A First: Tobacco Harm Reduction included in smoking cessation algorithm

[Vocalek]

This study is the first known medical journal article on smoking cessation treatment that includes the concept of tobacco harm reduction in the strategies.

Intern Emerg Med. 2013 Feb;8(1):7-12. doi: 10.1007/s11739-012-0864-z. Epub 2012 Oct 7.

[h=1]Handling relapse in smoking cessation: strategies and recommendations.[/h]Caponnetto P, Keller E, Bruno CM, Polosa R.
[h=3]Source[/h]Centro per la Prevenzione e Cura del Tabagismo (CPCT), Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele", Università di Catania, Catania, Italy.

[h=3]Abstract[/h]Once established, smoking is a very difficult addiction to break. Many smokers persist in tobacco use for several years and typically cycle through multiple periods of remission and relapse. Smoking cessation is not a single event but a process, and relapse is an ordinary component of this process. While international guidelines place great emphasis on relapse prevention, very little can be found about managing smokers who have relapsed. This article is intended to address the challenge of managing smokers who relapse in the course of a smoking cessation program. This knowledge may lead to an improved smoking cessation outcomes.

http://www.ncbi.nlm.nih.gov/pubmed/23054409


The algorithm flowchart starts with "Relapse"

The next step is to assess reasons for the relapse and emphasize the importance of continued efforts.

Next is a Decision Point: "Willing to try again?"

If Yes, a number of different strategies are suggested, including increasing dose or changing medication, adding or increasing counseling, etc. These lead to either "Cessation" or "Relapse"

If Cessation, the path ends.

If Relapse, "Consider Tobacco Harm Reduction (THR) options (e.g. electronic-cigarette)" and the path ends.


If No to "Willing to Try Again?"
• Offer to help in future
• Consider smoking reduction
• Consider Tobacco Harm Reduction (THR) options (e.g. electronic-cigarette)

Path Ends.

Personally, I am driven crazy by the "public health experts" who advise smokers to avoid e-cigarettes and then state that smokers who want to quit should try the "safe and effective" approved treatments. DUH! Why didn't I think of that.

The thing that they just cannot imagine is somebody trying to quit over and over again, using darn near everything but the kitchen sink as a quitting method, and relapsing time after time. They assume we are so unenlightened that we did not know about nicotine gum or the patch, or have not seen the ubiquitous Chantix TV and magazine commercials.

 

[Vocalek]

And yes, that "Keller E" in the list of authors is me.