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An A B CD approach to supporting people who …

An A B CD. approach to supporting people who smoke: A guide for health services smoking is the largest preventable cause of death and disease in Australia. supporting people to quit smoking Advice from a health professional is one of the most cost effective is the greatest external trigger in healthcare interventions. prompting someone who smokes to attempt to quit. people accessing health services are likely to demonstrate higher It could be as simple as a one rates of smoking than the general minute conversation with a health population. prompts a person to make a quit attempt.

Smoking is the largest preventable cause of death and disease in Australia. Supporting people to quit smoking is one of the most cost effective

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1 An A B CD. approach to supporting people who smoke: A guide for health services smoking is the largest preventable cause of death and disease in Australia. supporting people to quit smoking Advice from a health professional is one of the most cost effective is the greatest external trigger in healthcare interventions. prompting someone who smokes to attempt to quit. people accessing health services are likely to demonstrate higher It could be as simple as a one rates of smoking than the general minute conversation with a health population. prompts a person to make a quit attempt.

2 One in every 33 conversations will lead to a patient successfully quitting smoking . The Victorian Government is committed to building the capacity of health services and health professionals to provide the best A Ask B Brief intervention CD Communication at Discharge possible support for people who Ask all patients about Provide brief intervention Communicate smoking smoke to quit. smoking which may include: status and action taken in discharge documentation Advise all smokers to quit Ideally, all health services would Offer written information adopt a systematic approach to ( Quit pack).

3 Identifying people who smoke, Offer nicotine providing brief intervention replacement therapy responses and including smoking Offer referral to relevant within discharge communication. supports ( Quitline, GP, smoking cessation clinic). Hear what the experts and patients have to say . start the conversation Start the conversation has been developed by Alfred Health and funded by the Victorian Government. It is designed to challenge health professionals to raise the topic of smoking with their patients. The stories on this site start the conversation' are about real patients and clinicians.

4 They share their experiences about the life-changing conversations that resulted in people stopping smoking . Every person who accesses a health A Ask service should be asked about smoking . Health Service Health Professional living with a family member who smokes. A health service should: A health professional should: Ideally, identify the level of Ensure clear clinical Ask every patient, as soon nicotine dependency, past responsibility for asking as practical, whether or not smoking history, successes patients about smoking they smoke and failures with previous (this may be one health Do you smoke?)

5 Quit attempts. discipline organisation wide Do you currently smoke? or varied within the health Do you currently, or have service). you ever smoked? Integrate smoking status Document smoking status within medical record in the medical record documentation Consider an individual's exposure to passive smoke, whether or not they smoke themselves. For example, Every person who smokes B Brief intervention should be offered support to quit. An offer of support should be Health Service Timely access to nicotine attractive and emotionally salient. replacement therapy for The way in which support is A health service should: patients (this may include offered may vary depending on Ensure clear clinical a full range of nicotine the needs and preferences of the responsibility for providing a replacement therapies on individual.

6 Ward imprests across the brief intervention response Ideally, brief intervention support for patients who smoke health service). aims to assist long term quitting. (this may include strategies Integrate brief interventions In some cases, brief interventions such as nurse initiated or within medical record may be more focussed on pharmacist initiated nicotine documentation temporary management of replacement therapy). nicotine withdrawal. Support health professionals to build their skills in brief interventions (this may include communication skills to prompt behaviour change).

7 Every person who smokes B Brief intervention should be offered support to quit. Health Professional Consider referral to relevant supports (this may include A health professional should: Quitline or other smoking Provide brief advice to quit cessation services). smoking (which may be Document brief intervention based on health, financial within medical record and/or social grounds depending on the individual circumstances). Offer pharmacotherapy such as nicotine replacement if clinically appropriate Provide access to written or digital materials people are more likely to stay quit when CD Communication at Discharge they have access to long term supports.

8 It is important to ensure Health Service Health Professional smoking status and action taken to support quitting is A health service should: A health professional should: included in the documentation Ensure clear clinical Document smoking to the general practitioner, responsibility for inclusion of status in the discharge referrer and/or other smoking status and action communication healthcare provider. taken within discharge Explain any action taken documentation such as provision of Consider templates for medication to support a discharge communication quit attempt and/or referral which include smoking to other smoking cessation status and action taken supports (electronic templates may Potentially, request be preferable) continued support for the quit attempt by the primary care provider References 1.

9 Australian Institute of Health & Welfare. Australia's health 2008. Cat. No. AUS 99. Canberra:AIHW, 2008. 2. West, R. (2006) Feasibility of a national longitudinal study ( The smoking Toolkit Study') to monitor smoking cessation and attempts at harm reduction in the UK. 3. Stead L., Bergson G., Lancaster T. Physician advice for smoking cessation. Cochrane Database Syst Rev 2008; (2): CD0001654. 4. West, R, Fidler J (2011) smoking and smoking Cessation in England 2010. London: Vasco-Graphics. Available from Developed by Alfred Health Funded by Victorian Government Start the conversation Quit learning hub supporting Patients to be Smokefree Date of publication: 22 September 2015.

10 ALH25385.


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