Skip to main content

09.04.2024 | Rauchen und Raucherentwöhnung | CME Zertifizierte Fortbildung

Tabakentwöhnung – eine der effektivsten medizinischen Maßnahmen

verfasst von: PD Dr. med. Matthias Raspe, M.Sc., Kevin Lo, Natascha Sommer, Stefan Andreas

Erschienen in: Zeitschrift für Pneumologie

Einloggen, um Zugang zu erhalten

Zusammenfassung

Tabakrauchen ist in Deutschland weitverbreitet. Sorge bereitet zuletzt ein Anstieg rauchender Jugendlicher und junger Erwachsener. Der hohen Prävalenz stehen die im internationalen Vergleich unzureichenden präventiven Maßnahmen in Deutschland konträr gegenüber. Das Rauchverhalten sollte analog einem Vitalzeichen immer erfragt und dokumentiert werden. Bei allen Rauchenden sollte unabhängig von Kontaktanlass und Motivation eine niedrigschwellige Kurzberatung erfolgen, beispielsweise nach dem ABC-Ansatz („ask, brief advice, cessation“). Für den Erfolg einer Entwöhnung ist neben wiederholten Gesprächen und der Vermittlung an weiterführende Angebote der Einsatz einer Nikotinersatztherapie bzw. medikamentösen Behandlung essenziell. Die Kombination von lang und kurz wirksamen Nikotinersatzpräparaten verdoppelt die Erfolgsrate. Elektronische Nikotininhalationssysteme werden für die Tabakentwöhnung nicht empfohlen.
Literatur
1.
Zurück zum Zitat Kurz C, Osterloh F (2023) Vorbeugen statt Heilen. DÄB 120:B249–B254 Kurz C, Osterloh F (2023) Vorbeugen statt Heilen. DÄB 120:B249–B254
2.
Zurück zum Zitat Assunta M (2021) Global Tobacco Industry Interference Index 2021. Global Center for Good Governance in Tobacco Control. GGTC, Bangkok, Thailand Assunta M (2021) Global Tobacco Industry Interference Index 2021. Global Center for Good Governance in Tobacco Control. GGTC, Bangkok, Thailand
3.
Zurück zum Zitat Joossens L, Feliu A, Fernandez E (2022) The Tobacco Control Scale 2019 in Europe. Association of European Cancer Leagues CIoO Joossens L, Feliu A, Fernandez E (2022) The Tobacco Control Scale 2019 in Europe. Association of European Cancer Leagues CIoO
5.
Zurück zum Zitat Hanewinkel R, Hansen J (2023) Use of tobacco cigarettes, e‑cigarettes, and shishas among children and adolescents: Results of the ‘Praventionsradar’ from 2016 to 2023. Pneumologie Hanewinkel R, Hansen J (2023) Use of tobacco cigarettes, e‑cigarettes, and shishas among children and adolescents: Results of the ‘Praventionsradar’ from 2016 to 2023. Pneumologie
6.
Zurück zum Zitat Batra A, Kiefer F, Kopp I et al (2021) S3-Leitlinie Rauchen und Tabakabhängigkeit: Screening, Diagnostik und Behandlung. 076-006 Batra A, Kiefer F, Kopp I et al (2021) S3-Leitlinie Rauchen und Tabakabhängigkeit: Screening, Diagnostik und Behandlung. 076-006
7.
Zurück zum Zitat Hartmann-Boyce J, Lindson N, Butler AR et al (2022) Electronic cigarettes for smoking cessation. Cochrane Database Syst Rev 11:CD10216PubMed Hartmann-Boyce J, Lindson N, Butler AR et al (2022) Electronic cigarettes for smoking cessation. Cochrane Database Syst Rev 11:CD10216PubMed
8.
Zurück zum Zitat Hughes JR, Keely J, Naud S (2004) Shape of the relapse curve and long-term abstinence among untreated smokers. Addiction 99:29–38PubMedCrossRef Hughes JR, Keely J, Naud S (2004) Shape of the relapse curve and long-term abstinence among untreated smokers. Addiction 99:29–38PubMedCrossRef
9.
