Comprehensive Literature Review: Smoking Cessation and Public Health

This literature review synthesizes research on smoking cessation, examining various strategies, policies, and their impact on public health. The review analyzes studies conducted in England and other regions, focusing on the effectiveness of smoking cessation programs, the influence of legislative changes (such as smoke-free legislation and raising the legal age for cigarette sales), and the role of socioeconomic factors in quitting behaviors. Key findings include the positive impact of legislative interventions, the association between socioeconomic status and smoking rates, and the importance of tailored interventions to address disparities. The review also explores the effectiveness of NHS smoking cessation services, the role of electronic cigarettes, and the use of various support methods, including pharmacological aids and psychological support. Studies highlight the challenges faced by smokers, the importance of healthcare settings in promoting cessation, and the need for ongoing public health campaigns to reduce smoking prevalence. The review emphasizes the significance of comprehensive approaches that consider both individual and societal factors in promoting successful smoking cessation.

LITERATURE REVIEW
In order to evaluate and inform strategies for tobacco control, it is essential to carry out
up-to-date tracking of national patterns of smoking as well as behavior associated with its
cessation. Fidler and et.al. (2011), conducted a study on smoking and smoking cessation in
England. The authors carried out a smoking toolkit study in which monthly, cross sectional
household interviews were conducted with adults of above 16 years of age. The study was
conducted in England and recent ex-smokers were included in the research. As per the views of
authors, a number of policy changes took place in UK since 2007.
However, it was found that the number of smokers attempting to stop smoking increased
temporarily after the smoke free legislation was introduced. It can be analysed that smoking
cessation strategies significantly impacts adults if it is implied by law. Moreover, the authors also
found that with the increase in the legal age for sale of cigarettes from 16 to 18 years, the
prevalence of smoking was decreased. This suggests that smoking cessation programs, if coupled
with legislative changes, significantly impact the smoking cessation.
The study done by Reid and et.al. (2010), states that people who have lower socio-
economic status uses tobacco on higher rates and they are also less likely to quit smoking. Thus,
in this respect the study conducted shows association between socio economic status and quitting
related behaviours. In this research work, it is clearly identified that smokers with higher
education are more likely to intend to quit as early as possible. While organizing smoking
cessation programs, it is crucial to ascertain potential effects on socio economic disparities. This
is essential in adopting proper intervention for reducing smoking practices.
According to Hiscock (2010), smokers belonging to lower socio- economic groups are
less likely to be successful in quitting smoking when they come across such practices. In the
study data were collection from smoking cessation service users. The study states that more
encouragement is required to be generated so that the practices of smoking can be minimized.
Social inequalities are also observed in the same area and socio-economic groups are less likely
in the domain of quitting smoking. In the area of service delivery, there are certain causes of
inequalities that affects quitting practices.

However the study done by Bauld (2009), analyzes the effectiveness of intensive NHS
treatment for smoking cessation that helps smokers to quit the practice respectively. In the study,
systematic review was conducted which helped the researcher to find out the evidence of the
effectiveness of cessation programs. The research work made it clear that younger smokers,
females and pregnant smokers are more deprived smokers who have lower short term quit rates
as compared to other age groups. On the contrary, the study does not produce specific analysis of
the results.
On the contrary to this, study done by Strecher (2006), was conducted the aim to examine
moderate and mediating factors that helps in developing smoking cessation aspects. Potential
treatment moderators were examined in the study using sub-groups of established predictors of
smoking cessation. In terms of results, the study has identified presence of tobacco illness.
Internet- based survey has been conducted after analyzing the continuous abstinence rate with 12
week follow up procedure (Strecher and et.al., 2006).
Further, study done by Peletidi and et.al. (2016), states that tobacco smokers faces
difficulties especially when they decide to discontinue smoking habits. The research work also
states that they are unable to quit smoking because of their dependency on nicotine. The study
also states that smoking cessation services are such services that encourage smokers to make use
of combination of pharmacological aids and psychological support which can help them to quit
smoking. In this respect, focus has been laid on phrenologists who are first accessible option for
adults who want to quit smoking.
As per the research done by Jones (2013), smoking is a risk factor that causes cancer in
many smokers and even after that they are not motivated to quit smoking. The study states that
the provision of smoking cessation services in health care entities is more helpful for such
patients. Thus, in this context the study explored the user experience of one such service in UK
hospital (Jones and Hamilton, 2013). In the research work, a qualitative approach is being used
wherein face to face structured interview is being conducted with 44 patients across 4 clinical
specialties in an acute hospital of UK. The study found out that participants supported the
conception that hospitals provide a suitable environment to promote stop smoking initiatives.
However, at the same time, participants were also at risk of resuming smoking once they were

