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Richtlinien der Tabakentwöhnung Stand 2010

Guidelines for smoking cessation – Update 2010

  • Konsensusbericht
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Summary

In 2005, the ÖGP (Austrian Society of Pneumology) worked out the first standards of smoking cessation. With many new therapies, it is timely to update the guidelines of smoking cessation. This time all relevant professionals who are active in smoking cessation in Austria worked together in a big consensus process, not only the diverse medical professionals such as internists, pneumologists, or gynecologists but also psychotherapists, psychologists, and nurses. The Austrian standards for smoking cessation is closely related to the Update for smoking cessation 2008 of the USDHHS (US Department of Health and Human Services) and the Cochrane Reports. Ten main recommendations for smoking cessation have been worked out. The guidelines for smoking cessation was reviewed by three international reviewers.

Zusammenfassung

2005 hat die ÖGP (Österreichische Gesellschaft für Pneumologie) die Standards der Raucherentwöhnung publiziert. Nach vielen Neuerungen in der Tabakentwöhnung war es an der Zeit, die Standards zu überarbeiten. Diesmal ist es gelungen, nahezu alle Anbieter einer Tabakentwöhnung einschließlich aller relevanten Berufsgruppen in die Überarbeitung einzuschließen. Mehr als 20 ExpertInnen haben in vielen Stunden ihr wissenschaftliches Know-how eingebracht. Es ist ein Werk mit über 80 Druckseiten entstanden. Aus diesen Standards haben wir die Richtlinien der Tabakentwöhnung in kurzer und übersichtlicher Form zusammengefasst. Diese Richtlinien zeigen die wissenschaftliche Evidenz der einzelnen Maßnahmen in der Tabakentwöhnung auf. Wer sich einen tieferen Einblick in die einzelnen Bereiche verschaffen will, findet ihn in den Standards der Tabakentwöhnung. Besonders hervorheben möchten wir, dass diese Standards mithelfen sollen, den ständig wachsenden Umfang an wissenschaftlichen Arbeiten in "best clinical practice" umzusetzen. Sie wollen Hilfestellung und Empfehlung sein. Sie sind keine Gesetze, die zwingend vorschreiben, wie im Einzelfall vorzugehen ist. Das ist Sache der Arzt bzw. Therapeut – Patient Beziehung, die die spezifische Therapie im Detail formt. Die Erarbeitung der Guidlines erfolgte nach dem Standards der Erarbeitung von Richtlinien der ÖGP unter Einbindung von internationalen Reviewern.

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Literatur

  • U.S. Department of Health and Human Services. Public Health Service. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline; 2008

  • Aigner K, Homeier I, Koessler W, Lichtenschopf A, Zwick H. Standards der Raucherentwöhnung, Konsensus der ÖGP. Wien Klin Wochenschr, 117(Suppl. 2): 2005

  • Rebhandl E, et al. Raucherentwöhnung in der allgemeinmedizinischen Praxis, ÖGAM Konsensus Statement. Internationale Zeitschrift für ärztliche Fortbildung; 2007

  • Mathers CD, et al. Projections of global mortality and burden of disease from 2002 to 2030. PloS Med 2006;3:e442

    Article  PubMed  Google Scholar 

  • HBSC (Health behavior in school-aged children) international report from the 2005/2006 survey. Inequalities in young people's health, Chapter 2, Section 4, 2008. http://www.euro.who.int/Document/E91416_Ch2_4.pdf, 25.5.2009

  • Doll R, Peto R. Mortality in relation to smoking: 50 years observation on male British doctors. BMJ 2004;328:1519

    Article  PubMed  Google Scholar 

  • Henschke CI, et al. Women's susceptibility to tobacco carcinogens and survival after diagnosis of lung cancer. JAMA 2006;296:180–4

    Article  PubMed  Google Scholar 

  • Jee SH, Suh I, Kim IS, Appel LJ. Smoking and atherosclerotic cardiovascular disease in men with low levels of serum cholesterol: the Korea Medical Insurance Corporation Study. JAMA 1999;282:2149–55

    Article  PubMed  CAS  Google Scholar 

  • Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, McQueen M, Budaj A, Pais P, Varigos J, Lisheng L; INTERHEART Study Investigators. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 2004;364:937–52

    Article  PubMed  Google Scholar 

  • Willi C, Bodenmann P, Ghali WA, Faris PD, Cornuz J. Active smoking and the risk of type 2 diabetes: a systematic review and meta-analysis. JAMA 2007;12(22):2654–64

