タバコ の 喫煙 の 治療: レビュー
Nancy A Rigotti1,2, Gina R Kruse1,2, Jonathan Livingstone-Banks3
1Tobacco Research and Treatment Center, Mongan Institute, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston.
JAMA
|February 8, 2022
まとめ
禁煙は健康と長寿を 大きく改善します 薬物療法と 行動支援を組み合わせることで 禁煙する上で 最も効果的な戦略となり 寿命を10年伸ばすことができます
科学分野:
- 公衆衛生
- 予防 医療
- 依存症 医学
背景:
- アメリカでは 予防可能な死因の1つとして 喫煙者が3400万人います
- 喫煙をやめると 平均寿命が10年長くなり 喫煙による罹病率と死亡率を 減らすことができます
- ニコチン依存症と 学習した行動によって 喫煙は慢性的な障害となり 多くの個人が 何度もやめようとします
研究 の 目的:
- 様々な禁煙戦略の有効性を検討する.
- 薬物療法と行動支援を組み合わせたタバコ依存症治療の利点を強調する.
- 禁煙のための第一線介入を 特定する.
主な方法:
- 19,488人の喫煙者のメタアナリシスで 薬物療法と行動カウンセリングを 簡潔に比較した結果です
- ヴァレニクリン,ブプロピオン,ニコチンパッチ,プラセボを比較したEAGLES試験 (8,144人の喫煙者).
- 組み合わせた薬剤療法と行動支援の異なる方法に関する証拠のレビュー
主要な成果:
- 薬物療法と行動カウンセリングを組み合わせると 6ヶ月で禁煙率は15.2%で 短期的なカウンセリングは8.6%でした
- ヴァレニクリン (21. 8%) は,ブプロピオン (16. 2%) とニコチンパッチ (15. 7%) よりも,EAGLES試験で6ヶ月の禁煙率が高いことを示した.
- 組み合わせたニコチン置換療法 (NRT) と異なるメカニズム (例えばバレニクリンとNRT) を用いた薬剤の組み合わせは,単一の製品と比較して禁煙率を増加させた.
結論:
- 禁煙の第一線療法には,薬剤療法と行動支援の両方が含まれます.
- ヴァレニクリンまたは併用NRTは,禁煙のための好ましい初期介入として推奨されます.
- 臨床医の簡潔なアドバイスと 治療を受けるための支援は 医療のあらゆる場面で有効です
関連する概念動画
Chronic Obstructive Pulmonary Disease-V: Management
2.7K
Managing Chronic Obstructive Pulmonary Disease (COPD) involves a multifaceted approach to reduce symptoms, prevent exacerbations, improve overall health status, and slow disease progression. Key strategies include lifestyle modifications, pharmacotherapy, supportive therapies, and, in some cases, surgery. Here is an overview of the primary COPD management strategies:
Smoking Cessation
Smoking Cessation
2.7K
Drugs Acting on Autonomic Ganglia: Stimulants
1.7K
Ganglionic stimulants activate NM nicotinic receptors in autonomic ganglia, falling into two categories: nicotine mimetics [e.g., lobeline, dimethylpiperazine, tetramethylammonium] and muscarinic receptor agonists [e.g., muscarine, methacholine]. The first category's action is rapid and blocked by nicotinic receptor antagonists, while the second category's action is delayed and blocked by atropine-like agents. Nicotine, an alkaloid, affects the heart rate by stimulating...
1.7K
Stress Prevention and Stress Management Techniques IV
68
Stress often leads to unhealthy habits like smoking, excessive drinking, and overeating, which offer short-term relief but ultimately increase long-term health risks. These behaviors create a cycle that temporarily lowers stress levels but can result in severe long-term health consequences. Breaking these habits is essential to reduce the risk of chronic diseases and improve overall well-being. Three primary changes that support better health include quitting smoking, reducing alcohol intake,...
68
COPD: Management Using Bronchodilators and Corticosteroids
451
Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...
451
CNS Depressants: Alcohol and Nicotine
437
Ethanol, a clear colorless alcohol, has been consumed by humans for millennia, but its effects on the body are far from benign. At lower doses, it induces decreased inhibitions and loquaciousness, leading to its social appeal. However, it can cause severe consequences at higher doses, such as coma and respiratory depression, due to its zero-order elimination kinetics. Chronic ethanol abuse wreaks havoc on multiple organ systems, particularly the CNS and the liver. Abrupt cessation of ethanol...
437
Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
268
Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
268


