Supporting smoking cessation

A guide for health professionals

The role of health professionals

☰ Table of contents

Smoking cessation advice and support from health professionals are key aspects of a comprehensive approach to tobacco control. Health professionals can make an important contribution to tobacco control in Australia and to the health of the community by providing opportunities for smokers to quit. An encouraging environment can be provided in health settings (primary and community care, hospitals, dental, eye care and pharmacies)6,8,2730,42 and in non-health settings (workplaces, prisons, schools, state housing, social welfare services).43,44 All types of health professionals can play an important role – WHO states that involvement in offering smokers advice and assistance with quitting should be based on factors such as access, rather than professional discipline.13 In general practice, primary healthcare nurses (often referred to as practice nurses) can play an important role and potentially upskill to become tobacco treatment specialists.

Health professionals play an important role in educating and motivating smokers as well as assessing their dependence on nicotine and providing assistance to quit. All health professionals should systematically identify smokers, assess their smoking status and offer them advice and cessation treatment at every opportunity.27–30,45 Where a client presents with a problem caused or exacerbated by smoking, it is of vital importance for health professionals to raise the issue of smoking cessation.

There is a range of evidence-based strategies that can improve the implementation of effective smoking cessation intervention in the practice setting.46–49 Providing a systematic approach to smoking cessation is associated with higher levels of success.11 Routine enquiry through waiting room surveys48,50 or use of additional practice staff to provide counselling is associated with higher quit rates.30 Where health professionals are not able to offer support or treatment within their own practices, they should refer smokers for help elsewhere – for example, to Quitline, to one of the increasing number of accredited tobacco treatment specialists  and to local programs such as the Fresh Start course by Quit Victoria.51

Brief interventions for smoking cessation involve opportunistic advice, encouragement and referral. Interventions should include one or more of the following:7,11,52

  • brief advice to stop smoking
  • an assessment of the smoker’s interest in quitting
  • an offer of pharmacotherapy where appropriate
  • providing self-help material
  • offering counselling within the practice or referral to external support such as Quitline (see Appendix 2), an accredited tobacco treatment specialist or other local programs in your area.

Beliefs that can be barriers to optimal smoking cessation advice

Asking about smoking and offering advice and assistance are key roles for health professionals. Barriers raised by health professionals to engaging in greater efforts to provide smoking cessation advice include:

  • a perception that it is ineffective
  • lack of time
  • lack of smoking cessation skills
  • reluctance to raise the issue due to perceived patient sensitivity about smoking
  • perceived lack of patient motivation.53,54

Table 3 presents evidence in relation to these barriers.


Table 3. Barriers to smoking cessation



Assistance with smoking cessation is not part of my role

Most patients think smoking cessation assistance is part of your clinical role45,55

I have counselled all my smokers

Only 45–71% of smokers are counselled56,57

Smokers aren’t interested in quitting

Nearly all smokers are interested in quitting although some are temporarily put off by past failures. More than 40% of smokers make quit attempts each year and more think about it58

I routinely refer patients for smoking cessation assistance

Referrals to Quitline are low (10–25%)59

I’m not effective

Clinicians can achieve substantial quit rates over 6–12 months, 12–25% abstinence, which have important public health benefits27,43,51

Smokers will be offended by enquiry

Visit satisfaction is higher when smoking is addressed appropriately57,60

I don’t have time to counsel smokers

Effective counselling or referral can take as little as a minute11


Smoking cessation advice from health professionals is effective in increasing  quit rates. The major effect is to help motivate a quit attempt. Level I. All health professionals can be effective in providing smoking cessation advice. Level I


All smokers should be offered brief advice to quit. Strength A

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