AGREED

General Director

OOO “Dinamika”

____________ S.V.Zhirov

«__»____________2013

APPROVED

Director, Narcology Research Center

Moscow Healthcare Department

_________________________

Dr. (Med. Sci), Prof. E.A. Bryun

“___”______________2013

REPORT ON RESEARCH

EFFECTIVENESS OF USING AN ESSENTIAL OIL INHALER IN TREATING

TOBACCO ADDICTION

Head of the Center for Prophylactics

And Treatment of Tobacco and Non-Chemical

Addictions

Honored Doctor of the Russian Federation

Candidate (Med. Sci.) O. Kutushev______________

Moscow 2013

List of performers:

1. Scientific leader – director of Narcology Research Center, Moscow Healthcare

Department, Doctor (Med.) Prof. E.A. Bryun

2. Study director – Head of the Center for Prophylactics and Treatment of Tobacco

and Non-Chemical Addictions at the Narcology Research Center, Moscow

Healthcare Department, Honored Doctor of the Russian Federation, Candidate

(Med. Sci.) O.T. Kutushev

3. Performers:

- Senior researcher at the Narcology Research Center, Moscow Healthcare

Department, Candidate (Med.) Gornov S.VC.;

- Psychiatrist-narcologist of the Center for Prophylactics and Treatment of

Tobacco and Non-Chemical Addictions at the Narcology Research Center,

Moscow Healthcare Department, Cand. (Med.) Smyshlyaev A.V.

LIST OF CONTENTS

1. Introduction……………………………………………………………

2. Relevance of prophylactics of tobacco addiction among the younger

generation……………………………………………………….

3. Goals, objectives, and design of the study.…………………..…………

4. Study results ……………………………………….

5. Inference……………………………………………………………… 6. Conclusions………………………………………………….. ………

7. References………………………………………………………………

1. INTRODUCTION

In 2013, the Russian Federation adopted the law “On protecting citizens’

health from the impact of surrounding cigarette smoke and the consequences of

tobacco consumption", which sets forth the legal basis for cutting tobacco smoking

for the purposes of decreasing population mortality. The adoption of this law was

caused by the ratification of the Framework Convention against tobacco of the

World Health Organization by the Russian Federation in 2003. According to data

as of 2009, there are 39.1% (43.9 million) active tobacco smokers among the adult

population of Russia. Prevalence of tobacco smoking among men makes up 60.1%

(30.5 million). On average, men smoke 17 cigarettes per day (Global inquiry of the

Russian adult population under guidance of the Ministry of Health and Social

Development of the Russian Federation). Cutting tobacco consumption is the

determinant factor in prophylactics of non-infectious diseases, especially given the

fact that smoking is a factor which can be rather easily prevented (Sakharova G.M.

and Antonov N.S.).

Treatment of tobacco addiction requires a systemic and individualized

approach to each separate case. According to the data of demonstrative medicine,

effective methods of tobacco addiction treatment are a conversation with a doctor,

behavioral psychotherapy and pharmacological therapy. Nicotine-substitution

therapy (NST) until recently remained the major preparation of choice for doctors

of all specializations.

NST is underlain by the idea that it is necessary to support will power in the

process of quitting smoking by reducing withdrawal symptoms (Oganov R.G. and

Tkachenko G.B., 2001). NST has certain side effects and complications: nicotine is

absorbed by the blood more slowly, its amount is difficult to control, and the dose

assimilated by the organism can be much higher than with smoking and renders a

local irritant effect (Sayette MA, Parrott DJ.,1999).

It was found that aromas of essential oils (lemon, eucalypt, and pepper) have

the ability to correct the psycho-emotional condition, which allows one to use them

in anti-smoking programs (Rose J.E, Behm F.M.,1994). Fragrant ingredients

render a relaxing effect and consequently reduce smoking withdrawal symptoms,

including cravings (M.A. Sayette, 1999). Using essential oil aromas is an important

component of combined tobacco addiction therapy.

2. RELEVANCE OF PROPHYLACTICS OF TOBACCO ADDICTION

AMONG THE YOUNGER GENERATION.

A field surgery of prophylactics and treatment of tobacco addiction is

constantly operating to implement the combined program for prophylactics of

teenager smoking, approved by the head of the Moscow Healthcare Department,

who was guided by the “Clinical picture and treatment of tobacco addiction in

teenagers” Methodological Recommendations by the management of the Moscow

Power Engineering Institute (Technical University) (hereinafter referred to as

MPEI), and by employees of the Center for Prophylactics and Treatment of

Tobacco and Non-Chemical Addictions at the Narcology Research Center. In this

surgery, the treatment process and prophylactic and sanitary-instructive work for

students and teachers of MPEI are performed.

