Introduction: A new nicotine film that releases nicotine quickly may lead to faster craving relief.

Aims: This study compares the efficacy of 2.5 mg nicotine film with 2 mg nicotine lozenge and 2 mg nicotine gum on relieving provoked craving in low dependence smokers.

Methods: A randomised, open-label, active comparators controlled study was conducted in 120 subjects. Subjects were abstinent from smoking for 4 hours prior to being provoked with smoking cues. After post-provocation craving assessment, subjects were administered one dose of the 3 treatments: nicotine film, lozenge, or gum. Craving intensity was then assessed at 50 seconds, 3, 5, 7, 15, 20, 25 and 30 minutes after administration.

Results/Findings: Three treatments reduced craving with similar maximum effects. The effect was maintained up to 30 minutes. Nicotine film significantly reduced more craving than lozenge at 50 seconds, 3 and 5 minutes. It also significantly reduced more craving than gum at 50 seconds and 3 minutes. There was no significant difference between lozenge and gum.

Conclusions: Nicotine film, lozenge and gum have similar maximum craving relief. Nicotine film significantly reduced more craving than lozenge and gum at early time points. Nicotine film may be particularly useful to provide acute craving relief.

Smoking prevalence of pregnant Aboriginal and Torres Strait Islander women is quadruple that of pregnant women in the Australian population, and is associated with significant adverse outcomes in pregnancy. While cessation is a priority, there is as yet little evidence for effective interventions. This paper provides a pragmatic approach to addressing the complexities of smoking in pregnant Aboriginal and Torres Strait Islander peoples and informs clinicians about the initiation of nicotine replacement therapy (NRT) in pregnancy. Experts agree that nicotine replacement is safer than continuing to smoke in pregnancy. Although a pharmacotherapy-free attempt is initially recommended, if abstinence is not able to be achieved in the first few days, the women should be offered an accelerated option of NRT starting with oral forms and then, if required, progressing to nicotine patch or combined oral and transdermal therapy. Support should be offered for at least 12 weeks and post-partum. Offering counselling and cessation support to partners and family is also important, as is linking the woman in with appropriate social and community support and Aboriginal specific services. As long as oral forms of NRT are not included in the Pharmaceutical Benefit Scheme for Aboriginal and Torres Strait Islander women a significant and inequitable barrier will remain.

Introduction: The use of applications (apps) on smartphones and tablet devices is a fast growing component of health behaviour change efforts, including smoking cessation. While the content and utility of iPhone apps for smoking cessation have been systematically reviewed, Android apps have not been examined.

Aims: This study reviewed and evaluated free Android apps for smoking cessation available for download from Google Play and Amazon's USA homepage in January 2013.

Methods: Apps were reviewed; those targeting smoking cessation were identified and examined to ensure that they targeted tobacco smoking and were focused on quitting. Remaining apps were independently rated by three reviewers for 24 clinical strategies for smoking cessation. Results: Overall, 284 free apps were identified using the search terms ‘quit smoking’, ‘smoking cessation’, and ‘stop smoking’; 113 apps that targeted smoking cessation were downloaded for further review. Of these, 21 targeted tobacco smoking and were focused on quitting. These apps had moderate to low ratings for the 24 strategies, indicating that they lacked several of the most helpful strategies for quitting smoking. The apps were strongest in helping users track the number of cigarettes smoked. None connected users to on-line sources of support, referred users to smoking cessation counselling, or recommended the use of nicotine replacement therapies.

Conclusions: While Android apps for smoking cessation have some strengths, they would benefit from incorporating a broader range of strategies for helping people quit smoking.

Introduction: Digital smoking cessation aids may benefit pregnant smokers who do not wish to receive face-to-face behavioural support. Healthcare providers (HCPs) who interact with pregnant smokers may have valuable insights into their development and use.

Aims: To explore HCPs’ views of using digital smoking cessation interventions with pregnant women in order to inform the design and delivery of digital smoking cessation interventions.

Methods: Two structured focus groups were conducted with HCPs (n = 16) who provided smoking cessation support for pregnant women in England. Discussions covered participants’ general views about digital smoking cessation interventions, the potential of such interventions for smoking cessation support for pregnant smokers, and recommendations for future intervention development. Transcripts were analysed thematically.

Results: HCPs identified a variety of ways in which digital interventions could benefit pregnant smokers, such as by providing anonymity, offering consistent quality of advice, and being available on demand. The identified limitations of digital smoking cessation interventions included lack of access among those most economically disadvantaged, the need for high levels of self-motivation, and lack of human contact. Addressing pregnant smokers’ negative perceptions of smoking cessation support, providing rewarding experiences, and tailoring the intervention to smokers’ level of confidence were among HCPs’ recommendations.

Conclusions: HCPs indicated that digital interventions offer a range of potential benefits that could make them useful for pregnant smokers. Nonetheless, important limitations and recommendations regarding their design and delivery were identified and these need to be addressed in intervention development.

Smoking prevalence amongst service users from the mental health and addictions sectors is higher than the general population. Cross-sectional web- or paper-based surveys comprising open and closed response options were used to examine changes in prevailing attitudes and practices amongst non-government mental health service staff and users. Thematic analysis was used to interpret and present open response answers. Multi-variate logistic models were used to investigate which factors are associated with smoke-free attitudes and practices. Staff who smoke were found to be less likely to provide cessation support to clients (AOR 0.51, 95% CI 0.31–0.82) and gave significantly lower estimates of the percentage of clients who wish to stop smoking (30% vs 44%, p < 0.0001). Those who had completed cessation training also had more positive views about the importance of providing cessation support and service user desire to stop smoking. Staff who had not completed cessation training had significantly lower odds of reporting they carried out quit smoking support often and routinely (AOR 0.33, 95% CI 0.23–0.47) The results suggest that continuing improvement will be enabled by increasing rates of cessation training amongst staff of mental health and addictions non-government organisations. In addition, there is a need for increased incentive and support for staff who smoke to quit.

