We have re-examined an anticholinergic block method described by Bachynsky in 1986 using an injection consisting of hyoscyamine, scopolamine and hydroxyzine in a community smoking cessation clinic.
The patient first reviews a smoking cessation video and literature. During the office visit, a history and physical examination is performed and counseling may be done as well as any ancillary tests. Patients felt suitable for the anticholinergic block method of smoking cessation were injected. The patient is then prescribed anticholinergic medications to continue the anticholinergic block for up to 14 days. Routine contact with the patients was made via telephone interviews and counseling sessions throughout the first two months, as well as a weekly group conference calls. This study was from observational data and was not approved by the Institutional Review Board.
A total of 20 patients were observed between January 1, 2004 and April 19, 2004. In the first week after the anticholinergic shot 16 patients (80%) had quit smoking immediately after the shot and were smoke free. Four patients (20%) had reduced smoking considerably. Over the next month after the shot, eight more patients (40%) started to smoke, however through close follow up and counseling and or a repeat anticholinergic shot, we were able to convert five of these to nonsmokers. At the end of our observation period, 13 (65%) patients had quit smoking for over 2 months. Three patients were still trying to quit and four patients had stopped trying. The most common adverse reactions were dry mouth, blurred vision, fatigue and drowsiness. No serious complications occurred. The number of patients and length of follow up was limited by the date of starting our clinic and the application deadline for ACCP abstracts. Additional data will follow.
In smokers highly motivated to quit, an anticholinergic block may be of significant help in smoking cessation with a tolerable side effect profile.
An anticholenergic block may be useful in helping patients quit smoking.
K.G. Voelker, Medical Innovations LLC