INTRODUCTION

Smoking is one of the biggest global public health problems. It is known that the use of tobacco can have detrimental effects on a person’s overall health. Thus, this study is geared towards determining the knowledge and attitude of medical residents about tobacco cessation.

The study determined the knowledge and attitudes of smoking cessation among VSMMC residents and assessed their understanding of the risks associated with tobacco use.

A descriptive cross-sectional research design was used employing an online survey of 171 medical residents from December 2022 to March 2023. An in-depth analysis of categorical variables related to demographic factors using chi-square and Fisher’s exact tests was subsequently done.

Most have average knowledge and a good knowledge foundation about tobacco cessation. The majority, primarily aged 25 to 34, single are more knowledgeable about quitting smoking and its benefits as well as the women, although statistically not significant in proportion of the knowledge base. Approximately 69% were nonsmokers, and 87.7% lacked training in tobacco cessation. Only 8.2% demonstrated poor knowledge of smoking cessation, while 91.8% had average to good knowledge. Knowledge levels did not significantly differ based on demographics, smoking status, or training, except for residency type. Generally, they have a positive attitude towards tobacco cessation and agreed that it is part of their responsibility to assist and motivate patients. They recognized the positive impact on healthcare provider-patient relationships, and the minority felt discomfort counseling patients. Most believed in the availability of time to provide advice, and some acknowledged potential patient resistance or viewed quitting smoking as an individual choice.

The significant difference in knowledge based on residency type emphasizes the necessity for interventions to fill knowledge gaps and suggest areas for targeted educational interventions. The findings also underscore the importance of early education, as evidenced by the majority obtaining training during medical school.

OBJECTIVE: To compare the clinical efficacy between auricular point sticking combined with transcutaneous electrical acupoint stimulation (TEAS) and nicotine patch for smoking cessation. METHODS: Two hundred patients who voluntarily quit smoking were randomly divided into a combination group and a nicotine patch group, 100 cases in each group. In the combination group, auricular point sticking (Shenmen [TF₄], Neifenmi [CO₁₈], Pizhixia [AT₄], Jiaogan [AH_6a], etc., once every other day) combined with TEAS（Lieque [LU 7] and Zusanli [ST 36], with continuous wave, 20 Hz in frequency, 1 mA in current intensity, 30 min each time, once a day) were applied. In the nicotine patch group, nicotine patch was applied. Both groups were treated for 8 weeks. The immediate withdrawal rate and persistent withdrawal rate 8 weeks into treatment and in follow-up of 16 weeks after treatment in the two groups were compared; before treatment, 8 weeks into treatment and in follow-up of 16 weeks after treatment, the degree of nicotine dependence was evaluated by using Fagerström test for nicotine dependence (FTND); 1 week into treatment, 8 weeks into treatment and in follow-up of 16 weeks after treatment, the withdrawal symptoms and smoking craving were evaluated by using Minnesota nicotine withdrawal scale (MNWS); the safety and compliance (dropped off rate and treatment completeness) were evaluated in the two groups. RESULTS: There was no statistical significance of the differences in the immediate withdrawal rate and persistent withdrawal rate 8 weeks into treatment and during follow-up between the two groups (P>0.05). The FTND scores were decreased 8 weeks into treatment and during follow-up in the two groups compared with those before treatment (P<0.01); the FTND score during follow-up in the combination group was lower than the nicotine patch group (P<0.05). The MNWS scores were decreased 8 weeks into treatment and during follow-up in the two groups compared with those 1 week into treatment (P<0.05); the changes of MNWS scores 8 weeks into treatment and during follow-up in the combination group were greater than the nicotine patch group (P<0.05, P<0.01). There were no serious adverse reactions in either group. Eight weeks into treatment and during follow-up, the dropped off rates were all 16.0% (16/100) in the combination group, which were 20.0% (20/100) and 23.0% (23/100) in the nicotine patch group, there was no statistical significance of the differences in the two groups (P>0.05). There was no significant difference in treatment completeness between the two groups (P>0.05). CONCLUSION Auricular point sticking combined with TEAS could effective decrease the degree of nicotine dependence, improve withdrawal symptoms in smokers, its effect is superior to nicotine patch.
Humans ; Smoking Cessation ; Tobacco Use Disorder ; Acupuncture Points ; Administration, Cutaneous ; Nicotine ; Substance Withdrawal Syndrome/drug therapy*

