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Smoking Cessation (smoking + cessation)
Terms modified by Smoking Cessation Selected AbstractsBEHAVIOURAL INTERVENTIONS TO PREVENT WEIGHT GAIN ON SMOKING CESSATION: A RESPONSEADDICTION, Issue 12 2009AMANDA PARSONS No abstract is available for this article. [source] [Commentary] FINANCIAL STRESS AND SMOKING CESSATION,A SILVER LINING TO THE DARK CLOUDS OF THE GLOBAL ECONOMY?ADDICTION, Issue 8 2009FRANK J. CHALOUPKA No abstract is available for this article. [source] Manual of Smoking Cessation: A Guide for Counsellors and PractitionersADDICTION, Issue 7 2007GARY J. TEDESCHI No abstract is available for this article. [source] Smoking Cessation a Byproduct of EEG Telemetry MonitoringEPILEPSIA, Issue 4 2005Syed Nizamuddin Ahmed Summary:, Smoking is a common problem in epilepsy patients. The inpatient video-EEG monitoring (VEEG) unit provides a unique and conducive environment for epilepsy patients to participate actively in a smoking-cessation program. The restrictions and confinement to the telemetry bed impose a forced abstinence from smoking. It has been suggested that patients who are hospitalized may be more receptive to smoking-cessation advice. We report two patients who were successfully able to quit smoking after admission for VEEG. [source] Patterns and Predictors of Smoking Cessation in an Elderly CohortJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2006Heather E. Whitson MD OBJECTIVES: To identify subject characteristics that predict smoking cessation and describe patterns of cessation and recidivism in a cohort of elderly smokers. DESIGN: Prospective cohort study. SETTING: Piedmont region, North Carolina. PARTICIPANTS: Five hundred seventy-three subjects enrolled in the North Carolina Established Populations for Epidemiologic Studies of the Elderly who responded "yes" to question 179 on the baseline survey (Do you smoke cigarettes regularly now?) and survived at least 3 years, until the next in-person follow-up (1989/90). Subjects were classified as quitters (n=100) or nonquitters (n=473) based on subsequent smoking behavior. MEASUREMENTS: Reported smoking behavior, demographic characteristics of the smokers at baseline or subsequent interviews, 7-year mortality. RESULTS: After controlling for all characteristics studied, subjects who quit smoking were more likely to be female (P=.03) and showed a trend toward greater likelihood of a recent cancer diagnosis (P=.11). Recidivism was observed in only 16% (19/119) of subjects who reported no smoking in 1989/90. The percentage of subjects who died during 7 years of follow-up was 44.0% of quitters, compared with 51.6% of nonquitters. Smoking cessation was not associated with a statistically significant decrease in risk of death after controlling for other variables (odds ratio=0.78, 95% confidence interval=0.48,1.26). CONCLUSION: Smoking cessation in this elderly cohort was associated with different subject characteristics from those that predict successful cessation in younger populations, suggesting that older smokers may have unique reasons to stop smoking. Further study is needed to assess potential motives and benefits associated with smoking cessation at an advanced age. [source] Perception of Computer-tailored Feedback for Smoking Cessation: Qualitative Findings from Focus GroupsJOURNAL OF APPLIED BIOBEHAVIORAL RESEARCH, Issue 1 2009Hazel Gilbert Tobacco smoking continues to be a major public health problem. Few smokers present themselves for treatment, and it is important to offer a range of interventions that appeal to different individual needs and preferences. Computer-tailored feedback can fill the gap between generic self-help and intensive clinical therapy. Using focus groups, we investigated smokers' perceptions of generic self-help materials and computer-generated individually tailored feedback reports. Participants recognized the generic nature of self-help material and welcomed the concept of personal support, but were concerned about some aspects of the material. Findings supported the continuation of the development and delivery of computer-tailored feedback, but more research is warranted to optimize the content and style of the feedback for individual perceptions and expectations. [source] Racial and Ethnic Differences in the Timing of First Marriage and Smoking CessationJOURNAL OF MARRIAGE AND FAMILY, Issue 3 2007Margaret Weden Using data from the National Longitudinal Survey of Youth 1979 (N = 4,050), we consider the relationship between the timing of family formation and positive changes in health behavior. Theories that predict both positive and negative associations are tested. The findings suggest that both mechanisms operate and that the direction of the association depends on the respondent's race or