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An algorithm for optimal smoking cessation treatment
John Hughes, Professor of Psychiatry, Psychology and Family Practice at the University of Vermont, USA
Abstract
A box and arrow algorithm for allocating treatments to smokers who have decided to quit is presented. Often seeing an entire program via a visual aid is helpful for teaching or to monitor the comprehensivity and quality of care. The algorithm is based on the UK, US and WHO guidelines. The algorithm suggests an assessment of past quitting and treatments, interest in gradual vs abrupt cessation, cigs/day, psychiatric history and medication cautions. This is to be followed by a discussion of the pros and cons of the seven validated, first line medications and the three validated psychosocial treatments. The algorithm suggests combined use of a long-acting and short-acting medication or use of varenicline plus use of the most intensive psychosocial treatment acceptable. If a smoker relapses, the algorithm suggests an assessment of the reason for relapse and then use of a different or more intense or second line treatment. This algorithm can be useful as a teaching aid or to monitor the quality of treatment.
Biography
John R Hughes, MD is a Professor of Psychiatry, Psychology and Family Practice at University of Vermont, USA. He has over 330 publications on nicotine and other drug dependencies. He was chair of Vermont's multi-million dollar tobacco control program for 3 yrs.
John R Hughes
Dept of Psychiatry, Univ VT
38 Fletcher Pl
Burlington, VT
05401-1419
USA
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