smoking%20cessation
SMOKING CESSATION
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. Studies have shown that unplanned efforts to quit is as successful as planned attempts, stressing the benefits in encouraging smokers to quit smoking whenever opportunity arises.
Advice should be clear, personalized, supportive and non-judgmental.
Determine the willingness of smoker to make a quit attempt.
Patient is in action stage when he already stopped smoking within the last 6 months.

Lifestyle Modification

Reasons Patient May be Unwilling to Quit

  • Lack of information regarding the benefits of quitting & the harmful effects of tobacco (ie cancer, stroke, cardiovascular diseases, & chronic pulmonary diseases)
  • Previous failed attempts may have demoralized patient
    • Severe withdrawal symptoms during previous quit attempts
  • Presence of other tobacco users in home or workplace
  • Lack of required resources
  • Fear/concerns regarding quitting (eg fear of weight loss, fear of losing benefits or function of smoking such as overcoming feelings of boredom, stress, anxiety)

Motivational Intervention

  • An approach that enhances patients’ motivation to quit smoking
  • Composed of 5 components:
    • Relevance - Patient to indicate why quitting is personally relevant
    • Risks - Ask patient to identify potential negative consequences of smoking
    • Rewards - Patient should realize & understand the potential benefits of quitting
    • Roadblocks - Ask patient to identify barriers to quitting & note actions to address the barriers
    • Repetition - Patient’s current motivation to quit should be asked every patient visit
  • Motivational intervention will be more successful if the clinician is empathetic, promotes patient autonomy, supports the patient’s self-efficacy & avoids arguments
  • Patients who have failed in previous attempts to quit should be informed that most people make repeated failed attempts before they have succeeded
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Respirology - Malaysia digital copy today!
DOWNLOAD
Editor's Recommendations
Most Read Articles
Pearl Toh, 19 Jun 2016
Infants with persistent rhinitis have a higher abundance of Actinobacteria, especially Corynebacterium spp., in their nasal microbiome compared with healthy controls, according to a Singapore-based study presented at the European Academy of Allergy and Clinical Immunology (EAACI) Annual Congress 2016 held in Vienna, Austria.
Gabriel Angelo Sembrano, 16 Sep 2014

“At present, there is a limited development of new antibiotics. There is also a fast development of resistance to antibiotics. There are pathogens no longer susceptible to all antibiotics, and many pathogens are no longer susceptible to most antibiotics,” said Dr. Andre Villanueva, chief of party of the USAID’s Innovations and Multisectoral Partnerships to Achieve Control of TB (IMPACT) Project at the recent Annual Convention of the Philippine Pharmacists’ Association in Davao City.

Audrey Abella, 06 Jan 2017
Persistent wheeze or childhood asthma may be reduced by fish oil supplementation, particularly n-3 long-chain polyunsaturated fatty acids (LCPUFAs), during pregnancy, a recent Danish study found.
Pearl Toh, 31 May 2016
Synbiotic mixture of oligosaccharides and Bifidobacterium breve (B. breve) M-16V probiotic strain in infant formula restores gut colonisation by B. breve and supports healthy gut development in infants delivered by Caesarean-section (C-section), according to a study presented at the recent European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) annual meeting held in Athens, Greece.