Training for Clinicians:

CINSW online training lesson 3: Introducing the 3As brief intervention model

This short online lesson provides an interactive overview of the Ask Advise Act brief smoking cessation intervention

Medical Oncologist 3As referral to Quitline (1:24min; CINSW resource)

Medical Oncologist Dr Deme Karikios asks, advises about quitting and referral to Quitline

Emily Stone Full Interview (4:22min; C2Q resource)

Dr Emily Stone discusses the importance of the 3As

Pharmacotherapy:

Pharmacist education about the NRT options (4:24min; CINSW resource)

Pharmacist Nicolas Holton provides a summary of NRT:

• Gum

• Lozenges

• Patch

• Inhaler

• Mouth spray

• Contraindications/ Precautions

Oncologist education about the use of patches (2:46min; ACT; C2Q resource)

Oncologist Dr Fiona Day with patient Jessica 

• Administering the patch

• Usage

• Top-up dosage is useful if cravings persist 

Care to Quit Nicotine Replacement Therapy Pharmacotherapy Training (56:38min)

• Pharmacotherapy training session delivered by Dr James McLennan to the Calvary Mater Newcastle Oncology Department, on 30th Nov 2022

Care to Quit Pharmacotherapy Training 11 Questions (39:59min)

• Varenicline training session delivered by Dr James McLennan to the Calvary Mater Newcastle Oncology Department, on 21st February 2023

Does Champix work better than NRT or other medications? (3:44min)

• Clinical Psychologist, James McLellan provides evidence that patients are more likely to quit using Champix than single-form NRT, Bupropion or placebo (27 studies)

• For non-motivated people, even low dose Champix is better than placebo (1 study) 

• Number needed to treat (for quitting) with Champix is 11, single form NRT 15-23 and Bupropion 22.

Champix drug interactions and contraindications (6:03min)

• No meaningful drug interactions however not recommended for pregnant, breastfeeding and under 18 years

• For severe renal disease – a lower dosage is recommended (50% lower dose) according to TGA / product info leaflet

• Contraindication: alcohol consumption 

• Does not directly cause serious psychiatric issues (EAGLE trial) 

• Can be used if having mental health or drug using populations

Champix dosage and administration (3min)

• There are three modes for prescribing Champix:

  • Set date to stop then start Champix 1-2 weeks before, 

  • Flexible quit date – begin dose and quit day between 8-35 days

  • Slow reduction (for unmotivated smoker) e.g. start dose, then reduce smoking with 50% in the first 4 weeks, 50% again for next 4 weeks. Aim to stop after 12 weeks.

• Go back to GP at week 3 and 11 (program is 12 weeks in total)

• Low cost and covered if having healthcare card (available on PBS)

Champix side-effects (2:30min)

• Main side-effects:

  • Nausea (most common, 30%)

  • Headache

  • Insomnia

  • Possible to increase cardiovascular adverse events

Suggested advice and language to use about Champix (3:24min)

• Common patient beliefs about using Champix

• Suggested advice for patients e.g. Champix is not the miracle cure but one slice of the pie and of the overall plan. “Its not the pie”.

Quitline:

Oncologist education about Quitline (0:37min; ACT; C2Q resource)

Oncologist Dr Fiona Day with patient Jessica 

• Quitline will assist with forming new habits

GP referral:

GPs on the oncologists’ role in smoking cessation (6:58min)

• GPs Dr Nin Kiu, Dr Charles Ellis, Dr Jimmy Cheng and Dr Jo Thomas on the oncologists’ role in smoking cessation

Patients not willing to quit and difficult patients (2:18min)

• GPs Dr Charles Ellis, Dr Jimmy Cheng and Dr Jo Thomas discuss patients not willing to quit and difficult patients

What should the oncology team know about how GPs assist with quitting (3:36min)

• GPs Dr Charles Ellis and Dr Jimmy Cheng talk about what oncology teams should know about how they assist with quitting

Pharmacotherapy: