Zusammenfassung
Das vorliegende Kapitel bietet die Behandlungsempfehlungen der Tabakleitlinie mit ihren Hintergrundtexten. Es ist untergliedert in die Abschnitte Motivationsbehandlung und Kurzinterventionen, Harm Reduction, Psychotherapeutische Interventionen, Arzneimittel zur Entzugsbehandlung und Rückfallprophylaxe, Somatische Therapieverfahren, Gender- und Altersaspekte, Somatische Komorbidität, Psychische Komorbidität sowie Setting, Versorgungsorganisation und Aspekte der Finanzierung.
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Notes
- 1.
Ergänzende Position der DEGAM: Wenn eine leitliniengerecht durchgeführte medikamentöse Behandlung mit einer Nikotinersatztherapie nicht ausreichend wirksam war, soll der Einsatz von Bupropion zur Tabakentwöhnung angeboten werden.
- 2.
Ergänzende Position der DEGAM: Wenn eine leitliniengerecht durchgeführte medikamentöse Behandlung mit einer Nikotinersatztherapie nicht ausreichend wirksam war, soll der Einsatz von Vareniclin zur Tabakentwöhnung angeboten werden.
- 3.
Die Fachgesellschaft „Deutsche Gesellschaft für Suchtmedizin“ (DGS e.V.) ist der Auffassung, dass die elektronische Zigarette angesichts der Datenlage zur Unterstützung der Tabakabstinenz unter Beachtung von und nach Aufklärung über mögliche Risiken berücksichtigt werden sollte, wenn andere, evidenzbasierte Maßnahmen zur Erreichung einer Tabakabstinenz für Raucher nicht in Frage kommen. Die Fachgesellschaft bittet darum, bei der nächsten Überarbeitung der Leitlinie eine konsensbasierte Empfehlung auf Basis der vorhandenen Evidenz zu formulieren.
- 4.
Die Fachgesellschaft „Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin e.V.“ (DGP) hält die Risiken von E-Zigaretten insbesondere im dualen Konsum in der Darstellung der zuständigen Leitliniengruppe für unterschätzt. Die DGP kritisiert, dass mindestens eine Publikation (Polosa et al.) zitiert wird, die im Verdacht der Einflussnahme durch die E-Zigarettenindustrie steht. Eine Stellungnahme der DGP wurde in der Zeitschrift Pneumologie veröffentlicht (Pankow W, Andreas A, Rupp A, Pfeifer M. Tabakentwöhnung mit E-Zigarette? Pneumologie 2020: DOI: 10.1055/a-1323–6045).
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Andreas, S. et al. (2022). Behandlung von schädlichem und abhängigem Tabakkonsum. In: Batra, A., Petersen, K.U., Kiefer, F., Hoffmann, S. (eds) S3-Leitlinie Rauchen und Tabakabhängigkeit: Screening, Diagnostik und Behandlung. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-63679-4_4
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