Adopting Tobacco Cessation in Real World Clinical Practice

The firstever full symposium focussing on tobacco Cessation was held at the just concluded 23rd Foundation for Head and Neck Oncology National Conference held at Daman from 22nd to 24th December. Thanks to the organizing committee for including this important topic in FHNO – Dr. Rajesh Kantharia, Dr. Prathamesh Pai, Dr. P. Arun, Dr. Dushyant Mandlik

The symposium was Chaired by Dr. Naresh Sharma,  HOD – Oro-maxillofacial Surgery, BHU, Varanasi, and conducted by Dr Pawan Gupta Sr. Director Surgical Oncology, MAX Institute of Cancer Care, Vaishali and founder of ICanCaRe.

Dr. Ajay Vidyarthi, HOD Surgical Oncology, Bhagwan Mahavir Cancer Sansthan, Patna spoke on “Integrating Tobacco Cessation to Improve Treatment Outcome in Clinical Practice”, highlighting the evidence for Tobacco Cessation in oncology practice.

A QUIZ – EVOLVE and ENGAGE Tobacco Cessation was conducted by the quiz MASTER – Dr. Suman Kharkwal (Delhi), HOD, Surgical oncology, ESI Hospital Delhi, and Coordinator – Dr. Bhavya Mishra fellow at MAX Hospital Delhi. The winners of the quiz were selected for the Scholarship for Certified Tobacco Cessation Specialist Course accredited by Gujarat University.

This was followed by a panel discussion. Prathamesh Pai, Dr. P. Arun, Dr. Dushyant Mandlik

The symposium was Chaired by Dr. Naresh Sharma,  HOD – Oro-maxillofacial Surgery, BHU, Varanasi, and conducted by Dr Pawan Gupta Sr. Director Surgical Oncology, MAX Institute of Cancer Care, Vaishali and founder of ICanCaRe.

Dr. Ajay Vidyarthi, HOD Surgical Oncology, Bhagwan Mahavir Cancer Sansthan, Patna spoke on “Integrating Tobacco Cessation to Improve Treatment Outcome in Clinical Practice”, highlighting the evidence for Tobacco Cessation in oncology practice.

A QUIZ – EVOLVE and ENGAGE Tobacco Cessation was conducted by the quiz MASTER – Dr. Suman Kharkwal (Delhi), HOD, Surgical oncology, ESI Hospital Delhi, and Coordinator – Dr. Bhavya Mishra fellow at MAX Hospital Delhi. The winners of the quiz were selected for the Scholarship for Certified Tobacco Cessation Specialist Course accredited by Gujarat University.

This was followed by a panel discussion “ADOPTING TOBACCO CESSATION in Real World Clinical  Practice”. The panel was moderated by Dr. Pawan Gupta and panelists were –

·      Dr. Ajay Vidyarthi (Patna)

·       Susan Samson Anant Mrs. Susan Samson, NGO (Vadodara)President, Faith Foundation, Vadodara

·       Dr Snehal Shah HN (Mumbai)

·       Dr. Suman Kharkwal (Delhi)

·       Dr AMEYA BIHANI HN Sr. Consultant, HCG Hospital (Indore)

·       Dr. Akhilesh Kumar Singh, Asso Prof, OMFS, BHU (Varanasi)

·       Dr. Uma Shankar Pal, HOD, OMFS, KGMU,  (Lucknow)

·       ghatdeep kaur Dr. Ghatdeep Kaur, Fellow, FHNO, MAX Hospital (Delhi)

TrisCaRe was given away to all the panelists and enthusiastic participants in the audience.

The symposium ended on a high note with everyone agreeing that Tobacco Cessation should be an integral part of the head and neck oncology practice and an integral part of the training during fellowship or specialization.

#icancareacademy #icancare #icancareepharmacy #icancarescholarships #CTCS #Tobaccocessation #FHNO #Bhavyamishra #IAPSM #sumankharkwal #pawangupta #ahmadzahoor #rajeshkantharia

Smokers with diabetes and hypertension at higher risk of Cardiovascular events

“Smokers with diabetes and hypertension at higher risk of Cardiovascular events”. – ICanCaRe

Introduction:

I continuation of our previous blog article on the risk of smoking and diabetes type 2, a recent article on a link of CVD with diabetes, highlights the need for a comprehensive smoking cessation program for such patients.

In the complex landscape of managing type 2 diabetes, the link between blood pressure levels and cardiovascular disease (CVD) mortality has emerged as a critical focal point. A recent study published in the Journal of the American Heart Association delves into the intricate relationship between systolic and diastolic blood pressure (BP) levels and their impact on mortality in patients with type 2 diabetes. The findings, drawn from a multi-institutional diabetes registry in Singapore, underscore the urgency for comprehensive interventions like ICanCaRe to address the cardiovascular risks associated with type 2 diabetes.

