Helping Smokers Quit A Clinicians Guide - Crozer-Keystone Health System - PA

Helping Smokers Quit: A Guide for Physicians

Attachment D 

"Even brief tobacco dependence treatment is effective and should be offered to every patient who uses tobacco."

-  Public Health Service (PHS) Clinical Practice Guideline, Treating Tobacco Use and Dependence: 2008 Update


Ask about tobacco use at every visit.

Implement a system in your clinic that ensures that tobacco-use status is obtained and recorded at every patient visit.

Vital Signs

Blood Pressure: ______________________________

Pulse: ____________  Weight: __________________


Respiratory Rate:  ____________________________

Tobacco Use: Current        Former        Never        (circle one)


Advise all tobacco users to quit.

Use clear, strong, and personalized language. For example:

"Quitting tobacco is the most important thing you can do to protect your health."


Assess readiness to quit.

Ask every tobacco user if he/she is willing to quit at this time.

  • If willing to quit, provide resources and assistance (go to Assist section below).
  • If unwilling to quit at this time, help motivate the patient:
    • Identify reasons to quit in a supportive manner.
    • Build patient's confidence about quitting.


Assist tobacco users with a quit plan.

Assist the smoker to:

  • Set a quit date, ideally within 2 weeks.
  • Remove tobacco products from their environment.
  • Get support from family, friends, and coworkers.
  • Review past quit attempts—what helped, what led to relapse.
  • Anticipate challenges, particularly during the critical first few weeks, including nicotine withdrawal.
  • Identify reasons for quitting and benefits of quitting.

Give advice on successful quitting:

  • Total abstinence is essential—not even a single puff.
  • Drinking alcohol is strongly associated with relapse.
  • Allowing others to smoke in the household hinders successful quitting.

Encourage use of medication:

  • Recommend use of over-the-counter nicotine patch, gum, or lozenge; or give prescription for varenicline, bupropion SR, nicotine inhaler, or nasal spray, unless contraindicated.

Go to to view Suggestions for the Clinical Use of Medications for Tobacco Dependence Treatment.”  Refer to Attachment G for the CKHS prescription order set.

Provide resources:

  • Recommend toll free 1-800-QUIT NOW (784-8669), the national access number to State-based quitline services.

Refer to Web sites for free materials:


Arrange follow-up visits.

Schedule follow-up visits to review progress toward quitting.

If a relapse occurs, encourage repeat quit attempt.

  • Review circumstances that caused relapse. Use relapse as a learning experience.
  • Review medication use and problems.
  • Refer to 1-800-QUIT NOW (784-8669).

For more information on prescribing, precautions, and side effects, go to the Public Health Service Clinical Practice Guideline, Treating Tobacco Use and Dependence: 2008 Update

U.S. Department of Health and Human Services
Public Health Service

Current as of May 2008 

Internet Citation: 

Helping Smokers Quit: A Guide for Clinicians. Revised May 2008. Agency for Healthcare Research and Quality. Rockville, MD.

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