Disposición de profesionales de la salud chilenos hacia la consejería breve anti-tabaco en pacientes hospitalizados de una institución privada / Readiness of chilean healthcare professionals towards brief tobacco cessation counseling in hospitalized smoking patients of a private institution

OBJETIVO: Evaluar la disposición pre y post intervención de profesionales de la salud de una consejería breve antitabaco (CBA) para pacientes fumadores hospitalizados. MATERIAL Y MÉTODO: Estudio cuantitativo, descriptivo correlacional de corte transversal, con 65 sujetos participantes. RESULTADOS: El 84,6% de los participantes son mujeres, con edad promedio de 33.8 años (DS±9,1). El 52,3% se desempeñaba como técnico en enfermería, seguidos por los enfermeros(as) (18,5%). El 34,9% de los sujetos eran fumadores, de ellos el 21,6% fumaba entre 1 y 5 cigarrillos diarios. Se observó mayor disposición y aceptabilidad hacia la CBA en los proveedores de salud que no fuman versus los fumadores en la medición basal. Post intervención hay diferencias significativas n el grupo de profesionales fumadores, mejorando su disposición y aceptabilidad hacia la CBA. CONCLUSIONES: A mayor consumo de tabaco en los proveedores de salud, menor es la disposición, la aceptabilidad y la conducta habitual de realizar la CBA a los pacientes adultos hospitalizados. Una intervención de CBA dirigida a personal fumador ha demostrado ser efectiva en mejorar su disposición. Si bien el ser fumador constituye una barrera de implementación, es algo que se puede mejorar con capacitación, por lo que se invita a tomar en considerar el nivel de consumo de tabaco de los funcionarios en futuras intervenciones de CBA en pacientes hospitalizados.

OBJECTIVE: To assess readiness among healthcare providers in pre- and post- brief tobacco cessation counseling (BTCC) intervention for hospitalized smoking patients. MATERIAL AND METHOD: Quantitative, descriptive, cross-sectional correlational study, with 65 participants. RESULTS: 84,6% of the participants are women, with an average age of 33,8 years (DS9,1). 52,3% work as nursing technicians, followed by nurses (18,5%). 34,9% of the participants are smokers, of which 21,6% smoke between 1 and 5 cigarettes a day. Greater readiness and acceptability towards BTCC are observed in non-smoking healthcare providers. Significant differences are found in the post BTCC intervention group of smoking healthcare providers, improving their readiness and acceptability towards BTCC. CONCLUSIONS: The greater the tobacco consumption of healthcare providers, the lower readiness, acceptability, and common practice of performing BTCC on hospitalized adult patients. A BTCC intervention aimed at smoking healthcare providers has been shown to be effective in improving their readiness. Although being a smoking healthcare provider has shown to be a barrier to BTCC implementation, it is something that can be overcome with intervention, which is why it is important to consider the level of tobacco consumption of healthcare providers in future implementation of BTCC in hospitalized patients.

Tobacco Use: Quitting Plan, Attempts and Obstacles for Cessation- A Cross-Sectional Study from A Sub-Urban Neighbourhood of Chennai-Tamil Nadu

Introduction: Tobacco consumption is a preventable public health problem. GATS -2 survey in Tamil Nadu shows that 20% of adults use tobacco, 40% had plans to quit and 48% had made quit attempts. The purpose of the study was to assess factors associated with tobacco use; quitting plan, attempts and identify obstacles for tobacco cessation. Methods: A Cross-sectional study was done among 300 tobacco users in a suburban neighbourhood of Chen-nai and data was analysed using SPSS software. Results: Ninety five percent were smokers and 86% smoked cigarettes. 70% knew that it causes cancer and respiratory diseases. 60% planned to quit, 69% made quit attempts. Those with quit plans and health prob-lems had an increased odds (AOR of 1.02 and 1.004 respectively) of making quit attempts. Advice from health professionals (48%) and family (52%) triggered quit attempts. Stress and work pressure were obstacles for quitting (70%). Availability of therapy and professional help for tobacco cessation was known only to 49% and 14.7% respectively and none availed it. Conclusion: Awareness of health hazards of tobacco use was high. Quit attempts have increased but with high failure rates due to lack of information and access to tobacco cessation services. Provision of community and facility-based tobacco cessation services and integration with existing health programmes is the present need.

