Objective: To explore the role of interprofessional collaboration in the delivery of team-based tobacco dependence treatments within primary care. Methods: A narrative review of the literature was completed to examine FHT team functioning in Ontario, followed by a single, multi-site qualitative exploratory case study. Results: Interprofessional collaboration contributed to changes in tobacco dependence treatment through the initiation of system-wide change, cultivation of collective action, and supporting enhanced quality of smoking cessation care. Conclusion: Interprofessional collaboration can enhance the comprehensive delivery of evidence-based treatments for individuals trying to quit smoking. Supportive public policy, education for patients and providers, and evaluation research is needed to advance FHT functioning.

Objective: To examine sociodemographic, medical, and substance use factors associated with smoking continuation during pregnancy. Methods: Data from 221 consecutive prenatal patients were analyzed. Results: Of the 67% who were pre-pregnancy smokers (n=148), 27% quit during pregnancy, whereas another 43% reduced by > 1/4 pack/day. Women who continued to smoke had lower incomes, more prior pregnancies, were less likely to have adequate prenatal care, and smoked more and for more years than did women who quit during pregnancy. Conclusion: Several characteristics predicted pregnancy smoking in this sample. Results suggest ways to more effectively target pregnant women for successful smoking cessation.

Cigarette smoking is the leading cause of preventable morbidity and mortality in the United States. While smoking rates have steadily declined among the general population, smoking is becoming increasingly concentrated among socioeconomically disadvantaged groups due to higher initiation and lower cessation rates. This dissertation examines determinants and mechanisms of smoking cessation in the context of the Kick it for Good study (KIG), a community smoking intervention for Boston public housing residents. In the first study, we explored mediators and moderators of the KIG intervention effect on smoking cessation. We did not find any significant mediators for 3-mo cessation outcomes, although there was modest evidence for mediation by self-efficacy to quit at 12-months. We found living with other smokers and perceived stress were moderators of the KIG intervention effect on smoking cessation. In the second study, we examined predictors of attitudes and knowledge of nicotine replacement therapy (aNRT). We found discussing smoking cessation with a healthcare provider and use of nicotine replacement therapy (NRT) were associated with more positive attitudes and greater knowledge of NRT. The KIG intervention did not impact aNRT outcomes throughout the study period. In the third study, we examined the effect of depression on smoking cessation and whether this effect was moderated by social support. We found smokers with depression classified by the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10) were more likely to report smoking abstinence than those without depression. Social support did not moderate the effect of depression on cessation. We also conducted a sensitivity analysis to determine if the cutoff of 10 for the CES-D was valid in this population of low-income and racially/ethnically diverse smokers. We did not find evidence of depression misclassification by the CES-D-10, although there remains the need to validate the scale in socioeconomically disadvantaged populations. These findings provide valuable information on how smokers living in Boston public housing were able to achieve smoking abstinence in the context of a cessation intervention. The insights gained from these results may be applied to future intervention studies to help address the disparity in smoking rates among socioeconomically disadvantaged smokers.

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Yes / Smokers usually lack confidence to quit smoking due to previous unsuccessful attempts. This study aimed to assess self-efficacy and quitting smoking among current adult smokers in Suva, Fiji. Methods: This study applied a mixed method design among current adult smokers who attended three randomly selected healthcare centers in Suva, Fiji between 1st May to 31st July 2020. A self-administered questionnaire was used to collect quantitative information on smoking and smoking cessation, self-efficacy, and stage of smoking. A semi-structured, open-ended questionnaire was used to guide the interviews. Qualitative data was transcribed and thematic analysis was applied to identify the common themes. Results: Four hundred sixty-four smokers participated in the quantitative study, with a mean age of 32.7 (SD=12.1). Only 16.6% of participants were at the stage of “Preparation” and 4.95% of them were at the stage of “Action”, according to the stage of change model. Majority of participants (43.1%) had low self-efficacy to quit smoking. Thirty-five smokers participated in in-depth interviews, with majority (48.57%) in the age group of 18-24. Two themes were identified including “Determinants of self-efficacy” and “Factors affecting quit smoking”. Conclusions: This study showed that adult smokers had low confidence to quit smoking. Developing a tailored intervention using models such as Transtheoretical Model (TTM) and stage of change may help smokers to quit smoking in Fiji. / This project was funded by the Fiji National University grant.

