13 December 2012

Smoking cessation – one page treatment algorithm launched

The RACGP has developed a one-page treatment algorithm to assist GPs and other primary healthcare professionals help their patients quit smoking.

Following the successful release of the RACGP Supporting smoking cessation: a guide for health professionals (December 2011)GPs called on the College to produce a succinct summary of the guidelines, resulting in a one-page treatment algorithm and guide to pharmacotherapy in special populations.

Professor Nicholas Zwar, lead author of the guidelines and RACGP spokesperson, said early evaluation on the impact of the initial guidelines has shown that GPs and other health professionals are modifying their cessation activity in response to the recommended advice.

“Health practitioners are fortunately now exposed to a wide range of treatment options when it comes to assisting their patients quit smoking. However often, identifying the most appropriate treatment option, or combination of, can be somewhat of a challenge,” Professor Zwar said.

“The newly developed one-page treatment algorithm, narrows down suitable treatment options taking into account nicotine dependency and whether the patient is willing to use pharmacotherapy or not.

“The flip side of the treatment algorithm has clear pharmacotherapy advice for more challenging treatment groups, for example, mental health patients, pregnant women who are smokers, amongst others.”

“GPs and other health professionals can now refer to a clearly labeled table listing three commonly prescribed smoking cessation medications (Varenicline, Bupropion and nicotine replacement therapy), viewing indications and contraindications when prescribing for special population groups,” Professor Zwar concluded.

Smoking statistics in Australia

The benefits of quitting smoking are well established. It is the most cost-effective preventive activity a health professional can offer. Successfully quitting smoking can result in an increase in life expectancy of up to 10 years, if it occurs early enough.1

While Australia’s level of smoking continues to fall and is the third lowest for OECD (Organisation for Economic Cooperation and Development) countries,2 Indigenous Australians are still more than twice as likely as non-Indigenous Australians to be current daily smokers.3

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.4

  1. Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years’ observations on male British doctors. Br Med
    J 2004; 328:1519.Epub.
  2. Miller M, Wood L. Effectiveness of smoking cessation interventions: review of evidence and implications for best practice in Australian
    health care settings. Aust NZ J Public Health 2003;27(3):300–9.
  3. Australian Institute of Health and Welfare. Substance use among Aboriginal and Torres Strait Islander people. Cat. no. IHW 40.Canberra: AIHW, 2011. Available at www.aihw.gov.au/publicationdetail/?id=10737418268 [accessed 19 August 2011].
  4. Stead LF, Bergson G, Lancaster T.Physician advice for smoking cessation. Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No: CD000165. DOI: 10.1002/14651858.CD000165.pub3.

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