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Physiotherapists can play a key role in helping their patients quit smoking

Quit smoking
Photo: Physiotherapists can play a key role in helping their patients quit smoking
Physiotherapists can play a central role in helping their patients quit smoking with a simple three-step intervention model, according to new ACU research from cardiorespiratory physiotherapist Nia Luxton.

Published in the latest issue of the Journal of Physiotherapy, Dr Luxton said the Ask, Advise, Help (AAH) model, created by Quit Victoria, is a simple and effective way for physiotherapists to help patients quit.

As advocates of health and wellbeing across the lifespan, she said physiotherapists are well placed to inspire quitting attempts as they often have repeated contact with their patients.

The AAH model gives physiotherapists the opportunity to screen (Ask), provide advice and information on the best way to quit (Advise) and then help people to access a telephone Quitline, general practitioner or a smoking cessation specialist (Help).
“Physiotherapists routinely promote physical activity and prescribe exercise, provide advice on how to improve general health and educate patients on how to reduce their risk factors for developing cardiovascular disease, cancer and chronic pain for example,” Dr Luxton said

“Yet they less routinely ‘intervene’ to help a patient’s quit attempt for a number of reasons, despite patients expecting smoking cessation to be addressed as part of their health advice.”

Dr Luxton said local physiotherapists have previously followed the gold standard ‘5As’ approach (Ask, Assess, Advise, Assist, Arrange) used by state or territory health departments, services such as Quit Victoria and Cancer Council Victoria and other professional bodies’ guidelines such as the Royal Australian College of General Practitioners.

However, many feel they do not have enough time, support or resources to meet the recommended smoking cessation guidelines, leading to inconsistent care.

Often, they are reluctant to start a conversation with patients about quitting smoking because they think the patient is unlikely to successfully stop due to health or socio-demographic factors.

“While the 5As guidelines are evidence based and comprehensive, they also require time and expertise to implement, a knowledge of available smoking support services and an ability to provide follow-up care to effectively help a patient maintain a long-term quit attempt,” she said.

“The AAH model, which the Royal Australian College of General Practitioners recommend, is a much simpler way for physiotherapists to refer patients who smoke for help.”

Dr Luxton emphasised the need for physiotherapy university curricula to be redesigned to include health-promoting skills and competencies around smoking cessation guidelines, along with training to help new graduates confidently follow the guidelines.

She added that there is insufficient evidence that nicotine-delivering e-cigarettes are more effective for stopping smoking. No e-cigarette has been approved for use as a therapeutic aid for quitting tobacco smoking.


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