SMOKING CESSATION TEAM, PERSAHABATAN HOSPITAL
BACKGROUND
Diseases caused by smoking WHO report on the global epidemic of tobacco, 2008
Diseases caused by secondhand smoke WHO report on the global epidemic of tobacco, 2008
Tobacco use is a risk factor for six of the eight leading causes of death in the world WHO Report on the Global Tobacco Epidemic, 2008
Cancer Lung Leukemia Laryngeal (AML, ALL, CLL) 2-4 Oral cavity/pharynx Esophageal Stomach Pancreatic Kidney Bladder Cervical Cardiovascular Ischemic heart disease Stroke Vascular dementia 5 Peripheral vascular disease 6 Abdominal aortic aneurysm Respiratory COPD Pneumonia Poor asthma control Reproductive Low-birth weight Pregnancy complications Reduced fertility Sudden Infant Death Syndrome Other Adverse surgical outcomes/wound healing Hip fractures Low-bone density Cataract Peptic ulcer disease 1. Surgeon General s Report. The Health Consequences of Smoking. 2004; 2. Sandler DP et al. J Natl Cancer Inst. 1993;85:1994-2003; 3. Crane MM et al. Cancer Epidemiol Biomarkers Prev. 1996;5:639-644; 4. Miligi L et al. Am J Ind Med. 6 1999;36(1):60-69; 5. Roman GC. Cerebrovasc Dis. 2005;20(Suppl 2):91-100; 6. Willigendael EM et al. J Vasc Surg. 2004;40:1158-1165. 6
Estimated mortality from tobacco use in Australia in 2004 05
COPD prevalence by periode of survey publication Eur Respir J 2007; 30: 993-1013
COPD Cases in Persahabatan Hospital 2000-2008
Lung cancer Cases in Persahabatan Hospital 2000-2009
Cholesterol Reduction Blood Pressure Reduction 1. Unal B et al. BMJ. 2005;331:614
SMOKING CESSATION CLINIC AT PERSAHABATAN HOSPITAL
Only 5%-10% can do it unassisted
multidimentional Physiology - Nicotine addiction - Withdrawal effect Psychological - Behavioral - Environment
Nicotine replacement therapy (NRT)1 Long acting1-3 Patch Short acting1-3 Gum Inhaler Nasal spray Sublingual tablets/lozenges Antidepressant Bupropion SR4 Varenicline Strenght of evidence = A 19
That clinic vacuum aproximately 18 years There is no patient Because drugs medication for smoking cessation is no available Counselling alone is not effective in patient perspective
Okt 2008 Smoking Cessation Team at Persahabatan Hospital were declared November, 7 th 2008 re-opening smoking cessation clinic
Multimodality approach Combined non pharmacotherapy and pharmacotherapy Continuous programme
Place : Griya Puspa Building, 2 nd floor Time open : Monday - Friday 09.00 15.00
Major - General Practicioner (2) - Pulmonologist (3) - Pshyciatric specialist (1) - Medical Rehabilitation specialist (1) Support : Cardiologist, Internist, radiologist, clinical pathologist, occupational, nutritionist, et.al
1. Promotion and prevention programme - Education, meeting, symposium, training (personal, group, institution or company) - Addiction nicotine test 2. Early detection of disease related smoking - Screening programme for abnormality or disease correlated with smoking - Consultation with related specialist doctors 3. Smoking cessation programme
Health education Talkshow Health effect of smoking
Health education about smoking cessation Outpatient clinic
Health education about health effect of smoking School
Health education about health effect of smoking In population
Health education about health effect of smoking In company
Outpatient clinic Inpatient
Counseling for smoking cessation - Short counseling - Pshyciatric counseling Pharmacotherapy Behaviour therapy Respiratory rehabilitaion and exercise programme Withdrawal effect management Hypnotherapy Weight gain programme Measurement of urine nicotine Lung function test Measurement of CO exhalation Screening programme for disease related smoking
* In selected patient
Referral system (external)
Referral system (internal)
Symposium Smoking Cessation Programme Workshop workshop smoking cessation
Colaboration with PT Pfizer Indonesia to give workshop smoking cessation programme for : - Primary care doctor at Bekasi - Pimary care doctor at Jakarta - Doctor in company or institution likely Pertamina, BPKP - Primary care and private doctor at East Java - Private doctor at Jakarta - Medical student
Collaboration with PT Pfizer Indonesia in Quitter Are Champions (QAC) programme 2009-2010 Free smoking cessation programme 18 participant 100% succes to cessation in 3 month
Collaboration with PT Pfizer Indonesia in Quitter Are Champions (QAC) programme in : - PEMDA Bekasi - PT Pertamina
Type Total patient Method Outpatient 26 Counseling + pharmacotherapy Inpatient 38 Counseling Total 64
Type Total patient Method Outpatient 12 Counseling + pharmacotherapy Inpatient 40 Counseling Total 52
Type Total patient Method Outpatient 8 Counseling + pharmacotherapy Inpatient 24 Counseling Total 32
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