RESUMO
Artificial irradiation due to tobacco smoking is a widely accepted phenomenon, but the possible health implications are controversial. The IAEA has estimated that smoking twenty cigarettes a day induces a total "radiation exposure" of 53 mSv, but several other authors have estimated that the effective dose is only about 0.4 mSv/year. The irradiation associated with smoking results from the use of fertilizers containing a emitters and from tobacco leaf fixation of radon 222 gas of telluric origin. Critical analysis of the literature suggests that irradiation due to smoking is much closer to 0.4 mSv/year than to 53 mSv/year. In order to avoid further confusion and controversy, human exposure to such radiation should be expressed as the annual effective dose.
Assuntos
Contaminação Radioativa do Ar , Poluição por Fumaça de Tabaco/efeitos adversos , Humanos , Doses de Radiação , Nicotiana/químicaRESUMO
BACKGROUND: In comparison to other European countries, the number of smokers remains high in France. Approximately five million smokers wish to quit within the year and need support that is local, easily accessible, and efficient. As public health actors, pharmacists could provide this service. The Sevrage Tabagique à l'Officine: Smoking Cessation Program at the Pharmacy (STOP) study was carried out to explore the feasibility of a smoking cessation program provided at pharmacies. MATERIALS AND METHODS: Pharmacists participating in the study were trained to provide a smoking cessation program to smokers recruited at the pharmacy, which included five pharmaceutical interviews in six months, along with counseling and support, in addition to nicotine replacement therapy. This observational, longitudinal, prospective study assessed the feasibility of the program by measuring the percentage of participants remaining at the six-month visit, the proportion of invited pharmacies that actually participated in the program, and the benefits to the participants. RESULTS: Ninety pharmacies were invited to participate, 79 (88%) pharmacies entered the study, and 49 (54%) included study participants and treated 227 subjects with a mean age of 45.4 years. At six months, 23.3% of participants attended their follow-up visit, among which 75% had been abstinent since their last visit and more than half for 90 days. From the second follow-up visit, their Short Form 12 physical and mental health composite scores were improved in comparison with baseline. Participants and pharmacists all reported being highly satisfied with the program; however, the attrition rate was substantial, possibly due to some study limitations. CONCLUSION: The provision of support for smoking cessation by pharmacies is feasible despite some barriers such as lack of awareness and difficulty to change habits for the smokers or lack of time and training for the pharmacists. The conditions necessary for this program to be implemented on a large scale include training of pharmacists, access to a private space in the pharmacy, remuneration for the pharmaceutical interviews, collaboration with other health care professionals, and an effective communications program regarding the service, both inside and outside of pharmacies. The relatively low number of participants at the end of the study could be improved by increasing awareness of the program, involving health authorities, and enlarging the number of pharmacies engaged in the program.