Receiving support to quit smoking and quit attempts among smokers with and without smoking related diseases: Findings from the EUREST-PLUS ITC Europe Surveys
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The Tobacco Control Committee of the European Respiratory Society, Lausanne, Switzerland
Division of Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, The OLIN Unit, Umeå University, Umeå, Sweden
National and Kapodistrian University of Athens (UoA), Athens, Greece
Department of Primary Care and Public Health, Imperial College, London, United Kingdom
Health Sciences Research Centre (CICS-UBI), Faculty of Health Sciences, University of Beira Interior, Covilha, Portugal
Public Health Research Centre, National School of Public Health, NOVA University, Lisbon, Portugal
Department of Medical Sciences, Uppsala University, Uppsala, Sweden
Medical Clinic I, Department of Respiratory Medicine, Goethe University Hospital, Frankfurt, Germany
European Network for Smoking and Tobacco Prevention (ENSP), Brussels, Belgium
University of Crete (UoC), Heraklion, Greece
Cancer Prevention Unit and WHO Collaborating Centre for Tobacco Control, German Cancer Research Center (DKFZ), Heidelberg, Germany
Institut Català d’Oncologia and Bellvitge Biomedical Research Institute (IDIBELL), Catalonia, Spain
School of Medicine and Health Sciences, Universitat de Barcelona, Catalonia, Spain
University of Medicine and Pharmacy ‘Grigore T. Popa’ Iasi, Iasi, Romania
Aer Pur Romania, Bucharest, Romania
Smoking or Health Hungarian Foundation (SHHF), Budapest, Hungary
Health Promotion Foundation (HPF), Warsaw, Poland
Maria Skłodowska-Curie Institute-Oncology Center (MSCI), Warsaw, Poland
Department of Psychology and School of Public Health and Health Systems, University of Waterloo (UW), Waterloo, Canada
Ontario Institute for Cancer Research, Toronto, Canada
Linnea Hedman*   

Division of Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, The OLIN Unit, Umeå University, Umeå, Sweden
Publish date: 2019-03-20
Tob. Induc. Dis. 2018;16(Suppl 2):A14

*Contributed equally

**EUREST-PLUS consortium members: European Network on Smoking and Tobacco Prevention (ENSP), Belgium: Constantine I. Vardavas, Andrea Glahn, Christina N. Kyriakos, Dominick Nguyen, Katerina Nikitara, Cornel Radu-Loghin, Polina Starchenko University of Crete (UoC), Greece: Aristidis Tsatsakis, Charis Girvalaki, Chryssi Igoumenaki, Sophia Papadakis, Aikaterini Papathanasaki, Manolis Tzatzarakis, Alexander I. Vardavas Kantar Public (TNS), Belgium: Nicolas Bécuwe, Lavinia Deaconu, Sophie Goudet, Christopher Hanley, Oscar Rivière Smoking or Health Hungarian Foundation (SHHF), Hungary: Tibor Demjén, Judit Kiss, Piroska A. Kovács Catalan Institut of Oncology (ICO); Bellvitge Biomedical Research Institute (IDIBELL), Spain: Esteve Fernández, Yolanda Castellano, Marcela Fu, Sarah O. Nogueira, Olena Tigova Kings College London (KCL), United Kingdom: Ann McNeill, Katherine East, Sara C. Hitchman Cancer Prevention Unit and WHO Collaborating Centre for Tobacco Control, German Cancer Research Center (DKFZ), Germany: Ute Mons, Sarah Kahnert National and Kapodistrian University of Athens (UoA), Greece: Yannis Tountas, Panagiotis Behrakis, Filippos T. Filippidis, Christina Gratziou, Paraskevi Katsaounou, Theodosia Peleki, Ioanna Petroulia, Chara Tzavara Aer Pur Romania, Romania: Antigona C. Trofor, Marius Eremia, Lucia Lotrean, Florin Mihaltan European Respiratory Society (ERS), Switzerland; Goethe University Frankfurt, Germany: Gernot Rohde, Tamaki Asano, Claudia Cichon, Amy Far, Céline Genton, Melanie Jessner, Linnea Hedman, Christer Janson, Ann Lindberg, Beth Maguire, Sofia Ravara, Valérie Vaccaro, Brian Ward Maastricht University, the Netherlands: Marc Willemsen, Hein de Vries, Karin Hummel, Gera E. Nagelhout Health Promotion Foundation (HPF), Poland: Witold A. Zatoński, Aleksandra Herbeć, Kinga Janik-Koncewicz, Krzysztof Przewoźniak, Mateusz Zatoński University of Waterloo (UW); Ontario Institute for Cancer Research, Canada: Geoffrey T. Fong, Thomas K. Agar, Pete Driezen, Shannon Gravely, Anne C. K. Quah, Mary E. Thompson
Having a chronic disease either caused or worsened by tobacco smoking does not always translate into quitting smoking. Although smoking cessation is one of the most cost-effective medical interventions, it remains poorly implemented in healthcare settings. The aim was to examine whether smokers with chronic and respiratory diseases were more likely to receive support to quit smoking by a healthcare provider or make a quit attempt than smokers without these diseases.