Clinicopathological Features of Buccal Squamous Cell Carcinoma with Focus on Patients Who Never Smoke and Never Drink

Abstract Introduction Oral carcinoma has been reported at a substantial proportion in patients who never smoke and never drink. However, the proportion may vary by subsite and ethnicity. Objective We aimed to determine the clinicopathological features of buccal squamous cell carcinoma (SCC) in a Japanese population. Methods We retrospectively analyzed the records of patients diagnosed with buccal SCC at our institution from September 2002 to November 2015. We reviewed the gender, age, tumor status, treatment, smoking, alcohol drinking, multiple primary cancers, and prognosis of the patients. The overall and cause-specific survival rates were calculated, and the effects of clinicopathological variables were assessed by univariate analysis. Furthermore, the cause of death was evaluated. Results Among the 63 patients (men: 38; women: 25) included in the present study, 29 (46.0%) never smoked or drank. Women were almost 5 years older than men (p = 0.014). The number of women in the group who never smoked or drank was disproportionately higher than that of those in the smoker or drinker groups (p < 0.001). In total, 29 patients (46.0%) had 59 multiple primary cancers, including 26 oral cancers. Surgeries and radiotherapy were performed in 57 (90.5%) and 6 (9.5%) cases, respectively. The 5-year overall survival and disease-specific survival rates were 74.6 and 78.8%, respectively. Conclusion Our study confirms that buccal SCC may develop in older adult Japanese patients, especially in women who have never smoked or drank. These patients could be at risk for second primary malignancy.

Technology-based Tobacco Cessation Training in Indian Context

In tobacco use disorders (TUDs), technology-based training of health-care professionals can reduce the treatment gap and bring attitudinal change. The study aimed to assess the practices and determine the change in knowledge and attitude among health-care professionals following an online training program (OTP). Half-day OTP on tobacco cessation using prepost quasi-experimental study design with a structured questionnaire?based assessment was conducted. Among 293 completed surveys, knowledge post?OTP was higher but insignificant (P = 1.2). Post?OTP, participants felt less angry and disappointed toward tobacco users(mean of difference (MOD) =0.21, P = 0.0007); more sympathetic and concerned (MOD = ?0.22, P = 0.0005); and acknowledged tobacco users deserve the same medical care as nonusers (MOD = ?0.177, P = 0.001). Post?OTP scores in attitudes did not change significantly for the responsibility domain (P < 0.05). In practice, relatively greater number of health-care professionals asked about tobacco use and advised cessation, however lesser assessed, assisted, and referred. To conclude, technology-based training program can result in attitudinal changes toward tobacco users.

Advanced Virtual Mentoring of Dentists in Oral Cancer Screening and Tobacco Cessation - An Interventional Study

Context: Oral cancer is the third common cancer in India. Its mortality can be reduced through early detection and tobacco cessation ideally by dentists owing to their forte of work. Aim: This study was conducted to discuss effectiveness of an advanced tele?mentoring programme in oral cancer screening and tobacco cessation for dentists across India. Settings and Design: Online, interventional study. Methods and Material: The 14?week long training programme with 52 participants/spokes from across India had weekly hour?long online sessions comprising of an expert?led didactic and case discussions by spokes. Online evaluation (pre? and post?training, post?session), weekly and post?one?year feedback were conducted. Successful spokes attended a hands?on workshop subsequently. Statistical Analysis Used: One and independent sample t?tests determined the significance of the evaluation scores of the participants. Findings on attitudes and practice?related questions are presented as simple percentages. Results: A notable increase in the overall and per?session mean knowledge score, and confidence in oral cancer screening was observed. Many participants started these services at their clinics, thereby reducing further referrals, and were also motivated to spread community awareness about the same. Conclusion: This tele?mentoring programme, based on the novel Extension for Community Healthcare Outcomes model, is the first oral cancer screening training programme for dentists. This model—comprising of expert didacts, case discussions, and significant spoke?expert interaction—is a promising best?practices tool for reducing the disparity in knowledge and skills regarding oral cancer prevention among dentists across different locations. This would enable these most appropriate healthcare providers to contribute toward the overall goal of oral cancer prevention

