ARRANGE

Schedule Followup Contacts

• Set a followup visit within 2 weeks after the patient's quit date, preferably in the first week.
• Most relapses happen within the first two weeks.


• Continued support through this time is critical to success. The first two weeks are most difficult because of physical withdrawal and the breaking of multiple habits surrounding the smoking experience.


• A short-term goal of 2 weeks can seem much more manageable than forever.


• Have someone in the office call within 1 week of initial visit to reinforce their decision to stop, and remind patient of quit date.


• A time-saving strategy is to ask the patient to follow-up with a phone call, such as 1 week after their quit date. Assure them that if you are not available, you will document messages in their chart. This reinforces your involvement and expectations, without requiring a great deal of time.


• At first followup, ask about smoking status.
• If they are still abstinent, congratulate success, emphasize your continued support, and ask about difficulties and coping strategies.


• If they have relapsed, discuss circumstances of the relapse, try to identify triggers and brainstorm ways to prevent future relapses. Assess pharmacotherapy use and problems. Emphasize that a relapse is a learning experience, not a failure. Explain that most people require several quit attempts before they finally succeed, and relapses are part of the normal process of stopping smoking. Consider and discuss whether they may be interested in an intensive smoking cessation program.


• Arrange a second followup visit in 1-2 months.