Change in vaping, smoking and dual use identities predicts quit success and cigarette usage: A prospective study of people quitting smoking with electronic cigarette support

OBJECTIVE: Electronic cigarettes (ECs) are an efficacious support for some but not all people wishing to stop using tobacco. While advice and practical support have been identified as increasing quit success, little research has explored the role of changes in smoking and EC-related social identities. METHODS: A prospective study following 573 people attempting to quit smoking with EC support. Self-report measures of identification with being a smoker, non-smoker, vaper, and dual user (people using ECs and tobacco products) were taken prior to the quit attempt and at a 12-week follow-up. RESULTS: Baseline identifications with being a smoker, non-smoker or dual user were not associated with smoking outcomes. Baseline vaper identity baseline was linked to more frequent tobacco abstinence at follow-up and lower levels of cigarette smoking. Levels of social identification at follow-up were consistently linked with outcomes, with vaper identity and non-smoking identities being protective, and dual user identity being related to lower abstinence rates but decreased tobacco usage. Changes in identity over time were the most consistent predictor of outcomes. CONCLUSIONS: Findings have implications for smoking cessation practice, informing how and when identity-based interventions may be effective and our understanding of how identity transitions occur

Mobile Phone Text Messages to Support People to Stop Smoking by Switching to Vaping: Codevelopment, Coproduction, and Initial Testing Study.

SMS text messages are affordable, scalable, and effective smoking cessation interventions. However, there is little research on SMS text message interventions specifically designed to support people who smoke to quit by switching to vaping. Over 3 phases, with vapers and smokers, we codeveloped and coproduced a mobile phone SMS text message program. The coproduction paradigm allowed us to collaborate with researchers and the community to develop a more relevant, acceptable, and equitable SMS text message program. In phase 1, we engaged people who vape via Twitter and received 167 responses to our request to write SMS text messages for people who wish to quit smoking by switching to vaping. We screened, adjusted, refined, and themed the messages, resulting in a set of 95 that were mapped against the Capability, Opportunity, and Motivation-Behavior constructs. In phase 2, we evaluated the 95 messages from phase 1 via a web survey where participants (66/202, 32.7% woman) rated up to 20 messages on 7-point Likert scales on 9 constructs: being understandable, clear, believable, helpful, interesting, inoffensive, positive, and enthusiastic and how happy they would be to receive the messages. In phase 3, we implemented the final set of SMS text messages as part of a larger randomized optimization trial, in which 603 participants (mean age 38.33, SD 12.88 years; n=369, 61.2% woman) received SMS text message support and then rated their usefulness and frequency and provided free-text comments at the 12-week follow-up. For phase 2, means and SDs were calculated for each message across the 9 constructs. Those with means below the neutral anchor of 4 or with unfavorable comments were discussed with vapers and further refined or removed. This resulted in a final set of 78 that were mapped against early, mid-, or late stages of quitting to create an order for the messages. For phase 3, a total of 38.5% (232/603) of the participants provided ratings at the 12-week follow-up. In total, 69.8% (162/232) reported that the SMS text messages had been useful, and a significant association between quit rates and usefulness ratings was found (χ =9.6; P=.002). A content analysis of free-text comments revealed that the 2 most common positive themes were helpful (13/47, 28%) and encouraging (6/47, 13%) and the 2 most common negative themes were too frequent (9/47, 19%) and annoying (4/47, 9%). In this paper, we describe the initial coproduction and codevelopment of a set of SMS text messages to help smokers stop smoking by transitioning to vaping. We encourage researchers to use, further develop, and evaluate the set of SMS text messages and adapt it to target populations and relevant contexts. [Abstract copyright: ©Vassilis Sideropoulos, Eleni Vangeli, Felix Naughton, Sharon Cox, Daniel Frings, Caitlin Notley, Jamie Brown, Catherine Kimber, Lynne Dawkins. Originally published in JMIR Formative Research (https://formative.jmir.org), 27.09.2023.

