1,721,153 research outputs found
Fumo, malattie respiratorie e terapie per smettere di fumare
No full textIl fumo di tabacco è la principale causa di morte
prematura e prevenibile: continua ad uccidere circa
6 milioni di persone ogni anno, inclusi 600.000
non fumatori esposti al fumo passivo, e si stima che
il numero delle morti causate dal fumo potrebbe
ammontare a 8,3 milioni nell’anno 2030 [http://
www.who.int/tobacco/en/].
In Italia è attribuibile al fumo di tabacco un
numero di decessi variabile tra 70.000 e 83.000
ogni anno, circa 220 morti al giorno (http://www.
ministerosalute.it).
L’Organizzazione Mondiale della Sanità (OMS)
ha implementato e incoraggiato la Convenzione
Quadro per il Controllo del Tabacco (WHO Framework
Convention on Tobacco Control, FCTC).
La FCTC è il primo trattato internazionale per la
tutela della salute pubblica che stabilisce obiettivi
e principi giuridicamente vincolanti che i firmatari
sono tenuti a rispettare; hanno formalmente
aderito 172 Paesi corrispondenti all’87% della
popolazione mondiale (http://www.who.int/fctc/
reporting/en/).
Nonostante l’impatto epidemiologico ed economico
legato alla patologia fumo-correlata sia
considerato uno dei maggiori problemi sanitari
del pianeta, l’attenzione al problema del fumo, il
riconoscimento e la diagnosi della dipendenza da
tabacco e il trattamento del tabagismo sono ancoralontani dalla pratica clinica degli operatori sanitari
medici e non medici, compresi coloro che operano
in ambito pneumologico.
L’obiettivo di questo capitolo è quello di fornire
elementi di base per la conoscenza delle dimensioni
dell’epidemia da tabacco, dei danni sulla salute
causati e correlati all’abitudine al fumo, dei benefici
conseguenti alla sua cessazione, dei meccanismi
pato-fisiologici e sociali del tabagismo e del trattamento
della malattia fumo. Attenzione verrà rivolta
alle problematiche connesse alla patologia respiratoria
e al trattamento in ambito pneumologico. A
causa della vastità delle conoscenze scientifiche, la
trattazione che segue è necessariamente sintetica e
propone al suo interno strumenti e riferimenti fruibili
per l’approfondimento dei molteplici aspetti
del problema
Weight gain after smoking cessation
No full textBoth overweight or obesity and cigarette smoking are
relevant risk factors for public health. Cigarette smoking is
associated with lower body weight while smoking cessation
is associated with weight gain. Most smokers who quit experience
a weight gain, particularly within one year, and it
may persist up to 8 years after smoking cessation. However,
only a minority of quitters gain excessive weight. Some
individual characteristics have been found to be associated
with excessive weight gain after smoking cessation while
methodological problems may affect estimates of weight
gain observed in different studies. Main mechanisms to explain
weight gain after smoking cessation include increased
energy intake, decreased resting metabolic rate, and decreased
physical activity. The health benefits of smoking
cessation far exceed any health risks that may result from
smoking cessation-induced body weight gain. As weight
gain may be a barrier against quitting smoking or a reason
to restart smoking, behavioural and pharmacological
methods have been evaluated to control weight gain after
smoking cessation. Physicians should apply efficient strategies
to promote smoking cessation on their weight-concerned
smoking patient. This review briefly addresses
some issues on the relationship between smoking cessation
and weight gain, with regard to the size of the problem,
mechanisms, health risks and control strategies
Smoking cessation as a therapeutic and preventive intervention: a meeting report
No full textIn november 2000, a meeting tool place on “Smoking cessation as a therapeutic and preventive intervention”. The venue of the Meeting was Venice, in the old Monastery of the Isola San Giorgio, and it was jointly organised by the Italian Association of Hospital Pulmonologists (AIPO) and the European Section of the Society for Research on Nicotine and Tobacco (SRNT – Europe). The meeting was also sponsored by the European Respiratory Society (ERS).
