Smoking Cessation



Smoking Cessation

Introduction

According to the National Institute on Drug Abuse, nearly 35 million people make a serious attempt to quit smoking each year. About 7% of those who try to quit on their own succeed, defined as being able to stop smoking for more than 1 year. Many smokers try to quit about 7-8 times before they are successful; these numbers mean that most persons return to smoking after a few days of attempting to quit.

Benefits Smoking Cessation

Many people continue to smoke despite all of this knowledge because they feel—or hope—that they are personally immune to these problems, because they believe that the benefits (pleasure, relief from stress and anxiety, or weight maintenance) outweigh the risks, or—more often than not—because quitting is difficult (Fernander, Rayens, Hahn, Zhang & Adkins 2010, 105-114). Many of the risks associated with cigarette smoking—including lung and other cancers, heart attack, stroke, chronic lung disease, and peptic ulcer disease—can be reversed or substantially reduced by quitting. Ten to 15 years after stopping, an ex-smoker's overall risk of death from these diseases is close to that of a person who has never smoked.

Description

The 2002 U.S. Department of Health and Human Services/Public Health Service Guideline, Treating Tobacco Use and Dependence, a comprehensive, evidence-based blueprint for smoking cessation, established the necessity for medical practitioners to take a proactive stance in regard to patients' smoking. This article was based on a review of some peer reviewed articles on tobacco addiction that had been published from 2005 to 2010. The guideline was designed to provide clinicians and others with specific information regarding effective cessation treatments, and it advocated the “frank discussion of personal health risks, the benefits of smoking cessation, and available methods to assist in stopping smoking,” an approach designed to raise physician concern about smoking, which had generally not been a topic broached with patients until associated diseases developed. The guidelines provide a strategy by which to approach the problem of patient smoking: The “Five A's” model. The model of the Five A's specifies (SharingInHealth, 2012):

Ask to systematically identify all tobacco users at every visit.

Advise smokers to quit smoking.

Assess the smoker's willingness to stop. If the smoker is not willing, educate as to the “Five Rs” (see below).

Assist smokers who are willing to stop smoking. Tests of nicotine dependence help set levels for pharmaceutical interventions.

Arrange follow-up support. Quick follow-up can prevent or curtail early relapse.

One research estimate is that 5% of smokers will stop smoking if their doctor advises them to, and that educating smokers about the health effects of smoking can motivate them to quit in higher numbers. Motivation to stop smoking can be increased by social support and pharmaceutical interventions, and early relapse can be prevented more easily if the smoker has a follow-up appointment within a week of the stated quitting date.

Smoking cessation methods focus on getting smokers into treatment in the first place by targeting resistance and increasing motivation. If patients are not willing to quit, medical personnel are expected to employ the ...