It was discovered the largest black hole

It was discovered the largest black hole

Astronomers say they have discovered the largest black hole ever observed that a genuine "monster" with a mass of 17 billion times that of the Sun, which is at the center of distant galaxies.

This huge black hole is 14% of the total mass of its galaxy, unlike the 0.1% recorded usually in other galaxies. Is a rate so high that it could compel specialists to review their theories about the formation of galaxies.

Huge black hole in NGC 1277 is located 220 million light-years from Earth, in a galaxy 10 times smaller than the Milky Way. Diameter black hole is huge, being 11 times greater than Neptune's orbit around the Sun.

"It's really an unusual galaxy," said in a statement Karl Gebhardt of the University of Texas at Austin American city.


"It's almost entirely a black hole. Could be the first object found in a new class, the galactic black holes," added the researcher, co-author of the study, published Wednesday in the British journal Nature.

NGC 1277 is certainly occupy at least the second-largest black holes identified and has a real chance to actually be in first place in the ranking.

Mass black hole considered current Number 1, discovered in 2011, has not yet been calculated accurately - it could be between 6 and 37 billion times the mass of the Sun.

Black holes are the most powerful forces in the universe, creating a gravitational field so intense that even light can not escape them.

A stellar mass black hole is formed when a star collapses very big inside her, towards the end of his life. Black hole can continue to grow, engulfing other stars and merging with other black holes, leading sometimes these supermassive black holes that occupy the centers of galaxies.

But NGC 1277 questions this theory by disproportionate to its size galaxy belongs.

Further studies will be necessary to determine whether the abnormally large black hole is unique in its own way or if it actually reveals a mechanism yet unknown cosmic training.

"Galaxy which hosts the black hole seems to have formed as a result of over 8 billion years old and it does not seem to have changed much since then," said researchers at the Max Planck Institute, study coordinators.

Dentists advice to parents

Dentists advice to parents

Parents are constantly bombarded with information about how to feed their children, how to sleep and how to raise them healthy and safe. However, even the most conscientious parents can give children food or drinks that can damage children's teeth.

Some nutrition experts advise us to eat 5 servings daily of fruits and vegetables. However, dentists warn us of the dangers of so-called healthy foods. Beverages containing fruit, which have large amounts of sugar and can have a negative effect on teeth. Dentists say the juices are high in sugar composition, which encourages bacteria attack the protective enamel of the teeth.

We recommend your dentist about baby food?

Many parents give their children fruit juice, considering that so encourage children to eat fruits and vegetables. To reduce the negative effects of these drinks, dentists advise parents to dilute them with water or buy drinks that have sugar in their composition.

Also sweetened tea or milk bottles before bedtime children are always present in most cases. Many children fall asleep faster if I drink a little tea or warm milk, but this contributes to the decay of the bottle, because milk contains sugar and teeth are most vulnerable at night. Dentists recommend daily intake of calcium for milk, but it should not be taken late and bedtime child to be given a bottle of water after washing teeth.

What's good to know about the oral health of children?

For imbunanatatirea oral health of children, dentists advise parents to involve their children in oral hygiene from an early age yet, just create a routine in dentifrices. Parents are encouraged to take their children to the dentist since the age of one year, thus creating a good relationship and stable child-dentist, which will reduce the risk of early installation dentofobiei. Dentists recommend their parents to care for children with food, as much as possible to avoid sugars and carbonated drinks that are dangerous to the gums and teeth.

Preventing caries in children with fluoride

Preventing caries in children with fluoride

Why is prevention (prophylaxis) decay so important and why particular program can help the doctor will explain Valerica Giusca in the article below.

Fluoride is a natural nutrient that supports the development of healthy teeth significantly. Sodium fluoride occurs in the enamel making it resistant to acids produced by plaque bacteria, while stimulating and remineralization of enamel. For effective protection antiquarian, fluoridation should start before the eruption of their teeth when fluoride is transported through the bloodstream to the dental bud. After the eruption, the teeth directly take fluoride content in saliva. For this reason, tablets Zymafluor (fluoride supplements) should not be swallowed, but allowed to dissolve slowly in the mouth.
Preventing caries in children with fluoride
Appropriate use of fluoride in children

When used properly, zymaflorul (fluoride tablets) is very effective in the prevention and control of caries. Statistically demonstrated that fluoride passes the placenta in 5 and 6 months of pregnancy when actually formed deciduous teeth of children. Thus it may be advisable in some cases zymafluor administration to pregnant women.

Zymafluor's administration during pregnancy and lactation protects teeth fluoridation ensure optimal maternal and fetal bones.

Caries prevention with zymafluor is for a long time, and doses are reevaluated periodically dentist 3 in 3 years to 12 years when the last molar erupts on the arch. Administration of fluoride is recommended that the pill be on hand when you tuck the sides of the arch for having and local effect.

Zymafluor treatment is continuous - not interrupted once started it can cause unpleasant side effects such as dental fluorosis.
Preventing caries in children with fluoride
Dental fluorosis in children

Fluorosis occurs after exposure to high levels of fluoride during enamel formation and is characterized by hipomineralizarea surface layer of enamel. Changes increased in severity with increasing fluoride levels. Dental fluorosis occurs only during tooth formation - that while they do not yet erupted on the arch, so at younger ages 8 years. After the teeth have erupted developed and they can not be affected by fluorosis.

To prevent overdosing is very important to know the level of fluoride in drinking water and in table salt. Must also be evaluated and other fluoride sources including diet.

How our country the amount of fluoride in drinking water and mineral water is negligible / undetectable and as there is no food sold with added fluoride then the risk of overdose is very small. For this reason, experts say preventing decay from Oralmed dosed and controlled by administering fluoride supplements at different stages of age (or lakes chewable tablets, gels fluorinated topical)

How to whiten your teeth at home

How to whiten your teeth at home

Teeth white as pearls have yellowed or have spots? Regain your beautiful smile and whiten your teeth at home. Your teeth have a yellowish color to various substances: coffee, soft drinks, tobacco, drugs or food. Get rid of stains on teeth, keep them clean and change your oral hygiene habits.


What can you do to whiten your teeth at home?

 Dentist.ro you make some recommendations about teeth whitening at home:
 How to whiten your teeth at home
1. Consult a dentist:

Dentist.ro recommend you consult a doctor every 6 months to have your teeth examninati and clean. Some people have problems with dental plaque deposit, which is why going to the dentist more often. Your dentist can give you more tips about how to turn your yellow teeth in white and how to have a healthy and bright smile.
 How to whiten your teeth at home
2. Use baking soda:

Brush your teeth with baking soda. If you have access to a sonic electric toothbrush or visible results. Mix baking soda with water to make it easier you to brush your teeth and part of a good brushing. Should not insist on brushing teeth should not be aggressive, in turn, need to make sure you brush each tooth surface. Ask your dentist that you have reached the area by brushing and the teeth need attention.
 How to whiten your teeth at home
3. Use hydrogen peroxide:

Mix 2/3 water and 1/3 hydrogen peroxide (hydrogen peroxide), the latter one can find in any drugstore. Use a glass where they mix. You can use this mixture as a mouthwash. Hydrogen peroxide has antibacterial properties and is used most often to disinfect wounds. It also has bleaching properties, used in bleaching hair. Hydrogen peroxide not only removes stains from teeth, but also prevents stains and bacteria.
 How to whiten your teeth at home
4. Use the "milk of magnesium"

After using teeth whitening kit home teeth become sensitive. To reduce this sensitivity, use the "milk of magnesium" is the common name for magnesium hydroxide, a substance used in medicine. Does the term 'milk' is a composition for white, milk, natural minerals magnesium. This substance acts as a protective barrier for your teeth, reducing tooth sensitivity without interefa with effective whitening gel.
How to whiten your teeth at home
5. Avoid certain foods:

Especially those that stick to teeth. Foods that stain teeth were strong in their composition or artificial colors or natural. Coffee, tea, mustard, red wine, blueberries are natural dyes. Many of these foods are healthy and need to eat. But do not forget that you should brush your teeth right after each consume them.
 How to whiten your teeth at home
6. Quit smoking:

Smoking not only makes your teeth yellow, but it is dangerous for your health. Smokers should use a toothpaste especially if they continue to smoke.

History toothpaste

History toothpaste

Toothpaste started to be used since i 500 Hours, both in India and in China. However, at that time, toothpaste does not describe the product you use all day, which was invented only in the 1800s. In 1824, a dentist named Peabody was the first to add soap to toothpaste composition, and in 1850, John Harris has used chalk as an ingredient.

Two decades later, in 1873, Colgate toothpaste began to mass commercialization of container used is at the moment a jar. Only in 1892, Dr. Washington Sheffield of Connecticut chose to use a collapsible tube as toothpaste container. Colgate was not late to take the idea doctor said, so in 1896, it produced toothpaste was sold in collapsible tubes similar to those of Sheffield.

After the Second World War, progress in synthetic detergents have facilitated the soap in toothpaste composition to be replaced with agents based emulsifiers sodium.
A few years later, Colgate started using fluoride as an ingredient.

Did you know ...?

The oldest recipe for toothpaste dating from 400 BC and was discovered in ancient Egypt, was written by a scribe on a parchment sheet. The document is now in a Viennese museum. According to him, for a perfectly clean teeth were needed: 1/100 ounce of rock salt, 2/100 ounce of mint, 1/100 ounce of dried iris flower and 20 grains of pepper.

History of orthodontics

History of orthodontics

Straightening teeth, namely by tooth extraction which helps proper alignment of the teeth was practiced since ancient times, although the branch of dentistry orthodontics appeared only in the 1880s.

