Combined smoking and heavy drinking is a significant health burden. Varenicline, an efficacious tobacco pharmacotherapy that also shows promise for drinking, has yielded mixed results among heavy-drinking smokers. This pilot study investigated integrated tobacco and alcohol counselling plus varenicline for this vulnerable group.

Twelve-week parallel, randomized controlled pilot trial of two behavioural interventions in combination with open-label varenicline. Participants were randomized using computer-generated tables, stratified by sex.

Outpatient academic medical centre research clinic.

Volunteers who reported smoking and heavy drinking and sought tobacco or alcohol treatment (N = 26).

(1) Integrated tobacco + alcohol counselling (INT; n = 13) or (2) counselling focused on their presenting concern (i.e., tobacco or alcohol) (SINGLE; n = 13), plus varenicline (2 mg) for 12 weeks.

Feasibility/acceptability, smoking quit rates and heavy drinking.

INT feasibility/acceptability was high among men but not women. More participants quit smoking in INT than SINGLE. This outcome was only in men, not significant, but had a medium effect size. Both conditions yielded significant drinking reductions.

Integrated tobacco and alcohol behavioural counselling plus varenicline may be feasible and promote smoking cessation among men who smoke and drink heavily, but a larger sample is needed to replicate this finding.

A health coach-led smoking cessation program was implemented in a community of immigrant Chinese Americans. Follow-up was provided face-to-face or over-the-phone to provide support and address barriers. Free nicotine replacement treatment was provided for eligible participants.

The aim is to assess smoking cessation outcome by program components.

Quitting was defined as self-reported smoking abstention for at least 3 months. Factors contributing to successful cessation were evaluated using chi-squared tests and regression analysis. Participants were randomly surveyed to measure the helpfulness of and satisfaction with the program.

The program enrolled 184 participants from November 2015 to January 2017. Participants were mostly men (89%) with a mean age of 44. An intent-to-treat analysis found that 19% quit. Phone counseling had the same success as face-to-face counseling. Each additional session attended was associated with 2.1 times the odds of quitting, P < 0.001. Among the participants who quit, 70% reported the health coach was helpful in their cessation.

A health coach-led smoking cessation program that offered phone-based counseling was successful in reducing smoking. Future programs should consider using a health coach to reduce physician burden and phone-based counseling for difficult-to-access patients to increase program reach.

Systemic barriers impacting smoking cessation in pregnant women may include nicotine replacement therapy (NRT) access and training.

Assess general practitioner (GP) and obstetrician's agreement with system-based changes to improve the management of smoking in pregnancy; compare group responses.

National cross-sectional survey with two samples: (1) online survey emailed to a random sample of 500 GPs from Royal Australian College of General Practitioners (RACGP); (2) paper survey posted to 5571 GPs and obstetricians from Royal Australia and New Zealand College of Obstetricians and Gynaecologists (RANZCOG). Percentages agreeing that specified changes would improve the management of smoking in pregnancy were calculated. Pairwise comparisons used Kruskal–Wallis tests (RACGP/RANZCOG GPs/obstetricians).

N = 378 participated. Response rates 8.4% (N = 42; online survey) and 6% (N = 335; paper survey), respectively. Total percentages agreeing with system-based changes: 79% training, 64% oral NRT subsidy, 62% Medicare item for smoking cessation, 54% improved access to NRT patches. Within RANZCOG, more GPs (73.1%) agreed that oral NRT should be subsidised (P = 0.001) than obstetricians (53.7%).

GPs and obstetricians agreed that system changes would improve their management of smoking in pregnancy. Oral NRT subsidy was the only pairwise group difference. Subsequently, oral NRT has been subsidised; in time, this may influence prescribing and quit rates.

Recent evidence suggests that quitline text messaging is an effective treatment for smoking cessation, but little is known about the relative effectiveness of the message content.

A pilot study of the effects of gain-framed (GF; focused on the benefits of quitting) versus loss-framed (LF; focused on the costs of continued smoking) text messages among smokers contacting a quitline.

