Clinicians can have a great impact on smoking cessation in their practices. Such counseling is more cost-effective than treating hypertension. The following tips are adapted from the evidence-based AHCPR practice guidelines on smoking cessation.*

Identify smokers

Ask every patient at every visit if she smokes. Write patient's smoking status in chart under vital signs.

Advise / strongly urge all smokers to quit

Urge every smoker to quit in a clear, strong and personalized manner. Ask patients about their desire to quit.

Help those willing to quit

• Help these smokers set a quit date.
• Prescribe pharmacotherapy if appropriate:
  • nicotine replacement therapy (nicotine gum, patch or nasal spray).
  • bupropion
• Arrange smoking cessation counseling interventions as is feasible.

Plan smoking cessation interventions / counseling

Arrange meetings for support and counseling with patients 1 week after the quit date and for as many subsequent weeks as is feasible (4-7 sessions are ideal). This may include group or individual counseling, hotline support or provider office visits. Help smokers recognize and cope with problems encountered in quitting (problem solving /skills training).

Encourage relapsed smokers to try quitting again.

Web resources for your patients

http://www.quitnet.org/

http://www.cdc.gov/tobacco/tipsteen.htm

*Adapted from recommendations by
the HHS Agency for Health Care Policy and Research. http://www.ahcpr.gov/clinic/smokepcc.htm