This population-based study included a sample of 6011 adult smokers in six European countries. The participants were interviewed face-to-face and asked questions on sociodemographic characteristics, current diagnoses for chronic diseases, healthcare visits in the last 12 months and, if so, whether they had received any support to quit smoking. Questions on smoking behavior included nicotine dependence, motivation to quit smoking and quit attempts in the last 12 months. The results are presented as weighted percentages with 95% confidence intervals (CI) and as adjusted odds ratios with 95% CI based on logistic regression analyses.

Smokers with chronic respiratory disease, those aged 55 years and older, as well as those with one or more chronic diseases were more likely to receive smoking cessation advice from a healthcare professional. Making a quit attempt in the last year was related to younger age, high educational level, higher motivation to quit, lower nicotine dependence and having received advice to quit from a healthcare professional but not with having chronic diseases. There were significant differences between countries with smokers in Romania consistently reporting more support to quit as well as quit attempts.

Although smokers with respiratory disease did indeed receive smoking cessation support more often than smokers without disease, many smokers did not receive any advice or support to quit during a healthcare visit.

The authors declare that they have no competing interests, financial or otherwise, related to the current work. A Lindberg reports personal fees from Boehringer-Ingelheim, from AstraZeneca, from Novartis, and from Active Care, outside the submitted work. G Rohde reports personal fees from Pfizer, Boehringer Ingelheim, Solvay, GSK, Essex Pharma, MSD, Grifols, Chiesi, Vertex, Berlin Chemie, Astra-Zeneca, Bayer, Roche and Novartis for lectures including service on speakers’ bureaus outside the submitted work and/or consultancy during advisory board meetings and personal fees from GSK for travel accommodation/meeting expenses, outside the submitted work. K Przewoźniak reports grants and personal fees from Polska Liga Walki Z Rakiem (Polish League Against Cancer) outside the submitted work. CI Vardavas reports that he is the Strategic Development Editor of TID and that there are no conflicts of interest with this current work. The rest of the authors have also completed and submitted an ICMJE form for disclosure of potential conflicts of interest.
The EUREST-PLUS project has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No 681109 (CIV) and the University of Waterloo (GTF). Additional support was provided to the University of Waterloo by the Canadian Institutes of Health Research (FDN-148477). GTF was supported by a Senior Investigator Grant from the Ontario Institute for Cancer Research. Author EF is supported by the Ministry of Universities and Research, Government of Catalonia (2017SGR319). EF was supported by the Instituto de Salud Carlos III, Government of Spain (INT16/00211 and INT17/00103), co-funded by the European Regional Development Fund (FEDER).
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