الفهرس 
Smoking and its hazards
Tobacco Usage PercentageOnly 14 pages are availabe for public view
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Abstract
The effects of smoking on human health are serious and in many cases, deadly. There are approximately 4000 chemicals in cigarettes, hundreds of which are toxic. The ingredients in cigarettes affect everything from the internal functioning of organs to the efficiency of the body’s immune system. Tobacco addiction is both mental and physical. For most people, the best way to quit is a combination of medicine, a method to change personal habits, and emotional support (Martin, 2008).
Despite methods for cessation of smoking, smoking is still a big problem, thus there is a need for new alternative approach to control smoking.
Cessation of smoking programs is designed to help smokers recognize and cope with problems that come up during quitting. This helps the ex-smoker avoid common pitfalls of quitting. The programs should also provide support and encouragement in staying quit. Studies have shown that the best programs include either one-on-one or group counseling (American Cancer Society, 2011).
There is a strong link between how often and how long counseling lasts (its intensity). and the success rate. Overall, the more intense the program, the greater the chance of success (American Cancer Society, 2011).
Aim of the work : study of some methods of smoking cessation This study was a prospective randomized case control study which was conducted on a sample of sixty smokers divided into three groups during the period from July 2016 to January 2017 at Ain shams university hospitals inpatient and outpatient clinics. These groups are:
group I:
Consists of 20 subjects were recruited and subjected to the brief intervention method for smoking cessation, the five ‘A’s for assessing tobacco use and addressing smoking cessation. Ask patients about their smoking status. Advice smokers to quit. Assess their readiness to quit. Assist them with their smoking cessation effort. Arrange for follow-up visits or contact.
group II:
Consists of 20 subjects were recruited and subjected to the brief intervention method for smoking cessation, the five ‘A’s for assessing tobacco use and addressing smoking cessation and nicotine replacement therapy (nicotine gum).
Nicotine replacement therapy was conducted by providing the smoker with nicotine gum according to number of cigarette per day NRT works by making it easier to abstain from tobacco by partially replacing the nicotine previously obtained from tobacco through:
Reducing general withdrawal symptoms.
Reducing the reinforcing effects of tobacco delivered nicotine.Exerting some psychological effect on mood and attention states.
Weekly interviews were conducted for follow up and giving nicotine gum according to the craving episodes.
group III:
Consists of 20 subjects were recruited and subjected to the brief intervention method for smoking cessation, the five ‘A’s for assessing tobacco use and addressing smoking cessation. In addition to aversion therapy. Aversion therapy was conducted by providing the smoker with a single onion powdered cigarette for each craving episode and avoiding ‘usual’ tobacco cigarettes. Weekly interviews were conducted for follow-up and refill of the powdered cigarettes pack according to the frequency of the craving episodes.
All smokers will be subjected to:
Medical history: (age, occupation, smoking history, co- morbidities, presence of any chest complaints).
Clinical examination: (complete general and local chest examination especially auscultation of wheezes).
Verbal consent.
Patients who use tobacco and are willing to quit should be managed using the ”5 A’s” (Ask, Advise, Assess, Assist, and Arrange). Treatments involving person-to-person contact (individual, group, or proactive telephone counseling) are consistently effective, and their effectiveness increases with treatment intensity.
Most smokers make many attempts to quit before they achieve success. Smokers should be made aware of this when they are attempting to quit.
Relapse prevention strategies should be applied to patients who have recently quit using tobacco. As an example, any problems encountered as a result of abstinence (e.g., weight gain, depression) should be addressed promptly.
In the present study, there was a significant difference correlation (p value less than 0.05).was found between outcome and age, pack per year, duration of smoking, persistence of comorbidity, craving time, nicotine dependence score.
However there was no statistically significant correlation (p value more than 0.05) was found between outcome and the age of initiation, occupation, marital status and pervious quit attempt
In the present study there was significant difference between the studied groups as regards the outcome; the success rate was significantly higher among group subjected to psychological therapy (group I) (6 out of 20), versus (group 1I) (3 out of 20) versus (group 111) (3 out of 20).