Introduction: Each year about two thirds of U.S. smokers make a quit attempt. Yet, less than 5% remain abstinent three months post-quit date. One factor that may affect abstinence is negative feelings about the self-associated with being a smoker (disequilibrium), particularly if smoking is important to the sense of self and one is trying to quit.

Aims: We evaluated a multivariate structural equation model proposing that smoking's subjective importance to a smoker would influence carbon monoxide verified smoking abstinence at 24 weeks (post-quit date). Further, we assessed whether the relation would be moderated by the smoker's experience of disequilibrium.

Methods: Participants were 440 regular smokers taking part in a clinical trial assessing the effectiveness of different durations of nicotine replacement therapy use. Participants completed the subjective importance of smoking survey at baseline and were assessed for carbon monoxide verified seven-day point prevalence abstinence at 24 weeks

Results: Using exploratory structural equation modelling, the subjective importance of smoking was associated with point prevalence abstinence at 24 weeks, but only for smokers with high disequilibrium.

Conclusions: The results of this study suggest that experiencing negative feelings about being a smoker could motivate smokers to remain abstinent, despite the importance of smoking to the smoker's sense of self.

Introduction: The use of quitlines for smoking cessation has contracted, with service providers adapting through the development of comprehensive interactive online smoking cessation services. The primary aim of this review is to investigate the continuum of online cessation services, innovations in design and service components, measures used in formative, process and outcome evaluations, as well as evidence of effectiveness.

Methods: This review includes the peer-reviewed literature, scholarly articles and the grey literature material. Databases searched included: PubMed, Google Scholar, SCOPUS and the Cochrane Collaboration.

Results/findings: 56 academic journal articles and the 5 grey literature reports met the inclusion criteria for this review. Developmental stages of online/combination services included: static websites, tailored feedback, email and text services, interactive components, social media, pharmacological offers; as well as social and professional support mechanisms. Innovations in online smoking cessation include: chat rooms, new recruitment strategies, mobile apps, service tailoring and messaging support groups. Online cessation services were significantly cheaper and more popular than quitlines; however, abstinence rates appear higher amongst quitline users.

Conclusions: Three likely catalysts for the shift from quitlines to online services are the rapid development of technology, increased internet access and the general movement of the goods and services sector to digital channels. The challenge for online cessation service providers is to leverage their comparative cost advantage and develop strategies that keep pace, engage users and increase service effectiveness.

Implications: Our paper synthesises a wide-range of the literature that evaluates the effectiveness and scope of online smoking cessation programs. Through applying this literature to the stages of evaluation framework, we also provide one of the first detailed roadmaps towards developing comprehensive evaluation methodology for online smoking cessation services.

Introduction: We have undertaken four online surveys of Stop Smoking Service (SSS) practitioners in England, between 2011 and 2016, in order to enhance our understanding of e-cigarettes: a fast moving new phenomenon. It is important to understand whether e-cigarettes can ameliorate or exacerbate health inequalities given that smoking is one of the most serious causes of excessive mortality and morbidity among disadvantaged groups globally.

Aims: To update findings of previous surveys and examine socioeconomic status differences in e-cigarette use and efficacy.

Methods: Analysis was undertaken of electronic surveys, particularly, the most recent 2016 survey (n = 514) and 2015/16 SSS client routine monitoring data.

Results: SSS practitioners were becoming more positive about e-cigarettes: 42% agreed that e-cigarettes were a good thing compared with 15% in 2011. Reported use of e-cigarettes among SSS clients was low (about 3%) despite higher quit rates (63% of clients reported being quit at four week follow-up, compared with 51% overall). Where socioeconomic differences in e-cigarettes’ efficacy for quitting were identified, affluent and working smokers were advantaged.

Conclusions: Low use of e-cigarettes by clients and practitioner opinions suggest that further education of SSS staff is needed if they are to adopt the current service recommendations about e-cigarettes.

Objectives: Examine correlates of initiation of e-cigarette use among smokers and determine the impact of e-cigarette use on cessation among smokers in a national U.S. consumer panel.

Methods: This study used the Nielsen Homescan Panel data from 2011 to 2013, augmented with state-specific measures of tobacco control activities, to examine (1) correlates of single and repeat e-cigarette purchasing among panellists currently purchasing cigarettes; and (2) correlates of ‘cessation’. Participating panellists scanned all retail purchases, and Nielsen recorded over 3 million product types. The key explanatory variable for cessation was e-cigarette purchase. Parallel analysis was conducted for conventional nicotine replacement therapy (NRT) purchase. Cessation was defined as no purchases for at least 6 months and no subsequent purchases until the end of 2013. Analysis was conducted in 2015. E-cigarettes tracked by Nielsen during this period were cig-a-like products resembling tobacco cigarettes in appearance.

Results: Single e-cigarette purchase was associated with whether the panellist resided in a single person male household and bought a higher volume of cigarettes. Repeat purchase was associated with higher state cigarette taxes, less stringent state public smoke-free policies, lower cigarette prices, and more frequent cigarette purchasing. Cessation was associated with repeat e-cigarette purchasing, repeat NRT purchasing, younger age, lower monthly cigarette volume, less frequent purchasing of cigarettes, less recent cigarette purchase at baseline, and single e-cigarette purchase before baseline.

