1/9. Treatment of nicotine dependence in the chronic mentally ill.Since rates of smoking cessation in psychiatric patients are low, the manner in which information on the importance of abstinence is presented and the scope of the treatment provided to psychiatric patients who have decided not to smoke are very important. This article will describe the development and implementation of a smoking-cessation group for chronic mentally ill patients. Components of the program are described and a detailed case example is provided. The smoking behavior of patients who participated in the first year of programming is reviewed, along with patient evaluation of program effectiveness. Our experience demonstrates the importance of psychoeducation for chronic psychiatric patients who tend not to have received formal education on the dangers of smoking and the possibility of addiction. Our findings indicate that patients are willing to learn more about smoking and the consequences of this behavior, even though many of them were not able to set quit dates. The provision of information through education groups increases the possibility of moving patients to the precontemplation stage.- - - - - - - - - - ranking = 1keywords = dependence, addiction (Clic here for more details about this article) |
2/9. nicotine dependence and withdrawal in an oncology setting: a risk factor for psychiatric comorbidity and treatment non-adherence.Highly nicotine dependent oncology patients are at high risk for psychiatric morbidity when they enter the medical care setting where smoking restrictions apply. nicotine withdrawal symptoms exacerbate cancer-related distress as well as common physical side effects of cancer treatment. This case report illustrates the management of a patient whose ongoing treatment for bladder cancer was jeopardized as a result of nicotine dependence and withdrawal. Several associated complications are described, the most serious of which were his acute anxiety and non-adherence to medical recommendations. A short-term management approach that included anxiolytics and nicotine replacement was effectively used to reduce this patient's excessive anxiety and thus facilitate compliance with stressful treatments. The severity of complications that can result from untreated nicotine dependence and withdrawal underscores the importance of assessing and monitoring smoking status in every patient. Greater staff awareness of the clinical practice guidelines regarding the diagnosis and treatment of nicotine dependence will likely result in improved patient care and compliance.- - - - - - - - - - ranking = 1.4656467395147keywords = dependence (Clic here for more details about this article) |
3/9. Smoking withdrawal and prolonged hospitalization.Many individuals who smoke are hospitalized for extended periods of time for treatment of their diseases. These patients are at increased risk for developing withdrawal symptoms and maladaptive behavior because hospitals have adopted smoke-free policies in accordance with federal law and consumer pressures. Tobacco addiction often is overlooked by healthcare providers or receives low priority on admission. Oncology nurses care for a chronic population of people who often require lengthy treatments and frequent complications resulting in admissions to the hospital. nurses need to identify high-risk patients; continually educate themselves, their patients, and their patients' families about smoking withdrawal and cessation therapies; anticipate coping difficulties; and be prepared to manage inappropriate behavior when necessary. A multidisciplinary team approach using consistent reinforcement and support offers the best patient outcomes while maximizing safety.- - - - - - - - - - ranking = 0.16248757742016keywords = addiction (Clic here for more details about this article) |
4/9. A case series of nicotine nasal spray in the treatment of tobacco dependence among patients with schizophrenia.A retrospective case series of 12 smokers with schizophrenia or schizoaffective disorder who had not successfully quit smoking with previous treatments for tobacco dependence were treated with nicotine nasal spray. All but one patient (92 percent) tolerated the nasal spray well, and nine (75 percent) used it at maximal doses for prolonged periods. After treatment five patients (42 percent) were abstinent from smoking for more than 90 days, and four patients (33 percent) substantially reduced the amount that they smoked. Ten patients (83 percent) used the spray in combination with other medications, and all received psychosocial support. nicotine nasal spray was found to be well tolerated.- - - - - - - - - - ranking = 1.0468905282248keywords = dependence (Clic here for more details about this article) |
5/9. Successes and failures of the teachable moment: smoking cessation in cancer patients.BACKGROUND: Successful cancer treatment can be significantly compromised by continued tobacco use. Because motivation and interest in smoking cessation increase after cancer diagnosis, a window of opportunity exists during which healthcare providers can intervene and assist in the quitting process. methods: The authors conducted a comprehensive literature review to discuss 1) the benefits of smoking cessation in cancer patients, 2) current knowledge regarding smoking cessation interventions targeted to cancer patients, and 3) treatment models and state-of the-art guidelines for intervention with cancer patients who smoke. The authors present clinical cases to illustrate the challenging nature of smoking cessation treatment for cancer patients. RESULTS: Continued smoking after cancer diagnosis has substantial adverse effects on