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All those who ask for
advice, both sexes, 15 to 64 years old. Pregnant women
represent a group of special interest.
It should be made known that the
consumption of tobacco is the principal preventable cause of
deterioration of health and avoidable cause of premature
death; addiction to tobacco is, therefore, the main
preventable public health problem. The personal and social
benefits obtained from giving up smoking must be
highlighted and educational and support material must be
distributed. Doctors must develop a global risk profile of
patients, investigating the existence of other risk
factors, such as hypertension, hypercholesterolemia,
diabetes or pollution in the work environment, and advise patients
that smoking is particularly harmful in these cases. Pregnant women
have to be advised that smoking should be avoided during
pregnancy in order to avoid delayed fetal growth or complications
during pregnancy, birth or the first days of life of the newborn
child.
Anti-tobacco advice must be given in a
systematic and repetitive way.
Health care staff should assume an
exemplary role and stop smoking, especially in front of patients
and at work. Staff must systematically ask all patients who
visit them, or who they have an opportunity
to question, if they smoke and record the answer on the
patient's clinical record. where a patient is a smoker, an attempt
should be made to know their degree of addiction by asking
about their daily consumption of cigarettes and the nature of their
habit. Health professionals must help patients who want to
stop smoking through a structured program which includesan agreed
date to stop, a schedule of visits and/or periodic telephone
contact, and where necessary, pharmacological help(xiclet or
nicotine patches). Health Centre environments must favour giving up
smoking (posters, prohibitions signs and an absence of
ashtrays).
It is important to take into account
that smoking is a socially tolerated addiction, that diagnostic and
therapeutic tools (such as those for arterial hypertension or
hypercholesterolemia, for example) are not available to health
professionals in this area, and that a high proportion (about 35%)
of health professionals in Catalonia smoke, all aspects which
hinder, to a large extent, the fight against
tobacco. Primary Health Care teams must actively
collaborate with anti-tobacco initiatives and defend the rights of
passive smokers, especially by ensuring compliance with
the prohibition of smoking in the waiting room.
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