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Article ; Online: The effectiveness of a telephone smoking cessation program in mental health clinic patients by level of mental well-being and functioning

Sarah Swong / Andrew Nicholson / David Smelson / Erin S. Rogers / Omar El-Shahawy / Scott E. Sherman

BMC Public Health, Vol 23, Iss 1, Pp 1-

a secondary data analysis of a randomized clinical trial

2023 Volume 8

Abstract: Abstract Background Few studies have examined the effectiveness of telephone smoking cessation interventions by severity of behavioral health symptoms. Using data from a telephone counseling study, we examined whether abstinence rates varied by level of ... ...

Abstract	Abstract Background Few studies have examined the effectiveness of telephone smoking cessation interventions by severity of behavioral health symptoms. Using data from a telephone counseling study, we examined whether abstinence rates varied by level of behavioral health symptoms. Methods The parent study recruited adults who smoke cigarettes (N = 577) referred by mental health providers at six Veterans Health Administration facilities. Participants were randomized to specialized telephone counseling (intervention) or state Quitline referral (control). Participants completed assessments at baseline and 6 months, including the BASIS-24, a self-report measure of behavioral health symptoms and functioning. We used the BASIS-24 median to dichotomize participants as having high or low scores. The primary outcome was 30-day self-reported abstinence at 6 months. We compared groups on outcomes by logistic regression and performed an interaction effect analysis between treatment assignment and groups. Results At baseline, those with high behavioral health symptoms scores reported heavier nicotine dependence and more sedative and/or antidepressant use, compared to participants with low behavioral health symptoms. At 6 months, participants with low behavioral health symptoms scores in the intervention reported higher rates of 30-day abstinence compared to those in the control arm (26% vs 13%, OR = 2.3, 95% CI = 1.8, 2.9). People with high behavioral health symptoms scores reported no difference in 30-day abstinence between the treatment assignments at 6 months (12% vs. 13%, OR = 1.1, 95% CI = 0.6, 2.0). Conclusions Only participants with low behavioral health symptoms scores reported higher abstinence rates in the intervention compared to the state Quitline. Future research can examine alternative approaches for people with worse mental well-being and functioning. Trial registration The parent study is registered at www.clinicaltrials.gov NCT00724308.
Keywords	Smoking cessation ; Telephone counseling ; Mental health ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2023-11-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Mediating Effect of E-Cigarette Harm Perception in the Relationship between E-Cigarette Advertising Exposure and E-Cigarette Use

Nan Jiang / Shu Xu / Le Li / Omar El-Shahawy / Nicholas Freudenberg / Jenni A. Shearston / Scott E. Sherman

International Journal of Environmental Research and Public Health, Vol 19, Iss 6215, p

2022 Volume 6215

Abstract: Exposure to e-cigarette advertising is associated with e-cigarette use among young people. This study examined the mediating effect of e-cigarette harm perception on the above relationship. Cross-sectional survey data were collected from 2112 college ... ...

Abstract	Exposure to e-cigarette advertising is associated with e-cigarette use among young people. This study examined the mediating effect of e-cigarette harm perception on the above relationship. Cross-sectional survey data were collected from 2112 college students in New York City in 2017–2018. The analytic sample comprised 2078 participants (58.6% females) who provided completed data. Structural equal modeling was performed to examine if e-cigarette harm perception mediated the relationship between e-cigarette advertising exposure (via TV, radio, large signs, print media, and online) and ever e-cigarette use and susceptibility to e-cigarette use. About 17.1% of participants reported ever e-cigarette use. Of never users, 17.5% were susceptible to e-cigarette use. E-cigarette advertising exposure was mainly through online sources (31.5%). Most participants (59.4%) perceived e-cigarettes as equally or more harmful than cigarettes. Advertising exposure showed different effects on e-cigarette harm perception depending on the source of the advertising exposure, but perceiving e-cigarettes as less harmful than cigarettes was consistently associated with e-cigarette use and susceptibility. Low harm perception mediated the association between advertising exposure (via online, TV, and radio) and ever e-cigarette use and between online advertising exposure and e-cigarette use susceptibility. Regulatory actions are needed to address e-cigarette marketing, particularly on the Internet.
Keywords	e-cigarette ; smoking ; advertising ; perception ; mediator ; college student ; Medicine ; R
Subject code	380
Language	English
Publishing date	2022-05-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Conservation Practices for Personal Protective Equipment

