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SMOKING CESSATION
Treatment Guideline Chart
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.

Smoking Cessation References

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  2. Bader P, McDonald P, Selby P. An algorithm for tailoring pharmacotherapy for smoking cessation: results from a Delphi panel of international experts. Tob Control. 2009 Feb;18(1):34-42. doi: 10.1136/tc.2008.025635. PMID: 18845621
  3. Lingford-Hughes AR, Welch S, Peters, et al. BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction and comorbidity: recommendations from BAP. J Psychopharmacol. 2012 Jul 23 May 2012;26(7):899-952. doi: 10.1177/0269881112444324. Accessed 23 May 2012. PMID: 22628390
  4. Bartra A. Treatment of tobacco dependence. Dtsch Arztebl Int. 2011 Aug;108(33):555-564. doi: 10.3238/arztebl.2011.0555. PMID: 21912578
  5. MedWormhttp://www.medworm.com/rss/index.php/Respiratory-Medicine/40/http://www.medworm.com/rss/medicalfeeds/specialities/Respiratory-Medicine.xml
  6. Ministry of Health Singapore. Clinical practice guideline: smoking cessation. MOH (Singapore). http://www.moh.gov.sg/. Apr 2002.
  7. National Cancer Institute. Cigarette smoking: health risks and how to quit. National Cancer Institute. http://www.cancer.gov/. Feb 2013. Accessed 03 Mar 2013.
  8. European Network for Smoking and Tobacco Prevention (ENSP). European smoking cessation guidelines: the authoritative guide to a comprehensive understanding of the implications and implementation of treatments and strategies to treat tobacco dependence. 1st ed. ENSP. http://www.toraks.org.tr/. Oct 2012. Accessed 03 Mar 2013.
  9. Disease Control Division, Ministry of Health Malaysia. Clinical practice guidelines: treatment of tobacco smoking and dependence. http://www.moh.gov.my/. 2003
  10. Serlin DC, Clay MA, Van Harrison R, Thomas LA, for the Tobacco Treatment Guideline Team. Guidelines for clinical care: tobacco treatment. University of Michigan. http://www.med.umich.edu/. Mar 2012. Accessed 03 Mar 2013.
  11. Ministry of Health New Zealand. New Zealand Smoking Cessation Guidelines. Ministry of Health New Zealand. http://www.health.govt.nz/. Aug 2007.
  12. Medscape Drug Info with First Data Bank and ASHP. Nicotine gum buccal pharmacology & chemistry. http://www.medscape.com/druginfo. 2002.
  13. National Institute for Health and Care Excellence. NICE technology appraisal guidance 123. Varenicline for smoking cessation. NICE. http://www.nice.org.uk/. Jul 2007. Accessed 28 Aug 2007.
  14. Zwar N, Richmond R, Borland R, et al. Smoking cessation: a guide for health professionals. The Royal Australian College of General Practicioners. http://www.racgp.org.au/. 2011
  15. Fiore MC, Jaén CR, Baker TB, et al. Treating tobacco use and dependence: 2008 update. U.S. Department of Health and Human Services. http://www.ahrq.gov/. May 2008.
  16. World Health organization. Policy recommendations for smoking cessation and treatment of tobacco dependence. WHO. http://www.who.int/. 2003.
  17. Bullen C, Howe C, Laugesen M, et al. Electronic cigarettes for smoking cessation: a randomised controlled trial. Lancet. 2013 Nov;382(9905):1629-1637. doi: 10.1016/S0140-6736(13)61842-5. Accessed 12 Aug 2014. PMID: 24029165
  18. Heatherton TF, Kozlowski LT, Frecker RC, Fagerström KO. The Fagerström Test for Nicotine Dependence: a revision of the Fagerström Tolerance Questionnaire. Br J Addict. 1991 Sep;86(9):1119-1127. http://www.aafp.org/. PMID: 1932883
  19. Larzelere MM, Williams DE. Promoting smoking cessation. Am Fam Physician. 2012 Mar;85(6):591-598. http://www.aafp.org/. PMID: 22534270
  20. Rustin TA. Assessing nicotine dependence. Am Fam Physician. 2000 Aug;62(3):579-584. http://www.aafp.org/. PMID: 10950214
  21. McDonough M. Update on medicines for smoking cessation. Australian Prescriber. 2015 Aug;38(4):106-111. http://www.australianprescriber.com/. Accessed 21 Jan 2016
  22. Ministry of Health Singapore. HPB-MOH clinical practice guidelines 1/2013. Treating tobacco use and dependence. Ministry of Health Singapore. http://www.hpb.gov.sg/. May 2013. Accessed 21 Jan 2016.
  23. Rigotti NA. Pharmacotherapy for smoking cessation in adults. UpToDate. http://www.uptodate.com/. 12 Jan 2016. Accessed 21 Jan 2016.
  24. European Network for Smoking and Tobacco Prevention. ENSP guidelines for treating tobacco dependence: the comprehensive guide to the implementation of treatments and strategies to treat tobacco dependence. ENSP. http://ensp.org/. Mar 2016.
  25. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: smoking cessation. Version 1.2017. NCCN. https://www.nccn.org/. Mar 2017. Accessed 01 Aug 2017.
  26. The Royal Australian College of General Practitioners (RACGP). Supporting smoking cessation: a guide for health professionals. RACGP. http://www.racgp.org.au/. Jul 2014.
  27. National Comprehensive Cancer Networ. NCCN clinical practice guidelines in oncology: smoking cessation version 2.2017. NCCN. https://www.nccn.org. 21 Aug 2017.
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