Resources and Strategies

The Evidence-Informed Chiropractor

Week 5 - Smoking Cessation


As healthcare professionals we have an obligation to our patient's overall health and smoking cessation must be part of our goal with our patients who smoke.  

Diid you know . . .

As of January, 2007, all U.S. chiropractic colleges must teach wellness measures and health promoting efforts  including smoking cessation.  

(Marion W Evans, Ronald Rupert: The Council on Chiropractic Education's New Wellness 

Standard: A call to action for the chiropractic profession. Chiropractic & Osteopathy 2006, 14:23)

Recently, a publication is Chiropractic and Manual Therapies entitled, Systems change to improve tobacco use identification and referral in the chiropractic setting: a pilot study by Kelly Buettner-Schmidt, et al. tested an intervention to assist chiropractors to implement sustainable changes for tobacco use based on U.S. Public Health Service guidelines. Chiropractors were taught the Ask, Advise, Refer (AAR) approach, provided with ongoing guidance, and followed for six months to assess systems change. The study was conducted from March 2016 to July 2017. Five clinics succeeded in having individual months of ≥50% of tobacco users being advised, and three clinics achieved the formal definition of systems change. Four clinics had individual months of ≥50% of tobacco users being referred. The patient quit rate was 13.3% (n= 15) for the 30-day follow-up and 16.7% (n= 6) for the three-month follow-up. It has previously been reported that 6% of patients quit because their doctor advised them to . This makes this study's stats even more impressive. 

Scroll down for a list of resources.

Also, similar to the tobacco industry, a targeted approach to a younger demographic may be prudent. Maryville University has a great resource page for information regarding the unique demographics of college students who smoke.  Certainly, levels of stress and past exposure are important features, yet the “social setting” is often expressed by college students as significant. 

Here is a link to that resource:  Maryville University Link

Did you know that . . .

Smoking has a dose-dependent effect on the risk for disc herniation; the more cigarettes per day the higher the risk.

   Jhawar BS, Fuchs CS, Colditz GA, Stampfer MJ. Cardiovascular risk factors for physician-diagnosed lumbar disc herniation. Spine J. Nov-Dec 2006;6(6):684-691.

There are a remarkable number of resources for smoking cessation including a clear plan for health care professionals Being persistent with patients yields a measurable effect. It is worth your time.

Here is the summary of the plan:     Ask, Advise, Assess, Assist

If you are a smoker, you need to stop first to set an example for your patients. they will not listen to you if you don't walk the walk.


Smoking Cessation: Support for Patients

Resources to Help Your Patients Quit Smoking

Clinician Resources: What You Can Do

Your Plan to Help Your Patients Stop Smoking

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