Smoking cessation strategies in primary care, including pharmacotherap

Clinical answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Smoking cessation strategies in primary care include:

Offering advice and support to all people who smoke to stop, including referral to local NHS stop smoking services or providing information on how to access these services .
Encouraging people who are more dependent on nicotine to attend smoking cessation services, as they may need higher support, medication doses, and multiple attempts .
Providing evidence-based interventions such as behavioral support (individual and group), advice on stop smoking treatments (NRT, cytisinicline, varenicline, bupropion), and e-cigarettes .
Using behavioral support techniques like individual counseling, group counseling, and adjunctive counseling by health professionals to increase cessation rates .
Follow-up visits with repeat support to improve long-term abstinence, especially in the first few weeks after quitting .
Monitoring CO levels as a motivational behavioral support technique .

Pharmacotherapy options in primary care include:

Nicotine Replacement Therapy (NRT), varenicline, and bupropion, which are effective and more successful than placebo at maintaining abstinence for at least 6 months .
Offering NRT, including patches, lozenges, mouth sprays, and combination NRT (patch plus short-acting forms), tailored to individual preferences and nicotine dependence levels .
Starting NRT on the quit date, with sufficient supply for at least 2 weeks after the quit date .
Providing behavioral support alongside pharmacotherapy to increase success rates .

Smoking cessation strategies in primary care, including pharmacotherapy?