7.19 Interventions for particular groups

Last updated: August 2020

Suggested citation: Greenhalgh, EM., Hanley-Jones, S., Jenkins, S, Stillman, S.& Ford, C & 7.19 Interventions for particular groups. In Greenhalgh, EM, Scollo, MM and Winstanley, MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2020. Available from: http://www.tobaccoinaustralia.org.au/chapter-7-cessation/7-19-interventions-for-special-groups

 

Every smoker is different, but there are some groups that share social, cultural, and personal characteristics to a sufficient degree to justify the development of tailored evidence-based approaches to smoking cessation. These include groups with very high smoking rates, with disproportionate tobacco-related health disparities, where special barriers and less access to cessation treatment exist, or where current mainstream approaches are less successful. They are also groups where the research as to most effective approaches is often limited.1,2

Smoking rates remain very high among those who are both socially excluded and socio-economically disadvantaged.3 Some population-level interventions are effective in reducing smoking among disadvantaged groups, however there is very limited published research on the most effective smoking cessation strategies for highly disadvantaged groups.4  Findings regarding the outcomes for behavioural interventions, though inconsistent, show some promise.5  An Australian study of disadvantaged smokers attending social and community service organisations highlights their interest in quitting and the importance of overcoming barriers, including increasing their knowledge and use of evidence-based cessation strategies and support services.3  

Some groups who have received particular attention in state and national tobacco strategies are described below. These include:

7.19.1 Aboriginal and Torres Strait Islander people

7.19.2 Low-income groups

7.19.3 Homeless people

7.19.4 Single parents

7.19.5 People with serious health conditions, including surgical patients, cardiovascular disease, respiratory diseases, cancer, diabetes, and HIV/AIDs

7.19.6 People with substance use and other mental disorders

7.19.7 Culturally and linguistically diverse groups

7.19.8 Smokers living in remote areas

7.19.9 Lesbian, gay, bisexual, and transgender (LGBT) people

7.19.10 Prisoners and others involved in criminal justice system

7.19.11  Veterans

7.19.12 Younger smokers

7.19.13 Older smokers

7.19.14 Women

7.19.15 Users of other tobacco products

7.19.1 Aboriginal peoples and Torres Strait Islanders

The prevalence of smoking is substantially higher among Indigenous Australians compared with the general population,6  and  tobacco use plays a significant role in their poorer health status and lower life expectancy.7,8  Tobacco use among Aboriginal peoples and Torres Strait Islanders, and interventions to address it, are covered in greater detail in  Chapter 8. For further information on smoking, ill-health, financial stress and smoking-related poverty among Indigenous communities see  Chapter 9, Section 9.6.9.

7.19.2 Smoking cessation among low-income groups

While smoking has declined over time in most developed countries, inequalities in smoking rates have persisted or increased.9  Smoking cessation interventions aimed at the general population have successfully reduced overall smoking prevalence, but have likely increased inequalities in smoking.10  An analysis of smoking in 11 European countries found that while socioeconomic inequalities in smoking cessation rates declined between 1987 and 1995, they strongly increased since the 1990s and during the 2000s, suggesting that tobacco control measures implemented over this period  were not able to counter this trend.11 Similarly, a systematic review in Europe found higher proportions of tobacco users among those with lower socioeconomic level, and that people who suffered downward mobility (i.e., began life in a higher socioeconomic group and subsequently moved downward) tended to mimic smoking habits of the new group when they migrated to a lower social group.12  In Australia, the prevalence of smoking remains substantially higher among those with low educational attainment and lower income levels compared with the general population (see Section 1.7). Such smokers are also more highly dependent on nicotine, and are less likely to intend to quit.13  Further, smoking exacerbates financial stress and poverty both for adults,14  and children.15  

Social (e.g. low social support for quitting), psychological (e.g., low self-efficacy) and physical factors (e.g. greater nicotine dependence) all contribute to the higher tobacco use among socially disadvantaged populations.16  An analysis of the effects of wages on a person’s smoking decisions found that a 10 per cent increase in wages led to about a 5 per cent drop in smoking rates among men and those with a high school education or less, and significantly improved their chances of quitting.17  The development of interventions that address smoking among low-socioeconomic status (low-SES) groups is a high clinical and economic priority to reduce health inequalities and improve life expectancies,9  and to reduce the financial burden of smoking.15  However, a systematic review of research over the past decade into cessation among low-SES and other disadvantaged groups concluded that the current research output is not ideal or optimal to decrease smoking rates.9  Nonetheless, recent research has attempted to develop interventions to reduce socioeconomic disparities caused by tobacco use. 

Researchers in the US have attempted to adapt evidence-based treatment to more fully meet the needs of lower SES smokers, and have produced a revised treatment that will be examined in a randomised controlled trial.18  Another US study assessed two strategies (direct mail and opportunistic telephone referrals) that offered financial incentives to low-income smokers for being connected to the Quitline. Both strategies successfully connected smokers to the Quitline and encouraged quit attempts and continuous smoking abstinence.19  A large randomised controlled trial in Switzerland similarly found that large financial incentives improved long-term quit rates in low-income smokers.20  Two studies have examined interventions among Salvation Army client smokers: one that challenged beliefs about the effectiveness of various quit methods, which was associated with greater smoking reduction and greater likelihood of contacting the Quitline,21  and another that showed that a brief, targeted motivational intervention increased the initiation of an evidence-based tobacco cessation treatment.22  A brief intervention comprising counselling, referral to the Quitline, and free nicotine replacement therapy resulted in quit attempts and successful quits among low-income smokers visiting an emergency department.23  Barrier to using the Quitline among low socioeconomic smokers can include not having access to a phone,24  and the cost of making the call from a mobile.25  

Integrating interventions into existing community programs also holds promise for promoting cessation among low-income smokers.26, 27  In the UK, NHS stop-smoking services appear to reduce inequalities in smoking through increased relative reach through targeting services to low-SES smokers.10  In terms of recruiting socioeconomically disadvantaged smokers into smoking cessation studies, mailed invitations and follow-up from health professionals appears to be effective, while recruitment via community outreach approaches may be largely ineffective.28  One study found that a smoking reduction intervention for economically disadvantaged smokers that involved personal support to increase physical activity was more effective than usual care in achieving reduction and may promote cessation.29  Peer support interventions also appear to have potential to address the high prevalence of smoking in vulnerable populations, particularly among disadvantaged groups who experience fewer opportunities to access such support informally.16

In terms of population-wide strategies, researchers in the US concluded that population-based proactive tobacco treatment (proactive outreach plus free cessation treatment) increases engagement in evidence-based treatment and is effective in long-term smoking cessation among socioeconomically disadvantaged smokers.30  A qualitative study explored how Australian socioeconomically disadvantaged smokers respond to rising cigarette prices. Participants reported frequent experiences of deprivation and financial stress caused by their smoking, such as going without meals, substituting food choices and paying bills late in order to purchase cigarettes. In order to maintain smoking, price-minimisation strategies (such as switching to roll-your-own) and sharing tobacco resources within social networks were adopted. Price increases were perceived as helpful for preventing uptake, with larger price rises and subsidised cessation aids needed to assist with quitting. The authors highlight that assistance for socioeconomically disadvantaged smokers who struggle to quit should be a priority.31  Another Australian qualitative study aimed to better understand why socially disadvantaged populations may be resistant to cessation interventions. Findings showed that smoking behaviour, smoking identity and feelings about smoking were reflective of individual circumstances and social and environmental context. Participants felt 'trapped' by their smoking, due to not being able to control the stressful life circumstances that triggered and sustained their smoking:

The people who can give it [smoking] up have support, they’re 9 to 5ers…they have good friends, a good place to live, they’re not homeless, they don’t have to go to the 139 club for a rotten meal. 

—Male, mature person at risk of homelessness (Pateman et al.,32  p. 1052)

The smokers' views involved contradictions between believing that smoking cessation involves individual responsibility while at the same time being caused by factors outside of their control. The authors conclude that tobacco control programs aiming to reduce smoking among disadvantaged groups are unlikely to be successful unless the complex interplay of social factors is carefully considered.32  

7.19.3 Homeless people

People who are homeless have disproportionately high smoking and low quitting rates compared with those who are housed. (See  Chapter 1 Section 1.10.4 and Chapter  9 Section 9.6.6.) Homeless people are more likely to smoke discarded cigarette butts or used filters or to share cigarettes in order to save money, which puts them at greater risk for infectious diseases, in addition to the usual risks of cancer, respiratory illness, and cardiovascular disease. 33  Although motivated to stop smoking, homeless smokers are faced with unique social and environmental barriers that make quitting more difficult and therefore flexible and innovative interventions are needed.33  Qualitative research in the UK revealed that homeless smokers were generally highly dependent and did not display good knowledge of smoking related harms. Many also reported engaging in high risk smoking behaviours. Despite this, most participants reported motivation and confidence to quit in the future. Many had tried to quit in the past, all unassisted, and several described a lack of support or active discouragement by practitioners to address smoking.34  Another qualitative study with homeless smokers, this time in the US, found that most planned to quit eventually, citing concern for their children as their primary motivation. Significant barriers to quitting included the ubiquity of cigarette smoking, its central role in social interactions in the family shelter setting, and its importance as a coping mechanism. Participants expressed interest in quitting "cold turkey" and in e-cigarettes, but were sceptical of the nicotine patch and pharmacotherapy.35   

Despite being interested in doing so, providers of homeless services often do not provide cessation assistance, citing lack of resources (e.g., money, personnel) to support the programs, staff training, and concern that smoking cessation may not be a high priority for homeless youth themselves as significant barriers.36  On the contrary, surveys have shown that many homeless youth are motivated to quit and are interested in smoking cessation products and services.37  Research in the US found that healthcare providers were equally likely to use the 5A’s with homeless patients, but among patients for whom treatment was ‘Arranged’, homeless patients were less likely than housed patients to attend the smoking cessation program suggesting that they may experience barriers to participation.38   

A relatively small body of research has examined cessation interventions for people experiencing homelessness. Among homeless men attending a cessation clinic in Sydney, about half were receiving treatment for psychotic illness, and there were high rates of other psychiatric disorders, physical illness and substance use disorder. Although quit rates were low, attendees significantly the reduced the number of cigarettes smoked per day, and reduced their carbon monoxide readings.39  A 12-week program for homeless smokers was conducted in Melbourne, which offered weekly nurse-delivered smoking cessation appointments, doctor-prescribed free nicotine patch, bupropion or varenicline, and Quitline phone support. While quit rates were low, the program was feasible and acceptable, and led to meaningful benefits for participants including reduced consumption and butt smoking, significant financial savings, and psychological benefits.40  In the US, one small study found that homeless adults preferred NRT as the method of assistance and were more likely to be ready to quit if they had tried previously and had social support for their attempt.41  Another focused on motivational interviewing approaches and found the intervention feasible, with promising results for NRT and counselling.33 Similarly, results from a 12-week program for sheltered homeless people suggested that counselling plus pharmacotherapy approaches may be feasible and effective.42   

Researchers have also explored factors that might promote success or failure in quit attempts. Reducing negative affect, restlessness, and stress appear to predict abstinence among homeless people,43  while lower subjective social status (i.e., ranking one’s own social standing lower than others) has been shown to predict increased risk of relapse on the quit day or the inability to quit at all.44  Achieving smoking abstinence may be associated with a reduction in alcohol consumption but appears not to be associated with a substantial change in other drug use.45

7.19.4 Smoking cessation for single parents

The prevalence of smoking in single-parent households is significantly higher than among those with two parents, with single mother families making up the vast majority of one parent families. (See  Chapter 1, Section 1.10.3.) Lone parenthood is associated with social and economic disadvantage (see  Chapter 9), and low-income single mothers experience heightened stress, loneliness, depression and anxiety.46,47   

The strong relationship between single motherhood and smoking can be partly explained by low SES, younger age, living alone,48  poor mental health, higher proportion of friends who smoke, and earlier smoking initiation;49  however, Australian research has also shown that being a single mother is independently associated with a greater likelihood of smoking.50  While improving the socio-economic status, mental health, and social environment of lone mothers may help to reduce smoking rates, further research is needed to better understand smoking and quitting among this group.50   

7.19.5 Serious health conditions

Health concerns are a major motivator for smoking cessation, named by two-thirds of smokers changing their smoking behaviour as a major factor motivating that change (refer NDHS 29019, tables 2.42 and 2.41).51  Diagnosis of a smoking-related illness, especially if it results in a period of hospitalisation or intensive treatment, is a good opportunity to promote smoking cessation.52  Treatment of some health problems is substantially improved if patients stop smoking. For example, quitting after a heart attack improves recovery and reduces the risk of recurrence.53, 54 Cancer patients show improved response to treatment if they quit, and have a lower rate of recurrence.54, 55  The management and progression of many chronic and acute diseases, including diabetes, asthma, peripheral vascular disease and emphysema, is improved after quitting,56  and intervention is worthwhile. 54, 56-63  Smoking is a serious problem after orthotopic liver transplantation and increases the risk for malignancy.64  There has been a vigorous debate in the medical profession about the ethics, economics, and health effects of refusing some hospital treatments for patients who fail to stop smoking.65   

A review of interventions for smoking cessation in hospitalised patients concluded that high intensity behavioural interventions that begin during a hospital stay and include at least one month of supportive contact after discharge promote smoking cessation.52  Smoking cessation advice and/or counselling given by nurses also appears to be effective.66  Oncology nurses play a pivotal role in supporting cessation among cancer survivors.67  For smokers receiving outpatient treatment, brief or intense interventions by their physician will increase quit rates,68  which may include referral of those interested in quitting to appropriate services. A randomised clinical trial found that a post-hospital discharge intervention comprising automated telephone calls and free medication resulted in higher rates of smoking cessation at 6 months compared with a standard recommendation to use counselling and medication.69  In hospital, people are likely to be more open to receiving help, and they are likely to find it easier to quit in a place where smoking is prohibited.52  At the very least, there is a need to encourage abstinence, provide nicotine replacement therapy (NRT) to manage withdrawal symptoms, and/or explain the necessity of smoking offsite or in a designated area if available. More intensive programs are likely to have greatest success.70  For example, referral to the Quitline or in-house support staff for cessation may help improve outcomes, as may consideration of smoking status and intentions for discharge planning, and providing support for continued abstinence or encouragement to consider quitting in the future. New South Wales Health has developed a good example of a comprehensive policy approach for all inpatient facilities.71   

Current practice falls well short of potential.72  For example, healthcare providers working with cancer survivors do not always take advantage of opportunities to provide cessation advice and interventions.73 Another study found that the majority of smokers continued to smoke five years after stroke, and few recalled smoking cessation advice from their health professionals.74  For more information on the role of healthcare professionals in supporting cessation, see  Section 7.10.

