Manual of Smoking Cessation A Guide for Counsellors and Practitioners

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Edition: 1st
Format: Paperback
Pub. Date: 2006-06-30
Publisher(s): Wiley-Blackwell
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Summary

Manual of Smoking Cessation provides the crucial knowledge required if you are involved in helping smokers to stop. The manual provides facts, figures, suggested interventions and sources of further information to assist in providing evidence-based treatment for smokers wishing to stop. This manual covers the core content areas and key learning outcomes described in the Standard for Training in Smoking Cessation (Health Development Agency, 2003). Manual of Smoking Cessation is structured in two concise parts: Part 1 provides essential information on smoking demographics, along with the risks of smoking and the benefits of stopping; Part 2 offers a range of practical advice to implement with clients. The Smoking Cessation Manual is an essential text for all those involved in the provision of smoking cessation services, including smoking cessation counsellors, nurses, pharmacists, doctors, health promotion officers, dental professionals, and other members of the health care team. The book is an invaluable resource for those learning about smoking cessation, and a succinct aide-memoire to those already practicing in the field. The authors represent the 'who's who' in the field of smoking cessation and are affiliated to University College London and Cancer Research UK (Andy McEwen and Robert West), St Bartholomew's & Royal London School of Medicine and Dentistry (Peter Hajek), and the University of Auckland (Hayden McRobbie).

Author Biography

Andy McEwen is Senior Research Nurse at the Cancer Research UK Health Behaviour Unit at University College London. His current research includes surveys of smokers and health professionals, pharmacokinetic studies on nicotine delivery systems and clinical trials of behavioural treatments; he also retains an interest in nursing research. In 1997 he began his clinical and academic career in smoking cessation with Robert West. In 2003 he took up his current post and is Director of the Smoking Cessation Services Research Network (SCSRN) and Programme Director of the UK National Smoking Cessation Conference (UKNSCC).


Peter Hajek is Professor of Clinical Psychology, Head of Psychology, and Director of Tobacco Dependence Research Unit at Barts and The London, Queen Mary's School of Medicine and Dentistry, University of London. His research is concerned primarily with understanding smoking behaviour, and developing and evaluating smoking cessation treatments. He has authored or co-authored over 200 publications, holds various academic and editorial appointments, and had input into the UK Government’s initiative to establish smoking cessation services. His Unit is involved in examining both behavioural and pharmacological interventions, and in offering treatment to dependent smokers who seek help.


Dr Hayden McRobbie is a Research Fellow at the Clinical Trials Research Unit, University of Auckland, New Zealand where he specialises in smoking cessation research and treatment. He studied medicine at the University of Otago and after a several years in clinical medicine he moved to London to work with Professor Peter Hajek. He worked on a large number of projects and clinical trails looking at ways to help people stop smoking, as well pharmacological and behavioural methods that alleviate the symptoms of tobacco withdrawal. In New Zealand Hayden continues his research into treatment to help people stop smoking and retains close links with the UK where he is a Visiting Lecturer at Barts and The London, Queen Mary’s School of Medicine and Dentistry, and Programme Director of the UK National Smoking Cessation Conference.


Robert West is Director of Tobacco Studies at the Cancer Research UK Health Behaviour Unit at University College London. He has been researching tobacco and nicotine dependence since 1982 and has published more than 250 scientific works. His research involves surveys of smoking patterns, clinical trials of aids to smoking cessation and laboratory studies of nicotine withdrawal symptoms. He is co-author of the English National Smoking Cessation Guidelines that provided the blueprint for the English Stop Smoking Services and is also Editor-in-Chief of the journal, Addiction.

