Update on Smoking Cessation: E-Cigarettes, Emerging Tobacco Products Trends, and New Technology-Based Interventions
- 1.5k Downloads
Tobacco use disorders (TUDs) continue to be overly represented in patients treated in mental health and addiction treatment settings. It is the most common substance use disorder (SUD) and the leading cause of health disparities and increased morbidity/mortality amongst individuals with a psychiatric disorder. There are seven Food and Drug Administration (FDA) approved medications and excellent evidence-based psychosocial treatment interventions to use in TUD treatment. In the past few years, access to and use of other tobacco or nicotine emerging products are on the rise, including the highly publicized electronic cigarette (e-cigarette). There has also been a proliferation of technology-based interventions to support standard TUD treatment, including mobile apps and web-based interventions. These tools are easily accessed 24/7 to support outpatient treatment. This update will review the emerging products and counter-measure intervention technologies, including how clinicians can integrate these tools and other community-based resources into their practice.
KeywordsTobacco Mobile health Nicotine Addiction E-Cigarettes Smoking cessation Tobacco use disorder
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance
- 1.•Gfroerer J et al. Vital signs: current cigarette smoking among adults aged ≥18 years with mental illness—United States, 2009–2011 [Internet]. Atlanta: Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report (MMWR). 2013; 62(5); 81–87. Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6205a2.htm. Data from the 2009–2011 National Survey on Drug Use and Health (NSDUH) identified 36.1% of individuals 18 years of age or older with mental illness as smokers (compared to 21.4% with no mental illness).
- 2.Lasser K, Boyd JW, Woolhandler S et al. Smoking and mental illness: a population-based prevalence study. JAMA. 2000;284:22–9.Google Scholar
- 3.Grant BF, Hasin DS, Chou SP et al. Nicotine dependence and psychiatric disorders in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Arch Gen Psychiatry. 2004;61:1107–15.Google Scholar
- 4.Diaz FJ, Velásquez DM, Susce MT et al. The association between schizophrenia and smoking: unexplained by either the illness or the prodromal period. Schizophr Res. 2008;104:214–9.Google Scholar
- 5.Diaz FJ, James D, Botts S, Maw L et al. Tobacco smoking behaviors in bipolar disorder: a comparison of the general population, schizophrenia, and major depression. Bipolar Disord. 2009;11:154–65.Google Scholar
- 6.American Psychiatric Association: practice guideline for the treatment of patients with substance use disorders, 2nd edition [Internet]. Arlington: APA Work Group on Substance Use Disorders, 2006. Available from: http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/substanceuse.pdf.
- 7.•Substance abuse and mental health services administration: tobacco, 2014. Rockville: SAMHSA. 2014. Available from: http://www.samhsa.gov/topics/alcohol-tobacco-other-drugs/tobacco. Among individuals in addiction treatment, 77%-93% use tobacco.
- 8.Parks J, Jewell P, editors: Technical report on smoking policy and treatment in state operated psychiatric facilities, 2006. Alexandria: National Association of State Mental Health Program Directors Medical Directors Council (www.nasmhpd.org/docs/publications/MDCdocs/Oct2006%20Final%20Report%20on%20Smoking%20Policy%20and%20Treatment%20atState%20Operated%20Psychiatric%20Facilities.pdf).
- 9.McClave AK, McKnight-Eily LR, Davis SP et al. Smoking characteristics of adults with selected lifetime mental illnesses: results from the 2007 National Health Interview Survey. Am J Public Health. 2010;100(12):2464–72.Google Scholar
- 10.Prochaska JJ, Delucchi K, Hall SM. A meta-analysis of smoking cessation interventions with individuals in substance abuse treatment or recovery. J Consult Clin Psychol. 2004;72(6):1144–56.Google Scholar
- 11.Parks J, Svendsen D, Singer P et al. Morbidity and mortality in people with serious mental illness. Alexandria: National Association of State Mental Health Program Directors (NASMHPD) Medical Directors Council. 2006. Available from: http://www.nasmhpd.org/docs/publications/MDCdocs/Mortality%20and%20Morbidity%20Final%20Report%208.18.08.pdf.
