Canadian Smoking Cessation Clinical Practice Guideline

More documents

Recommendations

Info

CANADIAN SMOKING CESSATION GUIDELINEBACKGROUNDIt should be recognized by healthcare providers thattobacco has played an important part in traditionaland spiritual practices in many Aboriginalcommunities. Traditionally tobacco was used bymany First Nations for ceremonial and medicinalpurposes and is still practiced across many FirstNations.However, it is well documented that mis-use/abuseof tobacco is of growing concern not only to thegeneral Canadian population, but as well as to FirstNations. For example, studies have demonstrated thatsmoking rates amongst First Nations peoples are morethan double that of the general Canadian population.Furthermore, it has been documented that within FirstNations populations, there are instances of smokingbeginning as early as 6-8 years with an increase inuptake between the ages of 10-12, and peaking at 16years of age. The relevance of targetingchildren/youth within this population is thereforeevident.Not only are rates of smoking higher in thispopulation, but the poorer health status of FirstNations people in Canada has also been welldocumented in the literature which together points tosignificantly higher rates of smoking related illnessesin this population.There is limited evidence available demonstratingeffective strategies for smoking cessation withinAboriginal populations. It should be noted that thisdoes not suggest weak evidence of effective strategieswithin this population, but rather, a limited amountof research available (see Research Gaps section).However, generally those strategies which areeffective for the general Canadian population shouldbe considered effective within Aboriginal peoples.One recent Canadian study provides evidence thatquitlines are an effective option for Aboriginalpopulations 17 .Cultural adaptations should also be considered totailor interventions for this population. Similarly, allinterventions must consider the spiritual andtraditional role within the culture and acknowledgeother barriers to smoking cessation with the FirstNations population such as the concurrent high ratesof drug use and alcohol consumption.CAN-ADAPTT SUMMARYSTATEMENTSCAN-ADAPTT’s development process reflects adynamic opportunity to ensure that its guideline ispractice informed and addresses issues ofapplicability in the Canadian context. It has built fromthe evidence and recommendations contained inexisting guidelines. It did not review the primaryliterature to inform the development of its SummaryStatements unless emerging evidence was identifiedby the Guideline Development Group. The CAN-ADAPTT Guideline Development Group hasprovided the below Summary Statements forAboriginal Peoples.SUMMARY STATEMENT #1Tobacco misuse ∆ status should be updatedfor all Aboriginal peoples by all health careproviders on a regular basis.GRADE*: 1ASUMMARY STATEMENT #2All health care providers should offerassistance to Aboriginal peoples who misusetobacco with specific emphasis on culturallyappropriate methods.GRADE*: 1CSUMMARY STATEMENT #3All health care providers should be familiarwith available cessation support services forAboriginal peoples.GRADE*: 1CSUMMARY STATEMENT #4All individuals working with Aboriginalpeoples should seek appropriate training inproviding evidence-based smoking cessationsupport.GRADE*: 1C* GRADE: See Appendix B for Grade of Recommendation andLevel of Evidence Summary Table.∆Tobacco misuse does not refer to tobacco use fortraditional/ceremonial purposes.ABORIGINAL PEOPLES 17
CANADIAN SMOKING CESSATION GUIDELINECLINICAL CONSIDERATIONSThe Guideline Development group found thatthere was a significant gap in the research onAboriginal peoples and tobacco misuse.Guidelines developed in New Zealand wereutilized recognizing that these guidelines alsorequire further research. Despite the lack ofresearch there is evidence that there is adisproportionate burden of tobacco useamongst Aboriginal peoples. For example,youth uptake of tobacco is at a much earlierage than that of the general Canadianpopulation (See Youth Section).It should be emphasized that providersshould recognize and distinguish between useof traditional (ceremonial/sacred) tobaccoand misuse of commercial tobacco. Thereforeassessment and questions need to beconducted with care and respect for thisdifference.Health care practitioners should work withcommunity members including health careproviders, community health representatives,caregivers, elders and other leaders wherepossible, to deliver smoking cessationinterventions for Aboriginal peoples. Thereare a growing number of materials andmethods to assist with tobacco cessation andprevention that have been developed and/oradapted for Aboriginal peoples. (see Tools/Resources Section).Efforts should also be made to identify,engage and understand the range of resourcesavailable to provide appropriate referrals andconnectivity to the Aboriginal community.For example, local First Nations communities,urban Aboriginal programs, FriendshipCentres etc. (see Tools/Resources Section).In general, interventions that have beenproven to be effective in the generalpopulation are also likely to be effective forthese population groups. However, themanner in which these interventions aredelivered may need to be adapted for eachgroup in order to be as acceptable, accessibleand appropriate as possible. Therefore, toolsand strategies that have been developed forother populations should be tailoredappropriately with a full understanding of thecontext, barriers, and possible approacheswhen providing care to Aboriginal peopleswithin practice settings.Practitioners should recognize theheterogeneity of individuals and communitieswithin the Aboriginal population and tailorinterventions appropriately.ABORIGINAL PEOPLES 18
Page 1: CANADIANSMOKING CESSATIONCLINICAL P
Page 4 and 5: CANADIAN SMOKING CESSATION GUIDELIN
Page 27: CANADIAN SMOKING CESSATION GUIDELIN
Page 64: Canadian Action Network for the Adv

Canadian Smoking Cessation Clinical Practice Guideline

Create successful ePaper yourself

Delete template?

Save as template?