While developed countries have enjoyed a decreasing incidence of smoking over the last 30 years, in the developing world there are still reports of rapid smoking take-up. It seems that in developing countries tobacco smoking remains the number one cause of preventable death well into the future. To combat this costly habit, many governments have employed smoking cessation strategies since the 1960s. These programs have involved advertising the negative health impacts of smoking, increased taxation, targeted legislation, and even clinical counselling. This project aimed to explore and critically review the body of literature related to smoking cessation strategies in Saudi Arabia and assess their effectiveness. The project also aimed to use the data gathered to recommend legislative changes to smoking cessation programs. For the Saudi Arabian context, the results of the project found that the smoking cessation strategies, despite being revolutionary in many regards, still lacked depth, and that both males and females, particularly adolescents, were adopting smoking in increasing numbers. The recommendations of the project were for Saudi Arabian authorities to review a number of the current initiatives, and initiate further approaches to smoking cessation, such as stringent requirements for health warnings on cigarette packets.

This study evaluated the association between psychological variables, measured by questionnaire at the start of a smoking cessation treatment, and smoking abstinence, 8 years after treatment. A total of 124 patients presenting at the stop-smoking clinic of the University Hospital in Ghent, Belgium, were included. Besides the Reasons for Smoking Scale (RSS), Fagerstrom Test for Nicotine Dependence (FTND), and smoking status, a psychological questionnaire (NEO PI-R) was presented at baseline. A postal survey after 8 years was executed in order to assess smoking status and smoke-free survival. In 2008, 103/124 answered the postal survey. 66/103 (64.1%) had relapsed. More men then women were smoke-free (46.2% vs. 18.4%; p = .004). Several associations between psychological baseline characteristics and smoking status at follow-up were detected: lower abstinence at follow-up was associated with lower self-discipline (p = .001), lower goal-directedness (p = .03), higher score on symptoms of depression (p = .03), higher anxiety score (p = .01), higher score on the variable shame (p = .02). Some of these associations are confirmed by Kaplan-Meier survival scores that show borderline significance in case of depression (p = .06), statistically significance in case of self-discipline (p = .05) and shame (p = .05) and clear statistical significance in case of anxiety (p = .007). An association between psychological variables at the start of a smoking cessation treatment and smoking abstinence, even after 8 years, can be accepted.

Water pipe (WP) smoking is prevalent in several countries and is emerging as a major international public health issue. This article reviews the literature on WP smoking practices and its health effects. Water pipe smoking in the Middle East is more common in women compared to cigarette smoking. WP smoking has harmful effects similar to cigarette smoking, and the nicotine and tar content of WP smoke is higher than that of cigarettes. Still, many users believe that WP is less harmful than cigarettes and are unaware of the damage that WP can cause to their health. There is limited literature on WP smoking, highlighting the need for research in several areas including: epidemiology of WP smoking, sociological dimensions and tobacco control. The unique social and traditional role of WP smoking renders forgiving, culture-sensitive and patient approach.

Background: Few smoking cessation interventions have made extensive use of e-mail. Objective: This study set out to document how the e-mail component of an e-mail-based smoking cessation program was received by college smokers. Methods: Participants were randomised after enrolment to receive either a moderately intensive, e-mail-based intervention — the X-Pack Group — or a less intensive program based on a widely available smoking cessation guidebook. Participants were assessed at baseline and 3 months post-enrolment. This analysis is limited to those in the X-Pack Group (n = 48). Results: Twelve e-mails on average were sent out to each participant over the course of 6 months. Ninety-one per cent of participants reported reading all or most of the e-mails and 73% replied to at least one of the e-mails they received. On average, participants were positive about the e-mails received and most reported that they had liked the e-mails because of the social support and encouragement provided. The average time for counsellors to write and send each e-mail from the templates was 12 minutes, with a range from 2 to 60 minutes. Conclusions: These findings offer evidence of feasibility of an e-mail-based smoking cessation intervention in a college population.