Cassandra L. Thiel / Pallavi Sreedhar / Genevieve S. Silva / Hannah C. Greene / Meenakshi Seetharaman / Meghan Durr / Timothy Roberts / Rajesh Vedanthan / Paul H. Lee / Gizely Andrade / Omar El-Shahawy / Sarah E. Hochman

International Journal of Environmental Research and Public Health, Vol 20, Iss 2575, p

A Systematic Review with Focus on Lower-Income Countries

2023 Volume 2575

Abstract: During the start of the COVID-19 pandemic, shortages of personal protective equipment (PPE) necessitated unprecedented and non-validated approaches to conserve PPE at healthcare facilities, especially in high income countries where single-use disposable ... ...

Abstract	During the start of the COVID-19 pandemic, shortages of personal protective equipment (PPE) necessitated unprecedented and non-validated approaches to conserve PPE at healthcare facilities, especially in high income countries where single-use disposable PPE was ubiquitous. Our team conducted a systematic literature review to evaluate historic approaches for conserving single-use PPE, expecting that lower-income countries or developing contexts may already be uniquely conserving PPE. However, of the 50 included studies, only 3 originated from middle-income countries and none originated from low-income countries. Data from the included studies suggest PPE remained effective with extended use and with multiple or repeated use in clinical settings, as long as donning and doffing were performed in a standard manner. Multiple decontamination techniques were effective in disinfecting single use PPE for repeated use. These findings can inform healthcare facilities and providers in establishing protocols for safe conservation of PPE supplies and updating existing protocols to improve sustainability and overall resilience. Future studies should evaluate conservation practices in low-resource settings during non-pandemic times to develop strategies for more sustainable and resilient healthcare worldwide.
Keywords	PPE ; sustainability ; waste ; resilience ; conservation ; efficiency ; Medicine ; R
Subject code	333
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Primary Care Physicians’ Beliefs and Practices Regarding E-Cigarette Use by Patients Who Smoke

Omar El-Shahawy / Richard Brown / Jennifer Elston Lafata

International Journal of Environmental Research and Public Health, Vol 13, Iss 5, p

A Qualitative Assessment

2016 Volume 445

Abstract: We explored primary care physicians’ (PCPs’) beliefs and practices about e-cigarettes. Cross-sectional, semi-structured interviews with PCPs in 2014 were conducted and audio-recorded. Participants were 15 general internal and family medicine physicians ... ...

Abstract	We explored primary care physicians’ (PCPs’) beliefs and practices about e-cigarettes. Cross-sectional, semi-structured interviews with PCPs in 2014 were conducted and audio-recorded. Participants were 15 general internal and family medicine physicians practicing in two settings in Virginia, USA. Interview recordings were transcribed, and the content analyzed using the Constant Comparative Method to identify key themes regarding PCPs’ reported current practices and beliefs. Five themes were identified: (1) existing clinic processes do not include mechanisms to screen for noncombustible tobacco products (such as e-cigarettes); (2) e-cigarette discussions are becoming commonplace with patients initiating the discussions and seeking physician guidance regarding e-cigarette use; (3) a lack of knowledge regarding the potential harms and benefits of e-cigarettes, yet a willingness to support their patients’ desire to use e-cigarettes (4) believing e-cigarettes are a safer alternative to smoking combustible tobacco products; and (5) abandoning concerns regarding the potential harms of e-cigarettes in the context of highly addicted patients and those with extensive comorbidities. Despite acknowledging limited knowledge regarding e-cigarettes, findings suggest that some PCPs are currently recommending e-cigarettes to their patients for smoking cessation and relative harm reduction, often personalizing recommendations based on the patient’s perceived addiction level and current health status. Physicians need to be informed about the evolving evidence regarding the risks and benefits of e-cigarettes.
Keywords	primary care ; decision making ; smoking cessation ; harm reduction ; e-cigarettes ; Medicine ; R
Language	English
Publishing date	2016-04-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Comprehensive review of the national surveys that assess E-cigarette use domains among youth and adults in the United States

Ellen Boakye / John Erhabor / Olufunmilayo Obisesan / Erfan Tasdighi / Mohammadhassan Mirbolouk / Ngozi Osuji / Albert D. Osei / Jieun Lee / Andrew P. DeFilippis / Andrew C. Stokes / Glenn A. Hirsch / Emelia J. Benjamin / Rose Marie Robertson / Aruni Bhatnagar / Omar El Shahawy / Michael J. Blaha

The Lancet Regional Health. Americas, Vol 23, Iss , Pp 100528- (2023)

2023

Abstract: Summary: Surveillance of e-cigarette use among different population groups is important for the timely implementation and evaluation of tobacco regulatory policies. In this review, we identified 13 nationally representative, repeatedly conducted ... ...

