European Medical Association on Smoking or Health - EMASH

Association Médicale Européenne Tabac ou Santé - AMETOS

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The role of health professionals in offering treatment and helping smokers stop smoking

The main ingredients for stopping smoking are motivation and the will to stop. It has been proved that as little as a simple prompting and advice by the physician can convince a good number of smokers to quit. Giving up the addiction, however, usually entails a rather long and difficult process and one which may require professional advice especially by those health professionals with whom the smoker first comes into contact: the family doctor and/or the pharmacist.

Several methods have been proposed at various times which allegedly helped smokers stop smoking. However, only few such methods have been scientifically tested. Those which proved in many independent studies to be useful usually include nicotine replacement therapy (NRT) through pharmacological aids like nicotine-containing chewing-gums, trans-dermal patches, inhalers and tablets. The basic principle being that smokers smoke mostly because of the pharmacological and addictive properties of nicotine, it is possible to let them have access only to the alcaloid that they need without the many other and much more harmful substances present in tobacco smoke. This opens the way to gradually wean them out of the nicotine addiction. The nicotine replacement aids, of which there are several on the market, have been found to provide quantifiable help to strongly addicted smokers in overcoming withdrawal symptoms and in improving cessation rates. Their credibility rests not only on the extensive research carried out by very numerous and highly reputed independent investigators, but also on the acceptance contained in reports of the US Surgeon General and the W.H.O. More recently, non-nicotine replacement tablets have appeared in commerce, and seem promising. Therapy is more effective if followed up professionally, especially if personalised to the individual smoker. This is why the doctor's advice and involvement are important. Another relevant area of action is the promotion of no-smoking policies in hospitals and health centres. In most countries no-smoking policies do exist but are weak and need strengthening. In addition, hospital health personnel would be in a good position to provide smokers with professional guidance in stopping smoking and in using, if required, pharmacological therapy. New nicotine delivering devices like electronic cigarettes or E-cigarettes, have been proposed on the market by tobacco interest to lure smokers into continuing to consume nicotine.