Toolkit for delivering the 3Es and 6As tobacco interventions in dental care

Tobacco use is one of the major public health problems in India and also the single most important remediable public health problem. Tobacco cessation is the need of the hour. The dentists have a unique opportunity and professional obligation to be a positive influence in reducing the economic and social burden inflicted by tobacco use on dental and general health. However, dentists, in general, have not widely embraced tobacco cessation in practice. In this article, an evidence-based model (an adaptation of the World Health Organization “5As” tobacco cessation model) is presented for the dentist to help patients avoid tobacco initiation, to encourage and assist patients in tobacco cessation

Knowledge, Attitudes, Practices, Perceptions and Expectations of Clients Attending a Primary Care Based Tobacco Cessation Clinic in Trinidad / Conocimiento, Actitudes, Prácticas, Percepciones y Expectativas de los Clientes que Asisten a una Clínica de Cesación del Tabaquismo en el Contexto de la Atención Primaria en Trinidad

ABSTRACT Objectives: The study aimed to determine the demographics of the clients attending a primary care based tobacco cessation clinic, examine the characteristics regarding current tobacco use among clinic attendees, identify the methods associated with previous successful quit attempts and attitudes towards and perceptions regarding the role of pharmacotherapy in tobacco cessation and determine current levels of tobacco use among attendees, reasons for successes and relapses, satisfaction with the service provided and suggestions for improvement. Methods: A descriptive cross-sectional survey was conducted at the Arima Health Facility during the period March 1st to June 30th 2013 using both quantitative and qualitative measures. Results: A total of 31 patients were interviewed during the study period. Amongst smokers who tried to quit cigarette smoking in the past, Willpower (n = 11) was cited as the most common method that assisted in smoking cessation. However, amongst clinic attendees the most popular perceived methods for promoting tobacco cessation amongst respondents was joining a Tobacco Cessation clinic (n = 23), followed by Quitting on your own (n = 13) and seeing a Physician (n = 8). Significant gaps in knowledge exist regarding the role and availability of pharmacologic agents in promoting tobacco cessation, 22.6% of respondents were not using tobacco at the time of the study and 96.7% of all patients attending this clinic would recommend it to a friend or co-worker who is trying to quit using tobacco. Conclusion: This study highlights the knowledge, attitudes, practices, perceptions and expectations of clients accessing care at this tobacco cessation clinic in order to obtain a better understanding of the demographics of the clients and provide feedback on what is being done to date. It is hoped that the baseline findings of this study will serve a useful purpose for improving the quality of care by addressing deficiencies in knowledge and meeting the expectations of the clients. The results will enable future efforts geared towards assessing the effectiveness of the interventions provided at this clinic.

RESUMEN Objetivos: El estudio estuvo encaminado a determinar la demografía de los clientes que asisten a una clínica de cesación del tabaquismo en el contexto de la atención primaria, examinar las características relativas al consumo actual de tabaco entre los asistentes a la clínica, identificar los métodos asociados con el éxito previo de los intentos por abandonar su consumo, identificar las actitudes y percepciones sobre el papel de la farmacoterapia en el cese del tabaquismo, y determinar los niveles actuales de consumo de tabaco entre los asistentes, las razones de los éxitos y las recaídas, la satisfacción con el servicio prestado y sugerencias para la mejoría. Métodos: En el Centro de Salud de Arima, se realizó un estudio descriptivo transversal durante el período del 1ero. de marzo al 30 de junio de 2013, haciendo uso de mediciones tanto cuantitativas como cualitativas. Resultados: Se entrevistó un total de 31 pacientes durante el período de estudio. Entre los fumadores que trataron de dejar el hábito de fumar cigarrillos en el pasado, la fuerza de voluntad (n = 11) fue citada como el método que más comúnmente ayudó a abandonar el hábito de fumar. Sin embargo, entre los asistentes a la clínica, los métodos percibidos como más populares para promover el cese del tabaquismo fueron, en primer lugar, el incorporarse a una Clínica de Cesación del Tabaquismo (n = 23), seguido por dejar de fumar por su cuenta (n = 13), y por último, ver a un médico (n = 8). Existen lagunas significativas en el conocimiento sobre el papel y la disponibilidad de los agentes farmacológicos en la promoción del cese del tabaquismo. El 22.6% de los encuestados no estaban consumiendo tabaco en el momento del estudio, y el 96.7% de todos los pacientes que asistían a esta clínica, la recomendarían a un amigo o compañero de trabajo que estuviera tratando de dejar de consumir tabaco. Conclusión: Este estudio resalta los conocimientos, actitudes, prácticas, percepciones y expectativas de los clientes que acceden a la atención en esta clínica de cesación del tabaquismo, con el fin de obtener una mejor comprensión de la demografía de los clientes y proporcionar retroalimentación sobre lo que se está haciendo hasta la fecha. Se espera que las conclusiones de referencia de este estudio sirvan para un propósito útil que permita mejorar la calidad de la atención, abordando las deficiencias en el conocimiento y satisfaciendo las expectativas de los clientes. Los resultados permitirán futuros esfuerzos orientados a evaluar la efectividad de las intervenciones proporcionadas en esta clínica.

