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Benefits of e-cigarettes in smoking reduction and in pulmonary health among Chronic Smokers Undergoing a Lung Cancer Screening Program at 6 Months

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Introduction: Electronic cigarettes (e-cigarettes) might be a valid and safe device to support smoking cessation. However, the available evidence is divergent. The aim of the present work was to assess the effects of an e-cigarette program on pulmonary health (cough, breath shortness, catarrh) and to evaluate the effectiveness of e-cigarettes in reducing tobacco consumption. Methods: The study is a double-blind randomized controlled trial. Two hundred and ten smokers were randomized into three groups: nicotine e-cigarette (8 mg/mL nicotine concentration), nicotine-free e-cigarettes (placebo), and control with 1:1:1 ratio. All participants received a 3 months cessation program that included a cognitive-behavioral intervention aimed at supporting people in changing their behavior and improving motivation to quit. Results: Pulmonary health, assessed with self-reported measures, clinical evaluations and the Leicester Cough Questionnaire, improved in participants who stopped smoking compared to their own baseline. No differences in pulmonary health were found between groups. Statistical tests showed a significant effect of Group (F (2, 118) = 4.005, p < .020) on daily cigarette consumption: after 6 months participants in the nicotine e-cigarette group smoked fewer cigarettes than any other group. Moreover, participants in this group showed the lowest level of exhaled carbon monoxide (CO) (M = 12.012, S.D. = 8.130), and the lowest level of dependence (M = 3.12, S.D. = 2.29) compared to the nicotine-free e-cigarette and control conditions. Conclusions: After 6 months about 20% of the entire sample stopped smoking. Participants who used e-cigarettes with nicotine smoked fewer tobacco cigarettes than any other group after 6 months (p < .020). Our data add to the efficacy and safety of e-cigarettes in helping smokers reducing tobacco consumption and improving pulmonary health status.
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... Ten RCTs reported in 16 publications 39-54 met the inclusion criteria for efficacy (N=8) 39,40,45,[47][48][49]51,54 and safety (N=10) 39,40,45,[47][48][49][51][52][53][54] of ENDS in smoking cessation. Two trials reported safety data only 52,53 . ...
... Ten RCTs reported in 16 publications 39-54 met the inclusion criteria for efficacy (N=8) 39,40,45,[47][48][49]51,54 and safety (N=10) 39,40,45,[47][48][49][51][52][53][54] of ENDS in smoking cessation. Two trials reported safety data only 52,53 . ...
... Risk of bias was assessed using the Cochrane Risk of Bias (Version 2) tool for trials 28 . Of the ten RCTs, nine were rated high risk of bias 39,40,[47][48][49][51][52][53][54] and one was rated as having some concerns 45 . ...
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Introduction: This systematic review of randomized controlled trials (RCTs) evaluated the efficacy and safety of electronic cigarettes (e-cigarettes, ENDS) in helping people who smoke to achieve abstinence compared with electronic non-nicotine delivery systems (ENNDS, no nicotine) or any smoking cessation comparator treatment or combination of treatments at 24-26 weeks and at 52 weeks. Methods: Systematic review techniques involved searches of three databases in February 2020 with update searches run on 14 May 2021, two-person independent screening, two-person independent assessment of bias, formal extraction of data with verification by a second person, a feasibility assessment to decide if meta-analysis was appropriate, and network meta-analysis (NMA) of data at 24-26 weeks. Data at 52 weeks were narratively summarized. Results: Ten RCTs met the inclusion criteria, eight for efficacy and ten for safety. Eight of the nine RCTs were assessed as at high risk of bias. The sample sizes of the RCTs were 30-2012. Using nicotine replacement therapy (NRT) as the reference treatment, the incidences of smoking cessation at 24-26 weeks were comparable between ENDS and NRT groups (RR=1.17; 95% CrI: 0.66-1.86). Three sensitivity analyses were carried out indicating the main findings for 24-26 weeks were robust to assumptions. The findings at 52 weeks were inconclusive. Conclusions: This systematic review and NMA indicates that there is no clear evidence of a difference in effect between nicotine containing e-cigarettes and NRT on incidences of smoking cessation at 24-26 weeks, and substantial uncertainty remains.
