Displaying publications 61 - 80 of 167 in total

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  1. TPPA and tobacco control: threats to APEC countries
    Sy DK, Stumberg RK
    Tob Control, 2014 Nov;23(6):466-70.
    PMID: 25170023 DOI: 10.1136/tobaccocontrol-2014-051900
    Twelve-member countries of the Asia Pacific Economic Cooperation (APEC) are negotiating the Trans-Pacific Partnership Agreement (TPPA), a free trade agreement to facilitate international trade and investment. As reported by multiple sources, the TPPA would grant the same trade benefits and legal protections to tobacco products, services and investments that it would provide to other sectors. Malaysia proposed excluding tobacco control measures from the scope of all TPPA chapters while the US proposed only to establish a consultation process in tobacco-related disputes and to declare that tobacco control measures serve a health objective within the scope of the general exceptions.
    Matched MeSH terms: Smoking Cessation/legislation & jurisprudence*
  2. Effectiveness of a brief physician counselling session on improving smoking behaviour in the workplace
    Han YW, Mohammad M, Liew SM
    Asian Pac J Cancer Prev, 2014;15(17):7287-90.
    PMID: 25227830
    BACKGROUND: Brief physician counselling has been shown to be effective in improving smokers' behaviour. If the counselling sessions can be given at the workplace, this would benefit a larger number of smokers. This study aimed to determine the effectiveness of a ten-minute physician counseling session at the workplace in improving smoking behaviour.

    MATERIALS AND METHODS: This prospective randomised control trial was conducted on smokers in a factory. A total of 163 participants were recruited and randomised into control and intervention groups using a table of random numbers. The intervention group received a ten-minute brief physician counselling session to quit smoking. Stages of smoking behaviour were measured in both groups using a translated and validated questionnaire at baseline, one month and three months post intervention.

    RESULTS: There was a significant improvement in smoking behaviour at one-month post intervention (p=0.024, intention to treat analysis; OR=2.525; CI=1.109-5.747). This was not significant at three-month post intervention (p=0.946, intention to treat analysis; OR=1.026; 95% CI=0.486-2.168).

    CONCLUSIONS: A session of brief physician counselling was effective in improving smokers' behaviour at workplace, but the effect was not sustained.

    Matched MeSH terms: Smoking Cessation/methods*
  3. Fulltext Impact of additional counselling sessions through phone calls on smoking cessation outcomes among smokers in Penang State, Malaysia
    Blebil AQ, Sulaiman SA, Hassali MA, Dujaili JA, Zin AM
    BMC Public Health, 2014;14:460.
    PMID: 24886549 DOI: 10.1186/1471-2458-14-460
    Studies all over the world reported that smoking relapses occur during the first two weeks after a quit date. The current study aimed to assess the impact of the additional phone calls counselling during the first month on the abstinence rate at 3 and 6 months after quit date among smokers in Penang, Malaysia.
    Matched MeSH terms: Smoking Cessation/methods*
  4. Predictors of sustained six months quitting success: efforts of smoking cessation in low intensity smoke-free workplaces
    Yasin SM, Retneswari M, Moy FM, Taib KM, Ismail N
    Ann Acad Med Singap, 2013 Aug;42(8):401-7.
    PMID: 24045376
    INTRODUCTION: This study aims to identify the predictors of a 6-month quitting success among employees involved in workplace smoking cessation with low-intensity smoke-free policy.

    MATERIALS AND METHODS: A multicentre prospective cohort study was conducted among employees from 2 different public universities in Malaysia. Interventions include at least 2 sessions of behavioural therapy combined with free nicotine replacement therapy (NRT) for 8 weeks. Participants were followed up for 6 months. Independent variables assessed were on sociodemographic and environmental tobacco smoke. Their quit status were determined at 1 week, 3 months and 6 months.

    RESULTS: One hundred and eighty- five smokers volunteered to participate. Among the participants, 15% and 13% sustained quit at 3 months and 6 months respectively. Multivariate analysis revealed that at 6 months, attending all 3 behavioural sessions predicted success. None of the environmental tobacco exposure variables were predictive of sustained cessation.

    CONCLUSION: Individual predictors of success in intra-workplace smoking cessation programmes do not differ from the conventional clinic-based smoking cessation. Furthermore, environmental tobacco exposure in low intensity smoke-free workplaces has limited influence on smokers who succeeded in maintaining 6 months quitting.

