The effectiveness of distance-based interventions for smoking cessation and alcohol moderation among cancer survivors: A meta-analysis

Objective: The objective of this study is to evaluate current evidence for the effectiveness of distance-based interventions to support smoking cessation (SC) or alcohol moderation (AM) among cancer survivors. Secondary, differences in effectiveness are explored regarding multibehaviour interventions versus single-behaviour interventions targeting SC or AM only. Methods: A systematic search of PubMed, PsycINFO, Web of Science, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials was conducted. Intervention studies with and without control groups and randomized controlled trials were included. Random effects meta-analyses were conducted for the main outcomes: SC and AM rates at the follow-up closest to 6 months. Using subgroup analyses and meta-regression, effectiveness of single-behaviour versus multibehaviour interventions was evaluated. Results: A total of 17 studies with 3796 participants; nine studies on SC only, eight studies on multibehaviour interventions including an SC or AM module, and no studies on AM only were included. All studies had at least some concerns regarding bias. Distance-based SC interventions led to higher cessation rates than control conditions (10 studies, odds ratio [OR] = 1.56; 95% CI, 1.13-2.15, P =.007). Single-behaviour SC interventions reduced smoking rates compared with baseline (risk difference [RD] = 0.29; 95% CI, 0.19-0.39, P <.0001), but multibehaviour interventions did not (RD = 0.13; 95% CI, −0.05 to 0.31, P = 0.15). There was insufficient evidence that distance-based multibehaviour interventions reduced alcohol use compared with controls (three studies, standardized mean difference [SMD] = 0.12; 95% CI, −0.08 to 0.31, P =.24). Conclusions: Distance-based SC interventions are effective in supporting SC among cancer survivors. Single-behaviour SC interventions appear more effective than multibehaviour interventions. No evidence was found for the effectiveness of distance-based AM interventions for cancer survivors

Identifying subgroups among hardcore smokers: A latent profile approach

Introduction Hardcore smokers are smokers who have little to no intention to quit. Previous research suggests that there are distinct subgroups among hardcore smokers and that these subgroups vary in the perceived pros and cons of smoking and quitting. Identifying these subgroups could help to develop individualized messages for the group of hardcore smokers. In this study we therefore used the perceived pros and cons of smoking and quitting to identify profiles among hardcore smokers. Methods A sample of 510 hardcore smokers completed an online survey on the perceived pros and cons of smoking and quitting. 000358622000101We used these perceived pros and cons in a latent profile analysis to identify possible subgroups among hardcore smokers. To validate the profiles identified among hardcore smokers, we analysed data from a sample of 338 non-hardcore smokers in a similar way. Results We found three profiles among hardcore smokers. 'Receptive' hardcore smokers (36%) perceived many cons of smoking and many pros of quitting. 'Ambivalent' hardcore smokers (59%) were rather undecided towards quitting. 'Resistant' hardcore smokers (5%) saw few cons of smoking and few pros of quitting. Among non-hardcore smokers, we found similar groups of 'receptive' smokers (30%) and 'ambivalent' smokers (54%). However, a third group consisted of 'disengaged' smokers (16%), who saw few pros and cons of both smoking and quitting. Discussion Among hardcore smokers, we found three distinct profiles based on perceived pros and cons of smoking. This indicates that hardcore smokers are not a homogenous group. Each profile might require a different tobacco control approach. Our findings may help to develop individualized tobacco control messages for the particularly hard-to-reach group of hardcore smokers

Mean scores on pros and cons of smoking and quitting in hardcore smokers.

<p>Higher scores indicate higher average agreement with pros or cons.</p

Latent profile analysis models in hardcore smokers and non-hardcore smokers.

<p><i>Note</i>: The optimal number of classes is presented in bold.</p><p>Latent profile analysis models in hardcore smokers and non-hardcore smokers.</p

Characteristics of profiles in hardcore smokers and non-hardcore smokers.

<p><i>Note</i>: Profiles were based on pros and cons scales. If profiles within a sample share a superscript character, they are not significantly different from each other (<i>p</i> < .05).</p><p>Characteristics of profiles in hardcore smokers and non-hardcore smokers.</p

Sample characteristics.

<p>^a Socioeconomic status was measured as the highest completed education.</p><p>^b Hardcore smokers had smoked > 15 years by definition.</p><p>^c Higher scores indicate more quitting self-efficacy.</p><p>Sample characteristics.</p