Therapy goal Alleviation of withdrawal symptoms. Therapy recommendations Note any symptoms of tobacco withdrawal syndrome that may occur: First withdrawal symptoms after 1-2 h. Increase in symptoms in the first 6-12 h. Maximum of complaints after 1-3 days Persistence of complaints up to 3 weeks Typical withdrawal symptoms include craving (violent desire for tobacco), dysphoric … Tobacco Dependence: Drug Therapy
Medical device diagnostics are generally not indicated for mental and behavioral disorders related to tobacco dependence. Diseases – see self-history – that can be or are a consequence of atherosclerosis (arteriosclerosis, hardening of the arteries) – as a consequence of tobacco dependence – require diagnostic clarification according to the guidelines of Evidence Based Medicine. Optional … Tobacco Dependence: Diagnostic Tests
An at-risk group indicates the possibility that the disease may be associated with the risk of micronutrient deficiency (vital substance deficiency). The complaint “Mental and behavioral disorders due to tobacco: dependence syndrome” indicates micronutrient deficiency for: Vitamins Vitamin A Vitamin E Vitamin C Riboflavin Trace elements Iodine Secondary plant substances Alpha-carotene Zeaxanthin The above vital … Tobacco Dependence: Micronutrient Therapy
To prevent the mental and behavioral disorders caused by tobacco, attention must be paid to reducing risk factors. Behavioral risk factors that may trigger tobacco use: Psycho-social situation Curiosity Stress Social reinforcement such as integration into groups Secondary prevention Pulmonary function: increased consumption of fruit (apples and bananas) and tomatoes was associated with a slower … Tobacco Dependence: Prevention
The following symptoms and complaints may indicate tobacco dependence: Symptoms of continuous use Increase in blood pressure Pulse increase (possibly tachycardia: heartbeat too fast: > 100 beats per minute). Cold extremities Cough, especially in the morning (“smoker’s cough“). Stress Mood elevation/calming/feeling safe – in turn, further reinforce addiction Symptoms of nicotine withdrawal Restlessness/anxiety Irritability Depression … Tobacco Dependence: Symptoms, Complaints, Signs
Pathogenesis (development of disease) Cigarette smoke contains more than 4,000 substances that have very different modes of action. Nicotine mediates neurobiological effects; for example, it has stimulating, appetite-reducing, rewarding, vigilance-increasing, and sedative effects. The psychotropic effects are manifold and are due to the nicotine-mediated release of dopamine, serotonin, norepinephrine or beta-endorphin. Physical dependence results from … Tobacco Dependence: Causes
The following are the most important diseases or complications that may be contributed to by tobacco dependence: Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Maldescensus testis (undescended testis). Respiratory system (J00-J99) Acute bronchitis Bronchial asthma Chronic bronchitis Chronic obstructive pulmonary disease (COPD) Interstitial lung disease (differential diagnosis to be considered in smokers with exertional dyspnea … Tobacco Dependence: Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Of the skin, mucous membranes, pharynx (throat) and sclerae (white part of the eye) [due topossible sequelae: pharyngitis (pharyngitis), tonsillitis (tonsillitis)]. Extremities [cold, in nicotine intoxication: muscle tremors]. Auscultation … Tobacco Dependence: Examination
Determination of laboratory parameters are generally not indicated for mental and behavioral disorders associated with tobacco dependence. Diseases – see self-history – that can be or are the consequence of atherosclerosis (arteriosclerosis, hardening of the arteries) – as a consequence of tobacco dependence – require diagnostic clarification according to the guidelines of Evidence Based Medicine. … Tobacco Dependence: Test and Diagnosis
General measures Smoking cessation counseling Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day) – alcohol has a disinhibiting effect. Thus, made resolutions to stop smoking can be invalidated. Avoidance of psychosocial stress: Stress Important notice. E-cigarettes (called electronic cigarette or vaporizer; vaping) are not a recognized … Tobacco Dependence: Therapy
Medical history (history of illness) represents an important component in the diagnosis of tobacco-related mental and behavioral disorders. Family history Social history Is there any evidence of psychosocial stress or strain due to your family situation? Current medical history/systemic history (somatic and psychological complaints). How long have you been smoking? What do you smoke? (Cigarette, … Tobacco Dependence: Medical History