    Article  Google Scholar 

  • Batra A, Schütz CG, Lindinger P. Tabakabhängigkeit. In: Schmidt LG, Gastpar M, Falkai P, Gaebel W (Hrsg.) Evidenzbasierte Suchtmedizin. Behandlungsleitlinie Substanzbezogene Störungen. Köln: Deutscher Ärzte-Verlag;2006

    Google Scholar 

  • Benowitz NL. Pharmacologic aspects of cigarette smoking and nicotine addiction. N Engl J Med 1988;319:1318-30

    Article  PubMed  CAS  Google Scholar 

  • Fidler JA, Warle J, Brodersen NH, et al. Vulnerability to smoking after a single cigarette can lie dormant for three years or more. Tob Control 2006;15:205–9

    Article  PubMed  CAS  Google Scholar 

  • Dilling H, Monbour W, Schmidt MH, (Hrsg.) Internationale Klassifikation psychischer Störungen: ICD 10, Kapitel V (F). Göttingen: Huber; 1991

    Google Scholar 

  • Di Chiara G, Imperato A. Drugs abused by humans preferentially increase synaptic dopamine concentrations in the mesolimbic system of freely moving rats. Proc Natl Acad Sci USA 1988;85:5274–8

    Article  PubMed  CAS  Google Scholar 

  • Balfour DJ. Neural mechanisms underlying nicotine dependence. Addiction 1994;89:1419–23

    Article  PubMed  CAS  Google Scholar 

  • Andreas S, Batra A, Behr J, Berck H, Chenot J-F, Gillissen A, Hering T, Herth F, Meierjürgen R, Mühlig S, Nowak D, Pfeifer M, Raupach T, Schultz K, Sitter H, Worth H. Tabakentwöhnung bei COPD. S3 Leitlinie herausgegeben von der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin. Pneumologie 2008;62:255–72

    Article  PubMed  CAS  Google Scholar 

  • Riemann K, Gerber U. Standardisierung von Fragestellungen zum Rauchen: Ein Beitrag zur Qualitätssicherung in der Präventionsforschung. 4ed. BZgA. Köln, Bundeszentrale für gesundheitliche Aufklärung;2000

  • Schoberberger R, Kunze U, Schmeiser-Rieder A, Groman E, Kunze M. Wiener Standard zur Diagnostik der Nikotinabhängigkeit: Wiener Standard Raucher Inventar (WSR). Wien Med Wochenschr 1998;145:70–3

    Google Scholar 

  • West R, Hajek P, Stead L, Stapleton J. Outcome criteria in smoking cessation trials: proposal for a common standard. Addiction 2005;100:299–303

    Article  PubMed  Google Scholar 

  • Stead LF, Bergson G, Lancaster T. Physician advice for smoking cessation. Cochrane Database Syst Rev 2008;(2):CD000165. DOI: 10.1002/14651858.CD000165.pub3

    PubMed  Google Scholar 

  • Stead LF, Lancaster T. Group behaviour therapy programmes for smoking cessation. Cochrane Database Syst Rev 2008;(2):CD001007. DOI: 10.1002/14651858.CD001007.pub2

    Google Scholar 

  • Abbot NC, Stead LF, White AR, Barnes J (2005). Hypnotherapy for smoking cessation. Cochrane Database Syst Rev 1998, Update 2005;(2):CD001008. DOI: 10.1002/14651858.CD001008

    Google Scholar 

  • Rice VH, Stead LF. Nurse interventions for smoking cessation. Cochrane Database Syst Rev 2008;(1): CD001188. DOI: 10.1002/14651858.CD001188.pub3

    PubMed  Google Scholar 

  • Stead LF, Perera R, Bullen C, Mant D, Lancaster T. Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev 2008;(1):CD000146. DOI: 10.1002/14651858.CD000146.pub.3

    PubMed  Google Scholar 

  • Meine TJ, Patel MR, Washam JB, et al. Safety and effectiveness of transdermal nicotine patch in smokers admitted with acute coronary syndromes. Am J Cardiol 2005;95:976–8

    Article  PubMed  CAS  Google Scholar 

  • Mohiuddin SM, Mooss AN, Hunter CB, Grollmes TL, Cloutier DA, Hilleman DE. Intensive smoking cessation intervention reduces mortality in high-risk smokers with cardiovascular disease. Chest 2007;131:446–52

    Article  PubMed  Google Scholar 

  • Working Group for the Study of Transdermal Nicotine in Patients with Coronary artery disease. Nicotine replacement therapy for patients with coronary artery disease. Arch Intern Med 1994;154:989–95

    Article  Google Scholar 

  • Hughes J, Shiffman S, Callas P, Zhang J. A meta-analysis of the efficacy of over-the-counter nicotine replacement. Tob Control 2008;12:21–7