Besides the active prophylactic and sanitary-instructive work, the surgery

performs an assessment of the students’ motivation for a healthy lifestyle,

determines the presence of direct and indirect signs of smoking, and the rejection

of tobacco addication in smokers is formed in the process of group

psychotherapeutic interaction. It is explained to students that nicotine penetrates

the cerebrovascular barrier and spreads over the brain tissue with high

concentration in hypothalamus, thalamus, midbrain, and cortex of the brain (Kukes

V.G., Marinin V.F., and Gavrisyuk E.V., 2009). It reacts with nicotine cholinergic

receptors of the brain, vegetative ganglia, and neuromuscular synapses. Activation

of nicotine receptors causes release of catecholamines, including acetylcholine,

noradrenaline, dopamine, serotonin, beta-endorphine, and glutamate (Oganov R.T.,

Deev A.D., and Zhukovskiy T., 1999). It results in the feeling of increased capacity

for work, decrease of anxiety, and decrease of hunger. With developing tolerance,

lasting suppression of CNS functions begins, and, to maintain them at the previous

level, more and more nicotine is required. So the smoker increases the number of

smoked cigarettes to get the same effect or increase it. In this regard, experts face

the problem of how to break a student’s established behavior stereotype using the

least invasive method.

The global experience shows that treatment of tobacco addiction should be

complex because nicotine dependence is manifested on several levels: psychic and

physical (Glazunov I.S. and Oganov R.G., 2000). There is a distinction between

tobacco addiction with a psychic component of dependence – obtrusive thoughts

about cigarettes, nervousness, reflex habits when lighting a cigarette; and tobacco

addiction with a physical component – smoking cravings. This kind of dependence

is characterized by the presence of an abstinence syndrome. If the person has not

yet developed a physical dependence from tobacco addiction (a smoker with a

short experience of smoking), and only psychological dependence is in place, then

the basic treatment will be psychotherapy, aimed at eliminating the pathological

reflex for tobacco addiction; decrease of strong cravings for cigarettes (Smirnov

V.K., Ermolova O.I., and Speranskaya O.I., 2010). In addition to

psychotherapeutic methods of treatment, methods of reflex therapy (acupuncture)

and pharmaceutical treatment are applied.

Development of an individual refusal and pharmaceutical aid program for a

teenage smoker (student) must provide for a differentiated approach, taking into

account the degree of nicotine addiction, as the effectiveness of methods of

quitting smoking is inversely proportion to the initial intensity of nicotine

dependence (Chuchalin A.G., Sakharova G.M., and Novikov K.Yu.,2010) . To

determine the degree of nicotine dependence, the authors used a questionnaire,

developed by K. Vagerstrem, which defines the connection between the individual

score and severity of the abstinence syndrome. At a high degree of nicotine

dependence, it is necessary to assess the need in nicotine-substituting

pharmacotherapy (Shal’nova S.A., Deev A.D., and Oganov R.G., 1998).

The greatest demonstrative base is currently accumulated for a series of

pharmaceuticals used in pharmacotherapy of nicotine addiction. NST is underlain

by the idea that it is necessary to maintain the strength of will power in the process

of abandoning smoking by way of alleviating withdrawal symptoms. Nicorette was

the first NST preparation, which embodied a new approach to tobacco addiction

treatment: for the first time, both the psychological and physiological factors were

taken into account (Foulds J., 2006).

In 1980s, nicotine plasters appeared and won popularity: the nicotine they

contain penetrates into the organism through skin, relieving withdrawal symptoms

(Raw, Martin, A. McNeill, and R.West., 1999). The Maximum blood concentration

of nicotine appears in 6–10 hours, but, according to studies by Obach R., Reed-

Hagen A., Krueger S. et аl. (2006), nicotine activates ionic channels in skin cells,

which causes inflammation and itching.

Studies showed that people trying to stop smoking who chew such nicotine-

containing gums achieve results that are two times better than those who try to

drop this harmful habit without them.

