Face to face lectures, role-playing and real life scenario learning.

Face to face lecture and experiential learning attendance is not mandatory.

Power point presentations and videos are used for lectures.

The learning process is supported through the e-Class of the Department of Medicine.

The lecture, the role-playing and real life scenario learning programs, the learning objectives – detailed material, the relevant bibliography, the lecture presentation in the form of pdf files and all information related to the course are posted on the e-class page of the course.

Grading:

The final grade is set by the performance of the students in oral examinations as described below.

Examination:

Assessment in oral examination in course topics requiring critical thinking and analysis.

Assessment of active participation and answering in real life scenarios during classes.

The course provides the background for the understanding of the need for smoking cessation and smoking abstinence given that smoking constitutes the main and one of the most frequent causes of early and reversible morbidity and mortality in the Western societies. The course content aims at providing knowledge for the multi-dimensional issue of nicotine addiction. Furthermore, it addresses the complexity of the addiction behavior that needs to be approached though different angles, from the biological level to the behavioral level. In this context the course provides the basis for students to develop skills for approaching and communicating with smokers and in providing structured and effective aid in smoking cessation. Finally, one of the learning objectives is to provide students with the understanding of the importance of smoking control as a part of the clinical practice of all medical specialties.

Upon successful completion of the course, the students will be able to:

• Understand the chronic nature of nicotine dependence and main steps of the smoking cessation guidelines.
• Provide effective counseling to smokers, motivated or not, for smoking cessation.
• Develop effective communication skills for interacting with smokers and to use these skills in everyday clinical practice.
• Adopt an attitude of empathy towards the smoker.
• Prepare smokers for smoking cessation, by discussing the main barriers for success and providing aid in organizing a smoking cessation plan.

General Abilities

Research, analysis and synthesis of data and information.

Adaptation to new situations

Decision making

Autonomous work

Teamwork

Promoting free, creative and inductive thinking

Section 1: Introduction.

• History of smoking.
• Smoking as a chronic relapsing disease.
• Definition of smoking.
• The magnitude of the problem.
• Smoking initiation.
• Epidemiological data on smoking.

Section 2: Detrimental effects of smoking.

• Smoking-related mortality.
• Smoking and life expectancy.
• Detrimental effects of smoking on health status. 

Section 3: Smoking cessation benefits.

The short- and long-term health benefits of smoking cessation.

Short- and long-term benefits:

• Cardiovascular system.
• Respiratory system.
• Other body systems.
• Health benefits of smoking cessation during pregnancy.
• Overall survival.
• Quality of life. 

Section 4: Second hand and third hand smoking.

4.1. Passive smoking or Second hand smoking.

• Definition of passive hand smoking.
• Epidemiological data on passive smoking.
• Effects of passive smoking on adults.
• Effects of passive smoking on children.
• The effects of third hand smoking.
• Protection from exposure to passive smoking.

4.2. Third hand smoking.

• Definition of third hand smoking.
• Epidemiological data on third hand smoking.
• Effects of third hand smoking.
• Protection from exposure to third hand smoking. 

Section 5: Novel (Alternative) tobacco products.

• Definition, classification and features.
• Electronic nicotine delivery systems (ENDS), heated tobacco product, and nicotine pouch
• Marketing and promotion.
• Prevalence.
• Reasons for starting.
• Health hazards due to novel tobacco products use.
• Use novel tobacco products for smoking cessation.

Section 6: Neurobiology and physiology of nicotine dependence.

• Nicotine and other additives in tobacco.
• Definition of addiction.
• Mechanisms for nicotine dependence.
• Dopaminergic theory of dependence.
• Systems affected by addictive substances.
• Symptoms of nicotine withdrawal. 

Section 7: Smoking Cessation

7.1. Guidelines for smoking cessation

• Necessity to resolve the smoking issue.
• Effective smoking cessation techniques.
• International guidelines on smoking cessation.
• The 5As Strategy.
• The 5Rs Strategy.

7.2. Pharmacological therapy for smoking cessation.

• Need for pharmacotherapy for smoking cessation.
• Approved pharmacotherapy for smoking cessation.
• Nicotine replacement therapy.
• Treatment with varenicline.
• Treatment with bupropion.
• Future directions.

7.3. Οther therapies for smoking cessation.

• Non pharmacological therapy for smoking cessation.
• Counseling intervention in smoking cessation.
• Brief advice on smoking cessation.
• Group and individual counseling.
• Other non-pharmacological methods such as active telephone counseling, self-help etc.).
• Management of barriers in the treatment of nicotine dependence.

7.4. Smoking cessation in special populations.

• Smokers with frequent respiratory disorders.
• Smokers with Cardiovascular Diseases.
• Smokers with Psychiatric Diseases.
• Hospitalized smokers.
• Smokers in pregnancy or breast-feeding.
• Smokers under 20 years of age.
• Smokers of a few cigarettes per day.

7.5. Experimental learning on smoking cessation.

Section 8: Smoking relapse and management.

• Definitions of relapse and diversion.
• Frequency of relapse.
• Risk factors for relapse.
• Understanding smoking relapse.
• Relapsing prevention strategies.
• Prevention effectiveness.
• Relapse treatment.

Section 9: Motivation techniques for smoking cessation.

• Behavior change theories.
• Motivational interviewing.
• Video presentation of ineffective and effective smoking cessation interviews.

Section 10: How to organize a smoking cessation clinic.

• Necessity to identify smokers in modern, everyday clinical practice.
• Medical history.
• Clinical examination.
• History of smoking.
• Lab tests when required.
• Determination of degree of dependence and motivation for smoking cessation.
• Criteria for determining high baseline levels of nicotine dependence.
• Determination of exhaled CO (eCO).
• Indicators of increased monitoring and evaluation
• Follow-up visits.

Scientific papers published in peer-reviewed international journals. International and European smoking cessation guidelines.