ethnicity. Whites who marry early are less likely to quit smoking, whereas Whites who marry on time and Blacks and Hispanics who marry at all ages are more likely to quit. The analysis refines the understanding of how family formation shapes changes in health behaviors differentially across the life course, and it underscores the difference in this process for individuals from different racial and ethnic backgrounds. [source] Role of Naltrexone in Initial Smoking Cessation: Preliminary FindingsALCOHOLISM, Issue 12 2002Andrea C. King No abstract is available for this article. [source] Varenicline: A New Pharmaceutical Approach to Smoking CessationNURSING FOR WOMENS HEALTH, Issue 1 2008Patricia L Dougherty CNM First page of article [source] Behavioral Medicine Strategies for Heart Disease Prevention: The Example of Smoking CessationPREVENTIVE CARDIOLOGY, Issue 1 2000Barrie J Guise PhD Health related behavior change is one of the most important challenges in the prevention of cardiovascular disease. Lifestyle patterns, such as high fat diet, lack of exercise, persistent smoking, and poor compliance with prescribed medications present the core of this challenge. Conventional wisdom and considerable scientific evidence establish that the barriers to health related behavior change are many and varied. However, much is also known about methods of improving behavioral outcomes. Behavioral medicine strategies incorporate fundamental principles of behavior change together with biomedical and interpersonal approaches to facilitate successful cardiac risk factor modification. Physicians have the most potent opportunity to assist patients with health behavior change. Unfortunately, physicians are least familiar with behavior change technology and the contemporary physician-patient relationship lacks the partnership needed to succeed in these difficult areas. The good news is that medical education has begun to incorporate training in behavior change and interpersonal effectiveness. A description of the behavioral medicine approach to smoking cessation provides an excellent model for a thoughtful and practical approach to heart disease prevention in every day practice. [source] Relationship of DSM-IV-Based Depressive Disorders to Smoking Cessation and Smoking Reduction in Pregnant SmokersTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 4 2006Janice A. Blalock PhD This study investigated DSM-IV depressive disorders as predictors of smoking cessation and reduction in 81 pregnant smokers participating in a smoking cessation trial. Thirty-two percent of the sample met criteria for current dysthymia, major depressive disorder in partial remission, or minor depression. There was no significant reduction in smoking among women with or without current depressive disorders. Unexpectedly, as compared to women without depressive disorders, women with dysthymia significantly increased the mean number of cigarettes smoked (from 8 to 23 cigarettes per day during the 2 to 30 days post-targeted quit date period) and were smoking significantly more cigarettes at 30 days. A main effect approaching significance suggested that women with current depressive disorders were less likely to be abstinent than women without current depressive disorders (OR = 6.3; 3.9% vs. 12.7% at 30 days post-targeted quit date; 0% vs. 6.2% at 30 days post-partum). Results add to previous findings indicating a correlation between depressive symptoms and continued smoking in pregnant women. Further investigation of mood-focused smoking cessation interventions may be warranted. [source] The use of Bupropion for Smoking Cessation in Rural New South WalesAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 2 2004Bo S. Wong No abstract is available for this article. [source] Bayesian Inference for Smoking Cessation with a Latent Cure StateBIOMETRICS, Issue 3 2009Sheng Luo Summary We present a Bayesian approach to modeling dynamic smoking addiction behavior processes when cure is not directly observed due to censoring. Subject-specific probabilities model the stochastic transitions among three behavioral states: smoking, transient quitting, and permanent quitting (absorbent state). A multivariate normal distribution for random effects is used to account for the potential correlation among the subject-specific transition probabilities. Inference is conducted using a Bayesian framework via Markov chain Monte Carlo simulation. This framework provides various measures of subject-specific predictions, which are useful for policy-making, intervention development, and evaluation. Simulations are used to validate our Bayesian methodology and assess its frequentist properties. Our methods are motivated by, and applied to, the Alpha-Tocopherol, Beta-Carotene Lung Cancer Prevention study, a large (29,133 