ASSIST

Help the patient quit

Assist those ready to make a quit attempt by:

• Helping the patient set a QUIT DATE.


Quit date abstinence is a strong predictor of long-term success. The quit date should be soon; ideally within 2 weeks in order to give the patient time to prepare to stop. Advise against stopping at high-stress times; suggest instead a significant date (e.g. the patient's or spouse's birthday or the first day of the month). In order to ensure a successful quit date; advise and assist the patient in anticipating challenges:

• Inform family, friends, and co-workers of quitting and request understanding and support.
• Remove cigarettes from your environment. Prior to quitting, avoid smoking in places where you spend a lot of time (e.g. home, car).
• Review previous quit attempts. "What helped you?" "What led to relapse?"

• Anticipate challenges to planned quit attempt, particularly during the critical first few weeks. These include NICOTINE WITHDRAWAL SYMPTOMS

• Consider signing a STOP-SMOKING CONTRACT with the patient, acknowledging the patient's decision to stop smoking and noting the quit date.
  

  

• Give key advice on successful quitting.




• Abstinence--total abstinence is essential.




• Alcohol--Inform the patient that drinking alcohol is highly associated with relapse. Those who stop smoking should review their alcohol use and consider limiting/abstaining from alcohol during the quit process.




• Other smokers in the Household--The presence of other smokers in the household, particularly a spouse, is associated with lower success rates. If another smoker lives in the home, urge the patient to quit with the other smoker and/or develop specific plans to stay quit in a household where others still smoke.

• Encourage PHARMACOLOGIC THERAPY for all smokers without contradictions.
  

  Consider nicotine replacement especially for highly addicted patients (those who smoke one pack a day or more or who smoke their first cigarette within 30 minutes of waking).

  
  

  • Click HERE for information on Pharmacotherapy options and patient handouts.

  
   
  

  • Click HERE for a Patient Handout in PDF format.

• Provide self-help materials and information on community programs.
  

  • The information should be culturally/racially/educationally/age appropriate for the patient
  
  
  • It should be readily available in every clinic office.
  
  
  • The smoking cessation coordinator and/or the physician should review the self-help material to be prepared to answer patient questions about it.
  
  

• Refer to more intensified counseling as appropriate.
  

• Give congratulations, encouragement, and a statement of concern that he/she remain abstinent. Assure the patient that a slip is not a disaster and encourage the patient to keep trying.
  

• If the patient is not willing to quit now:
  
  • Provide motivating literature (or call 1-800-4-CANCER for NCI's Why Do You Smoke? pamphlet)
  • Ask again at the next visit.