7.19.5.1 Surgical patients

For people undergoing surgery, smoking cessation decreases postoperative complications. A systematic review published in 2012 concluded that at least four weeks of abstinence from smoking reduces respiratory complications, and abstinence of at least three to four weeks reduces wound-healing complications.75  The Australian and New Zealand College of Anaesthetists recommend that, based on the current available evidence, anaesthetists and surgeons should not be dissuaded from advising patients to quit at any time before surgery.76  A Cochrane review of interventions for preoperative smoking cessation concluded that preoperative smoking interventions providing behavioural support and offering NRT increase short-term smoking cessation and may reduce postoperative morbidity. One trial of varenicline found a benefit on long-term cessation but did not detect an effect on early abstinence or on postoperative complications.77  Another systematic review and meta-analysis found that preoperative smoking cessation programs will likely precipitate long-term cessation, highlighting the additional benefits of cessation support at this time.78

7.19.5.2 Cardiovascular disease

Quitting smoking is the single greatest lifestyle change people with cardiovascular disease (CVD) can make to reduce their morbidity and mortality risk; however, many continue to smoke, even after experiencing a major cardiac event.79  While many smokers hospitalised with CVD report being prepared to quit smoking, many who do try do not use effective methods.80  There is also high underreporting of smoking status among cardiac patients who participate in smoking cessation programs.81  Factors such as higher income, fewer household smokers, having a partner, and being a lighter smoker are associated with successful quitting among people with CVD.82,83  Alternatively, the inability to engage in previously valued activities may contribute to depressed mood and failure to quit smoking in people with heart conditions.84 Understanding the relationship between depressive symptoms often experienced by patients hospitalised for acute CVD and relapse following discharge may assist the development of more effective interventions.85  One study found that those with stroke/transient ischaemic attack do not necessarily associate their illness with smoking and boredom and lack of social support were cited as additional barriers to quitting. Pharmacotherapy and vocational and rehabilitation programs were perceived positively as resources to assist quitting.86   

A review of smoking cessation for cardiovascular patients concluded that there are promising approaches for enhancing quit rates with existing cessation medications, such as combination treatment, extended use of pharmacotherapy, reduce-to-quit strategies, and tailored treatments. The use of cytisine appears promising, and despite its relatively low use, the Quitline is also effective.87  The safety of pharmacotherapy for smoking cessation in cardiovascular patients has been demonstrated by a network meta-analysis.88  Another review highlighted the importance of a systematic approach with focus on the 5A's (Ask, Advise, Assess, Assist, and Arrange), as well as the efficacy of pharmacotherapies, NRT, and counselling for smoking cessation in patients with vascular disease.61  A Cochrane review of psychosocial interventions for smoking cessation in patients with coronary heart disease concluded that such interventions are effective in promoting long-term abstinence, as long as they are sufficiently intensive.79   

Providing intensive smoking cessation programs for patients hospitalised for CVD increases abstinence.89  In the UK, a nurse-led preventive cardiology program in high CVD risk smokers using optional varenicline substantially increased smoking abstinence over 16 weeks and also reduced overall cardiovascular risk compared with usual care.90  A systematic review and meta-analysis of bupropion for cessation in patients hospitalised with cardiovascular disease found that while bupropion improved abstinence over placebo at the end of treatment, this effect did not persist at 12 months.91  German research found that a low-intensity smoking intervention embedded in an adherence program for patients with an increased risk for cardiovascular disease promoted smoking cessation, although the intervention effect diminished over time.92  There is some evidence that intensive outpatient cessation intervention is effective for patients with peripheral vascular disease.93  A small study found support for the use of phone counselling and text messaging for smoking cessation and lifestyle changes among patients who had undergone percutaneous coronary intervention.94   

7.19.5.3 Respiratory diseases

Smoking has detrimental effects on asthma.95  There is a significant association between asthma and early smoking,96, 97  and adolescents with asthma who smoke are more likely to be girls, have a relatively higher body mass index, be in higher school levels, use marijuana or alcohol, have minor to severe depressive symptoms, not live with both biological parents, be exposed to environmental tobacco smoke at home, and have friends who smoke. Cessation interventions are more likely to assist this group if they address such psychosocial and environmental factors.98, 99  A qualitative study found that most patients understood that smoking exacerbates asthma. Fear of asthma-related exacerbations and poor self-control appeared to be the major triggers for quitting smoking. Most patients wanted quit smoking; however, motivation often needed to be combined with public, social, professional, and therapeutic support to achieve and maintain abstinence.100  Counselling and use of pharmacological treatments is a good approach for smoking cessation in asthma patients; however, there is a lack of smoking cessation trials in this patient population.95  Further research is warranted in this area.96   

Smoking cessation is the most effective measure for controlling the progression of chronic obstructive pulmonary disease (COPD).95  A 2016 Cochrane review concluded that there is high-quality evidence that smokers with COPD who receive a combination of high-intensity behavioural support and medication are more than twice as likely to quit as those who receive behavioural support alone. There was no clear evidence that one particular form of behavioural support or medication is better than another.101  First-line drugs licensed to aid smoking cessation (nicotine replacement therapy, bupropion, and varenicline) are effective in patients with COPD.102  A combination of two or more NRT products, higher than usual dosing, extended use prior to quitting and extended use post-quitting can improve treatment efficacy. Extended use of varenicline prior to and after the target quit date, and the combination of varenicline with nicotine patches or bupropion can improve treatment outcomes.95  A meta-analysis of behaviour change techniques in cessation interventions for people with COPD concluded that such interventions appear to benefit from focusing on forming detailed plans and self-monitoring.103

For smokers with either COPD or asthma, an intensive smoking cessation program with regular and long-term follow-up can help them to achieve high abstinence rates and prevent relapse.104  Several studies have called for the development of tailored interventions for people with COPD, taking into account both inter- and intragroup differences.105, 106  COPD patients express motivation to quit and often make multiple quit attempts; however, boredom, mood disturbances, the strong sense of identity as a smoker, peer reinforcement, irritability, cravings, hunger, and weight gain can act as barriers to quitting,107  along with patient misinformation, levels of motivation, health beliefs and poor communication with health professionals.108  Depression also appears to decrease the likelihood that patients with chronic respiratory conditions will quit smoking.109  Qualitative research found that smokers with COPD often trivialise the health consequences of smoking, and may be less knowledgeable about its health effects. Autonomy was very important among participants, and many were indignant about a perceived lack of empathy from doctors. There was little faith in the efficacy of smoking cessation aids.110  Some patients may inaccurately report their smoking status, which hampers effective intervention.111,112   

The prevalence of smoking among people with tuberculosis (TB) is higher than in the general population, and smoking leads to worse TB outcomes. Smoking cessation strategies for TB patients include: a combination of counselling (brief behavioural intervention at diagnosis followed by monthly behavioural support throughout the TB treatment course) and pharmacological treatment (nicotine replacement therapy, bupropion and varenicline).95  Motivational interviewing also appears to increase self-efficacy and abstinence rates among tuberculosis patients.113,114

7.19.5.4 Cancer

A diagnosis of cancer, even a cancer not strongly related to smoking and with a relatively good prognosis, may be associated with increased quitting that is sustained well after diagnosis.115  Motivation and interest in smoking cessation appear to greatly increase following cancer diagnosis, therefore this could be an effective time for encouraging and supporting quitting.96,116  However, many patients and family members continue to smoke following cancer diagnosis, and feelings of guilt can lead to the concealment of smoking status from health care professionals.117  Continued tobacco use limits the effectiveness of major cancer treatments and increases the risk of complications and of developing secondary cancers.118   

There is limited research regarding smoking consumption, smoking cessation interventions and relapse prevention strategies among cancer patients.116  A systematic review concluded that interventions combining non-pharmacological and pharmacological approaches have resulted in an improvement in smoking cessation rates compared to usual care.119  Bupropion may have advantages for cancer patients, including low risk for nausea.120  A systematic review and meta-analysis of smoking cessation counselling for patients with head and neck cancer found that patients who received counselling supplemented with NRT achieved cessation considerably more often that those who received usual care.121  The US National Comprehensive Cancer Network clinical practice guidelines recommend that treatment plans for all smokers with cancer include evidence-based pharmacotherapy, behaviour therapy, and close follow-up with retreatment, as needed.122  However, a lack of appropriate resources and provider training has been cited as a major barrier to integrating tobacco treatment in healthcare systems.118   

Among childhood and young adult cancer survivors, factors such as self-efficacy, social support, fear of recurrence, perceived vulnerability and depression are associated with smoking.123  Web-, print-, and telephone-based interventions appear to be equally effective for this group,124  and educational and behavioural risk-counselling interventions may also be beneficial in reducing smoking risk up to 12 months after intervention.116   

Cigarette smoking causes most cases of lung cancer, and adversely impacts prognosis once lung cancer is diagnosed (see  Chapter 3, Section 3.4). However, most smokers with lung cancer continue to smoke post-diagnosis, or fail to maintain abstinence following quit attempts. A recent Cochrane review aimed to examine smoking cessation interventions for people diagnosed with lung cancer, which represents an important factor in improving their prognosis. The review found no randomised controlled trials that met selection criteria, therefore the efficacy of cessation interventions could not be evaluated. These authors call for further research in this area.125  Limited research suggests that smoking cessation strategies for lung cancer patients should include counselling and use of pharmacological treatment (nicotine replacement therapy, bupropion and varenicline).95  Screening programs for lung cancer might also benefit from the inclusion of cessation interventions.126  Lung cancer survivors who are exposed to secondhand smoke, particularly those exposed in multiple settings, are less likely to quit.127

In general, because each patient with cancer has unique medical, psychological, and social circumstances, cessation treatment needs to be individualised.128  Patient age, gender and type of cancer may be important factors to consider when developing and implementing smoking cessation interventions for cancer patients. Persistent smoking post-diagnosis is associated with younger age, lower education and income, greater alcohol consumption,129  the presence of household members who smoke, high body mass index, and a longer duration of smoking.130  Pain may also be a barrier to quitting among cancer patients who smoke.131  People who continue smoking subsequent to a cancer diagnosis often perceive fewer health risks from smoking and fewer benefits of quitting.132, 133  Other challenges for people with cancer can include long histories of smoking, pressure for immediate quitting, high levels of stress and distress, delayed relapse, and medical contraindications to certain pharmacotherapies.96,134   

7.19.5.5 Diabetes

People with diabetes who quit smoking have a lower risk of death and cardiovascular events compared with those who continue to smoke.135  However, recent research has shown while quitting generally decreases the risk of diabetes overall, smoking cessation is associated with an increased risk and deterioration in blood glucose control in the first 2–3 years of abstinence.136, 137  A recent review similarly found that cessation can cause weight gain and can be associated with diabetes or obesity onset.138  Therefore, it is important that quit attempts are accompanied by preparation, extra care, and careful monitoring to keep the person’s blood glucose well controlled during this time.136,139  Additional challenges to achieving abstinence for people with diabetes include early uptake of smoking, difficulty with weight management, negative affect, and low motivation for quitting at the time of hospitalisation.96  Lower education level is also associated with smoking in young people with diabetes.140

There is a dearth of evidence to inform treatment strategies for smoking cessation in type 2 diabetes. A randomised controlled trial found that an intensive, individualised intervention using motivational interviewing, therapies, and medications adapted to the patient's stage of change delivered to people with diabetes in primary care was feasible and effective, with a smoking cessation rate of 26.1% after 1 year.141  One program partnership in California that aimed to promote referrals to the quitline by diabetes educators resulted in an increase in the percentage of quitline calls from people with diabetes and the proportion of callers referred by healthcare providers142   

A systematic review of randomised trials of smoking cessation interventions in diabetes published in 2014 identified only a small number of trials, which tested interventions similar to those used in the general population, comprising counselling, referral and advice, and for some, the addition of diabetes-specific education. The results did not provide evidence of efficacy for the interventions. Only one trial reported data on glycaemic outcomes, which were not significantly different between intervention groups.143  A more recent review of randomized, placebo-controlled studies of varenicline in smokers with diabetes concluded that it was an effective and well-tolerated aid for smoking cessation, and safety was comparable with participants without diabetes.144  Bupropion should be used with great caution among people with diabetes, as the risk of seizures is greater in individuals taking insulin or oral diabetes medication.145

7.19.5.6 HIV/AIDS

Adults with HIV are more likely to smoke and less likely to quit than the general population.146  Data from the Australian HIV Futures 6 study show that 42.3% of people living with HIV/AIDS smoke.147  HIV infection appears to confer an increased susceptibility to the harmful effects of smoking,148  including non-AIDS-defining cancers, cardiovascular disease, and pulmonary disease.149  Smoking also adversely affects the health-related quality of life of people living with HIV/AIDS.149  Cessation may result in better disease management and increased length of survival.149 When asked, as many as two-thirds of smokers with HIV report being interested in or considering quitting.150 Diagnosis of HIV may be an effective time for intervention.149

Successful quitting among people with HIV is influenced by a complex range of social, economic, psychiatric, and medical factors.149, 151, 152  Research in the US found that among people with HIV, current smokers had higher unemployment and increased rates of other substance use than former smokers or never smokers. Being unemployed and having used inhalant drugs were also associated with current smoking. Lower education was associated with decreased readiness to quit.153  National surveys in the US have found that people with HIV who binge drink or who have been treated for drug or alcohol use are more than 5 times more likely to be current smokers than never smokers.154  Another study found that older age and lifetime use of NRT/medications were associated with interest in quitting smoking, while older age and having a supporter who had used NRT/medications for cessation were associated with lifetime NRT/medications use.155  Surveys in the US found that people with HIV cite cost and a belief that they can quit unassisted as the main reasons for not using pharmacotherapy. Physician assistance was the strongest correlate of prior use. Willingness to use pharmacotherapy was associated with perceived benefits and self-efficacy.156  Self-efficacy plays an important role in outcomes of smoking cessation interventions157  and cessation medication adherence,158  and measures aimed at increasing self-efficacy to abstain may enhance the effect of targeted tobacco treatment strategies.159  Social support can also promote NRT use adherence.160

Limited evidence shows that interventions for this group are potentially effective, can significantly decrease smoking rates, and can be incorporated within HIV clinics.96,149,151,161,162  A review published in 2013 found that smoking cessation rates ranged from 6% to 50% across studies employing pharmacologic and behavioural approaches. However, the studies were often small and the effect was often not sustained over time. Smoking was associated with emotional distress, which may be a barrier to successful cessation. Declining adherence to pharmacologic therapy also may have contributed to low cessation rates. Nicotine replacement therapy combined with a mobile phone-delivered intensive counselling intervention appears to be a promising intervention. The authors highlight need for innovative and effective interventions tailored to this population.150  Preliminary findings from a recent randomised controlled trial suggest that web-based treatment is a feasible and effective cessation strategy for smokers with HIV.163   

A meta-analysis published in 2016 concluded that targeted behavioural smoking cessation interventions are effective for people with HIV, with interventions consisting of eight sessions or more having the greatest treatment efficacy.164  Another 2016 review also found evidence (albeit sparse and mixed) for the efficacy of behavioural interventions.165  A Cochrane review published in 2016 found very low quality evidence that combined cessation interventions (behavioural support and pharmacotherapy) were effective in helping achieve short-term abstinence among people living with HIV/AIDS, and moderate quality evidence that the effects were not sustained. Despite this, the authors recommend that interventions be offered to this group, given the benefits of short-term cessation.166

While health professionals working with patients living with HIV/AIDS agree on the importance of smoking cessation, they often fail to implement interventions.167  Healthcare professionals should actively pursue smoking cessation as a major objective in the clinical care of people with HIV.168  Future cessation interventions for HIV-infected smokers may be enhanced by the inclusion of medical adherence and depression as components of the program. 152,169   

7.19.5.7 Other conditions

Research related to smokers who are hearing or sight impaired is scarce. Access to smoking cessation programs for those who are deaf is limited due to cultural, linguistic and geographic barriers. Internet-based interventions may provide greater access to cessation assistance, but research is very limited. One pilot study of an interactive website has been positively evaluated by deaf community members.170   

Little is known about the smoking rates of adults with intellectual disability or about effective interventions for this population. UK data suggest that those not using disability services are more likely to smoke.171 Limited research supports the use of mindfulness-based cessation programs.172,173  A systematic review concluded that the body of evidence on the feasibility, appropriateness, meaningfulness, and effectiveness of tobacco-related interventions for people with intellectual disability is small, and the evidence that does exist is of poor/moderate quality. The strongest study developed materials that educated people with intellectual disabilities about smoking, which led to significantly lower rates of smoking.174   

this?

7.19.6 Substance use and other mental disorders

Compared with the general population, people with mental illness have higher smoking rates, higher levels of nicotine dependence, and a disproportionate health and financial burden from smoking.175  Health professionals and smokers with mental health disorders often erroneously believe that smoking is helpful for relieving or managing psychiatric symptoms, such as feelings of depression, anxiety, and stress.176 However, recent evidence suggests that the reverse is true; quitting smoking actually improves mental health, mood, and quality of life.176  Interventions for reducing smoking among those with a mental health problem are covered in detail in  Section 7.12.

