Smoking Cessation: A Comprehensive Guide for Healthcare Professionals

Posted on Apr 30, 2024 in Physical Education

SMOKING CESSATION: INTRODUCTION

The Leading Cause of Avoidable Death

Smoking is the primary cause of preventable death in Spain. Therapeutic interventions for smoking cessation are effective, particularly when tailored to individual smokers. This guide emphasizes the importance of efficient, evidence-based interventions and programs to reduce smoking prevalence and improve health outcomes.

The Role of Healthcare Professionals

Tobacco addiction is a chronic disease requiring treatment. Approximately 70% of smokers visit their primary care physician at least once a year. Healthcare professionals play a crucial role in smoking cessation efforts.

DIAGNOSING SMOKING DEPENDENCE

Correct diagnosis of smoking dependence is essential for successful treatment. Early detection and intervention are key strategies.

Minimum Data Set for Diagnosing Smoking Dependence

The following data set is crucial for diagnosing smoking dependence:

  1. Phase of Change: This assesses the smoker’s readiness to quit. The stages include:
  • Preparation Phase: Willing to quit within the next month.
  • Contemplation Phase: Considering quitting within the next 6 months.
  • Precontemplation Phase: Not willing to quit.
Degree of Physical Dependence on Nicotine: The Fagerström Test assesses nicotine dependence based on factors such as the number of cigarettes smoked per day, time to first cigarette, and difficulty refraining from smoking in restricted areas. Scores range from mild (less than 20 cigarettes/day) to severe (more than 20 cigarettes/day, first cigarette within 30 minutes of waking, and strong cravings).Smoking Grade: This categorizes individuals based on their smoking habits:
  • Smoker: Regularly smokes any amount of tobacco.
  • Ex-smoker: Has quit smoking for at least one year.
  • Non-smoker: Has never smoked regularly.

It’s important to note that there is no safe threshold for tobacco consumption. A dose-response relationship exists, meaning higher consumption leads to a greater risk of developing smoking-related diseases and increased difficulty quitting.

PREPARATION FOR QUITTING

Most smokers can be effectively treated in primary care settings. The goal is to help patients achieve permanent smoking cessation. Treatment should include both pharmacological and psychological support.

Providing Support and Resources

Healthcare professionals should:

  • Offer advice on quitting and maintaining abstinence.
  • Provide ongoing monitoring and support.
  • Offer written materials with tips for staying smoke-free.

Cooximetry: A Valuable Tool

Cooximetry measures carbon monoxide (CO) levels in exhaled air, providing valuable information about smoking status and pack-years. Smokers typically have CO levels greater than or equal to 10 ppm, while non-smokers have levels below 6 ppm. Cooximetry offers several benefits:

  • Demonstrates the rapid decrease in CO levels after quitting, which can be motivating for patients.
  • Provides diagnostic information.
  • Assists in the process of raising awareness and encouraging smoking cessation.
  • Offers a simple and non-invasive technique.

TIPS FOR QUITTING SMOKING

Here are some helpful tips to share with patients who want to quit smoking:

  • Seek support from healthcare professionals, family, and friends.
  • Identify triggers and develop alternative coping mechanisms.
  • Make a list of reasons for quitting, focusing on health benefits and cost savings.
  • Set a specific quit date within the next two weeks.
  • Remove smoking-related items from the environment.
  • Engage in physical activity.
  • Reflect on past quit attempts to identify helpful strategies and reasons for relapse.
  • Consider pharmacological treatment options if needed.
  • Distract yourself from cravings with activities like chewing sugar-free gum, drinking water, or taking a walk.
  • Avoid caffeine and other stimulants if experiencing insomnia.
  • Focus on short-term goals rather than thinking about never smoking again.
  • Adopt a healthy diet rich in fruits and vegetables.
  • Remember that one cigarette can lead to relapse.
  • Be aware that cravings will diminish over time.

BRIEF SMOKING CESSATION INTERVENTIONS

Over 70% of smokers desire to quit and find medical advice to be a motivating factor. Brief interventions lasting 3-10 minutes can be highly effective, with a 4.5% annual abstinence rate. These interventions should be offered to all smokers and include the following characteristics:

  • Simple and understandable information.
  • Motivational and encouraging approach.
  • Accurate and up-to-date information.
  • Empathy and respect for the patient.
  • Avoidance of judgmental language.
  • Encouragement and support.

By implementing these strategies, healthcare professionals can play a vital role in helping patients achieve successful smoking cessation and improve their overall health and well-being.