Impact of health education and cognitive behavioural therapy intervention during tobacco cessation session for smokers: A comparative study in Eastern India.
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Abstract
Background: Tobacco use remains the leading cause of death worldwide. Smoking cessation is the only way to fight the most feared disease in the world. Current evidence-based treatment approaches to smoking cessation include several behavioural treatments and health education-such as cognitive behavioural therapy, and individual and group counseling which tobacco cessation can help control global causes of preventable death. Health professionals play an important role in combating the tobacco epidemic.
Materials and methods: All the current smokers who had participated in this study submitted their self-reported case record forms. Baseline data was collected, tobacco history was obtained, the Fagerstrom nicotine dependency questionnaire was administrated and for the quitter, a standardized cotinine test was used. The total number of participants enrolled in this study is 240, but only 190 participants completed the entire program study. Tobacco users who met the inclusion criteria were randomly assigned to three intervention groups: the health education (HE) group, the cognitive behavioural therapy group (CBT), and the combination of health education with the cognitive behavioural therapy (HE+CBT) group. All the participants were visited five times within the six-month duration. Pearson's Chi-square test, paired and unpaired t-tests, Fagerstrom score scale, and Fisher's exact test were used to test the effectiveness of all interventions among the groups. SPSS 22.0, IBM, USA, was used for the analysis of all statistical events.
Results: Both groups showed no difference in attempts to quit and had no statistical significance. The reduction in Fagerstrom's score was greater in the HE+CBT group than in the individual CBT and HE groups. Among all the groups, the HE+CBT group shows more effectiveness in cessation therapy than those in the individual groups, which improves the possibility of smoking cessation.
Conclusion: In term of tobacco habit reduction, the combination of HE and CBT is more effective than individual therapy for smokers. Further, it can be studied that which kind of barriers are faced by the health professionals during the practice of HE and CBT intervention in their tobacco cessation practices in order to making the sessions clinically effective and educationally more impactful, as well as the heavy tobacco users are can be given immediate attention and prior opportunity for the treatment.
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Personal views expressed by the contributors in their articles are not necessarily those of the Journal of Associated Medical Sciences, Faculty of Associated Medical Sciences, Chiang Mai University.
References
Rudgley R. Biopsychiatry. The Encyclopedia of Psychoactive Substances. New York, United States: Little, Brown and Company Publishers; 1998.
International Agency for Research on Cancer. IARC monographs on the evaluation of carcinogenic risks to humans. Lyon (France): IARC; 2004.
Pezzuto A, Citarella F, Croghan I, Tonini G. The effects of cigarette smoking extracts on cell cycle and tumor spread: novel evidence. Future Sci OA. 2019; 5(5): FSO394.
WHO Data. Tobacco Fact Sheet; No. 339. Available from: https://www.who.int/news-room/fact-sheets/ detail/tobacco[Last accessed on 2020].
World Health Organization. Report on the Global Tobacco Epidemic, 2008: The MPOWER Package. Geneva: World Health Organization, Available from: https://apps.who.int/iris/handle/10665/43818, [accessed on 2019 July 05].
Drake P, Driscoll AK, Mathews TJ. Cigarette smoking during pregnancy: United States, 2016. NCHS Data Brief. 2018; 305: 1-8.
Yue, Xinping & Basting, Tyler & Flanagan, Thomas & Xu, Jiaxi & Lobell, Thomas & Gilpin, Nicholas & Gardner, Jason & Lazartigues, Eric. (2018). Nicotine Downregulates the Compensatory Angiotensin- Converting Enzyme 2/Angiotensin Type 2 Receptor of the Renin–Angiotensin System. Annals of the American Thoracic Society. 15. S126-S127. 10.1513/AnnalsATS.201706-464MG. Li F: Structure of SARS Coronavirus Spike Receptor Binding Domain Complexed with Receptor. Science 2005; 309: 1864-8.
Wan Y, Shang J, Graham R, Baric RS, Li F. Receptor recognition by the novel coronavirus from Wuhan: an analysis based on decade-long structural studies of SARS coronavirus. J Virol. 2020; 94(7): e 00127-20.
