scholarly journals Automated Mobile Delivery of Financial Incentives for Smoking Cessation Among Socioeconomically Disadvantaged Adults: Feasibility Study

10.2196/15960 ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. e15960 ◽  
Author(s):  
Darla E Kendzor ◽  
Michael S Businelle ◽  
Joseph J C Waring ◽  
Ashley J Mathews ◽  
Daryl W Geller ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Low Income ◽  
Financial Incentives ◽  
Credit Card ◽  
Smoking Status ◽  
Self Report ◽  
Socioeconomically Disadvantaged ◽  
Quit Attempt ◽  
Cessation Treatment

Background Socioeconomic disadvantage is associated with a reduced likelihood of smoking cessation. Smartphone ownership is increasing rapidly, including among low-income adults, and smartphone interventions for smoking cessation may increase access to smoking cessation treatment among socioeconomically disadvantaged adults. Objective This study aimed to evaluate the feasibility of an automated smartphone-based approach to delivering financial incentives for smoking cessation. Methods Socioeconomically disadvantaged adults initiating tobacco cessation treatment were followed from 1 week before a scheduled quit attempt through 26 weeks after the quit date. Participants received telephone counseling and nicotine replacement therapy. Smoking cessation was verified 5 times per week via smartphone prompts to self-report smoking status and submit a breath sample via a portable carbon monoxide (CO) monitor that was connected with participants’ smartphones. Identity was verified during smoking status assessments using smartphone-based facial recognition software. When smoking abstinence and identity were verified, an automated credit card payment was triggered. Participants were incentivized for abstinence on the quit date and up to five days per week during the first 4 weeks after the scheduled quit date, with additional incentives offered during postquit weeks 8 and 12. In total, participants had the opportunity to earn up to US $250 in abstinence-contingent incentives over the first 12 weeks of the quit attempt. Results Participants (N=16) were predominantly female (12/16, 75%) and non-Hispanic white (11/16, 69%), black (4/16, 25%), or Hispanic of any race (1/16, 6%). Most participants (9/16, 56%) reported an annual household income of <US $11,000. During the first 4 weeks after the scheduled quit date, participants completed a median of 16 (out of 21; range 1-21) mobile smoking status assessments, and they earned a median of US $28 in abstinence-contingent incentives (out of a possible US $150; range US $0-US $135). Median earnings did not change during the 8- and 12-week incentivized follow-up periods (total median earnings over 12 weeks=US $28; range US $0-US $167). During the first 4 weeks after the scheduled quit date, participants abstained from smoking on a median of 5 (out of 21) assessment days (range 0-20). At the in-person follow-up visits, the expired CO-confirmed 7-day point prevalence abstinence rates were 19% (3/16) and 13% (2/16) at 12 and 26 weeks postquit, respectively. Overall, most participants reported that the system was easy to use and that they would recommend this treatment to their friends and family. Conclusions Preliminary data suggest that this smartphone-based approach to verifying identity and smoking status and automating the delivery of abstinence-contingent incentives to a credit card is feasible for use among socioeconomically disadvantaged adults. However, continued refinement is warranted.

scholarly journals Automated Mobile Delivery of Financial Incentives for Smoking Cessation among Socioeconomically Disadvantaged Adults: A Feasibility Study (Preprint)

2019 ◽  
Author(s):  
Darla E. Kendzor ◽  
Michael S. Businelle ◽  
Joseph J. C. Waring ◽  
Ashley Mathews ◽  
Daryl W. Geller ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Low Income ◽  
Financial Incentives ◽  
Credit Card ◽  
Facial Recognition ◽  
Smoking Status ◽  
Telephone Counseling ◽  
Socioeconomically Disadvantaged ◽  
Annual Household Income ◽  
Cessation Treatment

