creation date: 2025-10-30 17:31
tags: Interventions
Smoking Cessation
Non-Pharmacological Options
Action Plan
An action plan is a structured and personalized roadmap designed to help quit by systematically addressing the preparation, quitting, and maintenance phases.
This involves:
- Setting a quit date and mentally preparing for it
- Identifying possible triggers (eg. stress, social situations, habitual timing)
- Develop coping strategies (eg. chewing gum) to manage triggers or avoid triggers entirely
- Preparation of environment (eg. remove cigarettes, lighters)
- Plan behavioural strategies (eg. politely declining social offers)
- Plan follow-ups with providers to monitor progress
Behavioural Counselling
Behavioural counselling options may be available in individual or group settings. This may consist of motivational interviewing or CBT.
Use of the 5 A’s approach: ask, advise, assess, assist, arrange can be effective.
Community Programs
Community support programs may provide motivational messages and tips, educational resources, and more.
Pharmacological Options
Craving and Withdrawal Management
Other medications are available to reduce the effects of cravings and withdrawal.
- Varenicline (partial agonist of nicotine receptors) - first line option, recommended to start even before the official quit date to reduce withdrawal
- Bupropion SR (antidepressant)
- Cytisine
Nicotine Replacement Therapy
Provides a controlled nicotine dose to reduce symptoms without harmful tobacco smoke. NRT has a NNT of 15, making it highly effective.
Routes of administration include:
- Transdermal patch
- Gum
- Lozenge
- Oral inhaler
- Nasal spray
Dosing depends on the route and also the amount of cigarettes smoked per day initially. The dosing is then adjusted based on withdrawal symptoms, cravings, and patient confidence.
Combination of therapy may be necessary for heavier smokers. The dosing is then gradually tapered safely over time.