Automated Telephone Monitoring for Relapse Risk among Recent Quitters Enrolled in Quitline Services

poster abstractThis study is part of a randomized controlled trial to test the efficacy of interactive voice response (IVR) technology for enhancing existing quitline services (Free & Clear’s Quit for Life® program) to prevent smoking relapse and achieve abstinence. The IVR system screens for six indicators of risk for relapse including smoking lapse, physical withdrawal symptoms, depressive symptoms, perceived stress, decreased self-efficacy for quitting, and decreased motivation to quit. Participants can screen positive on any one or more risks, resulting in a rollover call to a telephone counselor. There are two intervention arms that differ in timing and frequency of IVR screening. In the Technology Enhanced Quitline arm (TEQ-10), 10 automated calls are placed at decreasing frequency for 8 weeks post-quit (twice a week for the first two weeks, then weekly). The High Intensity Technology-Enhanced Quitline arm (TEQ-20) includes 20 IVR calls (daily for the first 2 weeks, then weekly). This preliminary analysis includes IVR data collected on calls from 4/12/2010 to 10/31/2010. 2620 calls were made to 98 participants in the two intervention arms, TEQ-10 (n=44) and TEQ-20 (n=54). The two arms did not differ significantly on demographics or comorbid conditions. Three outcomes were analyzed: completed screening assessments, positive screen for relapse risk, and smoking lapse (i.e., smoking even a puff since the last call). 136 of the 736 (18.5%) completed assessments were positive for relapse risk: 66 for smoking lapse (49%), 42 craving (31%), 32 depressive symptoms (24%), 27 lack of confidence (20%), 8 stress (6%), and 8 lack of motivation (6%). Logistic regression models (adjusted for age and gender), with GEE estimation to account for withinperson correlation, showed that compared to the TEQ-10 study group, participants in the TEQ-20 study group were more likely to complete assessments (OR=1.7; 95% CI=1.2-2.4), less likely to screen positive for relapse risk (OR=.3; 95% CI=.2-.6), and less likely to have smoked (OR=.2; 95% CI=.09-.4). These results indicate that frequent IVR monitoring during the immediate postquit period may have a positive effect on relapse risk

Parent and peer evaluations of the social competence of children with mild asthma

The social competence of children with asthma has been studied primarily using self- and parent reports; peer evaluations rarely have been used. This research examined parent and peer reports of the social competence of 22 children (ages 6 to 12) with mild asthma compared to a group of children without asthma. Young children with asthma (Grades 1-3) had lower social competence based on parent reports using the Achenbach and Edelbrock Social Competence Scale, and had fewer close friends based on both parent and peer reports compared to a) older children with asthma (Grades 4-6) and to b) children without asthma (Grades 1-6). Children with asthma did not differ from children without asthma on peer measures of popularity or social acceptability. Although parents and peers both perceived reduced social competence of young children with asthma (as measured by number of friends), parents considerably underestimated their child\u27s social competence, as indicated by measures of peer standing. That is, young children with asthma were as popular and as socially acceptable as their classmates without asthma. The present study highlights the importance of considering both parent and peer reports of social competence of children with asthma, as well as developmental differences

Gender and ethnic differences in young adolescents\u27 sources of cigarettes

Objective - To identify the sources used by young adolescents to obtain cigarettes. Design - In early 1994 a survey assessing usual sources of cigarettes and characteristics of the respondents was administered in homeroom classes. Setting - A large urban, predominantly African American school system. Subjects - A population-based sample of 6967 seventh graders averaging 13 years of age. Main outcome measure - Reports of usual sources of cigarettes. Results - At this age level, young smokers were more likely to get cigarettes from friends (31.2%) than buy them in stores (14.3%). However, the odds of purchasing varied for different groups of children. Regular smokers were much more likely (48.3%) to have purchased cigarettes than experimental smokers (9.6%), p\u3c0.001. Girls were less likely to have bought their cigarettes than boys (p\u3c0.001), and black smokers were less likely to have purchased cigarettes than white children (p\u3c0.001). Results suggested that family members who smoke may constitute a more important source of tobacco products than previously recognised, particularly for young girls. Conclusions - In this middle-school sample, peers provided the major point of cigarette distribution. However, even at this age, direct purchase was not uncommon. Sources of cigarettes varied significantly with gender, ethnicity, and smoking rate