7.19.7 Culturally and linguistically diverse groups

Generally speaking, people born outside of Australia are less likely to be smokers than those born in Australia. Similarly, the prevalence of smoking is higher in English-speaking households compared with those that mainly speak a language other than English (See  Chapter 1, Section 1.8). Nonetheless, among some smaller population sub-groups, smoking is much more common. For example, small studies have found that as many as half of men with Chinese or Vietnamese backgrounds in Australia are smokers. 177, 178  Smoking rates among women immigrants from non-Western countries (where smoking is typically rare) may also increase as they acculturate and adopt new social norms.179  Morbidity and mortality from smoking-related diseases can therefore disproportionately affect culturally and linguistically diverse (CALD) populations.180   

Patterns of tobacco use and types of products used can differ between groups, and along with the interplay between smoking and complex psychosocial and cultural factors, this necessitates tailored and targeted cessation interventions. Such interventions should consider unique patterns of risk and protective factors among CALD groups, as well as other potentially relevant dimensions such as values, beliefs and practices.180,181  Qualitative research in Sydney found that among Arabic speakers, male smoking was normalised in home, social and religious settings. While there was concern about children's exposure to secondhand smoke, there was less concern for adults, particularly wives. Smoking created conflict within families, and attempts to quit were often unassisted. There was a lack of enthusiasm for telephone support services, however participants suggested that free NRT and programs in religious settings might be useful strategies.182   

A systematic review of adapted cessation interventions for ethnic minority groups found that while such interventions are more acceptable, this does not translate into improvements in smoking cessation outcomes.180  Another systematic review reported more promising results for the effectiveness of specific cultural adaptations for cessation, and highlighted that interventions may be more effective if adaptations are implemented as a package, the adaptation includes family level, and where the adaptation results in a higher intensity of the intervention.183

The Quitline service provides access to many printed resources in a range of community languages, and callers can request an interpreter. Some culturally specific programs have been initiated by various Australian organisations, mostly on a short-term basis.184,185  One New Zealand pilot study suggests that a language-specific home-, workplace- or clinic-based intervention is acceptable and effective among Asian communities in assisting cessation and establishing smokefree homes.186  An Australian study investigating a telephone support service for Arabic smokers initiated in primary medical care found the support acceptable, but there were no significant abstinence differences compared to usual care at six or 12 months.187   

7.19.8 Smokers living in remote areas

People living in remote and very remote areas are about twice likely to smoke than those living in major cities.51  Those who live in rural and remote areas face unique challenges regarding smoking cessation. Living some distance from major population centres, such people often lack access to specialist medical and other health services. Availability of pharmaceutical treatments and free telephone and internet services providing advice and assistance to quit are therefore very important for Australian smokers living in rural and remote areas.188  (See Chapter 9, Section 9.6.) The role of health professionals in rural and remote areas in promoting cessation is important despite lack of services in many regions.189  

7.19.9 Lesbian, gay, bisexual, trans and intersex (LGBTI) people

A growing body of evidence shows that smoking rates are significantly higher among lesbian, gay, bisexual, trans and intersex (LGBTI) people compared with the heterosexual population.190-192 In the 2019 National Drug Strategy Household Survey, people who were homosexual or bisexual were more likely than heterosexuals to smoke daily (16.0 +/-1.5 compared with 10.7% =/-0.3 (see National Drug Strategy Household Survey, table 2.58).51  US research found that sexual minority cancer survivors had twice the odds of current smoking as their heterosexual counterparts.193  The roles of gender non-conformity, masculine self-consciousness and sexual orientation stress appear to be important influences on smoking behaviour in young gay men.194  A survey in the US found that psychological distress was higher among lesbian, gay, bisexual, and trans smokers than non-smokers,195  while another found that sexual minority-specific traumatic experiences increased the odds of smoking among gay and bisexual men.196 Less educational attainment, hazardous drinking, and cocaine/heroin use are associated with continued smoking among sexual minority women.192  Findings from a community sample of trans women in the US showed that discrimination was associated with smoking, unsuccessful cessation, and never making a quit attempt.197

There is some international evidence that sexual and gender minority persons may be less positive about public and private smokefree environments, highlighting a need to examine ways to increase their support.198  Social environments that encourage tobacco use among gay men is an important consideration in cessation interventions for this group.199  Limited findings suggest that because of the relationships between smoking and other behaviours, cessation interventions for young gay men should be part of larger more holistic health and wellbeing programs.200  For young lesbian and bisexual women, addressing experiences of gay-related stress, internalised homophobia, and emotional distress should inform effective cessation interventions.191

A 2014 review of cessation promotion for LGBT people found evidence that tailored group programs are feasible and effective. Community interventions, although feasible, lack rigorous outcome evaluations. Clinical interventions show little difference between LGBT and heterosexual people. Findings from focus groups suggested that care is needed in selecting the messaging used in media campaigns.201  An analysis of national US survey data found that LGBT individuals have similar exposure to tobacco cessation advertising, as well as similar awareness of and use of evidence-based cessation methods as compared to heterosexual peers. This highlights the need for LGBT-specific efforts to reduce smoking disparities, such as increasing awareness, access, and acceptability of existing interventions, developing tailored interventions, and denormalising smoking.202  A study in San Francisco concluded that sexual and gender minority smokers appear as likely to quit or abstain as nonminority smokers in extended, non-tailored interventions; however, the authors note that the findings may not generalise to geographic areas where access to treatment is limited or a higher stigma of sexual orientation exists.203  In Switzerland, a modified version of a British smoking intervention program tailored to gay men improved short-term and sustained abstinence rates, as well as participants’ mental health.204  The design of a randomised controlled trial was published in 2014, the results of which will examine the effectiveness of a culturally targeted versus standard smoking cessation intervention for LGBT smokers.205   

A 2016 systematic review of smoking cessation programs for LGBTI people concluded that quit rates were high across studies; however, none included control groups. Most studies included cultural modifications, such as meeting in LGBTI spaces, discussing social justice, and discussing LGBTI-specific triggers. Common behaviour change techniques included providing normative information, boosting motivation/self-efficacy, relapse prevention, social support, action planning, and discussing consequences. Individual populations were not proportionately represented in the studies, with findings most often relevant to gay men.206

7.19.10 Prisoners and others involved in the criminal justice system

The prevalence of smoking in the prison population has traditionally been far higher than among the general population, with tobacco use commonly accepted as part of prison life.207 In 2018, two in three (66%–69%) prison entrants aged 18–44 were daily smokers, compared with just one in seven (14%–16%) people of the same age in the general community.208 Priority populations that have much higher smoking prevalence than the general population, such as those from socially disadvantaged backgrounds, those with a history of mental illness and substance abuse, and those from Aboriginal or Torres Strait Islander backgrounds, are substantially overrepresented in Australian prisons.207, 209-212

Despite very high smoking rates, and fewer than one in 10 (5%–10%) prison entrants having successfully quit smoking in the past, many detainees express an interest in quitting. In 2018, about two in five (41%) prison entrants who were current smokers wanted to quit.208 Of the 41% of prison entrants who wanted to quit smoking, almost half (47%) thought NRT would help, 25% thought counselling would help, 22% thought a quit program would help, and one-third (33%) said they did not want any help to quit. Upon exiting prison, dischargees, who were current smokers on entry, were asked what cessation assistance they had utilised while in prison. Eighteen per cent had utilised nicotine replacement, 2% had utilised counselling or other, 6% had utilised a quit smoking program, and 27% had not wanted assistance to quit.

Barriers to quitting in this population have included a strong smoking culture in prison; the role of tobacco as a de facto currency; high levels of nicotine dependence; mental illness; limited access to nicotine replacement therapy and cessation programs; boredom; and stressful events such as prison transfer, family and legal stressors. Further problems include a lack of evidence for best practice for smoking cessation in this group, confusion over the ownership of the problem between the health department and custodial authorities, and poor access to smoking cessation programmes while outside the prison system.207,209,210,213

As at February 2020, all Australian territories and states (except Western Australia) have introduced or announced intentions to introduce complete smoking bans in prisons. Prior to the implementation of bans, prisoners were provided with access to intensive cessation support.214  In The health of Australia’s prisoners 2018 report, about one-third (30%) of dischargees from prisons that had banned smoking said they were current smokers, compared with more than half (56%) of dischargees from prisons which allowed smoking. However, there was only a two percentage point difference between prison dischargees’ intentions to smoke upon release from prisons that had banned smoking and prisons which allowed smoking (42% and 44% respectively).208

A 2018 systematic review investigating factors influencing smoking following release from smokefree prisons found a high and rapid rate of smoking relapse among dischargees.215 A systematic review in 2016 similarly found indoor bans on smoking in prisons to have little impact on prisoner smoking behaviour, with prisoners who had experienced a ban typically resuming smoking shortly after release. 216 Pre-release intentions to remain abstinent using motivational counselling have been cited as positively associated with post release smoking abstinence.215 Multi-component interventions using a combination of behavioural support and smoking-cessation pharmacotherapy has also been found to maximise chances of sustained cessation,215 as was refraining from risky drinking.217 Despite the availability of smoking cessation pharmacotherapy (SCP) at a heavily subsidised rate in Australia, once released, only a small proportion of prison dischargees go on to use SCP, pointing to a missed opportunity in this vulnerable community.218 While maintaining support for dischargees post release is important for successful smoking abstinence, this support has typically fallen outside the scope of the implementation of smokefree prisons.218 Findings from a 2019 pilot study in Victoria Australia suggest more intensive support is required in order to reduce post-release relapse to smoking and to encourage those who do relapse to make further quit attempts.219

For further information on smoking, ill-health, financial stress and smoking-related poverty among the prison population see Chapter 9, Section 9.6.6.

 

7.19.11 Veterans

Australian research published in 2010 that examined smoking in the Australian Defence Force found that the highest prevalence of current smoking was among individuals with lower levels of education and those serving in the Navy (26%). The percentage of current smokers in the Army was 22% and the lowest prevalence of smokers was in the Air Force (8%).220 Based on the relative incidence of smoking-related cancers, smoking rates among veterans of the Korean War are estimated to be higher than those of the general population.221 (See Chapter 9, Section 9.6.8.) Data in the US also show that the prevalence of smoking is higher among veterans than the general population, particularly among younger veterans; for those born between 1975 and 1989, the prevalence of smoking is similar to that of the US adult population during the late 1960s/early 1970s, at about 36%.222

There is limited Australian research on cessation interventions for veteran populations, however a number of US studies have provided evidence as to which strategies may be most effective. A large multi-site study concluded that the Tobacco Tactics program, which comprises nurse counselling, informational materials, pharmaceuticals, and post-discharge telephone calls, has the potential to significantly decrease smoking among veterans.223 Intensive interventions that combine medication with counselling from the tobacco cessation pharmacists also appear promising.224 A small study found that a smartphone-based contingency management intervention may be a useful adjunctive smoking cessation treatment component for reducing smoking among homeless veterans.225 A larger study found that a smoking cessation text messaging intervention developed for veterans effectively supported abstinence, particularly among veterans who were highly engaged with the program or who also used cessation medications.226 Including tobacco cessation education in veterans’ treatment for other substance use disorders can promote quitting,227 but smoking cessation is often not prioritised in these settings.228 Chaplains, who provide meaningful physical and mental healthcare support to veterans, have expressed willingness to be involved in cessation efforts, and could represent another avenue for promoting quitting.229   One study found that, among veterans with a history of mental health treatment, smoking abstinence was associated with improvements on a number of behaviour and symptom measures.230

7.19.12 Younger smokers

Although adults experience the major burden of disease from tobacco use, interventions that influence children’s and adolescents’ smoking behaviours are an integral part of ending the tobacco epidemic. Almost all smokers start smoking when they are teenagers, and those who start earlier appear to have more difficulty quitting and be more susceptible to tobacco-related disease.231 Young people with mental health or behavioural problems are also far more likely to smoke than their peers, with emerging evidence showing that smoking appears to play a causal role in some mental disorders.232, 233

In a 2017 survey of Australian school students aged 12–17 years, about 13% of those who had smoked more than 100 cigarettes in their lifetime (who comprised about 2% of students) identified as ex-smokers. Just over half (53%) of students who had smoked in the past twelve months intended not to smoke in the next year.234

7.19.12.1 Factors influencing smoking and quitting

A complex range of factors influence adolescent smoking and quitting. Some findings suggest that while many younger smokers intend to quit, they have negative attitudes towards most formal cessation approaches and their quit attempts are more likely to be unaided compared to adults.235,236 Quitting may be a much more stressful, uncomfortable, and socially isolating experience for youth than research typically acknowledges.237, 238 Young smokers may receive little active support from family and friends in their quit attempts238 They may rationalise continuing to smoke by downplaying the health risks of smoking, emphasising the perceived health benefits such as stress relief, and thinking of smoking as a temporary activity that they can easily stop once they enter adulthood.239

In terms of individual differences, lower nicotine dependence, being older at smoking initiation, perceived peer and parental tolerance of smoking, self-efficacy, resisting peer pressure to smoke, negative beliefs about the consequences of smoking, not having intentions to smoke in the future, and less smoking among social networks are associated with quitting among young people.240-244 Maintenance of regular physical activity among young smokers also appears to help to facilitate smoking cessation,245 as does adding physical activity to an adolescent cessation program, particularly among boys.246   Factors that can predict relapse include socialising with friends, cravings, social pressure, desire for a cigarette, abstinence–violation cognitions (it’s okay to smoke occasionally, wanted to see what it was like) and negative emotions.247 Although withdrawal symptoms may be uncomfortable for adolescent smokers trying to quit, they do not appear to be the most important factors causing relapse.248

7.19.12.2 Cessation interventions

Unlike the extensive body of literature studying smoking cessation among adults, there is a paucity of good quality studies focusing on smoking cessation intervention and cessation programs for young people. Prevention and cessation are intertwined, but most of the effort with young people to date has focused on preventing uptake rather than promoting cessation.249 A 2013 Cochrane review of cessation interventions for young people concluded that complex approaches show promise, with some promoting maintained abstinence, especially those incorporating elements sensitive to stage of change and using motivational enhancement and cognitive-behavioural therapy.  A small number of studies investigated the use of pharmacological interventions for adolescent smokers (nicotine replacement and bupropion), but none demonstrated effectiveness. The authors call for well-designed and robust trials of interventions for young smokers.250

Despite limited evidence of its efficacy, nicotine replacement therapy is recommended for use with teenagers who exhibit symptoms of dependence.249 If used, it should be individualised and combined with psychosocial and behavioural interventions.251 Counselling is a vital component of interventions for young people.252  

There is some evidence that specialist youth settings can be effective venues for the delivery of tailored cessation programs for young people.253 A systematic review and meta-analysis published in 2015 found that the mostly moderate quality evidence suggested targeted behavioural interventions can assist with cessation in school-aged children and adolescents.254 Earlier research found that programs that are delivered in a context that is structured for youth, such as a school, and that extend for at least five sessions seem to be more effective than community-based and single session interventions;255, 256 however, there are many barriers to delivering such programs within schools.256 Further, a seven-year follow up study found no evidence that previously positive effects of a high school-based cessation intervention for teens were sustained long-term.257 One of the single most inexpensive actions a school can take to reduce smoking is to introduce and enforce a no-smoking policy for students, teachers and visitors.258, 259 Similarly, community youth services should develop policy that addresses smoking by clients and staff, and encourages and supports smoking cessation. A national evaluation of community-based youth cessation programs in the US concluded that providing evidence-based treatment to youth in community-based settings results in successful cessation.260

Proactive, personalised telephone counselling is effective for adolescent smoking cessation.261 About 4% of callers to the Victorian Quitline are under 18 years of age, and protocols for young callers have been developed as part of the set of national minimum standards.262 These recommend that services focus on the immediate harmful effects of smoking and issues of appearance and youth-specific reasons for smoking, such as rebellion or aspiring to be more grown up. Recognising differences in patterns of smoking between adolescents and adults, for example infrequent and situation-dependent smoking, is important in appropriately tailoring interventions, as is referring young people to youth-specific resources, especially internet sites.263 Internet- and mobile phone-based interventions offer enormous potential for reaching young people, and these are discussed in detail in Section 7.14.

7.19.12.3 Social marketing and public education campaigns

Population-wide approaches can also effectively shape young people’s smoking-related attitudes and behaviours. Despite primarily targeting young to middle-aged adults, the impact of Australia’s national campaigns to promote smoking cessation also reach younger people. For example, evaluation of the early National Tobacco Campaign showed that adolescents learnt as much, if not more, than the 18–40 years target group from the television advertisements, and the campaigns prompted changes in smoking behaviour.264, 265 A systematic review that assessed the equity impact of interventions/policies on youth smoking found that price/tax increases had the most consistent positive equity impact (i.e., reduced smoking inequity between high- and low-SES young people).266

7.19.12.4 The role of health professionals

As with adult smokers, health professionals play an important role in encouraging and assisting younger smokers to quit, and paediatric-based interventions are feasible and effective.267 Paediatric healthcare professionals can provide opportunistic evidence-based brief interventions to adolescents and their carers, and/or can provide referrals to specialist services and resources. However, many health professionals have not received appropriate smoking cessation training.249 Practitioners’ low levels of confidence in helping young smokers to quit, their lack of clarity about what strategies and pharmacotherapies should be used, their concern for maintaining rapport with their adolescent patients, and the health problem of the patient can hinder the delivery of interventions in this setting.255, 268, 269 Nonetheless, health professionals’ training should emphasise the importance of smoking cessation as a part of their everyday practice.249  

7.19.13 Older smokers

The greatest proportion of burden of disease due to smoking affects those aged 55–75 years. (See Chapter 1, Section 1.5.) A comprehensive study on the impact of smoking and smoking cessation on cardiovascular events and mortality among adults aged 65 years and over found that smoking cessation in these age groups is still beneficial in reducing the excess risk, thus should be supported and encouraged.270 A large Australian study similarly found that smoking cessation, even at older ages, reduces the risk of preventable hospitalisation for chronic conditions.271

7.19.13.1 Factors influencing smoking and quitting

Results from surveys in the UK, US, Canada, and Australia suggest that older smokers tend to perceive themselves as being less vulnerable to the health effects of smoking, are less convinced or concerned about these health effects, believe that smoking has not affected their own health so far, are less confident about being able to quit, do not see any health benefit of quitting, and are overall less willing to quit.272 Depression273 and loneliness274 also appear to act as important barriers to quitting in older smokers. Factors that appear to encourage older smokers to quit include increasing the price of cigarettes, advice from a health professional, and cheaper stop-smoking medications.272 As in the general population, developing health problems can also trigger cessation attempts275 A large German survey found that high-risk older patients with comorbidities are highly motivated to quit and would benefit from effective assistance.276 One study found that continuing older smokers who quit tended to be those who took more medications and had greater cognitive dysfunction.274

There is evidence that transition into retirement represents a time when smokers are more likely to quit, suggesting that interventions could be developed to take greater advantage of this lifestyle change.277 Older people’s continued smoking, quitting, and relapse appear to be significantly influenced by friends and family members, especially a spouse, and their attempts to quit are often unplanned.278 When provided with an appropriate intervention, older smokers can and do quit successfully.279 Indeed, Danish research found that, following a “gold standard” intensive six-week smoking cessation program, participants over the age of 60 years had significantly higher continuous abstinence rates than participants under 60 years.280

7.19.13.2 Cessation interventions

A number of recent studies have reviewed the evidence on smoking cessation interventions for middle-aged and older adults. Although the research is limited, a systematic review and meta-analysis study found support for pharmacological, non-pharmacological, and multimodal interventions in adults over fifty years,281 while another suggested that the use of NRT may be an effective strategy for smokers aged 65 and over.282 Research in the US demonstrated that adding extended cognitive behavioural therapy to standard cessation treatment (i.e., 12 weeks of NRT) was cost-effective.283 Among community-dwelling elderly smokers, one study found that behavioural group therapy achieved higher short-and long-term abstinence rates than education alone.284 Interventions may need to address the underestimation by older smokers of the risks of smoking and their misperceptions that there are no benefits of quitting. 272 Findings from focus groups in the US revealed that anti-tobacco messages with a positive frame that outline immediate and long-term benefits of cessation would be an effective approach for older long-term smokers.285

7.19.13.3 The role of health professionals

Health professionals have an important role to play in educating older people about the health benefits of quitting and a range of opportunities exist in which to advise and assist older patients to stop smoking.272 (See Section 7.10.) Older adults tend to visit their health professionals more frequently, creating many opportunities for intervention. They are able to quit at high rates when given effective advice and support by health professionals, including behavioural therapy and pharmacotherapy.272, 279,286 Studies have found however, that health professionals may be less likely to promote smoking cessation to older patients.279 Interviews with older ex-smokers revealed that they may need additional education on tobacco risks and cessation benefits provided by health care providers during routine office visits.287 Health professionals cite a number of misperceptions and perceived barriers to providing interventions, including that older smokers are unwilling and unable to quit, that they would not respond positively to advice, that they understand the risks of continuing to smoke, that quitting would not have any great benefit, that it is wrong to take away something pleasurable in their life, and that quitting might actually harm the patient’s health. They also report lack of organisational support and concerns about harming the health professional–patient relationship. There is some evidence that nurses who do not smoke are more likely to provide advice to quit.279, 288

Cigarette smoking may contribute to worse health outcomes for peri- and postmenopausal women and cessation may be particularly challenging for this group. (See Chapter 3, Section 3.6.1.3.) Further research is warranted in this area.289

7.19.14 Women

Cessation interventions for pregnant women are covered in detail in Section 7.11.

While the prevalence of smoking has typically been higher among men than women, this gap has narrowed over time (See Chapter 1, Section 1.3). This has largely been attributed to aggressive tobacco industry marketing targeting women, as well as the production of specially formulated products for women, such as ‘light’, ‘slim’, ‘super-slim’, low-tar, light-coloured packaging, and menthol cigarettes290 Although women and men who smoke share excess risks for diseases such as cancer, heart disease, and emphysema, women also experience unique smoking-related disease risks related to pregnancy, oral contraceptive use, menstrual function, and cervical cancer. 291 Women and men tend to have different reasons for initiating and continuing tobacco use and may experience different barriers to quitting smoking, some of which are gendered.292 Barriers to quitting that are unique to or experienced to a greater degree among women include fear of weight gain, certain social factors, withdrawal and craving in response to environmental cues, the point in the menstrual cycle in which an attempt is made to quit, and depression.293 For example, while depression consistently predicts lower rates of abstinence, the effects are stronger among women.294 Women taking oral contraceptives also appear to experience different patterns of smoking-related symptomatology during short-term smoking abstinence.295 Further, during the follicular phase (the first half) of the menstrual cycle, cognitive control appears to be lower and cue reactivity higher, which could potentially hinder quit attempts. 296 Gendered roles and experiences can limit women’s ability to access treatment and support due to heightened stigma surrounding substance use among women, particularly pregnant women and mothers.297

Compared with men, women may be less successful at quitting,298,299 and have worse health outcomes.291,299 Results from the International Tobacco Control Four Country Survey showed that although women were equally as likely as men to want, plan, and try to quit,  among quit attempters, women had 31% lower odds of success.300 Women also tend to relapse faster, and experience more difficulties with maintaining abstinence.290 While bupropion and varenicline appear to be equally effective among men and women,301, 302 results regarding NRT are mixed. A number of studies have suggested that NRT may be less effective in women,303,304 and that women experience less quitting success when using nicotine patches.305 Others have found no gender differences.306 Another study found that abstinence rates were lower in women who used gum, patches and spray compared with men; however, women experienced greater success than men after using an inhaler.307 Regardless, due to its safety and efficacy, NRT is also recommended for women trying to quit.293 A meta-analysis of sex differences in the comparative efficacy of transdermal nicotine, varenicline, and sustained release bupropion for smoking cessation concluded that the advantage of varenicline over bupropion and nicotine patches is greater for women than men, and the authors suggest that clinicians should strongly consider varenicline as the first-line treatment for women. Among men, the relative advantages were less clear.308

Together, these issues have led to calls for the importance of attending to gender to be recognised in health promotion interventions292 One of the recommendations of a 2007 policy brief by the WHO was to “Increase availability and access to treatment services for tobacco dependence and train health professionals in these services to take into account sex and gender specificities when treating tobacco dependence.”309 The preamble to the FCTC likewise highlights “the need for gender-specific tobacco control strategies.”310 However, a recent review found that tobacco use interventions designed with an understanding of the effect of gender roles, norms, and behaviours on women’s health are limited, and primarily focused on pregnant and postpartum women. The authors conclude that much work remains to encourage practitioners to use a gender-sensitive approach when designing interventions.292 Others have called for policy and program developers to apply gender theory in designing their initiatives, with the goal of changing negative gender and social norms and improving social, economic, health and social indicators along with tobacco reduction.311 A recent study examining cessation outcomes following an intervention that included gender-tailored components found no short- or long-term gender differences in the effectiveness of the intervention.312 A small qualitative study from Canada suggests that smoking cessation programs for women should ideally include: a women's centred approach with sufficient variety and choice; free pharmacotherapy; non-judgmental support; accessible services; and clear communication of program options and changes.313

Gender-sensitive approaches to medication development for smoking cessation may also be a critical next step for addressing low quit rates and exacerbated health risks among women. Smoking appears to activate different brain systems modulated by noradrenergic activity in women compared with men, and noradrenergic compounds may preferentially target these gender-sensitive systems.314 Researchers have also suggested that investigation of any nicotine addiction protective effect of progesterone in women may be worthwhile.315,316 A recent cessation medication trial found that increases in progesterone level in women smokers were associated with a 23% increase in the odds for being abstinent within each week of treatment.317  

7.19.15 Users of other tobacco products

Use of waterpipes (hookah/shisha) has increased dramatically throughout the world in recent years.318 (For prevalence of use in Australia, see Section 1.11). Researchers have called for waterpipe-specific cessation programs, which address unique features of waterpipe smoking (e.g., its cultural significance, social uses, and intermittent use pattern) and characteristics and motivations of users who want to quit.319 A randomised controlled trial concluded that brief behavioural cessation treatment for waterpipe users appears to be feasible and effective.320 A 2015 review of cessation interventions concluded that people who received either behavioural treatment or behavioural treatment plus buproprion were more likely to quit waterpipe smoking at six months follow-up than those who received usual care.321 A subsequent systematic review concluded that there is a lack of evidence of effectiveness for most interventions for waterpipe smoking. Limited evidence supports bupropion/behavioural support and group behavioural support.322

Relatively few treatment programs have been developed specifically for smokeless tobacco users who want to quit. A 2015 Cochrane review concluded that varenicline, nicotine lozenges, and behavioural interventions may help smokeless tobacco users to quit; however, the authors report limited confidence in the results regarding lozenges and behavioural interventions.323 A systematic review and meta-analysis concluded that varenicline is effective in achieving abstinence from smokeless tobacco at 12 weeks, but this effect was not sustained at 26 weeks.324 A randomised trial found that combining nicotine lozenges and phone counselling significantly increased tobacco abstinence rates compared with either intervention alone.325 Another randomised trial found that internet- and phone-based interventions were more effective than self-help in helping motivated smokeless tobacco users quit tobacco, but a combination of the two did not increase their effectiveness.326

Relevant news and research

For recent news items and research on this topic, click  here. ( Last updated October 2020)

 

References 

1. Borrelli B. Smoking cessation: Next steps for special populations research and innovative treatments. Journal of Consulting and Clinical Psychology, 2010; 78(1):1–12. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20099945

2. Murray R, Bauld L, Hackshaw L, and McNeill A. Improving access to smoking cessation services for disadvantaged groups: A systematic review. Journal of Public Health, 2009; 31(2):258–77. Available from: http://jpubhealth.oxfordjournals.org/content/31/2/258.long

3. Bryant J, Bonevski B, Paul C, O'Brien J, and Oakes W. Developing cessation interventions for the social and community service setting: A qualitative study of barriers to quitting among disadvantaged Australian smokers. BMC Public Health, 2011; 11:493. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21699730

4. Siahpush M. Commentary on bryant et al. (2011): Behavioral and population-level interventions for reducing disparities in tobacco use. Addiction, 2011; 106(9):1586–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21815922

5. Bryant J, Bonevski B, Paul C, McElduff P, and Attia J. A systematic review and meta-analysis of the effectiveness of behavioural smoking cessation interventions in selected disadvantaged groups. Addiction, 2011; 106(9):1568–85. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21489007

6. Australian Bureau of Statistics. 4727.0.55.006 - Australian Aboriginal and Torres Strait Islander health survey: Updated results, 2012–13. 2014. Available from: http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/4727.0.55.006main+features12012-13

7. Measey M, d’Espaignet E, and Cunningham J. Adult morbidity and mortality due to tobacco smoking in the Northern Territory 1986-1995., Darwin: Northern Territory Government Department of Health and Community Services, 1998. Available from: http://www.nt.gov.au/health/health_gains/epidemiology/mortality_morbidity_smoking_1986.pdf.

8. Unwin C, Gracey M, and Thomson  N. The impact of tobacco smoking and alcohol consumption on Aboriginal mortality in Western Australia, 1989-1991. Medical Journal of Australia, 1995; 162(9):475–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/7746204

9. Courtney RJ, Naicker S, Shakeshaft A, Clare P, Martire KA, et al. Smoking cessation among low-socioeconomic status and disadvantaged population groups: A systematic review of research output. International Journal of Environmental Research and Public Health, 2015; 12(6):6403–22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26062037

10. Brown T, Platt S, and Amos A. Equity impact of European individual-level smoking cessation interventions to reduce smoking in adults: A systematic review. European Journal of Public Health, 2014; 24(4):551–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24891458

11. Bosdriesz JR, Willemsen MC, Stronks K, and Kunst AE. Socioeconomic inequalities in smoking cessation in 11 European countries from 1987 to 2012. Journal of Epidemiology and Community Health, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25841241

12. Motta JV, Lima NP, Olinto MT, and Gigante DP. Social mobility and smoking: A systematic review. Cien Saude Colet, 2015; 20(5):1515–20. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26017952

13. Siahpush M, McNeill A, Borland R, and Fong GT. Socioeconomic variations in nicotine dependence, self-efficacy, and intention to quit across four countries: Findings from the International Tobacco Control (ITC) four country survey. Tobacco Control, 2006; 15(Suppl 3):iii71–5. Available from: http://tc.bmjjournals.com/cgi/content/abstract/15/suppl_3/iii71

14. Siahpush M, Borland R, and Scollo M. Smoking and financial stress. Tobacco Control, 2003; 12(1):60–6. Available from: http://tobaccocontrol.bmj.com/content/12/1/60.abstract

15. Belvin C, Britton J, Holmes J, and Langley T. Parental smoking and child poverty in the UK: An analysis of national survey data. BMC Public Health, 2015; 15:507. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26021316

16. Ford P, Clifford A, Gussy K, and Gartner C. A systematic review of peer-support programs for smoking cessation in disadvantaged groups. International Journal of Environmental Research and Public Health, 2013; 10(11):5507–22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24169412

17. Du J and Leigh JP. Effects of wages on smoking decisions of current and past smokers. Annals of Epidemiology, 2015; 25(8):575–82 e1. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26066536

18. Evans SD, Sheffer CE, Bickel WK, Cottoms N, Olson M, et al. The process of adapting the evidence-based treatment for Tobacco dependence for smokers of lower socioeconomic status. Journal of Addiction Research & Therapy, 2015; 6(1). Available from: http://www.ncbi.nlm.nih.gov/pubmed/26435879

19. Slater JS, Nelson CL, Parks MJ, and Ebbert JO. Connecting low-income smokers to tobacco treatment services. Addictive Behaviors, 2015; 52:108–14. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26489597

20. Etter J-F and Schmid F. Effects of large financial incentives for long-term smoking cessationa randomized trial. Journal of the American College of Cardiology, 2016; 68(8):777-85. Available from: http://dx.doi.org/10.1016/j.jacc.2016.04.066

21. Christiansen B, Reeder K, Fiore MC, and Baker TB. Changing low income smokers' beliefs about tobacco dependence treatment. Substance Use and Misuse, 2014; 49(7):852–63. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24502374

22. Christiansen BA, Reeder KM, TerBeek EG, Fiore MC, and Baker TB. Motivating low socioeconomic status smokers to accept evidence-based smoking cessation treatment: A brief intervention for the community agency setting. Nicotine & Tobacco Research, 2015; 17(8):1002–11. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26180226

23. Mahabee-Gittens EM, Khoury JC, Ho M, Stone L, and Gordon JS. A smoking cessation intervention for low-income smokers in the ed. American Journal of Emergency Medicine, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25976268

24. Sheffer C, Brackman S, Lercara C, Cottoms N, Olson M, et al. When free is not for me: Confronting the barriers to use of free Quitline telephone counseling for Tobacco dependence. International Journal of Environmental Research and Public Health, 2015; 13(1). Available from: http://www.ncbi.nlm.nih.gov/pubmed/26703662

25. Bernstein SL, Rosner JM, and Toll B. Cell phone ownership and service plans among low-income smokers: The hidden cost of quitlines. Nicotine & Tobacco Research, 2016. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26920647

26. Levinson AH, Valverde P, Garrett K, Kimminau M, Burns EK, et al. Community-based navigators for tobacco cessation treatment: A proof-of-concept pilot study among low-income smokers. BMC Public Health, 2015; 15(1):627. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26155841

27. Moody-Thomas S, Sparks M, Hamasaka L, Ross-Viles S, and Bullock A. The head start tobacco cessation initiative: Using systems change to support staff identification and intervention for tobacco use in low-income families. Journal of Community Health, 2014; 39(4):646–52. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24532307

28. Thompson TP, Greaves CJ, Ayres R, Aveyard P, Warren FC, et al. Lessons learned from recruiting socioeconomically disadvantaged smokers into a pilot randomized controlled trial to explore the role of exercise assisted reduction then stop (ears) smoking. Trials, 2015; 16(1):1. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25971836

29. Thompson TP, Greaves CJ, Ayres R, Aveyard P, Warren FC, et al. An exploratory analysis of the smoking and physical activity outcomes from a pilot randomized controlled trial of an exercise assisted reduction to stop smoking intervention in disadvantaged groups. Nicotine & Tobacco Research, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25969453

30. Fu SS, van Ryn M, Nelson D, Burgess DJ, Thomas JL, et al. Proactive tobacco treatment offering free nicotine replacement therapy and telephone counselling for socioeconomically disadvantaged smokers: A randomised clinical trial. Thorax, 2016. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26931362

31. Guillaumier A, Bonevski B, and Paul C. 'Cigarettes are priority': A qualitative study of how Australian socioeconomically disadvantaged smokers respond to rising cigarette prices. Health Education Research, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26116583

32. Pateman K, Ford P, Fitzgerald L, Mutch A, Yuke K, et al. Stuck in the catch 22: Attitudes towards smoking cessation among populations vulnerable to social disadvantage. Addiction, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26615055

33. Okuyemi KS, Caldwell AR, Thomas JL, Born W, Richter KP, et al. Homelessness and smoking cessation: Insights from focus groups. Nicotine & Tobacco Research, 2006; 8(2):287–96. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16766421

34. Garner L and Ratschen E. Tobacco smoking, associated risk behaviours, and experience with quitting: A qualitative study with homeless smokers addicted to drugs and alcohol. BMC Public Health, 2013; 13:951. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24112218

35. Stewart HC, Stevenson TN, Bruce JS, Greenberg B, and Chamberlain LJ. Attitudes toward smoking cessation among sheltered homeless parents. Journal of Community Health, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25980523

36. Shadel WG, Tucker JS, Mullins L, and Staplefoote L. Providing smoking cessation programs to homeless youth: The perspective of service providers. Journal of Substance Abuse Treatment, 2014; 47(4):251–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25012554

