Brief Advice in Primary Care According to the S3-Clinical Practice Guideline “Screening, Diagnosis and Treatment of Harmful and Addictive Tobacco Use”
DOI: 10.3238/zfa.2017.0210-0215german translation / full article
Summary: Smoking tobacco and tobacco-associated diseases are among the largest avoidable mortality risks. Nevertheless, the prevalence of smoking in Germany remains high, at 30 %. While continuous tobacco abstinence reduces mortality risks, smokers struggle to successfully stop using tobacco without assistance, due to tobacco’s highly addictive properties. Only about 3–5 % of unassisted attempts at quitting can be sustained long-term. Therefore, the S3-clinical practice guideline on screening, diagnosis and treatment of harmful and addictive tobacco use recommends implementing evidence-based brief advice on smoking cessation into routine primary care to assist a large number of smokers. However, these recommendations are only rarely put fully into practice in Germany. Reasons include uncertainties concerning the skillful application of brief advice strategies, time constraints, and lack of reimbursement. This article aims at providing an overview of the issue of tobacco cessation in primary care. To reduce uncertainties on how to implement the clinical practice guideline, key aspects of the guideline are summarized, and two models of brief smoking cessation advice (5A and ABC) are presented together with information on their use in family medicine.