Tobacco Consumption In Patients Research Articles

Relapse of Tobacco Consumption in Patients Treated for Head and Neck Cancer: a Cross Sectional Study.

Head and neck cancers are a major healthcare burden in the Indian Subcontinent mainly due to tobacco consumption. While advances in treatment have resulted in better control rates and survival, relapse of tobacco consumption contributes to recurrences. The authors embarked upon a cross-sectional questionnaire-based study to assess the burden of tobacco relapse along with factors resulting into relapse. Patients on follow-up after treatment of tobacco-related head and neck cancers in a dedicated cancer institute were included in the study. Demographic data was noted, and responses were obtained on a five-point Likert's scale for reasons of relapse which were analyzed with a median and interquartile range. Predictors of relapse were assessed using multivariate logistic regression analysis. In our sample size of 500, relapse rate was 15%, majority of which occurred in the first year of follow-up when disease was loco-regionally controlled. Most common causative factor for relapse was lower motivation to quit. Care givers must incorporate tobacco cessation counseling as an integral part of head and neck cancer treatment.

Perfil ocupacional, consumo de álcool e tabaco em pacientes com câncer de cabeça, pescoço e pulmão na cidade Uberlândia/MG

Perfil ocupacional, consumo de álcool e tabaco em pacientes com câncer de cabeça, pescoço e pulmão na cidade Uberlândia/MG

Factors associated with tobacco consumption in patients with depression.

Smoking and depression are related in a bidirectional way: smoking is the primary avoidable cause of illness and death in patients with depression, and depression is one of the most consistent risk factors for smoking. The main objective of this study is to investigate the relationship between smoking and depression, analyzing sociodemographic and clinical variables such as severity of symptoms, subtype of affective disorder, and its impact on suicidal behavior in the clinical population.A sample of 201 patients, over 18 years of age [mean age (SD) = 53.76 (10.36) years; women = 132 (65.7%)], with a history of depressive episode (unipolar or bipolar) or dysthymia (ICD 10 criteria) was studied.Current smoking prevalence was 43.2% and life-time prevalence 61.2%. No statistically significant differences in smoking prevalence between men and women were found (X2 = 3.896, p = 0.143). The average age of onset was 17.81 (5.60) years. There was a tendency towards a linear association between number of cigarettes/day consumed and severity of depression according to the Hamilton Depression Scale (HDRS) in current smokers (Pearson's R = 0.298, p = 0.050). Multinomial logistic regression analysis showed that current tobacco consumption was associated with higher HDRS scores, with each additional point on the HDRS increasing the likelihood of smoking by 0.062 [p = 0.032; OR (95% CI) = 1.064 (1.005-1.125)].Our results showed that depressed patients present higher prevalence of current smoking than the general population, also suggesting a relationship between severity of consumption and severity of depressive symptoms.

Survey of physicians on dealing with the topic "Tobacco consumption in patients with lung cancer"

About 40 % of the patients are active smokers when diagnosed lung cancer. Half of these patients is the nicotine consumption continues despite the existence of cancer. The overall mortality in these patients is a factor of 3 higher. In addition, the quality of life increases and symptoms such as cough and dyspnoea are reduced. How do the treating physicians deal with the tobacco consumption of their patients with lung carcinoma? A total of 14 physicians from the Bonn University Hospital were interviewed from the departments of pneumology, oncology and thoracic surgery involved in the treatment of the lung carcinoma. The interviews were transcribed and analysed according to the qualitative content analysis Mayring with MAXQDA® 12. The doctors handled the nicotine consumption of their patients very individually. In doing so, the doctors were primarily oriented on the possible life expectancy of the patients. In a curative treatment approach, the doctors presumed a smoking stop in their patients for successful treatment. In the context of a palliative treatment, many doctors no longer wanted the burden of smoking cessation to their patients. Came the desire for a cessation therapy in patients were referred generally to colleagues who were trained in smoking cessation. Obstacles to the independent execution of a smoking cessation were in particular lack of knowledge and short treatment times or high number of patients, especially during the consultation hours. The doctors were quite convinced of the benefit of a smoking stop in the treatment of the lung carcinoma. Lung cancer patients would benefit if smoking cessation would be even more integrated into the overall therapy. For that one could rely on already established cessation programs and concepts for clinics.

Changes in tobacco consumption in cannabis dependent patients with schizophrenia versus non-psychiatric controls during 28-days of cannabis abstinence

BackgroundTobacco and cannabis are highly co-morbid in the general population and in patients with schizophrenia. Given the putative causal mechanisms facilitating co-use, it is important to determine how cannabis cessation may influence concurrent tobacco use. Using a 28-day cannabis abstinence paradigm, we prospectively examined changes in tobacco consumption in patients with schizophrenia and controls with cannabis dependence and daily cigarette use. MethodsCannabis dependent patients with schizophrenia (n = 19) and controls (n = 20) completed the study with abstinence rates of 42% and 55%, respectively. Participants completed measures of substance use, withdrawal, and clinical symptoms weekly. Urine samples were collected twice weekly to biochemically verify abstinence. ResultsPatients reported a greater increase in cigarettes smoked per day (CPD) on Day 7 relative to baseline (2.97 cigarette increase for abstinent subgroup, p < .01) compared to controls (.06 cigarette increase for abstinent subgroup, p = .95). Initially, greater reductions in cannabis use related to greater increases in CPD relative to baseline in the patient subsample (simple slope = −2.31, p = .05), but by Day 28, CPD returned to baseline levels independent of cannabis use. CPD changes were unrelated to cannabis withdrawal. Results were similar for changes in caffeine consumption, but not for alcohol. ConclusionsFindings suggest transient tobacco substitution for cannabis in patients with schizophrenia. This provides further support for a strong association between cannabis and tobacco in schizophrenia. Future studies should focus on targeting underlying mechanisms that promote co-use to better address potential changes in concurrent substance use during treatment interventions.

