***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background There is limited evidence regarding the best approaches to helping Indigenous Australians to stop smoking . The composite analysis of the only two smoking cessation r and omised controlled trials ( RCTs ) investigating this suggests that one-on-one extra support delivered by and provided to Indigenous Australians in a primary health care setting appears to be more effective than usual care in encouraging smoking cessation . This paper describes the lessons learnt from one of these studies , the Be Our Ally Beat Smoking ( BOABS ) Study , and how to develop and implement an integrated smoking cessation program . Methods Qualitative study using data collected from multiple documentary sources related to the BOABS Study . As the project neared completion the research team participated in four workshops to review and conduct thematic analyses of these documents . Results Challenges we encountered during the relatively complex BOABS Study included recruiting sufficient number of participants ; managing the project in two distant locations and ensuring high quality work across both sites ; providing appropriate training and support to Aboriginal research ers ; significant staff absences , staff shortages and high workforce turnover ; determining where and how the project fitted in the clinics and consequent siloing of the Aboriginal research ers relating to the requirements of RCTs ; resistance to change , and maintaining organisational commitment and priority for the project . The results of this study also demonstrated the importance of local Aboriginal ownership , commitment , participation and control . This included knowledge of local communities , the flexibility to adapt interventions to local setting s and circumstances , and taking sufficient time to allow this to occur . Conclusions The keys to the success of the BOABS Study were local development , ownership and participation , worker professional development and support , and operating within a framework of cultural safety . There were difficulties associated with the BOABS Study being an RCT , and many of these are shared with st and -alone programs . Interventions targeted at particular health problems are best integrated with usual primary health care . Research to investigate complex interventions in Indigenous health should not be limited to r and omised clinical trials and funding needs to reflect the additional , but necessary , cost of providing for local control of planning and implementation Background Disadvantaged groups are an important target for smoking cessation intervention . Smoking rates are markedly higher among severely socially disadvantaged groups such as indigenous people , the homeless , people with a mental illness or drug and alcohol addiction , and the unemployed than in the general population . This proposal aims to evaluate the efficacy of a client-centred , caseworker delivered cessation support intervention at increasing vali date d self reported smoking cessation rates in a socially disadvantaged population . Methods / Design A block r and omised controlled trial will be conducted . The setting will be a non-government organisation , Community Care Centre located in New South Wales , Australia which provides emergency relief and counselling services to predominantly government income assistance recipients . Eligible clients identified as smokers during a baseline touch screen computer survey will be recruited and r and omised by a trained research assistant located in the waiting area . Allocation to intervention or control groups will be determined by time periods with clients r and omised in one-week blocks . Intervention group clients will receive an intensive client-centred smoking cessation intervention offered by the caseworker over two face-to-face and two telephone contacts . There will be two primary outcome measures obtained at one , six , and 12 month follow-up : 1 ) 24-hour expired air CO vali date d self-reported smoking cessation and 2 ) 7-day self-reported smoking cessation . Continuous abstinence will also be measured at six and 12 months follow up . Discussion This study will generate new knowledge in an area where the current information regarding the most effective smoking cessation approaches with disadvantaged groups is limited . Trial registration numberIS RCT N : IS RCT Background Regular exercise has been proposed as a potential smoking cessation aid . Purpose This study aim ed to determine the effects of an exercise counseling program on cigarette smoking abstinence at 24 weeks . Methods A parallel , two-arm , r and omized controlled trial was conducted . Adult cigarette smokers ( n = 906 ) who were insufficiently active and interested in quitting were r and omized to receive the Fit2Quit intervention ( 10 exercise telephone counseling sessions over 6 months ) plus usual care ( behavioral counseling and nicotine replacement therapy ) or usual care