... ab 18 Jahre, 18-70 Jahre). Leider ging in die Metaanalyse nur eine Studie mit Schwerpunkt auf Ältere ab 55 Jahren ein, die zum einen Personen mit kardiovaskulären oder respiratorischen Vorerkrankungen oder mit regulärer Medikamenteneinnahme ausschloss und die zum anderen nur geringen bis keinen Nutzen der nikotinhaltigen E-Zigarette im Vergleich zur nikotinfreien E-Zigarette plus Beratung aufwies (Lucchiari et al., 2016;Lucchiari et al., 2020;Masiero et al., 2019;Masiero et al., 2020;NCT02422914, 2015). Eine kürzlich erschienene Metaanalyse von Wang und Kollegen (2021) fand Belege für einen zusätzlichen Nutzen von E-Zigaretten in der Rauchentwöhnung, wenn diese kostenlos angeboten und in den jeweiligen Versuchsgruppen zusätzliche Informationen zur Tabakentwöhnung (Halpern et al., 2018) oder zur Unterstützung von Verhaltensänderungen (Hajek et al., 2019;Lucchiari et al., 2020;Walker et al., 2020;Wang/Bhadriraju/Glantz, 2021) angeboten wurden. ...
... Leider ging in die Metaanalyse nur eine Studie mit Schwerpunkt auf Ältere ab 55 Jahren ein, die zum einen Personen mit kardiovaskulären oder respiratorischen Vorerkrankungen oder mit regulärer Medikamenteneinnahme ausschloss und die zum anderen nur geringen bis keinen Nutzen der nikotinhaltigen E-Zigarette im Vergleich zur nikotinfreien E-Zigarette plus Beratung aufwies (Lucchiari et al., 2016;Lucchiari et al., 2020;Masiero et al., 2019;Masiero et al., 2020;NCT02422914, 2015). Eine kürzlich erschienene Metaanalyse von Wang und Kollegen (2021) fand Belege für einen zusätzlichen Nutzen von E-Zigaretten in der Rauchentwöhnung, wenn diese kostenlos angeboten und in den jeweiligen Versuchsgruppen zusätzliche Informationen zur Tabakentwöhnung (Halpern et al., 2018) oder zur Unterstützung von Verhaltensänderungen (Hajek et al., 2019;Lucchiari et al., 2020;Walker et al., 2020;Wang/Bhadriraju/Glantz, 2021) angeboten wurden. Auch diese Metaanalyse fokussierte sich auf Studien mit Studienteilnehmer*innen ab 18 Jahre und älter und inkludierte lediglich zwei Studien mit einem spezifischen Fokus auf Ältere (45-80 Jahre (Bowler et al., 2017), ab 55 Jahre ). ...
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DO SENIORS’ VAPE OR SMOKE? COMPARISON OF SMOKING AND VAPING IN THE OLDER POPULATION IN 26 EUROPEAN COUNTRIES AND ISRAEL. DATA FROM THE SHARE SURVEY 2019/ 2020 (WAVE 8) Significance. Currently, only moderately informative data on the use of e-cigarettes and tobacco products are available for Europe’s oldest population. The present study describes the distribution of e-cigarette and tobacco product use in the elderly population in 26 European countries and Israel. Methods. Wave 8 (release 1.0.0) of the SHARE Survey on Health, Aging and Retirement in Europe served as data basis. A total of n = 46,077 persons aged 50 years and older (42.6 percent male, 57.4 percent female) were interviewed about their smoking behavior. The mean age was 71.3 years (minimum = 50 years, maximum = 104 years). For the extrapolation to the population, we used calibrated cross-sectional weights. Results. Overall, the sample’s prevalence for e-cigarette use was 0.45 percent (extrapolated to 811,000 persons aged 50 and above in the 26 European countries and Israel). The proportion of e-cigarette users was found to decline with age. Among those aged 50 to 69, 0.64 percent (extrapolated to 725,000) used e-cigarettes; among those aged 70 to 79, 0.16 percent (extrapolated to 62,000) used e-cigarettes; and among those aged 80 and older, 0.1 percent (extrapolated to 23,000) used e-cigarettes. The overall prevalence for the use of tobacco products was 43.9 percent in the sample (extrapolated to 80 million). Tobacco product use also declined as age increased. For example, among those aged 50 to 69, 49.1 percent (extrapolated to 55 million) used tobacco products; among those aged 70 to 79, 41.3 percent (extrapolated to 17 million) used tobacco products; and among those aged 80 and older, 27.7 percent (extrapolated to 8 million) used tobacco products. Conclusion. As of late 2020, e-cigarette use is far from a mass phenomenon among older persons. However, it could become significant if it were suitable for the cessation of the more widespread tobacco smoking.
