Pharmacotherapies | Alternative Approaches | Special Groups | References
Most smokers see their family doctor at least once per year. Although there is good evidence that smoking cessation advice from general practitioners (GPs) is effective, there are many barriers to this advice becoming part of routine practice.
One of these barriers is lack of time or, at least, a perception that time constraints impede the ability of GPs to provide effective smoking cessation advice. But brief advice has been shown to be effective in helping smokers' decide to commit to a quit attempt. Many smokers will make a quit attempt after GP advice, with up to 3% quitting for at least six months after brief advice from a family doctor. Based on quit rates amongst smokers in the trials included in the Cochrane review, there would be one extra quitter as a result of minimal intervention from a physician for every 40 people who receive such advice.
More intensive intervention (behavioural support offered in sessions >30 minutes long or support in sessions < 30 minutes with follow up appointments and pharmacological support) result in quit rates of 19%.
Levels of intervention
The pyramid represents a series of sequential steps that the GP can take. (see Background to the reality pyramid) The base of the pyramid represents interventions that do not require any GP time within a consultation. For very busy practitioners, this represents an option that will not increase the pressure on the limited time available within the consultation. Moving up the pyramid, the intensity of the GP's intervention increases with options for GPs who have longer consultations. Clicking on the layers in the pyramid will reveal evidence-based activities which may be incorporated depending on the time available.