Nicola Lindson

Nicola Lindson
University of Oxford | OX · Department of Primary Care Health Sciences

Behavioural Medicine PhD

About

80
Publications
8,409
Reads
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3,048
Citations
Introduction
Nicola Lindson works as a University Research Lecturer at the Nuffield Department of Primary Care Health Sciences, University of Oxford. She is the Managing Editor of the Cochrane Tobacco Addiction Group. Nicola does research in the areas of smoking cessation and tobacco harm reduction and is an Associate Lecturer for Cochrane UK.
Additional affiliations
October 2011 - August 2013
University of Birmingham
Position
  • Research Associate
Education
October 2008 - September 2011
University of Birmingham
Field of study
  • Behavioural Medicine

Publications

Publications (80)
Article
Moderate certainty evidence supports use of nicotine electronic cigarettes to quit smoking combustible cigarettes. However, there is less certainty regarding how long people continue to use e-cigarettes after smoking cessation attempts. We set out to synthesise data on the proportion of people still using e-cigarettes or other study products at 6 m...
Article
Full-text available
Background: Smoking is a leading cause of cardiovascular disease (CVD), particularly coronary heart disease (CHD). However, quitting smoking may prevent secondary CVD events in people already diagnosed with CHD. OBJECTIVES: To examine the impact of smoking cessation on death from CVD and major adverse cardiovascular events (MACE), in people with i...
Article
Background: Mindfulness-based smoking cessation interventions may aid smoking cessation by teaching individuals to pay attention to, and work mindfully with, negative affective states, cravings, and other symptoms of nicotine withdrawal. Types of mindfulness-based interventions include mindfulness training, which involves training in meditation; a...
Article
Full-text available
Background: Smoking is a risk factor for most respiratory infections, but it may protect against SARS-CoV-2 infection. The objective was to assess whether smoking and e-cigarette use were associated with severe COVID-19. Methods: This cohort ran from 24 January 2020 until 30 April 2020 at the height of the first wave of the SARS-CoV-2 epidemic i...
Article
Aims To investigate the comparative and combined effectiveness of four types of components of behavioural interventions for cigarette smoking cessation: behavioural (e.g. counselling), motivational (e.g. focus on reasons to quit), delivery mode (e.g. phone), and provider (e.g. nurse). Design Systematic review and component network meta-analysis of...
Article
Aims To summarise evidence on tobacco addiction interventions published by the Cochrane Tobacco Addiction Group (CTAG) from 2019 to 2020. Methods Narrative summary of all new and updated Cochrane Reviews published by CTAG in 2019 and 2020, outlining key results and promising avenues for future research. Results CTAG published six new reviews and...
Article
Background and aim Observational and trial evidence conflict on the efficacy of two contrasting behavioural approaches to quitting smoking – gradual and abrupt. Observational data suggests an abrupt approach to quitting is superior to a gradual approach, whilst trials show no difference. One potential explanation is self-selection in observational...
Article
Full-text available
Background Conflicting evidence has emerged regarding the relevance of smoking on risk of COVID-19 and its severity. Methods We undertook large-scale observational and Mendelian randomisation (MR) analyses using UK Biobank. Most recent smoking status was determined from primary care records (70.8%) and UK Biobank questionnaire data (29.2%). COVID-...
Article
Background: Electronic cigarettes (ECs) are handheld electronic vaping devices which produce an aerosol formed by heating an e-liquid. Some people who smoke use ECs to stop or reduce smoking, but some organizations, advocacy groups and policymakers have discouraged this, citing lack of evidence of efficacy and safety. People who smoke, healthcare...
Article
Background: Primary care is an important setting in which to treat tobacco addiction. However, the rates at which providers address smoking cessation and the success of that support vary. Strategies can be implemented to improve and increase the delivery of smoking cessation support (e.g. through provider training), and to increase the amount and...
Article
Background: Electronic cigarettes (ECs) are handheld electronic vaping devices which produce an aerosol formed by heating an e-liquid. Some people who smoke use ECs to stop or reduce smoking, but some organizations, advocacy groups and policymakers have discouraged this, citing lack of evidence of efficacy and safety. People who smoke, healthcare...
Article
Full-text available
Background Previous studies suggested that the prevalence of chronic respiratory disease in patients hospitalised with COVID-19 was lower than its prevalence in the general population. The aim of this study was to assess whether chronic lung disease or use of inhaled corticosteroids (ICS) affects the risk of contracting severe COVID-19. Methods In...