E‐cigarette support for smoking cessation: Identifying the effectiveness of intervention components in an on‐line randomized optimization experiment

Aims, Design and Setting The aim of this study was to determine which combination(s) of five e-cigarette-orientated intervention components, delivered on-line, affect smoking cessation. An on-line (UK) balanced five-factor (2 × 2 × 2 × 2 × 2 = 32 intervention combinations) randomized factorial design guided by the multi-phase optimization strategy (MOST) was used. Participants A total of 1214 eligible participants (61% female; 97% white) were recruited via social media. Interventions The five on-line intervention components designed to help smokers switch to exclusive e-cigarette use were: (1) tailored device selection advice; (2) tailored e-liquid nicotine strength advice; (3): tailored e-liquid flavour advice; (4) brief information on relative harms; and (5) text message (SMS) support. Measurements The primary outcome was 4-week self-reported complete abstinence at 12 weeks post-randomization. Primary analyses were intention-to-treat (loss to follow-up recorded as smoking). Logistic regressions modelled the three- and two-way interactions and main effects, explored in that order. Findings In the adjusted model the only significant interaction was a two-way interaction, advice on flavour combined with text message support, which increased the odds of abstinence (odds ratio = 1.55, 95% confidence interval = 1.13–2.14, P = 0.007, Bayes factor = 7.25). There were no main effects of the intervention components. Conclusions Text-message support with tailored advice on flavour is a promising intervention combination for smokers using an e-cigarette in a quit attempt

Tailored interventions to assist smokers to stop smoking using e-cigarettes (TASSE): Study protocol [version 3]

Background: T here is increasing evidence that e-cigarettes (EC) are an effective smoking cessation aid when combined with behavioural support. T here is further evidence for digital tailored interventions as cost effective approaches that can increase smoking cessation rates. Experimental work also suggests the addition of a ‘nicotine fact sheet’ can improve smokers’ risk perceptions related to EC. However, multifaceted approaches to deliver ‘tailored advice’ for smoking cessation combining various key evidenced based components are lacking. T he aim of this study is to use a Multiphase Optimisation Strategy (MOST ) to determine which of five, or a combination thereof, EC-orientated intervention components is associated with self-reported cessation over the previous 4-weeks at 12-week follow-up. Methods/Design: T his online study will utilise a 2x2x2x2x2 factorial design resulting in 32 experimental conditions. T he five intervention components will be: 1: tailored advice on EC device; 2: tailored advice on e-liquid nicotine strength; 3: tailored advice on eliquid flavour; 4: e-cigarette written information; 5: text message support. A sample of N=1184 adult, UK resident smokers will be randomly allocated to one of the 32 conditions, which will be permutations of the 5 components (counter-balanced). T he primary outcome is 4 weeks of self-reported complete abstinence at 12 weeks post randomisation. Secondary outcomes are 7-day point prevalence, 50% reduction in baseline cigarettes smoked per day, time to switch and adherence to recommendation. T he primary analysis will be by intent-to-treat with the assumption that missing equals smoking. Logistic regression will be used to model the five main effects and the ten 2x2 interactions. A number of secondary analyses will also be conducted including models adjusting for demographic and smoking indices and including only those who received the intervention. Discussion: T o date, components that assist quitting by use of EC or other aids have largely been studied in isolation. T his study presents the first attempt to combine evidenced based interventions, using the MOST method, to test which components are associated with quitting. T he findings will be used to inform which components to include and their estimated effect sizes for a definitive randomised controlled trial (RCT ) to examine the efficacy of the intervention compared with usual care (own choice and no support)

The impact of COVID-19 on anxiety and wellbeing for families of individuals with Special Education Needs and Disabilities in the UK

COVID-19 has affected people across the world. However, it has been suggested that individuals with Special Education Needs and Disabilities (SEND) and their families might have been particularly impacted by the first national lockdown in the UK. In contrast to previous studies, the current study examined wellbeing and anxiety at different time points and included a control group matched for family situation. Parents of 402 individuals with SEND reported on their own anxiety and wellbeing as well as that of their son/daughter at three time points (before COVID-19, when COVID-19 pandemic started, and during the national lockdown). In addition, data from 186 typically developing (TD) siblings was obtained. Repeated measures ANOVAs and regression analyses showed that, although both individuals with SEND and their TD siblings showed increased anxiety across the three time points, levels of anxiety were not predicted by age, gender or health. Instead, levels of anxiety in the SEND group, but not the TD siblings, were predicted by awareness about COVID-19, diagnosis of an existing anxiety disorder as well as parental anxiety. In addition, whilst TD individuals were reported to increasingly worry about social related issues as well as family related issues, those with SEND were reported to worry about issues related to school closures. These findings show that COVID-19 impacts the wellbeing of those with SEND differently to that of their TD siblings and that school closures have a particular effect on this group. Further implications for policy impact and interventions are discussed

