Objective of Treatment ebooksclub.org Tobacco or Health Physiological and Social Damages Caused by Tobacco Smoking Second Edition
10.3 Self-Help Interventions by the Smoker
Undoubtedly,theidealsituationisforthesmokertodecideoneday,moreorlesssponta- neously,togiveupsmokingandfromthattimeonwardsnevertosmoke.Thistypeof decisioniscommonlytakenonspecialdaysoftheyeare.g.asaNewYear’sresolution Oddsratio Assessment Reference Reducedsmoking – ßß – Self-helpinterventions 1.231.01–1.49 Û [25] Self-helpinterventionwith telephonecounselling 1.621.33–1.97 Ý [25] Trainingbyhealthcare professionals 1.481.20–1.83 Û [56] Nurse-managedcounselling 1.431.24–1.66 Ý [65] Physiciancounselling 1.691.45–1.98 Ý [59] Individualcounsellingshort counsellingsession, booklet,etc. 1.551.27–1.90 Û [114] Grouptherapybehavioural therapy 2.101.64–2.70 ÝÝ [70,114] Hypnotherapy + Û [115] Aversiontherapyaversive stimulation 2.081.39–3.12 Ý [77] Aversiontherapygeneral 1.190.77–1.83 Û [77] Acupuncture 1.220.99–1.49 ßß [106] Table 10.2 Assessmentofnon-drugtreatmentmodalitiestopromotesmokingcessation,compiled fromtheCochraneDatabase ÝÝ Claime.g.oneficacysupportedbyseveralsuitable,validclinicalstudiese.g.randomised clinicaltrialsorbyoneormorevalidmeta-analysesorsystematicreviews.Positiveclaimclearly conirmed Ý Claime.g.oneficacysupportedbyatleastonesuitable,validclinicalstudye.g.randomised clinicaltrial.Positiveclaimconirmed ßß Negativeclaime.g.oneficacysupportedbyoneormoresuitable,validclinicalstudiese.g. randomisedclinicaltrialsorbyoneormorevalidmeta-analysesorsystematicreviews.Negative claimclearlyconirmed Û Noreliablestudyresultsavailabletoconirmapositiveornegativeeffect.Thismaybeduetothe absenceofsuitablestudies,butalsototheavailabilityofseveralstudieswithcontradictoryresults +Nousablestudies and,morerarely,isalsoactedupon.Greaterseriousnessisattachedtodecisionsthatare promptedbypersonalillnessorbytheillnessordeathofafamilymemberorclosefriend. Fromourownexperienceofcounsellingsmokers,weknowthatevenheavysmokers 40–60cigarettesdaycancarrythroughsuchdecisionswithoutmajoreffort.The6stud- iespublishedtodateinwhichself-helpinterventionsledtosuccessfulsmokingcessation for6–9monthsOR=1.08;CI:0.81–1.44or12monthsOR=1.0;CI:0.75–1.34are of limited value because biochemical variables were measured in only isolated cases [12] .Thesupportofapartnerwasdescribedasanincreasingsuccessfulaspectforquit- ting in only 2 of the 6 studies [12] . Smokers whose partners are non-smokers or ex- smokersaremorelikelytobesuccessfulatquitting [13,14] .Currentlymarriedsmokers haveahigherchanceofsuccessthandivorced,widowedornevermarriedsmokers [15] . Thesupportofthespousemaybebeneicialforsuccess [16,17] .Ifsmokersarecon- stantly nagged, face complaints about their behaviour or are repeatedly criticised for failedattemptsto quitsmoking,then their positionbecomesentrenched [18] .Studies indicatingthepositiveinluenceofthespousepartnerinthiscontextarecounteredby otherswhicharecriticaloftheirrole [19,20] .Twosystematicstudiesreportthesupport- iveeffectofapartnerinachievingsmokingcessation [21,22] ,inonecaseincludingthe recommendationsoftheAHQR [21] . However, numerous organisations also provide self-help manuals designed to assist smokerswhowishtoquit [23,24] .Consultingatherapist,inaddition,mayenhancethe effectivenessofthemethod [23] .Standardinstructionshavebeenfoundtobelesseffective thanpersonalisedinstructionstailoredforagroupofsmokersOR=1.41;CI:1.14–1.75 [25] .Overall,instructionsonsmokingcessationareassessedasusefulandmoreeffective thanattemptingsmokingcessationwithoutinstructions. Sporting activities are a key aspect of self-help to achieve smoking cessation [26] . Physicalexercisehasabeneicialeffectoncravings [27] ,depressedmood [28] ,sleepdis- turbances [29] ,feelingsoftension [30] ,stresssituations [31] andonweightgainfollowing smokingcessation,anaspectthatisespeciallyimportantforwomen [32–34] .Sportalso hasapositiveeffectonrelapses [35] ,copingwiththesmokingproblem [36] andself- esteem [37] .Overall,ofcourse,physicalactivityconfershealthbeneitsontheex-smoker [38] ;heavysmokersoftenalreadynoticethisjust2or3weeksafterstoppingsmokingand theyvolunteerthisinformationspontaneouslyduringcounsellingsessions.Outofatotal of8studiesofthisaspectpublishedtodate,6couldnotbeassessedbecausepatientnum- bersweretoosmall.Intheinalanalysis,therefore,only1studyprovidedpositiveevi- denceoftheeffectofvigorousexerciseintermsofsmokingcessationOR=2.36;CI: 0.97–5.70 [39] ,withadeiniteincreaseincontinuousabstinencecomparedwithcontrols 11.9vs.5.4;p=0.05 [39] . Todeterminewhetherexercise-basedinterventionsaloneorcombinedwithasmoking cessationprogrammearemoreeffectivethanasmokingcessationinterventionalone, UsshersearchedtheCochraneTobaccoAddictionGroupspecializedregisterforstudies including the terms “exercise” or “physical activity” and MEDLINE, EMBASE, PsycINFO, CINAHL, Dissertation Abstracts and SPORTDiscus. Randomized trials whichcomparedanexerciseprogrammealoneoranexerciseprogrammeasanadjunct toacessationprogrammewithacessationprogrammerecruitingsmokersorrecentquit- ters,andwithafollow-upof6monthsormorewereincludedinthe [40] .EleventrialsParts
» Tobacco Plants and Their Origin Use of Tobacco for Religious Purposes
» The Appropriation of Tobacco by Europeans
» Development of the Cigarette
» Objections to Smoking on Health Grounds
» Women Won Over by the Cigarette
» The Medical Use of Tobacco in the Nineteenth Century
» Tobacco Research in the Twentieth Century
» Tobacco Consumption in the Twentieth Century
» Cigarette Smoking in the USA Since 1965
» Cigarette-Related Mortality in Different Countries
» Smokers and Other Risk Factors
» Smoking Behaviour and Educational Level in the EU
» Non-Disclosure of Findings by the Tobacco Industry
» The Cigarette as a Vehicle for Nicotine Release
» Modifications of Nicotine Release
» Maintaining Nicotine Dependence Nicotine and Dependence
» Marketing of Cigarettes with a “Reduced” Health Risk
» Compensatory Behaviour by Smokers
» Optimising Nicotine Release Nicotine and Dependence
» Importance of Absorption Rate
» Ammonium and pH Manipulation
» Cigarettes with Reduced Tar Yield
» Agonists and Antagonists of the nAChR and its Subtypes
» Effects of Nicotine on Receptors in Different Organs
» Metabolic and Hormonal Effects of Nicotine
» Central Nervous System Effects of Nicotine
» Types of Dependence Nicotine Dependence
» Molecular Biological Aspects of Dependence
» Genetic Aspects Nicotine Dependence
» Withdrawal Symptoms Nicotine Dependence
» Immunological Reactions Caused by Cigarette Smoking
» Association Between Smoking and Lung Cancer
» Tobacco-Specific Carcinogens Genetic Factors That Increase the Risk for Bronchial Carcinoma
» The Cytochrome P450 and GST System and Carcinogenesis
» Peptide Receptors, Genetic Factors That Increase the Risk for Bronchial Carcinoma
» Exogenous Factors and Lung Cancer
» Pathophysiology of COPD Cigarette Smoking and COPD
» Genetic Factors Important Risk Factors for COPD
» Occupational and Environmental Factors
» Caveats Concerning the Informative Value of Studies
» Cigarette Smoking and Bronchial Asthma in Adults
» Bronchial Asthma in Children
» Other Lung Diseases Influenced by Cigarette Smoking
» Coronary Artery Disease and Myocardial Infarction
» Changes in Endothelial Function and Microcirculation
» Microcirculation and O Systemic Vascular Changes
» Arteriosclerotic and Inflammatory Vascular Reactions
» Genetic Factors Blood Coagulation and Fibrinolysis
» Nicotine and Ischaemic Heart Disease
» Cognitive Impairment Central Nervous System
» Influence on Cognitive Performance
» Intellectual Impairment in Childhood
» Smoker Personality Profiles and Genetic Inheritance of Smoking
» Peculiarities of the Smoker’s Personality
» Reasons for Increased Cigarette Consumption
» Comorbidity Between Depression and Smoking
» Extent of Cigarette Consumption
» Effects of Smoking in Forms of Dementia
» Smoking and Parkinson’s Disease
» Diabetic Retinopathy Ocular Diseases
» Graves’ Ophthalmopathy Ocular Diseases
» Macular Degeneration Ocular Diseases