... Nevertheless, among LCS patients not interested in smoking cessation, a tobacco harm reduction option may be both appealing and beneficial. Lucchiari and colleages recently conducted a randomized controlled trial of e-cigarettes in LCS patients (N = 210) (Lucchiari et al., 2020). All participants received smoking cessation counseling and were randomized to receive (1) a nicotine e-cigarette, (2) a nicotine-free e-cigarette, or (3) no e-cigarette. ...
... Importantly, not all LCS patients are interested in smoking cessation (Joseph et al., 2018). Yet, only one study has examined alternate tobacco products for this population (Lucchiari et al., 2020). ...
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Given accumulating evidence that electronic nicotine delivery systems (ENDS) may be a harm-reduction alternative to combustible tobacco products, it is important to understand the real-world implications of these devices in the populations that may benefit from them the most. We surveyed the use, perceptions of, and interest in using ENDS among patients attending their initial low-dose CT scan (LDCT) for lung cancer screening (LCS) who reported current smoking, a cohort older individuals at high-risk for lung cancer and other smoking-related illnesses due to their heavy smoking history (30 or more pack years). Participants (N=107) completed the survey in clinic immediately before their shared decision-making visit for lung cancer screening on the day of their LDCT. Approximately a quarter of participants reported ever use of ENDS in the past; nearly a third expressed a willingness to try switching to them in the future. Prior ENDS use was significantly associated with willingness to try switching to ENDS in the future. The most common reasons to consider switching included smoking cessation and harm reduction. Only about a third were aware that ENDS are not approved by the FDA for smoking cessation; knowledge significantly varied by demographic and clinical characteristics. These findings have important implications for ENDS public health campaigns and tobacco harm reduction strategies for older individuals who smoke.
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Das vorliegende Kapitel bietet die Behandlungsempfehlungen der Tabakleitlinie mit ihren Hintergrundtexten. Es ist untergliedert in die Abschnitte Motivationsbehandlung und Kurzinterventionen, Harm Reduction, Psychotherapeutische Interventionen, Arzneimittel zur Entzugsbehandlung und Rückfallprophylaxe, Somatische Therapieverfahren, Gender- und Altersaspekte, Somatische Komorbidität, Psychische Komorbidität sowie Setting, Versorgungsorganisation und Aspekte der Finanzierung.
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Introduction: Smoking cessation integration within lung cancer screening programs is challenging. Currently, phone counselling is available across Canada for individuals referred by healthcare workers and by self-referral. We compared quit rates after phone counselling interventions between participants who self-refer, those referred by healthcare workers, and those referred by a lung cancer screening program. Methods: This is a retrospective cohort study of participants referred to provincial smoking cessation quit line in contemporaneous cohorts: self-referred participants, healthcare worker referred, and those referred by a lung cancer screening program if they were still actively smoking at the time of first contact. Baseline, covariates (sociodemographic information, smoking history, and history of mental health disorder) and quit intentions (stage of change, readiness for change, previous use of quit programs, and previous quit attempts) were compared among the three cohorts. Our primary outcome was defined as self-reported 30-day abstinence rates at 6 months. Multivariable logistic regression was used to identify whether group assignment was associated with higher quit rates. Results: Participants referred by a lung cancer screening program had low quit rates (12%, 95% CI: 5-19) at six months despite the use of phone counselling. Compared to patients who were self-referred to the smoking cessation phone helpline, individuals referred by a lung cancer screening program were much less likely to quit (adjusted OR 0.37; 95% CI: 0.17-0.8), whereas those referred by healthcare workers were twice as likely to quit (adjusted OR 2.16 (1.3-3.58)) even after adjustment for differences in smoking intensity and quit intentions. Conclusions: Phone counselling alone has very limited benefit in a lung cancer screening program. Participants differ significantly from those who are otherwise referred by healthcare workers. This study underlines the importance of a dedicated and personalized tobacco treatment program within every lung cancer screening program. The program should incorporate best practices and encourage treatment regardless of readiness to quit.
