BACKGROUND: Tobacco is the leading cause of cancer in the Czech Republic. More than one-third of the population older than 15 years smokes, including many nurses. Most smokers want to quit, but the extent of nurses' involvement in tobacco cessation is unknown. OBJECTIVE: The purposes of this study are to describe the frequency of nurses' interventions in helping smokers quit, examine their attitudes and skills, and explore the relationship of nurses' smoking status to level of intervention. METHODS: A convenience sample of nurses in the Czech Republic completed a survey about their frequency of interventions according to the 5As for tobacco dependence treatment (i.e., ask, advise, assess, assist, arrange), their attitudes and perceived skills, and their smoking status (never, former, current). RESULTS: A total of 157 nurses completed the survey; 26% "always" or "usually" assisted patients with smoking cessation. Few (22%) reported that nurses could play an important role in helping patients quit, and 65% rated their ability to help smokers quit as "fair/poor." Nurse who smoked (30%) were less likely to consistently assess smoking status or arrange for follow-up support. CONCLUSION: Few nurses in the Czech Republic consistently provide smoking cessation support to patients, have the skills to do so, or view this role as an important part of their role. IMPLICATIONS FOR PRACTICE: To reduce tobacco-related cancers in the Czech Republic, capacity-building efforts are needed to enhance nurses' skills and confidence in providing smoking cessation interventions. Support is also need to help nurses who smoke quit.

• MeSH
• dospělí MeSH
• klinické kompetence MeSH
• kouření epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• odvykání kouření psychologie   MeSH
• ošetřovatelství - vzorové postupy statistika a číselné údaje   MeSH
• personál sesterský nemocniční psychologie   statistika a číselné údaje   MeSH
• postoj zdravotnického personálu * MeSH
• prevence kouření * MeSH
• průzkumy zdravotní péče MeSH
• role ošetřovatelky psychologie   MeSH
• sociální opora MeSH
• vztahy mezi ošetřovatelkou a pacientem MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

BACKGROUND: Since 2005, in the Czech Republic the Centres for Tobacco-Dependent are being established at hospitals. METHODS: Evaluation of the activity of these 37 centres in 2012, economic analysis of treatment costs and assessment of the cost of life year gained (LYG). RESULTS: Most of the centres (26 of 37) are based at pulmonary clinics with opening hours for smokers: on average 7 hours/week. Treatment codes 25501 and 25503 are used at 28 centres. Entry visit usually takes on average 61 minutes, follow-up visits 22 minutes. Nicotine replacement therapy and varenicline are indicated in all centres, but only 14 centres use bupropion. Virtually all centres use links to other clinical disciplines, about 10.5 % of patients are sent to other departments. The most common barriers for wider activity are insufficient salaries and staffing. In 2012, the Centre for Tobacco-Dependent at the 3rd Medical Department, 1st Faculty of Medicine, Charles University in Prague and the General University Hospital treated 430 patients for the price of 3792 CZK per treated patient ( 150 Euro), respectively, with 38 % success rate for the price of 10,003 CZK per abstinent patient ( 400 Euro), or for 1,334 CZK per LYG ( 50 Euro/LYG). CONCLUSION: In the future it would be good to improve working conditions in centres and to take advantage of their potential for the indispensable, effective and highly cost-effective treatment.

• MeSH
• analýza nákladů a výnosů MeSH
• centra pro terapii drogových závislostí ekonomika   organizace a řízení   MeSH
• lidé MeSH
• odvykání kouření ekonomika   metody   MeSH
• poruchy vyvolané užíváním tabáku ekonomika   rehabilitace   MeSH
• prostředky pro ukončení závislosti na tabáku ekonomika   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

Smoking is the leading risk factor for cardiovascular (CV) diseases. Eliminating exposure to tobacco smoke reduces CV risk in half. Tobacco dependence is similar to heroin addiction in its mechanisms and level of addictiveness or treatment success. Treatment includes both a change of daily stereotypes and pharmacotherapy. The most effective medication, varenicline, which depending on intensity of intervention triples the success rate, has been used since 2006, in the Czech Republic since 2007. It is a pity that its wider application is limited by the fear of its side effects; though it would be difficult to find a comparable risk of smoking with any drug. Papers describing this association were not methodologically correct and this relationship was also refused by the recent Cochrane Review publication - increased cardiovascular risk in connection with varenicline was not proved. Because the negative reports have been highly publicized, we consider to be useful to bring the overview, from which it is recognizable that varenicline is safe in terms of CV risks.