    Article  Google Scholar 

  • Hughes JR, Stead LF, Lancaster T. Antidepressants for smoking cessation. Cochrane Database Syst Rev 2007;(1):CD000031. DOI: 10.1002/14651858.CD000031.pub3

    PubMed  Google Scholar 

  • Cahill K, Stead LF, Lancaster T. Nicotine receptor partial agonists for smoking cessation. Cochrane Database Syst Rev 2008;(3):CD006103. DOI: 10.1002/14651858.CD006103.pub3

    PubMed  Google Scholar 

  • Rigotti NA, Pipe AL, Benowitz NL, Arteaga C, Garza D, Tonstad S. Efficacy and safety of varenicline for smoking cessation in patients with cardiovascular disease: a randomized trial. Circulation 2010;121:221–9

    Article  PubMed  CAS  Google Scholar 

  • Gourlay SG, Stead LF, Benowitz N. Clonidine for smoking cessation. Cochrane Database Syst Rev 2004;(3):CD000058. DOI: 10.1002/14651858.CD000058.pub2

    PubMed  Google Scholar 

  • Hughes JR, Stead LF, Lancaster T. Anxiolytics for smoking cessation. Cochrane Database Syst Rev 2000;(4):CD002849. DOI: 10.1002/14651858.CD002849

    PubMed  Google Scholar 

  • Lancaster T, Stead LF. Mecamylamine (a nicotine antagonist) for smoking cessation. Cochrane Database Syst Rev 1998;(2):CD001009. DOI: 10.1002/14651858.CD001009

    Google Scholar 

  • Glover ED, Laflin MT, Schuh KJ, et al. A randomized, controlled trial to assess the efficacy and safety of a transdermal delivery system of nicotine/mecamylamine in cigarette smokers. Addiction 2007;102:795–802

    Article  PubMed  Google Scholar 

  • Lancaster T, Stead LF. Silver acetate for smoking cessation. Cochrane Database Syst Rev 1997;(3):CD000191. DOI: 10.1002/14651858.CD000191

    Google Scholar 

  • David S, Lancaster T, Stead LF, Evins AE. Opioid antagonists for smoking cessation. Cochrane Database Syst Rev 2006;(4): CD003086. DOI: 10.1002/14651858.CD003086.pub2

    PubMed  Google Scholar 

  • Stead LF, Lancaster T. Nicobrevin for smoking cessation. Cochrane Database Syst Rev 2006;(2):CD005990. DOI: 10.1002/14651858.CD005990

    PubMed  Google Scholar 

  • Stead LF, Hughes JR. Lobeline for smoking cessation. Cochrane Database Syst Rev 1997;(3) CD000124. DOI: 10.1002/14651858.CD000124

    Google Scholar 

  • White AR, Rampes H, Campbell J. Acupuncture and related interventions for smoking cessation. Cochrane Database Syst Rev 2006;(1):CD000009. DOI: 10.1002/14651858.CD000009.pub2

    PubMed  Google Scholar 

  • Hasan FM, Pischke K, Saiyed S, et al. Hypnotherapy as an aid to smoking cessation of hospitalised patients: Preliminary results. Chest 2007;132:527s

    Google Scholar 

  • Hajek P, Stead LF. Aversive smoking for smoking cessation. Cochrane Database Syst Rev 2001;(3):CD000546. DOI: 10.1002/14651858.CD000546.pub2

    Google Scholar 

  • Ussher MH, Taylor A, Faulkner G. Exercise interventions for smoking cessation. Cochrane Database Syst Rev 2008;(4):CD002295. DOI: 10.1002/14651858.CD002295.pub3

    PubMed  Google Scholar 

  • Taylor AH, Ussher MH, Faulkner G. The acute effects of exercise on cigarette cravings, withdrawal symptoms, affect and smoking behaviour: a systematic review. Addiction 2007;102:534–43

    Article  PubMed  Google Scholar 

  • Parsons AC, Shraim M, Inglis J, Aveyard P, Hajek P. Interventions for preventing weight gain after smoking cessation. Cochrane Database Syst Rev 2009;(1):CD006219

    PubMed  Google Scholar 

  • Sussman S, Dent CW, Stacy AW. Project towards no tobacco use: 1-year behavior outcomes. Am J Public Health 1993;83:1245–50

    Article  PubMed  CAS  Google Scholar 

  • Sussman S, Sun P, Dent CW. A meta-analysis of teen cigarette smoking cessation. Health Psychol 2006;25:549–57

    Article  PubMed  Google Scholar 

  • Kaufman NJ, Castrucci BC, Mowery PD, et al. Predictors of change on the smoking uptake continuum among adolescents. Arch Pediatr Adolesc Med 2002;156:581–8