Abstract	Summary: Surveillance of e-cigarette use among different population groups is important for the timely implementation and evaluation of tobacco regulatory policies. In this review, we identified 13 nationally representative, repeatedly conducted epidemiologic surveys that assess e-cigarette use among U.S. youth and/or adults and have been instrumental in e-cigarette surveillance. These surveys included National Youth Tobacco Survey, Youth Risk Behavior Surveillance System, Monitoring the Future Survey, International Tobacco Control Policy Evaluation Project (ITC) Youth Tobacco and Vaping Survey, Behavioral Risk Factor Surveillance System, National Health Interview Survey, Tobacco Use Supplement of the Current Population Survey, Health Information National Trends Survey, Tobacco Products and Risk Perception Surveys, ITC Four Country Smoking and Vaping Survey, National Health and Nutrition Examination Survey, National Survey on Drug Use and Health, and Population Assessment of Tobacco and Health. These surveys vary in scope and detail, with their unique strengths and the regulatory questions that can be answered using each survey data. We also highlighted the gaps in these surveys and made recommendations for improvement.
Keywords	E-cigarette ; Surveillance ; United States ; Surveys ; Youth ; Adults ; Public aspects of medicine ; RA1-1270
Subject code	310
Language	English
Publishing date	2023-07-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Using a Syndemics Framework to Understand How Substance Use Contributes to Morbidity and Mortality among People Living with HIV in Africa

Emmanuel Peprah / Bronwyn Myers / Andre-Pascal Kengne / Nasheeta Peer / Omar El-Shahawy / Temitope Ojo / Barbara Mukasa / Oliver Ezechi / Juliet Iwelunmor / Nessa Ryan / Fatoumata Sakho / John Patena / Joyce Gyamfi

International Journal of Environmental Research and Public Health, Vol 19, Iss 1097, p

A Call to Action

2022 Volume 1097

Abstract: Substance use is increasing throughout Africa, with the prevalence of alcohol, tobacco, cannabis, and other substance use varying regionally. Concurrently, sub-Saharan Africa bears the world’s largest HIV burden, with 71% of people living with HIV (PWH) ... ...

Abstract	Substance use is increasing throughout Africa, with the prevalence of alcohol, tobacco, cannabis, and other substance use varying regionally. Concurrently, sub-Saharan Africa bears the world’s largest HIV burden, with 71% of people living with HIV (PWH) living in Africa. Problematic alcohol, tobacco, and other substance use among PWH is associated with multiple vulnerabilities comprising complex behavioral, physiological, and psychological pathways that include high-risk behaviors (e.g., sexual risk-taking), HIV disease progression, and mental health problems, all of which contribute to nonadherence to antiretroviral therapy. Physiologically, severe substance use disorders are associated with increased levels of biological markers of inflammation; these, in turn, are linked to increased mortality among PWH. The biological mechanisms that underlie the increased risk of substance use among PWH remain unclear. Moreover, the biobehavioral mechanisms by which substance use contributes to adverse health outcomes are understudied in low- and middle-income countries (LMIC). Syndemic approaches to understanding the co-occurrence of substance use and HIV have largely been limited to high-income countries. We propose a syndemic coupling conceptual model to disentangle substance use from vulnerabilities to elucidate underlying disease risk for PWH. This interventionist perspective enables assessment of biobehavioral mechanisms and identifies malleable targets of intervention.
Keywords	substance use ; people living with HIV (PWH) ; Africa ; syndemics ; Medicine ; R
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Tobacco Use and Exposure to Environmental Tobacco Smoke amongst Pregnant Women in the United Arab Emirates

Mohammed Nagdi Taha / Zaki Al-Ghumgham / Nasloon Ali / Rami H. Al-Rifai / Iffat Elbarazi / Fatima Al-Maskari / Omar El-Shahawy / Luai A. Ahmed / Tom Loney

International Journal of Environmental Research and Public Health, Vol 19, Iss 7498, p

The Mutaba’ah Study

2022 Volume 7498

Abstract: Self-reported tobacco use is high in the male adult Emirati population (males ~36% vs. females ~3%); however, there are minimal data on tobacco use or exposure to environmental tobacco smoke (ETS) during pregnancy in the United Arab Emirates (UAE). This ... ...