    Matched MeSH terms: Smoking Cessation*
  5. Fulltext Secular versus religious norms against smoking: which is more important as a driver of quitting behaviour among Muslim Malaysian and Buddhist Thai smokers?
    Yong HH, Savvas S, Borland R, Thrasher J, Sirirassamee B, Omar M
    Int J Behav Med, 2013 Jun;20(2):252-8.
    PMID: 22302214
    BACKGROUND: This paper prospectively examined two kinds of social normative beliefs about smoking, secular versus religious norms.
    PURPOSE: The purpose of this paper is to determine the relative importance of these beliefs in influencing quitting behaviour among Muslim Malaysian and Buddhist Thai smokers.
    METHODS: Data come from 2,166 Muslim Malaysian and 2,463 Buddhist Thai adult smokers who participated in the first three waves of the International Tobacco Control Southeast Asia project. Respondents were followed up about 18 months later with replenishment. Respondents were asked at baseline about whether their society disapproved of smoking and whether their religion discouraged smoking, and those recontacted at follow-up were asked about their quitting activity.
    RESULTS: Majority of both religious groups perceived that their religion discouraged smoking (78% Muslim Malaysians and 86% Buddhist Thais) but considerably more Buddhist Thais than Muslim Malaysians perceived that their society disapproved of smoking (80% versus 25%). Among Muslim Malaysians, religious, but not societal, norms had an independent effect on quit attempts. By contrast, among the Buddhist Thais, while both normative beliefs had an independent positive effect on quit attempts, the effect was greater for societal norms. The two kinds of normative beliefs, however, were unrelated to quit success among those who tried.
    CONCLUSIONS: The findings suggest that religious norms about smoking may play a greater role than secular norms in driving behaviour change in an environment, like Malaysia where tobacco control has been relatively weak until more recently, but, in the context of a strong tobacco control environment like Thailand, secular norms about smoking become the dominant force.
    Matched MeSH terms: Smoking Cessation/psychology*
  6. Fulltext Can initial perceptions about quitting predict smoking cessation among Malaysian smokers?
    Yasin SM, Masilamani R, Ming MF, Koh D, Zaki RA
    Southeast Asian J. Trop. Med. Public Health, 2012 Mar;43(2):501-9.
    PMID: 23082600
    Perceived risks and benefits of quitting smoking may be important factors in successful treatment. This study examined the association between initial perceived risks and benefits of quitting smoking and outcomes during a two month smoking cessation attempt. Participants (n = 185) were treatment-seeking smokers attending two smoking cessation clinics in Klang Valley, Malaysia. They received structured behavioral therapy and free Nicotine Replacement Therapy (NRT). Prior to treatment, a 12 item Perceived Risks and Benefits Questionnaire (PRBQ) was administered. This was used to assess the smoker's initial perceptions during their quit attempt. Participants were re-contacted at the end of two months to determine their smoking status. The results show participants intending to quit demonstrated a greater understanding of the benefits of quitting smoking than the risks of quitting. Those with a higher education level had a greater understanding of the benefits of quitting (p = 0.02). PRBQ items, such as perceived risks of quitting (ie weight gain, negative affect, social ostracism, loss of enjoyment and craving) were not associated with abstinence at two months. However, those who perceived a benefit of higher physical attraction post-cessation were less likely to have stopped smoking at two months (OR 0.18; 95% CI 0.08-0.45). Other perceived benefits at baseline, such as health, general well-being, self-esteem, finances and social approval, were not associated with smoking cessation at two months. The results suggest that in our study population, smokers' baseline perceptions of the benefits of cessation of smoking prior to therapy are not associated with quit results at two months. Counseling patients regarding the advantages and disadvantages of quitting may have changed their perceptions during quitting process and should be further explored in future studies.
    Study site: Smoking cessation clinics, University Malaya and Universiti Teknology Mara, Klang Valley, Malaysia
    Matched MeSH terms: Smoking Cessation/psychology*
  7. Factors associated with success or failure of quit attempts: a clinical approach for lung cancer prevention
    Su TT, Sallehuddin BA, Murniati HH, Swinder J, Al Sadat N, Saimy I
    Asian Pac J Cancer Prev, 2012;13(1):175-9.
    PMID: 22502663
    The objective of the study is to investigate the success rate of quit attempts and identify factors associated with success or failure of quit attempts in a quit smoking clinic. A cohort study was conducted with 495 smokers who enrolled in a quit smoking clinic from 2005 to 2008. The factors leading to quit smoking successfully were "being Malay", "having high blood pressure" "type of Nicotine Replacement Therapy" and "duration of follow up". In contrast, clerical staff had negative association to quit smoking. People who started smoking in their teenage years had a high risk of relapse. Integration of active follow up and tailor-made support programmes for quitters appear necessary in order to maintain their non-smoking status and encourage them to be permanent quitters. Integration of quit smoking clinics and primary care clinics could be another potential step for the success of quit smoking programmes.
    Matched MeSH terms: Smoking Cessation/methods*