Kuanar A, Kabi SK, Satapathy S, Mishra S, Bhuyan R, Kar D. Corona Virus-A review concerns about the present scenario. Annals of the Romanian Society for Cell Biology. 2021; 25(2): 1301-15.
Pappas RS. Toxic elements in tobacco and in cigarette smoke: inflammation and sensitization. Metallomics. 2011; 3(11): 1181-98. doi: 10.1039/ c1mt00066g. Epub 2011 Jul 28. PMID: 21799956; PMCID: PMC4542087.
Department of Health and Human Services (US) The health consequences of smoking: a report of the Surgeon General. Washington: DHHS, Centres for Disease Control and Prevention, National Centre for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2004. Available on: https://www.ncbi.nlm.nih.gov/books/NBK44695/ [ Last accessed on 2019 June 1st].
Banks E., Joshy G., Weber M.F., Liu B., Grenfell R., Egger S., Paige E., Lopez A.D., Sitas F., Beral V. Tobacco smoking and all-cause mortality in a large Australian cohort study: Findings from a mature epidemic with current low smoking prevalence. BMC Med. 2015; 13: 38.
Shah S.R., Cole J.W. Smoking and stroke: The more you smoke the more you stroke. Expert Rev Cardiovasc Ther. 2010; 8: 917-32.
Jethwa A.R., Khariwala S.S. Tobacco-related carcinogenesis in head and neck cancer. Cancer Metastasis Rev. 2017; 36: 411-23.
World Health Organization. WHO Report on the Global Tobacco Epidemic, 2009. Implementing smoke-free environments. https://www.who.int/ publications/i/item/9789241563918 [Last accessed on 2020 April 27th].
Ockene JK, Emmons KM, Mermelstein RJ, Perkins KA, Bonollo DS, Voorhees CC, et al. Relapse and maintenance issues for smoking cessation. Health Psychol. 2000; 19: 17-31.
Silagy C, Mant D, Fowler G. Meta-analysis on efficacy of nicotine replacement therapies in smoking cessation. Lancet. 1994; 343: 139-42.
Hu N, Yu Z, Du Y and Li J (2022) Risk Factors of Relapse After Smoking Cessation: Results in China Family Panel Studies From 2010 to 2018. Front. Pub Health. 10:849647. doi: 10.3389/fpubh.2022. 849647.
Lorimer B, Kellett S, Nye A, Delgadillo J. Predictors of relapse and recurrence following cognitive behavioural therapy for anxiety-related disorders: a systematic review. Cogn Behav Therap. 2021; 50(1): 1-8.
Lee SE, Kim CW, Im HB, Jang M. Patterns and predictors of smoking relapse among inpatient smoking intervention participants: a 1-year follow-up study in Korea. Epidemiol Health.
Hofmann SG, Asnaani A, Vonk IJ, Sawyer AT, Fang A. The efficacy of cognitive behavioural therapy: A review of meta-analyses. Cognit Ther Res. 2012; 36(5): 427-40.
Golechha M. Health Promotion Methods for Smoking Prevention and Cessation: A Comprehensive Review of Effectiveness and the Way Forward. Int J Prev Med. 2016 Jan 11; 7: 7.
Hatsukami DK, Stead LF, Gupta PC. Tobacco addiction. Lancet. 2008; 371(9629): 2027-38.
Bouton ME. Why behavioural change is difficult to sustain. Prev Med. 2014; 68: 29-36.
Farooq MU, Puranik MP, Uma SR. Effectiveness of cognitive-behavioural therapy compared with basic health education for tobacco cessation among smokers: A randomized controlled trial. J Indian Assoc Public Health Dent. 2020; 18: 25-30.
An Overview of Tobacco Cessation Counseling. A Fact Sheet by WorkSHIFTS October; 2009. Available from: https://www. publichealthlawcentre.org/. [Last accessed on 2019 July 05].
Raja M, Saha S, Mohd S, Narang R, Reddy LV, Kumari M. Cognitive behavioural therapy versus basic health education for tobacco cessation among tobacco users: A randomized clinical trial. J Clin Diagn Res. 2014; 8: ZC47-9.
Hall SM, Reus VI, Muñoz RF, Sees KL, Humfleet G, Hartz DT, et al. Nortriptyline and cognitive behavioural therapy in the treatment of cigarette smoking. Arch Gen Psychiatry. 1998; 55: 683-90.
