Tag Archives: smoking cessation

SmokerStop App Review: A Motivational Tool for Your Patients

Douglas Maurer, DO/MPH/FAAFP | August 2, 2018

Tobacco use remains the #1 preventable cause of morbidity and mortality in the United States and worldwide. Overall, cigarette smoking among U.S. adults (aged ≥18 years) declined from 20.9 percent in 2005 to 15.5 percent in 2016. Still nearly 38 million

smoking cessation info graphic for article, SmokerStop App Review: A Motivational Tool for Your PatientsAmerican adults smoked cigarettes in 2016, according to the Centers for Disease Control and Prevention (CDC). Smoking remains the leading cause of cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD). National efforts have included tobacco taxes and smoking bans which have both proven effective.

More recently, the prescribing of apps for cessation has been utilized and shown to be effective. We recently reviewed and praised the outstanding QuitMedKit from the University of Texas MD Anderson Cancer Center. The app includes nearly everything the primary provider would want to have to aid patients in tobacco cessation: the 5A’s approach, information on medications for cessation, tips on motivational interviewing, graphics to assist in cessation, and links to online resources.

The QuitMedKit app does not include much information tailored to patients regarding personal health and financial goals. The SmokerStop app by Dr Titus Brinker in Germany uses personal motivation as its primary smoking cessation technique. The app uses data input by the patient to calculate health information such as reduction in blood pressure, lung cancer risk, as well as financial goals such as when an ex-smoker will have enough cash for movie tickets, an iPhone, etc. The app also allows patients to put in their own goals. All of this information is tracked by the app and reminders are periodically sent to to the patient to help keep them motivated.


QuitMedKit: An Essential Guide to Tobacco Cessation App

Douglas Maurer, DO/MPH/FAAFP | 

Tobacco use remains the #1 preventable cause of morbidity and mortality in the United States and worldwide. Overall, cigarette smoking among U.S. adults (aged ≥18 years) declined from 20.9 percent in 2005 to 15.5 percent in 2016. Still, nearly 38 million American adults smoked cigarettes in 2016, according to the Centers for Disease Control and Prevention (CDC).

Screenshot of app for article, QuitMedKit: An Essential Guide to Tobacco Cessation App
And it’s FREE!

Smoking remains the leading cause of cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD). Efforts to promote tobacco cessation are encouraged at the national, state, local, and individual practice level. The CDC reports only California and Alaska spend the recommended amount on tobacco cessation.

National efforts have included tobacco taxes and smoking bans which have both proven effective. Efforts to prevent the initiation of tobacco use in youths include Tar Wars from the AAFP. More recently, the prescribing of apps for cessation has been utilized and shown to be effective. I have studied the Smartquit app myself via a randomized controlled trial in the military population (unpublished data) served by our residency program. What are the options for providers just wanting to counsel patients outside of a research study and/or paying for a smoking cessation app to prescribe?

The University of Texas MD Anderson Cancer Center has just released a new app called QuitMedGuide. The app was developed by Alexander V. Prokhorov, MD, PhD and Mario Luca, MS, at MD Anderson. The app is intended to assist healthcare providers in counseling and treatment of tobacco dependence. The app includes the evidence-based 5As approach, information on medications for cessation, tips on motivational interviewing, graphics to assist in cessation, and links to online resources.

Evidence-based medicine

Developed by the University of Texas MD Anderson Cancer Center, QuitMedKit uses the current 2008 US Department of Health and Human Services Clinical Practice Guideline for tobacco cessation. The app includes detailed information on the proven 5As approach to cessation, tips on motivational interviewing, and current FDA-approved medications for tobacco cessation.

Who would benefit from this App?

Medical students, primary care physicians, midlevels, hospital medicine physicians, nurses, pharmacists, or any provider who counsels patients on tobacco cessation.