- 12.Lutterman T, Ganju V, Schacht L et al. Sixteen state study on mental health performance measures. Rockville: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. 2003 DHHS Publication No. (SMA) 03–3835.Google Scholar
- 13.Siru R, Hulse GK, Tait RJ. Assessing motivation to quit smoking in people with mental illness: a review. Addiction. 2009;104:719–33.Google Scholar
- 14.Prochaska JJ, Rossi JS, Redding CA et al. Depressed smokers and stage of change: implications for treatment interventions. Drug Alcohol Depend. 2004;76(2):143–51. doi: 10.1016/j.drugalcdep.2004.04.017.
- 15.Williams JM, Ziedonis DM, Vreeland B et al. A wellness approach to addressing tobacco in mental health settings: learning about healthy living. Am J Psychiatr Rehabil. 2009;12:352–69.Google Scholar
- 16.Schroeder SA, Morris CD. Confronting a neglected epidemic: tobacco cessation for persons with mental illnesses and substance abuse problems. Annu Rev Public Health. 2010;31:297–314.Google Scholar
- 17.•Szatkowski L, McNeill A. Diverging trends in smoking behaviors according to mental health status. Nicotine Tob Res. 2015;17(3):356–60. doi: 10.1093/ntr/ntu173. Adults (16 years or older) with a history of mental illness or recent use of psychoactive medication, have not seen much of a decrease in tobacco use over the last two decades, compared to those without these indicators of mental disorders, as reported in the 1993–2011 Health Survey for England.
- 18.American Association of Medical Colleges. Physician behavior and practice patterns related to smoking cessation, summary report. Washington DC: Association of American Medical Colleges; 2007.Google Scholar
- 19.Prochaska JJ. Smoking and mental illness—breaking the link. N Engl J Med. 2011;365(3):196–8. doi: 10.1056/NEJMp1105248.
- 20.Prochaska JJ. Failure to treat tobacco use in mental health and addiction treatment settings: a form of harm reduction? Drug Alcohol Depend. 2010;110(3):177–82. doi: 10.1016/j.drugalcdep.2010.03.002.
- 21.•Prochaska JJ, Hall SE, Delucchi K et al. Efficacy of initiating tobacco dependence treatment in inpatient psychiatry: a randomized controlled trial. Am J Public Health. 2014;104(8):1557–65. This randomized control trial evaluated the efficacy of a combined NRT and motivational-based (tailored-Transtheoretical Model) tobacco cessation intervention for smokers receiving care in an acute inpatient psychiatry unit. The 7-day point prevalence abstinence was significantly greater for the intervention group versus usual care group at 3-, 6-, 12-, and 18-month follow-ups.Google Scholar
- 22.•Shahab L. Changes in prevalence of depression and anxiety following smoking cessation: results from an international cohort study. Psychol Med. 2014;44:127–41. Smoking cessation is associated with a significant decrease in self-reported mental health conditions among individuals in the general population with a 1 in 3 incidence rate of depression and/or anxiety.Google Scholar
- 23.•Cavazos-Rehg PA, Breslau N, Hatsukami D et al. Smoking cessation is associated with lower rates of mood/anxiety and alcohol use disorders. Psychol Med. 2014;44:1–13. Smoking cessation is associated with decreased vulnerability to the reoccurrence/continuation of alcohol use disorders (AUD) and mood/anxiety disorders among individuals with a pre-existing AUD or mental health condition.Google Scholar
- 24.Ziedonis DM, Williams JM, Steinberg M et al. Addressing tobacco addiction in office-based management of psychiatric disorders: practical considerations. Prim Psychiatr. 2006;13(2):51–63.Google Scholar
- 25.•Ziedonis DM, Das S, Tonelli ME. Smoking and mental illness: strategies to increase screening, assessment, and treatment. FOCUS. 2015;13(3):290–306. doi: 10.1176/appi.focus.20150008. This article reviews specific assessment strategies and evidence-based tobacco use disorder treatment interventions for individuals with psychiatric disorders (including for higher and lower motivated patients).
- 26.Mackowick KM, Lynch MJ, Weinberger AH et al. Treatment of tobacco dependence in people with mental health and addictive disorders. Curr Psychiatry Rep. 2012;14(5):478–85. doi: 10.1007/s11920-012-0299-2.