Nicotine spray is injected in two nostrils where it is absorbed from the

mucous membrane and passes into the heart and brain. It has adverse effects: short-

term irritation of the nose and throat, sneezing, lacrimation, and elution from the

nose. With the use of fragrances of essential oils in therapy, which are able to

positively influence the psychic and emotional condition of the person (Rose

J.E, Behm F.M., 1994), adverse effects of the sprays are absent.

Essential oils are volatile extractions of plants, consisting of hundreds of

organic compounds – terpenes, alcohols, aldehydes, ketones and other

hydrocarbons produced by essential oil plants. Essential oils are transparent,

colorless or slightly colored liquids that have a pronounced characteristic smell.

They are volatile, do not leave fat spots on paper, are virtually insoluble in water,

and are oxidized and tarred under influence of light and oxygen.

In the superior part of the nasal cavity, there are olfactory cilia, or receptors,

which release a nerve impulse when by molecules of the aromatic chemical

compound. This impulse reaches the olfactory bulb, where the obtained data are

processed, and then comes to the brain olfactory center where the diverse effect on

the entire organism is defined. Three possible mechanisms of action of

aromatherapy are distinguished (Sayette MA, Parrott DJ.,1999):

Pharmacological: after using essential oils, the organism suffers chemical

changes caused by the interaction of components of essential oils with

hormones, enzymes, and acids of the organism, etc.;

Physiology: Essential oils render stimulating or calming action on organs or

tissues of the organism, and this process can involve the nervous system;

Psychology: as a result of inhaling essential oils, an individual (conscious or

subconscious) response of the organism to the smell emerges. Emotional

reaction, in turn, can evoke psychical processes or changes in the organism.

Using the above mechanisms of action of essential oils is extremely demanded

in the complex therapy of tobacco addiction.

Given the emerging regulatory basis (the federal law), but clearly insufficient

methodological basis, development of individual complex therapy of tobacco

addiction will help resolve the problem of treatment of the latter. Development of

the individual program of refusal and pharmaceutical aid to the smoker should with

certainty provide the differential approach, with the account for the degree of

tobacco dependence (Chuchalin A.G., Sakharova G.M., and Novikov K.Yu.,

2010). To anticipate medical procedures for already smoking students is possible

with the help of intense psychoprophylactics of tobacco addiction among all

students.

Intense psychoprophylactics among the students can be conducted at all

stages of medical and psychological support in the higher school.

The important period of intense psychoprophylactics of tobacco addiction is

the stage of sanatorium-and-spa treatment (on the basis of the MPEI sanatorium

preventorium). It is explained by the possibility of a combined approach, presence

of objective information about health condition of a student (medical check by the

physician) and availability of the time resource (the treatment course lasts for 21

day) for rendering dedicated aid. With the purpose of executing the Federal Law,

the anti-tobacco marathon was held among MPEI students; all interested students

could participate in it. All smoking students of any year of study, with high

motivation to reject nicotine addiction, were offered to be subjected to the 21-day-

long program (including low-invasive methods of influence) on the basis of

sanatorium-preventorium of MPEI.

3. GOALS AND DESIGN OF THE STUDY

Objective of work:

To study the influence of the essential oil inhaler made by the LLC

Dynamica Company on the intensity of tobacco smoking of students at the

Moscow Power Engineering Institute.

Goals

1. To examine the profile of tobacco smoking of MPEI students and objectively

assess the degree of tobacco addiction (СО level in exhalant air).

2. To assess the efficiency and safety of the essential oil inhaler “Antifume”.

3. To develop the technique of using the essential oil inhaler for the therapy of

tobacco addiction of students.

4. To develop assessment criteria of efficiency of the offered technique.

Study design. The survey of students will be held on the basis of the

sanatorium-preventorium of the Moscow Energetic Institute. The total number of

the study’s participants is 67 students of the 1st, 2nd and 4th years of study in MPEI,

with the age from 19 to 22 years (the average age constituted 20.2 года). The

length of the time of smoking for each examined student was at least 1 year, and

the average period of nicotine smoking was 4.6 years. Percentage of girls was 39%

(26 female students), and of youths, 61% (41 students).

Exclusion criteria: allergy to essential oils, contained in the formula,

pregnancy, epilepsy, mental disorders, holding other procedures aimed at tobacco

addiction treatment.

Inclusion criteria: systemic tobacco smoking more than 1 year, age over 17

years.

Level of СО in exhalant air should be over 7 molecules.

