Research Papers

Tzelepis F, Paul C, Walsh RA, Wiggers J, Knight J, Lecathelinais C, Daly J, Neil A Telephone Recruitment into a Randomized Controlled Trial of Quitline Support American Journal of Preventive Medicine 2009; 37(4): 324-329.

Background: Given many smokers want to quit but few actually seek help pro active telephone contact offering support to quit may be useful in helping smokers to get help to quit. Aims: This study aimed to (1) determine the proportion of adult daily smokers who agree to quitline support when pro actively contacted by phone; (2) calculate the cost per smoker recruited. Methods: Over an 8 month period 1562 adult daily smokers randomly selected from the electronic NSW telephone directory agreed to be in a study where they would receive some form of support to quit smoking. The proportion of smokers and the cost per smoker recruited were examined. Results: More than half (52%) of eligible smokers contacted by telephone were recruited into cessation support. The cost per smoker recruited was AU$71 (US$59). So what: These results suggest that proactively phoning smokers and offering them support to quit is acceptable. Even if small quit rates result such a strategy has the potential to be widely applied and any could have a population effect on smoking prevalence. The smokers contacted in this study will receive either telephone support or self help materials. Follow up contact at 4,7 and 13 months will be used to assessed the effectiveness of these interventions among the smokers

http://linkinghub.elsevier.com/retrieve/pii/S0749379709004206

Tzelepis F, Paul CL, Walsh RA, Wiggers J, Duncan SL, Knight J Active telephone recruitment to quitline services: Are nonvolunteer smokers receptive to cessation support? Nicotine & Tobacco Research Advance Access 2009; 1-11.

Passive recruitment strategies relying on smoker initiated contact probably contribute to particular groups of smokers using quitlines. Compared with the smoking population, smokers who call quitlines are more likely to be female, younger, higher educated, more addicted, quit previously, and motivated to quit. Quitlines could adopt new recruitment approaches such as active telephone recruitment involving recruiter-initiated contact, since this may enroll a broader representation of smokers. This study explored acceptability of active telephone recruitment to quitline support, smokers ’ use, and acceptability of assistance and predictors of acceptability. Smokers ( N = 1,562) randomly selected from the New South Wales telephone directory were actively recruited by telephone into a randomized controlled trial that offered proactive telephone counseling ( n = 769) or self-help materials (control: n = 793). Overall, 1,369 completed the 4-month postrecruitment interview, which examined acceptability.

http://ntr.oxfordjournals.org/cgi/content/abstract/ntp125

Wolfenden L, Wiggers J, Campbell E, Knight J, Kerridge K, Spigelman A Providing comprehensive smoking cessation care to surgical patients: The case for computers. Drug and Alcohol Review 2009; 28(1): 60-65.

Introduction and Aims. Providing smoking cessation care to surgical patients before admission can reduce operative risk and promote long-term smoking cessation. Our aim was to show how a comprehensive computer-based smoking cessation intervention addresses barriers to care provision by preoperative clinic staff. Design and Methods. Consultations with staff and reviews of the literature identified a number of barriers to the provision of effective smoking cessation care. Based on these findings and a small pilot trial, a comprehensive computer-based smoking cessation intervention was developed and implemented in a preoperative clinic. Data from previous evaluations of the intervention were used to assess the extent to which the intervention addressed clinician barriers to care. Results. The computer-based intervention was found to accurately identify smokers, require little clinical staff time, was considered an acceptable form of care by staff and patients, was effective in encouraging patient cessation and inexpensive to deliver relative to other surgical costs. Discussion and Conclusions.The implementation of such a model of care should be considered by clinical services interested in reducing the smoking related morbidity and mortality of patients.

http://0-www3.interscience.wiley.com.library.newcastle.edu.au/cgi-bin/fulltext/121640588/PDFSTART

Freund M, Campbell E, Paul C, Sakrouge R, McElduff P, Walsh RA, Wiggers J, Knight J, Girgis A Increasing smoking cessation care provision in hospitals: A meta-analysis of intervention effect Nicotine & Tobacco Research 2009; 11(6): 650-662

