The following clinical considerations are included in CAN-ADAPTT's guideline and have been approved by the Guideline Development Group (GDG).
· Health care providers should be encouraged to ask about all forms of tobacco use including tobacco that is smoked (cigarettes, cigarillos, cigars, blunts, pipe, shisha, hookah, electronic cigarette) and smokeless (chewing tobacco, dipping tobacco, dissolvable tobacco, snus, snuff). This can be best asked by “Have you used any form of tobacco in the past six months?”
· A systematic approach to asking about tobacco use is best. Documenting tobacco status can involve medical questionnaires, stickers on client charts, electronic health records, chart reminders or through computer reminder systems.
· Encourage smoke-free homes, including skills to modify habits in order to minimize, avoid and/or counter triggers.
· Health care providers functioning within a team should be encouraged to discuss their smoking cessation strategy for their practice to ensure consistent application and to increase effectiveness.
· Evidence demonstrates that tobacco dependence treatment can be effective and should be considered even where specialized assessments are not used or available.
· Where appropriate, counselling can be delegated by arranging for referral, when barriers to the provision of counselling exist (i.e. limited time, resources, staff etc.) There are effective programs available to support health care providers and their patients/clients (see tools/resources section).
· All health care providers should be encouraged to obtain training in cessation counselling.
· Education of health care providers and patients should have consistent messaging, align tools and services to serve both targets. This includes addressing collaboration across the continuum of care (i.e. clinical or community setting) and across disciplines.
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Note that these clinical considerations were developed by the Guideline Development Group (GDG) and then edited or added to by CAN-ADAPTT network members.
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