Article
Background: There is a common perception that smoking generally helps people to manage stress, and may be a form of 'self-medication' in people with mental health conditions. However, there are biologically plausible reasons why smoking may worsen mental health through neuroadaptations arising from chronic smoking, leading to frequent nicotine wit...
Article
Background: Smoking is a leading cause of disease and death worldwide. In people who smoke, quitting smoking can reverse much of the damage. Many people use behavioural interventions to help them quit smoking; these interventions can vary substantially in their content and effectiveness. Objectives: To summarise the evidence from Cochrane Review...
Article
Abstract Background Populations experiencing homelessness have high rates of tobacco use and experience substantial barriers to cessation. Tobacco‐caused conditions are among the leading causes of morbidity and mortality among people experiencing homelessness, highlighting an urgent need for interventions to reduce the burden of tobacco use in thi...
Article
Background: Electronic cigarettes (ECs) are handheld electronic vaping devices which produce an aerosol formed by heating an e-liquid. People who smoke report using ECs to stop or reduce smoking, but some organisations, advocacy groups and policymakers have discouraged this, citing lack of evidence of efficacy and safety. People who smoke, healthc...
Article
This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the efficacy of mindfulness interventions for smoking cessation among people who smoke, and whether mindfulness interventions for smoking cessation have an effect on mental health outcomes.
Article
Introduction: Around half of smokers attempt to stop by cutting-down first. Evidence suggests this results in similar quit rates to abrupt quitting. Evidence for the effectiveness and popularity of different gradual cessation methods is sparse. Method: Secondary, exploratory, analyses of a randomized trial of gradual versus abrupt smoking cessat...
Preprint
Full-text available
Introduction Epidemiological and laboratory research seems to suggest that smoking and perhaps nicotine alone could reduce the severity of COVID-19. Likewise, there is some evidence that inhaled corticosteroids could also reduce its severity, opening the possibility that nicotine and inhaled steroids could be used as treatments. Methods In this pro...
Article
Background: Whilst the pharmacological profiles and mechanisms of antidepressants are varied, there are common reasons why they might help people to stop smoking tobacco. Firstly, nicotine withdrawal may produce depressive symptoms and antidepressants may relieve these. Additionally, some antidepressants may have a specific effect on neural pathwa...
Article
Background: The standard way most people are advised to stop smoking is by quitting abruptly on a designated quit day. However, many people who smoke have tried to quit many times and may like to try an alternative method. Reducing smoking behaviour before quitting could be an alternative approach to cessation. However, before this method can be r...
Article
Background: Pharmacological treatments for tobacco dependence, such as nicotine replacement therapy (NRT), have been shown to be safe and effective interventions for smoking cessation. Higher levels of adherence to these medications increase the likelihood of sustained smoking cessation, but many smokers use them at a lower dose and for less time...
Article
Background: Motivational Interviewing (MI) is a directive patient-centred style of counselling, designed to help people to explore and resolve ambivalence about behaviour change. It was developed as a treatment for alcohol abuse, but may help people to a make a successful attempt to stop smoking. Objectives: To evaluate the efficacy of MI for sm...
Article
Background: Nicotine replacement therapy (NRT) aims to replace nicotine from cigarettes to ease the transition from cigarette smoking to abstinence. It works by reducing the intensity of craving and withdrawal symptoms. Although there is clear evidence that NRT used after smoking cessation is effective, it is unclear whether higher doses, longer d...
Article
Background: Competitions might encourage people to undertake and/or reinforce behaviour change, including smoking cessation. Competitions involve individuals or groups having the opportunity to win a prize following successful cessation, either through direct competition or by entry into a lottery or raffle. Objectives: To determine whether comp...
Article
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: The primary objectives are to summarise the evidence from Cochrane Reviews that assessed the effect of behavioural interventions designed to support smoking cessation attempts, and address the following two questions: How do modes of delivery, person delivering...
Article
Full-text available
