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.

Supportive Therapy

  • There is not enough evidence to support the use of alternative non-pharmacological treatments (eg acupuncture, exercise, hypnotherapy, nutritional supplements) for smoking cessation
  • Electronic cigarettes (e-cigarettes)
    • A device similar to a real cigarette that produces a vapor which does not contain tar & other chemicals found in normal cigarettes & makes use of a replaceable cartridge containing flavoring, additives & sometimes nicotine
    • Though recent evidence suggests it may be of help in quitting smoking, the US Preventative Services Task Force (USPSTF), the American Heart Association (AHA), & the American Association for Cancer Research (AACR) suggest that clinicians focus more on proven current pharmacotherapeutic agents & interventions
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