Killen JD, Fortmann SP, Schatzberg AF, Arredondo C, Murphy G, Hayward C, et al. Extended cognitive behavioural therapy for cigarette smoking cessation. Addiction. 2008; 103: 1381-90.
Swanson AN, Shoptaw S, Heinzerling KG, Wade AC, Worley M, McCracken J, et al. Up in smoke? A preliminary open label trial of nicotine replacement therapy and cognitive behavioural motivational enhancement for smoking cessation among youth in Los Angeles. Subst Use Misuse. 2013; 48: 1553-62.
Hill KP, Toto LH, Lukas SE, Weiss RD, Trksak GH, Rodolico JM, et al. Cognitive behavioural therapy and the nicotine transdermal patch for dual nicotine and cannabis dependence: A pilot study. Am J Addict. 2013; 22: 233-8.
Becker J, Haug S, Kraemer T, Schaub MP. Feasibility of a group cessation program for co smokers of cannabis and tobacco. Drug Alcohol Rev. 2015; 34: 418-26.
Malhi R, Patthi B, Singla A, Dhama K, Niraj LK, Ali I. Breaking the hurdle with three tobacco cessation interventions in your life: A randomized controlled trial. J Indian Assoc Public Health Dent. 2018; 16: 103-8.
Park CB, Choi JS, Park SM, Lee JY, Jung HY, Seol JM, et al. Comparison of the effectiveness of virtual cue exposure therapy and cognitive behavioural therapy for nicotine dependence. Cyber Psychol Behav Soc Netw. 2014; 17: 262-7.
Hiscock R, Bauld L, Amos A, Fidler JA, Munafò M. Socioeconomic status and smoking: A review. Ann N Y Acad Sci. 2012; 1248: 107-23.
U.S. Department of Health and Human Services. The Health Consequences of Smoking - 50 Years of Progress: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centres for Disease Control and Prevention, National Centre for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014. Available from: https://www.cdc.gov/ tobacco/data_ statistics/fact_sheets/youth_data/tobacco_use/in dex. htm. [Last accessed on 2019 Aug 08].
Kumar MS, Sarma PS, Thankappan KR. Community-based group intervention for tobacco cessation in rural Tamil Nadu, India: a cluster randomized trial. Journal of substance abuse treatment. 2012; 43(1): 53-60.
Reddy UK, Siyo RKN, UlHaque MA, Basavaraja H, Acharya BLG, Divakar DD. Effectiveness of health education and behavioural intervention for tobacco de-addiction among degree students: a clinical trial. Internet J Int Soc Prev Community Dent. 2015 Dec; 5(suppl 2): S93eS100.
U.S. Department of Health and Human Services. Preventing Tobacco Use among Youth and Young Adults: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centres for Disease Control and Prevention, National Centre for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2012. Available from: https://www.cdc. gov/tobacco/data_statistics/ fact_sheets/youth_ data/tobacco_use/in dex.htm. [Last accessed on 2019 Aug 08].
Raja M, Saha S, Mohd S, Narang R, Reddy LV, Kumari M. Cognitive behavioural therapy versus basic health education for tobacco cessation among tobacco users: A randomized clinical trial. J Clin Diagn Res. 2014; 8: ZC47-9.
Schnoll RA, Rothman RL, Wielt DB, Lerman C, Pedri H, Wang H, et al. A randomized pilot study of cognitive behavioural therapy versus basic health education for smoking cessation among cancer patients. Ann Behav Med. 2005; 30: 1-10.
Webb MS, de Ybarra DR, Baker EA, Reis IM, Carey MP. Cognitive behavioural therapy to promote smoking cessation among African American smokers: A randomized clinical trial. J Consult Clin Psychol. 2010; 78: 24-33.
Sykes CM, Marks DF. Effectiveness of a cognitive behaviour therapy self help programme for smokers in London, UK. Health Promot Int 2001; 16: 255-60.
Evins AE, Mays VK, Rigotti NA, Tisdale T, Cather C, Goff DC. A pilot trial of bupropion added to cognitive behavioural therapy for smoking cessation in schizophrenia. Nicotine Tob Res. 2001; 3: 397-403.