How Retail Clinicians Can Help Smokers Quit

Many smokers may be resolving to turn over a new leaf in 2016 by kicking the habit for good.

While quitting tobacco can prove challenging, retail clinicians are ideally situated to help smokers combat their addiction.

In apreviousinterview, Bill Blatt, MPH, director of tobacco programs for the American Lung Association, offered several suggestions for providers looking to encourage smoking cessation, including:

• Use any clinic visit as an opportunity to ask patients whether or not they smoke, and emphasize the importance of quitting if they do.
• Recommend the use of a smoking cessation medication currently available in the United States. These options include 5 OTC nicotine replacement products (patches, gum, inhalers, nasal sprays, and lozenges) and 2 prescription drugs: Pfizer’s Chantix and GlaxoSmithKline’s bupropion (Zyban).Monitor the effectiveness of smoking cessation medications in patients taking such drugs.Work with pharmacists to ensure that there are no interactions between currently prescribed medications and either smoking cessation drugs or the tobacco product itself.
• Refer patients to a hotline available in each state (1-800-QUIT-NOW) that can provide support and direct patients to additional local resources.

There are also a number ofhealth benefitsassociated with smoking cessation that clinicians can communicate to their patients.

For example, quitting tobacco can:

• Significantly reduce the risk of premature death.
• Reduce the risk of developing chronic obstructive pulmonary disease and other respiratory symptoms.
• Decrease the risk of stroke and peripheral vascular disease.
• Improve circulation and lung function by up to 30%.
• Reduce the risk of low birth weight, preterm delivery, and decreased fertility in women.
• Significantly reduce the risk of coronary heart disease within 1 to 2 years.
• Decrease the risk of lung cancer by 50% after 10 years.

Although health care providers have served on the frontlines of the fight against tobacco-related illness, there have also been efforts by policymakers to discourage smoking altogether.

In response to a 2009 law requiring warning labels to appear on all cigarette packs, the FDA developed several particularly graphic images, including one of a man smoking through a tracheostomy. A federal appeals court, however, deemed the proposed warnings to be unconstitutional, ruling that the images were “unabashed attempts to evoke emotion...and browbeat consumers into quitting.”

The FDA’s rejected images recently became the focus of a study that sought to examine the effect of graphic warnings on smokers.

The researchers found that smokers who saw these graphic warning labels on every pack of cigarettes they smoked for 4 weeks felt worse about their habit than those who saw just text warnings. This, in turn, led those in the former group to take the warnings more seriously and made them more likely to consider quitting.

The study authors ultimately determined that graphic warning labels had a small yet notable effect on encouraging smoking cessation, and they suggested that the appeals court was mistaken in its earlier decision.

“Smokers weren't browbeaten by the images. The images definitely did stir their emotions, but those emotions led them to think more carefully about the risks of smoking and how those risks affected them,” said study co-author Ellen Peters, PhD, in a press release. “What the court is missing is that without emotions, we can't make decisions. We require having feelings about information we collect in order to feel motivated to act. These graphic warnings helped people to think more carefully about the risks and to consider them more.”

The study was published inPLOS ONE.