Cessation using the Cold Turkey Method for Asthmatic patient

CTCS Tutorial #13 Case 2

 

On 15 September 2023, the 13th monthly tutorial session was conducted for Certified Tobacco Cessation Specialists. One of the two cases discussed a 38-year-old, chronic cigarette smoker, owner of a travel agency, referred for cessation by a pulmonologist. He had been smoking for the last 25 years, consuming around 40 cigarettes a day. He was married, had 2 children, and was accompanied by his mother to the cessation center. He gave a history of bronchial asthma for 3 years and diabetes, and blood pressure for 2 years, and was under medications for the same.

            He had been consuming 40 cigarettes in a day, with maximum consumption during morning hours, around 6-7 cigarettes reportedly before using the washroom. Apart from this, he had increased frequency while driving, meeting friends, after meals, and under stress. He stated that a few times when he could not smoke for 2-3 days, he felt extreme anger, stress, and restlessness. He reported sweating, thirst, constipation, and increased appetite during this phase. Presently, he was quite motivated to quit smoking due to health issues.

            He was explained the adverse effects of smoking and the benefits of quitting in the long run. A detailed treatment plan was made for him after counseling. He was guided for a Cold Turkey method of quitting smoking, replacing it using a 21-mg Nicotine patch to be used for three weeks and Nobacco gums (4 mg) to be used for severe craving episodes. He was allowed 2 puffs of smoking a day initially, which he stopped after 2 days. He complained of body cramps and worsening asthma in 2-3 days of withdrawal. He was supplemented with SleepNova, Lycoedge, Cbinan, ELC, and Mg tablets.  He was suggested to use the Acapella device for breathing exercises, which helps in clearing mucous in the throat. Mucolytics and anti-asthmatic drugs were also modified accordingly by the consulting pulmonologist. He was kept on a nebulizer, steam inhalation, and a modified diet plan and showed considerable improvement in asthma over 2 weeks.

The Nicotine replacement patch would be reduced to a 14-mg dose after 3 weeks, further to a 7-mg dose in 2 weeks, continuing, in addition with 1mg BD Varnitrip, over 3 months duration. He would be regularly monitored by a cessation specialist and pulmonologist over this period and the treatment plan would be modified accordingly.

ICanCaRe Academy Tutorial for Certified Tobacco Cessation Specialists (CTCS) is a monthly program on the 15th, from 9-10 PM. We welcome our CTCS to present complex cases on tobacco cessation for discussion and finding solutions for successful quitting. Please contact Dr. Mariya, Dr Siddhi, or Dr. Monalee for tutorial cases.

ICanCaRe Academy encourages you to take part in our monthly session and learn in-depth details about practical tobacco cessation through cases discussed here.

To be a Certified Tobacco Cessation Specialists go to www.icancare.in/academy/ctcs

#icancareacademy #tutorial #icancare #siddhi #pawangupta #CTCS #icancare #mariya #monalee #reenarkumar

Case presented by – Dr. Anshika Pandey, BDS, Certified Tobacco Cessation Specialist with MAX – ICanCaRe Centre.

Blog composed by  – Dr. Siddhi Hathiwala, MDS (Public Health Dentistry), CTCS(GU) – ICanCaRe. Assoc. Prof. & HoD, HDCH, Jabalpur)

Expert – Dr. Pawan Gupta M.Ch. Cancer Surgeon and Master Trainer Tobacco Cessation

Cessation using Plateau Therapy for chronic Smokeless Tobacco consumer

CTCS TUTORIAL #13 Case 1 ICanCaRe Academy

On 15 September 2023, the 13th monthly tutorial session was conducted for Certified Tobacco Cessation Specialists. One of the two cases discussed a 60-year-old retailer, chronic tobacco chewer. He had a history of consuming tobacco, 6-7 pouches in a day, for over 40 years, with added supari, chutney, and slaked lime. He consumed tobacco after breakfast, and had quid in his mouth the whole day, even while sleeping.

He had a known case of hypertension for 4 years, under medications including Aspirin, Telmisartan, and Rabeprazole. Also, he had a history of phobia of crossing roads and uneasiness and had been taking Escitalopram oxalate and Clonazepam for 5 months. He was self-motivated to quit tobacco and had come to the clinic with his wife. He had himself tried to quit earlier twice but failed within a week duration. He developed cold and cough, fever, and uneasiness during quit attempts. Presently, he has been gradually tapering his tobacco consumption for 1 month, 1 pouch per week following his behavioral motivation.

Our team has now suggested asking him to set a committed Quit Date for himself, within 14 days; while the specialist is handholding him to cope with withdrawal symptoms. He has to be kept on a gradual reduction of tobacco consumption while using nicotine patches continuously. Initially, apply a 7-mg patch for a week, reducing tobacco by 50%, then a 14-mg patch and complete stoppage of tobacco consumption in the next 7-10 days. He would then be continued with a 14-mg or 21-mg patch beyond the quit date. Also, Varenicline (1mg BD) would be added at this stage during the maintenance phase and reduced gradually over a 2-3 month period. Other supplements would include Nobacco pastilles or lozenges (only in the beginning to curb intense craving episodes) and oral supplementation with Aquazyl, Turmnova, or chia seeds. He would be prescribed multivitamins and minerals, Vit. C, Folic Acid, as needed. He would be kept on regular follow-ups every week for 3 months duration along with his medical assessment at regular intervals.

