Smoking characteristics and cessation in patients with thromboangiitis obliterans

Aim. Describe the smoking characteristics and the results of a smoking intervention programme involving 27 cigarette smokers with Thromboangiitis Obliterans (TAO). Methods. Clinical records of all cigarette smokers with TAO that attended our smoking treatment clinic from 1990 to 2004 were reviewed. Demographic and smoking characteristics, the type of smoking treatment received and its efficacy and safety up to 12 months was abstracted. Treatment consisted of the combination of behavioural and pharmacological treatment. The behavioural treatment was delivered in eight individual visits: one baseline visit and seven follow-up visits. Pharmacological treatment consisted of combinations of nicotine patches and nicotine gum (NRT) and/or bupropion. This is an‘intent to treat’ analysis. A descriptive analysis of the variables was performed. Qualitative variable relationships were tested using the χ-square test for independence, or Fisher’s Exact Test when expected values were less than five. Statistical significance was accepted at a level of p<0.05. Results. 27 cigarette smokers (23 male and 4 female), mean (SD) age 36.07 (7.23), mean FTND-score 8.4 (1.4), smoked a mean of 29.6 (7.71) cigarettes daily. They attended our clinic a mean of 45.48 (8.63) months after onset of TAO. Their mean number of attempts to stop was 3.22 (2.75). The continuous abstinence rate decreased from 29% at the end of treatment to 18.5% at 12-month follow up. The seven day point prevalence abstinence rate at the 12th month of follow up was 40.7%. We found that continuous abstinence at 6 and 12 months was more frequent among those with multiple previous stop attempts (p=0.003 and p=0.001, respectively). There were no significant differences in abstinence outcomes between groups. Incidence of adverse effects was similar to other smokers seeking treatment. All the smokers who achieved continuous tobacco abstinence had improvement in their disease and none of them underwent amputation, compared to 50% of those who resumed smoking and later required an amputation. Conclusions. Continuous abstinence rates among treated cigarette smokers with TAO are relatively low, but abstinence does improve symptoms and reduce the likelihood of amputation. More aggressive treatment programmes need to be developed for this high risk, highly tobacco dependent population

Scientometric Analysis and Combined Density-Equalizing Mapping of Environmental Tobacco Smoke (ETS) Research

Background: Passive exposure to environmental tobacco smoke (ETS) is estimated to exert a major burden of disease. Currently, numerous countries have taken legal actions to protect the population against ETS. Numerous studies have been conducted in this field. Therefore, scientometric methods should be used to analyze the accumulated data since there is no such approach available so far. Methods and Results: A combination of scientometric methods and novel visualizing procedures were used, including density-equalizing mapping and radar charting techniques. 6,580 ETS-related studies published between 1900 and 2008 were identified in the ISI database. Using different scientometric approaches, a continuous increase of both quantitative and qualitative parameters was found. The combination with density-equalizing calculations demonstrated a leading position of the United States (2,959 items published) in terms of quantitative research activities. Charting techniques demonstrated that there are numerous bi- and multilateral networks between different countries and institutions in this field. Again, a leading position of American institutions was found. Conclusions: This is the first comprehensive scientometric analysis of data on global scientific activities in the field o

Budgetary impact analysis on funding smoking-cessation drugs in patients with COPD in Spain

