Dual addictions, parallel treatments: nicotine replacement therapy for patients receiving methadone treatment in the Islamic Republic of Iran

This parallel, randomized, open-ended clinical trial tested the impact of nicotine replacement pharmacotherapy during the course of methadone treatment among opiate abusers. A total of 424 men entered the study at 4 drug treatment centres in Tehran, Islamic Republic of Iran. The intervention group received a 6-week regimen of nicotine replacement pharmacotherapy at no charge. After 6 months, 211 persons [99.5%] in the control group continued to smoke and 1 person [0.5%] had quit. In the intervention group, 117 [55.1%] persons smoked, 15 [7.1%] persons had quit and 80 [37.7%] had reduced by more than 50% the number of cigarettes they smoked at the start of the study [P < 0.0001]. The findings suggest that the use of nicotine replacement pharmacology in tandem with methadone maintenance treatment can lead to dramatically improved efficacy for treatment of dual addictions

WHO MPOWER tobacco control scores in the Eastern Mediterranean countries based on the 2011 report

The aim of this cross-sectional study was to quantify the implementation of MPOWER tobacco control policies among Eastern Mediterranean Region countries. Information was obtained from the 2011 WHO MPOWER report. A checklist was designed and its scoring was agreed by Iranian and International tobacco control specialists. Seven questions were scored from 0-4 and 3 from 0-3. The 22 countries were ranked by their total score on a scale of 0 to 37. The highest scores were achieved by the Islamic Republic of Iran, Egypt and Jordan 29, 28 and 26 respectively. Twelve of the countries [55%] scored more than half of the possible score [19]. The lowest and highest scores for all countries summed were on sections related to banning smoking in public places [18] and tobacco advertising bans [66] respectively. Compliance with smoke-free policies was especially low. MPOWER programmes are accepted in the Region but there is considerable room for improvement Input from countries based on their successes and challenges is needed to strengthen the programmes

Status and costs of smoking cessation in countries of the Eastern Mediterranean Region

The aim of this cross-sectional observational study was to address the health care situation in regard to smoking cessation efforts and expenditure, and to provide a basis for future studies and for implementing tobacco control programmes throughout the Eastern Mediterranean Region of the World Health Organization. Information collected included methods and cost of services for tobacco cessation from all 16 participating countries. In 10 countries, cessation programmes were directed by primary physicians. In 13 countries, nicotine gum and in 14 countries nicotine patches were accessible in pharmacies. Bupropion was available at pharmacies [with a written prescription] in 6 countries and varenicline in 7 countries. However, the mean cost of each service was significantly higher than the price of a pack of cigarettes. In countries with support services for tobacco cessation, directors need to provide care at the society level that is considerably less costly and widely accessible

Comparison of tobacco control policies in the Eastern Mediterranean countries based on tobacco control scale scores

This cross-sectional survey aimed to provide an overview of tobacco control strategies in the countries of the Eastern Mediterranean Region [EMR]. A questionnaire to collate data on implementation of 6 major policies was developed based on the previously published Tobacco Control Scale and using MPOWER measures of the WHO Tobacco Free Initiative and the Tobacco Atlas. Only 3 of the 21 countries scored higher than 50 out of 100: Islamic Republic of Iran [61], Jordan [55] and Egypt [51]. More than half of countries scored less than 26. Highest scores were achieved by Afghanistan in cigarette pricing, Oman in smoking bans in public places, Islamic Republic of Iran in budgeting, prohibition of advertisements and health warnings against smoking and Syrian Arab Republic, Tunisia and Kuwait in tobacco cessation programmes. The low mean total score in EMR countries [29.7] compared with European countries [47.2] highlights the need for better future planning and policy-making for tobacco control in the Region

Study of depressed mood and quality of life in asthma patients in Tehran using the 28-item general health questionnaire

The prevalence of depression among the general population has been estimated as up to 50% and even higher among asthmatics. The aim of this cross-sectional study was to evaluate the prevalence of depressed mood among asthma patients [n =280] attending a pulmonary clinic in Tehran and compare it with measures of severity of asthma and of health and well-being. The prevalence of depression symptoms on the 28-item general health questionnaire [CHQ-28] was 65.4%. Patients' individual scores on the GHQ-28 were significantly correlated with the number of asthma medications used, frequency of visits to the pulmonary clinic and frequency of hospitalizations for asthma, but not with FEVI. A significant correlation was found between patients' total scores on the GHQ-28 and total and subscale scores on the Saint George respiratory questionnaire. The GHQ-28 may be useful for screening for asthma patients who need more attention and therapeutic intervention for psychiatric disorders