Ask, Advise to quit and Assess are the steps in approaching patients regarding smoking cessation.
All patients should be asked if they use tobacco and should have their tobacco status documented on a regular basis.
Patient with nicotine dependence is characterized by smoking within 30 minutes of waking, consuming >10 cigarettes/day and had withdrawal symptoms in previous attempts of quitting smoking.
Smokers should be strongly urged to quit at every physician encounter.
Advice should be clear, personalized, supportive and non-judgmental.
Determine the willingness of smoker to make a quit attempt.
Dr Ong Kian Chung, a respiratory specialist at the KC Ong Chest & Medical Clinic, Mount Elizabeth Medical Centre, Singapore spoke on the evils of tobacco use and how clinicians can help in smoking cessation.
Over two-thirds of respondents who try the first cigarette progress to daily smoking, at least temporarily, according to a meta-analysis of large-scale national surveys, demonstrating “the remarkable hold that cigarettes can establish after a single experience” ─ in the words of study senior co-author Professor Peter Hajek.
A study finds no evidence that using pharmaceutical aids alone for smoking cessation helps improve the chances of successful quitting despite promising results in previous randomized trials and routine prescription of such drugs to help quit smoking.
Varenicline use for greater than 12 months may elevate smoking cessation rates in heavy smokers with mild chronic obstructive pulmonary disease (COPD) who are unmotivated to quit, a pilot study has shown.
Varenicline treatment may help in smoking cessation or reduction compared with placebo among patients with severe mental illness, as presented in a systematic review and meta-analysis of randomised controlled trials.
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Due to the apparent risk of adverse outcomes of disease and adverse events (AEs) associated with short-acting beta-agonists (SABA), the Global Initiative for Asthma (GINA) 2019 guideline recommends that all patients with mild asthma should receive symptom-driven or regular low-dose inhaled corticosteroid (ICS)−containing controller treatment.