Helping people to stop smoking: the role of treatment products

Advising patients to stop smoking is an important intervention that will have an effect on their immediate and future health. Nurses need to be familiar with the numerous products that are available to assist smokers to give up cigarettes. Jennifer Percival describes how nicotine replacement therapy and bupropion can help smokers achieve success.     

How to help patients stop smoking

With the introduction of nicotine gum as a pharmacologic substitute source of nicotine, the clinician now has a tangible tool to aid the addicted cigarette smoker who wants to quit. However, without a physician's support and guidance, few patients achieve long-term abstinence with gum therapy alone. In this article, Drs Werther and Dayal describe a smoking cessation program that is easily implemented in a primary care practice and that can serve as a basic structure within which to incorporate individual modifications.     

Helping people to stop smoking: a study of the nurse''s role

Sixteen trained nurses from various clinical backgrounds participated in a project designed to describe the process and assess the outcome of their attempts to help a range of patients and clients to stop smoking. A case-study approach was employed and the nurses initiated 68 health education interventions related to smoking cessation. All interventions were tape-recorded and data on patients' and clients' characteristics, smoking history, health beliefs and motivation to give up smoking were also collected. Forty-two patients were followed up 1 year post-intervention. Data collected at this time revealed that 17% had successfully given up smoking, while a further 12% had substantially reduced their cigarette consumption. These findings compare very favourably with those of previous studies in which general practitioners have attempted to help patients stop smoking. The results of the research reported here therefore suggest that nurses have enormous potential for fulfilling a highly effective health education function.     

How to help your patients stop smoking

Family physicians can effectively help their patients stop smoking by using brief intervention and simple office organizational procedures. Intervention involves asking all patients about smoking, advising smokers to stop, assisting with self-help materials, establishing a date for quitting, possibly prescribing nicotine gum and, finally, arranging for follow-up visits. Office procedures include selecting an office coordinator, ensuring a smoke-free office, establishing a mechanism to identify and monitor patients who smoke, and involving the office staff in intervention and follow-up. With this protocol, intervention is possible at every office visit.     

GPs have key role in helping patients to stop smoking

Eighteen per cent of all deaths in adults aged 35 or over in England are still attributable to smoking. Almost all these premature deaths could be avoided if smokers stopped before their mid-thirties but only a quarter of people who have ever smoked regularly manage to quit by this age. Advice from the patient's GP is one of the most important triggers to a smoker making an attempt to quit. All patients attending a surgery for any reason who have smoked within the past three years should be offered advice on stopping smoking. Smokers without smoking-related diseases are just as likely to respond to advice as those with them. It is also important to re-assess the status of former smokers who were recorded as having stopped within the past three years. Half of those who stopped six months ago will relapse at some point as will 40% of those who stopped a year ago. Offer help with stopping to all smokers. The National Centre for Smoking Cessation and Training has launched a new online training module on how GPs can best deliver smoking cessation support to their patients. Optimum treatment involves behavioural support plus one of the smoking cessation medications. Behavioural support includes a number of specific behaviour change techniques that enhance the smoker's chances of remaining abstinent. These include: measurement of carbon monoxide in expired air; advice on best use of medication and helping smokers to put in place a clear 'not a puff' rule.     

Strategies to help adolescents stop smoking

Since most people who smoke begin doing so during adolescence, there is a need for an effective intervention aimed at this age group. This article looks at the factors that increase the probability of smoking and tobacco addiction during adolescence, and concludes with some useful approaches to smoking cessation.