human
***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: The majority of regular adult smokers begin smoking in adolescence and there is a clear need for youth-targeted smoking cessation interventions . The present r and omized , controlled trial tested the effectiveness of motivational enhancement therapy ( MET ) to reduce  smoking among 81 adjudicated adolescents . Participants received either MET or an education control .  Smoking abstinence , quantity , and frequency were assessed at 1 and 6 months post treatment . Results suggest that although between-group differences on outcome measures were not significant at follow-up , smoking behavior decreased in both groups with approximately 10 % achieving 1-month smoking abstinence at 6-month follow-up . Furthermore , participant response to MET varied by level of alcohol use and impulsivity such that participants with lower levels of alcohol use and impulsivity had significantly greater response to MET . In contrast , participants who endorsed higher rates of alcohol use and impulsivity responded better to the control than the MET condition . Results suggest that MET may be an effective intervention for some adolescent smokers but may be contraindicated for adolescents who have concomitant problems with alcohol use or impulsivity This study reports on the evaluation of the feasibility , cost , and cost-effectiveness of a proactively provided telephone-based motivational smoking cessation intervention to an underserved population of pregnant smokers who may or may not receive ongoing prenatal care . As part of the New Engl and SCRIPT r and omized clinical trial comparing the efficacy of three types of smoking cessation interventions for pregnant smokers , one-third of the women ( n = 358 ) received a motivational telephone counseling intervention ( MI ) delivered by trained counselors using a semistructured protocol . Although this population was very mobile , the MI counselors were able to reach 86 % of the women with at least one call and 46 % received all three calls . The group receiving three MI calls had a cotinine-confirmed quit rate of 23 % . Cost-effectiveness analyses for those women receiving telephone counseling supported the net benefit in favor of the three phone calls compared with the women who did not receive any telephone calls , with an effectiveness to cost ratio of 1:US dollars 84 . Our results suggest that telephone-based motivational smoking cessation counseling may be a feasible and cost-effective method for low-income pregnant smokers enrolled in prenatal care BACKGROUND A multicomponent motivational smoking cessation intervention was evaluated in 33 prenatal , family planning , and pediatric services in 12 public health clinics .  Clinic-based intervention components were implemented by clinic personnel as part of routine medical visits . METHODS The evaluation design included pre- and postintervention measurements of multiple study outcomes in a baseline ( all clinics prior to the start of the intervention ) and an experimental period ( matchedpair r and om assignment of clinics to intervention or control conditions ) . Subjects were 683 ( baseline ) and 1,064 ( experimental ) smokers with measurements of smoking outcomes at both times . Mixed-effects regressions analyzed individual outcomes clustered within clinics and services . RESULTS Control and intervention clinics had similar outcomes in the baseline period . In the experiment , outcomes improved in the intervention but not in the control clinics . Compared to controls , smokers exposed to the intervention were more likely to have quit ( 14.5 versus 7.7 % ) or take actions toward quitting and had higher mean action , stage of readiness , and motivation to quit scores . These positive effects persisted when clustering within clinics and services was controlled . CONCLUSIONS This intervention , implemented by clinic personnel as part of routine medical visits , was effective under these natural conditions across different types of clinic service OBJECTIVE Smoking is highly prevalent and refractory among people with posttraumatic stress disorder ( PTSD ) . This study aim ed to improve the rate of quitting smoking for veterans with PTSD by integrating treatment for nicotine dependence into mental health care . METHOD Smokers undergoing treatment for PTSD ( N=66 ) were r and omly assigned to 1 ) tobacco use treatment delivered by mental health providers and integrated with psychiatric care ( integrated care ) versus 2 ) cessation treatment delivered separately from PTSD care by smoking-cessation specialists ( usual st and ard of care ) . Seven-day point prevalence abstinence was the primary outcome , measured at 2 , 4 , 6 , and 9 months after r and om assignment . Data were analyzed by using a generalized estimating equations approach following