Abstract	Self-reported tobacco use is high in the male adult Emirati population (males ~36% vs. females ~3%); however, there are minimal data on tobacco use or exposure to environmental tobacco smoke (ETS) during pregnancy in the United Arab Emirates (UAE). This study investigated the prevalence of, and factors associated with, tobacco use and exposure to environmental tobacco smoke (ETS) amongst pregnant women in the UAE. Baseline cross-sectional data were analysed from the Mutaba’ah Study. Expectant mothers completed a self-administered questionnaire collecting sociodemographic information, maternal tobacco use, and ETS exposure during antenatal visits at three hospitals in Al Ain (UAE; May 2017–February 2021). Amongst 8586 women included in the study, self-reported tobacco use during pregnancy was low (0.7%), paternal tobacco use was high (37.9%), and a third (34.8%) of expectant mothers were exposed to ETS (28.0% at home only). Pregnant women who were employed (adjusted odds ratio (aOR): 1.35, 95% confidence interval (CI): 1.19–1.52), with childbirth anxiety (aOR 1.21, 95% CI 1.08–1.36), and with an increased number of adults living in the same household (aOR 1.02 95% CI 1.01–1.03) were independently more likely to be exposed to ETS. Pregnant women with higher education levels (aOR 0.84, 95% CI 0.75–0.94) and higher gravidity (aOR 0.95, 95% CI 0.92–0.99) were less likely to be exposed to ETS. Public health efforts targeting smoking cessation amongst husbands and promoting smoke-free homes are warranted to help reduce prenatal ETS exposure in the UAE.
Keywords	birth ; cohort ; early-life exposures ; indoor air pollution ; mother ; pregnancy ; Medicine ; R
Subject code	150
Language	English
Publishing date	2022-06-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Electronic cigarettes as a harm reduction strategy among patients with COPD

Elizabeth R. Stevens / Lei Lei / Charles M. Cleland / Mahathi Vojjala / Omar El-Shahawy / Kenneth I. Berger / Thomas R. Kirchner / Scott E. Sherman

Addiction Science & Clinical Practice, Vol 17, Iss 1, Pp 1-

protocol for an open-label two arm randomized controlled pilot trial

2022 Volume 11

Abstract: Abstract Background Smoking cessation is the most effective means of slowing the decline of lung function associated with chronic obstructive pulmonary disease (COPD). While effective smoking cessation treatments are available, they are underutilized and ...

Abstract	Abstract Background Smoking cessation is the most effective means of slowing the decline of lung function associated with chronic obstructive pulmonary disease (COPD). While effective smoking cessation treatments are available, they are underutilized and nearly half of people with COPD continue to smoke. By addressing both nicotine and behavioral dependence, electronic cigarettes (EC) could help people with COPD reduce the harm of combustible cigarettes (CC) through reductions in number of Cigarettes per Day (CPD) or quitting CC completely. The purpose of this pilot study is to identify barriers and facilitators to the use of and assess the preliminary effectiveness of EC as a harm reduction strategy among people with COPD. Methods In an open-label two-arm randomized controlled trial pilot study, 60 patients identified as smokers with a COPD diagnosis via electronic health records from a large urban health center are randomized in a 1:1 ratio to either standard care [counseling + nicotine replacement therapy (NRT)] or counseling + EC. The NRT arm will receive nicotine patches and nicotine lozenges for 12 weeks. The EC arm will receive EC for 12 weeks. Both cohorts will receive counseling from a licensed mental health counselor. Using ecological momentary assessment, participants will report their use of CC in both arms and EC use in the EC arm daily via text message. Primary outcomes will be feasibility and acceptability of intervention, and secondary outcomes will be reduction in CPD and change in COPD symptoms as measured by COPD Assessment Tool (CAT) score at 12-weeks. EC displacement of CC. To explore attitudes towards the use of EC as a harm-reduction strategy for patients with COPD, interviews will be performed with a sample of participants from both study arms. Discussion Despite decades of availability of smoking cessation medications, nearly half of people with COPD still smoke. This study aims to address the unmet need for feasible and effective strategies for reducing CC use among those with COPD, which has the potential to significantly improve the health of people with COPD who smoke. Trial Registration ClinicalTrials.gov Identifier: NCT04465318.
Keywords	Medicine (General) ; R5-920 ; Social pathology. Social and public welfare. Criminology ; HV1-9960
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Comparison of Barriers to Cessation among Arab American Smokers of Cigarettes and Waterpipe