Zurück zum Zitat Kotz D, Batra A, Kastaun S (2020) Smoking Cessation Attempts and Common Strategies Employed. Dtsch Ärztebl Int 117:7–13PubMedPubMedCentral Kotz D, Batra A, Kastaun S (2020) Smoking Cessation Attempts and Common Strategies Employed. Dtsch Ärztebl Int 117:7–13PubMedPubMedCentral
10.
Zurück zum Zitat Mühlig SFL, Winkler D, Vorbeck M, Mackert J, Bickhardt J, Heindl T (2017) Zwischenergebnisse der ATEMM-Studie der AOKplus zur vollfinanzierten Tabakentwöhnung bei COPD-Patienten. Pneumologie 71(S 01):S1–S125 Mühlig SFL, Winkler D, Vorbeck M, Mackert J, Bickhardt J, Heindl T (2017) Zwischenergebnisse der ATEMM-Studie der AOKplus zur vollfinanzierten Tabakentwöhnung bei COPD-Patienten. Pneumologie 71(S 01):S1–S125
11.
Zurück zum Zitat Khadjesari Z, Brown TJ, Ramsey AT et al (2022) Novel Implementation Strategy to Electronically Screen and Signpost Patients to Health Behavior Apps: Mixed Methods Implementation Study (OptiMine Study). JMIR Form Res 6:e34271PubMedPubMedCentralCrossRef Khadjesari Z, Brown TJ, Ramsey AT et al (2022) Novel Implementation Strategy to Electronically Screen and Signpost Patients to Health Behavior Apps: Mixed Methods Implementation Study (OptiMine Study). JMIR Form Res 6:e34271PubMedPubMedCentralCrossRef
12.
Zurück zum Zitat Bernstein SL, Weiss J, Dewitt M et al (2019) A randomized trial of decision support for tobacco dependence treatment in an inpatient electronic medical record: clinical results. Implement Sci 14:8PubMedPubMedCentralCrossRef Bernstein SL, Weiss J, Dewitt M et al (2019) A randomized trial of decision support for tobacco dependence treatment in an inpatient electronic medical record: clinical results. Implement Sci 14:8PubMedPubMedCentralCrossRef
13.
Zurück zum Zitat Rigotti NA, Chang Y, Davis EM et al (2022) Comparative Effectiveness of Postdischarge Smoking Cessation Interventions for Hospital Patients: The Helping HAND 4 Randomized Clinical Trial. JAMA Intern Med 182:814–824PubMedPubMedCentralCrossRef Rigotti NA, Chang Y, Davis EM et al (2022) Comparative Effectiveness of Postdischarge Smoking Cessation Interventions for Hospital Patients: The Helping HAND 4 Randomized Clinical Trial. JAMA Intern Med 182:814–824PubMedPubMedCentralCrossRef
14.
Zurück zum Zitat Mullen KA, Walker KL, Hobler LA et al (2021) Performance Obligations to Improve Delivery of Hospital-Initiated Smoking Cessation Interventions: A Before-and-After Evaluation. Nicotine Tob Res 23:77–84PubMedCrossRef Mullen KA, Walker KL, Hobler LA et al (2021) Performance Obligations to Improve Delivery of Hospital-Initiated Smoking Cessation Interventions: A Before-and-After Evaluation. Nicotine Tob Res 23:77–84PubMedCrossRef
15.
Zurück zum Zitat Stead LF, Buitrago D, Preciado N et al (2013) Physician advice for smoking cessation. Cochrane Database Syst Rev 2013:CD165PubMedPubMedCentral Stead LF, Buitrago D, Preciado N et al (2013) Physician advice for smoking cessation. Cochrane Database Syst Rev 2013:CD165PubMedPubMedCentral
16.
Zurück zum Zitat Mcrobbie H, Bullen C, Glover M et al (2008) New Zealand smoking cessation guidelines. N Z Med J 121:57–70PubMed Mcrobbie H, Bullen C, Glover M et al (2008) New Zealand smoking cessation guidelines. N Z Med J 121:57–70PubMed
17.