• MeSH
• benzazepiny terapeutické užití   MeSH
• chinoxaliny terapeutické užití   MeSH
• chování snižující riziko MeSH
• kardiovaskulární nemoci * MeSH
• kouření farmakoterapie   MeSH
• lidé MeSH
• nikotinoví agonisté terapeutické užití   MeSH
• odvykání kouření metody   MeSH
• poruchy vyvolané užíváním tabáku farmakoterapie   MeSH
• rizikové faktory MeSH
• vareniklin MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• benzazepiny MeSH
• chinoxaliny MeSH
• nikotinoví agonisté MeSH
• vareniklin MeSH

PURPOSE: To evaluate a brief educational program about smoking cessation on the frequency of nurses' interventions with smokers, and impact of nurses' smoking status on outcomes. DESIGN: Prospective, single group design with prestudy and 3 months post-study data. METHODS: Nurses in the Czech Republic attended hospital-based 1-hr educational programs about helping smokers quit. They completed surveys about the frequency (i.e., always, usually, sometimes, rarely, never) of their smoking cessation interventions with patients using the five A's framework (i.e., ask, advise, assess, assist, arrange), and their attitudes prior to and 3 months after the course. Demographic data included smoking status. FINDINGS: Among the 98 nurses with prestudy and post-study data, all were female, mean age was 43 years, 33% were current smokers, and 64% worked in a medical or surgical or oncology settings. At 3 months, compared to baseline, significantly (p < .05) more nurses assessed patients' interest in quitting, assisted with quit attempts, and recommended the use of the quitline for cessation. At 3 months after the program, nurses who smoked were less likely to ask about smoking status (odds ratio [OR] = 4.24, 95% confidence interval [CI; 1.71, 10.53]), advise smokers to quit (OR = 3.03, 95% CI [1.24,7.45]), and refer patients to a quitline (OR = 2.92, 95% CI [0.99, 8.63]) compared to nonsmokers, despite no differences in delivery of interventions at baseline. CONCLUSIONS: Three months after attendance at an educational program focused on the nurses' role in supporting smoking cessation efforts, more nurses engaged in interventions to help smokers quit. However, the program was less effective for nurses who smoked. CLINICAL RELEVANCE: This program demonstrated promise in building capacity among Czech nurses to assist with smoking cessation, but nurses' smoking poses a challenge.

• Klíčová slova
• Czech Republic, Eastern Europe, Smoking, intervention, nurses, tobacco,
• MeSH
• dospělí MeSH
• horké linky MeSH
• konziliární vyšetření a konzultace MeSH
• kouření psychologie   MeSH
• lidé MeSH
• odvykání kouření metody   MeSH
• ošetřovatelství - výzkum vyhodnocovací MeSH
• ošetřovatelství - vzorové postupy statistika a číselné údaje   MeSH
• personál sesterský nemocniční výchova   psychologie   statistika a číselné údaje   MeSH
• postoj zdravotnického personálu MeSH
• prevence kouření * MeSH
• prospektivní studie MeSH
• průzkumy zdravotní péče MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

Smoking represents the most widespread substance dependence in the world. Nicotine alters women hormonal homeostasis. Women smokers have higher testosterone and lower estradiol levels throughout life compared to nonsmokers. We monitored the effect of smoking discontinuation on steroid spectrum with 25 postmenopausal women smokers. They had been examined before discontinuation of smoking and after 6, 12, 24 and 48 weeks of abstinence. Blood was collected to determine steroid spectrum (measured by GC-MS), luteinizing hormone, follicle stimulating hormone and sex hormone binding globulin (measured by IRMA). Repeated measures ANOVA model was used for evaluation of the data. In postmenopausal women, an increase in testosterone, dihydrotestosterone, dehydroepiandrosterone and other androgens occurred. Neither nicotine replacement therapy nor weight changes nor age play a role in androgen level increase. The higher androgens levels correlated with failure in smoking cessation. Women smokers have higher androgen levels, which might play a role in smoking dependence development. Women successful in smoking cessation, compared to the non-successful ones, have lower androgen levels initially and also after smoking discontinuation.