According to the American Association of Orthodontists (AAO), archaeologists discovered the mummified bodies of ancient people who were raw metal bands around the teeth, and the Etruscans were buried still wearing the devices used in life to prevent damage teeth and teeth change position. Also, the findings made by a researcher in a Roman tomb in Egypt show some teeth bound with gold wire - the first document of a link.

However, in terms of appearance and evolution of orthodontics, great discoveries came later, around 1800, the credit from many people who have left their mark on the progress of dentistry.
History of orthodontics
First, we should mention the "father of dentistry," Pierre Fauchard (photo), who in his work from 1728 - "Surgeon Dentist" - devote an entire chapter methods of straightening teeth. Fauchard used for straightening teeth a device called "bandits", a piece of precious metal horseshoe shaped what was intended to expand the maxillary arch.

A few years later, in 1757, French dentist Bourdet in turn published a book, "The Art dentist", of which a section was reserved for ways to correct alignment of teeth and also devices used for this purpose. Bourdet, dentist king of France, has perfected the "band" of the Fauchard, being the first premolars extraction recommended to correct "clutter" that has been scientifically proven teeth and jaw growth.
History of orthodontics
Scottish surgeon John Hunter wrote, among other works, "The natural history of teeth" (1771) and "practical treatise on diseases of the teeth," describing in detail the anatomy of the tooth, or dental pathology. He was the one who coined the term "cusp," "bicuspid" "incisive" and "molar."

In 1819, Delebarre introduced in practice clasp wire straightening teeth, and in 1841, Joachim Lafoulon coined the term "orthodontics."

Historians believe that the title "father of orthodontics" to be offered so Norman W. Kingsley, a dentist, sculptor, writer and artist, author of "Treatise on jaw abnormalities" (1880), and JN Farrar, author of two books "Treatise on dental irregularities and ways of correcting teeth." Latter owe the invention of braces, he was also the first to suggest the use of pressure on the teeth at regular intervals to straighten.

Another leading figure in the evolution of orthodontics is Edward H. Angle (1855-1930), who developed the first classification system for malocclusions, a system that is used today. System or offer dentists a simple way to describe how crooked teeth are, what direction they are pointing and how they are arranged in the oral cavity. All Angle is one who, in 1901, founded the first school of orthodontics and organized the American Society of Orthodontics, which became the American Association of Orthodontics in 1930.
In the early 1900s, Orthodontists using gold, platinum, steel, silver, rubber (sometimes wood, ivory, zinc, copper and brass) to manufacture ligatures, hooks and loops used to straighten teeth. The most commonly used was gold (from 14 to 18 carats) due to its malleability. Were made of gold wires, ligatures, clips, while the iridium-platinum alloy sheets were made braces that were fixed on maxillary arch. Gold teeth straightening devices are wrapped around each tooth individually.

In 1929 the first commission was established specialist orthodontic American Commission and the late 1930s, was invented toothbrush with nylon bristles ('38) and stainless steel throughout the '40s began to be used scale. However, using this alloy braces was controversial, being fully accepted in the 1960s.

Before we get to the inventor of Invisalign, braces device "invisible"-should I mention in this History of orthodontics and Dr. New York SC Barnum, who invented the rubber dam (rubber wrap that is used to isolate teeth when a dental), Eugene Solomon Talbot's (1847-1924), who first used radiographs in orthodontics and Calvin S. Case, the first person who used rubber elastic braces.

As braces "invisible," its inventor is Zia Chishti, along with business partner, Kelsey Wirth, founded Align Technology company in 1997, the company manufactures and markets Invisalign appliances. They were sold for the first time in May 2000.

Flossing history

Flossing history

Have you ever thought who invented floss when you enjoy how it cleans teeth?
Dental floss is an ancient invention. Some researchers have found evidence that prehistoric human teeth using dental floss and toothpicks.

Who invented dental floss?

Levi Spear Parmly (1790-1859), a dentist in New Orleans is the inventor of modern dental floss (or perhaps reinvented the term is more appropriate). Dentist Parmly promoted in 1815, cleaning teeth with a silk thread.
  In 1882, a Massachusetts company began mass production of silk floss for commercial home use.
Flossing history
Who patented floss?

In 1898, The Johnson and Johnson Company of New Jersey has received a patent for dental floss. Dr. Charles C. Bass has improved floss existence at that time, changing the use of silk using nylon, because the latter has a high strength and elasticity. This replacement took place during the Second World War. Dr. Bass was responsible to perform a type of floss as an important part of oral hygiene.

Flossing history
Today we provide a wide range of types of floss, the most commonly used is the nylon menthol to give a touch of freshness in the mouth. Companies producing nylon floss using a biodegradable, not to harm the environment.

How to get rid of the fear of going to the dentist?

How to get rid of the fear of going to the dentist?

Many of us try hard to avoid a visit to your dentist even if the pain you feel is unbearable, for fear of the dentist, a "disease" that can suffer from too many people, makes us resort to any other solutions Besides the safest and most also indicated.

However, small oral hygiene problems or you feel the slight discomfort due to toothaches we choose to treat themselves can turn into more serious problems not only be treated solely on the recommendation of the dentist, but we oral health can affect irreversibly.

In general, fear of dentist is the result of previous experiences more or less traumatic that has left its mark on the way we relate to a dental check. It can be painful treatment or procedure that created a high degree of discomfort is substantially stronger impact if these experiences occurred in childhood.

Also, the experiences of others can cause a person to fear a visit to the dentist, even if it has not been herself through an event of such nature, which makes the expectations from a dental checkup be some negative .

Fear of the dentist, which can sometimes reach up to a real phobia, manifested by refusing to call a dentist may be associated often with feelings of shame, considering that some people will rebuke expert on how protecting their teeth from disease.

As I look on dentists, the main way to avoid that patients come to fear the future control of anesthesia or sedation is used to eliminate any discomfort resulting from treatments applied during the visit.
Moreover, for those who are afraid of the pain it might feel after anesthesia goes, dentists may recommend painkillers.

As for patients, they first need to undergo routine inspections conducted at regular intervals to prevent such serious oral health problems or allow them to be detected early and treated as soon as possible so as not to cause complications.

Also, choosing appropriate dentist is a very important step to get rid of the fear of a dental appointment.
Visited several dentists and choose the one who best meets your expectations, raspunzadu you any questions, explaining in detail the procedures and treatments applied and informing you about the risks and benefits.

Also, make so that first visit to a dentist to be just a consultation without involving treatment, so you can tell if your dentist that you called it as your needs and expectations.

So if you find that you want to see other specialists in the future, you will avoid going through an experience that might lead to fear of visiting the dentist.

Last but not least, do not hesitate to ask for explanations, preferably as detailed. You will feel much more comfortable if you are informed and prepared for what lies ahead and know the potential problems that might arise.

Dentofobia

Dentofobia

Dentofobia afraid of applying a dental treatment, which by extension is the fear of the dentist. Dentofobia even if the person is not experiencing a physical stimulus, but the memory process or situation that caused this fear. Thus, a total dentofob refuse to get in touch with your dentist or any situation that it includes.

People worldwide suffer from an intense fear of the dentist and back can be many reasons, such as embarrassment to the doctor about poor oral hygiene, fear of pain, traumatic experiences in the past, fear of dentist end after others said so.

Dentofobia is caused by our unconscious mechanism that protects us from what they think on some level may be a danger to us, in this case the dentist as a threat. It is usually caused by unresolved emotional conflict.

Whether it's genetic or just luck, oral health is different from one person to another. Some people are able to withstand years between visits to the dentist without having a huge impact on their oral health. Others are likely to have tooth decay and gum disease, no matter how often wash their teeth and floss. These things sometimes lead to an attitude of rejection of a dental treatment, creating a vicious circle with serious repercussions.

Most people exhibit instinctive fear of the dentist, which is dental anxiety. It can be a reaction which occurs when they are dealing with something new, unknown.

Dental anxiety is different from dental phobia. Most people can face anxiety related to visiting the dentist, but for those suffering from dentofobie this visit is scary, avoid visiting the dentist, enduring pain. This has a negative impact on oral health of the patient.

Also dentofobiei implications are also found in the patient's general health status. Sufferers dentofobie, besides poor oral health are prone to heart disease or lung.

Dentist.ro team has identified a deficiency of information on this topic and also dentofobilor need information about their problem. Therefore, if you find yourself in the above description, watch our site shortly. Will follow, for you, a series of articles in which we try to answer all your questions and help you to understand the problem and why not to solve.

Who's afraid of the dentist?

Who's afraid of the dentist?

Many people still fear going to the dentist despite Dental techniques have improved considerably in recent years, almost completely eliminating the pain. If you make a visit to the dentist will notice, certainly things have improved a lot since your last visit.

The general impression is one of relaxation, dental techniques and sterilization procedures are newer and more efficient, and equipment is the latest generation.
Who's afraid of the dentist?
FAQ of patients

Fear of the dentist can have various causes. To overcome your fear would not hurt to do a classification of things that you're afraid the man and find some solutions to overcome them. Trying to help, we thought we'd offer you some answers to the most common questions asked by those who are afraid of dental treatments.

The good news is that dentists understand increasingly more patients' fears and combining with gentleness kindness can make dental treatment to be a common experience that we not be afraid.
Who's afraid of the dentist?
There are specific practices in treating difficult patients?

You must not be afraid to inform you about some practice before you choose the one that suits you. If you do not like what you find, do not make an appointment and keep looking until you find services on your taste. You may be required to travel the distance, but it will be worth your effort to not be afraid.

I have not been to the dentist for a long time. We need more treatments?

Years ago, the treatments were long, but today technology shortens amazing breakthrough in dental clinics much solve any dental problems.