Table of Contents

About the authors ix
Acknowledgements xi
Statements of professional interest xii
Foreword xiii
Introduction xv
Part One: Essential Information 1(32)
1 Smoking demographics
3(12)
1.1 Smoking patterns
3(5)
1.1.1 Smoking prevalence
3(4)
1.1.2 Smoking consumption
7(1)
1.1.3 Exposure to environmental tobacco smoke
7(1)
1.1.4 Beliefs about smoking
7(1)
1.2 Smoking cessation
8(2)
1.3 Sources for updating prevalence statistics
10(1)
1.4 Multiple choice questions
10(5)
2 The health risks of smoking and the benefits of stopping
15(18)
2.1 Smoking mortality
15(4)
2.1.1 Lung cancer
17(1)
2.1.2 Cardiovascular disease
17(1)
2.1.3 Chronic obstructive pulmonary disease (COPD)
18(1)
2.1.4 Other life-threatening diseases
18(1)
2.2 Smoking morbidity
19(4)
2.2.1 Non-life-threatening physical diseases linked to smoking
20(1)
2.2.2 Smoking and mental health
20(1)
2.2.3 Reproductive health
21(1)
2.2.4 Environmental tobacco smoke
22(1)
2.3 Health benefits of smoking cessation
23(3)
2.3.1 Lung cancer
24(1)
2.3.2 Cardiovascular disease
24(1)
2.3.3 Chronic obstructive pulmonary disease (COPD)
24(1)
2.3.4 Other life-threatening diseases
25(1)
2.3.5 Smoking cessation and reproductive health
25(1)
2.3.6 Smoking cessation and mental health
25(1)
2.3.7 Morbidity and smoking cessation
25(1)
2.3.8 The protective effects of smoking
26(1)
2.4 Sources for updating health information and statistics
26(1)
2.5 Multiple choice questions
26(7)
Part Two: Practical Advice 33(93)
3 Brief interventions
35(27)
3.1 Assessment and recording of smoking status
35(3)
3.1.1 Asking about smoking status
36(1)
3.1.2 Recording smoking status
37(1)
3.2 Advising smokers to stop and assessing interest in quitting
38(3)
3.2.1 Advising clients to stop smoking
38(2)
3.2.2 Assessment of interest in quitting
40(1)
3.2.3 Recording advice given and responses
41(1)
3.3 Compensatory smoking
41(2)
3.3.1 Evidence of compensatory smoking
41(1)
3.3.2 Cutting down
42(1)
3.4 Reasons why stopping smoking can be difficult
43(6)
3.4.1 Perceived benefits of smoking
43(1)
The special case of 'stress relief'
43(1)
3.4.2 Nicotine dependence
44(3)
3.4.3 Tobacco withdrawal syndrome
47(2)
The special case of anxiety
48(1)
3.5 Treatment to help with stopping smoking
49(4)
3.5.1 Principles of specialist treatment
49(1)
3.5.2 Types of medication
49(3)
Nicotine replacement therapy (NRT)
50(1)
Bupropion (Zyban)
51(1)
3.5.3 Other treatments and interventions
52(1)
3.6 Referral to local services
53(1)
3.7 Wider context
53(3)
3.8 Multiple choice questions
56(6)
4 Intensive one-to-one support and advice
62(46)
4.1 Smoking cessation treatments and their outcome
62(6)
4.1.1 Evaluation of smoking cessation methods
62(2)
4.1.2 Short-term treatment outcomes
64(1)
4.1.3 Long-term treatment outcomes
65(1)
4.1.4 Relapse
65(3)
4.2 Assessment
68(6)
4.2.1 Nicotine dependence
68(1)
4.2.2 Interest in quitting and willingness to attend for treatment
69(2)
4.2.3 Smoking characteristics
71(1)
4.2.4 Carbon monoxide monitoring
72(2)
4.3 Pharmacotherapy
74(16)
4.3.1 Nicotine replacement therapy (NRT)
74(6)
Nicotine transdermal patch
75(1)
Nicotine nasal spray
76(1)
Oral products
76(1)
Nicotine chewing gum
77(1)
Nicotine sublingual tablets
78(1)
Nicotine inhalator
78(1)
Nicotine lozenge
78(2)
4.3.2 Bupropion
80(2)
4.3.3 Explanation of medications
82(1)
4.3.4 Supplying medications
83(4)
4.3.5 Treatment points in special populations of smokers
87(2)
4.3.6 Other medications
89(1)
4.4 Behavioural support - withdrawal oriented treatment
90(8)
4.4.1 Preparation
90(2)
4.4.2 Quit date
92(1)
4.4.3 Urges to smoke and what to do about them
93(2)
4.4.4 Post-quit sessions
95(1)
4.4.5 End of treatment and relapse prevention
96(2)
4.5 Monitoring
98(2)
4.5.1 National monitoring
98(1)
4.5.2 Local monitoring
99(1)
4.6 Multiple choice questions
100(8)
5 Telephone counselling
108(5)
5.1 Recruiting smokers into treatment by telephone
108(2)
5.2 Behavioural support by telephone
110(1)
5.2.1 Telephone counselling
110(1)
5.2.2 Combined telephone and face-to-face counselling
110(1)
5.2.3 Telephone follow-ups to treatment
111(1)
5.3 Multiple choice questions
111(2)
6 Group interventions
113(13)
6.1 Recruitment and assessment
113(3)
6.1.1 Recruiting for groups
113(2)
6.1.2 Assessing clients for group treatment
115(1)
6.1.3 Logistics of group treatment
116(1)
6.2 Treatment programme for groups
116(1)
6.3 Group treatment content
117(6)
6.3.1 Preparation
117(2)
6.3.2 Quit date
119(2)
6.3.3 Post-quit groups
121(1)
6.3.4 End of treatment, relapse prevention and ongoing support
122(1)
6.4 Monitoring and follow-up
123(1)
6.4.1 Record keeping
123(1)
6.5 Multiple choice questions
123(3)
Answers to multiple choice questions 126(2)
Appendix 1 Bupropion (Zyban) — special patient groups 128(2)
Appendix 2 Bupropion (Zyban) — drug interactions 130(2)
Appendix 3 Effect of tobacco abstinence on metabolism of some drugs 132(2)
Appendix 4 Resources 134(4)
Appendix 5 Examples of what to say when intervening with smoking clients 138(8)
Index 146

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