Unraveling the Study’s Objectives:

Led by Loraine Liping Seng and her colleagues, the study aimed to unravel the correlation between systolic and diastolic BP levels and the risk of CVD mortality in patients with type 2 diabetes. Additionally, the study explored associations with all-cause mortality, the composite outcome of all-cause mortality and CVD hospitalization, and the composite outcome of CVD mortality and hospitalization due to specific cardiovascular events such as myocardial infarction (MI), heart failure (HF), stroke, bypass surgery (CABG), and percutaneous coronary intervention (PCI).

The Singaporean Perspective:

Utilizing data from a multi-ethnic Asian patient pool – Chinese, Malay, and Indian – the study delved into a rich repository of information encompassing primary care to hospital-based care. The comprehensive analysis included 83,721 patients with type 2 diabetes over a span of seven years. Notably, almost 80% of the participants were on antihypertensive treatment, highlighting the prevalence of the condition in this population.

Key Findings and Implications:

The study’s primary outcome revealed a notable association between clinic systolic BP of 130 mm Hg or higher and/or diastolic BP of 90 mm Hg or greater with an increased risk of CVD mortality in patients with type 2 diabetes. Intriguingly, adverse cardiovascular outcomes were also paradoxically linked to diastolic blood pressure levels below 70 mm Hg. While the authors acknowledge the potential influence of reverse causality, the study emphasizes the importance of maintaining systolic BP below 130 mm Hg and diastolic BP below 90 mm Hg in individuals with type 2 diabetes.

ICanCaRe: A Holistic Approach to Cardiovascular and diabetic Health:

In light of these findings, the ICanCaRe Tobacco Intervention program takes center stage as a holistic approach to address the multifaceted challenges posed by type 2 diabetes. Recognizing the intricate interplay between cardiovascular health, diabetes, and other lifestyle factors, ICanCaRe empowers individuals to make informed choices and adopt a comprehensive approach to well-being. The ICanCaRe program is designed to offer personalized support to individuals seeking to quit Tobacco. Understanding that each journey is unique, the program tailors its strategies to meet each participant’s specific needs and challenges. (www.app.icancare.in). Medical assistance in a protocol-based approach is provided by Certified Tobacco Cessation Specialists. This multi-faceted ABCD approach for tobacco cessation ensures that individuals have access to all necessary resources to 100% quit smoking or Chewing tobacco.

Conclusion:

As the nexus between type 2 diabetes, blood pressure levels, and cardiovascular risks becomes clearer, interventions like ICanCaRe gain significance in the realm of patient care. By integrating the latest research findings into its framework, ICanCaRe supports tobacco cessation, guiding individuals through the complexities of managing diabetes and promoting cardiovascular health. In a world where data illuminates the path to better outcomes, the ICanCaRe program becomes an invaluable tool in the fight against the complications of type 2 diabetes with increased risk with smoking, offering a lifeline to those seeking a healthier, more empowered future.

Reference:

  1. Loraine Liping Seng, et al. Real-world systolic and diastolic blood pressure levels and cardiovascular mortality in patients with type 2 diabetes-results from a large registry cohort in Asia. J Am Heart Assoc. 2023 Nov 28:e030772. doi: 10.1161/JAHA.123.030772.
  2. World Health Organization, International Diabetes Federation, and the University of Newcastle. “Policy Brief on Smoking and Type 2 Diabetes.” This brief offers a comprehensive overview of the research linking smoking cessation to a reduced risk of type 2 diabetes.
  3. ICanCaRe. “Tobacco Cessation Program Overview.” www.icancare.in
  4. American Diabetes Association. “The Impact of Smoking on Diabetes and Diabetes Management.” This article discusses the implications of smoking on diabetes management and the benefits of cessation.
  5. National Institute of Diabetes and Digestive and Kidney Diseases. “Smoking and Diabetes.” This resource offers a deeper understanding of how smoking affects diabetes risk and control.
  6. ICanCaRe. (2021). ABCD of Tobacco Cessation. https://www.icancare.org/abcd.html

#icancare #diabetesandSmoking #smoking #quittobacco #icancareapp #CVDandsmoking

PRISm – A COPD Risk factor and Smoking Cessation advocated by ICanCaRe

Introduction:

Preserved Ratio Impaired Spirometry (PRISm) is a critical indicator characterized by an FEV1 of <80% predicted and a FEV1/FVC ratio of >0.70. Identified as a precursor to Chronic Obstructive Pulmonary Disease (COPD), PRISm demands careful monitoring, particularly in individuals with respiratory symptoms. The studies by Mariko Kogo et al. and Daniel H Higbee et al. shed light on the significant correlation between PRISm, respiratory symptoms, and the heightened risk of developing COPD, emphasizing the urgency for effective tobacco cessation interventions. In this context, the ICanCaRe tobacco cessation intervention program emerges as a beacon of hope, advocating for smoking cessation on an individual basis. (www.icancare.in). This blog is in series with the previous blog on Increased risk of Asthma in Children exposed to secondhand smoke.( ICanCaRe Blog) (ICanCaRe LinkedIn)

Understanding the PRISm Challenge:

PRISm, when associated with respiratory symptoms such as cough, sputum, and dyspnea, poses an independent risk factor for COPD development, especially in individuals with a history of smoking. Even without symptoms at baseline, PRISm can progress within five years, leading to airflow limitations. In addition, individuals with PRISm could exhibit increased respiratory symptoms, poor health-related quality of life, multiple comorbidities, and increased mortality compared with those with normal spirometry. The quantitative assessment capability of PRISm becomes a crucial tool for identifying and addressing the risks faced by smokers, reinforcing the need for smoking cessation.

