Forced smoking abstinence: not enough for smoking cessation
Jennifer G Clarke1, L A R Stein, Rosemarie A Martin
1Brown University Center for Primary Care and Prevention, Pawtucket, Rhode Island, USA. Jennifer_Clarke@brown.edu
JAMA Internal Medicine
|April 10, 2013
Summary
The WISE intervention, a program combining motivational interviewing and cognitive behavioral therapy, significantly improved sustained smoking abstinence after prison release. This behavioral intervention is crucial for long-term success in quitting tobacco use post-incarceration.
Area of Science:
- Public Health
- Behavioral Science
- Addiction Medicine
Background:
- Millions of individuals are compelled to quit smoking during incarceration but frequently relapse upon release.
- There is a critical need for interventions to support sustained tobacco abstinence after release from correctional facilities.
Purpose of the Study:
- To assess the effectiveness of the WISE (Working Inside for Smoking Elimination) intervention in reducing smoking relapse after release from a smoke-free prison.
- The WISE intervention utilizes motivational interviewing (MI) and cognitive behavioral therapy (CBT) principles.
Main Methods:
- Participants (N=262) were recruited 8 weeks before release from a US tobacco-free prison.
- Randomization to either the WISE intervention (6 weekly sessions) or educational videos (control group).
- Smoking abstinence was validated by urine cotinine measurement at 3-week and 3-month follow-ups.
Main Results:
- At 3 weeks, 25% of the WISE group achieved tobacco abstinence versus 7% in the control group (OR, 4.4).
- Logistic regression showed WISE participants were 6.6 times more likely to remain abstinent.
- At 3 months, 12% of the WISE group remained tobacco-free compared to 2% in the control group (OR, 5.3).
Conclusions:
- Forced abstinence during incarceration has minimal long-term impact on smoking cessation.
- A pre-release behavioral intervention like WISE significantly enhances cotinine-confirmed smoking cessation rates in the community.
- The WISE intervention demonstrates efficacy in promoting sustained tobacco abstinence post-incarceration.
Related Concept Videos
01:23Chronic Obstructive Pulmonary Disease II: Emphysema
Emphysema, a major phenotype of chronic obstructive pulmonary disease (COPD), is characterized by irreversible destruction of alveolar walls and permanent enlargement of distal airspaces. Unlike chronic bronchitis, which primarily affects the airways, emphysema predominantly involves the lung parenchyma, where structural damage leads to airflow limitation.PathophysiologyIt most commonly results from prolonged exposure to cigarette smoke and other toxic gases, particularly cigarette smoke.
01:26Stress Prevention and Stress Management Techniques IV
Stress often leads to unhealthy habits like smoking, excessive drinking, and overeating, which offer short-term relief but ultimately increase long-term health risks. These behaviors create a cycle that temporarily lowers stress levels but can result in severe long-term health consequences. Breaking these habits is essential to reduce the risk of chronic diseases and improve overall well-being. Three primary changes that support better health include quitting smoking, reducing alcohol intake,...
01:24Chronic Obstructive Pulmonary Disease III: Chronic Bronchitis Features
Chronic bronchitis is a key phenotype of chronic obstructive pulmonary disease (COPD), characterized by airway-centered inflammation and mucus overproduction. It develops from long-term exposure to harmful particles or gases, most commonly cigarette smoke, which triggers a persistent inflammatory response.Cellular and Structural ChangesInflammation initially affects the large bronchi and later the smaller airways, with infiltration by immune cells, including neutrophils, macrophages, and...
01:20COPD: Pathogenesis and Clinical Features
Chronic obstructive pulmonary disease (COPD) is a group of lung conditions that progressively worsen over time, including chronic bronchitis and emphysema. This cluster of diseases collectively leads to a gradual and irreversible decline in lung function over time.
The primary cause for the onset of COPD is cigarette smoking and exposure to air pollution. These hazardous factors initiate a chain reaction within the lungs, resulting in chronic inflammation, damage to the airways, and a...
The primary cause for the onset of COPD is cigarette smoking and exposure to air pollution. These hazardous factors initiate a chain reaction within the lungs, resulting in chronic inflammation, damage to the airways, and a...
01:29Chronic Obstructive Pulmonary Disease-V: Management
Managing Chronic Obstructive Pulmonary Disease (COPD) involves a multifaceted approach to reduce symptoms, prevent exacerbations, improve overall health status, and slow disease progression. Key strategies include lifestyle modifications, pharmacotherapy, supportive therapies, and, in some cases, surgery. Here is an overview of the primary COPD management strategies:
Smoking Cessation
Smoking Cessation
01:26COPD: Management Using Bronchodilators and Corticosteroids
Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...