The Role Of Varenicline In Smoking Cessation And The Relative Study

Tobacco is a serious public health problem.Smoking is a preventable and controllable disease risk factor.Currently the efficacy of drug treatment for smoking cessation is poor.varenicline,a selective nicotinic acetylcholine receptor(nAChR) partial agonist,is the latest drug for smoking cessation.Many foreign studies have shown that varenicline is superior to currently available treatments for smoking cessation.In China,its efficacy and safety have not been proved.It is very necessary to be in china,Because of smoking situation in Chinese people and the smoking status of doctors.THE FIRST PART The efficacy and safety of varenicline for smoking cessationBackground:Rate of smoking in china is 50.2%and are increasing in women and the young.Objective:This study evaluated the efficacy and tolerability of varenicline,a novelα₄β₂ nicotinic acetylcholine receptor partial agonist,for smoking cessation in smokers in Guangzhou.Methods:A randomized,double-blind,placebo-controlled,12-week treatment,12-week follow-up trial was conducted in Guangzhou.Eligible subjects were randomly assigned in a 1:1 ratio to varenicline ling BID(titrated during the first week) or placebo.Smoking status was determined by self-report and confirmed at clinic visits by end-expiratory carbon monoxide≤10ppm.The primary end point was continuous abstinence rate(CAR) during the last 4 weeks of treatment.Secondary end points included CAR from weeks 9 to 24 and 7-day point prevalence(PP) of abstinence at weeks 12 and 24.Safety was evaluated by the rate of adverse reactions,the changes of laboratory data and vital sign.Results:27 subjects were enrolled,of which 13 subjects were in the varenicline group and 14 subjects in the control group.Smoking-cessation rates at the end of treatment were 53.8%with varenicline versus 35.7%with placebo(P＞0.05).CARs through 12 weeks post-treatment(weeks 9-24) were 30.8%with varenicline and 21.4%with placebo (P＞0.05).The 7-day PP was 61.5%with varenicline versus 35.7%with placebo at week 12,and 30.8%versus 28.6%with placebo at week 24(both,P＞0.05). Vareniline was well tolerated,with the most frequent adverse effects of digestive symptoms.Conclusion:Varenicline is a safe agent for smoking cessation.But its efficacy need to be debatedTHE SECOND PART Epidemiology of Smoking in China:Meta-analysis for Literature Published in 1997-2007objectiveTo knowledge the prevalence and the effect factors of human smoking,which offer the basis for smoking cessation.MethodsThrough extensive search and collection,using meta-analysis to analysis the data on the human smoking in articles which published in the past 10 years.ResultTotal 27articles were enrolled from 155articles.the prevalence of human smoking was 30.8%.in different age groups,the highest smoking rate is 35.23%in 60-70 age group,in different educational levels,the highest smoking rate is 31.44% in smoking post-secondary and tertiary crowd,.In different marital status,the highest smoking rate is 31.05%in married people,in different occupations;the highest smoking rate is 35.59%in fishermen.ConclusionsCompared with in 1996,the smoking rate has dropped,the 60-69 year-old group,married,college and above,fishermen is the focus of smoking intervention.As well as health professionals smoking should not be overlooked.THE THIRD PART An international review of tobacco smoking in the medical profession:1996-2006BackgroundThe doctors play an important role in the global anti-smoking campaign. Though doctors are well-known that smoking is harmful to health,there are still plenty of doctors smoke,therefore we describe physicians at home and abroad on the smoking habits in this article.MethodsA keyword search of appropriate MeSH terms was initially undertaken to identify relevant material,after which the reference lists of manuscripts were also examined to locate further publications.Results A total of 33 English-language studies published in the past 30 years met the inclusion criteria.Two distinct trends were evident.Firstly,most developed countries have shown a steady decline in physicians' smoking rates during recent years.On the other hand,physicians in some developed countries and newly-developing regions still appear to be smoking at high rates.The lowest smoking prevalence rate were consistently documented in the United States,Australia and the United Kingdom.ConclusionOverall,this review suggests that while physicians' smoking habits appear to vary from region to region,they are not uniformly low when viewed from an international perspective.It is important that smoking in the medical profession declines in future years,so that physicians can remain at the forefront of anti-smoking programs and lead the way as public health exemplars in the 21st century.