| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS | REGISTER |
|
|
|
|
|||||||||||||
|
|
|||||||||||||||
a Professor of
Psychology, St George's Hospital Medical School, University of London,
London SW17 0RE, UK, b Freelance Consultant, Kent, UK, c Freelance Consultant and Honorary Senior
Lecturer, Guy's, King's and St Thomas' School of Medicine,
University of London, London, UK
Correspondence to: Dr A McNeill, 78 Kenwood Drive, Beckenham, Kent BR3 6QZ, UK annmcneill{at}qwas.net
This paper updates the evidence base and key recommendations of
the Health Education Authority (HEA) smoking cessation guidelines for
health professionals published in Thorax in
1998. The strategy for updating the evidence base makes use of updated
Cochrane reviews supplemented by individual studies where appropriate.
This update contains additional detail concerning the effectiveness of
interventions as well as comments on issues relating to implementation.
The recommendations include clarification of some important issues addressed only in general terms in the original guidelines. The conclusion that smoking cessation interventions delivered through the
National Health Service are an extremely cost effective way of
preserving life and reducing ill health remains unchanged. The strategy
recommended by the guidelines involves: (1) GPs opportunistically advising smokers to stop during routine consultations, giving advice on
and/or prescribing effective medications to help them and referring
them to specialist cessation services; (2) specialist smokers'
services providing behavioural support (in groups or individually) for
smokers who want help with stopping and using effective medications
wherever possible; (3) specialist cessation counsellors providing
behavioural support for hospital patients and pregnant smokers who want
help with stopping; (4) all health professionals involved in smoking
cessation encouraging and assisting smokers in use of nicotine
replacement therapies (NRT) or bupropion where appropriate. The key
points of clarification of the previous guidelines include: (1) primary
health care teams and hospitals should create and maintain readily
accessible records on the current smoking status of patients; (2) GPs
should aim to advise smokers to stop, and record having done so, at
least once a year; (3) inpatient, outpatient, and pregnant smokers
should be advised to stop as early as possible and the advice recorded
in the notes in a readily accessible form; (4) there is currently
little scientific basis for matching individual smokers to particular
forms of NRT; (5) NHS specialist smokers' clinics should be the first
point of referral for smokers wanting help beyond what can be provided through brief advice from the GP; (6) help from trained health care
professionals specialising in smoking cessation such as practice nurses
should be available for smokers who do not have access to specialist
clinics; (7) the provision of specialist NHS smokers' clinics should
be commensurate with demand; this is currently one or two full time
clinics or their equivalent per average sized health authority, but
demand may rise as publicity surrounding the services increases.
This article has been cited by other articles:
|
|
 |
|
  N. A. Rigotti, E. R. Park, Y. Chang, and S. Regan Smoking Cessation Medication Use Among Pregnant and Postpartum Smokers Obstet. Gynecol., February 1, 2008; 111(2): 348 - 355. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Rovina, I. Nikoloutsou, E. Dima, M. Michailidou, C. Roussos, and C. Gratziou Smoking cessation treatment in a real-life setting: the Greek experience Therapeutic Advances in Respiratory Disease, December 1, 2007; 1(2): 93 - 104. [Abstract] [PDF]
|
|
|
|
 |
|
