The majority of smokers indicate that they would like to quit. It has been estimated that approximately three quarters of Australian smokers have tried to change their behaviour in the last 12 months (Scollo & Winstanley, 2008); similarly, more than half of US smokers report having tried to quit in the last year (Centers for Disease Control and Prevention [CDC], 2011). Despite their interest in quitting, the proportion of smokers who successfully quit each year is very low (CDC, 2011). While other factors are also important, poor cessation rates can partly be attributed to the low uptake of efficacious smoking cessation methods, particularly pharmacotherapies (Shiffman, Brockwell, Pillitteri, & Gitchell, 2008).

Inpatient smokers with major depressive disorder (MDD) have high rates of relapse to smoking after hospital discharge. The risk of health consequences that may contribute to increased morbidity and mortality among this population underscores the need to develop a program for psychiatric inpatient cigarette smokers with MDD. Using a motivational interviewing (MI) intervention, we sought to facilitate engagement of smokers with elevated depression symptoms in an outpatient treatment with demonstrated efficacy for nicotine dependence. In Phase 1 of this program, we recruited 15 smokers with MDD who were receiving inpatient psychiatric services. This preliminary report focuses on the development of the intervention, and explores perceived barriers to quitting, methods of quitting, and interest in smoking cessation treatment following discharge from an inpatient stay. Understanding inpatient cigarette smokers’ interests in making changes in smoking, and in willingness to attempt cessation and engage in cessation treatment can inform efforts to curb smoking in this high-risk population.

Background and aims: This study examined whether providing smokers with a personal monitor for measuring expired-air carbon monoxide (CO) concentrations would be a feasible method of achieving a reduction in smoke intake. Methods: Ten smokers were given a CO monitor and asked to use it regularly throughout the day for 6 weeks with the aim of maintaining their CO reading below 10 ppm. They were advised to use nicotine replacement therapy, but this was not provided. At baseline and follow-up, smokers were asked to comment on their use of the monitors and motivation to stop smoking. Demographic characteristics, cigarette consumption, and nicotine dependence, was also assessed. Additionally, during the first 2 weeks participants were instructed to record how often they used their CO monitor, their average readings and cigarette consumption. Results: Eight smokers had an average daily CO concentration below their baseline on at least 93% of the days in the 2 weeks of daily monitoring, while three had CO levels below 10 ppm on 36% of the days. At the 6-week follow-up, all participants’ CO concentrations were below their baseline value; two were below 10 ppm. Average daily cigarette consumption reduced from 14.1 (SD 6.03) at baseline to 9.8 (SD 4.95) during the 2 weeks of daily CO monitoring (t = 2.46, df 9, p = 0.036) and 9.5 (SD 5.50) at 6 weeks follow-up (t = 1.73, df 7, p = 0.127). Use of the CO monitors was generally found to be acceptable and to increase motivation to stop smoking completely. Five smokers attempted to quit smoking. Conclusions: Regular personal CO monitoring may be a useful method for reducing smokers’ cigarette intake and increasing their motivation to stop completely. A controlled trial with long-term follow up is warranted.

Research studies indicate that smoking cigarettes is related to a premature development of facial wrinkles. Given that facial wrinkles may act as motivation for people to quit smoking, it is crucial that smoking cessation professionals be able to accurately inform clients about research concerning smoking and wrinkles. Therefore, the purpose of this article is to provide an updated overview of the literature which can be used by cessation clinicians as a practical reference on smoking and facial wrinkles. Databases were searched for peer-reviewed articles that study the association with smoking and wrinkles. In all, 17 articles were located and reviewed for research methods and results. Although facial wrinkles and smoking were measured inconsistently between studies, the overall literature indicates that those who smoke have a higher risk of developing premature facial wrinkles as compared to those who do not smoke. The implications of this review for smoking cessation professionals are described.

Introduction: In English National Health Service (NHS) Stop Smoking Services, stop smoking practitioners provide behavioural support and medication to support smokers wanting to quit. There is a need to develop an evidence base for the training of such practitioners. This study evaluated a national face-to-face skills training course in behavioural support for practitioners. Methods: Data were gathered from 169 trainees attending the NHS Centre for Smoking Cessation and Training (NCSCT) courses between October 2010 and August 2011. They provided confidence in competence ratings for 16 core competences before, immediately following and 3 months after training. At 3-month follow-up, they also described what they believed were the most important learning outcomes. Trainees also provided course evaluations in the form of ratings (n = 386, courses not yet followed up included). Results: Confidence ratings increased overall by 40% immediately after the course and the higher level of confidence was maintained at 3-month follow-up; 92% agreed or strongly agreed that the course was very useful and very interesting; 90% that it was very enjoyable; 88% that it improved their skills and 87% that they would recommend it. The learning outcomes rated as most important reflected the relevant behaviour change techniques. Conclusion: The NCSCT skills training course appears to result in a substantial improvement in confidence in ability to deliver smoking cessation support and trainees evaluate it highly. The next step is to assess improvements in observed practice and success rates.

