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Underner M, Perriot J, Peiffer G, Ruppert AM, de Chazeron I, Jaafari N. [Combinations of pharmacological treatments in smoking cessation. A systematic review]. Rev Mal Respir 2021; 38:706-720. [PMID: 34215484 DOI: 10.1016/j.rmr.2021.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 05/30/2021] [Indexed: 02/08/2023]
Abstract
INTRODUCTION The effectiveness of the three validated smoking cessation medications, nicotine replacement therapy, varenicline and bupropion, may be insufficient, in hard-core smokers. OBJECTIVES This systematic review investigates the efficacy of combinations of different medications in smoking abstinence and their tolerability. RESULTS Three randomized controlled trials (RCTs) compared the combined medications with varenicline and nicotine patches vs. varenicline; two found an increase in abstinence rates with the combined medications. In one study, the beneficial effect was only observed in heavy smokers. The four RCTs comparing the combined medications with varenicline and bupropion (vs. varenicline) demonstrated an increase in abstinence rates with the combined medications, most often in heavy smokers who are very dependent on tobacco. The results of the three RCTs comparing the combined medications with bupropion and nicotine replacement therapy vs. varenicline were discordant. Three studies included other molecules (mecamylamine, selegiline, sertraline, buspirone). Combined medications were well tolerated. CONCLUSION Combination treatments can achieve higher smoking abstinence rates than monotherapies, especially in smokers who have failed to quit (Hard-core smokers). Treatment with a combination of varenicline and nicotine replacement therapy is a therapeutic option in smoking cessation.
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Affiliation(s)
- M Underner
- Unité de recherche clinique, université de Poitiers, centre hospitalier Henri-Laborit, 370, avenue Jacques-Cœur, CS 10587, 86021 Poitiers, France.
| | - J Perriot
- CLAT 63, dispensaire Emile-Roux, centre de tabacologie, 63100 Clermont-Ferrand, France
| | - G Peiffer
- Service de pneumologie, CHR Metz-Thionville, 57038 Metz, France
| | - A-M Ruppert
- Service de pneumologie et oncologie thoracique, GRC n(o) 04 Theranoscan, unité de tabacologie, Sorbonne Université, hôpital Tenon, Assistance publique-Hôpitaux de Paris, 4, rue de la Chine, 75970 Paris cedex 20, France
| | - I de Chazeron
- Service de psychiatrie-addictologie, CMP-B, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - N Jaafari
- Unité de recherche clinique, université de Poitiers, centre hospitalier Henri-Laborit, 370, avenue Jacques-Cœur, CS 10587, 86021 Poitiers, France
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Underner M, Perriot J, Brousse G, de Chazeron I, Schmitt A, Peiffer G, Afshari R, Ebrahimighavam S, Jaafari N. [Contribution of electronic cigarettes in smoking patients with psychotic disorders. A literature review]. L'ENCEPHALE 2021; 47:452-460. [PMID: 33863511 DOI: 10.1016/j.encep.2020.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 11/09/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVES This systematic literature review focused on patients suffering from schizophrenia (SZ), psychotic disorders or mental illness (MI) including SZ. It was interested in data on prevalence of electronic cigarette (EC) use, patient perceptions and expectations, as well as caregivers' attitudes towards the EC and its benefit in helping to stop or reduce smoking. METHOD The research was carried out on Medline for the period 2000-2020. Cross-sectional, case-control, prospective, randomized controlled studies and preliminary studies were included in this review. RESULTS EC is widely used by MI patients with current and lifetime use from 7.4% to 28.6%. More specifically, patients with SZ and schizoaffective disorders observe current and lifetime use from 7% to 36%, respectively. Many reasons are given by patients for its use including the possibility of using it in places where smoking is prohibited, its lower toxicity compared to cigarettes for oneself and those around, its lower cost, and the help provided to reduce consumption. CONCLUSION EC is used by smokers with MI; several studies confirm the possibility for these smokers to reduce tobacco consumption through EC and without disturbing their mental state. However, its value in helping to quit smoking remains uncertain.
