Prevalence of use and real-world effectiveness of smoking cessation aids during the COVID-19 pandemic: a representative study of smokers in England.

AIM: To measure whether the prevalence of use and real-world effectiveness of different smoking cessation aids has changed in England since the coronavirus disease 2019 (COVID-19) pandemic. DESIGN: Representative monthly cross-sectional surveys, January 2015-June 2021. SETTING: England. PARTICIPANTS: A total of 7300 adults (≥18 y) who had smoked within the previous 12 months and had made ≥1 quit attempt during that period. MEASUREMENTS: The independent variable was the timing of the COVID-19 pandemic (pre-pandemic [January 2015-February 2020] vs pandemic [April 2020-June 2021]). We analysed (i) the association between the pandemic period and self-reported use (vs non-use) during the most recent quit attempt of: prescription medication (nicotine replacement therapy [NRT]/varenicline/bupropion), NRT bought over-the-counter, e-cigarettes, traditional behavioural support and traditional remote support (telephone support/written self-help materials/websites) and (ii) the interaction between the pandemic period and use of these cessation aids on self-reported abstinence from quit date to survey. Covariates included age, sex, social grade, level of cigarette addiction and characteristics related to the quit attempt. FINDINGS: After adjustment for secular trends, there was a significant increase from the pre-pandemic to pandemic period in the prevalence of use of traditional remote support by past-year smokers in a quit attempt (OR = 2.18; 95% CI, 1.42-3.33); specifically telephone support (OR = 7.16; 95% CI, 2.19-23.45) and websites (OR = 2.39; 95% CI, 1.41-4.08). There was also an increase in the prevalence of use of prescription medication (OR = 1.47; 95% CI, 1.08-2.00); specifically varenicline (OR = 1.66; 95% CI, 1.09-2.52). There were no significant changes in prevalence of use of other cessation aids after adjustment for secular trends. People who reported using prescription medication (OR = 1.41; 95% CI, 1.09-1.84) and e-cigarettes (OR = 1.87; 95% CI, 1.62-2.16) had greater odds of reporting abstinence than people who did not. There were no significant interactions between the pandemic period and use of any cessation aid on abstinence, after adjustment for covariates and use of the other aids, although data were insensitive to distinguish no change from meaningful modest (OR = 1.34) effects (Bayes factors 0.72-1.98). CONCLUSIONS: In England, the COVID-19 pandemic was associated with an increase in use of remote support for smoking cessation and varenicline by smokers in a quit attempt up to June 2021. The data were inconclusive regarding an association between the pandemic and changes in the real-world effectiveness of popular smoking cessation aids.

A quantitative evaluation of a regional Positive Behavioural Support workforce development approach.

BACKGROUND: Research suggests that providing staff with input in relation to Positive Behavioural Support (PBS) can have beneficial outcomes. Much of this research, however, fails to take account of systemic issues and does not include a control group. METHOD: We used a non-randomised, controlled group design to evaluate accredited PBS programmes, delivered as part of a systemic, regional and workforce development approach. We compared outcomes of those attending the programmes (n = 240) with a control group (n = 54), pre- and post-intervention and at 3-months follow-up. RESULTS: The programme and its wider impact were rated positively. Significant intervention effects were found for staff practice and retention, but not for staff knowledge and attributions, or behaviours that challenge and quality of life of those being supported. CONCLUSIONS: The results are discussed in the context of the study limitations and restrictions resulting from the Covid-19 pandemic.

The impact of COVID-19 restrictions in the United Kingdom on the positive behavioural support of people with an intellectual disability.

The way that people with an intellectual disability are supported is very important.The COVID-19 virus has changed the way that staff help people with an intellectual disability.We wanted to know about those changes and whether learning about positive behavioural support (PBS) helped staff to cope with them.The main changes were that people with an intellectual disability could not go out or see family and friends as often.Staff came up with new things to do for the people they supported, and PBS learning seemed to help staff to cope. Background: It has been suggested that COVID-19 and the associated restrictions are likely to have a negative impact on the provision of positive behavioural support (PBS) to people with an intellectual disability. Methods: Fifty-eight staff, who had recently completed an accredited positive behavioural support (PBS) programme, responded to an online questionnaire, which asked them to rate the impact of COVID-19 on factors related to PBS. Results: Participants reported a neutral or somewhat positive impact on all the areas measured, with the exception of the activities and quality of life of those they supported, which were somewhat negatively affected. The participants rated the learning from their PBS programme as helping them cope with COVID-19 to some extent. Examples of positive and negative effects and ways in which PBS helped staff to cope are presented. Conclusions: Many staff developed creative solutions that allowed them to provide PBS despite the COVID-19 restrictions. PBS learning appeared to help staff cope with the negative impact of the restrictions.

'It's been adapted rather than impacted': A qualitative evaluation of the impact of Covid-19 restrictions on the positive behavioural support of people with an intellectual disability and/or autism.

BACKGROUND: We used a qualitative approach to explore the experiences of social care staff regarding the provision of positive behavioural support (PBS) to people with an intellectual disability at the height of the Covid-19 restrictions. METHOD: We conducted semi-structured interviews with 19 staff who had recently completed a PBS workforce development programme. Data were analysed using thematic analysis. RESULTS: Three themes were identified in the context of the restrictions: The challenges to maintaining quality of life and PBS of the people being supported and staff attempts to overcome these; the ways in which PBS and behaviour support plans were implemented and the impact on behaviours that challenge; the ways in which PBS principles were applied at organisational levels to help to understand and address staff stress and distress. CONCLUSIONS: Overall, the staff identified many unexpected benefits of the restrictions. The results are discussed in the context of the study limitations.