Objectives: Stopping smoking leads to greater happiness and life satisfaction. This raises the question as to whether harm reduction, i.e. smoking reduction (SR) and the use of Nicotine Replacement Therapy (NRT) for SR, might lead to a similar benefit. This is of importance, given that the National Institute of Clinical Excellence in the UK is due to release guidance on harm reduction in 2013.

Design: Data were collected from 1,532 smokers involved in the Smoking Toolkit Study.

Method: Participants were asked if they were cutting down and if they were using Nicotine Replacement Therapy (NRT). Smokers also rated happiness and life satisfaction.

Results: There was no evidence of an association between SR or use of NRT for SR and either reported ‘happiness’ or ‘life satisfaction’. Nor was there an association between measures of ‘happiness’ or ‘life satisfaction’ and cigarette consumption.

Conclusion: It appears that SR is not associated with mental health benefits. This suggests that complete cessation may be necessary for benefits to be incurred. Prospective studies are necessary to confirm these findings.

Nicotine is naturally found in the plants belonging to the Solanaceae family. Concentrations high enough to have a pharmacological effect are seen only in the tobacco sub-family, approximately 2% of dry weight and in Duboisia Hopwoodii that has been used by Australian aborigines (http://en.wikipedia.org/wiki/Duboisia_hopwoodii). It is also present in the range of 2–7 microgram per kg of various edible plants.

Introduction: Individuals with severe and persistent mental illnesses have a greater prevalence of smoking than the general population and are disproportionately affected by tobacco-related morbidity and mortality. Evidence-based tobacco treatment can aid such populations in their efforts at smoking cessation. Few studies have examined the effectiveness of tobacco treatment programmes within Mental Health and Addictions Services in Canada.

Aims: This study examines outcomes from an evidence-based tobacco treatment programme provided within community mental health services in Vancouver, Canada.

Methods: A retrospective chart review was conducted of 134 participants (from June 2010 to February 2012). Information on demographics, tobacco use and cessation history, substance use history, psychiatric disorder diagnosis, expired carbon monoxide level, and duration of treatment in the programme were obtained. Programme completion and smoking cessation/reduction were examined.

Results: Sixty-seven per cent completed the programme. Of those who completed, 26.7% were abstinent at the end-of-treatment and 50% (of those not achieving abstinence) reduced their consumption to at least 50% of their baseline cigarette consumption. Predictors of smoking cessation included having a social support for smoking cessation and lower nicotine dependence at baseline.

Conclusions: Evidence-based tobacco treatment within community mental health services is well received by individuals with severe and persistent mental illness. Such treatment can aid in their efforts towards smoking cessation. Future studies may need to assess factors that can enhance the integration of tobacco treatment within mental health services while providing tailored treatment that addresses the unique needs of smokers who have severe and persistent mental illness.

Introduction: Smokers with depressive and alcohol use disorders report more severe tobacco abstinence effects (e.g., tobacco withdrawal and craving, mood and sleep disturbance), but less is known about abstinence effects among smokers with subclinical features of these disorders.

Aims: The time-course and severity of acute abstinence effects were evaluated in smokers with and without subclinical depressive symptoms (DEP) and with and without subclinical alcohol consumption (ALC). Methods: Participants (N = 106) received smoking cessation counselling and were contingently compensated for biochemically-verified smoking abstinence. Abstinence effects were assessed pre-quit and daily for eight days post-quit.

Results/Findings: Seventy-four participants (70%) achieved eight-day continuous smoking abstinence. Generalised estimating equations revealed that time and DEP group significantly interacted to predict change in Wisconsin Smoking Withdrawal Scale (WSWS) Anxiety (Wald = 21.18, p < .01) and Questionnaire of Smoking Urges Relief from Negative Affect (Wald = 20.12, p < .01) subscale scores. Time and ALC group significantly interacted to predict change in Profile of Mood States (POMS) Fatigue subscale score (Wald = 19.78, p < .01). Compared to non-DEP smokers, DEP smokers reported higher mean post-quit scores on several measures of abstinence effects, including WSWS Sadness and POMS Total; however, pre-quit differences between DEP groups may have confounded post-quit differences.

Conclusions: Smokers with subclinical depressive symptoms endorsed high levels of abstinence effects, but it was unclear if these were related to the absence of tobacco. Smokers with subclinical alcohol consumption did not endorse high levels of abstinence effects but abstinence-related fatigue took longer to improve.

