Not Ready to Kwit? A Mobile App Preparation Program for Smoking Cessation: Assessing Feasibility in Ecological Context

Aim: The main purpose of this feasibility study was to estimate compliance and acceptability rate of a 9-Steps mobile app preparation program. Subsequently, to assess its impact regarding attitudes towards smoking cessation. Methods: The program was only available on versions above iOS 13.3. The ecological study collected user’s data via the app from 04/07/2021 to 28/07/2021. Results: A total of 2331 ecological users completed onboarding; 1926 users (73.9%) completed the step 0 and only 265 users continued in step 1. On average, participants actively engaged with intra-steps activities (85,1%). Most users were highly satisfied at the end of each step. On average 86% found the content of each step comprehensive and relevant. Mann-Whitney tests demonstrated positive changes in attitudes toward smoking cessation on the less confident users: willing (3 to 5, p <.05); confidence (3 to 5, p <.001) and readiness to quit (3 to 5, p <.001). Conclusions: This ecological study corroborates the expected dropout between first use and regular use of health mobile apps. However, engagement and satisfaction rates support the feasibility and acceptability of a 9-step preparation program. Additional research is needed to better understand determinants of regular use of mobile apps and its impact on the target behavior.

Feasibility of a Smoking Cessation Smartphone App (Quit with US) for Young Adult Smokers: A Single Arm, Pre-Post Study

While smartphone applications (apps) have been shown to enhance success with smoking cessation, no study has been conducted among young adult smokers aged 18–24 years in Thailand. Quit with US was developed based on the 5 A’s model and self-efficacy theory. This single arm, pre-post study was conducted aiming to assess results after using Quit with US for 4 weeks. The primary outcome was a biochemically verified 7-day point prevalence of smoking abstinence. The secondary outcomes included smoking behaviors, knowledge and attitudes toward smoking and smoking cessation, and satisfaction and confidence in the smartphone app. A total number of 19 young adult smokers were included; most participants were males (68.4%) with the mean (SD) age of 20.42 (1.46) years. After 4 weeks of study, the primary outcome demonstrated a smoking cessation rate of 31.6%. All 19 participants expressed better smoking behaviors and better knowledge and attitudes toward smoking and smoking cessation. Further, they were satisfied with the smartphone app design and content and expressed confidence in using it. These findings provided preliminary evidence that Quit with US was found to be a potentially effective smoking cessation smartphone app for young adult smokers.

Behaviors and Attitudes Toward Smoking Among Health Care Workers at Health Facilities in 4 Provinces of Vietnam: A Representative Cross-Sectional Survey

Tobacco smoking is a leading cause of premature death. Smoking prevalence in Vietnam ranks among the highest in Southeast Asia. Given the important role of health care workers (HCWs) in promoting and supporting smoking cessation, this project aimed to characterize the prevalence of smoking among HCWs in Vietnam, and their attitudes toward smoking cessation interventions. A cross-sectional survey was conducted among care workers in 4 levels of the health system, within 4 provinces of Vietnam. Descriptive statistics evaluated participant attitudes, perception, behaviors, and knowledge about smoking. Multivariable logistic regression models evaluated risk factors for smoking. Among 3343 HCWs, 7.5% identified as current smokers, comprising 22.2% males and 0.5% of females. Males had substantially greater odds (adjusted odds ratio = 55.3; 95% confidence interval = 29.0-105.6) of identifying as current smokers compared with females. HCWs in urban settings had higher odds of identifying as smokers compared with rural workers (adjusted odds ratio = 1.72; 95% confidence interval = 1.23-2.24). Strong support for smoking cessation policies and interventions were identified, even among staff who smoked. HCWs play an integral role in identifying smokers and supporting smoking cessation interventions for their patients. Efforts to support affordable smoking cessation interventions within health facilities are likely to contribute to a reduction in smoking prevalence in Vietnam.

Smoking Cessation Experience in Indonesia: Does the Non-smoking Wife Play a Role?

ObjectiveMore than 63% of Indonesian men are smokers, and smoking has long been a part of Indonesian culture and the concept of masculinity in Indonesian culture. Given the pro-smoking environment, we were interested in examining why smokers would willingly quit and whether their wives played a role in their quitting process as social factors are mentioned second most frequent as a reason for quitting smoking.DesignIn-depth interviews.MethodWe interviewed 11 couples (N = 22)—ex-smoking husbands and non-smoking wives—in Yogyakarta, Indonesia. The data were analysed by using the thematic analysis approach.ResultsFour themes were discussed: (1) reasons for stopping smoking, (2) the process of quitting smoking, (3) the wives’ attitudes toward smoking, and (4) the families’ attempts to make the (ex-)smokers quit. The most commonly cited reasons for quitting were family and personal motivation. The (ex-)smokers preferred to quit without assistance and in private. The wives’ attitude toward smoking ranged from dislike to tolerance, and most did not know when their husbands were trying to quit. Both husbands and wives reported that the wives did not influence the smoking cessation process.ConclusionIndonesian ex-smokers often had multiple reasons for quitting smoking. The process was typically difficult and kept private. While wives had little influence on the cessation process, they provided support and could institute a smoking ban in the house.

Tobacco Use and Cessation Among a National Online Sample of Men Who Have Sex With Men in Malaysia

Previous studies documented the health disparities in smoking among sexual minority populations, including men who have sex with men (MSM). However, smoking behaviors have never been examined among Malaysian MSM, a sexual minority group in a predominantly Muslim country. A total of 622 Malaysian MSM completed an anonymous online survey in 2017. Data on the demographics, smoking and substance use behaviors, psychosocial factors, and attitudes toward smoking cessation were collected and analyzed. The mean age was 28 years and 67% of participants were of Malay ethnicity. The prevalence of current smoking was 23% (n = 143), while former smokers were 9% (n = 59). Current smoking status was associated with HIV-positive status and risk behaviors, such as suicidality, alcohol use, and illicit drug use ( P = .001). Almost two thirds of current smokers had attempted to quit in the past year. Hence, comprehensive smoking cessation interventions addressing the psychosocial needs of MSM should be prioritized.

Potential impact of a COVID-19 and smoking paper on Twitter users’ attitudes toward smoking: Observational Study (Preprint)

BACKGROUND A cross-sectional study conducted by French researchers showed that the rate of current daily smoking was significantly lower in COVID-19 patients than in the French general population. OBJECTIVE We aim to examine the dissemination of this French study among Twitter users and whether a shift in their attitudes towards smoking occurred after its publication on April 21st, 2020. METHODS Twitter posts were crawled between April 14th and May 4th, 2020 by the Tweepy stream API, using a COVID-19 related keyword query. After filtering, the final 1,929 tweets were classified into three groups: 1) tweets not related to French study before it was published; 2) tweets not related to French study after it was published; 3) tweets related to French study after it was published. The tweets’ attitudes towards smoking were compared among the above three groups using multinomial logistic regression models in statistical analysis software R. RESULTS The temporal analysis showed a peak in the number of tweets discussing the results from the French study right after its publication. Multinomial logistic regression models on sentiment scores showed the proportion of negative attitudes toward smoking in tweets related to French study after it was published (17.07%) was significantly lower than tweets not related to the French study either before (34.92%, P < 0.001) or after the French study was published (34.34%, P < 0.001). CONCLUSIONS The public’s attitude toward smoking shifted in a positive direction after the French study found a lower incidence of COVID-19 cases in daily smokers.