Smoking cessation guidelines: evidence-based recommendations of the French Health Products Safety Agency.

Tobacco use is the leading preventable cause of death in developed countries. Millions of smokers are willing to stop, but few of them are able to do so. Clinicians should only use approaches that have demonstrated their efficacy in helping patients to stop smoking. This article summarizes the evidence-based major findings and clinical recommendations for the treatment of tobacco dependence of the French Health Products Safety Agency (AFSSAPS). Clinicians should enquire about the smoking status of each patient and provide information about health consequence of smoking and effective treatments available. These treatments include counseling (mainly individual or social support and behavioral and cognitive therapy) and pharmacological treatment with either nicotine replacement therapy (NRT) or bupropion LP. Pharmacological treatments should be used only for proven nicotine dependence, as assessed by the Fagerstrom test for Nicotine Dependence. The choice of pharmacologic treatment depends of the patient's preference and history and of the presence of contra-indications. The clinician should start with a single agent, but these treatments may be used in combination. Smoking behavior is a chronic problem that requires long-term management and follow-up. Access to intensive treatment combining pharmacological treatment and extensive behavioral and cognitive therapy should be available for highly dependent patients.

[Evaluation and comparison of tobacco control legislation in member states of the European Union]. / Evaluation et comparaison de la législation de contrôle du tabagisme dans les Etats membres de l'Union Européenne.

BACKGROUND: Nowadays, tobacco use represents the main cause of avoidable deaths in Europe. Public health authorities have several means at their disposal to fight against this epidemic. For instance, legislative action can operate on the supply side as well as on the demand side, with the aim of reducing tobacco consumption in the targetted populations. METHODS: A systematic data collection of all legislative texts dealing with tobacco control was carried out within the framework of the EuroLego project. This was done, either through direct contact with the countries or through a systematic computer and manual search of data bases concerning the 15 member states of the European Union. RESULTS: At present, the legislative context varies widely from one country to another, whether regarding the number of texts adopted or the subject that is covered. Since the 1950s, a marked increase in the number of legislative texts has been noted as well as a trend towards harmonization of the texts among the different member states. CONCLUSIONS: Several health recommendations can be put forward in the context of public health activities with priority to be given to the protection of the children and the young and to the defense of the rights of non-smokers.