CHEST Guidelines-Helping-Patients-to-Quit-Smoking

Helping-Patients-to-Quit-Smoking_chest

Pdf Summary

The article discusses the challenges and inefficiencies in current smoking cessation efforts and suggests new approaches as necessary. While many smokers desire to quit, success rates remain low because evidence-based treatments, such as combining medication and counseling, are underutilized. Most smokers, including those with significant medical conditions, frequently visit physicians, indicating that clinics are opportune settings for cessation interventions. Yet, current strategies like the 5 A’s (Ask, Advise, Assess, Assist, Arrange follow-up) are not translating into high smoking quit rates.<br /><br />A study by Almaaitah et al. analyzed real-world cessation rates and found significant variability in success across healthcare providers, with adjusted quit rates ranging widely between different physicians, practices, and health systems. Only a small percentage of patients are prescribed cessation medication or referred for counseling, practices essential for successful quitting. The study suggests that individual physician awareness, attitudes, and training significantly impact cessation outcomes.<br /><br />To improve efficacy in smoking cessation, the article advocates for system-level strategies like Ask-Advise-Connect, where patients are directly connected with cessation support via electronic health systems, and proactive outreach programs that identify smokers efficiently through electronic health records and engage them with cessation resources. These strategies, viewed as cost-effective, are suggested to be more successful than traditional methods that depend on the initiative of patients and physicians.<br /><br />The authors urge increased physician training in motivational interviewing, a method to bolster patient motivation for quitting, alongside using evidence-based cessation tools. There’s a call for updated quality performance measures that include outcomes like tobacco abstinence to replace merely process-focused indicators. These enhanced, systematic approaches could bridge the disparity in quit rates and improve overall cessation success.

Keywords

smoking cessation

quit rates

evidence-based treatments

5 A's strategy

Ask-Advise-Connect

electronic health records

physician training

motivational interviewing

system-level strategies

tobacco abstinence