Nicotine is the main addictive component in cigarettes that motivates dependence on tobacco use for smokers and makes it difficult to quit through regulating a variety of neurotransmitter release and receptor activations in the brain. Even though nicotine has an analgesic effect, clinical studies demonstrated that nicotine abstinence reduces pain threshold and increases pain sensitivity in smoking individuals. The demand for opioid analgesics in nicotine abstinent patients undergoing surgery has greatly increased, which results in many side effects, such as nausea, vomiting, and respiratory depression, etc. In addition, these side effects would hinder patients' physical and psychological recovery. Therefore, identifying the neural mechanism of the increase of pain sensitivity induced by nicotine abstinence and deriving a way to cope with the increased demand for postoperative analgesics would have enormous basic and clinical implications. In this review, we first discussed different experimental pain stimuli (e.g., cold, heat, and mechanical pain)-induced pain sensitivity changes after a period of nicotine dependence/abstinence from both animal and human studies. Then, we summarized the effects of the brain neurotransmitter release (e.g., serotonin, norepinephrine, endogenous opioids, dopamine, and γ-aminobutyric acid) and their corresponding receptor activation changes after nicotine abstinence on pain sensitivity. Finally, we discussed the limits in recent studies. We proposed that more attention should be paid to human studies, especially studies among chronic pain patients, and functional magnetic resonance imaging might be a useful tool to reveal the mechanisms of abstinence-induced pain sensitivity changes. Besides, considering the influence of duration of nicotine dependence/abstinence and gender on pain sensitivity, we proposed that the effects of nicotine abstinence and individual differences (e.g., duration of abstinence from smoking, chronic/acute abstinence, and gender) on abstinence-induced pain sensitivity should be fully considered in formulating pain treatment protocols. In summary, this paper could deepen our understanding of nicotine abstinence-induced pain sensitivity changes and its underlying neural mechanism, and could also provide effective scientific theories to guide clinical pain diagnosis and treatment, which has important clinical significance.
Animals ; Humans ; Nicotine/adverse effects* ; Pain ; Pain Threshold ; Smoking Cessation ; Tobacco Use Disorder

PURPOSE: Adverse health effects of smoking could be made worse by worker's tobacco use, and combining tobacco use with occupational hazards could enhance the likelihood of occupational disease and injury. This study was aimed to develop a workplace smoking cessation program based on self-determination theory (SDT) and then to examine the effectiveness of the program. METHODS: A quasi-experimental design with nonequivalent control group pretesteposttest design was used. An intervention group (n = 30) received a smoking cessation program using individual counseling and tailored text messaging based on SDT during 12 weeks. Participants in the control group (n = 30) received a smoking cessation leaflet and telephonic follow-up for 3 times. RESULTS: At 6 and 12 weeks, there were significant differences between the two groups on autonomous regulation, perceived competence, nicotine dependence, tobacco abstinence rate, and exhaled carbon monoxide concentration. At 12 weeks, the abstinence rate in the intervention group was 96.7%, whereas that in the control group was 12.9%. CONCLUSION: SDT-based workplace smoking cessation program using individual counseling and tailored text messaging is effective in encouraging autonomous regulation and competence for workers.
Carbon Monoxide ; Counseling ; Follow-Up Studies ; Mental Competency ; Occupational Diseases ; Pilot Projects ; Smoke ; Smoking Cessation ; Smoking ; Text Messaging ; Tobacco ; Tobacco Use ; Tobacco Use Disorder