BACKGROUND Socioeconomic disadvantage is associated with a reduced likelihood of smoking cessation. Smartphone ownership is increasing rapidly, including among low-income adults, and smartphone interventions for smoking cessation may increase access to smoking cessation treatment within socioeconomically disadvantaged populations. OBJECTIVE The purpose of this project was to develop and test the feasibility of an automated smartphone-based approach to delivering financial incentives for smoking cessation. METHODS Socioeconomically disadvantaged adults initiating tobacco cessation treatment were followed from one week before a scheduled quit attempt through 26 weeks after the quit date. All participants received telephone counseling and nicotine replacement therapy. Smoking cessation was verified five times per week via smartphone prompts to complete a smoking status assessment and submit a breath sample with a portable breath carbon monoxide monitor that connects with participants’ smartphones. Identity was verified during smoking status assessments using smartphone-based facial recognition software. When smoking abstinence and identity were verified, an automated credit card payment was triggered. Participants were incentivized for abstinence on the quit date and up to five days per week during the first four weeks after the scheduled quit date, with additional incentives offered at post-quit weeks eight and 12. RESULTS Participants (N = 16) were predominantly female (75.00%) and non-Hispanic White (68.75%) or Black (25.00%), or Hispanic of any race (6.25%). Most participants (56.25%) reported an annual household income of < $11,000. During the first four weeks after the scheduled quit date, participants were abstinent on 29.46% of days, they completed an average of 68.45% of mobile smoking status assessments. Participants earned an average of $37.56 during the first four weeks post-quit, with an additional $5.00 and $3.00 earned on average during post-quit weeks eight and 12 respectively (M = $45.56 total). Over the 12-week incentive period, 48.58% of facial recognition assessments worked as expected. At the in-person follow-up visits, CO-confirmed 7-day point prevalence abstinence rates were 18.75% and 12.50% at 12 and 26 weeks post-quit-date, respectively. Notably, all feasibility metrics improved between the first half of participants enrolled and the latter half, which suggests improved intervention delivery over time. Overall, most participants reported that the system was easy to use and that they would recommend this treatment to their friends and family. CONCLUSIONS Preliminary data suggest that this smartphone-based approach to verifying identity and smoking status, and automating the delivery of abstinence-contingent incentives to a credit card may be feasible for use among socioeconomically disadvantaged adults. CLINICALTRIAL This study is registered at www.clinicaltrials.gov (NCT03517397).

scholarly journals The Preliminary Efficacy and Feasibility of Group-Based Smoking Cessation Treatment Program for Incarcerated Smokers

2020 ◽  
Vol 14 (4) ◽  
pp. 155798832094335
Author(s):  
Pamela Valera ◽  
Nicholas Acuna ◽  
Ismary Vento
Keyword(s):  
Smoking Cessation ◽  
Treatment Program ◽  
Group Treatment ◽  
Electronic Cigarettes ◽  
Smoking Status ◽  
Exhaled Breath ◽  
Smoking Cessation Treatment ◽  
Nicotine Patches ◽  
Cessation Treatment

Group-based tobacco dependence treatment has been known to help smokers to quit in general adult populations, but the feasibility and efficacy of this type of smoking cessation treatment in correctional settings remain uncertain. A 6-week group-based smoking cessation treatment with nicotine replacement therapy (NRT) in the form of nicotine patches was implemented in seven male prison facilities, in the Northeast, among smokers who were born biologically as male. Exhaled breath carbon monoxide (CO) levels were collected from participants at each session to confirm smoking status. Participants were evaluated at the 1-month post-group treatment follow-up to determine abstinence. Those who were lost to follow-up were recorded as continued smoking and not using NRT nicotine patches. The goal of the study was to explore the feasibility and preliminary efficacy of conducting a smoking cessation treatment program for incarcerated smokers. A total of 350 inmates were screened, 177 inmates were enrolled across the prison sites for the 6-week program, and 102 inmates completed the program. A majority of those enrolled reported that they began smoking when they were between 15 and 19 years of age (44.9%) and were smoking on average for 26 years. Less than half (21.3%) reported ever using electronic cigarettes at baseline and in Session 1,116 individuals who attended reported a median CO level of 18.0 parts per million (ppm). At a 1-month follow-up, 43 individuals reported a median CO level of 5.00 ppm. The study demonstrated preliminary efficacy and feasibility of group-based smoking cessation treatment with NRT nicotine patches in incarcerated smokers.

scholarly journals Increasing access to smoking cessation treatment among Latino smokers using case management

