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Nocturnal sleep-disturbing nicotine craving MICHAEL KUNZE AND E. GROMAN 753 Working with heavy dependent patients we have noticed a sleep disturbance, which is a further symptom of extreme tobacco dependence. We call this symptom ‘nocturnal sleep-disturbing nicotine craving’ (NSDNC). NSDNC is characterized by craving for cigarettes during the individual sleep times. The smoker awakes (one or several times per week) during his regular sleep time, and has to smoke a cigarette before he/she continues sleeping. This symptom can be explained by the decreasing nicotine levels during sleeping, which results in nicotine craving. However, NSDNC should be carefully separated from other sleep disturbances, or sleep disturbing events (nocturia, medication side effects), when nicotine craving is not the main reason for awakening (Rieder et al. 2001). State of the art To review the state of the art of treatment of tobacco dependence three important documents are reviewed: M. Raw, P. Anderson, A. Batra, G. Dubois, P. Harrington, A. Hirsch, J. Le Houezec, A. McNeill, D. Milner, M. Pötschke-Langer, W. Zatonski: WHO Europe evidence-based recommendations on the treatment of tobacco dependence. Tobacco Control 2002; 11:44–46; Michael C. Fiore: Consensus Statement: A clinical practice guideline for treating tobacco use and dependence. JAMA, June 28, 2000, Vol. 283, 3244–3254; National Institute for Clinical Excellence: Guidance on the use of nicotine replacement therapy (NRT) and bupropion for smoking cessation. Technology Appraisal Guidance, No. 39, March 2002. The WHO Europe Recommendations (Raw et al. 2002) have been written as an initiative of the World Health Organization European Partnership Project to Reduce Tobacco Dependence. These recommendations so far have been endorsed by many professional organizations dealing with the tobacco problem. For brief intervention this document provides the following guidelines. ◆ As part of their normal clinical work doctors should include the following essential features: ◆ ask about, and record smoking status, keep record up to date; ◆ advise smokers of the benefit of stopping in a personalized and appropriate manner (this may include linking the advice to their clinical condition) ◆ Assess motivation to stop. ◆ Assist smokers in their stop attempt if possible; this might include the offer of support, recommendation to use NRT or bupropion, and accurate information and advice about them, referral to a specialist cessation service if necessary. ◆ Arrange follow up if possible.
754 TREATMENT OF TOBACCO DEPENDENCE If help can be offered a few key points can be covered in a few minutes: ◆ set a stop day and stop completely on that day; ◆ review past experience and learn from it (what helped? what hindered?); ◆ make a personalized action plan; ◆ identify likely problems and plan how to cope with them; ◆ ask family and friends for support. For smoking cessation specialists the WHO Europe Recommendations conclude: The health care system should offer treatment as back up to brief opportunistic interventions for those smokers who need more intensive support. This support can be offered individually or in groups, and should include coping skills training and social support. A well-tested group format includes around five sessions of about one hour over about one month with follow up. Intensive support should include the offer of or encouragement to use NRT or bupropion (as appropriate) and clear advice and instruction on how to use them. With regard to pharmacotherapies it is stated: At the moment the principal aids in this category are NRT and bupropion. There are currently six NRT products: patch, gum, nasal spray, inhalator, tablet, lozenge. In addition the WHO Europe Recommendations offer guidelines for specific groups: Treatment research has tended to focus on health professionals such as doctors (especially in primary care), nurses, midwives, pharmacists, and smoking cessation specialists. However, advising and supporting smokers in stopping is an activity for the whole health care system and should, eventually, be integrated into as many settings as possible throughout the system. This includes hospital and community settings. In many countries, however, there is still a high smoking prevalence among health professionals, so in addition to the education and training recommended below, health professionals should be targeted for help in stopping smoking. Hospital staff should ask about patients’ smoking status before or on admission, and offer brief advice and assistance to those interested in stopping. Patients should be advised of the hospital’s smoke free status before admission. Hospital patients who need it should also be offered NRT or bupropion. Healthcare premises and their immediate surroundings should be smoke free. Pregnant smokers should receive clear and accurate information on the risks of smoking to the fetus, and be advised to stop smoking. They should be offered specialist support to stop. Cessation interventions shown to be effective with adults should be considered for use with young people, with the content modified as necessary. The WHO recommendations for health care purchasers and systems include among other the following statements: Purchasing treatment for tobacco dependence represents an extremely cost effective way of reducing ill health and prolonging life. Health care purchasers should purchase
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Tobacco and Public Health: Science
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Tobacco and Public Health: Science
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Preface Tobacco: The public health
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PREFACE vii The cigarette companies
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dramatically. Once more, I am not s
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it impairs quality of life for year
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documents and through litigation by
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PREFACE xv it will not succeed. Now
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Stratton, K., Shetty, P., Wallace,
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Contents Preface v C. Everett Koop
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27 Tobacco and pancreas cancer 479
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Contributors Amanda Amos Reader in
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Stephen S. Hecht University of Minn
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Cecily S. Ray Project Assistant Epi
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Abbreviations AAA Abdominal aortic