It is important to make regular visits to the dentist not only to monitor the status of your teeth, but also to prevent periodontal disease. Once your teeth is healthy, visits to the dentist will become simple control and brushing sessions.
Who's afraid of the dentist?
How to go to a dentist if I scared?

You can be helpful to see what it is first before you make an appointment. Call reception, see the atmosphere, you can even move around to see if there are doctors dentists willing and attentive.

Do you have a sense of confidence? You could even talk to a dentist and get treatment only interested in a simple visitor.

What happens at the first meeting?

The first meeting should be only for consultation. Look at this as an opportunity for you to interview the dentist, assistant secretary at the front desk or dentist.

You have made a warm welcoming and attentive? The doctor is interested in your problem? If you liked what you heard and what you saw, you still will want to make an appointment for a short session of treatments such as: an ultrasonic scaler, a filling etc. Give way to take things in your pace without feeling compelled to do something that is not your liking.

You should tell your dentist that there are more agitated?

Tell medical professionals that are restless or concerns, just so I can help you. Tell the doctor what specifically bothers you about dental treatment.
Who's afraid of the dentist?
I'm afraid of injections. What can I do?

Again, make sure you tell the dentist that this is an issue that bothers you. There anesthetic gel is applied to the gums before injecting anesthesia to numb gums that are designed to reduce total and pain.

What is the best time of day to make a visit to the dentist?

It would be recommended that you make an appointment at a time that you feel best, at a time when you do not have other duties to worry about. Give yourself enough time to go to the dentist so relaxed. Rushing to get to the dental clinic will only agitate you more.

I decided to do a check. What's the next step?

Advice: you have to take things slowly. Discuss the proposed treatment with your dentist and decide if you feel able to do it. This could mean a simple dental mirror examination. If you pass this stage to continue with scaling. You must not be afraid to say you want to stop, continuing on another day.

What can I do to relax during the treatment?

Can you pay attention to treatment trying to plan your next vacation each day or, more simply, to focus your attention on the music of the cabinet. You can thus get dental treatment distance as the music fades turbine noise.

I can tell the doctor if you feel the need to stop?

Before you start treatment puts you agree with the doctor on a gesture to mean: "Stop now - I need a break." It is enough to raise my hand and the doctor will stop, resuming treatment when you're ready to go. When you feel like you can control the situation, you'll be safer.

FAREWELL fears! As your dentist you know and you trust him and other members of the clinic, you will realize that the fears were gone. Meanwhile, you gain control over your fears and dental care will become a regular habit in your life.

Fear, anxiety or dental phobia?

Fear, anxiety or dental phobia?

It happens often to use the terms "fear of the dentist", "dental anxiety" and "dental phobia" as having the same meaning. But these terms are different. And to really understand your problem, we present the following peculiarities of each and the differences between them:

Fear of the dentist

It is a reaction to a known danger occurs when a person faces threatening stimulus. Reaction might be called the "fight or flight". When this reaction is becoming stronger, becoming phobic.
Fear, anxiety or dental phobia?
Dental Phobia

It is based on fear, stronger and irrational. The reaction is going on, image, memory of that situation, for example. This can lead to an immediate anxiety response, which may take the form of a panic attack. Hence the total refusal of the person who comes in contact with your dentist.

Dentofobiei causes can be previous bad experiences with dentists or family or heard stories from different people about dental treatment.

Its consequences on the social life of the patient are major depression occurring, maximum stress, fear the appearance of teeth and unable to integrate.
Fear, anxiety or dental phobia?
Dental Anxiety

It is a reaction to an unknown danger when an individual anticipates the worst from simple dental procedures. Anxiety is a common problem and a lot of people is tested by this feeling especially when they are faced with something new, unknown.

Cause of the shows and types of anxiety. The exogenous occur because of a medical act traumatic childhood and is manifested by tremors, damp palms and hands, rapid heart rate and stomach pain. On the other hand, endogenous anxiety occurs after frightening experiences in adolescence or in adulthood and is manifested by shortness of breath and nervousness.

The major difference between anxiety and phobia is that most people can live with this anxiety feeling restless or just embarrassed, fear exaggerating. But those with dental phobia feel intense fear and dental control becomes a traumatic experience. They are the ones who support any dentist not work.

Health – Future Vision

We have all imagined how the future will look like in one way or another. This movie is trying to show us how the medical and health will will look like.
At the beginning of the movie we have a runner measures her performance using a small tablet. Arriving home, the runner sends her performance graphs taken during her running on a screen. Meanwhile, her doctor suggestsa control by observing something suspicious in the graphs.
Movie is done in a completely futuristic air. The doctor select an area of the hospital where he wants to go, then arrives there as from teleportation.
Some people may find these facts funny or crazy, but modern science has shown that it can overcome many barriers.

Read more about this on Transhumanmedicine website

New York City pushes earlier treatment for AIDS

In an effort to halt the spread of AIDS, health officials in New York City recommended yesterday that treatment with anti-AIDS drugs should begin as soon as an individual is diagnosed with the human immunodeficiency virus (HIV), the virus that causes AIDS, rather than waiting for it to begin harming the immune system.

New York City Health Commissioner Dr. Thomas Farley sees the switch as a new way to fight the disease. As he told the Wall Street Journal, “I’m more optimistic now than I’ve ever been about this epidemic that we can drive our new rates down to zero or close to it—eventually.”

As my Harvard Health colleague Peter Wehrwein described in a post on Worlds AIDS Day 2011, drug therapy can help prevent the transmission of HIV. Using it earlier may help protect the immune system.

HIV destroys the type of infection-fighting white blood cells known as CD4 cells. As the number of CD4 cells dwindle, the body becomes more susceptible to infections. These are often infections that people with healthy immune systems fight off easily.

Some AIDS experts question the value of waiting until CD4 counts begin to dip, and recommend—as New York City officials have done—starting anti-HIV therapy as soon as the virus is detected. These drugs can’t totally rid the body of the virus. But they can keep the number of HIV particles low enough to slow down, and perhaps even prevent, destruction of the immune system.

Early treatment is especially important for people with a high number of HIV particles in the bloodstream (called the viral load). A higher viral load increases the chances of a more rapid decline in immune function. It is also a good choice for people who aren’t comfortable waiting to treat a medical problem that could be treated now. For them, early treatment could be an important psychologic boost.

Read more on TRANSHUMENMEDICINE

Substitutes drugs

Substitutes drugs

Bupropion (Zyban) - is the first drug that does not contain nicotine whose effectiveness has been proven scientifically. It is also the first product that can be taken in tablet form. Bupropion belongs to the class of antidepressant drugs and is marketed under the name Zyban. Substance acts on dopamine receptors. There are contraindications to the use of bupropion, and possible side effects. Medicine is released on prescription.
Substitutes drugs
FDA approved new drugs used in tobacco withdrawal works by blocking nicotinic receptors in the brain. Thus, smoking will not cause a sensation of pleasure, and smokers are able to quit easily.
For example varenicline (Chantix) is taken twice a day. Once inside the body, varenicline is fixed on nicotine receptors in the brain, reducing the feeling of pleasure caused by smoking and reduces withdrawal symptoms. Some studies have shown that varenicline increases by 50% the chances of smokers quit smoking. Other studies suggest that varenicline is more effective than bupropion, at least in the short term.
Side effects of varenicline are: headache, nausea, vomiting, sleep disorders, flatulence and taste perversion. Overall, varenicline is well tolerated.
Other drugs have shown some effectiveness in tobacco withdrawal, but to a lesser extent than bupropion and cause serious side effects. For these reasons, they are prescribed only if bupropion is ineffective. These are: Clonidine (antihypertensive), buspirone (an anxiolytic, in the presence of symptoms of anxiety), moclobemide and nortriptyline (antidepressants).
Substitutes drugs
Quitting smoking is the most important decision that smokers can take to improve the quality of life and life expectancy.
Quitting smoking is not easy. To have as much chance of success, smokers should know the benefits, the difficulties they face and the options available.

Choosing a nicotine substitute

Choosing a nicotine substitute

Choosing a type of nicotine replacement therapy is depending on the degree of addiction, lifestyle and personal preferences of the smoker.

Before deciding, here are some comparative data:
Choosing a nicotine substitute
 - Gum, nicotine inhaler are tablets and oral substitutes that enable better control the dose of nicotine and helps reduce withdrawal symptoms.
 - Nicotine nasal spray has a very fast action.
 - Nicotine inhaler allows imitating gestures made while smoking by bringing your hand to your mouth and inhaling vapors.
 - Nicotine patch is easy to use and should be applied once a day.
 - Both inhaler and nasal spray require a prescription.
 - Some people can not use patches, inhalers or nasal sprays due to allergies or other conditions.
Choosing a nicotine substitute
Combining nicotine patch and other nicotinic substitutes

Using a nicotine patch in combination with other fast acting (gum, tablets, nasal spray, inhaler) is another method of nicotine replacement therapy. Action principle is simple: to provide a constant dose of nicotine by patch and use a fast acting product in difficult situations where the person feels the need to smoke.

