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<h4>Importance</h4>Annual tobacco-related death estimates are 480 000 in the US and 8 million worldwide, surpassing mortality for other abused substances. Most smoking cessation interventions result in modest long-term success.<h4>Objective</h4>To compare prolonged smoking abstinence rates in smokers receiving psilocybin plus cognitive behavioral therapy (CBT) with those receiving the nicotine patch plus CBT.<h4>Design, setting, and participants</h4>In this pilot randomized clinical trial, participants and investigators were unblinded to treatment condition, including an optional crossover after completion of the primary end point. Data were collected from psychiatrically healthy adult smokers from January 20, 2015, to May 8, 2023, at the Johns Hopkins Bayview Medical Center, an academic medical center and teaching hospital in Baltimore, Maryland.<h4>Intervention</h4>The trial randomized cigarette smokers to receive either 1 high dose (30 mg/70 kg) of psilocybin or initiate 8 to 10 weeks of US Food and Drug Administration-approved nicotine patch treatment on the target quit date. Both groups received a 13-week manualized CBT program for smoking cessation.<h4>Main outcomes and measures</h4>Biochemically verified prolonged smoking abstinence (primary) and 7-day point prevalence abstinence (secondary) at 6 months after the target quit date were compared between groups using intention-to-treat analysis.<h4>Results</h4>A total of 82 psychiatrically healthy adult smokers (mean [SD]

<h4>Objectives</h4>Smoking remains a major preventable cause of lung and cardiovascular disease. This randomised controlled trial evaluated EILA, a mobile application using artificial intelligence, for promoting smoking cessation among hospital workers.<h4>Methods</h4>A randomised controlled trial was conducted. Hospital workers (n=43) were recruited from a German university hospital from May 2022 to March 2023. Inclusion criteria comprised age ≥18, Fagerström score ≥3 or 10 cigarettes per day, ownership of a suitable smartphone, motivation to quit smoking and no addiction to other psychoactive substances. Participants were randomised by sealed envelopes to EILA intervention (n=25) or a wait-list control (n=18) receiving a primary care-style intervention, with crossover after 3 months. The primary outcome was the cessation rate. Secondary outcomes comprised nicotine dependence, mental health and cardiovascular risk, all measured using validated questionnaires.<h4>Results</h4>At the 6-month follow-up, the relative risk for continued smoking was reduced to 0.91 (n=51, 95% CI 0.7 to 1.2), and nicotine dependence, measured by the Fagerström Test, decreased significantly from 4.41±1.93 to 3.32±2.69 (n=19, p=0.014). PROCAM score for cardiovascular risk was reduced from 35.22±12.47 to 31.9±13.24 (n=36, p=0.008).<h4>Conclusion</h4>The digital health application EILA was linked to increased smoking cessation rates, although without achieving statistical significance. Nevertheless, the

<h4>Background and aims</h4>Electronic cigarettes (EC) are considered a smoking cessation tool in some countries, such as the United Kingdom, but uncertainty remains internationally over whether their benefits outweigh potential harms when used for this purpose. This overview (1) synthesised existing evidence from systematic reviews (SR) on the effectiveness and safety of ECs to explore and address these uncertainties and disagreements and (2) mapped primary intervention studies to identify priorities for further research.<h4>Methods</h4>Overview of SRs published from 1 January 2015 and meeting the inclusion criteria of the Cochrane review of EC for smoking cessation. We searched seven databases to April 2024. We followed Cochrane screening and data extraction methods. We adapted Campbell Collaboration and 3ie methods for the Evidence and Gap Map (EGM). We assessed review quality using AMSTAR-2.<h4>Results</h4>We included 14 reviews of intervention studies (7 high quality; 7 low quality), with search dates from 2014 to 2023, in adult populations including the general population, people at risk of lung cancer, with comorbid health conditions and pregnant people. Eighteen studies were included across multiple reviews, some of which included multiple meta-analyses. Across 21 meta-analytic comparisons of nicotine EC versus other interventions, all reported point estimates favouring nicotine EC for smoking cessation, with relative risks/odds ratios typically in the range 1.17-1.67

