M. Underner

Sevrage tabagique du fumeur atteint de bronchopneumopathie chronique obstructive

One out of two smokers who smoke throughout their lifetime will die from a disease related to smoking. Tobacco smoking therefore represents a major global public health issue. Smoking is the leading cause of chronic obstructive pulmonary disease (COPD). Projections for 2020 indicate that by then, COPD will have become the third cause of death and the fifth cause of disability worldwide. Stopping smoking reduces the risk of developing COPD and is an essential treatment for this inflammatory disease. Smoking cessation decreases the prevalence of respiratory symptoms, number of hospitalizations, and decline in FEV1, as well as exacerbation frequency and overall mortality. Among the patients, 38-77% with COPD are smokers. Their daily cigarette consumption and level of nicotine dependence are often high. The combination of high intensity behavioral interventions and medication treatments (nicotine replacement therapy, varenicline, bupropion) is the most effective strategy for smokers with COPD. In contrast, behavioral interventions without medication are not more effective than simple advice to stop. Two factors seem to predict the success of the attempt to quit in smokers with COPD: a strong motivation to quit and the use of smoking cessation medications.

Sevrage tabagique des fumeurs en situation de précarité sociale

Smoking is a major of public health policy issue; one in two lifelong smokers will die from a disease related to tobacco use. In France, smoking is responsible for more than 70,000 deaths every year. The benefits linked to stopping smoking include reduced mortality and morbidity related to the use of tobacco. Recent data show an increase in the prevalence of smoking in the lowest socioeconomic population. Tobacco control needs a better understanding of the determinants of smoking in this population, which are also factors in the failure of cessation attempts. Based on international literature, this review specifies the educational and socioeconomic factors involved in tobacco smoking and in the result of an attempt to quit. Its aim is to propose ways to improve the management of smoking cessation in a socially deprived population.

Influence du tabagisme sur la qualité de vie des patients atteints de cancer bronchique

Tobacco smoking is the leading cause of lung cancer. This cancer is the most specific indicator of the effects of tobacco on health. Regardless of the type of lung cancer and the stage of the disease, continued smoking has a negative impact on its development and its treatment. For this reason, smoking cessation is an essential step in the management of patients with lung cancer who smoke. It has been clearly demonstrated that quality of life is worse in smokers than in non-smokers. The aim of this general review is to study the relationship between tobacco use and quality of life specifically in patients with lung cancer. Among the twelve studies selected, six of them clearly demonstrate a deleterious effect of continued smoking tobacco or a beneficial effect of smoking cessation on the quality of life in patients with lung cancer. These findings should lead clinicians to offer support to smokers with lung cancer in order to assist them to quit smoking.

Efficacité de l’activité physique dans l’aide à l’arrêt du tabac

One over two smokers who smokes all his lifetime will die from a disease related to tobacco use. Tobacco smoking is the primary cause of avoidable death in the world. Medications have an important role in smoking cessation, but physical activity, as well as improving health generally may also represent an important non-pharmacological therapy to help people to stop smoking. The aim of this review was to evaluate the use of physical activity as an aid for smoking cessation and maintaining abstinence. We included 17 randomized controlled trials where the main objective was stopping smoking, and which included at least a six-month follow-up of participants. At the end of this review, only 4 trials revealed a benefit of physical activity on smoking cessation; two of them did not show any persistent benefit after the end of the exercise program. On the basis of this, physical activity cannot itself be considered as a way to help stopping smoking. The heterogeneity among studies summarized in this review was an important methodological bias. However, there is strong evidence that physical activity reduces withdrawal symptoms, craving, negative affect and weight gain during smoking cessation. Advice to practice physical activity should therefore be incorporated into smoking cessation programs.

Revue généraleEfficacité de l’activité physique dans l’aide à l’arrêt du tabacThe efficacy of physical activity as an aid to smoking cessation

One over two smokers who smokes all his lifetime will die from a disease related to tobacco use. Tobacco smoking is the primary cause of avoidable death in the world. Medications have an important role in smoking cessation, but physical activity, as well as improving health generally may also represent an important non-pharmacological therapy to help people to stop smoking. The aim of this review was to evaluate the use of physical activity as an aid for smoking cessation and maintaining abstinence. We included 17 randomized controlled trials where the main objective was stopping smoking, and which included at least a six-month follow-up of participants. At the end of this review, only 4 trials revealed a benefit of physical activity on smoking cessation; two of them did not show any persistent benefit after the end of the exercise program. On the basis of this, physical activity cannot itself be considered as a way to help stopping smoking. The heterogeneity among studies summarized in this review was an important methodological bias. However, there is strong evidence that physical activity reduces withdrawal symptoms, craving, negative affect and weight gain during smoking cessation. Advice to practice physical activity should therefore be incorporated into smoking cessation programs.

Le tabagisme et l’aide à l’arrêt du tabac des patients atteints de tuberculose

Tuberculosis and tobacco smoking are two major public health problems causing significant mortality worldwide. Tobacco smoke increases the risk of Mycobacterium tuberculosis infection, severe pulmonary or extrapulmonary TB, and death of TB. In emerging countries, quitting smoking is one way to control the TB epidemic. Compared with non-smokers, smokers with tuberculosis are less observant of anti-tuberculosis treatment. Smoking abstinence improves the course of their illness, the treatment compliance and facilitates the final cure justifying smoking cessation interventions. The involvement of all healthcare professionals in helping smokers stopping smoking is required.

L’aide à l’arrêt du tabac des fumeurs atteints de BPCO, d’asthme, de cancer bronchique, et opérés

Smoking is the cause of addictive behavior. Tobacco addiction is a chronic disease that makes difficult to stop smoking and leads to further use. Smoking is a risk factor for COPD, asthma and lung cancer; it may be the cause of severe perioperative complications. This finding justifies that smokers benefit from advice of stopping smoking and smoking cessation assistance. Helping patients to stop smoking increases the chances of quitting, improves the prognosis of tobacco-related diseases, the effectiveness of their treatments and the quality of life of the patients. This article updates the modalities of smoking cessation assistance in smokers with COPD, asthma and lung cancer in operated patients. The goal of the management must be the complete cessation of tobacco smoke intoxication, which alone reduces tobacco mortality.

Les effets respiratoires du tabagisme

A marked increase in the morbidity and mortality of a large number of broncho-pulmonary diseases has been documented in relation to smoking. The influence of tobacco smoking on various respiratory conditions. is discussed: incidence, severity or natural history modification of some respiratory illnesses: obstructive lung diseases (COPD, asthma), lung cancer, bacterial, viral respiratory infections, with the impact of smoking on tuberculosis. Finally, the relationship of tobacco with diffuse interstitial lung disease: protective role of smoking (controversial in sarcoidosis, real in hypersensitivity pneumonitis). The benefits of smoking cessation are described.