The combination of different nicotine replacement therapy products not approved by the FDA. We recommend consulting a physician before using these products in combination.
Choosing a nicotine substitute
Sublingual tablets
Tablets are the most recent nicotine Nicotine replacements on the market. Similarly nicotine gums, tablets are available in two doses: 2 mg or 4 mg.
As recommended by the manufacturer launched these tablets, their use should be part of a program of 12 weeks. The recommended dose is one tablet every 1 -2 hours for 6 weeks, then one tablet every 2-4 hours in the next three weeks and finally, a tablet every 4 -8 hours in the last three weeks. In addition, we recommend:
 - Quitting smoking with the beginning of the use of these tablets
 - Avoid foods and drinks with 15 minutes of taking the tablet onwards (some beverages may reduce their effectiveness)
 - Dissolving sublingual tablet for 30 minutes
 - Up to 5 tablets in 6 hours, which means a maximum of 20 tablets daily
 - Cessation of use tablets after 12 weeks

Nicotine tablets are not indicated people who continue to smoke or consume other products containing nicotine (nicotine patch or gum).
Possible side effects of using nicotine tablets are:
 - Sleep disorders
 - Nausea
 - Cough
 - Heartburn (heartburn)
 - Headache (headache)
 - Flatulence (intestinal gas)

Sublingual tablets

Sublingual tablets

Tablets are the most recent nicotine Nicotine replacements on the market. Similarly nicotine gums, tablets are available in two doses: 2 mg or 4 mg.
As recommended by the manufacturer launched these tablets, their use should be part of a program of 12 weeks. The recommended dose is one tablet every 1 -2 hours for 6 weeks, then one tablet every 2-4 hours in the next three weeks and finally, a tablet every 4 -8 hours in the last three weeks. In addition, we recommend:
  - Quitting smoking with the beginning of the use of these tablets
  - Avoid foods and drinks with 15 minutes of taking the tablet onwards (some beverages may reduce their effectiveness)
  - Dissolving sublingual tablet for 30 minutes
  - Up to 5 tablets in 6 hours, which means a maximum of 20 tablets daily
  - Cessation of use tablets after 12 weeks
Sublingual tablets
Nicotine tablets are not indicated people who continue to smoke or consume other products containing nicotine (nicotine patch or gum).
Possible side effects of using nicotine tablets are:
  - Sleep disorders
  - nausea
  - cough
  - Heartburn (heartburn)
  - Headache (headache)
  - Flatulence (intestinal gas)

Nicotine inhaler

Nicotine inhaler

Nicotine inhaler is designed as a cigarette and act on the same pathways. Person aspires tobacco nicotine withdrawal in the form of a cigarette tube. This product is particularly useful for people with addictive behavior, they fail to stop the gesture of hand on mouth. The disadvantage is that the inhaler should be used frequently enough to get a dose of nicotine.

Inhaler consists of a plastic tab that contains a nicotine cartridge inside. Unlike other types of inhalers, which provides most of the dose to the lungs, nicotine inhaler delivers nicotine vapor to the mouth. In terms of behavior, the use of nicotine inhalers is closest to smoking, something appreciated by some smokers.
Nicotine inhaler
The recommended dose is between 6 and 16 cartridges a day for up to 6 months.
Nicotine inhaler
Adverse effects, especially common in the first use, refer to:
  - cough
  - Throat irritation

Nasal spray

Nasal spray
Nicotine crosses the nasal membranes, enters the venous system, flow to the heart, and the brain. Through cigarettes, it reaches the brain faster than using the nasal spray, nicotine patch or gum. However, the mode of absorption of nicotine nasal spray is similar to that of nicotine in cigarettes.

Nasal spray immediately reduce tobacco withdrawal symptoms. The main advantage of this product is simple to use and how. However, as it contains nicotine, this product is addictive. Therefore, the nasal spray is prescribed for a period of 3 months and maximum period of use should not exceed 6 months.
Nasal spray
Side effects usually lasts between 1 and 2 weeks and include the following:
  - Irritation of the nasal mucosa
  - Runny nose
  - Watery eyes
  - sneezing
  - Throat irritation
  - cough
Nasal spray
Nasal sprays are not suitable for people with asthma, allergies, nasal polyps or sinus problems.

Gum

Gum

With nicotine gum, former smoker can decide when ingesting nicotine, allowing immediate reaction to feelings of lack of nicotine.

Nicotine gum is a fast-acting substitute that enters the body through the oral mucosa. It comes in two doses: 2 mg for patients with moderate dependence or 4 mg for smokers with strong dependence. Not require a prescription.
Gum
Food intake may affect the absorption of nicotine. At least 15 minutes before and during gum use, avoid acidic foods and drinks: coffee, juices, etc.

People who smoke more than one pack of cigarettes per day, or every 30 minutes can start with a dose of 4 mg. A maximum of 20 gums per day and have tapered over 1 to 3 months. Using nicotine gum should not exceed 6 months.
An advantage of chewing gum is able to control the dose of nicotine. Gum can be chewed "as needed" or according to a schedule (at 1 to 2 hours). Recent data show that scheduled doses are more effective.
Gum
Possible side effects:
  - Bad taste
  - Throat irritation
  - Nausea and vomiting
  - tachycardia
Gum
Long-term dependence is a possible risk of nicotine gums. In fact, studies show that between 15% and 20% of former smokers continue to consume nicotine gum for a year or more. Although the maximum recommended use is 6 months gums consumption is considered to be less dangerous than going back to smoking.
Health effects caused by prolonged use of nicotine gums are not yet known.

Nicotine patch

Nicotine patch

The patch delivers a measured dose of nicotine through the skin. Since the release nicotine gradually over a period of 16 or 24 hours, the patch offers the advantage of providing a regular and measurable nicotine intake. Regular intake is helpful to normalize the secretion of dopamine, while measurable aspect allows dose adjustment according to specific needs of former smokers. The maximum duration of use is 8 weeks.

Doses are calculated either for 16 hours or for 24 hours:
Nicotine patch
 - Patch for 16 hours is effective in smokers with mild to moderate dependence. Risk of adverse effects is lower. This does not provide nicotine patch during the night, so no control withdrawal symptoms in the morning.
 - 24-hour patch provides a steady dose of nicotine and is effective in controlling the symptoms of withdrawal in the morning. But there are risks of adverse effects such as skin irritation and sleep disorders.

Depending on body weight, most smokers can start with a patch with a large dose of nicotine (15-22 mg) daily for 4 weeks, then going to a weaker patch (5-14 mg) another 4 weeks. The patch should be applied morning on a stretch of dry skin without excessive hairiness. Should be placed below the neck and above the abdomen (eg, arm). The duration of use should not exceed 8 weeks.
Nicotine patch
Side effects of nicotine patch depends on: nicotine dose, duration of use, method of application and individual characteristics (predisposition to skin reactions at the patch application).

Side effects of nicotine patch refer to:
 - Irritation - redness and itching
 - Dizziness
 - Tachycardia (accelerated heartbeat)
 - Headache (headache)
 - Sleep disorders
 - Nausea and vomiting
 - Muscle pain
Nicotine patch
Conduct for harm:
 - Reducing the amount of nicotine by using a lower dose patch
 - Sleep disorders can be temporary and disappear in 3 or 4 days. Otherwise, people using 24-hour patch can try a patch for 16 hours.
 - Stopping the use of nicotine patches and adoption of other forms of treatment.

Nicotine replacement therapy

Nicotine replacement therapy

Nicotine replacement therapy (NRT) refers to the use of drugs to reduce or eliminate withdrawal symptoms by providing controlled doses of nicotine, which does not contain any hazardous substances present in cigarette smoke. TSN is available in five formulations: nicotine patches, gums, nasal sprays, inhalers or sublingual tablets.
Nicotine replacement therapy
This product are designed to deliver a certain amount of nicotine in the body, thus alleviating withdrawal symptoms considerably, even in smokers with a strong nicotine addiction. Although toxin that is found at the base of tobacco, nicotine substitutes are much less dangerous for the body, because it contains no carcinogens created by combustion and pose little risk of addiction.

TSN is for controlling reactions caused by nicotine withdrawal in cases of physical dependence. For best results, TSN be associated with Tobacco counseling programs, the role of psycho-behavioral addiction to overcome.
Nicotine replacement therapy
The best time to initiate this therapy is the beginning of the tobacco withdrawal. To avoid overdosing nicotine, smoking must be stopped with the beginning of nicotine replacement therapy.
People with certain diseases and pregnant women nicotinic substitutes will be used only under medical supervision.
Nicotine replacement therapy
Experts say that to be effective, the degree of substitution (the amount of nicotine delivered by nicotinic substitutes) must be at least 60% of the nicotine tobacco consumption before weaning. To check, we can compare urinary cotinine levels during treatment and before it. According to one researcher, tobacco withdrawal success rate is much higher when the degree of compensation is close to 100%, at least in the short term.

Although nicotine replacement therapy can be used for several months, pharmaceutical products involve certain risks and can lead to headaches, palpitations, tremors, etc..

Ways to quit smoking

Ways to quit smoking

There are as many ways to quit smoking many people smoke. Smoking behavior is determined by multiple factors specific to each individual: personality, psychological balance, social and environmental situation. Therefore, smoking cessation should be adapted to each smoker and modified by evolution and its reactions.

All the experts agree that the first factor in smoking cessation should be motivation. Without it, success is not possible.
Ways to quit smoking
According to the National Center for Chronic Disease Prevention and Health Promotion (CDC) in the United States, the four conditions for smoking cessation are:

Mental 1.Preparation - immediate exclusion of all cigarettes in the living environment
2.Gasirea a support group. As the support of family, loved ones or medical staff is stronger, the chances of success are greater
3.Crearea new daily habits to replace smoking-related activities.
4.Pregatirea for difficult times for failure
Ways to quit smoking
Considering the two aspects of addiction (psycho-behavioral and physiological), experts in anti-smoking organizations claim that one should act simultaneously on both fronts:

  - Balancing chemical processes in the brain
  - Suppression of behavioral mechanisms (more or less consciously) that smoking has become an inseparable part of many everyday activities
Ways to quit smoking
Studies have shown that treatment with a pharmaceutical product that combines behavioral therapy has a higher rate of success.

Weight gain after quitting smoking

Weight gain after quitting smoking

Although many smokers gain weight after quitting smoking usually does not exceed 5 kg, even in the absence of attempts on a diet or doing exercises. Women tend to gain slightly more than men. Some sources indicate that former smokers gain weight even if you eat more.