Zurück zum Zitat Fiore MC, Jaen CR (2008) A clinical blueprint to accelerate the elimination of tobacco use. JAMA 299:2083–2085PubMedCrossRef Fiore MC, Jaen CR (2008) A clinical blueprint to accelerate the elimination of tobacco use. JAMA 299:2083–2085PubMedCrossRef
18.
Zurück zum Zitat Cobos-Campos R, Cordero-Guevara JA, Apinaniz A et al (2023) The Impact of Digital Health on Smoking Cessation. Interact J Med Res 12:e41182PubMedPubMedCentralCrossRef Cobos-Campos R, Cordero-Guevara JA, Apinaniz A et al (2023) The Impact of Digital Health on Smoking Cessation. Interact J Med Res 12:e41182PubMedPubMedCentralCrossRef
19.
Zurück zum Zitat Rupp A, Hering T, Bubeck A et al (2023) Guideline-based digital smoking cessation with computer, tablet or smartphone. Dtsch Med Wochenschr 148:e29–e36PubMed Rupp A, Hering T, Bubeck A et al (2023) Guideline-based digital smoking cessation with computer, tablet or smartphone. Dtsch Med Wochenschr 148:e29–e36PubMed
20.
Zurück zum Zitat Lancaster T, Stead LF (2017) Individual behavioural counselling for smoking cessation. Cochrane Database Syst Rev 3:CD1292PubMed Lancaster T, Stead LF (2017) Individual behavioural counselling for smoking cessation. Cochrane Database Syst Rev 3:CD1292PubMed
21.
Zurück zum Zitat Hartmann-Boyce J, Chepkin SC, Ye W et al (2018) Nicotine replacement therapy versus control for smoking cessation. Cochrane Database Syst Rev 5:CD146PubMed Hartmann-Boyce J, Chepkin SC, Ye W et al (2018) Nicotine replacement therapy versus control for smoking cessation. Cochrane Database Syst Rev 5:CD146PubMed
22.
Zurück zum Zitat Windle SB, Filion KB, Mancini JG et al (2016) Combination Therapies for Smoking Cessation: A Hierarchical Bayesian Meta-Analysis. Am J Prev Med 51:1060–1071PubMedCrossRef Windle SB, Filion KB, Mancini JG et al (2016) Combination Therapies for Smoking Cessation: A Hierarchical Bayesian Meta-Analysis. Am J Prev Med 51:1060–1071PubMedCrossRef
23.
Zurück zum Zitat Lindson N, Theodoulou A, Ordonez-Mena JM et al (2023) Pharmacological and electronic cigarette interventions for smoking cessation in adults: component network meta-analyses. Cochrane Database Syst Rev 9:CD15226PubMed Lindson N, Theodoulou A, Ordonez-Mena JM et al (2023) Pharmacological and electronic cigarette interventions for smoking cessation in adults: component network meta-analyses. Cochrane Database Syst Rev 9:CD15226PubMed
24.
Zurück zum Zitat Theodoulou A, Chepkin SC, Ye W et al (2023) Different doses, durations and modes of delivery of nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev 6:CD13308PubMed Theodoulou A, Chepkin SC, Ye W et al (2023) Different doses, durations and modes of delivery of nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev 6:CD13308PubMed
25.
Zurück zum Zitat Livingstone-Banks J, Fanshawe TR, Thomas KH et al (2023) Nicotine receptor partial agonists for smoking cessation. Cochrane Database Syst Rev 5:CD6103PubMed Livingstone-Banks J, Fanshawe TR, Thomas KH et al (2023) Nicotine receptor partial agonists for smoking cessation. Cochrane Database Syst Rev 5:CD6103PubMed
26.
Zurück zum Zitat Jorenby DE, Hays JT, Rigotti NA et al (2006) Efficacy of varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs placebo or sustained-release bupropion for smoking cessation: a randomized controlled trial. JAMA 296:56–63PubMedCrossRef Jorenby DE, Hays JT, Rigotti NA et al (2006) Efficacy of varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs placebo or sustained-release bupropion for smoking cessation: a randomized controlled trial. JAMA 296:56–63PubMedCrossRef
27.