All the surveyed students were randomized into 2 groups:

The first group: the procedure (inhalation) is to be conducted in accord with

the standard schedule – once per 2 hours, 8 times a day, following such technique:

First inhalation is to be carried out in 30-40 minutes after awakening, and

the next ones, approximately in 2 hours. Inhalation was not related to smoking;

students were to abstain from smoking for 15 minutes after inhalation or be

subjected to inhalation not earlier than post 15 minutes after smoking.

The surveyed students in the second group held the procedure (inhalation) in

that period when they wanted to light a cigarette. The number of inhalations could

be up to 12-15 times a day.

Prior to the first act of use of the inhaler, the procedure was conducted

during 1-2 minutes to assess individual tolerance to components of the inhalation

device. There were no cases of increased sensibility to aroma components of the

inhaler.

Students filled in a questionnaire before the beginning of the study, in 10

days and in 21 days after the beginning. Besides, recording the number of smoked

cigarettes was made daily, time of smoking the first cigarette (start of smoking),

volume of the smoked cigarette (half cigarette, 2/3 cigarette, 3/4 cigarette), and

inhalation frequency.

Study methods: Fagerstrom’s questionnaire, apparatus method of

measuring СО level, individual diary, interviewing in the course of observations,

and statistical processing.

Statistical processing

Mathematical and statistical processing of results of study of students’

groups was performed using personal computing machine IBM with the use of

packages of applied computer programs Microsoft Excel XP. The given applied

programs allow one to calculate the following values and parameters of one-

dimensional statistics: arithmetical mean, dispersion, standard error of the average,

and standard deviation. Study results were subjected to comparative analysis.

Statistical significance of differences was determined by t-test of Student

(Nasledov A.D., 2008).

Equipment

The nasal inhaler (hereinafter referred to as the Inhaler) is intended for

treatment and prophylactics of respiratory organs’ diseases in the combined

therapy and for decreasing tobacco addiction by means of local effect of the

inhaled mix of essential oils.

The composition of the formula of essential oils

- Essential oil – black pepper – 30 %

- СО2 – extract of fennel – 30 %

- Essential oil – sweet basil – 20 %

- СО2 – extract of tobacco plant leaves – 20 %

Studied phenomena:

Status of the smoker, level of СО in exhalant air, daily smoking profile,

intensity of smoking with the use of the nasal inhaler with essential oils of black

pepper, fennel, sweet basil, and extract of tobacco leaves.

Site of the work:

MPEI sanatorium (city of Moscow)

4. STUDY RESULTS Efficiency of anti-tobacco therapy methods to a certain extent depends on

the degree of nicotine addiction. Results of interviewing, carried out before the

start of therapeutic effect, revealed the following (Table 1).

Table 1

Determining the degree of nicotine addiction in

different groups of MPEI students on the basis of the Vagerstrom

questionnaire

Degree of nicotine

addiction

Group No.1

(n=37)

Group No.2

(n=30)

Not revealed 0 (0%) 2 (6.6%)

Low or moderate 28 (75.7%) 21 (70%)

Pronounced or strong 9 (24.3%) 7 (23.4%)

In accord with Vagerstrom’s questionnaire, only 6.6% of respondents did

not have any nicotine addiction, while 24% had strong nicotine addiction, that, in

the authors’ opinion, is related to the young age of the examined people and their

not so long length of the smoking period (average population indicators vary in the

range 50-60%). It was revealed from literature that low degree of nicotine

addiction in students causes difficulties in the organization and carrying-out of

preventive measures aimed at limiting smoking due to low motivation towards

therapy.

Apart from self-assessment with the help of Vagerstrom’s questionnaire, in

the course of the study, the objective assessment of the degree of tobacco addiction

was conducted through the estimation of the level of carbon oxide (СО) in exhalant

air by means of gas analyzer Micro CO (UK) (Table 2).

Table 2

Determining the degree of nicotine addiction in

different groups of MPEI students with the help of the Micro CO gas

analyzer

Degree of nicotine

addiction

Group No.1

(n=37)

Group No.2

(n=30)

Not revealed 14 (37.8%) 4 (13.3%)

Low or moderate 6 (16.3%) 12 (40%)

Pronounced or strong 17 (45.9%) 14 (46.7%)

The obtained data show that students subjectively underestimate the degree

of their nicotine addiction that, in turn, requires that the medical staff explains and

provides motivation of students to the therapy. In connection with the obtained

data, in this study, the objective criterion – the level of carbon oxide in blood and

the number of CO molecules in exhalant air – was selected as basic.