Study on oral smokeless tobacco use among migrant labourers and their attitude towards tobacco cessation in an urban settlement in Ernakulam district of Kerala

Background: Interstate migrant workers in the state of Kerala are increasing day by day. Tobacco usage is quite common among them; however, there are only few studies about oral smokeless tobacco consumption among them. The objectives of the study were to study the prevalence of oral smokeless tobacco use among migrant labourers in an urban settlement in Ernakulam district of Kerala and to assess the knowledge and attitude of users towards cessation. Methods: A cross sectional study was conducted among 140 migrant workers residing in an urban settlement in Kochi. Data regarding their socio demographic characteristics, knowledge, attitude and practices of smokeless tobacco consumption was collected using a questionnaire adapted from the global adult tobacco survey questionnaire (GATS). Data was entered into excel sheet and was analyzed using Epi Info. Results: The prevalence of oral smokeless tobacco was found to be 32.85%. Of which, majority of them used a tobacco-lime mixture called Khani (50%) and used tobacco on a daily basis (65.2%). It was observed that 71.74% of the users were unaware of the ill effects of the use of smokeless tobacco and 69.57% of them were not interested in quitting this habit. Among those who had quit, majority of them had done it on their will power alone. Conclusions: The use of smokeless tobacco is quite prevalent among the migrant population. Effective behavioural change communication activities need to be directed towards them.

Feasibility and acceptability of using Wi-Fi access points to provide smoking cessation help at 17 airports and 38 railway stations across China / 中华医学杂志(英文版)

Background:@#The use of mobile phone significantly improved the outcomes of tobacco cessation. However, its feasibility and acceptability were unclear in the Chinese population. This study was to explore the feasibility of using Wi-Fi access points (APs) as a platform to provide smoking cessation help at 17 airports and 38 railway stations across China.@*Methods:@#This study was divided into two stages: platform development and population survey. In the first stage, a survey platform was developed and incorporated into Wi-Fi service at airports and railway stations, which could provide survey content as a pop-up window when participants tried to access the Wi-Fi service. In the second stage, a population survey was conducted to explore the intention to receive tobacco cessation support.@*Results:@#A total of 20,199 users participated and 13,628 users submitted the survey, with a response rate of 67.47%. The smoking rate was 30.9%. A total of 86.58% of smoking participants and 2.44% of non-smoking participants wished to receive tobacco cessation support, respectively. The multivariate analysis showed intention to receive support did not differ in age, gender, and heaviness of smoking (P > 0.05).@*Conclusion:@#Providing tobacco cessation support via Wi-Fi APs is feasible and efficient, and smokers have high intention to receive tobacco cessation support. It is suggested hospitals, academia, information technology industries, and government agencies must work together to provide tobacco cessation support via mHealth.

Terapia de reemplazo de nicotina / Nicotine replacement therapy

Resumen Todas las formas comercialmente disponibles de terapia de reemplazo de nicotina (TRN) (chicles, parche transdérmico, aerosol nasal, inhalador y tabletas sublinguales / lozenges) pueden ayudar a de dejar de fumar con éxito. TRN aumenta la tasa cesación en un 50 a 70%. La combinación de un parche de nicotina con una forma de administración rápida de TRN es más eficaz que un solo tipo de NRT. No hay diferencia en la eficacia entre TRN y bupropión, la combinación de NRT y bupropión es más efectiva que bupropión solamente. Los efectos de TRN son en gran parte independientes de la duración de la terapia, la intensidad del apoyo prestado o lugar en el que se ofreció. Según expertos chilenos, se puede usar TRN en adolescentes, en forma de chicles de 2 mg asociado a terapia conductual. Si una embarazada expresa un claro deseo de recibir TRN, se sugiere (i) discutir con ella los riesgos y beneficios asociados, (ii) utilizarla sólo si falla la cesación con medidas no farmacológicas y (iii) utilizar el criterio profesional al decidir si ofrecer la prescripción de TRN, tomando en cuenta el nivel de adicción de la embarazada y la presencia de comorbilidades. Estos fármacos existen en Chile, pero no están hasta el momento disponibles en el sistema público de salud.