treatment effectiveness, overall survival, risk of second primary malignancies, and quality of life. Although some encouraging results have been demonstrated with smoking cessation interventions targeted to cancer patients, few empirical studies of such interventions have been conducted. A range of intervention components and state-of-the-art cessation guidelines are available that can be readily applied to cancer patients. Case illustrations highlight the crucial role of healthcare providers in promoting smoking cessation, the harmful impact of nicotine addiction manifested in delayed and failed reconstructive procedures, and unique problems encountered in treating patients who have particular difficulty quitting. CONCLUSIONS: Despite the importance of stopping smoking for all cancer patients, the diagnosis of cancer is underused as a teachable moment for smoking cessation. More research is needed to empirically test cessation interventions for cancer patients, and attention must be given to complex and unique issues when tailoring cessation treatment to these individuals.- - - - - - - - - - ranking = 0.16248757742016keywords = addiction (Clic here for more details about this article) |
6/9. Tobacco addiction as a psychiatric disease.Tobacco is the most widely used addictive substance in the world. Since the Surgeon General's 1964 report, medicine has sought out the genesis of tobacco addiction (TA) and has evolved methods of treatment and prevention. psychiatry was slower than other medical specialties to acknowledge TA as a legitimate area for psychiatric intervention, probably because the many psychiatrists who were smokers identified with their smoking patients. Since 1980, the American Psychiatric association has recognized nicotine dependence and nicotine withdrawal as diagnostic entities. The complications of TA are in the province of other medical specialists, but psychiatrists have unique tools for treating addictive disorders. This paper describes some of the addictive qualities of tobacco, and presents illustrative cases of successful treatment of TA using hypnosis. It describes an effective cooperative community program under medical aegis, focusing on education, therapy, and prevention, which has resulted in the virtual disappearance of tobacco consumption in hospitals and schools in the community. By sharing their expertise in the treatment of individual patients, and the design of effective community programs that include education, prevention, and treatment, psychiatrists will be active leaders in the medical community's program to reduce tobacco addiction.- - - - - - - - - - ranking = 1.1843035701659keywords = dependence, addiction (Clic here for more details about this article) |
7/9. Psychiatric aspects of head and neck cancer surgery.Psychiatric problems of patients with head and neck cancer include reactions to disfiguring illness and treatment; adjustment to alterations of speech, eating, and other functions, including sex; changes in body image; alcohol and tobacco addiction; pain; organic brain syndromes; and dealing with terminal illness. Although speech is often compromised, head and neck patients can communicate and psychiatric work is possible. The consultation-liaison psychiatrist can provide considerable assistance by utilizing psychodynamic, behavioral, and pharmacologic modes of treatment and by working with family members and staff.- - - - - - - - - - ranking = 0.16248757742016keywords = addiction (Clic here for more details about this article) |
8/9. Controlled smoking: single case study with multicomponent intervention.The case study of controlled smoking treatment reported here includes multicomponent behavioral interventions. Follow-up data of 30 months' duration are examined with particular reference to shifts in topographical aspects of smoking and a focus on other health-related behaviors. Cigarette smoking was reduced by 85% without compensatory shifts in topography and with successful long-term maintenance. The need to specify detailed ingredients of multicomponent smoking packages for individual clients is discussed, paying particular attention to the potential for development of "positive addictions".- - - - - - - - - - ranking = 0.16248757742016keywords = addiction (Clic here for more details about this article) |
9/9. nicotine absorption and dependence in unlicensed lozenges available over the counter.AIM: To demonstrate the nicotine absorption and dependence potential from unlicensed nicotine containing lozenges. DESIGN: A single case report of dependence on nicotine lozenges, plus measurements of nicotine levels before and after consumption of eight nicotine lozenges over 2 hours in volunteers. SETTING: Hospital Smokers' Clinic. PARTICIPANTS: One male patient suffering from schizophrenia who had consumed 150 "Stoppers" lozenges per day for the previous 5 years, plus seven non-smoker volunteers. MEASUREMENTS: blood nicotine concentration. FINDINGS: The patient's low expired carbon monoxide level (5 p.p.m.) and high plasma nicotine (32 ng/ml) and cotinine levels (947 ng/ml) were consistent with very heavy lozenge consumption. The non-smoker volunteers obtained nicotine concentrations of around 11 ng/ml by consuming eight Stoppers lozenges over 2 hours. Other brands of nicotine lozenges produced lower initial levels, but also produced delayed intestinal absorption and vomiting after food consumption. CONCLUSION: nicotine lozenges are a potential aid to smoking cessation but their safety, efficacy and abuse potential remain to be properly evaluated.- - - - - - - - - - ranking = 1.2564751580785keywords = dependence, abuse (Clic here for more details about this article) |