Linda Haddad / Omar El-Shahawy / Roula Ghadban

International Journal of Environmental Research and Public Health, Vol 11, Iss 9, Pp 9522-

2014 Volume 9531

Abstract: This cross-sectional study examined the differences in barriers to cessation and reasons for quitting smoking among dual smokers of cigarettes and waterpipe tobacco, exclusive cigarette smokers and exclusive waterpipe smokers. Participants were Arab ... ...

Abstract	This cross-sectional study examined the differences in barriers to cessation and reasons for quitting smoking among dual smokers of cigarettes and waterpipe tobacco, exclusive cigarette smokers and exclusive waterpipe smokers. Participants were Arab American adults residing in Richmond, Virginia, who were recruited from Middle Eastern grocery stores, restaurants/lounges and faith and charity organizations. The study yielded several key findings: (1) Exclusive cigarette and waterpipe smokers had similar mean barriers to quitting and were more concerned about their health than dual smokers. (F(2, 150) = 5.594, p = 0.0045). This implies that barriers to smoking and health concerns could be a function of the individual who smokes rather than the modality of smoking itself. (2) Exclusive cigarette or waterpipe smokers and dual smokers may have different reasons for quitting, since they have different reasons for smoking. The proportion of smokers who endorsed smoking as a messy habit as the reason among exclusive cigarette smokers was 0.37, whereas the proportion among exclusive waterpipe smokers was 0.04 and among dual smokers 0.39. The difference in proportions is significant, χ2 (df = 2, N = 154) = 13.17, p = 0.0014. In summary, this study supports the need to further investigate dual cigarette and waterpipe smokers, as the study results indicate greater barriers to smoking cessation in this group. Recognition and understanding of these barriers among dual tobacco users would be important for any future tobacco intervention among waterpipe smokers.
Keywords	dual smokers ; waterpipe smokers ; Arab American ; barriers to cessation ; Medicine ; R
Subject code	616
Language	English
Publishing date	2014-09-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Prevalence, attitudes, behaviours and policy evaluation of midwakh smoking among young people in the United Arab Emirates

Mohammed Jawad / Mohammed Al-Houqani / Raghib Ali / Yehya El Sayed / Omar ElShahawy / Michael Weitzman / Scott E Sherman

PLoS ONE, Vol 14, Iss 4, p e

Cross-sectional analysis of the Global Youth Tobacco Survey.

2019 Volume 0215899

Abstract: Introduction Non-cigarette tobacco products are an increasing public health concern globally. Little is known about midwakh, a pipe indigenous to the United Arab Emirates (UAE). This study aimed to assess the prevalence, attitudes, behaviours and policy ... ...

Abstract	Introduction Non-cigarette tobacco products are an increasing public health concern globally. Little is known about midwakh, a pipe indigenous to the United Arab Emirates (UAE). This study aimed to assess the prevalence, attitudes, behaviours and policy evaluation of midwakh smoking among 13 to 15 year olds in the UAE. Methods We conducted secondary analyses of the 2013 UAE Global Youth Tobacco Survey. The main three outcomes were ever use, current use (past-30 days), and the number of midwakhs smoked per day. We assessed cessation, attitude, and policy measures. Regression models identified the association between each outcome measure and sex, school grade, nationality, weekly spending money, cigarette use, and parent and peer tobacco use. Results The prevalence of ever and current midwakh use were 18.5% and 9.0%, respectively. Daily midwakh users smoked a median of 8.0 per day while non-daily users smoked 3.8 per month. Higher midwakh prevalence was reported among wealthier males, older age groups, concurrent cigarette users and among participants having peers or parents who use tobacco. There was also variation by nationality. Reduced harm perception was greater among midwakh users than non-users. About 39.6% reported being declined a midwakh purchase due to age, and 35.5% reported noticing health warnings on packages. Conclusions Midwakh use is prevalent among 13 to 15 year olds in the UAE, and burden lies mainly with daily users. Further needed research should not delay implementation and evaluation of policies known to curb tobacco use among youth, including taxation, media campaigns, and provision of cessation services.
Keywords	Medicine ; R ; Science ; Q
Subject code	380
Language	English
Publishing date	2019-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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