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Smoking Cessation Pharmacotherapy
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Other Elements of Cessation Treatment
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- •Introduce a systematic approach to the delivery of smoking cessation interventions in all of their professional settings. Clinical practice guidelines have stressed the importance of system changes to embed treatment for nicotine dependence in institutional policies and practice.26,59,60Examples of systems to promote smoking cessation during hospitalization for CAD have recently been described.3,19,61
- •Identify and document the smoking status of all patients. Clinicians should ask about any tobacco use during the previous 6 months. Doing so will identify both current users and those who may have recently quit and are at increased risk for relapse.
- •Provide clear, concise, unambiguous, and nonjudgemental advice regarding the importance of cessation.
- •Become familiar with the use and prescription of validated smoking-cessation pharmacotherapies (NRT, bupropion, varenicline).
- •Provide clinical leadership to trainees and colleagues in the appropriate management of the tobacco-addicted patient.
- •Advocate for public policies to appropriately control all tobacco products.
|Introduce a systematic approach to smoking cessation in all professional settings.|
|Become familiar with the principles and practice of smoking cessation, including the use and prescription of validated pharmacotherapies (NRT, bupropion, varenicline).|
|Identify and document the smoking status of all patients.|
|Provide clear, concise, unambiguous, and nonjudgemental advice regarding the importance of cessation.|
|Offer specific assistance in initiating a cessation attempt.|
|For hospitalized smokers, commence interventions for smoking cessation during the period of hospitalization and facilitate ongoing follow-up.|
|Provide clinical leadership to trainees and colleagues in the appropriate management of the tobacco-addicted patient.|
|Advocate for public policies to appropriately control all tobacco products.|
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This statement was developed following a thorough consideration of medical literature and the best available evidence and clinical experience. It represents the consensus of a Canadian panel comprised of multidisciplinary experts on this topic with a mandate to formulate disease-specific recommendations. These recommendations are aimed to provide a reasonable and practical approach to care for specialists and allied health professionals obliged with the duty of bestowing optimal care to patients and families, and can be subject to change as scientific knowledge and technology advance and as practice patterns evolve. The statement is not intended to be a substitute for physicians using their individual judgment in managing clinical care in consultation with the patient, with appropriate regard to all the individual circumstances of the patient, diagnostic and treatment options available and available resources. Adherence to these recommendations will not necessarily produce successful outcomes in every case.