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How to Help Patients Quit Smoking

Each year, more than 70% of American smokers see a physician, and more than 50% see a dentist. Yet physicians and dentists rarely help their patients quit smoking. In fact, one recent survey found that fewer than 15% of smokers who saw a physician in the previous year were offered assistance in quitting. Goldstein, M G., Niauru, R., Willey-Lessne, C., DePue, J., Eaton, C., Rakowski, W. (1997). Physicians counseling smokers: A population-based survey of patients' perceptions of health care provider-delivered smoking cessation interventions. Archives of Internal Medicine, 157, 1313-1319.

Tomar, S. L., Husten, C. G., & Manley, M. W. (1996). Do dentists and physicians advise tobacco users to quit? Journal of the American Dental Association, 127, 259-265.

If you're a doctor, dentist, or other health professional, the U.S. Public Health Service recommends you take the steps below. Public Health Service. (2000). Treating tobacco use and dependence. Washington, DC: U.S. Department of Health and Human Services.

STEP 1. Find out whether your patients smoke. This information can be collected on patient intake forms or vital sign forms:

Patient Intake Form

Patient name: _____________________

Are you allergic to any medications?

No
Yes (specify: _____________________)

What is your smoking status?

Current smoker
Former smoker
Never a smoker

Reason for today's visit:

STEP 2. Advise smokers to quit. For example, you might say to smokers, "As your physician, I have to tell you that quitting smoking is the single most important thing you can do to protect your health." Simply by urging their patients to quit, physicians can achieve cessation rates of 5-10% per year. U.S. Department of Health and Human Services. (2000). Reducing tobacco use: A report of the Surgeon General. Atlanta, GA: Centers for Disease Control and Prevention.

STEP 3. Ask smokers whether they are willing to quit. If the answer is positive, encourage patients to set a quit date that falls within the next two weeks. If the answer is negative, stress that the decision is theirs to make, and give them information on the benefits of quitting (e.g., suggest that they visit JoeChemo.org).

STEP 4. Help smokers who wish to quit. Suggest that smokers make their quit date known to others and that they seek the support of friends, family members, and coworkers. Recommend nicotine replacement therapy for patients who are not pregnant or nursing. Advise patients to avoid smoking in their typical places (e.g., work, home, car) prior to the quit date, and to remove tobacco products from their environment after quitting. Even a 3-minute consultation can increase tobacco abstinence. Public Health Service. (2000). Treating tobacco use and dependence. Washington, DC: U.S. Department of Health and Human Services.

STEP 5. Schedule a telephone or office follow-up. Talk with patients a few days after they've quit and again later in the month. Congratulate them if they've been successful or offer them assistance if they haven't. Discuss more intensive treatments if necessary.

Health care professionals are uniquely positioned to help smokers quit. If 100,000 health care providers were to help just 10% of their smoking patients quit, an estimated 3 million additional smokers would quit each year. Manley, M., Epps, R. P., Husten, C., Glynn, T., & Shopland, D. (1991). Clinical interventions in tobacco control: A National Cancer Institute training program for physicians. JAMA, 266, 3172-3173.

What easier way is there to save lives?

 
 

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