Harry Lando

Publications (15)41.74 Total impact

• Article: Chronic disease management for tobacco dependence: a randomized, controlled trial.

  Anne M Joseph, Steven S Fu, Bruce Lindgren, Alexander J Rothman, Molly Kodl, Harry Lando, Brandon Doyle, Dorothy Hatsukami
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  ABSTRACT: Tobacco dependence disorder is a chronic relapsing condition, yet treatment is delivered in discrete episodes of care that yield disappointing long-term quit rates. We conducted a randomized controlled trial from June 1, 2004, through May 31, 2009, to compare telephone-based chronic disease management (1 year; longitudinal care [LC]) with evidence-based treatment (8 weeks; usual care [UC]) for tobacco dependence. A total of 443 smokers each received 5 telephone counseling calls and nicotine replacement therapy by mail for 4 weeks. They were then randomized to UC (2 additional calls) or LC (continued counseling and nicotine replacement therapy for an additional 48 weeks). Longitudinal care targeted repeat quit attempts and interim smoking reduction for relapsers. The primary outcome was 6 months of prolonged abstinence measured at 18 months of follow-up. At 18 months, 30.2% of LC participants reported 6 months of abstinence from smoking, compared with 23.5% in UC (unadjusted, P = .13). Multivariate analysis showed that LC (adjusted odds ratio, 1.74; 95% CI, 1.08-2.80), quit attempts in past year (1.75; 1.06-2.89), baseline cigarettes per day (0.95; 0.92-0.99), and smoking in the 14- to 21-day interval post-quit (0.23; 0.14-0.38) predicted prolonged abstinence at 18 months. The LC participants who did not quit reduced smoking more than UC participants (significant only at 12 months). The LC participants received more counseling calls than UC participants (mean, 16.5 vs 5.8 calls; P < .001), longer total duration of counseling (283 vs 117 minutes; P < .001), and more nicotine replacement therapy (4.7 vs 2.4 boxes of patches; P < .001). A chronic disease management approach increases both short- and long-term abstinence from smoking. clinicaltrials.gov Identifier: NCT00309296.
  Archives of internal medicine 11/2011; 171(21):1894-900. · 11.46 Impact Factor
• Article: Faculty development in tobacco cessation: training health professionals and promoting tobacco control in developing countries.

  Myra L Muramoto, Harry Lando
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  ABSTRACT: Cessation programs are essential components of comprehensive tobacco control. Health-care providers, especially physicians, have major responsibility for role modeling and promoting cessation. For successful, sustainable cessation training programs, countries need health-care professionals with knowledge and skills to deliver and teach tobacco cessation. Review literature relevant to faculty development in tobacco cessation and discuss its strategic potential in tobacco control. Faculty development is essential for sustainable tobacco cessation training programs, and a potentially powerful strategy to shift professional and societal norms towards cessation and support of comprehensive tobacco control in countries with normative tobacco use and underdeveloped tobacco control programs. Medical faculty are in a key position to influence tobacco cessation and control programs because of their roles as educators and researchers, receptivity to innovation and, influence on competencies and standards for medical education and practice. Faculty development programs must consider the number and type of faculty, and tobacco cessation curricula needed. Faculty development fosters the ability to institutionalise cessation education for students and community practitioners. Academic faculty are often leaders in their professional disciplines, influential in establishing clinical practice standards, and technical experts for government and other key health organisations. Training health-care professional faculty to become knowledgeable and committed to tobacco cessation opens opportunities to promote cessation and shift professional and societal norms away from tobacco use.
  Drug and Alcohol Review 10/2009; 28(5):498-506. · 1.55 Impact Factor
• Article: Trial design: The St. Jude Children's Research Hospital Cancer Survivors Tobacco Quit Line study.

