GP · addiction-medicine
Tobacco dependence
Also known as Smoking cessation · Nicotine addiction
GP-fellowship guide to tobacco dependence: pharmacotherapy evidence from Cochrane reviews (NRT, varenicline, bupropion), the 5As brief intervention framework, combination therapy, relapse prevention, and the GP's role in the single most impactful intervention for health.
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Target exams
RACGP AKTRACGP KFPRACGP CCE
Red flags
- A smoker with exertional chest pain, new neurological deficit, or claudication — tobacco-related vascular disease is the working diagnosis until excluded
- A pregnant smoker needs intensive support, not just brief advice — smoking in pregnancy causes low birth weight, preterm delivery and stillbirth
Overview
Tobacco smoking is the leading preventable cause of death and disease. The GP is the most effective touchpoint for cessation: brief advice from a doctor increases quit rates, and pharmacotherapy doubles or triples them further.[1][3]
References3ShowHide
- [1]Cahill K, Stevens S, Perera R, et al. Pharmacological interventions for smoking cessation: an overview and network meta-analysis Cochrane Database Syst Rev, 2013.PMID 23728690
- [2]Livingstone-Banks J, Fanshawe TR, Thomas KH, et al. Nicotine receptor partial agonists for smoking cessation Cochrane Database Syst Rev, 2023.PMID 37142273
- [3]Stead LF, Perera R, Bullen C, et al. Nicotine replacement therapy for smoking cessation Cochrane Database Syst Rev, 2012.PMID 23152200