brief intervention for tobacco cessation

7/30/2019 Brief Intervention for tobacco cessation

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Brief Intervention

Jayne Wright

Health &Wellbeing Lead

for smoking cessation


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The Need to RefocusStanding on the shore of a fast flowing river I hear

the cry of a drowning man. I jump into the river, save

him and give artificial respiration. Just when he

begins to breathe, there is another cry for help.Again, I jump in and rescue him. Just as he begins to

breathe, another cry for help. Without end the

sequence continues. I am so busy rescuing, I have

no time to see what is happening upstream causingthem to fall in. [McKinlay,1979]


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Smoking-related Costs to the NHS(2008/09)

Estimated cost of treating illness and diseaseassociated with smoking was 5.2 billion

These costs are rising as admission rates increase

Stop Smoking Services cost 74 millionPharmacotherapies cost 57 million


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The percentage of over 16swho smoke has virtually

halved since 1980

39%

22%

21%

0%

25%

50%

1980 2006 2009Source:www.ic.n

hs.u

k,

2009

Reduction in the Prevalence of Smoking


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You cannot make

someone stopsmoking

But..

You must stop


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MakingChanges

Ive set a quit

date

Maintaining

Change

I am an ex-

smoker

Relapsing

I have learnt a

lot and when I

am ready I will

try again

Not

Sure/Thinking

About Change

I have heardabout a new

treatment to stop

smoking

Ready/Preparing to

Change

How do I go about

it?

I am not

interested in

stopping smoking

Stable Safer

Lifestyle

Im a non smoker

Cycle of Change


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However these rates are not reflected inpresent quit rates for hospital referrals

5% 10

%

20%

0%

10%

20%

BI BI & NRT BI, NRT &

Behavioural

Support

Sourc

e:

2005

,Su

therlan

d.G,S

tap

leton,J.

Mau

ds

ley

Hospi

talSmo

king

Cessa

tionC

lin

ic,

Ins

tituteo

fPsyc

hia

try

Quit Rates in Primary Care

Effectiveness of Brief Intervention


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Brief Intervention for smoking cessation is

delivered effectively using the

3As

ACTADVISEASK

Effective Delivery


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Ask and record a patients smokingstatus

ACTADVISEASK


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Advise patients that CGH & WUTH are

smoke free environments

ACTADVISEASK

How do they

feel aboutthat?

Is this a time

to help themto quit?

Have they

tried to quitbefore?

May we discuss the

benefits of quitting and

the support available?


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Advice is more effective when delivered in a

sensitive, appropriate, non-confrontationalmanner[NICE,2006]

ACTADVISEASK


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Inform patient of support for smoking cessation andsuccess rates of Champix, Zyban, NicotineReplacement Therapy and motivational support

ACTADVISEASK Prompt referralto Stop Smoking Service (SSS) via

PCIS/Cerna - do not wait until an in-patient

Offer booklets to patient


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For acute or unstable cardiac patients

If NRT is contra-indicated then still offer

behavioural support supporting literature

referral to SSS

Follow on support is essentialto support quitattempt


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Document responses to 3As in theSmoker Assessment form

Smoker yes/no If yes, amount per day?

Requires NRT yes/no

Referral to Stop yes/no

Smoking service refused

Assessing Nurse signature: Date:


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Whats in tobacco smoke?

Nicotine

Tar

Carbon Monoxide

4,000 other harmful chemicals


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Yoursupport can really make thedifference!

Remember66% of smokers wantto quit


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Benefits of quitting smoking

Improving patients health, fewer hospital admissions

Patients will be more motivated if they define their own

perceived benefits themselves

Quitting smoking is the single most effective healthpromoting intervention

Quitting pre-op reduces post-op respiratory complications

and promotes wound healing


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Barriers

Fear of changing relationship with

patient

Not my job

No time

Lack of knowledgePersonal lifestyle choices


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Benefits to you?


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The Satisfaction of Making the

Difference!


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Questions


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Thank you.

Please help yourself to a 3As booklet and keepit in your pocket!

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