Introduction: Given the increased rates of nondaily smoking and the lack of validated measures to assess factors related to nondaily smoking, we aimed to develop a measure of reasons for nondaily smoking among young adults. Specifically, we developed a scale assessing reasons or triggers for nondaily smoking and examined its reliability, factor structure, and concurrent validity. Methods: We administered an online survey to 2,000 students at six colleges in the Southeastern US, and 718 (35.9%) returned a completed survey. The current analyses focused on the 95 participants who reported nondaily smoking (i.e., smoking between 1 and 29 days of the past 30 days). In addition to the items created for scale development, measures included socio-demographics, other measures of motivation and confidence/self-efficacy, past smoking/quitting history, readiness to quit, and other psychosocial factors related to smoking. Results: The 19-item Reasons for Nondaily Smoking Scale (RNS) demonstrated an average score of 45.36 (SD = 15.55) and internal consistency (Cronbach's alpha of 0.79). Factor analysis of the items extracted four factors which accounted for 57.4% of score variance: Social influences; Enhancing buzzes and positive affect; Negative affect regulation; and Lack of concern of addiction. Concurrent and discriminant validity were documented. Conclusions: Developing validated measures designed to assess factors associated with nondaily smoking will enhance our ability to address this growing public health concern. The development and validation of the RNS for young adults may be critical in informing our intervention strategies and potentially for effecting or predicting cessation among young adult nondaily smokers.

Introduction: In March 2011, the New Zealand government committed to the goal of reducing the prevalence of current smokers to less than 5% by 2025. Smoking prevalence is significantly higher for Māori and Pacific peoples. To ensure a proportionately larger decrease in smoking prevalence for Māori and Pacific peoples by 2025, more effective strategies for prompting cessation among these groups are needed. Aim: This study aimed to identify what motivates Māori and Pacific people to quit smoking so that communications and mass media quit campaigns can be more effective at triggering quitting among them. Method: A qualitative approach utilising focus groups (N = 168) was used to ask participants to rank reasons why people say they should quit smoking (the ‘talk’) which we compared with participants’ reasons for actually quitting (the ‘walk’). The results were plotted on a scatter graph using a method devised by the authors. Results: Health, children and pregnancy were perceived to be strong motivating reasons to quit and they were frequently cited as triggering past quit attempts. Cost was plotted high for Pacific but low for Māori especially for talk. ‘It stinks’ was cited as triggering past quit attempts, but was not perceived as a reason to quit. Conclusion: Emotionally important reasons and more immediate reasons for quitting are likely to be more effective at prompting Māori and Pacific peoples to stop smoking.

Introduction: Patients of specialized nicotine dependence clinics are hypothesized to form a distinct subpopulation of smokers due to the features associated with treatment seeking. The aim of the study was to describe this subpopulation of smokers and compare it to smokers in general population.

Material and methods: A chart review of 796 outpatients attending a specialized nicotine dependence clinic, located in Toronto, Ontario, Canada was performed. Client smoking patterns and sociodemographic characteristics were compared to smokers in the general population using two Ontario surveys – the Ontario Tobacco Survey (n = 898) and the Centre for Addiction and Mental Health Monitor (n = 457).

Results: Smokers who seek treatment tend to smoke more and be more heavily addicted. They were older, had longer history of smoking and greater number of unsuccessful quit attempts, both assisted and unassisted. They reported lower education and income, had less social support and were likely to live with other smokers.

Conclusions: Smokers who seek treatment in specialized centers differ from the smokers in general population on several important characteristics. These same characteristics are associated with lower chances for successful smoking cessation and sustained abstinence and should be taken into consideration during clinical assessment and treatment planning.

Introduction: This article describes the process and evaluation of a smoking cessation support programme for mental health clients in Sydney.

Aim: The objective of the study was to assess a group-based smoking cessation support model for community mental health clients.

Methods: Two community mental health services participated; 29 clients received free NRT products and weekly education for 12 weeks on: effects of smoking, nicotine dependence, NRT use, withdrawal process and the benefits of quitting. Evaluation included face-to-face interviews, telephone or postal survey using a semi-structured questionnaire.

Results: The baseline (n = 29) and follow-up (n = 14) surveys showed reduction in the number of cigarettes (30 to 21) smoked a day (55% vs. 36%). At one month 47% (n = 19) were confident about stopping smoking permanently whereas 19% (n = 14) reported the same after six months. Participants reported concerns of health effects, illness, physical symptoms (77% n = 27) and financial cost (93% n = 27) were the motivating factors in quitting. None of the findings was statistically significant.

Conclusions: Community based interventions to address the rate of smoking in this group is needed. Financial and health benefits can be used as motivating factors, and integration of smoking cessation assistance in treatment and rehabilitation of mental health consumers would be useful.

