Leading health groups welcome new recommendations for embedding smoking cessation in healthcare

Cancer Council Australia and Quit Victoria have welcomed new smoking cessation recommendations released today by the Royal Australian College of General Practitioners, saying the latest guide highlights the crucial role of health professionals in supporting smokers to quit and notes there is insufficient evidence to endorse the use of e-cigarettes for cessation.

The new evidence-based guidelines, “Supporting smoking cessation: A guide for health professionals (Second Edition)” are based on the latest evidence and provide guidance to clinicians to ensure smokers get the best possible advice and support to quit successfully.

Cancer Council and Quit Victoria say that the new guidelines also support the need for continued Government action to drive down smoking rates.

Within the new guide is a recommendation that doctors adopt a three step model developed by Quit Victoria, which focuses on 1) asking and recording an individual’s smoking status, 2) advising people who do smoke to quit and the best ways to do so – and 3) offering them practical help to quit by referring to Quitline and including encouraging the use of pharmacotherapy.

Dr Sarah White, Director Quit Victoria and Smoking Cessation Advisor to Cancer Council Australia said that currently very few smokers receive best practice care to help them quit.

“While most people who smoke want to quit, very few doctors provide ‘brief interventions’, which is simply giving clear advice to smokers about the best approach to quitting and actively helping their patients to access the most effective smoking cessation treatments.”

According to Dr White, the most effective approach to quitting is to combine smoking cessation counselling provided by Quitlines with stop smoking medications or products. This combined approach doubles the chances of quitting successfully compared to cold turkey.

“A lot of health professionals don’t appreciate how much smoking affects immediate health problems, including reducing how well some medications work, slowing down wound healing, and increasing the likelihood of infection.

“All health professionals should be asking if their patient smokes, advising them to quit and explaining the best ways to quit, and then referring them to the Quitline and helping them access stop smoking products or medications. The new RACGP guidelines spell out how every health professional can provide best practice care in any clinical setting.”

Following the new recommendations, Cancer Council Australia and Quit Victoria are jointly urging the Commonwealth Government to meet their obligations as a signatory to the World Health Organization (WHO) Framework Convention on Tobacco Control by embedding best practice smoking cessation care as a part of everyday health care.

Professor Sanchia Aranda, CEO, Cancer Council Australia said that addressing smoking at every GP visit, ensuring Quitline is available to all smokers, increasing access to stop smoking medications and products, and encouraging smokers to quit with public education are all recommended by leading international bodies such as the WHO and the US Surgeon-General's Office.

“We know that mass media campaigns are really important because they prompt smokers to go to their doctor or to call the Quitline for advice or help to quit. But campaigns are also vital in supporting health professionals to provide best practice care. When smokers see or hear campaign messages they are far more likely to be receptive to advice from their doctor about quitting.”

Professor Aranda added that the dual effect of embedding the new recommendations into health practice and funding mass media campaigns was crucial to achieving the Government’s aim of reducing the adult daily smoking rate to 10% by 2025.

“Importantly, a well-funded mass media campaign could reduce the tobacco-related inequalities experienced by groups with higher smoker rates, such as First Nations Australians.”

The RACGP guidelines also note the need to amend the PBS subsidisation of stop smoking products and medications to make them more accessible and promote their best use.

The guidelines also note there is insufficient evidence to endorse e-cigarettes as a smoking cessation device or harm reduction strategy. The guidelines state “Nicotine-containing e-cigarettes are not first-line treatments for smoking cessation. The strongest evidence base for efficacy and safety is for currently approved pharmacological therapies combined with behavioural support.”