Conclusions: Both individual and policy variables were associated with e-cigarette use. Repeat e-cigarette purchase was associated with cigarette purchase discontinuation, as were various smoking intensity measures.

Previous research suggests that persistence, an individual difference characteristic representing the ability and willingness to maintain engagement in challenging or aversive contexts, may relate to smoking relapse. Improving understanding of the persistence-relapse risk association could guide improvements in behavioural interventions. We explored whether persistence and gender related to change in smoking urges across multiple cue exposure trials (an analogue of extinction learning and relapse risk). Participants included abstinent smokers who completed 12 massed, 5-minute smoking cue exposure trials using guided imagery as well as olfactory, tactile, visual and motor cues associated with smoking. We used multilevel logistic growth curve modelling to explore predictor associations with change in urge. Results suggested that gender related to urge whereby males showed greater initial and sustained reactivity than females. Persistence was not associated with female urge trajectories. However, compared to males with high persistence, males with low persistence evidenced sustained urge reactivity over time. Results suggest that greater persistence relates to reduction of conditioned responding (e.g., urges) among abstinent male smokers when exposure trials include complex cues most closely related to nicotine self-administration. Because persistence is modifiable, males with low persistence may benefit from interventions that include elements designed to increase persistence in urge eliciting situations.

Introduction: Run to Quit is a national community-based program that combines smoking cessation support with physical activity through learn to run group-based curriculum, self-help and smoking cessation materials. The program is currently in a three-year scaling up phase.

Aims: The aim of the current study is to explore participant experiences of the Run to Quit program after its first year, and identify potential areas of improvement for future iterations of the program.

Methods: Participants (n = 55) were interviewed over the phone at the end of the 10-week program. Participant interviews were recorded and transcribed. A thematic analysis was conducted.

Results/Findings: Participants were satisfied with the program. Strengths of the program were the group aspect, supervised participation and the running. Weaknesses were seen as the variability in walking and running abilities and inadequate engagement by the Smokers Helpline. Many people who successfully quit smoking reported using additional quit aids. Non-completers of the program gave mostly logistical and personal reasons for dropout.

Conclusions: Overall, Run to Quit was well received by participants. Multiple health behaviour interventions at a scalable level appear feasible. Based on participant feedback, key recommendations to improve the program in the future include greater tailoring to walking or running preference, and increasing engagement with the Smokers Helpline.

Introduction: Cigarette addiction results from both pharmacological effects of nicotine and the rewarding effects of associated cues, including respiratory tract sensations.

Aims: This study sought to evaluate the initial acceptability of a non-nicotine botanical formulation that provided similar respiratory tract cues.

Methods: Two active test products and matching placebos were evaluated. One test product, an e-cigarette-like device, delivered a visible aerosol upon puffing; the other test product delivered an invisible vapour at ambient temperature. Test products delivered a botanical extract with flavourings and vehicle; the placebos delivered flavourings and vehicle only. Sixteen participants had 3-h ad libitum access to each test product and associated placebos, and were deprived of combustible cigarettes for 1 h before and throughout the 3-h evaluation period. Subjects rated the satisfaction (primary outcome) and other sensory qualities of the products. Safety evaluations included pulmonary function testing and monitoring vital signs.

Results: Satisfaction ratings (seven-point scale) were significantly greater for the active e-cigarette-like condition; M = 3.18, SD = 1.04 versus M = 2.69, SD = 1.22. Safety evaluations showed no clinically significant changes.

Conclusions: The results support the potential acceptability of a non-nicotine cigarette substitute in providing satisfaction to smokers. This approach merits further evaluation for safety and acceptability in tobacco harm reduction and cessation.

Background: Many people with cancer continue smoking despite evidence that it negatively effects cancer treatment, worsens chemotherapy toxicity, and increases risk for a second cancer.

Aims: We examined tobacco treatment services offered to cancer patients at hospitals providing oncology services, including National Cancer Institute (NCI)-Designated Cancer Centers (NDCCs).

Methods: We examined survey data of 6,400 U.S. hospitals from 2008 to 2015 to determine the manner in which tobacco treatment/cessation program services were provided among NDCCs and non-NDCC hospitals providing oncology services (HPOs).

Results: From 2008 to 2015, 784 responses from NDCCs and 18,281 responses from HPOs were received. NDCCs (86%) reported significantly higher tobacco treatment/cessation programs owned by the hospital compared to HPOs (68%) (p < 0.001). Among NDCCs, there was a significant increasing trend of tobacco treatment/cessation programs reported owned by the hospital, the health system, or other contractual mechanism from 2008 to 2015 (p = 0.03).

Conclusions: More than 80% of oncology providing hospitals report providing tobacco cessation programs, with higher percentages reported in NDCCs. As hospitals implement smoking cessation programs, partnerships between hospitals and cancer coalitions could help bring tobacco cessation activities to communities they both serve, and link discharged patients to these cessation resources so they can continue quit attempts that they initialised while hospitalised.