Ziyad Ben Taleb1, Kenneth D Ward2,3, Taghrid Asfar3,4, Rana Jaber5, Rehab Auf5, Wasim Maziak5,3. 1. Department of Epidemiology, Florida International University, Miami, FL, USA. zbent002@fiu.edu. 2. Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN, USA. 3. Syrian Center for Tobacco Studies, Aleppo, Syria. 4. Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA. 5. Department of Epidemiology, Florida International University, Miami, FL, USA.
Abstract
OBJECTIVES: To identify predictors of nicotine withdrawal symptoms among smokers who participated in a randomized cessation trial in a low-income country. METHODS: We analyzed data from 269 smokers who participated in a randomized, placebo-controlled smoking cessation trial conducted in primary healthcare in Aleppo, Syria. All participants received behavioral counseling and were randomized to receive either 6 weeks of nicotine or placebo patch and were followed for one year. RESULTS: Throughout the study, lower total withdrawal score was associated with greater education (p = 0.044), older age of smoking initiation (p = 0.017), lower nicotine dependence (p = 0.024), higher confidence in ability to quit (p = 0.020), lower reported depression (p < 0.001), higher adherence to patch (p = 0.026), belief of receiving nicotine patches rather than placebo (p = 0.011), and waterpipe use (p = 0.047). CONCLUSIONS: Lower nicotine dependence, greater educational attainment, higher confidence in ability to quit and waterpipe use predict lower withdrawal severity. Waterpipe smoking may serve as a barrier to smoking cessation efforts in countries where its use is highly prevalent. Further, expectancies about the effects of pharmacotherapy appear to mediate the experience of nicotine withdrawal.
RCT Entities:
OBJECTIVES: To identify predictors of nicotine withdrawal symptoms among smokers who participated in a randomized cessation trial in a low-income country. METHODS: We analyzed data from 269 smokers who participated in a randomized, placebo-controlled smoking cessation trial conducted in primary healthcare in Aleppo, Syria. All participants received behavioral counseling and were randomized to receive either 6 weeks of nicotine or placebo patch and were followed for one year. RESULTS: Throughout the study, lower total withdrawal score was associated with greater education (p = 0.044), older age of smoking initiation (p = 0.017), lower nicotine dependence (p = 0.024), higher confidence in ability to quit (p = 0.020), lower reported depression (p < 0.001), higher adherence to patch (p = 0.026), belief of receiving nicotine patches rather than placebo (p = 0.011), and waterpipe use (p = 0.047). CONCLUSIONS: Lower nicotine dependence, greater educational attainment, higher confidence in ability to quit and waterpipe use predict lower withdrawal severity. Waterpipe smoking may serve as a barrier to smoking cessation efforts in countries where its use is highly prevalent. Further, expectancies about the effects of pharmacotherapy appear to mediate the experience of nicotine withdrawal.
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