BRIEF INTERVENTION IN SMOKING CESSATIONPresentation Transcript
BRIEF INTERVENTION IN SMOKING CESSATION Encouraging Smokers to Stop Smoking A guide for health care professionals
‘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
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)
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.
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.
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
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.
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.
Smoking and Oral Health
Smoking is associated with:
halitosis (bad breath)
premature tooth loss
gingivitis (inflammation of the gums)
staining and abrasion of teeth
other malignant oral lesions
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).
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.
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
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
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.
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
Do you use tobacco?”
Do you want to stop?
Have you tried before?
Discuss any health problems which may be related to smoking
Personalise the cessation message
Advise clearly the necessity of stopping now
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
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
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.
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.