 D. E Levy, A. N Thorndike, L. Biener, and N. A Rigotti Use of nicotine replacement therapy to reduce or delay smoking but not to quit: prevalence and association with subsequent cessation efforts Tob. Control, December 1, 2007; 16(6): 384 - 389. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Bauld, K. Judge, and S. Platt Assessing the impact of smoking cessation services on reducing health inequalities in England: observational study Tob. Control, December 1, 2007; 16(6): 400 - 404. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Le Foll MD PhD and T. P. George MD Treatment of tobacco dependence: integrating recent progress into practice Can. Med. Assoc. J., November 20, 2007; 177(11): 1373 - 1380. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Aveyard, K. Brown, C. Saunders, A. Alexander, E. Johnstone, M. R Munafo, and M. Murphy Weekly versus basic smoking cessation support in primary care: a randomised controlled trial Thorax, October 1, 2007; 62(10): 898 - 903. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Gray, J. T. Mao, E. Szabo, M. Kelley, J. Kurie, and G. Bepler Lung Cancer Chemoprevention: ACCP Evidence-Based Clinical Practice Guidelines (2nd Edition) Chest, September 1, 2007; 132(3_suppl): 56S - 68S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Siahpush, R. Borland, and H.-H. Yong Sociodemographic and psychosocial correlates of smoking-induced deprivation and its effect on quitting: findings from the International Tobacco Control Policy Evaluation Survey Tob. Control, April 1, 2007; 16(2): e2 - e2. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Tonnesen, L. Carrozzi, K. O. Fagerstrom, C. Gratziou, C. Jimenez-Ruiz, S. Nardini, G. Viegi, C. Lazzaro, I. A. Campell, E. Dagli, et al. Smoking cessation in patients with respiratory diseases: a high priority, integral component of therapy Eur. Respir. J., February 1, 2007; 29(2): 390 - 417. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. T. Lawrence and C. Haslam Smoking during Pregnancy: Where Next for Stage-based Interventions? J Health Psychol, January 1, 2007; 12(1): 159 - 169. [Abstract] [PDF]
|
|
|
|
|
|
A Knox and J Britton Thorax 1996-2002 Thorax, December 1, 2006; 61(12): 1020 - 1021. [Full Text] [PDF]
|
|
|
|
|
|
Spoken sessions Thorax, December 1, 2006; 61(suppl_2): ii3 - ii56. [Full Text] [PDF]
|
|
|
|
 |
|
 A Wilson, P Sinfield, S Rodgers, V Hammersley, and T Coleman Drugs to support smoking cessation in UK general practice: are evidence based guidelines being followed? Qual. Saf. Health Care, August 1, 2006; 15(4): 284 - 288. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Srivastava, G. P Currie, and J. Britton Smoking cessation. BMJ, June 3, 2006; 332(7553): 1324 - 1326. [Full Text] [PDF]
|
|
|
|
|
|
M Siahpush, A McNeill, R Borland, and G T Fong Socioeconomic variations in nicotine dependence, self-efficacy, and intention to quit across four countries: findings from the International Tobacco Control (ITC) Four Country Survey Tob. Control, June 1, 2006; 15(suppl_3): iii71 - iii75. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. White, J. Bush, J. Kai, R. Bhopal, and J. Rankin Quitting smoking and experience of smoking cessation interventions among UK Bangladeshi and Pakistani adults: the views of community members and health professionals J. Epidemiol. Community Health, May 1, 2006; 60(5): 405 - 411. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. A. Dye, N. M. Morin, and V. Robison The relationship between cigarette smoking and perceived dental treatment needs in the United States, 1988-1994 J Am Dent Assoc, February 1, 2006; 137(2): 224 - 234. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Scholte op Reimer, E. de Swart, D. De Bacquer, K. Pyorala, U. Keil, J. Heidrich, J. W. Deckers, K. Kotseva, D. Wood, E. Boersma, et al. Smoking behaviour in European patients with established coronary heart disease Eur. Heart J., January 1, 2006; 27(1): 35 - 41. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J A Wedzicha, E C Howard, S L Johnston, and D M Mitchell Thorax Annual Report October 2004-September 2005 Thorax, December 1, 2005; 60(12): 987 - 988. [Full Text] [PDF]
|
|
|
|
 |
|