In helping smokers quit, cash is king, e-cigarettes strike out

Date: May 23, 2018
Source: University of Pennsylvania School of Medicine

Free smoking cessation aids, such as nicotine patches and chewing gum, are a staple of many corporate wellness programs aimed at encouraging employees to kick the habit.

info graphic showing stages of quitting smoking for article, In helping smokers quit, cash is king, e-cigarettes strike outBut, new research shows that merely offering such aids for free does not help employees quit, whereas supplementing them with financial incentives is three times more effective.

The study, led by researchers at the Perelman School of Medicine at the University of Pennsylvania, also provides the first large-scale evidence that offering e-cigarettes to known smokers is not effective at helping smokers stay smoke-free. The results are published today in the New England Journal of Medicine and may hold significant policy implications as the U.S. Food and Drug Administration continues to weigh e-cigarette regulation.

“Smoking remains the leading cause of preventable deaths in the United States, and nearly all large employers offer wellness programs aimed at getting people to quit. But, these programs vary considerably, and to date, there has been little evidence to suggest which designs and strategies are most effective,” said lead author Scott D. Halpern, MD, PhD…


FDA campaign reframes quitting for smokers

The Food and Drug Administration’s Every Try Counts anti-smoking campaign is competing with tobacco ads for a smoker’s attention at the convenience store counter.

print ad for smoking cessation campaign mentioned in article, FDA campaign reframes quitting for smokersEvery Try Counts, which will launch in January, is the FDA’s first smoking cessation campaign targeting adults. The FDA wants to reframe quitting smoking for this audience as a process that often takes more than one attempt.

See also: Anti-smoking group Truth releases musical FOMO spot for MTV Video Music Awards

“The messaging is very different from a cessation standpoint,” said Kathy Crosby, director of the Office of Health Communication and Education in the FDA’s Center for Tobacco Products. “How we’re approaching the messaging is by not talking about the final quit, but trying to convince people to try to quit again and change how they perceive the fact that they tried to quit in the past as failures.”

The goal is to provide messages of support and encouragement for smokers trying to quit. The campaign will have ads in convenience stores and gas stations near the cigarettes, online, in print, on radio and TV, and on billboards. Every Try Counts also has a website with tips for how to get through a craving and an option to sign up for encouraging text messages Continue reading FDA campaign reframes quitting for smokers

SmartQuit App Helps Spanish Speaking Patients Break Tobacco Habit

Paul Cerrato | July 14, 2016

SmartQuit App Helps Spanish Speaking Patients Break Tobacco Habit2Morrow, Inc, has launched a Spanish version of its smoking cessation online program, now available on mobile devices. With 39 million Americans speaking Spanish, the company saw an acute need for the translated program.

As Brandon Masterson, CEO of 2Morrow explains the issue: “By offering SmartQuit in Spanish, 2Morrow hopes to make clinically tested smoking cessation techniques more accessible to underserved communities in the United States.”

A lite version of the SmartQuit app is available from iTunes and Google Play while the full version requires a $49.99 subscription. It is also available through select employers, health plans, and state programs that have contracted with the vendor.

The Spanish version of the SmartQuit program has been partially funded by the Washington State Department of Health and the CDC Prevention and Public Health Fund. Citing a paper presented at the 2016 Society for Research on Nicotine & Tobacco 2016 Annual Meeting, the company says a Fred Hutchinson Cancer Research Center study found that “SmartQuit participants were about twice as likely to quit smoking as those who try to quit on their own. And, people who completed the core program saw quit rates of about 28% – which is significantly higher than the 4-5% of smokers who successfully quit on their own.”


Smoking Cessation App SmartQuit Adopted by State Health Agency

Satish Misra, MD | July 8, 2016

SmartQuit smoking cessation app logoThe SmartQuit app, developed by 2Morrow Inc, will soon be free for many people in Louisiana thanks to a deal with that state’s health department.

There are a ton of smoking cessation apps out but, like many areas of digital health, quantity does not mean quality. A survey of smoking cessation apps a few years ago found very poor adherence to clinical practice guidelines. That quality gap is something we’ve also seen in other chronic conditions like high blood pressure.