Carlos A Jim&eacute;nez-Ruiz,1 Segismundo Solano-Reina,2 Jaime Signes-Costa,3 Eva de Higes-Martinez,4 Jos&eacute; I Granda-Orive,5 Jos&eacute; J Lorza-Blasco,6 Juan A Riesco-Miranda,7 Neus Altet-Gomez,8 Miguel Barrueco,9 Itziar Oyag&uuml;ez,10 Javier Rejas11 On behalf of the SEPAR&rsquo;s Integrated Tobacco Research Program 1Specialised Tobacco Unit, Community of Madrid, 2Tobacco Unit, Department of Pulmonary Medicine, Hospital General Universitario Gregorio Mara&ntilde;&oacute;n, Madrid, 3Department of Pulmonary Medicine, Hospital Universitario San Juan, Alicante, 4Department of Pulmonary Medicine, Hospital Universitario Fundaci&oacute;n Alcorc&oacute;n, 5Department of Pulmonary Medicine, Hospital Universitario 12 de Octubre, Madrid, 6Department of Pulmonary Medicine, Complejo Hospitalario de Navarra, Pamplona, Navarre, 7Department of Pulmonary Medicine, Hospital de San Pedro Alc&aacute;ntara, C&aacute;ceres, 8Drassanes Tobacco Unit, Hospital Universitari Vall-d&rsquo;Hebron-Drassanes, The Jordi Gol University Institute for Research Primary Healthcare, Barcelona, 9Department of Pulmonary Medicine, Hospital Universitario de Salamanca, Biomedical Research Institute, Salamanca, 10Pharmacoeconomics &amp; Outcomes Research Iberia, 11Department of Pharmacoeconomics and Health Outcomes Research, Pfizer, Sociedad Limitada Unificada, Alcobendas, Madrid, Spain Abstract: The aim of the study was to assess the budgetary impact of funding smoking-cessation drugs in COPD patients in Spain. A hybrid model (cohort and Markov) was developed for a 5-year time horizon. Only approved cessation drugs (varenicline, bupropion, and nicotine replacement therapy) were considered. Irrespective of the drug, the model allowed for an initial cessation attempt, and up to three additional attempts in case of failure or smoking relapse during a 5-year period. Drug effectiveness was based on controlled clinical trials. National Health System perspective was applied; therefore, only medical resources were included. The pharmaceutical costs for smoking-cessation drugs, extra medical follow-up as a consequence of public reimbursement, and annual savings for health costs avoided due to stopping smoking were considered. The model estimated that 17,756 COPD patients would stop smoking if public funding was available, compared with 1,303 without reimbursement. In the reimbursement scenario, the savings accounted for a total of &euro;48.0 million, compensating for expenditures on drugs and medical visits (&euro;40.4 million). Accumulated total additional savings in 5&nbsp;years (&euro;4.3 million) compared with the scenario without reimbursement was shown. Sensitivity analyses supported the results robustness. Funding smoking-cessation drugs in COPD patients seems to be an efficient option and a National Health System drug reimbursement scheme would represent a cost-saving policy in Spain. Keywords: pharmacotherapy, COPD, smoking cessation, budgetary impact, health servic

Smoking control is a priority to promote heart, lung, blood, and sleep health

SCOPUS: le.jinfo:eu-repo/semantics/publishe

Common errors in inhalation therapy: impact and solutions

Objective: Inhalation therapy is one of the key pillars in the treatment of chronic obstructive diseases, such as asthma and COPD (Chronic obstructive pulmonary disease); however, wide number of errors occur with high frequency in the inhalation manoeuvres among these patient. This review discuss the main errors made with inhalation devices, factors associated with poor IT (inhalation technique), their consequences and possible solutions. Data sources: To do this, we performed a search of any publications available in PubMed between the years 2000 and 2019, using the key words: asthma, COPD, obstructive lung disease, inhalers, misuse and errors. Study selections: After a review of the titles and abstracts by the working group, the articles chosen were considered the most relevant in providing evidence of the problems and establishing solutions in the inhalation treatment of asthma and COPD. Results: There are several publications that associated the errors in the inhalation technique with a poor prognosis both of asthma and COPD. Most authors generally agree in that a poor IT is associated with poor control of the symptoms. Conclusions: It is essential to review the IT in all our patients with asthma and COPD due to the high socio-economic impact that it involves; an effort must be made to homogenise the evaluation of IT, so that it helps to transmit a clear message to the patients, as well as to the health professionals on what is and what is not a correct manoeuvre