Levels of hospital smoking cessation care are less than optimal. This study aimed to examined the evidence regarding the effectiveness of interventions in increasing smoking cessation care provision in hospitals. A review identified studies published in 1994-2006. Intervention effectiveness in increasing smoking cessation care practices was examined for controlled studies using meta-analysis. The methodological qulaity of the identified studies was also examined. Of the 25 identifi ed studies, 18 were U.S. based and in inpatient settings. Of the 10 controlled trials, 4 addressed car-diac patients, 5 measured one smoking cessation care practice, and 9 implemented multistrategic interventions. The methodology described in these studies was generally of poor quality. Meta-analysis of controlled trials demonstrated a signifi cant intervention effect for provision of assistance and counseling to quit (pooled risk difference = 16.6, CI = 4.9 – 28.3) but not for assessment of smoking status, advice to quit, or the provision or discussion of NRT. Statistical heterogeneity was indicated for all smoking cessation care practices. An insufficient number of studies precluded examination of follow-up or referral for further assistance. The study concluded that interventions can be effective in increasing the routine provision of hospital smoking cessation care. Future research should use more rigorous study design, examine a broader range of smoking cessation care practices, and focus on hospital-wide intervention implementation.

http://ntr.oxfordjournals.org/cgi/reprint/11/6/650

Freund M, Campbell E, Paul C, Sakrouge R, Lecathelinais, Knight J, Wiggers J, Walsh RA, Jones T, Girgis A, Nagle A. Increasing hospital-wide delivery of smoking cessation care for nicotine-dependent in-patients: a multi-strategic intervention trial Addiction 2009; 104(5): 839-849

Smoking care provision to in-patients is important in assisting smoking cessation and for management of nicotine withdrawal. A controlled trial, involving two intervention and two control hospitals in NSW, Australia, investigated whether a multi-strategic intervention increased hospital-wide smoking care provision. Patient surveys , medical notes audits and health professional surveys used to collect outcome data. Greater increases in intervention hospitals compared to control hospitals were found for patient-reported offer of nicotine replacement therapy (NRT) (intervention 34% versus control 12%), provision of NRT (16% versus 4%) and provision of written resources (11% versus 2%), and for the recording in medical notes of smoking management discussion (13% versus 3%), offer of NRT (24% versus 3%) and provision of NRT (21% versus 5%). Intervention group clinicians reported greater increases in the mean estimate of patients who: had their smoking management discussed (30% versus 17%); were offered or provided with NRT (30% versus 18%); were asked their intention to smoke post-discharge (22% versus 10%); and were provided with discharge NRT (21% versus 4%). The outcomes of this research suggest implementation of a multi-strategic intervention is effective in increasing hospital smoking care delivery, particularly the provision of NRT. Further research is required to identify methods to enhance the delivery of this and other forms of smoking care.

http://www3.interscience.wiley.com/journal/122309351/issue

Wolfenden L, Wiggers J, Campbell L, Knight J, Kerridge R, Moore K, Spigelman A, Harrison M. Feasibility, acceptability, and cost of referring surgical patients for postdischarge cessation support from a quitline Nicotine and Tobacco Research 2008; 10(6): 1105-1108.

The aim of the study was to assess the feasibility, acceptability, and cost of referral of smoking patients to a proactive quitline service for cessation support following discharge. Participants were recruited from the preoperative clinic. The study found that 64% of participants accepted an offer of referral to the quitline by preoperative clinic staff, 74% of which were contacted by the quitline after discharge. Smokers and preoperative clinic staff reported that the Quitline service and the referral process was appropriate and acceptable. Referral to the quitline service cost less than US$2 per patient. Referral of patients to a quitline represents a feasible means of ensuring surgical patients are provided with smoking cessation care following hospital discharge.

Knight J, Slatter C, Green S, Porter A, Valentine M, Wolfenden L. Smoke-free hospitals: an opportunity for public health Journal of Public Health 30(4): 516

Although reported levels of enforcement activity were low and compliance with the policy less than perfect, it seems that these levels were adequate to motivate and sustain increases in withdrawal management and smoking cessation care. However, the challenge remains to achieve and maintain visible reductions in tobacco use on health service grounds and across all sites to prompt the continued provision of withdrawal management and smoking cessation care to help manage the imposed period of abstinence.

http://jpubhealth.oxfordjournals.org/cgi/content/citation/30/4/516

Wolfenden L, Wiggers J, Campbell E, Knight J Pilot of a preoperative smoking cessation intervention incorporating post-discharge support from a Quitline Health Promotion Journal of Australia 19(2): 78-80

The preoperative period has been identified as an opportune time to provide smoking cessation care to patients. Surgical patients are highly motivated to quit and are also receptive to smoking cessation intervention. However, evidence of effective intervention strategies to capatalise on this opportunity and encourage permanent smoking cessation is limited. A recent review of the past 20 years of all English language publications identified just one randomised controlled trial examining the efficacy of the intervention on long-term cessation (6-12 months post-discharge). The multi-component intervention significantly increased cessation at the six, but not the 12- month follow-up. Given the limited available evidence, the aim of this pilot study was to assess the potential efficacy of an intensive, multi-component, smoking cessation intervention.