individuals) longitudinal cohort study of smokers from Finland. [source] Decrease in Risk of Lung Cancer Death in Males after Smoking Cessation by Age at Quitting: Findings from the JACC StudyCANCER SCIENCE, Issue 8 2001Kenji Wakai To evaluate the impact of smoking cessation in individuals and populations, we examined the decrease in risk of lung cancer death in male ex-smokers by age at quitting in the Japan Collaborative Cohort Study for Evaluation of Cancer Risk Sponsored by Monbusho (JACC Study), which was initiated from 1988 to 1990 in Japan. For simplicity, subjects were limited to male non-smokers, and former/current smokers who started smoking at ages 18-22, and 33 654 men aged 40-79 years were included. We modeled the mortality rates in non-smokers and current smokers, and compared the rates in ex-smokers with those expected from the model if they had continued smoking. During the mean follow-up of 8.0 years, 341 men died from lung cancer. The mortality rate ratio for current smokers, compared to non-smokers, was 5.16, and those for ex-smokers who had quit smoking 0-4, 5-9,10-14,15-19 and >20 years before were 4.84, 3.19, 2.03,1.29 and 0.99, respectively. The functions of 3.20×l0 -7×(age)45 and 1.96×lO -5×(age-29.6)4.5 fitted the observed mortality rates (per 100 000 person-years) in non-smokers and continuing smokers, respectively. A greater decrease in lung cancer mortality was estimated among those who quit smoking at younger ages. Stopping smoking earlier in life appears preferable to keep the individual risk low. The absolute rate, however, substantially decreased after smoking cessation even in those who quit at ages 60-69, reflecting the high mortality rate among continuing smokers in the elderly. [source] Smoking cessation in severe mental illness: what works?ADDICTION, Issue 7 2010Lindsay Banham ABSTRACT Aims The physical health of people with severe mental illness (SMI) is poor. Smoking-related illnesses are a major contributor to excess mortality and morbidity. An up-to-date review of the evidence for smoking cessation interventions in SMI is needed to inform clinical guidelines. Methods We searched bibliographic databases for relevant studies and independently extracted data. Included studies were randomized controlled trials (RCTs) of smoking cessation or reduction conducted in adult smokers with SMI. Interventions were compared to usual care or placebo. The primary outcome was smoking cessation and secondary outcomes were smoking reduction, change in weight, change in psychiatric symptoms and adverse events. Results We included eight RCTs of pharmacological and/or psychological interventions. Most cessation interventions showed moderate positive results, some reaching statistical significance. One study compared behavioural support and nicotine replacement therapy (NRT) to usual care and showed a risk ratio (RR) of 2.74 (95% CI 1.10,6.81) for short-term smoking cessation, which was not significant at longer follow-up. We pooled five trials that effectively compared bupropion to placebo giving an RR of 2.77 (95% CI 1.48,5.16), which was comparable to Hughes et al.'s 2009 figures for general population data; RR = 1.69 (95% CI 1.53,1.85). Smoking reduction data were too heterogeneous for meta-analysis, but results were generally positive. Trials suggest few adverse events. All trials recorded psychiatric symptoms and the most significant changes favoured the intervention groups over the control groups. Conclusions Treating tobacco dependence is effective in patients with SMI. Treatments that work in the general population work for those with severe mental illness and appear approximately equally effective. Treating tobacco dependence in patients with stable psychiatric conditions does not worsen mental state. [source] If you try to stop smoking, should we pay for it?ADDICTION, Issue 6 2010The cost, utility of reimbursing smoking cessation support in the Netherlands ABSTRACT Background Smoking cessation can be encouraged by reimbursing the costs of smoking cessation support (SCS). The short-term efficiency of reimbursement has been evaluated previously. However, a thorough estimate of the long-term cost,utility is lacking. Objectives To evaluate long-term effects of reimbursement of SCS. Methods Results from a randomized controlled trial were extrapolated to long-term outcomes in terms of health care costs and (quality adjusted) life years (QALY) gained, using the Chronic Disease Model. Our first scenario was no reimbursement. In a second scenario, the short-term cessation rates from the trial were extrapolated directly. Sensitivity analyses were based on the trial's confidence intervals. In the third scenario the additional use of SCS as found in the trial was combined with cessation rates from international meta-analyses. Results