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E-cigarettes and its use in smoking cessation and as harm reduction
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 providers and regulators want to know if ECs can help people quit and if they are safe to use for this purpose. This is an update conducted as part of a living systematic review. Objectives: To examine the effectiveness, tolerability, and safety of using electronic cigarettes (ECs) to help people who smoke tobacco achieve long-term smoking abstinence. Search methods: We searched the Cochrane Tobacco Addiction Group's Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and PsycINFO to 1 May 2021, and reference-checked and contacted study authors. We screened abstracts from the Society for Research on Nicotine and Tobacco (SRNT) 2021 Annual Meeting. SELECTION CRITERIA: We included randomized controlled trials (RCTs) and randomized cross-over trials, in which people who smoke were randomized to an EC or control condition. We also included uncontrolled intervention studies in which all participants received an EC intervention. Studies had to report abstinence from cigarettes at six months or longer or data on safety markers at one week or longer, or both. Data collection and analysis: We followed standard Cochrane methods for screening and data extraction. Our primary outcome measures were abstinence from smoking after at least six months follow-up, adverse events (AEs), and serious adverse events (SAEs). Secondary outcomes included the proportion of people still using study product (EC or pharmacotherapy) at six or more months after randomization or starting EC use, changes in carbon monoxide (CO), blood pressure (BP), heart rate, arterial oxygen saturation, lung function, and levels of carcinogens or toxicants or both. We used a fixed-effect Mantel-Haenszel model to calculate risk ratios (RRs) with a 95% confidence interval (CI) for dichotomous outcomes. For continuous outcomes, we calculated mean differences. Where appropriate, we pooled data in meta-analyses. Main results: We included 61 completed studies, representing 16,759 participants, of which 34 were RCTs. Five of the 61 included studies were new to this review update. Of the included studies, we rated seven (all contributing to our main comparisons) at low risk of bias overall, 42 at high risk overall (including all non-randomized studies), and the remainder at unclear risk. There was moderate-certainty evidence, limited by imprecision, that quit rates were higher in people randomized to nicotine EC than in those randomized to nicotine replacement therapy (NRT) (risk ratio (RR) 1.53, 95% confidence interval (CI) 1.21 to 1.93; I2 = 0%; 4 studies, 1924 participants). In absolute terms, this might translate to an additional three quitters per 100 (95% CI 1 to 6). There was low-certainty evidence (limited by very serious imprecision) that the rate of occurrence of AEs was similar (RR 0.98, 95% CI 0.80 to 1.19; I2 = 0%; 2 studies, 485 participants). SAEs were rare, but there was insufficient evidence to determine whether rates differed between groups due to very serious imprecision (RR 1.30, 95% CI 0.89 to 1.90: I2 = 0; 4 studies, 1424 participants). There was moderate-certainty evidence, again limited by imprecision, that quit rates were higher in people randomized to nicotine EC than to non-nicotine EC (RR 1.94, 95% CI 1.21 to 3.13; I2 = 0%; 5 studies, 1447 participants). In absolute terms, this might lead to an additional seven quitters per 100 (95% CI 2 to 16). There was moderate-certainty evidence of no difference in the rate of AEs between these groups (RR 1.01, 95% CI 0.91 to 1.11; I2 = 0%; 3 studies, 601 participants). There was insufficient evidence to determine whether rates of SAEs differed between groups, due to very serious imprecision (RR 1.06, 95% CI 0.47 to 2.38; I2 = 0; 5 studies, 792 participants). Compared to behavioural support only/no support, quit rates were higher for participants randomized to nicotine EC (RR 2.61, 95% CI 1.44 to 4.74; I2 = 0%; 6 studies, 2886 participants). In absolute terms this represents an additional six quitters per 100 (95% CI 2 to 15). However, this finding was of very low certainty, due to issues with imprecision and risk of bias. There was some evidence that non-serious AEs were more common in people randomized to nicotine EC (RR 1.22, 95% CI 1.12 to 1.32; I2 = 41%, low certainty; 4 studies, 765 participants), and again, insufficient evidence to determine whether rates of SAEs differed between groups (RR 1.51, 95% CI 0.70 to 3.24; I2 = 0%; 7 studies, 1303 participants). Data from non-randomized studies were consistent with RCT data. The most commonly reported AEs were throat/mouth irritation, headache, cough, and nausea, which tended to dissipate with continued use. Very few studies reported data on other outcomes or comparisons, hence evidence for these is limited, with CIs often encompassing clinically significant harm and benefit. Authors' conclusions: There is moderate-certainty evidence that ECs with nicotine increase quit rates compared to NRT and compared to ECs without nicotine. Evidence comparing nicotine EC with usual care/no treatment also suggests benefit, but is less certain. More studies are needed to confirm the effect size. Confidence intervals were for the most part wide for data on AEs, SAEs and other safety markers, with no difference in AEs between nicotine and non-nicotine ECs. Overall incidence of SAEs was low across all study arms. We did not detect evidence of harm from nicotine EC, but longest follow-up was two years and the number of studies was small. The main limitation of the evidence base remains imprecision due to the small number of RCTs, often with low event rates, but further RCTs are underway. To ensure the review continues to provide up-to-date information to decision-makers, this review is now a living systematic review. We run searches monthly, with the review updated when relevant new evidence becomes available. Please refer to the Cochrane Database of Systematic Reviews for the review's current status.
