How your family doctor can help you stop smoking

Smoking is the most important single eliminable risk factor for many diseases, including fatalities. Family doctors can effectively reduce the frequency of smoking among their patients.

“Six years ago, we talked about 6 million deaths caused by nicotinism worldwide, now 7 million. For comparison, around 1 million people die in traffic accidents around the world. ”

Longer life after quitting smoking

It is known from numerous studies that smoking shortens life. In 2004, the life expectancy of smokers compared to non-smokers was 10 years shorter. Since then, life expectancy has increased and the number of years lost for smokers is now probably 11-12.

“If a smoker quits smoking, his life will be longer. There is strong evidence that even patients who are 65 years of age or older smoke a few dozen years, after quitting, they live longer than those who did not stop smoking. Of course, they will not reach life expectancy like non-smokers, but they will live longer. ”

“If younger people give up cigarettes, they have the chance, at some point in their lives, to live to the point where the risk of dying from smoking will be the same as for a non-smoker. This shows that anti-smoking activities are worth taking because they are effective and translate into such hard endpoints as life expectancy. It is worth taking them as soon as possible. ”

WOBASZ I (conducted in the first decade of the 21st century) and WOBASZ II (10 years later) epidemiological studies show that virtually all disease risk factors are now more widespread than 10 years ago, with the exception of smoking. In this case, a decrease was noted: in the previous decade about 33 percent smoked. adult Poles, now we talk about 25-27 percent Statistics in Western European countries, however, are better because the percentage of smokers in the adult population reaches over a dozen percent there.

Nicotine addiction is a chronic disease

The cigarette has about 4 thousand. various chemicals, including nicotine. She is responsible for the development of addiction, but does not cause tobacco-related diseases by itself. It does not occur naturally in the human body, but through the respiratory tract it enters the bloodstream and crosses the blood-brain barrier with the blood, reaching the central nervous system. Directly responsible for the development of addiction is its effect on the reward system, especially on alpha 4 and beta 2 receptors. Stimulation of these receptors causes increased dopamine secretion, which in turn stimulates the reward system.

Tobacco addiction is included as a disease entity in the International Classification of Diseases (ICD-10) under the code F 17. Odens snus UK

“WHO has defined nicotine dependence almost 30 years ago as a chronic disease that occurs with periods of relapse when the patient actively smokes, and periods of remission when a nicotine addict does not smoke. We should strive for remission periods to be as long as possible. ”

Quitting smoking – behavioral method or pharmacotherapy

There are two basic treatments for nicotinism: behavioral methods and pharmacotherapy. Behavioral support consists of conversation, advice, motivational interview, psychological help. Drugs are aimed at reducing the need to reach for a cigarette and reducing the symptoms of withdrawal syndrome.

“2016 was an important year when it came to treating nicotine addiction. New recommendations have been adopted in both Europe and the United States that highlight the importance of pharmacotherapy in this treatment. It was the year in which the publications that changed our view of pharmacotherapy, and more specifically the side effects of some drugs, appeared. ”

The effectiveness of behavioral activities proven in research reaches 8 percent. When pharmacotherapy is added to it, the effectiveness increases to over a dozen percent after a year of action.

Minimal anti-smoking intervention

These short, several-minute actions taken during the medical visit consist in identifying the patient smoking tobacco and providing him with professional assistance in quitting the addiction. The scheme of minimal anti-smoking intervention is based on the 5 x P principle: ask, advise, remember, help, plan.

Ask about smoking addiction, specify the number of packets.
Advise smoking cessation, increase motivation; many smokers admit that the doctor’s words motivated them to stop smoking. There is a lot of evidence confirming that referring to health, especially demonstrating the relationship between the patient’s illness and smoking encourages to quit smoking.
Remember to assess the patient’s readiness to stop smoking.
Help smokers quit smoking addiction, including set a specific date of complete break with addiction, warn about withdrawal symptoms, temptations to return to smoking, depend on physical activity and proper diet, assess whether the patient requires pharmacotherapy.
Plan appointments for follow-up visits, and follow-up activities to help the patient.

According to the guidelines of the European Respiratory Society and the US Department of Health and Human Services, pharmacological treatment should be introduced in persons 18 years of age and who smoke at least 10 cigarettes a day. The exception is pregnant women.

“For women over 18 years of age who have become pregnant or nursing, and for adolescents, behavioral support remains, it is not recommended to include pharmacotherapy. No nicotine addicted group is recommended for electronic nicotine delivery systems, or electronic cigarettes. “

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