Sarah Lewis

Sarah Lewis
University of Nottingham | Notts · Division of Epidemiology and Public Health

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218
Publications
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Introduction
Skills and Expertise

Publications

Publications (218)
Article
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Objective Nicotine replacement therapy (NRT) helps people stop smoking. Monitoring treatment adherence is important as poor adherence to NRT limits its effectiveness. As e-cigarettes contain nicotine, their use (‘vaping’) is likely to affect both NRT use and smoking. We wished to measure adherence to NRT, and to investigate relationships between NR...
Article
Aim: To measure the cost-effectiveness of adding text message (TMB), exercise (EB), and abstinent-contingent financial incentive-based (CFIB) stop smoking interventions to standard smoking cessation support for pregnant women in England. Design: Modelling cost-effectiveness outcomes by separately adding three cessation interventions to standard...
Article
Full-text available
Nicotine replacement therapy, in the form of nicotine patches, is commonly offered to pregnant women who smoke to help them to stop smoking, but this approach has limited efficacy in this population. Electronic cigarettes (e-cigarettes) are also used by pregnant women who smoke but their safety and efficacy in pregnancy are unknown. Here, we report...
Article
Objectives: Postpartum return to smoking (PPRS) is an important public health problem. E-cigarette (EC) use has increased in recent years, and in a contemporary UK pregnancy cohort, we investigated factors, including ECs use, associated with PPRS. Design: Secondary analyses of a longitudinal cohort survey with questionnaires at baseline (8-26 we...
Article
Introduction Although most of the disease burden is due to tobacco smoking, smokeless tobacco (SLT) use contributed to an estimated 76,000 deaths in 2017. We have studied the potential risk factors for SLT use among adolescents in South India. Methods A cross-sectional questionnaire survey of all students in grades 6 to 8 in schools in the Udupi d...
Preprint
BACKGROUND Few studies have investigated how to best measure adherence to smoking cessation medications, but continuous usage measures are recommended. OBJECTIVE In this first study of its kind, we compared methods for measuring adherence to nicotine replacement therapy (NRT), investigating the completeness and validity of data collected from dail...
Article
Full-text available
Background: Postpartum return to smoking (PPRS) is a common and important public health problem. Interventions to prevent PPRS have not been shown to be effective. We aimed to qualitatively explore the barriers and facilitators to staying smoke-free after having a baby, and women's views on the support needed to avoid PPRS to inform future interve...
Article
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Background and Aims Although English Stop Smoking Services routinely offer dual nicotine replacement therapy (NRT) to help pregnant women quit smoking, little is known about how nicotine and tobacco smoke exposures following this compares with that from smoking. We compared, in pregnant women when smoking and after being offered dual NRT, saliva co...
Article
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Background Exposure to tobacco imagery in films causes young people to start smoking. Popular Indian films contain high levels of tobacco imagery, but those that do are required by law to display onscreen health warnings when smoking imagery occurs and to include other health promotion messaging before and during the film. We report a prospective c...
Article
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Introduction There is limited information about longitudinal patterns of vaping during pregnancy and the postpartum. We describe the prevalence, frequency, and reasons for vaping throughout pregnancy and postpartum. We also describe temporal patterns in pregnant women’s vaping. Methods A longitudinal cohort study across England and Scotland, with...
Article
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Objective: To estimate prevalence of vaping in pregnancy. Compare characteristics and attitudes between exclusive smokers and vapers, and between exclusive vapers and dual users (smoke and vape). Design: Cross-sectional survey. Setting: Hospitals across England and Scotland. Population: Pregnant women attending antenatal clinics in 2017. Me...
Preprint
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Background Financial incentives are an effective way of helping women to stop smoking during pregnancy. Unfortunately, most women who stop smoking at this time return to smoking within 12 months of the infant’s birth. There is no evidence for interventions that are effective at preventing postpartum smoking relapse. Financial incentives provided af...
Article
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Objective To review the evidence on the health risks associated with smoking kretek cigarettes compared with not smoking or smoking regular cigarettes. Data Sources We conducted a systematic literature search in five electronic databases: EMBASE (Ovid), ASSIA, PubMed and Scopus. Since kretek use is largely restricted to Indonesia, we identified ad...
Preprint
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Key points: • Quality Improvement Collaboratives bring staff from different organisations together to improve healthcare in care homes. • Healthcare improvement should align with existing work priorities and be led by staff with experience of collaboration. 2 • Care home staff can lead healthcare improvement if approaches and structures are adopted...
Article
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Background Relapse remains an unresolved issue in smoking cessation. Extended stop smoking medication use can help, but uptake is low and several behavioural relapse prevention interventions have been found to be ineffective. However, opportunistic ‘emergency’ use of fast-acting nicotine replacement treatment or electronic cigarettes may be more at...