2019 ◽  
Vol 14 (3) ◽  
pp. 168-175
Author(s):  
Francisco Cartujano-Barrera ◽  
Jaime Perales ◽  
Evelyn Arana ◽  
Lisa Sanderson Cox ◽  
Hung-Wen Yeh ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Case Management ◽  
Smoking Status ◽  
Educational Materials ◽  
Smoking Cessation Treatment ◽  
Assistance Programs ◽  
Intention To Treat ◽  
Phone Calls ◽  
Cessation Treatment

AbstractIntroductionDisparities exist among Latino smokers with respect to knowledge and access to smoking cessation resources. This study tested the feasibility of using case management (CM) to increase access to pharmacotherapy and quitlines among Latino smokers.MethodsLatino smokers were randomized to CM (n = 40) or standard care (SC, n = 40). All participants received educational materials describing how to utilize pharmacy assistance for cessation pharmacotherapy and connect with quitlines. CM participants received four phone calls from staff to encourage pharmacotherapy and quitline use. At 6-months follow-up, we assessed the utilization of pharmacotherapy and quitline. Additional outcomes included self-reported smoking status and approval for pharmacotherapy assistance.ResultsUsing intention-to-treat analysis, CM produced higher utilization than SC of both pharmacotherapy (15.0% versus 2.5%; P = 0.108) and quitlines (12.5% versus 5.0%; P = 0.432), although differences were not statistically significant. Approval for pharmacotherapy assistance programs (20.0% versus 0.0%; P = 0.0005) was significantly higher for CM than SC participants. Self-reported point-prevalence smoking abstinence at 6-months were 20.0% and 17.5% for CM and SC, respectively (P = 0.775).ConclusionsCM holds promise as an effective intervention to connect Latino smokers to evidence-based cessation treatment.

Psychological Factors and Long-Term Abstinence After Smoking Cessation Treatment

2009 ◽  
Vol 4 (1) ◽  
pp. 10-17 ◽  
Author(s):  
Hedwig Boudrez
Keyword(s):  
Smoking Cessation ◽  
Smoking Status ◽  
Statistical Significance ◽  
Postal Survey ◽  
University Hospital ◽  
Smoking Abstinence ◽  
Psychological Variables ◽  
Smoking Cessation Treatment ◽  
Cessation Treatment

AbstractThis study evaluated the association between psychological variables, measured by questionnaire at the start of a smoking cessation treatment, and smoking abstinence, 8 years after treatment. A total of 124 patients presenting at the stop-smoking clinic of the University Hospital in Ghent, Belgium, were included. Besides the Reasons for Smoking Scale (RSS), Fagerstrom Test for Nicotine Dependence (FTND), and smoking status, a psychological questionnaire (NEO PI-R) was presented at baseline. A postal survey after 8 years was executed in order to assess smoking status and smoke-free survival. In 2008, 103/124 answered the postal survey. 66/103 (64.1%) had relapsed. More men then women were smoke-free (46.2% vs. 18.4%; p = .004). Several associations between psychological baseline characteristics and smoking status at follow-up were detected: lower abstinence at follow-up was associated with lower self-discipline (p = .001), lower goal-directedness (p = .03), higher score on symptoms of depression (p = .03), higher anxiety score (p = .01), higher score on the variable shame (p = .02). Some of these associations are confirmed by Kaplan-Meier survival scores that show borderline significance in case of depression (p = .06), statistically significance in case of self-discipline (p = .05) and shame (p = .05) and clear statistical significance in case of anxiety (p = .007). An association between psychological variables at the start of a smoking cessation treatment and smoking abstinence, even after 8 years, can be accepted.

scholarly journals Financial Incentives for Abstinence Among Socioeconomically Disadvantaged Individuals in Smoking Cessation Treatment

2015 ◽  
Vol 105 (6) ◽  
pp. 1198-1205 ◽  
Author(s):  
Darla E. Kendzor ◽  
Michael S. Businelle ◽  
Insiya B. Poonawalla ◽  
Erica L. Cuate ◽  
Anshula Kesh ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Financial Incentives ◽  
Socioeconomically Disadvantaged ◽  
Smoking Cessation Treatment ◽  
Cessation Treatment

1442Implementation and outcomes of systematic approaches to tobacco treatment: the Ottawa Model for Smoking Cessation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Coja ◽  
K A Mullen ◽  
A L Pipe ◽  
R D Reid
Keyword(s):  
Primary Care ◽  
Smoking Cessation ◽  
Smoking Status ◽  
Evidence Based ◽  
Quit Attempt ◽  
Healthcare Settings ◽  
Tobacco Treatment ◽  
Quit Rate ◽  
Quitting Smoking

