Key words: Smoking cessation, primary care, practice nurse, general practitioner, combination therapy, counselling

"Smoking cessation in primary care - intensive practice nurse counselling versus brief general practitioner advice"

A combination of behavioural support and pharmacotherapy is most effective for smoking cessation, but it is not applied sufficiently to effectively help smokers quit. An exploratory study showed that GPs have too little time and have negative feelings about stop-smoking medication and preventive tasks in general. Patients, on the other hand, do not know that they can get smoking cessation assistance in their primary healthcare centre. Also, patients and caregivers were positive about the assistance of the practice nurse in smoking cessation, although their effectiveness had not yet been evaluated. A pragmatic randomised controlled trial showed that intensive counselling by a practice-nurse versus brief advice by a general practitioner, in combination with varenicline, was not more effective. The long-term smoking cessation rate (6-months) was 32.2% for the practice nurse and 39.0% for the GP, which shows both practice nurses and GPs are highly effective in smoking cessation when medication is given. In addition, this research also showed that smokers with COPD experience more and different difficulties in quitting, which indicates that this group of smokers needs specific smoking cessation assistance, potentially from the practice nurse.

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