SmartQuit is a great example of how a health app can be done right and (hopefully) have large scale, meaningful impacts. SmartQuit was developed by Dr. Jonathan Bricker, Ph.D., a behavioral scientist at Fred Hutchinson Cancer Research Center and the University of Washington. Dr. Bricker and colleagues have developed an app called SmartQuit that applies acceptance and commitment therapy (ACT) in addition to usual strategies to smoking cessation.

In 2014, they published a small randomized study comparing SmartQuit to another great smoking cessation app, QuitGuide. They found SmartQuit to be more effective at getting people to quit, at least in the short term. They then got follow up funding in the amount of $3 million from the National Cancer Institute for a larger study that will enroll 2,000 people. Continue reading Smoking Cessation App SmartQuit Adopted by State Health Agency

New California Tobacco Laws Go Into Effect

California 21 tobacco law signEffective June 9, 2016, the minimum age of sale for tobacco products in California increases from 18 to 21, and for the first time e-cigarettes are added to the existing definition of tobacco products. California is the second state in the nation, following Hawaii, to raise the minimum age for tobacco sales to 21.

“Today marks a significant moment in California history as new tobacco control laws go into effect statewide. This is the first time the Golden State has raised the age of sale for tobacco since the law first took effect 144 years ago,” said Dr. Karen Smith, California Department of Public Health (CDPH) director and state health officer. “

Our focus is on reaching more than 34,000 retailers with tobacco licenses and vape shops to provide them the information and resources needed to comply with the new tobacco 21 law.”

To help retailers comply with these new laws, CDPH developed a series of educational materials, including age-of-sale warning signs, window clings reminding customers of the new law and tips to help clerks check identification.

About 34,000 Californians die each year from tobacco use. In addition, tobacco-related diseases cost Californians $18.1 billion each year in both direct and indirect healthcare costs due to premature death and low productivity due to illness.


Raising Pay Can Reduce Smoking Rates

Increasing the minimum wage could benefit health

Infographic: effects of smoking on the bodyIn addition to restricting when and where tobacco is used at work, UC Davis Health System research shows that employers can do something else to reduce smoking: raise wages.

Published in the August issue of the Annals of Epidemiology, the study found that a 10 percent increase in wages leads to about a 5 percent drop in smoking rates among workers who are male or who have high school educations or less and improves their overall chances of quitting smoking from 17 to 20 percent.

“Our findings are especially important as inflation-adjusted wages for low-income jobs have been dropping for decades and the percentage of workers in low-paying jobs has been growing nationwide,” said study senior author Paul Leigh, professor of public health sciences and researcher with the Center for Healthcare Policy and Research at UC Davis. “Increasing the minimum wage could have a big impact on a significant health threat.”

Smoking rates are declining in the U.S., but it remains the leading cause of preventable deaths from illnesses such as heart disease, stroke, chronic obstructive pulmonary disease and lung cancer. Leigh and lead author Juan Du, who received her doctoral degree at UC Davis, wanted to know if wage changes could leverage a further reduction in the number of people who smoke.

The team evaluated data on wages, smoking status and state of residence for full-time employees aged 21 to 65 years from the 1999 to 2009 Panel Study of Income Dynamics. They excluded those under 21, since wage variation is small for this age group. They also excluded those who never smoked, as the goal was to evaluate influences on quitting rather than starting smoking.

“We assume that people begin smoking for reasons other than wages,” said Leigh. “About 90 percent of smokers in the United States started smoking before age 20, so the data captured a sample of most full-time workers who have ever smoked.”


Can e-cigarettes be a public health victory?

hand holding an e-cigaretteJUSTIN BERK, MPH, MBA | MEDS | SEPTEMBER 12, 2013

Annoying mall vendors have been pushing what may be one of public health’s greatest accomplishments—and few have taken notice. Behind pillow pet stations and the candle stand, mall shoppers can find electronic cigarettes, or “vapes.” Often targeted at smokers wanting to quit, e-cigarettes offer many of the joys of smoking without one of its major components: smoke.