There is widespread recognition of the need for preventive healthcare to support people in adopting healthy lifestyles that will reduce their risk of long term conditions such as diabetes, cardiovascular disease and cancer. In recent years, a number of observational studies have shown that social networks may play an important role in health behaviour change. Thus far, however, there has been limited success in translating these findings into effective interventions, suggesting a failure to tap into real-world social processes. The aim of my thesis is to develop our understanding of the role that social networks play in one key area of health behaviour change, namely smoking cessation, with a view to gaining insights into how networks can be better utilised to improve quit outcomes. Whilst most research into health behaviour change is rooted in psychological theory, this study draws on a somewhat different perspective, that of social network studies in health. More specifically, it uses a longitudinal qualitative approach to investigate the role of social networks in giving up smoking. Thirteen participants from diverse sociodemographic backgrounds were recruited through three stop smoking services in central Scotland, and interviewed four weeks after quitting; nine participants took part in a follow-up interview two months later. In-depth interviews combined an interactive network mapping exercise with a detailed exploration of the complex inter-relationships between participants’ social networks and their experiences of quitting. A thematic data analysis was undertaken. Quitting was found to be enmeshed in an intricate web of social relationships and interactions. Quitters were not, though, powerless in the face of these social forces, but rather actively sought to navigate their social networks. Existing theorisations tend to view the social network as acting on a passive individual and, as such, overlook the importance of subjective meaning and dynamic interaction in shaping the quit attempt. My thesis demonstrates, however, that the mechanisms of subjectivity and interaction operate in complex ways, encompassing a myriad of overlapping sources of meaning which include the immediate context of interactions, the wider nature of individual relationships, and the overall construction of the social network. These processes jointly unfold, moreover, as the quit attempt proceeds. Efforts to develop network-based cessation interventions must, therefore, move away from attempts to “fix” the network, and must instead seek to find ways of helping quitters to more effectively navigate their social networks.

<p>Att sluta eller inte sluta? En litteraturstudie om tobaksavvänjningsmetoder Bjellman, K. Tobaksbruket har en lång historia, och de tobaksrelaterade sjukdomarna kostar samhället miljarder i sjukvårdskostnader och produktionsbortfall varje år. Andelen rökare minskar stadigt i Sverige, idag röker ca 15 procent av befolkningen. Resultaten från olika metoder för tobaksavvänjning är tämligen blygsamma, och ugefär nittio procent av de som slutar röka gör det på egen hand. Syftet med denna studie var att beskriva och analysera metoder för tobaksavvänjning. Detta gjordes utifrån följande frågeställningar: Hur tar metoderna hänsyn till människors behov av att uppleva självbestämmande, kompetens och tillhörighet? Hur arbetar metoderna med att stärka människors inre motivation? Hur tar metoderna hänsyn till människors hela livssituation? Metoden var en litteraturstudie av vetenskapliga artiklar om olika metoder för tobaksavvänjning, samt olika typer av handlednings- och självhjälpsmaterial för tobaksavvänjare och tobaksanvändare. Slutsatsen är att få metoder tar hänsyn både till människors behov av att uppleva självbestämmande, kompetens och tillhörighet, arbetar för att stärka den inre motivation att sluta röka, samt beaktar hela klientens livssituation. Även de metoder som uppfyller detta ganska väl har problem med många återfall den första tiden efter rökstoppet. Andelen långvarigt rökfria tycks vara ungefär densamma, oavsett vilken metod man använder och hur väl den uppfyller ovanstående. Nyckelord Tobaksavvänjning, Rökavvänjning, Tobacco cessation, Självbestämmandeteorin, Self-determination Theory, Litteraturstudie</p><p>To quit or not to quit? A literature study of tobacco cessation methods Bjellman, K. The tobacco custom has a long history, and the tobacco related diseases cost the society billions in healthcare costs and production losses. The results from different methods for tobacco cessation are rather modest. The aim with this study was to describe and analyze methods for tobacco cessation. This was done on the basis of the following issues: How takes the methods considerations to people's needs of experiencing self determination, competence and property? How works the methods with starching people's internal motivation? How takes the methods considerations to the people's living environment? The method was a literature study off scientific articles about different methods for tobacco cessation, and different types of guidance's - and self-help materials for tobacco workers and tobacco users. The conclusion is that few methods take considerations both to people's needs of experiencing self determination, competence and property, works in order to starch the internal motivation to stop to smoke, and takes into consideration the client's living environment. Also those methods that meet this quite well have problems with many relapses. The proportion prolonged smoke free clients seems to last approximately the same, irrespective of which method one uses and how well it meets the factors above. Key Words Tobacco cessation, Smoking Cessation, Self-determination Theory, Literature study</p>