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Although e-cigarettes have not been FDA approved as a smoking cessation device, questions arise about their public health impact. Do e-cigarettes provide a public health benefit as an aid to promote smoking cessation and reduction with adult smokers? Or, do these products create a public health harm by attracting new users, who might then transition to combustible cigarettes? Or, both? Over 90 studies examining the impacts of e-cigarettes on smoking cessation or reduction have produced disparate findings regarding this first question. At least 16 reviews have attempted to synthesize these studies and have also reached disparate conclusions. The lack of randomized controlled trials and the evolving landscape of e-cigarette products reduce the generalizability of studies and hamper a strong consensus concerning the impact of e-cigarettes on smoking cessation, although several reviews agree that e-cigarettes can have at least a modest impact on smoking reduction. However, any potential harm-reduction benefit of e-cigarettes to adult cigarette smokers is offset by sharp increases in e-cigarette use among adolescents and by the consistent prospective research demonstrating that nonsmoking adolescents and young adults who initiate e-cigarette use are at increased risk of transitioning to combustible cigarette use.
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Several previous studies have investigated the association between smoking, attachment style and personality, but they were either focused on personality or on attachment style and considered these variables separately. Starting from such findings, the study aims to investigate both factors, as they might not be independent, in order to clarify their role in the onset of smoking behavior in adolescence. This study was conducted on a convenience sample of 338 adolescents [male: 55% (186) – female: 45% (152)] (aged 16.63 ± 1.63). All participants completed a set of standardized questionnaires that assessed attachment style, personality and smoking behavior (starting age, daily cigarettes, nicotine dependence). Results showed that the dismissing attachment style, novelty seeking, and older age were associated with a higher likelihood of having a cigarette smoking experience; while self-directedness and gender (being female) were associated with a lower likelihood of having a cigarette smoking experience (p < .001). The secure and avoidant attachment styles were associated with a late smoking onset, whereas dismissing attachment and reward dependence were associated with an earlier smoking onset (p < .009). These findings highlight the possibility of developing a psycho-cognitive profile of adolescent smokers, and help to describe a smoking trajectory that may aid in designing tailored interventions and treatments to discourage smoking.
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Scholars underline the pivotal role of tobacco cigarette smoking in carcinogenesis process for blood tumors. A controversial debate is represented by the diffusion of tobacco use in young cancer survivors that had a previous diagnosis of blood tumor during the childhood. Compared with their peers, scientific evidence highlights that pediatric survivors have more difficult to give-up cigarette smoking. Furthermore, tobacco-smoking is frequently linked with others risk behaviors as drinking or substance abuse. In reviewing the main knowledge on this topic, authors affirm the need for increasing research on blood cancer survivors in order to depict psychological characteristics of pediatric blood cancer survivors. Improving health decision-making skills in young survivors could reduce the risk to adopt un-healthy behaviors and increase psychological wellbeing. Furthermore, authors propose tailored antismoking interventions based on the knowledge of the psychological and cognitive factors that support smoking during the transition toward emerging-adulthood.