http://www.healthpromotion.org.au/journal/August_articles/article13.php

Freund M, Campbell E, Paul C, McElduff P, Walsh RA, Sakrouge R, Wiggers J, Knight J Smoking care provision in hospitals: A review of prevalence Nicotine and Tobacco Research Journal 2008; 10(5): 757-774

Despite hospitals being an important settings for the provision of smoking, limited evidence has described the prevalence such care delivered routinely in hospitals. We reviewed studies conducted in hospitals that were published between 1994 and 2005 and reported levels of smoking care delivery. This review describes the proportion of patients receiving, and the proportion of clinical staff providing, various smoking cessation care practices. Both descriptive and meta-analytic approaches were used. Meta-analytic outcomes demonstrated smoking status was assessed in 60% of patients, 42% were advised or counseled to quit, 14% were provided with or advised to use nicotine replacement therapy (NRT), and 12% received referrals or follow-up. Approximately 81% of clinical staff reported they assessed smoking status, 70% advised or counseled patients to quit, 13% provided NRT or advised its use, and 39% provided referrals or follow-up. Statistical heterogeneity was indicated for all smoking care practices. It was concluded the level of smoking cessation care currently provided in hospitals is less than optimal. Research should endeavour to identify effective methods for increasing smoking care provision in hospitals. Hospitals should enhance and continue to monitor their delivery of smoking care.

http://www.informaworld.com/smpp/content~content=a793512112~db=all~jumptype=rss

Freund M, Campbell E, Paul C, Wiggers J, Knight J, Mitchell E Provision of smoking care in NSW hospitals: opportunities for further enhancement NSW Public Health Bulletin 2008; 19(3-4): 50-55

The provision of smoking care is an important part of overall care for hospitalised patients, however, levels of smoking care delivery in hospitals are reported to be inadequate. Increasing smoking care across multiple units and hospitals within NSW Health will be challenging. This paper examines smoking care delivery levels in NSW hospitals, and potential strategies to increase such care. It also reviews NSW Health initiatives designed to enhance the delivery of smoking care and suggests further strategies that may facilitate this.

http://www.publish.csiro.au/?act=view_file&file_id=NB07102.pdf

WolfendenL. Smoke-free licensed premises: what will be the broader public health benefits? Australian and New Zealand Journal of Public Health 2008; 32(1): 88.

While supporting the pre-legislation assertions of the industry, the findings may be indicative of broader social and public health benefits of the ban. A rigorous evaluation of the effect of the legislation on other social and health-related behaviours may also strengthen the case for other governements to adopt such a strong public policy.

http://www.blackwell-synergy.com/toc/azph/32/1

Wolfenden L, Dalton A, Bowman J, Knight J, Burrows S, Wiggers J Computerized assessment of surgical patients for tobacco use: accuracy and acceptability Journal of Public Health 2007; 29(2): 183-185.

Despite increased risks of postoperative complications among patients who use tobacco, a number of barriers hinder the systematic identification of the surgical patients who smoke. The study investigated the accuracy and the acceptability of a patient-co

http://jpubhealth.oxfordjournals.org/cgi/reprint/fdm015v1.pdf

Johnstone E, Knight J, Gillham K, Campbell E, Nicholas C, Wiggers J System-wide adoption of health promotion practices by schools: evaluation of a telephone and mail-based dissemination strategy in Australia Health promotion International Oxford Journals 2006; 21(3).

Schools can potentially benefit from system-wide approaches to the dissemination of health promotion practices. This intervention study undertaken in the Hunter Region of NSW, Australia used a pre-post design to assess whether the phone and mail interven

http://heapro.oxfordjournals.org/cgi/reprint/dal020v1

Campbell E, Walsh RA, Sanson-Fisher R, Burrows S, Stojanovski E A group randomised trial of two methods for disseminating a smoking cessation programme to public antenatal clinics: Effects on patient outcomes Tobacco Control 2006; 15(2): 97-102.

The intervention was directed at the clinic with the intention of changing patient outcomes. Public antenatal clinics were allocated at random to either the SD or ID condition. Outcome data was collected using two independent cross sectional surveys of wo

http://tc.bmjjournals.com/cgi/reprint/15/2/97

Baratiny G, Campbell E, Sanson-Fisher R, Cockburn J. Hospital patients receptive to quit smoking advice Health Promotion Journal of Australia 2003; 14(1): 69-69.

