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A guide for physicians to help patients quit or reduce smoking

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Physicians can help smokers reduce or quit smoking, and a new review published in the Canadian Medical Association Journal (CMAJ) aims to help them manage smoking cessation for their patients.

“Tobacco addiction is Canada’s leading cause of preventable disease, disability and death,” states lead author Dr. Robert Reid, Ottawa Heart Institute, Ottawa, Ontario. “Clinicians can enhance the likelihood of successful smoking cessation by employing systematic approaches to the identification and treatment of smokers.”

The review, based on recent evidence, provides pharmaceutical and behavioral treatments, advice on how to combine these therapies for patients with varying smoking cessation goals and updates on treatments for special populations such as pregnant women and people with mental illness.

The authors describe four goals that smokers may have. They:

  • Want to quit smoking abruptly
  • Want to gradually reduce smoking and eventually quit on a specific date
  • Want to reduce their smoking
  • Are not interested in quitting or reducing their smoking at this time.

Almost two-thirds of smokers in Canada (64.4%) want to quit, and half (49.6%) report having tried to quit in the past year; however, less than 5% are successful in the long-term.

“It is important to establish practice routines that ensure a consistent systematic approach to treatment for tobacco use. Systematic approaches, such as the Ottawa Model for Smoking Cessation, are associated with significant long-term abstinence in smokers,” states Dr. Reid.

Quitting smoking before age 40 can have substantial health benefits by eliminating 90% of illness and mortality among smokers.

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