- 27.•King BA, Patel R, Nguyen KH et al. Trends in awareness and use of electronic cigarettes among US adults, 2010–2013. Nicotine Tob Res. 2015;17(2):219–27. doi: 10.1093/ntr/ntu191. Between 2010 and 2013, prevalence of U.S. adults reporting having ever used electronic cigarettes rose significantly from 3.3% to 8.5%.
- 28.•Leventhal AM, Strong DR, Kirkpatrick MG et al. Association of electronic cigarette use with initiation of combustible tobacco product smoking in early adolescence. JAMA. 2015;314(7):700–7. doi: 10.1001/jama.2015.8950. Findings from this study demonstrate the increased likelihood of adolescents who have tried electronic cigarettes (versus those who have not) using combustible tobacco products.
- 29.Altria Client Services Inc. Comments on the Institute of Medicine Report “scientific standards for studies on modified risk tobacco products.” Altria Client Services Inc. 2012. Available at: http://www.altria.com/About-Altria/Federal-Regulation-of-Tobacco/Regulatory-Filing/FDAFilings/Comments-to-FDA-on-IOM-MRTP-Report.pdf.
- 30.Calantzopoulos A. Remarks by Andre Calantzopoulos, Chief Operating Officer, Philip Morris International Inc. Investor Day, Lausanne. 2012. Available at: https://www.media-server.com/m/instances/8hjnb6wm/items/v2b4bx9m/assets/m8djui39/0/file.pdf.
- 31.Reynolds American Inc. Tobacco harm reduction: market leadership through transformation. 2012. Available at: http://www.reynoldsamerican.com/harm-reduction.cfm?plank=harmReduction2.
- 32.•Richardson A, Pearson J, Xiao H et al. Prevalence, harm perceptions, and reasons for using noncombustible tobacco products among current and former smokers. Am J Public Health. 2014;104(8):1437–44. doi: 10.2105/AJPH.2013.301804. Among a large sample of 1,487 current or former smokers, 33% reported using non-combustible tobacco products, with many reporting that they used the product as a smoking cessation aid; however, use of a noncombustible product was not linked to quitting nor reduction in smoking.
- 33.Tynan MA, McAfee T, Promoff G et al. Consumption of cigarettes and combustible tobacco—United States, 2000–2011 [Internet]. Atlanta: Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report (MMWR). 2012; 61(30); 565–569. Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6130a1.htm?s_cid=mm6130a1_x
- 34.National Cancer Institute. Cigar smoking and cancer [Internet]. Bethesda: National Cancer Institute, National Institutes of Health. 2010. Available from: http://www.cancer.gov/about-cancer/causes-prevention/risk/tobacco/cigars-fact-sheet.
- 35.Dugas E, Tremblay M, Low N et al. Water-pipe smoking among North American youths. Pediatrics. 2010;125(6):1184–9.Google Scholar
- 36.•Salloum RG, Thrasher JF, Kates FR et al. Water pipe tobacco smoking in the United States: findings from the National Adult Tobacco Survey. Prev Med. 2015;71:88–93. doi: 10.1016/j.ypmed.2014.12.012. Waterpipe use is prevalent among 9.8% of U.S. adults in a national sample.
- 37.•U.S. Food and Drug Administration (FDA). Electronic cigarettes (e-Cigarettes) [internet]. Silver Spring: U.S. FDA. 2015. Available from: http://www.fda.gov/NewsEvents/PublicHealthFocus/ucm172906.htm. This article discloses safety risks report to FDA by consumers concerning e-cigarette use.
- 38.•Goniewicz ML, Gupta R, Lee YH et al. Nicotine levels in electronic cigarette refill solutions: a comparative analysis of products from the U.S., Korea, and Poland. Int J Drug Policy. 2015;26(6):583–8. doi: 10.1016/j.drugpo.2015.01.020. This study evaluated 32 e-cigarette cartridges and identified trace amounts of nicotine in three U.S. manufactured products labeled as nicotine-free.
