Tobacco cessation fall 2011 Instructor (1)_ For use in lecture (3)

Withdrawal symptoms occur patients are at risk for

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Withdrawal symptoms occur. Patients are at risk for relapse. STAGE 4: Action GOAL:  Remain tobacco-free for at least 6 months. ASSESSING  READINESS to QUIT  (cont’d)
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STAGE 4: ACTION Evaluate the Quit Attempt Status of attempt Ask about social support Identify ongoing temptations and triggers for relapse (negative affect, smokers, eating, alcohol, cravings, stress) Encourage healthy behaviors to replace tobacco use Slips and relapse Has the patient used tobacco at all—even a puff? Medication compliance, plans for termination Is the regimen being followed? Are withdrawal symptoms being alleviated? How and when should pharmacotherapy be terminated?
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Congratulate success! Encourage continued abstinence Discuss benefits of quitting, problems encountered, successes  achieved, and potential barriers to continued abstinence Ask about strong or prolonged withdrawal symptoms (c hange  dose, combine or extend use of medications) Promote smoke-free environments Social support Discuss ongoing sources of support Schedule additional follow-up as needed; refer to support groups STAGE 4: ACTION Facilitate Quitting Process Relapse Prevention
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Tobacco-free for 6 months Patients remain vulnerable to relapse. Ongoing relapse prevention is needed. STAGE 5: Maintenance GOAL:  Remain tobacco-free for life. ASSESSING  READINESS to QUIT  (cont’d)
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STAGE 5: MAINTENANCE Counseling Strategies Assess status of quit attempt Slips and relapse Medication compliance, plans for termination Has pharmacotherapy been terminated? Continue to offer tips for relapse prevention  Encourage healthy behaviors Congratulate continued success Continue to assist throughout the quit attempt.
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Brief interventions have been shown to be effective  In the absence of time or expertise: Ask, advise, and refer to other resources, such as  local programs or the toll-free quitline 1-800-QUIT-NOW BRIEF COUNSELING:  ASK, ADVISE, REFER This brief intervention can be achieved in 30 seconds.
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WHAT ARE  “TOBACCO QUITLINES”? Tobacco cessation counseling, provided at no  cost via telephone to all Americans Staffed by trained specialists Up to 4 6 personalized sessions (varies by state)  Some state quitlines offer nicotine replacement  therapy at no cost (or reduced cost) Up to 30% success rate for patients who complete  sessions Most health-care providers, and most patients, are not familiar with tobacco quitlines.
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Courtesy of Mell Lazarus and Creators Syndicate. Copyright 2000, Mell Lazarus.
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AIDS for CESSATION & CASE SCENARIO  OVERVIEW
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METHODS for QUITTING Nonpharmacologic Counseling and other non-drug approaches
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