Text messages to support e-cigarette use for smoking cessation: a tool for researchers

E-cigarettes are now the most popular quit aid chosen by smokers in England. Mobile phone text messages have been shown to be a useful tool in facilitating smoking cessation attempts by providing behaviour change support. To date, no published examples of text messages exist specifically aimed at smokers attempting to quit with e-cigarettes (vaping). As part of a parent study, we led an online call to vapers asking what advice and information they would give, in the form of a text message, to smokers wishing to quit smoking by vaping. We received 102 initial suggestions. Alongside behaviour change and smoking cessation experts, we checked the messages for readability and scientific accuracy, removed inappropriate messages, refined and edited others, and added additional messages. Messages were also grouped by theme and relevance to the stage of quitting. 95 messages were taken forward for further evaluation by 376 smokers, ex-smokers and vapers. Here we present the full set of 95 messages along with a final set of 78 that were selected and ordered for our parent study by two members of the research team along with four vapers. We encourage engagement with this resource and further validation from researchers interested in smoking cessation with e-cigarettes

Anxiety and worries of individuals with down syndrome during the COVID-19 pandemic : a comparative study in the UK

The present study explored the effects of the pandemic on individuals with Down Syndrome (DS; n=67) compared to other groups with Special Education Needs and Disabilities (SEND; n=48) and their Typically Developing Siblings (TDS; n=56). In total, 115 caregivers reported on their own anxiety and worries and of their children. Anxiety levels for individuals with DS appeared to be lower compared to other SEND populations and to TDS. In terms of worries, individuals with DS worried more about social-related worries but worried less about family-related aspects compared to the other groups. In sum, individuals with DS might show less anxiety but still worried more about specific aspects related to the impact of COVID-19 pandemic on their lives

The impact of COVID-19 on the mental health and wellbeing of children with special education needs and disabilities : a systematic review

The COVID-19 pandemic has impacted greatly the mental health of children. We performed a systematic review to better understand the impact of the pandemic on children with special educational needs and disabilities (SEND) across different SEND categories. Following PRISMA guidelines, of 1699 search results, 66 studies were included in our analysis as they met our inclusion criteria concerning: a) children with SEND; b) focus on COVID-19; c) longitudinal or cross-sectional design; d) quantitative or qualitative measures; and e) mental health or well-being outcomes. Our review suggests that there was a typically negative impact on mental health and well-being for children with SEND, yet experiences varied on the basis of individual differences, rather than category of SEND. Findings highlight the need for interventions and policy implementations to improve the everyday mental well-being of this population

Anxiety, concerns and COVID-19: Cross-country perspectives from families and individuals with neurodevelopmental conditions

BACKGROUND: The COVID-19 pandemic had a major impact on the mental health and well-being of children with neurodevelopmental conditions (NDCs) and of their families worldwide. However, there is insufficient evidence to understand how different factors (e.g., individual, family, country, children) have impacted on anxiety levels of families and their children with NDCs developed over time. METHODS: We used data from a global survey assessing the experience of 8043 families and their children with NDCs (mean of age (m) = 13.18 years, 37% female) and their typically developing siblings (m = 12.9 years, 45% female) in combination with data from the European Centre for Disease Prevention and Control, the University of Oxford, and the Central Intelligence Agency (CIA) World Factbook, to create a multilevel data set. Using stepwise multilevel modelling, we generated child-, family- and country-related factors that may have contributed to the anxiety levels of children with NDCs, their siblings if they had any, and their parents. All data were reported by parents. RESULTS: Our results suggest that parental anxiety was best explained by family-related factors such as concerns about COVID-19 and illness. Children’s anxiety was best explained by child-related factors such as children’s concerns about loss of routine, family conflict, and safety in general, as well as concerns about COVID-19. In addition, anxiety levels were linked to the presence of pre-existing anxiety conditions for both children with NDCs and their parents. CONCLUSIONS: The present study shows that across the globe there was a raise in anxiety levels for both parents and their children with NDCs because of COVID-19 and that country-level factors had little or no impact on explaining differences in this increase, once family and child factors were considered. Our findings also highlight that certain groups of children with NDCs were at higher risk for anxiety than others and had specific concerns. Together, these results show that anxiety of families and their children with NDCs during the COVID-19 pandemic were predicted by very specific concerns and worries which inform the development of future toolkits and policy. Future studies should investigate how country factors can play a protective role during future crises