Quitting smoking helps smokers maintain their health and extend their lifespan by 10 or more years. Treatment strategies for smoking cessation should be tailored to individual smokers with special needs based on their specific circumstances. It is recommended that pregnant women adopt smoking cessation through counseling and behavioral interventions because the safety of medications has yet to be established. Counseling is the main strategy for smoking cessation in adolescents and nicotine replacement therapy can be used with caution in individuals with serious nicotine dependence. It is important for smokers with psychiatric diseases to quit smoking following accurate assessment of their depression status. Nicotine replacement therapy, varenicline, and bupropion can be used for smoking cessation in smokers with psychiatric disorders. The incidence of cardiovascular disease decreased according to the smoking status and the duration of smoking cessation. In smokers with chronic obstructive pulmonary disease (COPD) who used a combination of counseling and pharmacotherapy the quitting rate was more than twice as high as subjects who used behavioral interventions alone. Varenicline can be used as the most effective anti-smoking drug by most smokers including those with psychiatric disorders, cardiovascular disease, and COPD.
Adolescent ; Bupropion ; Cardiovascular Diseases ; Counseling ; Depression ; Drug Therapy ; Female ; Humans ; Incidence ; Nicotine ; Pregnant Women ; Pulmonary Disease, Chronic Obstructive ; Smoke* ; Smoking Cessation* ; Smoking* ; Tobacco Use Disorder ; Varenicline

OBJECTIVE: To evaluate the clinical effect of acupuncture on smoking cessation and withdrawal symptoms and to explore the influence factors of acupuncture on smoking cessation. METHODS: A total of 500 subjects with tobacco dependence were randomized into an acupuncture group, an auricular therapy group, an acupuncture plus auricular therapy group, a TENS group and a nicotine replacement therapy group (NRT group), 100 cases in each one. In the acupuncture group, acupuncture was applied at Baihui (GV 20), Lieque (LU 7), Hegu (LI 4) and Zusanli (ST 36). The treatment was given 5 times a week, once a day in the first 2 weeks. The treatment was given once every 2 days in the week 3 and 4, 3 times a week, and twice a week, once every 3 days in the week 5 to 8. In the auricular therapy group, the ear point pressure therapy was used at shenmen (TF), neifenmi (CO), pizhixia (AT) and jiaogan (AH), 3 times a week. In the acupuncture plus auricular therapy group, acupuncture and auricular therapy were adopted with the same points and manipulation as the previous two groups. Acupuncture was given 3 times a week and the auricular therapy was given twice a week. In the TENS group, SDZ-Ⅱ B type electric acupuncture apparatus was used to stimulate Lieque (LU 7) and Zusanli (ST 36), once a day. In the NRT group, the nicotine patch was used on the chest, back and the upper arms of the subjects, once a day. The duration of treatment was 8 weeks as one course in every group. Afterwards, the 16-week follow-up was conducted. The time-point withdrawal rate was evaluated by the level of urine cotinine in 8 weeks of treatment and in the follow-up in the subjects of 5 groups. The persistent withdrawal rate was evaluated by the self-report of the subjects in 8 weeks of treatment as well as in the follow-up in the 5 groups. The withdrawal effect, the score of the fagerstrom test for nicotine dependence (FTND) and the score of the heaviness of smoking index (HSI) were compared among the groups. Twenty indexes were selected as the potential influence factors, the 72 h withdrawal rate based on the level of urine cotinine in 8 weeks of treatment and in the follow-up was taken as the dependent variable. Using the two categories of Logistic regression analysis, the influence factors of therapeutic effect of acupuncture were screened for smoking cessation. RESULTS: After 8 weeks of treatment, the time-point withdrawal rate in the subjects among the groups was NRT group > acupuncture plus auricular therapy group > auricular therapy group > acupuncture group > TENS group. In the follow-up, the time-point withdrawal rate was acupuncture plus auricular therapy group > NRT group > acupuncture group > TENS group > auricular therapy group, but without statistical significance in comparison (>0.05). After 8 weeks of treatment, the persistent withdrawal rate in the subjects among the groups was auricular therapy group > TENS group > acupuncture group > acupuncture plus auricular therapy group > NRT group. In the follow-up visit, the persistent withdrawal rate was auricular therapy group > TENS group > acupuncture plus auricular therapy group > acupuncture group > NRT group. The result in the auricular therapy group was better than all of the other 4 groups (<0.05). Except in the follow-up visit, FTND score in the acupuncture group was lower than the auricular therapy group (<0.05), FTND score and HSI score were not different significantly in statistics among the groups either in 8 weeks of treatment or in the follow-up (>0.05). The regression analysis showed that the factors, i.e. nationality, educational background, drinking frequency, pre-treatment FTND score, pre-treatment HSI score and smoking cessation for physical reason in family, were correlated significantly with the withdrawal result after 8-week treatment (<0.05). The factors, i.e. education background, smoking age, pre-treatment FTND score and different therapeutic methods, were correlated significantly with the withdrawal result in the follow-up (<0.05). CONCLUSION Acupuncture combined with auricular therapy effectively reduce nicotine dependence and smoking intensity and relieve withdrawal symptoms. There are many factors that affect the withdrawal effect in smoking cessation. Hence, the influence factors in smoking cessation with acupuncture should be clearly determined so as to develop the individual regimen for smoking cessation and improve the clinical therapeutic effect of acupuncture on smoking cessation.
Acupuncture Therapy ; Humans ; Smoking ; Smoking Cessation ; Tobacco Use Cessation Devices ; Treatment Outcome