<h4>Introduction</h4>A significant proportion of patients with chronic airway diseases continue to smoke even after the diagnosis. In addition, smoking cessation support continues to be a neglected issue in real-life settings by physicians for that patient group. Therefore, in our search for a solution to this issue, we conducted our study to evaluate the effect of arranging immediate appointments to smoking cessation outpatient clinics on smoking cessation success in patients with chronic airway disease.<h4>Methods</h4>This multicenter, randomized, parallel-arm prospective study (NCT05764343) was conducted in pulmonary outpatient clinics between November 2022 and June 2023. Current smoker patients aged ≥18 years diagnosed with COPD, asthma, or bronchiectasis for at least 6 months were included and sequentially randomized in a 1:1 ratio. Both arms received brief smoking cessation interventions, and the intervention arm had immediate access to a smoking cessation clinic appointment. In contrast, the control arm received a standard quitline appointment for routine service. The primary endpoint was the self-reported smoking cessation rate at 3 months, analyzed using an intentionto-treat approach.<h4>Results</h4>The study comprised 198 patients in the immediate appointment arm and 199 in the usual care arm. The quit rate was significantly higher in the immediate appointment arm (26.7%) than in the usual care arm (16.5%, p=0.014). Access to smoking cessation medication was 69.3% i

Smoking cessation is a major public health goal, yet concerns about post-cessation weight gain remain a significant barrier for many smokers. The metabolic and behavioral changes following nicotine withdrawal frequently lead to increased caloric intake and reduced energy expenditure, potentially triggering relapse. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), originally developed for type 2 diabetes and later approved for weight management, have recently been investigated as a potential strategy to address both nicotine dependence and weight control. Emerging evidence from preclinical studies and limited clinical trials suggests that GLP-1 RAs may reduce nicotine cravings and intake by modulating central reward pathways while simultaneously curbing appetite and supporting weight loss. This dual mechanism may improve quit success rates and mitigate the psychological burden of post-cessation weight gain. However, the current human evidence base is limited, with small sample sizes, short follow-up periods, and reliance on preliminary data. While the pharmacological profile and cardiometabolic benefits of GLP-1 RAs make them a promising candidate for adjunctive use in smoking cessation, more rigorous randomized controlled trials are required to confirm efficacy, evaluate safety, and establish clinical guidelines. This narrative review synthesizes existing evidence to highlight both the potential and the current uncertainties surrounding GLP-1 RAs as dual-target pharmaco

<h4>Background and aims</h4>Metabolic dysfunction-associated steatotic liver disease (MASLD) is highly prevalent, and smoking is associated with greater disease severity. We investigated whether documented smoking cessation attempts among adults with MASLD were associated with liver-related outcomes, cardiovascular outcomes, and all-cause mortality.<h4>Methods</h4>We performed a retrospective cohort study using the TriNetX Research Network. Adults (≥ 18 years) with MASLD and documented smoking history were included. A smoking cessation attempt was defined by cessation counseling and/or cessation pharmacotherapy; comparators had no documented cessation attempt. Patients with depressive disorders and competing liver etiologies were excluded. Cohorts were matched 1:1 using propensity scores, and outcomes were analyzed using Cox proportional hazards models. Sensitivity analyses were performed at fixed follow-up horizons of 6 months, 1 year, and 2 years.<h4>Results</h4>Among 418,784 eligible patients, 85,639 had a documented cessation attempt and 333,145 did not; after matching, 83,315 patients remained in each cohort. In the matched cohort, cessation attempt was associated with lower hazards of cirrhosis progression (1.7% vs. 2.1%; HR 0.87, 95% CI 0.81-0.93), hepatocellular carcinoma (0.2% vs. 0.3%; HR 0.58, 95% CI 0.48-0.70), portal hypertension (0.8% vs. 1.1%; HR 0.77, 95% CI 0.70-0.86), and MASH progression (2.2% vs. 2.9%; HR 0.76, 95% CI 0.71-0.81). The cessation attempt was