All commercially available forms of nicotine replacement therapy (NRT) (gum, transdermal patch, nasal spray, inhaler and sublingual tablets/pills) can help to quit smoking successfully. NRT increases the cessation rate by 50 to 70%. The combination of a nicotine patch with a rapid dosage form of NRT is more effective than a single type of NRT. There is no difference in efficacy between NRT and bupropion, the combination of NRT and bupropion is more effective than bupropion alone. The effects are largely independent of the duration of therapy, the intensity of the support provided or the setting in which the NRT was offered. According to Chilean experts, NRT can be used in adolescents, as chewing gum 2 mg adding behavioral therapy. If a pregnant woman expresses a clear desire to use NRT, it is suggested (i) discuss the associated risks and benefits with her, (ii) use it only if the cessation fails with non-pharmacological measures and iii) use the professional approach when deciding whether to offer the prescription of NRT, considering the level of addiction of the pregnant woman and the presence of comorbidities. TRN exists in Chile, but is not currently available in the public health system.

Assessment of patient' s opinion towards tobacco cessation program in various de- addiction centers of Hyderabad, India: a cross sectional survey

Aim: To assess the opinion of patients towards the tobacco cessation program that were enrolled / attending various tobacco de-addiction centers in Hyderabad. Material and Methods: Data were collected from a sample of 128 tobacco users through a well-designed questionnaire which includes information on demographic data, duration and frequency of tobacco use, type of tobacco use etc. Results: Sixty-eight percent of the participants recommended this program to those who wants to quit tobacco use. Fifty-four percent of the participants were satisfied with the tobacco cessation program. Conclusions: Majority of the patients were satisfied with the counseling given to them in the de-addiction center. Periodic counseling is needed for the tobacco users to cease the habit.

Knowledge, Attitude and Practices of Dental Surgeons towards Tobacco Cessation In Kanpur City.

Background & Objective: The prevention and control of tobacco use is an emerging issue of global significance and of central importance to oral health and dental care. The dental profession is in an excellent position to play a major role in several emerging issues, such as helping the public and policymakers understand the chronic nature of tobacco dependence and supporting cessation services for all people. Objective is to assess the knowledge, attitude and practices of dental surgeons in Kanpur city towards tobacco cessation. Methodology: A cross sectional descriptive study was conducted among dental surgeons by using self-administered questionnaire with23 closed-ended questions. A total of100 dental practitioners who fulfilled the eligibility criteria, participated in the study. Out of this 85 people returned the filled questionnaire form and the response rate was 85%. Descriptive statistics included computation of percentages. Results: Most of the respondents were male (80%) and had practiced dentistry for 5-10 years (91.8%). All the respondents (100%) had the knowledge of harmful effects of tobacco use. A less percentage (8.3%) used tobacco themselves. All the respondents (100%) did not maintain any records on tobacco use. Most of the respondents (82.4%) provided information on harmful effects of tobacco to less than thirty percent of the patients. Only 48.2% dental surgeons advised users to quit. Conclusion: The results of this study call for sensitizing health professionals on a larger scale on the issue of tobacco use and its treatment.

A Tobacco Cessation Intervention with Rural, Medically Underserved, Blue-collar Employees: A Quasiexperimental Study

