Current cessation work includes evaluations of quit smoking initiatives in a variety of settings including the workplace and health care settings, further analysis of data from OTRU’s Ontario Tobacco Survey, a multi component study of electronic cigarettes including their use as a cessation aid, research on tobacco reduction in aboriginal communities, ongoing development of a smokers’ panel that provides a platform for studies on cessation pathways, factors related to relapse, and intervention outcomes, and studies reaching across the three pillars of tobacco control that model the impact of policy and program measures.

Current Cessation Projects

Evaluation of the Workplace Cessation Initiative

Focus Area: Evaluation, Workplace

OTRU has been working with Smoke-Free Ontario partners to evaluate the development, implementation and outcomes of workplace-based smoking cessation demonstration projects in 11 public health units (representing 13 health unit partners) across Ontario. This project investigates which approaches, strategies, tools and resources work best in meeting the needs of blue collar (construction, mining, manufacturing), and hospitality and service sector workers who are trying to quit smoking. A variety of quantitative and qualitative data collection methods are used, including baseline, 6-month and 12-month follow-up surveys with participants, and in-depth case study interviews and focus groups.

Exploring Opportunities and Challenges for Developing a New Coordinated Smoking Cessation System in Ontario

Focus Areas: Cessation Program/Service Use

Cessation is a complex process that may span from many months to years, and evidence shows that the paths to cessation are varied. A coordinated system would be able to attract tobacco users and support them throughout their entire cessation process. Currently, there is not a coordinated tobacco user support system in Ontario. However, existing services/programs provide a basis for such a coordinated system. This project explores the experience of tobacco users with existing cessation services/programs and identifies opportunities for strengthening linkages across these services/programs.

Evaluation of STOP with Family Health Teams and STOP with Community Health Centres, and Addiction Agencies

Focus Areas: Evaluation, Nicotine Replacement Therapy, Health Care Providers

The STOP program is a province-wide initiative coordinated by the Centre for Addiction and Mental Health (CAMH), which uses the existing health care infrastructure to provide free nicotine replacement therapy (NRT) and cessation counselling to patients interested in quitting smoking. This project evaluates the implementation of the STOP program in three different health practice settings (Family Health Teams, Community Health Centres and Addiction Agencies) to inform improvements and adjustments to the program.

Modelling Interventions and Strategy Effects

Focus Areas: Tobacco Control Indicators, Modelling

This cross cutting project continues to refine the Ontario SimSmoke model in order to improve its validity, accuracy and usefulness as a tool to inform policy and program decision making in the province.

Ontario Tobacco Survey Analysis

Focus Areas: Survey Analysis

The Ontario Tobacco Survey (OTS) is a population-based longitudinal survey of smokers and a cross-sectional survey of nonsmokers in Ontario designed to evaluate and inform the impact of the Smoke-Free Ontario Strategy, monitor trends in tobacco-related knowledge and exposures for both smokers and nonsmokers, and provide baseline and longitudinal data to better understand the processes of, and influences on, smoking cessation and relapse. Data collection was completed in 2011 and analysis in a number of topic areas related to cessation is ongoing.

Quitting Smoking in Canada

Focus Areas: Survey Analysis

Reducing the prevalence of smoking is one of the most important challenges needed to be overcome in order to reduce the burden of cancer in Canada. However, most research on quitting smoking has been done in clinical settings, and much more is needed to understand quitting in the real world. This CCSRI funded project will use the Ontario Tobacco Survey, a cohort study designed specifically to understand the dynamics of smoking cessation to identify solutions to help Canada quit smoking. This research program will gain understanding in the general population of how often smokers try to quit, how long, on average, smokers can stay abstinent, how many times, on average, it takes to quit, which subgroups have more difficultly quitting and which interventions and aids have been most effective.

RECIG: Research on E-Cigarettes

Focus Areas: Electronic Cigarettes

The Ontario Tobacco Research Unit (OTRU), in partnership with the Centre for Addiction and Mental Health (CAMH), has recently undertaken a multi-component research study of e-cigarettes (RECIG) that will inform the current evidence base, and future provincial policy and legislation. The study will: determine the prevalence of e-cigarette use, particularly among youth, and examine patterns of change over time; review and assess research on health effects and related exposures to nicotine, aerosols and contaminants; explore use of e-cigarettes to reduce, replace or stop smoking traditional cigarettes; and examine the role of e-cigarettes as a “gateway” to uptake of traditional cigarettes.

Methods include: a knowledge synthesis of existing peer-reviewed and grey literature; a survey to determine knowledge of health effects, symptoms and perceived harm, and attitudes of users and non-users about e-cigarettes; an examination of correlates of use and demographic profiles from existing population surveys; analysis of promotional material to understand market segments and motives for purchase; analysis of social media to examine context of use and uptake to tobacco; a randomized clinical trial comparing smoking cessation effectiveness of e-cigarettes and nicotine replacement therapy products, a biomarker study of e-cigarette users to measure concentrations of nicotine and other chemicals and a meeting of an Expert Panel of leading researchers, NGOs, and knowledge users to provide an integrated perspective on e-cigarettes for dissemination to the health community.

Research on Tobacco Reduction in Aboriginal Communities

Focus Areas: Aboriginal Populations, Cessation Interventions

The prevalence of non-traditional tobacco use among First Nations (on and off-reserve), Inuit and Métis populations in Canada is significantly higher than the general population. High rates of smoking have significance for disproportionately high rates of chronic disease among Ontario Aboriginal communities. This study will address gaps in knowledge about effective interventions to reduce uptake and use of tobacco in Aboriginal communities in Ontario and factors contributing to successful implementation of interventions.

Methods include: a realist informed knowledge synthesis; studies of exemplary communities through site visits and interviews with key informants; in-depth study of seven communities through interviews, focus groups, and community surveys, ongoing knowledge exchange with community partners and a knowledge forum, and seed money and research support for future community projects.

RNAO Provincial Nursing Best Practice Smoking Cessation Initiative Assessment

Focus Area: Best Practices, Nurses, Ontario

This project examines how the RNAO smoking cessation initiative builds capacity for smoking cessation and affects treatment of tobacco dependence under a variety of contexts.

Smokers’ Panel

Focus Area: Data Platform Development, Surveys

The Ontario Tobacco Research Unit and a variety of partners are developing an Ontario-based smokers’ panel that consists of current tobacco users and those who are trying to quit. Members of the panel are being recruited through cessation services and via a question included in the minimal dataset (Data Standards project). A series of innovative studies will use the powerful interlinked data platform of a Smokers’ Panel, incorporating both quantitative studies with in-depth qualitative exploration to better understand areas such as long-term relapse, smoking cessation pathways and outcomes with planned interventions.

Knowledge and Evaluation Support

OTRU responds to the knowledge needs, evaluation and research requests from Ontario’s Public Health Units (PHUs), Tobacco Control Area Networks (TCANs), and other tobacco Transfer Payment Agencies (TPAs) across the three pillars of tobacco control.