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Are Sociodemographic Properties or is Carbon Monoxide Measured in Exhaled Air More Effective in the Treatment of Tobacco Addiction?

Author(s): Aydin Balci, Sule Cilekar


According to the World Health Organization (WHO), the use of tobacco products ranks first as the most preventable health problem in the world. According to the data of the World Health Organization, 1.3 million people worldwide use tobacco products and approximately 5 million people die every year due to tobacco use-related causes. Approximately 100 thousand people die every year due to tobacco products in our country. While the mortality rate due to tobacco use is expected to be approximately 8.4 million people by 2030 in the entire world, it is expected to be around 240,000 in Turkey [1]. While the use of tobacco products is gradually decreasing in developed countries, it is increasing in underdeveloped and developing countries. It is estimated that 80% of deaths expected to occur due to tobacco use in 2030 will be in underdeveloped and developing countries [1,2]. There are three main cases in terms of the use of tobacco products (cigarettes etc.). The first one is people who do not smoke tobacco products (cigarettes, etc.) or have not used them at any time in their life. The second case is people who have quit using tobacco products or used tobacco products in the past but have not been smoked for a certain period of time (at least 6 months). The third case describes people who use tobacco products and who still smoke tobacco products regularly or non-regularly [3]. According to the data of 2016, Turkey's current rate of tobacco product use is 40.1% in men, 13.3% women, while it is 26.5% in the general population [4]. Turkey is among the countries in the first place in terms of rates of the use of tobacco derivatives and is among the countries with the highest tobacco product addiction among the male population in Europe, according to WHO [5]. In Turkey, one of the widespread uses of tobacco products will also cause a decrease in the rates of quitting tobacco-product. Although tobacco users are often unaware of this addiction, they consider it more of a habit, but it is addictive due to nicotine in tobacco products. Tobacco products are among the substances with high addiction potential. While 70% of the people who use tobacco products in our country think that they are thinking of getting rid of their addictions, 80% reported that they tried to quit tobacco products with or without support at a certain time in their lives [6,7]. Most tobacco users try to get rid of their addiction without help, and many result in relapse after a short time [8]. There are many studies reporting different results on the factors affecting the success of quitting in tobacco users. Motivation and determination, sociodemographic features, addiction, psychological and environmental factors, chronic diseases are the significant factors [3]. About 75-80% of tobacco addicts want to quit these habits [9]. There are two approaches that have been shown to be beneficial in quitting tobacco products. These are supportive therapy and pharmacotherapy, consisting of behavioral therapy and motivation (Nicotine Replacement Therapy, Bupropion, and Varenicline) [10]. Better results are achieved with the combined use of these two approaches [11]. In 2010, the Tobacco Products Cessation Hotline (ALO 171) was introduced by the Ministry of Health in order to encourage those using tobacco products in our country to get rid of these habits [12]. Addicts of tobacco products calling ALO 171 are directed to the nearest tobacco product (smoking cessation) cessation clinic. Socioeconomic and cultural factors often play an important role in determining who will start tobacco products or who and how they will continue this habit. In our country, an increase in the level of social awareness causes an increase in polyclinic admissions of people who use tobacco products. The process of quitting tobacco products in these polyclinics is supported by pharmacological treatment and behavioral education. In our study, patients who were admitted to our tobacco products outpatient clinic in a district state hospital within 1 year and who were registered to the Ministry of Health's tobacco addiction treatment monitoring system were included. In our study, it was evaluated whether the sociodemographic features or the level of carbon monoxide (CO) measured in exhaled air are effective in the success of quitting tobacco products (commercial tobacco and rolling tobacco) in the light of the literature.

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