Smoking is a leading cause of respiratory disorders. Smoking cessation is crucial for improving and even for curing many respiratory diseases. Smokers with respiratory diseases can suffer from comorbidities and a higher degree of nicotine dependency than ‘healthy smokers’. For this reason, smoking cessation services (SCS) should be an integral part of a chest unit. The SCS must be run by professionals with expertise and must be well-equipped. They should provide cessation support for all patients who smoke, and educational programs for health professionals. They also have a role in investigation of new treatment strategies.

With more medications available for smoking cessation treatment the need to diagnose the tobacco dependence for better tailoring of treatment is growing. It has been suggested that smokers can be peak seekers or trough maintainers vis-à-vis blood nicotine concentrations (Russell, 1990), or smoking predominantly for coping with withdrawal or smoking for pleasure (Juniper et al., 2005). In this article a related concept, smoking for negative reinforcement (NR) or positive reinforcement (PR), is investigated. A simple 1-question assessment of type of reinforcement is suggested. From data from smokers attending smoker's clinics — 2 from Sweden using varenicline and 1 from Spain using nicotine patches — it looks as if smokers smoking predominantly for PR do better than NR smokers when treated with varenicline, while there is no difference when they are treated with nicotine replacement. When degree of nicotine dependence is crossed with type of reinforcement it looks as if NR/low nicotine dependent smokers have the best outcome (64%) compared with 47% (p < .01) for the whole sample treated with nicotine replacement. When varenicline is used, the PR/low dependent group had the best quit rate with 85% compared with 67% (p < .05) for the whole sample. This brief report proposes that smoking for PR or NR, possibly combined with degree of dependence, should be further studied as a tool for tailoring smoking cessation treatments.

Objective: To look for evidence of changing nicotine dependency self-reported by new callers to a national quitline in New Zealand between 2001 and 2005. Methods: Levels of self-reported nicotine dependence of new callers were compared across 5 years to determine changes over time. Results: Statistically significant decreases were found in all 3 measures of nicotine dependence over the 5-year period: time to first cigarette (7.9% decline for smoking within 30 minutes of waking), intensity of inhalation (36.8% decline for ‘heavy’ inhalation), and number of cigarettes per day (29.8% decline for 21+ cigarettes per day). Conclusions: The results showed the proportion of callers with high nicotine dependency remains large but decreased continuously during the 5-year period. A decline of highly nicotine dependent callers to the Quitline may indirectly suggest an increased proportion of hard-core smokers in the overall smoking population as this group tends to be less likely to consider quitting smoking. However, the results may also suggest that the overall smoking population was less nicotine dependent in 2005, than it was in 2001, or that the Quitline has become less appealing to heavily nicotine dependent smokers.

Objective: We assessed exercise levels and psychosocial aspects of exercise among pregnant smokers. Methods: A cross-sectional telephone survey of 88 pregnant smokers assessed levels of participation in exercise and psychosocial aspects of exercise; namely, self-efficacy, beliefs, perceived social support, perceived barriers, intentions and stage of change. Results: The women reported slightly higher levels of physical activity than for the general population of young women. The vast majority of women interviewed reported that exercise was important in their pregnancy, that they intended exercising regularly during pregnancy and were interested in exercise classes as an aid to smoking cessation. Fatigue was the most commonly reported barrier to physical activity during pregnancy, followed by ‘it takes too much time’, ‘uncomfortable when I exercise’ or ‘not sure what to do’. The vast majority of women expressed very little confidence and social support towards exercising. Conclusion: The results suggest that there is potential for using physical activity as an aid to smoking cessation during pregnancy. However, such interventions would need to be sufficiently intensive to address perceived barriers to exercise, lack of social support, low self-efficacy and be tailored to different stages of pregnancy.

Latino No Fumes: Protege tu Salud was a smoking cessation demonstration project carried out in 2003 to 2004 that recruited Spanish-speaking smokers in 8 Connecticut cities. Recruitment was through radio and TV announcements, by mail, and at clinics and hospitals. 252 current smokers — mainly of Puerto Rican ancestry — signed up for the program; 75% of them attended one or more of the program's 6 weekly, group counselling sessions. One third of the registrants attended at least 5 of the sessions offered. Attendance of one or more sessions was only 55% for summer or winter groups, but 98% for sessions held in the fall. For the summer or winter sessions (only), attendance at one or more sessions was significantly greater in small than in larger cities. At program end, 14% of the participants were verified nonsmokers (self-reported abstinence and carbon monoxide readings < 9 ppm). The reported quit rates were 18% and 13%, respectively, at 3 and 6 months. The amount of attendance was not significantly related to the reported end of program quit-rates. Nearly all nonsmokers at program end had attended groups conducted by just 3 (of the 7) trained counsellors, who were presumably more effective in helping these Latino smokers to quit.

The health care setting, and most notably dental clinics, may hold promise in delivering effective tobacco intervention to adolescents. Adolescents between the ages of 14 and 17 were randomly assigned to brief advice from dental hygienists and dentists only or to brief advice plus a motivational interview and follow-up telephone contact from a study hygienist. Due to difficulties in identifying and recruiting subjects, study goals were expanded from cessation only to cessation and prevention. No differences in smoking prevalence were found between treatment conditions at either 3- or 12-month follow-up. Firm conclusions cannot be drawn about the effectiveness of treatment due both to problems in enrolling subjects and limited implementation of the motivational intervention.