BACKGROUND: Smoking addiction is the most important reversible risk factor affecting many organs, including the heart, lungs, and central nervous system. Smoking cessation alone should not be the sole focus of smoking addiction, and comorbidities should be considered. AIMS: In our study, the relationship between successful smoking cessation and vitamin D levels was analyzed. METHODS: This was a retrospective cohort study. Our study included patients who visited the smoking cessation outpatient clinic. All patients were started on the same dosage of cytisine active ingredient at the same time. After one month of treatment, smoking cessation success and vitamin D levels were compared. In addition, demographic data, the amount and duration of smoking, and smoking cessation success after treatment were recorded. RESULTS: Our study included 327 patients and the smoking cessation rate after treatment was 58.7%. A statistically significant correlation was found between vitamin D level and smoking cessation success. We found that patients with higher vitamin D levels had a higher smoking cessation success rate CONCLUSION: Many studies have reported a relationship between addiction and vitamin D level. Vitamin D supplementation has been used in many addiction treatments, and positive results have been obtained with this treatment. In our study, we found that patients with low vitamin D levels had low smoking cessation success rates. In our study, we found a relationship between high v

<h4>Introduction</h4>This study aimed to evaluate smoking cessation status and factors associated with cessation among individuals aged ≤20 years who attended a smoking cessation outpatient clinic during the first month of follow-up.<h4>Methods</h4>This was a single-center, descriptive study conducted among adolescents who applied to a Smoking Cessation Outpatient Clinic. Patients' sociodemographic characteristics and smoking histories were recorded, and nicotine dependence was assessed using the Fagerström test for nicotine dependence (FTND). Statistical analyses included descriptive statistics, group comparisons using appropriate parametric or nonparametric tests, and multivariable logistic regression.<h4>Results</h4>A total of 229 adolescents were included. At one month, the overall cessation rate was 7.9% (n=18). At one month, adolescents who quit smoking had lower daily cigarette consumption and lower nicotine dependence scores. In multivariable analysis, only the FTND score remained independently associated with cessation (AOR=0.807; 95% CI: 0.660-0.987).<h4>Conclusions</h4>Among Turkish adolescents seeking smoking cessation support, lower nicotine dependence was the primary predictor of short-term quitting success. For public health policies, early identification and timely intervention in adolescent smoking are essential to reduce the potential long-term health risks and future healthcare costs, particularly given the increasingly early age of smoking initiation.

<h4>Background</h4>Tobacco smoking remains one of the leading preventable causes of morbidity and mortality worldwide and is associated with cardiovascular, respiratory, oral, and psychological disorders. Although conventional smoking cessation interventions are effective, barriers related to accessibility, adherence, healthcare costs, and continuity of care frequently limit long-term success. Recent advances in technology may offer innovative opportunities to improve multidisciplinary smoking cessation pathways.<h4>Methodology</h4>The Wear-Smile project is a non-profit, monocentric, randomized controlled trial registered in the Clinical Trial Protocol Registry and Results System (code No.: NCT07593742), designed to evaluate the effectiveness of a multidisciplinary telemedicine-based smoking cessation program assisted by wearable remote-monitoring devices. Adults who smoke combustible or heated tobacco or electronic nicotine delivery systems will be randomly allocated in a 1:1 ratio to either an experimental group receiving telemedicine-assisted rehabilitation integrated with wearable monitoring devices or a control group receiving standard in-person smoking cessation care. The intervention will include a multidisciplinary behavioral smoking cessation intervention involving cardiology, respiratory, dental, and psychology specialists. Primary outcomes will include Continuous Abstinence Rates and Point Prevalence Abstinence assessed at 6 and 12 months. Secondary outcomes will i

<h4>Introduction</h4>Smoking cessation is a central component of disease management in chronic obstructive pulmonary disease (COPD). Hospitalisation provides an opportunity to initiate smoking cessation support. The present study aimed to explore how patients with COPD perceived the usefulness of smoking cessation support in the context of hospitalisation.<h4>Methods</h4>Patients receiving smoking cessation support during hospitalisation at the Department of Medicine, Lillebaelt Hospital, Denmark, were invited to semi-structured interviews via telephone one week after discharge. Interviews were transcribed verbatim and analysed inductively using qualitative content analysis.<h4>Results</h4>Eight patients with COPD (mean age 73 years) were interviewed between January and March 2024. Patients described how their acute respiratory symptoms, the smoke-free environment and the easy access to pharmacological smoking cessation treatment during hospitalisation made smoking both impractical and unreasonable. A respectful, non-judgmental approach to smoking cessation support was emphasised as central to its perceived usefulness and acceptance. One week after discharge, seven patients remained abstinent and reported increased confidence in managing cravings with practical strategies and pharmacological smoking cessation treatment. However, many expressed uncertainty regarding long-term maintenance.<h4>Conclusions</h4>Hospital-initiated smoking cessation support was perceived as timely a

