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New smoking cessation guidelines
for health professionals
Robert West, Professor of Health Psychology and Director of Tobacco Studies, Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health,
University College London, UK
Abstract
Clinical practice guidelines for England were first published in 1998 and then updated in 2000. Very recently NICE has produced guidance on brief interventions, workplace smoking policies and the NHS stop smoking services. The US published its latest clinical practice guidelines in May 2008. This presentation draws on systematic reviews supplemented by studies too recent to be included in previous guidelines to provide recommendations on: 1) brief health professional advice to all smokers, 2) behavioural support provided face-to-face, by telephone or the internet to smokers attempting to stop, and 3) medications for smokers attempting to stop or cut down. With brief advice, it is recommended that this involve encouraging all smokers to use available help with stopping. Smokers should be advised to stop abruptly if possible. For behavioural support, it is recommended that smokers be offered face-to-face and telephone support and proven internet-based packages, and strongly encouraged to engage with the most intensive form of help that is practicable for them. A voucher system should be considered to encourage pregnant smokers
to stop. Subject to contraindications smokers should be allowed to choose between varenicline, bupropion and NRT and given information on relative effectiveness and side effects. Smokers using NRT should be encouraged to start using it before the quit date and use combinations of NRT products. Smokers not ready to stop should be encouraged to cut down with the aid of NRT on a formal programme with a view to quitting later.
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About the presenter
Robert West is Director of Tobacco Studies at the Cancer Research UK Health Behaviour Research Centre, University College London. He started researching tobacco and nicotine use in 1982 under the direction of Professor Michael Russell. His early research focused on the nicotine withdrawal syndrome but since then he has also contributed to clinical trials of behavioural and pharmacological aids to cessation, population surveys and cohort studies of smokers looking at patterns of smoking and smoking cessation, as well as surveys of health professionals examining attitudes, knowledge and behaviours relating to smoking cessation. He has also contributed to the development of national and international clinical practice guidelines on smoking cessation.
He is Editor-in-Chief of the journal, Addiction and has recently written a book detailing a theory of human motivation (PRIME theory) and its application to understanding addiction.
More information can be found at www.rjwest.co.uk.
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