Update on the evidence to support deprescribing, a presentation by David Erskine, Director – London & South East Medicine Information Service (July 2017).
Poster: Psychotropic Medications in Eating DisordersDavid Garner
Poster Presentation at the Association for Psychological Science. Psychotropic Medications in Adult and Adolescent Eating Disorders: Clinical Practice Versus Evidence-Based Recommendations., May 29, 2016, Chicago, Illinois.
Update on the evidence to support deprescribing, a presentation by David Erskine, Director – London & South East Medicine Information Service (July 2017).
Poster: Psychotropic Medications in Eating DisordersDavid Garner
Poster Presentation at the Association for Psychological Science. Psychotropic Medications in Adult and Adolescent Eating Disorders: Clinical Practice Versus Evidence-Based Recommendations., May 29, 2016, Chicago, Illinois.
OMICS Publishing Group, Journal of Clinical Pharmacology & Biopharmaceutics (CPB) emphasizes the phases of drug development from absorption, disposition, metabolism, excretion interactions and rational design of drug products to deliver the drug at a specific rate to the body in order to optimize the therapeutic effect and minimize any adverse effects. The CPB acts as an interface between academics, those in research and developments, explicates the research on various developmental applications for contemporary drug development and utilization.
Comparative evaluation of 2g single dose versus conventional dose azithromycin in uncomplicated skin and skin structure infections. Indian Journal Of Pharmacology. August 2015;Vol. 47; Issue 4
Cochrane reviews: Summarising the best evidence to inform healthcare decisionsCochraneTAG
Talk given at the UKCTAS early career researcher conference Sept 2015 by Jamie Hartmann-Boyce & Nicola Lindson-Hawley of Cochrane Tobacco Addiciton Group
Behavioral Counseling and Pharmacotherapy Interventions for Tobacco Cessation in Adults, Including Pregnant Women: A Systematic Review for the U.S. Preventive Services Task Force
OMICS Publishing Group, Journal of Clinical Pharmacology & Biopharmaceutics (CPB) emphasizes the phases of drug development from absorption, disposition, metabolism, excretion interactions and rational design of drug products to deliver the drug at a specific rate to the body in order to optimize the therapeutic effect and minimize any adverse effects. The CPB acts as an interface between academics, those in research and developments, explicates the research on various developmental applications for contemporary drug development and utilization.
Comparative evaluation of 2g single dose versus conventional dose azithromycin in uncomplicated skin and skin structure infections. Indian Journal Of Pharmacology. August 2015;Vol. 47; Issue 4
Cochrane reviews: Summarising the best evidence to inform healthcare decisionsCochraneTAG
Talk given at the UKCTAS early career researcher conference Sept 2015 by Jamie Hartmann-Boyce & Nicola Lindson-Hawley of Cochrane Tobacco Addiciton Group
Behavioral Counseling and Pharmacotherapy Interventions for Tobacco Cessation in Adults, Including Pregnant Women: A Systematic Review for the U.S. Preventive Services Task Force
Observations about controlled clinical trials expressed by Max Haidvogl
in the book Ultra High Dilution (1994) have been appraised from a perspective two
decades later. The present commentary briefly examines changes in homeopathy
research evidence since 1994 as regards: the published number of randomised controlled
trials (RCTs), the use of individualised homeopathic intervention, the ‘proven efficacy of
homeopathy’, and the quality of the evidence.
Running head ROUGH DRAFT QUANTITATIVE RESEARCH CRITIQUE AND ETHIC.docxtodd521
Running head: ROUGH DRAFT QUANTITATIVE RESEARCH CRITIQUE AND ETHICAL CONSIDERATIOS 1
Running head: ROUGH DRAFT QUANTITATIVE RESEARCH CRITIQUE AND ETHICAL
CONSIDERATIOS 6
Rough Draft Quantitative Research Critique and Ethical Considerations
RINU GEORGE
Grand Canyon University
NRS-433V-0500
03/22/2020
Title of Paper Comment by ESC: Missing title
PICOT Question: In cigarette smokers whose ages are more than 17 years (P), does nicotine substitution treatment (I), as opposed to utilizing other smoking discontinuation treatments (C) influence smoking end results (O) over a time of a quarter of a year (T)?