Participants were randomized to receive LF (N = 300) or GF (N = 300) text messages for 30 weeks. Self-reported 7-day point prevalence abstinence and number of 24 h quit attempts were assessed at week 30. Intent-to-treat (ITT) and responder analyses for smoking cessation were conducted using logistic regression.

The ITT analysis showed 17% of the GF group quit smoking compared to 15% in the LF group (P = 0.508). The responder analysis showed 44% of the GF group quit smoking compared to 35% in the LF group (P = 0.154). More participants in the GF group reported making a 24 h quit attempt compared to the LF group (98% vs. 93%, P = 0.046).

Although there were no differences in abstinence rates between groups at the week 30 follow-up, participants in the GF group made more quit attempts than those in the LF group.

Individuals with schizophrenia are more likely to smoke and less likely to quit smoking than those without schizophrenia. Because task persistence is lower in smokers with than without schizophrenia, it is possible that lower levels of task persistence may contribute to greater difficulties in quitting smoking observed among smokers with schizophrenia.

To develop a feasible and acceptable intervention for smokers with schizophrenia.

Participants (N = 24) attended eight weekly individual cognitive behavioral therapy sessions for tobacco use disorder with a focus on increasing task persistence and received 10 weeks of nicotine patch.

In total, 93.8% of participants rated the intervention as at least a 6 out of 7 regarding how ‘easy to understand’ it was and 81.3% rated the treatment as at least a 6 out of 7 regarding how helpful it was to them. A total of 62.5% attended at least six of the eight sessions and session attendance was positively related to nicotine dependence and age and negatively related to self-efficacy for quitting.

This intervention was feasible and acceptable to smokers with schizophrenia. Future research will examine questions appropriate for later stages of therapy development such as initial efficacy of the intervention and task persistence as a mediator of treatment outcome.

A household-level constant visual deterrent advocacy campaign to reduce tobacco intake was conducted in rural Bangladesh.

To evaluate smoking tobacco expenditure by campaign components.

We conducted a single-blind clustered randomized controlled trial on 630 adult male household heads from 16 chars (riverine islands) in rural northern Bangladesh, between November 2018 and January 2019. Intervention allotment was randomized at the char level to minimize spillovers, with 8 chars in treatment and control groups each. The intervention provided households in treatment chars (n = 323) with two visual warning posters, detailing the health effects of tobacco on oneself and external actors, to be hung inside the household for 4 weeks. Households in control chars (n = 307) received nothing. Reported daily smoking (log) tobacco expenditure values were the primary outcome of interest.

Final analysis was conducted using 251 and 210 smokers in treatment and control chars respectively. The intervention reduced relative smoking tobacco expenditure by 12.8% (95% CI −31.45 to 5.81) but was not statistically significant (P-value = 0.163). Weak to moderate emotional reactions to the posters was identified as a reason for the statistical insignificance.

For a visual anti-tobacco intervention to have a substantial impact, it must induce strong emotional responses.

Recent studies have led to suggest that the multifunctional protein clusterin could be envisaged as a potential diagnostic biomarker of addictive behaviours. However, this hypothesis has not been yet tested in nicotine addicts.

We have studied possible associations between clusterin levels in saliva from smokers under cessation treatment and variables related to tobacco consumption, dependence and addiction.

Eighty-one patients were included in an ambulatory smoking cessation programme that involved the use of pharmacological and behavioural therapy. The participants underwent psychological assessment of addiction and dependence (DAST-20, ASSIST, Fagerström tests) and provided saliva samples at the onset of the intervention and 6 months after smoking discontinuation to study the evolution of clusterin levels by enzyme-linked immunosorbent assays.

Clusterin concentration did not correlate with nicotine addiction/dependence scores but was significantly elevated in smokers with prolonged tobacco use and high intensity of tobacco consumption. Moreover, the levels of the protein significantly decreased 6 months after smoking cessation.

The results obtained provide strong evidence of a close association between tobacco use and salivary clusterin, a protein that emerges as a biomarker of tobacco toxicity with potential interest to monitor the beneficial effects of smoking cessation.