Intervention costs per QALY gained compared to the reference scenario were approximately ,1200 extrapolating the trial effects directly, and ,4200 when combining the trial's use of SCS with the cessation rates from the literature. Taking all health care effects into account, even costs in life years gained, resulted in an estimated incremental cost,utility of ,4500 and ,7400, respectively. In both scenarios costs per QALY remained below ,16 000 in sensitivity analyses using a life-time horizon. Conclusions Extrapolating the higher use of SCS due to reimbursement led to more successful quitters and a gain in life years and QALYs. Accounting for overheads, administration costs and the costs of SCS, these health gains could be obtained at relatively low cost, even when including costs in life years gained. Hence, reimbursement of SCS seems to be cost-effective from a health care perspective. [source] Smoking cessation during alcohol treatment: a randomized trial of combination nicotine patch plus nicotine gumADDICTION, Issue 9 2009Ned L. Cooney ABSTRACT Aims The primary aim was to compare the efficacy of smoking cessation treatment using a combination of active nicotine patch plus active nicotine gum versus therapy consisting of active nicotine patch plus placebo gum in a sample of alcohol-dependent tobacco smokers in an early phase of out-patient alcohol treatment. A secondary aim was to determine whether or not there were any carry-over effects of combination nicotine replacement on drinking outcomes. Design Small-scale randomized double-blind placebo-controlled clinical trial with 1-year smoking and drinking outcome assessment. Setting Two out-patient substance abuse clinics provided a treatment platform of behavioral alcohol and smoking treatment delivered in 3 months of weekly sessions followed by three monthly booster sessions. Participants Participants were 96 men and women with a diagnosis of alcohol abuse or dependence and smoking 15 or more cigarettes per day. Intervention All participants received open-label transdermal nicotine patches and were randomized to receive either 2 mg nicotine gum or placebo gum under double-blind conditions. Findings Analysis of 1-year follow-up data revealed that patients receiving nicotine patch plus active gum had better smoking outcomes than those receiving patch plus placebo gum on measures of time to smoking relapse and prolonged abstinence at 12 months. Alcohol outcomes were not significantly different across medication conditions. Conclusions Results of this study were consistent with results of larger trials of smokers without alcohol problems, showing that combination therapy (nicotine patch plus gum) is more effective than monotherapy (nicotine patch) for smoking cessation. [source] Reduction of quantity smoked predicts future cessation among older smokersADDICTION, Issue 1 2004Tracy Falba ABSTRACT Aim To examine whether smokers who reduce their quantity of cigarettes smoked between two periods are more or less likely to quit subsequently. Study design Data come from the Health and Retirement Study, a nationally representative survey of older Americans aged 51,61 in 1991 followed every 2 years from 1992 to 1998. The 2064 participants smoking at baseline and the first follow-up comprise the main sample. Measurements Smoking cessation by 1996 is examined as the primary outcome. A secondary outcome is relapse by 1998. Spontaneous changes in smoking quantity between the first two waves make up the key predictor variables. Control variables include gender, age, education, race, marital status, alcohol use, psychiatric problems, acute or chronic health problems and smoking quantity. Findings Large (over 50%) and even moderate (25,50%) reductions in quantity smoked between 1992 and 1994 predict prospectively increased likelihood of cessation in 1996 compared to no change in quantity (OR 2.96, P < 0.001 and OR 1.61, P < 0.01, respectively). Additionally, those who reduced and then quit were somewhat less likely to relapse by 1998 than those who did not reduce in the 2 years prior to quitting. Conclusions Reducing successfully the quantity of cigarettes smoked appears to have a beneficial effect on future cessation likelihood, even after controlling for initial smoking level and other variables known to impact smoking cessation. These results indicate that the harm reduction strategy of reduced smoking warrants further study. [source] Smoking cessation in HIV patients: rate of success and associated factorsHIV MEDICINE, Issue 10 2009M Fuster Background Smoking is the modifiable cardiovascular (CV) risk factor that contributes most to causing premature CV disease. Prevalence of smoking in patients with HIV infection is double that of the general population. Objectives To determine the rate of