Purpose: To determine whether the combination of bupropion SR and varenicline offers improved smoking cessation outcomes compared to varenicline monotherapy or to combination of bupro-pion SR and nicotine patch. Methods: This retrospective chart review included 489 volunteer enrolees in a Veterans Affairs (VA) tobacco cessation clinic who received one of the three treatments upon clinic enrolment. The study endpoints were smoking cessation and clinic completion rates, changes in the number of cigarettes smoked, carbon monoxide (CO) levels, urges to smoke, self-confidence to quit and medication-attributed adverse effects. Results: The relative smoking cessation rates were 33%, 32%, and 40% for bupropion SR and nicotine patch, bupropion SR and varenicline, and varenicline groups, respectively. The 0.21 p value established that no significant cessation rate differences existed between any of the groups. Varenicline alone or in combination was as well tolerated as the combination of bupropion SR and nicotine patch. Conclusions: The combination of bupropion SR and varenicline did not demonstrate any smoking cessation advantage over varenicline monotherapy or the combination of bupropion SR and nicotine patch and therefore do not support the use of bupro-pion SR and varenicline over varenicline monotherapy.

An important element of smoking cessation programs is the modification of health beliefs about risks and benefits. However, Janis and Mann's (1977) conflict-theory suggests only vigilant decision-makers are motivated by such outcome appraisals. Thus, this study examined the extent to which relations between health beliefs and cigarette smoking are moderated by decision-making competence. Over 150 university undergraduates completed a questionnaire survey assessing health beliefs about smoking (perceptions of susceptibility to and severity of lung cancer, and benefits of not smoking), smoking intentions, and decision-making competence. Hierarchical regression analysis revealed interactions between risk perceptions and competence, whereby perceived susceptibility and severity appraisals better predicted smoking intentions in less proficient decision-makers. However, these interactions disappeared after controlling for smoking status. These findings suggest that risk perceptions are more important in college students averse to information search and appraisal, albeit this is confounded by smoking status.

Introduction:The aim of this study was to assess Veterans' and primary care clinic staff's knowledge about, and experiences with, tobacco cessation services available through their Department of Veterans Affairs (VA) medical facility. Methods:Qualitative, semi-structured, in-depth interviews and surveys were conducted with 7 patients and 12 providers/clinic staff members at three VA primary care clinics serving large numbers of rural Veterans. Interviews were transcribed and coded for the- matic content. Results:Five primary themes emerged: (1) lack of knowledge about available cessation services, (2) smoking cessation services provided to patients, (3) perceived barriers to cessation and the provision of treatment, (4) patient receptiveness to treatment and primary care provider involvement, (5) recommended strategies for improving smoking cessation services. Discussion:Our findings suggest there is a considerable lack of knowledge regarding available tobacco cessation services in VA primary care clinics serving rural Veterans. While many patients expressed the opinion that VA was providing adequate care for nicotine dependence, they also identified important barriers to cessation and offered opinions regarding what more could be done to help them to quit smoking. Clinicians/staff also provided insight into barriers they encounter in the delivery of cessation services. Future work should focus on attempting to address these barriers.

Aim: The purpose of this study is to explore how effective household smoking restrictions (HSRs) are in different age groups in predicting smoking abstinence. Methods: The study analysed the Canadian Community Health Survey (CCHS) cycle, 3.1. Smoking abstinence was defined as individuals who reported to not have smoked greater than 100 cigarettes (n = 1 024 578) and were selected for this analysis. Important covariates include sex, age, education and immigrant status. Logistic regression was used to assess the association between smoking household restrictions and smoking abstinence when taking covariates into consideration. Results: Individuals who implemented HSRs reported to be abstinent from smoking at 12% compared to those with no HSRs at 0.7%. When adjusted for covariates of interest, the odds ratio (OR) for smoking abstinence was 1.43 (95% confidence interval (CI): 1.04, 1.97; P < .026). It was found that age was a strong predictor of smoking abstinence particularly in youths at 3.11 (95% CI: 1.65, 5.84; P < .001) and young adults at 1.92 (95% CI: 1.44, 1.92; P < .001). Conclusion: It is suggested that HSRs is an important anti-tobacco socialisation tool in youths and young adults. Individuals living in a home with HSRs may internalise behavioural norms against the initiation or continuation of smoking.