Using Text Messaging to Prevent Relapse to Smoking: Intervention Development, Practicability and Client Reactions.

Using text messaging to prevent relapse to smoking: intervention development, practicability and client reactions.

Filed under: Addiction Rehab

Addiction. 2012 Dec; 107 Suppl 2: 39-44
Snuggs S, McRobbie H, Myers K, Schmocker F, Goddard J, Hajek P

The NHS Stop Smoking Service (NHS-SSS) helps approximately half its clients to quit for 4 weeks. However, most initially successful quitters relapse within 6 months. Short message service (SMS) texting has been shown to facilitate stopping smoking. We describe the development, implementation and subsequent evaluation, in terms of practicability and client response, of an SMS text-based relapse prevention intervention (RPI) delivered within routine community and specialist National Health Service (NHS) Stop Smoking Service (SSS) provision in four Primary Care Trusts.Text messages aimed at motivation to remain abstinent, preventing careless lapses and continuing the full course of medicine for smoking cessation were developed and sent weekly to clients’ mobile phones for 12 weeks and fortnightly for 6 months. They were asked to respond to some of the texts and contact the NHS SSS if they lapsed. They were also offered free nicotine mini lozenges to be sent via the mail on three occasions.NHS SSS.202 clients who had been abstinent for 4 weeks.Feasibility of introducing RPI into routine care; response to interactive messages and requests for the medication; rating of the helpfulness of RPI; self-reported and carbon monoxide (CO)-validated smoking status for up to 26 weeks.A text-based RPI was easy to implement within the NHS SSS provided by specialist advisers, but enrolment of clients from services provided by a network of pharmacists was difficult because client contact details were often lacking. Where records of the number of people invited to RPI were available, 94% of eligible participants enrolled. The RPI was well received by both SSS clients and staff, with 70% (n?=?63) of clients who completed follow-up considering the intervention helpful. Eighty-five per cent (n?=?172) of clients responded to at least one of the nine interactive text messages. Sixty-four clients (32% of the total, 47% of those we managed to contact) reported continuous abstinence at 6 months. Eighteen (9%) clients who relapsed to smoking used the RPI to re-engage with the NHS SSS and 10 (5%) successfully re-established abstinence.In smokers attending National Health Service Stop Smoking Services who are abstinent 4 weeks after their quit date, a relapse prevention intervention based on SMS text messaging was well received, and can be implemented economically and rapidly. A controlled trial is needed to establish whether it has a significant impact on relapse.
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Barriers and facilitators to a criminal justice tobacco control coordinator: an innovative approach to supporting smoking cessation among offenders.

Filed under: Addiction Rehab

Addiction. 2012 Dec; 107 Suppl 2: 26-38
Eadie D, Macaskill S, McKell J, Baybutt M

To examine the barriers and facilitators to effective operation of a regional tobacco control coordinator working within and across criminal justice and public health, whose goal was to raise tobacco control awareness and support the development of smoking cessation treatment for offenders.A reflexive, mixed-methods case study approach using in-depth interviews, project reports and observation of advisory board meetings.The coordinator worked with prisons, probation and police custody, where there are high levels of social disadvantage and smoking.Interviews (n?=?34) at different stages of project with the coordinator, project advisers and local stakeholders from criminal justice and public health.Analysis of facilitators and barriers and the coordinator role from different perspectives.Readiness to develop cessation services was a critical predictor of different criminal justice settings’ engagement with the coordinator role. The coordinator enhanced cessation service delivery in individual prisons where there was a requirement and infrastructure in place to provide such services. In police custody, where there was no central guidance or pre-existing requirements, efforts to establish smoking cessation on the local agenda proved ineffective. In probation settings, the coordinator documented examples of good practice and supported brief intervention training. Variability in willingness to engage limited the project’s ability to create joined-up working across criminal justice settings.In the English criminal justice system, the prison service appears to provide a favourable context for development of smoking cessation support and a means of accessing hard-to-reach groups. Other criminal justice settings, most specifically police custody, appear less responsive to such activity. A coordinator role can improve smoking cessation support in the prison setting, and develop local improvements in tobacco control interventions in other settings such as probation, but as configured here, does not have the capacity to effect change across the criminal justice system.
HubMed – addiction


Tailored tobacco dependence support for mental health patients: a model for inpatient and community services.

Filed under: Addiction Rehab

Addiction. 2012 Dec; 107 Suppl 2: 18-25
Parker C, McNeill A, Ratschen E

Although smoking prevalence among people with severe mental illness is high, it remains largely unaddressed. This pragmatic pilot project aimed to develop and implement a tailored tobacco dependence service in mental health settings and to assess its impact, as well as barriers and facilitators to implementation.An integrative service model, spanning acute, rehabilitation and community services, including the design of tailored instruments and referral pathways, delivered by two mental health professionals.Four adult acute and two rehabilitation wards (129 beds), and the community recovery team (2038 cases) of the United Kingdom’s largest Mental Health Trust.Audit of smoking information in patient notes; service uptake; quit attempts; smoking cessation and reduction; qualitative data on implementation barriers/facilitators.A total of 110 patients attended at least one support session: 53 inpatients (23% of inpatient smokers) and 57 community (of unknown number of community smokers, as recording of smoking status is not mandatory). Thirty-four of these (31%) made a quit attempt; 17 (15%) stopped smoking and 29 (26%) reduced cigarette consumption by up to 50% at the final contact. Barriers to service implementation related to: (i) trust policy, systems and procedures, (ii) staff knowledge and attitudes and (iii) illness-related factors.Despite the strong anti-smoking climate in the United Kingdom, including a law requiring smoke-free policies in mental health settings, establishing a smoking cessation treatment service for people with mental illness proved difficult, due to complex systemic barriers. However, there is clearly a demand, by patients, for such a service.
HubMed – addiction


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