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[Editor's note: The FDA hasapproved nicotine gum for over-the-counter use; the nicotine patch may be approved for OTC use by the end of 1996. no smoking clipart Nicotine testing. ]Help patients resolve problems that result from quitting. Counseling may behelpful to some patients to increase the likelihood of success. Encourage relapsed smokers to try quitting again. no smoking clipart Stop smoking methods. Other recommendations to health care administrators, purchasers, and insurers includechanging the health care delivery systems to make it a standard practice to identify and treat smokers and other tobacco users. The consumer brochure released along with the guideline urges smokers to:Be committed. Be aware that breaking nicotine addiction isn't easy and takes a significant individual effort, but that half the people who have ever smoked have quit. no smoking clipart Diabetes-and-smoking. Talk with their doctors and discuss nicotine replacement therapy and smokingcessation programs. Do everything possible to maximize the chance of success. Set a quit date; do not try to "taper off. "Build on past mistakes. Think about what helped and what hurt. Create a support network of family and friends to be supportive and reinforcestop smoking efforts. Learn how to cope with situations that make a person want to resume smoking. Focus less on weight gain. Most people who stop smoking will gain less than 10pounds, but the health benefits of quitting smoking outweigh the risks of weight gain. Avoid dieting while trying to give up smoking because it can undermine chancesof quitting. Whenever possible, smoking cessation treatments should be appropriately tailored toethnic or racial groups. The guideline also offers recommendations for pregnant women, hospitalized patients, and persons with psychological problems. Recommendations also address tobacco prevention and cessation in children and adolescents and use of smokeless tobacco products (snuff and chewing tobacco). No conclusions were drawn about the effectiveness of acupuncture, hypnosis, and drug therapies such as clonidine, antidepressants, and anxiolytics/benzodiazepines because of insufficient or inconclusive evidence. The panel also made no recommendations regarding the use of nicotine nasal sprays and nicotine inhalers, since data on these products were limited. At the time of the panel's deliberations, the products were not licensed for prescription use in the United States. [Editor's note: As the guideline went to press, the Food and Drug Administration approved the prescription use of nicotine nasal spray. ]AHCPR plans to disseminate the guideline, cosponsored by the Centers for Disease Control and Prevention, to a wide range of clinicians, smoking cessation specialists, health care administrators, purchasers, and insurers. A quick reference guide, pocket guide, and consumer version, in English and Spanish, also will be distributed. The American Medical Association has received an educational grant from the Robert Wood Johnson Foundation to send copies of the guideline to 200,000 primary care doctors. AHCPR also will work with the American Association of Health Plans (formerly GHAA/AMCRA) to develop a practical guide, based on the guideline recommendations, targeted to meet the needs of health care systems. The guideline publications Smoking Cessation: Quick Reference Guide for Primary Care Clinicians (AHCPR Publication No. 96-0693); Smoking Cessation: Quick Reference Guide for Smoking Cessation Specialists (AHCPR Publication No. 96- 0694); and You Can Quit Smoking: Guide for Consumers (AHCPR Publication No. 96-0695) are available from AHCPR. The full guideline, Smoking Cessation: Clinical Practice Guideline No. 18, is available from the U. S. Government Printing Office (GPO stock no. 017-026-00159-0, $4. 75 per copy); call the GPO order desk at 202-512-1800 for bulk price and ordering information.
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