South African tobacco smoking cessation clinical practice guideline
South African tobacco smoking cessation clinical practice guideline
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DOI：
10.7196/samj.7484
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发表时间：
2013-01-01
期刊：
影响因子：
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通讯作者：
Richards, G A
中科院分区：
文献类型：
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作者：
van Zyl-Smit, R N;Allwood, B;Richards, G A
吸烟（即香烟、卷烟、烟斗等）与重大健康风险、预期寿命缩短以及对个人和社会经济的负面影响有关。吸烟者患癌症（即肺癌、喉癌、膀胱癌）、慢性阻塞性肺病（COPD）、肺结核和心血管疾病（即中风、心脏病发作）的风险增加。吸烟会影响未出生的婴儿，儿童和其他暴露于二手烟的人。停止或“退出”并不容易。尼古丁具有高度成瘾性，吸烟通常与社交活动（如饮酒、进食）或心理因素（如工作压力、对体重的担忧、焦虑或抑郁情绪）有关。然而，戒烟的好处几乎是立竿见影的，可以迅速降低血压和心率，改善味觉和嗅觉，并长期降低患癌症、心脏病发作和慢性阻塞性肺病的风险。成功戒烟需要关注个人吸烟的原因（例如压力，抑郁，习惯等）。和尼古丁戒断相关的症状许多吸烟者还没有准备好或不愿意戒烟，需要经常的动机输入，概述将产生的好处。除了评估尼古丁依赖性，还应确定共存的医学或精神疾病以及戒烟障碍。一个量身定制的方法，包括心理和社会支持，除了适当的药物，以减少尼古丁戒断，可能会提供最好的成功机会。戒烟的关键步骤包括：（i）识别所有吸烟者，提醒他们吸烟的危害和戒烟的好处;（ii）评估开始尝试戒烟的准备程度;（iii）评估对尼古丁和吸烟的身体和心理依赖;（iv）评估吸烟者的吸烟行为;（iv）评估吸烟者的吸烟行为;（iv）评估吸烟者的吸烟行为。（iv）决定辅导/支援及药物治疗的最佳组合;（v）订定戒烟日期，并提供适当的资源及支援;（vi）尽可能透过文字/电话或亲身覆查;（vii）监察副作用、复吸及持续戒烟的情况;及（viii）如复吸，提供所需的支援，并在适当时鼓励再次尝试。
Tobacco smoking (i.e. cigarettes, rolled tobacco, pipes, etc.) is associated with significant health risks, reduced life expectancy and negative personal and societal economic impact. Smokers have an increased risk of cancer (i.e. lung, throat, bladder), chronic obstructive pulmonary disease (COPD), tuberculosis and cardiovascular disease (i.e. stroke, heart attack). Smoking affects unborn babies, children and others exposed to second hand smoke. Stopping or 'quitting' is not easy. Nicotine is highly addictive and smoking is frequently associated with social activities (e.g. drinking, eating) or psychological factors (e.g. work pressure, concerns about body weight, anxiety or depressed mood). The benefits of quitting, however, are almost immediate, with a rapid lowering of blood pressure and heart rate, improved taste and smell, and a longer-term reduction in risk of cancer, heart attack and COPD. Successful quitting requires attention to both the factors surrounding why an individual smokes (e.g. stress, depression, habit, etc.) and the symptoms associated with nicotine withdrawal. Many smokers are not ready or willing to quit and require frequent motivational input outlining the benefits that would accrue. In addition to an evaluation of nicotine dependence, co-existent medical or psychiatric conditions and barriers to quitting should be identified. A tailored approach encompassing psychological and social support, in addition to appropriate medication to reduce nicotine withdrawal, is likely to provide the best chance of success. Relapse is not uncommon and reasons for failure should be addressed in a positive manner and further attempts initiated when the individual is ready.Key steps in smoking cessation include: (i) identifying all smokers, alerting them to the harms of smoking and benefits of quitting; (ii) assessing readiness to initiate an attempt to quit; (iii) assessing the physical and psychological dependence to nicotine and smoking; (iv) determining the best combination of counselling/support and pharmacological therapy; (v) setting a quit date and provide suitable resources and support; (vi) frequent follow-up as often as possible via text/telephone or in person; (vii) monitoring for side-effects, relapse and on-going cessation; and (viii) if relapse occurs, providing the necessary support and encourage a further attempt when appropriate.