  Taghrid Asfar, Robert C Klesges, Stacy D Sanford, Deborah Sherrill-Mittleman, Leslie L Robison, Melissa M Hudson, Grant Somes, James M Boyett, Harry Lando
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  ABSTRACT: Nearly, one-fifth of childhood cancer survivors (CCSs) smoke cigarettes. Because CCSs are already at greater medical smoking-related risks, targeting them for smoking cessation efforts is a high priority. One of the major challenges with smoking cessation in CCSs is how to reach such a geographically dispersed population. This study aims to demonstrate that these challenges can be overcome through the use of telephone-based tobacco quit lines (QLs). This report describes the design of the St. Jude Cancer Survivor Tobacco QL study, which is a randomized controlled clinical trial that will examine the long-term (1-year) efficacy of a counselor initiated vs. participant initiated tobacco QL with adjunctive nicotine replacement therapy (NRT) in both groups. Participants (N=950) will be recruited nationally and randomly assigned to one of the two interventions. The counselor initiated intervention includes six scheduled telephone sessions of a behavioral intervention and provision of 8 weeks of NRT. The participant initiated intervention allows the participant to call the QL at their convenience, but includes the same six telephone sessions and provision of 2 weeks of NRT. Both groups will receive two follow-up phone calls at 8 weeks and 1 year after enrollment to assess their smoking status. The primary outcome measure is cotinine-validated self-reported smoking abstinence at 1-year follow-up. Results from this study will provide the first evidence about the efficacy of intensive QL cessation intervention in this high-risk population. Such evidence can lead as well to the dissemination of this intervention to other medically compromised populations.
  Contemporary clinical trials 09/2009; 31(1):82-91. · 1.51 Impact Factor
• Article: The impact of expectations and satisfaction on the initiation and maintenance of smoking cessation: an experimental test.

  Andrew W Hertel, Emily A Finch, Kristina M Kelly, Christie King, Harry Lando, Jennifer A Linde, Robert W Jeffery, Alexander J Rothman
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  ABSTRACT: Our primary objective was to test the thesis that the initiation of behavior change is dependent on favorable expectations, whereas maintaining a change in behavior is dependent on satisfaction with the outcomes afforded by behavior change. These hypotheses were tested in the context of a smoking cessation intervention. Adult smokers were randomized to an 8-week smoking cessation program designed to induce either optimistic or modest expectations about cessation. Participants were encouraged to quit smoking after Week 4 and were followed for 15 months after the end of the program. MAIN PROCESS AND OUTCOME MEASURES: The authors focused on participants' expectations about cessation, satisfaction with cessation, and smoking status. The effect of the expectation manipulation on smokers' beliefs about cessation was moderated by their prior cessation success. Those led to hold favorable expectations about cessation were more likely to initiate cessation. Although satisfaction was not affected by initial expectations, it predicted maintained cessation. Conclusions: Results highlight the challenge of altering how smokers think about cessation and the need for further research on intervention strategies that target different factors for the initiation and maintenance of cessation.
  Health Psychology 06/2008; 27(3 Suppl):S197-206. · 3.87 Impact Factor
• Article: Smoking reduction fails to improve clinical and biological markers of cardiac disease: a randomized controlled trial.

  Anne M Joseph, Stephen S Hecht, Sharon E Murphy, Harry Lando, Steven G Carmella, Myron Gross, Robin Bliss, Chap T Le, Dorothy K Hatsukami
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  ABSTRACT: Cigarette reduction has been proposed as a treatment goal for smokers who are not interested in stopping completely. This randomized controlled trial was designed to determine the effect of a smoking reduction intervention on smoking behavior, symptoms of heart disease, and biomarkers of tobacco exposure. It included 152 patients with heart disease who did not intend to stop smoking in the next 30 days. Participants were randomly assigned to smoking reduction (SR) or usual care (UC). SR subjects received counseling and nicotine replacement therapy to encourage > or =50% reduction in cigarettes per day (CPD). They were followed at 1, 3, 6, 12 and 18 months to assess smoking, heart disease symptoms, quality of life and nicotine, cotinine, carbon monoxide (CO), white blood cell (WBC) count, fibrinogen, hs-C-reactive protein (hs-CRP), F2-isoprostane, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol and its glucuronides (total NNAL), and 1-hydroxypyrene (1-HOP). At 6 months SR participants reduced by 10.9 CPD, compared with 7.4 CPD in UC (difference NS). At 18 months, 9/78 SR vs. 9/74 UC participants quit smoking. There were no significant differences between treatment groups in angina, quality of life or adverse events, nicotine, cotinine, CO, WBC count, fibrinogen, hs-CRP, F2-isoprostane, total NNAL or 1-HOP levels at any time point. To determine if smoking reduction, regardless of treatment condition, was associated with improved outcomes, we compared all subjects at 6 months to baseline (mean reduction in CPD from 27.4 to 18.1, p<.01). There were no significant changes in outcome variables except CO, which decreased by 5.5 ppm (p<.01). There were also no significant improvements considering only subjects who reduced by > or =50%, or those who had no history of reduction prior to enrollment in the study. The SR intervention did not significantly reduce CPD or toxin exposure, or improve smoking cessation or clinical outcomes compared to UC. These results emphasize the importance of abstinence for smokers with heart disease to minimize health risks from tobacco.
  Nicotine & Tobacco Research 04/2008; 10(3):471-81. · 2.58 Impact Factor
• Article: The cigarette manufacturers' efforts to promote tobacco to the U.S. military.