- 39.•McRobbie H, Bullen C, Hartmann-Boyce J et al. Electronic cigarettes for smoking cessation and reduction. Cochrane Database Syst Rev. 2014;12:CD010216. doi: 10.1002/14651858.CD010216.pub2. Cochrane review summarizes research findings of 2 randomized control trials investigating the efficacy of e-cigarettes as a smoking cessation aid, concluding that while there is an effect, the evidence is low grade, warranting further research.
- 40.•Bhatnagar A, Whitsel LP, Ribisl KM et al. Electronic cigarettes: a policy statement from the American Heart Association. Circulation. 2014;130:1418–36. The online resource provided by the American Heart Association discusses the population health and policy implications of electronic cigarette use.Google Scholar
- 41.•Maryland resource center for quitting use & initiation of tobacco. Cigars [Internet]. Baltimore: MDQuit Resource Center, University of Maryland, Baltimore County; 2014. Available from: http://mdquit.org/tobacco-information/cigars. This online resource provided by the University of Maryland, outlines the variation of cigar types and discusses nicotine yield.
- 42.•American Cancer Society. How are cigars different from cigarettes? [Internet]. Atlanta: American Cancer Society; 2014. Available from: http://www.cancer.org/cancer/cancercauses/tobaccocancer/cigarsmoking/cigar-smoking-cigars-vs-cigarettes. This ACS online resource discusses the health risks associated with tobacco smoke (cigarettes, cigars, and pipes).
- 43.Tobacco free U. Top facts: little cigars [internet]. Littleton: The BACCHUS Network; 2010. Available from: http://www.tobaccofreeu.org/cms-assets/documents/120708-368061.little-cigarsblackandmilds.pdf.
- 44.Knishkowy B, Amitai Y. Water-pipe (narghile) smoking: an emerging health risk behavior. Pediatrics. 2005;116(1):e113–9. doi: 10.1542/peds.2004-2173.
- 45.•Centers for Disease Control and Prevention (CDC). Hookahs [Internet]. Atlanta: CDC, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014. Available from: http://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/hookahs/. This CDC factsheet describes Hookah use and related health effects.
- 46.Eissenberg T, Shihadeh A. Waterpipe tobacco and cigarette smoking: direct comparison of toxicant exposure. Am J Prev Med. 2009;37:518–23.Google Scholar
- 47.Health Ways QuitNew, Inc. Treatment recommendations for smokeless tobacco [internet]. Available from: http://www.quitlinenc.com/health-professionals/tobacco-dependence-medication/treatment-for-smokeless-tobacco.
- 48.•Centers for Disease Control and Prevention (CDC). Smoking and tobacco use: types of smokeless tobacco [Internet]. Atlanta: National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014. Available from: http://www.cdc.gov/tobacco/data_statistics/fact_sheets/smokeless/use_us/types/index.htm. This factsheet describes the types of smokeless tobacco products, including chewing tobacco, snuff, and dissolvables.
- 49.Lunell E, Lunell M. Steady-state nicotine plasma levels following use of four different types of Swedish snus compared with 2-mg Nicorette chewing gum: a crossover study. Nicotine Tob Res. 2005;7(3):397–403. doi: 10.1080/14622200500125468.
- 50.•Digard H, Gale N, Errington G et al. Multi-analyte approach for determining the extraction of tobacco constituents from pouched snus by consumers during use. Chem Cent J. 2013;7(1):55. doi: 10.1186/1752-153X-7-55. This article used a multi-analyte approach to identify nicotine exposure from use of snus.
- 51.Indiana State Department of Health. Dissolvable tobacco products: a new threat. Indiana State Department of Health, Tobacco Prevention and Cessation Commission. http://www.in.gov/isdh/tpc/files/Dissolvable_tobacco_products_7_18_11.pdf.
- 52.•Centers for Disease Control and Prevention (CDC). Smokeless tobacco: health effects [internet]. Atlanta: National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014. Available from: http://www.cdc.gov/tobacco/data_statistics/fact_sheets/smokeless/health_effects/index.htm. This CDC factsheet describes the health effects of using smokeless tobacco products, including cancer, oral diseases, and reproductive and developmental risks.
