≥ 4 counselling sessions >10min each with 6-12 months f/u yield better result
Combination counselling and smoking cessation medication is more effective than either alone.
Provide practical counselling on problem solving skills + provide support as a part of Tx
Arrange:
Regular f/u to assess response, provide support, and modify Tx
Refer pt to relevant resources
Aboriginal People
Tobacco misuse status updated on a regular basis
Offer assistance to pt who misuse tobacco with specific emphasis on culturally appropriate methods
Familiar w/ available cessation support services
Seek appropriate training in providing evidence-based smoking cessation support
Hospital-Based population
All pt should be made aware of hospital smoke-free policies
Elective pt should be directed to resources to assist them to quit prior to admission or surgery
All hospital should have systems in place to
identify all smoker
Rx nicotine withdrawal during hospitalization
promote attempts toward long-term cessation
Provide pt with f/u support post-hospitalization
Pharmacotherapy
to assist pt to manage nicotine withdrawal in hospital
for use in-hospital & post-hospitalization to promote long term cessation
Mental health +/- other addicitons
Screen pt with mental illness / additions for tobacco use
Offer counselling & pharmacotherapy Tx to persons who smoke & have a mental illness / addiction to other substances
While reducing smoking or quiting, monitor pt’s psychiatric condition(s): mental health status, other addicitons. Medication dosage be monitored and adjusted as necessary
Pregnant and Breastfeeding women
Smoking cessation encourage for all pregnant, breastfeeding, postpartum women
Counselling is 1st line Tx in pregnancy and breastfeeding
If counselling ineffective, intermittent dosing nicotine replacement (lozenges, gum) are preferred over continuous dosing of the patch (↑risk)
Partners, friends, family should also be offered smoking cessation interventions.
A smoke-free home environment encouraged for pregnant and breastfeeding women to avoid exposure to second-hand smoke
Youth
Obtain info about tobacco use – cigarettes, cigarillos, waterpipe, etc on a regular basis
Couselling that supports abstinence from tobacco / cessation
Counsel parents about the potential harmful effects of 2nd-hand smoke on the health of their children
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