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Kicking butt: Primary care physicians can help smokers quit

Connecting smokers with the help they need to stop can make all the difference in freeing them from the addictive pull of nicotine.

By Susan J. Landers, amednews staff. Dec. 15, 2003.

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This isn't the first time the topic of smoking has come up with this patient. But this time, things are different. Maybe it's the fast-approaching New Year and thoughts of resolutions. Or maybe the patient was primed for action by November's Great American Smokeout. Or maybe this smoker is finally fed up with the idea of spending another winter shivering outside, just to get a nic fix. Regardless of the reason, the patient suddenly seems as ready as ever to kick the habit.

How can you help?

It is a critical question. Helping a smoker quit trumps almost anything else a physician can do to improve that patient's health, says Steven Schroeder, MD, director of the Smoking Cessation Leadership Center at the University of California, San Francisco. "If physicians can get 15% to 20% of smokers to quit there are going to be lives saved. It's really dramatic."

Patients who quit will immediately lower their risk of heart disease and bronchitis and, over time, reduce their risk of a long list of cancers, chronic pulmonary diseases and many other illnesses.

Nonetheless, while most of the 47 million adult smokers in the country say they would like to quit, only 5% manage to do so each year. Primary care physicians are in a particularly advantageous position to support efforts to escape the powerful pull of nicotine.

"Smokers don't typically go to intensive programs. What they do is visit their doctors," says Michael Fiore, MD, MPH, an internist and director of the University of Wisconsin Center for Tobacco Research and Intervention in Madison.