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Introduction The publication of thi
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Part 1 Tobacco: History
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Introduction Chapter 1 Evolution of
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RICHARD DOLL 5 However, little atte
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RICHARD DOLL 7 lung’ (Doll and Hi
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Table 1.1 Principal diseases caused
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Table 1.4 Manufactured cigarette co
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in 1995 was approaching the maximum
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References Adler, I. (1912). Primar
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Introduction Chapter 2 The great st
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MICHAEL J. THUN AND JANE HENLEY 19
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it seems likely that some of this v
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steady increase in lung cancer occu
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cigarette smoking in deaths from co
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the effects of smoking and smoking
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Lung cancer death rate (per 100,000
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Lickint, F. (1929). Zeitschrift fur
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Chapter 3 Dealing with health fears
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LYNN T. KOZLOWSKI AND RICHARD J. O
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Table 3.3 Selected cigarette advert
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Part 2 Tobacco: Composition
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Introduction Chapter 4 The changing
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ILSE HOFFMANN AND DIETRICH HOFFMANN
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Table 4.4 (continued) Carcinogens i
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Table 4.5 Standard conditions for m
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Table 4.7 Comparison of experimenta
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the lung in rats treated with NNK (
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serve as the scientific basis in su
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Senkus, M. (ed.) (1976). Leaf compo
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Introduction Chapter 5 Tobacco smok
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STEPHEN S. HECHT 95 Established pul
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STEPHEN S. HECHT 97 magnitude lower
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STEPHEN S. HECHT 99 generally great
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Table 5.1 1-Hydroxypyrene in the ur
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Table 5.2 NNAL and its glucuronides
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STEPHEN S. HECHT 105 Table 5.2 (con
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Table 5.3 Representative DNA adduct
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G No (Wang et al. 2001a) N 2 CHCH 2
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STEPHEN S. HECHT 111 N-Nitrosopyrro
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(Kozack et al. 2000; Seo et al. 200
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the DNA adducts resulting from toba
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Culp, S. J., Gaylor, D. W., Sheldon
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STEPHEN S. HECHT 119 International
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STEPHEN S. HECHT 121 Melchior, W. B
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STEPHEN S. HECHT 123 Rivenso, A., H
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Wang, M., McIntee, E. J., Cheng, G.
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Part 3 Nicotine and addiction
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Chapter 6 Pharmacology of nicotine
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JACK E. HENNINGFIELD AND NEAL L. BE
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Pickworth et al. 1995; Shiffman et
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American Caucasians and Hispanics (
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(US DHHS 2001). At doses delivered
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References JACK E. HENNINGFIELD AND
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Introduction Chapter 7 Behavioral p
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BRIDGETTE E. GARRETT ET AL. 151 How
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(Fischman and Foltin 1991). Another
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following repeated, infrequent and
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BRIDGETTE E. GARRETT ET AL. 157 oth
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BRIDGETTE E. GARRETT ET AL. 159 cli
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to tobacco product ingredients and
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BRIDGETTE E. GARRETT ET AL. 163 Gom
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BRIDGETTE E. GARRETT ET AL. 165 Ris
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Introduction Chapter 8 Cigarette sc
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JEFF FOWLES AND DENNIS SHUSTERMAN 1
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◆ The pressure drop of the filter
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Nitrosamines Nitrosamines are biolo
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Physical design features of cigaret
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Introduction Chapter 9 Nicotine dos
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world tobacco burden (World Health
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Table 9.2 The ranges of nicotine, n
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MIRJANA V. DJORDJEVIC 187 turing a
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Poland 19 1.4 n.a. n.a. 68−347 36
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MIRJANA V. DJORDJEVIC 191 cigarette
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MIRJANA V. DJORDJEVIC 193 Table 9.5
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MIRJANA V. DJORDJEVIC 195 MS wherea
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MIRJANA V. DJORDJEVIC 197 In recent
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MIRJANA V. DJORDJEVIC 199 Table 9.8
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MIRJANA V. DJORDJEVIC 201 Burns, D.
