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An update on the smoking cessation clinical pathway initiative

Iwa Yeung,SCCP project officer
7 November 2016

Our previous article, Quitting smoking in partnership with physiotherapy in Queensland, brought attention to the Queensland Health (QH) Metro South (MS) district-wide smoking cessation clinical pathway (SCCP) initiative. 

Since implementation of the SCCP initiative from January 2015, approximately 1000 patients at Brisbane’s Princess Alexandra Hospital who were smokers chose to make an active quit attempt and to be referred to the free Quitline service.

In addition to having smoking bans in both indoor and outdoor public places (five-metre buffer) on QH facilities, MS actively promotes the smoking cessation initiative by implementing the SCCP in inpatients. The program tied in with the Queensland Government’s quality improvement payment initiative, which set targets of 60 per cent completion rates of the SCCP across five MS facilities, as well as 75 per cent of inpatient smoking status identification rates, in order for MS health facilities to receive full government incentive funding. Here’s a summary of the integrated strategies to successful smoking cessation.

Professional support and involvement

The clinical pathway is a statewide initiative which utilises the evidence-based ‘5As’ (ask, assess, advise, assist, arrange) to address smoking cessation for all admitted inpatient smokers. The Royal Australian College of General Practitioners (RACGP)’s Supporting smoking cessation: a guide for health professionals (updated in 2014) recommends that every smoking patient should be asked and offered smoking cessation treatment at every visit.

The process outlined by the RACGP—a task that can be conducted by a multidisciplinary team (eg, physiotherapists, pharmacists, nurses, oral health professionals or doctors)—features the following steps:
  • ask: systematically identify all tobacco users at every visit
  • advise: strongly urge all smokers to quit 
  • assess: assess nicotine dependence and smokers' willingness to make a quit attempt
  • assist: aid the patient with a quit plan
  • arrange: refer for follow-up to monitor progress (Quitline, addiction and mental health services).

Behavioural support and proven pharmacotherapy

This involves personalised nicotine-replacement therapy and support by pharmacists or doctors for effective smoking-cessation treatment with the goal of long-term abstinence from tobacco.

The increased attention that smoking cessation received in the Quit4October initiative served as a reminder of a life-saving treatment. Across all MS health service districts, ‘quit smoking’ stalls and foyer displays successfully assisted to promote the important message of smoking cessation and encouraged smoke-free healthcare. The Quit4October campaign coincided with the recent (1 September) 12.5 per cent tobacco tax rise, which will also boost interest in quitting. A pack-a-day smoker will now save $6500 each year, and further tax rises are planned for the next four years.

For more information, visit, or email or project team leader Deepali Gupta


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