Authors' objectives:

The main objective of this study is to assess methods that can be used by the health services to help smokers break the smoking habit.

Authors' recommendations: Tobacco smoking is the largest, single, preventable and treatable public health problem, leading to disease and premature death in many individuals. Scientific studies show that basic questions regarding smoking habits asked by health services' staff, followed up by clear recommendations to stop smoking and advice on nicotine replacement agents (for those who smoke more than 10 to 15 cigarettes per day) is cost effective when done routinely. Several obstacles against carrying out these basic measures in practice have been identified. These include the smoking habits of health services' staff and a lack of faith in one's own ability to contribute to change. Furthermore, staff perceive that resources and time are insufficient for questions about smoking habits and advice on smoking cessation. Smokers who come into contact with health services should be 1) asked about smoking habits, 2) recommended to stop smoking, 3) offered advice, and where appropriate 4) recommended to use nicotine replacement agents. Most smokers, over the course of a few years, have contact with their general practitioner and dentist. The scientific literature verifies that brief, structured counseling sessions and treatment using nicotine replacement agents are effective in these settings, not only in special research contexts. Hence it is particularly important that staff and decision makers in primary care and dental services actively take responsibility for smoking cessation. In areas of health care which serve patients whose disease is exacerbated by smoking (patients with cardiovascular diseases, pulmonary diseases, diabetes, and cancer), staff should increase their knowledge about smoking cessation and, to a greater extent, offer smoking cessation programs or refer patients to such programs. Hypnosis and other psychological methods of smoking cessation are resource-demanding, and their effects are poorly documented. However, some evidence is available to show that cognitive therapy can reduce the risk that patients start smoking again after having stopped. Acupuncture is not shown to be an effective method of smoking cessation. A range of various drugs (other than nicotine replacement agents) have been tested, but they are either ineffective or associated with problematic side effects and hence cannot be recommended. A consolidated body of resources to develop and disseminate knowledge concerning smoking cessation, and develop special expertise concerning these issues, should be found in at least every health services region.

Authors' methods: Systematic review, Cost study

Project Status: Completed

URL for project: http://www.sbu.se/Published

Year Published: 1998

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Sweden

Organisation Name: Swedish Agency for Health Technology Assessment and Assessment of Social Services

Contact Address: P.O. Box 3657, SE-103 59 Stockholm, Sweden. Tel: +46 8 4123200, Fax: +46 8 4113260

Contact Name: registrator@sbu.se

Contact Email: registrator@sbu.se

Copyright: The Swedish Council on Technology Assessment in Health Care (SBU)