Introduction: Sleep disturbance is common among cigarette smokers and predicts smoking cessation failure. Aims: The purpose of this study was to conduct a pilot test of whether provision of a sleep intervention might bolster smoking cessation outcomes among this vulnerable group. Methods: Smokers with insomnia (N = 19) seeking smoking cessation treatment were randomly assigned to receive 8 sessions over 10 weeks of either: (1) cognitive-behavioural therapy for insomnia + smoking cessation counselling (CBT-I+SC; n = 9) or (2) smoking cessation counselling alone (SC; n = 10). Counselling commenced 4 weeks prior to a scheduled quit date, and nicotine patch therapy was also provided for 6 weeks starting on the quit date. Results: There was no significant effect of counselling condition on smoking cessation outcomes. Most participants had difficulty initiating and maintaining smoking abstinence in that 7-day point prevalence abstinence rates at end of treatment (CBT-I+SC: 1/7, 14%; SC: 2/10, 20%) and follow-up (CBT-I+SC: 1/7, 14%; SC: 0/10, 0%) were low for both conditions. CBT-I+SC participants reported improvements in sleep efficiency, quality, duration and insomnia symptoms. Sleep changes were not associated with the likelihood of achieving smoking abstinence. Conclusions: This randomised pilot study suggests that behavioural interventions may improve sleep among smokers with insomnia, but a larger sample is needed to replicate this finding and evaluate whether these changes facilitate smoking cessation.

Introduction: Women who continue to smoke during pregnancy are at risk of smoking-related diseases, maternity complications and expose the foetus to risks of perinatal mortality and morbidity. The number of women smoking at the time of delivery is estimated at 13.5% in England and 15.8% in the West Midlands. However, the prevalence can be elevated in certain areas, such as north Solihull.

Aims: This research consults past, current and non-users of specialist smoking cessation services and reports pregnant women's views of smoking cessation delivery and potential service developments.

Methods: Focus groups were conducted with 19 participants with experience of prenatal smoking.

Findings: Data was analysed using thematic analysis. The main themes included: (1) improving access to clear, sensitive information on smoking and pregnancy; (2) perceptions of existing services; (3) improving current services: the right delivery and the right person; and (4) encouraging participation of pregnant smokers.

Conclusions: In this area, pregnant smokers wanted easily-accessible, empathetic, non-judgemental and flexible support more than incentives or rewards to quit smoking. They also stated a preference for group cessation support as they believed that peer support would be advantageous.

This study examines young New Zealand smokers’ views of what would help them quit smoking. A qualitative investigation using 10 focus groups with 66 current young smokers, aged between 15 and 17 years, was conducted throughout New Zealand, in late 2011. Transcripts from the focus groups were analysed using NVivo, and common themes and categories within themes were identified. Around half the participants had made a quit attempt in the past, some had tried multiple times using a range of methods; all were unsuccessful. They described both mental and physical difficulties for young people quitting. The participants developed an array of ideas for how to help young people quit smoking, encompassing having supportive people around them, making personal changes and adopting alternative behaviours to smoking, legislative changes, and ideas that were unique to young people. Cessation strategies which reach high risk smokers such as young people, Māori and Pacific peoples, are going to be vital for achieving a smokefree Aotearoa by 2025.

Introduction: This study examined members of health issue-specific social networking sites (SNSs) for smoking cessation, applying Social Identity Theory (SIT).

Aims: The aim of the study was to test the relationships between perceived verbal, affective, cognitive and physical intimacy on the sites, participation level, social identification and smoking cessation self-efficacy.

Methods: An online questionnaire (N = 252) assessed members of SNSs for smoking cessation. Confirmatory factor analysis (CFA), structural equation modelling (SEM), mediation analysis, MANOVA and ANOVA tests were used to test the hypotheses.

Results/Findings: Verbal, affective, cognitive and physical intimacy significantly predicted participation; participation significantly predicted social identification and smoking cessation self-efficacy; and social identification mediated between participation and smoking cessation self-efficacy. Active participants and lurkers differed significantly on perceived verbal, affective, cognitive and physical intimacy, social identification, and smoking cessation self-efficacy.

Conclusions: Health issue-specific SNSs for smoking cessation have a positive impact on members’ smoking cessation self-efficacy. Higher perceived intimacy facilitates participation online, which in turn influences smoking cessation self-efficacy, with social identification mediating this relationship.

Introduction: Although smoking prevalence has declined dramatically among adults in the past 40 years, 19.3% of adults still smoke, including 20.1% of adults aged 18–24 years. Quitlines are effective, population-based interventions that increase successful cessation.

Aims: This study aims to describe the characteristics of young adult smokers aged 18–24 years who used telephone cessation counselling for assistance with quitting, to assess self-reported quit rates, and to examine predictors of quitting, compared to older adults.

Methods: We examined data from 4,542 young adult smokers aged 18–24 years and 46,094 smokers aged ≥25 years who enrolled in the American Cancer Society's quitline services during 2006–2008.

Results: Young adult smokers aged 18–24 years who called quitlines differed slightly from older adults in demographics and tobacco-use behaviours. There were no age-related differences in self-reported seven-day quit rates or 30-day quit rates at the seven-month follow-up. Predictors of quitting were mostly similar for the young adults and the older adults, although the odds of quitting were lower among young adults for living with vs. not living with a smoker.

Conclusions: Although young adult smokers under-utilise telephone cessation quitlines for assistance with quitting, those who do use these services have quit rates similar to older adults.