  Anne M Joseph, Monique Muggli, Kathryn C Pearson, Harry Lando
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  ABSTRACT: This article describes findings from review of tobacco industry documents regarding promotion of tobacco to the military, and efforts to influence Department of Defense policies regarding the use and sale of tobacco products. The documents reveal that the industry has targeted the military for decades for reasons including: (1) the volume of worldwide military personnel; (2) the opportunity to attract young men who fit a specific socioeconomic and cultural profile; (3) potential carryover of profits to civilian markets; and (4) the unusual price structure of commissaries and exchanges. The industry used distinctive promotion methods such as in-store merchandising, sponsorships, and even brand development to target the military, both in the United States and abroad during times of conflict. Legislative activity to protect tobacco promotion to this vulnerable population was carried out in response to smoking policy changes proposed by the Department of Defense. The tobacco industry has contributed to the high prevalence of smoking in the military and among veterans.
  Military medicine 11/2005; 170(10):874-80. · 0.92 Impact Factor
• Article: An analysis of messages about tobacco in military installation newspapers.

  C Keith Haddock, L Carrie Parker, Jennifer E Taylor, Walker S C Poston, Harry Lando, G Wayne Talcott
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  ABSTRACT: We sought to gauge the relative attention that tobacco control receives in military newspapers by comparing coverage of tobacco use with that of other health topics of importance to the military. We examined tobacco-related articles and industry advertisements in 793 newspapers published during 1 year at 16 representative military installations (4 Air Force, 6 Army, 2 Marine, 4 Navy). Newspaper content was coded with a standardized coding manual developed through previous research. Tobacco use received the fewest instances of coverage and the least print space in military installation newspapers of all the health topics examined. The primary "message frame" used in tobacco control articles was that smokers are putting themselves at health risk, a theme that has not been found to have a strong effect on smokers. Nearly 10% of the newspapers contained tobacco advertisements. Tobacco control messages are underrepresented in military installation newspapers compared with other health issues. Furthermore, military newspapers send mixed messages to military personnel by providing advertisements for tobacco while also claiming that tobacco use is harmful.
  American Journal of Public Health 09/2005; 95(8):1458-63. · 3.93 Impact Factor
• Article: How well does the health history form identify adolescent smokers?

  Deborah Hennrikus, D Brad Rindal, Raymond G Boyle, Eric Stafne, Deann Lazovich, Harry Lando
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  ABSTRACT: This study examines the accuracy of adolescents' reports of tobacco use on a health history form completed in the dental office and the relationship between these reports and cessation advice provided by dental professionals. The authors compared reports of smoking status provided by adolescents during phone interviews with the adolescents' reports of smoking on a health history form completed during a dental visit. Adolescents aged between 14 and 17 years who were scheduled for a dental hygiene visit in a large managed care system were eligible for the study: 1162 completed the phone interview, and the study staff members audited the charts of a stratified random sample (n=280) of these. The health history form identified only 38.0 percent of those who reported having smoked in the previous 30 days during the phone interview and 57.4 percent of those who reported having smoked daily. Only 8.9 percent of all subjects interviewed reported that a dentist or a dental hygienist had ever talked with them about smoking. An examination of the chart audit sample indicated that advice was reported more often by adolescents who had identified themselves as smokers on the health history form (odds ratio = 2.62, 95 percent confidence interval = 1.35 to 5.10), but the reported rate of receiving advice still was low (25 percent). Adolescents underreport tobacco use on health history forms that ask them to specify whether they use tobacco products. Dentists and dental staff members provide advice about tobacco use to adolescents only infrequently. The wording of tobacco-use screening questions on health history forms and the conditions under which the forms are completed might affect the accuracy of the information adolescents provide.
  Journal of the American Dental Association (1939) 09/2005; 136(8):1113-20. · 1.77 Impact Factor
• Article: Predictors of smoking reduction without formal intervention.

