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Three drugs are currently used as first line pharmacotherapy for smoking cessation, nicotine replacement therapy, bupropion and varenicline.
The 3 A's Protocol This can be summarised as follows: Ask and record smoking status. Advise patient of personal health benefits. Act on patient's response.
The process of smoking cessation involves progression through five stages of change: precontemplation, contemplation, preparation, action, and maintenance. Most patients are not prepared to take action on their smoking, yet most smoking cessation programs are designed for smokers who are so prepared.
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.Advise - In a clear, strong, and personalized manner, urge every tobacco user to quit.More items...
Items to document may include to following elements:The patient's tobacco use.Advised to quit and impact of smoking.Assessed willingness to attempt to quit.Providing methods and skills for cessation.Medication management of smoking session drugs.Resources provided.Setting quit date.Follow-up arranged.More items...
EVIDENCE-BASED ANSWER Among pharmacotherapy options, dual nicotine replacement therapy (NRT) and varenicline (Chantix) are equally effective for smoking cessation at six months and more effective than single NRT and bupropion (SOR A, meta-analysis of RCTs).
Items to document may include to following elements:The patient's tobacco use.Advised to quit and impact of smoking.Assessed willingness to attempt to quit.Providing methods and skills for cessation.Medication management of smoking session drugs.Resources provided.Setting quit date.Follow-up arranged.More items...
The 3 A's Protocol This can be summarised as follows: Ask and record smoking status. Advise patient of personal health benefits. Act on patient's response.
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)
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.