Zurück zum Zitat Anthenelli RM, Benowitz NL, West R et al (2016) Neuropsychiatric safety and efficacy of varenicline, bupropion, and nicotine patch in smokers with and without psychiatric disorders (EAGLES): a double-blind, randomised, placebo-controlled clinical trial. Lancet 387:2507–2520PubMedCrossRef Anthenelli RM, Benowitz NL, West R et al (2016) Neuropsychiatric safety and efficacy of varenicline, bupropion, and nicotine patch in smokers with and without psychiatric disorders (EAGLES): a double-blind, randomised, placebo-controlled clinical trial. Lancet 387:2507–2520PubMedCrossRef
28.
Zurück zum Zitat Kotz D, Viechtbauer W, Simpson C et al (2015) Cardiovascular and neuropsychiatric risks of varenicline: a retrospective cohort study. Lancet Respir Med 3:761–768PubMedPubMedCentralCrossRef Kotz D, Viechtbauer W, Simpson C et al (2015) Cardiovascular and neuropsychiatric risks of varenicline: a retrospective cohort study. Lancet Respir Med 3:761–768PubMedPubMedCentralCrossRef
29.
Zurück zum Zitat Howes S, Hartmann-Boyce J, Livingstone-Banks J et al (2020) Antidepressants for smoking cessation. Cochrane Database Syst Rev 4:CD31PubMed Howes S, Hartmann-Boyce J, Livingstone-Banks J et al (2020) Antidepressants for smoking cessation. Cochrane Database Syst Rev 4:CD31PubMed
30.
Zurück zum Zitat Hajizadeh A, Howes S, Theodoulou A et al (2023) Antidepressants for smoking cessation. Cochrane Database Syst Rev 5:CD31PubMed Hajizadeh A, Howes S, Theodoulou A et al (2023) Antidepressants for smoking cessation. Cochrane Database Syst Rev 5:CD31PubMed
31.
Zurück zum Zitat Stead LF, Koilpillai P, Fanshawe TR et al (2016) Combined pharmacotherapy and behavioural interventions for smoking cessation. Cochrane Database Syst Rev 3:CD8286PubMed Stead LF, Koilpillai P, Fanshawe TR et al (2016) Combined pharmacotherapy and behavioural interventions for smoking cessation. Cochrane Database Syst Rev 3:CD8286PubMed
32.
Zurück zum Zitat Nvl-003 A-R‑N (2021) Nationale Versorgungsleitlinie COPD Nvl-003 A-R‑N (2021) Nationale Versorgungsleitlinie COPD
34.
Zurück zum Zitat Raspe M, Bals R, Bolukbas S et al (2023) Smoking cessation in hospitalised patients—Initiate among inpatients, continue when outpatients—A Position Paper by the German Respiratory Society (DGP) Taskforce for Smoking Cessation. Pneumologie 77:341–349PubMed Raspe M, Bals R, Bolukbas S et al (2023) Smoking cessation in hospitalised patients—Initiate among inpatients, continue when outpatients—A Position Paper by the German Respiratory Society (DGP) Taskforce for Smoking Cessation. Pneumologie 77:341–349PubMed
35.
Zurück zum Zitat Van Westen-Lagerweij NA, Hipple Walters BJ, Potyka F et al (2023) Proactive Referral to Behavioral Smoking Cessation Programs by Healthcare Staff: A Systematic Review. Nicotine Tob Res 25:849–858PubMedCrossRef Van Westen-Lagerweij NA, Hipple Walters BJ, Potyka F et al (2023) Proactive Referral to Behavioral Smoking Cessation Programs by Healthcare Staff: A Systematic Review. Nicotine Tob Res 25:849–858PubMedCrossRef
36.
Zurück zum Zitat Andreas S, Kotz D, Batra A et al (2023) Smoking Cessation in Patients with COPD. Pneumologie 77:206–219PubMed Andreas S, Kotz D, Batra A et al (2023) Smoking Cessation in Patients with COPD. Pneumologie 77:206–219PubMed
37.
