Theodore W. Marcy

Interest in treatments to stop smoking.

We surveyed 884 Vermont (VT) tobacco smokers by random digit dialing to determine past and future use of treatment. Among those who had recently attempted to quit, 61% had ever used a treatment, 21% had ever used a psychosocial treatment, and 57% had used a medication. Among those who planned to quit in the next month, 68% stated they would use a treatment, 35% would use a psychosocial treatment, and 62% would use a medication. The major predictors of past or future use of treatment were greater cigarettes per day, older age, being a woman, and seeing a health professional. Although this survey suggests many smokers have used or plan to use a smoking cessation treatment, program data indicate less than 10% of VT smokers who try to quit use the state quitline, counseling, or free medication provision. Why smokers do not use these treatments needs to be determined.

Radon awareness and mitigation in Vermont: a public health survey.

Radon exposure is associated with an increased incidence of lung cancer, and elevated levels may be found in as many as 1 out of 15 homes. The U.S. EPA recommends testing homes for radon and mitigating over the advisory level of 4 picocuries per liter (4 pCi L−1, or 148 Bq m−3). A sample population from a list of Vermont residents who had tested their residence for radon through the Vermont Department of Health and who had elevated levels were mailed a survey to assess demographic characteristics, knowledge about radon, mitigation rates, types of mitigation, as well as barriers to mitigation. The response rate was 63%. Forty-three percent of respondents mitigated. Roughly half were not completely knowledgeable of radon based upon the ability to associate radon exposure with lung cancer risk. Reasons not to mitigate radon levels in homes were cost and lack of concern over elevated levels. A multivariate logistic regression analysis revealed factors associated with mitigating: an education level of college or higher (p = 0.02), concern that a high radon level would affect real estate value (p = 0.04), and home age less than 10 y (p = 0.05). In summary, less than half of Vermonters with elevated radon levels participating in the Department of Health program mitigated. We identify factors associated with radon mitigation that may lead to improved radon education and mitigation practice.

Motivating Smokers in the Hospital Pulmonary Function Laboratory to Quit Smoking by Use of the Lung Age Concept

INTRODUCTION The purpose of this study was to investigate the use of lung age to motivate a quit attempt among smokers presenting to a hospital pulmonary function testing (PFT) laboratory. METHODS Participants were randomized to receive a lung age-based motivational strategy (intervention group) versus standard care (control group). At 1 month, all participants were interviewed by telephone to determine whether they made a quit attempt. RESULTS A total of 67 participants were enrolled, and 51 completed the study. Baseline mean data included age = 52 years, 70% women, 40 pack-years of smoking, FEV(1) = 69% predicted, and lung age = 83 years. The quit attempt rates were not different between the intervention and control groups (32% vs. 24%, respectively, p = .59). There was a near significant interaction between lung age and intervention strategy (p = .089), with quit attempt rates among those with normal lung age of 18% in the intervention group versus 33% in the control group and among those with high (worse) lung age of 39% in the intervention group versus 17% in the control group; p = .38. CONCLUSIONS Using lung age to motivate smokers presenting to the PFT laboratory to quit may succeed in patients with high lung age but may undermine motivation in smokers with normal lung age. Further work is needed to refine the approach to smokers with normal lung age.

Use and outcomes of a state-funded in-person counselling program

Many tobacco control programs include cessation services; however, few include free in-person counselling. We could locate only three descriptions of use and outcomes of free in-person counselling in a real-world setting1–3; thus, we describe our experience with in-person counselling in Vermont. Vermont intensified its tobacco control program in 2001 using Master Settlement Agreement funds (http://humanservices.vermont.gov/tobacco). In the last few years, cessation components include (a) access to a quitline run by the American Cancer Society (http://www.cancer.org/docroot/PED/content/PED\_10\_5\_1x\_Quitline_Partnerships.asp), (b) a cessation website (http://www.quitnet.com), (c) free or reduced-cost nicotine replacement therapy (NRT) and (d) an in-person counselling program based at local hospitals (http://www.healthvermont.gov/prevent/tobacco/index.asp). Media spots refer smokers to the quitline or to their local hospital. The in-person program includes group programs based on the American Cancer Fresh Start (http://www.acsworkplacesolutions.com/freshstart.asp) or the American Lung Association Freedom From Smoking Programs (http://www.ffsonline.org) and individual counselling by tobacco treatment specialists (TTSs). The program has trained 30 TTSs and almost all completed the University of Massachusetts TTS training.4 In 2008 there were 9.0 FTE TTSs based at the 13 Vermont hospitals. The outcomes reported below are from …