The medical community is quite aware of how much damage smoking does to their patients. They see the results every day. There has been quite a bit of thought put into helping people overcome this insidious and common addiction.
Some guidelines for successful smoking cessation treatment.
Identify those who are ready to quit by asking directly. Start with the statement, “Quitting tobacco is the most important thing you can do to protect your health.”
If someone isn’t yet ready to quit, encourage them by identifying reasons to quit in a supportive manner and try to build up their self confidence. On subsequent visits, reassess their willingness to quit.
Set a quit date within 2 weeks. Waiting any longer will allow for a continued series of postponements.
Get a commitment to remove smoking materials from their environment. If possible, recruit family members and significant others.
Make family, friends, and coworkers aware of the commitment to quit.
Review past quit attempts—what helped, what led to relapse. Develop ideas on how to surmount previous barriers.
Educate about challenges, particularly during the first few weeks, including nicotine withdrawal. A follow-up phone call to assess progress and discuss symptoms is very helpful.
Identify the individual reasons for quitting and the benefits – writing them down is an excellent way to reinforce the decision.
Counsel about alcohol use. Drinking alcohol is strongly associated with relapse.
Allowing others to smoke in the household or work environment lower success rate.
Identify smoking related behaviors. Meals, coffee, waking up in the morning, stress, driving – all these are common situational triggers that need to be identified.
- Recommend use of over-the-counter nicotine patch, gum, or lozenge; or give prescription for varenicline, bupropion SR, nicotine inhaler, or nasal spray, unless contraindicated.
- All medications come with literature on quitting smoking. These materials should be reviewed before the quit date. Promote the use of any help lines provided and have patients seek out their own information on the Internet.
Follow up in subsequent contacts. Smoking is a killer. The extra effort needed to help patients over the barriers to quitting (and long term abstinence) will do more to improve their life than any other single intervention. If this means a few phone calls or additional treatment, it is well worth the effort.
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