In some cases, fear of weight gain leads smokers continue to smoke. But weight gain is generally negligible and the benefits of smoking cessation are more important.
Weight gain after quitting smoking
A good way to approach this problem is successfully quitting smoking and then taking steps to weight loss. Eating fruits and vegetables is beneficial, as well as drinking water, recreation and physical activity frequency.
Weight gain after quitting smoking
Walking is an ideal way to remain active and to counter nicotine addiction as:
  - Reduce stress
  - Burn calories and tone muscles
  - Decreases craving as pleasantly occupy during
Are recommended 30 minutes of physical activity per day, 5 times a week.

The immediate effects of quitting smoking

The immediate effects of quitting smoking

The immediate effects of quitting smoking
Quitting smoking blocks the harmful effects of tobacco on physical appearance:
  - Premature wrinkling of the skin
  - Staining teeth
  - Gum disease
  - Yellowing nails
The immediate effects of quitting smoking
Some advantages are immediately visible, while other positive effects appear gradually over time and may improve quality of life:
  - Food tastes better
  - Sense of smell is normal
  - Physical activititatile not seem so difficult (eg, climbing stairs or running)

Benefits of quitting smoking

Benefits of quitting smoking

It's never too late to quit smoking. As usual interruption that occurs early, the risk of cancer and other diseases are lower.
Benefits of quitting smoking
A few minutes after the last cigarette, the body begins to recover:
1. 20 minutes after quitting smoking: Heart rate and blood pressure decrease.
2. 12 hours after quitting: The carbon monoxide is reduced, reaching normal.
3. 2 weeks to 3 months after quitting: Circulation is improved and pulmonary function improved.
4. 1 to 9 months after quitting: Coughing and breathing problems are reduced, cilia (hair-like structures of streams from which they move from bottom to top, training impurities out) regain normal function and their ability to cleanse the lungs and to reduce the risk of infection is enhanced.
5. At 1 year after quitting: The risk of coronary heart disease is reduced to half that of a smoker.
6. At 5 years after quitting: The risk of stroke (CVA) is reduced, thus being equal to that of a nonsmoker 5 to 15 years after quitting.
Benefits of quitting smoking
7. After 10 years of quitting: Lung cancer death rate is reduced by half compared to that of smokers. The risk of cancer of the mouth, throat, esophagus, bladder, cervix and pancreas decreases.
8. At 15 years after quitting: The risk of coronary heart disease is equal to that of non-smokers.

Quitting smoking

Quitting smoking

For most smokers, quitting the habit is the best solution for improving the quality and duration of life. People who quit smoking reduce their risk of developing heart disease, cancer, respiratory problems or infections.

Benefits of quitting smoking are the same for all smokers, male or female, young or adults. Even people with smoking-related problems (heart disease, etc.) get benefits from this decision. For example, people who quit smoking after a heart attack reduced by 50% risk of having another episode, unlike smokers. Also, they reduce by 50% the risk of premature death.
Quitting smoking
Women who stop smoking before pregnancy reduce their risk of having a low birth weight baby. Quitting smoking can reduce the risk of stillbirth and birth to improve the health of women.

But the adverse effects of smoking are not limited to smokers. Conversely, exposure to secondhand smoke - involuntary inhalation of cigarette smoke - causes thousands of deaths from lung cancer and heart disease in nonsmokers without other health problems.
Quitting smoking
In conclusion:

 - Quitting smoking shows major and immediate benefit to the health of the men and women of all ages. Even people with smoking-related problems (heart disease, etc.) benefit from this decision.
 - Life expectancy of people quit smoking is higher than those who continue to smoke.
 - Quitting smoking decreases the risk of lung cancer and other cancers, heart attack, stroke and chronic lung disease.
 - Women who quit smoking before or in early pregnancy reduces the risk of having a baby with low birth weight.
 - Health benefits of smoking cessation are more important than the psychological effects caused by this decision.
Quitting smoking
Success rate

Between 5% and 16% of smokers are able to quit smoking for at least 6 months without medication to reduce withdrawal symptoms. Success rate increases to 25% - 33% in people who enlists the help of pharmaceuticals. It seems that the combination of different products is more effective.

Measures against passive smoking

Measures against passive smoking

Cigarette smoke contains over 4000 chemicals known, of which at least 50 are carcinogenic to humans. In closed spaces where smoking, so smokers and nonsmokers inhale cigarette smoke, are exposed to its harmful effects.
Measures against passive smoking
World Health Organization (WHO) estimates that about 700 million children, or almost half of children around the world, breathe air polluted by tobacco smoke.
Measures against passive smoking
No ventilation and no air filter are not sufficient to reduce exposure to tobacco smoke in enclosed spaces to acceptable levels. Reserved spaces non-smokers only provides protection against risks to health.
Article 8 of the WHO Framework Convention on Tobacco Control states that exposure to cigarette smoke train diseases and even death. It requires countries to adopt and implement legislation that provides protection against passive smoking.
Measures against passive smoking
Framework Convention on Tobacco Control (FCTC) provides for the establishment of a global ban all forms of advertising and promotion of tobacco products. Are also provided legislative measures for the protection of people against exposure to environmental tobacco smoke at work, in public transport and other public places. Also, are implemented awareness programs to educate people on the consequences and active or passive smoking.
Many countries have already enacted laws to protect people against cigarette smoke in public places. International events organized on the occasion of World No Tobacco Day (31 May) encourage more people to quit smoking.

Consequences of passive smoking

Consequences of passive smoking

Cigarette smoke contains over 4000 chemicals known, of which at least 50 are carcinogenic. Besides increasing the risk of cancer, these substances can cause diseases such as asthma, heart disease and emphysema. Cigarette smoke affects both smokers and nonsmokers.
Secondhand smoke consists of involuntary inhalation of fumes by one or more smokers.
Risks faced by passive smoker are smaller than those of active smokers, but health consequences can not be ignored.

Exposure to cigarette smoke, even 8 - 20 minutes train these physical reactions:
 - Increased heart rate
 - Reduction of oxygen supply
 - Constriction of blood vessels, bringing about an increase in blood pressure and cardiac muscle effort
Thousands of non-smokers die each year from diseases caused by passive smoking.
Consequences of passive smoking
World Health Organization (WHO) reached the following conclusions:

 - Secondhand smoke is responsible for many diseases and can even lead to death of the non-smokers
 - Passive smoking causes cancer in adult nonsmokers
 - Passive smoking causes heart disease in adults, is responsible for sudden infant death syndrome, ear infections and asthma for children.
 - Tobacco smoke is the most dangerous source of indoor air pollution due to its high concentration of toxic substances exposure of young age, and the fact that the exposure time is greater than in air pollution.
 - There is no risk-free level of exposure to environmental tobacco smoke.
 - A group particularly affected by environmental tobacco smoke as children. Negative effects on children's health as pneumonia, bronchitis, cough, wheezing (wheezing), aggravation of asthma and cardiovascular disease in adulthood.
Consequences of passive smoking
Effects of passive smoking on the fetus

 - Increased risk of miscarriage, ectopic pregnancy or premature birth
 - Intrauterine growth retardation
 - Child with birth defects or low birth weight
 - Increased risk of fetal death in utero

Effects of passive smoking on children

 - Increased frequency and otitis rinofaringitelor
 - Increased risk of asthma and respiratory infections such as pneumonia and bronchitis
 - Slight but significant decrease in lung development
 - Increased risk of sudden infant death
 - In addition, children are 2 times more prone to smoke if their parents are smokers.
Consequences of passive smoking
Effects of passive smoking on adult

Exposure to cigarette smoke increases the risk of lung cancer 25%, 10% risk of heart disease. Passive smoking is a risk factor for breast cancer, cervix, thyroid, brain tumors or leukemia.
Environmental Protection Agency U.S. (EPA) estimates that the risk of developing cancer due to passive smoking is 57 times greater than the risk posed by all other pollutants in the air.
 - Myocardial infarction - risk increases by 25% for a person who has never smoked, but whose partner is a smoker
 - Lung cancer - risk increases by 25% for daily exposure to cigarette smoke
 - Stroke (CVA) - passive smoking damage arterial walls, doubling the risk of stroke

Passive smoking

Passive smoking

Health consequences of smoking are not limited to smokers. Conversely, exposure to cigarette smoke - passive smoking - dramatically increases the risk of lung cancer and heart disease among non-smokers, but also the respiratory diseases in children.

Environmental tobacco smoke is the combination of mainstream (smoke exhaled by the smoker) and secondary (smoke emitted from the lit end of the cigarette). Exposure to ambient smoke is called involuntary or passive smoking.
Two thirds of the smoke emitted from a burning cigarette is not inhaled by the smoker, but are released into the atmosphere and contaminate the air. Thus, environmental tobacco smoke contains 2 times more nicotine and tar and five times more carbon monoxide than the smoke inhaled by the smoker.
Passive smoking
Many international institutions, including the Environmental Protection Agency (EPA) and World Health Organization (WHO) classified as a known carcinogen ambient smoke (category reserved for agents for which there is insufficient scientific data demonstrating that causes cancer).
In the United States, passive smoking is believed to be the cause of 46,000 deaths by heart disease each year. In addition, EPA has estimated that exposure to cigarette smoke causes about 3,000 lung cancer among non-smokers and is responsible for 300,000 cases of lower respiratory tract infections in children under 18 months each year.
People are exposed to ambient smoke at home, in the car, at work, in bars, restaurants and other public places.
Although only 3 out of 10 people admit they were exposed to cigarette smoke, 9 out of 10 show a detectable level of exposure in the body. The test measures the level of exposure in the last three days.
Environmental tobacco smoke is assessed by measuring nicotine and other compounds in the air.
Passive smoking
Exposure to cigarette smoke can be detected by measuring levels of cotinine (a metabolic product of nicotine) in the blood or urine of non-smokers. Nicotine, cotinine, carbon monoxide and other compounds were found in nonsmokers exposed to environmental tobacco smoke.

