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Clinical and public health significance of treatments to aid smoking cessation

R. West, J. Stapleton
European Respiratory Review 2008 17: 199-204; DOI: 10.1183/09059180.00011005
R. West
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J. Stapleton
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Figures

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  • FIGURE 1.
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    FIGURE 1.

    The number of life-years gained from smoking cessation at different ages. Data taken from [11].

  • FIGURE 2.
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    FIGURE 2.

    The typical relapse rates with unaided quitting in three different ways. a) The classic survival curve, b) the prognosis curve, and c) the relapse-risk curve.

  • FIGURE 3.
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    FIGURE 3.

    The “route to quit” model, which indicates the contribution of different ways of quitting to overall rates of smoking cessation. #: in most cases nicotine replacement therapy was bought over the counter.

Tables

  • Figures
  • Table 1—

    Fatal and serious nonfatal disorders for which tobacco use is a known or probable cause or exacerbating factor

    Smoking
        Cancer of the lung
        Cancer of the larynx
        Cancer of the oesophagus
        Cancer of the oropharynx
        Cancer of the kidney
        Cancer of the cervix
        Cancer of the pancreas
        Cancer of the stomach
        Cancer of the bladder
        Leukaemia
        COPD
        Pneumonia
        Asthma attacks
        Coronary heart disease
        Aortic aneurism
        Cerebrovascular disease
        Peripheral vascular disease
        Vascular dementia
        Macular degeneration
        Cataract
        Hearing loss
        Infertility
        Spontaneous abortion
        Stillbirth
        Low birth weight
        SIDS
        Low back pain
        Osteoporosis
        Tuberculosis
        Type II diabetes
        Peptic ulcer disease
        Surgical complications
    Smokeless tobacco use
        Cancer of the oropharynx
    • COPD: chronic obstructive pulmonary disease; SIDS: Sudden Infant Death Syndrome. Sources: All [3], except vascular dementia [4], macular degeneration [5], low back pain [6], tuberculosis [7], diabetes [8] and smokeless tobacco [9]. Reproduced from [2] with permission from the publisher.

  • Table 2—

    Definition of cigarette addiction and nicotine dependence

    DescriptionMeasurement
    Cigarette addictionPowerful motivation# to smoke cigarettes arising primarily from abnormalities in physiological functioning of CNS pathways underlying motivationRatings of frequency and strength of urge, want or need to smoke; behavioural evidence of strong motivation to smoke
    Nicotine dependencePhysiological abnormalities underlying addiction to cigarettes or other nicotine-delivery systemsMarkers of strength of physiological need for nicotine
    • CNS: central nervous system. #: motivation is used here in the broad sense of all those mental processes that direct and energise behaviour, not merely “reasons”.

  • Table 3—

    Effectiveness of treatments to aid smoking cessation

    TreatmentComparisonIncrease in those abstinent for 6 months#Increase in permanent abstinence as a result of treatment¶
    Nicotine replacement therapy all forms 8–12 weeks
        Without behavioural supportPlacebo52.5
        With behavioural supportPlacebo with behavioural support105
    Drug with behavioural support
        Bupropion 300 mg b.i.d 8 weeksPlacebo with behavioural support105
        Nortriptyline 1.5 mg b.i.d. 8 weeksPlacebo with behavioural support105
        Varenicline 1.5mg b.i.d. 12 weeksPlacebo with behavioural support157.5
    Behavioural support 4–8 weeks
        Face-to-face from a specialistBrief advice or written materials52.5
        Telephone-basedBrief advice or written materials52.5
    Combination of behavioural support and medicationQuitting without help10–205–10
    • Data are presented as %. #: percentage of all smokers treated; thus if the placebo rate is 5% and the active treatment rate is 10% the increase is 5%. Figures are based on percentage differences in relevant tables from the Cochrane reviews [20–25] rounded to the nearest 5%. ¶: 50% of the effect size at 6 months.

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Clinical and public health significance of treatments to aid smoking cessation
R. West, J. Stapleton
European Respiratory Review Dec 2008, 17 (110) 199-204; DOI: 10.1183/09059180.00011005

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Clinical and public health significance of treatments to aid smoking cessation
R. West, J. Stapleton
European Respiratory Review Dec 2008, 17 (110) 199-204; DOI: 10.1183/09059180.00011005
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  • Article
    • Abstract
    • THE IMPORTANCE OF EARLY CESSATION
    • TREATMENT TO AID SMOKING CESSATION
    • WHAT EFFECT DOES PROMOTING TREATMENT HAVE ON THE POPULATION OF SMOKERS?
    • MODELLING THE POPULATION BENEFIT OF TREATMENT TO AID SMOKING CESSATION
    • CONCLUSIONS
    • Statement of interest
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More in this TOC Section

  • Implications and priorities of tobacco control in Belgium and Europe
  • The psychobiology of nicotine dependence
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