the intent-to-treat principle . RESULTS Subjects assigned to integrated care were five times more likely than subjects undergoing the usual st and ard of care to abstain from smoking across follow-up assessment intervals ( odds ratio=5.23 ) . Subjects in the integrated care condition were significantly more likely than subjects in usual st and ard of care to receive transdermal nicotine and nicotine gum . They also received a greater number of smoking-cessation counseling sessions . Stopping smoking was not associated with worsening symptoms of PTSD or depression . CONCLUSIONS Smoking-cessation interventions can be safely incorporated into routine mental health care for PTSD and are more effective than treatment delivered separately by a specialized smoking-cessation clinic . Integrating cessation treatment into psychiatric care may have the potential for improving smoking quit rates in other population s of chronically mentally ill smokers Objective : To test the hypothesis that among adolescent smokers hospitalised for psychiatric and substance use disorders , motivational interviewing ( MI ) would lead to more and longer quit attempts , reduced smoking , and more abstinence from smoking over a 12 month follow up . Design : R and omised control trial of MI versus brief advice ( BA ) for smoking cessation , with pre- and post-intervention assessment of self efficacy and intentions to change , and smoking outcome variables assessed at one , three , six , nine , and 12 month follow ups . Setting : A private , university affiliated psychiatric hospital in Providence , Rhode Isl and , USA . Patients or other participants : Consecutive sample ( n = 191 ) of 13–17 year olds , admitted for psychiatric hospitalisation , who smoked at least one cigarette per week for the past four weeks , had access to a telephone , and did not meet DSM-IV criteria for current psychotic disorder . Interventions : MI versus BA . MI consisted of two , 45 minute individual sessions , while BA consisted of 5–10 minutes of advice and information on how to quit smoking . Eligible participants in both conditions were offered an eight week regimen of transdermal nicotine patch upon hospital discharge . Main outcome measures : Point prevalence abstinence , quit attempts , changes in smoking rate and longest quit attempt . Proximal outcomes included intent to change smoking behaviour ( upon hospital discharge ) , and self efficacy for smoking cessation . Results : MI did not lead to better smoking outcomes compared to BA . MI was more effective than BA for increasing self efficacy regarding ability to quit smoking . A significant interaction of treatment with baseline intention to quit smoking was also found . MI was more effective than BA for adolescents with little or no intention to change their smoking , but was actually less effective for adolescents with pre-existing intention to cut down or quit smoking . However , the effects on these variables were relatively modest and only moderately related to outcome . Adolescents with comorbid substance use disorders smoked more during follow up while those with anxiety disorders smoked less and were more likely to be abstinent . Conclusions : The positive effect of MI on self efficacy for quitting and the increase in intention to change in those with initially low levels of intentions suggest the benefits of such an intervention . However , the effects on these variables were relatively modest and only moderately related to outcome . The lack of overall effect of MI on smoking cessation outcomes suggests the need to further enhance and intensify this type of treatment approach for adolescent smokers with psychiatric comorbidity OBJECTIVES We tested the efficacy of a combined pharmacologic and behavioral smoking cessation intervention among women in a state prison in the southern United States . METHODS The study design was a r and omized controlled trial with a 6-month waitlist control group . The intervention was a 10-week group intervention combined with nicotine replacement therapy .  Two hundred and fifty participants received the intervention , and 289 were in the control group .  