There is no risk-free level exposure to environmental tobacco smoke. Studies have shown that even low levels of smoke can be harmful. The only way to truly protect nonsmokers from exposure to cigarette smoke is full and definitive cessation smoking in enclosed spaces. Separating smokers from nonsmokers, aeration and ventilation rooms can not completely eliminate exposure to cigarette smoke.

Tips for Parents

Tips for Parents

Many kids smoke a few cigarettes to experience, then stop. But unfortunately, many others continue and become daily smokers. Half of these smokers become addicted to nicotine.
Tips for Parents
Only a small proportion of smokers believe that teens will smoke all your life, for the vast majority, however, smoking is just an experiment. Their confidence may come from the fact that young people can more easily control the number of cigarettes smoked than adults, or where smoke. For example, many of them are forced to give up when they are away from friends who gave them cigarettes or you do not have enough money to buy themselves.
The most important thing parents can do is to become a role model for children. Those who smoke may try to quit. The least they can do is to not smoke in front of children.
Tips for Parents
Secondly, it is a direct dialogue with children in which to explain all risks to which they are exposed. Many children are not aware of the gravity of the situation and the negative effects of cigarettes on health.
This dialogue can be a good opportunity for children to reasons for smoking, and peer pressure from their plans to quit smoking. Parents can offer to help in this endeavor, offering their support.
Tips for Parents
Humiliation, rebuke or punishment of children is not a solution. It is preferable to treating them as a people capable of making a responsible decision. Parents may bring into question the benefits that will not delay occur after smoking cessation. For example, young people could save some money and would get better in sports.

Reasons for smoking initiation in young

Reasons for smoking initiation in young

Children and young people start smoking for a variety of reasons, including:

  - The feeling of a group of friends apartenanta
  - Likeness of adults
  - Desire to experience
  - Rebellion against parental authority
  - To draw attention to their
  - To deal with stress or depression
  - To weaken
Reasons for smoking initiation in young
Entourage behavior plays a key role in young people about tobacco use. Persons important in this regard are friends, brothers and sisters and parents.
Smoking close friends play an important role. Overall, a third of minors who smoke at least one friend. The more friends who smoke is higher, the greater the risk that the young man to follow suit.
Reasons for smoking initiation in young
Parental smoking also has an influence. If one parent smokes, young will be more inclined to turn to smoke. When both parents are smokers, the risk is even greater.

Parents' attitudes on smoking initiation in youth is not without consequences. Generally permissive attitude will encourage smoking. However, most young people say their parents know they smoke.
Reasons for smoking initiation in young
As the number of people who smoke at home is higher, the greater the risk that the young person to smoke in turn. On average, 30% of youth live in an environment where at least one person smokes.

Smoking in young

Smoking in young

According to a WHO report, about 30% of young people aged between 15 and 18 are smokers. In addition, since 1995, the number of young people who smoke increased. In Romania, we find the same emphasis on the habit of smoking among youth and even minors.
Smoking in young
Unlike the adult population, the prevalence of smoking is higher in men than in women, prevalence among young people is gender.
Smoking in young
The vast majority of smokers begin consuming tobacco before they reach adulthood. Among young people who smoke, almost a quarter smoked their first cigarette before 10 years. Several factors increase the risk of smoking initiation among youth. These include advertising campaigns, easy access to tobacco products and low prices. An important role is played by pressure from peers or older siblings who smoke. Other risk factors associated with tobacco use in young people are poor self-image and impression that smoking is normal or "cool". Numerous studies show that smoking parents is a risk factor for smoking initiation among youth.
Smoking in young
Although the worst effects of tobacco use are felt after a few decades, there is immediate negative effects of smoking on young people. Most young smokers become addicted to nicotine since adolescence. As tobacco initiation occurs earlier, the risk of developing a smoking related diseases are higher.

Conclusion

Conclusion

Reducing the number of cigarettes smoked during pregnancy reduces the risk of toxic tobacco really the fetus. The explanation is that women will tend to inhale more deeply and more often cigarette smoke to get the same amount of nicotine. So, the amount of carbon monoxide that reach the placenta and fetus will not be diminished.
Therefore, smoking on pregnancy risks and complications persist, even by reducing the number of cigarettes smoked.
Conclusion
The only truly effective method is quitting smoking and avoiding secondhand smoke.
For pregnant women with a very strong addiction of nicotine that fails to quit smoking, a solution can be nicotine replacement therapy.

Consequences of smoking during pregnancy on child development

Consequences of smoking during pregnancy on child development

  - The risk of occurrence of nicotine withdrawal symptoms in newborns when the number of cigarettes consumed by the mother during pregnancy exceeds 10 cigarettes a day
Consequences of smoking during pregnancy on child development
  - Increased risk of respiratory disorders in functioning characterized by decreasing respiratory function, bronchial hyperactivity and increased frequency of childhood respiratory diseases (bronchitis, bronchiolitis, pneumonia, etc.).

  - All epidemiological studies show that smoking during pregnancy and passive smoking during childhood increase the risk of sudden infant death (risk increases 3 times). According to some authors, the number of sudden infant deaths could be reduced by two thirds if there is parental smoking.
Consequences of smoking during pregnancy on child development
  - Tobacco supply has reduced by decreasing prolactin levels by 30% - 50%. Nicotine in cigarette smoke quickly get milk because it is less bound to plasma proteins. However, breast milk of a smoker is better than artificial formula milk for baby's development.

- Effects of smoking during pregnancy continues to be felt later, when the child will have growth retardation, learning disabilities, behavioral disorders and other problems of intellectual skills.
Consequences of smoking during pregnancy on child development
- Increased risk of systolic hypertension (at age 6)

There seems to be a higher level of nicotine dependence in children whose mothers smoke and a significant correlation between uterine exposure to smoking and tobacco use in adolescence.

Consequences of smoking on fetal growth and development

Consequences of smoking on fetal growth and development

1. intrauterine growth retardation

A U.S. study shows that the prevalence of growth retardation is 17.7% if pregnant smoke throughout the pregnancy, from 15.4% in the first quarter smokes 2 and 3 of pregnancy and smokes only 7.2% in the first quarter of pregnancy. Nonsmoking women, average prevalence is 8.5%.

The relationship between the number of cigarettes daily and birth weight deficit is not linear. Even a small tobacco consumption affects fetal growth.
Consequences of smoking on fetal growth and development
Intrauterine growth retardation associated with smoking the weight, height, thorax perimeter and head perimeter. Effects of smoking on biparietal diameter visible since the 22nd week of amenorrhea in ultrasound.
 Consequences of smoking on fetal growth and development
Tobacco use during pregnancy decrease from 150 to 300 g birth weight
Passive smoking Decrease by 100 g
<5 cigarettes / day decrease of 100 g
> 20 cigarettes / day decrease of 400 g
Consequences of smoking on fetal growth and development
2. increased risk of malformations

Some birth defects are more common (greater risk of 1-2 fold) in children born to mothers who smoked during pregnancy. Among these defects, increased risk was detected labiopalatina slot, congenital heart disease, optic nerve hypoplasia, limb malformations, etc..
This risk is greater if consumption> 20 cigarettes / day.

Consequences of smoking on pregnancy carrying

Consequences of smoking on pregnancy carrying

1. increased risk of ectopic pregnancy

Smoking increases the risk of ectopic pregnancy in a Dose - effect. Nicotine has a direct toxic action on tubal mobility. If smoking is stopped one month before conception, the risk is again equal to that of the general population.

<10 cigarettes / day relative risk (RR) is 1, 5 times greater
> 20 cigarettes / day x 3 RR
> 30 cigarettes / day x 5 RR
2. increased risk of miscarriage
Consequences of smoking on pregnancy carrying
The relative risk of miscarriage in women smokers is 1, 5 to 3, and is dose-dependent. Thus, women who smoke more than 20 cigarettes / day, the risk is 20% compared to 10% for nonsmokers and may reach 35% for consumption of 35 cigarettes / day.
The risk of miscarriage increases in exposure to passive smoking (at least one hour per day).
Consequences of smoking on pregnancy carrying
3. increased risk of uterine

The risk of uterine bleeding (abnormal bleeding) in the third trimester of pregnancy, smoking is also related to dose-dependent. Retroplacentar doubles the risk of hematoma and the placenta praevia is 2-3 times higher in women who smoke during pregnancy.

4. increased risk of preterm birth

Risk does not lead to pregnancy to term is 2 times higher in smokers woman. This risk is dose dependent (consumption <20 cigarettes a day increases the risk of premature birth by 20% and consumption of> 20 cigarettes per day increases the risk by 50%). Moreover, the risk of prematurity related to smoking increases with maternal age.
Consequences of smoking on pregnancy carrying
It should be noted that this increased risk disappears if women quit smoking before conception.
Consequences of smoking on pregnancy carrying
In addition to increased frequency of obstetric complications that may be at the origin of prematurity (placenta praevia or hematoma retroplacentar), there are specific mechanisms.
- Increased risk of fetal death in utero
11% of cases of fetal death in utero can be attributed to tobacco use.
Increased risk of fetal death in utero is explained by intrauterine growth retardation, occurrence of hematoma retroplacentar or placenta praevia.

