[Also Published in Indian Journal of Chest Diseases and Allied Sciences. 2004,46: 137-153 And Lung India 2004,21:11-26.]
 
Preface
Introduction
Epidemilogy & Risk Factors
Pathogenesis & Pathophysiology
How to diagnose COPD?
Investigations
Treatment of patient with stable COPD
Management of acute exacerbations
Progression and Prognosis
COPD Algorithm
References
Tables
List of participants
Consultants & Reviewers
Rapporteurs
 
 
 
Table 5. Guidelines for Physicians on Tobacco Cessation.

Follow the 5A Strategy
  • ASK (about tobacco use)
  • ASSESS (the status and severity of use)
  • ADVISE (to stop)
  • ASSIST (in smoking cessation)
  • ARRANGE (follow-up programme)

Details of ADVICE for the patient
  • Review your tobacco use. Accept that smoking is a problem and harmful for your health.
  • Make a decision and determination to quit. Don’t be over confident that you can quit any time you like.
  • Share your decision with family, friends, doctor. Accept their help.
  • Fix a quit date. Don’t postpone.
  • Remove ashtrays and other objects that are reminders to the habit.
  • Keep away from trigger situations.
  • Adopt healthy lifestyle such as relaxation, exercise, plenty of water, fruits, vegetables and avoid tea/coffee/alcohol.
  • Take help from family, friends and doctor.

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Table 6. First few steps of quitting tobacco smoking.
  1. To reduce quantity
    1. Change to non-preferred brand.

    2. Keep a record of the amount and frequency of tobacco use.

    3. Decrease the number of puffs when smoking.

    4. Leave large stubs.

    5. Don’t inhale deeply.

  2. To deal with triggers when you have an urge to smoke (Trigger coping)
    1. For extra-ordinary urge to take tobacco, try alternatives (chewing gum, toffee, peppermint, cardamom)

    2. Increase your water intake

    3. Breathe deeply and quietly

    4. Do some other work to engage your mind and to keep your mind off tobacco

    5. Delay the act of smoking – count till 100 and think of pleasant situations.

  3. Once you quit
    1. Learn to say “no” to tobacco offers from others.

    2. Don’t take even a single puff.

    3. Try to remain in smoke free areas.

    4. Avoid company of smokers and even tobacco chewers.

    5. Make a group of people who have quit tobacco – share their experiences.

    6. Collect the money saved from each pack of cigarette or “paan masaala”.Buy a gift for your loved ones with that money.

    7. Try alternate ways to deal with mental stress and tension, such as Relaxation, Deep breathing, Listening to music.

    8. Remember there can be some withdrawal symptoms after quitting, such as headache, irritability, lack of concentration, etc. But bear with them. These are temporary and disappear in a few days.

     Even if you fail in quitting smoking.
  • Don’t get disheartened – TRY AGAIN

  • Seek help of those who have quit smoking

  • Seek professional help and medical advice


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Copyright © 2003 Prof. S.K.Jindal, Head, Department of Pulmonary Medicine, PGIMER, Chandigarh. All rights reserved.