BACKGROUND: The aim of this study was to increase knowledge regarding the dangers associated with tobacco use, and decrease secondhand smoke exposure and tobacco use behaviors with an antitobacco messaging campaign among rural, medically underserved, blue-collar workers. METHODS: A quasiexperimental study was conducted with employees at two worksites. One worksite received the intervention, which consisted of nine different antitobacco messages. Baseline and follow-up surveys were conducted at each worksite to assess change in knowledge and behavior; the data were compared across the two worksites. RESULTS: Two hundred twenty-two and 243 participants completed baseline and follow-up surveys at the intervention and comparison sites, respectively. A statistically significant difference was seen over time between the worksites on knowledge of the dangers of tobacco (p < 0.0001); the mean knowledge score increased at the intervention site, but remained unchanged at the comparison site. In general, nonsmokers at both worksites appeared to try to decrease exposure to secondhand smoke over the follow-up period. Repeated measures analysis indicated that there were no differences in motivation to quit (p = 0.81), interest in quitting (p = 0.40), thinking about quitting (p = 0.53), or several tobacco-use behaviors over time among smokers at the intervention and comparison worksites. There were slight increases over time in the proportion of smokers who do not allow smoking in their homes/vehicles at the intervention worksite, although not statistically significant. CONCLUSION: Participants at the intervention worksite increased their knowledge regarding the dangers of tobacco use and secondhand smoke exposure. Among current tobacco users, the intervention appeared to increase family rules regarding secondhand smoke exposure in their homes and vehicles.

Intervenções de cessação de tabagismo em fumantes leves: uma revisão sistemática / Smoking cessation interventions in light smokers: a systematic review

Apesar da diminuição da prevalência de fumantes, o número de tabagistas de baixo consumo de cigarro tem aumentado, comumente denominados de fumantes leves ou intermitentes. É sabido que qualquer quantidade de consumo de tabaco pode trazer danos à saúde. A pesquisa sobre essa população é escassa e pouco se sabe sobre intervenções de cessação de tabagismo direcionadas a esses grupos. Dessa forma, o objetivo do presente estudo foi realizar uma revisão sistemática a fim de descrever estudos que apresentam intervenções para fumantes leves e intermitentes. As pesquisas foram conduzidas nas bases de dados PubMed, PsycInfo, SciELO e Pepsic. Palavras-chave incluíram: [light smoker, non-daily smoker, intermittent smoker; social smoking, occasional smoking, low-level smoking] AND [intervention studies, clinical trial and evaluation studies] AND [tobacco use cessation, tobacco use disorder]. Nove artigos preencheram os critérios de inclusão e foram analisados. Os resultados apontaram que intervenções bem-sucedidas incluíram aconselhamento e uso de medicamentos, tais como intervenção breve, tratamento de reposição de nicotina, Vareniclina, educação em saúde, entre outros. No entanto, intervenções ainda estão em estágio inicial. Destaca-se a necessidade de mais investigações sobre intervenções específicas para fumantes de baixo consumo, desenvolvimento de escalas de dependência exclusivas para esse grupo e estudos epidemiológicos para compreender quem são os fumantes leves e intermitentes, especialmente no Brasil

Despite decreases in the prevalence of smoking, the number of low-rate smokers – commonly called light or intermittent smokers – is increasing. Any dose of tobacco can be hazardous to health. Research about this population is scarce and little is known about tobacco cessation interventions that focus on these groups. The aim of the present paper is to conduct a systematic review to describe research on interventions for light and intermittent smokers. Searches were conducted in PubMed, PsycInfo, SciELO and Pepsic. Search terms included: [light smoker, non-daily smoker, intermittent smoker; social smoking, occasional smoking, low-level smoking] AND [intervention studies, clinical trial and evaluation studies] AND [tobacco use cessation, tobacco use disorder]. Nine studies met the inclusion criteria. Successful interventions included counseling and pharmacotherapy such as brief intervention, health education, nicotine replacement, and varenicline. Interventions for light smokers are in the early stages of development. Future studies should test interventions specifically designed for low-rate smokers, develop dependence scales designed for low-rate smokers, and pursue epidemiologic studies to better profile light and intermittent smokers, especially in Brazil.

Community-based tobacco cessation program among women in Mumbai, India.

BACKGROUND: Globally tobacco epidemic kills nearly six million people annually. Consumption of tobacco products is on the rise in low‑ and middle‑income countries. Tobacco is addictive; hence, tobacco users need support in quitting. AIMS: Providing tobacco cessation services to women in community enabling them to quit tobacco, identifying factors associated with quitting and documenting the processes involved to establish a replicable “model tobacco cessation program.” SETTINGS AND DESIGN: This is a community based tobacco cessation program of one year duration conducted among women in a low socioeconomic area of Mumbai, India. SUBJECTS AND METHODS: It involved three interventions conducted at three months interval, comprised of health education, games and counseling sessions and a post intervention follow‑up. STATISTICAL ANALYSIS: Uni and multivariate analysis was performed to find out association of various factors with quitting tobacco. RESULTS: The average compliance in three intervention rounds was 95.2%. The mean age at initiation of tobacco was 17.3 years. Tobacco use among family members and in the community was primary reasons for initiation and addiction to tobacco was an important factor for continuation, whereas health education and counseling seemed to be largely responsible for quitting. The quit rate at the end of the programme was 33.5%. Multivariate logistic regression analysis found that women in higher age groups and women consuming tobacco at multiple locations are less likely to quit tobacco. CONCLUSIONS: Changing cultural norms associated with smokeless tobacco, strict implementation of antitobacco laws in the community and work places and providing cessation support are important measures in preventing initiation and continuation of tobacco use among women in India.