37. Tucker JS, Shadel WG, Golinelli D, Ewing B, and Mullins L. Motivation to Quit and interest in cessation treatment among homeless youth smokers. Nicotine & Tobacco Research, 2015; 17(8):990–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26180224

38. Connor SE, Scharf DM, Jonkman LJ, and Herbert MI. Focusing on the five a's: A comparison of homeless and housed patients' access to and use of pharmacist-provided smoking cessation treatment. Research in Social and Administrative Pharmacy, 2014; 10(2):369–77. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24607151

39. Power J, Mallat C, Bonevski B, and Nielssen O. An audit of assessment and outcome of intervention at a quit smoking clinic in a homeless hostel. Australas Psychiatry, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26139703

40. Segan CJ, Maddox S, and Borland R. Homeless clients benefit from smoking cessation treatment delivered by a homeless persons' program. Nicotine & Tobacco Research, 2015; 17(8):996–1001. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26180225

41. Connor SE, Cook RL, Herbert MI, Neal SM, and Williams JT. Smoking cessation in a homeless population: There is a will, but is there a way? Journal of General Internal Medicine, 2002; 17(5):369–72. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1495046/

42. Shelley D, Cantrell J, Wong S, and Warn D. Smoking cessation among sheltered homeless: A pilot. American Journal of Health Behavior, 2010; 34(5):544–52. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20524884

43. Businelle MS, Ma P, Kendzor DE, Reitzel LR, Chen M, et al. Predicting quit attempts among homeless smokers seeking cessation treatment: An ecological momentary assessment study. Nicotine & Tobacco Research, 2014; 16(10):1371–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24893602

44. Reitzel LR, Kendzor DE, Cao Y, and Businelle MS. Subjective social status predicts quit-day abstinence among homeless smokers. American Journal of Health Promotion, 2014; 29(1):43–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25170885

45. Reitzel LR, Nguyen N, Eischen S, Thomas J, and Okuyemi KS. Is smoking cessation associated with worse comorbid substance use outcomes among homeless adults? Addiction, 2014; 109(12):2098–104. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25041459

46. Peden AR, Rayens MK, Hall LA, and Grant E. Negative thinking and the mental health of low-income single mothers. Journal of Nursing Scholarship, 2004; 36(4):337–44. Available from: http://dx.doi.org/10.1111/j.1547-5069.2004.04061.x

47. Olson SL and Banyard V. "Stop the world so I can get off for a while": Sources of daily stress in the lives of low-income single mothers of young children. Family Relations, 1993; 42(1):50–6. Available from: http://www.jstor.org/stable/584921

48. Siahpush M, Borland R, and Scollo M. Factors associated with smoking cessation in a national sample of Australians. Nicotine & Tobacco Research, 2003; 5(4):597–602. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12959798

49. Siahpush M. Smoking and social inequality. Australian & New Zealand Journal of Public Health, 2004; 28(3):297. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15707179

50. Siahpush M. Why is lone-motherhood so strongly associated with smoking? Australian & New Zealand Journal of Public Health, 2004; 28(1):37–42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15108745

51. Australian Institute of Health and Welfare (2020). Data tables: National Drug Strategy Household Survey 2019 - 2. Tobacco smoking chapter, Supplementary data tables. Canberra, AIHW. https://www.aihw.gov.au/reports/illicit-use-of-drugs/national-drug-strategy-household-survey-2019/data

52. Rigotti NA, Clair C, Munafo MR, and Stead LF. Interventions for smoking cessation in hospitalised patients. Cochrane Database of Systematic Reviews, 2012; 5:CD001837. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22592676

53. France E, Glasgow R, and Marcus A. Smoking cessation interventions among hospitalized patients: What have we learned? Preventive Medicine, 2001; 32(4):376–88. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11304099

54. Wu J and Sin D. Improved patient outcome with smoking cessation: When is it too late? International Journal of Chronic Obstructive Pulmonary Disease, 2011; 6:259–67. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21814462

55. Cinciripini P, Hecht S, Henningfield J, Manley M, and Kramer B. Tobacco addiction: Implications for treatment and cancer prevention. Journal of the National Cancer Institute, 1997; 89(24):1852–67. Available from: http://jnci.oxfordjournals.org/cgi/reprint/89/24/1852

56. US Department of Health and Human Services. The health benefits of smoking cessation. A report of the Surgeon General. Atlanta, GA: Centers for Disease Control, Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1990. Available from: http://www.cdc.gov/tobacco/data_statistics/sgr/pre_1994/index.htm.

57. Gey D, Lesho E, and Manngold J. Management of peripheral arterial disease. American Family Physician, 2004; 69(3):525–32. Available from: http://www.ncbi.nlm.nih.gov/pubmed/14971833

58. Tonnesen P, Pisinger C, Hvidberg S, Wennike P, Bremann L, et al. Effects of smoking cessation and reduction in asthmatics. Nicotine & Tobacco Research, 2005; 7(1):139–48. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15804686

59. Boulet L, FitzGerald J, McIvor R, Zimmerman S, and Chapman K. Influence of current or former smoking on asthma management and control. Canadian Respiratory Journal, 2008; 15(5):275–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18716691

60. Roig L, Perez S, Prieto G, Martin C, Advani M, et al. Cluster randomized trial in smoking cessation with intensive advice in diabetic patients in primary care. Itadi study. BMC Public Health, 2010; 10:58. Available from: http://www.biomedcentral.com/1471-2458/10/58

61. Ratchford E and Black J, 3rd. Approach to smoking cessation in the patient with vascular disease. Current Treatment Options in Cardiovascular Medicine, 2011; 13(2):91–102. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21267681

62. van der Heide F, Dijkstra A, Albersnagel F, Kleibeuker J, and Dijkstra G. Active and passive smoking behaviour and cessation plans of patients with crohn's disease and ulcerative colitis. Journal of Crohn's & Colitis, 2010; 4(2):125–31. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21122495

63. Wahed M, Goodhand J, West O, McDermott A, Hajek P, et al. Tobacco dependence and awareness of health risks of smoking in patients with inflammatory bowel disease. European Journal of Gastroenterology & Hepatology, 2011; 23(1):90–4. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21030867

64. van der Heide F, Dijkstra G, Porte R, Kleibeuker J, and Haagsma E. Smoking behavior in liver transplant recipients. Liver Transplantation, 2009; 15(6):648–55. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19479809

65. Peters M. Should smokers be refused surgery? British Medical Journal, 2007; 334(20 (6 January)). Available from: http://www.bmj.com/content/334/7583/20

66. Rice VH, Hartmann-Boyce J, and Stead LF. Nursing interventions for smoking cessation. The Cochrane Library, 2013. Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001188.pub4/abstract

67. de Moor J, Elder K, and Emmons K. Smoking prevention and cessation interventions for cancer survivors. Seminars in Oncology Nursing, 2008; 24(3):180–92. Available from: http://www.seminarsoncologynursing.com/article/S0749-2081(08)00030-2/abstract

68. Stead LF, Bergson G, and Lancaster T Physician advice for smoking cessation. Cochrane Database of Systematic Reviews, 2008. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18425860

69. Rigotti NA, Regan S, Levy DE, Japuntich S, Chang Y, et al. Sustained care intervention and postdischarge smoking cessation among hospitalized adults: A randomized clinical trial. Journal of the American Medical Association, 2014; 312(7):719–28. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25138333

70. Wolfenden L, Campbell E, Walsh R, and Wiggers J. Smoking cessation interventions for in-patients: A selective review with recommendations for hospital-based health professionals. Drug and Alcohol Review, 2003; 22(4):437–52. Available from: http://www.ncbi.nlm.nih.gov/pubmed/14660134

71. NSW Health Department. Guide for the management of nicotine dependent inpatients. Sydney: NSW Health Department, 2002. Available from: http://www.health.nsw.gov.au/pubs/2002/nicotine_sum.html.

72. Freund M, Campbell E, Paul C, Sakrouge R, and Wiggers J. Smoking care provision in smoke free hospitals in Australia. Preventive Medicine, 2005; 41(1):151–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15917006

73. Coups EJ, Dhingra LK, Heckman CJ, and Manne SL. Receipt of provider advice for smoking cessation and use of smoking cessation treatments among cancer survivors Journal of General Internal Medicine, 2009; 24(suppl. 2):480–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19838854

74. Gall S, Dewey H, and Thrift A. Smoking cessation at 5 years after stroke in the North east melbourne stroke incidence study. Neuroepidemiology, 2009; 32(3):196–200. Available from: http://content.karger.com/ProdukteDB/produkte.asp?Doi=195689

75. Wong J, Lam DP, Abrishami A, Chan MT, and Chung F. Short-term preoperative smoking cessation and postoperative complications: A systematic review and meta-analysis. Canadian Journal of Anesthesia/Journal canadien d'anesthésie, 2012; 59(3):268–79. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22187226

76. Australian and New Zealand College of Anaesthetists. Statement on smoking as related to the perioperative period. 2007. Available from: http://www.anzca.edu.au/resources/professional-documents/documents/professional-standards/professional-standards-12.html

77. Thomsen T, Villebro N, and Moller AM. Interventions for preoperative smoking cessation. Cochrane Database of Systematic Reviews, 2014; 3:CD002294. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24671929

78. Berlin NL, Cutter C, and Battaglia C. Will preoperative smoking cessation programs generate long-term cessation? A systematic review and meta-analysis. American Journal of Managed Care, 2015; 21(11):e623–31. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26735296

79. Barth J, Jacob T, Daha I, and Critchley JA. Psychosocial interventions for smoking cessation in patients with coronary heart disease. Cochrane Database of Systematic Reviews, 2015; 7:CD006886. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26148115

80. Shah L, King A, Basu A, Krishnan J, Borden W, et al. Effect of clinician advice and patient preparedness to quit on subsequent quit attempts in hospitalized smokers. Journal of Hospital Medicine, 2010; 5(1):26–32. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20063403

81. Gerritsen M, Berndt N, Lechner L, de Vries H, Mudde A, et al. Self-reporting of smoking cessation in cardiac patients: How reliable is it and is reliability associated with patient characteristics? Journal of Addiction Medicine, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26083956

82. Holtrop JS, Stommel M, Corser W, and Holmes-Rovner M. Predictors of smoking cessation and relapse after hospitalization for acute coronary syndrome. Journal of Hospital Medicine, 2009; 4(3):E3–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19301384

83. Gerber Y, Koren-Morag N, Myers V, Benyamini Y, Goldbourt U, et al. Long-term predictors of smoking cessation in a cohort of myocardial infarction survivors: A longitudinal study. European Journal of Cardiovascular Prevention and Rehabilitation, 2011; 18(3):533–41. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21450653

84. Busch AM, Fani Srour J, Arrighi JA, Kahler CW, and Borrelli B. Valued life activities, smoking cessation, and mood in post-acute coronary syndrome patients. International Journal of Behavioral Medicine, 2015; 22(5):563–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25471466

85. Thorndike AN, Regan S, McKool K, Pasternak RC, Swartz S, et al. Depressive symptoms and smoking cessation after hospitalization for cardiovascular disease. Archives of Internal Medicine, 2008; 168(2):186–91. Available from: http://archinte.ama-assn.org/cgi/content/short/168/2/186

86. Zillich A, Hudmon K, and Damush T. Tobacco use and cessation among veterans recovering from stroke or tia: A qualitative assessment and implications for rehabilitation. Topics in Stroke Rehabilitation, 2010; 17(2):140–50. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20542856

87. Prochaska JJ and Benowitz NL. Smoking cessation and the cardiovascular patient. Current Opinion in Cardiology, 2015; 30(5):506–11. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26196657

88. Mills EJ, Thorlund K, Eapen S, Wu P, and Prochaska JJ. Cardiovascular events associated with smoking cessation pharmacotherapies: A network meta-analysis. Circulation, 2014; 129(1):28–41. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24323793

89. Smith P and Burgess E. Smoking cessation initiated during hospital stay for patients with coronary artery disease: A randomized controlled trial. Canadian Medical Association Journal, 2009; 180(13):1297–303. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19546455

90. Jennings C, Kotseva K, De Bacquer D, Hoes A, de Velasco J, et al. Effectiveness of a preventive cardiology programme for high cvd risk persistent smokers: The euroaction plus varenicline trial. European Heart Journal, 2014; 35(21):1411–20. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24616337

91. Grandi SM, Shimony A, and Eisenberg MJ. Bupropion for smoking cessation in patients hospitalized with cardiovascular disease: A systematic review and meta-analysis of randomized controlled trials. Can J Cardiol, 2013; 29(12):1704–11. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24267809

92. Muckelbauer R, Englert H, Rieckmann N, Chen CM, Wegscheider K, et al. Long-term effect of a low-intensity smoking intervention embedded in an adherence program for patients with hypercholesterolemia: Randomized controlled trial. Preventive Medicine, 2015; 77:155–61. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26051201

93. Hennrikus D, Joseph A, Lando H, Duval S, Ukestad L, et al. Effectiveness of a smoking cessation program for peripheral artery disease patients a randomized controlled trial. Journal of the American College of Cardiology, 2010; 56(25):2105–12. Available from: http://www.ncbi.nlm.nih.gov/PubMed/21144971

94. Park AH, Lee SJ, and Oh SJ. The effects of a smoking cessation programme on health-promoting lifestyles and smoking cessation in smokers who had undergone percutaneous coronary intervention. International Journal of Nursing Practice, 2015; 21(2):107–17. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25860913

95. Jimenez-Ruiz CA, Andreas S, Lewis KE, Tonnesen P, van Schayck CP, et al. Statement on smoking cessation in COPD and other pulmonary diseases and in smokers with comorbidities who find it difficult to quit. European Respiratory Journal, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25882805

96. Gritz E, Vidrine D, and Fingeret M. Smoking cessation a critical component of medical management in chronic disease populations. American Journal of Preventative Medicine, 2007; 33(6):S414–22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18021917

97. Ringlever L, Otten R, Van Schayck O, and Engels R. Early smoking in school-aged children with and without a diagnosis of asthma. European Journal of Public Health, 2011; 22(3):394–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21746750

98. Guo B, Aveyard P, Fielding A, and Sutton S. Do the transtheoretical model processes of change, decisional balance and temptation predict stage movement? Evidence from smoking cessation in adolescents. Addiction, 2009; 104(5):828–38. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19413796

99. Vazquez-Nava F, Peinado-Herreros J, Saldivar-Gonzalez A, Barrientos Gomez Mdel C, Beltran-Guzman F, et al. Association between family structure, parental smoking, friends who smoke, and smoking behavior in adolescents with asthma. The Scientific World Journal, 2010; 10:62–9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/20062951

100. Saba M, Dan E, Bittoun R, and Saini B. Asthma and smoking - healthcare needs and preferences of adults with asthma who smoke. The Journal of Asthma, 2014; 51(9):934–42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24894741

101. van Eerd E, A., van der Meer RM, van Schayck OCP, and Kotz D. Smoking cessation for people with chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews, 2016; (8). Available from: http://dx.doi.org/10.1002/14651858.CD010744.pub2

102. Rigotti NA. Smoking cessation in patients with respiratory disease: Existing treatments and future directions. The Lancet Respiratory Medicine, 2013; 1(3):241–50. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24429130

103. Bartlett YK, Sheeran P, and Hawley MS. Effective behaviour change techniques in smoking cessation interventions for people with chronic obstructive pulmonary disease: A meta-analysis. British Journal of Health Psychology, 2014; 19(1):181–203. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24397814

104. Gratziou C, Florou A, Ischaki E, Eleftheriou K, Sachlas A, et al. Smoking cessation effectiveness in smokers with COPD and asthma under real life conditions. Respiratory Medicine, 2014; 108(4):577–83. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24560410

105. Yap SY, Lunn S, Pang E, Croft C, and Stern M. A psychological intervention for smoking cessation delivered as treatment for smokers with chronic obstructive pulmonary disease: Multiple needs of a complex group and recommendations for novel service development. Chronic Respiratory Disease, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25990130

106. van Eerd EA, van Rossem CR, Spigt MG, Wesseling G, van Schayck OC, et al. Do we need tailored smoking cessation interventions for smokers with COPD? A comparative study of smokers with and without COPD regarding factors associated with Tobacco smoking. Respiration, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26022403

107. Vuong K, Hermiz O, Razee H, Richmond R, and Zwar N. The experiences of smoking cessation among patients with chronic obstructive pulmonary disease in Australian general practice: A qualitative descriptive study. Family Practice, 2016. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27567010

108. Coronini-Cronberg S, Heffernan C, and Robinson M. Effective smoking cessation interventions for COPD patients: A review of the evidence. JRSM Short Reports, 2011; 2(10):78. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22046497

109. Ho SY, Alnashri N, Rohde D, Murphy P, and Doyle F. Systematic review and meta-analysis of the impact of depression on subsequent smoking cessation in patients with chronic respiratory conditions. General Hospital Psychiatry, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26022383

110. van Eerd EA, Risor MB, van Rossem CR, van Schayck OC, and Kotz D. Experiences of tobacco smoking and quitting in smokers with and without chronic obstructive pulmonary disease-a qualitative analysis. BMC Family Practice, 2015; 16(1):164. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26537703

