Tabakentwöhnung – wirksam und kosteneffektiv

Was ist neu?

Tabakentwöhnung in der Klinik – OPS 9–501 Tabakentwöhnung Im Krankenhaus kann durch Gespräche, pharmakologische Hilfen und vor allem eine Weiterbetreuung in ambulanten Strukturen eine effektive Entwöhnung organisiert werden. Medizinische Fachgesellschaften bemühen sich um eine adäquate Finanzierung im DRG-System.

Pharmakologische Unterstützung Eine pharmakologische Unterstützung auch mit Vareniclin ist effektiv und sicher.

Goldstandard: Gespräche plus Pharmakotherapie Gespräche plus Pharmakotherapie sind wirksamer als jede Therapie für sich allein.

Tabakentwöhnung bei manifesten Erkrankungen Für die wesentlichen tabakassoziierten Erkrankungen wie die koronare Herzerkrankung oder die chronisch-obstruktive Lungenerkrankung sind positive Effekte auf Morbidität und Mortalität durch hochwertige Metaanalysen abgesichert.

Schwere Verläufe von COVID-19 bei Rauchern Rauchen ist ein erheblicher Risikofaktor für eine Coronavirus-Infektion und einen schweren Krankheitsverlauf.

E-Zigarette zur Tabakentwöhnung? Die Daten zu toxischen Langzeitfolgen wie zur langfristigen Effektivität der E-Zigaretten in der Tabakentwöhnung sind noch unklar. Dual use ist häufig. Die E-Zigarette kann daher weiterhin nicht zur Tabakentwöhnung empfohlen werden.

Abstract

In hospital, effective smoking cessation can be organized through counselling, pharmacological aids and, above all, continuous care in outpatient structures following discharge. Pharmacological treatment has proven to be effective and safe with nicotine replacement therapy as well as varenicline. Counselling plus pharmacotherapy is more effective in combination than either therapy is on its own. To better implement structures medical societies in Germany are seeking adequate funding e. g. in the DRG system for hospitalised patients.

There are obvious and relevant benefits in smoking cessation. Not only for the main tobacco-related diseases such as coronary heart disease or chronic obstructive pulmonary disease (COPD), positive effects of quitting on morbidity and mortality have been confirmed by high-quality meta-analyses. Furthermore, quality of life is increasing following cessation. Presently, smoking is found to be a significant risk factor for severe disease and mortality following coronavirus infection.

Do e-cigarettes offer an alternative in smoking cessation? No. Animal and human data are suggesting toxic effects especially following longer use. The long-term effectiveness of e-cigarettes in tobacco cessation is still uncertain and epidemiologic data clearly point toward ineffectiveness. Furthermore, dual use with potentiation of the toxic effects is common. Therefore, e-cigarettes cannot be recommended for tobacco cessation.

Schlüsselwörter

Tabakentwöhnung - Krankenhaus - Pharmakotherapie - E-Zigaretten - COVID-19

Key words

smoking cessation - hospitalised patients - pharmacotherapy - E-cigarettes - COVID-19

Publikationsverlauf

Artikel online veröffentlicht:
01. Juni 2021

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