Impacto de las políticas de control de tabaco en el Uruguay. 2006-2009.: Programa Nacional para Control del Tabaco / Impact of the tobacco control policies. 2006-2009: National Program for Tobacco Control

La Organización Mundial de la Salud (OMS) reconoce el consumo de tabaco como una de las principales causas prevenible de muerte prematura y enfermedad. Por lo tanto, el consumo de tabaco representa un grave problema de salud pública. Como consecuencia las políticas de control de tabaco adquieren una dimensión que la transforma en una política de estado dado el impacto sobre la salud de toda la población. En Uruguay a partir de 2005 se implementó un paquete de medidas para el control del tabaco. Se evaluó el cambio en la prevalencia del consumo de tabaco entre los años 2006 y 2009, a través de encuestas comparables. Se analizaron los resultados globales y por grupos. Se encontró una importante disminución del 29,9% en la prevalencia. El descenso analizado según sexo, edad y nivel educativo no fue uniforme. Los resultados sugieren que la aplicación simultánea del conjunto de medidas establecidas en el Convenio Marco de la OMS para el Control del Tabaco constituye una estrategia efectiva para disminuir la prevalencia de consumo de tabaco en un corto período de tiempo.

The World Health Organization (WHO) recognizes the use of tobacco as one of the leading causes of preventable premature death and disease, highlighting tobacco consumption as a serious public health problem. Consequently, and given the impact of the use of tobacco on the health of its entire population, the policies designed in Uruguay to address it have acquired state-policy dimensions. In 2005, Uruguay implemented a package of measures for the control of tobacco; using comparable surveys, the study herein was designed to evaluate the change in the prevalence of the use of tobacco between 2006 and 2009. The analysis addressed both the overall outcomes and in certain groups. Albeit finding a significant decrease in the prevalence (29.9%), such a decline showed disparate results when analyzed by sex, age and educational level. The results suggest that the simultaneous implementation of all the measures set out in the WHO Framework Convention for the Control of Tobacco is an effective strategy to decrease the prevalence of tobacco in a short period of time.

Estrategias para dejar de fumar provistas por infectólogos a pesonas con VIH en la Ciudad Autónoma de Buenos Aires / Tobacco Cessation Strategies among Infectious Disease Specialists who Treat People with HIV in Buenos Aires

INTRODUCCIÓN: La efectividad del tratamiento antirretroviral altamente activo (TARAA) ha transformado la infección por VIH/Sida en una patología crónica, por lo cual resulta necesario limitar los factores de riesgo cardiovascular, en particular el tabaquismo. OBJETIVO: Describir las características de la ayuda para dejar de fumar que proveen los infectólogos a los pacientes con VIH atendidos en la Ciudad Autónoma de Buenos Aires. MÉTODOS: Se aplicó una encuesta validada autoadministrada a los infectólogos que atendían pacientes con VIH en hospitales universitarios, públicos y privados. RESULTADOS: Un total de 128 médicos respondió la encuesta (tasa del 75%). El 90% recomendabaa sus pacientes que dejaran de fumar, el 17% instaba a fijar una fecha de abandono, el 23% utilizaba la técnica del consejo breve, el 35% recurría a algún fármaco, el 8% usaba el consejo breve más fármacos, el 8% remitía a páginas web especializadas, el 5% sugería determinadas líneas telefónicas y el100% recomendaba tratamientos cognitivo-conductuales. Sólo el 40% consideró que el infectólogo debía ocuparse del tratamiento del tabaquismo, y el 92% opinó que debía ser un especialista quien se encargara de la cesación. Las principales barreras para tratar la adicción fueron el inadecuado entrenamiento y el escaso tiempo disponible. CONCLUSIONES: Se verificó una inadecuada capacitación: si bien los profesionales instaban a dejar de fumar, utilizaban de manera insuficiente las técnicas recomendadas