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International Agency for Research o
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Part 4 Tobacco use: Prevalence, tre
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Chapter 10 Tobacco in Great Britain
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Adult smoking PATTI WHITE 209 Since
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oys who were regular smokers report
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PATTI WHITE 213 cancer, and bringin
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Introduction Chapter 11 The epidemi
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since the late 1980s. In 2001, Phil
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YANG HONGHUAN 219 ◆ Among males,
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Table 11.1 Smoking among adolescent
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(57%) was higher than in males (45%
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20 cigarettes a day had double the
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Chapter 12 Patterns of smoking in R
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DAVID ZARIDZE 229 Ignatova et al. (
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DAVID ZARIDZE 231 Tyumen, respectiv
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References DAVID ZARIDZE 233 Alexee
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Chapter 13 Tobacco smoking in centr
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WITOLD ZATOŃSKI 237 The developmen
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especially post-Soviet countries, w
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No. of Cigarettes 3000 2500 2000 15
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WITOLD ZATOŃSKI 243 young men and
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DEATHS / 100,000 DEATHS / 100,000 7
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WITOLD ZATOŃSKI 247 According to d
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Unfortunately, available data on th
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Kaczmarczyk-Chalas, K., Gdulewicz,
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Chapter 14 The epidemic in India Pr
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aniseed, and musk, also available a
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PRAKASH C. GUPTA AND CECILY S. RAY
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Prevalence among youth PRAKASH C. G
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treatment and premature death were
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Although tobacco control legislatio
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PRAKASH C. GUPTA AND CECILY S. RAY
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Chapter 15 Tobacco in Africa: More
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In assessing tobacco use in Africa
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YUSSUF SALOOJEE 271 plug the gap th
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Table 15.2 Cigarette taxes as perce
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YUSSUF SALOOJEE 275 In recent years
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World Bank (2001). Economics of Tob
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Part 5 Tobacco and health. Global b
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Chapter 16 The future worldwide hea
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RICHARD PETO AND ALAN D LOPEZ 283 a
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UK male death rate at ages 35-69 ha
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Overview Chapter 17 Passive smoking
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evidence have proved to be effectiv
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JONATHAN M. SAMET 291 a thousand de
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Table 17.2 Occupational ETS exposur
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Table 17.3 Nicotine concentrations
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portable piezobalance to sample aer
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JONATHAN M. SAMET 299 Fetal effects
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JONATHAN M. SAMET 301 Investigation
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Table 17.4 Summary of pooled random
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JONATHAN M. SAMET 305 also reported
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and involuntary exposure to tobacco
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Glantz, S. A. and Parmley, W. W. (1
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JONATHAN M. SAMET 311 O’Connor, G
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JONATHAN M. SAMET 313 US Department
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Introduction Chapter 18 Adolescent
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JOHN P. PIERCE ET AL. 317 would be
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JOHN P. PIERCE ET AL. 319 Indeed, t
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JOHN P. PIERCE ET AL. 321 reached i
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subsequent consumption. Most studie
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Burns, D., Garfinkel, L., and Samet
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JOHN P. PIERCE ET AL. 327 US Depart
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The epidemic Chapter 19 Tobacco and
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AMANDA AMOS AND JUDITH MACKAY 331 w
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AMANDA AMOS AND JUDITH MACKAY 333 T
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AMANDA AMOS AND JUDITH MACKAY 335 w
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AMANDA AMOS AND JUDITH MACKAY 337 p
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AMANDA AMOS AND JUDITH MACKAY 339 T
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AMANDA AMOS AND JUDITH MACKAY 341 o
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AMANDA AMOS AND JUDITH MACKAY 343 M
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such as Jewel and Madonna, who woul
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AMANDA AMOS AND JUDITH MACKAY 347 t
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particularly in developing countrie
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AMANDA AMOS AND JUDITH MACKAY 351 L
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Part 6 Tobacco and cancer
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Chapter 20 Cancer of the prostate F
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Table 20.1 Summary of results of ca
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Andersson et al. 1996 Sweden 256 ca
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Table 20.2 Summary of results of co
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cancer in younger or elderly men, w
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FABIO LEVI AND CARLO LA VECCHIA 365
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Summary Chapter 21 Laryngeal cancer
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12-year follow-up of the American C
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Hedberg et al. USA, 235, 81% P, 547
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cigarettes as compared to blond-tob
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of 3.78 and 11.47. An interpretatio
