July 03, 2008
Technology and Smoking Cessation
There is a great deal of information on the Internet about smoking and a number of websites that offer self-help programs for those who wish to give up smoking, but interesting and new technologies are emerging to motivate quitters and help physicians track the progress.
Software
The Handheld Computer Smoking Intervention Tool (HCSIT) was developed by Scot Strayer, MD from the Department of Family Medicine at the University of Virginia for the National Cancer Institute. The software allows clinicians to access data about smoking cessation, drug interactions, addiction evaluations and other information to use in interviews as people begin the effort to quit. The HCSIT is designed for clinicians to assist with smoking cessation counseling at the point-of-care and was developed in accordance with current PHS guidelines. This easy-to-use program can be used with Palm, SmartPhone, and Pocket PC handheld computers.
The HCSIT includes a handheld version of the Fagerstrom Test for Nicotine Dependence. This test assesses a smoker's level of dependency on nicotine and has demonstrated validity and reliability in previous research. The tool guides clinicians through the appropriate questions and makes intervention recommendations based on the level of dependency. When medication therapy is strongly indicated, common prescription information is provided on the handheld tool to assist the physician with dispensing the appropriate medication. Additionally, this tool contains: Public Health Service (PHS) Tobacco Cessation Guidelines; second-line pharmacotherapy; brief motivational interventions for tobacco users (the "5 R's"); and evidence-based recommendations from the PHS Guidelines (the "5 A's").
The software can be downloaded from the Smokefree.gov website
Social Networks
A recent article in the New England Journal of Medicine studied a social network of 12,067 individuals. The research suggested that whole groups of people were quitting in concert and that smokers were progressively moving to the periphery of the social network. The study also found that smoking cessation by a spouse decreased a person's chances of smoking by 67%, smoking cessation by a sibling decreased the chances by 25% and smoking cessation by a friend decreased the chances by 36%. Among persons working in small firms, smoking cessation by a coworker decreased the chances by 34%. Friends with more education influenced one another more than those with less education. These effects were not seen among neighbors in the immediate geographic area.
The authors conclude that "network phenomena appear to be relevant to smoking cessation. Smoking behavior spreads through close and distant social ties, groups of interconnected people stop smoking in concert, and smokers are increasingly marginalized socially. These findings have implications for clinical and public health interventions to reduce and prevent smoking."
Websites
Finding reliable and credible information on the numerous websites can be a challenge for aspiring quitters or for clinicians to recommend to their patients. Beth Bock, PhD from the Department of Psychiatry and Human Behavior at Brown University Medical School is conducting an analysis of the top web search results and evaluating the quality of the websites for smokers. She described in an abstract presented at MedNet that "smokers seeking quality tobacco dependence treatment on the Internet may have difficulty distinguishing among the numerous websites available. Websites that provide direct treatment often fail to fully implement treatment guidelines and do not take full advantage of the interactive and tailoring capabilities of the Internet. Despite the importance of social support in the process of quitting smoking, few sites used chat rooms, electronic message boards, on-line counselor support (e.g., email) systems or other on-line support groups. "
Currently, the best websites for clinicians and consumers are the government based websites like the Health and Human Services Website located at http://www.surgeongeneral.gov/tobacco/ and the Center for Disease Control (CDC) site at http://www.cdc.gov/tobacco/quit_smoking/
These offer a diverse array of links, pamphlets and health information. However, they offer little in the way of blogs or online support networks for smokers who are trying to quit. Some of the most widely used resources for online quitters or potential quitters is About.com: smoking cessation or QuitNet.
Gadgets
Nico-stopper
Looks like an MP3 player but is a cigarette case that locks in your cigarettes and only releasaes them at preset intervals. And as the cigarette is released, the LCD screen flashes self-help messages. (link)
Smoke Signals
The Smoke Signals package enlists your computer into helping you give up smoking. It includes:
* a smart interactive case that holds a pack of cigarettes and monitors your habits and signals when to smoke.
* a personalized Quit Plan that is built to not only match your profile but also adjusts your profile as you progress.
* access to an online progress page which acts as your personal coach.
* daily emails and tips
* a DVD that offers a step-by-step guie to the Smoke Signal Process.
(link)
Quit Key
A handheld computer that you can keep on your key chain. It creates a personal quit smoking program based on information that you provide.
(link)
Quit Smoking Plugin
Give up smoking by public exposure with the Quit Smoking Plugin for weblogs. An interesting tool for those who have their own or are thinking of creating a word press blog. The plugin will display a counter on your blog showing all the relevant numbers - the time quit, how many not smoked, how much money saved, and how many lifetime hours regained.
(link)
References & Supplemental Material
PHS guidlines
Article: A Handheld Computer Smoking Intervention Tool and Its Effects on Physician Smoking Cessation Counseling
Article: NEJM - The Collective Dynamics of Smoking in a Large Social Network
Article: Reliability of Internet- Versus Telephone-Administered Questionnaires in a Diverse Sample of Smokers
Article: The Content, Quality and Usability of Smoking Cessation Treatments on the Internet
Article: Web-Based Smoking Cessation Medication Compliance System
Gadgets Source: HealthBolt