Why Quit? Potential Lifetime Health Benefits of Quitting Smoking1-2
Why Quit? Potential Lifetime Health Benefits of Quitting Smoking1-2
1. CDC. Surgeon General Report 2004: American Cancer Society. Guide to Quitting Smoking. 2. US Department of Health & Human Services. The Health Benefits of Smoking Cessation: A Report of the Surgeon General. 1990.
Lung function may start to improve with decreased cough, sinus
congestion, fatigue, and shortness of breath
3 m
on
ths
Lung cancer risk is 30-50% that of continuing smokersC
es
sa
tio
n
CHD: excess risk is reduced by 50% among ex-smokers
Cardiovascular heart disease (CHD) risk is similar to never smokers
Stroke risk returns to the level of people who have never smoked at 5-15 years post-cessation
1 ye
ar
5 ye
ars
10 y
ears
15 y
ears
PathogenesisPathogenesis
Managing tobacco use: the neglectedcardiovascular disease risk factorNancy A. Rigotti1*and Carole Clair
Managing tobacco use: the neglectedcardiovascular disease risk factorNancy A. Rigotti1*and Carole Clair
Risk and BenefitsRisk and Benefits
Ingredient Rating Ingredient Rating Ingredient Rating
In-person support Abrupt stop (vs gradual) Deep breathing
NRT (supported) Identity change Exercise
Champix Avoiding smokers Isometric exercise
Zyban Avoiding alcohol Mental exercises
Cytisine Changing routine Healthy snacks
Quitline Keep busy Go to bed early
Internet One day at a time Get rid of cigs
SMS support Tell others Smartphone app
Book or booklet Quit together
E-cigs Count savings
Glucose
6 Strong evidence Moderate evidence Some evidence
Current Methods 2013Current Methods 2013
The Cycle of Nicotine AddictionThe Cycle of Nicotine Addiction
Nicotine binding causes an increase in dopamine release 1
Dopamine gives feelings of pleasure and calmness 2
The dopamine decrease between cigarettes leads to withdrawal symptoms of irritability and stress 3,4
A smoker craves nicotine to release more dopamine to restore pleasure and calmness 2,3
DopamineDopamine
NicotineNicotine
1. Foulds J. Int J Clin Pract 2006;60:571-576.2. Fagerstrom K. Drugs 2002;62(Suppl2):1-9.3. Jarvis MJ. BMJ 2004; 328:277-279.4. Rigotti NA. N Engl J Med 2002;346:506-512.
10
When the desire is stronger than abstinence and cigarettes are close .... You will be tempted to start!
Urge to
smoke
Time
Resolve Strength of urge
Withdrawal Symptoms from Stopping SmokingWithdrawal Symptoms from Stopping Smoking
0 1 2 3 4 5 6 7 8 9 10
Duration (weeks)or more
Jarvis MJ. BMJ 2004;328:277-279.
Incidence
Increased appetite
Restlessness
Depression
Irritability/aggression
Craving for nicotine
Poor concentration
Sleep disturbance
Lightheadedness
70%
60%
60%
50%
70%
60%
25%
10%
Withdrawal Syndrome: a Combination of Physical and Psychological Conditions, Making Smoking Hard to
Treat1,2
Withdrawal Syndrome: a Combination of Physical and Psychological Conditions, Making Smoking Hard to
Treat1,2
Restlessness or impatience
Increased appetite or weight gain
Withdrawal Syndrome
Anxiety
Dysphoric or depressed mood
Irritability, frustration, or anger
Difficulty concentrating
Insomnia/sleep disturbance
1. Diagnostic and Statistical Manual of Mental Disorders, IV-TR. Washington, DC: APA; 2006.2. West RW et al. Fast Facts: Smoking Cessation. 1st ed. Oxford, United Kingdom. Health Press Limited, 2004.
0,0
0,5
1,0
1,5
1 2 3 4 5 6 7 8 9 10
1 2 3 4 5 6 7 8 9 10
Anxiety/Tension
Irritability/Anger
Excessive Hunger
Select Withdrawal Symptoms Over TimeSelect Withdrawal Symptoms Over Time
N = 40. Mean adjusted withdrawal scores are from an analysis of covariance with baseline cigarettes per day and baseline scores on the items shown as covariates. Gross et al. Psychopharmacology. 1989;98:334-341.
Impatience
0,0
0,5
1,0
1,5
1 2 3 4 5 6 7 8 9 10
Placebo Nicotine Gum
Mea
n A
dju
sted
Wit
hd
raw
al S
core
Mea
n A
dju
sted
Wit
hd
raw
al S
core
Postcessation Weeks
0.0
0.5
1.0
1.5
0,0
0,5
1,0
1,5
1 2 3 4 5 6 7 8 9 10
Postcessation Weeks
Postcessation WeeksPostcessation Weeks
About Vaping
Executive Agency for Health and Consumers Specific Request EAHC/2011/Health/11 for under EAHC/2010/Health/01 Lot 2 Economic analysis of the EU market of tobacco, nicotine and related products Revised Final Report 20 September 2013
Truth About Vaping
Executive Agency for Health and Consumers Specific Request EAHC/2011/Health/11 for under EAHC/2010/Health/01 Lot 2 Economic analysis of the EU market of tobacco, nicotine and related products Revised Final Report 20 September 2013
People who quit smoking after a heart attack or cardiac surgery reduce their risk of death by 36%
Cochrane Database of Systematic Reviews 2003;4:CD003041
Slide courtesy of Andrew Pipe, CM, MD, LLD(Hon), DSc(Hon)
Over the long term, even in a higher risk population of patients with stable CVD, the benefits of smoking cessation likely outweigh potential short-term harms of varenicline.
However, this increase in risk may be important in choosing between medical therapies for smoking cessation in patients at increased risk of cardiovascular events.
A (shock) Well Informed E Cig Media Report
Публикуван на 28.04.2014 г.BBC Breakfast from 28th April 2104
19
How to stop smoking cigarettes: these lines must be separated!
Жел
ание за
пушене
Време
Resolve Strength of urge
22Proven as the most effective medicament in the world for the last 50 years!
Medical specialist claims 2012-2015Medical specialist claims 2012-2015
Product promotional campaign in pharmacy stores
New Key opinion leader in BulgariaNew Key opinion leader in Bulgaria
Product promotional campaign at Workplaces
Health promotional campaign at Sopharmacy 31-05 2015
We can be the next Dunhill ….
ANTI GENERIC STRATEGY
Smoking cessation market in Bulgaria in sales unitsSmoking cessation market in Bulgaria in sales units
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