烟草使用混乱和处理：新的挑战和机遇
2018/01/19
摘要
烟草使用仍是全球性问题，随着电子烟和其他尼古丁和烟草制品的不断增多，烟民们的选择也日益增加，例如：“热而不燃”烟草和可溶性烟草。而这些新鲜事物的出现于公共健康和临床诊治选择并驾齐驱，包括移动医疗和社交媒体。在基础有精神疾病的人群中烟草使用混乱频率高发，而这一现象也引发全球关注，包括个体化治疗和统一组织管理。但药物联合行为治疗以及社会干预可以获得最佳疗效。在精神治疗场所谈及烟草问题需要一定训练和技术支持以移除陈旧的文化束缚。而在宣教尼古丁替代治疗的正确使用上依然成果有限，戒烟如何改变血液中相关药物和咖啡因的浓度计如何将戒断和移动技术相结合也进步不明显。需要进一步创新地将药物基因学和新型个人、家庭和社会融合技术进行开发。
Tobacco use disorder and treatment: new challenges and opportunities.
Dialogues Clin Neurosci. 2017 Sep;19(3):271-280.
Ziedonis D, Das S, Larkin C.
Abstract
Tobacco use remains a global problem, and options for consumers have increased with the development and marketing of e-cigarettes and other new nicotine and tobacco products, such as "heat-not-burn" tobacco and dissolvable tobacco. The increased access to these new products is juxtaposed with expanding public health and clinical intervention options, including mobile technologies and social media. The persistent high rate of tobacco-use disorders among those with psychiatric disorders has gathered increased global attention, including successful approaches to individual treatment and organizational-level interventions. Best outcomes occur when medications are integrated with behavioral therapies and community-based interventions. Addressing tobacco in mental health settings requires training and technical assistance to remove old cultural barriers that restricted interventions. There is still "low-hanging fruit" to be gained in educating on the proper use of nicotine replacement medications, how smoking cessation can change blood levels of specific medications and caffeine, and how to connect with quitlines and mobile technology options. Future innovations are likely to be related to pharmacogenomics and new technologies that are human-, home-, and community-facing.
烟草使用仍是全球性问题，随着电子烟和其他尼古丁和烟草制品的不断增多，烟民们的选择也日益增加，例如：“热而不燃”烟草和可溶性烟草。而这些新鲜事物的出现于公共健康和临床诊治选择并驾齐驱，包括移动医疗和社交媒体。在基础有精神疾病的人群中烟草使用混乱频率高发，而这一现象也引发全球关注，包括个体化治疗和统一组织管理。但药物联合行为治疗以及社会干预可以获得最佳疗效。在精神治疗场所谈及烟草问题需要一定训练和技术支持以移除陈旧的文化束缚。而在宣教尼古丁替代治疗的正确使用上依然成果有限，戒烟如何改变血液中相关药物和咖啡因的浓度计如何将戒断和移动技术相结合也进步不明显。需要进一步创新地将药物基因学和新型个人、家庭和社会融合技术进行开发。
（上海交通大学医学院附属瑞金医院呼吸与危重症医学科 周剑平 万欢英 摘译）
（Dialogues Clin Neurosci. 2017 Sep;19(3):271-280.）
（Dialogues Clin Neurosci. 2017 Sep;19(3):271-280.）
Tobacco use disorder and treatment: new challenges and opportunities.
Dialogues Clin Neurosci. 2017 Sep;19(3):271-280.
Ziedonis D, Das S, Larkin C.
Abstract
Tobacco use remains a global problem, and options for consumers have increased with the development and marketing of e-cigarettes and other new nicotine and tobacco products, such as "heat-not-burn" tobacco and dissolvable tobacco. The increased access to these new products is juxtaposed with expanding public health and clinical intervention options, including mobile technologies and social media. The persistent high rate of tobacco-use disorders among those with psychiatric disorders has gathered increased global attention, including successful approaches to individual treatment and organizational-level interventions. Best outcomes occur when medications are integrated with behavioral therapies and community-based interventions. Addressing tobacco in mental health settings requires training and technical assistance to remove old cultural barriers that restricted interventions. There is still "low-hanging fruit" to be gained in educating on the proper use of nicotine replacement medications, how smoking cessation can change blood levels of specific medications and caffeine, and how to connect with quitlines and mobile technology options. Future innovations are likely to be related to pharmacogenomics and new technologies that are human-, home-, and community-facing.