- 53.•U.S. Food and Drug Administration (FDA). Nicotine replacement therapy labels may change [internet]. Silver Spring: Consumer Updates, U.S. FDA. 2015. Available from: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm345087.htm. This article discusses FDA guidelines for proper use of Nicotine Replacement Therapy and lists proposed changes to drug fact labeling to allow more flexibility on appropriate use and duration.
- 54.•Kandel ER, Kandel DB. A molecular basis for nicotine as a gateway drug. N Engl J Med. 2014;371(10):932–43. doi: 10.1056/NEJMsa1405092. Review of the literature supporting the gateway effect of nicotine, and its molecular and neurobiological underpinnings, as well as sheds light on e-cigarettes as a potential gateway to cigarettes.
- 55.Stepanov I, Carmella SG, Han S et al. Evidence for endogenous formation of N’-nitrosonornicotine in some long-term nicotine patch users. Nicotine Tob Res. 2009;11(1):99–105. doi: 10.1093/ntr/ntn004.
- 56.•Tonini G, D'Onofrio L, Dell'Aquila E et al. New molecular insights in tobacco-induced lung cancer. Future Oncol. 2013;9(5):649–55. doi: 10.2217/fon.13.32. This review summarizes research findings delineating the physiological mechanisms by which nicotine and tobacco use leads to the development of lung cancer.
- 57.•Hu N, Ren J. Nicotine, cigarette smoking and cardiac function: an update. Toxicol Res. 2014;3:7–10. doi: 10.1039/C3TX50044F. This article reviews research findings on smoking and cardiac implications, and identifies underlying pathophysiological mechanisms of smoking-related coronary diseases.
- 58.•U.S. Food and Drug Administration (FDA). Update from FDA on the tobacco products scientific advisory committee’s report and recommendations on dissolvable tobacco products [internet]. Silver Spring: Tobacco Products Scientific Advisory Committee, U.S. FDA. 2015. Available from: http://www.fda.gov/AdvisoryCommittees/CommitteesMeetingMaterials/TobaccoProductsScientificAdvisoryCommittee/ucm294183.htm. This FDA update presents the Tobacco Products Scientific Advisory Committee (TPSAC)’s recommendations on dissolvable tobacco products, including risks and benefits, and related public health implications.
- 59.•Abrams DB, Niaura R. The importance of science-informed policy and what the data really tell us about e-cigarettes. Isr J Health Policy Res. 2015;4:22. doi: 10.1186/s13584-015-0021-z. This article shines light on the potential role of electronic cigarettes in accelerating the demise of cigarettes and serving as a temporary transition to cessation.
- 60.•Businelle MS. The potential of mHealth for tobacco dependence treatment: domestic and international examples from NCI’S Smokefree.gov initiative. Nicotine Tob Res. 2014;16(7):1033. doi: 10.1093/ntr/ntu071. This article discusses the utilization of mHealth technology-based interventions for smoking cessation across various formats (i.e., websites, apps, text-messaging programs, and social media platforms).
- 61.•Abroms LC, Lee Westmaas J, Bontemps-Jones J et al. A content analysis of popular smartphone apps for smoking cessation. Am J Prev Med. 2013;45(6):732–6. This study found that popular smoking cessation apps have low adherence rate and suggests that these resources be better integrated with Clinical Practice Recommendations in order to enhance these applications.Google Scholar
- 62.•Boudreaux ED, Waring ME, Hayes RB et al. Evaluating and selecting mobile health apps: strategies for healthcare providers and healthcare organizations. Transl Behav Med. 2014;4(4):363–71. This paper provides helpful strategies for health care professionals on how to select new technology applications available for tracking and enhancing health outcomes.Google Scholar
- 63.•Stoyanov SR, Hides L, Kavanagh DJ et al. Mobile app rating scale: a new tool for assessing the quality of health mobile apps. JMIR Mhealth Uhealth. 2015;3(1):e27. doi: 10.2196/mhealth.3422. This article discusses the development and psychometric properties of the mobile application rate scale (MARS) for evaluating the quality of mobile health applications.