Is smoking associated with lower body mass in adolescents?: A large- scale biracial investigation

The present investigation evaluated the relationship between smoking and body weight (body mass index [BMI]) in a large, biracial sample of seventh- grade students. Participants were 6751 (5,607 African American, 1,144 White) seventh-grade students participating in an evaluation of smoking determinants in adolescence. In addition to providing, in this survey design, information about their smoking status, participants self-reported both their height and weight, which was converted into a BMI. Contrary to predictions, smoking was positively related to BMI. That is, with increasing levels of smoking exposure, BMI significantly increased. Thus, it appears that smoking is not related to lowered BMI in adolescent populations. Implications and possible reasons for these findings are discussed

Predictors of risk for different stages of adolescent smoking in a biracial sample

This investigation was designed to identify the risk factors associated with different stages of cigarette use in a large biracial adolescent sample. A questionnaire assessing smoking habits and variables thought to be related to smoking was administered to 6,967 7th graders. Analysis revealed that the best predictor of experimentation with cigarettes was the perception that they were easily available. Regular smoking appeared to be heavily influenced by cost. Social influences contributed to both experimental end regular smoking, but the impact of social models varied with ethnicity and gender. Analysis further revealed that weight-related variables were closely tied to regular smoking. Implications of the findings for smoking prevention programs are discussed

Risk factors for smoking among adolescents with asthma

Purpose: To examine the prevalence of smoking among youth with asthma and explore potential risk factors for smoking among these youth, compared with youth without asthma. Methods: In March 1997, a questionnaire assessing risk factors for smoking was administered to students attending public high school in Memphis, Tennessee. The sample (n = 3234) ranged from 15 to 18 years of age, was predominately African-American (76.7%), and 56.7% female. Based on a single self-reported item, 15.7% of youth reported having asthma. Logistic regression analyses assessed asthma status differences in current smoking and the association between risk factors and smoking. Results: Nearly 20% of youth reported current smoking. Adolescents with asthma (current or past) were nearly 1.5 times more likely to smoke than peers without asthma. The association between risk factors and current cigarette smoking was equivalent for youth regardless of whether they had asthma and did not differ for those youth with current vs. past asthma. Conclusions: Results suggest that adolescents with or without asthma smoke for similar reasons. Research is needed to elucidate whether there are unique risk factors, not examined here, for smoking among adolescents with asthma. Smoking prevention and cessation programs are needed for youth with asthma. Copyright © 2002 Society for Adolescent Medicine

Use of nicotine replacement therapy in adolescent smokers and nonsmokers

Background: Assessing whether and how adolescents use nicotine replacement therapy (NRT) will be important given recent recommendations to make NRT more accessible by lowering its price, increasing its distribution, and advising health care professionals to suggest its use for smoking cessation. Objectives: To report the prevalence, ease of access, and reasons for NRT use and describe inappropriate use in adolescent smokers and nonsmokers. Design: Cross-sectional survey of 4078 high school students during the school term of 1998. Setting: City schools in Memphis, Tenn. Main Outcome Measures: Community-based self-reported prevalence of NRT use and characteristics of those using NRT. Results: Approximately 5% of adolescents reported trying or using nicotine gum or patches. Females were less likely than males and African Americans were less likely than others to use NRT. For African American smokers, NRT use was highest at lower smoking levels, while other smokers showed the opposite pattern. Almost 40% of former smokers reported using NRT to try to quit smoking; however, 75% of current smokers endorsed using NRT for reasons other than trying to quit smoking. Other inappropriate use of NRT was reported; 18% of NRT users reported themselves as never smokers. More than 50% of students reported that it would be easy for them to get NRT. Conclusions: Nicotine replacement therapy is used by adolescent smokers and nonsmokers, is easily accessible, and is used for reasons other than trying to quit smoking. Efforts are needed to discourage NRT use in nonsmoking youth and to encourage appropriate use of NRT in young smokers to maximize its potential for successful cessation