Professional Documents
Culture Documents
Determinants of smoking
behavior and cessation
strategy
Presentation Prepared for:
https://www.cdc.gov/pcd/issues/2016/pdf/
15_0458.pdf
Cessation
Cessation
Raising cigarette price through
increased taxation can lead to a
win-win-win situation in
Bangladeshit will reduce
cigarette consumption, increase
tobacco tax revenue and
potentially decrease socio-
Bangladesh: economic
Evidence from theinequities.
The Price Sensitivity of Cigarette Consumption in
International Tobacco
Control (ITC) Bangladesh Wave 1 (2009) and Wave 2 (2010)
Surveys https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4090419/
Tobacco Cessation
Tobacco cessation(quitting smoking) is the process of
discontinuing tobacco smoking. Tobacco contains
nicotine which makes the process of quitting often very
prolonged and difficult.
Quitting smoking significantly reduces the risk of dying
from tobacco-related diseases such as heart disease and
lung cancer.
Seventy percent of smokers would like to quit smoking,
and 50 percent report attempting to quit within the past
year.
Many different strategies can be used for smoking
cessation, including quitting without assistance
medications such as nicotine replacement therapy,
cytisine or varenicline, and behavioral counseling.
The majority of smokers who try to quit do so without
assistance, though only 3% to 6% of quit attempts
without assistance are successful.
The role of health professionals
Health professionals play an important role in educating and
motivating smokers as well as assessing their dependence on
nicotine and providing assistance to quit.
All health professionals should systematically identify
smokers, assess their smoking status and offer them advice
and cessation treatment at every opportunity.
Brief interventions for smoking cessation involve
opportunistic advice, encouragement and referral.
Interventions should include one or more of the following:
brief advice to stop smoking
an assessment of the smokers interest in quitting
an offer of pharmacotherapy where appropriate
providing self-help material
offering counseling within the practice or referral to
external support such as Quilting an accredited tobacco
treatment specialist or other local programs in your area.
Nicotine Replacement Therapy
Nicotine has both stimulant and depressant actions.
Research showed using Nicotine Replacement Therapy
(NRT) can reduce number of cigarettes smoked and cut
down the amount of dangerous inhaled smoke which
contains harmful Polycyclic aromatic hydrocarbons
(PAHs) responsible for most of harmful health effects.
Patients should be counseled to stop smoking
completely prior to initiating NRT to avoid the potential
risk of nicotine overdose.
Using two forms of nicotine replace (e.g. patch plus
resin) results in higher quit rates and should be
recommended if other forms of nicotine replacement
are not effective alone.
Use of NRT is recommended for a minimum of 6-8
weeks.
Quit rates with use of NRT range between 20% and
Behavioral and Advice Based support for tobacco
cessation
Smoking reduction rather than smoking cessation
Some smokers are unable or unwilling to completely quit smoking. It has been
proposed that reducing the number of cigarettes smoked per day has long-term
benefits.
However, it is not clear whether this strategy decreases the risk for tobacco-related
diseases.
Research has shown that smoking reduction by 50% modestly reduces the risk of lung
cancer in heavy smokers (15 or more cigarettes each day). There is insufficient
evidence about long-term benefit to support the use of interventions intended to help
smokers reduce, but not quit, smoking.
Some people who do not wish to quit can be helped to cut down the number of
cigarettes smoked by using nicotine gum or nicotine inhaler.
Because the long-term health benefit of a reduction in smoking rate is unclear, this
use of NRT is more appropriate before quitting.
Smokers who use NRT for smoking reduction are approximately twice as likely to
progress to quitting than those who do not.
Relapse
For any individual attempt to quit , failure to quit is more likely than
successful cessation.
Most smokers make repeated quit attempts before finally achieving
long-term abstinence.
Relapse in the first weeks of a quit attempt is common.
Relapse is associated with the severity of withdrawal symptoms and
other factors, such as stress and weight gain, may be more important.
There is no intervention that is proven to prevent relapse, but advice
and pharmacotherapy are recommended to treat symptoms of
withdrawal, stress and weight gain.
Thank You