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Journey to quit smoking

Most smokers want to quit, but for many, it takes multiple attempts

Resetting expectations: quitting may take multiple attempts

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  • Nearly 2/3 of smokers seriously contemplate quitting in the next 6 months1

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  • Almost half of smokers and recent quitters had made at least one quit attempt in the past year while 1/3 made multiple attempts1

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  • 96% of smokers who try to quit “cold turkey” will fail within 1 year2

  • Smokers not ready to quit actually quit at the same rate as those who were ready to quit, when offered pharmacotherapy3


For many smokers, it may take 30 or more quit attempts before being successful4

The path to quitting5

Like any other health conditions (diabetes, hypertension), offer all patients treatment that they must choose to opt out of.3

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  • Motivation to quit may not predict abstinence
    In one study, only 50% of those who ultimately quit initially said they were planning to.6

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  • Same quit rate
    Smokers not ready to quit actually quit at the same rate as those who were ready to quit, when offered pharmacotherapy.3

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  • Intervention matters to patients
    Advising all patients to quit, compared to no advice, significantly increases long-term abstinence.7



Smokers generally go through a series of stages on their way to quitting. People go through these stages at different rates and may go back to previous ones at different times.5

The stages of change

Precontemplation
Not thinking about quitting

May be discouraged by previous quit attempts so they think it’s impossible to quit

Contemplation
Thinking about quitting, but not yet ready

Thinks about quitting in the next 6 months or less. Patient will most likely respond to motivational interviews

Preparation
Getting ready to quit

Makes the decision to quit and takes small steps to formulate an action plan

Action
Quitting

Solidifies an action plan to stop smoking and to help deal with potential ‘slip-ups’

Maintenance
Remaining a non-smoker

Stays on track and has completed the recommended length of treatment. Patient may also may need continued reinforcement to help prevent a relapse


You make a difference
Physicians, nurses and pharmacists can have a significant effect on the smoking behaviour of their patients.8

Even less than 3 minutes of your counselling can make a big impact.9

Knowing which drugs interact with tobacco smoke can help inform dose adjustments, monitoring and smoking status changes.

Learn more about quick counselling

References

1. Reid JL, Hammond D, Rynard VL, Burkhalter R. Tobacco Use in Canada- Patterns and Trends, 2015 Edition
2. Action on Smoking and Health. Cessation. Accessed Nov 2022 at
https://ash.org/programs/cessation/
3. Richter KP, et al. It’s time to change the default for tobacco treatment. Addiction 2014;110:381-6
4. Chaiton M, Diemert L, Cohen JE, et al. Estimating the number of quit attempts it takes to quit smoking successfully in a longitudinal cohort of smokers. BMJ Open 2016;6:e011045.
5. Prochaska JO, DiClemente CC and Norcross JC. In search of how people change. Am Psychol1992;47(9):1102-14
6. Pisinger C, et al. It is possible to help smokers in early motivational stages to quit? The Inter99 study. Preventive Medicine 40 (2005) 278-84.
7. Reid RD, Pritchard G, Walker K, et al. Managing smoking cessation. CMAJ 2016;188:E484-E492.
8. Ockene IS and Miller NH. Cigarette smoking, cardiovascular disease, and stroke: A statement for healthcare professionals from the american heart association. Circulation 1997;96(9):3243-7.
9. Fiore MC, Jaén CR, Baker TB, et al. Clinical Practice Guideline: Treating Tobacco Use and Dependence: 2008 Update.