Abstract Background/Introduction Tobacco use is a major risk factor for the leading chronic diseases, is a leading cause of preventable death worldwide, and is a large cost driver of healthcare spending. Quitting smoking is the single most effective thing a patient can do to improve their health. The Ottawa Model for Smoking Cessation (OMSC) is a systematic, comprehensive approach to clinical tobacco dependence treatment. It provides support to healthcare settings in establishing a high quality tobacco treatment protocol and addressing common barriers to ensure optimal delivery of evidence-based smoking cessation interventions. Purpose The OMSC assists healthcare professionals to transform clinical practices through knowledge translation, implementation support, and quality evaluation. It promotes the delivery of evidence-based interventions to a greater number of smokers using a systematic approach, ultimately increasing cessation rates. The OMSC assists providers to identify smoking status, provide strategic advice to quit, support patients in making a quit attempt, and provide follow-up support. Methods OMSC Outreach Facilitators work with healthcare setting to assist with implementing evidence-based smoking cessation interventions. This is guided by an OMSC workplan which covers planning, implementing, evaluating and sustainability. Pre and post implementation along with program-level data is collected and used to determine rates of smoking status documentation, brief advice to stop smoking, delivery of cessation support and patient quit rates. Results The OMSC program has worked with approximately 450 healthcare settings, trained over 20,000 healthcare professionals, and supported approximately 500,000 patients with quitting smoking. Of those not ready to quit, 45% of patients seen in primary care were supported in reducing the amount they smoke. For OMSC hospital and specialty care patients receiving follow-up support, the six month responder-quit rate was 48%. For OMSC primary care patients, the two month responder-quit rate was 57%. Patients who had previously been supported by their OMSC primary care practice but had not presented to their provider in at least 6 months were contacted to assess their smoking status. Of those reached, 44% were smoke-free. Of those who relapsed, 53% indicated they would be willing to make another quit attempt, 37% of which went back to their healthcare provider to try again. Conclusion The OMSC has shown to be a simple, systematic step-by-step approach to addressing tobacco use in healthcare settings. It provides a way to create clinical efficiencies while increasing the rates at which evidence-based smoking cessation interventions are being delivered to patients, which leads to more patients making further quit attempts. The OMSC continues to expand across Canada and internationally in hopes of creating a wider smoking cessation network to support more patients with quitting smoking. Acknowledgement/Funding Ontario Ministry of Health and Long-Term Care

Interpersonal Communication in Response to an Intervention and Its Impact on Smoking Cessation Within a Low-Income Population

2017 ◽  
Vol 45 (4) ◽  
pp. 550-558 ◽  
Author(s):  
Michael J. Parks ◽  
Soyoon Kim
Keyword(s):  
Smoking Cessation ◽  
Interpersonal Communication ◽  
Low Income ◽  
Population Level ◽  
Population Based ◽  
Effect Sizes ◽  
Full Spectrum ◽  
Quit Attempt ◽  
Quasi Experimental

Background. It is a priority to develop population-based strategies for reducing barriers to smoking cessation among low-income populations. Harnessing secondary transmission such as interpersonal communication (IC) has helped to reduce tobacco use, but there is a dearth of quasi-experimental research that examines IC and the full spectrum of smoking cessation behaviors, particularly in the context of population-level programs. Aims. Using quasi-experimental methods, we examined IC in response to a population-level intervention and its impact on the full spectrum of smoking cessation outcomes among low-income smokers. Method. We used propensity score matching; three different propensity score matching procedures were used to estimate and approximate experimental effects. We assessed four cessation outcomes: utilization of a free tobacco quitline (QL), making a quit attempt, and being smoke-free for 7 and 30 days at follow-up. We also examined predictors of IC. Results. IC was significantly related to QL utilization (effect sizes ranging from 0.135 to 0.166), making a quit attempt (effect sizes ranging from 0.115 to 0.147), being smoke-free for 7 days (effect sizes ranging from 0.080 to 0.121), and being smoke-free for 30 days at follow-up (effect sizes ranging from 0.058 to 0.082). Program-related and participant characteristics predicted IC, such as receiving emotional direct mail materials and living with a fellow smoker. Discussion. IC in response to a population-based program affected the cessation process, and IC had a marked impact on sustained cessation. Conclusion. Population-based programs should aim to harness psychosocial dynamics such as IC to promote sustained cessation among low-income populations.