alone . Results There were no significant group differences in 7-day point-prevalence and continuous abstinence at 6 months . The more intervention calls successfully delivered , the lower the probability of smoking ( OR , 0.88 ; 95 % CI 0.81–0.97 , p = 0.01 ) in the intervention group . A significant difference was observed for leisure time physical activity ( difference = 219.11 MET-minutes/week ; 95 % CI 52.65–385.58 ; p = 0.01 ) . Conclusions Telephone-delivered exercise counseling may not be sufficient to improve smoking abstinence rates over and above existing smoking cessation services . ( Australasian Clinical Trials Registry Number : ACTRN12609000637246 . OBJECTIVE To determine the effectiveness of an intensive quit-smoking intervention on smoking rates at 36 weeks ' gestation among pregnant Aboriginal and Torres Strait Isl and er women . DESIGN R and omised controlled trial . SETTING AND PARTICIPANTS Pregnant Aboriginal and Torres Strait Isl and er women ( n = 263 ) attending their first antenatal visit at one of three Aboriginal community-controlled health services between June 2005 and December 2009 . INTERVENTION A general practitioner and other health care workers delivered tailored advice and support to quit smoking to women at their first antenatal visit , using evidence -based communication skills and engaging the woman 's partner and other adults in supporting the quit attempts . Nicotine replacement therapy was offered after two failed attempts to quit . The control ( " usual care " ) group received advice to quit smoking and further support and advice by the GP at scheduled antenatal visits . MAIN OUTCOME MEASURE Self-reported smoking status ( vali date d with a urine cotinine measurement ) between 36 weeks ' gestation and delivery . RESULTS Participants in the  intervention group ( n = 148 ) and usual care group ( n = 115 ) were similar in baseline characteristics , except that there were more women who had recently quit smoking in the intervention group than the control group . At 36 weeks , there was no significant difference between smoking rates in the intervention group ( 89 % ) and the usual care group ( 95 % ) ( risk ratio for smoking in the intervention group relative to usual care group , 0.93 [ 95 % CI , 0.86 - 1.08 ] ; P = 0.212 ) . Smoking rates in the two groups remained similar when baseline recent quitters were excluded from the analysis . CONCLUSION An intensive quit-smoking intervention was no more effective than usual care in assisting pregnant Aboriginal and Torres Strait Isl and er women to quit smoking during pregnancy . Contamination of the intervention across groups , or the nature of the intervention itself , may have contributed to this result . TRIAL REGISTRATION Australian New Zeal and Clinical Trials Registry ACTRN12609000929202 Background : Smoking rates are high in indigenous population s and contribute to their poor health . In New Zeal and the indigenous Maori population has a high rate of smoking , with around 50 % of adults being smokers compared with 20 % of the adult European population . A study was undertaken to determine whether bupropion is effective in the treatment of smoking cessation in the indigenous Maori population in New Zeal and . Methods : A r and omised , placebo controlled , double blind , parallel group study was performed in 134 Maori smokers aged 16–70 years who smoked more than 10 cigarettes per day . The main outcome measures were continued abstinence from smoking at 3 and 12 months . Results : At each time point continued abstinence was better for the subjects allocated to bupropion , with a risk ratio for abstinence over all time points of 2.44 ( 95 % CI 1.22 to 4.88 ) . The rates of continued abstinence in the bupropion and placebo groups at 3 months were 44.3 % and 17.4 % , respectively , with a risk ratio of 2.54 ( 95 % CI 1.30 to 5.00 ) . The corresponding figures at 12 months were 21.6 % and 10.9 % , respectively , with a risk ratio of 1.99 ( 95 % CI 0.79 to 5.00 ) . Conclusion : Bupropion is an effective treatment for smoking cessation in the indigenous Maori population in New Zeal and ISSUE ADDRESSED This paper reports on the evaluation of a culturally specific smoking cessation training program ( SmokeCheck ) for health professionals working in Aboriginal health in NSW . Training aim ed to increase professionals ' knowledge , skills and confidence to offer an evidence -based quit smoking brief intervention to Aboriginal clients . METHODS Using a quasi-experimental pre-post with 165 matched intervention participants , surveys were completed immediately before ( baseline ) and 6-months post training . The control group were on a waiting list for 6 months before receiving the intervention , and completed surveys at baseline , immediately before training and 3 - 6 months following training . Surveys assessed knowledge , skills and confidence to deliver the intervention , availability of re sources , and smoke-free status of homes . RESULTS Post