  8. A qualitative exploration of the reasons for the discontinuation of smoking cessation treatment among Quit Smoking Clinics' defaulters and health care providers in Malaysia
    Lee ML, Hassali MA, Shafie AA
    Res Social Adm Pharm, 2013 Jul-Aug;9(4):405-18.
    PMID: 22835711 DOI: 10.1016/j.sapharm.2012.05.010
    BACKGROUND: Treatment default among the smokers hinders the effectiveness of the delivery of cessation services. While many studies have predicted the defaulters' characteristics, the reasons why these smokers dropped out and continued smoking are seldom explored.
    OBJECTIVES: This study examined the barriers encountered by such smokers and their respective health care providers (HCPs) in relation to the discontinuation of cessation treatment.
    METHODS: From May 2010 to March 2011, 15 current adult smokers and 9 HCPs from 2 Quit Smoking Clinics (QSCs) in the Melaka Tengah District, Malacca, Malaysia were interviewed on smoking, cessation, and the QSC. Interviews were audio recorded and transcribed verbatim. The transcripts were subsequently translated into English and analyzed using thematic analysis.
    RESULTS: The barriers encountered were categorized as Individual- and Clinic-level. Both smokers and HCPs acknowledged that the smokers' low intrinsic motivation was the individual-level barrier. The clinic-level barriers were the mismatched perceptions of smokers and HCPs regarding the HCPs' roles, skills, and attitudes, as well as the availability and efficacy of smoking cessation aids (SCAs). While the smokers viewed the program as not helpful, the HCPs cited the lack of organizational support as their main barrier.
    CONCLUSIONS: The reasons for treatment default centered on the overall dissatisfaction with the treatment (due to the program, HCP, and SCA factors) combined with the smokers' low intrinsic motivation. Optimizing the interplay of the extrinsic motivational cues, such as the HCP and SCA factors, would complement the smoker's low intrinsic motivation and thus encourage treatment retention. However, it is necessary to strike a balance between the individual smoker's needs and the availability of organizational support.
    KEYWORDS: Qualitative; Smoking cessation; Treatment discontinuation
    Study site: Quite smoking clinics, Klinik Kesihatan Ayer Keroh, Hospital Melaka, Melaka, Malaysia
    Matched MeSH terms: Smoking Cessation*
  9. Fulltext Reliability and construct validity of the Bahasa Malaysia version of transtheoretical model (TTM) questionnaire for smoking cessation and relapse among Malaysian adult
    Yasin SM, Taib KM, Zaki RA
    Asian Pac J Cancer Prev, 2011;12(6):1439-43.
    PMID: 22126478
    The transtheoretical model (TTM) has been used as one of the major constructs in developing effective cognitive behavioural interventions for smoking cessation and relapse prevention, in Western societies. This study aimed to examine the reliability and construct validity of the translated Bahasa Malaysia version of TTM questionnaire among adult smokers in Klang Valley, Malaysia. The sample consisted of 40 smokers from four different worksites in Klang Valley. A 26-item TTM questionnaire was administered, and a similar set one week later. The questionnaire consisted of three measures; decisional balance, temptations and impact of smoking. Construct validity was measured by factor analysis and the reliability by Cronbach' s alpha (internal consistency) and test-retest correlation. Results revealed that Cronbach' s alpha coefficients for the items were: decisional balance (0.84; 0.74) and temptations (0.89; 0.54; 0.85). The values for test retest correlation were all above 0.4. In addition, factor analysis suggested two meaningful common factors for decisional balance and three for temptations. This is consistent with the original construct of the TTM questionnaire. Overall results demonstrated that construct validity and reliability were acceptable for all items. In conclusion, the Bahasa Malaysia version of TTM questionnaire is a reliable and valid tool in ass.
    Matched MeSH terms: Smoking Cessation/methods*
  10. Health warning messages on tobacco products: a review
    Hammond D
    Tob Control, 2011 Sep;20(5):327-37.
    PMID: 21606180 DOI: 10.1136/tc.2010.037630
    OBJECTIVE: To review evidence on the impact of health warning messages on tobacco packages.
    DATA SOURCES: Articles were identified through electronic databases of published articles, as well as relevant 'grey' literature using the following keywords: health warning, health message, health communication, label and labelling in conjunction with at least one of the following terms: smoking, tobacco, cigarette, product, package and pack.
    STUDY SELECTION AND DATA EXTRACTION: Relevant articles available prior to January 2011 were screened for six methodological criteria. A total of 94 original original articles met inclusion criteria, including 72 quantitative studies, 16 qualitative studies, 5 studies with both qualitative and qualitative components, and 1 review paper: Canada (n=35), USA (n=29) Australia (n=16), UK (n=13), The Netherlands (n=3), France (n=3), New Zealand (n=3), Mexico (n=3), Brazil (n=2), Belgium (n=1), other European countries (n=10), Norway (n=1), Malaysia (n=1) and China (n=1).
    RESULTS: The evidence indicates that the impact of health warnings depends upon their size and
    DESIGN: whereas obscure text-only warnings appear to have little impact, prominent health warnings on the face of packages serve as a prominent source of health information for smokers and non-smokers, can increase health knowledge and perceptions of risk and can promote smoking cessation. The evidence also indicates that comprehensive warnings are effective among youth and may help to prevent smoking initiation. Pictorial health warnings that elicit strong emotional reactions are significantly more effective.