INTRODUCTION: Cigarette smoking is a leading cause of morbidity and mortality, and has a deleterious effect on dermatological conditions, such as skin cancers, hidradenitis suppurativa and psoriasis. The study aimed to evaluate the efficacy of a pharmacist-led smoking cessation clinic in reducing cigarette smoking at a tertiary referral dermatology centre. We described the impact of this clinic to provide guidance on how such a model could be further improved and implemented more widely. METHODS: In this single-centre, retrospective study, 74 currently smoking patients who received counselling at a structured smoking cessation clinic between January 2010 and March 2013 were identified. Information on baseline demographic characteristics and detailed past medical history, including smoking history, was collected. Follow-up was conducted at two weeks and three months. RESULTS: At the first follow-up at two weeks, which was attended by 57 patients, 9 (15.8%) had stopped smoking and 26 (45.6%) showed reduction in the number of cigarette sticks smoked per day, with an average reduction of 4.1 cigarette sticks per day. However, a few patients also reported no change or increased number of cigarette sticks smoked per day following counselling. CONCLUSION A structured pharmacist-led smoking cessation clinic is effective and can be made a part of the holistic management of dermatological conditions.
Adolescent ; Adult ; Dermatology ; organization & administration ; Female ; Hidradenitis Suppurativa ; complications ; Humans ; Male ; Middle Aged ; Program Development ; Psoriasis ; complications ; Retrospective Studies ; Skin Neoplasms ; complications ; Smoking Cessation ; methods ; Tobacco Use Disorder ; therapy ; Treatment Outcome ; Young Adult

