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SMOKING CESSATION. SMOKING PREVENTION.

Many women know that smoking is dangerous but few know that it is especially dangerous for women and children, that smoking related disease kills almost half the women in the US and reduces their life expectancy by 14.5 years. Both the scope of the problem and its economic costs are enormous.

Women are more susceptible to the harm of smoking and second-hand smoke than men. The fastest growing segment of the smoking population is young women. Smoking has a negative impact on 40 different physiological functions.

Meanwhile, the tobacco industry continues to aggressively market colorful candy-flavored nicotine products to young people. And funding for smoking cessation programs has been cut.

Fortunately, the recommendation by a provider to quit smoking increases the quit rate by 30%, especially when the right words are used, and counseling with medication is recommended.
More information: RI Tobacco Control Network

Good to Know

New tobacco screening measures will become mandatory in the next few years.

Government and community health policies aggressively seek to make tobacco use less normal, less available, more expensive and considered an environmental pollutant.

70& of smokers would like to quit. Only 15% are offered help.

Stats show providers are less likely to make a smoking diagnosis or order spirometry in women.

Women will quit smoking for the health of their unborn child. Then start again, not knowing that smoking contributes to post-natal morbidity.

A non-smoker who lives with a smoker has a 20% increased risk of disease.

Acupuncture reduces addiction in patients who are willing to quit, at the same rate of effectiveness as medicine and counseling.

Roadmap to Care

Each of the following interventions doubles the likelihood of quitting:

  • Physician’s recommendation
  • Counseling longer than 10 minutes
  • Cessation Medication beginning with the patch

A study of 4000 smokers in RI showed that 42% don’t consider quitting an option, and another 40% aren’t ready to quit.

Assess their motivational levels by asking:

  • “On a scale of 1 -10, how motivated are you to quit smoking right now?”
  • “What makes you not a 1 or a 2?”
  • “What will it take for you to get up to an 8 or 9?”
  • “What would it take to make you more motivated?

When they’re ready to quit, prescribe cessation medication (patch, gum, lozenge, inhaler, nicotine spray, buproprion, varenicline) and refer them to QuitWorks–RI for cessation counseling.

In Your Practice

The combination of counseling and medication have the highest quit rate, but only 6% of smokers take advantage of this combination.

To make the right thing to do the easiest thing to do in your practice:

  • Screen for tobacco use
  • Recommend quitting
  • Offer cessation medication
  • Encourage counseling
  • Follow-up

Remember that lecturing, labeling and statistics reduce motivation to quit. One way to increase motivation is to “develop a discrepancy.” Change is more likely to occur when a behavior is seen to be conflicting with important goals or values.

Step 1: Discover what is most important to the person (a value, relationship, goal or hobby)

Step 2: Explore the reasons why the person smokes

Step 3: Develop discrepancy by asking:

  • How does continuing to smoke move you closer to what is most important to you?
  • How does continuing to smoke move you further from getting what is most important to you?
  • What do you make of this difference?