    PubMed  Google Scholar 

  • Hanson K, Allen S, Jensen S, et al. Treatment of adolescent smokers with the nicotine patch. Nicotine Tob Res 2003;5:515–26

    Article  PubMed  Google Scholar 

  • Houtsmuller EJ, Henningfield JE, Stitzer ML. Subjective effects of the nicotine lozenge: assessment of abuse liability. Psychopharmacology (Berl) 2003;167:20–7

    CAS  Google Scholar 

  • Moolchan ET, Robinson ML, Ernst M, et al. Safety and efficacy of the nicotine patch and gum for the treatment of adolescent tobacco addiction. Pediatrics 2005;115:407–14

    Article  Google Scholar 

  • Muramoto ML, Leischow SJ, Sherrill D, et al. Randomized, double-blind, placebo-controlled trial of 2 dosages of sustained-release Bupropionhydochlorid for adolescent smoking cessation. Arch Pediatr Adolesc Med 2007;161:1068–74

    Article  PubMed  Google Scholar 

  • Niederhofer H, Huber M. Bupropionhydochlorid may support psychosocial treatment of nicotine-dependent adolescents: preliminary results. Pharmacotherapy 2004;24:1524–8

    Article  PubMed  CAS  Google Scholar 

  • Roddy E, Romilly N, Challenger A, et al. Use of nicotine replacement therapy in socioeconomically deprived young smokers: a community-based pilot randomised controlled trial. Tob Control 2006;15:373–6

    Article  PubMed  Google Scholar 

  • U.S. Department of Health and Human Services. Women and smoking: A report of the surgeon general. Atlanta, GA, U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health 2001

  • Van der Meer RM, Wagema E, et al. Smoking cessation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2009;(4)

  • VIDETIC GM, et al. Continued cigarette smoking by patients receiving concurrent chemoradiotherapy is associated with decreased survival. J Clin Oncol 2003;21:1544–9

    Article  PubMed  Google Scholar 

  • Mohiuddin SM, Mooss AN, Hunter CB, Grollmes TL, Cloutier DA, Hilleman DE. Intensive smoking cessation intervention reduces mortality in high-risk smokers with cardiovascular disease. Chest 2007;131:446–52

    Article  PubMed  Google Scholar 

  • Silagy C, Mant D, Fowler G, Lancaster T. Nicotine replacement for smoking cessation. Cochrane Database Syst Rev 2000;(3):CD000146

    PubMed  Google Scholar 

  • Joseph A, Nichol K, Anderson H. Effect of treatment for nicotine dependence on alcohol and drug treatment outcomes. Addict Behav 1993;18:635–44

    Article  PubMed  CAS  Google Scholar 

  • Lee AH, Afessa B. The association of nicotine replacement therapy with mortality in a medical intensive care unit. Crit Care Med, 35:1517–1521,2007

    Article  PubMed  CAS  Google Scholar 

  • Tonstad S, Farsang C, Klaene G, Lewis K, Manolis A, Perruchoud AP, Silagy C, van Spiegel PI, Astbury C, Hider A, Sweet R. Bupropionhydochlorid SR for smoking cessation in smokers with cardiovascular disease: a multicentre, randomised study. Eur Heart J 2003;24:946–55

    Article  PubMed  CAS  Google Scholar 

  • Sacco RL, Adams R, Albers G, Alberts MJ, Benavente O, Furie K, Goldstein LB, Gorelick P, Halperin J, Harbaugh R, Johnston SC, Katzan I, Kelly-Hayes M, Kenton EJ, Marks M, Schwamm LH, Tomsick T; American Heart Association/American Stroke Association Council on Stroke; Council on Cardiovascular Radiology and Intervention; American Academy of Neurology. Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack: a statement for healthcare professionals from the American Heart Association/American Stroke Association CouncilonStroke. Circulation 2006;113(10):e409–49

    PubMed  Google Scholar 

  • Shinton R, Beevers G. Meta-analysis of relation between cigarette smoking and stroke. BMJ 1989;298:789–94

    Article  PubMed  CAS  Google Scholar 

  • Fagerström KO, Introduction: studies of tobacco dependence treatment and methodology. Nicotine Tob Res 2003;5(2):141–4

    Article  Google Scholar 

  • Canga N, De Irala J, Vara E, Duaso MJ, Ferrer A, Martínez-González MA. Intervention study for smoking cessation in diabetic patients: a randomized controlled trial in both clinical and primary care settings. Diabetes Care 2000;23(10):1455–60

