Helping Smokers Quit A Guide for Clinicians

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Helping Smokers QuitA Guide for Clinicians

• AHRQ
• Revised May 2008

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Then

• Once upon a time.
• http//www.youtube.com/watch?vgCMzjJjuxQI

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And Now.

• 42,000 lives in the U. S. could be saved if 90
  percent of smokers were advised by a health
  professional to quit and were offered medication
  or other assistance.
• Dr. Ronald M. Davis, President
• American Medical Association
• Quoting a 2007 Report from the Partnership for
  Prevention

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AHRQ Guidelines

• Indeed, it is difficult to identify
• any other condition that presents such a mix of
  lethality, prevalence, and neglect, despite
  effective and readily available interventions.

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First Steps

• 70 of smokers see a physician every year
• 70 of smokers report wanting to quit
• 2/3rd of smokers who relapse want to try to quit
  again within 30 days

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So?

• Smokers cite a physicians advice to quit as
  an important motivator to stop smoking.

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Ask

• Set up an office wide system to
• Screen EVERY patient for tobacco use.
• Ask at every visit every time.
• Make it a part of any routine screening for any
  reason for every visit.

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Advise

• Clear
• Strong
• Personalized
• Urge every tobacco user to quit.

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Assess

• Ask every tobacco user if he or she is willing to
  make a quit attempt at this time.

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The Question is.

• Are you willing to give quitting a try?

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If they say no, motivate!

• Relevance
• Risks
• Rewards
• Roadblocks
• Repetition

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If they say yes, Assist

• Aid the patient in quitting
• provide counseling and medication

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Assist with Counseling

• Set a quit date
• Tell family, friends, and coworkers about
  quitting and request understanding and support
• Anticipate challenges to the upcoming quit
  attempt
• Remove tobacco products from your environment.

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Assist with Medication
Note Pilots, air traffic controllers, truck and
bus drivers are barred from taking Varenicline.
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Follow Up

• Problems
• Lack of support for cessation
• Negative mood or depression
• Strong or prolonged withdrawal symptoms
• Weight gain
• Smoking lapses

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Review of Process
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Conclusions

• Tobacco dependence is a disease.
• It is important to identify the users.
• It is essential that a clinician advise about
  cessation at every opportunity.
• Counseling and treatment do work.
• QuitLine is an effective resource that should be
  used.