[How to evaluate and treat tobacco dependence].

Tobacco smoking remains a major public health problem; although the number of smokers seems to diminish, the percentage of heavy smokers increases owing to a real dependence on tobacco. This dependence is a complex phenomenon, with a constant psychological component and a variable pharmacological component related to nicotine. These two types of dependence must be evaluated as best as possible by means of tests (personality tests eliciting depressive elements, Fagerström's test, etc.

[How to prevent vascular risk related to smoking: an aid to discontinue smoking].

In addition to hypertension and hypercholesterolemia, the third major risk factor in vascular diseases such as atherosclerosis and acute thrombosis is nicotinism, particularly that involving the smoking of cigarettes. Each cigarette smoked, with inhalation, is followed by increases in blood pressure and heart rate due to release of catecholamines and vasopressin. In addition, nicotine intake modifies the metabolism of certain drugs, such as beta-blockers, diminishing their antihypertensive action and hence nullifying the therapeutic benefit.

[Nicotine gum and lipid profile].

Smoking promotes for atherosclerosis by several mechanisms and particularly its actions on lipid metabolism; nicotine liability is well established. In one patient the use of nicotine-gum was reported to increase total cholesterol and LDL cholesterol. We studied lipid modifications in 14 voluntary students, heavy smokers (greater than 20 cigarettes/day) and nicotine dependent (Fagerström test; score greater than 7).