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Findings. All stakeholdershealth plans, employers, clinicians, smokers, and the governmentface barriers to broader smoking cessation activities.
You might say:"I'm so proud of you for trying to quit smoking. I'll help with whatever you need to make it happen.""Quitting smoking will be hard, but I know you can do it. Have you set a quit date?""You're not in this alone."Quitting smoking is the best thing I ever did!
The Ottawa Model for Smoking Cessation in 120 hospitals across Canada identifies the smoking status of all admitted patients, followed by brief advice, personalised bedside counselling, timely nicotine replacement therapy and/or pharmacotherapy, and follow-up after discharge 27.
Do praise them for trying to quit, and for whatever length of time (days, weeks, or months) of not smoking. Do remind them that they didn't fail they are learning how to quit and you're going to be there for them the next time and as many times as it takes. Do encourage them to try again.
The clinician can motivate patients to consider a quit attempt with the "5 R's": Relevance, Risks, Rewards, Roadblocks, and Repetition. Relevance - Encourage the patient to indicate why quitting is personally relevant.
If they light up, I simply say 'I don't like to be around cigarette smoke. I'll wait for you over here. ' Then I move myself away. They are less likely to take offense and usually will accommodate my decision by either not smoking or by moving away themselves.
Successful intervention begins with identifying users and appropriate interventions based upon the patient's willingness to quit. The five major steps to intervention are the "5 A's": Ask, Advise, Assess, Assist, and Arrange. Ask - Identify and document tobacco use status for every patient at every visit.
Risks: Patient identifies potential negative consequences of continued smoking. Rewards: Patient describes how quitting would benefit her and her family. Roadblocks: Patient identifies barriers to quitting. Repetition: Repeat at every visit for patients who smoke.
The US Preventive Services Task Force (USPSTF) recommends using the 5 As model; ask, advise, assess, assist and arrange.
5 Stages to QuittingPre-contemplation (not thinking about quitting)Contemplation (thinking about quitting but not ready to quit)Preparation (getting ready to quit)Action (quitting)Maintenance (remaining a non-smoker)16-Feb-2009