mixed regarding the impact of cannabis on tobacco outcomes and if co-use leads to increased use of non-treated substances. This secondary analysis from a youth smoking cessation trial aimed to (1) evaluate the impact of cannabis or alcohol co-use on smoking cessation, (2) examine changes in co-use during the trial, and (3) explore secondary effects of varenicline on co-use. Methods The parent study was a 12-week, randomized clinical trial of varenicline for smoking cessation among youth (ages 14–21, N = 157; Mage = 19, 40% female; 76% White). Daily cigarette, cannabis, and alcohol use data were collected via daily diaries during treatment and Timeline Follow-back for 14 weeks post-treatment. Results Baseline cannabis co-users (68%) had double the odds of continued cigarette smoking throughout the trial compared with noncannabis users, which was pronounced in males and frequent cannabis users. Continued smoking during treatment was associated with higher probability of concurrent cannabis use. Baseline alcohol co-users (80%) did not have worse smoking outcomes compared with nonalcohol users, but continued smoking was associated with higher probability of concurrent drinking. Varenicline did not affect co-use. Conclusions Inconsistent with prior literature, results showed that alcohol co-users did not differ in smoking cessation, whereas cannabis co-users had poorer cessation outcomes. Youth tobacco treatment would benefit from added focus on substance co-use, particularly cannabis, but may need to be tailored appropriately to promote cessation. Implications Among youth cigarette smokers enrolled in a pharmacotherapy evaluation clinical trial, alcohol and/or cannabis co-use was prevalent. The co-use of cannabis affected smoking cessation outcomes, but more so for males and frequent cannabis users, whereas alcohol co-use did not affect smoking cessation. Reductions in smoking were accompanied by concurrent reductions in alcohol or cannabis use. Substance co-use does not appear to affect all youth smokers in the same manner and treatment strategies may need to be tailored appropriately for those with lower odds of smoking cessation.

Impact of travel time on hospitalizations and patient cost responsibility by phase of care for older patients with cancer.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 37-37
Author(s):  
Courtney Williams ◽  
Kelly Kenzik ◽  
Maria Pisu ◽  
Stacey A. Ingram ◽  
Aidan Gilbert ◽  
...  
Keyword(s):  
Travel Time ◽  
Cancer Patients ◽  
Linear Models ◽  
Skilled Nursing Facility ◽  
Secondary Analysis ◽  
Community Hospitals ◽  
Patient Cost ◽  
Older Cancer Patients ◽  
The Impact ◽  
Drive Time

37 Background: Healthcare reimbursement changes are contributing to increased closures of community hospitals and oncology practices, which may lead cancer patients to travel greater distances for care. Limited data exists on the impact of travel time on hospitalization rates and patient cost responsibility by phase of care for older cancer patients. Methods: This was a secondary analysis of Medicare claims from 2012-2015 for cancer patients age ≥65 receiving care in the University of Alabama at Birmingham Cancer Community Network. Patient addresses were obtained from network data, hospitalizations from inpatient claims, and patient cost responsibility from inpatient, outpatient, skilled nursing facility, carrier, and durable medical equipment claims. Drive time was calculated from patient home to cancer care site (CCS). Phase of care-specific (initial, survivorship, end-of-life [EOL]) rates of hospitalizations overall and by CCS vs. other care site (OCS) were calculated per 100 person-years. Hierarchical linear models compared average monthly phase-specific costs by drive time to CCS. Results: Of 23,605 older cancer patients, median drive time to CCS was 32 minutes (IQR 18-59), with 24% driving ≥1 hour to CCS. Rates of hospitalizations by initial (n = 14,225), survivorship (n = 18,805), and EOL (n = 8,211) phases of care were 54, 26, and 301 per 100 person-years, respectively. Higher rates of hospitalizations at OCS vs. CCS were shown for patients traveling ≥1 hour to CCS (initial, survivorship, and EOL rate of 41 vs. 20, 21 vs. 6, and 220 vs. 95 per 100 person-years, respectively). Median monthly costs by phase were $401 (IQR $182-$814) for initial, $369 (IQR $123-$1046) for survivorship, and $2075 (IQR $1123-$3723) for EOL. Patients traveling ≥1 hour to their CCS had higher cost responsibility, with patients in initial, survivorship, and EOL phases having $303 (95% CI $130-$476), $75 (95% CI $46-$105), and $736 (95% CI $308-$1164) higher average costs per month than those traveling < 1 hour, respectively. Conclusions: Cancer patients traveling further to receive care are potentially vulnerable to higher cost responsibility and limited access to care if community hospitals close, especially at EOL.

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