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Affiliation(s)
- M Underner
- Unité de recherche clinique Pierre-Deniker, centre hospitalier Henri-Laborit, université de Poitiers, 370, avenue Jacques-Cœur, CS 10587, 86021 Poitiers cedex, France.
| | - J Perriot
- Dispensaire Émile-Roux, centre de tabacologie, 63100 Clermont-Ferrand, France
| | - G Brousse
- Service de psychiatrie-addictologie, CMP-B CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - I de Chazeron
- Service de psychiatrie-addictologie, CMP-B CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - A Schmitt
- Service de psychiatrie-addictologie, CMP-B CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - G Peiffer
- Service de pneumologie, CHR Metz-Thionville, 57038 Metz, France
| | - R Afshari
- Unité de recherche clinique Pierre-Deniker, centre hospitalier Henri-Laborit, université de Poitiers, 370, avenue Jacques-Cœur, CS 10587, 86021 Poitiers cedex, France; Prevention of social harms and substance use disorders center, Shiraz university of medical sciences, Shiraz, Iran
| | - S Ebrahimighavam
- Unité de recherche clinique Pierre-Deniker, centre hospitalier Henri-Laborit, université de Poitiers, 370, avenue Jacques-Cœur, CS 10587, 86021 Poitiers cedex, France; Département de psychologie de l'éducation, faculté de psychologie et de sciences de l'éducation, université Allameh Tabataba'i, Téhéran, Iran
| | - N Jaafari
- Unité de recherche clinique Pierre-Deniker, centre hospitalier Henri-Laborit, université de Poitiers, 370, avenue Jacques-Cœur, CS 10587, 86021 Poitiers cedex, France
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Perriot J, Underner M, Peiffer G, Arvers P. [Smoking cessation in smokers with pulmonary Langerhans cell histiocytosis - considerations from the management of ten patients]. Rev Mal Respir 2021; 38:157-163. [PMID: 33516597 DOI: 10.1016/j.rmr.2020.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 10/17/2020] [Indexed: 02/05/2023]
Abstract
Pulmonary Langerhans cell histiocytosis (PLCH) belongs to the spectrum of diffuse interstitial cystic pneumonias; it affects young people of both sexes and occurs almost exclusively in tobacco smokers or co-users of tobacco and cannabis. The management of this severe chronic disease is undertaken in specialized centers. A better understanding of the pathogenic mechanisms of the disease has opened up prospects for targeted therapies. However, supporting the abstinence from inhaling noxious materials which determine its prognosis remains the cornerstone of treatment. Patients with PLCH who persist in smoking despite the diagnosis may be very dependent on tobacco, experience significant difficulties in stopping smoking, and must have access to specialist smoking cessation clinics.
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Affiliation(s)
- J Perriot
- Dispensaire Emile Roux. Centre de tabacologie et Centre de lutte antituberculeuse (CLAT 63), 11, rue Vaucanson 63100 Clermont-Ferrand, France.
| | - M Underner
- Unité de recherche clinique, Centre Hospitalier Henri-Laborit, Université de Poitiers, 86021 Poitiers, France
| | - G Peiffer
- Service de pneumologie, CHR de Metz-Thionville, 57038 Metz, France
| | - P Arvers
- Hôpital de la Croix-Rousse, Institut Rhône-Alpes-Auvergne de Tabacologie (IRAAT), Hôpital de la Croix- Rousse, 69004 Lyon, France
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Underner M, Perriot J, Peiffer G, Jaafari N. [Electronic cigarette use and asthma in adolescents]. Rev Mal Respir 2019; 37:91-92. [PMID: 31864880 DOI: 10.1016/j.rmr.2019.11.644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 11/07/2019] [Indexed: 02/05/2023]
Affiliation(s)
- M Underner
- Unité de recherche clinique, centre hospitalier Henri-Laborit, université de Poitiers, 370, avenue Jacques-Cœur, CS 10587, 86021 Poitiers, France.
| | - J Perriot
- Centre de tabacologie, Dispensaire Émile-Roux, 63100 Clermont-Ferrand, France
| | - G Peiffer
- Service de pneumologie, CHR de Metz-Thionville, 57038 Metz, France
| | - N Jaafari
- Unité de recherche clinique, centre hospitalier Henri-Laborit, université de Poitiers, 370, avenue Jacques-Cœur, CS 10587, 86021 Poitiers, France
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Sakhri L, Bertocchi M. [Bronchial carcinoma and tobacco: An update]. Rev Mal Respir 2019; 36:1129-1138. [PMID: 31767264 DOI: 10.1016/j.rmr.2018.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 06/18/2018] [Indexed: 11/29/2022]
Abstract
Lung cancer remains the most lethal cancer. The most common cause is smoking, which is also preventable, unlike the causes of other types of cancer. A genetic characteristic has emerged over several years, which explains particular profiles of smokers, or highly dependent smokers. The emergence of new therapies for the treatment of lung cancer, and the impact of tobacco on reducing the effectiveness of these therapies must challenge practitioners to obtain a complete cessation of smoking regardless of the stage of the disease.