111. Hilberink S, Jacobs J, van Opstal S, van der Weijden T, Keegstra J, et al. Validation of smoking cessation self-reported by patients with chronic obstructive pulmonary disease. International Journal of General Medicine, 2011; 4:85–90. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21403797

112. Wilson J, Elborn J, Fitzsimons D, and McCrum-Gardner E. Do smokers with chronic obstructive pulmonary disease report their smoking status reliably? A comparison of self-report and bio-chemical validation. International Journal of Nursing Studies, 2011; 48(7):856–62. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21288520

113. Louwagie GM and Ayo-Yusuf OA. Predictors of tobacco smoking abstinence among tuberculosis patients in South Africa. Journal of Behavioral Medicine, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25655663

114. Louwagie GM, Okuyemi KS, and Ayo-Yusuf OA. Efficacy of brief motivational interviewing on smoking cessation at tuberculosis clinics in tshwane, South Africa: A randomized controlled trial. Addiction, 2014; 109(11):1942–52. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24962451

115. Westmaas JL, Newton CC, Stevens VL, Flanders WD, Gapstur SM, et al. Does a recent cancer diagnosis predict smoking cessation? An analysis from a large prospective US cohort. Journal of Clinical Oncology, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25897151

116. Klosky J, Tyc V, Garces-Webb D, Buscemi J, Klesges R, et al. Emerging issues in smoking among adolescent and adult cancer survivors: A comprehensive review. Cancer, 2008; 110(11):2408–19. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17932906

117. Shin DW, Park JH, Kim SY, Park EW, Yang HK, et al. Guilt, censure, and concealment of active smoking status among cancer patients and family members after diagnosis: A nationwide study. Psychooncology, 2014; 23(5):585–91. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24352765

118. Karam-Hage M, Cinciripini PM, and Gritz ER. Tobacco use and cessation for cancer survivors: An overview for clinicians. CA: A Cancer Journal for Clinicians, 2014; 64(4):272–90. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24817674

119. Nayan S, Gupta MK, and Sommer DD. Evaluating smoking cessation interventions and cessation rates in cancer patients: A systematic review and meta-analysis. ISRN Oncology, 2011; 2011:849023. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22091433

120. Karam-Hage M and Cinciripini P. Pharmacotherapy for tobacco cessation: Nicotine agonists, antagonists, and partial agonists. Current Oncology Reports, 2007; 9(6):509–16. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17991361

121. Klemp I, Steffenssen M, Bakholdt V, Thygesen T, and Sorensen JA. Counseling is effective for smoking cessation in head and neck cancer patients-a systematic review and meta-analysis. Journal of Oral and Maxillofacial Surgery, 2016. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26973223

122. Shields PG. New nccn guidelines: Smoking cessation for patients with cancer. Journal of the National Comprehensive Cancer Network, 2015; 13(5 Suppl):643–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25995418

123. de Moor J, Puleo E, Ford J, Greenberg M, Hodgson D, et al. Disseminating a smoking cessation intervention to childhood and young adult cancer survivors: Baseline characteristics and study design of the partnership for health-2 study. BMC Cancer, 2011; 11(1):165. Available from: http://www.biomedcentral.com/content/pdf/1471-2407-11-165.pdf

124. Emmons KM, Puleo E, Sprunck-Harrild K, Ford J, Ostroff JS, et al. Partnership for health-2, a web-based versus print smoking cessation intervention for childhood and young adult cancer survivors: Randomized comparative effectiveness study. Journal of Medical Internet Research, 2013; 15(11):e218. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24195867

125. Zeng L, Yu X, Yu T, Xiao J, and Huang Y. Interventions for smoking cessation in people diagnosed with lung cancer. Cochrane Database of Systematic Reviews, 2015; 12:CD011751. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26632766

126. Munshi V and McMahon P. Importance of smoking cessation in a lung cancer screening program. Current Surgery Reports, 2013; 1(4). Available from: http://www.ncbi.nlm.nih.gov/pubmed/24312745

127. Eng L, Su J, Qiu X, Palepu PR, Hon H, et al. Second-hand smoke as a predictor of smoking cessation among lung cancer survivors. Journal of Clinical Oncology, 2014; 32(6):564–70. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24419133

128. Wippold R, Karam-Hage M, Blalock J, and Cinciripini P. Selection of optimal tobacco cessation medication treatment in patients with cancer. Clinical Journal of Oncology Nursing, 2015; 19(2):170–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25840382

129. Westmaas JL, Alcaraz KI, Berg CJ, and Stein KD. Prevalence and correlates of smoking and cessation-related behavior among survivors of ten cancers: Findings from a nationwide survey nine years after diagnosis. Cancer Epidemiology, Biomarkers & Prevention, 2014; 23(9):1783–92. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25100826

130. Kim H, Kim MH, Park YS, Shin JY, and Song YM. Factors that predict persistent smoking of cancer survivors. Journal of Korean Medical Science, 2015; 30(7):853–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26130945

131. Aigner CJ, Cinciripini PM, Anderson KO, Baum GP, Gritz ER, et al. The association of pain with smoking and Quit attempts in an electronic diary study of cancer patients trying to Quit. Nicotine & Tobacco Research, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26038362

132. Li WH, Chan SS, and Lam TH. Helping cancer patients to quit smoking by understanding their risk perception, behavior, and attitudes related to smoking. Psychooncology, 2014; 23(8):870–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24493624

133. Lee Westmaas J, Berg CJ, Alcaraz KI, and Stein K. Health behavior theory constructs and smoking and cessation-related behavior among survivors of ten cancers nine years after diagnosis: A report from the American cancer society's study of cancer survivors-I. Psychooncology, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26137922

134. Vilensky D, Lawrentschuk N, Hersey K, and Fleshner N. A smoking cessation program as a resource for bladder cancer patients. Canadian Urological Association Journal, 2011; 6(5):E167–73. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21539769

135. Qin R, Chen T, Lou Q, and Yu D. Excess risk of mortality and cardiovascular events associated with smoking among patients with diabetes: Meta-analysis of observational prospective studies. International Journal of Cardiology, 2013; 167(2):342–50. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22251416

136. Lycett D, Nichols L, Ryan R, Farley A, Roalfe A, et al. The association between smoking cessation and glycaemic control in patients with type 2 diabetes: A thin database cohort study. The Lancet. Diabetes and Endocrinology, 2015; 3(6):423–30. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25935880

137. Sung Y-T, Hsiao C-T, Chang I-J, Lin Y-C, and Yueh C-Y. Smoking cessation carries a short-term rising risk for newly diagnosed diabetes mellitus independently of weight gain: A 6-year retrospective cohort study. Journal of Diabetes Research, 2016; 2016:7. Available from: http://dx.doi.org/10.1155/2016/3961756

138. Bush T, Lovejoy JC, Deprey M, and Carpenter KM. The effect of tobacco cessation on weight gain, obesity, and diabetes risk. Obesity (Silver Spring), 2016; 24(9):1834-41. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27569117

139. Kilpatrick ES. Risk factors: Smoking cessation in t2dm–not without issues but still worthwhile. Nature Reviews. Endocrinology, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26077265

140. Karter A, Stevens M, Gregg E, Brown A, Tseng C, et al. Educational disparities in rates of smoking among diabetic adults: The translating research into action for diabetes study. American Journal of Public Health, 2008; 98(2):365–70. Available from: http://www.ajph.org/cgi/reprint/98/2/365

141. Perez-Tortosa S, Roig L, Manresa JM, Martin-Cantera C, Puigdomenech E, et al. Continued smoking abstinence in diabetic patients in primary care: A cluster randomized controlled multicenter study. Diabetes Research and Clinical Practice, 2014. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25444354

142. Macaller T, Brown M, Black K, and Greenwood D. Collaborating with diabetes educators to promote smoking cessation for people with diabetes: The california experience. The Diabetes Educator, 2011; 37(5):625–32. Available from: http://tde.sagepub.com/content/37/5/625.long

143. Nagrebetsky A, Brettell R, Roberts N, and Farmer A. Smoking cessation in adults with diabetes: A systematic review and meta-analysis of data from randomised controlled trials. BMJ Open, 2014; 4(3). Available from: http://bmjopen.bmj.com/content/4/3/e004107.abstract

144. Tonstad S and Lawrence D. Varenicline in smokers with diabetes: A pooled analysis of 15 randomized, placebo-controlled studies of varenicline. Journal of Diabetes Investigation, 2016. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27223809

145. Therapeutic Goods Administration. Bupropion (zyban sr). Australian Government, 2001. Available from: https://www.tga.gov.au/alert/bupropion-zyban-sr

146. Mdodo R, Frazier EL, Dube SR, Mattson CL, Sutton MY, et al. Cigarette smoking prevalence among adults with HIV compared with the general adult population in the United States: Cross-sectional surveys. Annals of Internal Medicine, 2015; 162(5):335–44. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25732274

147. Grierson J PJ, Pitts M, Croy S, Clement T, Thorpe R, McDonald K HIV futures 6: Making positive lives count Monograph series number 74  Melbourne, Australia: The Australian Research Centre in Sex, Health and Society, Latrobe University; 2009. Available from: http://www.latrobe.edu.au/hiv-futures/.

148. Calvo M, Laguno M, Martinez M, and Martinez E. Effects of Tobacco smoking on HIV-infected individuals. AIDS Reviews, 2014; 17(1). Available from: http://www.ncbi.nlm.nih.gov/pubmed/25427101

149. Vidrine D. Cigarette smoking and HIV/aids: Health implications, smoker characteristics and cessation strategies. AIDS Education and Prevention, 2009; 21(3 suppl.):3–13. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19537950

150. Cioe PA. Smoking cessation interventions in HIV-infected adults in North America: A literature review. Journal of Addictive Behaviors, Therapy and Rehabilitation, 2013; 2(3):1000112. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24839610

151. Nahvi S and Cooperman N. Review: The need for smoking cessation among HIV-positive smokers. AIDS Education and Prevention, 2009; 21(3 suppl.):14–27. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19537951

152. Stewart D, Jones G, and Minor K. Smoking, depression, and gender in low-income african Americans with HIV/aids. Behavioral Medicine, 2011; 37(3):77–80. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21895424

153. Shirley DK, Kesari RK, and Glesby MJ. Factors associated with smoking in HIV-infected patients and potential barriers to cessation. AIDS Patient Care STDS, 2013; 27(11):604–12. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24138488

154. Pacek LR, Harrell PT, and Martins SS. Cigarette smoking and drug use among a nationally representative sample of HIV-positive individuals. American Journal on Addictions, 2014; 23(6):582–90. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25065609

155. Pacek LR, Latkin C, Crum RM, Stuart EA, and Knowlton AR. Interest in quitting and lifetime quit attempts among smokers living with HIV infection. Drug and Alcohol Dependence, 2014; 138:220–4. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24602364

156. McQueen A, Shacham E, Sumner W, and Overton ET. Beliefs, experience, and interest in pharmacotherapy among smokers with HIV. American Journal of Health Behavior, 2014; 38(2):284–96. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24629557

157. Vidrine DJ, Kypriotakis G, Li L, Arduino RC, Fletcher FE, et al. Mediators of a smoking cessation intervention for persons living with HIV/aids. Drug and Alcohol Dependence, 2014. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25542824

158. Shelley D, Tseng TY, Gonzalez M, Krebs P, Wong S, et al. Correlates of adherence to varenicline among HIV+ smokers. Nicotine & Tobacco Research, 2015; 17(8):968–74. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26180221

159. Shuter J, Moadel AB, Kim RS, Weinberger AH, and Stanton CA. Self-efficacy to Quit in HIV-infected smokers. Nicotine & Tobacco Research, 2014; 16(11):1527–31. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25151662

160. de Dios MA, Stanton CA, Cano MA, Lloyd-Richardson E, and Niaura R. The influence of social support on smoking cessation treatment adherence among HIV+ smokers. Nicotine & Tobacco Research, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26116086

161. Cummins D, Trotter G, Moussa M, and Turham G. Smoking cessation for clients who are HIV-positive. Nursing Standard, 2005; 20(12):41–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16350501

162. Stanton C, Lloyd-Richardson E, Papandonatos G, de Dios M, and Niaura R. Mediators of the relationship between nicotine replacement therapy and smoking abstinence among people living with HIV/aids. AIDS Education and Prevention, 2009; 21(3 suppl.):65–80. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19537955

163. Shuter J, Morales DA, Considine-Dunn SE, An LC, and Stanton CA. Feasibility and preliminary efficacy of a web-based smoking cessation intervention for HIV-infected smokers: A randomized controlled trial. Journal of Acquired Immune Deficiency Syndromes, 2014; 67(1):59–66. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25118794

164. Keith A, Dong Y, Shuter J, and Himelhoch S. Behavioral interventions for Tobacco use in HIV-infected smokers: A meta-analysis. Journal of Acquired Immune Deficiency Syndromes, 2016. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27028502

165. Ledgerwood DM and Yskes R. Smoking cessation for people living with HIV/aids: A literature review and synthesis. Nicotine & Tobacco Research, 2016. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27245237

166. Pool ER, Dogar O, Lindsay RP, Weatherburn P, and Siddiqi K. Interventions for tobacco use cessation in people living with HIV and aids. Cochrane Database of Systematic Reviews, 2016; 6:CD011120. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27292836

167. Shuter J, Salmo L, Shuter A, Nivasch E, Fazzari M, et al. Provider beliefs and practices relating to tobacco use in patients living with HIV/aids: A national survey. AIDS and Behavior, 2011; 16(2):288–94. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21301950

168. Calvo-Sanchez M and Martinez E. How to address smoking cessation in HIV patients. HIV Medicine, 2014. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25296689

169. Webb M, Vanable P, Carey M, and Blair D. Medication adherence in HIV-infected smokers: The mediating role of depressive symptoms. AIDS Education and Prevention, 2009; 21(3 suppl.):94–105. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19537957

170. Jones E, Goldsmith M, Effken J, Button K, and Crago M. Creating and testing a deaf-friendly, stop-smoking web site intervention. American Annals of the Deaf, 2010; 155(1):96–102. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20503910

171. Emerson E. Health status and health risks of the "hidden majority" of adults with intellectual disability. Intellectual and Developmental Disabilities, 2011; 49(3):155–65. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21639742

172. Singh N, Lancioni G, Winton A, Singh A, Singh J, et al. Effects of a mindfulness-based smoking cessation program for an adult with mild intellectual disability. Research in Developmental Disabilities, 2011; 32(3):1180–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21288689

173. Singh NN, Lancioni GE, Winton ASW, Karazsia BT, Singh ADA, et al. A mindfulness-based smoking cessation program for individuals with mild intellectual disability. Mindfulness, 2012; 4(2):148–57. Available from: http://dx.doi.org/10.1007/s12671-012-0148-8

174. Kerr S, Lawrence M, Darbyshire C, Middleton AR, and Fitzsimmons L. Tobacco and alcohol-related interventions for people with mild/moderate intellectual disabilities: A systematic review of the literature. Journal of Intellectual Disability Research, 2013; 57(5):393–408. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22458301

175. Williams JM, Steinberg ML, Griffiths KG, and Cooperman N. The need for smokers with behavioral health comorbidity to be designated as a tobacco use disparity group. American Journal of Public Health, 2013; 103(9):1549–55. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3776478/

176. Taylor G, McNeill A, Girling A, Farley A, Lindson-Hawley N, et al. Change in mental health after smoking cessation: Systematic review and meta-analysis. British Medical Journal, 2014; 348:g1151. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24524926

177. Rissel C, McLellan L, and Bauman A. Factors associated with delayed tobacco uptake among Vietnamese/Asian and Arabic youth in Sydney, NSW. Australian and New Zealand Journal of Public Health, 2000; 24:22–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10777974

178. Jiang W, Leung B, Tam N, Xu H, Gleeson S, et al. Smoking status and associated factors among male Chinese restaurant workers in metropolitan Sydney. Health Promotion Journal of Australia, 2016. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27324668

179. Reiss K, Lehnhardt J, and Razum O. Factors associated with smoking in immigrants from non-western to western countries - what role does acculturation play? A systematic review. Tobacco Induced Diseases, 2015; 13(1):11. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25908932

180. Liu JJ, Wabnitz C, Davidson E, Bhopal RS, White M, et al. Smoking cessation interventions for ethnic minority groups--a systematic review of adapted interventions. Preventive Medicine, 2013; 57(6):765–75. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24076130

181. Poureslami IM, Shum J, Cheng N, and FitzGerald JM. Does culture or illness change a smoker's perspective on cessation? American Journal of Health Behavior, 2014; 38(5):657–67. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24933135

182. Phillips A, Monaem A, and Newman C. A qualitative study of smoking within a Western Sydney Arabic-speaking community: A focus on men in the context of their families. Health Promotion Journal of Australia, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25798526

183. Nierkens V, Hartman MA, Nicolaou M, Vissenberg C, Beune EJ, et al. Effectiveness of cultural adaptations of interventions aimed at smoking cessation, diet, and/or physical activity in ethnic minorities. A systematic review. PLoS ONE, 2013; 8(10):e73373. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24116000

184. Culpin A, Gleeson S, Thomas M, and Bekiaris J. Evaluation of the 'good heart, good life’ project: A three year campaign to reduce smoking among the greek community of sydney's inner west. Health Promotion Journal of Australia, 1996; 6:44–9. Available from: http://search.informit.com.au/documentSummary;dn=461247238329638;res=IELHEA

185. NSW Multicultural Health Communication. New project raises awareness of passive smoking risks among Arabic speaking students. Polyglot: news from Multicultural Health Communication, 2008; 12(2). Available from: http://www.mhcs.health.nsw.gov.au/mhcs/subpages/polyglot/pdf/poly_40.pdf

186. Wong G, Whittaker R, Chen J, Cowling L, van Mil J, et al. Asian smokefree communities: Evaluation of a community-focused smoking cessation and smokefree environments intervention in New Zealand. The Journal of Smoking Cessation, 2010; 5(1):22–8. Available from: http://www.atypon-link.com/AAP/doi/pdf/10.1375/jsc.5.1.22

187. Girgis S, Adily A, Velasco M, Zwar N, Jalaludin B, et al. Feasibility, acceptability and impact of a telephone support service initiated in primary medical care to help Arabic smokers quit. Australian Journal of Primary Health, 2011; 17(3):274–81. Available from: http://www.publish.csiro.au/index.cfm

188. Ministerial Council on Drug Strategy. Australian national Tobacco strategy 2004-2009. Canberra: Department of Health and Ageing, 2005. Available from: http://www.health.gov.au/internet/wcms/publishing.nsf/Content/phd-pub-tobacco-tobccstrat2-cnt.htm.