• MeSH
• androgeny krev   MeSH
• folikuly stimulující hormon krev   MeSH
• globulin vázající pohlavní hormony metabolismus   MeSH
• lidé středního věku MeSH
• lidé MeSH
• luteinizační hormon krev   MeSH
• odvykání kouření * MeSH
• postmenopauza krev   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• androgeny MeSH
• folikuly stimulující hormon MeSH
• globulin vázající pohlavní hormony MeSH
• luteinizační hormon MeSH

OBJECTIVE: To identify possible predictors of post-cessation weight gain in smoking abstainers. PATIENTS AND METHODS: A sample of 607 successful abstainers seen at the Centre for Tobacco-Dependent in Prague, Czech Republic, between 2005 and 2010, was included in this analysis. This sample was followed up for 1year and included 47.9% women (N=291) with the mean age of 48years (18-85). FINDINGS: Post-cessation weight gain occurred in 88.6% of the 607 abstainers. The mean weight gain after one year post-quit was 5.1kg (95% confidence interval 4.7-5.5kg). Baseline characteristics associated with increased weight gain included a higher baseline smoking rate (p<0.001), more severe cigarette dependence (p=0.003), less physical activity (p=0.008), and a report of increased appetite on the baseline assessment of withdrawal symptoms (p<0.001). CONCLUSIONS: Smokers who are more dependent and have minimal physical activity are at increased risk for post-cessation weight gain. For these smokers, incorporating interventions targeting the weight issue into tobacco dependence treatment is recommended. Further research should be done to identify reasons for this important quitting complication.

• Klíčová slova
• CO, FTCD, Fagerström Test of Cigarette Dependence, MNWS, Minnesota Withdrawal Scale, NRT, Post-cessation, Smoking, Weight gain, carbon monoxide, nicotine replacement therapy,
• MeSH
• chuť k jídlu * MeSH
• dospělí MeSH
• hmotnostní přírůstek * MeSH
• kohortové studie MeSH
• kouření terapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• odvykání kouření metody   MeSH
• pohybová aktivita MeSH
• poruchy vyvolané užíváním tabáku terapie   MeSH
• prostředky pro ukončení závislosti na tabáku MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• sedavý životní styl * MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• sexuální faktory MeSH
• stupeň závažnosti nemoci MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

Current research concerning tobacco health impact revealed clear conclusions: both active and passive smoking cause diseases and premature death. No more research in this field is needed: we just need to eliminate tobacco from the society. Research outputs which have not been used represent wasting of resources. The evidence we have should be used to add more countries on the list of those with detailed End Game plans, like Finland, New Zealand or Australia. It means to decrease tobacco availability, protect population from tobacco smoke exposition, and support broadly available treatment of tobacco dependence.

• Klíčová slova
• smoking - tobacco - End Game.,
• MeSH
• kouření zákonodárství a právo   terapie   MeSH
• lidé MeSH
• politika MeSH
• poruchy vyvolané užíváním tabáku prevence a kontrola   terapie   MeSH
• prevence kouření MeSH
• tabák MeSH
• zdravotní politika * MeSH
• znečištění tabákovým kouřem zákonodárství a právo   prevence a kontrola   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• znečištění tabákovým kouřem MeSH

BACKGROUND: Electronic cigarettes (ECs) are becoming increasingly popular globally. If they were to replace conventional cigarettes, it could have a substantial impact on public health. To evaluate EC's potential for competing with conventional cigarettes as a consumer product, we report the first data, to our knowledge, on the proportion of smokers who try ECs and become regular users. METHODS: A total of 2,012 people seen smoking or buying cigarettes in the Czech Republic were approached to answer questions about smoking, with no mention made of ECs to avoid the common bias in surveys of EC users. During the interview, the volunteers' experience with ECs was then discussed. RESULTS: A total of 1,738 smokers (86%) participated. One-half reported trying ECs at least once. Among those who tried ECs, 18.3% (95% CI, 0.15.7%-20.9%) reported using them regularly, and 14% (95% CI, 11.6%-16.2%) used them daily. On average, regular users used ECs daily for 7.1 months. The most common reason for using ECs was to reduce consumption of conventional cigarettes; 60% of regular EC users reported that ECs helped them to achieve this. Being older and having a more favorable initial experience with ECs explained 19% of the variance in progressing to regular EC use. CONCLUSIONS: Almost one-fifth of smokers who try ECs once go on to become regular users. ECs may develop into a genuine competitor to conventional cigarettes. Government agencies preparing to regulate ECs need to ensure that such moves do not create a market monopoly for conventional cigarettes.