 S. Hall, F. Vogt, and T. M Marteau A short report: survey of practice nurses' attitudes towards giving smoking cessation advice Fam. Pract., December 1, 2005; 22(6): 614 - 616. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R Hubbard, S Lewis, C Smith, C Godfrey, L Smeeth, P Farrington, and J Britton Use of nicotine replacement therapy and the risk of acute myocardial infarction, stroke, and death Tob. Control, December 1, 2005; 14(6): 416 - 421. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S Wilkes, A Evans, M Henderson, and J Gibson Pragmatic, observational study of bupropion treatment for smoking cessation in general practice Postgrad. Med. J., November 1, 2005; 81(961): 719 - 722. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R Hubbard, S Lewis, J West, C Smith, C Godfrey, L Smeeth, P Farrington, and J Britton Bupropion and the risk of sudden death: a self-controlled case-series analysis using The Health Improvement Network Thorax, October 1, 2005; 60(10): 848 - 850. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A Wilson, J Hippisley-Cox, C Coupland, T Coleman, J Britton, and S Barrett Smoking cessation treatment in primary care: prospective cohort study Tob. Control, August 1, 2005; 14(4): 242 - 246. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R West, M E DiMarino, J Gitchell, and A McNeill Impact of UK policy initiatives on use of medicines to aid smoking cessation Tob. Control, June 1, 2005; 14(3): 166 - 171. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Whitelaw and J. Watson Whither health promotion events? A judicial approach to evidence Health Educ. Res., April 1, 2005; 20(2): 214 - 225. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J A Wedzicha, S L Johnston, and D M Mitchell Thorax annual report: 1 October 2003 to 30 September 2004 Thorax, December 1, 2004; 59(12): 1012 - 1015. [Full Text] [PDF]
|
|
|
|
|
|
N.C. Thomson, R. Chaudhuri, and E. Livingston Asthma and cigarette smoking Eur. Respir. J., November 1, 2004; 24(5): 822 - 833. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Tonnesen Essential communication skills in individual smoking cessation Chronic Respiratory Disease, October 1, 2004; 1(4): 221 - 227. [Abstract] [PDF]
|
|
|
|
 |
|
 A. R. Lingford-Hughes, S. Welch, and D. J. Nutt Evidence-Based Guidelines for the Pharmacological Management of Substance Misuse, Addiction and Comorbidity: Recommendations from the British Association for Psychopharmacology J Psychopharmacol, September 1, 2004; 18(3): 293 - 335. [PDF]
|
|
|
|
|
|
J Britton Smoking cessation services: use them or lose them Thorax, July 1, 2004; 59(7): 548 - 549. [Full Text]
|
|
|
|
|
|
A S M Abdullah and C G Husten Promotion of smoking cessation in developing countries: a framework for urgent public health interventions Thorax, July 1, 2004; 59(7): 623 - 630. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Coleman, J. Britton, and J. Thornton Nicotine replacement therapy in pregnancy BMJ, April 24, 2004; 328(7446): 965 - 966. [Full Text] [PDF]
|
|
|
|
|
|
P. Spice Setting up a cessation service BMJ, March 20, 2004; 328(7441): 699 - 701. [Full Text] [PDF]
|
|
|
|
|
|
T. Coleman Cessation interventions in routine health care BMJ, March 13, 2004; 328(7440): 631 - 633. [Full Text] [PDF]
|
|
|
|
 |
|
 I. Cormac, D. Martin, and M. Ferriter Improving the physical health of long-stay psychiatric in-patients Advan. Psychiatr. Treat., March 1, 2004; 10(2): 107 - 115. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E Roddy, P Rubin, and J Britton A study of smoking and smoking cessation on the curricula of UK medical schools Tob. Control, March 1, 2004; 13(1): 74 - 77. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Molyneux Nicotine replacement therapy BMJ, February 21, 2004; 328(7437): 454 - 456. [Full Text] [PDF]
|
|
|
|
|
|
N. A Rigotti Putting the research into practice BMJ, December 13, 2003; 327(7428): 1395 - 1396. [Full Text] [PDF]
|
|
|
|
|
|
J A Wedzicha, S L Johnston, and D M Mitchell Annual report October 2002 to September 2003 Thorax, December 1, 2003; 58(12): 1015 - 1017. [Full Text] [PDF]
|
|
|
|
 |
|