189. Chapman A, Bunker S, Dunbar J, Philpot B, McNamara K, et al. Rural smokers–a prevention opportunity. Australian Family Physician, 2009; 38(5):352–6. Available from: http://www.racgp.org.au/afp/200905/200905chapman.pdf

190. Remafedi G, Jurek AM, and Oakes JM. Sexual identity and tobacco use in a venue-based sample of adolescents and young adults. American Journal of Preventive Medicine, 2008; 35(6):S463–70. Available from: http://www.sciencedirect.com/science/journal/07493797

191. Rosario M, Schrimshaw E, and Hunter J. Butch/femme differences in substance use and abuse among young lesbian and bisexual women: Examination and potential explanations. Substance Use and Misuse, 2008; 43(8–9):1002–15. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18649226

192. Matthews AK, Riley BB, Everett B, Hughes TL, Aranda F, et al. A longitudinal study of the correlates of persistent smoking among sexual minority women. Nicotine & Tobacco Research, 2014; 16(9):1199–206. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24727370

193. Kamen C, Blosnich JR, Lytle M, Janelsins MC, Peppone LJ, et al. Cigarette smoking disparities among sexual minority cancer survivors. Preventive Medicine Reports, 2015; 2:283–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25984441

194. Pachankis J, Westmaas J, and Dougherty L. The influence of sexual orientation and masculinity on young men's tobacco smoking. Journal of Consulting and Clinical Psychology, 2011; 79(2):142–52. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21443320

195. Sivadon A, Matthews AK, and David KM. Social integration, psychological distress, and smoking behaviors in a midwest lgbt community. Journal of the American Psychiatric Nurses Association, 2014; 20(5):307–14. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25097233

196. O'Cleirigh C, Dale SK, Elsesser S, Pantalone DW, Mayer KH, et al. Sexual minority specific and related traumatic experiences are associated with increased risk for smoking among gay and bisexual men. Journal of Psychosomatic Research, 2015; 78(5):472–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25754971

197. Gamarel KE, Mereish EH, Manning D, Iwamoto M, Operario D, et al. Minority stress, smoking patterns, and cessation attempts: Findings from a community-sample of transgender women in the San Francisco bay area. Nicotine & Tobacco Research, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25782458

198. McElroy J, Everett K, and Zaniletti I. An examination of smoking behavior and opinions about smoke-free environments in a large sample of sexual and gender minority community members. Nicotine & Tobacco Research, 2011; 13(6):440–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21372088

199. Lombardi E, Silvestre AJ, Janosky JE, Fisher G, and Rinaldo C. Impact of early sexual debut on gay men's tobacco use. Nicotine & Tobacco Research, 2008; 10(11):1591–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18988071

200. Storholm E, Halkitis P, Siconolfi D, and Moeller R. Cigarette smoking as part of a syndemic among young men who have sex with men ages 13-29 in New York city. Journal of Urban Health, 2011; 88(4):663–76. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21479753

201. Lee JG, Matthews AK, McCullen CA, and Melvin CL. Promotion of tobacco use cessation for lesbian, gay, bisexual, and transgender people: A systematic review. American Journal of Preventive Medicine, 2014; 47(6):823–31. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25455123

202. Fallin A, Lee YO, Bennett K, and Goodin A. Smoking cessation awareness and utilization among lesbian, gay, bisexual, and transgender adults: An analysis of the 2009-2010 national adult Tobacco survey. Nicotine & Tobacco Research, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26014455

203. Grady ES, Humfleet GL, Delucchi KL, Reus VI, Munoz RF, et al. Smoking cessation outcomes among sexual and gender minority and nonminority smokers in extended smoking treatments. Nicotine & Tobacco Research, 2014; 16(9):1207–15. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24727483

204. Dickson-Spillmann M, Sullivan R, Zahno B, and Schaub MP. Queer quit: A pilot study of a smoking cessation programme tailored to gay men. BMC Public Health, 2014; 14:126. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24498915

205. Matthews AK, McConnell EA, Li CC, Vargas MC, and King A. Design of a comparative effectiveness evaluation of a culturally tailored versus standard community-based smoking cessation treatment program for lgbt smokers. BMC Psychology, 2014; 2(1):12. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25566383

206. Berger I and Mooney-Somers J. Smoking cessation programs for lesbian, gay, bisexual, transgender, and intersex people: A content-based systematic review. Nicotine & Tobacco Research, 2016. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27613909

207. Belcher J, Butler T, Richmond R, Wodak A, and Wilhelm K. Smoking and its correlates in the Australian prisoner population. Drug and Alcohol Review, 2006; 25(4):343–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16854660

208. Australian Institute of Health and Welfare. The health of Australia’s prisoners 2018. Cat. no. PHE 246. AIHW, 2019. Available from: https://www.aihw.gov.au/getmedia/2e92f007-453d-48a1-9c6b-4c9531cf0371/aihw-phe-246.pdf.aspx?inline=true.

209. Australian Institute of Health and Welfare. The health of Australia’s prisoners 2018. Cat. no. PHE 246. AIHW, 2019. Available from: https://www.aihw.gov.au/getmedia/2e92f007-453d-48a1-9c6b-4c9531cf0371/aihw-phe-246.pdf.aspx?inline=true.

210. Baker A, Ivers R, Bowman J, Butler T, Kay-Lambkin F, et al. Where there's smoke, there's fire: High prevalence of smoking among some sub-populations and recommendations for intervention. Drug and Alcohol Review, 2006; 25:85–96. Available from: http://www.informaworld.com/smpp/content~content=a741424195~db=all~order=page

211. Australian Institute of Health and Welfare, The health of Australia's prisoners 2009. Cat.No.Phe 123.  Canberra: AIHW; 2010. Available from: http://www.aihw.gov.au/publication-detail/?id=6442468371.

212. Australian Institute of Health and Welfare, The health of Australia's prisoners 2015.  Cat. no. PHE 207. Canberra: AIHW; 2015. Available from: http://www.aihw.gov.au/publication-detail/?id=60129553527.

213. Richmond R, Butler T, Wilhelm K, Wodak A, Cunningham M, et al. Tobacco in prisons: A focus group study. Tobacco Control, 2009:tc.2008.026393. Available from: http://tobaccocontrol.bmj.com/cgi/content/abstract/tc.2008.026393v1

214. Quit Victoria. Correctional settings. 2015. Available from: http://www.quit.org.au/resource-centre/communities/correctional-settings

215. Puljevic C and Segan CJ. Systematic review of factors influencing smoking following release from smoke-free prisons. Nicotine & Tobacco Research, 2018. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29733380

216. de Andrade D and Kinner SA. Systematic review of health and behavioural outcomes of smoking cessation interventions in prisons. Tobacco Control, 2016. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27798322

217. Frank MR, Blumhagen R, Weitzenkamp D, Mueller SR, Beaty B, et al. Tobacco use among people who have been in prison: Relapse and factors associated with trying to Quit. J Smok Cessat, 2017; 12(2):76-85. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29430256

218. Puljević C, de Andrade D, Carroll M, Spittal MJ, and Kinner SA. Use of prescribed smoking cessation pharmacotherapy following release from prison: A prospective data linkage study. Tobacco Control, 2017. Available from: http://tobaccocontrol.bmj.com/content/tobaccocontrol/early/2017/08/28/tobaccocontrol-2017-053743.full.pdf

219. Young JT, Puljevic C, Love AD, Janca EK, Segan CJ, et al. Staying Quit after release (square) trial protocol: A randomised controlled trial of a multicomponent intervention to maintain smoking abstinence after release from smoke-free prisons in Victoria, Australia. BMJ Open, 2019; 9(6):e027307. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31167867

220. Barton CA, McGuire A, Waller M, Treloar SA, McClintock C, et al. Smoking prevalence, its determinants and short-term health implications in the Australian defence force. Military Medicine, 2010; 175(4):267–72. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20446502

221. Australian Institute of Health and Welfare. Cancer incidence study 2003: Australian veterans of the korean war. PHE 48.Canberra: Australian Institute of Health and Welfare, 2003. Available from: http://www.aihw.gov.au/publications/index.cfm/title/9589.

222. Brown DW. Smoking prevalence among US veterans. Journal of General Internal Medicine, 2010; 25(2):147–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19894079

223. Duffy SA, Ronis DL, Karvonen-Gutierrez CA, Ewing LA, Dalack GW, et al. Effectiveness of the tobacco tactics program in the department of veterans affairs. Annals of Behavioral Medicine, 2014; 48(2):265–74. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24823842

224. Chen T, Kazerooni R, Vannort EM, Nguyen K, Nguyen S, et al. Comparison of an intensive pharmacist-managed telephone clinic with standard of care for Tobacco cessation in a veteran population. Health Promotion Practice, 2013; 15(4):512–20. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24231631

225. Carpenter VL, Hertzberg JS, Kirby AC, Calhoun PS, Moore SD, et al. Multicomponent smoking cessation treatment including mobile contingency management in homeless veterans. Journal of Clinical Psychiatry, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25699616

226. Christofferson DE, Hertzberg JS, Beckham JC, Dennis PA, and Hamlett-Berry K. Engagement and abstinence among users of a smoking cessation text message program for veterans. Addictive Behaviors, 2016; 62:47–53. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27318948

227. Vest BH, Kane C, DeMarce J, Barbero E, Harmon R, et al. Outcomes following treatment of veterans for substance and tobacco addiction. Archives of Psychiatric Nursing, 2014; 28(5):333–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25439975

228. Gifford E, Tavakoli S, Wisdom J, and Hamlett-Berry K. Implementation of smoking cessation treatment in vha substance use disorder residential treatment programs. Psychiatric Services, 2015; 66(3):295–302. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25727118

229. Van Voorhees EE, Hamlett-Berry K, Christofferson DE, Beckham JC, and Nieuwsma JA. No wrong door to smoking cessation care: A veterans affairs chaplain survey. Military Medicine, 2014; 179(5):472–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24806490

230. Krebs P, Rogers E, Smelson D, Fu S, Wang B, et al. Relationship between tobacco cessation and mental health outcomes in a tobacco cessation trial. Journal of Health Psychology, 2016. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27151069

231. US Department of Health and Human Services. Preventing tobacco use among young people: A report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2012. Available from: http://www.cdc.gov/tobacco/data_statistics/sgr/2012/.

232. Gurillo P, Jauhar S, Murray RM, and MacCabe JH. Does tobacco use cause psychosis? Systematic review and meta-analysis. The Lancet Psychiatry, 2015; 2(8):718–25. Available from: http://dx.doi.org/10.1016/S2215-0366(15)00152-2

233. Boden J, Fergusson D, and Horwood L. Cigarette smoking and depression: Tests of causal linkages using a longitudinal birth cohort. The British Journal of Psychiatry, 2010; 196(6):440–6. Available from: http://bjp.rcpsych.org/cgi/content/full/196/6/440

234. Guerin N and White V. ASSAD 2017 Statistics & Trends: Australian Secondary Students’ Use of Tobacco, Alcohol, Over-the-counter Drugs, and Illicit Substances. Second Edition. Cancer Council Victoria, 2020. Available from: https://www.health.gov.au/resources/publications/secondary-school-students-use-of-tobacco-alcohol-and-other-drugs-in-2017

235. Leatherdale S and McDonald P. Youth smokers' beliefs about different cessation approaches: Are we providing cessation interventions they never intend to use? Cancer Causes & Control, 2007; 18(7):783–91. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17549592

236. Solberg L, Boyle R, McCarty M, Asche S, and Thoele M. Young adult smokers: Are they different? The American Journal of Managed Care, 2007; 13(11):626–32. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17988188

237. Falkin G, Fryer C, and Mahadeo M. Smoking cessation and stress among teenagers. Qualitative Health Research, 2007; 17(6):812–23. Available from: http://qhr.sagepub.com/cgi/reprint/17/6/812

238. McVea K, Miller D, Creswell J, McEntarrfer R, and Coleman M. How adolescents experience smoking cessation. Qualitative Health Research, 2009; 19(5):580–92. Available from: http://qhr.sagepub.com/cgi/reprint/19/5/580

239. Gough B, Fry G, Grogan S, and Conner M. Why do young adult smokers continue to smoke despite the health risks? A focus group study. Psychology & Health, 2009; 24(2):203–20. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20186652

240. Henningfield J, Michaelides T, and Sussman S. Developing treatment for tobacco addicted youth–issues and challenges, in Nicotine addiction among adolescents.  Wagner E, Editor New York, NY: The Haworth Press; 2000.

241. Zhu SH, Sun J, Billings SC, Choi WS, and Malarcher A. Predictors of smoking cessation in US adolescents. American Journal of Preventive Medicine, 1999; 16(3):202–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10198659

242. Chen PH, White HR, and Pandina RJ. Predictors of smoking cessation from adolescence into young adulthood. Addictive Behaviors, 2001; 26(4):517–29. Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11456075

243. Costello D, Dierker L, Jones B, and Rose J. Trajectories of smoking from adolescence to early adulthood and their psychosocial risk factors. Health Psychology, 2008; 27(6):811–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19025277

244. Cengelli S, O'Loughlin J, Lauzon B, and Cornuz J. A systematic review of longitudinal population-based studies on the predictors of smoking cessation in adolescent and young adult smokers. Tobacco Control, 2012; 21(3):355–62. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21846777

245. Loprinzi PD and Walker JF. Association of longitudinal changes of physical activity on smoking cessation among young daily smokers. Journal of Physical Activity and Health, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25966498

246. Horn K, Dino G, Branstetter S, Zhang J, Noerachmanto N, et al. Effects of physical activity on teen smoking cessation. Pediatrics, 2011; 128(4):e801–11. Available from: http://pediatrics.aappublications.org/content/128/4/e801.long

247. Myers M, Gwaltney C, Strong D, Ramsey S, Brown R, et al. Adolescent first lapse following smoking cessation: Situation characteristics, precipitants and proximal influences. Addictive Behaviors, 2011; 36(12):1253–60. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21903332

248. Smith AE, Cavallo DA, McFetridge A, Liss T, and Krishnan-Sarin S. Preliminary examination of tobacco withdrawal in adolescent smokers during smoking cessation treatment. Nicotine & Tobacco Research, 2008; 10(7):1253–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18629736

249. Towns S, DiFranza JR, Jayasuriya G, Marshall T, and Shah S. Smoking cessation in adolescents: Targeted approaches that work. Paediatric Respiratory Reviews, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26187717

250. Stanton A and Grimshaw G. Tobacco cessation interventions for young people. Cochrane Database of Systematic Reviews, 2013; 8:Cd003289. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23975659

251. Karpinski JP, Timpe EM, and Lubsch L. Smoking cessation treatment for adolescents. The Journal of Pediatric Pharmacology and Therapeutics, 2010; 15(4):249–63. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3042263/

252. Fiore MC, Jaén M, Carlos Roberto, Baker TB, Bailey WC, Benowitz NL, et al. Treating tobacco use and dependence. Clinical practice guidelines. Rockville, MD: US Department of Health and Human Services, 2008. Available from: http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/tobacco/clinicians/update/index.html.

