[Why and how keep in mind cannabis in our smoking outpatients?] / ¿Por qué y cómo tener en cuenta al cannabis en nuestros pacientes fumadores?

EVICT project has noted the increase in cannabis use in the Spanish youth population, and has studied its association with tobacco, concluding that: It has an influence in the learning to smoke process: The beginning can be combined and with bi-directional influence. It has an influence on dependence the development of dependence Their interaction is relevant in the development of dependence. It has an influence on toxicity: Smoking tobacco and cannabis generates greater problems than smoking tobacco alone. And, therefore, the EVICT team issues some considerations: Prevention considerations. Differentiate between therapeutic and recreational use. Smoking cannabis is not therapeutic nor innocuous, and can affect the development of nicotine dependence, or, less frequently, cannabis dependence. Approach and treatment considerations. In A first option of cessation of both must be proposed in people who consume tobacco and cannabis Harm Reduction. To those that only consume tobacco/cannabis: Harm Reduction programs should be more applicable to those in whom consumption is considered more problematic.

¿Por qué y cómo tener en cuenta al cannabis en nuestros pacientes fumadores? / Why and how keep in mind cannabis in our smoking outpatients?

El Proyecto ÉVICT (Evictproject.org), a raíz del aumento de consumo de cannabis en población juvenil española, ha estudiado su asociación con el tabaco, concluyendo que el consumo conjunto de tabaco y cannabis: tiene una influencia en el proceso de aprender a fumar, pues el inicio puede ser conjunto y con influencia bidireccional; tiene una influencia en el desarrollo de dependencia pues su interacción es relevante para el desarrollo de este trastorno, y tiene una influencia en la toxicidad, pues probablemente, el fumar tabaco y cannabis genera mayores problemas que fumar solo una de las 2. Y, por tanto, el equipo EVICT emite unas consideraciones en prevención: diferenciar uso medicinal y recreativo; comunicar que fumar cannabis no es terapéutico ni inocuo, y puede ayudar a generar dependencia de nicotina o, menos frecuentemente, al propio cannabis. Consideraciones en abordaje y tratamiento: en personas que consumen tabaco/cannabis debemos plantear como primera opción el cese de las 2 sustancias. Consideraciones en reducción de daños: a quienes solo consumen productos de tabaco/cannabis, los programas serían más aplicables a aquella cuyo consumo se considere más problemático

EVICT project has noted the increase in cannabis use in the Spanish youth population, and has studied its association with tobacco, concluding that: It has an influence in the learning to smoke process: The beginning can be combined and with bi-directional influence. It has an influence on dependence the development of dependence. Their interaction is relevant in the development of dependence. It has an influence on toxicity: Smoking tobacco and cannabis generates greater problems than smoking tobacco alone. And, therefore, the EVICT team issues some considerations: Prevention considerations. Differentiate between therapeutic and recreational use. Smoking cannabis is not therapeutic nor innocuous, and can affect the development of nicotine dependence, or, less frequently, cannabis dependence. Approach and treatment considerations. In A first option of cessation of both must be proposed in people who consume tobacco and cannabis Harm Reduction. To those that only consume tobacco/cannabis: Harm Reduction programs should be more applicable to those in whom consumption is considered more problematic

[Consensus report for the clinical care of smoking cessation in Spain. Comité Nacional para la Prevención del Tabaquismo]. / Documento de consenso para la atención clínica al tabaquismo en España.

Tobacco use presents an odd confluence of circumstances: it is a significant and high threat to health, and there is a lack of motivation among health workers to act accordingly. Yet we have effective interventions. It is really hard to identify any other determinant of health presenting this mixture of lethality, prevalence, and lack of care, despite having effective treatments readily available. On the other hand, smoking cessation interventions are considered as the gold standard of preventive interventions, far above other preventive measures commonly used. This has prompted the National Committee for Smoking Prevention to develop a consensus document for the Clinical Care of Smoking Cessation in Spain. The purpose of this technical and scientific document is to agree on a basic proposal of quality of care to tackle smokers to quit. This document would serve as a guideline in the clinical practice in our country. The aims of this agreement are to review the effectiveness of the existing therapies for smoking cessation, to synthesize their available evidence, and to set the basic minimum standards of care in the clinical practice of patients who smoke. The consensus sets the strategies, and the evidences that support them, in order to assist both the smokers who want to quit, and the smokers who do not, setting out the steps to intervene in the most adequate.

Documento de consenso para la atención clínica al tabaquismo en España / Consensus report for the clinical care of smoking cessation in Spain

El consumo de tabaco presenta una rara confluencia de circunstancias: es una significativa y alta amenaza para la salud, hay una escasa motivación entre el personal sanitario para intervenir consecuentemente y, sin embargo, disponemos de intervenciones efectivas. Realmente es difícil identificar ningún otro condicionante de la salud que presente esta mezcla de letalidad, prevalencia y desatención, pese a que disponemos de tratamientos eficaces fácilmente disponibles. Por otra parte, la intervención en tabaco esta´ considerada como el patrón oro de las intervenciones preventivas, muy por encima de otras medidas preventivas usadas comúnmente. Todo ello ha motivado al Comité Nacional de Prevención de Tabaquismo a elaborar un Documento de Consenso para la Atención Clínica al Tabaquismo en España. La finalidad de este trabajo, de carácter técnico y científico, es consensuar una propuesta básica de calidad sobre el abordaje de las personas fumadoras que sirva como guía orientativa en la práctica clínica en el contexto de nuestro país. Los objetivos de consenso son revisar la eficacia de los tratamientos existentes del tabaquismo, sintetizar la evidencia disponible sobre el tratamiento de las personas fumadoras, consensuar unos mínimos básicos que permitan orientar las actuaciones asistenciales de calidad en España, proponiendo recomendaciones clínicas para el manejo del paciente que fuma. El consenso aborda las estrategias y las evidencias que las sustentan, para intervenir sobre los fumadores en la consulta tanto en aquellos que no quieren dejar de fumar, como en el que quiere dejar de fumar, estableciendo los pasos para intervenir de la forma más adecuada (AU)

Tobacco use presents an odd confluence of circumstances: it is a significant and high threat to health, and there is a lack of motivation among health workers to act accordingly. Yet we have effective interventions. It is really hard to identify any other determinant of health presenting this mixture of lethality, prevalence, and lack of care, despite having effective treatments readily available. On the other hand, smoking cessation interventions are considered as the gold standard of preventive interventions, far above other preventive measures commonly used. This has prompted the National Committee for Smoking Prevention to develop a consensus document for the Clinical Care of Smoking Cessation in Spain. The purpose of this technical and scientific document is to agree on a basic proposal of quality of care to tackle smokers to quit. This document would serve as a guideline in the clinical practice in our country. The aims of this agreement are to review the effectiveness of the existing therapies for smoking cessation, to synthesize their available evidence, and to set the basic minimum standards of care in the clinical practice of patients who smoke. The consensus sets the strategies, and the evidences that support them, in order to assist both the smokers who want to quit, and the smokers who do not, setting out the steps to intervene in the most adequate (AU)