Austė Bandzaitė 1, Gailė Damulevičiūtė 1, Rūta Bilinevičiūtė1
1Lithuanian university of health siences, faculty of Medicine
All over the world smoking remains the leading preventable cause of death and disease. According to the World Health Organization (WHO), around 6 million people worldwide die from tobacco-related illnesses each year, and will die up to 10 million by 2030. Tobacco smoking causes diseases such as malignant neoplasms of lung and other organs, chronic obstructive pulmonary disease and ischemic heart disease, but smoking cessation has a positive effect on health at any age. With the increase in smoking harm data and the increasing amount of smoking restrictions and other preventive measures, a large proportion of smokers are trying to quit smoking completely independently by abandoning tobacco or using ‘reduction’ tactics, but smoking cessation without specialist supervision is only 2 – 3 percent successful. There is no clear strategy in Lithuania to help a smoker, so doctors need simple and affordable tools. Based on NICE recommendations and selected scientific sources, this article presents the latest science-based tools available to general practitioners to advise their patients on how to stop smoking. Doctors are advised to use short interventions (5As Ask, Advise, Assess, Assist, Arrange) or a very brief advice. To support motivation, it is important to explain to patients the harm of smoking and health benefits after quitting. The smoker should be directed towards behavioral therapy. Alternative nicotine therapy or medical treatment (bupropion, varenicline) is also proposed. Short intervention increases smoking success by 1 to 3 percent, while co-administration of nicotine therapy or medication increases the likelihood of quitting smoking by another 0.7 – 2.1 percent. The combination of behavioral therapy and nicotine replacement therapy or varenicline produces the best effect. In order to avoid relapse, it is necessary to have the support of a doctor, relatives, it is important to plan ahead and take specific steps.
Keywords: smoking cessation, short interventions, evidence-based interventions