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Affiliation(s)
- L Sakhri
- Institut de cancérologie Daniel-Hollard, groupe hospitalier mutualiste de Grenoble, 8, rue Docteur-Calmette, 38028 Grenoble cedex 1, France.
| | - M Bertocchi
- Service de pneumologie, centre hospitalier Annecy Genevois, 1, avenue de l'Hôpital, 74374 Pringy, France
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Denis-Vatant C, Merieux C, Leclerc L, Duc H, Berton C, Jarrige R, Nekaa M, Vergnon JM, Pourchez J. [Relationship between vaping and smoking among 15-year-olds in high school. Results of a descriptive cross-sectional and monocentric observational study conducted in the metropolitan area of Saint-Étienne]. Rev Mal Respir 2019; 36:850-860. [PMID: 31202601 DOI: 10.1016/j.rmr.2019.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 03/18/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The initiation of smoking among adolescents by vaping is a subject of controversy. This study focuses on the prevalence of electronic cigarette use among teenagers and its connection with the consumption of tobacco. METHODS A cross-sectional and monocentric study was conducted in the spring of 2018 and included 1435 students (15-16years old) from the metropolitan area of Saint-Étienne in France. RESULTS Nearly half of the adolescents experimented with e-cigarettes (50.30%) or tobacco (50.40%). Nearly a quarter are vapers (23.60%) or smokers (28.20%), with low daily use (3.65% for vaping and 9.40% for smoking). In regard to the link between smoking and vaping, 64.85% of adolescents are "non-smokers and non-vapers", 17.60% "smokers and vapers", 11.25% "smokers and non-vapers", and 6.30% "non-smokers and vapers". DISCUSSION The portrait-types of the vaper and the smoker are similar: boy rather than girl, educated in private school rather than public, and enrolled in a vocational rather than a general educational course. On one hand, the use of electronic cigarettes in non-smoking adolescents does not appear to be a major mode of entry into smoking or nicotine addiction. On the other hand, the use of electronic cigarettes among adolescent's smokers seems to have a beneficial effect on their smoking habit (stopping or reducing the consumption of tobacco).
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Affiliation(s)
- C Denis-Vatant
- UCT pôle DocP2 CHU Saint-Étienne, 42000 Saint-Étienne, France
| | - C Merieux
- UCT pôle DocP2 CHU Saint-Étienne, 42000 Saint-Étienne, France
| | - L Leclerc
- Inserm, U 1059 Sainbiose, Centre CIS, Mines Saint-Étienne, université Lyon, université Jean-Monnet, 42023 Saint-Étienne, France
| | - H Duc
- Inserm, U 1059 Sainbiose, Centre CIS, Mines Saint-Étienne, université Lyon, université Jean-Monnet, 42023 Saint-Étienne, France
| | - C Berton
- La Rotonde, Centre de culture scientifique et technique industrielle, Mines Saint-Étienne, 42023 Saint-Étienne, France
| | - R Jarrige
- La Rotonde, Centre de culture scientifique et technique industrielle, Mines Saint-Étienne, 42023 Saint-Étienne, France
| | - M Nekaa
- Direction des services départementaux de l'Éducation nationale Loire/HESPER EA 7425, 69008 Lyon, France; HESPER EA 7425, université Lyon, université Jean-Monnet, 42023 Saint-Étienne, France
| | - J-M Vergnon
- UCT pôle DocP2 CHU Saint-Étienne, 42000 Saint-Étienne, France
| | - J Pourchez
- Inserm, U 1059 Sainbiose, Centre CIS, Mines Saint-Étienne, université Lyon, université Jean-Monnet, 42023 Saint-Étienne, France.
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Affiliation(s)
- Ubiratan Paula Santos
- . Divisão de Pneumologia, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo (SP) Brasil
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Peiffer G, Underner M, Perriot J. [COPD and smoking cessation: Patients' expectations and responses of health professionals]. REVUE DE PNEUMOLOGIE CLINIQUE 2018; 74:375-390. [PMID: 30455124 DOI: 10.1016/j.pneumo.2018.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The importance of smoking cessation in the management of COPD is well-established: the benefit of quitting smoking as regards morbidity and mortality outcomes in patients, is unquestioned. The smoking cessation in COPD patients is difficult: high levels of consumption, the duration of smoking, high dependence level, psychological co-morbidities such as anxiety and depression, lower socio-economic and intellectual level, constitute barriers. Studies have shown that patients often minimize the risks of smoking, that others do not believe in the benefits of quitting or doubt their ability to quit smoking. The patients' experience, and expectations with regard to smoking cessation are incompletely satisfied: are considered, the smoking characteristics of these patients, the understanding of the tobacco dependence, the beliefs and ideas of smokers, the knowledge of smoking cessation methods, the role of validated aids and alternative treatments, failure management. The answers of the health professionals can be in several directions: establishment of a better communication patient-doctor (empathy), more centered on the needs of the smoker, the role of the motivation and the place of the motivational interview, the understanding of the mechanisms of addiction, a better individualisation of therapeutics, the necessity of a extended follow-up, the contribution of modern technologies, the electronic cigarette, the smoking cessation in respiratory rehabilitation, guidelines that address smoking cessation treatment.