    CONCLUSIONS: Health warnings on packages are among the most direct and prominent means of communicating with smokers. Larger warnings with pictures are significantly more effective than smaller, text-only messages.
    Matched MeSH terms: Smoking Cessation/methods
  11. Fulltext Predictors of smoking cessation among staff in public Universities in Klang Valley, Malaysia
    Yasin SM, Masilamani R, Ming MF, Koh D
    Asian Pac J Cancer Prev, 2011;12(3):811-6.
    PMID: 21627389
    Smoking cessation studies are often performed in clinic based settings. The present example aimed to find predictors of success among staff in worksite smoking cessation programmes in two major public universities in Klang Valley, Malaysia. All staff from both universities received an open invitation via staff e-mail and letters to participate. At the start of treatment, participants were administered the Rhode Island Stress and Coping Questionnaire and Family Support Redding's Questionnaire. Behaviour therapy with free nicotine replacement therapy (NRT) were given as treatment. After two months, they were contacted to determine their smoking status. 185 staff from University A (n=138) and University B (n=47), responded and voluntarily showed interest to quit. There was no significant difference in respondents with respect to socio demographic characteristics and smoking history. After two months of treatment, quit rates were 24% in University A vs. 38 % in University B (p>0.05). Univariate predictors of cessation were adherence to NRT (p<0.001), smoking fewer cigarettes per day (p<0.05) and the number of behaviour therapy sessions attended (p<0.001). Logistic regression identified 3 significant predictors of smoking cessation. Participants attending more than one session (OR= 27.00; 95% CI : 6.50; 111.6), and having higher pre-treatment general stress (OR= 2.15; 95% CI: 1.14; 4.05) were more likely to quit, while a higher number of cigarettes smoked (OR= 0.19: 95% CI: 0.06; 0.59) reduced the likelihood of quitting. Increasing age, ability to cope with stress and family support were not significant predictors. We conclude that factors such as the number of counseling sessions, the amount of cigarettes smoked at baseline, adherence to NRT and pretreatment stress are important considerations for success in a worksite smoking cessation programme.
    Matched MeSH terms: Smoking Cessation*
  12. Fulltext Measurement of nicotine withdrawal symptoms: linguistic validation of the Wisconsin Smoking Withdrawal Scale (WSWS) in Malay
    Awaisu A, Samsudin S, Amir NA, Omar CG, Hashim MI, Mohamad MH, et al.
    BMC Med Res Methodol, 2010;10:46.
    PMID: 20492717 DOI: 10.1186/1471-2288-10-46
    The purpose of the linguistic validation of the Wisconsin Smoking Withdrawal Scale (WSWS) was to produce a translated version in Malay language which was "conceptually equivalent" to the original U.S. English version for use in clinical practice and research.
    Matched MeSH terms: Smoking Cessation/psychology*
  13. Fulltext The effects of smoking norms and attitudes on quitting intentions in Malaysia, Thailand and four Western nations: a cross-cultural comparison
    Hosking W, Borland R, Yong HH, Fong G, Zanna M, Laux F, et al.
    Psychol Health, 2009 Jan;24(1):95-107.
    PMID: 20186642 DOI: 10.1080/08870440802385854
    This research investigated the influence of smoking attitudes and norms on quitting intentions in two predominantly collectivistic countries (Malaysia and Thailand) and four predominantly individualistic Western countries (Canada, USA, UK and Australia). Data from the International Tobacco Control Project (N = 13,062) revealed that higher odds of intending to quit were associated with negative personal attitudes in Thailand and the Western countries, but not in Malaysia; with norms against smoking from significant others in Malaysia and the Western countries, but not in Thailand; and with societal norms against smoking in all countries. Our findings indicate that normative factors are important determinants of intentions, but they play a different role in different cultural and/or tobacco control contexts. Interventions may be more effective if they are designed with these different patterns of social influence in mind.
    Matched MeSH terms: Smoking Cessation*
  14. Socio-economic variations in tobacco consumption, intention to quit and self-efficacy to quit among male smokers in Thailand and Malaysia: results from the International Tobacco Control-South-East Asia (ITC-SEA) survey
    Siahpush M, Borland R, Yong HH, Kin F, Sirirassamee B
    Addiction, 2008 Mar;103(3):502-8.
    PMID: 18269370 DOI: 10.1111/j.1360-0443.2007.02113.x
