Smoking cessation: which aids are worthwhile?
Smoking is a major preventable health risk in western society. In the Netherlands, it is held responsible for 86 and 36% of annual mortality from lung cancer and cardiovascular disease, respectively. Nevertheless about 33% of Dutch people smoke. Only 2% of smokers quit successfully after being advised to stop once by a physician. Although the medical profession should play a leading role in campaigns to stop smoking, general practitioners advise only 10% of their smokers to quit. An overview was made of the various aids that can be used to support attempts to quit smoking. Three aids: supportive schedules, nicotine replacement and bupropion chloride had proven long-term effectiveness in up to 5-10, 3-13 and 11-15% of the subjects, respectively. In conclusion, supportive counselling combined with nicotine substitutes or bupropion chloride is the most worthwhile intervention to support quitting attempts. Wider application of this strategy is expected to have major implications on morbidity (50% myocardial infarct risk reduction) and mortality in the Netherlands.
van den Berkmortel
F W
FW
Department of Medicine, Division of General Internal Medicine, University Medical Centre, St. Radboud, Geert Grooteplein 8, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
Bootsma
G P
GP
Heijdra
Y F
YF
van Spiegel
P I
PI
Wollersheim
H
H
D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D016642:Bupropion / Q000627:therapeutic use; D003376:Counseling / Q000379:methods; D005194:Family Practice / Q000379:methods; D006801:Humans; D009426:Netherlands / Q000453:epidemiology; D009538:Nicotine / Q000627:therapeutic use; D018722:Nicotinic Agonists / Q000627:therapeutic use; D010353:Patient Education as Topic / Q000379:methods; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D012944:Social Support; D016896:Treatment Outcome
D018687:Antidepressive Agents, Second-Generation; D018722:Nicotinic Agonists; D016642:Bupropion; D009538:Nicotine