title: Best practices for smoking cessation interventions in primary care.
abstract: BACKGROUND
  In Canada, smoking is the leading preventable cause of premature death. Family physicians and nurse practitioners are uniquely positioned to initiate smoking cessation. Because smoking is a chronic addiction, repeated, opportunity-based interventions are most effective in addressing physical dependence and modifying deeply ingrained patterns of beliefs and behaviour. However, only a small minority of family physicians provide thorough smoking cessation counselling and less than one-half offer adjunct support to patients.
  
  
  OBJECTIVE
  To identify the key steps family physicians and nurse practitioners can take to strengthen effective smoking cessation interventions for their patients.
  
  
  METHODS
  A multidisciplinary panel of health care practitioners involved with smoking cessation from across Canada was convened to discuss best practices derived from international guidelines, including those from the United States, Europe, and Australia, and other relevant literature. The panellists subsequently refined their findings in the form of the present article.
  
  
  RESULTS
  The present paper outlines best practices for brief and effective counselling for, and treatment of, tobacco addiction. By adopting a simple series of questions, taking 30 s to 3 min to complete, health care professionals can initiate smoking cessation interventions. Integrating these strategies into daily practice provides opportunities to significantly improve the quality and duration of patients' lives.
  
  
  CONCLUSIONS
  Tobacco addiction is the most important preventable cause of morbidity and mortality in Canada. Family physicians, nurse practitioners and other front-line health care professionals are well positioned to influence and assist their patients in quitting, thereby reducing the burden on both personal health and the public health care system.
authors.affiliation: Department of Medicine, McMaster University, Firestone Institute for Respiratory Health, St Joseph's Healthcare, Hamilton, Ontario. amcivor@stjospham.on.ca
authors.forename: Andrew
authors.initials: A
authors.lastname: McIvor
authors.forename: John
authors.initials: J
authors.lastname: Kayser
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Assaad
authors.forename: Gerald
authors.initials: G
authors.lastname: Brosky
authors.forename: Penny
authors.initials: P
authors.lastname: Demarest
authors.forename: Philippe
authors.initials: P
authors.lastname: Desmarais
authors.forename: Christine
authors.initials: C
authors.lastname: Hampson
authors.forename: Milan
authors.initials: M
authors.lastname: Khara
authors.forename: Ratsamy
authors.initials: R
authors.lastname: Pathammavong
authors.forename: Robert
authors.initials: R
authors.lastname: Weinberg
mesh_terms: D019985:Benchmarking; D002170:Canada; D006801:Humans; D011320:Primary Health Care / Q000379:methods*; D016540:Smoking Cessation / Q000379:methods*
references.citation: Chronic Dis Can. 2007;27(4):154-62
references.pmid: 17623561
references.citation: CMAJ. 2007 Nov 20;177(11):1373-80
references.pmid: 18025429
references.citation: Prev Med. 2001 Dec;33(6):627-38
references.pmid: 11716660
references.citation: BMJ. 2004 Jun 26;328(7455):1519
references.pmid: 15213107
references.citation: CMAJ. 2008 Jul 15;179(2):135-44
references.pmid: 18625984
references.citation: Cochrane Database Syst Rev. 2006 Jan 25;(1):CD000009
references.pmid: 16437420
references.citation: JAMA. 2008 May 7;299(17):2083-5
references.pmid: 18460668
references.citation: Br J Gen Pract. 2006 Oct;56(531):768-74
references.pmid: 17007707
references.citation: JAMA. 2008 May 7;299(17):2037-47
references.pmid: 18460664
references.citation: Cancer Epidemiol Biomarkers Prev. 2006 Dec;15(12):2370-7
references.pmid: 17132767
references.citation: PLoS Med. 2006 Nov;3(11):e442
references.pmid: 17132052
references.citation: Tob Control. 2002 Mar;11(1):44-6
references.pmid: 11891367
references.citation: Can J Public Health. 2004 Jan-Feb;95(1):38-44
references.pmid: 14768740
references.citation: Am J Public Health. 2004 Feb;94(2):205-10
references.pmid: 14759928
references.citation: Addict Behav. 2004 Jan;29(1):207-13
references.pmid: 14667431
references.citation: Tob Control. 2006 Dec;15(6):472-80
references.pmid: 17130377
references.citation: CMAJ. 2008 Jul 15;179(2):145-6
references.pmid: 18625985