Canadian Smoking Cessation Clinical Practice Guideline

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CANADIAN SMOKING CESSATION GUIDELINEFORMAT OF GUIDELINEThe guideline is organized into the following sections:Clinical ApproachesCounselling & Psychosocial ApproachesPharmacotherapy (in progress using adifferent guideline developmentmethodology)Specific PopulationsAboriginal PeoplesHospital Based PopulationsMental Health and/or Other Addiction(s)Pregnant & Breastfeeding WomenYouth (Children & Adolescents)Each section of the guideline is divided into thefollowing sub-sections:1. Overview of Evidence includes therecommendations and supporting evidenceextracted from relevant pre-existing highquality CPGs, which have contributed to theCAN-ADAPTT summary statements.2. Summary Statements are based on the bestevidence identified, and are the importantmessages for health care providers to considerimplementing in practice. Each SummaryStatement includes the Grade ofRecommendation and Level of Evidencesupporting the Statement.3. Clinical Considerations is informationsupporting the Summary Statements, such ashow to best implement the Statements,important implications for specific practicesettings and key considerations. ClinicalConsiderations were informed by the input ofthe Guideline Development Group and CAN-ADAPTT Network Members. It was notinformed by a systematic review of theliterature.4. Tools and Resources provides a list ofresources that health care providers can use tohelp implement the Summary Statements. Thelists are not intended to be comprehensive; theyare a starting point informed by the GuidelineDevelopment Group and CAN-ADAPTTNetwork Members.5. Research Gaps describes any gaps in theevidence and recommendations for futureresearch in the area. See the CAN-ADAPTTResearch Agenda for more information 7 .CLARIFICATION AND LIMITATIONSIn this document, the term “tobacco” refers tomanufactured, commercial tobacco productsincluding, but not limited to, cigarettes, smokelesstobacco such as snuff, snus, and chewing tobacco, andcigars. Tobacco misuse does not refer to tobacco usefor traditional or ceremonial purposes by AboriginalPeoples.Most research in the area of smoking cessation hasexamined cigarette use; it is important to note thislimitation when using this guideline with smokelesstobacco users. More research is needed on smokelesstobacco products and the people who use smokelesstobacco to understand the impact of smokingcessation interventions.The term patient/client is used throughout thisguideline to reflect the diverse clinical settings wheresmoking cessation treatment is provided. The termhealth care provider is used throughout and isintended to reflect a broad range of providers in arange of different settings, including hospital, clinic,home care, acute, community, primary and long termcare.INTRODUCTION 3
CANADIAN SMOKING CESSATION GUIDELINEGuideline Development Group (GDG)• METHODSThe Guideline Development Group (GDG) wasformed in 2009 by the CAN-ADAPTT CoordinatingTeam and the GDG Chair, Dr. Peter Selby. There areseven members of the GDG ranging from familyphysician to public health researcher to physicianspecialists (see page ii for a list of GDG members).Each GDG member was a Section Lead for one of thesections listed on page 3. GDG Members wereidentified by the Chair to include experts in each topicarea while ensuring a multi-disciplinary andnationally representative committee. Each GDGmember was contracted through CAMH for theirparticipation on the GDG, which included a modesthonorarium to support their attendance at meetingsand compensation for travel and accommodation forin-person meetings. Each GDG member confirmedthat they had not received funds from the TobaccoIndustry. No conflicts of interest were identified bymembers of the GDG that could have compromisedthe summary statements contained within thisdocument. The GDG recognizes that representationfrom all potential guideline target end users was notpossible. The intent was to leverage the CAN-ADAPTT Network members that represented agreater number of professional groups involved insmoking cessation throughout the guidelinedevelopment process to provide critical input into thedrafting of the guideline.IDENTIFYING AND EVALUATINGTHE EVIDENCEIDENTIFYING EXISTING CLINICAL PRACTICEGUIDELINESPrior to being engaged in the CAN-ADAPTT Project,the Guidelines Advisory Committee had conducted,in November 2006, a full review of CPGs in the area ofsmoking cessation published in the English language.At that time, nine guidelines met the basic predeterminedquality criteria: they containedrecommendations linked to the evidence, andincluded some indication that a systematic search ofthe literature had been conducted. [Appendix C]In December 2008, a new systematic search wasconducted for the CAN-ADAPTT Project, to identifyCPGs published since the previous review. Thissearch used the same terms as November 2006, suchas smoking, tobacco, or nicotine. The search wasconducted in Ovid MEDLINE, Ovid Embase,guideline repositories such as National GuidelineClearinghouse, renowned developers with a history ofMETHODS 4
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Canadian Smoking Cessation Clinical Practice Guideline

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