Clearing the Air: A Scoping Review of Smoking Cessation and Reduction Program Implementation in Long-Term Care
Bibliographic record
Abstract
The past two decades have seen increased global commitment and coordinated efforts in tobacco control. However, individuals with chronic conditions continue to exhibit high smoking rates—a modifiable risk factor that contributes to disease progression and worsens health outcomes. Long-term care (LTC) settings, characterized by extended care duration and frequent provider contact, present a strategic opportunity to implement smoking cessation and reduction (SCR) programs alongside chronic care services. Although a range of SCR programs have demonstrated effectiveness in controlled research settings, to our knowledge, no review has yet applied an implementation science framework to systematically examine whether these programs sustain their impact when translated into real-world LTC practice—and if so, how and why. This scoping review aims to identify and synthesize: - The why: contextual barriers and facilitators that support or hinder successful implementation; - The how: implementation strategies (action-oriented approaches used to promote implementation); and - Implementation outcomes: such as feasibility, appropriateness, and acceptability. We searched five major health databases (MEDLINE, PubMed, PsycINFO, Web of Science, and CINAHL) and included peer-reviewed articles that described, reflected on, or evaluated the implementation of SCR programs aimed at supporting adults (aged 18 and older) in LTC or other inpatient non-acute/extended-care settings (e.g., nursing homes, group homes, rehabilitation centers, residential care facilities, inpatient psychiatric units). Data extraction and analysis are guided by established implementation science frameworks, including CFIR, ERIC, Proctor’s taxonomy of implementation outcomes, and RE-AIM. The goal is to provide a foundational evidence synthesis to inform future implementation and research efforts; for example, in guiding the use of evidence-informed strategies that leverage identified facilitators and address barriers to support program uptake, sustainability, and impact in LTC and beyond, ultimately advancing health equity for LTC residents.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.049 | 0.160 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.009 | 0.008 |
| Bibliometrics | 0.028 | 0.033 |
| Science and technology studies | 0.002 | 0.003 |
| Scholarly communication | 0.008 | 0.008 |
| Open science | 0.005 | 0.005 |
| Research integrity | 0.005 | 0.003 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".