GPs have key role in helping patients to stop smoking.

Eighteen per cent of all deaths in adults aged 35 or over in England are still attributable to smoking. Almost all these premature deaths could be avoided if smokers stopped before their mid-thirties but only a quarter of people who have ever smoked regularly manage to quit by this age. Advice from the patient's GP is one of the most important triggers to a smoker making an attempt to quit. All patients attending a surgery for any reason who have smoked within the past three years should be offered advice on stopping smoking. Smokers without smoking-related diseases are just as likely to respond to advice as those with them. It is also important to re-assess the status of former smokers who were recorded as having stopped within the past three years. Half of those who stopped six months ago will relapse at some point as will 40% of those who stopped a year ago. Offer help with stopping to all smokers. The National Centre for Smoking Cessation and Training has launched a new online training module on how GPs can best deliver smoking cessation support to their patients. Optimum treatment involves behavioural support plus one of the smoking cessation medications. Behavioural support includes a number of specific behaviour change techniques that enhance the smoker's chances of remaining abstinent. These include: measurement of carbon monoxide in expired air; advice on best use of medication and helping smokers to put in place a clear 'not a puff' rule.