training , a higher proportion of intervention group participants were more confident talking about health effects ( 22 % , p=0.001 ) , offering quit advice ( 27 % , p=0.001 ) , assessing readiness to quit ( 31 % , p=0.001 ) and initiating a conversation about smoking ( 24 % , p=0.001 ) . After training , more participants reported providing advice about NRT ( 15 % , p=0.001 ) , ETS ( 12 % , p=0.006 ) , and reducing tobacco use ( 10 % , p=0.034 ) , but no changes were reported in smoking or intention to quit . Conversely , the control group showed no significant changes . CONCLUSIONS SmokeCheck training strengthened participants ' knowledge , skills and confidence to deliver a smoking cessation intervention to Aboriginal clients . AIM To determine the combined effect of very low nicotine content ( VLNC ) cigarettes and usual Quitline care [ nicotine replacement therapy ( NRT ) and behavioural support ] on smoking abstinence , in smokers motivated to quit . DESIGN Single-blind , parallel r and omized trial . SETTING New Zeal and . PARTICIPANTS Smokers who called the Quitline for quitting support were r and omized to either VLNC cigarettes to use whenever they had an urge to smoke for up to 6 weeks after their quit date , in combination with usual Quitline care ( 8 weeks of NRT patches and /or gum or lozenges , plus behavioural support ) or to usual Quitline care alone . MEASUREMENTS The primary outcome was 7-day point-prevalence smoking abstinence 6 months after quit day . Secondary outcomes included continuous abstinence , cigarette consumption , withdrawal , self-efficacy , alcohol use , serious adverse events and views on the use of the VLNC cigarettes at 3 and 6 weeks and 3 and 6 months . FINDINGS A total of 1410 participants were r and omized ( 705 in each arm ) , with a 24 % loss to follow-up at 6 months . Participants in the intervention group were more likely to have quit smoking at 6 months compared to the usual care group [ 7-day point-prevalence abstinence 33 versus 28 % , relative risk ( RR ) = 1.18 , 95 % confidence interval ( CI ) : 1.01 , 1.39 , P = 0.037 ; continuous abstinence 23 versus 15 % , RR = 1.50 , 95 % CI : 1.20 , 1.87 , P = 0.0003 ] . The median time to relapse in the intervention group was 2 months compared to 2 weeks in the usual care group ( P < 0.0001 ) . CONCLUSIONS Addition of very low nicotine content cigarettes to st and ard Quitline smoking cessation support may help some smokers to become abstinent Objectives : To determine the effectiveness of a mobile phone text messaging smoking cessation programme . Design : R and omised controlled trial Setting : New Zeal and Participants : 1705 smokers from throughout New Zeal and who wanted to quit , were aged over 15 years , and owned a mobile phone were r and omised to an intervention group that received regular , personalised text messages providing smoking cessation advice , support , and distraction , or to a control group . All participants received a free month of text messaging ; starting for the intervention group on their quit day to assist with quitting , and starting for the control group at six months to encourage follow up . Follow up data were available for 1624 ( 95 % ) at six weeks and 1265 ( 74 % ) at six months . Main outcome measures : The main trial outcome was current non-smoking ( that is , not smoking in the past week ) six weeks after r and omisation . Secondary outcomes included current non-smoking at 12 and 26 weeks . Results : More participants had quit at six weeks in the intervention compared to the control group : 239 ( 28 % ) v 109 ( 13 % ) , relative risk 2.20 ( 95 % confidence interval 1.79 to 2.70 ) , p < 0.0001 . This treatment effect was consistent across subgroups defined by age , sex , income level , or geographic location ( p homogeneity > 0.2 ) . The relative risk estimates were 
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Aspects of intervention implementation related to the NATSIHP domains were less well described and evidence was limited ; however , review ers suggested that cultural tailoring , holistic approaches and building workforce capacity were important strategies to address barriers .
There was limited evidence regarding social media and mobile applications , for Indigenous youth , pregnant women and prisoners , and no evidence regarding interventions to protect communities from industry interference , the use of electronic cigarettes , interventions for people experiencing mental illness , juvenile justice , linguistic diversity or ‘ pubs , clubs and restaurants ’ .
Conclusions There is limited Indigenous-specific evidence for most tobacco interventions .
A ‘ comprehensive approach ’ incorporating NTS and NATSIHP Principles and Priorities of partnership and engagement , evidence from other setting s , programme logic and responsive evaluation plans may improve intervention acceptability , effectiveness and implementation and mitigate risks of adapting tobacco evidence for Indigenous Australians