<h4>Introduction</h4>Cigarette smoking remains disproportionately prevalent among people with HIV (PWH) and contributes substantially to preventable morbidity and mortality. Although exercise confers many health benefits, little is known about how PWH who smoke perceive exercise as a strategy to support smoking cessation. The purpose of this qualitative study was to explore barriers and facilitators to smoking cessation and exercise engagement, with particular attention to exercise as a potential cessation-support strategy.<h4>Methods</h4>Within this qualitative study, PWH were recruited from HIV clinics in Colorado and New England between September 2025 and February 2026, and were eligible if they were aged ≥21 years and current smokers. Guided by the Health Belief Model (HBM) and the Social Ecological Model (SEM), semi-structured interviews were transcribed verbatim and analyzed using a hybrid deductive-inductive framework.<h4>Results</h4>Ten PWH (50.6 ± 8.8 years) participated. Participants demonstrated high awareness of smoking-related harms yet described persistent individual and structural barriers to quitting. Exercise was frequently perceived as a supportive strategy that reduced cravings, improved mood, and provided behavioral structure, particularly when embedded in socially supportive contexts. Multilevel barriers included addiction, stress, physical limitations, limited organizational attention to exercise, and resource constraints. Facilitators included peer acco

Cigarette smoking remains a major modifiable contributor to cardiovascular morbidity and mortality through mechanisms involving systemic inflammation, oxidative stress, endothelial dysfunction, dyslipidemia, and hematologic abnormalities. Although the long-term cardiovascular benefits of smoking cessation are well-established, the temporal pattern of biologic recovery following cessation remains incompletely understood. This systematic review synthesized current evidence regarding the reversal of cardiovascular risk biomarkers after smoking cessation, with emphasis on the timing and magnitude of biomarker normalization. A comprehensive search of PubMed, Embase, Scopus, and Cochrane CENTRAL identified studies published between January 1990 and May 2024 evaluating biomarker changes following smoking abstinence. Eligible studies included randomized controlled trials, prospective clinical studies, and observational investigations involving adults who achieved smoking abstinence for at least seven days. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool and the Risk of Bias in Nonrandomized Studies-of Interventions (ROBINS-I) instrument, and findings were synthesized narratively because of methodological heterogeneity. Ten studies comprising 2,750 participants met the inclusion criteria. Biomarker recovery followed a staged temporal pattern, with oxidative stress markers improving within one to two weeks, inflammatory biomarkers declining over approximately t

<h4>Background</h4>Electrocardiographic left ventricular hypertrophy is a known risk factor for cardiovascular morbidity and mortality. Although smoking cessation has general cardiovascular benefits, its impact on left ventricular hypertrophy regression remains unclear.<h4>Objective</h4>To investigate whether smoking cessation is associated with regression of electrocardiographic left ventricular hypertrophy.<h4>Methods</h4>We analyzed data from 752 non-hypertensive participants (695 males; mean age, 47.8 ± 9.2 years) who underwent annual health checkups. Left ventricular hypertrophy was defined using the Sokolow-Lyon criteria (SV1 + RV5 > 3.5 mV). Measurements were compared between baseline and 6 years after smoking cessation. Multivariable logistic regression analysis was used to identify predictors of left ventricular hypertrophy progression.<h4>Results</h4>After 6 years, the average left ventricular voltage decreased significantly (2.47 → 2.41 mV, p < 0.0001), and the prevalence of left ventricular hypertrophy declined from 8.4% to 6.5%. This regression occurred despite increases in body weight (65.7 → 68.1 kg, p < 0.0001) and systolic blood pressure (112.8 → 122.0 mmHg, p < 0.0001). Left ventricular hypertrophy regression was observed in both participants who received antihypertensive medication and in those who did not. Multivariable analysis identified antihypertensive medication as an independent predictor of electrocardiographic LVH regression.<h4>Conclusions</h4>Smo

