Counselling pregnant smokers to quit is as difficult as it is essential. This article discusses a telephone counselling protocol designed to promote tobacco cessation among pregnant smokers. The protocol, validated in a large randomised, controlled trial, addresses three key elements of change for addictive behaviour — motivation, cognition and skill building — in ways tailored to pregnant smokers' unique needs. Details concerning scheduling, counsellor training and broader applicability are also presented.

This article characterises the social support received by a large sample of smokers attempting to stop and the relationship between this and the outcome of their attempt. A survey was conducted of 928 smokers attending a group-based program. Smoking among colleagues and a perception of having someone to turn to predicted outcome at the end of treatment, 4 weeks from the quit date (Odds ratio [OR] = 0.81, p = .008 and OR = 1.31, p = .003 respectively) Among those who abstained for the first week, smoking among colleagues and the frequency with which they had been offered cigarettes predicted outcome at the end of treatment (OR = 0.81, p = .04 and OR = 0.73, p = .01 respectively). There were no significant social support correlates of cessation for 26 weeks. Social support has a role to play in the short-term, but in the context of a group-based treatment program appears not to be related to long-term success.

The current practice of treating smokers as a homogenous group fails to recognise and adequately address the vast range (10–80ng/mL) of nicotine plasma levels (Russell, 1990) found among smokers. The Bittoun Model (Bittoun, 2006) individualises treatment according to the level of nicotine dependency. A total of 115 participants were enrolled in a 12-month program review based on the Bittoun Combination Nicotine Replacement Therapy (NRT) Algorithm (Bittoun, 2006). Participants found to be non nicotine dependent (Fagerstrom Test for Nicotine Dependence [FTND] = 0) (Heatherton et al., 1991) were excluded from the study. At 3 months, 52% (n = 99) of participants were total abstainers (self-reporting and expired CO ≤ 5ppm). Outcomes at 6 months (n = 58) and 12 months (n = 18; self-reporting) were 48% and 33% respectively. The Bittoun Model of Smoking Cessation offers an efficacious strategy for the assessment, management and delivery of tobacco intervention for the hard to treat smoker.

This article assesses whether the Fagerstrom Test for Nicotine Dependence (FTND), adequately reflects sex, gender and diversity related differences in nicotine dependence. Available studies on the FTND were reviewed and a sex, gender and diversity analysis (SGBA) of this instrument was conducted. Results indicate that sex and gender differences in nicotine dependence may undermine the ability of the FTND to present an adequate picture of dependence. Conducting a SGBA on this Fagerstrom test reveals that sex and gender differences likely limit the ability of this instrument to present an accurate picture of dependence in diverse groups. Further research is needed to enhance the sensitivity of the FTND.

This research examines the prevalence and attitudes of smoking among a Somali population in London. Eight focus groups and 77 assisted questionnaires were conducted. Findings show that there was little knowledge of local smoking cessation services and several themes arose including: the format and ineffective promotion of the United Kingdom National Health Service (NHS) Stop Smoking Services, health prom xotion and ambivalence towards preventative health behaviour. Smoking rates in this Somali population appear to be higher than in the UK general population, and higher still among men over 40 years old and those that regularly use qat. Smoking cessation services for the Somali population may be more popular if there were group clinics and culturally effective promotion of the services. The relationship between qat use and smoking should be considered when targeting services to the Somali population.

Smokers who need help to stop smoking cannot always attend clinical treatment sessions, so it is important for other alternatives to be offered. We report a case study of a smoking cessation intervention administered to a 29-year-old male cigarette smoker who had made no previous attempts to quit and who did not want to stop smoking, but who was obliged to because he was about to undergo a surgical intervention. The intervention was a mailed behavioural program combined with telephone support, administered over a six-week period. The subject quit smoking after 4 weeks, and remained abstinent at 3-, 6-, and 12-month follow-ups. At the 12-month follow-up the carbon monoxide in expired air was used to verify his abstinence.