Background
There are numerous quantitative studies relating to the topic of nicotine substitution treatment as a therapy for smoking. Two examples of such studies are High-Risk Smoking Behavior and Barriers to Smoking Cessation Among Homeless Individuals by Chen, Nguyen, Malesker, and Morrow (2016), and Effect of Nicotine Replacement Therapy on Quitting by Young Adults in a trial Comparison Cessation services by Buller et al., (2014). Noting the high major challenge in ending nicotine smoking is an addiction, the researchers in these two studies aim to understand how this bottleneck can be addressed. In the first research, the authors note the high risk of smoking among homeless persons, hence a need to study the factors that elevate smoking behaviors and bar smoking cessation among these individuals. In the second study, the researcher notes how despite the high number of young adult smokers, they rarely use or seek medication for smoking, hence evaluate how effective nicotine replacement therapy is effective in ending smoking among this population. Comment by ESC: Incomplete, review grading rubric criteria
How the Articles Support the Nursing Issue
These two articles play contribute to the intervention in the PICOT statement. In the first article, the authors note that one of the most preferred intervention methods by the population of the study is nicotine replacement treatment (NRT), which is similar to the nicotine substitution therapy (NST). It also provides statistics of high stress and the use of smoking to elevate stress and anxiety, hence suggesting why NST may be effective in helping to curbing smoking. While the study population is different to the one stated in the PICOT statement, it is general, representing the homeless individuals who are at high risk of nicotine addiction, hence may include even the individuals above the age of 17 years who are smokers (Chen, Nguyen, Malesker & Morrow, 2016).
In the second article, it offers quantitative evidence of how effective NRT intervention is, in helping to smoke quitting among young adults. This helps in answering the PICOT .
Effects of yogic practices on polypharmacy Dr. Balaji P.A Dr. smitha r varne.pdfDrBalaji8
The occurrence and concurrency of Noncommunicable chronic diseases increase
with age, and therefore, the number of medications used increases
correspondingly. Polypharmacy is a scenario in which five medications or more
are consumed concurrently (regardless of dose and duration of consumption),
which leads to reduced quality of life, physical problems, increased drug
interactions, adverse effects, and medical complications and increases the cost
of treatment. Moreover, polypharmacy increases the incidence of falls, frequency
of hospital admission, length of stay, and the death rate among patients, especially
in the elderly population. This would allow therapies like Yoga, pranayama,
and meditation to act as an effective mainstay or adjunctive or alternative therapy
for many disorders, as it can be cost-effective, patient-compliant, and clinically
efficacious with the most negligible side effects. However, very few studies
have focused on the impact of yogic practices on reducing drug dosage or
polypharmacy among patients. Hence, a Medline English literature search was
planned to review all the studies demonstrating a dose-response effect between
yogic practices and the number/dosage of medication reduction in different
disorders. Data extracted and analyzed depicted that the practice of Yoga,
pranayama, and meditation can result not only in reducing the number of
medications but also the dosages in hypertension, type 2 diabetes mellitus,
bronchial asthma, arthritis, sleep disorders, obsessive-compulsive disorder
(OCD), gastrointestinal disorders like constipation and irritable bowel syndrome
Comparison of registered and published intervention fidelity assessment in cl...valéry ridde
A methodologically oriented systematic review was conducted to study current practices concerning the assessment of intervention fidelity in CRTs of public health interventions conducted in LMICs.
Systematic reviews of complementary therapies – an annotated bibliography. Pa...home
Complementary therapies are widespread but controversial. We aim to provide a
comprehensive collection and a summary of systematic reviews of clinical trials in three major
complementary therapies (acupuncture, herbal medicine, homeopathy). This article is dealing with
homeopathy. Potentially relevant reviews were searched through the register of the Cochrane
Complementary Medicine Field, the Cochrane Library, Medline, and bibliographies of articles and
books. To be included articles had to review prospective clinical trials of homeopathy; had to
describe review methods explicitly; had to be published; and had to focus on treatment effects.
Information on conditions, interventions, methods, results and conclusions was extracted using a
pretested form and summarized descriptively.
Systematic reviews of complementary therapies – an annotated bibliography. Pa...home
Complementary therapies are widespread but controversial. We aim to provide a
comprehensive collection and a summary of systematic reviews of clinical trials in three major
complementary therapies (acupuncture, herbal medicine, homeopathy). This article is dealing with
homeopathy. Potentially relevant reviews were searched through the register of the Cochrane
Complementary Medicine Field, the Cochrane Library, Medline, and bibliographies of articles and
books. To be included articles had to review prospective clinical trials of homeopathy; had to
describe review methods explicitly; had to be published; and had to focus on treatment effects.
