Abstract
Smoking not only increases the risk of stroke, myocardial infarction, chronic obstructive pulmonary diseases, and cancers, but also the risk of tobacco-related ear, nose, and throat diseases, including upper respiratory infections and head and neck squamous cell carcinoma (HNSCC). In Japan, there are only a few ENT outpatient clinics that provide smoking cessation treatment covered by the national health insurance and few reports from ENT outpatient clinics on the results of smoking cessation treatment. The study group consisted of 73 Japanese patients (44 men and 29 women) with a median age of 56 years (range, 24 to 78 years) who had received smoking cessation treatment with varenicline during a 2-year period at the Department of Otolaryngology-Head and Neck Surgery of Hokuto Hospital. The patients were asked about their nicotine addiction behaviors, answered a tobacco dependence screening questionnaire, and underwent measurement of their expired carbon monoxide levels. The patients had received varenicline at the dose of 0.5 mg a day for 3 days, followed by 0.5 mg twice a day for 4 days, and then 1.0 mg twice a day for 11 weeks and were required to visit the hospital 5 times within the 12-week period. The main reason for receiving the smoking cessation treatment among the patients was recommendation by the ENT doctor in (27 patients, 37%), concern about the onset, exacerbation, or recurrence of chronic diseases (26 patients, 36%), or recommendation by the family (8 patients, 11%). Of the 73 patients, 52 (71%) successfully quit smoking following the smoking cessation treatment. Quitting smoking at the second visit (p<0.001) and a larger number of visits to the clinic times (p<0.001) were factors that contributed favorably to smoking cessation by the end of the treatment period of 12 weeks. Adverse events of varenicline appeared in 27 (37%) of the 73 patients, including nausea and vomiting in 20 (27%) patients. The major reason for failure to quit smoking in response to the treatment was discontinuation of varenicline due to the appearance of adverse events (9 patients, 12%). ENT doctors often treat patients with tobacco-related ear, nose, and throat diseases and sometimes also patients with HNSCC associated with smoking. Smoking cessation treatment should be administered at ENT outpatient clinics to promote smoking cessation by a larger number of smokers.