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Background: Smoking is a global public health problem. For this reason, experts have called smoking dependence a global epidemic. Over the past 5 years, sales of electronic cigarettes, or e-cigarettes, have been growing strongly in many countries. Yet there is only partial evidence that e-cigarettes are beneficial for smoking cessation. In particular, although it has been proven that nicotine replacement devices may help individuals stop smoking and tolerate withdrawal symptoms, e-cigarettes' power to increase the quitting success rate is still limited, ranging from 5% to 20% dependent on smokers' baseline conditions as shown by a recent Cochrane review. Consequently, it is urgent to know if e-cigarettes may have a higher success rate than other nicotine replacement methods and under what conditions. Furthermore, the effects of the therapeutic setting and the relationship between individual characteristics and the success rate have not been tested. This protocol is particularly innovative, because it aims to test the effectiveness of electronic devices in a screening program (the COSMOS II lung cancer prevention program at the European Institute of Oncology), where tobacco reduction is needed to lower individuals' lung cancer risks. Objective: This protocol was designed with the primary aim of investigating the role of tobacco-free cigarettes in helping smokers improve lung health and either quit smoking or reduce their tobacco consumption. In particular, we aim to investigate the impact of a 3-month e-cigarettes program to reduce smoking-related respiratory symptoms (eg, dry cough, shortness of breath, mouth irritation, and phlegm) through reduced consumption of tobacco cigarettes. Furthermore, we evaluate the behavioral and psychological (eg, well-being, mood, and quality of life) effects of the treatment. Methods: This is a prospective, randomized, placebo-controlled, double-blind, three-parallel group study. The study is organized as a nested randomized controlled study with 3 branches: a nicotine e-cigarettes group, a nicotine-free e-cigarettes group, and a control group. The study is nested in a screening program for early lung cancer detection in heavy smokers. Results: The study is open and is still recruiting. Conclusions: Stopping or reducing tobacco consumption should be a main goal of any health organization. However, traditional antismoking programs are expensive and not always effective. Therefore, favoring a partial or complete shift to e-cigarettes in heavy smokers (eg, persons at high risk for a number of diseases) could be considered a moral imperative. However, before following this path, sound and reliable data on large samples and in a variety of contexts are required. Trial registration: Clinicaltrials.gov NCT02422914; https://clinicaltrials.gov/ct2/show/NCT02422914 (Archived by WebCite at http://www.webcitation.org/6etwz1bPL).
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Electronic cigarettes (e-cigarettes) deliver an inhaled aerosol to the user that typically contains nicotine, flavorings, and other additives.¹ e-Cigarettes come in many shapes and sizes but generally contain a battery, a heating element, and an e-liquid reservoir.
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"Teachable moments" have been proposed as events or circumstances which can lead individuals to positive behavior change. However, the essential elements of teachable moments have not been elucidated. Therefore, we undertook a comprehensive review of the literature to uncover common definitions and key elements of this phenomenon. Using databases spanning social science and medical disciplines, all records containing the search term "teachable moment*" were collected. Identified literature was then systematically reviewed and patterns were derived. Across disciplines, 'teachable moment' has been poorly developed both conceptually and operationally. Usage of the term falls into three categories: (1) "teachable moment" is synonymous with "opportunity" (81%); (2) a context that leads to a higher than expected behavior change is retrospectively labeled a 'teachable moment' (17%); (3) a phenomenon that involves a cueing event that prompts specific cognitive and emotional responses (2%). The findings suggest that the teachable moment is not necessarily unpredictable or simply a convergence of situational factors that prompt behavior change but suggest the possible creation of a teachable moment through clinician-patient interaction. Clinician-patient interaction may be central to the creation of teachable moments for health behavior change.
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A self-assessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. It is suggested that the introduction of the scales into general hospital practice would facilitate the large task of detection and management of emotional disorder in patients under investigation and treatment in medical and surgical departments.
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A longitudinal randomized trial tested the self-determination theory (SDT) intervention and process model of health behavior change for tobacco cessation (N = 1006). Adult smokers were recruited for a study of smokers' health and were assigned to intensive treatment or community care. Participants were relatively poor and undereducated. Intervention patients perceived greater autonomy support and reported greater autonomous and competence motivations than did control patients. They also reported greater medication use and significantly greater abstinence. Structural equation modeling analyses confirmed the SDT process model in which perceived autonomy support led to increases in autonomous and competence motivations, which in turn led to greater cessation. The causal role of autonomy support in the internalization of autonomous motivation, perceived competence, and smoking cessation was supported.
Helping patients to reduce tobacco 414 consumption in oncology: a narrative review
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  • A Botturi
  • G Pravettoni
Lucchiari, C., Masiero, M., Botturi, A., & Pravettoni, G. (2016). Helping patients to reduce tobacco 414 consumption in oncology: a narrative review. SpringerPlus. https://doi.org/10.1186/s40064-415 016-2798-9
La disassuefazione dal fumo: L'ambulatorio
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