This study aimed to investigate the perception of smoking cessation services and products by pregnant Māori (New Zealand's Indigenous people) smokers and identify how these can be improved. Semi-structured face-to-face interviews were conducted with 60 pregnant Māori smokers. Most of the women (82%) had been advised to stop smoking, but few (21%) felt influenced by the advice. In addition, the women in this study felt that health provider support needed to be more encouraging, understanding and more readily available. Many (78%) had come across smokefree pamphlets, but few had read them. Only four women had been given a booklet specifically aimed at pregnant Māori women. Several women thought that the promotion of smokefree pregnancies needed to be aimed at the whole whānau (extended family). The main conclusions were that motivation to quit could be enhanced by delivery of a clear, consistent and repeated message from multiple sources, backed up with effective, supportive and encouraging services and education resources about risks and smoking cessation options. Primary health care interventions delivering a range of services need to be flexible – for example, by visiting pregnant women in their home – and need to target the whole expectant whānau, instead of focusing on pregnant women in isolation.

Background: Cigarette cravings are one of the most often expressed difficulties related to quitting. The effect of acute exercise on craving and withdrawal symptoms during a pharmacological based smoking cessation intervention is unknown. Methods: Participants included female smokers (n = 178) undertaking the Getting Physical on Cigarettes trial — a 14-week exercise-aided nicotine replacement therapy (NRT, i.e. patch) cessation program. They completed the Shiffman-Jarvik scale immediately before and after the first scheduled exercise session during weeks 5, 11, and 13. The first exercise session (week 5) occurred shortly after participants quit smoking (week 4) and began their 21 mg NRT patch dose. The second and third exercise bout coincided soon after participants stepped down their NRT strength to 14 mg (week 11) and 7 mg (week 13), respectively. Results: Significant reductions in cigarette craving were demonstrated following exercise at all three time points (i.e. week 5, 11, and 13). Significant reductions in psychological and sedation withdrawal symptoms were shown at week 5 and 11, but not at week 13. Significant increases in physical symptoms were found at week 5 and 11, but not week 13. No significant change in appetite was evident at any time point. Conclusions: An acute bout of moderate intensity exercise can alleviate cravings as well as psychological and sedation withdrawal symptoms in quitters during a 14-week exercise-aided NRT smoking cessation program. Promoting exercise among women using NRT is recommended.

Cessation is the single most important decision smokers can make to improve their health. The aim of this study was to investigate the effects of a novel biomarker feedback intervention on smoking cessation. Participants (n = 14) were block matched into two groups – biomarker feedback and standard care (control) – and encouraged to stop smoking without the support of any pharmacological aids. All participants received standard smoking cessation advice and also had physiological measures collected during both rest and sub-maximal exercise testing at baseline, week 6 and week 12. The standard care group only received the smoking cessation advice as their intervention, whereas the biomarker feedback group were also given individual feedback in relation to their physiological results. Cessation rates were not significantly different between groups (p = 0.56) at week 12 follow-up; however, a calculation of odds ratios (OR) suggests that the biomarker feedback group was more likely to be successful when compared to standard care (OR = 4.5). Results suggest that targeting health motivations may positively influence cessation rates. Future research is needed to verify this result with a larger group.

Background: While smoking rates in the United States have decreased, some population subgroups have smoking rates that exceed national and state averages. These higher rates often are associated with higher incidence rates of tobacco-associated cancers. Over time, a decrease in smoking rates leads to lower cancer incidence. Methods: Using spatial modelling techniques, we identified an underserved geographic locale in South Florida with higher than expected incidence rates of tobacco-associated cancers. We then used a community-based participatory research (CBPR) design to conduct focus groups in 2011 to elicit information about the acceptability of a smoking cessation intervention delivered by trained former smokers from within peer networks. Results: A variety of smoking cessation strategies was presented and discussed in separate, gender-stratified focus groups comprised of former and current smokers (n = 39). Focus group findings consistently indicated that support groups were the preferred cessation mechanism in this community. Based on this finding, we changed our initially proposed cessation approach to one which employed support groups as a quit method. Conclusions: Currently, we are collecting pilot data to test this intervention and to reach smokers who might not otherwise be directly targeted with cessation messaging from larger tobacco control initiatives. If successful, this strategy can be adapted to effect other important changes in health behaviours in at-risk populations.

Objective: To evaluate the extent to which a client's successful tobacco quit attempt and subsequent improvement in life satisfaction depend on the quitline counsellor assigned to provide the cessation counselling. Methods: A retrospective review of 2,944 Arizona Smokers’ Helpline client records was conducted on enrolment, follow-up, and programme treatment data. Seven month post-enrolment quit rates were calculated on an intent-to-treat sample for 30-day point prevalence during follow-up surveys. A variance components model was used to estimate counsellor effects, that is, the amount of variability in outcomes explained by individual counsellor differences. Similar analysis was done to detect presence of counsellor effects in clients’ Outcome Rating Scale (ORS) scores (Miller et al., 2003) ‒ a proxy measure of life satisfaction ‒ as they change from intake date to exit date. Results: Statistically significant differences in quit rates (2%) and ORS change scores (2%) were attributable to counsellor effects. Conclusions: The results suggest that counsellor effects have an impact on quitline outcomes that otherwise might have been overlooked if one assumed that only treatment factors and extraneous factors contributed significantly to outcomes. Additional research is required to determine the sources of counsellor effects, as well as whether additional efforts to eliminate these counsellor effects can be justified.

The purpose of this study was to examine the relationship between risks associated with smoking and the effectiveness of quit-smoking techniques and interest in quitting among pregnant smokers. It was hypothesised that both knowledge of smoking-related harm and knowledge of efficacious smoking cessation methods would be significant predictors of interest in quitting in the next 30 days. This preliminary study involved 72 pregnant smokers who completed a questionnaire assessing smoking-related knowledge and perceived efficacy of cessation methods. Of the 11 smoking-related risks probed, the least acknowledged were those associated with pregnancy and post-natal conditions, with 38% of the sample responding incorrectly to all four of the pregnancy and post-natal conditions probed. Knowledge of the efficacy of smoking medications was also poor: 32.9% of the sample reported believing that all three pharmacotherapies were ineffective for promoting cessation. A high level of knowledge about the harms of smoking was related to an increased intention to quit in the next 30 days (39.5% versus 15.8%; Odds Ratio [OR] = 3.5). Results from this preliminary study showed support for previous research regarding smoking-related knowledge in non-pregnant smokers. Further research in the area is viewed as particularly important to confirm the current results and guide intervention to increase the level of smoking related knowledge in this at-risk group.