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Redefining the role of cessation specialists: what needs to be done
John Hughes, Professor of Psychiatry, Psychology and Family Practice at the University of Vermont, USA
Abstract
Although smoking cessation specialists often get little respect in their organization, data show that, in fact, they save more lives each year that almost all other providers. For smoking cessation treatment to be taken seriously, specialists need to act as professionals: i.e. know the scientific literature, practice evidence-based medicine that includes knowledge other than from randomized trials, always be learning, educate other professionals, etc. Specialists also need to resist arguments that cessation services are valuable only if they decrease smoking prevalence or are cost-effective. Cessation services are valuable because they save lives. Specialists need to stop seeing their role as a one-night stand and rather see it, like most clinicians, as a long-term care giver; i.e. providing advice across repeated attempts to quit and working with patients whatever their motivational state. Finally, specialists need to organize; i.e., form a professional organization that promotes improved cessation treatment both via improving the skills of specialists (e.g., via a continuing education scientific journal) and via advocacy. They also need to form a credentialing body so the public can distinguish evidence-based and non-evidenced based therapies and can access skilled therapists. Finally, specialists need to work to transform the image of smoking cessation from "breaking a bad habit" to "overcoming a drug dependence" by learning from similar image transformations for depression, anxiety disorders, etc. In summary, specialists need to proactively assert evidence-based practice by acting as a professional, by organizing, and by challenging the paradigms others have promoted. Like AIDS, smoking cessation is too important to play by the rules.
Biography
John R. Hughes, M.D. is Professor of Psychiatry, Psychology and Family Practice at the University of Vermont. Dr. Hughes is board certified in Psychiatry and Addiction Psychiatry. His major focus has been clinical research on tobacco use. Dr. Hughes received the Ove Ferno Award for research in nicotine dependence and the Alton Ochsner Award Relating Smoking and Health. He is a co-founder and past president of the Society for Research on Nicotine and Tobacco and of the Association for the Treatment of Tobacco Use and Dependence.. Dr. Hughes has been Chair of the Vermont Tobacco Evaluation and Review Board which oversees VT's multi-million dollar tobacco control programs. He has over 300 publications on nicotine and other drug dependencies and is one of the top 25 most cited tobacco scientists. Dr. Hughes has been a consultant on tobacco policy to the World Health Organization, the U.S. Food and Drug Administration, and the White House. He has received fees from almost all of the companies who develop smoking cessation services, medications and devices and from various public and private organizations who promote tobacco control. His current research is supported solely by grants from the US National Institute of Health.
John Hughes
Professor
Dept of Psychiatry, Univ VT
38 Fletcher Pl
Burlington
VT
05401-1419
USA
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