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Smoking cessation--what works?

Nicholas Zwar1

  • 1School of Public Health and Community Medicine, University of New South Wales, New South Wales. nicholas.zwar@sswahs.nsw.gov.au

Australian Family Physician
|February 2, 2008
PubMed
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General practitioners can help patients quit smoking using evidence-based strategies like counselling and medication. The five As approach provides a structured intervention to improve quit rates and reduce relapse.

Area of Science:

  • General Practice
  • Public Health
  • Addiction Medicine

Background:

  • Tobacco smoking remains a significant cause of morbidity and mortality in Australia, despite declining prevalence.
  • General practitioners (GPs) are pivotal in supporting patients with smoking cessation efforts.

Purpose of the Study:

  • To outline evidence-based smoking cessation interventions applicable within general practice settings.
  • To provide GPs with a framework for assisting patients to quit smoking.

Main Methods:

  • The article reviews established and emerging pharmacotherapies for smoking cessation.
  • It details the "five As" approach (Ask, Assess, Advise, Assist, Arrange follow-up) as a structured intervention model.
  • Emphasis is placed on the importance of active follow-up to prevent relapse.

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Main Results:

  • Pharmacotherapies, including nicotine replacement therapy (NRT), bupropion, and varenicline, can significantly increase quit rates.
  • Varenicline shows particular promise as a highly effective smoking cessation aid.
  • The "five As" model offers a systematic method for GPs to integrate cessation support into routine care.

Conclusions:

  • A combination of brief counselling, pharmacotherapy, referral to specialized services (e.g., Quitline), and consistent follow-up is recommended for effective smoking cessation.
  • Tailoring pharmacotherapy choice to individual patient needs and preferences is crucial for success.
  • Managing smoking as a chronic relapsing condition with active follow-up is key to long-term abstinence.