Page 5 - guidelines_2018_english

Table of contents

Acknowledgements .............................................................................................................................................................7
Declarations of Interests ....................................................................................................................................................8
Level of evidence of recommendations in the guidelines ................................................................................................9
Preface ...............................................................................................................................................................................10

PART ONE
1.0 Assessment of tobacco use and tobacco dependence ..............................................................................................13
1.1 Tobacco use is a disease .....................................................................................................................................................13
1.2 Definitions, classifications, terms and specific explanations ....................................................................................... 14
1.2.1 Tobacco dependence: an acquired industrial disease ................................................................................................ 14
1.2.2 Mechanism of induction of tobacco dependence ......................................................................................................... 14
1.2.3 Nicotine is not the only driver of tobacco dependence ............................................................................................... 14
1.2.4 Nicotine dependence according to WHO ....................................................................................................................... 14
1.3 Smoking is a chronic relapsing disease .......................................................................................................................... 17
1.3.1 Relapse patterns .............................................................................................................................................................. 17
1.3.2 Treatment of tobacco dependence after cessation ...................................................................................................... 17
1.4 Routine identification of smokers is mandatory in current medical practice ............................................................ 18
1.5 Assessment/diagnosis of tobacco use and dependence .............................................................................................. 18
1.5.1. Clinical diagnosis of tobacco use and dependence .................................................................................................... 19
1.5.2 Analysis of previous quit smoking attempts ............................................................................................................... 20
1.5.3 Motivation to quit smoking .............................................................................................................................................. 20
1.5.4 Patient’s medical history ................................................................................................................................................. 21
1.5.5 Pregnancy/ Breast Feeding/ Contraception ................................................................................................................. 21
1.5.6 Patient’s anxiety and depression history ...................................................................................................................... 21
1.5.6.1 Initial Screening ............................................................................................................................................................. 21
1.5.6.2 Clinical Assessment of Anxiety and Depression ...................................................................................................... 21
1.5.7 Laboratory diagnosis of tobacco dependence ............................................................................................................. 22
References ................................................................................................................................................................................. 23

2.0 General recommendations for the treatment of tobacco use and tobacco dependence ........................................25
2.1 Tobacco use .......................................................................................................................................................................... 26
2.2 Tobacco dependence disease ............................................................................................................................................ 26
2.3 Smoking cessation ............................................................................................................................................................. 26
2.3.1 Therapeutic education ..................................................................................................................................................... 27
2.3.2 Behavioural support ........................................................................................................................................................ 27
2.3.3 Medications ....................................................................................................................................................................... 27

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