At an individual patient level, GPs and their teams can influence smoking rates by systematically providing opportunistic advice and offering support to all attending patients who smoke.67 Where this is insufficient, other effective treatment strategies include referral to the Quitline,68 pharmacotherapy 69,70 and motivational interviewing.71,72
Tobacco use is most effectively treated with a comprehensive approach involving behavioural support and pharmacotherapy. Combined pharmacotherapy and behavioural support increases the success of smoking cessation.73
Pregnant women find it especially difficult to quit; pregnancy alters nicotine metabolism and heightens withdrawal symptoms and the support from partners is an important element in quitting. Higher smoking rates in disadvantaged individuals reflect greater neighbourhood disadvantage, less social support, greater negative effect and lower self-efficacy.21,28 Removing access barriers and providing incentives to motivate patients to quit may improve quit rates.
Patients should be reviewed within one week and again after one month of stopping smoking in order to help increase the long-term chance of quitting.
There is a lack of consistent, bias-free evidence that acupuncture, acupressure or laser therapy have sustained benefit on smoking cessation for longer than six months.74 There is insufficient evidence that electronic cigarettes(e-cigarettes) help smokers to stop smoking when compared with nicotine patches or placebo.75
The CEITC provides resources and strategies.