ABSTRACT
OBJECTIVES: To characterize nonprescription nicotine replacement therapy (NRT) users with respect to sociodemographic characteristics, tobacco use history, and support for tobacco cessation received from health care professionals; assess the methods used for quitting (past and present) by NRT users; assess NRT users' perceptions of the need for and usefulness of pharmacist-facilitated cessation interventions; and determine the types of pharmacy-based interventions that would be most helpful before and during quit attempts. DESIGN: One-time attitudinal assessment. SETTING: Primarily Northern California. PARTICIPANTS: One hundred three individuals who had recently purchased nonprescription NRT products for use during their current or upcoming quit attempt. INTERVENTION: In-depth telephone interviews. MAIN OUTCOME MEASURE: Perceptions of pharmacy-based tobacco cessation counseling services. RESULTS: The concept of pharmacist-facilitated assistance was appealing to many NRT users. Sixty-three percent of participants believed that receiving advice or assistance from a pharmacist would either probably (46%) or definitely (17%) increase a smoker's likelihood of being able to quit. Twenty-one percent were unsure, and 16% thought pharmacist assistance would not increase the chance of success. Forty-six percent reported that they would be either very or extremely likely to meet with a pharmacist for one-on-one counseling if a nominal ($10) co-payment were required; this percentage increased to 68% if the service were provided free of charge. The preferred structure for counseling interventions varied widely among participants, suggesting that individually tailored counseling programs are necessary. CONCLUSION: A substantial proportion of nonprescription NRT users view pharmacist-assisted cessation as an appealing approach to smoking cessation.
Subject(s)
Community Pharmacy Services/organization & administration , Counseling , Health Promotion/methods , Nicotine/therapeutic use , Nonprescription Drugs/therapeutic use , Smoking Cessation/psychology , Adult , Aged , California , Community Pharmacy Services/economics , Female , Humans , Male , Middle Aged , Nicotine/administration & dosage , Nonprescription Drugs/administration & dosage , Smoking Cessation/methodsABSTRACT
This article describes the ongoing collaborative effort of six research teams to operationalize and execute an integrative approach to the study of gene x environment interactions in the development of tobacco dependence. At the core of the project is a longitudinal investigation of social and behavioral risk factors for tobacco use in individuals who were, on average, 13 years of age at intake and for whom smoking outcomes extending from early adolescence to young adulthood have been characterized previously (current average age of the cohort is 29 years). The conceptual framework for the integrative approach and the longitudinal investigation on which the study is based is presented. A description is also provided of the methods used to: (a) recruit participants and families to provide DNA samples and information on tobacco use; (b) assess participants for relevant tobacco-related phenotypes including smoking history, current use of tobacco, and nicotine metabolism; (c) assess the quality of the DNA samples collected from participants for genome-wide scanning and candidate gene analysis; (d) examine several research questions concerning the role of genetic and environmental factors in the onset and maintenance of tobacco use; and (e) ensure adherence to local and federal guidelines for ethical and legal investigations of genotypic associations with tobacco-related phenotypes in families. This investigation is unique among ongoing studies of the genetics of tobacco dependence in the extent to which equal importance has been assigned to both phenotypic and genotypic measurements.
Subject(s)
Adolescent Behavior , Family Health , Genetic Predisposition to Disease , Tobacco Use Disorder/etiology , Tobacco Use Disorder/genetics , Adolescent , Adult , DNA/analysis , Environment , Ethics, Professional , Female , Ganglionic Stimulants/metabolism , Genotype , Guidelines as Topic , Humans , Longitudinal Studies , Male , Middle Aged , Nicotine/metabolism , Patient Selection , Phenotype , Research Design , Risk FactorsABSTRACT
BACKGROUND: A comprehensive tobacco cessation training program, Rx for Change, was developed and implemented as required coursework at all California schools of pharmacy and at the University of California San Francisco Schools of Medicine and Dentistry. RESULTS: Post-training evaluations administered to pharmacy students (n = 544; 89% participation) show a positive impact of the training on students' self-reported abilities for providing tobacco cessation counseling to patients. CONCLUSION: Designed as a vehicle for nationwide dissemination of the U.S. Public Health Service Clinical Practice Guideline for Treating Tobacco Use and Dependence, Rx for Change equips students with skills to intervene with all tobacco users, including patients who are not yet considering quitting.
