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Abstract - 164 - Summary This study was a prospective randomized control study which was conducted on a sample of eighty smokers divided into two groups during the period from July 2014 to January 2015.These groups are: Group I: Consists of 40 subjects were recruited and subjected to the brief intervention method for smoking cessation, the five ̳ A ’s for assessing tobacco use and addressing smoking cessatio n. Ask patients about their smoking status. Advice smokers to quit. Assess their readiness to quit. Assist them with their smoking cessation effort. Arrange for follow - up visits or contact. Group II : Consists of 40 subjects were recruited and subjected to the brief intervention method for smoking cessation, the five ̳ A ’s for assessing tobacco use and addressing smoking cessation. In addition to aversion therapy. Aversion therapy was conducted by providing the smoker with a single onion powdered cigarette for each craving episode and avoiding ̳usual‘ tobacco cigarettes. Weekly interviews were conducted for follow - up and refill of the powdered cigarettes pack according to the frequency of the craving episodes. STUDY OF AVERSION THERAPY AS AN ADJUVANT IN SMOKING CESSATION Thesis Submitted For Partial Fulfillment of master Degree in Pulmonary Medicine and Tuberculosis By Samir Mohamed Mahmoud Fahyim M.B., B.Ch. Faculty of Medicine - Ain Shams University Under Supervision of Prof. Dr. Adel Mohamed Saeed Professor of Pulmonary Medicine & Tuberculosis Faculty of Medicine - Ain Shams University Dr. Nermine Mounir Riad Assist ant Professor of Pulmonary Medicine & Tuberculosis Faculty of Medicine - Ain Shams University Dr. Mahmoud Mamdouh ELHabiby Lecturer in Psychiatry Faculty of Medicine - Ain Shams University Faculty of Medicine Ain Shams University 201 5 List of Contents I Contents Subjects Page List of abbreviations ................................ .................. .................................... I I List of Figures ................................ ................................ ................................ .............. I V List of Tables ................................ ................................ ................................ .................. V Introduction ................................ ............... ............................................... 1 Aim of the work ................................ ................................ ................................ .. 4 Review of Literature Chapter (1): Hazards of Smoking ................................ .......... 5 Chapter (2): Smoking Cessation ................................ .......... 44 Chapter (3): Aversion Therapy ................................ ......... 10 2 Subjects and Methods ................................ ................................ .......... 120 Results ................................ ................................ ................................ ..................... 12 8 Discussion ................................ ................................ ................................ ............ 1 39 Summary ................................ ................................ ................................ .............. 16 4 Conclusion ................................ ................................ ................................ .......... 16 8 Recommendations ................................ ................................ ..................... 17 0 References ................................ ................................ ................................ ........... 1 7 1 Arabic Summary - 163 - administered by therapist or subject in study in aversion therapy Hajek and Stead, 2003 . In addition, It is now recommended that nicotine replacement therapy should routinely be used during quit attempts, Smoking cessation medication use (NRT or bupropion) at the time of the quit attempts was protective against relapse as recommended by Balfour et al., 2000 in treatment of nicotine dependence. - 164 - Summary This study was a prospective randomized control study which was conducted on a sample of eighty smokers divided into two groups during the period from July 2014 to January 2015.These groups are: Group I: Consists of 40 subjects were recruited and subjected to the brief intervention method for smoking cessation, the five ̳ A ’s for assessing tobacco use and addressing smoking cessatio n. Ask patients about their smoking status. Advice smokers to quit. Assess their readiness to quit. Assist them with their smoking cessation effort. Arrange for follow - up visits or contact. Group II : Consists of 40 subjects were recruited and subjected to the brief intervention method for smoking cessation, the five ̳ A ’s for assessing tobacco use and addressing smoking cessation. In addition to aversion therapy. Aversion therapy was conducted by providing the smoker with a single onion powdered cigarette for each craving episode and avoiding ̳usual‘ tobacco cigarettes. Weekly interviews were conducted for follow - up and refill of the powdered cigarettes pack according to the frequency of the craving episodes. - 165 - A ll smokers will be subjected to: Medical history : (age, occupation, smoking history, co - morbidities, presence of any chest complaints). Clinical examination : (complete general and local chest examination especially auscultation of wheezes). Group II smokers additionally received pack of dried onion powdered cigarettes . Tobacco dependence is a chronic condition that often requires repeated intervention. Effective treatments, including individu al, group, and telephone counseling, can produce lo ng - term or even permanent abstinence. Patients who use tobacco but are unwilling to quit should be approached with the ”5 R’s” of motivational intervention ( R elevance, R isks, R ewards, R oadblocks, and R epetition). Smokers may be unwilling to quit due to misinformation , concern about the effects of quitting, or demoralization because of previous unsuccessful quit attempts. Patients who use tobacco and are willing to quit should be managed using the ”5 A’s” ( A sk, A dvise, A ssess, A ssist, and A rrange) Treatm ents involving person - to - person contact (individu al, group, or proactive telephone - 166 - counseling) are consistently effective, and their effectiveness increases with treatment intensity. Most smokers make many attempts to quit before they achieve success. Smok ers should be made aware of this when they are attempting to quit. Relapse prevention strategies should be applied to patients who have recently quit using tobacco. As an example, any problems encountered as a result of abstinence (e.g., weight gain, depr ession) should be - 166 - counseling) are consistently effective, and their effectiveness increases with treatment intensity. Most smokers make many attempts to quit before they achieve success. Smok ers should be made aware of this when they are attempting to quit. Relapse prevention strategies should be applied to patients who have recently quit using tobacco. As an example, any problems encountered as a result of abstinence (e.g., weight gain, depr ession) should be addressed promptly. In the present study, no statistically significant correlation (p value> 0.05) was found between success rate and the age, occupation, marital status or smoking index of smokers among both groups. In the present study there was significant difference between the two studied groups as regards the outcome; the success rate was significantly higher among group subjected to aversion therapy (group II) (8 out of 40 ) versus (group I) (6 out of 40) (20% , 15 % respectively) . But, the difference between the two groups not high , which indicate that the aversion therapy cannot achieve the hopeful desired success. Aversion is a very old treatment technique, but a very new topic of empirical study by using different methods of it . As, in addition to our study depending on taste sensation by using dried onion powder there were other aversive techniques include rapid puffing (smoke not inhaled), smoke holding, excessive smoking, paced smoking, self - paced smoking, focused smoking, co vert sensitization, symbolic aversion, electric shocks administered by therapist or subject in study in aversion therapy. |