Smokeless cigarettes have become a hot product, with an estimated $1.7 billion in sales this year.  According to a recent article in the Journal of the American Medical Association, over 10% of smokers have tried e-cigarettes, and almost 5% have used them in the past month. Often marketed as smoking-cessation products, a small Italian study suggested that smokers do smoke fewer real cigarettes when given e-cigarettes.  A 2011 study in Addiction found that 77% of users used e-cigarettes for the purpose of smoking cessation and that 79% of users were afraid of relapse if they stopped using the e-cigarette. Their efficacy as a smoking cessation tool is still in question.

But for e-cigarettes to be a successful public health intervention, they do no not need to help smokers quit.

E-cigarettes need not be just a smoking cessation tool. Instead, their potential comes as a smoking maintenance tool that could greatly reduce individual and public health risks. Unlike other nicotine replacement therapies such as the patch or gum, e-cigarettes deliver the full smoking experience: as users put cigarettes to their lips, see a light when they inhale, and even receive a smoke-like “throat hit.”

Studies have not yet shown that e-cigarettes are healthier than tobacco cigarettes, since longitudinal studies of this kind are years down the line. But e-cigarettes lack the major carcinogens in tobacco cigarettes, which come not from nicotine but from other toxins. Most e-cigarettes use liquid cartridges with very few ingredients: water, nicotine, flavoring, and propylene glycol. Should these cartridges be shown to have toxic effects, they are likely to be orders of magnitude less severe than those of traditional tobacco cigarettes. Continue reading Can e-cigarettes be a public health victory?

The War on Smoking Expands to the Job Market


workers smoking on a beam suspended from skyscraperThere is no doubt that smoking cigarettes is not conducive to living a healthy lifestyle, and few places have done more to eradicate smoking than California. Ever since California became the first state to ban smoking in 1995, it has been spearheading the war against smoking tobacco. This was followed by a ban on smoking within 20 feet of a public building in 2004, and smoking in a car with a minor in 2008.

These bans seem to have struck a major blow in the fight for a smoke-free California, but some argue that the bans infringe on civil rights. With recent reports of companies that refuse to hire smokers, the issue of exactly what rights smokers have, and whether refusal to hire them qualifies as discrimination have come to light. From the company’s point of view, it’s understandable to not want a worker that is going to be taking a large amount of smoke breaks and racking up higher insurance premiums, not to mention the potential for unhappy, non-smoking coworkers who have to be exposed to it to some degree. But while laws have been put in place to prevent corporations from discriminating against sex, race, disability, and sexual preference, it is legal in 21 states to not hire smokers. Surprisingly, California is not yet among them.

Workplaces that Refuse to Hire Smokers

Early 2012, Baylor Health Care Systems of Dallas announced that it will refuse to hire smokers. They join companies like Cleveland Clinic, who has not hired anyone who tested positive for nicotine in the last five years. This trend is not limited to the health care industry. Hollywood Casino in Toledo, Ohio and the Georgia Power company have followed suit, conducting tests in the hiring process that identify nicotine users. This begs the question of what’s next? Will those who engage in other unhealthy habits, like drinking alcohol, eating fast food, or abusing prescription drugs be the next ones to be refused jobs? Very likely, the offensive nature of smoking is what has become its downfall. Many non-smokers hate cigarettes, and with major moves that make smoking as cumbersome as it is harmful, the future for tobacco users looks more grim than ever.

Related Links

American Lung Association: http://www.lung.org/associations/states/california/

Cleveland Clinic: http://my.clevelandclinic.org/default.aspx

Federal Tobacco Legislation: http://www.altria.com/en/cms/About_Altria/federal-regulation-of-tobacco/overview/default.aspx?WT.srch=1&WT.mc_id=FDA_Campaign