How to help patients stop smoking

Physicians can help patients stop smoking using some techniques and free resources from Norton Healthcare. In 2019, 14 of every 100 of U.S. adults ages 18 and over smoked cigarettes. The Truth Initiative reported that in 2018, 23.4% of Kentucky adults smoked cigarettes. While there are many benefits to quitting smoking, quitting proves a difficult challenge for many of our patients. Quitting smoking may be hard, but it can be a bit easier if you and your patient have a plan in place and some tools at the ready.

Talking to patients about smoking

The American Association of Family Physicians (AAFP) points out that cigarette smoking causes significant morbidity and mortality in the U.S. Further, AAFP suggests all physicians should ask about tobacco use and counsel patients to quit at every clinical encounter. AAFP recommends the Five A’s framework:

Ask: Tobacco users should be identified and tobacco use status should be documented at every visit. Questions such as these are helpful:

• Have you ever been a smoker?
• Have you ever used other tobacco products or e-cigarettes?
• Do you use tobacco now? How often?

Advise: Clear support for stopping smoking and the benefits of quitting should be presented in a nonjudgmental way. Physicians should highlight the benefits of cessation, including social, emotional and physical results of stopping smoking. Setting goals with the patient and scheduling follow-ups are also helpful.

Assess: Physicians should ask about barriers to quitting as well as willingness to quit. Discuss what social and emotional support is available to patients now, if they chose to quit.

Assist: Offer support, additional resources or referrals as needed. Include discussions of the temporary side effects of stopping smoking and aid with those situations as well, such as nicotine withdrawal, depression and weight gain.

Arrange: Patients should be contacted around the time of their assumed cessation date and congratulated. They should be contacted four more times to support their smoking-cessation attempts. Those who struggle or relapse should be reassessed and given referrals to counseling, pharmacological interventions or additional therapies.

The Centers for Disease Control and Prevention has more tips and resources for physicians.

Benefits of a smoking cessation program

There is some evidence that smoking cessation programs are helpful because of the social support they offer: a group of like-minded people focusing on the same goal. A physician working with a motivated patient who is part of a smoking cessation program might offer the best outcomes.