[NPInfo] Smoking questions/ (OT Humor)

[Andy Craig]

For some dark humor on the subject of smoking cessation, go to the video
store and rent "Cat's Eye", a series of vignettes--video adaptations of
stories by Stephen King.

The first one is called "Quitters, Inc."  It's about a mob boss (played by
Alan King) who goes legit by going into the smoking cessation business.  If
his crew catches you smoking, they rough you up--or worse!

Andy Craig, NP
Charlotte, NC




-----Original Message-----
From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On Behalf
Of Sue Wiers
Sent: Thursday, September 06, 2007 7:53 AM
To: npinfo at nurse.net
Subject: RE: [NPInfo] Smoking questions//not political, just clinical


I feel that I do an inadequate job of working on smoking cessation.  I 
discuss this with people who smoke at almost each and every appointment, but

don't have many resources to offer.

I know that there is a bit of research out there that I am not very familiar

with.  Anecdotally, some of the barriers that I most often note are:

1) Socially, cessation can be isolating.  If friends, family, and coworkers 
are all smoking around them, it is difficult.

2)  As Laura said, the cost of Chantix for those whose policies aren't 
covering it.  I tell patients to do the math and if there is any way to come

up with the money up front, they will certainly be saving themselves money 
over the long run.

3)  Weight gain. I believe that effective smoking cessations need to address

this and provide strategies to avoid weight gain.

I have prescribed quite a bit of Chantix.  I have seen some success, but 
have witnessed quite a bit of relapse.  The drug rep tells me that better 
long-term success is achieved by taking the full 3-month course of therapy.

I believe that jury is out on that one.  More likely a clinic or perhaps 
group approach (in the way Weight Watchers is done) will be more helpul as 
it would also address the other issues.

I would consider a smoking-cessation clinic at my site.  I am doubtful the 
additonal revenue would be that great, but indirectly it could be 
revenue-enhancing by bringing people into your practice.  Certainly, the 
other benefits for my patients would make it worthwhile.

Sue Wiers FNP

>From: David Mittman <dmittman at comcast.net>
>Reply-To: NP Info <npinfo at nurse.net>
>To: ACC Listserv <acc-circle at listserve.com>, NPinfo <NPinfo at nurse.net>,

>    <PAForum at mc.duke.edu>
>Subject: [NPInfo] Smoking questions//not political, just clinical
>Date: Tue, 04 Sep 2007 23:36:50 -0400
>
>Dear Colleagues:
>
>Please take 60 seconds out of your busy day to ponder these questions:
>
>What would REALLY help you in getting patients to stop smoking?
>
>What do you need that¹s not out there?
>
>I hear Chantix really works, if you are in primary care are you 
>prescribing it? What about the product itself do you need more info on?
>
>Would there be interest in opening up a smoking cessation clinic as 
>part of your normal practice? What if there was some info to receive on 
>how to do this? Would the extra revenue you brought in help?
>
>Just some questions, if you would be so pleased to let me know your 
>feelings.
>
>All my best,
>Dave
>
>
>
>
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