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Smoking cessation counseling
Smoking cessation reduces or reverses many of the lethal effects of long-term smoking and associated morbidity . Knowledge of these immediate and long-term benefits of smoking cessation to an individual and his or her family are components of the clinician’s arsenal by establishing goals and incentives for the smoker. Although long-term smoking can lead to irreversible lung damage, reduction in breathing space. Risk of heart disease, stroke, and cancer is largely commensurate with length of quit duration. For smokers who have difficulty quitting, advocating competing health strategies has been pro-posed (Naslund, Fredrikson, Hellenius, and de Faire, 1996). Improved nutrition and physical activity and exercise, however, do not necessarily counter the negative effects of smoking (Luedemann et al, 2002).
Physical therapists need to be informed about advances in the prevention of smoking in young people and smoking cessation programs that may include either nonprescription or prescription med-cation. In 1996 the APTA adopted the guidelines of the Agency for Health Care Policy and Research (AHCPR, 1997), and these have been revised since(AHCPR, 2000). These guidelines were adopted by the APTA to acknowledge publicly and professionally its commitment to health. These guide-lines provide clear, direct, and personal statements related to smoking cessation that are designed to be used by practitioners with their patients.
A decision will need to be made in consultation with the patient’s or client’s physician about whether pharmacological support is indicated (e.g., nicotine replacement therapy), and if so, what the prescription parameters should be in terms of coordination with noninvasive strategies. Smoking reduction warrants being monitored by both the physical therapist and physician to ensure pharmacological support is progressively withdrawn as indicated.
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