- 64.•Borrelli B, Bartlett YK, Tooley E et al. Prevalence and frequency of mHealth and eHealth use among US and UK smokers and differences by motivation to quit. J Med Internet Res. 2015;17(7):e164. doi: 10.2196/jmir.4420. Discusses the higher prevalence of use of eHealth or mHealth platforms among smokers highly motivated to quit and also proposes ways to engage lower motivated smokers to quit using technology-based interventions.
- 65.•Spohr SA, Nandy R, Gandhiraj D et al. Efficacy of SMS text message interventions for smoking cessation: a meta-analysis. J Subst Abus Treat. 2015;56:1–10. doi: 10.1016/j.jsat.2015.01.011. This study found a significant increase in smoking cessation rates using text messaging intervention method.
- 66.•Hunt YM, Auguston EM, Taylor SC et al. Self-reported quit rates among users of a national text message based cessation program: early data from the national cancer institute’s smokefreetxt. Boston: Poster presented at the Society for Research on Nicotine and Tobacco; 2013. Increased self-reported quit rates using the largest text messaging quit platform, SMOKEFREETXT, were found at one, three, and six month follow-ups.Google Scholar
- 67.•Abroms LC, Boal AL, Simmens SJ et al. A randomized trial of Text2Quit: a text messaging program for smoking cessation. Am J Prev Med. 2014;47(3):242–50. doi: 10.1016/j.amepre.2014.04.010. Results from this randomized trial demonstrated a biochemically confirmed 11.1% abstinence rate among smokers using Text2Quit (compared to 5% of the control group).
- 68.Whittaker R, Borland R, Bullen C et al. Mobile phone-based interventions for smoking cessation. Cochrane Database Syst Rev. 2009;4:CD006611. doi: 10.1002/14651858.CD006611.pub2.
- 69.•Zeng EY, Vilardaga R, Heffner JL et al. Predictors of utilization of a novel smoking cessation smartphone app. Telemed J E Health. 2015. doi: 10.1089/tmj.2014.0232. This pilot trial of the smoking cessation smartphone app, SmartQuit, linked lower education, heavier smoking, and depression, with reduced utilization of the app.
- 70.•BinDhim NF, McGeechan K, Trevena L. Who uses smoking cessation apps? A feasibility study across three countries via smartphones. JMIR Mhealth Uhealth. 2014;2(1):e4. doi: 10.2196/mhealth.2841. This cross-sectional study assessed accessibility of a smoking cessation app and found a high prevalence of smokers ready to quit who used the app and were able to make quit attempts, independent of seeking professional help.
- 71.•Garrison KA, Pal P, Rojiani R et al. A randomized controlled trial of smartphone-based mindfulness training for smoking cessation: a study protocol. BMC Psychiatry. 2015;15:83. doi: 10.1186/s12888-015-0468-z. This randomized controlled trial is the first to evaluate the use of a mindfulness-based smoking cessation intervention delivered using a mobile app.
- 72.Brewer JA, Mallik S, Babuscio TA et al. Mindfulness training for smoking cessation: results from a randomized controlled trial. Drug Alcohol Depend. 2011;119(1–2):72–80. doi: 10.1016/j.drugalcdep.2011.05.027.
- 73.Hutton HE, Wilson LM, Apelberg BJ et al. A systematic review of randomized controlled trials: web-based interventions for smoking cessation among adolescents, college students, and adults. Nicotine Tob Res. 2011;13(4):227–38. doi: 10.1093/ntr/ntq252.
- 74.•Civljak M, Stead LF, Hartmann-Boyce J et al. Internet-based interventions for smoking cessation. Cochrane Database Syst Rev. 2013;7:CD007078. doi: 10.1002/14651858.CD007078.pub4. This Cochrane review summarizing internet-based interventions used for smoking cessation, demonstrates that some of these interventions can be effective at six months or longer; however trials comparing internet interventions with usual care or self-help did not demonstrate consistent effects.
- 75.Raiff BR, Jarvis BP, Rapoza D. Prevalence of video game use, cigarette smoking, and acceptability of a video game-based smoking cessation intervention among online adults. Nicotine Tob Res. 2012;14(12):1453–7. doi: 10.1093/ntr/nts079.