    Article  PubMed  CAS  Google Scholar 

  • Nilsson PM, Cederholm J, Eeg-Olofsson K, Eliasson B, Zethelius B, Fagard R, Gudbjörnsdóttir S; Swedish National Diabetes Register. Eur J Cardiovasc Prev Rehabil 2009;16(4):506–12

    Article  PubMed  Google Scholar 

  • Munofo M, Bradburn M, Bowes L, et al. Are there sex differences in transdermal nicotine replacement therapy patch efficacy? A meta-analysis. Nicotine Tob Res 2004;6:769–76

    Article  Google Scholar 

  • Perkins KA, Scott MA. Sex differences in long-term smoking cessation rates due to nicotine patch. Nicotine Tob Res 2008(7):1245–51

    Article  Google Scholar 

  • Bobo J, McIlvain H, Lando H, Walker R, Leed-Kelly A. Effect of smoking cessation counselling on recovery from alcoholism: findings from a randomized community intervention trial. Addiction 1998;93(6):877–87

    Article  PubMed  CAS  Google Scholar 

  • Stuyt EB. Recovery rates after treatment for alcohol/drug dependence tobacco users vs. non-tobacco users. Am J Addiction 1997;6(2):159–67

    CAS  Google Scholar 

  • Cromwell J, Bartosch WJ, Fiore MC, Hasselblad V, Baker T. Cost-effectiveness of the clinical practice recommendations in the AHCPR guideline for smoking cessation. JAMA 1997;278(21):1759–66

    Article  PubMed  CAS  Google Scholar 

  • Smoke Free Partnership: Schluss mit dem blauen Dunst. 10 Gründe für ein rauchfreies Europa. ERSJ Ltd; 2006

  • Lesch OM, Dvorak A, Hertling I, Klingler A, Kunze M, Ramskogler K, Saletu-Zyhlarz G, Schoberberger R, Walter H. The Austrian multicentre study on smoking: subgroups of nicotine dependence and their craving. Neuropsychobiology 2004;50:78–88

    Article  PubMed  Google Scholar 

  • Brath H, Lasar D, Buchhäusl I, Kästenbauer T, Binter E. Acta Med Austriaca 1999;26(5):163–7

    PubMed  CAS  Google Scholar 

  • Tashkin D, et al. Efficacy and safety of varenicline for smoking cessation in patients with mild to moderate Chronic Obstructive Pulmonary Disease (COPD). Chest 2009

  • Lesch OM, Walter H, mit einem Beitrag von Wetschka C. Alkohol und Tabak. Medizinische und Soziologische Aspekte von Gebrauch, Mißbrauch und Abhängigkeit. Wien: Springer Verlag; 2009. ISBN 978-3-211-48624-5

    Google Scholar 

  • Fagerström KO, Heatherton TF, Kozlowski LT. Nicotine Addiction and its Assessment. Ear Nose Throat J 1991;69:763–8

    Google Scholar 

  • Killen JD, Fortman SP, Newman B, Varady A. Evaluation of a treatment approach combining nicotine gum with self-guided behavioural treatments for smoking relapse prevention. J Consult Clin Psychol 1990;13:17–27

    Google Scholar 

  • Benowitz NL. Toxicity of nicotine. Implications with regard to nicotine replacement therapy. In: Pomerleau OF, Pomerleau CS (eds) Nicotine replacement. A critical evaluation. New York: Alan R. Liss. mc;1988. pp. 187–218

    Google Scholar 

  • Fagerström KO, Säwe U, Tonnesen P. Therapeutic use of nicotine patches: efficacy and safety. J Smoking Rel Dis 1992;3:247–61

    Google Scholar 

  • Hughes JR, Adams EH, Franzon MA, Maguire MK, Guary J. A prospective study of off-label use of, abuse of, and dependence on nicotine inhaler. Tob Control 2005;14:49–54

    Article  PubMed  CAS  Google Scholar 

  • Glover ED, Glover PN, Franzon M, Sullivan CR, Cerullo CC, Howell RM, et al. A comparison of a nicotine sublingual tablet and placebo for smoking cessation. Nicotine Tob Res 2002;4: 441–50

    Article  PubMed  CAS  Google Scholar 

  • Sutherland G, Stapleton JA, Russel MAH, et al. Randomized controlled trial of a nicotine nasal spray in smoking cessation. Lancet 1992;340:324–9

    Article  PubMed  CAS  Google Scholar 

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    Alfred Lichtenschopf

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Lichtenschopf, A. Richtlinien der Tabakentwöhnung Stand 2010. Wien Klin Wochenschr 123, 299–315 (2011). https://doi.org/10.1007/s00508-011-1571-x

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