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Best practice support for smoking cessation care


Morgan Liotta


8/12/2022 4:40:39 PM

A new toolkit to support GPs providing smoking cessation advice also acts as a ‘supplement’ to RACGP guidelines.

GP checking patient blood pressure
‘Many of our patients will benefit from our proactive involvement in this process,’ says GP and addiction medicine specialist Dr Paul Grinzi.

When a patient is supported on their smoking cessation journey by health professionals providing up-to-date advice, interventions and clinically appropriate pharmacotherapy, their likelihood of quitting can more than double.
 
To help GPs implement smoking cessation clinical guidelines, including the RACGP’s the Quit Centre was launched in March, and its current national campaign, ‘Together we can make a difference’, illustrates the linked roles GPs, pharmacists and Quitline counsellors have in supporting patients to quit. 
 
Part of the campaign, which runs until 10 December, includes new ‘very practical’ clinical resources and CPD-accredited online training that RACGP addiction medicine specialist Dr Paul Grinzi says can be used to inform general practice consultations.
 
‘It also supplements the excellent RACGP guideline rather than replacing it,’ he told newsGP.
 
‘Smoking rates have been dropping over a number of years and many patients who still smoke are more open to the idea of quitting but may be unsure about how, when or why.’
 
The RACGP smoking cessation guidelines highlight that brief but structured interventions by GPs can help to increase the likelihood that patients will succeed at quitting smoking, such as the three-step ‘Ask, Advise, Help’ model.
 
Chair of the RACGP’s smoking cessation guidelines’ Expert Advisory Group Professor Nick Zwar, previously told newsGP the three-step model is designed to provide best practice care and ‘reduce the barrier of time’ for healthcare professionals providing smoking cessation advice.
 
Dr Grinzi believes that brief interventions can also involve exploring patient factors around ‘ready, willing or able’ to assist with selecting the best advice to offer patients.
 
‘We often feel frustrated with patients we assess to be “pre-contemplative”,’ he said.

‘I’ve found that focusing on developing contemplation in my patients – and not necessarily immediate action – helps me focus on an agenda that meets the patient where they are.
 
‘For example, exploring their “ready, willing or able” allows me to focus on their existing behaviour-change strengths and to support areas that need further support. 
 
‘The [Quit Centre] toolkit helps guide us with resources to address these factors.’

A recent survey of 502 Australian GPs and 505 pharmacists found that the majority (89%) agreed that smoking should be addressed as a clinical priority. 
 
However, the research also shows that this does not always translate into full implementation of smoking cessation support, with not all GPs following best practice smoking cessation care, such as following the ‘Ask, Advise, Help’ model.
 
Dr Grinzi said that although more time ‘can be helpful’, the smoking cessation support process does not necessarily require longer consultations and can be approached in small, brief interventions spread over different appointments. 

‘Having resources like this toolkit that one can use “in the moment” provides [GPs] with some confidence to be able to assist, when needed,’ he said.
 
‘Quitting smoking is a really important health action, and many of our patients will benefit from our proactive involvement in this process.’
 
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