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No preventable cause of death and disability kills more of our patients than cigarette smoking. Smoking will kill one billion people this century worldwide. Despite the high stakes of this addiction, we as practitioners frequently feel de-energized by the prospect of reviewing treatment options for smokers interested in quitting knowing that relapse is the most likely outcome. Virtually no time is spent on smokers who do not express a desire to quit. When we hear a negative response to the question, “Do you want to quit” we quickly move on to the next task at hand.
In a recently published study, investigators conducted a systematic review to examine the effect of single, minimal (less than 10 minutes long) interventions delivered by physicians to patients who were not selected for their motivation to quit (Addiction 2011 Dec 16.PubMed PMID: 22175545). The findings suggest that offering advice to stop smoking and assistance increases the number of quit attempts and abstinence rates. Offering support for quitting motivates an additional 50% of people to try to quit regardless of their willingness to quit. Offering nicotine replacement therapy increased long-term abstinence rates among this population. The authors conclude that giving advice to stop smoking would increase the number of people stopping smoking by one for every 21 people advised. Offering assistance would increase this by one for every 7 people offered assistance. Once again, this is regardless of the motivation to quit.
So what does this mean for our practice? This evidence suggests that we can change the conversation from starting out with “Are you interested in quitting?” Regardless of a smoker’s interest to quit, we should not ask, but tell them they need to quit to improve their health and offer them nicotine replacement therapy and behavioral counseling (e.g., refer to 1800QUITNOW). Instead of feeling hopeless in the face of a tough addiction, we should feel empowered by the finding that our advice and assistance will increase quit attempts and abstinence rates, regardless of whether patients initially want to quit or not.
Dr. Ebbert is professor of medicine at the Mayo Clinic in Rochester, Minn. He has received grants from the National Institutes of Health and Pfizer to conduct studies of interventions for tobacco use and has served as a consultant to GlaxoSmithKline, manufacturer of nicotine replacement products.
No preventable cause of death and disability kills more of our patients than cigarette smoking. Smoking will kill one billion people this century worldwide. Despite the high stakes of this addiction, we as practitioners frequently feel de-energized by the prospect of reviewing treatment options for smokers interested in quitting knowing that relapse is the most likely outcome. Virtually no time is spent on smokers who do not express a desire to quit. When we hear a negative response to the question, “Do you want to quit” we quickly move on to the next task at hand.
In a recently published study, investigators conducted a systematic review to examine the effect of single, minimal (less than 10 minutes long) interventions delivered by physicians to patients who were not selected for their motivation to quit (Addiction 2011 Dec 16.PubMed PMID: 22175545). The findings suggest that offering advice to stop smoking and assistance increases the number of quit attempts and abstinence rates. Offering support for quitting motivates an additional 50% of people to try to quit regardless of their willingness to quit. Offering nicotine replacement therapy increased long-term abstinence rates among this population. The authors conclude that giving advice to stop smoking would increase the number of people stopping smoking by one for every 21 people advised. Offering assistance would increase this by one for every 7 people offered assistance. Once again, this is regardless of the motivation to quit.
So what does this mean for our practice? This evidence suggests that we can change the conversation from starting out with “Are you interested in quitting?” Regardless of a smoker’s interest to quit, we should not ask, but tell them they need to quit to improve their health and offer them nicotine replacement therapy and behavioral counseling (e.g., refer to 1800QUITNOW). Instead of feeling hopeless in the face of a tough addiction, we should feel empowered by the finding that our advice and assistance will increase quit attempts and abstinence rates, regardless of whether patients initially want to quit or not.
Dr. Ebbert is professor of medicine at the Mayo Clinic in Rochester, Minn. He has received grants from the National Institutes of Health and Pfizer to conduct studies of interventions for tobacco use and has served as a consultant to GlaxoSmithKline, manufacturer of nicotine replacement products.
No preventable cause of death and disability kills more of our patients than cigarette smoking. Smoking will kill one billion people this century worldwide. Despite the high stakes of this addiction, we as practitioners frequently feel de-energized by the prospect of reviewing treatment options for smokers interested in quitting knowing that relapse is the most likely outcome. Virtually no time is spent on smokers who do not express a desire to quit. When we hear a negative response to the question, “Do you want to quit” we quickly move on to the next task at hand.
In a recently published study, investigators conducted a systematic review to examine the effect of single, minimal (less than 10 minutes long) interventions delivered by physicians to patients who were not selected for their motivation to quit (Addiction 2011 Dec 16.PubMed PMID: 22175545). The findings suggest that offering advice to stop smoking and assistance increases the number of quit attempts and abstinence rates. Offering support for quitting motivates an additional 50% of people to try to quit regardless of their willingness to quit. Offering nicotine replacement therapy increased long-term abstinence rates among this population. The authors conclude that giving advice to stop smoking would increase the number of people stopping smoking by one for every 21 people advised. Offering assistance would increase this by one for every 7 people offered assistance. Once again, this is regardless of the motivation to quit.
So what does this mean for our practice? This evidence suggests that we can change the conversation from starting out with “Are you interested in quitting?” Regardless of a smoker’s interest to quit, we should not ask, but tell them they need to quit to improve their health and offer them nicotine replacement therapy and behavioral counseling (e.g., refer to 1800QUITNOW). Instead of feeling hopeless in the face of a tough addiction, we should feel empowered by the finding that our advice and assistance will increase quit attempts and abstinence rates, regardless of whether patients initially want to quit or not.
Dr. Ebbert is professor of medicine at the Mayo Clinic in Rochester, Minn. He has received grants from the National Institutes of Health and Pfizer to conduct studies of interventions for tobacco use and has served as a consultant to GlaxoSmithKline, manufacturer of nicotine replacement products.