patients succeeding in quitting smoking after 12 months, factors associated with this success, and the characteristics of tobacco consumption and nicotine dependence. Methods Longitudinal descriptive study. Three hundred and sixty-eight HIV-infected patients were interviewed. Smokers in Prochaska's stage of action began a programme to quit smoking. We registered the variables related to tobacco consumption and the level of success of cessation. Results 63.9% of the patients were active smokers and 14% of them began the cessation programme. Average motivation for cessation was 7.8 ± 1.4 (Richmond) and nicotine dependence rate 5.5 ± 3.0 (Fagerström). After 1 year, 25% had quit smoking. Those patients who stopped smoking presented a higher motivation level (8.8 ± 1.3 vs. 7.5 ± 1.5, P=0.048). Cessation significantly reduced their CV risk at 12 months {2.5 [interquartile range (IQR) 2.0,5.2] vs. 1.7 [IQR 1.0,3.5], P=0.026}. Conclusions The prevalence of smokers in our population of HIV-infected patients was 63.9%. Only 14% began a smoking cessation programme. Twelve months after a programme to quit smoking, cessation rate was 25%; this was influenced mostly by the level of motivation of the patient. [source] Smoking cessation , medicine must triumph over politicsINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 10 2008G. Jackson Editor No abstract is available for this article. [source] Prevention of secondary stroke and transient ischaemic attack with antiplatelet therapy: the role of the primary care physician roleINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 10 2007H. S. Kirshner Summary Background:, Stroke risk is heightened among patients who have had a primary stroke or transient ischaemic attack (TIA). The primary care physician is in the best position to monitor these patients for stroke recurrence. Because stroke recurrence can occur shortly after the primary event, guidelines recommend initiating antiplatelet therapy as soon as possible. Aspirin, with or without extended-release dipyridamole (ER-DP), and clopidogrel are options for such patients. Low-dose aspirin (75,150 mg/day) has the same efficacy as higher doses but with less gastrointestinal bleeding. Clopidogrel remains an option for prevention of secondary events and may benefit patients with symptomatic atherothrombosis, but its combined use with aspirin can harm patients with multiple risk factors and no history of symptomatic cerebrovascular, cardiovascular or peripheral vascular disease. Results:, Low dose aspirin is effective in secondary stroke prevention. Trials assessing aspirin plus ER-DP have shown that the combination is more effective than aspirin monotherapy in preventing stroke, with efficacy increasing among higher risk patients, notably those with prior stroke/TIA. Clopidogrel does not appear to have as much advantage over aspirin in secondary stroke prevention as aspirin plus ER-DP. Smoking cessation and cholesterol, blood glucose and blood pressure control are also important concerns in preventing recurrent stroke. In choosing pharmacological therapy, the physician must consider the individual patient's risk factors and tolerance, as well as other issues, such as use of aspirin among patients with ulcers. Conclusion:, Antiplatelet therapy is effective in secondary stroke prevention. Low dose aspirin can be used first-line, but aspirin plus ER-DP improves efficacy. Clopidogrel is another option in secondary stroke prevention, especially for aspirin-intolerant patients, but it appears to have less advantage over aspirin than aspirin plus ER-DP, and its combined use with aspirin has only marginally better efficacy and increased bleeding risk. [source] Patterns and Predictors of Smoking Cessation in an Elderly CohortJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2006Heather E. Whitson MD OBJECTIVES: To identify subject characteristics that predict smoking cessation and describe patterns of cessation and recidivism in a cohort of elderly smokers. DESIGN: Prospective cohort study. SETTING: Piedmont region, North Carolina. PARTICIPANTS: Five hundred seventy-three subjects enrolled in the North Carolina Established Populations for Epidemiologic Studies of the Elderly who responded "yes" to question 179 on the baseline survey (Do you smoke cigarettes regularly now?) and survived at least 3 years, until the next in-person follow-up (1989/90). Subjects were classified as quitters (n=100) or nonquitters (n=473) based on subsequent smoking behavior. MEASUREMENTS: Reported smoking behavior, demographic characteristics of the smokers at baseline or subsequent interviews, 7-year mortality. RESULTS: After controlling for all characteristics studied, subjects who quit smoking were more likely to be female (P=.03) and showed a trend toward greater likelihood