    Aim To examine the association of socio-economic position (education, income and employment status) with cigarette consumption, intention to quit and self-efficacy to quit among male smokers in Thailand and Malaysia. Design and setting The data were based on a survey of adult smokers conducted in early 2005 in Thailand and Malaysia as part of the International Tobacco Control-South-East Asia (ITC-SEA) project. Participants A total of 1846 men in Thailand and 1906 men in Malaysia. Measurement Participants were asked questions on daily cigarette consumption, intention to quit and self-efficacy to quit in face-to-face interviews. Findings Analyses were based on multivariate regression models that adjusted for all three socio-economic indicators. In Thailand, higher level of education was associated strongly with not having self-efficacy, associated weakly with having an intention to quit and was not associated with cigarette consumption. Higher income was associated strongly with having self-efficacy, associated weakly with high cigarette consumption and was not associated with having an intention to quit. Being employed was associated strongly with having an intention to quit and was not associated with cigarette consumption or self-efficacy. In Malaysia, higher level of education was not associated with any of the outcomes. Higher income was associated strongly with having self-efficacy, and was not associated with the other outcomes. Being employed was associated moderately with higher cigarette consumption and was not associated with the other outcomes. Conclusion Socio-economic and cultural conditions, as well as tobacco control policies and tobacco industry activities, shape the determinants of smoking behaviour and beliefs. Existing knowledge from high-income countries about disparities in smoking should not be generalized readily to other countries.
    Matched MeSH terms: Smoking Cessation/psychology*
  15. Fulltext An assessment of the effectiveness of tobacco control measures on behavior changes related to tobacco use among adolescents and young adults in a district in Sri Lanka
    De Silva WD, Sinha DN, Kahandawaliyanag A
    Indian J Cancer, 2012 Oct-Dec;49(4):438-42.
    PMID: 23442410 DOI: 10.4103/0019-509X.107753
    Sri Lanka became a signatory to the WHO Frame Work Convention on Tobacco Control in September 2003, and this was ratified in November 2003. With a view to reduce the use of tobacco in Sri Lanka, the National Authority on Tobacco and Alcohol Act (NATA) No. 27 of 2006 was implemented.
    Matched MeSH terms: Smoking Cessation/psychology*
  16. Reasons for using electronic cigarettes and intentions to quit among electronic cigarette users in Malaysia
    Wong LP, Mohamad Shakir SM, Alias H, Aghamohammadi N, Hoe VC
    J Community Health, 2016 Dec;41(6):1101-1109.
    PMID: 27147418 DOI: 10.1007/s10900-016-0196-4
    The rapidly increasing uptake of e-cigarettes in Malaysia as of late demands a study to identify factors leading to its increased popularity and user intentions to quit smoking e-cigarettes. A convenience sample of e-cigarette smokers visiting e-cigarette retail shops in Selangor and Kuala Lumpur was recruited. The majority of e-cigarette smokers were youth in colleges or universities (39 %), and young professionals and managers (36 %). The main reasons for using e-cigarettes were to help the user quit tobacco cigarettes (88 %), the perception that e-cigarettes are not as intrusive as tobacco cigarettes (85 %) and can be used in public areas (70 %), the perception that e-cigarettes are healthier than tobacco cigarettes (85 %), and its relatively lower cost compared to tobacco cigarettes (65 %). A total of 65.3 % of respondents expressed intentions to quit e-cigarettes. In a multivariate analysis, the respondents who earned monthly income of RM1000 or less were significantly more likely to intend to quit smoking e-cigarettes [OR 1.551; 95 % CI 1.022-2.355; p = 0.015] compared to the respondents who earned a monthly income of more than RM2000. The respondents who disagreed with the statement 'Smoking e-cigs is relatively cheaper compared to tobacco cigarettes' were significantly more likely to intend to quit smoking e-cigarettes [OR 1.548; 95 % CI 1.045-2.293; p = 0.027] compared to respondents who did not agree. e-cigarette preventive interventions should target areas related to the identified main reasons for using e-cigarettes, namely as an aid for quitting tobacco cigarettes, the perception that e-cigarettes are not as intrusive as tobacco cigarettes and can be used in public areas, the idea that e-cigarettes are healthier than tobacco cigarettes, and its relatively lower cost compared to tobacco cigarettes.
    Matched MeSH terms: Smoking Cessation*
  17. Suitability of a Group Behavioural Therapy Module for Workplace Smoking Cessation Programs in Malaysia: a Pilot Study
    Maarof MF, Ali AM, Amit N, Bakry MM, Taha NA
    Asian Pac J Cancer Prev, 2016;17(1):207-14.
    PMID: 26838211
    In Malaysia, data on components suitability the established smoking cessation module is limited. This exploratory study aimed to evaluate the suitability of the components developed in the module for group behavioural therapy in workplace smoking cessation programs. Twenty staff were identified but only eight individuals were selected according to the study criteria during the recruitment period in May 2014. Focus group discussion was conducted to identify themes relevant to the behavioural issues among smokers. Thematic analysis yielded seven major themes which were reasons for regular smoking, reasons for quitting, comprehending smoking characteristics, quit attempt experiences, support and encouragement, learning new skills and behaviour, and preparing for lapse/relapse or difficult situations. As a result, the developed module was found to be relevant and suitable for use based on these themes.
    Matched MeSH terms: Smoking Cessation/methods*
  18. Fulltext Systematic review on international practices in controlling waterpipe tobacco smoking
    Tee GH, Hairi NN, Nordin F, Choo WY, Chan YY, Kaur G, et al.
    Asian Pac J Cancer Prev, 2015;16(9):3659-65.
    PMID: 25987018
    BACKGROUND: Waterpipe tobacco smoking has becoming popular especially among young people worldwide. Smokers are attracted by its sweeter, smoother smoke, social ambience and the misconception of reduced harm. The objective of this study was to systematically review the effects of waterpipe tobacco policies and practices in reducing its prevalence.