253. Bowles H, Maher A, and Sage R. Helping teenagers stop smoking: Comparative observations across youth settings in cardiff. Health Education Journal, 2009; 68(2):111–8. Available from: http://hej.sagepub.com/cgi/reprint/68/2/111

254. Peirson L, Ali MU, Kenny M, Raina P, and Sherifali D. Interventions for prevention and treatment of tobacco smoking in school-aged children and adolescents: A systematic review and meta-analysis. Preventive Medicine, 2015; 85:20–31. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26743631

255. Eureka Strategic Research for the Australian Government Department of Health and Ageing. Youth Tobacco prevention literature review. 2005. Available from: http://www.health.gov.au/internet/main/publishing.nsf/Content/phd-pub-tobacco-literature-cnt.htm

256. Sussman S and Sun P. Youth tobacco use cessation: 2008 update. Tobacco Induced Diseases, 2009; 5:3. Available from: http://www.tobaccoinduceddiseases.com/content/5/1/3

257. Peterson AV, Jr., Marek PM, Kealey KA, Bricker JB, Ludman EJ, et al. Does effectiveness of adolescent smoking-cessation intervention endure into young adulthood? 7-year follow-up results from a group-randomized trial. PLoS ONE, 2016; 11(2):e0146459.

258. Bellhouse B, Johnston G, Deed C, and Taylor N, Smoke-free schools: tobacco prevention and management guidelines for Victorian schools.  Melbourne, Vic: The State of Victoria, Department of Education & Training, Australian Government, Department of Education, Science and Training; 2003. Available from: http://www.sofweb.vic.edu.au/edulibrary/public/stratman/Policy/schoolgov/druged/SmokeFreeSchools.pdf.

259. Barylak M, Smith B, Oliver L, Davis B, Duigan P, et al., Intervention matters: A policy statement and procedural framework for the management of suspected drug-related incidents in schools.  Adelaide, SA: Australian Government, Department of Education, Science and Training, Government of South Australia, Department of Education and Children's Services, Drug Strategy with our eyes open; 2005.

260. Curry SJ, Mermelstein RJ, Emery SL, Sporer AK, Berbaum ML, et al. A national evaluation of community-based youth cessation programs: End of program and twelve-month outcomes. American Journal of Community Psychology, 2013; 51(1-2):15–29. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22395364

261. Peterson A, Jr, Kealey K, Mann S, Marek P, Ludman E, et al. Group-randomized trial of a proactive, personalized telephone counseling intervention for adolescent smoking cessation. Journal of the National Cancer Institute, 2009; 101(20):1378–92. Available from: http://jnci.oxfordjournals.org/cgi/content/full/101/20/1378

262. Ferretter I. Victorian Quitline data 2003–2007, 2008, The Cancer Council Victoria: Melbourne, Vic.

263. Quit Victoria. Youth protocol, minimum standards for Australian quitlines 2007, 2007, The Cancer Council Victoria: Melbourne, Vic.

264. Tan N, Montague M, and Freeman J. Impact of the national Tobacco campaign: Comparison between teenage and adult surveys, in Australia's national Tobacco campaign. Evaluation report  volume two. Canberra: Commonwealth Department of Health and Aged care; 2000. p 78–103 Available from: http://catalogue.nla.gov.au/Record/1402074.

265. White V, Tan N, Wakefield M, and Hill D. Do adult focused anti-smoking campaigns have an impact on adolescents? The case of the Australian national Tobacco campaign. Tobacco Control, 2003; 12(Suppl 2):ii23–ii9. Available from: http://tobaccocontrol.bmj.com/content/12/suppl_2/ii23.short

266. Brown T, Platt S, and Amos A. Equity impact of interventions and policies to reduce smoking in youth: Systematic review. Tobacco Control, 2014; 23(e2):e98–e105. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24842855

267. Pbert L, Flint AJ, Fletcher KE, Young MH, Druker S, et al. Effect of a pediatric practice-based smoking prevention and cessation intervention for adolescents: A randomized, controlled trial Pediatrics, 2008; 121(4):738–47. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18381502

268. Price J, Jordan T, and Dake J. Pediatricians' use of the 5a's and nicotine replacement therapy with adolescent smokers. Journal of Community Health, 2007; 32(2):85–101. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17571523

269. Stevens S, Pailler M, Diamond G, Levy S, Latif S, et al. Providers' experiences caring for adolescents who smoke cigarettes. Health Psychology, 2009; 28(1):66–72. Available from: www.ncbi.nlm.nih.gov/pubmed/19210019

270. Mons U, Müezzinler A, Gellert C, Schöttker B, Abnet CC, et al. Impact of smoking and smoking cessation on cardiovascular events and mortality among older adults: Meta-analysis of individual participant data from prospective cohort studies of the chances consortium. British Medical Journal, 2015; 350. Available from: http://www.bmj.com/bmj/350/bmj.h1551.full.pdf

271. Tran B, Falster MO, Douglas K, Blyth F, and Jorm LR. Smoking and potentially preventable hospitalisation: The benefit of smoking cessation in older ages. Drug and Alcohol Dependence, 2015; 150:85–91. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25769393

272. Yong H, Borland R, and Siahpush M. Quitting-related beliefs, intentions and motivations of older smokers in four countries: Findings from the International Tobacco Control policy evaluation survey. Addictive Behaviors, 2005; 30(4):777–88. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15833581

273. Shahab L, Gilchrist G, Hagger-Johnson G, Shankar A, West E, et al. Reciprocal associations between smoking cessation and depression in older smokers: Findings from the English longitudinal study of ageing. The British Journal of Psychiatry, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25999339

274. Cohen-Mansfield J. Predictors of smoking cessation in old-old age. Nicotine & Tobacco Research, 2016. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26783294

275. Choi NG and DiNitto DM. Role of new diagnosis, social isolation, and depression in older adults' smoking cessation. Gerontologist, 2015; 55(5):793–801. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24904055

276. Breitling L, Rothenbacher D, Stegmaier C, Raum E, and Brenner H. Older smokers' motivation and attempts to quit smoking: Epidemiological insight into the question of lifestyle versus addiction. Deutsches Ärzteblatt International, 2009; 106(27):451–5. Available from: http://www.aerzteblatt.de/int/article.asp?id=65282

277. Lang I, Rice N, Wallace R, Guralnik J, and Melzer D. Smoking cessation and transition into retirement: Analyses from the English longitudinal study of ageing. Age and Ageing, 2007; 36(6):638-43(6):638–43. Available from: http://ageing.oxfordjournals.org/cgi/content/full/36/6/638

278. Medbo A, Melbye H, and Rudebeck C. "I did not intend to stop. I just could not stand cigarettes anymore." A qualitative interview study of smoking cessation among the elderly. BMC Family Practice, 2011; 12(1):42. Available from: http://www.biomedcentral.com/content/pdf/1471-2296-12-42.pdf

279. Doolan D and Froelicher E. Smoking cessation interventions and older adults. Progress in Cardiovascular Nursing, 2008; 23(3):119–27. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19039892

280. Kehlet M, Schroeder TV, and Tonnesen H. The gold standard program for smoking cessation is effective for participants over 60 years of age. International Journal of Environmental Research and Public Health, 2015; 12(3):2574–87. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25734789

281. Chen D and Wu LT. Smoking cessation interventions for adults aged 50 or older: A systematic review and meta-analysis. Drug and Alcohol Dependence, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26094185

282. Cawkwell PB, Blaum C, and Sherman SE. Pharmacological smoking cessation therapies in older adults: A review of the evidence. Drugs Aging, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26025119

283. Barnett PG, Wong W, Jeffers A, Munoz R, Humfleet G, et al. Cost-effectiveness of extended cessation treatment for older smokers. Addiction, 2014; 109(2):314–22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24329972

284. Pothirat C, Phetsuk N, Liwsrisakun C, and Deesomchok A. Real-world comparative study of behavioral group therapy program vs education program implemented for smoking cessation in community-dwelling elderly smokers. Clinical Interventions in Aging, 2015; 10:725–31. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25926726

285. Cataldo JK, Hunter M, Petersen AB, and Sheon N. Positive and instructive anti-smoking messages speak to older smokers: A focus group study. Tobacco Induced Diseases, 2015; 13(1):2. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25653578

286. Eisenberg M, Blum L, Filion K, Rinfret S, Pilote L, et al. The efficacy of smoking cessation therapies in cardiac patients: A meta-analysis of randomized controlled trials. The Canadian Journal of Cardiology, 2010; 26(2):73–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20151052

287. Brown LM. Tobacco myths: The older adult perspective. Journal of Gerontological Nursing, 2015:1–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25642695

288. Rowa-Dewar N and Ritchie D. Smoking cessation for older people: Neither too little nor too late. British Journal of Community Nursing, 2010; 15(12):578–82. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21240081

289. McVay M and Copeland A. Smoking cessation in peri- and postmenopausal women: A review. Experimental and Clinical Psychopharmacology, 2011; 19(3):192–202. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21480728

290. Sieminska A and Jassem E. The many faces of tobacco use among women. Medical Science Monitor, 2014; 20:153–62. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24487778

291. US Department of Health and Human Services. Women and smoking. A report of the Surgeon General. Atlanta, Georgia: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2001. Available from: http://www.cdc.gov/tobacco/data_statistics/sgr/index.htm.

292. Fang ML, Gerbrandt J, Liwander A, and Pederson A. Exploring promising gender-sensitive tobacco and alcohol use interventions: Results of a scoping review. Substance Use and Misuse, 2014; 49(11):1400–16. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24827863

293. Allen SS. Cigarette smoking among women: How can we help? Minnesota Medicine, 2014; 97(3):41–3. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24720068

294. Cooper J, Borland R, McKee SA, Yong HH, and Dugue PA. Depression motivates quit attempts but predicts relapse: Differential findings for gender from the International Tobacco Control study. Addiction, 2016. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26888199

295. Hinderaker K, Allen AM, Tosun N, al'Absi M, Hatsukami D, et al. The effect of combination oral contraceptives on smoking-related symptomatology during short-term smoking abstinence. Addictive Behaviors, 2014; 41C:148–51. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25452059

296. Wetherill RR, Jagannathan K, Hager N, Maron M, and Franklin TR. Influence of menstrual cycle phase on resting-state functional connectivity in naturally cycling, cigarette-dependent women. Biol Sex Differ, 2016; 7:24. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27168932

297. Greaves L, Johnson J, Bottorff J, Kirkland S, Jategaonkar N, et al. What are the effects of tobacco policies on vulnerable populations? A better practices review. Canadian Journal of Public Health, 2006; 97(4):310–5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16967752

298. Scharf D and Shiffman S. Are there gender differences in smoking cessation, with and without bupropion? Pooled- and meta-analyses of clinical trials of bupropion sr. Addiction, 2004; 99(11):1462–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15500599

299. Perkins KA. Smoking cessation in women. Special considerations. CNS Drugs, 2001; 15(5):391–411. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11475944

300. Smith PH, Kasza KA, Hyland A, Fong GT, Borland R, et al. Gender differences in medication use and cigarette smoking cessation: Results from the international tobacco control four country survey. Nicotine & Tobacco Research, 2015; 17(4):463–72. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25762757

301. Jorenby D, Hays J, Rigotti N, Azoulay S, Watsky E, et al. Efficacy of varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs placebo or sustained-release bupropion for smoking cessation: A randomized controlled trial. Journal of the American Medical Association, 2006; 296(1):56–63. Available from: http://jama.ama-assn.org/cgi/content/full/296/1/56

302. Hurt R, Sachs E, Glover K, Offord K, Johnston J, et al. A comparison of sustained-release bupropion and placebo for smoking cessation. New England Journal of Medicine, 1997; 337(17):1195–202. Available from: http://content.nejm.org/cgi/content/abstract/337/17/1195

303. Hatsukami D, Skoog K, Allen S, and Bliss R. Gender and the effects of different doses of nicotine gum on tobacco withdrawal symptoms. Experimental and Clinical Psychopharmacology, 1995; 3(2):163. Available from: http://psycnet.apa.org/journals/pha/3/2/163/

304. Wetter DW, Fiore MC, Young TB, McClure JB, de Moor CA, et al. Gender differences in response to nicotine replacement therapy: Objective and subjective indexes of tobacco withdrawal. Experimental and Clinical Psychopharmacology, 1999; 7(2):135–44. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10340153

305. Swan GE, Jack LM, and Ward MM. Subgroups of smokers with different success rates after use of transdermal nicotine. Addiction, 1997; 92(2):207–17. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9158232

306. Shiffman S, Sweeney CT, and Dresler CM. Nicotine patch and lozenge are effective for women. Nicotine & Tobacco Research, 2005; 7(1):119–27. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15804684/

307. West R, Hajek P, Nilsson F, Foulds J, May S, et al. Individual differences in preferences for and responses to four nicotine replacement products. Psychopharmacology (Berl), 2001; 153(2):225–30. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11205423

308. Smith PH, Weinberger AH, Zhang J, Emme E, Mazure CM, et al. Sex differences in smoking cessation pharmacotherapy comparative efficacy: A network meta-analysis. Nicotine & Tobacco Research, 2016. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27613893

309. World Health Organization, Gender and tobacco control: A policy brief.  Geneva 2007. Available from: http://www.who.int/tobacco/resources/publications/general/policy_brief.pdf.

310. World Health Organization. Framework Convention on Tobacco Control. New York: United Nations, 2003. Available from: http://www.who.int/tobacco/framework/WHO_FCTC_english.pdf.

311. Greaves L. Can tobacco control be transformative? Reducing gender inequity and tobacco use among vulnerable populations. International Journal of Environmental Research and Public Health, 2014; 11(1):792–803. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24402065

312. Marqueta A, Nerin I, Gargallo P, and Beamonte A. Gender differences in success at quitting smoking: Short- and long-term outcomes. Adicciones, 2016; 29(1):13-21.

313. Minian N, Penner J, Voci S, and Selby P. Woman focused smoking cessation programming: A qualitative study. BMC Womens Health, 2016; 16(1):17. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26971306

314. Verplaetse TL, Weinberger AH, Smith PH, Cosgrove KP, Mineur YS, et al. Targeting the noradrenergic system for gender-sensitive medication development for Tobacco dependence. Nicotine & Tobacco Research, 2015; 17(4):486–95. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25762760

315. Lynch W and Sofuoglu M. Role of progesterone in nicotine addiction: Evidence from initiation to relapse. Experimental and Clinical Psychopharmacology, 2010; 18(6):451–61. Available from: http://psycnet.apa.org/index.cfm?fa=buy.optionToBuy&id=2010-26426-001

316. Wetherill RR, Franklin TR, and Allen SS. Ovarian hormones, menstrual cycle phase, and smoking: A review with recommendations for future studies. Curr Addict Rep, 2016; 3(1):1–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27134810

317. Saladin ME, McClure EA, Baker NL, Carpenter MJ, Ramakrishnan V, et al. Increasing progesterone levels are associated with smoking abstinence among free-cycling women smokers who receive brief pharmacotherapy. Nicotine & Tobacco Research, 2015; 17(4):398–406. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25762749

318. Maziak W, Taleb ZB, Bahelah R, Islam F, Jaber R, et al. The global epidemiology of waterpipe smoking. Tobacco Control, 2014. Available from: http://tobaccocontrol.bmj.com/content/early/2014/10/08/tobaccocontrol-2014-051903.abstract

319. Ward KD, Siddiqi K, Ahluwalia JS, Alexander AC, and Asfar T. Waterpipe tobacco smoking: The critical need for cessation treatment. Drug and Alcohol Dependence, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26054945

320. Asfar T, Al Ali R, Rastam S, Maziak W, and Ward KD. Behavioral cessation treatment of waterpipe smoking: The first pilot randomized controlled trial. Addictive Behaviors, 2014; 39(6):1066–74. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24629480

321. Maziak W, Jawad M, Jawad S, Ward KD, Eissenberg T, et al. Interventions for waterpipe smoking cessation. Cochrane Database of Systematic Reviews, 2015; 7:CD005549. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26228266

322. Jawad M, Jawad S, Waziry RK, Ballout RA, and Akl EA. Interventions for waterpipe tobacco smoking prevention and cessation: A systematic review. Scientific Reports, 2016; 6:25872. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27167891

323. Ebbert JO, Elrashidi MY, and Stead LF. Interventions for smokeless tobacco use cessation. Cochrane Database of Systematic Reviews, 2015; 10:CD004306. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26501380

324. Schwartz J, Fadahunsi O, Hingorani R, Mainali NR, Oluwasanjo A, et al. Use of varenicline in smokeless Tobacco cessation: A systematic review and meta-analysis. Nicotine & Tobacco Research, 2015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25646351

325. Severson HH, Danaher BG, Ebbert JO, van Meter Ba N, Lichtenstein E, et al. Randomized trial of nicotine lozenges and phone counseling for smokeless Tobacco cessation. Nicotine & Tobacco Research, 2014. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25168034

326. Danaher BG, Severson HH, Zhu SH, Andrews JA, Cummins SE, et al. Randomized controlled trial of the combined effects of web and Quitline interventions for smokeless Tobacco cessation. Internet Interventions, 2015; 2(2):143–51. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25914872