Assessment s occurred at baseline ; end of treatment ; 3 , 6 , and 12 months after treatment ; and at weekly sessions for participants in the intervention group . RESULTS The intervention was efficacious compared with the waitlist control group . Point prevalence quit rates for the intervention group were 18 % at end of treatment , 17 % at 3-month follow-up , 14 % at 6-month follow-up , and 12 % at 12-month follow-up , quit rates that are consistent with outcomes from community smoking-cessation interventions . CONCLUSIONS Female prisoners are interested in smoking cessation interventions and achieved point-prevalence quit rates similar to community sample s. Augmenting tobacco control policies in prison with smoking cessation interventions has the potential to address a significant public health need This prospect i ve r and omized study examined the impact of three tailored intervention approaches to increase quitting rates among African-American smokers who were clients of a community health center that serves primarily low-income and indigent persons . Smokers were r and omized to one of three groups : ( 1 ) health care provider prompting intervention alone , ( 2 ) health care provider prompting intervention with tailored print communications , and ( 3 ) health care provider prompting intervention with tailored print communications and tailored telephone counseling . Among the 160 smokers who completed the study , 35 ( 21.8 % ) had quit smoking at follow-up . Smokers who received the provider prompting intervention with tailored print material s were more likely to report having quit than smokers who received the provider intervention alone ( 32.7 % vs. 13.2 % , p < 0.05 ) . Smokers who received all three intervention components were not more likely to report having quit at follow-up than those who only received the provider intervention ( 19.2 % vs. 13.2 % ) . Smokers who at baseline were less educated , smoked less than half a pack of cigarettes per day , had a stronger desire to quit , felt more efficacious , and had thought about quitting were more likely to report having quit at follow-up . These results provide support for continued refinement of tailored communications to aid smoking cessation among African-American smokers One of the key goals of health promotion strategies in the UK and other developed countries is to reduce the prevalence of cigarette consumption . While overall smoking rates in the UK have fallen over the last few decades , they have barely fallen for the least advantaged adults ( Department of Health , 1998a ) . There is a need for interventions that are suitable for lower socio-economic status ( SES ) smokers that have undergone rigorous evaluation . This study describes a r and omized controlled trial of cognitive behaviour therapy ( CBT ) with smokers from a deprived area of London . At 6 months follow-up , 21 ( 17.2 % ) of 122 participants receiving therapy were abstinent and 14 ( 11.5 % ) had reduced cigarette consumption by at least 25 % of pre-treatment level . Six ( 5.6 % ) of 107 participants in the control group were abstinent and none had reduced consumption . These results suggest that this self-help CBT intervention has the potential to reduce the prevalence of smoking among lower SES smokers A smoking cessation and relapse prevention intervention was tested in an urban , prenatal clinic serving predominantly low-income , African-American women . At their first prenatal visit , 391 smokers were r and omly assigned to an experimental ( E ) group to receive usual clinic information plus a prenatal and postpartum intervention or to a control ( C ) group to receive only usual clinic information . The intervention consisted of individual skills instruction and counseling by a peer health counselor on the use of a self-help cessation guide and routine clinic reinforcement . Among the E group ( n = 193 ) , 6.2 % were cotinine-confirmed quitters at third trimester and among the C group ( n = 198 ) the quit rate was 5.6 % . Quitters were light smokers at entry into prenatal care . Many had tried to quit smoking at least once prior to pregnancy BACKGROUND Continued high rates of smoking among socioeconomically disadvantaged women lead to increases in children 's health problems associated with exposure to tobacco smoke . The pediatric clinic is a " teachable setting " in which to provide advice and assistance to parents who smoke . OBJECTIVE To evaluate a smoking cessation intervention for women . DESIGN Two-arm ( usual care vs intervention ) r and omized trial . SETTING Pediatric clinics serving an ethnically diverse population of low-income families in the greater Seattle , Wash , area . INTERVENTION During the clinic visit , women received a motivational message from the child 's clinician , a guide to quitting smoking , and a 10-minute motivational interview with a nurse or study interventionist . Women received as many as 3 outreach telephone counseling calls from the clinic nurse or interventionist in the 3 months following the visit . PARTICIPANTS Self-identified women smokers ( n = 303 ) whose children received care at participating clinics . MAIN OUTCOME MEASURE Self-reported abstinence from smoking 12 months after enrollment in the study , defined as not smoking , even a puff , during the 7 days prior to assessment . RESULTS Response rates at 3 and 12 months were 80 % and 81 % . At both follow-ups , abstinence rates were twice as great in the intervention group as in the control group ( 7.7 % 
    Output:
    
