3/2007General practitioner and a smoker

KRZYSZTOF BUCZKOWSKI (Katedra i Zakład Lekarza Rodzinnego Collegium Medicum w Bydgoszczy,Uniwersytet Mikołaja Kopernika w Toruniu;p.o. Kierownik: dr n. med. Krzysztof Buczkowski)

Summary
Smoking, which can be eliminated, is the most important single factor responsible for a series of diseases and deaths. Addiction results from the pharmacological effect of nicotine on the central nervous system and of the simultaneously developing behavioral changes. Although most patients with nicotine addiction syndrome declare they want to give up smoking, it is only a small percentage of them that are in fact capable of achieving their goal without any help or support. The help of the doctor in such cases is useful, particularly if they know the patient and their family well. The management of such a patient should be according to the rule 5 x P, which includes further steps of doctor’s intervention. What is extremely important a large scale intervention carried out by GPs concerning patients who smoke is effective and significantly improves upon the success indexes of giving up smoking. Apart from motivating the smoker to give up the doctor can apply pharmacological treatment. Drugs of proven efficiency are nicotine replacement therapy, bupropion and varenicline.

Key words: general practitioner, smoking, brief counseling intervention