of a recent cancer diagnosis (P=.11). Recidivism was observed in only 16% (19/119) of subjects who reported no smoking in 1989/90. The percentage of subjects who died during 7 years of follow-up was 44.0% of quitters, compared with 51.6% of nonquitters. Smoking cessation was not associated with a statistically significant decrease in risk of death after controlling for other variables (odds ratio=0.78, 95% confidence interval=0.48,1.26). CONCLUSION: Smoking cessation in this elderly cohort was associated with different subject characteristics from those that predict successful cessation in younger populations, suggesting that older smokers may have unique reasons to stop smoking. Further study is needed to assess potential motives and benefits associated with smoking cessation at an advanced age. [source] A long-term follow-up study on the natural course of oral leukoplakia in a Swedish population-based sampleJOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 2 2007A. Roosaar Aim:, To assess the natural course of screening-detected oral leukoplakia (OL) among non-consulting individuals. Methods:, A cohort of 555 individuals with OL, confirmed in 1973,1974 during a population-based survey, were followed through January 2002 via record linkages with nationwide and essentially complete registers. A sample of 104 drawn from the 297 surviving cohort members who still were living in the area in 1993,1995 was invited to a re-examination. Sixty-seven of them attended. Results:, At the time of re-examination OL had disappeared in 29 (43%) individuals. There was a statistically significant association between cessation of/no smoking habits in 1993,1995 and the disappearance of OL. Never/previous daily smokers were thus over-represented among individuals whose OL had disappeared compared to those with persisting OL [n = 23 (82%) vs. n = 18 (47%), P < 0.01]. Eighteen (78%) of the twenty three non-smokers with disappearing OL had quit after the initial examination. One man and two women developed oral cancer during follow-up while 0.7 and 0.07, respectively, were expected. Conclusion:, Smoking cessation was associated with an increased disappearance of OL. Hence, at least one-fourth had lesions that could be classified as tobacco-related. Small observed and expected numbers prohibited firm conclusions about a possible excess risk of developing oral cancer. [source] Review article: smoking cessation as primary therapy to modify the course of Crohn's diseaseALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 8 2005G. J. Johnson Summary This article aims to offer an updated review of the effects of smoking on inflammatory bowel disease, and provide a review of the methods of achieving smoking cessation. A systematic review of Embase and Medline databases was conducted. Smoking causes opposing effects on ulcerative colitis and Crohn's disease. The odds ratio of developing ulcerative colitis for smokers compared with lifetime non-smokers is 0.41. Conversely, smokers with Crohn's disease have a more aggressive disease requiring more therapeutic intervention. Smoking cessation is associated with a 65% reduction in the risk of a relapse as compared with continued smokers, a similar magnitude to that obtained with immunosuppressive therapy. Although difficult to achieve smoking cessation can best be encouraged by accessing appropriate counselling services, nicotine replacement therapy and bupropion. Using a combination of these treatments there is an improved chance of success of up to 20% compared with an unassisted quit attempt. Smoking cessation unequivocally improves the course of Crohn's disease and should be a primary therapeutic aim in smokers with Crohn's disease. [source] Effective management of smoking in an oral dysplasia clinic in LondonORAL DISEASES, Issue 1 2006TWJ Poate Background:, Precancerous lesions precede the development of oral cancer; of several clinical types the most common is leukoplakia. The risk factors include tobacco and excess alcohol use and diets low in antioxidants. Studies concerning the management of risk factors related to oral precancer are meager. Objectives:, We investigated the effectiveness of smoking cessation at a dysplasia clinic among patients followed up for at least for 12 months. Methods:, Data from case notes relating to180 patients with white and red patches of oral mucosa (excluding other benign disorders confirmed by biopsy findings) attending a dysplasia clinic at a teaching hospital in London and seen by one consultant between 1993 and 2003 were transcribed. Effect of referring to a smoker's clinic to receive specialist help was evaluated against brief advice given at the dysplasia clinic ± medications. Results:, The mean age at the first visit was 48.5 years (±12.5), 65% were male, and 88% were