1034F Current tobacco smoker (CAD, CAP, COPD, PV) (DM)

Name of the Procedure:

Smoking Cessation Counseling for Cardiac and Pulmonary Conditions (CAD, CAP, COPD, PV, DM)

Summary

Smoking cessation counseling is a clinical process involving evaluation and structured support to help individuals quit smoking. It includes behavioral therapy, education, and possibly pharmacotherapy to address nicotine dependence.

Purpose

Smoking cessation counseling is designed to reduce or eliminate smoking, thus lowering the risk of complications and progression of diseases such as Coronary Artery Disease (CAD), Chronic Airway Disease (CAP), Chronic Obstructive Pulmonary Disease (COPD), Peripheral Vascular Disease (PV), and Diabetes Mellitus (DM).

Indications

• Current use of tobacco products.
• Diagnosed with CAD, CAP, COPD, PV, or DM.
• Exhibiting symptoms such as chronic cough, shortness of breath, chest pain, or vascular insufficiency.
• Willingness to quit smoking or reduce tobacco usage.

Preparation

• Patients should compile a history of their smoking habits, including duration and quantity.
• No specific fasting or medical preparation is typically needed.
• Pre-assessment may include lung function tests, cholesterol levels, blood glucose levels, and a psychological evaluation.

Procedure Description

1. Initial consultation to review medical history and smoking habits.
2. Assess the patient’s readiness to quit and discuss potential challenges.
3. Develop a personalized quit plan, including setting a quit date.
4. Educate about withdrawal symptoms and coping strategies.
5. Prescribe medications like nicotine replacement therapy (patches, gum) or medications (varenicline, bupropion) if appropriate.
6. Schedule follow-up appointments for ongoing support and adjustments to the quit plan.

Duration

Initial consultation typically lasts about 30 to 60 minutes. Follow-up sessions may be shorter, around 15 to 30 minutes each.

Setting

Most often conducted in an outpatient clinic, primary care office, or specialized smoking cessation facility.

Personnel

• Primary care physician or pulmonologist
• Trained smoking cessation counselor or psychologist
• Nurse or medical assistant

Risks and Complications

• Possible side effects from cessation medications (e.g., nausea, insomnia).
• Psychological withdrawal symptoms, including anxiety and irritability.
• Relapse and continued smoking.

Benefits

• Improved cardiovascular and pulmonary function.
• Reduced risk of complications like heart attacks, strokes, and lung diseases.
• Better management of diabetes and peripheral vascular disease.
• Benefits can be realized shortly after quitting, with significant health improvements within a few months.

Recovery

• Continuous support through follow-up appointments and counseling sessions.
• Patients may experience cravings and withdrawal symptoms, but these typically diminish over time.
• Avoiding triggers and adopting a healthy lifestyle can aid in recovery and prevent relapse.

Alternatives

• Cold turkey: Quitting without any medical assistance or medications (high relapse rate).
• Use of mobile apps or online programs for quitting support.
• Hypnotherapy or acupuncture as complementary therapies.
• Pros and cons include variation in effectiveness and access to professional guidance.

Patient Experience

• Patients might feel initial discomfort due to withdrawal symptoms like irritability, restlessness, and cravings.
• Emotional and physical support is crucial; counseling sessions offer a platform for patients to discuss challenges and progress.
• Measures for comfort include stress-management techniques, appropriate use of medications, and support from family and friends.