Att sluta eller inte sluta? En litteraturstudie om tobaksavvänjningsmetoder Bjellman, K. Tobaksbruket har en lång historia, och de tobaksrelaterade sjukdomarna kostar samhället miljarder i sjukvårdskostnader och produktionsbortfall varje år. Andelen rökare minskar stadigt i Sverige, idag röker ca 15 procent av befolkningen. Resultaten från olika metoder för tobaksavvänjning är tämligen blygsamma, och ugefär nittio procent av de som slutar röka gör det på egen hand. Syftet med denna studie var att beskriva och analysera metoder för tobaksavvänjning. Detta gjordes utifrån följande frågeställningar: Hur tar metoderna hänsyn till människors behov av att uppleva självbestämmande, kompetens och tillhörighet? Hur arbetar metoderna med att stärka människors inre motivation? Hur tar metoderna hänsyn till människors hela livssituation? Metoden var en litteraturstudie av vetenskapliga artiklar om olika metoder för tobaksavvänjning, samt olika typer av handlednings- och självhjälpsmaterial för tobaksavvänjare och tobaksanvändare. Slutsatsen är att få metoder tar hänsyn både till människors behov av att uppleva självbestämmande, kompetens och tillhörighet, arbetar för att stärka den inre motivation att sluta röka, samt beaktar hela klientens livssituation. Även de metoder som uppfyller detta ganska väl har problem med många återfall den första tiden efter rökstoppet. Andelen långvarigt rökfria tycks vara ungefär densamma, oavsett vilken metod man använder och hur väl den uppfyller ovanstående. Nyckelord Tobaksavvänjning, Rökavvänjning, Tobacco cessation, Självbestämmandeteorin, Self-determination Theory, Litteraturstudie To quit or not to quit? A literature study of tobacco cessation methods Bjellman, K. The tobacco custom has a long history, and the tobacco related diseases cost the society billions in healthcare costs and production losses. The results from different methods for tobacco cessation are rather modest. The aim with this study was to describe and analyze methods for tobacco cessation. This was done on the basis of the following issues: How takes the methods considerations to people's needs of experiencing self determination, competence and property? How works the methods with starching people's internal motivation? How takes the methods considerations to the people's living environment? The method was a literature study off scientific articles about different methods for tobacco cessation, and different types of guidance's - and self-help materials for tobacco workers and tobacco users. The conclusion is that few methods take considerations both to people's needs of experiencing self determination, competence and property, works in order to starch the internal motivation to stop to smoke, and takes into consideration the client's living environment. Also those methods that meet this quite well have problems with many relapses. The proportion prolonged smoke free clients seems to last approximately the same, irrespective of which method one uses and how well it meets the factors above. Key Words Tobacco cessation, Smoking Cessation, Self-determination Theory, Literature study