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Clinical practice guidelines for smoking cessation and smoking cessation in clinical practice
Renee Bittoun
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Abstract
Background: Recommended treatment guidelines for smoking cessation have been based on global population assessment of smoking cessation interventions and may neglect and elucidate discrepancies specific to individual issues.
Main Points Arising:
1. Smokers are not an homogeneous group and may range from mild to severe tobacco dependency
2. RCT (randomised control trials) of pharmaceutical treatments upon which clinical practice guidelines are based exclude all but the oxymoronic well smoker rarely seen in real world clinical practice
3. The target smoker may suffer significant behavioural comorbidities
4. There is little to no review of evidence included supporting validated behavioural interventions
5. Conflicting imperatives may come from counsellors and drug manufacturers
6. Guidelines are often developed by non-clinicians
7. Guidelines are recommendations not law
Conclusions: Translating evidence based guidelines into smoking cessation practices may be problematic.
Biography
Has worked in Smoking Cessation for > 25 years. Set up first Smokers' Clinic in Australia at St.Vincent's Hospital, Sydney in 1979. Currently Director of the Smokers' Clinics, Central Sydney Area Health Service, Senior Research Fellow and Head of the Smoking Cessation Unit at the Woolcock Institute of Medical Research and Clinical Associate in the Faculty of Medicine at the University of Sydney. She is the author of several books on smoking and quitting both for the public and as texts and many research articles on smoking cessation. She established first university course on Nicotine Addiction and Smoking Cessation Course at University of Sydney and is President of AASCP, The Australian Association of Smoking Cessation Professionals.
Renee Bittoun
Director, Smokers Clinics and Smoking Research Unit, University of Sydney & Royal Prince Alfred Hospital
University of Sydney D06
Sydney
2006
Australia
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