Article
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Introduction: Integration of smoking cessation (SC) into lung cancer screening is essential to optimise clinical and cost effectiveness. The most effective way to use this 'teachable moment' is unclear. The Yorkshire Enhanced Stop Smoking study will measure the effectiveness of an SC service integrated within the Yorkshire Lung Screening Trial (YL...
Article
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Background: Exposure to smoking in films is a recognised cause of smoking uptake among children. In India, in an attempt to protect children, films containing smoking are required to include tobacco control messaging including audiovisual disclaimers, on-screen health warnings when tobacco imagery is displayed and antitobacco 'health spots' before...
Article
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Background: Avoidable use of diagnostic tests can both harm patients and increase the cost of healthcare. Nudge-type educational interventions have potential to modify clinician behaviour while respecting clinical autonomy and responsibility, but there is little evidence how this approach may be best used in a healthcare setting. This study aims t...
Article
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Polypharmacy in older adults is a growing problem, as some drugs may be either unnecessary or even harmful. Admission to hospital under a Medicine for the Elderly specialist physicians represents an opportunity to review patients’ medication. The recent introduction of electronic prescribing to some hospitals in the United Kingdom allows the develo...
Article
Background: The evaluation of large-scale public health policy interventions often relies on observational designs where attributing causality is challenging. Logic models-visual representations of an intervention's anticipated causal pathway-facilitate the analysis of the most relevant outcomes. We aimed to develop a set of logic models that coul...
Article
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Background: In the context of increasing availability of computed tomography (CT) scans, judicious use of ionising radiation is a priority to minimise the risk of future health problems. Hence, education of clinicians on the risks and benefits of CT scans in the management of patients is important. Methods: An educational message about the assoc...
Article
Background: Behavioural insights or 'nudge' theory suggests that non-directional interventions may be used to modify human behaviour. We have tested the hypothesis that the provision of the cost of common blood tests with their results may modify subsequent demand for blood assays. Methods: The study design was a prospective controlled intervent...
Article
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Objective To investigate relationships between maternal smoking status in pregnancy and infant development. The largest randomised controlled trial of nicotine replacement therapy (NRT) for smoking cessation in pregnancy, the smoking, nicotine and pregnancy (SNAP) trial, found that at 1 month after randomisation, smoking cessation rates were double...
Article
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Background Mass media campaigns can be used to communicate public health messages at the population level. Although previous research has shown that they can influence health behaviours in some contexts, there have been few attempts to synthesise evidence across multiple health behaviours. Objectives To (1) review evidence on the effective use of...
Data
Appendix S1 Technical summary of methods.
Data
Appendix S2 Transition probabilities used in model. Appendix S3 Prevalence of morbidities and mortality. Appendix S4 Detailed figures of model structure.
Data
Appendix S5 ICD‐10 codes and NHS reference costs codes.
Article
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Introduction care home residents are often unable to complete health-related quality of life questionnaires for themselves because of prevalent cognitive impairment. This study compared care home resident and staff proxy responses for two measures, the EQ-5D-5L and HowRU. Methods a prospective cohort study recruited residents ≥60 years across 24 c...
Article
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Smoking in pregnancy remains a public health problem. In the UK e-cigarettes are the most popular aid to quitting smoking outside of pregnancy, but we don’t know the extent of e-cigarette use in pregnancy or how English Stop Smoking Services (SSS) respond to pregnant women who vape. In 2015 we surveyed SSS managers about cessation support for pregn...
Article
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Background Second-hand smoke (SHS) causes numerous health problems in children such as asthma, respiratory tract infections and sudden infant death syndrome. The home is the main source of exposure to SHS for children, particularly for young children. We estimated the cost-effectiveness of a complex intervention designed to reduce SHS exposure of c...
Article
Background Emergency departments see uniquely large numbers of patients across all demographic groups who are more likely to smoke and who attend with acute health concerns that can provide an impetus for behaviour change. Despite this potential opportunity, no smoking cessation programme in any UK emergency department yet exists. This study sought...
Article
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Background/Aims Previous evaluations of smoking cessation interventions in pregnancy have several limitations. Our solution to these limitations is the Economics of Smoking in Pregnancy (ESIP) model which estimates the lifetime cost‐effectiveness of smoking cessation interventions in pregnancy from a National Health Service (NHS) and personal socia...
Method
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This paper outlines the statistical analysis plan for the PEACH study, describing how these challenges have been addressed. It acts as reference point for further publications from the PEACH study. https://www.nottingham.ac.uk/emran/documents/issue-22-emran-sep-2018.pdf
Article
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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
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Background Electronic cigarettes (e-cigs) are an increasingly popular alternative to smoking, helping to prevent relapse in those trying to quit and with the potential to reduce harm as they are likely to be safer than standard cigarettes. Many women return to smoking in the postpartum period having stopped during pregnancy, and while this can affe...
