Smoking cessation
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Unit 604
June 2023
The purpose of the activity is to learn about the practical aspects of smoking cessation for people presenting with significant comorbidities and common management problems.
Tobacco smoking is the single leading preventable cause of morbidity and mortality in Australia, and two in every three deaths among people who smoke are attributable to smoking,
In 2019, 11% of Australians aged 14 years and over reported smoking daily. Disproportionately higher daily smoking rates are reported in people living outside major cities, and in people considered ‘at risk’, including people living with mental health conditions or high psychological distress, Aboriginal and/or Torres Strait Islander people, and those living with addiction to alcohol and other drugs.
The majority of people who smoke make at least one quit attempt, however, those who smoke rarely visit a doctor with smoking addiction as their main complaint. The provision of smoking cessation care must remain a management priority, not only because of the numerous individual health benefits of quitting, but also because, as an intervention, the mortality benefit of successful smoking cessation eclipses that of other interventions frequently and routinely provided in general practice, such as cervical screening and pharmacological treatment of mild hypertension.
A recent Australian survey found a large increase in the six-month population prevalence of current vaping from late 2020 and continuing until early 2023, particularly in those aged under 35 years. Data on e-cigarette use revealed that fewer than 1% of adolescents aged 14–17 years reported vaping in 2018, increasing to 11.8% in 2022 and 14.5% in early 2023.
At the end of this activity, participants will be able to:
Below is a list of the case studies found in this month's edition of check. To see how these case studies unfold and gain valuable insights into this months topic, log into gplearning to complete the course.
David, aged 58 years, presents to see you for the first time following his recent discharge from the emergency department. The discharge summary provided informs you David presented with abdominal pain. Pathology and the abdominal ultrasound performed were consistent with cholecystitis and fatty liver. David tells you he is now on the waiting list for a laparoscopic cholecystectomy.
Mike, aged 45 years, has made an appointment in your clinic at the behest of his partner, who attends with him. Mike’s partner has been worried because Mike has seemed really overwhelmed and stressed lately. Mike’s partner saw Mike crying the other day in the garden, which he has not done for many years. While Mike’s partner is expressing their concern, Mike is sitting quietly, mostly looking at his lap. At times Mike runs his hands over his face and sighs.
Hira is a new patient to your practice, having been referred from the local maternity hospital to undertake shared maternity care with you.
Georgina, a single woman aged 38 years, has made an appointment to see you because she ‘can’t get into her psychiatrist for another three weeks’. Georgina’s mother is her main carer, and has joined her daughter in the consult. Both confirm that Georgina had been doing well after a recent lengthy admission to the nearby psychiatric inpatient unit, after a relapse of psychosis.
Olivia, aged 16 years, has been seeing you for a number of years for her asthma. Up until now it has been well controlled on a budesonide–formoterol (200/6 µg) turbuhaler preventer, one inhalation twice a day.
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Each unit of check comprises approximately five clinical cases, and the choice of cases will cover the broad spectrum of the unit’s topic. Each unit will be led by a GP with an interest and capability in the topic, and they will scope the five different cases for that unit in collaboration with the check team.