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Effect on survival In two studies f
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Cattaruzza, M. S., Maisonneuve, P.,
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USDHEW (1964). Laryngeal cancer. In
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Chapter 22 Smoking and cancer of th
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Table 22.1 Results from selected ca
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Asia Gao et al. 1994— Population
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EVA NEGRI 389 Ille-et-Vilaine, Fran
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Odds Ratio 2.5 2 1.5 1 0.5 0 0.30 2
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Garidou et al. 1996— Hospital ≤
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De Stefani, E., Barrios, E., and Fi
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Wynder, E. L. and Bross, I. J. (196
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Introduction Chapter 23 Tobacco use
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Table 23.1 Tobacco use and risk of
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Franceschi et al. Oral cavity, Oral
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Muscat et al. Oral cavity OR = 2.1
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Population-based case-control studi
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Lewin et al. Oral cavity, RR = 6.5
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TONGZHANG ZHENG ET AL. 411 the cont
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TONGZHANG ZHENG ET AL. 413 For smok
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TONGZHANG ZHENG ET AL. 415 per day
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TONGZHANG ZHENG ET AL. 417 than tha
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TONGZHANG ZHENG ET AL. 419 For exam
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TONGZHANG ZHENG ET AL. 421 decline
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Studies in India: Oral cancer is th
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carcinoma compared with other combi
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studies have demonstrated a positiv
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TONGZHANG ZHENG ET AL. 429 Garrote,
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TONGZHANG ZHENG ET AL. 431 Notani,
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Chapter 24 Smoking and stomach canc
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DAVID ZARIDZE 435 such as sex, age,
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DAVID ZARIDZE 437 (Kato et al. 1990
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DAVID ZARIDZE 439 respectively. The
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Gajalakshmi, C. K. and Shanta, V. (
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Pisani, P., Parkin, D. M., Bray, F.
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Introduction Chapter 25 Cigarette s
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attenuated in every study after con
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EDWARD GIOVANNUCCI 449 with a gener
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(Baron et al. 1994) of 352 colon ca
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(U.S. Dept. of Health Education and
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References EDWARD GIOVANNUCCI 455 A
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EDWARD GIOVANNUCCI 457 Kono, S., Ik
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Chapter 26 Smoking and cervical neo
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Tokuhata 1967* Williams 1977* Wigle
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Clarke 1985* Hellberg 1986* La Vecc
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ANNE SZAREWSKI AND JACK CUZICK 465
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case-control study nested in a scre
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five-fold risk of cervical cancer f
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(typically around two-fold), but be
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Introduction Chapter 27 Tobacco and
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Cigar, pipe, and chewing tobacco Wh
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Conclusion Overall, tobacco smoking
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Summary Chapter 28 Smoking and lung
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GRAHAM G. GILES AND PETER BOYLE 487
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quit for 20 years or more (Rogot an
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cancer and others where there is st
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Peto, R. (1986) Influence of dose a
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Chapter 29 Tobacco smoking and canc
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He further noted that case-control
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coefficients from the data in Table
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DIMITRIOS TRICHOPOULOS AND ARETI LA
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Epidemiology Chapter 30 Smoking and
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CRYSTAL N. HOLICK AND HARVEY A. RIS
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and at least the enteric variety of
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Chapter 31 Endometrial cancer Paul
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Table 31.1 Epidemiological studies
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studies (Terry et al. 1999, 2002a),
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Newcomer Population 740/2372 40-79
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PAUL D. TERRY ET AL. 531 levels, an
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Relative body weight Obesity is an
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Key et al. 1991 147 pre- and postme
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lood levels among current smokers,
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Table 31.7 Studies of cigarette smo
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of the association between cigarett
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Jensen, J., Christiansen, C., and R
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PAUL D. TERRY ET AL. 545 Weiderpass
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Part 7 Tobacco and heart disease
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citations of some of the best-known
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KONRAD JAMROZIK 553 because the dat
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KONRAD JAMROZIK 555 Fig. 32.2 Trend
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Table 32.3 Case-control studies of
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Table 32.5 Cohort studies of active
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Table 32.6 Effect of exclusion of p
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eadily addressed by cohort studies
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Specificity The entries in Table 32
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Table 32.8 Application of Bradford
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KONRAD JAMROZIK 569 arterial CVD re
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elationship goes beyond statistical