Introduction: Single-session group smoking cessation interventions have received little attention in the literature.

Aims: This study aimed to test the feasibility and outcomes of a single-session large group smoking cessation intervention in a rural area of New South Wales.

Methods: Participants from a smoking cessation course (N = 42) were asked about cigarette consumption, quit attempts, and readiness and confidence to quit at registration and six months. The two-hour intervention occurred in a group setting and comprised of cognitive behaviour therapy and pharmacotherapy advice.

Results: The analysis revealed a 26.2% (N = 11) quit rate based on self-report and/or carbon monoxide validation at 6 months (intention to treat). Those who quit all used pharmacotherapy: eight (73%) Nicotine Replacement Therapy (NRT); two (18%) varenicline and one (9%) bupropion with NRT. Seven people (17%) used medicines to reduce consumption of cigarettes. A paired samples t test of those still smoking showed a statistically significant decrease in the numbers of cigarettes smoked per day (p<.001).

Conclusion: The quit rate of 26.2% from this large single-session smoking cessation course is comparable to that expected from groups having multiple sessions. As a pilot study, these data suggest that a multi-faceted single-session two-hour smoking cessation intervention can successfully support quit attempts in a rural location.

Background: It is assumed that smokers rarely quit without ‘attempting’ to do so but the assumption does not appear to have been adequately tested. This study assessed the prevalence of reporting having stopped without reporting a quit attempt and the reasons given for this discrepancy.

Methods: Data were collected from ex-smokers who said they had quit within the last 12 months during nationally representative household surveys conducted monthly between 2006–12.

Results: Of the 1,892 ex-smokers who said that they had quit within the last 12 months, 13.9% (95%CI = 12.4%–15.5%) reported having made no serious quit attempts in that period. In a sub-group of 24 smokers who were asked why they had reported stopping without also reporting an attempt, nine cited inconsistency over timing; three reported stopping without attempting to do so; four did not consider it an ‘attempt’ because they had succeeded; and six had not ruled out the occasional cigarette in the future.

Conclusions: A substantial minority of people who report having stopped in the past year may fail to report a corresponding quit attempt. However, quitting smoking without considering that one has tried appears to be rare. Instead, the most common reason for the discrepancy is inconsistent reporting of the timing of quit attempts.

Recent systematic reviews have concluded that a single session of exercise ameliorates cravings and tobacco withdrawal symptoms; however, smoking behaviour (topography) has not been adequately addressed in the literature. This study examined the effect of an acute bout of exercise on smoking topography following a temporary period of smoking abstinence. Forty-eight adult smokers (Nfemale = 34, Mage = 43.14), who had been smoking for an average of 23.90 years, were randomised to an acute (10 minutes) bout of exercise (N = 23) or passive sitting (control) group. Cigarette cravings were assessed at baseline and immediately pre and post treatment condition during a 15-hour smoking abstinence period. Smoking topography which included puff count, puff volume, puff duration, inter-puff interval, and total cigarette duration was assessed at baseline and post treatment. Although exercise reduced cravings, compared to the control group, smoking topography remained unchanged across time between groups. Furthermore, craving reduction was unrelated to any smoking topography variables. Although there is evidence that exercise can delay time to first cigarette, this study demonstrates that the change to smoking topography is negligible when participants are invited to smoke.

Introduction: Despite smoking fewer cigarettes per day, African American smokers have greater difficulty quitting compared to Caucasian smokers. Further elucidating the impact of smoking motivations on smoking behaviour would contribute to understanding the factors that maintain smoking.

Aims: This study examined the factor structure of a brief assessment examining smoking dependence motives among a sample of African American light smokers.

Methods: Data from a double-blind, placebo-controlled randomised smoking cessation trial involving 540 participants. Results were analysed using an exploratory factor analysis (EFA) and a randomly split EFA.

Results/Findings: Findings from the initial EFA analysis produced an eight-factor model, explaining 69% of the variation in responses. The overall Measure of Sampling Adequacy (MSA) was 0.88 with item level MSA ranging 0.68–0.94 across the 30 items. Results from the randomly split EFA replicated the findings of the original EFA; with the exception of the item ‘I smoke within the first 30 minutes of awakening in the morning’.

Conclusions: These findings support the hypothesis of a multidimensional approach to conceptualising nicotine dependence, and provide information regarding characteristics of nicotine dependence in African American light smokers which may be helpful in identifying targets for cessation treatment in this population of smokers.

Introduction: Junior doctors are ideally placed to assist smokers quit yet little is known about their knowledge and practices.

Aims: To determine knowledge and practices in providing smoking cessation support, among junior doctors in a Malaysian teaching hospital.

Methods: In 2012, all junior doctors at University Malaya Medical Centre were invited to complete a self-administered questionnaire. The data were collated and analysed using standard descriptive methods.

Results/Findings: Seventy per cent (n = 122/173) of those eligible completed the questionnaire, 71% reporting cessation training at medical school. Most (90%) asked patients their smoking status but only 52% asked about quitting. Sixty-one per cent lacked confidence in providing assistance to quit, especially female doctors (70.8%, p<0.01). Most (80%) were unaware of local cessation clinics, and over half (59%) were unaware of the existence of guidelines for smoking cessation (p<0.001).

Conclusions: Asking about smoking was undertaken at satisfactory levels, but low knowledge, confidence and skills among this group of junior doctors indicates that cessation education should be included in undergraduate and in postgraduate curriculum training programmes. Awareness of specialist services and guidelines should be raised. Our findings are unlikely to be unique to this hospital, suggesting the need for a nationally consistent approach.