The importance of the topic cannot be underestimated. According to the World Health Organisation (WHO) tobacco smoking is the most important cause of preventable death in the industrialised world. When tobacco smoking constitutes a repetitive and compulsive behaviour, for instance when a person continues smoking when suffering from a smoking related disease, it is due to tobacco dependence, which both WHO and the American Psychiatric Association classify as a disease. Tobacco smoking is not only a disease in itself but can also cause other diseases, such as chronic obstructive lung disease, lung cancer and cardiovascular disease, and can worsen pre-existent disease, e.g. asthma. In the WHO European region, according to WHO estimates, tobacco smoking causes at least 1,200,000 deaths each year (14% of all death). So far, a preventive strategy based on protection of children and adolescents from initiation has not worked in decreasing the prevalence among young generations. Even with the best educational programs success is partial and ephermeral.
Smoking cessation with behavioural and pharmacological aid is a well established therapeutic intervention, supported by strong scientific evidence. But smoking cessation can also be a preventive intervention, because it can reduce the prevalence of smokers in a community. Obviously, smoking cessation is to be used together with all other interventions recognised as effective in tobacco control (cigarette and tobacco product pricing, regulatory approaches, smoking bans, health education)
Lung cancer and chronic obstructive pulmonary disease: the story goes on
No full textNo abstract availabl
Depressive, anxious, withdrawal symptoms, and craving as possible predictors of abstinence maintenance in smokers attending a 12-week quitting program
Full text linkBACKGROUND INFORMATION: Depressive, anxious, withdrawal symptoms, and craving might affect differently the probability to maintain abstinence after quitting smoking.
OBJECTIVE: The objective of this study was to assess depressive, anxious, nicotine withdrawal symptoms, and craving in a sample of smokers attending a smoking cessation program over a period of 12 weeks.
METHODS: A naturalistic study was conducted in which 78 smokers were consecutively recruited for a 12 week evaluation program. Socio-demographic data and clinical information were collected, rating scales were used to assess anxious and depressive symptoms, nicotine dependence, withdrawal symptoms, and craving.
RESULTS: Of the 78 recruited smokers, 17 remained abstinent and 61 reverted to smoking during the period of 12 weeks. The probability of maintaining abstinence was increased when low depressive symptoms or low craving occurred during the cessation program.
CONCLUSION: The present results strengthen the importance of assessing depressive symptoms and craving over the follow-up of a physician-assisted smoking cessation program to detect abstaining smokers at risk to relapse
Pharmacotherapy for smoking cessation
No full textTobacco dependence is a chronic relapsing disease that needs continuous
treatment. In combination with behavioural support, pharmacotherapy is a proven key
component for supporting smoking cessation. Effective drugs are available and recommended:
nicotine replacement therapy (NRT), bupropion and varenicline. Much research into new
pharmacological approaches is ongoing, combining ‘old’ and ‘new’ drugs and personalizing
a pharmacological treatment for a single smoker/patient; other new medications and vaccines
are in development. Overall, pharmacotherapy seems to have efficacy and cost-effectiveness
in real life, thus physicians should become familiar with these medicines. Further efforts
should be aimed at optimizing treatment management and increasing smoking cessation
rates in the general population
Nicotine dependence and psychological distress: outcomes and clinical implications in smoking cessation
Full text linkNicotine dependence is characteristically a chronic and relapsing disease. Although
75%–85% of smokers would like to quit, and one-third make at least three serious lifetime
attempts, less than 50% of smokers succeed in stopping before the age of 60. Relevant and
complex factors contributing to sustained cigarette consumption, and strongly implicated in
the clinical management of smokers, are the level of nicotine dependence and psychological
distress. In this review of the literature, these two factors will be examined in detail to show
how they may affect smoking cessation outcome and to encourage clinicians to assess patients
so they can offer tailored support in quitting smoking
- …