 F Jepsen, J Matthews, and F J Andrews Sustained release bupropion overdose: an important cause of prolonged symptoms after an overdose Emerg. Med. J., November 1, 2003; 20(6): 560 - 561. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. McRobbie, C. Darwin, and P. Hajek Smoke free hospitals: Rising to the challenge BMJ, October 4, 2003; 327(7418): 811 - 812. [Full Text]
|
|
|
|
|
|
L. Copeland An exploration of the problems faced by young women living in disadvantaged circumstances if they want to give up smoking: can more be done at general practice level? Fam. Pract., August 1, 2003; 20(4): 393 - 400. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Gorecka, M. Bednarek, A. Nowinski, E. Puscinska, A. Goljan-Geremek, and J. Zielinski Diagnosis of Airflow Limitation Combined With Smoking Cessation Advice Increases Stop-Smoking Rate Chest, June 1, 2003; 123(6): 1916 - 1923. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A Molyneux, S Lewis, U Leivers, A Anderton, M Antoniak, A Brackenridge, F Nilsson, A McNeill, R West, J Moxham, et al. Clinical trial comparing nicotine replacement therapy (NRT) plus brief counselling, brief counselling alone, and minimal intervention on smoking cessation in hospital inpatients Thorax, June 1, 2003; 58(6): 484 - 488. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T Lawrence, P Aveyard, O Evans, and K K Cheng A cluster randomised controlled trial of smoking cessation in pregnant women comparing interventions based on the transtheoretical (stages of change) model to standard care Tob. Control, June 1, 2003; 12(2): 168 - 177. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Bush, M. White, J. Kai, J. Rankin, and R. Bhopal Understanding influences on smoking in Bangladeshi and Pakistani adults: community based, qualitative study BMJ, May 3, 2003; 326(7396): 962 - 962. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S Tonstad, C Farsang, G Klaene, K Lewis, A Manolis, A.P Perruchoud, C Silagy, P.I van Spiegel, C Astbury, A Hider, et al. Bupropion SR for smoking cessation in smokers with cardiovascular disease: a multicentre, randomised study Eur. Heart J., May 2, 2003; 24(10): 946 - 955. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. J. Worsnop Smoking: Not for Anyone Chest, May 1, 2003; 123(5): 1338 - 1340. [Full Text] [PDF]
|
|
|
|
|
|
M D L Morgan and J R Britton Chronic obstructive pulmonary disease * 8: Non-pharmacological management of COPD Thorax, May 1, 2003; 58(5): 453 - 457. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G Sutherland Smoking: can we really make a difference? Heart, May 1, 2003; 89(90002): ii25 - 27. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Croucher, S. Islam, M. J. Jarvis, M. Garrett, R. Rahman, S. Shajahan, and G. Howells Oral tobacco cessation with UK resident Bangladeshi women: a community pilot investigation Health Educ. Res., April 1, 2003; 18(2): 216 - 223. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M Ussher, R West, A Steptoe, and A McEwen Increase in common cold symptoms and mouth ulcers following smoking cessation Tob. Control, March 1, 2003; 12(1): 86 - 88. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M Ussher and R West Interest in nicotine replacement therapy among pregnant smokers Tob. Control, March 1, 2003; 12(1): 108 - 109. [Full Text]
|
|
|
|
|
|
T Sethi Lung cancer * Introduction Thorax, November 1, 2002; 57(11): 992 - 993. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. West Banning smoking in the workplace BMJ, July 27, 2002; 325(7357): 174 - 175. [Full Text] [PDF]
|
|
|
|
 |
|
 S. Shiffman, C. M. Dresler, P. Hajek, S. J. A. Gilburt, D. A. Targett, and K. R. Strahs Efficacy of a Nicotine Lozenge for Smoking Cessation Arch Intern Med, June 10, 2002; 162(11): 1267 - 1276. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M Raw, P Anderson, A Batra, G Dubois, P Harrington, A Hirsch, J Le Houezec, A McNeill, D Milner, M Poetschke Langer, et al. WHO Europe evidence based recommendations on the treatment of tobacco dependence Tob. Control, March 1, 2002; 11(1): 44 - 46. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
