Smoking cessation: Difference between revisions

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==Treatment==
==Treatment==
===Demonstration of damage to lungs===
===Counseling===
In general, informing patients of their lung function as measured by spirometry does not increase smoking cession according to a [[systematic review]] by the [[US Preventive Services Task Force|               U.S. Preventive Services Task Force]]  (USPSTF).<ref name="pmid18316746">{{cite journal |author=Lin K, Watkins B, Johnson T, Rodriguez JA, Barton MB |title=Screening for Chronic Obstructive Pulmonary Disease Using Spirometry: Summary of the Evidence for the U.S. Preventive Services Task Force |journal=Ann. Intern. Med. |volume= |issue= |pages= |year=2008 |pmid=18316746 |doi= |url=http://www.annals.org/cgi/pmidlookup?view=long&pmid=18316746 |issn=}}</ref> However, in a more recent [[randomized controlled trial]], patients in the group who were informed of their 'lung age' were more likely to stop smoking.<ref name="pmid18326503">{{cite journal |author=Parkes G, Greenhalgh T, Griffin M, Dent R |title=Effect on smoking quit rate of telling patients their lung age: the Step2quit randomised controlled trial |journal=BMJ |volume= |issue= |pages= |year=2008 |pmid=18326503 |doi=10.1136/bmj.39503.582396.25 |url=http://bmj.com/cgi/pmidlookup?view=long&pmid=18326503 |issn=}}</ref> However, in this trial, "People with worse spirometric lung age were no more likely to have quit than those with normal lung age in either group".<ref name="pmid18326503"/>
Recording smoking status as a vital sign increases the frequency of brief advice to patients by physicians.<ref name="pmid18195316">{{cite journal |author=Rothemich SF, Woolf SH, Johnson RE, ''et al'' |title=Effect on cessation counseling of documenting smoking status as a routine vital sign: an ACORN study |journal=Ann Fam Med |volume=6 |issue=1 |pages=60-8 |year=2008 |pmid=18195316 |doi=10.1370/afm.750 |url=http://www.annfammed.org/cgi/pmidlookup?view=long&pmid=18195316 |issn=}}</ref>
 
====Demonstration of damage to lungs====
In general, informing patients of their lung function as measured by spirometry does not increase smoking cession according to a [[systematic review]] by the [[US Preventive Services Task Force| U.S. Preventive Services Task Force]]  (USPSTF).<ref name="pmid18316746">{{cite journal |author=Lin K, Watkins B, Johnson T, Rodriguez JA, Barton MB |title=Screening for Chronic Obstructive Pulmonary Disease Using Spirometry: Summary of the Evidence for the U.S. Preventive Services Task Force |journal=Ann. Intern. Med. |volume= |issue= |pages= |year=2008 |pmid=18316746 |doi= |url=http://www.annals.org/cgi/pmidlookup?view=long&pmid=18316746 |issn=}}</ref> However, in a more recent [[randomized controlled trial]], patients in the group who were informed of their 'lung age' were more likely to stop smoking.<ref name="pmid18326503">{{cite journal |author=Parkes G, Greenhalgh T, Griffin M, Dent R |title=Effect on smoking quit rate of telling patients their lung age: the Step2quit randomised controlled trial |journal=BMJ |volume= |issue= |pages= |year=2008 |pmid=18326503 |doi=10.1136/bmj.39503.582396.25 |url=http://bmj.com/cgi/pmidlookup?view=long&pmid=18326503 |issn=}}</ref> However, in this trial, "People with worse spirometric lung age were no more likely to have quit than those with normal lung age in either group".<ref name="pmid18326503"/>


===Medications===
===Medications===

Revision as of 04:55, 19 March 2008

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Etiology of smoking

Tobacco smoking as self-medication

Treatment

Counseling

Recording smoking status as a vital sign increases the frequency of brief advice to patients by physicians.[1]

Demonstration of damage to lungs

In general, informing patients of their lung function as measured by spirometry does not increase smoking cession according to a systematic review by the U.S. Preventive Services Task Force (USPSTF).[2] However, in a more recent randomized controlled trial, patients in the group who were informed of their 'lung age' were more likely to stop smoking.[3] However, in this trial, "People with worse spirometric lung age were no more likely to have quit than those with normal lung age in either group".[3]

Medications

Rimonabant

Rimonabant, a selective type 1 cannabinoid (CB1) receptor antagonist, improves smoking cessation and moderate weight gain associated with smoking cessation according to a meta-analysis of randomized controlled trials by the Cochrane Collaboration.[4] However, "there is current concern (August 2007) over rates of depression and suicidal thoughts in people taking rimonabant for weight control."[4]

References

  1. Rothemich SF, Woolf SH, Johnson RE, et al (2008). "Effect on cessation counseling of documenting smoking status as a routine vital sign: an ACORN study". Ann Fam Med 6 (1): 60-8. DOI:10.1370/afm.750. PMID 18195316. Research Blogging.
  2. Lin K, Watkins B, Johnson T, Rodriguez JA, Barton MB (2008). "Screening for Chronic Obstructive Pulmonary Disease Using Spirometry: Summary of the Evidence for the U.S. Preventive Services Task Force". Ann. Intern. Med.. PMID 18316746[e]
  3. 3.0 3.1 Parkes G, Greenhalgh T, Griffin M, Dent R (2008). "Effect on smoking quit rate of telling patients their lung age: the Step2quit randomised controlled trial". BMJ. DOI:10.1136/bmj.39503.582396.25. PMID 18326503. Research Blogging.
  4. 4.0 4.1 Cahill K, Ussher M (2007). "Cannabinoid type 1 receptor antagonists (rimonabant) for smoking cessation". Cochrane Database Syst Rev (4): CD005353. DOI:10.1002/14651858.CD005353.pub3. PMID 17943852. Research Blogging.