TOBACCO and ALCOHOL EARLY IDENTIFICATION AND BRIEF INTERVENTION in Primary Health Care Dagmar Schneidrová Dept. of Child and Youth Health

1. Provide feedback Findings on health status Level of dependence (Fagerstrőm test)

1. Provide feedback The health benefits of quitting smoking After 20 minutes: Your blood pressure drops to a normal rate for you. The temperature of your hands and feet increases to normal. After 24 hours: Your chance of a heart attack goes down. After 48 hours: Ability to smell and taste begins to improve. After 2 weeks to 3 months: Your circulation improves. Walking gets easier. Your lungs perform up to 30 percent better.

2. Give advice with permission Give clear, specific, and personalized advice for behaviour change (quit smoking, reduce alcohol consumption)

3. Assess readiness to change Making the decision to quit The decision to quit smoking is one that only you can make. Others may want you to quit, but the real commitment must come from you. Think about why you want to quit. Are you worried that you could get a smoking-related disease? Do you know someone who has had health problems because of their smoking? Do you really believe that the benefits of quitting outweigh the benefits of continuing to smoke? Are you ready to make a serious try at quitting? If you are thinking about quitting, setting a date and deciding on a plan will help move you to the next step.

4. Negotiate goals and strategies Setting a quit date and making a plan On your Quit Day: Do not smoke. This means none at all - not even one puff! Keep active - try walking, exercising, or doing other activities or hobbies. Drink lots of water and juices. Begin using nicotine replacement if that is your choice. Avoid situations where the urge to smoke is strong. Avoid people who are smoking. Reduce or avoid alcohol. Think about how you can change your routine.

4. Negotiate goals and strategies Avoid temptation Stay away from people and places where you are tempted to smoke. Later on you will be able to handle these with more confidence. Change your habits Staying quit Review your reasons for quitting and think of all the benefits to your health, your finances, and your family. Remind yourself that there is no such thing as just one cigarette -- or even one puff. Ride out the desire to smoke. It will go away, but do not fool yourself into thinking you can have just one. Avoid alcohol. Drinking lowers your chance of success.

5. Monitor progress Propose regular controls Propose following self-help plan Propose attending clinic for cessation smoking or stop-smoking class

Reference Gual, A., Anderson, P., Segura,L., Colom, J. (2005). Alcohol and Primary Care: Training Programme on Identification and Brief Interventions. Department of Health of the Government of Catalonia: Barcelona. ( – Resources and publications – Training Programme)