The ICanCaRe Tobacco Cessation Intervention program quantifies the need for individuals and the digital protocol puts the urgency for smoking cessation on an individual basis.

ICanCaRe: A Holistic Approach to Tobacco Cessation:

ICanCaRe tobacco cessation wellness program stands out as a comprehensive, evidence-based tobacco cessation program aligned with the latest research findings. Grounded in the insights from studies by Kogo et al. and Higbee et al., ICanCaRe adopts a holistic approach to empower individuals to overcome addiction, ensuring long-term abstinence, and reducing the risk of respiratory complications.

Key Components of ICanCaRe – ABCD of Tobacco Cessation:

1. ACTIVE MOTIVATION: ICanCaRe actively motivates tobacco users through quantitative and qualitative assessments, estimating the progressive risk associated with continued smoking.

2. BEHAVIOR INTERVENTION: Tailored behavioral counseling strategies address unique triggers contributing to tobacco addiction, crucial for addressing psychological aspects and enhancing successful cessation.

3. COMORBIDITY MANAGEMENT: Clinical assessments for associated morbidities are conducted, with specialists providing personalized care.

4. DRUGS and MEDICATIONS – Pharmacotherapy: The program integrates evidence-based pharmacotherapies to manage withdrawal symptoms and cravings, enhancing the effectiveness of the intervention and ensuring complete cessation.

Call 011-43077695 or write to info@icancare.in and download the ICanCaRe tobacco Wellness APP (http://app.icancare.in)

Conclusion – Empowering Individuals for a Tobacco-Free Future:

As we confront the challenges posed by PRISm and its link to respiratory symptoms, the ICanCaRe Tobacco Cessation Intervention program stands as a beacon of hope. By integrating the latest research findings into its framework, ICanCaRe not only recognizes the severity of the issue but actively addresses it through a personalized and holistic approach. It serves as a call to action for individuals to take charge of their respiratory health, break free from tobacco addiction, and embrace a future free from the shackles of compromised lung function.

ICanCaRe stands at the forefront of the battle against tobacco addiction, offering a lifeline to those grappling with the consequences of PRISm. Through its holistic approach, the program not only supports individuals in their journey to quit smoking but also contributes to a healthier, tobacco-free future for communities worldwide.

It is time we #savetheyouth. SAVE our next generation!! #knowtobacco to #notobacco

Reference:

1. Mariko Kogo et al. Longitudinal changes and association of respiratory symptoms with preserved ratio impaired spirometry (PRISm): The Nagahama Study. Ann Am Thorac Soc. 2023 Nov;20(11):1578-1586. doi: 10.1513/AnnalsATS.202301-050OC.

2. Daniel H Higbee et al. Prevalence, risk factors, and clinical implications of preserved ratio impaired spirometry: a UK Biobank cohort analysis. Lancet Respir Med. 2022 Feb;10(2):149-157. doi: 10.1016/S2213-2600(21)00369-6.

Author –

1. Dr Shikha Jindal Consultant Pulmonologist Dr Shikha Jindal Gupta MD, CTCS(GU)

– Sr Consultant Pulmonologist,

– Certified Tobacco Cessation Specialist (Gujarat University by ICanCaRe)

Neo Super-Speciality Hospital, Noida

2. Dr Pawan Gupta M.Ch. Cancer Surgeon

 –  Sr. Director, Surgical Oncology

MAX Institute of Cancer Care, Vaishali, Patparganj and Noida

–          Founder Director – ICanCaRe – Innovative Cancer Care and Rehabilitation ICanCaRe, ICanCaRe Academy

–          Master Trainer – Tobacco Cessation Courses, Oral Cancers

#icancare #asthmaawareness #secondhandsmoke #icancareapp #pawangupta #icancareacademy #knowtobacco #Prism #COPD #smoking #quitsmoking

Suneela Garg Dr. Paramita Sengupta Rakesh Gupta Dr Pawan Gupta Dr REENA R KUMAR Shruti Agrawal Rishabh Agrawal Dr. Siddhi Hathiwala Dr Neha Agrawal ICanCaRe – Innovative Cancer Care and Rehabilitation Dr Shikha Jindal Consultant Pulmonologist