Zwar Nicholas
School of Public Health and Community Medicine, University of New South Wales, New South Wales.
Aust Fam Physician. 2008 Jan-Feb;37(1-2):10-4.
Prevalence of tobacco smoking in the Australian community has fallen. However, tobacco smoking remains a major cause of illness and death. General practitioners play an important role in assisting their patients to quit smoking.
This article describes evidence based approaches to smoking cessation that can be applied in general practice.
Evidence based approaches to smoking cessation include brief counselling, pharmacotherapy, referral to a specialised service such as Quitline, and follow up. The five As approach--Ask, Assess, Advise, Assist and Arrange follow up--provides a structure for intervention. Smoking cessation pharmacotherapies (nicotine replacement therapy and bupropion) have been shown to double quit rates. A new pharmacotherapy (varenicline) has recently become available which evidence to date suggests is more effective. Clinical suitability, the context of the quit attempt, and patient preference are important considerations in choosing a pharmacotherapy. Active follow up helps to reduce the rate of relapse which is otherwise high in what is commonly a chronic relapsing condition.
澳大利亚社区吸烟率有所下降。然而，吸烟仍是疾病和死亡的主要原因。全科医生在帮助患者戒烟方面发挥着重要作用。
本文介绍了可应用于全科医疗的基于证据的戒烟方法。
基于证据的戒烟方法包括简短咨询、药物治疗、转介至戒烟热线等专门服务以及随访。“五A法”——询问、评估、建议、协助和安排随访——为干预提供了一个框架。戒烟药物治疗（尼古丁替代疗法和安非他酮）已被证明可使戒烟率翻倍。一种新的药物治疗（伐尼克兰）最近已上市，目前的证据表明其更有效。在选择药物治疗时，临床适用性、戒烟尝试的背景情况以及患者偏好是重要的考虑因素。积极随访有助于降低复发率，否则在这种通常为慢性复发性疾病的情况下复发率会很高。
