Smoking cessation interventions

Introduction:

Smoking remains the leading preventable cause of morbidity and mortality. With an estimated 1.22 billion smokers worldwide, the World Health Organization (WHO) reported that the global mortality of smoking was 5.4 million in year 2004. Cigarette smoking greatly increases the risk of lungcancer and heart attacks (coronary heart disease and acute myocardial infarction). It is also a risk factor for chronic obstructive pulmonary disease and cancers, including pharyngeal, esophageal, bladder, laryngeal, and pancreatic cancer. Life expectancy of a regular smoker is roughly 7-13 years shorter than that of a non-smoker on average.

In China, approximately 3000 deaths/day were attributable to smoking in 2005, reaching almost seven million deaths caused by smoking. With a prevalence of 67% among males in China, smoking is estimated to kill approximately one-third of Chinese men who are under 30 years old . Annually, over 320 million smokers consume an approximate 1.7 trillion cigarettes accounting for 40% of cigarettes smoked all over the world, and costing five billion U.S. dollars in 2000, 3.1% of China’s national health expenditures.

Smoking cessation is highly recommended by public health departments of various organizations, like WHO and Centers for Disease Control (CDC) However, it leads to physiological symptoms of withdrawal caused by nicotine dependence, which involves craving for tobacco and may lead to failing an attempt to quit smoking.

There are mainly two categories of available smoking cessation interventions, pharmacologic and behavioral interventions. Pharmacologic methods consist of five forms of nicotine replacement therapy (NRT) and two prescription medications, an antidepressant and a nicotinic receptor agonist. Behavioral methods consist of consulting from health care programs or/and educational programs, and mass media interventions. Both of these two methods have been reported successful in helping a smoker quit smoking.