Nicotine replacement therapy … - Carlos A ... - Entretiens du Carla

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Introduction
Nicotine
replacement therapy
for temporary
abstinence
Carlos A. Jiménez-Ruiz
Smoker’s Clinic, Communidad de Madrid
Madrid, Spain.
Smoking is the first preventable cause of
death. About half of smokers will prematuraly
die from smoking–related disorders.
Nevertheless, the mayority of smokers do not
want to make a serious attempt to quit in the
next month. Some of them want to reduce the
number of cigarettes smoked daily and most
of them want to continue smoking at the
same level (1-3).
Some smokers unwilling to quit can be
forced to temporary abstinence. A smoker in
temporary abstinence can be defined as a
smoker who does not want to quit and, for
different reasons, must refrain from smoking
during a period of time. For example: when
the smoker is at home, at workplace, in public
transports or at hospital. Moreover, different
studies have demonstrated that quitting
smoking before surgery is associated with a
significantly decrease in the rate of surgical
complications (4-6). So, physicians should
recommend their patients to quit smoking or,
at least, to maintain temporary abstinence
before being operated on.
On the other hand, we have to consider
that temporary abstinence can cause nicotine
withdrawal syndrome and craving. These
symptoms can bother the smoker his/her real
life and even can be dangerous for the subject
if he/she is hospitalized due to a disease
related or not with smoking. There are some
reasons that can support the use of Nicotine
Replacement Therapy (NRT) to help smokers
to keep temporary abstinence.
Temporary abstinence is a novel subject
and we are in lack of enough scientific
experience to be able to make evidence-based
guidelines for this issue. Nevertheless, taking
into account the results of different studies
some recommendations can be made. In this
chapter, several questions will be addressed.
At the end of the chapter, some
recommendations are written according to
the answers to these questions.
S. Nardini.
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