We evaluated the effect of feedback after opportunistic spirometry in general practice on motivation for smoking cessation using stage change in the transtheoretical model. A total of 328 smokers aged over 35 years were given immediate feedback on the presence or absence of lung damage due to smoking, plus brief standard cessation advice. At 3 months, 99 (30.2%) smokers reported making an attempt to quit and 17 (5.2%) smokers reported moving into action stage for cessation. Of 297 (80.5%) successfully followed up, 81 (27.3%) smokers demonstrated forward shift and 35 (11.8%) smokers demonstrated backward shift. Feedback on the presence of lung damage was not significantly associated with reporting a quit attempt (p = .31) or moving into action stage for cessation (p = .30). Odds of forward or backward shift were not independently associated with either feedback on the presence of lung damage or normal lung function. Odds of backward shift with feedback on lung damage depended on participants' assessments of quit benefits, which were correlated with their prior self-assessment of lung damage. Our findings suggest that feedback to smokers after spirometry about the absence of lung damage is not harmful. However, eliciting personal health attitudes is also important so cessation advice can be tailored especially for smokers who believe they already have lung damage from smoking.

Introduction: Buerger's disease (BD) is a chronic peripheral vascular disease that affects the young smokers from low socioeconomic backgrounds. The only effective therapy for this disease is smoking cessation; otherwise the outcome of BD will be several amputations. Aims & Methods: Via 12 sessions, an elective pattern of group therapy was designed and tried with six volunteer patients. The therapy commenced with motivation, mixed with a behavioural and cognitive model appropriate to the patients' socioeconomic and educational status. Two extra training sessions of apposite and supporting behaviour were allocated for their family members. Urine cotinine level was measured before and after the group therapy. The aim of study was to lead the patients towards a self-help group. Results: A partial remission of the disease in one patient and a complete remission in four patients were the consequences of the present study. The average decline of urine cotinine level was about two ranks. One patient was not helped. Conclusion: Although the study faced major loss of subjects, in regards to dramatic changes in urine cotinine level, this plan of group therapy seems to be an effective and cost-effective option for clinical improvement in patients with BD, as a chronic and smoking-related disease.

Self-perceived difficulty not smoking during a quit attempts is potentially an important factor mediating ability to remain abstinent during quit attempts. We investigated how far this could be explained by specific withdrawal symptoms (e.g., irritability, depressed mood, hunger etc.), strength of the urges to smoke and the time spent with urges to smoke. Thirty-five male and female smokers, who smoked at least 15 cigarettes per day were required to abstain overnight and attended the laboratory the next day and completed the Mood and Physical Symptoms Scale (MPSS), a validated questionnaire assessing cigarette withdrawal symptoms and urges to smoke. They also rated how difficult they had found it not smoking. Difficulty not smoking was independently and strongly predicted by both strength of urges to smoke and time spent with urges, but not by other withdrawal symptoms. The results support the idea that both time spent with urges and strength of urges to smoke are what primarily makes it difficult for smokers to abstain early in a quit attempt and that other withdrawal symptoms play a more modest role. Further research is needed to confirm this finding and examine how far difficulty not smoking mediates failure of quit attempts.

This pilot study aimed to develop a tool and methodology for measuring client satisfaction in UK National Health (NHS) Stop Smoking Services (SSS). A brief postcard questionnaire (measuring overall satisfaction with the service, willingness to recommend the service to others and smoking status) and a complete questionnaire (with 20 additional items measuring satisfaction with specific elements of the service) were developed. An NHS SSS mailed the postcard to 298 clients who had set a quit date in the previous quarter, they mailed the complete questionnaire to a subsample of 99 clients. Overall 34% (100/298) of those surveyed responded: 30% (90/298) for the card and 25% (25/99) for the questionnaire (15 people responded to both). Intraclass correlation coefficients (ICC) were found to be acceptable for both the overall service satisfaction item (ICC value = .43, p = .05) and the item regarding recommending the service to others (ICC-value = .83, p < .001). Hence the tool had reliability and at least face validity and the survey methodology proved practicable. The small modifications made to service delivery and the need for future research are discussed.