Smoking-cessation service

Along the same lines, another publication to be noted is Pharmacies and Smoking Cessation , which within the WHO s European program plan of action for a tobacco-free Europe was started in 1993 in pharmacies in Denmark. The result being that, at present, 20% of Danish pharmacies routinely offer a smoking cessation service for their population. 

Fiore MC, Smith SS, Jorenby DE, et al The effectiveness of the nicotine patch for smoking cessation. JAMA 271 1940-1947, 1994 Fiore MC, Bailey WC, Cohen SJ, et al Smoking Cessation. Clinical Practice Guideline No 18 (ACHPRPublNo 96-0692). Rockville, MD, U.S. Department of Health and Human Services, 1996... 

Smoking cessation counseling should be provided to all smokers, and those interested should be directed and assisted to achieve cessation. Furthermore, it is now a standard of practice for clinicians to screen for smoking and provide all smokers with brief advice and assistance with appropriate medications to quit or provide referral to specialized services when needed.24... 

Schwartz JL (1987) Review and evaluation of smoking cessation methods the United States and Canada, 1979-1985, NIH Publication no, 87-2940, Public Health Service, National Institutes of Health, US Department of Health and Human Services, Rockville, MD Schwartz RD, Kellar KJ (1983) Nicotinic chohnergic receptor binding sites in the brain regulation in vivo. Science 220 214-216... 

It is useful for clinicians in drug misuse services to know of the various approaches to smoking cessation, even though they may not be directly involved in deploying them. The treatments have been concisely reviewed by Aveyard and West (2007), and can be divided into four categories. Also, some reviews have particularly concentrated on smoking cessation in substance misusers (Sullivan Covey 2002). 

Treating nicotine and tobacco dependence can prevent a variety of costly chronic diseases, including heart disease, cancer, and chronic lung disease. It is estimated that smoking cessation efforts are more cost effective than other commonly provided preventive services such as screening for breast, colon, and cervical cancer, treatment of mildly elevated blood pressure, and treatment of high cholesterol. 

Now that Alan Brouchard (see Chapter 24) had his diabetes education clinic outlined, he wants to explore how to make the service financially viable. He has designed a service that would offer comprehensive diabetes education. Since patients with diabetes are at increased risk for heart disease, his patients might benefit from cholesterol education/monitoring, smoking cessation,... 

The type of education or management service offered may also influence compensation. For example, not all third-party payers cover preventive health education services such as weight-loss counseling or smoking cessation. If the service is not covered, the patient is personally responsible for the fees associated with the program. If it is not already known if the insurance carrier will or will not consider these services under the health plan, it would be prudent to contact the carrier before providing the service to a specific patient. In this way, the patient is aware of whether the services will be covered or if the patient will be responsible for the charges. 

Joan has been serving as the clinical coordinator for the department of pharmacy in a 500-bed hospital for more than 9 years. She provides clinical services to patients admitted to the general medicine service, manages clinical programs for the department, and is responsible for the continued professional development of 12 clinical pharmacists. Joan is a member of the pharmacy and therapeutics committee, the nutrition support committee, and an ad hoc committee to improve the patient discharge process. She also chairs the hospital s smoking-cessation campaign. 

Treating tobacco dependence is one of the most cost-effective preventive measures. It is estimated that smoking cessation is more cost-effective than several common clinical preventive services such as screening for cervical, breast, and colon cancer, treatment of mild-to-moderate high blood pressure, and treatment cf high cholesterol (163),... 

Fiore, M.C., Bailey. W.C., Cohen, S.J. et al., 1996. Smoking cessation. Clinical Practice Guideline No 18. Rockville, MD US Department of Flealth and Human Services, Public Health Service, Agency for Health Care Policy and Research. AHCPR Publication No. 96-0692. 

Department of Health and Human Services, Health Benefits of Smoking Cessation a Report of the Surgeon General, Centers for Disease Control, Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Rockville, MD, 1992. 

The following recommendations for an outpatient medical clinic-based smoking cessation protocol follow current US Public Health Service recommendations (58), with additional suggestions to specifically distinguish and address both nicotine withdrawd symptoms, conditioned cravings for cigarets, and relapse prevention. 

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