[Assisting smoking cessation].

Abstract

Smoking is the most important cause of preventable death in the world and the benefits of smoking cessation are clearly established regardless of the age of the smoker or the presence or absence of pathologies, whether caused by smoking or not. Even though this may appear obvious it is useful to recall that every medical consultation for any condition should include an assessment of smoking status, of the motivation to quit (which should be identified and reinforced) and of the readiness to quit. Assistance given can thus be adapted appropriately to the individual situation and should take into account validated recommendations for best practice. Advising and assisting smoking cessation requires a tailored approach which involves a number of elements centred on the addictive nature of smoking. The nature of dependence may differ and be of varying intensity in different individuals. The capacity to give up may also be very different. Obstructions to smoking cessation are often numerous and complex. Co morbidities and co-addictions can slow down the dynamics of change and their existence must be incorporated into an individualised approach. The transition of a smoker towards abstinence passes through numerous steps so that the addicted smoker is effectively a patient with a chronic disease. This explains many relapses and justifies the need to offer often specialised assistance over a prolonged period. Advising and assisting smokers to quit is a priority. It is thus necessary to organise the management of this process according to the specific skills of each health professional. This approach will address the global problem of tobacco while focusing on the specific problems of each smoker.