Smoking frequency on business days and in weekends is an important aspect

of the tobacco addiction therapy. The results of the students’ survey revealed that

the average number of lit cigarettes on the business day was 12.4 and 11.9 in two

groups, respectively. In weekends, the number of lit cigarettes decreased to 7.1 per

day. Such a difference (smoking decrease by approximately 40%) suggests that

smoking in the student environment depends on a number of factors and social and

everyday aspects.

Thereat, the values of the number of lit cigarettes on business days and days

free from work confirm the high degree of nicotine addiction in most respondents;

what evokes special concern is the age of the surveyed students. Dynamics of

observation was positive concerning the frequency of lighting cigarettes on

business days in both groups, but difference became reliable only in the second

group by the 21st day of the study (reliability of differences before and after

treatment, р< 0.05) (Fig. 1).

Fig. 1. Smoking frequency in the 2nd group in the observation dynamics

(number of cigarettes).

День – day;

Будние дни – business days; and

Выходные дни – weekends.

So using the inhaler “when necessary”, the unlimited number of times a day,

gives reliably better results compared with the group when inhalations were

“scheduled” and given the limited number of times.

According to literature, the volume of the lit cigarette is one of crucial

indicators of efficiency of nicotine addiction therapy: it allows one to make an

indirect judgment about the amount of nicotine and combustion products of

tobacco, which entered the smoker’s organism. In the study of students’ diaries,

conducted in MPEI, this indicator did not change reliably. A possible explanation

of the absence of dynamics of this criterion of the therapy efficiency is low

economic prosperity of the surveyed students. Thus, in the course of discussion of

obtained data with the student, the opinion was voiced repeatedly, that the tested

person preferred to reduce the smoking frequency rather than cut the volume of the

lit cigarette.

Relying on the objective indicator – carbon oxide level in blood and the

number of СО molecules in exhalant air, the study revealed that, when using the

inhaler, blood level of carbon oxide and the number of СО molecules reliably

decreased in both groups by the 21st day of the trial (Table 3).

Table 3

Defining carbon oxide level in blood and the number of СО molecules in

exhalant air in different groups of MPEI students

Days of trial

Group No.1

(n=37)

Group No.2

(n=30)

СО in air, molecules СОНВ СО in air СОНВ

1st 25.5 5.6 27.1 5.8

10th 20.7 3.2 22.0 3.5

21st 16.2* 1.9* 12.0* 1.6*

Note: * marks reliability of differences prior to and after treatment, р< 0.05.

No reliable differences in the number of the lit cigarettes were singled out in

the first group, but differences in objective criteria – the level of carbon oxide in

blood and number of CO molecules in exhalant air – were reliable. It proves that,

when working with tobacco addiction, one must conduct permanent objective

monitoring and visible demonstrate and use the obtained data in the

psychotherapeutic paradigm, explaining and showing the pattern to the patient,

backing and increasing motivation towards treatment. Even if the patient

insignificantly decreased the number of smoked cigarettes, indicators of the

number of СО molecules in exhalant air decrease more significant that is the

resource for the complete refusal of the addiction. The procedure of device-based

trial was always appreciated by the surveyed persons.

For different objective reasons, not all students in both groups managed to

participate in the program of psychotherapeutic backing in the course of the study

– 22.4% (15 students). We integrated both groups for statistical analysis that

objectively influenced the final result. Thus, the given group of students cut the

average number of smoked cigarettes per business day from 12.1 to 9.4 by the end

of the trial vs. students who received combined treatment: the number of smoked

cigarettes per business day shortened to 7.0 by the end of treatment that is reliably

lower.

The indicator of addiction degree appeared to be the important parameter of

treatment success. It has been established that persons with low addiction degree

are most prospective from the point of dropping smoking. Thus, persons with

objectively revealed low nicotine addiction decreased the average number of

smoked cigarettes vs. students with pronounced degree of nicotine addiction from

9.1 to 6.4 (for persons with pronounced degree of nicotine addiction, 12.1 before

the beginning of treatment to 9.4 by the end of treatment).

Frequency of applying these or those healing procedures to a significant

extent contributes to the program efficiency.

Table 4

Number of essential oil inhalations per day

in different groups of MPEI students

Days Group No.1

(n=37)

Group No. 2

(n=30)

1st 4.9±0.3 5.1±0.4

10th 5.8±0.6 6.8±0.7

21st 6.6±0.3* 7.5±0.4*

Note: * means reliability of difference prior to and after treatment, р< 0.05.