Inflammatory Articular Disease in Patients with Inflammatory Bowel Disease: Result of the Swiss IBD Cohort Study.

Inflammatory bowel diseases (IBD) are systemic conditions that commonly display extraintestinal manifestations. Inflammatory articular disease (IAD: axial or peripheral) is the most common extraintestinal manifestation. The aim of this study was to evaluate the prevalence and the clinical characteristics associated with IAD in patients with IBD. We analyzed patients enrolled in the Swiss IBD cohort study. IAD was defined as persistent or recurrent joint pain with an inflammatory pattern (night pain, progressive relief during the day, morning stiffness lasting at least 30 minutes) or the presence of arthritis as diagnosed by the physicians. A multivariate logistic regression was performed to analyze which disease characteristics were independently associated with the presence of IAD. A total of 2353 patients with IBD, 1359 with Crohn's disease, and 994 with ulcerative colitis (UC) were included. Forty-four percent of patients fulfilled the criteria for IAD, whereas 14.5% presented with other extraintestinal manifestations. IAD was associated with Crohn's disease, with female sex, with older age, and generally in patients with more active intestinal disease. Only in UC, IAD was further associated with tobacco smoking and with increasing body mass index. This population of patients with IBD displays a high prevalence of IAD. IAD was more strongly associated with Crohn's disease than UC. Other risk factors for IAD were female sex, advanced age, active digestive disease, and tobacco consumption in patients with UC, which is interesting given the established association between smoking and other inflammatory arthritides.

Le traitement de la dépendance du tabac

SUMMARY Several studies show that more than 60 to 70% of smokers want to stop smoking. The main difficulty in smoking weaning is usually important and is related to a physical and psychological smoking dependence. Smoking is considered as a chronic disease that often requires support in the long term, both pharmacological and psychological management. Smoker's motivation is a key element to start smoking weaning and to maintain it. In the first time, the management of smoking dependence is conducted by primary care doctors or by all specialized doctors graduated in this field. In case of difficulty, a recover by specialized physicians implicating in this management is desirable. The organizing of Tobacology Coordination Unit (TCU) in hospitals is also necessary. The physicians of TCU treat hospitalized patients and who are presents in consultation department. For a pragmatic point of view, it is necessary to establish a hierarchy of objectives: total stop smoking is both initial and final objective of the management of cigarette smoking weaning in smoker. The reduction of tobacco consumption in patients who do not want and / or can not quit smoking despite well conducted weaning attempts, should be considered as an intermediate step towards a definitive smoking weaning.

Neuroprotective and Neurotoxic Effects of Nicotine

The interest in the action of nicotine in the central nervous system (CNS) has significantly increased during the past 15 years. This is due in part to the growing importance of nicotine addiction and its consequences in terms of life quality and costs for public health systems in industrialized countries and, on the other hand, to the significantly higher prevalence of tobacco consumption in patients with psychiatric disorders. The actual data indicate opposite effects of nicotine in the CNS. Nicotine seems to have, at the same time, positive, neuroprotective as well as negative, neurotoxic effects. This suggests that nicotine's action is complex, probably involving different neuronal circuits influencing each other through complicated interactions. In the present review we summarize the most important results of experiments about nicotinic neuroprotection and neurotoxicity in humans and animals. Initially, we illustrate well known modifications of cholinergic transmission during physiological (normal aging) and pathological neurodegeneration. In the second part of the paper we describe neuroprotective and neurotoxic effects of nicotine also mentioning the underlying molecular mechanisms.

A survey of alcohol and tobacco consumption in patients and their partners following diagnosis and treatment for head and neck squamous cell carcinoma

A survey of alcohol and tobacco consumption in patients and their partners following diagnosis and treatment for head and neck squamous cell carcinoma

Calcification in coronary arteries as quantified by CT scans correlated with tobacco consumption in patients with inoperable non-small cell lung cancer treated with three-dimensional radiotherapy.

It has been shown that radiological manifestations of coronary artery sclerosis are an indirect measure of co-morbidity and predictive of survival. The aim of the present study is to evaluate the outcome and side effects after three-dimensional (3D) radiotherapy in patients with unresectable non-small cell lung cancer (NSCLC) stage I, II and IIIA, depending on coronary artery calcification, Karnofsky performance index (KI) and co-morbidity. Between 1993 and 1999, 89 patients with unresectable NSCLC were treated with 3D-radiotherapy. The median age was 66.6 years and median KI 80%. All patients had 3D-treatment planning, based on CT scans. The median total dose was 60 Gy in 2 Gy fractions five times a week. The mean follow-up period was 13.2 months and mean survival time 12.2 months. Significant prognostic factors for improved survival were KI and tumour stage. Patients with a KI<90% had a median survival of 6.5 months compared with 14 months, in patients with KI>/==" BORDER="0">90% (p<0.001). NSCLC stage I+II showed a significantly longer median survival than patients with NSCLC stage IIIA (16.5 months versus 7 months, p<0.004). A significant correlation was seen between pack-years and coronary artery calcification (p<0.05) and between age and marked coronary artery calcification. The incidence of calcification was 67% in smokers (>/==" BORDER="0">20 pack-years) and 43/58 in patients >60 years (p<0.007). Side effects, e.g. pneumonitis, did not correlate with coronary artery calcification but correlated with chronic obstructive lung disease in 19/89 patients. Conventional CT scans for 3D-treatment planning are able to detect coronary artery calcification. There is a significant correlation between age, KI, tobacco consumption and vascular calcification. Although there was a trend to worse overall survival, coronary artery calcification was not a significant predictor of progression-free and overall survival.