Tobacco use remains one of the leading preventable causes of morbidity and mortality worldwide, contributing to more than 7 million deaths annually and imposing a substantial economic burden on healthcare systems and global productivity. The addictive properties of tobacco are primarily mediated by nicotine, which exerts its effects through neuronal nicotinic acetylcholine receptors (nAChRs) within brain reward circuits. Among these receptor subtypes, α4β2-containing nAChRs play a central role in nicotine dependence by regulating dopaminergic signaling associated with reinforcement, craving, withdrawal, and relapse. Repeated nicotine exposure induces neuroadaptive changes in receptor expression and neural circuitry, contributing to the chronic and relapsing nature of addiction. Advances in addiction neuroscience and receptor pharmacology have enhanced the understanding of nicotine-mediated signaling and facilitated the development of evidence-based smoking cessation therapies. Current treatment approaches include nicotine replacement therapies, antidepressant-based interventions, and partial nAChR agonists such as varenicline and cytisine. Emerging strategies encompass subtype-selective ligands, allosteric modulators, immunotherapeutics, neuromodulation techniques, and digital health technologies aimed at improving cessation outcomes. This review summarizes the neuropharmacological mechanisms underlying nicotine addiction and critically examines current and emerging therapeut

<h4>Introduction</h4>Population-based analyses usually classify smoking status at survey enrollment, which combines people who quit before disease recognition with those who continued smoking through diagnosis and quit afterward. This study evaluated whether smoking cessation after a self-reported cardiopulmonary disease diagnosis was associated with subsequent all-cause and cause-specific mortality among adults reconstructed as smoking at diagnosis.<h4>Methods</h4>This secondary analysis pooled ten cross-sectional National Health and Nutrition Examination Survey (NHANES) cycles from 1999-2000 through 2017-2018 and linked survey records to mortality follow-up through 2019. Adults aged ≥40 years with self-reported cardiovascular or chronic lung disease were included when self-reported smoking initiation, diagnosis, cessation, and current-smoking information permitted classification as smoking at diagnosis. Survey-weighted Cox models compared post-diagnostic quitters with persistent smokers. Models were unadjusted, demographic-adjusted, and fully adjusted for prespecified demographic, disease-history, smoking-history, and survey-cycle covariates.<h4>Results</h4>Among 2319 participants, 975 were post-diagnostic quitters, and 1344 were persistent smokers. During a median follow-up of 6.33 years, 999 all-cause, 272 heart-disease, and 244 cancer deaths occurred. In the fully adjusted model, post-diagnostic quitting was associated with lower heart-disease mortality (adjusted hazard

<h4>Introduction</h4>Smoking cessation is important for healthy ageing, but accompanying weight change may influence subsequent functional vulnerability. We examined whether attained cessation duration and weight change across the observed cessation interval distinguished later frailty risk and frailty-index progression.<h4>Methods</h4>This longitudinal secondary analysis included 27020 Health and Retirement Study participants with self-reported smoking and body-weight data, and valid consecutive frailty assessments who were non-frail at risk-set entry during 1998-2020. Smoking status, body weight, and covariates were assessed biennially by structured interviews. Time-varying Cox models estimated incident frailty (frailty index ≥0.25), mixed-effects models assessed annual frailty-index change, and restricted cubic splines evaluated continuous associations.<h4>Results</h4>Over a median follow-up of 8.1 years, 10641 incident frailty cases occurred during 250439.9 person-years. Compared with current smokers, quitters before baseline had lower frailty risk (hazard ratio, HR=0.79; 95% CI: 0.75-0.84), whereas follow-up quitters overall did not (HR=0.98; 95% CI: 0.90-1.07). In the duration spline, HRs at 0, 7, and 10 years of attained cessation duration were 1.14 (95% CI: 1.01-1.28), 0.79 (95% CI: 0.67-0.93), and 0.73 (95% CI: 0.60-0.89), respectively. Among follow-up quitters, >10.0 kg versus 0.1-5.0 kg weight gain was associated with higher risk (HR=1.94; 95% CI: 1.44-2.61); stand