It can be seen from the presented table that the number of inhalations varied

significantly in the course of trial, being 4.9±0.3 on the first day to 6.8±0.7 in the

middle of the course and 7.5±0.4 in the end. It can be suggested that efficiency of

inhalation for preventing smoking served the incentive for increasing inhalation

frequency.

INFERENCE

Criteria of assessment of the blood level of carbon oxide and the number of

СО molecules in exhalant air, considered in the study, reliably and objectively

evaluate the dynamics of therapy. The poll, conducted after the end of the

observation, showed that self-assessment of respondents regarding smoking

decrease differed from the objective assessment carried out with the help of the

smokilyzer (Micro CO). Students surveyed subjectively underestimated he

significance of the therapy that matches well with peculiarities of the age period of

the studied population. Persons without nicotine addiction or with low nicotine

addiction did not note any significant changes after the end of the therapy, whereas

students with the pronounced nicotine addiction reliably noted positive dynamics

in the dropping of smoking.

In connection with it, based on the study, it was established that the essential

oil inhaler made by the LLC Dynamica Company reliably decreased the intensity

of tobacco smoking in students of GOU VPO Technical University (Moscow

Energetic Institute). With the help of the used inhaler, more directed and safe

influence on pathogenic mechanisms of tobacco addictions has become possible

that is extremely rarely used in the therapy of addictive behavior. Using the

obtained results is anticipated to be sufficiently prospective in the combined

therapy of tobacco addiction in the center for prophylactics and treatment of

tobacco and non-chemical addictions at the Narcology Research Center and other

health centers in the capital.

Social value of studies in this field is determined by high prevalence of

tobacco addiction in the modern society, especially among the rising generation

and students.

This area of research is anticipated to be prospective enough, and further

researches in this field will allow for development of methodological foundations

and practical recommendations for the use of the essential oil inhaler (with the use

of behavioral psychotherapy) in the combined treatment of tobacco addiction and

in psychoprophylactic arrangements among teenagers and students. In addition,

such practical inhalers, convenient in everyday usage, can be used in closed rooms

where smoking is prohibited (metropolitan, aircraft). It is important for tobacco

addicts who travel long.

CONCLUSIONS

1. It was found that the best effect is achieved when the nasal inhaler is used when

necessary, without limiting the number of inhalations per day, rather than with

strict regulation of the procedures. In the group of students No.2 (use of the inhaler

when necessary), the decrease of the level of the number of СО molecules in

exhalant air was observed vs. group No. 1 (12.0 and 16.2, respectively).

2. It was proved that the use of objective criteria – the blood level of carbon oxide

and the number of СО molecules in exhalant air – in the assessment of the therapy

dynamics was reliably more objective than methods of self-control of the patient.

Thus, the level of the number of СО molecules in exhalant air in group No.2 of

students reliably dropped (р< 0.05) over 21 days (27.2 on the first day and 12.0 in

the end of treatment).

3. It has been revealed that the use of objective indicators obtained by the device-

based method in dynamics provides broad opportunities for the therapeutic

interaction with the patient and increase of motivation towards refusal from

tobacco addiction.

4. Using the essential oil inhaler made by the LLC Dynamica Company and

elements of behavioral therapy reliably decreases the number of smoked cigarettes

in students and allow for boosting the patient’s rehabilitation potential and

outcome prognosis. Students that (for different reasons) refused from

psychotherapeutic support in the course of the trial did not reliably decrease the

average number of smoked cigarettes compared with students that received

psychotherapeutic aid. So the number of smoked cigarettes before the use of the

inhaler was 12.1, while in the end of treatment, this level was reduced to 9.4 in the

group without psychotherapeutic support vs. 7.0 cigarettes in students that received

the combined therapy.

5. It was established that, to get effect of inhalations of aromatic preparations, at

least 6-7 inhalations/day were necessary in case of persons with the pronounced

degree of nicotine addiction.

6. It was established that persons with low degree of addiction were most

prospective regarding drop of smoking. So students with objectively stated low

degree of nicotine addiction reduced the average number of smoked cigarettes vs.

students with the pronounced degree of addiction from 9.1 to 6.4.

7. It was established that the decrease of the volume of smoked cigarettes is not

typical of students for its economic disadvantage, and preference is given to the

decrease in the number of cigarettes.

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