Brief Interventions for Smoking Cessation Training
The HSE continues to deliver evidenced based brief intervention in smoking cessation training courses, targeting front line health professionals as per the HSE National Service Plan and Tobacco Control Programme Action Plan. Brief Intervention in Smoking Cessation training is now part of the Making Every Contact Count online training programme. The aim of the tobacco module is to increase confidence to raise the issue of smoking in routine and regular conversations with patients and support them to make a quit attempt. The tobacco module takes about 25 minutes to complete.
Brief Interventions are a range of effective behaviour change interventions that are client-centred, short in duration and provided in a variety of settings by healthcare professionals. They use an empathic approach, emphasising self efficacy, personal responsibility for change and information giving including details of resources available to support change.
For smoking cessation, brief interventions involve opportunistic advice, discussion, negotiation and encouragement and typically take between 3 and 10 minutes. Interventions may involve referral to a more intensive treatment. These interventions should be recorded and followed up as appropriate. They are commonly used in many areas of health care by a range of acute, primary and community care professionals.
The approach that is used by the healthcare professional will depend on a number of factors, including the individual's willingness to quit, how acceptable they find the intervention on offer and the previous ways they have tried to quit. It may include one or more of the following:
- simple opportunistic advice to stop
- an assessment of the patient's commitment to quit
- an offer of pharmacotherapy and/or behavioural support
- provision of self-help material and referral to more intensive support
All healthcare professionals are encouraged to complete this training and incorporate this skill set in to their core day to day work. Delivering of BI training has been recognised as one of the key actions in Healthy Ireland and in the Health Service National Implementation plan and attendance at this training has been a National Service Plan key performance indicator for a number of years.
Framework for Brief Interventions for Smoking Cessation
The 5 As
The five components of the Framework are:
- Ask: systematically identify all smokers at every visit. Record smoking status, no. of cigarettes smoked per day/week and year started smoking.
- Advise: urge all smokers to quit. Advice should be clear and personalised.
- Assess: determine willingness and confidence to make a quit attempt.
- Assist: aid the smoker in quitting. Provide behavioural support. Recommend/prescribe pharmacological aids. If not ready to quit promote motivation for future attempt.
- Arrange: follow-up appointment within 1 week or if appropriate refer to specialist cessation service for intensive support. Document the intervention.
REMEMBER Brief advice on the dangers of smoking and the benefits of stopping smoking should be given at every opportunity. Just 3 minutes of your time could help to improve the health and life expectancy of smokers.
30 Second Stop Smoking Advice
The Tobacco Control Programme and the National Cancer Control Programme have also developed a 30 Second QUIT Smoking Guide for Health Professionals. The guide is a simple A4 card, which is to be used by hospital and health care teams when they are caring for someone who is a smoker. The aim is to ensure that all patients are asked if they smoke, and if they do, they are offered support to quit and prescribed medication to help them. The 30 Second QUIT Guide has been distributed to hospitals and bulk supplies are available to order by registering as a health professional on www.healthpromotion.ie.