니코틴 중독의 평가와 치료

Abstract

Smoking is a tenacious addiction. Addictive property of nicotine lays on the pharmacology of nicotine itself, which share many common features of other addictive drugs. Assessment of nicotine addiction includes history of smoking, level of nicotine dependence, reason of smoking, and comorbid psychiatric conditions. Treatment of nicotine addiction can be divided into two major categories; pharmacological and non-phamacological. Pharmacotherapy consists of several kinds of nicotine replacement therapies and newly introduced non-nicotinic drug therapies, especially bupropion and some selected antidepressants. Among non-pharmacological modalities, cognitive-behavioral strategies have been on the main line therapy for nicotine addiction. In the real situation of smoking cessation clinic, a multicomponent program is recommended with combination of various behavioral approaches and possibly with pharmacological interventions. Establishment of clinical smoking cessation program usually needs essential ground elements, together with organizations, resources, and revenue and reimbursements. In this context, this country, however, lacks available resources and reimbursement system which are believed to be an important basic requirements for establishing the standard smoking cessation program. This lack of understanding, in turn, effects as a barrier for developing clinically relevant programs in the hospital setting. It is necessary that public recognition on the smoking behavior need to be changed, as it is actually a medical illness, not a personal problem, to overcome the difficult situation arising from fight against nicotine addiction in this country.