Introduction: This study was conducted to compare gender differences in the psychometric properties of the Fagerström Test for Nicotine Dependence (FTND). Methods: The sample comprised 334 Korean immigrants (97 women and 237 men) who reported daily smoking for the past 6 months. Item-by-item responses and exploratory factor analyses (EFA) were compared by gender. Promax rotation was selected based on findings from previous studies suggesting correlated factors. Results: Compared with men, women smoked fewer cigarettes per day, were more likely to smoke when ill in bed, and were less likely to smoke frequently in the morning. The entire sample and men within the sample had the same factor loading pattern, where three items (time to first cigarette, the cigarette most hate to give up, and smoke more frequently in the morning) were loaded on Factor 1 (morning smoking) and the remaining three items (difficult to refrain from smoking in public places, number of cigarettes smoked per day, and smoking even when ill in bed) on Factor 2 (daytime smoking). For women, however, neither the 1- nor 2-factor model fit the data well. Conclusions: For Korean American male smokers, the psychometric properties of the FTND were similar to those seen in other populations, but this was not the case with Korean American women. Clinicians may need to modify their interpretation of nicotine dependence severity if basing only on the FTND with Korean women. The FTND assesses smoking patterns which has a cultural influence and other measures of nicotine dependence should be considered.

Weather-related variables (temperature and rain) are examined for their association with daily cigarette smoking. Prior research has examined how the average monthly temperature and summer versus winter months are related to smoking, but daily fluctuations in weather have not been examined previously. The current research tests whether daily changes in weather are related to young adult cigarette use. In addition, nicotine dependency is tested as a moderator of such associations. Nine hundred and twelve participants were recruited to complete weekly measures of cigarette smoking for 35 weeks. Participants provided weekly self-reports of daily smoking for the last week and completed measures of nicotine dependence. In addition, data was obtained on daily temperature and presence of rain. A longitudinal growth curve model was calculated using daily temperature and rain data to predict daily cigarette smoking. A positive linear effect and negative quadratic effect of temperature was found along with a negative effect of rain. Nicotine dependency did not moderate the effect of temperature or rain on smoking. This study is the first to use daily measures of temperature and rain and corresponding daily measures of cigarette smoking to examine possible associations. Results support the relevance of weather-related variables in the prediction of cigarette smoking and the importance of considering environmental factors in understanding smoking behaviour.

To determine what support low socio-economic smokers perceive would help them stop smoking, 63 Māori, Pacific Island and New Zealand European/other smokers were interviewed in focus groups. Prompted discussion was used to determine what participants knew and thought about existing cessation services and products, and what their interest was in innovative cessation approaches. Most participants knew about Quitline, nicotine patches and gum, but had scant knowledge of other cessation services and products. They had a reasonable knowledge of smoking-related harm, but not the range of harm caused by smoking. They reported being influenced to quit by graphic health advertisements on television and health warnings on tobacco packages. They wanted extended access to a wider range of cessation services and more subsidised cessation products, and they were interested in innovative approaches. Low socio-economic and minority group smokers need clearer information to support use of effective cessation methods. They need to know about the efficacy and safety of cessation products, where and how to access products and support, and the cost involved. Cessation support needs to be more convenient and culturally salient.

This study aimed to explore smoker's perspectives of continued smoking and smoking cessation following the introduction of smoke-free legislation in England. Seventeen semi-structured interviews were conducted with smokers who were making a quit attempt with the support of stop smoking services delivered by the National Health Service. Interviews explored opinions of smoke-free legislation before it was implemented in July 2007, as well as attitudes towards the legislation, beliefs about the influence of legislation on smoking behaviours, as well as changes to public attitudes about smoking. Framework analysis highlighted five key themes: attitudes towards smoke-free legislation prior to its introduction, support for smoke-free legislation following implementation, smoke-free legislation and smoking behaviour, stigma, and returning to smoking. Overall, smokers were positive about smoke-free legislation and reported reductions in smoking and an increase in quit attempts after introduction of the legislation. Change in attitudes towards smoking and smokers were noted, which at times could transpire to stigmatisation felt by the participants. Few quitters expressed a wish to return to smoking if the legislation was reversed.

The ‘Txt2Stop’ SMS messaging programme has been found to double smokers’ chances of stopping. It is important to characterise the content of this information in terms of specific behaviour change techniques (BCTs) for the purpose of future development. This study aimed to (i) extend a proven system for coding BCTs to text messaging and (ii) characterise Txt2Stop using this system. A taxonomy previously used to specify BCTs in face-to-face behavioural support for smoking cessation was adapted for the Txt2Stop messages and inter-rater reliability for the adapted system assessed. The system was then applied to all the messages in the Txt2Stop programme to determine its profile in terms of BCTs used. The text message taxonomy comprised 34 BCTs. Inter-rater reliability was moderate, reaching a ceiling of 61% for the core program messages with all discrepancies readily resolved. Of 899 texts delivering BCTs, 218 aimed to maintain motivation to remain abstinent, 870 to enhance self-regulatory capacity or skills, 39 to promote use of adjuvant behaviours such as using stop-smoking medication, 552 to maintain engagement with the intervention and 24 were general communication techniques. The content of Txt2Stop focuses on helping smokers with self-regulation and maintaining engagement with the intervention. The intervention focuses to a lesser extent on boosting motivation to remain abstinent; little attention is given to promoting effective use of adjuvant behaviours such as use of nicotine replacement therapy. As new interventions of this kind are developed it will be possible to compare their effectiveness and relate this to standardised descriptions of their content using this system.