Information on conditions, interventions, methods, results and conclusions was extracted using a
pretested form and summarized descriptively.
Similar to EVIDENCE SUMMARY Rapid Review of Non-NHS Treatments for Smoking Cessation (20)
2006 a space oddity – the great pluto debate science _ the guardianGeorgi Daskalov
Long known as the ninth planet, Pluto was downgraded in 2006, sparking a scientific spat that raises basic questions about how we understand the universe
Getting cytisine licensed for use world-wide: a call to actionGeorgi Daskalov
Most tobacco users live in low and middle income countries where stop smoking medicines are unavailable or unaffordable. There is an urgent need for action by key stakeholders to get cytisine licensed worldwide so that its life-saving potential can be realised.
Evaluation of the efficacy and safety of tribulus terrestris in male sexual d...Georgi Daskalov
Evaluation of the efficacy and safety of tribulus terrestris in male sexual dysfunction – a prospective, randomized, double blinded, placebo controlled clinical trial 2015 poster
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
EVIDENCE SUMMARY Rapid Review of Non-NHS Treatments for Smoking Cessation
1. Evidence Summary Non-NHS Smoking Cessation Treatments 1
EVIDENCE SUMMARY
Rapid Review of Non-NHS Treatments for Smoking Cessation
Background
The NHS stop smoking service (SSS), which provides evidence based treatment for
smokers who seek help, is achieving long-term abstinence rates of approximately
15%. There are many commercial smoking cessation treatments available outside
SSS that quote success rates many times higher. There are also numerous
treatments not yet fully established which may hold promise.
This review assesses the current evidence for the effectiveness of nine smoking
cessation interventions that are not provided by the NHS: acupuncture, Allen Carr’s
Easyway, hypnosis, NicoBloc, Nicobrevin, St. Johns Wort, aversive smoking,
cytisine, and glucose.
The National Institute for Health and Clinical Excellence (NICE) has been asked to
produce public health programme guidance on the optimal provision of smoking
cessation services to all smokers, but in particular to specific population groups
(manual working groups, pregnant smokers and hard to reach communities). The
present review of the evidence of the effectiveness of non-NHS treatments for
smoking cessation is a part of this project.
Objective
• The objective of the evidence review is to assess the available evidence for
the effectiveness of nine smoking cessation interventions not currently used
within the NHS SSS.
Methods
Selection Criteria
Treatments were included based on awareness among the reviewers of the
existence of reviewable literature, and their knowledge of the literature. The three
best known and most widely advertised treatment approaches commercially available
within the UK (hypnosis, acupuncture, and Allen Carr’s Easy Way) were included.
Commercial medications and devices where there is at least some published
research available on their effects (NicoBloc, Nicobrevin, and St. John's Wort) were
included, as were pharmacological treatments not commercially disseminated in the
UK but considered promising (cytisine and glucose) and the behavioural treatment
with the largest volume of controlled trials which also has some evidence of efficacy
(rapid smoking).
Data sources
The searchable databases included Cochrane Database of Systematic Reviews,
Cochrane Controlled Trials Register (CENTRAL), DARE, ASSIA, AMED, British
Nursing Index, Embase, Cinahl, PsycINFO, Sociological Abstracts, and Controlled
Clinical Trials. Google Scholar was also used where there was paucity of data from
these sources. Unpublished data were also considered. Where limited evidence was
available the search limits were removed to include all literature contained in the
2. Evidence Summary Non-NHS Smoking Cessation Treatments 2
databases that were searched. The evidence base for this review was sourced from
reviews and trials published between 1990 and 2005.
Data extraction and quality assessment
The titles and abstracts of papers identified from the literature search were screened
by one reviewer to screen out papers that had no relevance to the review. The
selected papers were then independently assessed for inclusion by two other
reviewers (except for Nicobrevin and NicoBloc where only one reviewer made the
assessment). No discrepancies in identifying relevant papers occurred between the
reviewers.
Reviews were excluded if they were not conducted systematically. Where there was
uncertainty the full paper was obtained and its inclusion resolved by discussion. Full
papers were also obtained where there was no abstract and the relevance could not
be assessed by the title alone Trials were excluded if they did not report the results of
a randomised trial unless only non-randomised controlled trials were available, in
which case these are described but not included in meta-analysis. Trials included in
relevant reviews were not reassessed. Other relevant publications were considered
where no controlled trials were available.