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Garland, C., Barrett-Connor, E., Su
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National Health and Medical Researc
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Part 8 Tobacco and respiratory dise
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Introduction Chapter 33 Chronic obs
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Many of the constituents in both th
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DAVID M. BURNS rate of growth in lu
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Death rates from COPD in smokers an
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Fraction of Excess Risk 1.20 1.00 0
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DAVID M. BURNS Higgins, M. W., Enri
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Part 9 Tobacco and other diseases
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Introduction Chapter 34 Smoking and
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ALLAN HACKSHAW 595 several mechanis
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Table 34.4 Studies that reported re
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Table 34.5 Cohort studies that repo
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than non-smokers; they have about h
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Table 34.8 Cohort studies that repo
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esults from cohort studies. There i
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ALLAN HACKSHAW 607 (DiFranza and Le
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Table 34.12 Cohort studies that rep
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Caries and tooth loss Because perio
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Table 34.16 Summary of disorders in
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References ALLAN HACKSHAW 615 Allar
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Johnsen, R., Forde, O. H., Straume,
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Seddon, J. M., Willett, W. C., Spei
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Part 10 Genetics, nicotine addictio
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Chapter 35 Genes, nicotine addictio
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Cotinine (ng/ml) 750 500 250 OXCHEC
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MICHAEL MURPHY ET AL. 627 of those
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MICHAEL MURPHY ET AL. risk associat
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Table 35.2 (continued) Gene map Chr
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MICHAEL MURPHY ET AL. pre-clinical
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Steps to carcinogenesis Exposure to
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DNA repair As previously alluded to
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MICHAEL MURPHY ET AL. Lichtenstein,
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Part 11 Tobacco and alcohol
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Table 36.1 Comparison of alcohol an
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Although gene therapy has rarely be
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20+ TABAC 5.1 10-19 0-9 3.4 12.3 0-
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Heavy drinking is known to cause ga
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Treatment issues and co-dependence
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ALBERT B. LOWENFELS AND PATRICK MAI
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Part 12 Tobacco control: Successes
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Introduction Chapter 37 Global toba
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NIGEL GRAY (sometimes at state leve
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NIGEL GRAY The first attempt to red
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per litre of smoke. Reduction of th
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Borland, R., Cappiello, M. and Owen
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Chapter 38 Lessons in tobacco contr
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entangling relationships with negot
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successful country advocates deeply
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Thus, when the opportunity arose, t
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Chapter 39 A brief history of legis
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Committee, mentioned above, little
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4. Tobacco and its related processi
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RUTH ROEMER 683 advertising and adv
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or shows, and distribution of free
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RUTH ROEMER 687 threat to the peopl
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RUTH ROEMER 689 The case was settle
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Another study by Harvard researcher
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At the end of 2003, 83 countries ha
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Chapter 40 Roles of tobacco litigat
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NGOs obtained sanctions against tob
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RICHARD A. DAYNARD 699 In a 1980s c
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RICHARD A. DAYNARD 701 Fourth, the
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Page 740 and 741: Introduction Chapter 41 Impact of s
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Page 764 and 765: RON BORLAND AND CLAIRE DAVEY 731 Pr
Page 766 and 767: Introduction Chapter 42 Effective i
Page 768 and 769: PRABHAT JHA ET AL. 735 India (Gupta
Page 770 and 771: Average price or tax per pack (US$)
Page 772 and 773: PRABHAT JHA ET AL. 739 Bans on adve
Page 774 and 775: PRABHAT JHA ET AL. 741 Table 42.2 T
Page 776 and 777: PRABHAT JHA ET AL. 743 antismugglin
Page 778 and 779: Farrelly, M. C., Pechacek, T. F., a
Page 780 and 781: PRABHAT JHA ET AL. 747 Raw, M., Mc
Page 782 and 783: Part 13 Treatment of dependence
Page 784 and 785: Introduction Chapter 43 Treatment o
Page 788 and 789: MICHAEL KUNZE AND E. GROMAN 755 tob
Page 790 and 791: Fifteen different products were ide
Page 792 and 793: In summary, tobacco dependence amon
Page 794 and 795: medications for OTC sale in 1996, t
Page 796 and 797: MICHAEL KUNZE AND E. GROMAN 763 US
Page 798 and 799: Chapter 44 Regulation of the cigare
Page 800 and 801: as these correlate quite well with
Page 802 and 803: NIGEL GRAY 769 within three major g
Page 804 and 805: of carcinogens and toxins in its wa
Page 806 and 807: Index abdominal aortic aneurysm see
Page 808 and 809: aromatic amines 58, 60, 98 DNA addu
Page 810 and 811: central and eastern Europe (CEE) (C
Page 812 and 813: coronary thrombosis 5 see also myoc
Page 814 and 815: epinephrine 169 epoxide hydrolase g
Page 816 and 817: health professionals advice on smok
Page 818 and 819: laryngeal cancer (Continued) animal
Page 820 and 821: Morris, Philip 207 see also Philip
Page 822 and 823: nursing home residents 718 nutritio
Page 824 and 825: Polish Central Statistical Office (
Page 826 and 827: smoke, tobacco (including cigarette
Page 828 and 829: Sweden female smoking rates 330-1 l
Page 830 and 831: United Nations agencies 680-1 Unite
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Tobacco and Public Health - TCSC Indonesia

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