Smoking and GPs: time to cough up: successful interventions in general practice

Smoking is the largest single preventable cause of death and disease in Australia. Tobacco smoking causes an estimated 19 000 deaths and 142 500 hospital admissions per year. Approximately 23% of the population are smokers. Patients see general practitioners as having a key and supportive role in smoking cessation. Brief, repeated nonjudgmental advice by a GP is effective. However, GPs only identify just over half the smokers in their practice and counsel just a third to quit smoking.

This article discusses the role of the GP, provides a summary of the recent Australian smoking cessation guidelines, touches on the range of effective interventions available to GPs in their practices, and outlines an approach that can be offered routinely to all patients who smoke.

The implementation of smoking cessation by GPs can be significantly improved by the adoption of a systematic (whole practice) approach to smoking cessation, a more strategic approach to counselling, and utilisation of the 5As model. Motivational interviewing techniques to provide brief, behavioural counselling to patients who smoke, and more effective use of practice nurses and the active call back line offered by the Quit program are important strategies.