Läkartidningen 17-07-2021
Matz Larsson, överläkare, hjärt–lung–fysiologikliniken, Universitetssjukhuset Örebro; docent, Kliniskt centrum för hälsofrämjande vård, Lunds universitet
Mette Rasmussen, PhD, forskare, Kliniskt centrum för hälsofrämjande vård, Lunds universitet
Sanne Werjestam, leg sjuksköterska, tobaksavvänjare, Kliniskt centrum för hälsofrämjande vård, Lunds universitet
Thomas Björk-Eriksson, verksamhetschef, adjungerad professor, Regionalt cancercentrum väst, Sahlgrenska universitetssjukhuset
Hans Gilljam, professor emeritus, Karolinska institutet; ordförande, Läkare mot tobak
Hanne Tönnesen, professor, Kliniskt centrum för hälsofrämjande vård, Lunds universitet; direktör, WHO Collaborating Centre, DanmarkTobacco production and consumption have a large and negative impact on the environment [1].
Adolescents who become addicted to smoking shorten their lives by an average of ten years if the addiction cannot be broken [2]. The 30-year-old who quits smoking for good wins 10 years, the 50-year-old wins an average of 5-6 years of life. The benefits decrease with age, but
smoking cessation is still one of the most cost-effective treatments in healthcare. The price per year of life gained is a few thousand Swedish Krones (SEK) When new treatments and drugs are introduced into healthcare, careful analyzes and negotiations are made. A cost of approximately SEK 800,000 per year of life gained is then often considered reasonable.
Treating and helping daily smokers to quit smoking is a high priority in the Swedish National Board of Health and Welfare's guidelines [3]. In the last 20 years, more than a thousand Health Care Workers were certified to help people to quit smoking [4], but what happens after the training? What results are achieved? Do those who are trained at all get space to work with tobacco cessation? A survey shows [4] that in many cases too little time has been set aside or redirected to other tasks and precarious employment (eg projects).
In 2020, the Smoking Cessation Project started [5] - a national database on tobacco cessation (including snus and e-cigarettes). The research project is based on Lund University and is supported by, among others, FORTE / the Swedish Research Council. The Danish model for the project has been very successful [6]. The database in Denmark has collected knowledge from more than 150,000 smoking cessation projects, and the Smoking Cessation Project has the potential to become an equally important support for Swedish tobacco addicts. The project can generate an overview of Swedish tobacco cessation; where it takes place and what forms of support are offered and provide relief, feedback and knowledge to tobacco addicts through follow-ups (telephone surveys) six months after the tobacco stop.
Recruitment for the project began in the spring of 2020, and then clashed with the corona pandemic. During the pandemic, many tobacco addicts have been relocated, and patients have been afraid to seek care and / or have been denied help with smoking cessation. Tobacco cessation seems to have been given lower priority, despite studies suggesting that
smoking is associated with a more severe outcome of covid-19 [7]. Not to mention how smoking affects the risk factors COPD, cardiovascular disease and diabetes [7, 8].Despite covid-19, more and more people have joined the project. When the pandemic hopefully enters a more stable phase through vaccination, it is time for everyone who engages in professional tobacco cessation to join.
Being smoke-free protects against severe covid-19 and common flu and counteracts bacterial pneumonia [9]. Smoking cessation should therefore be a priority element in Health Care.
There is much to suggest that it can protect the population in future pandemics.Through a broad connection to the Swedish database, knowledge about effective treatments for different groups can increase, not least vulnerable and vulnerable groups who smoke more.
Smoking cessation is cost-effective, creates health and (on top of that) favorable environmental effects. The challenge is for more people to take part in individualized treatment and that we can make it as good as possible through research, structure and collaboration.
References:
1) Malmberg N. Tobaksindustrins miljöpåverkan – en genomgång av forskningsläget 2020. Stockholm:
Riksförbundet VISIR; 2020. p. 26.
2) Doll R, Peto R, Boreham J, et al. Mortality in relation to smoking: 50 years’ observations on male British doctors. BMJ. 2004;328(7455):1519.
3) Nationella riktlinjer för prevention och behandling vid ohälsosamma levnadsvanor. Stöd för styrning och ledning. Stockholm: Socialstyrelsen; 2018. Artikelnr 2018-6-24. p. 79.
4) Landgren AJ, Gilljam H. Barriers and supportive factors in certiced tobacco cessation counselors in Sweden. Tob Prev Cessat. 2019;5:4.
5) Rökstoppsprojektet (inklusive snus och e-cigaretter) – ett nationellt samarbetsprojekt. Δεν είναι ορατοί οι σύνδεσμοι (links).
Εγγραφή ή
Είσοδος6) Rasmussen M, Tønnesen, H. The Danish Smoking Cessation Database. Clin Health Promot. 2016;6(2):36-41.
7) Zhao Q, Meng M, Kumar R, et al. The impact of COPD and smoking history on the severity of COVID-19: a systemic review and meta-analysis. J Med Virol. 2020;92(10):1915-21.
8 ) National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. The health consequences of smoking – 50 years of progress: a report of the Surgeon General. Atlanta (GA): Centers for Disease Control and Prevention; 2014.
9) Arcavi L, Benowitz NL. Cigarette smoking and infection. Arch Intern Med. 2004;164(20):2206-16.
Δεν είναι ορατοί οι σύνδεσμοι (links).
Εγγραφή ή
Είσοδος
Ψηφοφορία
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21 Μαΐου 2009, 14:12:06