INTRODUCTION: The efficacy of Highly Active Antiretroviral Therapy (TARAA) has transformed HIV/AIDS into a chronic disease. As a consequence, it is necessary to reduce cardiovascular risk factors, particularly smoking. OBJECTIVE: To describe the characteristics of smoking cessation advice provided by infectious disease specialists to patients with HIV in the Autonomous City of Buenos Aires. METHODS: Across-sectional survey was performed on infectious disease specialists who treat HIV-infected patients in private, publicand university hospitals. RESULTS: 128 physicians answered the survey (response rate: 75%). 90% of them recommended their patients to stop smoking, 17% encouraged patients to set a stop date, 23% gave brief advice, 35% prescribed some drugs, 8% gave brief advice and prescribed drugs att he same time, 8% suggested certain web sites, 5% advised to use quit-smoking phone lines and 100% recommended cognitive-behavioral treatments. Only 40% considered that tobacco addiction should be treated by infectious disease specialists, while 92% said that the patients should be referred to a specialist on smoking cessation. The main barriers to treat the addiction were inadequate training and insufficient time. CONCLUSIONS: There is an inadequate training: – al though physicians encourage patients to stop smokin, they make insufficient use of recommended techniques

Tobacco cessation: what role can dental professionals play?

Introduction: Tobacco dependence is classified as a disease by the International Classification of Diseases (ICD-10), but, medical and dental professionals have neither seriously taken this fact nor made any serious attempt to tackle this disease. Apart from supporting wider tobacco control measures, oral health professionals can help patients to stop using tobacco. This may be the single most important service dentists can provide for their patients’ overall health. Objective:This review is prepared with the object to help both clinicians and oral health professionals to scale up their involvement in tobacco control activities, including advocacy and smoking cessation programs. Literature review:Studies have shown that 70% smokers indicate that they want to quit, but a meagre 2% succeed. The dental practice setting provides a unique opportunity to assist tobacco users in achieving tobacco abstinence. Still, More than 40% of dentists do not routinely ask about tobacco use and 60% do not routinely advise tobacco users to quit, while 61.5% of dentists believe their patients do not expect tobacco cessation services. Conclusion: Interventions by dentist has been found to be effective in helping people to quit tobacco consumption. A step-wise approach and patience must be adopted while dealing with such patients.

Initiating tobacco cessation services in India: Challenges and opportunities.

Background: Tobacco use contributes significantly to the diseases burden in India. Very few tobacco users spontaneously quit. Therefore, beginning 2002, a network of 19 tobacco cessation clinics (TCCs) was set up over a period of time to study the feasibility of establishing tobacco cessation services. Methods: Review of the process and operational aspects of setting up TCCs was carried out by evaluation of the records of TCCs in India. Baseline and follow-up information was recorded on a pre-designed form. Results: During a five-year period, 34 741 subjects attended the TCCs. Baseline information was recorded in 23 320 cases. The clients were predominantly (92.5%) above 20 years, married (74.1%) and males (92.2%). All of them received simple tips for quitting tobacco; 68.9% received behavioural counselling for relapse prevention and 31% were prescribed adjunct medication. At six-week follow-up, 3255 (14%) of the tobacco users had quit and 5187 (22%) had reduced tobacco use by more than 50%. Data for three, three-monthly follow-ups was available for 12 813 patients. In this group, 26% had either quit or significantly reduced tobacco use at first follow-up (three-months), 21% at the second (six-months) and 18% at the third follow-up (nine-months) had done so. Conclusions: It is feasible to set up effective tobacco cessation clinics in developing countries. Integration of these services into the health care delivery system still remains a challenge.

Tobacco cessation in India: A contemporary issue in public health dentistry.

In India, tobacco use is incredibly linked to poverty and accounts for the high public health costs of treating tobacco-related diseases. Dental public health programs aid in detecting the tobacco-related periodontal diseases, oral cancers, etc., where the majority belongs to the submerged portion of iceberg, which otherwise leads to substantial morbidity and mortality. Moreover, public health dentists plays a key role in identifying both clinical and subclinical cases and aid in tobacco use cessation through various modes of health education and counseling. Therefore, the community-based measures are deemed to be the most cost-effective tool for tobacco cessation.