discharged from hospital back to their previous environment. Hence, the results were
contradicted to a few extent.
In addition to this, study done by Denman (2015), reflects that smoking increases the
changes of lung cancer; hence in this respect health care entities in UK have been emphasizing
on public health campaigns so that people can continue to reduce smoking prevalence. The
methodology used in the study seems to be significant because that aids in evaluating localized
public health campaigns which aims to reduce smoking due to its impact on different parts of the
body. In the subsequent research work, smoking prevalence and radon levels prevailing in UK
have been mapped out at Primary Care Trust level. In addition to this, the study also extends the
research work through using commercial socio- demographic database for the purpose of
estimating smoking prevalence in every postcode sector level.
The study done by Mardle and et.al., (2012), contends that NHS stop smoking services
provide different options for support and counselling to all those who wish to quit smoking
practices. In the study, standardized interview with key personnel has been conducted with 400
clients who have access to such service. In the research work, three local service evaluations
were carried out to describe the outcomes associated with different services. Hence, the research
highlights different service structure, method of support and health care professional (who are
involved in pharmacotherapy) and their role in successful quit. Thus, in the research work
service provision for smoking have been stated.
On the other hand, Beard and et.al. (2016), states that changes have been prevailing in
smoking activities due to use of electronic cigarette. Hence, in England smoking related issues
have been minimized. Time series analysis of population trends have been conducted in the
research work. Survey is being carried out from participants who came from Smoking Toolkit
Study which involves repeated and cross sectional households of individuals aged 16 years and
above in England. In terms of results, it has been identified that success rates of smoking quitting
attempts is increasing. However, no clear association has been found out between e- cigarettes
and the rate of quit attempts.
Supporting the content, study done by Matcham (2014) is also considered in the research
work which states that NHS Stop Smoking Service is a cost effective method that enhances the
probabilities of smoking cessation. The study has been conducted with the help of underpinning

the link between motivation and attendance through forming an implementation intention. In the
current research work, a total of 160 newly enrolled smokers were recruited on the basis of
random sampling. Afterwards, conducting the study it is concluded that present research work
presents information about the effectiveness of the service improved attendance which is useful
in showing in effectiveness of the intervention.

REFERENCES
Fidler, A. J. and et.al., 2011. The smoking toolkit study': a national study of smoking and
smoking cessation in England. BioMed.
Reid, L. J. and et.al., 2010. Socioeconomic disparities in quit intentions, quit attempts, and
smoking abstinence among smokers in four western countries: Findings from the
International Tobacco Control Four Country Survey. Nicotine Tob Res. 12(1). pp. 20-33.
Hiscock, R. and et.al., 2010. Social inequalities in quitting smoking: what factors mediate the
relationship between socioeconomic position and smoking cessation?. J Public Health.
33(1). pp.39-47.
Bauld, L. and et.al., 2009. The effectiveness of NHS smoking cessation services: a systematic
review. J Public Health. 32(1). pp. 71-82.
Strecher, J. V. and et.al., 2006. Moderators and Mediators of a Web-Based Computer-Tailored
Smoking Cessation Program Among Nicotine Patch Users. Nicotine Tob Res. 8(1). pp.
95-101.
Peletidi, A. and et.al., 2016. Smoking Cessation Support Services at Community Pharmacies in
the UK: A Systematic Review. Hellenic Journal of Cardiology. 57(1). pp.7–15.
Jones, E. S. and Hamilton, S., 2013. Introducing a new stop smoking service in an acute UK
hospital: A qualitative study to evaluate service user experience. European Journal of
Oncology Nursing. 17(5). pp.563–569.
Denman, R, A. and et.al., 2015. Small area mapping of domestic radon, smoking prevalence and
lung cancer incidence – A case study in Northamptonshire, UK. Journal of
Environmental Radioactivity. 150. pp.159–169.
Mardle, T. and et.al., 2012. Real world evaluation of three models of NHS smoking cessation
service in England. BMC. 5(9).
Beard, E. and et.al., 2016. Association between electronic cigarette use and changes in quit
attempts, success of quit attempts, use of smoking cessation pharmacotherapy, and use of

stop smoking services in England: time series analysis of population trends. BMJ.
354(4645).
Matcham, F. and et.al., 2014. A pilot randomized controlled trial to increase smoking cessation
by maintaining National Health Service Stop Smoking Service attendance. British
Journal of Health Psychology. 19. pp.795–809.