  Anne M Joseph, Robin L Bliss, Fangyi Zhao, Harry Lando
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  ABSTRACT: The Reduction of Smoking in Cardiac Patients (ROSCAP) Study is a randomized controlled trial to test the effectiveness of a smoking reduction strategy to decrease tobacco-related harm, promote cessation, and improve biochemical and clinical indicators of toxin exposure among patients with heart disease. We analyzed baseline characteristics of patients enrolled for participation to investigate predictors of spontaneous smoking reduction prior to study enrollment. Past reducers were more likely to be males (p=.009) and had higher past peak smoking level (p<.0001) than nonreducers. Gender and number of heart disease diagnoses predicted the occurrence of spontaneous reduction and its extent. Age and a history of chronic obstructive pulmonary disease also predicted the extent of reduction. Cotinine and nicotine levels per cigarette per day were significantly higher among past spontaneous reducers than nonreducers. Spontaneous reduction is common among medically ill smokers. Past history of heart disease is a strong predictor of prior reduction. There is evidence of compensation among past spontaneous reducers.
  Nicotine & Tobacco Research 04/2005; 7(2):277-82. · 2.58 Impact Factor
• Article: Recent quitters' interest in recycling and harm reduction.

  Anne M Joseph, Kathryn Rice, Lawrence C An, Asra Mohiuddin, Harry Lando
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  ABSTRACT: Many smoking cessation attempts are followed by failure or relapse. The optimal time to initiate a new quit attempt is not known. Administrative databases documenting recent use of a pharmacological aid for smoking cessation provide access to a population of smokers recently in the action phase of quitting. This study describes interest in further treatment among this population. A total of 2,340 smokers from the Minneapolis Veterans Administration Medical Center received prescriptions for a smoking cessation aid during an 18-month period. We conducted a cross-sectional survey of a random sample of this population a minimum of 3 months following the prescription, using a structured telephone interview (N=391). The response rate was 75.8%. The 1-month point-prevalent abstinence rate was 19.7%. Of continuing smokers, 98% were willing to make another quit attempt--50% immediately, and 28% within 1 month. There was no relationship between time since the last quit attempt and interest in trying again immediately. Some 95% of continuing smokers were willing to try a reduction strategy. Of these, 82.7% were interested in using nicotine replacement therapy (NRT) to accomplish this goal. Most cessation programs do not systematically approach participants who relapse. These data suggest that this population would welcome further help in quitting or reducing smoking shortly following failure, and that smokers do not commonly relapse to a precontemplation stage of change.
  Nicotine & Tobacco Research 01/2005; 6(6):1075-7. · 2.58 Impact Factor
• Article: Modified tobacco use and lifestyle change in risk-reducing beliefs about smoking.

  C Keith Haddock, Harry Lando, Robert C Klesges, Alan L Peterson, Isabel C Scarinci
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  ABSTRACT: This study examined beliefs about potential risk-reduction strategies for tobacco users among a large group of young adults. Strategies examined included switching to low-yield cigarettes, replacing cigarettes with cigars, switching from cigarettes to smokeless tobacco, adopting a healthy diet, and engaging in regular exercise. One-year longitudinal survey of 36,012 young adults (mean 20.1 years) entering the U.S. Air Force from October 1999 to September 2000. Smokers generally rated the strategies as providing more risk-reduction potential than never smokers or ex-smokers, although the group differences were small. Diet, exercise, and switching to low-yield cigarettes were rated as providing the most health benefits, regardless of smoking status. Smokers who had either changed their diet or exercise to lower their risks from smoking had significantly lower perceived personal risk of developing a tobacco-related disease than other smokers. Smokers who believed that switching to smokeless tobacco would lower the health risks associated with smoking were more likely, while smokers reporting switching to low-yield cigarettes were significant less likely, to quit during a 1-year follow-up period. Beliefs about the risk-reduction benefits of both changes in tobacco use and health behaviors may impact tobacco use attitudes and practices.
  American Journal of Preventive Medicine 08/2004; 27(1):35-41. · 4.04 Impact Factor
• Article: Predictors of quitting in hospitalized smokers.