Article
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Background Electronic cigarettes (ECs) are increasingly used for reducing or stopping smoking, with some studies showing positive outcomes. However, little is known about views on ECs during pregnancy or postpartum and previous studies have nearly all been conducted in the US and have methodological limitations, such as not distinguishing between s...
Article
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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
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Background: Antenatal depression is associated with harmful consequences for both the mother and child. One intervention that might be effective is participation in regular physical activity although data on this question in pregnant smokers is currently lacking. Methods: Women were randomised to six-weekly sessions of smoking cessation behaviou...
Article
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Background: 'Vape shops' are a popular source for buying electronic cigarettes (e-cigarettes) and related products. The products that vape shops sell, their marketing techniques and the extent to which they provide information or encouragement to smokers to quit tobacco use, as well as the patterns of tobacco and e-cigarette use of their customers...
Article
Objectives: Standard smoking cessation pharmacotherapy is recommended in the post-quit period, but may also facilitate abstinence if used prior to quitting. The objective was to examine the effectiveness and cost-effectiveness of nicotine patch worn for four weeks before a quit attempt. Design: Randomised controlled open-label trial. Setting: Prima...
Article
Background Hospital admission provides an ideal opportunity to promote smoking cessation. Clinical guidelines recommend delivery of cessation interventions for all admissions but no research to date has focused on supporting smokers who successfully abstain from smoking whilst in hospital to maintain abstinence after discharge. We therefore desig...
Article
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Aims: To assess the effectiveness of mass media messages to reduce alcohol consumption and related harms using a systematic literature review. Methods: Eight databases were searched along with reference lists of eligible studies. Studies of any design in any country were included, provided that they evaluated a mass media intervention targeting...
Article
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Aim: To identify factors found in the research literature to be associated with smoking cessation in pregnancy. Methods: Electronic searches of the bibliographic databases of PubMed, EMBASE, PsycINFO, Elsevier, Scopus and ISI Web of Science were conducted to April 2017. All studies reporting factors associated with smoking cessation or continuin...
Article
We hypothesised that delays in providing non-urgent medication step-downs at weekends to medical management may be associated with increased length of stay.In a novel use of electronic prescribing data, we analysed emergency admissions from a busy acute medical hospital over 52 weeks from November 2014 to October 2015. The main outcomes of interest...
Article
Background There were 8758 alcohol-related deaths in the UK in 2015 and an estimated 1·1 million alcohol-related hospital admissions in England in 2014–15. Mass media campaigns are used to communicate public health messages at a population level but whether campaigns intended to reduce alcohol consumption achieve their aims is unclear. With a syste...
Article
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Objectives: Evidence from the US Truth® campaign suggests that interventions focusing on tobacco industry practices and ethics may be effective in preventing youth smoking uptake. We developed, piloted and evaluated a school-based intervention based on this premise. Methods: Exploratory study Students in Years 7–8 (aged 11–13) in two UK schools rec...
Article
Aim: To evaluate temporal changes in recorded alcohol consumption in Sri Lanka during and after the armed conflict 1998-2013. Methods: District level alcohol sales, and mid-year population data for the whole study period (1998-2013) were consistently available from the Department of Excise and the Department of Census and Statistics for 18 of 25...
Article
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Objectives: Exposing children to secondhand tobacco smoke (SHS) causes significant harm and occurs predominantly through smoking by caregivers in the family home. We report a trial of a complex intervention designed to reduce secondhand smoke exposure of children whose primary caregiver feels unable or unwilling to quit smoking. Design: An open-...
Article
Background Smokers who start smoking at an early age are less likely to quit and more likely to die from their habit. Evidence from the US Truth® campaign suggests that interventions focusing on tobacco industry practices and ethics may be effective in preventing smoking uptake. Objectives In an exploratory study, to develop, pilot and provide pre...
Article
Full-text available
Background Globally, 40 % of children under 14 years are regularly exposed to secondhand smoke (SHS), typically in their homes. There is limited evidence of the effectiveness of interventions to reduce children’s SHS exposure, and so the aim of this study was to test the feasibility and acceptability of a novel intervention to help parents and care...
Article
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Background: Evidence from the US Truth campaign suggests that interventions focusing on tobacco industry tactics can be effective in preventing smoking uptake by children. Operation Smoke Storm is the first school-based intervention based on this premise and comprises three classroom sessions in which students act as secret agents uncovering tobac...
Article
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Background: Many women stop smoking during pregnancy but relapse shortly afterwards, potentially putting their infants at risk of secondhand smoke (SHS) exposure. Women who were able to stop during pregnancy may be a motivated group, receptive to making behaviour changes postpartum to protect their infant from SHS exposure. Understanding more abou...