***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: Tobacco use is the single most important preventable cause of death in military personnel . The purpose of this r and omized clinical trial was to evaluate the effectiveness of two behavioral interventions when added to nicotine-replacement therapy on smoking cessation .  The sample of 512 included 52 % active duty military , 29 % family , 11 % retirees , and 8 % Department of Defense civilians . There was a main effect of compliance at the end of the program ( EOP ) ; 69 % of those who attended 75 % of the classes were abstinent from tobacco ; regression analysis found the more intensive program to be twice as effective at EOP and at 3 months , an outcome not continued at 6 months . The longer , more intensive V and erbilt University Medical Center program was significantly more effective at helping the civilian portion of the population ( 85 % versus 60 % in the American Cancer Society program ) but not the active duty participants Residential treatment for substance use disorders ( SUD ) provides opportunity for smoking intervention . A r and omized controlled trial compared : ( 1 ) motivational interviewing ( MI ) to brief advice ( BA ) , ( 2 ) in one session or with two booster sessions , for 165 alcoholics in SUD treatment . All received nicotine replacement ( NRT ) . MI and BA produced equivalent confirmed abstinence , averaging 10 % at 1 month , and 2 % at 3 , 6 and 12 months . However , patients with more drug use pretreatment ( > 22 days in 6 months ) given BA had more abstinence at 12 months ( 7 % ) than patients in MI or with less drug use ( all 0 % ) . Boosters produced 16 - 31 % fewer cigarettes per day after BA than MI . Substance use was unaffected by treatment condition or smoking cessation . Motivation to quit was higher after BA than MI . Thus , BA plus NRT may be a cost-effective way to reduce smoking for alcoholics with comorbid substance use who are not seeking smoking cessation Background There is no more effective intervention for secondary prevention of coronary heart disease than smoking cessation . Yet , evidence about the (cost-)effectiveness of smoking cessation treatment methods for cardiac in patients that also suit nursing practice is scarce . This protocol describes the design of a study on the (cost-)effectiveness of two intensive smoking cessation interventions for hospitalised cardiac patients as well as first results on the inclusion rates and the characteristics of the study population . Methods / design An experimental study design is used in eight cardiac wards of hospitals throughout the Netherl and s to assess the (cost-)effectiveness of two intensive smoking cessation counselling methods both combined with nicotine replacement therapy . R and omization is conducted at the ward level ( cross-over ) . Baseline and follow-up measurements after six and 12 months are obtained . Upon admission to the cardiac ward , nurses assess patients ’ smoking behaviour , ensure a quit advice and subsequently refer patients for either telephone counselling or face-to-face counselling . The counselling interventions have a comparable structure and content but differ in provider and delivery method , and in duration . Both counselling interventions are compared with a control group receiving no additional treatment beyond the usual care .  Between December 2009 and June 2011 , 245 cardiac patients who smoked prior to hospitalisation were included in the usual care group , 223 in the telephone counselling group and 157 in the face-to-face counselling group . Patients are predominantly male and have a mean age of 57 years . Acute coronary syndrome is the most frequently reported admission diagnosis . The ultimate goal of the study is to assess the effects of the interventions on smoking abstinence and their cost-effectiveness .  Telephone counselling is expected to be more (cost-)effective in highly motivated patients and patients with high SES , whereas face-to-face counselling is expected to be more (cost-)effective in less motivated patients and patients with low SES . Discussion This study examines two intensive smoking cessation interventions for cardiac patients using a multi-centre trial with eight cardiac wards . Although not all eligible patients could be included and the distribution of patients is skewed in the different groups , the results will be able to provide valuable insight into effects and costs of counselling interventions varying in delivery mode and intensity , also concerning subgroups . Trial registration Dutch Trial Register Subjects ( N = 139 ) were assigned to intensive behavioral or to low-contact smoking treatment and to 2-mg nicotine gum or to placebo gum in a 2 X 2 factorial design . The 2-mg gum produced higher abstinence rates than did the placebo . Subjects