  Harry Lando, Deborah Hennrikus, Maribet McCarty, John Vessey
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  ABSTRACT: Hospitalization represents a teachable moment for quitting. The current study examined predictors of quitting among hospitalized smokers. Patients reported smoking history and demographic characteristics during in-hospital baseline interviews. Discharge diagnosis also was collected. Smoking status was ascertained in interviews at 7 days and at 12 months after discharge. A total of 2,350 patients in four Minneapolis and St. Paul (Twin Cities), Minnesota, area hospitals participated in the study; 1,477 patients who provided data at both follow-ups and whose 12-month self-report of quitting was corroborated by cotinine analysis of saliva samples were included in the current analyses. Predictors of both short- and long-term abstinence in the multivariate analysis included smoking-related illness, age (those who were older were more likely to be abstinent), stage of change (precontemplators were least likely to quit, and those initially in action were most likely to quit), and time to first cigarette (those who reported smoking within 5 min of awakening were least likely to quit). The predictors presented few surprises; the most important finding may have been that the experience of hospitalization itself led to substantial long-term quitting for virtually all categories of hospitalized smokers.
  Nicotine & Tobacco Research 05/2003; 5(2):215-22. · 2.58 Impact Factor
• Article: Prevalence and Risk Factors for Frequent Dieting and Weight Concerns Among U.S. Air Force Personnel

  C. Keith Haddock, Risa J. Stein, Walker S. C. Poston, Robert C. Klesges, Gerald W. Talcott, Harry Lando
  Eating Disorders 01/1999; 7(2):83-97.
• Article: Evidence That Smokeless Tobacco Use Is a Gateway for Smoking Initiation in Young Adult Males

  C.Keith Haddock, Mark Vander Weg, Margaret DeBon, Robert C. Klesges, G.Wayne Talcott, Harry Lando, Alan Peterson
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  ABSTRACT: Background. This study was designed to test the hypothesis that smokeless tobacco (SLT) serves as a gateway drug for smoking among young adult males.Methods. A cohort (n = 7,865) of U.S. Air Force recruits who claimed to have never smoked cigarettes was followed prospectively for 1 year. The participants were male, 32.9% were ethnic minorities, and their average age was 19.84 years (SD = 2.29). Among recruits entering basic military training, 403 (5.1%) reported current SLT use and 198 (2.5%) reported a past history of SLT use.Results. At the 1-year follow-up current SLT users were 233% more likely to have initiated smoking than nonusers (odds ratio = 2.33, 95% CI = 1.84–2.94). Similarly, recruits who reported past SLT use were 227% more likely to begin smoking than participants who had never used SLT (odds ratio = 2.27, 95% CI = 1.64–3.15). SLT use remained a potent predictor of smoking initiation in a multivariate logistic model that included demographic factors and other risk factors for initiation.Conclusions. SLT use appears to be an important predictor of smoking initiation among young adult males. This study suggests that smoking prevention and cessation programs should also include strategies related to SLT use.
  Preventive Medicine.
• Article: Demographics and risky lifestyle behaviors associated with willingness to risk sexually transmitted infection in Air Force recruits.

  Theodore V Cooper, Margaret DeBon, C Keith Haddock, Denise Rodríguez Esquivel, Robert C Klesges, Harry Lando, G Wayne Talcott
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  ABSTRACT: To investigate sexually transmitted infection (STI) risk-taking behaviors relative to other lifestyle and risk-taking behaviors. The study design is cross sectional. Lackland Air Force Base in San Antonio, Texas. Participants (N = 32,144) were 100% of Air Force recruits beginning basic military training from August 1995 to August 1996. Recruits completed a questionnaire that included rating the statement "Sex without condoms is sometimes worth the risk of possibly getting AIDS or sexually transmitted diseases." Risky behaviors, such as risk taking, rebelliousness, seat belt use, smoking, alcohol use and binge drinking, opinions of illicit drug use, and lifestyle behaviors, such as dietary intake and physical activity, were also assessed. Univariate and multivariate logistic regression analyses examined the relationships between participant characteristics and willingness to risk STI. Sixteen percent stated willingness to risk STI to have sex without a condom. Women and white/non-Hispanic participants were less likely to agree with the statement than men and minority participants. Those who reported willingness toward risky sexual behaviors were less likely to use seat belts, were more likely to binge drink, had more positive views of illicit drugs, and reported eating fewer fruits and vegetables. Results of this study suggest the importance of continued education on condom use and the possibility that multiple risk behavior interventions include sexual risk components.
  American journal of health promotion: AJHP 22(3):164-7. · 2.37 Impact Factor