Zurück zum Zitat General S (2020) Smoking Cessation: A Report of the Surgeon General. Services UDoHaH, Washington (DC) General S (2020) Smoking Cessation: A Report of the Surgeon General. Services UDoHaH, Washington (DC)
38.
Zurück zum Zitat Andreas S, Rittmeyer A, Hinterthaner M et al (2013) Smoking Cessation in Lung Cancer-Achievable and Effective. Dtsch Ärztebl Int 110:719–724PubMedPubMedCentral Andreas S, Rittmeyer A, Hinterthaner M et al (2013) Smoking Cessation in Lung Cancer-Achievable and Effective. Dtsch Ärztebl Int 110:719–724PubMedPubMedCentral
39.
Zurück zum Zitat Caini S, Del Riccio M, Vettori V et al (2022) Quitting Smoking At or Around Diagnosis Improves the Overall Survival of Lung Cancer Patients: A Systematic Review and Meta-Analysis. J Thorac Oncol 17:623–636PubMedCrossRef Caini S, Del Riccio M, Vettori V et al (2022) Quitting Smoking At or Around Diagnosis Improves the Overall Survival of Lung Cancer Patients: A Systematic Review and Meta-Analysis. J Thorac Oncol 17:623–636PubMedCrossRef
40.
Zurück zum Zitat Reinhardt C, Harden M, Herrmann-Lingen C et al (2022) Smoking cessation by combined medication and counselling: a feasibility study in lung cancer patients. BMC Pulm Med 22:252PubMedPubMedCentralCrossRef Reinhardt C, Harden M, Herrmann-Lingen C et al (2022) Smoking cessation by combined medication and counselling: a feasibility study in lung cancer patients. BMC Pulm Med 22:252PubMedPubMedCentralCrossRef
41.
Zurück zum Zitat Park ER, Perez GK, Regan S et al (2020) Effect of Sustained Smoking Cessation Counseling and Provision of Medication vs Shorter-term Counseling and Medication Advice on Smoking Abstinence in Patients Recently Diagnosed With Cancer: A Randomized Clinical Trial. JAMA 324:1406–1418PubMedPubMedCentralCrossRef Park ER, Perez GK, Regan S et al (2020) Effect of Sustained Smoking Cessation Counseling and Provision of Medication vs Shorter-term Counseling and Medication Advice on Smoking Abstinence in Patients Recently Diagnosed With Cancer: A Randomized Clinical Trial. JAMA 324:1406–1418PubMedPubMedCentralCrossRef
42.
Zurück zum Zitat Deutsche Gesellschaft Fur Pneumologie Und Beatmungsmedizin in Zusammenarbeit Mit Medizinischen Fachgesellschaften Und Organisationen: Deutsche Gesellschaft Fur Innere M, Deutsche Gesellschaft Fur Kardiologie – Herz- Und K, Deutsche Gesellschaft Fur Angiologie – Gesellschaft Fur G et al (2022) German Respiratory Society Position Statement: Recommondations for handling electronic cigarettes (e-cigarettes). Pneumologie 76:473–478 Deutsche Gesellschaft Fur Pneumologie Und Beatmungsmedizin in Zusammenarbeit Mit Medizinischen Fachgesellschaften Und Organisationen: Deutsche Gesellschaft Fur Innere M, Deutsche Gesellschaft Fur Kardiologie – Herz- Und K, Deutsche Gesellschaft Fur Angiologie – Gesellschaft Fur G et al (2022) German Respiratory Society Position Statement: Recommondations for handling electronic cigarettes (e-cigarettes). Pneumologie 76:473–478
43.
Zurück zum Zitat Pisinger C, Dagli E, Filippidis FT et al (2019) ERS and tobacco harm reduction. Eur Respir J 54: Pisinger C, Dagli E, Filippidis FT et al (2019) ERS and tobacco harm reduction. Eur Respir J 54:
44.
45.
Zurück zum Zitat Wills TA, Soneji SS, Choi K et al (2021) E‑cigarette use and respiratory disorders: an integrative review of converging evidence from epidemiological and laboratory studies. Eur Respir J 57: Wills TA, Soneji SS, Choi K et al (2021) E‑cigarette use and respiratory disorders: an integrative review of converging evidence from epidemiological and laboratory studies. Eur Respir J 57:
46.
