Assessment+of+Nicotine+Dependence

=Assessment of Nicotine Dependence=

Stages of Change
1. **Pre-contemplation.** Smokers think about quitting 2. **Contemplation.** Smokers want to do something about it e.g. because of health scare, or sick of SOB/Cough 3. **Determination.** Smokers prepare to quit E.g. Set date, develop personalised plan 4. **Action.** Where smokers work the hardest. Cold turkey, cut down on cigarettes, NRT, Bupropion, Varenicline, Behavioural therapy 5. **Maintenance.** This phase can last for months or years, and is where people work to prevent relapse. They need to remind themselves why they quit 6. **Termination.** Successful in quitting smoking



5As Smoking Cessation Guideline

 * __1. Ask__**

Identify patients with risk factors //If suffered from mental conditions such as depression, anxiety etc. in the past see GP before quitting//




 * __2. Assess__**

Readiness/Determination to change
 * Health concerns
 * Incentives (Health, Financial)
 * Previous attempts

//The most important step to smoking cessation is for smokers to acknowledge that smoking is a problem Only those that are committed are likely to succeed//



Smoking Habit/Dependence severity
 * Number of cigarettes/day
 * Time to first cigarette after waking
 * Attempts to stop
 * Confidence to quit




 * __3. Advice__**

Provide written information on how to quit Advice on treatment options Lifestyle advice

Be supportive but non-ambiguous

//If they fail its not the end of the world - Get them to analyse their relapse// //"What went wrong?" "What have you learnt?"//

//Most people who succeed to quitting take 5-8 serious attempts before they succeed//




 * __4. Assist__**

Pharmacotherapies Support for self monitoring




 * __5. Arrange__**

Referral to special services Social Support Groups Phone information/counselling services Follow up with GP