☰ Table of contents
Behavioural and advice-based support for smoking cessation
Although many smokers are likely to attempt quitting unassisted, this approach has a low likelihood of succeeding (3–6% success rate) on any given attempt.11,141,142 The most successful quit approach for those who are nicotine-dependent is counselling and support combined with first line pharmacotherapy and follow-up.11,139,143 Health professionals should offer to assist their patients/clients with a quit attempt, using pharmacotherapy and counselling, either within the health service or by referring them for intensive support to a telephone Quitline (13 7848),51 or to a tobacco treatment specialist.
Health professionals should be aware of extravagant claims of success for interventions that have not been subjected to rigorous testing and for which there is no clinical evidence.
The following smoking cessation interventions have been proven to be effective.
Brief motivational advice from health professionals
There is strong evidence that advice from health professionals (doctors, nurses, nurse practitioners, Aboriginal health workers, medical assistants, dentists, hygienists, respiratory therapists, mental health counsellors, pharmacists) is effective in encouraging smoking cessation.27–31,42Health professionals can make a difference with even a minimal (less than 3 minutes) intervention RR 1.66; 95% CI: 1.42–1.94).27 More intense interventions can result in better outcomes, but may not be practical in many clinical contexts.11 (See page 8, The role of health professionals.)
Every smoker should be offered at least a brief intervention for smoking cessation, which should include one or more of the following:144
- simple opportunistic advice to consider quitting
- an assessment of the smoker’s commitment to quit
- offer of pharmacotherapy and/or behavioural support
- self-help material
- referral to more intensive, proactive support such as Quitline (13 7848), a tobacco treatment specialist or cessation program.
Brief smoking cessation advice from health professionals delivered opportunistically during routine consultations has a modest effect size, but substantial potential public health benefit. Level I
Offer brief cessation advice in routine consultations whenever possible (at least annually). Strength A