    MATERIALS AND METHODS: A systematic review was conducted electronically using the PubMed, OVID, Science Direct, Proquest and Embase databases. All possible studies from 1980 to 2013 were initially screened based on titles and abstracts. The selected articles were subjected to data extraction and quality rating.

    RESULTS: Three studies met the inclusion criteria and were eligible for this review. Almost all of the waterpipe tobacco products and its accessories did not comply with the regulations on health warning labelling practices as stipulated under Article 11 of WHO FCTC. In addition, the grisly new warning labels for cigarettes introduced by Food and Drug Administration did not affect hookah tobacco smoking generally. Indoor air quality in smoking lounges was found to be poor and some hookah lounges were operated without smoke shop certification.

    CONCLUSIONS: Our findings revealed the availability of minimal information on the practices in controlling waterpipe smoking in reducing its prevalence. The lack of comprehensive legislations or practices in controlling waterpipe smoking warrants further research and policy initiatives to curb this burgeoning global epidemic, especially among the vulnerable younger population.
    Matched MeSH terms: Smoking Cessation/methods*
  19. Smoking and All-cause Mortality in Older Adults: Results From the CHANCES Consortium
    Müezzinler A, Mons U, Gellert C, Schöttker B, Jansen E, Kee F, et al.
    Am J Prev Med, 2015 Nov;49(5):e53-e63.
    PMID: 26188685 DOI: 10.1016/j.amepre.2015.04.004
    INTRODUCTION: Smoking is known to be a major cause of death among middle-aged adults, but evidence on its impact and the benefits of smoking cessation among older adults has remained limited. Therefore, we aimed to estimate the influence of smoking and smoking cessation on all-cause mortality in people aged ≥60 years.

