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  • 1. BRIEF INTERVENTION IN SMOKING CESSATION Encouraging Smokers to Stop Smoking A guide for health care professionals
  • 2.
    • ‘All health professionals should understand the principles of Brief Intervention for smoking cessation. It is to be routine practice to consider the need for Brief Intervention at every patient contact’
    • Surgeon General’s Policy Letter 02/04
  • 3. What is Brief Intervention?
    • “ Brief intervention is used to motivate attempts at smoking cessation.
    • It is aimed at individual smokers and should be used by all health care professionals opportunistically.
    • Brief intervention is part of the framework for smoking cessation”
    • (Surgeon General’s Policy Letter, 2004)
  • 4. Role of the health worker
    • Your role is Important and the
    • time spent is Worthwhile
    • Brief advice is one of the most cost effective interventions in medicine.
    • The key messages to get across are that smoking is dangerous and it is worthwhile stopping.
  • 5. Why?
    • By raising the issue of smoking and referring smokers to a local smoking cessation clinic, you are offering them the best chance to stop smoking.
    • Smoking cessation is the most effective way to help smokers quit and preserve life.
  • 6. Some examples of health risks from smoking Stroke Depression Hearing loss Mouth cancer, tooth & gum disease Heart disease Back pain Osteoporosis (females ) Impotence, infertility (males) Reduced fertility, miscarriage (females)+ low birth weight babies, still birth, cot death Disease of the blood vessels Eye disease Neck pain Cancer of gullet Lung disease: cancer, bronchitis, emphysema etc Stomach ulcers / cancer Ulcers and cancer of the gut Tendon injuries
  • 7. Health Risks
    • Smoking causes thickening of the blood vessels and high blood pressure & is a major cause of stroke. Female smokers using the contraceptive pill are especially at risk.
    • Smoking increases the risk of heart disease such as angina and aortic aneurysm.
    • Smokers are 10 times more likely to die from lung cancer than non-smokers.
  • 8.
    • Smoking is one of the leading cause of male impotence, lower quality and quantity of sperm.
    • The incidence of low birth weight is twice as high among smokers as non-smokers.
    • Women who smoke during pregnancy have a greater chance of premature labour and miscarriage.
  • 9. Smoking and Oral Health
    • Smoking is associated with:
    • halitosis (bad breath)
    • premature tooth loss
    • gingivitis (inflammation of the gums)
    • staining and abrasion of teeth
    • periodontal disease
    • other malignant oral lesions
  • 10. Passive smoking and children
    • Children exposed to cigarette smoke are:
    • More likely to suffer from chronic cough, wheeze and acute respiratory illness.
    • More likely to suffer from chronic middle ear infections (glue ear).
    • At increased risk of sudden infant death (Cot death).
  • 11. Benefits of Stopping Smoking (1)
    • 20 minutes: blood pressure and pulse rate returns to normal
    • 24 hours: Carbon Monoxide is eliminated from the body. The lungs start to clear out mucus.
  • 12. Benefits of stopping smoking (2)
    • 48 hours: Nicotine is no longer detectable in the body.
    • 3 days: breathing becomes easier as the bronchial tubes begin to relax.
    • 2-12 weeks: circulation improves
  • 13. More Benefits….
    • 3-9 months: lung function increased by about 10%.
    • 5 years: risk of heart attack falls to about half that of a smoker.
    • 10 years: risk of lung cancer falls to about half that of a smoker
  • 14. How to give Brief Advice
    • Keep the discussion brief and offer the smoker a leaflet he/she can keep.
    • Adapt the information you give as necessary.
    • Most smokers know smoking is bad. So, your main aim is to let them know there is now effective help available if they want to stop.
  • 15. The 4 “A’s” of Brief Intervention
    • ASK about smoking at every opportunity
    • ADVISE all smokers to stop
    • ASSIST the smoker to stop
    • ARRANGE a referral to the smoking cessation service
  • 16. 1. ASK
    • Do you use tobacco?”
    • How much?
    • Do you want to stop?
    • Have you tried before?
  • 17. 2. ADVISE
    • Discuss any health problems which may be related to smoking
    • Personalise the cessation message
    • Advise clearly the necessity of stopping now
    • Commend nonusers
  • 18. 3. ASSIST
    • Provide information literature
    • Consider advising use of NRT for strongly addicted patients
    • Provide motivating literature for the patient who is not ready to stop
    • Refer to a smoking cessation clinic
  • 19. 4. ARRANGE
    • Telephone call to smoking cessation adviser / clinic or provide contact details
    • Follow up the referral
    • Ask uninterested patients again at their next regular visit if they have reconsidered
  • 20. Nicotine Replacement Therapy
    • Patch: it is discreet and easy to use.
    • Gum: it allows good control of nicotine dose.
    • Inhalator: if the smoker misses the ritual of smoking.
    • Lozenge: discreet and good dose control
    • Spray: better for very addicted smokers.
  • 21. REMEMBER
    • Brief advice on the dangers of smoking and the benefits of stopping smoking should be given at any opportunity.
    • Just 3 minutes of your time could help to improve the health and life expectancy of smokers.
    • The time spent really is worthwhile .