• MeSH
• design vybavení MeSH
• dospělí MeSH
• elektronika přístrojové vybavení   MeSH
• incidence MeSH
• kouření škodlivé účinky   epidemiologie   MeSH
• lidé MeSH
• následné studie MeSH
• nebulizátory a vaporizátory * MeSH
• odvykání kouření metody   MeSH
• poruchy vyvolané užíváním tabáku epidemiologie   prevence a kontrola   MeSH
• retrospektivní studie MeSH
• surveillance populace * MeSH
• tabákové výrobky statistika a číselné údaje   MeSH
• vzdělávání pacientů jako téma * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

INTRODUCTION: Higher prevalence of smoking among depressed patients, as well as the risk of depression in smokers, is well documented. The proportion of patients with a history of depression among those seeking intensive treatment of tobacco dependence is also high. In contrast, evidence of treatment success in this subgroup of patients is controversial. The aim of this study was to compare smoking abstinence rates after tobacco treatment in smokers with and without a history of depression. METHODS: We reviewed retrospective data from 1,730 smokers seeking treatment in Prague, Czech Republic. History of depression was defined as past diagnosis of depression or current treatment of depression. After a 1-year, self-reported smoking status was validated by expired-air carbon monoxide. We used logistic regression to analyze associations between abstinence rates, history of depression, and other factors (eg, age, sex, tobacco dependence). RESULTS: Of 1,730 smokers treated, 289 (16.7%) had a history of depression. The smoking abstinence rate at 1 year was 32.5% for smokers with a history of depression and 38.7% for those with no history (P = .048). Among women, abstinence did not differ between groups (35.0% vs 35.7%; P = .86). However, among men, those with a history of depression had lower rates of abstinence (27.4% vs 41.3%; P = .009). After adjustment for baseline covariates, history of depression was not significantly associated with smoking abstinence in men or women. CONCLUSION: Intensive outpatient tobacco treatment programs can achieve abstinence rates among smokers with a history of depression similar to rates among the general population.

• MeSH
• deprese komplikace   MeSH
• kouření epidemiologie   MeSH
• lidé MeSH
• odvykání kouření metody   MeSH
• poruchy vyvolané užíváním tabáku etiologie   terapie   MeSH
• retrospektivní studie MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

BACKGROUND AND AIMS: Cross-study comparisons of effect sizes suggest that varenicline is more effective than nicotine replacement therapy (NRT) in aiding smoking cessation, but evidence from direct comparisons is limited. This study compared biochemically verified 52-week sustained abstinence rates in smokers attending the same clinical service according to whether they used varenicline or NRT in their quit attempt. METHODS: This was a prospective cohort study of 855 smokers attending a large smoking cessation clinic who used their choice of NRT product or varenicline in their quit attempt. All received the same behavioural support programme and chose their medication option (n = 519 varenicline; n = 336 NRT). The primary outcome measure was self-report of 52 weeks' abstinence following the target quit date confirmed by expired air carbon monoxide concentration. Baseline measures included socio-demographic variables, mental health diagnoses, measures of smoking, cigarette dependence and past use of NRT or varenicline. RESULTS: The 52-week abstinence rates were 42.8% versus 31.0% in those using varenicline versus NRT, respectively (P < 0.001). After adjusting for all baseline variables, the odds of remaining abstinent for 52 weeks were 2.03 (95% CI 1.46-2.82), P < 0.001 times higher in those using varenicline than those using NRT. CONCLUSIONS: Smokers in the same behavioural support programme who use varenicline appear to have a greater probability of achieving long-term abstinence than those using their choice of nicotine replacement therapy options, even after adjusting for potentially confounding smoker characteristics.

• Klíčová slova
• NRT, smoking cessation, varenicline,
• MeSH
• benzazepiny aplikace a dávkování   MeSH
• chinoxaliny aplikace a dávkování   MeSH
• dechové testy MeSH
• lidé středního věku MeSH
• lidé MeSH
• nikotinoví agonisté aplikace a dávkování   MeSH
• odvykání kouření metody   MeSH
• oxid uhelnatý analýza   MeSH
• prevence kouření MeSH
• prospektivní studie MeSH
• prostředky pro ukončení závislosti na tabáku statistika a číselné údaje   MeSH
• vareniklin MeSH
• výsledek terapie MeSH
• způsoby aplikace léků MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH
• Názvy látek
• benzazepiny MeSH
• chinoxaliny MeSH
• nikotinoví agonisté MeSH
• oxid uhelnatý MeSH
• vareniklin MeSH