Background Nicotine preloading means using nicotine replacement therapy prior to a quit date while smoking normally. The aim is to reduce the drive to smoke, thereby reducing cravings for smoking after quit day, which are the main cause of early relapse. A prior systematic review showed inconclusive and heterogeneous evidence that preloading was ef...
Article
Full-text available
Objective To examine the effectiveness of a nicotine patch worn for four weeks before a quit attempt. Design Randomised controlled open label trial. Setting Primary care and smoking cessation clinics in England, 2012-15. Participants 1792 adults who were daily smokers with tobacco dependence. 899 were allocated to the preloading arm and 893 to t...
Article
Background: Most tobacco control programmes for adolescents are based around prevention of uptake, but teenage smoking is still common. It is unclear if interventions that are effective for adults can also help adolescents to quit. This is the update of a Cochrane Review first published in 2006. Objectives: To evaluate the effectiveness of strat...
Article
Full-text available
Background and aims: The Cochrane Tobacco Addiction Group (TAG) conducts systematic reviews of the evidence for tobacco cessation and prevention interventions. In 2016 TAG conducted a priority-setting, stakeholder engagement project to identify where further research is needed in the areas of tobacco control and smoking cessation. Design: The pr...
Chapter
Background: Although smoking cessation is currently the only guaranteed way to reduce the harm caused by tobacco smoking, a reasonable secondary tobacco control approach may be to try and reduce the harm from continued tobacco use amongst smokers unable or unwilling to quit. Possible approaches to reduce the exposure to toxins from smoking include...
Article
Cochrane is a global organization committed to carrying out high-standard systematic reviews and meta-analyses to inform health care and those associated with it, from patients to providers. The Cochrane Tobacco Addiction Group (TAG) has been reviewing the evidence for interventions to treat and prevent tobacco addiction for 20 years. During this t...
Article
Background and Aims: Previous studies have reported that people who use a smoking cessation medication while smoking and reduce cigarette consumption spontaneously are three times more likely to stop smoking after a quit date. The aim was to replicate this and assess whether it arises because of willed effortful reduction rather than unwilled reduc...
Chapter
Background: Nicotine receptor partial agonists may help people to stop smoking by a combination of maintaining moderate levels of dopamine to counteract withdrawal symptoms (acting as an agonist) and reducing smoking satisfaction (acting as an antagonist). Objectives: To review the efficacy of nicotine receptor partial agonists, including vareni...
Article
BACKGROUND: Most smoking cessation guidelines advise quitting abruptly. However, many quit attempts involve gradual cessation. If gradual cessation is as successful, smokers can be advised to quit either way. OBJECTIVE: To examine the success of quitting smoking by gradual compared with abrupt quitting. DESIGN: Randomized, controlled noninferiority...
Article
Full-text available
© 2016 American College of Physicians.Background: Most smoking cessation guidelines advise quitting abruptly. However, many quit attempts involve gradual cessation. If gradual cessation is as successful, smokers can be advised to quit either way. Objective: To examine the success of quitting smoking by gradual compared with abrupt quitting. Design:...
Article
Full-text available
Background: Promoting and supporting smoking reduction in smokers with no immediate intention of stopping smoking is controversial given existing fears that this will deter cessation and that reduction itself may not improve health outcomes. Discussion: Evidence shows that smokers who reduce the number of daily cigarettes smoked are more likely...
Article
Background: Motivational Interviewing (MI) is a directive patient-centred style of counselling, designed to help people to explore and resolve ambivalence about behaviour change. It was developed as a treatment for alcohol abuse, but may help people to a make a successful attempt to quit smoking. Objectives: To determine whether or not motivatio...
Article
Full-text available
Background: Pharmacological treatments for tobacco dependence, such as nicotine replacement therapy (NRT), have been shown to be safe and effective interventions for smoking cessation. Higher levels of adherence to these medications increase the likelihood of sustained smoking cessation, but many smokers use them at a lower dose and for less time...
Article
Full-text available
Background: The use of nicotine replacement therapy before quitting smoking is called nicotine preloading. Standard smoking cessation protocols suggest commencing nicotine replacement therapy only on the first day of quitting smoking (quit day) aiming to reduce withdrawal symptoms and craving. However, other, more successful smoking cessation phar...
Article
Paul Aveyard and Nicola Lindson-Hawley say that reducing smoking is a worthwhile step towards cessation, but Gerard Hastings and Marisa de Andrade argue that the lifelong nicotine replacement therapy being recommended in support may benefit industry more than public health
