背景:除了预防烟草消费,在德国,建立和确保对有害使用和依赖烟草产品的高质量治疗仍然是一项重要的与健康有关的任务。定期更新科学医学会协会(AWMF)S3指南“吸烟和烟草依赖:筛查,诊断,和治疗”(烟草指南)提供了一个可持续和信誉良好的戒烟知识来源。
方法:在德国精神病学会的主持下,心理治疗,心身学,和神经病学(DGPPN)和德国成瘾研究和成瘾治疗学会(DG-Sucht),烟草指南在2019-2020年由63名专家修订,他们参与了文本的开发过程,11个工作组。通过谨慎的利益冲突管理,可以最大程度地减少利益冲突对准则的不当影响。来自50个专业协会的代表讨论了80个指南建议,并在网上投票。
结果:除了筛查和诊断的建议,《烟草指南》对使用低门槛咨询和支持服务持积极态度。如果,由于烟草相关疾病的严重程度,简短的咨询,电话咨询,或者基于互联网或智能手机的方法不够有效,个人或团体行为疗法,可能与药物结合,表示。如果尼古丁替代疗法无效,应提供伐尼克林或安非他酮。推荐水平较低的替代策略是催眠疗法,基于正念的治疗,或与金雀花碱的药物。在青少年和孕妇中,药物的使用应限于明确的例外情况和尼古丁替代。与建议的平均一致性达到98%。三种临床算法提供了烟草指南治疗建议的一般概述。
BACKGROUND: In addition to the prevention of tobacco consumption, the establishment and assurance of high-quality treatment for harmful use and dependence on tobacco products remains an important health-related task in Germany. Regular updating of the Association of the Scientific Medical Societies (AWMF) S3
guideline \"Smoking and
Tobacco Dependence: Screening, Diagnosis, and Treatment\" (
Tobacco Guideline) offers a sustainable and reputable source of knowledge on smoking cessation.
METHODS: Under the auspices of the German Society for Psychiatry, Psychotherapy, Psychosomatics, and Neurology (DGPPN) and the German Society for Addiction Research and Addiction Therapy (DG-Sucht), the Tobacco Guideline was revised in 2019-2020 by 63 experts, who were involved in the development process of the text, in 11 working groups. Undue influence of conflicts of interest on the
guideline could be minimized through careful conflict of interest management. Delegates from 50 professional societies discussed the 80 guideline recommendations and voted online.
RESULTS: In addition to recommendations for screening and diagnostics, the
Tobacco Guideline takes a positive stance towards the use of low-threshold counseling and support services. If, due to the severity of the tobacco-related disorder, brief counseling, telephone counseling, or internet- or smartphone-based methods are not sufficiently effective, individual or group behavioral therapy, possibly in combination with medication, is indicated. If nicotine replacement therapy is not effective, varenicline or bupropion should be offered. Alternative strategies with a lower level of recommendation are hypnotherapy, mindfulness-based treatments, or medication with cytisine. In adolescents and pregnant women, the use of medication should be limited to well-specified exceptions and nicotine replacement. The mean agreement with the recommendations reached a value of 98%. A general overview of the treatment recommendations of the
Tobacco Guideline is provided by three clinical algorithms.