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​​​​​​​​​​Counselling and Psychosocial Approaches Summary Statements

CAN-ADAPTT’s development process reflects a dynamic opportunity to ensure that its guideline is practice informed and addresses issues of applicability in the Canadian context. It has built from the evidence and recommendations contained in existing guidelines. It did not review the primary literature to inform the development of its Summary Statements unless emerging evidence was identified by the Guideline Development Group. The CAN-ADAPTT Guideline Development Group has provided the below Summary Statements for Counselling and Psychosocial Approaches.

 Summary Statement #1 –
ASK: Tobacco use status should be updated, for all patients/clients, by all health care providers on a regular basis. GRADE*: 1A

Summary Statement #2 –  
ADVISE: Health care providers should clearly advise patients/clients to quit. GRADE*: 1C

Summary Statement #3 –
ASSESS: Health care providers should assess the willingness of patients/clients to begin treatment to achieve abstinence (quitting). GRADE*: 1C

Summary Statement #4 –
ASSIST: Every tobacco user who expresses the willingness to begin treatment to quit should be offered assistance. GRADE*: 1A

a) Minimal interventions, of 1-3 minutes, are effective and should be offered to every tobacco user.  However, there is a strong dose-response relationship between the session length and successful treatment, and so intense interventions should be used whenever possible. GRADE*: 1A. 
b) Counselling by a variety or combination of delivery formats (self-help, individual, group, helpline, web-based) is effective and should be used to assist patients/clients who express a willingness to quit. GRADE*: 1A
c) Because multiple counselling sessions increase the chances of prolonged abstinence, health care providers should provide four or more counselling sessions where possible. GRADE*: 1A
d) Combining counselling and smoking cessation medication is more effective than either alone, therefore both should be provided to patients/clients trying to stop smoking where feasible. GRADE*: 1A
e) Motivational interviewing is encouraged to support patients/clients willingness to engage in treatment now and in the future.  GRADE*: 1B
f) Two types of counselling and behavioural therapies yield significantly higher abstinence rates and should be included in smoking cessation treatment: 1) providing practical counselling on problem solving skills or skill training and 2) providing support as a part of treatment.  GRADE*: 1B

Summary Statement #5 –
ARRANGE: Health care providers:

a) should conduct regular follow-up to assess response, provide support and modify treatment as necessary.  GRADE*: 1C
b) are encouraged to refer patients/clients to relevant resources as part of the provision of treatment, where appropriate. GRADE*: 1A

*GRADE: Click here for Grade of Recommendation and Level of Evidence Summary Table.

 Couselling and Psychosocial Approaches