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SMOKING CESSATION COUNSELING IN FAMILY MEDICINE Ali Naji A Albalawi 1

lNihab 1 , Noor Ali Juma 2 , Duaa Abdulkadir Al Muslim 3 , Rakan Ali Al_hamoud 4 , Ibtihaj Qaseem Alenezi 5 , Maram Mubarak Barkoot 6 , Lujain Safwan Filfilan 7 , Abdullah Ibrahim Alfawzan 8 , Musaab Khalil Albalawi 9 , Abdullah Kahlil

Introduction: Smoking of cigarettes is known to be significantly associated with many short- and long-term morbidities and mortality in the US and around the world. To assist the cessation of cigarettes smoking, clinicians can benefit from the 5 As method that consists of: Ask, Advise, Assess, Assist, and Arrange. Generally, it is acceptable that any patient with any presentation must be asked about smoking history, and if is a smoker, assessed for the ability to quite at each encounter with the clinician. The advice for smoking cessation should always be given to patients though strong motivation during interviews, especially when dealing with patients who are still not accepting cessation Aim of work: In this review, we will discuss smoking cessation counseling and methods in different subpopulations, and we will mention most recent advances in this topic. Methodology: We did a systematic search about smoking cessation counseling in family medicine practice using PubMed search engine (http://www.ncbi.nlm.nih.gov/) and Google Scholar search engine (https://scholar.google.com). Our search also looked for the adverse effects of medications. All relevant studies were retrieved and discussed. We only included full articles. Conclusions: Intervention for smoking cessation has become on urgent need because of increasing tobacco use and health hazards, especially in developing countries. Smoking cessation will be at different states of readiness. The states may be: (i) not ready (pre-contemplation), (ii) unsure (contemplation), (iii) ready (preparation), (iv) action, and (v) maintenance. Counselling and behavioural management is important. The '5 A's-based intervention in the form of Ask, Advise, Assess, Assist and Arrange is implemented. Pharmacologic management is based on first-line treatment in the form of nicotine replacement therapy, bupropion and varinicline and second-line treatment as clonidine and nortriptalin. Key words: Smoking cessation, behavioral techniques, pharmacological, family medicine.

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