Predictors of treatment success in smoking cessation with varenicline combined with nicotine replacement therapy v. varenicline alone

Background.Identification of the predictors of treatment success in smoking cessation may help healthcare workers to improve the effectiveness of attempts at quitting.Objective. To identify the predictors of success in a randomised controlled trial comparing varenicline alone or in combination with nicotine replacement therapy (NRT).Methods. A post-hoc analysis of the data of 435 subjects who participated in a 24-week, multicentre trial in South Africa was performed. Logistic regression was used to analyse the effect of age, sex, age at smoking initiation, daily cigarette consumption, nicotine dependence, and reinforcement assessment on abstinence rates at 12 and 24 weeks. Point prevalence and continuous abstinence rates were self-reported and confirmed biochemically with exhaled carbon monoxide readings.Results. The significant predictors of continuous abstinence at 12 and 24 weeks on multivariate analysis were lower daily cigarette consumption (odds ratio (OR) 1.86, 95% confidence interval (CI) 1.21 - 2.87, p=0.005 and OR 1.83, 95% CI 1.12 - 2.98, p=0.02, respectively) and older age (OR 1.52, 95% CI 1.00 - 2.31, p=0.049 and OR 1.79, 95% CI 1.13 - 2.84, p=0.01, respectively). There was no difference in the predictors of success in the univariate analysis, except that older age predicted point prevalence abstinence at 12 weeks (OR 1.47, 95% CI 1.00 - 2.15, p=0.049). The findings were inconclusive for an association between abstinence and lower nicotine dependence, older age at smoking initiation and positive reinforcement.Conclusion. Older age and lower daily cigarette consumption are associated with a higher likelihood of abstinence in patients using varenicline, regardless of the addition of NRT

Nicotine dependence and role of pharmacist in nicotine addiction control

There are about one billion smokers in the world and death toll due to smoking is almost six million people a year. The tobacco use is increasing specially in the third world countries. By 2020, death will increase to more than 70% of smokers in some developing countries. Continuous tobacco use can cause tolerance and dependence. Tobacco dependence is the main cause of morbidity and mortality among smokers. Nicotine dependence is assumed to be present if tolerance, withdrawal and compulsive desire to consume tobacco are existing. It is well documented that environmental and genetic factors influence the possibility of nicotine addiction. Thus, actions are needed at different levels to avoid the health hazards induced by tobacco smoking. Governments have to play a vital role in smoking control. People at large needs to be involved in the fight against smoking. Within the health-sector, health professionals as physicians and pharmacists have a leading role to play because of their knowledge about the dangerous of smoking and its treatment in general. Community pharmacist is one of the most accessible health care professional to the public and can fulfil fundamental role in public health as key providers of tobacco cessation and prevention services. In addition, pharmacists have a significant knowledge of nicotine withdrawal symptoms, drugs used in smoking cessation and with special training can be involved in the treatment programs. Moreover, media campaigns (pharmacy and non-pharmacy groups) are needed to encourage smoking cessation and discourage smoking initiation. However, with any tobacco-use prevention program, it should always be remembered that long time is needed before success becomes effective and apparent

Evaluation des connaissances du tabagisme dans la population abidjanaise

Dans le but de contribuer a la lutte contre le tabagisme en Cote d'Ivoire; nous avons effectue une etude transversale prospective dans les communes d'Adjame et du Plateau. Notre objectif etait d'evaluer les connaissances des abidjanais sur le tabagisme; en particulier selon le niveau d'etude et le statut tabagique. Elle s'est deroulee sur 3 mois allant de Novembre a Janvier. Cette etude nous a permis de noter que: -la prevalence du tabagisme etait de 3 6;5pour cent dans la population abidjanaise avec une nette predominance masculine (44;31pour cent contre 12;28pour cent pour les femmes). -La population des frimeurs etait jeune avec un age moyen de 27;44 ans. -les mass medias representaient la principale source d'information. -D'une facon generale; les sujets interroges n'avaient pas une bonne connaissance du tabagisme et ses consequences avec un taux important de fausses reponses (25;3pour cent). -Les pathologies respiratoires notamment le cancer broncho-pulmonaire et les pathologies cardio-vasculaires ont ete les plus citees dans des proportions respectives de 53;1pour cent et 18;1pour cent. En ce qui concerne les composants du tabac; la nicotine represente la substance la plus connue. Elle a ete citee dans une proportion de 92;6pour cent. -Les connaissances des sujets sont influencees par leur niveau d'etude. Les sujets du superieur sont ceux qui connaissent plus les consequences du tabagisme (47pour cent contre 6;9pour cent pour les non scolarises). Il en decoule que les sujets moins instruits soient ceux qui s'adonnent le plus au tabagisme. Pour combattre l'avancee de ce fleau; la population interrogee souhaite que les actions de sensibilisation soient intensifiees

Leukokeratosis nicotinica; tobacco/snuff and tobacco smoking-pre-cancerous and malignant potentials

Leukokeratosis nicotinica is keratosis found in the oral mucosa of chronic chain smokers especially pipe smokers and commonest in the palate. There is no sex predilection so far as the smoking habit is chronic. The lesion is also known as nicotine stomatitis and smoker's keratosis. Though leukokeratosis nicotinica is not ranked mainly as precancerous lesion; it may have some degrees of dyplastic changes indicative of premalignancy and in some cases carcinoma in situ