agent
***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: The majority of regular adult smokers begin smoking in adolescence and there is a clear need for youth-targeted smoking cessation interventions . The present r and omized , controlled trial tested the effectiveness of motivational enhancement therapy ( MET ) to reduce  smoking among 81 adjudicated adolescents . Participants received either MET or an education control .  Smoking abstinence , quantity , and frequency were assessed at 1 and 6 months post treatment . Results suggest that although between-group differences on outcome measures were not significant at follow-up , smoking behavior decreased in both groups with approximately 10 % achieving 1-month smoking abstinence at 6-month follow-up . Furthermore , participant response to MET varied by level of alcohol use and impulsivity such that participants with lower levels of alcohol use and impulsivity had significantly greater response to MET . In contrast , participants who endorsed higher rates of alcohol use and impulsivity responded better to the control than the MET condition . Results suggest that MET may be an effective intervention for some adolescent smokers but may be contraindicated for adolescents who have concomitant problems with alcohol use or impulsivity This study reports on the evaluation of the feasibility , cost , and cost-effectiveness of a proactively provided telephone-based motivational smoking cessation intervention to an underserved population of pregnant smokers who may or may not receive ongoing prenatal care . As part of the New Engl and SCRIPT r and omized clinical trial comparing the efficacy of three types of smoking cessation interventions for pregnant smokers , one-third of the women ( n = 358 ) received a motivational telephone counseling intervention ( MI ) delivered by trained counselors using a semistructured protocol . Although this population was very mobile , the MI counselors were able to reach 86 % of the women with at least one call and 46 % received all three calls . The group receiving three MI calls had a cotinine-confirmed quit rate of 23 % . Cost-effectiveness analyses for those women receiving telephone counseling supported the net benefit in favor of the three phone calls compared with the women who did not receive any telephone calls , with an effectiveness to cost ratio of 1:US dollars 84 . Our results suggest that telephone-based motivational smoking cessation counseling may be a feasible and cost-effective method for low-income pregnant smokers enrolled in prenatal care BACKGROUND A multicomponent motivational smoking cessation intervention was evaluated in 33 prenatal , family planning , and pediatric services in 12 public health clinics .  Clinic-based intervention components were implemented by clinic personnel as part of routine medical visits . METHODS The evaluation design included pre- and postintervention measurements of multiple study outcomes in a baseline ( all clinics prior to the start of the intervention ) and an experimental period ( matchedpair r and om assignment of clinics to intervention or control conditions ) . Subjects were 683 ( baseline ) and 1,064 ( experimental ) smokers with measurements of smoking outcomes at both times . Mixed-effects regressions analyzed individual outcomes clustered within clinics and services . RESULTS Control and intervention clinics had similar outcomes in the baseline period . In the experiment , outcomes improved in the intervention but not in the control clinics . Compared to controls , smokers exposed to the intervention were more likely to have quit ( 14.5 versus 7.7 % ) or take actions toward quitting and had higher mean action , stage of readiness , and motivation to quit scores . These positive effects persisted when clustering within clinics and services was controlled . CONCLUSIONS This intervention , implemented by clinic personnel as part of routine medical visits , was effective under these natural conditions across different types of clinic service OBJECTIVE Smoking is highly prevalent and refractory among people with posttraumatic stress disorder ( PTSD ) . This study aim ed to improve the rate of quitting smoking for veterans with PTSD by integrating treatment for nicotine dependence into mental health care . METHOD Smokers undergoing treatment for PTSD ( N=66 ) were r and omly assigned to 1 ) tobacco use treatment delivered by mental health providers and integrated with psychiatric care ( integrated care ) versus 2 ) cessation treatment delivered separately from PTSD care by smoking-cessation specialists ( usual st and ard of care ) . Seven-day point prevalence abstinence was the primary outcome , measured at 2 , 4 , 6 , and 9 months after r and om assignment . Data were analyzed by using a generalized estimating equations approach following