Cornuz J, Zellweger J P, Burnand B
Policlinique médicale universitaire, Lausanne.
Schweiz Med Wochenschr. 1994 Jul 30;124(30):1315-25.
Tobacco is the single most important cause of avoidable morbidity and early mortality in many countries. Smoking cessation is associated with a reduction in the prevalence of related symptoms as well as a progressive decrease in the occurrence of related diseases. Thus, there is a rapid decline in the occurrence of cardiovascular diseases in individuals who stop smoking; there is also a decline in the occurrence of lung cancer, although delayed and with a slower decrease rate. This is an important message for physicians and patients: Physicians should systematically offer counselling and information to their patients who smoke. The message should be tailored to the patient's status and must be different for a patient who has already decided to quit than for a patient who is not considering cessation in the near future. To help patients who have decided to stop and incite other patients who smoke to quit, physicians should be aware of the mechanisms involved in acquiring and breaking tobacco dependence (learning pathways, physiological dependence, behavioral analysis). Physicians should be trained to use methods which have proved effective in a physician's practice and to manage difficulties which may arise during cessation (e.g. craving, weight gain), as well as appropriate use of nicotine skin patches or chewing gum. From a public health standpoint, widespread action by physicians to promote smoking cessation among their patients could be one of the most effective clinical preventive measures.
在许多国家，烟草是可避免的发病和过早死亡的唯一最重要原因。戒烟与相关症状患病率的降低以及相关疾病发生率的逐渐下降有关。因此，戒烟者心血管疾病的发生率会迅速下降；肺癌的发生率也会下降，尽管有所延迟且下降速度较慢。这对医生和患者来说是一个重要信息：医生应该系统地为吸烟患者提供咨询和信息。信息应根据患者的情况量身定制，对于已经决定戒烟的患者和近期不考虑戒烟的患者必须有所不同。为了帮助已决定戒烟的患者并激励其他吸烟患者戒烟，医生应该了解获得和戒除烟草依赖所涉及的机制（学习途径、生理依赖、行为分析）。医生应该接受培训，使用在医生实践中已被证明有效的方法，并应对戒烟过程中可能出现的困难（如渴望、体重增加），以及正确使用尼古丁皮肤贴片或口香糖。从公共卫生的角度来看，医生广泛采取行动促进患者戒烟可能是最有效的临床预防措施之一。
