USING THE CONCEPT OF HARM REDUCTION AND COGNITIVE BEHAVIORAL THERAPY FOR THE TREATMENT OF PSYCHOLOGICAL TOBACCO ADDICTION
Authors: Volkova *Elena , Gridneva Svetlana Valeryevna , Tashcheva Anna Ivanovna , Egorov Vladimir Nikolaevich , Afrikian Oleg Arturovich 
Published: February 2025

Abstract

Background
According to the All-Russian Center for the Study of Public Opinion, the number of smokers in Russia has stopped decreasing, and the number of people who are not motivated to quit smoking has increased [1]. We analyzed the methods of treatment of nicotine addiction available in Russia and concluded that new solutions are needed to effectively reduce the number of smokers. Since there are smokers who are not motivated to quit smoking, and the existing methods of helping them in Russia have exhausted themselves, an alternative solution is needed, which can be the use of the harm reduction concept. In addition, the modern requirements of tobacco addiction therapy in the structure of an integrated approach include the need to solve personal psychological problems [2].

Aims and Objectives
The main tasks that need to be solved with a client/patient with tobacco addiction: collecting psychological and psychological anamnesis and establishing mutual understanding with a specialist, increasing the level of motivation, discussing goals, familiarization with the model of cognitive behavioral therapy (CBT), the application of an individual scenario of the CBT model in life, the use of algorithms for counseling a smoking patient in accordance with clinical recommendations.

Methods
Theoretical analysis of sources on the problem, psychodiagnostics, CBT, the concept of harm reduction.

Results
We have a clinical example of successful work with a patient who had a tobacco addiction. Patient A., male, 52 years old, smokes for 25 years, smoker index equals 25 pack/years. The work was started by a cardiologist at an outpatient appointment. After collecting anamnesis, the degree of nicotine addiction and the level of motivation to quit smoking were determined (Fagerstrom test, Prohaska questionnaire).
Then motivational counseling was conducted, after which the patient was referred to psychologists. The patient had a high degree of dependence on nicotine and was not motivated to quit smoking. At this stage, the patient was offered the use of products with a reduced risk to health — alternative sources of nicotine delivery, namely the electronic tobacco heating system (ETHS).
At the next stage, CBT based on cognitive model was carried out. The main goal of CBT was to reduce existing symptoms and improve the patient's quality of life and develop his psychological flexibility. After the comprehensive work was carried out, a positive result was achieved. The patient stopped smoking tobacco and using of ETHS. Dynamic monitoring and support are currently underway.

Discussion and Conclusion
Tobacco addiction therapy must consider the altered reactivity of the body, the state of each individual link of pathogenesis (medical, psychological and social), providing a comprehensive approach.

References
1.https://wciom.ru/analytical-reviews/analiticheskii-obzor/kurenie-v-rossii-monitoring- 2022?ysclid=l9yjbwovy7602439778
2.A patient with tobacco addiction: methodological guidelines / Shulzhenko L.V., Bozhko O.V., Gridneva S.V., Tasheva A.I., Pelevina I.D., Mirzaliev A.Sh. - M.: Helen gift Publishing house, 2023. - 76 p. https://elibrary.ru/item.asp?id=54385762