Consequences of smoking on female fertility

Consequences of smoking on female fertility

Studies show a decrease in fertility in women smokers. Smoking reduces ovarian reserve of eggs, has an anti-estrogen and favors adrenal androgen secretion.
Consequences of smoking on female fertility
The success rate of in vitro fertilization (IVF) is lower in smokers compared with nonsmokers women.

Smoking and pregnancy

Smoking and pregnancy

Despite the efforts of researchers and health professionals, smoking during pregnancy remains a public health problem. Between 20 and 30% of women smoke during pregnancy, while others reduce the number of cigarettes consumed daily.
Smoking and pregnancy
Smoking during pregnancy train serious risks for both the woman and the fetus. It was shown that smoking increases the risk of pregnancy complications and cause serious problems such as stillbirth birth to, miscarriage, intrauterine growth retardation, prematurity, placenta praevia and sudden infant death. Smoking trains and other effects on the mother, is associated with early menopause and infertility.

Quitting smoking during pregnancy has many benefits for women's health, and reducing the fetus and cause health problems in children whose mothers smoke are exposed.
Smoking and pregnancy
During pregnancy, smoking risks to the embryo and fetus are directly related to inhalation by the mother of the two main toxic substances in cigarette smoke, carbon monoxide and nicotine.

Carbon monoxide (CO) is a toxic effect on pregnancy because:
- Fetal hemoglobin has a higher affinity for CO than maternal hemoglobin, bringing about a decrease in fetal oxygenation
- Reduction of fetal blood oxygenation explained by CO toxicity of this substance, which is the origin of many negative effects of tobacco on carrying pregnancy and embryo development and fetal
Smoking and pregnancy
Nicotine has vasoconstrictive effects on uterine and placental blood flow. Concentration of nicotine is 15% higher in the fetal circulation and amniotic fluid.
Tobacco reduces the bioavailability of vitamin B12, vitamin C, folic acid and zinc.

These negative effects of CO and nicotine explains that tobacco consumption before and during pregnancy is a risk factor for many fertility problems in developing pregnancy, fetal growth and development and child development after birth.

Smoking and stroke

Smoking and stroke

Smoking is the major modifiable risk factor for stroke (CVA), which often lead to disability and even death.

The risk of stroke is 2 times higher in smokers compared with nonsmokers and increases with the number of cigarettes smoked daily. It is estimated that up to 11% of cases of stroke are due to tobacco.

The cause is the nicotine and carbon monoxide in cigarette smoke, which reduces the amount of oxygen in the blood and affects blood vessel walls.
Smoking and stroke
For women, smoking associated with taking oral contraceptives increase the risk of stroke.

Consitituie stroke the third leading cause of death in Western countries after myocardial infarction and cardiovascular disease. Numerous epidemiological studies have shown smoking as a major risk factor for stroke. We now have concrete evidence that smoking itself is a cause of stroke.
There is a strong link between type of stroke, the amount of tobacco consumed and the effects of quitting.
The relative risk of hardcore smokers (> 40 cigarettes per day) is 2 -4 times that of nonsmokers.
Therefore, smoking is an independent risk factor for stroke, especially ischemic stroke.
All smokers who quit the habit will benefit from reduced risk of stroke, regardless of previous exposure to cigarette smoke. 2 years after tobacco withdrawal, risks decrease by 50% and within 5 years, the risk of stroke returns to normal (equal to that of the general population).
Smoking and stroke
About stroke

Stroke is running obstruarii (blockage) of blood vessels, which prevents blood flow to the brain. Reduction or interruption of blood supply to the brain and vital nutrients can cause irreversible damage it.

A stroke cause serious sequelae mentally and emotionally, complete or partial paralysis and loss of speech or vision.
Smoking and stroke
There are several types of stroke:

Transient ischemic attack (TIA) - is a sign of alarm that can announce the occurrence of a stroke up. In general, TIA does not cause major sequelae, but consult a doctor promptly is required to reduce the risk of stroke.
Hemorrhagic stroke - occurs due to rupture of a blood vessel in the brain. Are less common than ischemic stroke, representing 20% ​​of cases of stroke.
Ischemic - blockage of blood flow is triggered by the brain by a blood clot. Is worse than the previous type and degrade irreversibly brain cells, depriving them of oxygen and nutrients.

Smoking and cardiovascular disease

Smoking and cardiovascular disease

Smoking is a major risk factor for cardiovascular disease, which is the first cause of death in developed countries.

Cardiovascular diseases are disorders or damage to the heart muscle (myocardium), blood vessels of the heart or blood vessels system (veins and arteries).
Smoking and cardiovascular disease
Causes of cardiovascular disease (CVD) are poor nutrition, physical inactivity and smoking. They are "modifiable risk factors". Avoidance would reduce 80% of premature deaths caused by CVD.

Recognized as the leading cause of premature death in developed countries, smoking is considered as the most important modifiable risk factor for cardiovascular disease.
Smoking and cardiovascular disease
Tobacco smoke contains over 4,000 chemicals, of which about 60 are recognized as carcinogenic. They affect the cardiovascular system by:
Smoking and cardiovascular disease
- High blood pressure
- Acceleration of heart rate
- Reduction of oxygen supply
- Cause the formation of plaque
- Reducing the level of HDL cholesterol (good cholesterol)
- Onset of angina attacks

Risk of myocardial infarction in smokers are twice higher than the non-smokers. Smokers who suffered a heart attack are more susceptible to sudden death than nonsmokers.
Smoking and cardiovascular disease
Nicotine and carbon monoxide in cigarette smoke reduces the amount of oxygen in the blood and affects blood vessel walls, causing plaque formation. In addition, smoking favors the occurrence of cardiovascular disease by reducing the amount of HDL cholesterol (good cholesterol).

Smoking is the major risk factor for peripheral vascular disease characterized by narrowing the blood vessels that carry blood to the arms and legs.

For smokers, quitting the habit is the most important measure to reduce risk. After a year of tobacco abstinence, the risk of coronary heart disease (angina or heart attack) is reduced by half. On average, hardcore smokers who quit the habit of smoking extend their life expectancy by four years.

Smoking and lung cancer

Smoking and lung cancer

Smoking is the leading cause of lung cancer and deaths from cancer in general, responsible for 90% of lung cancers in men and 78% women.
Toxic products contained in cigarette smoke explain these devastating effects on health. Frequent exposure to passive smoking or inhalation of carcinogenic particles in the air (those arising from asbestos or radon gas) may also be responsible for lung cancer.
Lung cancer is responsible for 31% of deaths in men and 28% of female deaths due to diseases attributable to smoking.
Smoking and lung cancer
 - The chances of survival of this disease are minimal
 - 60% of those affected die in less than 1 year
 - Less than 15% of lung cancer victims survive 5 years after diagnosis
 - Smoking is responsible for 85% of all lung cancers
 - Quitting smoking reduces the risk of occurrence of lung cancer
Smoking and lung cancer
Smokers are 10 -25 times more at risk of suffering from lung cancer than nonsmokers. The risk depends on age of smoking initiation, duration and number of cigarettes consumed per day. Although lung cancer occurs after several years, the physiological changes of lung tissue are visible long before.
Increasing prevalence of smoking in women is a major source of concern in public health. In the U.S., deaths from lung cancer caused by smoking is higher in women than breast cancer deaths. In the Nordic countries, lung cancer kills more women than among men. If one takes into account that in many European countries, about 50% of women are smokers in the next decades will see a significant increase in morbidity in women.
Smoking and lung cancer
Lung Cancer Prevention

According to experts, choosing low-tar cigarettes or nicotine has no way diminish the risk of cancer. In fact, most people who smoke this cigarette inhale the smoke more deeply, without realizing it, to get the same amount of nicotine. Studies have shown that people who smoke cigarettes "light" are not more protected against various types of cancer.
It should be noted that chewing tobacco is a leading cause of oral cancer.
Lung cancer is a cancer with poor chances of healing. Instead, it can be effectively prevented through smoking cessation or reduction of exposure to cigarette smoke.
Regardless of age smoker, quitting smoking reduces the risk of suffering from lung cancer and many other diseases and conditions.
At 5 years after withdrawal nicotinic risk of lung cancer is cut in half, and at 10 -15 years after quitting, the risk is almost identical to that of a person who has never smoked.

Smoking and cancer risk

Smoking and cancer risk

According to the World Health Organization (WHO), cancer incidence could increase by 50% worldwide, with 15 million new cases every year by 2020.
World Cancer Report shows that measures taken against smoking, infections and in favor of a healthier diet could prevent a third of cases.

Tobacco use is the most important avoidable risk factor for cancer. In the 20th century, approximately 100 million people worldwide have died from smoking related illnesses (cancer, chronic lung disease, cardiovascular disease, stroke).
Smoking and cancer risk
Half of smokers die from the consequences of this practice. A quarter of smokers die prematurely (between 35 and 69 years).

Risk of lung cancer for smokers compared with that of non-smokers (relative risk) is 20 or even 30 times higher. In countries with a high prevalence of smoking, tobacco is believed to be responsible for 90% of lung cancers in both sexes. For bladder and kidney cancer, the relative risk is 5 or 6, which means that over 50% of cases are due to smoking.
Smoking and cancer risk
The relative risk for cancers mouth, pharynx, larynx and esophagus is 6, and the pancreatic cancer is 4. For women, it was found a relative risk of 2 -3 new forms of cancer associated with smoking: stomach, liver, cervix, kidney, nasal cavity and sinuses, esophagus and myeloid leukemia.

Involuntary inhalation of cigarette smoke (passive smoking) promotes cancer, increasing by 20% the risk of lung cancer. No data at this time to demonstrate that tobacco causes cancers of the breast, prostate and endometrium.
Smoking and cancer risk
Worldwide, young people tend to smoke increasingly earlier, which predisposes them to negligible risks in later stages of life.

