To address this global health problem, in 2010 the American Heart Association (AHA) introduced concept cardiovascular health, which currently includes eight components: a nutritionally balanced diet, regular physical activity, avoidance of bad habits, healthy sleep, control of body mass index (BMI), fasting blood glucose, total cholesterol and blood pressure.
The main risk factors leading to disability over the past 30 years are smoking, high BMI and lack of control of blood counts. However, when adjusting lifestyle to quit smoking, many patients experience the greatest problems, notes Artur Tuktarov.
“From a medical point of view, any form of smoking must be immediately stopped, since this bad habit is an independent cause of cardiovascular diseases,” said Artur Tuktarov. “However, quitting smoking is not always easy. Smokers with a strong tobacco addiction and low motivation to quit should consider applying the concept of harm reduction, which involves switching to less harmful alternatives – innovative smokeless tobacco products.” At the same time, quitting smoking is recommended regardless of possible weight gain, since weight gain is disproportionately less harmful to health and increases the risk of cardiovascular diseases than smoking cigarettes.
“Of course, we must fight tobacco use, but we should use all available ways to help patients with low motivation to quit,” Artur Tuktarov clarified. — A practicing doctor must have up-to-date information, a wide selection of methods and practices. Leaving the doctor’s office, the patient begins to take responsibility for his own lifestyle. It is vital that he does not feel helpless when it comes to quitting smoking and is informed about new options based on the latest scientific research.”
Scientists from St. Petersburg State University conducted a large-scale study of the level of awareness of medical workers about the types of nicotine-containing products, the sources of health risks when using them, and the peculiarities of the practice of influencing smokers to quit their addiction.
The study was conducted in eight regions of Russia. It was attended by 965 respondents, of which 29% were general practitioners, 21% were cardiologists, 15% were clinical laboratory diagnostic staff, and 35% were other medical specialists. The majority (89%) of doctors agreed with the statement that a patient’s chances of quitting largely depend on the advice of a medical professional, and only 8% were skeptical about this statement. At the same time, only every fifth (20%) doctor is ready to ask patients about their smoking history if they have a smoking-related disease, and the majority of doctors (79%) clarify their smoking status in any case.
The study also showed that doctors are extremely poorly informed about the principles of operation of electronic cigarettes (vapes): more than half of respondents (58%) confirmed that they “don’t know much,” 14% know nothing at all, and only a third of doctors (28%) They replied that they knew well. 72% of doctors “don’t know much” and “don’t know anything” about the differences between electronic tobacco heating systems (ESHT) and conventional cigarettes. However, the majority believe that the harmful effects in cigarettes are due to exposure to combustion products of tobacco—720 out of 965 respondents had this information.
“Unfortunately, the survey shows that most of the medical community has no idea how electronic cigarettes and ESNTs actually work, how one system differs from another, what their features and principles of impact on the consumer’s body are,” commented Arthur Tuktarov. “Confusion in definitions and lack of information about new approaches and tools lead doctors to use the same categorical approach when talking to a smoker.”
According to the doctor, this state of affairs is directly or indirectly promoted by the World Health Organization (WHO). The policy of total bans also applies to information about new approaches and methods for reducing the risk of smoking. As a result, both doctors and patients found themselves in an “information vacuum.”
“In practice, doctors’ categorical prohibitions addressed to smokers are, as a rule, ignored – they are already accustomed to them, and they are not taken seriously,” Tuktarov explained. “To solve the problem, a more flexible way is needed – for example, reducing the risk to an acceptable minimum, to the extent that the patient himself is ready for this.”
Health care professionals should receive accurate information about the role and potential of harm reduction concepts for patients with low motivation to quit smoking and the difference between smoke-free products and traditional cigarettes. “In addition, it is advisable to introduce sections on the concept of harm reduction into training programs for doctors and into relevant clinical guidelines,” noted Artur Tuktarov. “This will help adult smokers who have no motivation to quit smoking to receive qualified medical advice not only from the point of view of completely quitting smoking, but also from the point of view of harm reduction, which is especially important in the treatment of a wide range of pathologies where cigarette smoking negatively affects on the outcome of therapy.”