Opening the dialogue in a nonjudgmental but direct manner with patients is best, said Michael V. Burke, EdD, treatment program coordinator at the NDC. Emphasize the value of treating tobacco dependence using methods similar to those used for a chronic medical condition, and then either provide medication and counseling support or refer the patient for specialist care.
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February 2016“Most patients do not realize that medications and counseling can dramatically increase their likelihood for success, and there is a dose-response relationship so that more/longer medications and longer-term counseling are more effective than shorter doses of either,” said Dr. Burke. “Otolaryngologists have an important teachable moment to address this.”
Renee Barcher is a freelance medical writer based in Louisiana.
The Five A’s
Carla Berg, PhD, associate director of population sciences at Winship Cancer Institute of Emory University in Atlanta and associate professor in the department of behavioral sciences and health education at Emory’s Rollins School of Public Health, has written extensively about smoking cessation and smoking behavior. She says the “five A’s” are very important for otolaryngologists to practice with their patients:
- Ask all patients if they smoke.
- Assess their motivation to quit and find out whether they have made recent attempts to stop smoking. Ask questions such as, “For what reasons might you want to quit smoking?” and, “If you’re not willing to quit, would you be willing to cut down?”
- Advise patients to quit smoking. While this sounds simple enough, some physicians may be so rushed for time that they overlook this step. “Brief advice from healthcare workers has been shown to have a big impact,” Dr. Berg said.
- Assist them. Have brochures in your office about smoking cessation and the number of a quitline available to hand out. Talk with patients about nicotine replacement or medications such as Zyban or Chantix.
- Arrange to follow up. “Accountability is a big factor in helping people who are quitting. Knowing your doctor is paying attention increases the urgency, and people think, ‘Oh, wow, that really is a big deal if my doctor is this concerned about it.’”
Smoking Cessation Medications
Nicotine replacement products (skin patches, gum, lozenges)
Buproprion hydrochloride (Zyban)
Varenicline tartrate (Chantix)
Clonidine
Nortriptyline
Source: National Institutes of Health
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