Or after the development of a tobacco related disease

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Unformatted text preview: expectancy, even when smokers stop smoking after the age of 65 years or after the development of a tobacco-related disease. Proportion of smokers who try to Approximately 1/3 of smokers try to stop smoking each year, but only 20% of them seek quite each year; % seeking help; h elp. Fewer than 10% of smokers who attempt to quit on their own are successful over the % of those who are successful long term. Smokers have a higher rate of success when they seek help with quitting. What is the chief physiological obstacle to quitting? Nicot ine wit hdrawal Addictive nature of nicotine. Nonspecific, vary widely in intensity and duration, and are not correctly identified by smokers. Symptoms begin a few hours after the last cigarette, peak 2 - 3 days later, and wane over a period of several weeks or months. 1. Pharmacotherapy 2. Counseling: Group or individual counseling is effective when it is provided by trained c ounselors and includes repeated contacts over a period of at least 4 weeks. Smokers t ypically learn to identify smoking cues, then use cognitive and behavioral methods to break t he link between the cues and smoking. % by which a physician's advice 30% . to stop smoking increases the rates of smoking cessation among patients. 2 approaches that have strong evidence of efficacy for smoking cessation Nicot ine-replacement t herapy Nicotine-replacement therapy provides an alternative form of nicotine to relieve symptoms of w ithdrawal. It is safe in patients with cardiovascular disease, including stable angina. Unlike s moking, it does not increase the coagulability of blood or expose a patient to carbon monoxide or oxidizing gases that damage endothelium. 1. The patch provides a relatively stable, fixed dose of nicotine over a period of 16 - 24 hrs. Slow onset and long duration. Blood nicotine levels peak 2 - 4 hrs after administration 2. Nicotine gum - blood nicotine levels peak 20 mins after administration 3. Nasal spray - blood nicotine levels peak 5 - 10 mins after administration 4. Vapor inhaler - blood nicotine levels peak 20 mins after administration Non-nicot ine t herapy Buproprion is an anti-depressant with dopaminergic and noradrenergic activity. Efficacious f or smoking cessation when combined with counseling. May temporarily reduce weight gain after cessation. Average weight gain after 2.3 - 4.5 kg (5 - 10 lbs) smoking cessation Characteristics associated with a 1. Coexisting psychiatric conditions low rate of successful treatment 2. Alcohol or substance abuse 3. Strong nicotine dependence 4. Lack of social support for quitting 5. Low level of confidence in one's ability to quit Smokers with a history of depression who attempt to quit smoking not only have lower rates of success but also have more depressive symptoms during nicotine withdrawal and a greater risk of recurrent depression after cessation. CHAPTER 10: COMPLEMENTARY/ALTERNATIVE MEDICINE Lecture: Complementary & Wednesday, September 21, 2005 Alternative Medicine 6 t ypes of CA...
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