white European. One hundred and sixty-two patients (90%) had used tobacco and 83% were current smokers. Of the smokers 95% had smoked over 10 years, the majority smoking over 10 cigarettes per day. Nine were alcohol misusers including two binge drinkers. One hundred and forty-six were diagnosed with oral leukoplakia, 16 with non-homogeneous types (speckled or nodular). Three patients were diagnosed with an erythroplakia. Nineteen per cent exhibited the presence of dysplasia and one subject had in situ carcinoma. Five patients in the sample quit smoking prior to arrival in the dysplasia clinic. Twenty-seven cases (20%) with oral leukoplakia quit smoking while registered as a patient at the dysplasia clinic: 17 of 100 subjects quit with brief advice ± medications and 10 of 30 following referral to the smoker's clinic. The difference between the two groups was significant for point prevalence abstinence at the last visit to the clinic (minimum 12 months follow up). Out of a total of 180 precancer cases managed in the dysplasia clinic (mean follow up 4.2 years) three patients subsequently developed invasive carcinoma during follow up. Conclusions:, Smoking cessation needs to be an integral component of management of cases attending a dysplasia clinic and referring to smoker's clinics could help to improve the effectiveness of managing patients with oral precancer to quit smoking. [source] Cessation in the use of tobacco , pharmacologic and non-pharmacologic routines in patientsTHE CLINICAL RESPIRATORY JOURNAL, Issue 1 2008Petter Quist-Paulsen Abstract Introduction:, Approximately one-third of the adult population in industrial countries and 70% in several Asian countries are daily smokers. Tobacco is now regarded as the world's leading cause of death. Approximately two-thirds of lifelong smokers eventually die because of smoking. Smoking cessation is the most effective action to reduce mortality in patients with chronic obstructive pulmonary disease (COPD) and coronary heart disease. Objective:, The aim of this study was to determine the effectiveness of smoking cessation programmes in patients with smoking-related disorders. Methods:, Medline was searched for studies of interventions for smoking cessation in patients. Results:, In patients with cardiovascular diseases and COPD, smoking cessation programmes with behavioural support over several months significantly increase quit rates. The intensity of the programmes seems to be proportional to the effect. A long follow-up period is probably the most important element in the programmes. Even the most intensive programmes are very cost-effective in terms of cost per life-year gained. Effective programmes can be delivered by personnel without special education in smoking cessation using simple intervention principles. Conclusions:, In patients with smoking-related disorders, smoking cessation interventions with several months of follow-up are effective and easily applicable in clinical practice. Wider implementation of such programmes would be a cost-effective way of saving lives. Please cite this paper as: Quist-Paulsen P. Cessation in the use of tobacco , pharmacologic and non-pharmacologic routines in patients. The Clinical Respiratory Journal 2008; 2: 4,10. [source] Recrudescent Tobacco Exposure Following Heart Transplantation: Clinical Profiles and Relationship with Athero-Thrombosis Risk MarkersAMERICAN JOURNAL OF TRANSPLANTATION, Issue 5 2005Mandeep R. Mehra To identify tobacco recidivism among 86 heart transplant recipients who were smokers but demonstrated compliance with a smoking cessation program pre-transplant, we used a questionnaire and randomly tested urine for nicotine and its by-products. In 36 patients, we also evaluated circulating levels of HS-CRP, homocysteine and MPV. Twenty-eight (32.5%) of 86 patients met our definition for tobacco exposure. In this cohort, 28 (32.5%) of 86 patients met our definition for tobacco exposure. Of these 28, 12 patients self-reported tobacco use and demonstrated biochemical verification; 14 patients demonstrated only biochemical evidence of significant tobacco exposure; 2 patients self-reported tobacco use but did not demonstrate biochemical positivity. Smoking cessation within 6 months of transplantation (r = 0.52) and time post-transplantation (r = 0.43) were independent predictors for recidivism of tobacco use, p < 0.01. No differences in HS-CRP, homocysteine and MPV levels were noted among the groups. Our investigation demonstrates a high rate of tobacco recidivism among heart transplant recipients, yet few admit to it. The adverse effects of tobacco do not appear to be directly modulated by an effect on athero-thrombotic risk markers. [source] A retrospective evaluation of the impact of total smoking cessation on psychiatric inpatients taking clozapineACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2010I. Cormac Cormac I, Brown A, Creasey S, Ferriter M, Huckstep B. A retrospective evaluation of the impact of total smoking cessation on psychiatric inpatients taking clozapine. Objective:, To investigate the effect of a complete smoking ban on a group of psychiatric inpatients maintained on the antipsychotic medication clozapine. Method:, Retrospective data on clozapine dose and plasma levels were collected from a three month period before and a six month period after the introduction of the smoking ban. Results:, Before the ban only 4.2% of patients who smoked had a plasma clozapine level ,1000 ,g/l but after the ban this increased to 41.7% of the sample within the six month period following the ban despite dose reductions. Conclusion:, Abrupt cessation of smoking is associated with a potentially serious risk of toxicity in patients taking clozapine. Plasma clozapine levels must be monitored closely and adjustments made in dosage, if necessary, for at least six months after cessation. [source] Postgraduate education for doctors in smoking cessationDRUG AND ALCOHOL REVIEW, Issue 5 2009NICHOLAS A. ZWAR Abstract Introduction and Aims. Smoking cessation advice from doctors helps improve quit rates but the opportunity to provide this advice is often missed. Postgraduate education is one strategy to improve the amount and quality of cessation support provided. This paper describes a sample of postgraduate education programs for doctors in smoking cessation and suggests future directions to improve reach and quality. Design and Methods. Survey of key informants identified through tobacco control listserves supplemented by a review of the published literature on education programs since 2000. Programs and publications from Europe were not included as these are covered in another paper in this Special Issue. Results. Responses were received from only 21 key informants from eight countries. Two further training programs were identified from the literature review. The following components were present in the majority of programs: 5 As (Ask, Advise, Assess, Assist and Arrange) approach (72%), stage of change (64%), motivational interviewing (72%), pharmacotherapies (84%). Reference to clinical practice guidelines was very common (84%). The most common model of delivery of training was face to face. Lack of interest from doctors and lack of funding were identified as the main barriers to uptake and sustainability of training programs. Discussion and Conclusions. Identifying programs proved difficult and only a limited number were identified by the methods used. There was a high level of consistency in program content and a strong link to clinical practice guidelines. Key informants identified limited reach into the medical profession as an important issue. New approaches are needed to expand the availability and uptake of postgraduate education in smoking cessation.[Zwar NA, Richmond RL, Davidson D, Hasan I. Postgraduate education for doctors in smoking cessation. Drug Alcohol Rev 2009;28:466,473] [source] Role of the general practitioner in smoking cessationDRUG AND ALCOHOL REVIEW, Issue 1 2006NICHOLAS A. ZWAR Abstract This paper reflects on the role of general practitioners in smoking cessation and suggests initiatives to enhance general practice as a setting for effective smoking cessation services. This paper is one of a series of reflections on key issues in smoking cessation. In this article we highlight the extent that general practitioners (GPs) have contact with the population, evidence for effectiveness of GP advice, barriers to greater involvement and suggested future directions. General practice has an extensive population reach, with the majority of smokers seeing a GP at least once per year. Although there is level 1 evidence of the effectiveness of smoking cessation advice from general practitioners, there are substantial barriers to this advice being incorporated routinely into primary care consultations. Initiatives to overcome these barriers are education in smoking cessation for GPs and other key practice staff; teaching of medical students about tobacco and cessation techniques, clinical practice guidelines; support for guideline implementation; access to pharmacotherapies; and development of referral models. We believe the way forward for the role of the GPs is to develop the practice as a primary care service for providing smoking cessation advice. This will require education relevant to the needs of a range of health professionals, provision of and support for the implementation of clinical practice guidelines, access for patients to smoking cessation pharmacotherapies and integration with other cessation services such as quitlines [source] | |||||||||||||||||||