1. Assistant professor Family Medicine - Suez Canal University
Smoking Cessation By
Dr : Mohamed Salem
Assistant professor Family Medicine - Suez Canal University
November 2016

2. OBJECTIVES : 1- Describe tobacco dependence
2- Recognize importance of counseling
3- Describe and apply practical approaches to help tobacco users who are ready to quit
4- Demonstrate 5As technique and Motivational Interviewing
4- Describe effective tobacco medications
5- Apply tools to assess tobacco users level of dependence

3. EXERCISE

4. ANSWER EXERCISE

5. WHY PEOPLE SMOKE ?

6. SMOKING IS ADDICTION

7. WHAT IS THE IMPACT OF TOBACCO USE ?

8. Cigarette Smoke Component

9. BENEFITS OF SMOKING CESSATION

10. AAFP : Behavioural and Pharmacotherapy Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Women

14. USPSTF :THE ROLE OF PRIMARY HEALTH CARE PHYSICIAN

15. AAFP : KEY RECOMMENDATIONS

16. COUNSEL SMOKING CESSATION

17. AAFP: FIVE As FRAMEWORK

18. AAFP: FIVE As FRAMEWORK

19. COUNSEL SMOKING CESSATION

21. TOBACCO PRODUCTS IN QATAR

23. SHISHA SMOKERS (WATER PIPE)

24. AAFP:STAGES OF BEHAVIORAL CHANGES

25. STAGES OF BEHAVIORAL CHANGES

26. AAFP:5 R’S STRATEGY FOR MOTIVATING PATIENTS TO QUIT SMOKING

27. MOTIVATIONAL INTERVIEWING

28. STEPS IN MOTIVATIONAL INTERVIEWING

30. VIDEO FOR MOTIVATIONAL INTERVIEWING

31. TOOLS TO MOTIVATE (MI)

32. TOOLS TO MOTIVATE (MI)

33. ROLE PLAY

34. PHARMACOLOGICAL INTERVENTIONS

35. NRT

36. NRT

37. NRT AND CIGARETTE NICOTINE

38. NRT PURPOSE

39. NRT USES

40. NRT CAUTIONS

41. BUPROPION

42. HOW TO USE PROPION ?

43. VARENCLINE

44. WHY VARENCLINE ?

45. HOW TO USE VARENCLINE ?

46. COMBINED THERAPY

47. HOW TO ASSESS NICOTINE DEPENDANCE ?

48. SCORING FAGERSTROM

49. HEAVY SMOKING INDEX

50. SCORING HIGH SMOKING INDEX

51. LAPSE AND RELAPSE

52. WHY RELAPSE ?

53. CASE (1)
Haifa is a 55-year-old married female who has smoked one pack per day for the past 40 years. She has tried to quit several times. The only medication she ever tried was patches.
Haifa is interested in trying the patch again. During a previous quit she used a 14 mg patch. She said "it helped" but she was never able to remain abstinent for more than two days
because the cravings were so strong. Haifa reported concern that the patches may have made her irritable and anxious. Haifa smokes her first cigarette immediately after waking up.
Please recommend a quit medication plan for Haifa to use over the next 8 weeks.

54. ANSWER CASE (1)

55. CASE (2)
Majd is a 35-year-old male who has smoked approximately 15 cigarettes per day for the past
20 years. He usually smokes his first cigarette about an hour after he wakes up.
- After discussing all medication options, he has decided he does not want the patch and he does not like pills. He is most interested in the lozenge Majd expresses concern about the cost of the lozenge.
Please make a recommendation to Majd for prescribing the lozeng

56. ANSWER CASE (2)

57. References http://www.aafp.org/afp/2012/0315/p591.pdf
Sub regional workshop on Tobacco Dependence Treatment 11-12/10/2015 Qatar / WHO.
American Family Physician Volume 93, Number 10 , May 15, 2016

58. THANK YOU