Public hospitals are well positioned to play an active role in encouraging patients to quit smoking. Bans on smoking in hospital precincts make attending a public hospital an opportune trigger to motivate smokers to quit. As smokers are not allowed to smo

www.healthpromotion.org.au/journal

Freund M, Campbell E, Paul C, Sakrouge R, Wiggers J. Smoking care provision in smoke-free hospitals in Australia. Preventive Medicine 2005; 41(1): 151-158.

Background: The study aimed to (1) measure the current routine smoking care that public hospitals in New South Wales (NSW), Australia, provide to inpatient smokers; (2) determine current strategies supporting such care; and (3) examine the association be

http://www.sciencedirect.com/science?_ob=JournalURL&_cdi=6990&_auth=y&_acct=C000047922&_version=1&_urlVersion=0&_userid=915767&md5=5f7c3a216070e159ec657fd0a4351b18

Wolfenden L, Wiggers J, Knight J, Campbell E, Spigelman A, Kerridge R, Moore K. Increasing smoking cessation care in a preoperative clinic: a randomized controlled trial. Preventive Medicine 2005; 41(1): 284-290.

Background: Evidence suggests that preoperative clinics fail to systematically provide smoking cessation care to patients having planned surgery. Methods: The aim of the study was to assess the efficacy, acceptability, and cost of a multifaceted inte

http://www.sciencedirect.com/science?_ob=JournalURL&_cdi=6990&_auth=y&_acct=C000047922&_version=1&_urlVersion=0&_userid=915767&md5=5f7c3a216070e159ec657fd0a4351b18

Freund M, Campbell E, Paul C, Sakrouge R, Wiggers J. Smoking care provision in smoke-free hospitals in Australia. Preventive Medicine 2005; 41(1): 151-158.

http://www.sciencedirect.com/science?_ob=JournalURL&_cdi=6990&_auth=y&_acct=C000047922&_version=1&_urlVersion=0&_userid=915767&md5=5f7c3a216070e159ec657fd0a4351b18

Daly J, Licata M, Gillham K, Wiggers J. Increasing the health promotion practices of workplaces in Australia using a proactive telephone based intervention. American Journal of Health Promotion 2005; 19(3): 163-166.

The efficacy of a proactive telephone-based intervention aimed at increasing workplace adoption of health promotion initiatives in Australia was examined. Of the 320 eligible worksites in the region, 227 (71%) provided data at baseline and again 4 years

http://www.healthpromotionjournal.com/

Wolfenden L, Wiggers J, Knight J, Campbell E, Rissel C, Kerridge R, Spigelman AD, Moore KA. A programme for reducing smoking in pre-operative surgical patients: randomised controlled trial. Anaesthesia 2005; 60(2): 172-9.

The primary aim of the study was to assess the efficacy of a comprehensive smoking cessation intervention in increasing the smoking abstinence rates of surgical patients. Two hundred and ten smoking patients attending a preoperative clinic were randomly

http://www.blackwell-synergy.com/links/doi/10.1111/j.1365-2044.2004.04070.x

Wolfenden L, Freund M, Campbell E, Wiggers J, Paul C, Mitchell E. Managing nicotine dependence in hospital patients: Meeting the ongoing challenges in NSW. NSW Public Health Bulletin 2004; 15(5-6): 98-101.

This article describes the implications of the NSW Smoke-Free Workplace Policy on hospitals and discusses the development and utility of the Guide in the context of the ongoing challenge of improving care for patients who are dependent on nicotine.

http://www.health.nsw.gov.au/public-health/phb/phb.html

Radvan D, Wiggers J, Hazell T. HEALTH C.H.I.P.s: Opportunistic community use of computerized health information programs. Health Education Research 2004; 19: 581-590.

This paper describes two studies which investigate the potential of using touchscreen computer kiosks for health education in a range of community settings.

http://her.oupjournals.org/

Paul C, Wiggers J, Daly J, Green S, Walsh R, Knight J, Girgis A. Direct telemarketing of smoking cessation interventions: Will smokers take the call? Addiction 2004; 99: 907-913.

This paper explores the views of current adult smokers regarding the acceptability, likely uptake and barriers to update of smoking cessation services offered by direct telemarketing. The data suggests there is support for this method of marketing smoki

http://www.addictionjournal.org/