Agency For Healthcare Research And Quality Smoking Cessation Guideline Overview

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Smoking Cessation Guideline Overview

Overview:

• Identify the smokers - Adding smoking status to chart
• Advise smokers to quit - clear advice about quitting
• Assess smoker's willingness to quit and provide informational support appropriate to their readiensss to quit
• For patient who is willing to quit, develop plan for initiating treatment and followup
• For patients unwilling to attempt to quit, provide counselling to promote patient's readiness to quit

The model Stages Of Behavior Change can also help with smoking cessation intervention.

Identify the smokers

Advise smokers to quit

It is now known that quitting smoking ads 15 years to life expectancy.

Assess smoker's willingness to quit

Ask the patient how important they feel it is to quit smoking. Encourage them to talk about their personal reasons for quitting smoking. Discuss previous attempts to quit smoking, and ask the patient why they feel they did not succeed. Help them identify the problem areas, and point out successful strategies.

Encourage the discussion in a way that builds the patient's confidence in their ability to quit smoking.

For patients willing to quit smoking

Help the patient set a date to quit smoking, and help the patient arrange support to quit smoking.

Evaluate the patient for alternatives like nicotine patches, tapering plan to minimize nicotine withdrawal symptoms, and other medications to reduce smoking cravings.

Look at any other reasons the patient may need specialized smoking cessation services.

Arrange a followup plan.

For patients who don't want to try to quit smoking

For these patients, the five Rs must be emphasized:

• Personal relevance to the medical social situation
• Risks associated with smoking - Both acute, long-term, and risks to others
• Rewards of quitting - Financial savings, quality of life
• Roadblocks that can interfere with quitting, or increase risk of relapse
• Repetition of a stop-smoking message

Other links:

• Smoking Cessation Guideline - http://www.surgeongeneral.gov/tobacco/default.htm

Sources:

• ahrq.org
• Hurst's 12th Ed. "The Heart", pg 2450

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