receiving the low-contact condition plus the 2-mg nicotine gum had excellent abstinence rates at both 26 weeks ( 56 % abstainers ) and 52 weeks ( 50 % abstainers ) . Smokers who scored at the median on a measure of physical dependence to nicotine were more likely to benefit by nicotine gum treatment than subjects who scored either higher or lower , but this relation was nonsignificant . The results of this study are compared with an earlier nonblind trial PURPOSE / OBJECTIVES To determine the predictors of participation in a smoking-cessation program among patients with head and neck cancer . DESIGN This cross-sectional study is a sub study of a larger , r and omized trial of patients with head and neck cancer that determined the predictors of smokers ' participation in a cessation intervention . SETTING Otolaryngology clinics at three Veterans Affairs medical centers ( Ann Arbor , MI , Gainesville , FL , and Dallas , TX ) , and the University of Michigan Hospital in Ann Arbor . SAMPLE 286 patients who had smoked within six months of the screening survey  were eligible for a smoking-cessation intervention . METHODS Descriptive statistics and bivariate and multivariate logistic regression were used to determine the independent predictors of smokers ' participation in an intervention study . MAIN RESEARCH VARIABLES Perceived difficulty quitting ( as a construct of self-efficacy ) , health behaviors ( i.e. , smoking and problem drinking ) , clinical characteristics ( i.e. , depression and cancer site and stage ) , and demographic variables . FINDINGS Forty-eight percent of those eligible participated . High perceived difficulty quitting was the only statistically significant predictor of participation , whereas problem drinking , lower depressive symptoms , and laryngeal cancer site approached significance . CONCLUSIONS Special outreach may be needed to reach patients with head and neck cancer who are overly confident in quitting , problem drinkers , and patients with laryngeal cancer . IMPLICATION S FOR NURSING Oncology nurses are in an opportune position to assess patients ' perceived difficulty quitting smoking and motivate them to enroll in cessation programs , ultimately improving quality of life , reducing risk of recurrence , and increasing survival for this population OBJECTIVES To investigate the effects on serum lipids , plasma fibrinogen , plasma insulin , plasma C-peptide and blood glucose , of smoking cessation after 4 months . To develop a group-based smoking intervention programme in primary health care . SETTING Twenty health centres in primary health care in southern Sweden . SUBJECTS Four hundred habitual smokers ( > 10 cigarettes per day-1 , > 10 years ) , recruited by advertisement in local papers . INTERVENTION The smokers were r and omized , after stratification for age and sex , to one intervention group ( n = 200 ) and one control group ( n = 200 ) . The intervention group was offered supportive group sessions and free nicotine supplementation ( patches , chewing gum ) . MAIN OUTCOME MEASURES All participants were investigated at the start and after 4 months ( medical history , physical examination , laboratory evaluation ) . Blood sample s were drawn for determination of glucose , insulin and C-peptide , both in the fasting state and during an oral glucose tolerance test ( OGTT ) , and for measurement of lipoproteins , fibrinogen , nicotine and cotinine . RESULTS In the intervention group 98 of the subjects ( 48 % ) had quit smoking after 4 months . They were compared with the 156 subjects in the control group ( 91 % ) who were still daily smokers during the whole period . There were no significant differences in any variable between the two ( total ) experimental groups at baseline . Plasma nicotine and cotinine decreased ( P < 0.001 ) in the intervention group following smoking cessation , and weight increased by 2.7 kg . In the intervention group HDL-cholesterol increased by 11 % ( P < 0.001 ) , whereas HbA1c increased by 2 % ( P < 0.05 ) only in the control group . No changes occurred in levels of glucose , insulin , C-peptide and fibrinogen . CONCLUSION The smoking cessation programme had a success rate of almost 50 % over 4 months . Smoking cessation was associated with a marked increase in HDL-cholesterol levels but did not affect glucose tolerance . A concomitant weight increase may have blunted any independent beneficial effect of smoking cessation on glucose metabolism Tobacco Dependence among smokers with psychiatric disorders has been under-addressed by the mental health , addictions , and tobacco control communities . This study examined depressed smokers ' readiness to quit and the applicability of the Stages of Change framework to a psychiatric sample . Currently depressed smokers ( N=322 ) were recruited from four outpatient psychiatric clinics . Participants averaged 16 cigarettes per day ( S.D.