Treatment for cigarette smoking in a Department of Veterans Affairs outpatient clinic

Article Abstract:

To compare the effectiveness of two kinds of stop-smoking programs in Department of Veteran Affairs outpatient settings, a study was carried out of 466 male smokers who had smoked more than 20 cigarettes in the week before they started the study. Men who visited the general medicine or the walk-in clinic were referred to a ''quit-smoking'' clinic nearby, where they were randomly assigned to either: (1) the control group (173 subjects), where they received a pamphlet concerning the health hazards of smoking; (2) the low-intensity treatment group (143 subjects), where they underwent a counseling session, completed a quit-smoking contract, received a booklet about behavioral strategies for quitting, and were told of a six-month follow-up interview; or (3) the high-intensity treatment group (150 subjects), where they underwent all the low-intensity treatments plus a follow-up telephone call, counseling session, a prescription for nicotine-containing chewing gum, and other interventions. Evaluation of the treatments' effectiveness was carried out by telephone interview and analysis of subjects' urine specimens for nicotine metabolites. Results for the 432 subjects who participated in follow-up indicated that quit-smoking rates (defined in the most restrictive way, including the absence of nicotine metabolites in the urine specimen) were 1.2 percent, 6.3 percent, and 6.0 percent for the control, low-intensity, and high-intensity treatment groups, respectively. While rates for the two treatment groups differed significantly from the control group rate, the rates for the high- and low-intensity treatment groups did not differ from each other. Other research has not found a clear superiority for one kind of stop-smoking treatment over others. The results indicate that a moderately intensive stop-smoking program is as effective as a more intensive one. Both approaches used here are suitable and practical for use in typical clinical settings. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Reports, Clinical trials, Smoking cessation programs, Smoking cessation

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Adverse behavioral reactions attributed to triazolam in the Food and Drug Administration's Spontaneous Reporting System

Article Abstract:

Triazolam (Halcion) is a drug in the category known as benzodiazepines; these drugs are used for sleep and sedation. Much publicity in recent years has been given to the apparently high incidence of side effects caused by triazolam. To determine if these reports did indeed reflect a high rate of adverse effects, the number of reported side effects for triazolam was compared with those of a similar drug, temazepam, for the first seven years each drug was marketed. Temazepam was first marketed in the United States in 1981, and triazolam in 1983. Triazolam is the most commonly prescribed drug in this sedative category in the nation, and temazepam is second. During the first 7 years of marketing, 260 adverse reactions to triazolam were reported. During its first 7 years on the market, there were 10 adverse reactions reported for temazepam. The five most common side effects were hallucinations, agitation, bizarre behavior, amnesia and confusion. Depending on the particular reaction, the reported rates of the various reactions were 22 to 99 times greater for triazolam than for temazepam. The adverse effects of triazolam were more likely to affect the elderly, and more likely to occur at higher doses. The manufacturer of triazolam has stated that it provides approximately twice as many reports of adverse effects for its products than other manufacturers because of better reporting techniques. To negate this apparent difference in reporting, the rates of adverse effects due to temazepam were doubled, and the comparison was refigured. Adverse reactions were still 3 to 29 times more common for triazolam than temazepam. Even in years when temazepam was prescribed more frequently than triazolam, the latter still caused more side effects. Clearly, on the basis of these data, prudence in the use of triazolam is warranted, especially in the elderly. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Benzodiazepines, Triazolam, Halcion (Medication)

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