scholarly journals Association between socioeconomic status and self-reported, tested and diagnosed COVID-19 status during the first wave in the Northern Netherlands: a general population-based cohort from 49 474 adults

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e048020
Author(s):  
Yinjie Zhu ◽  
Ming-Jie Duan ◽  
Hermien H. Dijk ◽  
Roel D. Freriks ◽  
Louise H. Dekker ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
General Population ◽  
Low Income ◽  
Smoking Status ◽  
Sleep Time ◽  
Population Based ◽  
Lifestyle Factors ◽  
Self Report ◽  
Low Education ◽  
Tv Watching

ObjectivesStudies in clinical settings showed a potential relationship between socioeconomic status (SES) and lifestyle factors with COVID-19, but it is still unknown whether this holds in the general population. In this study, we investigated the associations of SES with self-reported, tested and diagnosed COVID-19 status in the general population.Design, setting, participants and outcome measuresParticipants were 49 474 men and women (46±12 years) residing in the Northern Netherlands from the Lifelines cohort study. SES indicators and lifestyle factors (i.e., smoking status, physical activity, alcohol intake, diet quality, sleep time and TV watching time) were assessed by questionnaire from the Lifelines Biobank. Self-reported, tested and diagnosed COVID-19 status was obtained from the Lifelines COVID-19 questionnaire.ResultsThere were 4711 participants who self-reported having had a COVID-19 infection, 2883 participants tested for COVID-19, and 123 positive cases were diagnosed in this study population. After adjustment for age, sex, lifestyle factors, body mass index and ethnicity, we found that participants with low education or low income were less likely to self-report a COVID-19 infection (OR [95% CI]: low education 0.78 [0.71 to 0.86]; low income 0.86 [0.79 to 0.93]) and be tested for COVID-19 (OR [95% CI]: low education 0.58 [0.52 to 0.66]; low income 0.86 [0.78 to 0.95]) compared with high education or high income groups, respectively.ConclusionOur findings suggest that the low SES group was the most vulnerable population to self-reported and tested COVID-19 status in the general population.

scholarly journals Electronic cigarettes in standard smoking cessation treatment by tobacco counselors in Flanders: E-cigarette users show similar if not higher quit rates as those using commonly recommended smoking cessation aids

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Karolien Adriaens ◽  
Eline Belmans ◽  
Dinska Van Gucht ◽  
Frank Baeyens
Keyword(s):  
Smoking Cessation ◽  
Cohort Study ◽  
Replacement Therapy ◽  
Electronic Cigarettes ◽  
Evidence Based ◽  
Smoking Abstinence ◽  
Smoking Cessation Treatment ◽  
Cessation Treatment ◽  
Point Prevalence Abstinence

Abstract Background This interventional-cohort study tried to answer if people who smoke and choose an e-cigarette in the context of smoking cessation treatment by tobacco counselors in Flanders are achieving smoking abstinence and how they compare to clients who opt for commonly recommended (or no) aids (nicotine replacement therapy, smoking cessation medication). Methods Participants were recruited by tobacco counselors. They followed smoking cessation treatment (in group) for 2 months. At several times during treatment and 7 months after quit date, participants were asked to fill out questionnaires and to perform eCO measurements. Results One third of all participants (n = 244) achieved smoking abstinence 7 months after the quit date, with e-cigarette users having higher chances to be smoking abstinent at the final session compared to NRT users. Point prevalence abstinence rates across all follow-up measurements, however, as well as continuous and prolonged smoking abstinence, were similar in e-cigarette users and in clients having chosen a commonly recommended (or no) smoking cessation aid. No differences were obtained between smoking cessation aids with respect to product use and experiences. Conclusions People who smoke and choose e-cigarettes in the context of smoking cessation treatment by tobacco counselors show similar if not higher smoking cessation rates compared to those choosing other evidence-based (or no) smoking cessation aids.

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