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Affiliation(s)
- G Peiffer
- Service de pneumologie, hôpital de Mercy, CHR Metz-Thionville, 57038 Metz, France.
| | - M Underner
- Centre hospitalier Henri Laborit, unité de recherche clinique, 86000 Poitiers, France
| | - J Perriot
- Dispensaire Emile Roux - CLAT 63, 11, rue Vaucanson, 63100 Clermont-Ferrand, France
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Dautzenberg B. [Tobacco dependence: Change the paradigm?]. REVUE DE PNEUMOLOGIE CLINIQUE 2018; 74:121-123. [PMID: 29773264 DOI: 10.1016/j.pneumo.2018.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Accepted: 04/10/2018] [Indexed: 06/08/2023]
Affiliation(s)
- B Dautzenberg
- CHU Pitié-Salpêtrière (AP-HP), Sorbonne université, 75651 Paris cedex 13, France.
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Perriot J, Underner M, Peiffer G, Dautzenberg B. [Helping smoking cessation in COPD, asthma, lung cancer, operated smokers]. REVUE DE PNEUMOLOGIE CLINIQUE 2018; 74:170-180. [PMID: 29748064 DOI: 10.1016/j.pneumo.2018.03.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 03/22/2018] [Accepted: 03/27/2018] [Indexed: 02/05/2023]
Abstract
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.
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Affiliation(s)
- J Perriot
- Dispensaire Emile-Roux, CLAT63, centre de tabacologie, 11, rue Vaucanson, 63100 Clermont-Ferrand, France.
| | - M Underner
- Centre hospitalier Henri-Laborit, unité de recherche clinique, 86000 Poitiers, France
| | - G Peiffer
- Service de pneumologie, CHR Metz-Thionville, 57038 Metz, France
| | - B Dautzenberg
- Groupe hospitalier Pitié-Salpêtrière, AP-HP, 75013 Paris, France
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Underner M, Pourrat O, Perriot J, Peiffer G, Jaafari N. [Smoking cessation and pregnancy]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2017; 45:552-557. [PMID: 29033021 DOI: 10.1016/j.gofs.2017.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 08/13/2017] [Indexed: 02/05/2023]
Abstract
Active and passive smoking during pregnancy induce several deleterious effects that may have a negative impact on pregnancy progress, fetus development and both mother and newborn health. Smoking cessation should be a rule for any woman as soon as the beginning of her pregnancy, or better in anticipation of a pregnancy when contraception is no more taken. Every caregiver must help every pregnant woman who smokes to quit smoking. Smoking cessation interventions in pregnant women must combine a psychological support (mainly with cognitive behavioral therapy) and nicotine replacement therapy, which can also be used during breast feeding. It is recommended to adjust the dosage of nicotine replacement therapy according to the symptoms of under or over dosage at the end of the first week of use. On the other hand, vareniclin and bupropion are contra-indicated during pregnancy or breast-feeding. Electronic cigarette is not advised during pregnancy. Prevention of smoking relapse in postpartum period is essential since a percentage as high as 50% of women having quit during their pregnancy resume smoking during the 6 months following delivery.
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Affiliation(s)
- M Underner
- Consultation de tabacologie, unité de recherche clinique, centre hospitalier Henri-Laborit, 86000 Poitiers, France.
| | - O Pourrat
- Médecine interne, faculté de médecine, CHU Jean-Bernard, BP 577, 86021 Poitiers cedex, France
| | - J Perriot
- Dispensaire Emile-Roux, centre de tabacologie, 63100 Clermont-Ferrand, France
| | - G Peiffer
- Service de pneumologie, CHR Metz-Thionville, 57038 Metz, France
| | - N Jaafari
- Consultation de tabacologie, unité de recherche clinique, centre hospitalier Henri-Laborit, 86000 Poitiers, France
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