Abstract
BackgroundThe provision of tobacco dependence treatment in health care settings, particularly in countries lacking a history of strong tobacco control policy implementation, is limited by continued misconceptions on the part of health professionals and decision-makers regarding its worth and efficacy. In this paper, we rebut 9 arguments against the provision of tobacco dependence treatment that we have encountered in our experiences implementing and maintaining a dedicated smoking cessation service at a large university hospital in southern Germany.DiscussionBroadly, the arguments relate to the nature of addiction, the efficacy and safety of stop-smoking medication and behavioural support, and the benefits and challenges of quitting. They include: (a) If smokers really want to quit, they will be able to do it alone (without help); (b) You can’t forbid patients from doing what they want; (c) Patients will be upset if you talk to them about their smoking; (d) Stop-smoking medication has side effects that are more dangerous than smoking; (e) You have to be well trained to help smokers to quit (otherwise you can do more harm than good); (f) If you smoke yourself, you lack credibility; (g) If you have cancer, it is too late to quit; (h) Nicotine withdrawal is dangerous for heavy smokers; and (i) Smokers die earlier, thus reducing costs to the health system.SummaryIt is hoped that the counter-arguments presented here arm tobacco control advocates and practitioners working in health care settings, particularly in countries which have not prioritised tobacco control, to respond appropriately and convincingly to those opposed to the provision of tobacco dependence treatment.
Highlights
The provision of tobacco dependence treatment in health care settings, in countries lacking a history of strong tobacco control policy implementation, is limited by continued misconceptions on the part of health professionals and decision-makers regarding its worth and efficacy
Summary: It is hoped that the counter-arguments presented here arm tobacco control advocates and practitioners working in health care settings, in countries which have not prioritised tobacco control, to respond appropriately and convincingly to those opposed to the provision of tobacco dependence treatment
There is increasing recognition that treating tobacco use should be a high priority for health professionals and those who fund health care provision (e.g. [6]), and that all patients should be asked about tobacco use, advised to quit, and given appropriate assistance both during the hospital stay and postdischarge [6]
Summary
Clinicians can learn to administer very brief, effective advice and assistance by obtaining minimally intensive training [48] Those who do not feel confident about their ability to provide more extensive behavioral support, where patients need it, usually have a number of treatment options to which smokers can be referred. Hospitalization provides a unique opportunity to help smokers initiate a smoking cessation attempt, and receive the support they need to ensure that the attempt is successful It is a potentially powerful ‘teachable moment’ in which smokers are often motivated to quit and receptive to assistance due to concerns about their health [61].
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