the intent-to-treat principle . RESULTS Subjects assigned to integrated care were five times more likely than subjects undergoing the usual st and ard of care to abstain from smoking across follow-up assessment intervals ( odds ratio=5.23 ) . Subjects in the integrated care condition were significantly more likely than subjects in usual st and ard of care to receive transdermal nicotine and nicotine gum . They also received a greater number of smoking-cessation counseling sessions . Stopping smoking was not associated with worsening symptoms of PTSD or depression . CONCLUSIONS Smoking-cessation interventions can be safely incorporated into routine mental health care for PTSD and are more effective than treatment delivered separately by a specialized smoking-cessation clinic . Integrating cessation treatment into psychiatric care may have the potential for improving smoking quit rates in other population s of chronically mentally ill smokers Objective : To test the hypothesis that among adolescent smokers hospitalised for psychiatric and substance use disorders , motivational interviewing ( MI ) would lead to more and longer quit attempts , reduced smoking , and more abstinence from smoking over a 12 month follow up . Design : R and omised control trial of MI versus brief advice ( BA ) for smoking cessation , with pre- and post-intervention assessment of self efficacy and intentions to change , and smoking outcome variables assessed at one , three , six , nine , and 12 month follow ups . Setting : A private , university affiliated psychiatric hospital in Providence , Rhode Isl and , USA . Patients or other participants : Consecutive sample ( n = 191 ) of 13–17 year olds , admitted for psychiatric hospitalisation , who smoked at least one cigarette per week for the past four weeks , had access to a telephone , and did not meet DSM-IV criteria for current psychotic disorder . Interventions : MI versus BA . MI consisted of two , 45 minute individual sessions , while BA consisted of 5–10 minutes of advice and information on how to quit smoking . Eligible participants in both conditions were offered an eight week regimen of transdermal nicotine patch upon hospital discharge . Main outcome measures : Point prevalence abstinence , quit attempts , changes in smoking rate and longest quit attempt . Proximal outcomes included intent to change smoking behaviour ( upon hospital discharge ) , and self efficacy for smoking cessation . Results : MI did not lead to better smoking outcomes compared to BA . MI was more effective than BA for increasing self efficacy regarding ability to quit smoking . A significant interaction of treatment with baseline intention to quit smoking was also found . MI was more effective than BA for adolescents with little or no intention to change their smoking , but was actually less effective for adolescents with pre-existing intention to cut down or quit smoking . However , the effects on these variables were relatively modest and only moderately related to outcome . Adolescents with comorbid substance use disorders smoked more during follow up while those with anxiety disorders smoked less and were more likely to be abstinent . Conclusions : The positive effect of MI on self efficacy for quitting and the increase in intention to change in those with initially low levels of intentions suggest the benefits of such an intervention . However , the effects on these variables were relatively modest and only moderately related to outcome . The lack of overall effect of MI on smoking cessation outcomes suggests the need to further enhance and intensify this type of treatment approach for adolescent smokers with psychiatric comorbidity OBJECTIVES We tested the efficacy of a combined pharmacologic and behavioral smoking cessation intervention among women in a state prison in the southern United States . METHODS The study design was a r and omized controlled trial with a 6-month waitlist control group . The intervention was a 10-week group intervention combined with nicotine replacement therapy .  Two hundred and fifty participants received the intervention , and 289 were in the control group .  