Multidimensional smoker profiles and their prediction of smoking following a pharmacobehavioral intervention

The ability to predict the success or failure of smoking cessation efforts will be useful for clinical practice. Stress response is regulated by two primary neuroendocrine systems. Salivary cortisol has been used as a marker for the hypothalamus-pituitary-adrenocortical axis and salivary alpha-amylase as a marker for the sympathetic adrenomedullary system. We studied 62 chronic smokers (34 women and 28 men with an average age of 45.2+/-12.9 years). The levels of salivary cortisol and salivary alpha-amylase were measured during the period of active smoking, and 6 weeks and 24 weeks after quitting. We analyzed the men separately from the women. The men who were unsuccessful in cessation showed significantly higher levels of salivary alpha-amylase over the entire course of the cessation attempt. Before stopping smoking, salivary cortisol levels were higher among the men who were unsuccessful in smoking cessation. After quitting, there were no differences between this group and the men who were successful in cessation. In women we found no differences between groups of successful and unsuccessful ex-smokers during cessation. In conclusions, increased levels of salivary alpha-amylase before and during smoking cessation may predict failure to quit in men. On the other hand, no advantage was found in predicting the failure to quit in women. The results of our study support previously described gender differences in smoking cessation.

/pdf/higher-levels-of-salivary-a-amylase-predict-failure-of-28kl7mzqbx.pdf

Higher Levels of Salivary α-Amylase Predict Failure of Cessation Efforts in Male Smokers

Introduction Higher prevalence of smoking among depressed
patients, as well as the risk of depression in smokers, is well
documented The proportion of patients with a history of
depression among those seeking intensive treatment of tobacco
dependence is also high In contrast, evidence of treatment
success in this subgroup of patients is controversial The aim
of this study was to compare smoking abstinence rates after
tobacco treatment in smokers with and without a history of
depression Methods We reviewed retrospective data from 1,730
smokers seeking treatment in Prague, Czech Republic History of
depression was defined as past diagnosis of depression or
current treatment of depression After a 1-year, self-reported
smoking status was validated by expired-air carbon monoxide We
used logistic regression to analyze associations between
abstinence rates, history of depression, and other factors (eg,
age, sex, tobacco dependence) Results Of 1,730 smokers
treated, 289 (167%) had a history of depression The smoking
abstinence rate at 1 year was 325% for smokers with a history
of depression and 387% for those with no history (P = 048)
Among women, abstinence did not differ between groups (350% vs
357%; P = 86) However, among men, those with a history of
depression had lower rates of abstinence (274% vs 413%; P =
009) After adjustment for baseline covariates, history of
depression was not significantly associated with smoking
abstinence in men or women Conclusion Intensive outpatient
tobacco treatment programs can achieve abstinence rates among
smokers with a history of depression similar to rates among the
general population

/pdf/tobacco-treatment-outcomes-in-patients-with-and-without-a-4q855cm07o.pdf

Tobacco treatment outcomes in patients with and without a history of depression, Czech Republic, 2005-2010.

Kouřeni patři k uznavaným rizikovým faktorům aterosklerozy, jeho aktivni i pasivni formy se podileji na iniciaci a progresi aterosklerozy i na rozvoji nestabilnich forem - akutnich koronarnich syndromů. Jak vyplýva z ceských Doporuceni pro lecbu zavislosti na tabaku, je kouřeni v Evropě i v Ceske republice přicinou každeho pateho umrti, což u nas představuje každý rok přibližně 18 000 umrti. Vliv kouřeni na rozvoj kardiovaskularnich onemocněni je zprostředkovan řadou mechanismů. Uplatňuji se geneticka predispozice, změny vasomotorických funkci endotelu, strukturalni poskozeni endotelu, změny poddajnosti cevni stěny, změny spektra krevnich lipidů, změny funkce krevnich desticek a trombofilie, působeni volných kyslikových radikalů, sniženi koncentraci antioxidantů, přitomnost zanětlivých změn a infekce v cevni stěně. V přehledu jsou uvedeny zakladni poznatky o vlivu kouřeni na rozvoj aterosklerozy a jejich komplikaci, uvedených změn. Zminěna je take zavažnost kouřeni v populaci děti s přihlednutim k tomu, že z patnactiletých děti v Ceske republice kouři 25 % divek a 23 % chlapců (druhe a ctvrte misto na světě, data z roku 2009). Ceska kardiologicka spolecnost se proto teto problematice v nasledujicich letech bude věnovat systematicky a ve větsim rozsahu, než tomu bylo dosud.

Kouření a kardiovaskulární onemocnění

Stručný souhrn doporučení pro dlouhodobou péči o nemocné po infarktu myokardu

1. Úvod 1S5 2. Diagnostika 1S6 3. Léčba 1S7 3.1. Behaviorální a psychosociální intervence 1S8 3.2. Farmakologická léčba 1S9 3.2.1. Vareniklin 1S9 3.2.2. Náhradní terapie nikotinem (NTN) 1S9 3.2.3. Bupropion 1S10 3.2.4. Kombinace farmakoterapie 1S10 3.3. Krátká intervence 1S10 3.4. Centra pro závislé na tabáku 1S11 4. Harm reduction v užívání tabáku 1S11 5. Doporučení pro specifické skupiny 1S11 6. Závislost na tabáku v rámci zdravotnictví 1S12 7. Společnost pro léčbu závislosti na tabáku 1S13 8. Zkratky 1S13 9. Literatura 1S14

Doporučení pro léčbu závislosti na tabáku

This first Czech version of guidelines formulated by the working group of mentioned medical associations is based on current literature and international guidelines. They are aimed mainly on clinical medicine and on incorporation of this treatment into the health care system according to WHO recommendations. They should serve to the treatment of tobacco dependence at any level: during any contact with the smoking patient (short intervention), in specialised centres or for the health care providers or health system itself.

Recommendations for the treatment of tobacco dependence

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Doporučení pro léčbu závislosti na tabáku

Recommendations for the treatment of tobacco dependence