=10 ) and 24 years ( S.D.=13 ) of smoking . The majority ( 79 % ) reported intention to quit smoking with 24 % ready to take action in the next 30 days . Individuals in the preparation stage reported more prior quit attempts , a greater commitment to abstinence , increased recognition of the cons of smoking , and greater use of the processes of change . Precontemplators were least likely to identify a goal related to their smoking behavior . Depressive symptom severity and history of recurrent depressive episodes were unrelated to readiness to quit . This study is one of the first to examine the smoking behaviors of currently depressed psychiatric out patients . The level and longevity of their tobacco use underscore the need for cessation interventions . The consistency in hypothesized patterns among theoretical constructs of the Stages of Change model supports the transfer of stage-tailored interventions to this clinical population Smoking exerts detrimental effects on dental treatment and oral health . Our goal was to evaluate effectiveness in terms of the abstinence rate in  smoking-cessation intervention delivered by dental professionals . Individuals who were willing to quit smoking were r and omly assigned to either an intervention or a non-intervention group . Intensive intervention was provided , consisting of 5 counseling sessions , including an additional nicotine replacement regimen . Reported abstinence was verified by the salivary cotinine level .  Thirty-three persons in the intervention and 23 in the non-intervention group started the trial . On an intent-to-treat basis , 3- , 6- and 12-month continuous abstinence rates in the intervention group were 51.5 % , 39.4 % , and 36.4 % , respectively , while the rates in the non-intervention group were consistent at 13.0 % . Adjusted odds ratios ( 95 % confidence interval ) by logistic stepwise regression analyses were 7.1 ( 1.8 , 28.5 ) , 8.9 ( 1.7 , 47.2 ) , and 6.4 ( 1.3 , 30.7 ) , respectively .  Intensive smoking-cessation intervention in the dental setting was therefore effective INTRODUCTION Identifying successful smoking treatment interventions and methods of delivery is critical given the smoking rates among HIV-positive population s and the medical implication s of smoking in this population . This study compared the efficacy of 3 smoking cessation interventions provided in HIV clinical treatment setting s. METHODS Following a baseline assessment , 209 HIV-positive smokers were r and omly assigned to 1 of 3 conditions in a parallel group design . Treatment conditions were individual counseling plus nicotine replacement treatment ( NRT ) , a computer-based Internet smoking treatment plus NRT , and self-help plus NRT .  Smoking status was determined at follow-up assessment s completed at 12 , 24 , 36 , and 52 weeks following treatment initiation . RESULTS Cessation rates ranged from 15 % to 29 % ; however , no statistically significant differences in abstinence were found among the treatment conditions over time . Those employed , those who reported a greater desire to quit , or those with lower mood disturbance scores were more likely to achieve abstinence ( p < .01 ) . The number of cigarettes participants reported smoking in the 24hr prior to each assessment significantly declined over time ( p < .001 ) . CONCLUSIONS Although we found no differences in abstinence rates across groups , the results indicate that integration of smoking cessation interventions is feasible in HIV clinical treatment setting s , and cessation results are promising . The overall abstinence rates we report are comparable to those found in similar treatment studies across multiple population s. Further research is warranted Background Tobacco use continues to be a global public health problem . Helping patients to quit is part of the preventive role of all health professionals . There is now increasing interest in the role that the dental team can play in helping their patients to quit smoking . The aim of this study was to determine the feasibility of undertaking a r and omised controlled smoking cessation intervention , utilising dental hygienists to deliver tobacco cessation advice to a cohort of periodontal patients . Methods One hundred and eighteen patients who attended 
    Output:
    
Interventions that combine pharmacotherapy and behavioural support  increase smoking cessation success compared to a minimal intervention or usual care .
Although trials differed in the details of their population s and interventions , we did not detect any factors that modified treatment effects apart from the recruitment setting .
We did not find evidence from indirect comparisons that offering more intensive behavioural support was associated with larger treatment effects