Zurück zum Zitat Bhatta DN, Glantz SA (2020) Association of E‑Cigarette Use With Respiratory Disease Among Adults: A Longitudinal Analysis. Am J Prev Med 58:182–190PubMedCrossRef Bhatta DN, Glantz SA (2020) Association of E‑Cigarette Use With Respiratory Disease Among Adults: A Longitudinal Analysis. Am J Prev Med 58:182–190PubMedCrossRef
47.
Zurück zum Zitat Osei AD, Mirbolouk M, Orimoloye OA et al (2020) Association Between E‑Cigarette Use and Chronic Obstructive Pulmonary Disease by Smoking Status: Behavioral Risk Factor Surveillance System 2016 and 2017. Am J Prev Med 58:336–342PubMedPubMedCentralCrossRef Osei AD, Mirbolouk M, Orimoloye OA et al (2020) Association Between E‑Cigarette Use and Chronic Obstructive Pulmonary Disease by Smoking Status: Behavioral Risk Factor Surveillance System 2016 and 2017. Am J Prev Med 58:336–342PubMedPubMedCentralCrossRef
48.
Zurück zum Zitat Bullen C, Howe C, Laugesen M et al (2013) Electronic cigarettes for smoking cessation: a randomised controlled trial. Lancet 382:1629–1637PubMedCrossRef Bullen C, Howe C, Laugesen M et al (2013) Electronic cigarettes for smoking cessation: a randomised controlled trial. Lancet 382:1629–1637PubMedCrossRef
49.
Zurück zum Zitat Oelsner EC, Balte PP, Bhatt SP et al (2020) Lung function decline in former smokers and low-intensity current smokers: a secondary data analysis of the NHLBI Pooled Cohorts Study. Lancet Respir Med 8:34–44PubMedCrossRef Oelsner EC, Balte PP, Bhatt SP et al (2020) Lung function decline in former smokers and low-intensity current smokers: a secondary data analysis of the NHLBI Pooled Cohorts Study. Lancet Respir Med 8:34–44PubMedCrossRef
50.
Zurück zum Zitat Simmons MS, Connett JE, Nides MA et al (2005) Smoking reduction and the rate of decline in FEV(1): results from the Lung Health Study. Eur Respir J 25:1011–1017PubMedCrossRef Simmons MS, Connett JE, Nides MA et al (2005) Smoking reduction and the rate of decline in FEV(1): results from the Lung Health Study. Eur Respir J 25:1011–1017PubMedCrossRef
51.
Zurück zum Zitat Banks E, Yazidjoglou A, Brown S et al (2023) Electronic cigarettes and health outcomes: umbrella and systematic review of the global evidence. Med J Aust 218:267–275PubMedPubMedCentralCrossRef Banks E, Yazidjoglou A, Brown S et al (2023) Electronic cigarettes and health outcomes: umbrella and systematic review of the global evidence. Med J Aust 218:267–275PubMedPubMedCentralCrossRef
52.
Zurück zum Zitat Van Den Brand FA, Nagelhout GE, Reda AA et al (2017) Healthcare financing systems for increasing the use of tobacco dependence treatment. Cochrane Database Syst Rev 9:CD4305PubMed Van Den Brand FA, Nagelhout GE, Reda AA et al (2017) Healthcare financing systems for increasing the use of tobacco dependence treatment. Cochrane Database Syst Rev 9:CD4305PubMed
Metadaten
Titel
Tabakentwöhnung – eine der effektivsten medizinischen Maßnahmen
verfasst von
PD Dr. med. Matthias Raspe, M.Sc.
Kevin Lo
Natascha Sommer
Stefan Andreas
Publikationsdatum
09.04.2024
Verlag
Springer Medizin
Erschienen in
Zeitschrift für Pneumologie
Print ISSN: 2731-7404
Elektronische ISSN: 2731-7412
DOI
https://doi.org/10.1007/s10405-024-00555-y