Tobacco use is the most important preventable cause of mortality in South Korea and worldwide. This study aimed to evaluate the tobacco control policies of the Moon Jae-in government, which was established in May 10, 2017. Before the Moon Jae-in government, the tobacco tax was raised by the Park Geun-hye government from 2,500 won to 4,500 won (80% increase), but the price of cigarettes was still much lower in Korea than in other high-income countries. Cigarette smoking has been prohibited in all restaurants and bars since 2015; however, smoking rooms are allowed. Only large buildings are smoke-free. Pictorial warnings on cigarette packages were introduced in December 2016; however, they cover only 30% of the main packaging. Smoking cessation services provided by health care facilities have been subsidized by public health insurance since 2015. However, the advertisement, promotion, and sponsorship of tobacco are not further regulated. Since the beginning of the Moon Jae-in government, there has been no further strengthening of major tobacco control policies except for limited expansion of smoke-free public places and introduction of a lung cancer screening program. The first government-level tobacco control policies by the Moon Jae-in government, announced in May 2019, included increasing the size of the pictorial warnings and introducing standardized packaging by 2025, along with incremental expansion of smoke-free public places with prohibition of smoking rooms. These moves are positive; however, they do not include increasing tobacco taxes and regulating advertisement, promotion, and sponsorship of tobacco, which together are the backbone of tobacco control policies. The Moon Jae-in government should strengthen comprehensive tobacco control policies, ncluding tobacco taxes and banning tobacco advertisement, promotion, and sponsorship, to protect public health.
Delivery of Health Care ; Insurance ; Korea ; Lung Neoplasms ; Mass Screening ; Moon ; Mortality ; Product Packaging ; Public Health ; Republic of Korea ; Restaurants ; Smoke ; Smoking ; Smoking Cessation ; Taxes ; Tobacco Products ; Tobacco Use ; Tobacco

BACKGROUND: This study evaluated the association between nicotine dependence and depressive mood in patients who visited a secondary hospital for smoking cessation treatment.METHODS: From March 2016 to February 2017, a total of 48 patients who visited the smoking cessation clinic of a secondary hospital in Seoul were surveyed through questionnaires. Nicotine dependence was assessed by the Fagerström Test for Nicotine Dependence. The Beck Depression Inventory (BDI) was used to assess depressive mood.RESULTS: The mean BDI score was positively associated with nicotine dependence (P=0.01). In multivariable logistic regression analysis, increasing BDI was associated with higher odds (1.21, 95% confidence interval; 1.02–1.44) of high nicotine dependence after adjusting for all confounding variables.CONCLUSION: Depressive mood was positively associated with nicotine dependence among patients who visited a smoking cessation clinic. Consideration of depressive mood in smoking cessation treatment may be helpful for smoking cessation among patients with a willingness to quit smoking.
Confounding Factors (Epidemiology) ; Depression ; Humans ; Logistic Models ; Nicotine ; Seoul ; Smoke ; Smoking Cessation ; Smoking ; Tobacco Use Disorder

Recently, fatal nicotine intoxications with electronic cigarette liquid have increased in Korea, but various kinds of cigarettes and smoking cessation aids may also cause fatal poisoning. We report cases of fatal nicotine intoxications involving causes other than the use of liquid nicotine. A 29-year-old woman (case 1) found dead in a hotel room with about 70 patches (21 mg dose) of nicotine on her body. Blood nicotine levels were 7.68 mg/L (heart) and 3.25 mg/L (femoral). A toxic level of zolpidem was also detected. A 28-year-old Uzbekistan man (case 2) was found dead in his uncle's room with his face covered with chewing tobacco. Blood nicotine levels were 7.3 mg/L (heart) and 4.6 mg/L (femoral). Blood alcohol level was 0.139%. A 55-year-old man (case 3) bit his tongue. As he was taken to the hospital, his wife put tobacco powders in his mouth for hemostasis, and he died of cardiac arrest. Blood nicotine levels were 2.01 mg/L (heart) and 0.96 mg/L (femoral). Nicotine-related deaths can be caused by various types of administration including transdermal and transmucosal routes, and relatively small doses may cause death, so meticulous investigation should be taken when such deaths are suspected.
Adult ; Blood Alcohol Content ; Electronic Cigarettes ; Female ; Heart Arrest ; Hemostasis ; Humans ; Korea ; Middle Aged ; Mouth ; Nicotine ; Poisoning ; Powders ; Smoking Cessation ; Spouses ; Tobacco ; Tobacco Products ; Tobacco Use Cessation Products ; Tobacco, Smokeless ; Tongue ; Uzbekistan