- 76.Abroms LC, Padmanabhan N, Thaweethai L et al. iPhone apps for smoking cessation: a content analysis. Am J Prev Med. 2011;40(3):279–85. doi: 10.1016/j.amepre.2010.10.032.
- 77.•Krebs P, Burkhalter JE, Snow B et al. Development and alpha testing of QuitIT: an interactive video game to enhance skills for coping with smoking urges. JMIR Res Protoc. 2013;2(2):e35. doi: 10.2196/resprot.2416. Evaluation of videogame prototype that enables smokers to practice strategies for coping with urges and maintaining abstinence done by experts and former/current smokers demonstrates that this has a strong potential for engaging smokers with suggestions on user interface, pacing, and diversity of the game characters.
- 78.•Ramo DE, Liu H, Prochaska JJ. A mixed-methods study of young adults’ receptivity to using Facebook for smoking cessation: if you build it, will they come? Am J Health Promot. 2015;29(4):e126–35. doi: 10.4278/ajhp.130326-QUAL-128. Mixed-methods study of 570 young adult smokers to evaluate interest (31%) in using Facebook to get help to quit smoking, identify important factors of use such as respect of privacy and tailoring to readiness to quit to maximize participation.
- 79.•Struik LL, Baskerville NB. The role of Facebook in crush the crave, a mobile- and social media-based smoking cessation intervention: qualitative framework analysis of posts. J Med Internet Res. 2014;16(7):e170. doi: 10.2196/jmir.3189. Descriptive study to characterize the content of posts on the Facebook page of Crush the Crave, an evidence-informed smoking cessation intervention directed toward young adults aged 19 to 29 years.
- 80.•Cobb NK, Jacobs MA, Saul J et al. Diffusion of an evidence-based smoking cessation intervention through Facebook: a randomised controlled trial study protocol. BMJ Open. 2014;4(1):e004089. doi: 10.1136/bmjopen-2013-004089. Methodology paper for a fractional factorial, randomized control trial of the diffusion of a Facebook application for smoking cessation.
- 81.•Jacobs MA, Cobb CO, Abroms L et al. Facebook apps for smoking cessation: a review of content and adherence to evidence-based guidelines. J Med Internet Res. 2014;16(9):e205. doi: 10.2196/jmir.3491. Review of features and functionality of Facebook apps (n = 9) for smoking cessation that found that adherence to cessation treatment guidelines was low.
- 82.•Pechmann C, Pan L, Delucchi K et al. Development of a Twitter-based intervention for smoking cessation that encourages high-quality social media interactions via automessages. J Med Internet Res. 2015;17(2):e50. doi: 10.2196/jmir.3772. Stage I early therapy development trial of a novel social media intervention for smoking cessation called Tweet2Quit was delivered online over closed, 20-person quit-smoking groups on Twitter in 100 days, and found automessages to have a positive effect on the social network participation.
- 83.Fiore M, 2008 PHS Guideline Update Panel, Liaisons, and Staff. Treating tobacco use and dependence: 2008 update. Rockvillle, MD: U.S. Department of Health and Human Services, Public Health Service Clinical Practice Guideline executive summary. Respir Care. 2008;53(9):1217.Google Scholar
- 84.•U.S. Food and Drug Administration. Modifications to labeling of nicotine replacement therapy products for over-the-counter human use. U.S. Department of Health and Human Services, Federal Register Volume 78, Number 63, Docket No. FDA–2013–N–0341; 2013. Available from: http://www.gpo.gov/fdsys/pkg/FR-2013-04-02/pdf/2013-07528.pdf. Changes to FDA labelling of NRT based on gathering of evidence from research and clinical practice to determine that users can use NRT while smoking and that they can use more than one NRT safely.
- 85.•Chelladurai Y, Singh S. Varenicline and cardiovascular adverse events: a perspective review. Ther Adv Drug Saf. 2014;5(4):167–72. doi: 10.1177/2042098614530421. Perspective review citing three systematic reviews by Singh and colleagues, Prochaska and Hilton, and Ware and colleagues, published between 2011 and 2013, comments on cardiovascular adverse events with varenicline use.