    METHODS: Relative mortality and mortality rate advancement periods (RAPs) were estimated by Cox proportional hazards models for the population-based prospective cohort studies from Europe and the U.S. (CHANCES [Consortium on Health and Ageing: Network of Cohorts in Europe and the U.S.]), and subsequently pooled by individual participant meta-analysis. Statistical analyses were performed from June 2013 to March 2014.

    RESULTS: A total of 489,056 participants aged ≥60 years at baseline from 22 population-based cohort studies were included. Overall, 99,298 deaths were recorded. Current smokers had 2-fold and former smokers had 1.3-fold increased mortality compared with never smokers. These increases in mortality translated to RAPs of 6.4 (95% CI=4.8, 7.9) and 2.4 (95% CI=1.5, 3.4) years, respectively. A clear positive dose-response relationship was observed between number of currently smoked cigarettes and mortality. For former smokers, excess mortality and RAPs decreased with time since cessation, with RAPs of 3.9 (95% CI=3.0, 4.7), 2.7 (95% CI=1.8, 3.6), and 0.7 (95% CI=0.2, 1.1) for those who had quit <10, 10 to 19, and ≥20 years ago, respectively.

    CONCLUSIONS: Smoking remains as a strong risk factor for premature mortality in older individuals and cessation remains beneficial even at advanced ages. Efforts to support smoking abstinence at all ages should be a public health priority.

    Matched MeSH terms: Smoking Cessation*
  20. Should the threshold for expired-air carbon monoxide concentration as a means of verifying self-reported smoking abstinence be reduced in clinical treatment programmes? Evidence from a Malaysian smokers' clinic
    Wee LH, West R, Mariapun J, Chan CM, Bulgiba A, Peramalah D, et al.
    Addict Behav, 2015 Aug;47:74-9.
    PMID: 25889913 DOI: 10.1016/j.addbeh.2015.03.021
    BACKGROUND: It has been proposed that the expired-air carbon monoxide (CO) threshold for confirming smoking abstinence in clinical practice be reduced below 10 ppm. Optimal thresholds may vary across regions. Data are needed to assess the impact of such a change on claimed success.
    METHODS: A total of 253 smokers who attended the Tanglin quit smoking clinic in Malaysia were followed-up 1, 3 and 6 months after the target quit date. All participants received a standard behavioural support programme and were prescribed either varenicline or nicotine replacement therapy. Expired-air CO was measured at every visit. Respondents' smoking status was assessed using a range of different CO thresholds (3, 5 and 10 ppm) and the impact on quit rates was calculated. Predictors of success as defined using the different thresholds were assessed.
    RESULTS: The 6-month abstinence rates were: 1 month - 54.9% at 10 ppm, 54.9% at 5 ppm and 48.6% at 3 ppm; 3 months - 36.0% at 10 ppm, 35.2% at 5 ppm and 30.4% at 3 ppm; 6 months - 24.1% at 10 ppm, 24.1% at 5 ppm and 20.6% at 3 ppm. Older smokers were more likely to be recorded as abstinent at 6 months regardless of the threshold used.
    CONCLUSIONS: Reducing the threshold for expired-air carbon monoxide concentrations to verify claimed smoking abstinence from 10 ppm to 5 ppm makes minimal difference to documented success rates in Malaysian smoker's clinic patients. Reducing to 3 ppm decreases success rates slightly. Predictors of success at stopping appear to be unaffected by the threshold used.
    KEYWORDS: Carbon monoxide; Predictors for abstinence; Smoking cessation; Success rates
    Matched MeSH terms: Smoking Cessation/statistics & numerical data*
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