Studies were evaluated by assessing the methods used in relation to the research
question(s) being addressed. They were assessed for their methodological rigour
and quality against a number of criteria using the critical appraisal checklists provided
by NICE (Appendix B of the Public Health Guidance. Methods Manual – version 1).
A critical appraisal form was completed for each review and trial. Data were extracted
using a standardised data extraction sheet. Data were extracted about the
intervention/programme’s: aim, objectives, setting, target population, intervention,
content, method and duration.
The completed critical appraisal and data extraction forms were used to produce
evidence tables.
Research questions
1. What is the aim of the treatment?
2. What is the content of the treatment?
3. Does the treatment have any effect on at least six months continuous
abstinence?
If there was an effect on abstinence:
4. What is the estimated cost of the treatment?
5. How does the structure and content of the treatment/ intervention influence
effectiveness?
6. Does effectiveness vary with site/setting or intensity/ duration of the
intervention?
7. What are the views of those receiving and delivering the intervention?
8. Is there evidence of unintended or harmful effects?
9. Are there barriers to replication of effective interventions?
3. Evidence Summary Non-NHS Smoking Cessation Treatments 3
Results
Evidence Statement 1
A body of level 1+ evidence from meta-analyses of randomised controlled trials
suggests that acupuncture, acupressure, laser therapy and electrostimulation do not
improve long-term abstinence rates over that of a placebo effect. (White, A. R., H.
Rampes, et al. (2006); Docherty, G., D. Gordon, et al. (2003))
Evidence Statement 2
There are no controlled data available on the efficacy of Allen Carr’s Easyway
Programme.
Evidence Statement 3
A body of level 1+ evidence from a meta-analysis of randomised controlled trials
suggests that hypnotherapy does not improve long-term continuous abstinence rates
over that of attention control. A body of level 1- evidence suggests that hypnotherapy
may be more effective than no treatment. (Abbot, N. C., L. F. Stead, et al. (2006);
Carmody, T., C. Duncan, et al. (2006); Tindel, H., N. Rigotti, et al. (2006); Casmar, P.
V. (2003); Valbo, A. and T. Eide (1996))
Evidence Statement 4
One good quality trial (level 1+) indicates that NicoBloc has no effect on long-term
smoking cessation rates. (Gariti, P., A. I. Alterman, et al. (2004))
Evidence Statement 5
There is level 1- evidence that Nicobrevin may have a short-term effect but no data
are available on its long-term efficacy. (Dankwa, E., L. Perry, et al. (1988); Schmidt,
F. (1974))
Evidence Statement 6
A body of level 1+ evidence from meta-analyses of randomised controlled trials
suggests that rapid smoking improves 6-month abstinence rates. (Hajek, P. and L. F.
Stead (2006)
Evidence Statement 7
Level 1+ evidence from one randomised controlled trial shows that cytisine improves
6-month abstinence rates. Scharfenberg, G., S. Benndorf, et al. (1971); Paun, D. and
J. Franze (1968); Schmidt, F. (1974)
Evidence Statement 8
A body of level 1+ evidence from one randomised controlled trial shows that glucose
on its own does not increase long-term abstinence rates. Post hoc analyses suggest
that it may increase the efficacy of other smoking cessation medications. West, R.
and N. Willis (1998). West, R., S. May, et al. (Unpublished).
4. Evidence Summary Non-NHS Smoking Cessation Treatments 4
Evidence Statement 9
There are no data available on long-term effects of St John’s Wort, but level 1-
evidence from one randomised controlled trial shows lack of efficacy at one month.
Becker, B., B. Bock, et al. (2003)
Conclusions
This review assessed the current evidence for the effectiveness of nine smoking
cessation interventions that are not provided by the NHS: Acupuncture, Allen Carr’s
Easyway, hypnosis, NicoBloc, Nicobrevin, St. Johns Wort, aversive smoking,
cytisine, and glucose.
Because there is variation in the proportions of smokers in different groups that are
able to stop smoking without help, demonstration of efficacy of a class of intervention
designed to aid smoking cessation requires experimental studies involving a
comparison group, ideally with random allocation to the treatment of interest and to
the comparison group. In addition, the definition of ‘success’ can vary widely
depending on the criteria adopted, so it is essential to specify clearly the basis on
which it is calculated. Finally, for a smoking cessation method to be regarded as
effective, it has to increase abstinence over an extended period of time, with 6-
months after stopping smoking date considered as the benchmark.
