Smoking cessation in patients with respiratory diseases: a high priority, integral component of therapy

Abstract

Smoking cessation is the one of the most important ways to improve the prognosis of patients with respiratory disease. The Task Force on guidelines for smoking cessation in patients with respiratory diseases was convened to provide evidence-based recommendations on smoking cessation interventions in respiratory patients.Based on the currently available evidence and the consensus of an expert panel, the following key recommendations were made. 1) Patients with respiratory disease have a greater and more urgent need to stop smoking than the average smoker, so respiratory physicians must take a proactive and continuing role with all smokers in motivating them to stop and in providing treatment to aid smoking cessation. 2) Smoking cessation treatment should be integrated into the management of the patient's respiratory condition. 3) Therapies should include pharmacological treatment (i.e. nicotine replacement therapy, bupropion or varenicline) combined with behavioural support. 4) Respiratory physicians should receive training to ensure that they have the knowledge, attitudes and skills necessary to deliver these interventions or to refer to an appropriate specialist. 5) Although the cost of implementing these recommendations will partly be offset by a reduction in attendance for exacerbations, etc., a budget should be established to enable implementation.Research is needed to establish optimum treatment strategies specifically for respiratory patients.

Diagnóstico y tratamiento del hábito tabáquico en pacientes con EPOC. Estudio ADEPOCLE

“…El tratamiento farmacológico más utilizado fue la vareniclina en un 35,7% (32,5), seguido del bupropion en el 25,1% (22,0-28,1), p < 0,05 (Tabla V). Tan solo el 2,8% (1,7-4,0) utilizaba terapia farmacológica combinada.…”

“…El diagnóstico de los fumadores con EPOC previa, requiere, además, de la valoración de la autoeficacia y del estado de ánimo. El tratamiento del tabaquismo en estos fumadores es obligado y consiste en la combinación de terapia cognitivo-conductual (TCC) (10,11) y tratamiento farmacológico (12)(13)(14)(15)(16).…”

Tabagismo: parte I

“…Elas podem trocar suas experiências e relatar os benefícios do apoio mútuo entre os integrantes do grupo. Porém, não existem evidências suficientes para avaliar se a abordagem em grupo é mais efetiva ou custoefetivo, do que a abordagem individual intensiva 18 (a) 17 (d). Em relação ao tempo de abordagem, chegou-se à conclusão que uma abordagem intensiva de 90 minutos é o ideal.…”

Varenicline: a new pharmacotherapy for smoking cessation in primary care practice

“…9 The risk of coronary heart disease is reduced by 50% among ex-smokers one year after quitting and, by five years, the risk of stroke returns to the level of people who have never smoked. By 10 years after quitting, the risk of lung cancer reduces to 30 to 50% of those who continue to smoke and, by 15 years, the risk of cardiovascular heart disease becomes similar to those who have never smoked.…”

“…7,9,10 Thus, smoking cessation increases life expectancy regardless of age at quitting, although the effect is better when quitting at an earlier age, in those who smoked fewer cigarettes and in those who smoked for fewer years. 9 For example, stopping smoking at the age of 30 was shown to avoid smokingrelated mortality, whereas stopping smoking at the age of 50 reduces the risk of death from smoking by half.…”