Rising popularity of e-cigarettes linked to higher quit rate

Findings from US observational study suggest E-cigarettes appear to have helped to increase smoking cessation at the population level.| OnMedica |BMJ

Researchers have looked at whether the increase in the use of e-cigarettes in the US was associated with a change in overall smoking cessation rate.

They drew on responses to five population surveys from 2001 to 2015. E-cigarette users were identified from the most recent survey (2014-15) and smoking cessation rates were obtained from those who said they had smoked cigarettes in the preceding 12 months. Rates from this most recent survey were then compared to those of four earlier surveys.

Of 161,054 respondents to the 2014-15 survey, 22,548 were current smokers and 2,136 recent quitters. More than a third (38%) of current smokers and nearly half (49%) of recent quitters said they had tried e-cigarettes.

E-cigarette users were more likely than non-users to make a quit attempt (65% vs 40%) and more likely to succeed in quitting for at least three months (8.2% vs 4.8%).

The overall population quit rate for 2014-15 was significantly higher (5.6%) than that for 2010-11 (4.5%), and higher than those for all other survey years.

The 1.1 percentage point difference might appear small, but it represents approximately 350,000 additional US smokers who quit in 2014-15, emphasise the researchers.

Full story at OnMedica

Full reference: Shu-Hong Zhu et al.  E-cigarette use and associated changes in population smoking cessation: evidence from US current population surveys  BMJ 2017; 358 (Published 26 July 2017)

Related BMJ editorial: Rise in e-cigarette use linked to increase in smoking cessation rates

Tobacco control playbook

This resource highlights the arguments and approaches that leaders in health systems across Europe have developed and used to counteract and succeed against the tobacco industry. |WHO Europe

The Tobacco Control Playbook has been developed by collecting numerous evidence-based arguments from different thematic areas, reflecting the challenges that tobacco control leaders have faced while implementing various articles of the WHO FCTC and highlighting arguments they have developed in order to counter and succeed against the tobacco industry.

This is the start of what is intended to be a living document, which will be updated and extended with further arguments and on the basis of feedback, as well as any developments in tobacco industry approaches. Everyone concerned with tobacco control is invited to contribute to its success by continuing to offer arguments and responses, and sharing their experiences through a dedicated website.

Towards a smoke-free generation: tobacco control plan for England

Outlining plans to reduce smoking in England, with the aim of creating a smoke-free generation | Department of Health

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The objectives of the tobacco control plan are to:

  • reduce the number of 15 year olds who regularly smoke from 8% to 3% or less
  • reduce smoking among adults in England from 15.5% to 12% or less
  • reduce the inequality gap in smoking prevalence, between those in routine and manual occupations and the general population
  • reduce the prevalence of smoking in pregnancy from 10.5% to 6% or less

The aim is to achieve these objectives by the end of 2022.

Full report available here

Efficacy of mindfulness meditation for smoking cessation

This systematic review summarizes randomized controlled trials of mindfulness meditation for smoking cessation.

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Smokers increasingly seek alternative interventions to assist in cessation or reduction efforts. Mindfulness meditation, which facilitates detached observation and paying attention to the present moment with openness, curiosity, and acceptance, has recently been studied as a smoking cessation intervention.

MM did not differ significantly from comparator interventions in their effects on tobacco use. Low-quality evidence, variability in study design among the small number of existing studies, and publication bias suggest that additional, high-quality adequately powered RCTs should be conducted.

Full reference: Maglionea, M.A. et al. (2017) Efficacy of mindfulness meditation for smoking cessation: A systematic review and meta-analysis. Addictive Behaviors
69(June) pp. 27–34

Use of e-cigarettes among adults in Great Britain

 Findings from its annual Smokefree GB survey into the use of electronic cigarettes and vapourisers in Great Britain | Action on Smoking and Health

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The study, conducted by YouGov on behalf of ASH, shows an estimated 2.9 million adults in Great Britain currently use electronic cigarettes.

For the first time ever, the survey finds more ex-smokers (1.5 million) who use e-cigarettes than current smokers and the main reason people offered for their use of e-cigarettes was to stop smoking. While this is positive, there are still many people who “dual-use” combustible and electronic cigarettes which still exposes them to the toxic, cancer causing substances in tobacco smoke.

The summary of findings is available for download here

Tobacco packaging design for reducing tobacco use

The Cochrane Database of Systematic Reviews has published ‘Tobacco packaging design for reducing tobacco use’.

Tobacco use is the largest single preventable cause of death and disease worldwide. Standardised tobacco packaging is an intervention intended to reduce the promotional appeal of packs and can be defined as packaging with a uniform colour (and in some cases shape and size) with no logos or branding, apart from health warnings and other government-mandated information, and the brand name in a prescribed uniform font, colour and size. Australia was the first country to implement standardised tobacco packaging between October and December 2012, France implemented standardised tobacco packaging on 1 January 2017 and several other countries are implementing, or intending to implement, standardised tobacco packaging.

The objective of the study was to assess the effect of standardised tobacco packaging on tobacco use uptake, cessation and reduction.

The available evidence suggests that standardised packaging may reduce smoking prevalence. Only one country had implemented standardised packaging at the time of this review, so evidence comes from one large observational study that provides evidence for this effect. A reduction in smoking behaviour is supported by routinely collected data by the Australian government. Data on the effects of standardised packaging on non-behavioural outcomes (e.g. appeal) are clearer and provide plausible mechanisms of effect consistent with the observed decline in prevalence. As standardised packaging is implemented in different countries, research programmes should be initiated to capture long term effects on tobacco use prevalence, behaviour, and uptake. The researchers did not find any evidence suggesting standardised packaging may increase tobacco use.

Read the full text here

Personalised letters and a “taster session” help double attendance at NHS stop smoking services

Gilbert H, Sutton S, Morris R, et al. Start2quit: a randomised clinical controlled trial to evaluate the effectiveness and cost-effectiveness of using personal tailored risk information and taster sessions to increase the uptake of the Unstop Smoking Services. Health Technol Assess. 2017;21(3):1-206.

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Attendance at NHS stop smoking services (SSS) almost doubled after smokers were sent letters showing their personalised risk of serious illness if they continued to smoke alongside invitations to try the service.

Less than 5% of smokers attend these services in England and numbers are on the decline, although this is one of the most effective ways of stopping smoking.

A personalised risk letter was sent to 2,636 smokers alongside an invitation to a local taster session. 17.4% attended, compared to 9.0% of 1,748 smokers who received a standard letter advertising the service. The letter and invitation to a taster session also increased the number who had quit smoking by six months (9% vs. 5.6%).

This proactive recruitment looked likely to be cost effective over a person’s lifetime compared to the usual non-specific invitation.

Those recruited represented only a small proportion of smokers wishing to quit and who may be more motivated than most. There remains a need across all of society to increase accessibility to stop smoking services.