- 86.Cerimele JM, Durango A. Does varenicline worsen psychiatric symptoms in patients with schizophrenia or schizoaffective disorder? A review of published studies. J Clin Psychiatry. 2012;73(8):e1039–47. doi: 10.4088/JCP.11r07410.
- 87.•Kishi T, Iwata N. Varenicline for smoking cessation in people with schizophrenia: systematic review and meta-analysis. Eur Arch Psychiatry Clin Neurosci. 2015;265(3):259–68. doi: 10.1007/s00406-014-0551-3. Updated meta-analysis of randomized double-blind placebo-controlled trials (RCTs) on the effects of varenicline adjuvant therapy for smoking cessation in people with schizophrenia, including 7 studies (total n = 439), found no significant difference in suicidal ideation and depression between varenicline and placebo as well as no significant difference in smoking outcome.
- 88.•North American Quitline Consortium (NAQC). Retrieved October 15, 2015; (n.d.). Available from http://www.naquitline.org/. Central Website of North American Quitline Consortium (NAQC), an international, non-profit membership organization that is comprised of quitline service providers, funders of quitlines, researchers and strategic partners.
- 89.•Stead LF, Hartmann-Boyce J, Perera R et al. Telephone counseling for smoking cessation. Cochrane Database Syst Rev. 2013;8:CD002850. doi: 10.1002/14651858.CD002850.pub3. Cochrane Review of 77 trials found that proactive telephone counselling aids smokers who seek help from quitlines, that call-back counselling enhances their usefulness and that there is limited evidence about the optimal number of calls but that there is a likely dose benefit response.
- 90.North American Quitline Consortium (NAQC). Results from the 2012 NAQC Annual Survey of Quitlines [Internet]. Pheonix: NAQC Annual Survey Workgroup. Available from: http://c.ymcdn.com/sites/www.naquitline.org/resource/resmgr/2012_annual_survey/oct23naqc_2012_final_report_.pdf.
- 91.•Morris CD, Burns EK, Waxmonsky JA et al. Smoking cessation behaviors among persons with psychiatric diagnoses: results from a population-level state survey. Drug Alcohol Depend. 2014;136:63–8. doi: 10.1016/j.drugalcdep.2013.12.010. Colorado population survey (n = 14,118) found that smoking rates doubled among people with mental health diagnoses and that they were also more likely to attempt quitting, use nicotine replacement therapy more often, and succeed in quitting at similar rates, aside from those with anxiety/PTSD.
- 92.University of Colorado Behavioral Health & Wellness Program. Do quitlines have a role in serving the tobacco cessation needs of persons with mental illnesses and substance abuse disorders? A background report [internet]. Aurora: University of Colorado Behavioral Health & Wellness Program, Quitline Behavioral Health Advisory Forum; 2010. Available from: http://www.bhwellness.org/wp-content/uploads/2010/09/BHAFQuitlines_BH9_27_10.pdf.
- 93.Hebert KK, Cummins SE, Hernández S et al. Current major depression among smokers using a state quitline. Am J Prev Med. 2011;40(1):47–53. doi: 10.1016/j.amepre.2010.09.030.
- 94.Williams J, Ziedonis DM, Speelman N et al. Learning about health living: tobacco and you [internet]. New Brunswick: Robert Wood Johnson Medical School, Division of Addiction Psychiatry, 2012. Available from: http://www.nysmokefree.com/ConfCalls/CCNYSDownloads/UMDNJLearningAboutHealthyLiving.pdf.
- 95.Ziedonis DM, Zammarelli L, Seward G et al. Addressing tobacco use through organizational change: a case study of an addiction treatment organization. J Psychoactive Drugs. 2007;39(4):451–9.Google Scholar
- 96.Williams JM, Zimmermann MH, Steinberg ML et al. A comprehensive model for mental health tobacco recovery in New Jersey. Admin Pol Ment Health. 2011;38:368–83.Google Scholar
- 97.•American Academy of Addiction Psychiatry (AAAP). Education and training: CME opportunities [Internet]. East Providence: AAAP; 2015. Available from http://www.aaap.org/education-training/cme-opportunities/. Online Performance in Practice (PIP) entitled “Improving patient outcomes in treating patients with substance use disorders who are also tobacco users.”