Although it is preferable to avoid initiating tobacco, epidemiological data highlight the enormous benefits of quitting smoking. These include reducing the number of cancer deaths in the coming years. The best results are found to youth 30 years who quit smoking, but risk mitigation is impressive - over 60% - even in smokers who quit after age 50 years.

Diseases caused or aggravated by active or passive smoking

Diseases caused or aggravated by active or passive smoking

Smoking is a major risk factor for 24 diseases:
Diseases caused or aggravated by active or passive smoking
»Oral cancer (tongue, gums or mouth floor), pharyngeal or laryngeal - the risk is 6 times greater than the population of smokers
»Lung cancer - smoking is responsible for 90% of lung cancers
»Bladder cancer - carcinogens or toxic residues are partially discharged through urine, increasing the risk of bladder cancer
"Cancer of the pancreas
»Kidney Cancer
»Cardiovascular diseases (arteriosclerosis, heart muscle damage, stroke, aortic aneurysm) - risk of dying from heart disease is 70% higher in smokers population
»Chronic bronchitis and emphysema
»Erectile dysfunction - the risks are twice higher than in nonsmokers
prenatal and postnatal problems - miscarriage, pregnancy complications, fetal growth deficiency, sudden infant death syndrome, increased susceptibility to infections, learning disabilities, etc..
»Hypotension
»Hypercholesterolemia
»Chronic obstructive pulmonary disease
»Pneumonia
»Flu
»Cold
»Gastroduodenal ulcer
»Chronic bowel disease (Crohn's disease)
»Dental caries
»Gum disease
»Osteoporosis
»Sleep disorders
»Cataracts
»Thyroid disease (Graves' disease)
Diseases caused or aggravated by active or passive smoking
In women, increases the risk of:
»Cervical cancer
»Menstrual disorders
»Fertility problems
»Miscarriage

In men, there is an increased risk of:
»Erectile dysfunction (impotence)
»Fertility problems
Diseases caused or aggravated by active or passive smoking
There are studies according to which tobacco may be related to bowel cancer and the leukemia.
Smoking can also cause health problems orodental including gingival retraction, discoloration of teeth and gums.
Besides these diseases, smoking is responsible for wrinkles, giving skin a premature aging. Smoking reduces the sense of taste and smell.
Diseases caused or aggravated by active or passive smoking
Attention! Shortly after quitting smoking reduces risks considerably above. For example, the risk of heart attack is reduced by 50% from a year of withdrawal. 5 years of tobacco abstinence, the risk is almost equivalent to that of a person who has never smoked. Instead, reaching the lungs is irreversible, although breathing difficulties and coughing disappear with smoking cessation.

Some evidence

Some evidence
Smoking causes 87% of lung cancer deaths and is responsible for most cancers of the mouth, larynx, pharynx, esophagus and bladder. In addition, contrary to general parrerii consumption of cigarettes "light" or "ultra-light" does not reduce the risk of lung cancer.

Passive smoking is responsible for approximately 3,000 lung cancer deaths among nonsmokers each year.
Some evidence
Tobacco smoke contains thousands of chemical compounds, among which 60 substances recognized as carcinogenic.
Some evidence
The risk of smoking-related cancers, and other diseases increases with exposure to cigarette smoke.
Some evidence
Quitting smoking shows major and immediate benefits, including reducing the risk of lung cancer and other cancers, heart attack, stroke and chronic lung disease.

Oxygen as treatment helpful

Oxygen as treatment helpful

    Administration of oxygen the body is beneficial and useful for both prevention and treatment of diseases and for improving overall body condition.

    As a method of therapy, administration of oxygen is essential for patients with severe respiratory failure when the doctor recommends it as an indispensable method to continue the fight with the disease.

    There are, however, a number of situations where oxygen administration, if not indispensable, is beneficial and make improvements consistent patient's condition. In these cases there is no need sophisticated equipment or expensive because therapy is only helpful. Often, when the patient is at rest, is sufficient oxygen administration without mask near his face. Also, use only low flow rates and short-term administration.
Oxygen as treatment helpful
Oxygen as treatment helpful
    These treatments are indicated for potential beneficiaries account such as:
- For those in a period of intense intellectual effort, as if in preparation for an exam students. Ensure regaining attention given oxygen, increases concentration and decreases the need for sleep.
- Recovery after strenuous exercise such as sports training or fitness sessions. Oxygen generates force, energy, increase stamina and decrease recovery time.
- For pregnant women, activating blood circulation and exchange of substances between mother and fetus.
- For seniors, giving freshness and vitality, ensuring at the same time, a state of relaxation.
- For smokers and drinkers. Restores normal lung function, eliminate hangovers and maximize organ function.
- In the case of female beauty treatments, dissolved oxygen in the water for washing the skin elasticity, restore its beautiful color and healthy and finesse.
- For drivers you have to drive vehicles over long distances, oxygen administered solve drowsiness, headache, dizziness and breathing difficulties due to inhalation of exhaust in traffic and helps maintain attention.
- For patients with lower respiratory difficulties such as shortness of breath offset, etc. asthmatics in crisis.
- To relieve stress.

Smoking and health

Smoking and health

Tobacco-related diseases are the leading cause of preventable death worldwide, causing 5 million deaths each year. Scientific studies have shown that all tobacco products cause numerous health problems, often leading to death or disability. In the United States, smoking is directly responsible for about 30% of all cancer deaths occurring annually.

Total consumption of tobacco growing. If the current trend remains unchanged, the number of smokers, currently estimated at 1.3 billion, will reach 1.7 billion in 2025, and 1 smoker of 2 will die from smoking related illness.
Smoking and health
Almost 50% of people who smoke die lifelong complications due to smoking, most before 70 years and in recent years the quality of life is greatly reduced. It is estimated that the life expectancy of male smokers is reduced by an average of 13 years and that of women 14.5 years smoking fumatului.Totusi because it may improve if the person quit smoking.
Smoking and health
The risk of developing smoking-related diseases (such as lung cancer and other cancers) increases with total exposure to cigarette smoke. This includes the number of cigarettes smoked daily, age of initiation, the number of years a person smokes and exposure to environmental tobacco smoke.
Tobacco use affects nearly all major organs of the body.
According to scientific studies, smoking is associated with over 20 diseases and conditions. Fortunately, most regress when the smoker quit tobacco. Sometimes the benefits are visible in a few hours.
Smoking and health

Smoking is responsible for:

90% of lung cancers
75% of cases of chronic bronchitis and emphysema
25% of cases of coronary heart disease

Nicotine withdrawal

Nicotine withdrawal

Nicotine addiction is a physical dependence. Withdrawal symptoms are intense, and most smokers fail to quit this vice from the first attempt because of these symptoms.
Most severe withdrawal symptoms occur during the first week, although by the feeling persists for several months or even years. Stress, social activities and active boredom craving.
Here are classic withdrawal symptoms:
  - Headache (headache)
  - Anxiety and irritability
  - Attention deficit
  - Difficulty concentrating
  - Sleep disorders
  - Increased appetite - hungry
  - Decrease in heart rate and blood pressure
  - Sense of lack (of nicotine)
Nicotine withdrawal
Other side effects such as cough and fatigue shows that the body is going to reestablish itself as toxins associated with smoking are eliminated.
Metabolism is slower in the first days of withdrawal and increases appetite, so weight gain is predictable (average of 2 to 3 kg).
Nicotine withdrawal
Nicotine withdrawal is particularly difficult for at least two groups of people:

»Women
Studies show that nicotine dependence form varies slightly depending on the sex. Thus, women are less available than men to quit the habit of smoking and shows a higher degree of failure when trying this. For women, psycho-behavioral aspect of addiction is stronger than physiological.
In addition, withdrawal side effects (weight gain, for example) are more important for women than for men, making the process more difficult.
Nicotine withdrawal
"Depressed people
Depressives already suffering from a neurological imbalance, so smoking cessation in their case should be carefully studied with a doctor.

Levels of nicotine dependence

Levels of nicotine dependence

Number of cigarettes smoked daily is not a reliable indicator of the degree of smoking: two people can smoke the same number of cigarettes, but one can inhale 20 times more nicotine than the other, depending on the frequency and depth of inhalation of cigarette smoke .
There are several degrees of nicotine dependence: mild, medium, strong and very strong.
Degree of nicotine dependence can be measured by Fagerstrom questionnaire.
Levels of nicotine dependence
1. How long after waking smoke your first cigarette?
- Less than 10 0
- Between 11 and 20 January
- Between 21 and 30 February
-than March 31
2. It seems difficult not to smoke in public places? (cinema, library, etc.).
- Yes 1
- No 0
3. Which seem indispensable cigarette?
- First (1)
- Any other (0)
4. How many cigarettes you smoke on average per day?
- Less than 10
0
- Between 11 and 20 January
- Between 21 and 30 February
-than March 31
5. Smoke more frequently during the first hours after waking than the rest of the day?
- Yes 1
- No 0
6. Smoke even if you are ill (a) and must stay in bed?
- Yes 1
- No 0
 Levels of nicotine dependence
Interpretation of results:
0-2 Very low dependence
3-4 mild dependence
5 average dependence
6-7 strong dependence
8 to 10 very strong dependence
Levels of nicotine dependence
Physiological level of intoxication can be determined by tests conducted by medical personnel:
  - The concentration of exhaled carbon monoxide, measured in ppm (parts per million) - measured immediately after smoking one cigarette. This test works on the same principle as Alcooltest.
  - Determination of plasma or urinary cotinine. Cotinine is a metabolite of nicotine.
Order to assess the degree of dependence is to determine the optimal method of treatment, and dose nicotine substitute, if applicable, and during its use.