Póster de Pardavila-Belio,M. I., Canga-Armayor, N., Carcia-Vivar-C., et al "Smoking cessation interventions for college students. A meta-analysis" en 15th SRNT - EuropeAnnual Meeting 2014, celebrado en Santiago de Compostela (España) el 20 de septiembre de 201

Canga-Armayor, A.D. (Ana Dolores)

Canga-Armayor, N. (Navidad)

Garcia-Vivar, C. (Cristina)

Pardavila-Belio, M.I. (Miren Idoia)

Toledo, E. (Estefanía)

Dadun, University of Navarra

 SMOKING CESSATION INTERVENTIONS FOR COLLEGE STUDENTS. A META-ANALYSIS  Miren I Pardavila-Belio1, Navidad Canga-Armayor2, Cristina García-Vivar3, Estefanía Toledo3, Ana Canga-Armayor2, Karla Y Mijangos-Fuentes1  School of Nursing. University of Navarra. 1. MS;  BN. 2. PhD; BN . 3. PhD; MS; BN.  BACKGROUND Tobacco use and the exposure to tobacco smoke are associated with premature death from chronic disease, economic losses to society, and substantial burden on the healthcare system(Centers for Disease Control and Prevention, 2008). In young adults, the more immediate health effects include increased respiratory symptoms, as shortness of breath, persistent cough, wheezing and increased breathlessness after exercise (Oliveira-Vianna et al., 2008), and cardiovascular diseases (U.S. Department of Health and Human Services, 2012). While people start using tobacco in early adolescence (before age 18), the college years are a critical time in the development of smoking behavior and tobacco use (Centers for Disease Control and Prevention, 2007). In fact some undergraduates start smoking at university and the consumption of smoking is consolidated at this age (Brown, 2013). However, most tobacco pro-grams, for this group of age, are based around prevention and not in cessation of tobacco use.  OBJECTIVE To evaluate the effectiveness of smoking cessation programs for college students. METHOD This meta-analysis was conducted according to the PRISMA Statement.   A systematic search (PubMed, CINAHL, PsycINFO (OVID), ISI Web of Knowledge, Cochrane Plus, Cochrane Tobacco Addiction Group, and CUIDEN) was performed to identify eligible articles. The reference list of identified studies was also examined. Randomized controlled trials (RCT) and quasi-randomized trials (QRT) comparing a smoking cessation program for college student versus traditional approach. The studies were considered eligible if they primary outcome was the incidence of smoking cessation and if they follow-up was longer than 6 month. The selection studies (k= 0.88 (p>0.001)) and the quality of studies (k=1 (p>0.001)) was made independently by 2 authors. Odds ratios (OR) were summarized for each individual study and a pooled OR using the random effects model was estimated. To assess statistical heterogeneity between summary data and a trial level Cochran’s Q statistic (p<0.10), the I2 statistics (I2>50%) and between-study variance (2) were used. Publication bias was assessed using Begg’s Correlation Model test, and Egger’s Regression Model . CONCLUSION  〇 This meta-analysis suggests that programs specifically designed for college students are more effective than traditional tobacco cessation programs. 〇 Further high-quality intervention studies are needed (Brown, 2013).  〇 To reduce bias and heterogeneity among studies, power calculation, an adequate follow-up (at least, 6 months), and cotinine as biochemical validation, should be included  〇 To generalize our results more interventions should be tested in other countries. REFERENCES  Abroms, L.C., Windsor, R., Simons-Morton, B. (2008). Getting young adults to quit smoking: a formative evaluation of the X-Pack Program. Nicotine & Tobacco Research, 10(1), 27-33. doi: 10.1080/14622200701767852. An, L.C., Klatt, C., Perry, C.L., Lein, E.B., Hennrikus, D.J., Pallonen, U.E., … Ehlinger, E.P. (2008). The RealU online cessation intervention for college smokers: a randomized controlled trial. Preventive Medicine, 47(2), 194-199. doi: 10.1016/j.ypmed.2008.04.011. Brown, J.A. (2013). Review of the Evidence on Technology-Based Interventions for the Treatment of Tobacco Dependence in College Health. Worldviews on Evidence-Based Nursing, 10 (3), 150-162. doi: 10.1111/wvn.12000. Centers for Disease Control and Prevention. (2007). Best Practices for Comprehensive Tobacco Control Programs—2007. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. Centers for Disease Control and Prevention. (2008). Smoking-attributable mortality, years of potential life lost, and productivity losses--United States, 2000-2004. MMWR Morbidity and Mortality Weekly Report, 57(45), 1226-1228. Herman, K.C., Fahnlander, B. (2003). A Motivational Intervention to Reduce Cigarette Smoking Among College Students: Overview and Exploratory Investigation. Journal of College counselling, 6, 46-55. doi: 10.1002/j.2161-1882.2003.tb00226.x Hellmann, R., O´Shea, R,M,, Kunz, M.L., Schimpfhauser, F.T. (1988).  