TORONTO, Nov. 26 /CNW/ - Scientists at the Centre for Addiction and
Mental Health (CAMH) are defining the most effective ways to treat tobacco
dependence, and in an article released in the November issue of the Canadian
Medical Association Journal (CMAJ) they highlight the surprisingly significant
role that the health practitioner can play in helping people quit smoking.
Many people's attempts to quit are unsuccessful, so effective interventions
are critical for the 4.5 million smokers in Canada alone.
"Advising patients to quit, even just once, helps to double quit rates,"
write CAMH researchers Dr. Bernard Le Foll and Dr. Tony George. Their article
Treatment of tobacco dependence: integrating recent progress into practice is
a comprehensive summary of tobacco use, causes of nicotine dependence, and
advances in treatment and intervention. "To initiate as many cessation
attempts as possible, practitioners should advise all of their patients who
smoke to quit."
Research shows that since an estimated 70% of smokers visit a physician
each year, family doctors have a substantial opportunity to influence smoking
behaviour. "Even a short intervention (three minutes or less) can increase a
person's motivation to quit and can significantly increase abstinence rates,"
the authors write. They provide an algorithm topped by the simple question
"Are you smoking?" to help physicians integrate a patient's smoking status and
his or her readiness to quit, taking a comprehensive approach that combines
assessment, behavioural interventions and pharmacologic treatment of tobacco
The article also showed that smokers with moderate to severe tobacco
dependence have been found to respond best to three types of pharmacotherapy
-- nicotine replacement therapy (NRT), bupropion and varenicline -- but there
is no clear threshold that can help clinicians decide whether a particular
patient will benefit from a particular pharmacotherapy, and there is no
consensus on which one should be used first. The authors provide physicians
with a clear comparative table of these three first-line pharmacologic
treatments, as well as advice on whether to combine these pharmotherapies, or
to consider nortriptyline and clonidine as second-line medications.
Epidemiologic studies have indicated that the majority of successful
attempts to quit smoking occur without direct medical assistance or without
pharmacotherapy. "The use of nonpharmacologic methods (such as counseling)
should be encouraged, especially for people for whom medication use is
problematic," say the authors. "The goal is to motivate the patient to try to
quit smoking." Moreover, pharmacological interventions are clearly effective
and allow doctors to double or triple the odds of success.
Visit www.cmaj.ca for a copy of the article and the Journal's press
release on this issue.
The Centre for Addiction and Mental Health (CAMH) is Canada's leading
addiction and mental health teaching hospital. Integrating clinical care,
scientific research, education, policy development and health promotion, CAMH
transforms the lives of people impacted by mental health and addiction issues.
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For further information: or to schedule interviews please contact
Michael Torres, Media Relations, CAMH at (416) 595-6015