ICanCaRe Academy Tutorial for Certified Tobacco Cessation Specialists (CTCS) is a monthly program on the 15th, from 9-10 PM. We welcome our CTCS to present complex cases on tobacco cessation for discussion and finding solutions for successful quitting. Please contact Dr. Mariya, Dr Siddhi, or Dr. Monalee for tutorial cases.

ICanCaRe Academy encourages you to take part in our monthly session and learn in-depth details about practical tobacco cessation through cases discussed here.

To be a Certified Tobacco Cessation Specialists go to www.icancare.in/academy/ctcs

#icancareacademy #tutorial #icancare #siddhi #pawangupta #CTCS #icancare #mariya #monalee #reenarkumar

 Case presented by – Dr. Mariya, BDS, Certified Tobacco Cessation Specialist, Mumbai

Blog composed by  – Dr. Siddhi Hathiwala, MDS (Public Health Dentistry), CTCS(GU) – ICanCaRe. Assoc. Prof. & HoD, HDCH, Jabalpur)

Expert – Dr. Pawan Gupta M.Ch. Cancer Surgeon and Master Trainer Tobacco Cessation

ICanCaRe at the Global Sustainability Alliance Summit SDG 5th Edition by Economic times

ICanCaRe at the GLOBAL SUSTAINABILITY ALLIANCE SUMMIT SDG 5th Edition by Economic Times

ICanCaRe, an organization dedicated to Tobacco Cessation, participated as a supporting partner for the GLOBAL SUSTAINABILITY ALLIANCE SUMMIT SDG 5th Edition. The Global Sustainability Alliance SDG Summit is dedicated to converting ideas into solutions to transform the world, adopt eco-friendly practices, and promote entrepreneurial solutions for addressing and promoting sustainable development.

ICanCaRe is committed and aligned with The Global Goals and has been working to meet Sustainable Development Goal No. 3 to ensure Good Health and well-being. The focus of ICanCaRe has been specifically 3 a – Implementation of WHO FCTC- reduce tobacco use by 30% by 2030. Within this context, ICanCaRe highlighted their efforts in educating Healthcare Professionals (HCPs) to combat tobacco use and their campaign, #advisequittobacco.

ICanCaRe creates sustainable business practices, products, and services for Tobacco Cessation and Tobacco Control in line with WHO FCTC to meet SDG 3a.Empowerment through the Education of Health Care Professionals to skill up to be Certified Tobacco Cessation Specialists to be able to provide the needed services to quit tobacco and bring down the mortality and morbidity due to tobacco and directly reduce NCDs, Tuberculosis, and Lung Health.

ICanCaRe also focuses on Sustainable Development Goal 5, which aims to achieve gender equality and empower all women and girls. With the program of empowering women as TOBACCO MARSHALs, ICanCaRe’s involvement underscores their dedication to addressing the critical issue of tobacco use and its impact on public health.

ICanCaRe is a change maker as we assessed the skill gap and came up with the idea of transformation of health and well-being of people exposed to / and using all forms of tobacco by providing a solution through education of HCPs in tobacco cessation. The Digital ICanCaRe Tobacco Wellness app makes the business model sustainable with an ability to reach even the underserved community.

ICanCaRe is conscious of our role in SDG 8,10,11,14,15,16 and 17 which are indirectly related to health while we can positively impact SDG 1, 2, 4, 5, and 6 as we work specifically with SDG No 3a and 5. We at ICanCaRe aim to take all healthcare professionals into the ambit of Tobacco Cessation through Education and reach this service to every person in the country and not leave anyone
behind.

ICanCaRe’s #advisequittobacco campaign likely emphasizes the importance of advising and supporting individuals in their journey to quit tobacco. This campaign likely includes a multi-faceted approach, such as public awareness, educational materials, counseling support, and community engagement to encourage individuals to quit tobacco consumption.

Tobacco use is a pressing global health challenge, leading to numerous health issues and premature deaths. ICanCaRe’s mission likely involves creating awareness, providing education, and implementing strategies to help individuals quit tobacco use, thereby contributing to a healthier and more sustainable future.

Their participation at the summit demonstrates their commitment to aligning with Sustainable Development Goals and contributing to a more sustainable and equitable world, particularly concerning public health and gender-related aspects related to tobacco use. ICanCaRe’s efforts and contributions to the cause of tobacco cessation within the context of the summit and SDG 3 and 5 are well recognized.

ICanCaRe, an organization dedicated to Tobacco Cessation, is a supporting partner for the GLOBAL SUSTAINABILITY ALLIANCE SUMMIT SDG 5th Edition. Dr. Pawan Gupta participated in the Summit.

Author – Dr. Reena R Kumar, Academic Director, ICanCaRe

#SDG #economictimes #pawangupta #globalsustainibilty #icancare #icancareacademy #icancareepharmacy #tobacco #tobaccocessation #icancareapp #advisequittobacco #savetheyouth #tobaccomarshal #reenarkumar