Assessment s occurred at baseline ; end of treatment ; 3 , 6 , and 12 months after treatment ; and at weekly sessions for participants in the intervention group . RESULTS The intervention was efficacious compared with the waitlist control group . Point prevalence quit rates for the intervention group were 18 % at end of treatment , 17 % at 3-month follow-up , 14 % at 6-month follow-up , and 12 % at 12-month follow-up , quit rates that are consistent with outcomes from community smoking-cessation interventions . CONCLUSIONS Female prisoners are interested in smoking cessation interventions and achieved point-prevalence quit rates similar to community sample s. Augmenting tobacco control policies in prison with smoking cessation interventions has the potential to address a significant public health need This prospect i ve r and omized study examined the impact of three tailored intervention approaches to increase quitting rates among African-American smokers who were clients of a community health center that serves primarily low-income and indigent persons . Smokers were r and omized to one of three groups : ( 1 ) health care provider prompting intervention alone , ( 2 ) health care provider prompting intervention with tailored print communications , and ( 3 ) health care provider prompting intervention with tailored print communications and tailored telephone counseling . Among the 160 smokers who completed the study , 35 ( 21.8 % ) had quit smoking at follow-up . Smokers who received the provider prompting intervention with tailored print material s were more likely to report having quit than smokers who received the provider intervention alone ( 32.7 % vs. 13.2 % , p < 0.05 ) . Smokers who received all three intervention components were not more likely to report having quit at follow-up than those who only received the provider intervention ( 19.2 % vs. 13.2 % ) . Smokers who at baseline were less educated , smoked less than half a pack of cigarettes per day , had a stronger desire to quit , felt more efficacious , and had thought about quitting were more likely to report having quit at follow-up . These results provide support for continued refinement of tailored communications to aid smoking cessation among African-American smokers One of the key goals of health promotion strategies in the UK and other developed countries is to reduce the prevalence of cigarette consumption . While overall smoking rates in the UK have fallen over the last few decades , they have barely fallen for the least advantaged adults ( Department of Health , 1998a ) . There is a need for interventions that are suitable for lower socio-economic status ( SES ) smokers that have undergone rigorous evaluation . This study describes a r and omized controlled trial of cognitive behaviour therapy ( CBT ) with smokers from a deprived area of London . At 6 months follow-up , 21 ( 17.2 % ) of 122 participants receiving therapy were abstinent and 14 ( 11.5 % ) had reduced cigarette consumption by at least 25 % of pre-treatment level . Six ( 5.6 % ) of 107 participants in the control group were abstinent and none had reduced consumption . These results suggest that this self-help CBT intervention has the potential to reduce the prevalence of smoking among lower SES smokers A smoking cessation and relapse prevention intervention was tested in an urban , prenatal clinic serving predominantly low-income , African-American women . At their first prenatal visit , 391 smokers were r and omly assigned to an experimental ( E ) group to receive usual clinic information plus a prenatal and postpartum intervention or to a control ( C ) group to receive only usual clinic information . The intervention consisted of individual skills instruction and counseling by a peer health counselor on the use of a self-help cessation guide and routine clinic reinforcement . Among the E group ( n = 193 ) , 6.2 % were cotinine-confirmed quitters at third trimester and among the C group ( n = 198 ) the quit rate was 5.6 % . Quitters were light smokers at entry into prenatal care . Many had tried to quit smoking at least once prior to pregnancy BACKGROUND Continued high rates of smoking among socioeconomically disadvantaged women lead to increases in children 's health problems associated with exposure to tobacco smoke . The pediatric clinic is a " teachable setting " in which to provide advice and assistance to parents who smoke . OBJECTIVE To evaluate a smoking cessation intervention for women . DESIGN Two-arm ( usual care vs intervention ) r and omized trial . SETTING Pediatric clinics serving an ethnically diverse population of low-income families in the greater Seattle , Wash , area . INTERVENTION During the clinic visit , women received a motivational message from the child 's clinician , a guide to quitting smoking , and a 10-minute motivational interview with a nurse or study interventionist . Women received as many as 3 outreach telephone counseling calls from the clinic nurse or interventionist in the 3 months following the visit . PARTICIPANTS Self-identified women smokers ( n = 303 ) whose children received care at participating clinics . MAIN OUTCOME MEASURE Self-reported abstinence from smoking 12 months after enrollment in the study , defined as not smoking , even a puff , during the 7 days prior to assessment . RESULTS Response rates at 3 and 12 months were 80 % and 81 % . At both follow-ups , abstinence rates were twice as great in the intervention group as in the control group ( 7.7 % 
    Output:
    