Carbon Monoxide

Many of these injuries are preventable by taking simple steps to make your home safer and knowing what to do when a fire occurs. Most accidental home fires start from cooking, heating equipment, electrical items, or smoking materials. Never leave food unattended on the stove while cooking. Use the back burners, when possible, to keep the hot stove surface and the hot pots and pans out of young children’s reach. Keep a fire extinguisher readily available in the kitchen, and make sure all caregivers know how to use it. Place space heaters away from anything that can catch fire, and always turn them off before going to bed or leaving the room. Ensure fireplaces and wood stoves are screened so that young children are not accidentally burned. This ensures embers stay inside, too. To prevent electrical fires, cover all unused electrical outlets, avoid overloading outlets, and replace any old cords. If you smoke, avoid doing so in the home, especially in bed. Carefully dispose of smoking waste, such as cigarette butts, used matches, and ashes.

If there is a fire, a smoke alarm can warn you to leave the home early and safely. Ensure that a smoke alarm is present on each floor and near every bedroom, avoiding areas like the kitchen to prevent false alarms. Check your smoke alarms monthly and change the batteries once a year unless your alarm has long-life batteries. If you need help, the local fire department can check your fire alarms and can often provide free new ones or replacements. Families with caregivers or children with hearing impairments should use alarms that include flashing lights.

Carbon monoxide is a poisonous gas created from fuel-burning heaters, cars, generators, and appliances. Many smoke alarms are combined with carbon monoxide detectors. If your smoke alarms are not, install a separate carbon monoxide detector on each floor of your home.

A fire escape plan prepares families to understand how to safely exit each room in the home during a fire. To create a fire escape plan, draw a simple map of your home showing 2 escape routes from each room. If you live in an apartment, talk to your children about the importance of using the stairs and avoiding elevators during fires. Establish a common meeting place outside the house. Review the plan with your whole family and with caregivers, such as babysitters, so everyone knows what to do. Practice your escape plan every 6 months so everyone becomes familiar. Children younger than 5 years will need a caregiver to help them during a fire.

Author/s:

Mickey A Emmanuel, Mikhail Goldenberg, Lindsay A Thompson

Electronic Cigarettes vs Varenicline for Smoking Cessation in Adults: A Randomized Clinical Trial

Alex Haga — Thu, 20 Jun 2024 21:26:42 +0000

Date Added:

June 20, 2024

Journal/Publication:

JAMA Internal Medicine

Publication Date:

June 17, 2024

URL:

Electronic Cigarettes vs Varenicline for Smoking Cessation in Adults: A Randomized Clinical Trial

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1001/jamainternmed.2024.1822

Keywords

PMID (1):

38884987

MeSH

electronic nicotine delivery systems

Cigarette Smoking

Tobacco Products

In cigarette smokers highly motivated to quit, both varenicline and e-cigarettes were equally effective in achieving abstinence at 6 months (around 40%) and twice as effective as placebo (20%). James W. Mold, MD, MPH

Free full text

View

Importance: Little is known about the relative effectiveness of nicotine-containing electronic cigarettes (ECs) compared with varenicline as smoking cessation aids.

Objective: To determine the relative effectiveness of ECs in smoking cessation.

Design, setting, and participants: This randomized placebo-controlled single-center trial was conducted in northern Finland. Participants aged 25 to 75 years who smoked daily and had volunteered to quit smoking were recruited from August 1, 2018, to February 20, 2020, via local media. The trial included 52 weeks of follow-up. All data analyses were conducted from September 1, 2022, to January 15, 2024. The participants, study nurses, and researchers were masked to group assignment.

Intervention: The participants were assigned by block randomization to receive 18 mg/mL of nicotine-containing ECs together with placebo tablets, varenicline with standard dosing together with nicotine-free ECs, or placebo tablets together with nicotine-free ECs, all combined with a motivational interview, with the intervention phase lasting for 12 weeks.

Main outcome and measure: The primary outcome was self-reported 7-day conventional cigarette smoking abstinence as confirmed by the exhaled carbon monoxide level on week 26. The analysis followed the intent-to-treat principle.

Results: Of the 561 recruited participants, 458 (81.6%) eligible participants (257 women [56%]; 201 men [44%]; mean [SD] age, 51 [11.6] years) were randomized. The primary outcome occurred in 61 of 152 participants (40.4%) in the EC group, 67 of 153 (43.8%) in the varenicline group, and 30 of 153 (19.7%) in the placebo group (P < .001). In the pairwise comparison, placebo differed statistically significantly from ECs (risk difference [RD], 20.7%; 95% CI, 10.4-30.4; P < .001) and varenicline (RD, 24.1%; 95% CI, 13.7-33.7; P < .001), but the difference was statistically insignificant between ECs and varenicline (RD, 3.4%; 95% CI, -7.6 to 14.3; P = .56). No serious adverse events were reported.

Conclusions: This randomized clinical trial found that varenicline and nicotine-containing ECs were both effective in helping individuals in quitting smoking conventional cigarettes for up to 6 months.

Author/s:

Anna Tuisku, Mikko Rahkola, Pentti Nieminen, Tuula Toljamo