Article
AimsTo examine the association between future orientation (how individuals consider and value outcomes in the future) and smoking cessation at four weeks and six months post quit-date in individuals enrolled in a smoking cessation study.DesignCohort analysis of randomised controlled trial data.SettingUK primary care.ParticipantsAdults aged ≥18 year...
Article
Full-text available
Sanderson and colleagues wonder whether people try to quit smoking when mood improves and whether this could explain the association between quitting and improved mood in some of our cohorts. 1 2 However, in more than half the studies, participants' mood was assessed initially and then all attempted to quit immediately, so improved mood cannot have...
Article
Full-text available
To investigate change in mental health after smoking cessation compared with continuing to smoke. Systematic review and meta-analysis of observational studies. Web of Science, Cochrane Central Register of Controlled Trials, Medline, Embase, and PsycINFO for relevant studies from inception to April 2012. Reference lists of included studies were hand...
Article
Full-text available
Clinical question: Is gradual smoking cessation associated with poorer success rates than abrupt cessation in smokers who want to quit? Bottom line: Gradual reduction may not be associated with a clinically significant difference in smoking cessation rates compared with abrupt cessation.
Article
Objective: To investigate the smoking status of stop smoking practitioners, the impact of this on their practice, and clients' quit rates. Methods: Smoking cessation practitioners in the UK NHS Stop Smoking Service were asked about their smoking status, client quit rates and practitioner-client interaction, using an online survey. Associations b...
Article
Full-text available
Background: Smoking is common in people infected with HIV but cessation support is not a routine part of clinical care. The aim was to assess whether smoking is a risk factor for pneumonia in people with HIV and whether smoking cessation ameliorates excess risk. Methods: We performed MEDLINE and Embase database searches and included cohort or ca...
Data
Search strategy, quality criteria, and funnel plots. A line-by-line search strategy, the criteria used to assign quality points to studies, and the funnel plots of each of Figures 2 to 7.
Article
OBJECTIVES: To develop models to estimate the likely prevalence of medically unexplained symptoms (MUS) and severe MUS in a primary care practice from existing patient electronic records collected in the previous 2 years for secondary prevention and commissioning of psychological treatment. STUDY DESIGN: Cross-sectional survey comparing general pra...
Data
A sub-group analysis comparing the effect of NRT preloading on long-term abstinence in studies where participants reduced their cpd by less than 50% and in studies where participants reduced by more than 50%
Data
A sub-group analysis comparing the effect of NRT preloading on long-term abstinence in studies where continuous abstinence was used as the outcome measure and studies where prolonged or point prevalence abstinence was used as the outcome measure.
Article
In response to our review of nicotine preloading trials (Lindson and Aveyard 2011 )R ose ( 2011 )r aises two discussion points. Firstly, that the effect of nicotine preloading may be correlated with the extent to which smokers reduce smoking during preloading, and secondly that the use of measures of non-continuous abstinence may underestimate the...
Article
Full-text available
Using nicotine replacement therapy (NRT) whilst smoking, prior to quitting, is called preloading. Two reviews have estimated the effect of preloading on abstinence, but need updating. Neither investigated possible mediators or moderators of the effect, which could have implications for individual treatment plans. To update the nicotine preloading e...
Article
Background: The standard way to stop smoking is to quit abruptly on a designated quit day. A number of smokers have tried unsuccessfully to quit this way. Reducing smoking before quitting could be an alternative approach to cessation. Before this method is adopted it is important to determine whether it is at least as successful as abrupt quitting...
Article
Full-text available
Background The standard way to stop smoking is to stop abruptly on a quit day with no prior reduction in consumption of cigarettes. Many smokers feel that reduction is natural and if reduction programmes were offered, many more might take up treatment. Few trials of reduction versus abrupt cessation have been completed. Most are small, do not use p...
Data
Appendix 1. Adverse Event Reporting.

Projects

Projects (4)
Archived project
To investigate whether reducing smoking before quitting is as efficacious as abrupt quitting as a strategy to quit smoking in people motivated to quit
Archived project
To test the effectiveness of nicotine patch pre-treatment for smokers who want to quit smoking, in a pragmatic randomised controlled trial