University health service physician intervention with cigarette smokers.  journal of American college health, 37(2):91-3.  O'Neill HK1, Gillispie MA, Slobin K. (2000). Stages of change and smoking cessation: a computer-administered intervention program for young adults. American Journal of Health promotion,15(2):93-6  Oliveira-Vianna, E., Romeu-Pereira, M., Barbieri, M.A., Duraes-Caldeira, R., Bettiol, H., Moura da Silva, A.A. (2008). Respiratory Effects to Tobacco Smoking Among Young Adults. The American Journal of Medical Sciences, 336(1), 44-49. doi: 10.1097/MAJ.0b013e31815c3b47. Prochaska, J.O., DiClemente, C.C. (1983). Stages and processes of self-change of smoking: toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51(3), 390-395. Prokhorov, A.V., Yost, T., Mullin-Jones, M., de Moor, C., Ford, K.H., Marani, S., … Emmons, K.M., 2008. "Look at your health": outcomes associated with a computer-assisted smoking cessation counseling intervention for community college students. Addictive Behaviors, 33(6), 757-771. doi: 10.1016/j.addbeh.2007.12.005. Tevyaw, T.O., Colby, S.M., Tidey, J.W., Kahler, C.W., Rohsenow, D.J., Barnett, N.P., … Monti, P.M. (2009). Contingency management and motivational enhancement: a randomized clinical trial for college student smokers. Nicotine & Tobacco Research, 11(6), 739-749. doi: 10.1093/ntr/ntp058. U.S. Department of Health and Human Services. (2012). Preventing Tobacco Use among Youth and Young Adults: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health CONTACT DETAILS: Miren Idoia Pardavila Belio; School of Nursing. University of Navarra; C/ Irunlarrea, 1; 31008 Pamplona - Spain; PN.  (+0034) 948 42 56 45   (806525); Email address: mpardavila@unav.es RESULTS  Table 1: Summarized characteristics of the seven studies included in the meta-analysis. Figure 2: Effects of smoking cessation programs on university students  Figure 1 shows the results of the literature review. A total of six RCT and two QRT (O`Neill et al, 2000; Hellman et al, 2000; Herman and Fahnlander, 2003; An et al, 2008; Abroms et al, 2008; Prokhorov et al, 2008; Tevyaw et al, 2009) with a total of 1594 participants met the inclusion criteria. These studies were conducted between 2000 and 2009 in colleges and universities in the United States. The characteristics of these studies are presented in Table 1.  The principals characteristics of the participants of the six studies included are (n=1243): 〇 The mean age in the intervention group was 20.9 and the participants in the control group had a mean age of 21.0.  〇 The average number of cigarettes smoked daily was 8.52 in the intervention group, and 8.07 in the control group.  〇 Female participants represented 73.1% of the population in the intervention group, and 72.3% in the control group.  〇 Prochaska’s Stages of Change (Prochaska and DiClemente, 1983), 57.0% of participants in the intervention group and 56.4% of participants in the control group were in the contemplation phase. Figure 2 illustrates the incidence of smoking cessation for the intervention. Publication bias was not evident according to Begg’s Correlational Model (Tau=1.13; p=0.26), or to Egger’s Regression Model (a=0.36; p=0.58).  Figure 1: Flowchart of meta-analysis  Articles of studies identified by initial search on PubMed, CINAHL, PsycINFO (OVID), ISI Web of Knowledge, Cochrane Plus, Cochrane Tobacco Addiction Group, and CUIDEN (n= 468) Articles of studies identified by the review of the reference list (n=3) Reports of potentially relevant studies, identified and screened for retrieval (n= 21) After reviewing the titles and abstracts, 450 reports did not fulfill the criteria for this review. Included studies (n= 7) 14 articles were excluded:  4 articles did not have comparison group (without control group or not usual control group)  8 articles were excluded because their follow-up was shorter than 6 months   2 studies did not focused their intervention on helping university students to quit Studies included in Meta-analysis (n= 6) 

Smoking cessation interventions for college students. A meta-analysis

Universidad de Navarra

http://dadun.unav.edu/bitstream/10171/43249/1/poster%20final%20Idoia%20Pardavila.pdf

Smoking cessation interventions for college students. A meta-analysis

Abstract

Similar works

Full text

Available Versions

Dadun, University of Navarra

Universidad de Navarra