» Ocular Tumours Ocular Diseases
» Retinal Detachment Ocular Diseases
» Lipid and Cholesterol Metabolism
» Insulin Resistance Diabetic Nephropathy
» Oesophageal Cancer Gastrointestinal Tract
» Gastrointestinal Ulcers Gastrointestinal Tract
» Cancers of the Gastrointestinal Tract
» Pancreatic Cancer Gastrointestinal Tract
» Toxic Substances and Inducers
» Kidney Cancer Urinary Tract Diseases
» Bladder Cancer Urinary Tract Diseases
» Prostatic Hyperplasia and Prostatic Cancer
» Fertility Disorders Urinary Tract Diseases
» Vitamin D and Oestrogen Metabolism
» Osteoporosis Disorders of Mineral Metabolism and Bone
» Hip Fractures Disorders of Mineral Metabolism and Bone
» Skin Changes Skin and Mucosa
» Skin Tumours Skin and Mucosa
» Breast Cancer Skin and Mucosa
» Effects of Smoking on the Placenta
» Malformations Possibly Caused by Smoking
» Smoking and Sudden Infant Death Syndrome SIDS
» Effects of Nicotine on the Foetus
» Medical Care Costs Attributable to Smoking During Pregnancy
» ETS in the Workplace and at Home
» Fibrinogen Cholesterol Endothelium and Platelets
» Markers of Inflammation Changes at the Molecular and Cellular Level
» Passive Smoking During and After Pregnancy
» Coronary Heart Disease Cardiovascular Disease
» Stroke and Subarachnoid Haemorrhage
» Respiratory Tract in Children and Teenagers
» Bronchial Carcinoma Respiratory Tract
» Indications and Diagnostic Considerations
» Self-Help Interventions by the Smoker
» Physician Advice for Smoking Cessation
» Group Behaviour Therapy Programmes
» Mass Media Communication Strategies
» E-Learning, Email and Internet for Smoking Cessation
» Evaluation of Nicotine Products
» Nicotine Chewing Gum Nicotine
» Nicotine Sublingual Tablet Nicotine Nasal Spray
» Treatment and Dosage Nicotine
» Nicotine Chewing Gum Adverse Events Associated with NRT
» Nicotine Patch Adverse Events Associated with NRT
» Nicotine Nasal Spray Adverse Events Associated with NRT
» Nicotine Inhaler Adverse Events Associated with NRT
» Nicotine Sublingual Tablet Adverse Events Associated with NRT
» Nicotine Lozenge Adverse Events Associated with NRT
» Drug Interactions During Smoking Cessation
» Contraindications for the Use of Nicotine Products
» Nicotine Formulations as OTC Products
» Contraindications and Drug Interactions
» Tranquillisers and Buspirone Other Pharmacotherapies
» Various Antidepressants Other Pharmacotherapies
» Opioid Antagonists Other Pharmacotherapies
» Silver Acetate Other Pharmacotherapies
» Therapeutic Monitoring in Smoking Cessation
» Ischaemic Heart Disease Special Therapeutic Situations
» Pregnancy Special Therapeutic Situations
» Weight Gain Special Therapeutic Situations
» Alcohol Consumption Special Therapeutic Situations
» Organic Depression Organic Depression and Schizophrenia
» Schizophrenic Patients Organic Depression and Schizophrenia
» Interactions Between Cigarette Smoking and Administration of Psychopharmaceuticals
» Pre-operative Smoking Cessation Special Therapeutic Situations
» Social Influence Inoculation Strategy
» Life Skills Strategy Prevention Programmes for Schools
» Class 2000 Health Promotion Programme
» Trier University Health Programme Long-Term Studies
» Role of Teachers in Primary Prevention
» Prevention by Restricting Sales of Tobacco Products to Minors
» Role of the Mass Media in Sales of Tobacco Products to Adolescents
» Role of Government and Community in Primary Prevention
» Effect of Tobacco Industry Advertising Messages
» Tobacco Advertising and Adolescent Smoking Initiation
» Advertising with “Light” Cigarettes
» Smoking Bans in Public Buildings and Public Spaces
» Tobacco Industry, Governmental and Non-governmental Organisations
» Politicians and Their Attitude to Smoking
» Scientists and the Tobacco Industry
» Governmental Control of Toxic Tobacco Constituents
» Bans on Advertising in Various Countries
» Tobacco Industry: Playing Down the Risks of Smoking and Passive Smoking
» Smoking and Non-smoking: Weighing the Benefits
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