On this basis, this rapid review suggests that acupuncture, St. John's Wort and
NicoBloc are probably not effective. There is insufficient evidence to determine the
effectiveness of Allen Carr’s Easyway Programme and Nicobrevin. Hypnosis has not
been found to be more effective than simple advice. Studies of glucose show mixed
evidence of efficacy. Rapid smoking may have some efficacy, but its implementation
within the contemporary treatment formats is problematic. Cytisine (Tabex) also
shows evidence of efficacy.
References to Included Studies
Abbot, N. C., L. F. Stead, et al. (2006). "Hypnotherapy for smoking cessation
[Systematic Review]." Cochrane Database of Systematic Reviews (1): 1-15.
Barnes, J., N. Barber, et al. (2006). "A Pilot Randomised, Open, Uncontrolled,
Clinical Study of Two Dosages of St John's Wort (Hypericum perforatum) Herb
Extract (LI-160) as an Aid to Motivational/Behavioural Support in Smoking
Cessation." Planta Med 72(4): 378-82.
Becker, B., B. Bock, et al. (2003). "St. John's Wort oral spray reduces withdrawal
symptoms during quitting smoking (POS4-82)." Society for Research on Nicotine and
Tobacco 9th Annual Meeting February.
Csillag, H., A. Feuerstein, et al. (2005). "The long term success of occupational non-
smoking seminars." Sichere Arbeit: 28-34.
Dankwa, E., L. Perry, et al. (1988). "A double-blind, placebo-controlled study to
determine the efficacy of Nicobrevin anti-smoking capsules." Br J Clin Pract 42(9):
359-63.
5. Evidence Summary Non-NHS Smoking Cessation Treatments 5
Etter, J.-F. (2006). Cytisine for smoking cessation: a literature review and a meta-
analysis (RPOS3-59). Society for Research on Nicotine and Tobacco, 12th Annual
Meeting, Orlando, Florida.
Ferguson, J., L. Bauld, et al. (2005). "The English smoking treatment services: one-
year outcomes." Addiction 100 Suppl 2: 59-69.
Foulds, J. (1996). Brief evaluation of the "Easy Way To Stop Smoking" Clinic,
Raynes Park. London, St George's Hospital Medical School: 1-7.
Gariti, P., A. I. Alterman, et al. (2004). "Adding a nicotine blocking agent to cigarette
tapering." J Subst Abuse Treat 27(1): 17-25.
Hajek, P. and L. F. Stead (2006). "Aversive smoking for smoking cessation
[Systematic Review]." Cochrane Database of Systematic Reviews 1: 1.
Hutter, H. P., H. Moshammer, et al. (2006). "Smoking cessation at the workplace: 1
year success of short seminars." International Archives of Occupational &
Environmental Health 79(1): 42-48.
Judge, K., L. Bauld, et al. (2005). "The English smoking treatment services: short-
term outcomes." Addiction 100 Suppl 2: 46-58.
Leahy, M. (2003). Stop smoking gradually with NicoBloc. The 2003 National
Conference on Tobacco or Health, Boston, USA.
NicoBloc (2003). Summary of data available. Available online:
http://www.stopsmokingnow.co.uk/nicobloc/research.pdf (Accessed: 09/05/06).
Scharfenberg, G., S. Benndorf, et al. (1971). "[Cytisine (Tabex) as a pharmaceutical
aid in stopping smoking]." Deutsche Gesundheitswesen 26(10): 463-5.
Schmidt, F. (1974). "Drug support during breaking of smoking habit - report about
experiment with over 5000 smokers (double blind experiment)." Munchener
Medizinsicher Wochenschrift 116(11): 557-564.
Valbo, A. and T. Eide (1996). "Smoking cessation in pregnancy: the effect of
hypnosis in a randomized study." Addictive Behaviors 21(1): 29-35.
West, R., S. May, et al. (Unpublished [a]). "A randomised trial of glucose tablets to
aid smoking cessation."
White, A. R., H. Rampes, et al. (2006). "Acupuncture and related interventions for
smoking cessation." Cochrane Database of Systematic Reviews(1): CD000009.
Yiming, C., Z. Changxin, et al. (2000). "Laser acupuncture for adolescent smokers--a
randomized double-blind controlled trial." The American journal of Chinese medicine
28(3-4): 443-9.