Department of Medicine, Harvard Medical School, Boston, MA, USA; Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA, USA.
Lancet Respir Med. 2013 May;1(3):241-50. doi: 10.1016/S2213-2600(13)70063-8. Epub 2013 May 3.
Tobacco use is a leading cause of preventable death worldwide. Respiratory diseases, including chronic obstructive pulmonary disease (COPD) and lung cancer, account for a large proportion of tobacco-related deaths. Smoking cessation benefits almost all smokers, irrespective of the age at which they quit, making smoking cessation a core component of prevention and treatment of respiratory diseases. Evidence shows that psychosocial counselling and pharmacotherapy are effective smoking cessation methods and are most effective when used together. The first-line drugs licensed to aid smoking cessation (nicotine replacement therapy, bupropion, and varenicline) are effective in patients with COPD. Efforts are underway to improve the efficacy of existing treatments and increase the proportion of smokers who try to quit, and who use treatment when doing so. However, existing smoking cessation counselling and drugs are among the most cost-effective clinical preventive services available. Incorporation of such treatment into routine clinical practice is essential for provision of high-quality care to all patients, especially those with respiratory disease.
吸烟是全球可预防死亡的主要原因。呼吸系统疾病,包括慢性阻塞性肺疾病(COPD)和肺癌,占与烟草相关的死亡的很大一部分。戒烟对几乎所有吸烟者都有益,无论他们戒烟的年龄如何,因此戒烟是预防和治疗呼吸系统疾病的核心组成部分。有证据表明,心理社会咨询和药物治疗是有效的戒烟方法,当两者结合使用时效果最佳。获准帮助戒烟的一线药物(尼古丁替代疗法、安非他酮和伐尼克兰)对 COPD 患者有效。目前正在努力提高现有治疗方法的疗效,并增加试图戒烟的吸烟者比例,以及在戒烟时使用治疗的比例。然而,现有的戒烟咨询和药物是最具成本效益的临床预防服务之一。将这种治疗纳入常规临床实践对于为所有患者,特别是患有呼吸系统疾病的患者提供高质量的护理至关重要。